Multidisciplinary Ophthalmic Imaging Group (MOI)

117 Pages·2012·7.85 MB·English

by  Michele Appley

ARVO 2012 Annual Meeting Abstracts by Scientific Section/Group – Multidisciplinary Ophthalmic Imaging Group (MOI)

124 Imaging of Posterior Eye I cells.
Sunday, May 6, 2012, 11:15 AM - 1:00 PM
Hall B/C Poster Session
Program #/Board # Range: 791-840/D729-D778
Organizing Section: Multidisciplinary Ophthalmic Imaging Group
Program Number: 791 Poster Board Number: D729
Presentation Time: 11:15 AM - 1:00 PM
Healing Of The Retinal Pigment Epithelium (RPE) Imaged ‘In Vivo’ By
Fundus Autofluorescence In A Series Of Patients With RPE Tears
Kanishka R. Mendis1, Noemi Lois2. 1Ophthalmology, The Canberra Hospital, ACT
Government Health, Canberra, Australia; 2Ophthalmology Department, Grampian
Univ Hosp/NHS Trust, Aberdeen, United Kingdom.
Purpose: To describe findings on fundus auto fluorescence (AF) in a group of
consecutive patients presenting with retinal pigment epithelial (RPE) tears
secondary to age related macular degeneration and to report on functional and
anatomical outcomes following the occurrence of the event.
Methods: All RPE tears that occurred between 01/03/2008-01/03/2011 were
included. AF images were assessed qualitatively and quantitatively. There was an
area of reduced AF signal corresponding to the area, debrided of RPE. This area
was measured at baseline (B) and last follow-up (L) on 30° AF image frames in all
patients with Heidelberg HRA-2 image analysis software. The change in the
reduced AF signal area was calculated by subtraction, from baseline the last follow-
up, reduced AF signal area. The resultant, reduced, AF signal area was used to
determine recovery or progression (image 1). Recovery was defined as a reduction
in the area of reduced AF signal and progression was defined as an increase in the
area of reduced AF signal.
Results: Fourteen eyes of 13 patients (mean age 82) with RPE tears followed for a
median of 11.5 months (range, 1-39) were included in this study. The median Log-
MAR VA pre/post RPE tear was 0.5 (6/12) and 0.8 (6/36) respectively. A typical
RPE tear on AF imaging had an area of reduced AF signal (black area- debrided of
RPE) and increased AF signal (bright area- rolled, torn RPE). There was recovery
of AF signal area in 10 eyes (median recovery 1.3; range- 0.03-6.78) and
progression of the reduced AF signal area in 4 (median progression 0.7; range-
0.11-5.58).
Conclusions: A characteristic pattern of fundus AF was observed in RPE tears that
allowed for non-invasive diagnosis of this condition. Recovery of the AF signal
around the RPE tear was noted in majority of the cases. These results may indicate
a degree of „healing‟ of the RPE defect possibly by proliferating and sliding RPE

