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Nonarath HJT, Simpson SL, Slobodianuk TL, Collery RF, Dinculescu A, Link BA. The USH3A causative gene clarin1 functions in Müller glia to maintain retinal photoreceptors. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.02.29.582878. [PMID: 38464015 PMCID: PMC10925332 DOI: 10.1101/2024.02.29.582878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Mutations in CLRN1 cause Usher syndrome type IIIA (USH3A), an autosomal recessive disorder characterized by hearing and vision loss, and often accompanied by vestibular balance issues. The identity of the cell types responsible for the pathology and mechanisms leading to vision loss in USH3A remains elusive. To address this, we employed CRISPR/Cas9 technology to delete a large region in the coding and untranslated (UTR) region of zebrafish clrn1. Retina of clrn1 mutant larvae exhibited sensitivity to cell stress, along with age-dependent loss of function and degeneration in the photoreceptor layer. Investigation revealed disorganization in the outer retina in clrn1 mutants, including actin-based structures of the Müller glia and photoreceptor cells. To assess cell-specific contributions to USH3A pathology, we specifically re-expressed clrn1 in either Müller glia or photoreceptor cells. Müller glia re-expression of clrn1 prevented the elevated cell death observed in larval clrn1 mutant zebrafish exposed to high-intensity light. Notably, the degree of phenotypic rescue correlated with the level of Clrn1 re-expression. Surprisingly, high levels of Clrn1 expression enhanced cell death in both wild-type and clrn1 mutant animals. However, rod- or cone-specific Clrn1 re-expression did not rescue the extent of cell death. Taken together, our findings underscore three crucial insights. First, clrn1 mutant zebrafish exhibit key pathological features of USH3A; second, Clrn1 within Müller glia plays a pivotal role in photoreceptor maintenance, with its expression requiring controlled regulation; third, the reliance of photoreceptors on Müller glia suggests a structural support mechanism, possibly through direct interactions between Müller glia and photoreceptors mediated in part by Clrn1 protein.
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Affiliation(s)
- Hannah J. T. Nonarath
- Department Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin 53226
| | - Samantha L. Simpson
- Department of Ophthalmology and Vision Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin 53226
| | - Tricia L. Slobodianuk
- Department Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin 53226
| | - Ross F. Collery
- Department of Ophthalmology and Vision Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin 53226
| | - Astra Dinculescu
- Department of Ophthalmology, University of Florida, Gainesville, Florida 32611
| | - Brian A. Link
- Department Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin 53226
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Mesen A, Mesen S, Oz F, Beyoglu A. Investigation of Retinal Vascular Parameters and Choroidal Vascular Index in Patients Developing Hyphema After Unilateral Blunt Trauma. Photodiagnosis Photodyn Ther 2023; 43:103681. [PMID: 37390853 DOI: 10.1016/j.pdpdt.2023.103681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND To evaluate retinal and choroidal vascular changes in cases with hyphema after blunt ocular trauma that did not cause globe rupture or any retinal pathology. METHODS This cross-sectional study included 29 patients who developed hyphema after unilateral blunt ocular trauma (BOT). The other healthy eyes of the same patients were evaluated as the control group. Optical coherence tomography-angiography (OCT-A) was used for imaging. In addition, choroidal parameters were compared by calculating the choroidal vascular index (CVI) and using choroidal thickness measurements by two independent researchers. RESULTS Superior and deep flow values were significantly decreased in the traumatic hyphema group compared to the control group (p<0.05). Parafoveal deep vascular density (parafoveal dVD) values were decreased in traumatized eyes compared to control eyes (p=0.000). Vascular density values were similar other than that. In addition, there was a significant decrease in optic disc blood flow (ODF) and optic nerve head density (ONHD) values compared to the control group (p<0.05). In addition, no significant difference was observed between the groups in terms of mean CVI values (p>0.05). CONCLUSION Non-invasive diagnostic tools such as OCTA and EDI-OCT can be used to detect and monitor early changes in retinal and choroidal microvascular flow in cases of traumatic hyphema.
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Affiliation(s)
- Ali Mesen
- Kahramanmaraş Sutcu Imam University Health Practice and Research Hospital, Ophthalmology Department
| | - Selma Mesen
- Turkoglu Dr. Kemal Beyazit State Hospital, Eye Clinic.
| | - Furkan Oz
- Kahramanmaraş Sutcu Imam University Health Practice and Research Hospital, Ophthalmology Department
| | - Abdullah Beyoglu
- Kahramanmaraş Sutcu Imam University Health Practice and Research Hospital, Ophthalmology Department
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Foveal photoreceptor disruption in ocular diseases: An optical coherence tomography-based differential diagnosis. Surv Ophthalmol 2023:S0039-6257(23)00046-2. [PMID: 36934831 DOI: 10.1016/j.survophthal.2023.03.003] [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: 07/06/2022] [Revised: 03/07/2023] [Accepted: 03/13/2023] [Indexed: 03/19/2023]
Abstract
Fovea centralis, located at the center of the macula, is packed with cone photoreceptors and is responsible for central visual acuity. Isolated foveal photoreceptor disruption may occur in a variety of hereditary, degenerative, traumatic, and toxic chorioretinal diseases. These have been known previously by multiple synonyms including macular microhole, foveal spot, and outer foveal microdefects. A common clinical feature underlying these conditions is the presence of apparently normal fovea or subtle hypopigmented lesion at the foveal or juxtafoveal area. A detailed history along with high-resolution optical coherence tomography is often helpful to derive a conclusive diagnosis in majority of these cases. Focal photoreceptor disruption usually involves loss or rarefaction of ellipsoid/interdigitation zone, either in isolation or associated with external limiting membrane or retinal pigment epithelium disruption in the fovea. Vitreomacular interface (VMI) disorders including vitreomacular traction, posterior vitreous detachment, epiretinal membrane, and impending macular hole possibly remain the most common cause. Retinal dystrophies such as cone dystrophy, occult macular dystrophy, and achromatopsia may present with diminution of vision and normal appearing fundus in a younger age group. Other causes include photic retinopathy (e.g., from a history of sun gazing, or laser pointer exposure), blunt trauma, drug exposure (e.g., poppers maculopathy or tamoxifen retinopathy), and acute retinal pigment epitheliopathy (ARPE). Visual prognosis depends on the underlying etiology with complete recovery common in the subset of patients with VMI, and ARPE, whereas persistent outer retinal defects are the rule in other conditions. We discuss the differential diagnoses that lead to isolated foveal photoreceptor defects. Identifying and understanding the underlying disease processes that cause foveal photoreceptor disruption may help predict visual prognosis.
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OUTER FOVEAL DEFECTS IN TYPE-2 MACULAR TELANGIECTASIA. Retina 2023; 43:111-119. [PMID: 36542082 DOI: 10.1097/iae.0000000000003640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 09/24/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE To report characteristics of outer foveal defects (OFDs) in type-2 macular telangiectasia (MacTel) on spectral domain optical coherence tomography. METHODS This was a single-center observational study. From a registry of 745 patients with MacTel, patients with OFDs were characterized. All patients underwent multimodal imaging including color fundus photography, confocal blue reflectance, fundus autofluorescence, and spectral domain optical coherence tomography. Staging of eyes was done using the Gass and Blodi classification. Spectral domain optical coherence tomography characteristics in the central 1 mm of the macula in eyes with OFD are reported. RESULTS Outer foveal defect was observed in 21 eyes of 15/745 (2%) patients with MacTel. These defects were bilateral in 6/15 (40%) patients and seen in stage 2 MacTel eyes. In order of prevalence, foveal parameters seen in OFD included hyper-reflective dots in outer retina in 19/21 (90%), ellipsoid zone loss in 18/21 (86%) eyes, interdigitation zone loss in 17/21 (81%) eyes, outer retinal hyporeflective cavitation in 14 (67%) eyes, hyporeflective cavitation at foveal pit in 8 (38%) eyes, and loss of external limiting membrane in 1 (5%) eye. The mean baseline length of the foveal ellipsoid zone loss was 240.17 ± 117.249 µm. The mean baseline central subfield thickness was 155.43 ± 17.215 µm. A total of 8/11 eyes (73%) showed an increase in size of OFD on follow-up. CONCLUSION Outer foveal defect in MacTel eyes is characterized predominantly by foveal loss of ellipsoid zone and interdigitation zone with relative preservation of external limiting membrane.
