Toco Yuen Ping Chui1,2, Alexander Pinhas1,2, Alexander Gan1, Moataz Razeen1,3, Nishit Shah1, Eric Cheang1,4, Chun L Liu1,5, Alfredo Dubra6,7,8, Richard B Rosen1,2. 1. Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA. 2. Icahn School of Medicine at Mount Sinai, New York, NY, USA. 3. Alexandria Faculty of Medicine, University of Alexandria, Alexandria, Egypt. 4. Stuyvesant High School, New York, NY, USA. 5. Bronx High School of Science, New York, NY, USA. 6. Department of Biomedical Engineering, Marquette University, Milwaukee, WI, USA. 7. Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA. 8. Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, WI, USA.
Abstract
PURPOSE: To characterise longitudinal changes in the retinal microvasculature of type 2 diabetes mellitus (T2DM) as exemplified in a patient with proliferative diabetic retinopathy (PDR) using an adaptive optics scanning light ophthalmoscope (AOSLO). METHODS: A 35-year-old T2DM patient with PDR treated with scatter pan-retinal photocoagulation at the inferior retina 1 day prior to initial AOSLO imaging along with a 24-year-old healthy control were imaged in this study. AOSLO vascular structural and perfusion maps were acquired at four visits over a 20-week period. Capillary diameter and microaneurysm area changes were measured on the AOSLO structural maps. Imaging repeatability was established using longitudinal imaging of microvasculature in the healthy control. RESULTS: Capillary occlusion and recanalisation, capillary dilatation, resolution of local retinal haemorrhage, capillary hairpin formation, capillary bend formation, microaneurysm formation, progression and regression were documented over time in a region 2° superior to the fovea in the PDR patient. An identical microvascular network with same capillary diameter was observed in the control subject over time. CONCLUSIONS: High-resolution serial AOSLO imaging enables in vivo observation of vasculopathic changes seen in diabetes mellitus. The implications of this methodology are significant, providing the opportunity for studying the dynamics of the pathological process, as well as the possibility of identifying highly sensitive and non-invasive biomarkers of end organ damage and response to treatment.
PURPOSE: To characterise longitudinal changes in the retinal microvasculature of type 2 diabetes mellitus (T2DM) as exemplified in a patient with proliferative diabetic retinopathy (PDR) using an adaptive optics scanning light ophthalmoscope (AOSLO). METHODS: A 35-year-old T2DM patient with PDR treated with scatter pan-retinal photocoagulation at the inferior retina 1 day prior to initial AOSLO imaging along with a 24-year-old healthy control were imaged in this study. AOSLO vascular structural and perfusion maps were acquired at four visits over a 20-week period. Capillary diameter and microaneurysm area changes were measured on the AOSLO structural maps. Imaging repeatability was established using longitudinal imaging of microvasculature in the healthy control. RESULTS:Capillary occlusion and recanalisation, capillary dilatation, resolution of local retinal haemorrhage, capillary hairpin formation, capillary bend formation, microaneurysm formation, progression and regression were documented over time in a region 2° superior to the fovea in the PDR patient. An identical microvascular network with same capillary diameter was observed in the control subject over time. CONCLUSIONS: High-resolution serial AOSLO imaging enables in vivo observation of vasculopathic changes seen in diabetes mellitus. The implications of this methodology are significant, providing the opportunity for studying the dynamics of the pathological process, as well as the possibility of identifying highly sensitive and non-invasive biomarkers of end organ damage and response to treatment.
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Authors: Toco Y P Chui; Michael Dubow; Alexander Pinhas; Nishit Shah; Alexander Gan; Rishard Weitz; Yusufu N Sulai; Alfredo Dubra; Richard B Rosen Journal: Biomed Opt Express Date: 2014-03-13 Impact factor: 3.732
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