Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus.
Retina. 2024 Sep 1;44(9):1619-1632. doi: 10.1097/IAE.0000000000004144.
To investigate changes to the vitreoretinal interface in uveitis with multimodal imaging including adaptive optics.
Four eyes (four patients) affected by fovea-attached (subtype 1A) or fovea-sparing epiretinal membranes (ERMs) on spectral-domain optical coherence tomography or visible internal limiting membrane (ILM) on infrared scanning laser ophthalmoscope (SLO) fundus imaging were recruited in this pilot study. The microstructure of the vitreoretinal interface was imaged using flood-illumination adaptive optics (FIAO), and the images were compared with the cross-sectional spectral-domain optical coherence tomography data.
Adaptive optics images revealed multiple abnormalities of the vitreoretinal interface, such as deep linear striae in ERM, and hyperreflective microstructures at the location of ERMs and ILMs. The cone mosaic was imaged by FIAO and was found altered in the four eyes with ERMs or visible ILM. The same four eyes presented alteration of photopic 30 Hz flicker that was reduced in amplitude indicating cone inner retinal layer dysfunction.
FIAO imaging can identify specific patterns associated with ERMs and ILMs. Correlating FIAO imaging of the vitreomacular interface with the structural alterations seen in FIAO at the level of the outer retinal structures can help understand the cause of significant macular dysfunction associated with ERM.
利用多模态成像技术(包括自适应光学)研究葡萄膜炎患者的玻璃体视网膜界面变化。
本研究为一项前瞻性研究,纳入了 4 只眼(4 例患者),这些眼均存在累及黄斑区的(亚型 1A)或不伴有黄斑区受累的视网膜前膜(ERM),在频域光相干断层扫描(SD-OCT)上表现为后极部附着的(亚型 1A)或黄斑区未受累的视网膜内界膜(ERM),在红外扫描激光检眼镜(SLO)眼底成像上表现为可见的内界膜。应用漫射照明自适应光学(FIAO)技术对玻璃体视网膜界面的微观结构进行成像,并与横断面 SD-OCT 数据进行比较。
自适应光学图像显示了玻璃体视网膜界面的多种异常,如 ERM 中的深线性条纹,以及 ERM 和内界膜位置的高反射性微观结构。FIAO 可对圆锥体马赛克成像,发现 4 只眼的 ERM 或可见内界膜均存在改变。这 4 只眼的明视 30Hz 闪烁也发生了改变,振幅降低,提示视锥细胞内节功能障碍。
FIAO 成像可识别与 ERM 和内界膜相关的特定模式。将黄斑区 FIAO 成像与外视网膜结构水平的 FIAO 所见的结构改变相关联,有助于了解与 ERM 相关的显著黄斑功能障碍的原因。