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Wynne N, Heitkotter H, Woertz EN, Cooper RF, Carroll J. Comparison of Cone Mosaic Metrics From Images Acquired With the SPECTRALIS High Magnification Module and Adaptive Optics Scanning Light Ophthalmoscopy. Transl Vis Sci Technol 2022; 11:19. [PMID: 35583887 PMCID: PMC9123519 DOI: 10.1167/tvst.11.5.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/18/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose To compare cone mosaic metrics derived from adaptive optics scanning light ophthalmoscopy (AOSLO) images with those derived from Heidelberg Engineering SPECTRALIS High Magnification Module (HMM) images. Methods Participants with contiguous cone mosaics had HMM imaging performed at locations superior and temporal to the fovea. These images were registered and averaged offline and then aligned to split-detection AOSLO images; 200 × 200-µm regions of interest were extracted from both modalities. Cones were semi-automatically identified by two graders to provide estimates of cone density and spacing. Results Thirty participants with contiguous cone mosaics were imaged (10 males, 20 females; age range, 11-67 years). Image quality varied, and 80% of our participants had analyzable HMM images. The intergrader intraclass correlation coefficients for cone metrics were good for both modalities (0.688-0.757 for HMM; 0.805-0.836 for AOSLO). Cone density estimates from HMM images were lower by 2661 cones/mm2 (24.1%) on average compared to AOSLO-derived estimates. Accordingly, HMM estimates of cone spacing were increased on average compared to AOSLO. Conclusions The cone mosaic can be visualized in vivo using the SPECTRALIS HMM, although image quality is variable and imaging is not successful in every individual. Metrics extracted from HMM images can differ from those from AOSLO, although excellent agreement is possible in individuals with excellent optical quality and precise co-registration between modalities. Translational Relevance Emerging non-adaptive optics-based photoreceptor imaging is more clinically accessible than adaptive optics techniques and has potential to expand high-resolution imaging in a clinical environment.
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Affiliation(s)
- Niamh Wynne
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Heather Heitkotter
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Erica N. Woertz
- School of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Robert F. Cooper
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
- Joint Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI, USA
| | - Joseph Carroll
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA
- Joint Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI, USA
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Lee KE, Heitkotter H, Carroll J. Challenges Associated With Ellipsoid Zone Intensity Measurements Using Optical Coherence Tomography. Transl Vis Sci Technol 2021; 10:27. [PMID: 34665233 PMCID: PMC8543396 DOI: 10.1167/tvst.10.12.27] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/16/2021] [Indexed: 12/11/2022] Open
Abstract
Translational Relevance Qualitative evaluation of the ellipsoid zone band on optical coherence tomography is a valuable clinical tool for assessing photoreceptor structure, though more quantitative metrics are emerging. Awareness of the challenges involved in interpreting quantitative metrics is important for their clinical translation.
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Affiliation(s)
- Karen E. Lee
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - Heather Heitkotter
- Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Joseph Carroll
- Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA
- Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
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7
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Salmon AE, Chen RCH, Atry F, Gaffney M, Merriman DK, Gil DA, Skala MC, Collery R, Allen KP, Buckland E, Pashaie R, Carroll J. Optical Coherence Tomography Angiography in the Thirteen-Lined Ground Squirrel. Transl Vis Sci Technol 2021; 10:5. [PMID: 34232271 PMCID: PMC8267221 DOI: 10.1167/tvst.10.8.5] [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] [Indexed: 11/24/2022] Open
Abstract
Purpose To assess the performance of two spectral-domain optical coherence tomography-angiography systems in a natural model of hypoperfusion: the hibernating thirteen-lined ground squirrel (13-LGS). Methods Using a high-speed (130 kHz) OCT-A system (HS-OCT-A) and a commercial OCT (36 kHz; Bioptigen Envisu; BE-OCT-A), we imaged the 13-LGS retina throughout its hibernation cycle. Custom software was used to extract the superior, middle, and deep capillary plexus (SCP, MCP, and DCP, respectively). The retinal vasculature was also imaged with adaptive optics scanning light ophthalmoscopy (AOSLO) during torpor to visualize individual blood cells. Finally, correlative histology with immunolabeled or DiI-stained vasculature was performed. Results During euthermia, vessel density was similar between devices for the SCP and MCP (P = 0.88, 0.72, respectively), with a small difference in the DCP (−1.63 ± 1.54%, P = 0.036). Apparent capillary dropout was observed during torpor, but recovered after forced arousal, and this effect was exaggerated in high-speed OCT-A imaging. Based on cell flux measurements with AOSLO, increasing OCT-A scan duration by ∼1000× would avoid the apparent capillary dropout artifact. High correspondence between OCT-A (during euthermia) and histology enabled lateral scale calibration. Conclusions While the HS-OCT-A system provides a more efficient workflow, the shorter interscan interval may render it more susceptible to the apparent capillary dropout artifact. Disambiguation between capillary dropout and transient ischemia can have important implications in the management of retinal disease and warrants additional diagnostics. Translational Relevance The 13-LGS provides a natural model of hypoperfusion that may prove valuable in modeling the utility of OCT-A in human pathologies associated with altered blood flow.
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Affiliation(s)
- Alexander E Salmon
- Cell Biology, Neurobiology, & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA.,Translational Imaging Innovations, Hickory, NC, USA
| | - Rex Chin-Hao Chen
- Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - Farid Atry
- Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - Mina Gaffney
- Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Daniel A Gil
- Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA.,Morgridge Institute for Research, Madison, WI, USA
| | - Melissa C Skala
- Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA.,Morgridge Institute for Research, Madison, WI, USA
| | - Ross Collery
- Cell Biology, Neurobiology, & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA.,Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kenneth P Allen
- Microbiology & Immunology, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Ramin Pashaie
- Computer & Electrical Engineering, Florida Atlantic University, Boca Raton, FL, USA
| | - Joseph Carroll
- Cell Biology, Neurobiology, & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA.,Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA.,Biomedical Engineering, Marquette University, Milwaukee WI, USA
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8
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Cohen SY, Mrejen S, Nghiem-Buffet S, Dubois L, Fajnkuchen F, Gaudric A. Outer Foveal Microdefects. ACTA ACUST UNITED AC 2021; 5:553-561. [DOI: 10.1016/j.oret.2020.09.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 08/19/2020] [Accepted: 09/14/2020] [Indexed: 12/28/2022]
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9
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Wynne N, Carroll J, Duncan JL. Promises and pitfalls of evaluating photoreceptor-based retinal disease with adaptive optics scanning light ophthalmoscopy (AOSLO). Prog Retin Eye Res 2020; 83:100920. [PMID: 33161127 DOI: 10.1016/j.preteyeres.2020.100920] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/28/2020] [Accepted: 10/31/2020] [Indexed: 12/15/2022]
Abstract
Adaptive optics scanning light ophthalmoscopy (AOSLO) allows visualization of the living human retina with exquisite single-cell resolution. This technology has improved our understanding of normal retinal structure and revealed pathophysiological details of a number of retinal diseases. Despite the remarkable capabilities of AOSLO, it has not seen the widespread commercial adoption and mainstream clinical success of other modalities developed in a similar time frame. Nevertheless, continued advancements in AOSLO hardware and software have expanded use to a broader range of patients. Current devices enable imaging of a number of different retinal cell types, with recent improvements in stimulus and detection schemes enabling monitoring of retinal function, microscopic structural changes, and even subcellular activity. This has positioned AOSLO for use in clinical trials, primarily as exploratory outcome measures or biomarkers that can be used to monitor disease progression or therapeutic response. AOSLO metrics could facilitate patient selection for such trials, to refine inclusion criteria or to guide the choice of therapy, depending on the presence, absence, or functional viability of specific cell types. Here we explore the potential of AOSLO retinal imaging by reviewing clinical applications as well as some of the pitfalls and barriers to more widespread clinical adoption.
