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Gómez-Benlloch A, Garrell-Salat X, Cobos E, López E, Esteve-Garcia A, Ruiz S, Vázquez M, Sararols L, Biarnés M. Optical Coherence Tomography in Inherited Macular Dystrophies: A Review. Diagnostics (Basel) 2024; 14:878. [PMID: 38732293 PMCID: PMC11083341 DOI: 10.3390/diagnostics14090878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 04/20/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
Macular dystrophies (MDs) constitute a collection of hereditary retina disorders leading to notable visual impairment, primarily due to progressive macular atrophy. These conditions are distinguished by bilateral and relatively symmetrical abnormalities in the macula that significantly impair central visual function. Recent strides in fundus imaging, especially optical coherence tomography (OCT), have enhanced our comprehension and diagnostic capabilities for MD. OCT enables the identification of neurosensory retinal disorganization patterns and the extent of damage to retinal pigment epithelium (RPE) and photoreceptor cells in the dystrophies before visible macular pathology appears on fundus examinations. It not only helps us in diagnostic retinal and choroidal pathologies but also guides us in monitoring the progression of, staging of, and response to treatment. In this review, we summarize the key findings on OCT in some of the most common MD.
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Affiliation(s)
- Alba Gómez-Benlloch
- Oftalmologia Mèdica i Quirúrgica (OMIQ) Research, c/Tamarit 39, 08205 Sabadell, Spain; (X.G.-S.); (E.L.); (S.R.); (M.V.); (L.S.); (M.B.)
- Department of Ophthalmology, Hospital General de Granollers, Av Francesc Ribas s/n, 08402 Granollers, Spain
| | - Xavier Garrell-Salat
- Oftalmologia Mèdica i Quirúrgica (OMIQ) Research, c/Tamarit 39, 08205 Sabadell, Spain; (X.G.-S.); (E.L.); (S.R.); (M.V.); (L.S.); (M.B.)
- Department of Ophthalmology, Hospital General de Granollers, Av Francesc Ribas s/n, 08402 Granollers, Spain
| | - Estefanía Cobos
- Hospital Universitari de Bellvitge, c/De la Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat, Spain;
| | - Elena López
- Oftalmologia Mèdica i Quirúrgica (OMIQ) Research, c/Tamarit 39, 08205 Sabadell, Spain; (X.G.-S.); (E.L.); (S.R.); (M.V.); (L.S.); (M.B.)
| | - Anna Esteve-Garcia
- Clinical Genetics Unit, Laboratori Clinic Territorial Metropolitada Sud, Hospital Universitari de Bellvitge, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), c/De la Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat, Spain;
| | - Sergi Ruiz
- Oftalmologia Mèdica i Quirúrgica (OMIQ) Research, c/Tamarit 39, 08205 Sabadell, Spain; (X.G.-S.); (E.L.); (S.R.); (M.V.); (L.S.); (M.B.)
| | - Meritxell Vázquez
- Oftalmologia Mèdica i Quirúrgica (OMIQ) Research, c/Tamarit 39, 08205 Sabadell, Spain; (X.G.-S.); (E.L.); (S.R.); (M.V.); (L.S.); (M.B.)
| | - Laura Sararols
- Oftalmologia Mèdica i Quirúrgica (OMIQ) Research, c/Tamarit 39, 08205 Sabadell, Spain; (X.G.-S.); (E.L.); (S.R.); (M.V.); (L.S.); (M.B.)
- Department of Ophthalmology, Hospital General de Granollers, Av Francesc Ribas s/n, 08402 Granollers, Spain
| | - Marc Biarnés
- Oftalmologia Mèdica i Quirúrgica (OMIQ) Research, c/Tamarit 39, 08205 Sabadell, Spain; (X.G.-S.); (E.L.); (S.R.); (M.V.); (L.S.); (M.B.)
