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A New Method for Visualizing Drusen and Their Progression in Flood-Illumination Adaptive Optics Ophthalmoscopy
Ethan A Rossi1,2,3, Nathaniel Norberg4, Chiara Eandi4,5
1Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Translational Vision Science & Technology
|December 20, 2021
Summary
A new flood-illumination adaptive optics (FIAO) imaging method reveals drusen, key risk factors for age-related macular degeneration (AMD), with unprecedented clarity. This technique allows for better detection and monitoring of drusen progression in aging eyes.
Area of Science:
- Ophthalmology
- Medical Imaging
- Retinal Disease Research
Background:
- Drusen are deposits under the retinal pigment epithelium (RPE) and are significant risk factors for age-related macular degeneration (AMD).
- Current imaging methods may not fully capture the extent and dynamics of drusen, limiting early detection and monitoring.
Purpose of the Study:
- To introduce and validate a novel imaging technique using flood-illumination adaptive optics (FIAO) for high-contrast and high-resolution visualization of drusen.
- To assess the capability of this new method in detecting and monitoring drusen dynamics in aging eyes and AMD patients.
Main Methods:
- Acquisition of fovea-centered FIAO images and surrounding images with gaze displacement.
- Utilized custom software for image registration and statistical data fusion to create gaze-dependent images.
- Included a dataset of 104 AMD patients and 15 controls, with longitudinal imaging for 83 participants.
Main Results:
- The FIAO method visualized drusen smaller than 20 µm, revealing more and smaller drusen than conventional color fundus images.
- Longitudinal imaging demonstrated drusen expansion and fusion over time.
- Subretinal drusenoid deposits (SDDs) showed lower contrast, and RPE atrophy was not consistently visualized.
Conclusions:
- Gaze-dependent imaging with FIAO, combined with advanced image processing, enables high-contrast, high-resolution visualization of drusen and their progression.
- This technique shows promise for robust and sensitive detection, mapping, quantification, and monitoring of drusen dynamics in aging and AMD.