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Affiliation(s)
- Niamh Wynne
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Joseph Carroll
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA; Department of Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA; Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jacque L Duncan
- Department of Ophthalmology, University of California, San Francisco, CA, USA.
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Devalla SK, Subramanian G, Pham TH, Wang X, Perera S, Tun TA, Aung T, Schmetterer L, Thiéry AH, Girard MJA. A Deep Learning Approach to Denoise Optical Coherence Tomography Images of the Optic Nerve Head. Sci Rep 2019; 9:14454. [PMID: 31595006 PMCID: PMC6783551 DOI: 10.1038/s41598-019-51062-7] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 09/19/2019] [Indexed: 01/14/2023] Open
Abstract
Optical coherence tomography (OCT) has become an established clinical routine for the in vivo imaging of the optic nerve head (ONH) tissues, that is crucial in the diagnosis and management of various ocular and neuro-ocular pathologies. However, the presence of speckle noise affects the quality of OCT images and its interpretation. Although recent frame-averaging techniques have shown to enhance OCT image quality, they require longer scanning durations, resulting in patient discomfort. Using a custom deep learning network trained with 2,328 'clean B-scans' (multi-frame B-scans; signal averaged), and their corresponding 'noisy B-scans' (clean B-scans + Gaussian noise), we were able to successfully denoise 1,552 unseen single-frame (without signal averaging) B-scans. The denoised B-scans were qualitatively similar to their corresponding multi-frame B-scans, with enhanced visibility of the ONH tissues. The mean signal to noise ratio (SNR) increased from 4.02 ± 0.68 dB (single-frame) to 8.14 ± 1.03 dB (denoised). For all the ONH tissues, the mean contrast to noise ratio (CNR) increased from 3.50 ± 0.56 (single-frame) to 7.63 ± 1.81 (denoised). The mean structural similarity index (MSSIM) increased from 0.13 ± 0.02 (single frame) to 0.65 ± 0.03 (denoised) when compared with the corresponding multi-frame B-scans. Our deep learning algorithm can denoise a single-frame OCT B-scan of the ONH in under 20 ms, thus offering a framework to obtain superior quality OCT B-scans with reduced scanning times and minimal patient discomfort.
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Affiliation(s)
- Sripad Krishna Devalla
- Ophthalmic Engineering & Innovation Laboratory, Department of Biomedical Engineering, Faculty of Engineering, National University of Singapore, Singapore, Singapore
| | - Giridhar Subramanian
- Ophthalmic Engineering & Innovation Laboratory, Department of Biomedical Engineering, Faculty of Engineering, National University of Singapore, Singapore, Singapore
| | - Tan Hung Pham
- Ophthalmic Engineering & Innovation Laboratory, Department of Biomedical Engineering, Faculty of Engineering, National University of Singapore, Singapore, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Xiaofei Wang
- Ophthalmic Engineering & Innovation Laboratory, Department of Biomedical Engineering, Faculty of Engineering, National University of Singapore, Singapore, Singapore
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Shamira Perera
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Tin A Tun
- Ophthalmic Engineering & Innovation Laboratory, Department of Biomedical Engineering, Faculty of Engineering, National University of Singapore, Singapore, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Leopold Schmetterer
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Nanyang Technological University, Jurong West, Singapore
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Alexandre H Thiéry
- Department of Statistics and Applied Probability, National University of Singapore, Singapore, Singapore.
| | - Michaël J A Girard
- Ophthalmic Engineering & Innovation Laboratory, Department of Biomedical Engineering, Faculty of Engineering, National University of Singapore, Singapore, Singapore.
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
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Walters S, Schwarz C, Sharma R, Rossi EA, Fischer WS, DiLoreto DA, Strazzeri J, Nelidova D, Roska B, Hunter JJ, Williams DR, Merigan WH. Cellular-scale evaluation of induced photoreceptor degeneration in the living primate eye. BIOMEDICAL OPTICS EXPRESS 2019; 10:66-82. [PMID: 30775083 PMCID: PMC6363191 DOI: 10.1364/boe.10.000066] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 11/15/2018] [Accepted: 11/15/2018] [Indexed: 05/06/2023]
Abstract
Progress is needed in developing animal models of photoreceptor degeneration and evaluating such models with longitudinal, noninvasive techniques. We employ confocal scanning laser ophthalmoscopy, optical coherence tomography (OCT) and high-resolution retinal imaging to noninvasively observe the retina of non-human primates with induced photoreceptor degeneration. Photoreceptors were imaged at the single-cell scale in three modalities of adaptive optics scanning light ophthalmoscopy: traditional confocal reflectance, indicative of waveguiding; a non-confocal offset aperture technique visualizing scattered light; and two-photon excited fluorescence, the time-varying signal of which, at 730 nm excitation, is representative of visual cycle function. Assessment of photoreceptor structure and function using these imaging modalities revealed a reduction in retinoid production in cone photoreceptor outer segments while inner segments appeared to remain present. Histology of one retina confirmed loss of outer segments and the presence of intact inner segments. This unique combination of imaging modalities can provide essential, clinically-relevant information on both the structural integrity and function of photoreceptors to not only validate models of photoreceptor degeneration but potentially evaluate the efficacy of future cell and gene-based therapies for vision restoration.
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Affiliation(s)
- Sarah Walters
- The Institute of Optics, University of Rochester, Rochester, NY, USA
- Center for Visual Science, University of Rochester, Rochester, NY, USA
| | - Christina Schwarz
- Center for Visual Science, University of Rochester, Rochester, NY, USA
- Currently with the Institute for Ophthalmic Research, University of Tübingen, Tübingen, Germany
| | - Robin Sharma
- The Institute of Optics, University of Rochester, Rochester, NY, USA
- Center for Visual Science, University of Rochester, Rochester, NY, USA
- Currently with Facebook Reality Labs, Redmond, WA, USA
| | - Ethan A. Rossi
- Center for Visual Science, University of Rochester, Rochester, NY, USA
- Currently with the Departments of Ophthalmology & Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | | | | | - Jennifer Strazzeri
- Center for Visual Science, University of Rochester, Rochester, NY, USA
- Flaum Eye Institute, University of Rochester, Rochester, NY, USA
| | - Dasha Nelidova
- Friedrich Miescher Institute for Biomedical Research, Basel, Switzerland
| | - Botond Roska
- Friedrich Miescher Institute for Biomedical Research, Basel, Switzerland
| | - Jennifer J. Hunter
- The Institute of Optics, University of Rochester, Rochester, NY, USA
- Center for Visual Science, University of Rochester, Rochester, NY, USA
- Flaum Eye Institute, University of Rochester, Rochester, NY, USA
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, USA
| | - David R. Williams
- The Institute of Optics, University of Rochester, Rochester, NY, USA
- Center for Visual Science, University of Rochester, Rochester, NY, USA
- Flaum Eye Institute, University of Rochester, Rochester, NY, USA
| | - William H. Merigan
- Center for Visual Science, University of Rochester, Rochester, NY, USA
- Flaum Eye Institute, University of Rochester, Rochester, NY, USA
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12
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Braza ME, Young J, Hammeke TA, Robison SE, Han DP, Warren CC, Carroll J, Stepien KE. Assessing photoreceptor structure in patients with traumatic head injury. BMJ Open Ophthalmol 2018; 3:e000104. [PMID: 30539149 PMCID: PMC6257382 DOI: 10.1136/bmjophth-2017-000104] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 08/29/2018] [Accepted: 10/11/2018] [Indexed: 11/17/2022] Open
Abstract
Objective Previous work using adaptive optics scanning light ophthalmoscopy (AOSLO) imaging has shown photoreceptor disruption to be a common finding in head and ocular trauma patients. Here an expanded trauma population was examined using a novel imaging technique, split-detector AOSLO, to assess remnant cone structure in areas with significant disruption on confocal AOSLO imaging and to follow photoreceptor changes longitudinally. Methods and Analysis Eight eyes from seven subjects with head and/or ocular trauma underwent imaging with spectral domain optical coherence tomography, confocal AOSLO and split-detector AOSLO to assess foveal and parafoveal photoreceptor structure. Results Confocal AOSLO imaging revealed hyporeflective foveal regions in two of eight eyes. Split-detector imaging within the hyporeflective confocal areas showed both remnant and absent inner-segment structure. Both of these eyes were imaged longitudinally and showed variation of the photoreceptor mosaic over time. Four other eyes demonstrated subclinical regions of abnormal waveguiding photoreceptors on multimodal AOSLO imagery but were otherwise normal. Two eyes demonstrated normal foveal cone packing without disruption. Conclusion Multimodal imaging can detect subtle photoreceptor abnormalities not necessarily detected by conventional clinical imaging. The addition of split-detector AOSLO revealed the variable condition of inner segments within confocal photoreceptor disruption, confirming the usefulness of dual-modality AOSLO imaging in assessing photoreceptor structure and integrity. Longitudinal imaging demonstrated the dynamic nature of the photoreceptor mosaic after trauma. Multimodal imaging with dual-modality AOSLO improves understanding of visual symptoms and photoreceptor structure changes in patients with head and ocular trauma.
