Changes in cellular structures revealed by ultra-high resolution retinal imaging in optic neuropathies
Changes in cellular structures revealed by ultra-high resolution retinal imaging in optic neuropathies
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DOI：
10.1167/iovs.07-0980
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发表时间：
2008-05-01
影响因子：
4.4
通讯作者：
Werner, John S.
中科院分区：
文献类型：
--
作者：
Choi, Stacey S.;Zawadzki, Robert J.;Werner, John S.
目的.应用高分辨率成像技术研究不同类型视神经病变患者视网膜内外层的完整性。使用加州戴维斯大学构建的三种高分辨率成像系统采集视神经病变患者的视网膜图像：（1）自适应光学（AO）-泛光照明眼底照相机，（2）高分辨率傅立叶域光学相干断层扫描（FDOCT），和（3）自适应光学-傅立叶域光学相干断层扫描（AO-FDOCT）。AO眼底照相机提供光感受器的正面图像，而视网膜的横截面图像（B扫描）通过FDOCT和AO-FDOCT两者获得。从体积FDOCT数据集，详细的厚度地图的三层复合体组成的神经纤维（NF），神经节细胞（GC），和内丛状（IP）层创建。然后将光感受器的正面图像中的可见视锥的数量与来自Humphrey视野的视觉敏感度图（HVF; Carl Zeiss Meditec，Inc.，都柏林，CA）测试，以及FDOCT和AO-FDOCT图像，包括NF GC-IP层复合体的厚度图。研究了五种类型的视神经病变：（1）视神经炎伴多发性硬化（MS），（2）特发性颅内高压（假性脑瘤），（3）非动脉炎性前部缺血性视神经病变（NAION），（4）视神经乳头玻璃疣伴NAION，（5）系统性红斑狼疮伴MS和关节炎。随着永久性视野丧失和NF-GC-IP层复合物变薄，视锥光感受器显示出结构变化，使其反射性降低，这导致正面图像中出现暗空间（因此，可见视锥的数量减少）和OCT图像中不清楚的外视网膜层。然而，当视野损失仅是短暂的，具有正常的NF-GC-IP层复合物时，在视锥光感受器中没有可检测到的异常（即，在OCT图像中，它们密集排列，并具有明显的感光细胞分层）。当视网膜内层受到永久性损伤时，视锥细胞感光器会发生结构变化。视网膜三层内层复合体厚度、视敏度和视锥镶嵌完整性之间呈正相关。
PURPOSE. To study the integrity of inner and outer retinal layers in patients with various types of optic neuropathy by using high-resolution imaging modalities.METHODS. Three high-resolution imaging systems constructed at the University of California Davis were used to acquire retinal images from patients with optic neuropathy: (1) adaptive optics (AO)-flood-illuminated fundus camera, (2) high-resolution Fourier domain optical coherence tomography (FDOCT), and (3) adaptive optics-Fourier domain optical coherence tomography (AO-FDOCT). The AO fundus camera provides en face images of photoreceptors whereas cross-sectional images (B-scans) of the retina are obtained with both FDOCT and AO-FDOCT. From the volumetric FDOCT data sets, detailed thickness maps of a three-layer complex consisting of the nerve fiber (NF), ganglion cell (GC), and inner plexiform (IP) layers were created. The number of visible cones in the en face images of photoreceptors was then compared with visual sensitivity maps from Humphrey visual field (HVF; Carl Zeiss Meditec, Inc., Dublin, CA) testing, as well as FDOCT and AO-FDOCT images, including the thickness maps of the NF GC-IP layer complex. Five types of optic neuropathy were studied: (1) optic neuritis with multiple sclerosis (MS), (2) idiopathic intracranial hypertension (pseudotumor cerebri), (3) nonarteritic anterior ischemic optic neuropathy (NAION), (4) optic nerve head drusen with NAION, and (5) systemic lupus erythematosus with MS and arthritis.RESULTS. With permanent visual field loss and thinning of the NF-GC-IP layer complex, cone photoreceptors showed structural changes, making them less reflective, which caused the appearance of dark spaces in the en face images (hence, reduced number of visible cones) and indistinct outer retinal layers in OCT images. However, when the visual field loss was only transient, with a normal NF-GC-IP layer complex, there were no detectable abnormalities in cone photoreceptors (i.e., they were densely packed and had distinct photoreceptor layering in the OCT images).CONCLUSIONS. Cone photoreceptors show structural changes when there is permanent damage to overlying inner retinal layers. There was a positive relation between the thickness of the three-layer inner retinal complex, visual sensitivity, and integrity of the cone mosaic.