Documentation of Intraretinal Retinal Pigment Epithelium Migration via High-Speed Ultrahigh-Resolution Optical Coherence Tomography

Abstract

PURPOSE-To describe the features of intraretinal retinal pigment epithelium (RPE) migration documented on a prototype spectral domain high speed, ultrahigh resolution optical coherence tomography (OCT) device in a group of patients with early to intermediate dry age-related macular degeneration (AMD). To correlate intraretinal RPE migration on OCT to RPE pigment clumping on fundus photographs. DESIGN-Retrospective, non-comparative, non-interventional case series. PARTICIPANTS-Fifty METHODS-3DOCT scan sets from all patients were analyzed for presence of intraretinal RPE migration, defined as small discreet hyper-reflective and highly-backscattering lesions within the neurosensory retina. Fundus photographs were also analyzed to determine the presence of RPE pigment clumping, defined as black-colored, often spiculated areas of pigment clumping within the macula. OCT en face images were correlated with fundus photographs to demonstrate correspondence of intraretinal RPE migration on OCT and RPE clumping on fundus photo.MAIN OUTCOME MEASURES-Drusen, Dry AMD, intraretinal RPE migration, RPE pigment clumping.© 2010 American Academy of Ophthalmology, Inc. Published by Elsevier Inc. All rights reserved.Corresponding Author/ Reprints: Jay S. Duker, MD, Department of Ophthalmology, Chairman, Tufts Medical Center, 800 Washington St., Box #450, Boston, MA, 02111, Tel: 617-636-4677; Fax: 617-636-4866, JDuker@tuftsmedicalcenter.org. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. DisclosuresThe sponsors had no role in the design or conduct of this research. Authors with financial/conflicting interests are listed after references. NIH Public Access Author ManuscriptOphthalmology. Author manuscript; available in PMC 2012 April 1. The area of intraretinal RPE migration on OCT always correlated to areas of pigment clumping on fundus photography. Conversely, all but one eye with RPE pigment clumping on fundus photography also had areas of intraretinal RPE migration on OCT. The high incidence of intraretinal RPE migration observed above areas of drusen suggests that drusen may play physical and catalytic roles in facilitating intraretinal RPE migration in dry AMD patients.

Quantity of Intraretinal Hyperreflective Foci in Patients With Intermediate Age-Related Macular Degeneration Correlates With 1-Year Progression

“…Several in vivo OCT studies have suggested that HRF in intermediate AMD eyes may represent the migration of activated RPE cells into the inner retinal layers. 5,8,20,21 This hypothesis was supported by some laboratory studies that demonstrated the potential ability of RPE cells to migrate when induced by cytokines and other inflammatory mediators in response to oxidative damage and complement activation. 22,23 Previous studies 7,24 showed that HRF in AMD were associated or colocalized with the drusen apex and showed an increased association with RPE atrophy at baseline, 24 or if atrophy was not already present, with an increased risk of developing atrophy at that location.…”

“…5 It has been demonstrated that there is a highly specific spatial correlation of HRF with the apex of drusen 6 and/or subretinal drusenoid deposits (SDD) 4 and that HRF overlying drusen are associated with an increased risk of atrophy at that location. 7 The AREDS2 Ancillary SD-OCT Study reported that GA lesions detected at 2 years were significantly correlated with the presence of HRF and with a greater number of HRF at baseline.…”

Multimodal Imaging of Nonneovascular Age-Related Macular Degeneration

“…79,80,82 Focal areas of RPE loss or depigmentation may be demonstrated by choroidal hypertransmission, 5 and pigment clumping and migration may be identified as outer retinal hyperreflective foci.…”

Optical Coherence Tomography in Dentistry

“…There is now a clear trend of extended interests towards the application side in addition to the technology development. Currently, the well established ophthalmic diagnostic application occupies about 50% of academic and industrial shares in OCT business [10][11][12][13][14][15][16][17][18][19] . Cardiovascular imaging [20][21][22][23][24][25][26][27] has become the next big thing when the coronary OCT products have seen FDA clearance in the United States.…”