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Affiliation(s)
- Matthew E Braza
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jonathon Young
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Thomas A Hammeke
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Scott E Robison
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Dennis P Han
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Clinton C Warren
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Joseph Carroll
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.,Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.,Department of Biophysics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Kimberly E Stepien
- Department of Ophthalmology and Visual Sciences, University of WI - Madison, Madison, Wisconsin, USA
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13
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Strampe MR, Huckenpahler AL, Higgins BP, Tarima S, Visotcky A, Stepien KE, Kay CN, Carroll J. Intraobserver Repeatability and Interobserver Reproducibility of Ellipsoid Zone Measurements in Retinitis Pigmentosa. Transl Vis Sci Technol 2018; 7:13. [PMID: 29881650 PMCID: PMC5989764 DOI: 10.1167/tvst.7.3.13] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 04/12/2018] [Indexed: 12/29/2022] Open
Abstract
Purpose To examine repeatability and reproducibility of ellipsoid zone (EZ) width measurements in patients with retinitis pigmentosa (RP) using a longitudinal reflectivity profile (LRP) analysis. Methods We examined Bioptigen optical coherence tomography (OCT) scans from 48 subjects with RP or Usher syndrome. Nominal scan lengths were 6, 7, or 10 mm, and the lateral scale of each scan was calculated using axial length measurements. LRPs were generated from OCT line scans, and the peak corresponding to EZ was manually identified using ImageJ. The locations at which the EZ peak disappeared were used to calculate EZ width. Each scan was analyzed twice by each of two observers, who were masked to their previous measurements and those of the other observer. Results On average, horizontal width (HW) was significantly greater than vertical width (VW), and there was high interocular symmetry for both HW and VW. We observed excellent intraobserver repeatability with intraclass correlation coefficients (ICCs) ranging from 0.996 to 0.998 for HW and VW measurements. Interobserver reproducibility was also excellent for both HW (ICC = 0.989; 95% confidence interval [CI] = 0.983–0.995) and VW (ICC = 0.991; 95% CI = 0.985–0.996), with no significant bias observed between observers. Conclusions EZ width can be measured using LRPs with excellent repeatability and reproducibility. Our observation of greater HW than VW is consistent with previous observations in RP, though the reason for this anisotropy remains unclear. Translational Relevance We describe repeatability and reproducibility of a method for measuring EZ width in patients with RP or Usher syndrome. This approach could facilitate measurement of retinal band thickness and/or intensity.
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Affiliation(s)
- Margaret R Strampe
- Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA.,University of Minnesota Medical School, Minneapolis, MN, USA
| | - Alison L Huckenpahler
- Cell Biology, Neurobiology, & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Brian P Higgins
- Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Sergey Tarima
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Alexis Visotcky
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kimberly E Stepien
- Ophthalmology & Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | - Joseph Carroll
- Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA.,Cell Biology, Neurobiology, & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA
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14
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Sajdak BS, Bell BA, Lewis TR, Luna G, Cornwell GS, Fisher SK, Merriman DK, Carroll J. Assessment of Outer Retinal Remodeling in the Hibernating 13-Lined Ground Squirrel. Invest Ophthalmol Vis Sci 2018; 59:2538-2547. [PMID: 29847661 PMCID: PMC5967598 DOI: 10.1167/iovs.17-23120] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 04/20/2018] [Indexed: 12/25/2022] Open
Abstract
Purpose We examined outer retinal remodeling of the euthermic and torpid cone-dominant 13-lined ground squirrel (13-LGS) retina using optical coherence tomography (OCT) imaging and histology. Methods Retinas and corneas of living 13-LGSs were imaged during euthermic and torpid physiological states using OCT. Retinal layer thickness was measured at the visual streak from registered and averaged vertical B-scans. Following OCT, some retinas were collected immediately for postmortem histologic comparison using light microscopy, immunofluorescence, or transmission electron microscopy. Results Compared to OCT images from euthermic retinae, OCT images of torpid retinae revealed significantly thicker inner and outer nuclear layers, as well as increases in the distances between outer retinal reflectivity bands 1 and 2, and bands 3 and 4. A significant decrease in the distance between bands 2 and 3 also was seen, alongside significant thinning of the choriocapillaris and choroid. OCT image quality was reduced in torpid eyes, partly due to significant thickening of the corneal stroma during this state. Conclusions The torpid retina of the hibernating 13-LGS undergoes structural changes that can be detected by OCT imaging. Comparisons between in vivo OCT and ex vivo histomorphometry may offer insight to the origin of hyperreflective OCT bands within the outer retina of the cone-dominant 13-LGS.
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Affiliation(s)
- Benjamin S. Sajdak
- Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Brent A. Bell
- Cole Eye Institute/Ophthalmic Research, Cleveland Clinic, Cleveland, Ohio, United States
| | - Tylor R. Lewis
- Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Gabriel Luna
- Neuroscience Research Institute, University of California Santa Barbara, Santa Barbara, California, United States
| | - Grayson S. Cornwell
- Neuroscience Research Institute, University of California Santa Barbara, Santa Barbara, California, United States
| | - Steven K. Fisher
- Neuroscience Research Institute, University of California Santa Barbara, Santa Barbara, California, United States
| | - Dana K. Merriman
- Biology & Microbiology, University of Wisconsin Oshkosh, Oshkosh, Wisconsin, United States
| | - Joseph Carroll
- Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Biophysics, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
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15
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Abstract
Zebrafish (Danio rerio) provide many advantages as a model organism for studying ocular disease and development, and there is great interest in the ability to non-invasively assess their photoreceptor mosaic. Despite recent applications of scanning light ophthalmoscopy, fundus photography, and gonioscopy to in vivo imaging of the adult zebrafish eye, current techniques either lack accurate scaling information (limiting quantitative analyses) or require euthanizing the fish (precluding longitudinal analyses). Here we describe improved methods for imaging the adult zebrafish retina using spectral domain optical coherence tomography (OCT). Transgenic fli1:eGFP zebrafish were imaged using the Bioptigen Envisu R2200 broadband source OCT with a 12-mm telecentric probe to measure axial length and a mouse retina probe to acquire retinal volume scans subtending 1.2 × 1.2 mm nominally. En face summed volume projections were generated from the volume scans using custom software that allows the user to create contours tailored to specific retinal layer(s) of interest. Following imaging, the eyes were dissected for ex vivo fluorescence microscopy, and measurements of blood vessel branch points were compared to those made from the en face OCT images to determine the OCT lateral scale as a function of axial length. Using this scaling model, we imaged the photoreceptor layer of five wild-type zebrafish and quantified the density and packing geometry of the UV cone submosaic. Our in vivo cone density measurements agreed with measurements from previously published histology values. The method presented here allows accurate, quantitative assessment of cone structure in vivo and will be useful for longitudinal studies of the zebrafish cone mosaics.