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Alberto-Pestano MM, Fernández-Núnez C, Durán Carrasco O, Pérez Llombet-Quintana N, Fabelo-Hidalgo I, Gil-Hernández MA, Abreu-Gonzalez R. Fotopic and scotopic retinal sensitivity and foveal fixation normal values using microperimetry in healthy population. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2022; 97:684-691. [PMID: 35871998 DOI: 10.1016/j.oftale.2022.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 04/25/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE To determine normal values of fotopic and scotopic retinal sensitivity and foveal fixation obtained by microperimetry, using MP3-S microperimeter (Nidek, Gamagori, Japan), in a healthy population. METHODS Observational, crossectional, single centre study. Fotopic and scotopic microperimetry was performed using with a customized 13-point fovea-centered pattern in healthy volunteers without ocular pathology. A intraclass correlation coefficient (ICC) was performed to evaluate fotopic and scotopic microperimetry reliability. RESULTS We analyzed 102 eyes of 54 patients with a mean age of 49.8 +/- 15 years old. The fotopic and scotopic mean retinal sensitivity (MRS) was 28.55±3.3dB (95% CI=[27.87-29.23]) and 15.72±1.9dB (95% CI=[15.35-16.09]) respectively, showing a significant statistical difference (p<0.05). No differences were found when comparing SRM by gender group. However, when analyzing the SRM by age groups, statistically significant differences were found in both modalities of the test; SRM being higher in the group of subjects under 35 years of age with 30.3±1.7dB in the photopic and 16.3±1.3dB in the scotopic; and lower in the group of older than 65 years with 26.7±2.2dB in the photopic and 13.8±1.8dB in the scotopic with p=0.0001. The reliability analysis of both tests, revealed an excellent reliability of the fotopic microperimetry with a Crombach alpha of 0.958 and a good reliability of 0.841 in scotopic microperimetry. CONCLUSIONS Microperimetry is a test with good reliability both under photopic and scotopic conditions. SRM and fixation stability under photopic and scotopic conditions do not differ according to sex, but it does decrease with age. There is a positive correlation between photopic and scotopic SRM.
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Affiliation(s)
- M M Alberto-Pestano
- Licenciado en Medicina, Servicio de Oftalmologia, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - C Fernández-Núnez
- Licenciado en Medicina, Servicio de Oftalmologia, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - O Durán Carrasco
- Licenciado en Medicina, Servicio de Oftalmologia, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - N Pérez Llombet-Quintana
- Licenciado en Medicina, Servicio de Oftalmologia, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - I Fabelo-Hidalgo
- Licenciado en Medicina, Servicio de Oftalmologia, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - M A Gil-Hernández
- Doctor en Medicina, Servicio de Oftalmologia, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - R Abreu-Gonzalez
- Doctor en Medicina, Servicio de Oftalmologia, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain.
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Al-Khuzaei S, Shah M, Foster CR, Yu J, Broadgate S, Halford S, Downes SM. The role of multimodal imaging and vision function testing in ABCA4-related retinopathies and their relevance to future therapeutic interventions. Ther Adv Ophthalmol 2021; 13:25158414211056384. [PMID: 34988368 PMCID: PMC8721514 DOI: 10.1177/25158414211056384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 10/08/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this review article is to describe the specific features of Stargardt disease and ABCA4 retinopathies (ABCA4R) using multimodal imaging and functional testing and to highlight their relevance to potential therapeutic interventions. Standardised measures of tissue loss, tissue function and rate of change over time using formal structured deep phenotyping in Stargardt disease and ABCA4R are key in diagnosis, and prognosis as well as when selecting cohorts for therapeutic intervention. In addition, a meticulous documentation of natural history will be invaluable in the future to compare treated with untreated retinas. Despite the familiarity with the term Stargardt disease, this eponymous classification alone is unhelpful when evaluating ABCA4R, as the ABCA4 gene is associated with a number of phenotypes, and a range of severity. Multimodal imaging, psychophysical and electrophysiologic measurements are necessary in diagnosing and characterising these differing retinopathies. A wide range of retinal dystrophy phenotypes are seen in association with ABCA4 mutations. In this article, these will be referred to as ABCA4R. These different phenotypes and the existence of phenocopies present a significant challenge to the clinician. Careful phenotypic characterisation coupled with the genotype enables the clinician to provide an accurate diagnosis, associated inheritance pattern and information regarding prognosis and management. This is particularly relevant now for recruiting to therapeutic trials, and in the future when therapies become available. The importance of accurate genotype-phenotype correlation studies cannot be overemphasised. This approach together with segregation studies can be vital in the identification of causal mutations when variants in more than one gene are being considered as possible. In this article, we give an overview of the current imaging, psychophysical and electrophysiological investigations, as well as current therapeutic research trials for retinopathies associated with the ABCA4 gene.
