Adaptive Optics Retinal Imaging in CNGA3-Associated Achromatopsia: Retinal Characterization, Interocular Symmetry, and Intrafamilial Variability. Invest Ophthalmol Vis Sci 2019 Jan 02;60(1):383-396
Date
01/27/2019Pubmed ID
30682209Pubmed Central ID
PMC6354941DOI
10.1167/iovs.18-25880Scopus ID
2-s2.0-85060537244 (requires institutional sign-in at Scopus site) 43 CitationsAbstract
PURPOSE: To investigate retinal structure in subjects with CNGA3-associated achromatopsia and evaluate disease symmetry and intrafamilial variability.
METHODS: Thirty-eight molecularly confirmed subjects underwent ocular examination, optical coherence tomography (OCT), and nonconfocal split-detection adaptive optics scanning light ophthalmoscopy (AOSLO). OCT scans were used for evaluating foveal hypoplasia, grading foveal ellipsoid zone (EZ) disruption, and measuring outer nuclear layer (ONL) thickness. AOSLO images were used to quantify peak foveal cone density, intercell distance (ICD), and the coefficient of variation (CV) of ICD.
RESULTS: Mean (±SD) age was 25.9 (±13.1) years. Mean (± SD) best corrected visual acuity (BCVA) was 0.87 (±0.14) logarithm of the minimum angle of resolution. Examination with OCT showed variable disruption or loss of the EZ. Seven subjects were evaluated for disease symmetry, with peak foveal cone density, ICD, CV, ONL thickness, and BCVA not differing significantly between eyes. A cross-sectional evaluation of AOSLO imaging showed a mean (±SD) peak foveal cone density of 19,844 (±13,046) cones/mm2. There was a weak negative association between age and peak foveal cone density (r = -0.397, P = 0.102), as well as between EZ grade and age (P = 0.086).
CONCLUSIONS: The remnant cone mosaics were irregular and variably disrupted, with significantly lower peak foveal cone density than unaffected individuals. Variability was also seen among subjects with identical mutations. Therefore, subjects should be considered on an individual basis for stratification in clinical trials. Interocular symmetry suggests that both eyes have comparable therapeutic potential and the fellow eye can serve as a valid control. Longitudinal studies are needed, to further examine the weak negative association between age and foveal cone structure observed here.
Author List
Georgiou M, Litts KM, Kalitzeos A, Langlo CS, Kane T, Singh N, Kassilian M, Hirji N, Kumaran N, Dubra A, Carroll J, Michaelides MAuthor
Joseph J. Carroll PhD Director, Professor in the Ophthalmology and Visual Sciences department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Child
Color Vision Defects
Cross-Sectional Studies
Cyclic Nucleotide-Gated Cation Channels
Electroretinography
Female
Humans
Male
Middle Aged
Ophthalmoscopy
Optics and Photonics
Photoreceptor Cells, Vertebrate
Retina
Tomography, Optical Coherence
Visual Acuity
Young Adult