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16
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Langlo CS, Erker LR, Parker M, Patterson EJ, Higgins BP, Summerfelt P, Razeen MM, Collison FT, Fishman GA, Kay CN, Zhang J, Weleber RG, Yang P, Pennesi ME, Lam BL, Chulay JD, Dubra A, Hauswirth WW, Wilson DJ, Carroll J. REPEATABILITY AND LONGITUDINAL ASSESSMENT OF FOVEAL CONE STRUCTURE IN CNGB3-ASSOCIATED ACHROMATOPSIA. Retina 2017; 37:1956-1966. [PMID: 28145975 PMCID: PMC5537050 DOI: 10.1097/iae.0000000000001434] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE Congenital achromatopsia is an autosomal recessive disease causing substantial reduction or complete absence of cone function. Although believed to be a relatively stationary disorder, questions remain regarding the stability of cone structure over time. In this study, the authors sought to assess the repeatability of and examine longitudinal changes in measurements of central cone structure in patients with achromatopsia. METHODS Forty-one subjects with CNGB3-associated achromatopsia were imaged over a period of between 6 and 26 months using optical coherence tomography and adaptive optics scanning light ophthalmoscopy. Outer nuclear layer (ONL) thickness, ellipsoid zone (EZ) disruption, and peak foveal cone density were assessed. RESULTS ONL thickness increased slightly compared with baseline (0.184 μm/month, P = 0.02). The EZ grade remained unchanged for 34/41 subjects. Peak foveal cone density did not significantly change over time (mean change 1% per 6 months, P = 0.126). CONCLUSION Foveal cone structure showed little or no change in this group of subjects with CNGB3-associated achromatopsia. Over the time scales investigated (6-26 months), achromatopsia seems to be a structurally stable condition, although longer-term follow-up is needed. These data will be useful in assessing foveal cone structure after therapeutic intervention.
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Affiliation(s)
- Christopher S. Langlo
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Laura R. Erker
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon
| | - Maria Parker
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon
| | - Emily J. Patterson
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Brian P. Higgins
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Phyllis Summerfelt
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Moataz M. Razeen
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin
- Alexandria Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Frederick T. Collison
- Pangere Center for Inherited Retinal Diseases, The Chicago Lighthouse, Chicago, Illinois
| | - Gerald A. Fishman
- Pangere Center for Inherited Retinal Diseases, The Chicago Lighthouse, Chicago, Illinois
| | | | - Jing Zhang
- Vitreo Retinal Associates, Gainesville, Florida
| | - Richard G. Weleber
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon
| | - Paul Yang
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon
| | - Mark E. Pennesi
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon
| | - Byron L. Lam
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida
| | | | - Alfredo Dubra
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, Wisconsin; and
| | | | - David J. Wilson
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon
| | - Joseph Carroll
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, Wisconsin; and
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Quantitative analysis of photoreceptor layer reflectivity on en-face optical coherence tomography as an estimator of cone density. Graefes Arch Clin Exp Ophthalmol 2017; 255:2119-2126. [DOI: 10.1007/s00417-017-3761-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 07/12/2017] [Accepted: 07/17/2017] [Indexed: 10/19/2022] Open
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18
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Vogel RN, Langlo CS, Scoles D, Carroll J, Weinberg DV, Kim JE. High-Resolution Imaging of Intraretinal Structures in Active and Resolved Central Serous Chorioretinopathy. Invest Ophthalmol Vis Sci 2017; 58:42-49. [PMID: 28055101 PMCID: PMC5225998 DOI: 10.1167/iovs.16-20351] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Purpose To improve our understanding of central serous chorioretinopathy (CSC), we performed an analysis of noninvasive, high-resolution retinal imaging in patients with active and resolved CSC. Methods Adaptive optics scanning light ophthalmoscopy (AOSLO) and spectral-domain optical coherence tomography (SD-OCT) were performed on five subjects with CSC. A custom AOSLO system was used to simultaneously collect confocal and split-detector images. Spectral domain–OCT volume scans were used to create en face views of various retinal layers, which then were compared to montaged AOSLO images after coregistration. Results Three distinct types of intraretinal hyperreflective clusters were seen with AOSLO. These clusters had a well-demarcated, round, and granular appearance. Clusters in active CSC over areas of serous retinal detachment were termed type-1. They were found primarily in the outer nuclear layer (ONL) and were associated with large defects in the photoreceptor mosaic and ellipsoid zone. Clusters in areas where the retina had reattached were termed type-2. They also were located primarily in the ONL but showed stability in location over a period of at least 8 months. Smaller clusters in the inner retina along retinal capillaries were termed type-3. Conclusions Retinal imaging in CSC using en face OCT and AOSLO allows precise localization of intraretinal structures and detection of features that cannot be seen with SD-OCT alone. These findings may provide greater insight into the pathophysiology of the active and resolved phases of the disease, and support the hypothesis that intraretinal hyperreflective foci on OCT in CSC are cellular in nature.
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Affiliation(s)
- Ryan N Vogel
- Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Christopher S Langlo
- Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Drew Scoles
- University of Rochester Medical Center, Rochester, New York, United States
| | - Joseph Carroll
- Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States 2Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - David V Weinberg
- Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Judy E Kim
- Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
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19
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Cooper RF, Wilk MA, Tarima S, Carroll J. Evaluating Descriptive Metrics of the Human Cone Mosaic. Invest Ophthalmol Vis Sci 2017; 57:2992-3001. [PMID: 27273598 PMCID: PMC4898203 DOI: 10.1167/iovs.16-19072] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
PURPOSE To evaluate how metrics used to describe the cone mosaic change in response to simulated photoreceptor undersampling (i.e., cell loss or misidentification). METHODS Using an adaptive optics ophthalmoscope, we acquired images of the cone mosaic from the center of fixation to 10° along the temporal, superior, inferior, and nasal meridians in 20 healthy subjects. Regions of interest (n = 1780) were extracted at regular intervals along each meridian. Cone mosaic geometry was assessed using a variety of metrics - density, density recovery profile distance (DRPD), nearest neighbor distance (NND), intercell distance (ICD), farthest neighbor distance (FND), percentage of six-sided Voronoi cells, nearest neighbor regularity (NNR), number of neighbors regularity (NoNR), and Voronoi cell area regularity (VCAR). The "performance" of each metric was evaluated by determining the level of simulated loss necessary to obtain 80% statistical power. RESULTS Of the metrics assessed, NND and DRPD were the least sensitive to undersampling, classifying mosaics that lost 50% of their coordinates as indistinguishable from normal. The NoNR was the most sensitive, detecting a significant deviation from normal with only a 10% cell loss. CONCLUSIONS The robustness of cone spacing metrics makes them unsuitable for reliably detecting small deviations from normal or for tracking small changes in the mosaic over time. In contrast, regularity metrics are more sensitive to diffuse loss and, therefore, better suited for detecting such changes, provided the fraction of misidentified cells is minimal. Combining metrics with a variety of sensitivities may provide a more complete picture of the integrity of the photoreceptor mosaic.