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Affiliation(s)
- Saoud Al-Khuzaei
- Oxford Eye Hospital, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Nuffield Laboratory of Ophthalmology, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Mital Shah
- Oxford Eye Hospital, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | | | | | - Stephanie Halford
- Nuffield Laboratory of Ophthalmology, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Susan M. Downes
- Nuffield Laboratory of Ophthalmology, Nuffield Department of Clinical Neurosciences, University of Oxford, Level 6 John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK
- Oxford Eye Hospital, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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Starace V, Battista M, Brambati M, Pederzolli M, Viganò C, Arrigo A, Cicinelli MV, Bandello F, Parodi MB. Genotypic and phenotypic factors influencing the rate of progression in ABCA-4-related Stargardt disease. EXPERT REVIEW OF OPHTHALMOLOGY 2020. [DOI: 10.1080/17469899.2021.1860753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Vincenzo Starace
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marco Battista
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria Brambati
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Matteo Pederzolli
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Viganò
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alessandro Arrigo
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria Vittoria Cicinelli
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Francesco Bandello
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Maurizio Battaglia Parodi
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
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Cicinelli MV, Battista M, Starace V, Battaglia Parodi M, Bandello F. Monitoring and Management of the Patient with Stargardt Disease. CLINICAL OPTOMETRY 2019; 11:151-165. [PMID: 31819694 PMCID: PMC6886536 DOI: 10.2147/opto.s226595] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 11/16/2019] [Indexed: 05/10/2023]
Abstract
Stargardt disease (STGD1) represents one of the major common causes of inherited irreversible visual loss. Due to its high phenotypic and genotypic heterogeneity, STGD1 is a complex disease to understand. Non-invasive imaging, biochemical, and genetic advances have led to substantial improvements in unveiling the disease processes and novel promising therapeutic landscapes have been proposed. This review recapitulates the modalities for monitoring patients with STGD1 and the therapeutic options currently under investigation for the different stages of the disease.
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Affiliation(s)
- Maria Vittoria Cicinelli
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
- Correspondence: Maria Vittoria Cicinelli Department of Ophthalmology, San Raffaele Vita-Salute University, Via Olgettina, 60, Milano20132, ItalyTel +39 02 26432648Fax +39 02 26483643 Email
| | - Marco Battista
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Vincenzo Starace
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Francesco Bandello
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
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Sheremet NL, Zhorzholadze NV, Ronzina IA, Grushke IG, Kurbatov SA, Chukhrova AL, Loginova AN, Shcherbakova PO, Tanas AS, Polyakov AV, Strel'nikov VV. [Molecular genetic diagnosis of Stargardt disease]. Vestn Oftalmol 2018; 133:4-11. [PMID: 28980559 DOI: 10.17116/oftalma201713344-11] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
AIM To comparatively evaluate the efficacy of genetic screening in patients with Stargardt disease (SD) by using an express panel of 5 most common ABCA4 mutations and performing massive parallel sequencing of all coding regions of the ABCA4, ELOVL4, PROM1, and CNGB3 genes. MATERIAL AND METHODS MLPA analysis for 5 ABCA4 mutations, namely p.G863A, p.L541P, p.A1038V, p.G1961E, and p.P1380L, was done in 54 patients with SD. In 25 patients, massive parallel sequencing of coding regions (exons) and neighboring introns of the ABCA4, ELOVL4, PROM1, and CNGB3 genes was also performed. RESULTS Gene testing for 5 ABCA4 mutations showed that 50% of patients (27 patients) harbored one mutation and 13% - two mutations. At massive parallel sequencing (25 patients), two pathogenic alleles were found in 21 patients (84%), one mutation - in 23 patients (91.7%). The majority of mutations was accounted for by the ABCA4 gene (83% of all mutation-positive patients). CONCLUSION Sequencing of exons and neighboring introns of the ABCA4, ELOVL4, PROM1, and CNGB3 genes with the new molecular genetic diagnostic system enabled confirmation of the diagnosis of SD in 84% of patients. High prevalence of p.L541P, p.A1038V, and p.G1961E mutations of the ABCA4 gene has been established.
