Three-Dimensional Analysis of Retinal Microaneurysms With Adaptive Optics Optical Coherence Tomography

Karst, Sonja; Salas, Matthias; Häfner, Julia; Scholda, Christoph; Vogl, Wolf‐Dieter; Drexler, Wolfgang; Pircher, Michael; Schmidt‐Erfurth, Ursula

doi:10.1097/iae.0000000000002037

Cited by 28 publications

(21 citation statements)

References 19 publications

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“…Whereas the OCT signal highlighted several retinal layers, 2PM allowed us to retrieve the localization of CX 3 CR1 + cells, presumably tissue‐resident microglia based on their GFP fluorescence. These cells play a crucial role in the disease development in the chronically inflamed central nervous system , in general, and chronically inflamed retina , in particular, as shown by us and by others.…”

Section: Resultssupporting

confidence: 53%

“…Whereas the axial resolution of OCT is typically higher than that of microscopy technologies including 2PM, its poor lateral resolution and poor contrast (due to the use of low NA lenses) are only able to determine information about organ structure at the tissue, and not at the single cell, level. In order to partially counteract this deficit, special experimental OCT setups have been developed and employed to retrieve skin architecture , the thickness of retinal layers , and to develop sensor‐free adaptive optics for in vivo imaging in the mouse retina . Still, OCT remains a technology characterized by poor lateral resolution.…”

Section: Discussionmentioning

confidence: 99%

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Coregistered Spectral Optical Coherence Tomography and Two‐Photon Microscopy for Multimodal Near‐Instantaneous Deep‐Tissue Imaging

et al. 2020

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Two-photon microscopy (2PM) has brought unique insight into the mechanisms underlying immune system dynamics and function since it enables monitoring of cellular motility and communication in complex systems within their genuine environment-the living organism. However, use of 2PM in clinical settings is limited. In contrast, optical coherence tomography (OCT), a noninvasive label-free diagnostic imaging method, which allows monitoring morphologic changes of large tissue regions in vivo, has found broad application in the clinic. Here we developed a combined multimodal technology to achieve near-instantaneous coregistered OCT, 2PM, and second harmonic generation (SHG) imaging over large volumes (up to 1,000 × 1,000 × 300 μm 3 ) of tendons and other tissue compartments in mouse paws, as well as in mouse lymph nodes, spleens, and femurs. Using our multimodal imaging approach, we found differences in macrophage cell shape and motility behavior depending on whether they are located in tendons or in the surrounding tissue compartments of the mouse paw. The cellular shape of tissue-resident macrophages, indicative for their role in tissue, correlated with the supramolecular organization of collagen as revealed by SHG and OCT. Hence, the herepresented approach of coregistered OCT and 2PM has the potential to link specific cellular phenotypes and functions (as revealed by 2PM) to tissue morphology (as highlighted by OCT) and thus, to build a bridge between basic research knowledge and clinical observations.

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Section: Resultssupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Coregistered Spectral Optical Coherence Tomography and Two‐Photon Microscopy for Multimodal Near‐Instantaneous Deep‐Tissue Imaging

et al. 2020

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“…12 With AO, visualization of changes in healthy and pathological aging has become possible in vivo on the subcellular level. However, up to now only a few patients have been imaged with AO-OCT [31][32][33] and no assessment of the detailed PR composition in patients with AMD is available. The following study presents insights into pathologically and healthy aged retinas as imaged with AO-OCT in 55 eyes of 32 participants.…”

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confidence: 99%

Three-Dimensional Adaptive Optics–Assisted Visualization of Photoreceptors in Healthy and Pathologically Aged Eyes

