THREE-DIMENSIONAL ANALYSIS OF RETINAL MICROANEURYSMS WITH ADAPTIVE OPTICS OPTICAL COHERENCE TOMOGRAPHY

Area of Science:

• Ophthalmology
• Medical Imaging
• Diabetic Retinopathy Research

Background:

• Diabetic retinopathy is a leading cause of vision loss.
• Microaneurysms (MAs) are early signs of diabetic retinopathy.
• Current imaging techniques have limitations in visualizing MA morphology.

Purpose of the Study:

• To characterize retinal microaneurysms (MAs) in diabetic patients using adaptive optics optical coherence tomography (AOOCT).
• To compare AOOCT findings with other commercial retinal imaging methods.
• To assess the in vivo imaging capabilities of AOOCT for retinal microvasculature.

Main Methods:

• Pilot study involving patients with diabetes and macular MAs.
• Imaging using AOOCT, AO fundus camera, OCT angiography, and fluorescein angiography.
• Characterization of MAs based on visibility, reflectivity, feeding/draining vessels, and location.

Main Results:

• Fifty-three MAs were imaged in 10 patients.
• AOOCT identified feeding/draining vessels in 34 MAs.
• OCT angiography visualized MAs in only 60% of cases, with 33% unidentifiable.
• Intraluminal hyperreflectivity in AO fundus camera images correlated poorly with AOOCT findings.

Conclusions:

• AOOCT revealed MAs in the inner nuclear layer connect to deeper capillary plexuses.
• Intraluminal hyperreflectivity in AO fundus images often reflects vessel wall, not clots.
• AOOCT is a superior in vivo method for detailed 3D imaging of retinal microvasculature.