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Affiliation(s)
- Robert F Cooper
- Biomedical Engineering, Marquette University, Milwaukee, Wisconsin, United States
| | - Melissa A Wilk
- Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Sergey Tarima
- Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Joseph Carroll
- Biomedical Engineering, Marquette University, Milwaukee, Wisconsin, United States 2Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States 4Biophysics, Medical College of Wisconsin, Milwaukee, Wisconsin, U
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20
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Sun LW, Johnson RD, Langlo CS, Cooper RF, Razeen MM, Russillo MC, Dubra A, Connor TB, Han DP, Pennesi ME, Kay CN, Weinberg DV, Stepien KE, Carroll J. Assessing Photoreceptor Structure in Retinitis Pigmentosa and Usher Syndrome. Invest Ophthalmol Vis Sci 2017; 57:2428-42. [PMID: 27145477 PMCID: PMC5089122 DOI: 10.1167/iovs.15-18246] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Purpose The purpose of this study was to examine cone photoreceptor structure in retinitis pigmentosa (RP) and Usher syndrome using confocal and nonconfocal split-detector adaptive optics scanning light ophthalmoscopy (AOSLO). Methods Nineteen subjects (11 RP, 8 Usher syndrome) underwent ophthalmic and genetic testing, spectral-domain optical coherence tomography (SD-OCT), and AOSLO imaging. Split-detector images obtained in 11 subjects (7 RP, 4 Usher syndrome) were used to assess remnant cone structure in areas of altered cone reflectivity on confocal AOSLO. Results Despite normal interdigitation zone and ellipsoid zone appearance on OCT, foveal and parafoveal cone densities derived from confocal AOSLO images were significantly lower in Usher syndrome compared with RP. This was due in large part to an increased prevalence of non-waveguiding cones in the Usher syndrome retina. Although significantly correlated to best-corrected visual acuity and foveal sensitivity, cone density can decrease by nearly 38% before visual acuity becomes abnormal. Aberrantly waveguiding cones were noted within the transition zone of all eyes and corresponded to intact inner segment structures. These remnant cones decreased in density and increased in diameter across the transition zone and disappeared with external limiting membrane collapse. Conclusions Foveal cone density can be decreased in RP and Usher syndrome before visible changes on OCT or a decline in visual function. Thus, AOSLO imaging may allow more sensitive monitoring of disease than current methods. However, confocal AOSLO is limited by dependence on cone waveguiding, whereas split-detector AOSLO offers unambiguous and quantifiable visualization of remnant cone inner segment structure. Confocal and split-detector thus offer complementary insights into retinal pathology.
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Affiliation(s)
- Lynn W Sun
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Ryan D Johnson
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Christopher S Langlo
- Department of Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Robert F Cooper
- Department of Biomedical Engineering, Marquette University, Milwaukee, Wisconsin, United States
| | - Moataz M Razeen
- Alexandria Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Madia C Russillo
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Alfredo Dubra
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States 2Department of Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States 3Department of Biomedical Engineering, Ma
| | - Thomas B Connor
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Dennis P Han
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Mark E Pennesi
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States
| | - Christine N Kay
- Vitreo Retinal Associates, Gainesville, Florida, United States
| | - David V Weinberg
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Kimberly E Stepien
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Joseph Carroll
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States 2Department of Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States 3Department of Biomedical Engineering, Ma
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Litts KM, Cooper RF, Duncan JL, Carroll J. Photoreceptor-Based Biomarkers in AOSLO Retinal Imaging. Invest Ophthalmol Vis Sci 2017; 58:BIO255-BIO267. [PMID: 28873135 PMCID: PMC5584616 DOI: 10.1167/iovs.17-21868] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 07/28/2017] [Indexed: 01/08/2023] Open
Abstract
Improved understanding of the mechanisms underlying inherited retinal degenerations has created the possibility of developing much needed treatments for these relentless, blinding diseases. However, standard clinical indicators of retinal health (such as visual acuity and visual field sensitivity) are insensitive measures of photoreceptor survival. In many retinal degenerations, significant photoreceptor loss must occur before measurable differences in visual function are observed. Thus, there is a recognized need for more sensitive outcome measures to assess therapeutic efficacy as numerous clinical trials are getting underway. Adaptive optics (AO) retinal imaging techniques correct for the monochromatic aberrations of the eye and can be used to provide nearly diffraction-limited images of the retina. Many groups routinely are using AO imaging tools to obtain in vivo images of the rod and cone photoreceptor mosaic, and it now is possible to monitor photoreceptor structure over time with single cell resolution. Highlighting recent work using AO scanning light ophthalmoscopy (AOSLO) across a range of patient populations, we review the development of photoreceptor-based metrics (e.g., density/geometry, reflectivity, and size) as candidate biomarkers. Going forward, there is a need for further development of automated tools and normative databases, with the latter facilitating the comparison of data sets across research groups and devices. Ongoing and future clinical trials for inherited retinal diseases will benefit from the improved resolution and sensitivity that multimodal AO retinal imaging affords to evaluate safety and efficacy of emerging therapies.
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Affiliation(s)
- Katie M. Litts
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Robert F. Cooper
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
- Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Jacque L. Duncan
- Department of Ophthalmology, University of California, San Francisco, California, United States
| | - Joseph Carroll
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
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22
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Wilk MA, Huckenpahler AL, Collery RF, Link BA, Carroll J. The Effect of Retinal Melanin on Optical Coherence Tomography Images. Transl Vis Sci Technol 2017; 6:8. [PMID: 28392975 PMCID: PMC5381330 DOI: 10.1167/tvst.6.2.8] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 02/13/2017] [Indexed: 11/24/2022] Open
Abstract
Purpose We assessed the effect of melanin on the appearance of hyperreflective outer retinal bands in optical coherence tomography (OCT) images. Methods A total of 23 normal subjects and 51 patients with albinism were imaged using the Bioptigen high-resolution spectral-domain OCT. In addition, three wild type, three albino (slc45a2b4/b4), and eight tyrosinase mosaic zebrafish were imaged with the hand-held Bioptigen Envisu R2200 OCT. To identify pigmented versus nonpigmented regions in the tyrosinase mosaic zebrafish, en face summed volume projections of the retinal pigment epithelium (RPE) were created from volume scans. Longitudinal reflectivity profiles were generated from B-scans to assess the width and maximum intensity of the RPE band in fish, or the presence of one or two RPE/Bruch's membrane (BrM) bands in humans. Results The foveal RPE/BrM appeared as two bands in 71% of locations in patients with albinism and 45% of locations in normal subjects (P = 0.0003). Pigmented zebrafish retinas had significantly greater RPE reflectance, and pigmented regions of mosaic zebrafish also had significantly broader RPE bands than all other groups. Conclusions The hyperreflective outer retinal bands in OCT images are highly variable in appearance. We showed that melanin is a major contributor to the intensity and width of the RPE band on OCT. One should use caution in extrapolating findings from OCT images of one or even a few individuals to define the absolute anatomic correlates of the hyperreflective outer retinal bands in OCT images. Translational Relevance Melanin affects the appearance of the outer retinal bands in OCT images. Use of animal models may help dissect the anatomic correlates of the complex reflective signals in OCT retinal images.
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Affiliation(s)
- Melissa A Wilk
- Department of Cell Biology, Neurobiology, & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA ; Current affiliation: HudsonAlpha Institute for Biotechnology, 601 Genome Way, Huntsville, AL, USA
| | - Alison L Huckenpahler
- Department of Cell Biology, Neurobiology, & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Ross F Collery
- Department of Cell Biology, Neurobiology, & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Brian A Link
- Department of Cell Biology, Neurobiology, & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Joseph Carroll
- Department of Cell Biology, Neurobiology, & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA ; Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, WI, USA ; Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA
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Sun LW, Johnson RD, Williams V, Summerfelt P, Dubra A, Weinberg DV, Stepien KE, Fishman GA, Carroll J. Multimodal Imaging of Photoreceptor Structure in Choroideremia. PLoS One 2016; 11:e0167526. [PMID: 27936069 PMCID: PMC5147929 DOI: 10.1371/journal.pone.0167526] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 11/15/2016] [Indexed: 12/31/2022] Open
Abstract
PURPOSE Choroideremia is a progressive X-linked recessive dystrophy, characterized by degeneration of the retinal pigment epithelium (RPE), choroid, choriocapillaris, and photoreceptors. We examined photoreceptor structure in a series of subjects with choroideremia with particular attention to areas bordering atrophic lesions. METHODS Twelve males with clinically-diagnosed choroideremia and confirmed hemizygous mutations in the CHM gene were examined. High-resolution images of the retina were obtained using spectral domain optical coherence tomography (SD-OCT) and both confocal and non-confocal split-detector adaptive optics scanning light ophthalmoscope (AOSLO) techniques. RESULTS Eleven CHM gene mutations (3 novel) were identified; three subjects had the same mutation and one subject had two mutations. SD-OCT findings included interdigitation zone (IZ) attenuation or loss in 10/12 subjects, often in areas with intact ellipsoid zones; RPE thinning in all subjects; interlaminar bridges in the imaged areas of 10/12 subjects; and outer retinal tubulations (ORTs) in 10/12 subjects. Only split-detector AOSLO could reliably resolve cones near lesion borders, and such cones were abnormally heterogeneous in morphology, diameter and density. On split-detector imaging, the cone mosaic terminated sharply at lesion borders in 5/5 cases examined. Split-detector imaging detected remnant cone inner segments within ORTs, which were generally contiguous with a central patch of preserved retina. CONCLUSIONS Early IZ dropout and RPE thinning on SD-OCT are consistent with previously published results. Evidence of remnant cone inner segments within ORTs and the continuity of the ORTs with preserved retina suggests that these may represent an intermediate state of retinal degeneration prior to complete atrophy. Taken together, these results supports a model of choroideremia in which the RPE degenerates before photoreceptors.
