Mohanna Safa, Eppenberger Leila S, Pfäffli Oliver, Ferdowsi Sohrab, Simon-Zoula Sonja, Amstutz Christoph, Bachmann Lucas M, Thiel Michael A, Schmid Martin K
Eye Clinic, Cantonal Hospital of Winterthur, 8400 Winterthur, Switzerland.
Eye Clinic, University Hospital of Bern, 3010 Bern, Switzerland.
Cells. 2025 Aug 24;14(17):1308. doi: 10.3390/cells14171308.
Adaptive optics transscleral flood illumination (AO-TFI) enables in vivo imaging of the retinal pigment epithelium (RPE) at near-cellular resolution. In this study, we evaluated its potential as a phenotyping tool in age-related macular degeneration (AMD) by analyzing disease-associated structural patterns and their correlation with optical coherence tomography (OCT) features. We examined AO-TFI images from 120 eyes diagnosed with either early-to-advanced dry AMD (including geographic atrophy, GA) or neovascular AMD (nvAMD). Images were graded by a masked reader, and patterns were matched to corresponding OCT findings. Four consistent morphologic patterns were identified: atrophy, pre-atrophy, soft drusen, and reticular pseudodrusen. Morphometric quantification of hyporeflective regions showed progressive changes in perimeter, diameter, and area from reticular pseudodrusen to soft drusen and pre-atrophy, returning to lower values in atrophy. Distinct nvAMD-specific signatures were not identified. AO-TFI offers a practical, high-resolution complement to OCT, AO-SLO, and AO-OCT for phenotypic characterization of AMD in clinical settings.
自适应光学经巩膜透照（AO-TFI）能够以近细胞分辨率对视网膜色素上皮（RPE）进行体内成像。在本研究中，我们通过分析与疾病相关的结构模式及其与光学相干断层扫描（OCT）特征的相关性，评估了其作为年龄相关性黄斑变性（AMD）表型分析工具的潜力。我们检查了120只被诊断为早期至晚期干性AMD（包括地图样萎缩，GA）或新生血管性AMD（nvAMD）的眼睛的AO-TFI图像。图像由一名盲法阅片者进行分级，并将模式与相应的OCT结果进行匹配。识别出四种一致的形态学模式：萎缩、萎缩前期、软性玻璃膜疣和网状假性玻璃膜疣。低反射区域的形态计量学量化显示，从网状假性玻璃膜疣到软性玻璃膜疣和萎缩前期，周长、直径和面积逐渐变化，在萎缩时恢复到较低值。未识别出明显的nvAMD特异性特征。对于临床环境中AMD的表型特征，AO-TFI为OCT、AO-SLO和AO-OCT提供了一种实用的高分辨率补充。