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Affiliation(s)
- N L Sheremet
- Research Institute of Eye Diseases, 11 A, B, Rossolimo St., Moscow, Russia, 119021
| | - N V Zhorzholadze
- Research Institute of Eye Diseases, 11 A, B, Rossolimo St., Moscow, Russia, 119021
| | - I A Ronzina
- Research Institute of Eye Diseases, 11 A, B, Rossolimo St., Moscow, Russia, 119021
| | - I G Grushke
- Research Institute of Eye Diseases, 11 A, B, Rossolimo St., Moscow, Russia, 119021
| | - S A Kurbatov
- Voronezh Regional Clinical Consultative and Diagnostic Center, 5a Lenina Sq., Voronezh, Russia, 394018
| | - A L Chukhrova
- Research Centre of Medical Genetics, 1 Moskvorech'e St., Moscow, Russia, 115478
| | - A N Loginova
- Research Centre of Medical Genetics, 1 Moskvorech'e St., Moscow, Russia, 115478
| | - P O Shcherbakova
- Pirogov Russian National Research Medical University, 1 Ostrovityanova St., Moscow, Russia, 117997
| | - A S Tanas
- Research Centre of Medical Genetics, 1 Moskvorech'e St., Moscow, Russia, 115478
| | - A V Polyakov
- Research Centre of Medical Genetics, 1 Moskvorech'e St., Moscow, Russia, 115478
| | - V V Strel'nikov
- Research Centre of Medical Genetics, 1 Moskvorech'e St., Moscow, Russia, 115478
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Manifestaciones clínicas en 4 casos con enfermedad de Stargardt. REVISTA MEXICANA DE OFTALMOLOGÍA 2016. [DOI: 10.1016/j.mexoft.2015.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Liu H, Bittencourt MG, Wang J, Sophie R, Annam R, Ibrahim MA, Sepah YJ, Moradi A, Scholl HPN, Nguyen QD. Assessment of Central Retinal Sensitivity Employing Two Types of Microperimetry Devices. Transl Vis Sci Technol 2014; 3:3. [PMID: 25237592 DOI: 10.1167/tvst.3.5.3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 06/26/2014] [Indexed: 01/31/2023] Open
Abstract
PURPOSE To compare the retinal sensitivity measurements obtained with two microperimeters, the Micro-Perimeter 1 (MP-1) and the Optos optical coherence tomography (OCT)/scanning laser ophthalmoscope (SLO) in subjects with and without maculopathies. METHODS Forty-five eyes with no known ocular disease and 47 eyes with maculopathies were examined using both microperimeters. A contrast-adjusted scale was applied to resolve the different stimuli and background luminance existing between the two devices. RESULTS There was a strong ceiling effect with the MP-1 in the healthy group, with 90.1% (1136 of 1260) test points clustered at 20 dB. The mean sensitivity for the corresponding points in the OCT/SLO was 25.8 ± 1.9 dB. A floor effect was also observed with the OCT/SLO in the maculopathy group with 9.7% (128 of 1316) points clustered at 9-dB values. The corresponding mean sensitivity in the MP-1 was 1.7 ± 3.9 dB. A regression equation between the two microperimeters was established in the common 10 to19 dB intervals as: OCT/SLO = 15.6 + 0.564 × MP-1 - 0.009 × MP-12 + k (k is an individual point constant; MP-1 coefficient P < 0.001; MP-12 coefficient P = 0.006). CONCLUSION The OCT/SLO and the MP-1 provide two different ranges of contrasts for microperimetry examination. Broadening the dynamic range may minimize the constraint of the ceiling and floor effect. There is a significant mathematical relationship in the common interval of the contrast scale. TRANSLATIONAL RELEVANCE Applying a unified and broadened dynamic range in different types of microperimeters will help to generate consistent clinical reference for measurements.
