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 (cg-BOT; n = 2), macular telangiectasia type 2 (MacTel; n = 1), blue cone monochromacy (BCM; n = 1) or cone-rod dystrophy (CRD; n = 1) were included. Images were acquired within and around photoreceptor lesions using spectral-domain OCT (SD-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 SD-OCT en face view of the ellipsoid zone (EZ).
Conclusions
Clinically available SD-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 EZ reflectivity with en face OCT and confocal AOSLO. While it is unclear if these photoreceptors are functional, their presence offers hope for therapeutic strategies aimed at preserving or restoring photoreceptor function.