In vivo adaptive optics microvascular imaging in diabetic patients without clinically severe diabetic retinopathy

Stephen A. Burns, Ann E. Elsner, Toco Y. Chui, Dean A. VanNasdale, Christopher A. Clark, Thomas J. Gast, Victor E. Malinovsky, Anh Danh T. Phan

Research output: Contribution to journalArticle

69 Scopus citations

Abstract

We used a confocal adaptive optics scanning laser ophthalmoscope (AOSLO) to image the retina of subjects with nonproliferative diabetic retinopathy (NPDR). To improve visualization of different retinal features, the size and alignment of the confocal aperture were varied. The inner retinal layers contained clearly visualized retinal vessels. In diabetic subjects there was extensive capillary remodeling despite the subjects having only mild or moderate NPDR. Details of the retinal microvasculature were readily imaged with a larger confocal aperture. Hard exudates were observed with the AOSLO in all imaging modes. Photoreceptor layer images showed regions of bright cones and dark areas, corresponding in location to overlying vascular abnormalities and retinal edema. Clinically undetected intraretinal vessel remodeling and varying blood flow patterns were found. Perifoveal capillary diameters were larger in the diabetic subjects (p<0.01), and small arteriolar walls were thickened, based on wall to lumen measurements (p<.05). The results suggest that existing clinical classifications based on lower magnification clinical assessment may not adequately measure key vascular differences among individuals with NPDR.

Original languageEnglish (US)
Pages (from-to)961-974
Number of pages14
JournalBiomedical Optics Express
Volume5
Issue number3
DOIs
StatePublished - Mar 2014

ASJC Scopus subject areas

  • Biotechnology
  • Atomic and Molecular Physics, and Optics

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    Burns, S. A., Elsner, A. E., Chui, T. Y., VanNasdale, D. A., Clark, C. A., Gast, T. J., Malinovsky, V. E., & Phan, A. D. T. (2014). In vivo adaptive optics microvascular imaging in diabetic patients without clinically severe diabetic retinopathy. Biomedical Optics Express, 5(3), 961-974. https://doi.org/10.1364/BOE.5.000961