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Affiliation(s)
- Lynn W. Sun
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Ryan D. Johnson
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Vesper Williams
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Phyllis Summerfelt
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Alfredo Dubra
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
- Department of Biomedical Engineering, Marquette University, Milwaukee, Wisconsin, United States of America
- Department of Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - David V. Weinberg
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Kimberly E. Stepien
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Gerald A. Fishman
- Department of Biomedical Engineering, Marquette University, Milwaukee, Wisconsin, United States of America
| | - Joseph Carroll
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
- Department of Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
- The Chicago Lighthouse, Chicago, Illinois, United States of America
- * E-mail:
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Oxygen Saturation in Closed-Globe Blunt Ocular Trauma. BIOMED RESEARCH INTERNATIONAL 2016; 2016:8232468. [PMID: 27699174 PMCID: PMC5028796 DOI: 10.1155/2016/8232468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 08/14/2016] [Accepted: 08/16/2016] [Indexed: 11/18/2022]
Abstract
Purpose. To evaluate the oxygen saturation in retinal blood vessels in patients after closed-globe blunt ocular trauma. Design. Retrospective observational case series. Methods. Retinal oximetry was performed in both eyes of 29 patients with unilateral closed-globe blunt ocular trauma. Arterial oxygen saturation (SaO2), venous oxygen saturation (SvO2), arteriovenous difference in oxygen saturation (SO2), arteriolar diameter, venular diameter, and arteriovenous difference in diameter were measured. Association parameters including age, finger pulse oximetry, systolic pressure, diastolic pressure, and heart rate were analyzed. Results. The mean SaO2 in traumatic eyes (98.1% ± 6.8%) was not significantly different from SaO2 in unaffected ones (95.3% ± 7.2%) (p = 0.136). Mean SvO2 in traumatic eyes (57.1% ± 10.6%) was significantly lower than in unaffected ones (62.3% ± 8.4%) (p = 0.044). The arteriovenous difference in SO2 in traumatic eyes (41.0% ± 11.2%) was significantly larger than in unaffected ones (33.0% ± 6.9%) (p = 0.002). No significant difference was observed between traumatic eyes and unaffected ones in arteriolar (p = 0.249) and venular diameter (p = 0.972) as well as arteriovenous difference in diameter (p = 0.275). Conclusions. Oxygen consumption is increased in eyes after cgBOT, associated with lower SvO2 and enlarged arteriovenous difference in SO2 but not with changes in diameter of retinal vessels.
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Kaizu Y, Nakao S, Yamaguchi M, Murakami Y, Salehi-Had H, Ishibashi T. Detection of airbag impact-induced cone photoreceptor damage by adaptive optics scanning laser ophthalmoscopy: a case report. BMC Ophthalmol 2016; 16:99. [PMID: 27391597 PMCID: PMC4939001 DOI: 10.1186/s12886-016-0275-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 06/16/2016] [Indexed: 11/30/2022] Open
Abstract
Background The purpose of this study was to report a case of traumatic maculopathy with para-central visual field defects following an impact by airbag deployment using adaptive optics scanning laser ophthalmoscopy (AO-SLO). Case presentation A 51-year-old man was involved in a motor vehicular accident and his left eye was struck by the deployed airbag, resulting in a para-central scotoma. The patient underwent a full ophthalmologic examination, spectral-domain optical coherence tomography (SD-OCT), and imaging with prototype AO-SLO systems (Canon Inc.) at 14 and 22 months after the injury. Images focused on the photoreceptor layer were recorded in the foveal area, and a montage of AO-SLO images was created. On AO-SLO, focal dark areas could be observed in the left eye at 14 months after the injury. The analysis showed that the cone mosaic (cone density, 16503/mm2; ratio of hexagonal Voronoi domain, 36.3 %; average nearest-neighbor distance (NND)/expected NND, 0.606) was disordered compared with the normal area of the same eye (cone density, 24821/mm2; ratio of hexagonal Voronoi domain, 44.1 %; average NND/expected NND, 0.739). The cone defect area corresponded to the area of the scotoma. A second AO-SLO was performed on the patient at 22 months after the injury and although there were still areas with reduced cone reflectivity, partial improvement of cone mosaic was detected by AO-SLO at this time point. Conclusion Partial recovery of damaged cone photoreceptors following closed globe blunt ocular trauma can be documented using AO-SLO longitudinal tracking.
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Affiliation(s)
- Yoshihiro Kaizu
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Shintaro Nakao
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.
| | - Muneo Yamaguchi
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Yusuke Murakami
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | | | - Tatsuro Ishibashi
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
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26
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Razeen MM, Cooper RF, Langlo CS, Goldberg MR, Wilk MA, Han DP, Connor TB, Fishman GA, Collison FT, Sulai YN, Dubra A, Carroll J, Stepien KE. Correlating Photoreceptor Mosaic Structure to Clinical Findings in Stargardt Disease. Transl Vis Sci Technol 2016; 5:6. [PMID: 26981328 PMCID: PMC4790429 DOI: 10.1167/tvst.5.2.6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 01/06/2016] [Indexed: 01/29/2023] Open
Abstract
Purpose To demonstrate a method for correlating photoreceptor mosaic structure with optical coherence tomography (OCT) and microperimetry findings in patients with Stargardt disease. Methods A total of 14 patients with clinically diagnosed Stargardt disease were imaged using confocal and split-detection adaptive optics scanning light ophthalmoscopy. Cone photoreceptors were identified manually in a band along the temporal meridian. Resulting values were compared to a normative database (n = 9) to generate cone density deviation (CDD) maps. Manual measurement of outer nuclear layer plus Henle fiber layer (ONL+HFL) thickness was performed, in addition to determination of the presence of ellipsoid zone (EZ) and interdigitation zone (IZ) bands on OCT. These results, along with microperimetry data, were overlaid with the CDD maps. Results Wide variation in foveal structure and CDD maps was seen within this small group. Disruption of ONL+HFL and/or IZ band was seen in all patients, with EZ band preservation in regions with low cone density in 38% of locations analyzed. Normality of retinal lamellar structure on OCT corresponded with cone density and visual function at 50/78 locations analyzed. Outer retinal tubulations containing photoreceptor-like structures were observed in 3 patients. Conclusions The use of CDD color-coded maps enables direct comparison of cone mosaic local density with other measures of retinal structure and function. Larger normative datasets and improved tools for automation of image alignment are needed. Translational Relevance The approach described facilitates comparison of complex multimodal data sets from patients with inherited retinal degeneration, and can be expanded to incorporate other structural imaging or functional testing.
