Kowalczuk Laura, Dornier Rémy, Navarro Aurélie, Jeunet Fanny, Moser Christophe, Behar-Cohen Francine, Mantel Irmela
Faculty of Biology and Medicine, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, 1004 Lausanne, Switzerland.
Laboratory of Applied Photonic Devices (LAPD), School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland.
Cells. 2025 Apr 24;14(9):633. doi: 10.3390/cells14090633.
Adaptive optics-transscleral flood illumination (AO-TFI) is a novel imaging technique with potential for detecting retinal pigment epithelium (RPE) changes in dry age-related macular degeneration (AMD). This single-center prospective study evaluated its ability to visualize pathological features in AMD. AO-TFI images were acquired using the prototype Cellularis camera over six 5 × 5° macular zones in patients with good fixation and no exudative changes. Conventional imaging modalities, including spectral-domain optical coherence tomography (OCT), color fundus photography and fundus autofluorescence, were used for comparison. AO-TFI images were correlated with OCT using a custom method (Fiji software, v. 2.9). Eleven eyes of nine patients (70 ± 8.3 years) with early (n = 5), intermediate (n = 1) and atrophic (n = 5) AMD were analyzed. AO-TFI identified relevant patterns in dry AMD. RPE cell visibility was impaired in affected eyes, but AO-TFI distinguished cuticular drusen with hyporeflective centers and bright edges, large ill-defined drusen and stage 3 subretinal drusenoid deposits as prominent hyperreflective spots. It provided superior resolution for small drusen compared to OCT and revealed crystalline structures and hyporeflective dots in atrophic regions. Atrophic borders remained isoreflective unless RPE displacement was absent, allowing precise delineation. These findings highlight AO-TFI's potential as a sensitive imaging tool for characterizing early AMD and clinical research.
自适应光学透巩膜泛光照明（AO-TFI）是一种新型成像技术，具有检测干性年龄相关性黄斑变性（AMD）中视网膜色素上皮（RPE）变化的潜力。这项单中心前瞻性研究评估了其可视化AMD病理特征的能力。使用Cellularis原型相机在六个5×5°黄斑区域采集AO-TFI图像，这些区域的患者注视良好且无渗出性改变。使用包括光谱域光学相干断层扫描（OCT）、彩色眼底照相和眼底自发荧光在内的传统成像方式进行比较。使用一种定制方法（Fiji软件，版本2.9）将AO-TFI图像与OCT相关联。分析了9例患者（70±8.3岁）的11只眼睛，这些眼睛患有早期（n = 5）、中期（n = 1）和萎缩性（n = 5）AMD。AO-TFI识别出了干性AMD中的相关模式。在受影响的眼睛中，RPE细胞的可见性受损，但AO-TFI将具有低反射中心和明亮边缘的玻璃膜疣、大的边界不清的玻璃膜疣以及3期视网膜下玻璃膜疣样沉积物区分为突出的高反射斑点。与OCT相比，它为小玻璃膜疣提供了更高的分辨率，并揭示了萎缩区域中的晶体结构和低反射点。除非不存在RPE移位，萎缩边界保持等反射，从而实现精确描绘。这些发现突出了AO-TFI作为一种敏感成像工具在表征早期AMD和临床研究方面的潜力。
