PMID- 21074858
OWN - NLM
STAT- MEDLINE
DCOM- 20110708
LR  - 20220410
IS  - 1549-4713 (Electronic)
IS  - 0161-6420 (Linking)
VI  - 118
IP  - 5
DP  - 2011 May
TI  - High-resolution imaging of the photoreceptor layer in epiretinal membrane using 
      adaptive optics scanning laser ophthalmoscopy.
PG  - 873-81
LID - 10.1016/j.ophtha.2010.08.032 [doi]
AB  - OBJECTIVE: To compare, in eyes with an idiopathic epiretinal membrane (ERM), 
      photoreceptor cell structural abnormalities identified on high-resolution images 
      obtained by adaptive optics scanning laser ophthalmoscopy (AO-SLO) with the 
      severity of metamorphopsia and anatomic findings on spectral-domain optical 
      coherence tomography (SD-OCT). DESIGN: Observational case series. PARTICIPANTS: 
      Twenty-five eyes of 24 patients with idiopathic ERM and 20 normal eyes of 20 
      volunteer subjects. METHODS: All participants underwent a full ophthalmologic 
      examination, SD-OCT, and imaging with an original prototype AO-SLO system that 
      incorporated liquid crystal-on-silicon technology. In eyes with ERM, M-CHARTS 
      results were used to quantify metamorphopsia. MAIN OUTCOME MEASURES: Cone mosaic 
      patterns on AO-SLO images and metamorphopsia severity. RESULTS: In normal eyes, 
      AO-SLO images showed a regular photoreceptor mosaic pattern. In 24 (96%) of 25 
      eyes with ERM, "microfolds" (multiple thin, straight, hyporeflective lines in the 
      photoreceptor layer) were identified on AO-SLO images; microfolds were not seen 
      in normal eyes. Individual microfolds were approximately 5 to 20 mum wide, which 
      is narrower than retinal folds seen in fundus photographs (>50 mum). Amsler charts 
      revealed metamorphopsia around the fixation point in 12 of 13 eyes with 
      microfolds in the fovea on AO-SLO but in none of 5 eyes without microfolds in the 
      fovea (P < 0.001). Compared with eyes without foveal microfolds, eyes with foveal 
      microfolds had more severe metamorphopsia (M-CHARTS distortion) in both 
      horizontal and vertical lines (P < 0.001 for both) and greater average foveal 
      thickness detected by SD-OCT (P=0.010). Voronoi analysis revealed that smaller 
      numbers of cones in eyes with ERM had 6 neighbors, compared with normal eyes 
      (P < 0.001). In eyes with ERM, average foveal thickness measured by SD-OCT 
      correlated with visual acuity (P=0.001) and metamorphopsia scores, both 
      horizontal (P=0.002) and vertical (P < 0.001), but visual acuity, metamorphopsia 
      scores, and average foveal thickness were not related to SD-OCT findings of 
      disruption in the photoreceptor inner and outer segment junction. CONCLUSIONS: 
      Adaptive optics scanning laser ophthalmoscopy images in eyes with ERM showed 
      abnormal cone mosaic patterns, described as microfolds in the foveal 
      photoreceptor layer. The presence of microfolds was associated with 
      metamorphopsia, suggesting that microfolds may be involved in the formation of 
      metamorphopsia.
CI  - Copyright (c) 2011 American Academy of Ophthalmology. Published by Elsevier Inc. 
      All rights reserved.
FAU - Ooto, Sotaro
AU  - Ooto S
AD  - Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School 
      of Medicine, Kyoto, Japan. ohoto@kuhp.kyoto-u.ac.jp
FAU - Hangai, Masanori
AU  - Hangai M
FAU - Takayama, Kohei
AU  - Takayama K
FAU - Sakamoto, Atsushi
AU  - Sakamoto A
FAU - Tsujikawa, Akitaka
AU  - Tsujikawa A
FAU - Oshima, Susumu
AU  - Oshima S
FAU - Inoue, Takashi
AU  - Inoue T
FAU - Yoshimura, Nagahisa
AU  - Yoshimura N
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20101112
PL  - United States
TA  - Ophthalmology
JT  - Ophthalmology
JID - 7802443
SB  - IM
CIN - Ophthalmology. 2012 Feb;119(2):430-1; author reply 431. PMID: 22305319
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Epiretinal Membrane/complications/*diagnosis
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Ophthalmoscopy
MH  - Optics and Photonics
MH  - Retinal Cone Photoreceptor Cells/*pathology
MH  - Tomography, Optical Coherence
MH  - Vision Disorders/*diagnosis/etiology
MH  - Visual Acuity/physiology
EDAT- 2010/11/16 06:00
MHDA- 2011/07/09 06:00
CRDT- 2010/11/16 06:00
PHST- 2010/01/26 00:00 [received]
PHST- 2010/08/15 00:00 [revised]
PHST- 2010/08/17 00:00 [accepted]
PHST- 2010/11/16 06:00 [entrez]
PHST- 2010/11/16 06:00 [pubmed]
PHST- 2011/07/09 06:00 [medline]
AID - S0161-6420(10)00880-8 [pii]
AID - 10.1016/j.ophtha.2010.08.032 [doi]
PST - ppublish
SO  - Ophthalmology. 2011 May;118(5):873-81. doi: 10.1016/j.ophtha.2010.08.032. Epub 
      2010 Nov 12.