Inner Retinal Changes in Primary Open-Angle Glaucoma Revealed Through Adaptive Optics-Optical Coherence Tomography.

Area of Science:

• Ophthalmology
• Neuroscience
• Medical Imaging

Background:

• Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness.
• Understanding microstructural retinal changes is crucial for early diagnosis and monitoring POAG progression.

Purpose of the Study:

• To investigate microstructural alterations in the inner nuclear layer (INL) and ganglion cell layer (GCL) of a POAG patient.
• To track these changes over a 4-month period using advanced imaging techniques.

Main Methods:

• A case-control study involving one POAG subject and one normal control.
• Utilized adaptive optics-optical coherence tomography-scanning laser ophthalmoscopy (AO-OCT-SLO) for high-resolution, 3D volumetric imaging of the inner retina.

Main Results:

• Significant thinning of the GCL was observed in the POAG subject, yet retinal ganglion cell somas remained visible.
• Microcystic lesions in the INL increased in diameter by approximately 124% over 4 months.
• Small, hyperreflective features within the INL correlated with microcyst development and were absent in the control subject.

Conclusions:

• Adaptive optics imaging can detect early microcystic lesions in the INL, potentially serving as a biomarker for POAG severity and progression.
• The identified hyperreflective structures may be precursors to microcyst formation.
• This technology allows visualization of retinal ganglion cells even in severely affected POAG eyes.