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Affiliation(s)
- Hongting Liu
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD ; Visual Science and Optometry Center, People's Hospital of Guanxi Zhuang Autonomous Region, Nanning, Guangxi province, China
| | | | - Jiangxia Wang
- Department of Biostatistics, School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Raafay Sophie
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD
| | - Rachel Annam
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD
| | - Mohamed A Ibrahim
- Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, NE
| | - Yasir J Sepah
- Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, NE
| | | | | | - Quan Dong Nguyen
- Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, NE
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Sun JP, Chen MS, Jou JR, Lin CP, Tsai TH, Ho TC. Clinical characteristics and visual function tests with retinal tomographic correlation in patients with Stargardt's disease in Taiwan. J Formos Med Assoc 2013; 112:79-86. [PMID: 23380609 DOI: 10.1016/j.jfma.2011.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Revised: 12/14/2011] [Accepted: 12/14/2011] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND/PURPOSE Stargardt's disease is the most common form of juvenile macular dystrophy. The purpose of this study is to report the clinical characteristics, visual function, and retinal tomography of patients diagnosed with Stargardt's disease in Taiwan. METHODS Retrospective case series; data collected include results of complete ophthalmic examinations: best-corrected visual acuity (BCVA), slit-lamp biomicroscopy, indirect ophthalmoscopy, fundus photography, fluorescein angiography, color sense discrimination test, electroculography (EOG), electroretinography (ERG), dark adaptation, visual field test, and optical coherence tomography (OCT) examinations focused on the macular area. RESULTS Twenty patients were enrolled in this study. The mean age of the patients was 32.1 years. The mean logMAR-converted visual acuity of all patients was 0.96. Maculopathy with or without flecks was evident in all patients. Fluorescein angiography revealed hyperfluorescence in the macula of all cases. Varying degrees of color sense discrimination dysfunction were noted. Electrophysiologic studies showed subnormal to abnormal responses in most patients. Decreased foveal thickness was evident on OCT and foveal thickness was inversely associated with logMAR visual acuity. Also, logMAR visual acuity was associated with total error scores on the color sense discrimination test and the Arden ratio of EOG. The Arden ratio of EOG correlated with the thickness of the outer ring of the macula. CONCLUSION Typical clinical presentations of Stargardt's disease were demonstrated in our case series. OCT findings showed a correlation between foveal thickness and visual acuity, making OCT a useful predictor for other visual function tests. Our results indicate that OCT is helpful in the evaluation of visual acuity and the progression of maculopathy in patients with Stargardt's disease.
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Affiliation(s)
- Jen-Pin Sun
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
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Infrared scanning laser ophthalmoscope imaging of the macula and its correlation with functional loss and structural changes in patients with stargardt disease. Retina 2011; 31:949-58. [PMID: 21293320 DOI: 10.1097/iae.0b013e3181f441f6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To correlate the degree of functional loss with structural changes in patients with Stargardt disease. METHODS Eighteen eyes of 10 patients with Stargardt disease were studied. Scanning laser ophthalmoscope infrared images were compared with corresponding spectral-domain optical coherence tomography scans. Additionally, scanning laser ophthalmoscope microperimetry was performed, and results were superimposed on scanning laser ophthalmoscope infrared images and in selected cases on fundus autofluorescence images. RESULTS Seventeen of 18 eyes showed a distinct hyporeflective foveal and/or perifoveal area with distinct borders on scanning laser ophthalmoscope infrared images, which was less evident on funduscopy and incompletely depicted in fundus autofluorescence images. This hyporeflective zone corresponded to areas of significantly elevated psychophysical thresholds on microperimetry testing, in addition to thinning of the retinal pigment epithelium and disorganization or loss of the photoreceptor cell inner segment-outer segment junction and external-limiting membrane on spectral-domain optical coherence tomography. CONCLUSION Scanning laser ophthalmoscope infrared fundus images are useful for depicting retinal structural changes in patients with Stargardt disease. A spectral-domain optical coherence tomography/scanning laser ophthalmoscope microperimetry device allows for a direct correlation of structural abnormalities with functional defects that will likely be applicable for the determination of retinal areas for potential improvement of retinal function in these patients during future clinical trials and for the monitoring of the diseases' natural history.
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