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Affiliation(s)
- Moataz M Razeen
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA ; Alexandria Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Robert F Cooper
- Department of Biomedical Engineering, Marquette University, Milwaukee, WI, USA
| | - Christopher S Langlo
- Department of Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Mara R Goldberg
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Melissa A Wilk
- Department of Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Dennis P Han
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Thomas B Connor
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Gerald A Fishman
- The Pangere Center for Hereditary Retinal Diseases, the Chicago Lighthouse for People Who Are Blind or Visually Impaired, Chicago, IL, USA ; Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Frederick T Collison
- The Pangere Center for Hereditary Retinal Diseases, the Chicago Lighthouse for People Who Are Blind or Visually Impaired, Chicago, IL, USA
| | - Yusufu N Sulai
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Alfredo Dubra
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA ; Department of Biomedical Engineering, Marquette University, Milwaukee, WI, USA ; Department of Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA ; Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Joseph Carroll
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA ; Department of Biomedical Engineering, Marquette University, Milwaukee, WI, USA ; Department of Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA ; Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kimberly E Stepien
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
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Scoles D, Flatter JA, Cooper RF, Langlo CS, Robison S, Neitz M, Weinberg DV, Pennesi ME, Han DP, Dubra A, Carroll J. ASSESSING PHOTORECEPTOR STRUCTURE ASSOCIATED WITH ELLIPSOID ZONE DISRUPTIONS VISUALIZED WITH OPTICAL COHERENCE TOMOGRAPHY. Retina 2016; 36:91-103. [PMID: 26166796 PMCID: PMC4843118 DOI: 10.1097/iae.0000000000000618] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE To compare images of photoreceptor layer disruptions obtained with optical coherence tomography (OCT) and adaptive optics scanning light ophthalmoscopy (AOSLO) in a variety of pathologic states. METHODS Five subjects with photoreceptor ellipsoid zone disruption as per OCT and clinical diagnoses of closed-globe blunt ocular trauma (n = 2), macular telangiectasia type 2 (n = 1), blue-cone monochromacy (n = 1), or cone-rod dystrophy (n = 1) were included. Images were acquired within and around photoreceptor lesions using spectral domain OCT, confocal AOSLO, and split-detector AOSLO. RESULTS There were substantial differences in the extent and appearance of the photoreceptor mosaic as revealed by confocal AOSLO, split-detector AOSLO, and spectral domain OCT en face view of the ellipsoid zone. CONCLUSION Clinically available spectral domain OCT, viewed en face or as B-scan, may lead to misinterpretation of photoreceptor anatomy in a variety of diseases and injuries. This was demonstrated using split-detector AOSLO to reveal substantial populations of photoreceptors in areas of no, low, or ambiguous ellipsoid zone reflectivity with en face OCT and confocal AOSLO. Although it is unclear if these photoreceptors are functional, their presence offers hope for therapeutic strategies aimed at preserving or restoring photoreceptor function.
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Affiliation(s)
- Drew Scoles
- Department of Biomedical Engineering, University of Rochester, Rochester, NY 14627
| | - John A. Flatter
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, WI 53226
| | - Robert F. Cooper
- Department of Biomedical Engineering, Marquette University, Milwaukee, WI 53201
| | - Christopher S. Langlo
- Department of Cell Biology, Neurobiology, & Anatomy, Medical College of Wisconsin, Milwaukee, WI 53226
| | - Scott Robison
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, WI 53226
| | - Maureen Neitz
- Department of Ophthalmology, University of Washington, Seattle, WA 98104
| | - David V. Weinberg
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, WI 53226
| | - Mark E. Pennesi
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239
| | - Dennis P. Han
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, WI 53226
| | - Alfredo Dubra
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, WI 53226
- Department of Biomedical Engineering, Marquette University, Milwaukee, WI 53201
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI 53226
| | - Joseph Carroll
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, WI 53226
- Department of Biomedical Engineering, Marquette University, Milwaukee, WI 53201
- Department of Cell Biology, Neurobiology, & Anatomy, Medical College of Wisconsin, Milwaukee, WI 53226
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI 53226
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Strauss RW, Dubis AM, Cooper RF, Ba-Abbad R, Moore AT, Webster AR, Dubra A, Carroll J, Michaelides M. Retinal Architecture in RGS9- and R9AP-Associated Retinal Dysfunction (Bradyopsia). Am J Ophthalmol 2015; 160:1269-1275.e1. [PMID: 26343007 PMCID: PMC4653116 DOI: 10.1016/j.ajo.2015.08.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 08/21/2015] [Accepted: 08/24/2015] [Indexed: 10/27/2022]
Abstract
PURPOSE To characterize photoreceptor structure and mosaic integrity in subjects with RGS9- and R9AP-associated retinal dysfunction (bradyopsia) and compare to previous observations in other cone dysfunction disorders such as oligocone trichromacy. DESIGN Observational case series. METHODS setting: Moorfields Eye Hospital (United Kingdom) and Medical College Wisconsin (USA). STUDY POPULATION Six eyes of 3 subjects with disease-causing variants in RGS9 or R9AP. MAIN OUTCOME MEASURES Detailed retinal imaging using spectral-domain optical coherence tomography and confocal adaptive-optics scanning light ophthalmoscopy. RESULTS Cone density at 100 μm from foveal center ranged from 123 132 cones/mm(2) to 140 013 cones/mm(2). Cone density ranged from 30 573 to 34 876 cones/mm(2) by 600 μm from center and from 15 987 to 16,253 cones/mm(2) by 1400 μm from center, in keeping with data from normal subjects. Adaptive-optics imaging identified a small, focal hyporeflective lesion at the foveal center in both eyes of the subject with RGS9-associated disease, corresponding to a discrete outer retinal defect also observed on spectral-domain optical coherence tomography; however, the photoreceptor mosaic remained intact at all other observed eccentricities. CONCLUSIONS Bradyopsia and oligocone trichromacy share common clinical symptoms and cannot be discerned on standard clinical findings alone. Adaptive-optics imaging previously demonstrated a sparse mosaic of normal wave-guiding cones remaining at the fovea, with no visible structure outside the central fovea in oligocone trichromacy. In contrast, the subjects presented in this study with molecularly confirmed bradyopsia had a relatively intact and structurally normal photoreceptor mosaic, allowing the distinction between these disorders based on the cellular phenotype and suggesting different pathomechanisms.
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Scoles D, Higgins BP, Cooper RF, Dubis AM, Summerfelt P, Weinberg DV, Kim JE, Stepien KE, Carroll J, Dubra A. Microscopic inner retinal hyper-reflective phenotypes in retinal and neurologic disease. Invest Ophthalmol Vis Sci 2014; 55:4015-29. [PMID: 24894394 DOI: 10.1167/iovs.14-14668] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE We surveyed inner retinal microscopic features in retinal and neurologic disease using a reflectance confocal adaptive optics scanning light ophthalmoscope (AOSLO). METHODS Inner retinal images from 101 subjects affected by one of 38 retinal or neurologic conditions and 11 subjects with no known eye disease were examined for the presence of hyper-reflective features other than vasculature, retinal nerve fiber layer, and foveal pit reflex. The hyper-reflective features in the AOSLO images were grouped based on size, location, and subjective texture. Clinical imaging, including optical coherence tomography (OCT), scanning laser ophthalmoscopy, and fundus photography was analyzed for comparison. RESULTS Seven categories of hyper-reflective inner retinal structures were identified, namely punctate reflectivity, nummular (disc-shaped) reflectivity, granular membrane, waxy membrane, vessel-associated membrane, microcysts, and striate reflectivity. Punctate and nummular reflectivity also was found commonly in normal volunteers, but the features in the remaining five categories were found only in subjects with retinal or neurologic disease. Some of the features were found to change substantially between follow up imaging months apart. CONCLUSIONS Confocal reflectance AOSLO imaging revealed a diverse spectrum of normal and pathologic hyper-reflective inner and epiretinal features, some of which were previously unreported. Notably, these features were not disease-specific, suggesting that they might correspond to common mechanisms of degeneration or repair in pathologic states. Although prospective studies with larger and better characterized populations, along with imaging of more extensive retinal areas are needed, the hyper-reflective structures reported here could be used as disease biomarkers, provided their specificity is studied further.
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Affiliation(s)
- Drew Scoles
- Department of Biomedical Engineering, University of Rochester, Rochester, New York, United States
| | - Brian P Higgins
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Robert F Cooper
- Department of Biomedical Engineering, Marquette University, Milwaukee, Wisconsin, United States
| | - Adam M Dubis
- Moorfields Eye Hospital, London, United Kingdom Institute of Ophthalmology, University College London, London, United Kingdom
| | - Phyllis Summerfelt
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - David V Weinberg
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Judy E Kim
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Kimberly E Stepien
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Joseph Carroll
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States Department of Biomedical Engineering, Marquette University, Milwaukee, Wisconsin, United States Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States Department of Biophysics, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Alfredo Dubra
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States Department of Biomedical Engineering, Marquette University, Milwaukee, Wisconsin, United States Department of Biophysics, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
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