Reumueller

Schmidt‐Erfurth

Salas

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To visualize and characterize photoreceptor (PR) layers on a subcellular level in healthy and pathologically aged eyes using adaptive-optics optical coherence tomography technology (AO-OCT). METHODS. AO-OCT scanning was performed within a 28 3 28 field of view, focused on the PR layer at different retinal regions in healthy aged eyes (n ¼ 32 eyes/16 subjects; 62-to 85-years old), eyes with early to intermediate AMD (n ¼ 16 eyes/8 subjects, 65-to 83-years old), and eyes with advanced nonneovascular AMD (n ¼ 16 eyes/8 subjects, 61-to 84-years old). Areas of interest were determined by AO-fundus camera, which is part of the AO-OCT system and spectral-domain (SD)-OCT. PR integrity was evaluated in AO-OCT en face and cross-sectional images at the level of inner/outer segment junction (IS/OS) and cone/PR end tips (COST/ ETPR). RESULTS. AO-OCT in healthy eyes showed clearly distinguishable and regular IS/OS and COST patterns and an inverse relation between cone density and eccentricity. In early to intermediate AMD, PR in between drusen showed more irregular patterns (P < 0.001) and slightly lower PR density (P 0.002). Drusen caused attenuated and distorted signals and a loss of PR mosaic. In advanced AMD, IS/OS and COST patterns were affected to different degrees between surrounding area, junctional zone, and atrophic area (P < 0.001), ranging from reduced PR densities to total signal loss. CONCLUSIONS. AO-OCT imaging allows the three-dimensional visualization of different PR layers in patients with AMD and age-matched healthy subjects. Thereby, AO-OCT provides a unique insight into PR morphology and shows potential to fill the gap between conventional OCT and histologic examination of the retina.

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“…13 However, we could recently demonstrate that AOOCT can reveal further details of MA morphology, which cannot be captured by these twodimensional AO techniques. 15 Here we conducted a systematic longitudinal imaging study with structured, regular AOOCT visits for a follow-up period of up to 21 months. Our results demonstrate that AOOCT imaging technology allows an accurate relocalization and follow-up of MAs to observe the highly dynamic and complex structural changes that occur in MA evolution with near-isotropic resolution in all three dimensions.…”

Section: Discussionmentioning

confidence: 99%

“…Though intraluminal clots were found in some MAs, most of the strong intraluminal reflections delineated with AO fundus camera imaging merely correlated to a thickening of the MA wall in the corresponding AOOCT volumes. 15 The purpose of the present study was to use AOOCT to prospectively observe retinal MAs in order to investigate changes of three-dimensional morphologic details in the natural history of their dynamic turnover.…”

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confidence: 99%

Dynamic Changes of Retinal Microaneurysms in Diabetes Imaged With In Vivo Adaptive Optics Optical Coherence Tomography

Häfner

Salas

Scholda

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To prospectively monitor microaneurysms (MAs) in three dimensions using adaptive optics optical coherence tomography (AOOCT). METHODS. Patients with diabetes mellitus and parafoveal MAs were included in this longitudinal study. At baseline, MAs were identified in standard fluorescein angiography (FA) and subsequently imaged with an AOOCT prototype, incorporated into an AO fundus camera (RTX1, Imagine Eyes) device. Imaging was repeated every 3 months in each patient to explore the potential structural change of MAs over time including size, shape, intraretinal position, (intra-) luminal reflectivity, and other qualitative morphologic characteristics. RESULTS. We imaged 18 MAs in seven eyes (two left eyes) of five patients (mean age: 69 6 7 years) over 18 months. All MAs appeared as saccular in the en face imaging plane at baseline, and no change in shape was observed in any of the MAs during follow-up. Evaluation of the AOOCT volumes revealed dynamic changes of MAs during follow-up including intermittent growth (n ¼ 2), progressive involution (n ¼ 3), total disappearance (n ¼ 2), and MA division (n ¼ 1). Intraluminal hyperreflective material was visualized in 11 out of 18 MAs, which remained stable (n ¼ 3), increased (n ¼ 2), regressed (n ¼ 1), or fluctuated (n ¼ 5). Three MAs without intraluminal spots at baseline progressively developed distinct hyperreflectivities. CONCLUSIONS. AOOCT illustrates the structurally dynamic evolution of MAs in vivo in three dimensions. Despite a consistent saccular shape in the en face view, AOOCT volumes revealed a heterogeneous behavior in regard to size and reflective status of MAs over time.

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Three-Dimensional Analysis of Retinal Microaneurysms With Adaptive Optics Optical Coherence Tomography

Cited by 28 publications

References 19 publications

Coregistered Spectral Optical Coherence Tomography and Two‐Photon Microscopy for Multimodal Near‐Instantaneous Deep‐Tissue Imaging

Coregistered Spectral Optical Coherence Tomography and Two‐Photon Microscopy for Multimodal Near‐Instantaneous Deep‐Tissue Imaging

Three-Dimensional Adaptive Optics–Assisted Visualization of Photoreceptors in Healthy and Pathologically Aged Eyes

Dynamic Changes of Retinal Microaneurysms in Diabetes Imaged With In Vivo Adaptive Optics Optical Coherence Tomography

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