Commercial Relationships: Kanishka R. Mendis, None; Noemi Lois, None
Support: None
Program Number: 792 Poster Board Number: D730
Presentation Time: 11:15 AM - 1:00 PM
Feasibility Of Telemedicine Retinal Screening In Children With Type I
Diabetes Mellitus
Melissa A. Simon1, Ben Szirth2, Khadija S. Shahid3, Albert S. Khouri1.
1Ophthalmology, UMDNJ-NJMS, Newark, NJ; 2Institute of Ophthalmogy and
Visual Sciences, New Jersey Medical School, Newark, NJ; 3Ophthalmology and
Visual Sciences, The University of Iowa, Iowa City, IA.
Purpose: Diabetic retinopathy is the leading cause of blindness in young adults.
The purpose of this study is to demonstrate the feasibility of teleocular screening in
a pediatric population with type 1 diabetes (DMI).
Methods: Data collected at a single screening convention in Orlando, FL, between
June 29 and July 2, 2010 were reviewed. All subjects were <17 years with a known
diagnosis of DMI. Images were captured by a Canon CX-1, a mydriatic and non-
mydriatic 45 degree retinal camera. All subjects were imaged without the use of
mydriatic agents and had two images captured of each eye. The first image was
captured using a flash setting of 60 watts/second followed by an autofluorescent
image at a flash setting of 300 watts/second. Canon proprietary software EyeScape
(Canon, Los Angeles, CA) was used to manage all Digital Imaging and
Communications in Medicine (DICOM) based images. The resolution of the
images was 15.1 megapixels on a complementary metal-oxide semiconductor
(CMOS) medical grade image sensor. Additional data collected included: Age, sex,
race, duration of diabetes, time since most recent eye exam, type of insulin therapy,
and body mass index (BMI).
Results: 104 subjects met inclusion criteria for analysis. Non-mydriatic fundus
imaging was possible in all subjects. Mean age was 11 yrs (standard deviation 3.8
yrs, range 2-17 yrs). 51 percent were male, 49 percent female. 92 percent of
subjects were Caucasian. Mean duration of DMI was 4.97 years (standard deviation

Copyright 2012 by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. For permission to reproduce any abstract, contact the ARVO Office at [email protected].
ARVO 2012 Annual Meeting Abstracts by Scientific Section/Group – Multidisciplinary Ophthalmic Imaging Group (MOI)

3.49 years, range 4 months-14 years). One subject was found to have diabetic with cellular infiltration and/or vitreous opacification, moreover, these OCT
retinopathy at screening (age 15, disease duration 10 years), and three subjects had findings show that there is a high prevalence of vitreoretinal abnormalities in
incidental findings (1 choroidal nevus, 1 cup to disc asymmetry, 1 myopic fundus). Fuchs‟ uveitis.
Of the 92 subjects with data on their most recent eye exam, 62% had an eye exam Commercial Relationships: Nadia Bouchenaki, None; Marina Papadia,
<1 yr prior to screening, 29.3% had an exam within 1-2 yrs, and 8.7% had an exam None; Carl P. Herbort, None
>2 yrs prior to screening. 22 subjects were on an insulin pump, for an average 3.5 Support: None
years. Mean BMI was 19.8 (standard deviation 3.4).
Conclusions: Screening a pediatric type I diabetic population with telemedicine
Program Number: 795 Poster Board Number: D733
fundus imaging is feasible. Our study population had characteristics consistent with
Presentation Time: 11:15 AM - 1:00 PM
those for patients recommended to be screened by the American Academy of
Rates of False Positive Peripapillary and Macular Optical Coherence
Pediatrics, the American Association for Pediatric Ophthalmology and Strabismus,
Tomography Scans in Healthy Myopic Eyes: Cirrus HD-OCT versus RTVue-
and the American Academy of Ophthalmology.
100
Commercial Relationships: Melissa A. Simon, None; Ben Szirth, Jean-Claude Mwanza1, Fouad E. Sayyad2, Ahmad A. Aref3, Donald L. Budenz1.
None; Khadija S. Shahid, None; Albert S. Khouri, None 1Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, NC;
Support: Research to Prevent Blindness 2Ophthalmology, University of Miami, Bascom Palmer Eye Institute, FL;
3Ophthalmology, University of Illinois at Chicago, Chicago, IL.
Program Number: 793 Poster Board Number: D731 Purpose: To compare false positive rates (FPR) of peripapillary and macular scans
Presentation Time: 11:15 AM - 1:00 PM acquired with Cirrus and RTVue in healthy myopic eyes and to asssess the
Evaluation of Posterior Pole Folds by SLO/OCT and Multispectral Fundus agreement between the two devices and between RNFL and ganglion cell scans in
Imaging classifying subjects as normal or abnormal.
Rustum Karanjia, John M. Hamilton, Brian C. Leonard, Vivek Patel, Stuart G. Methods: Forty-one healthy myopic eyes of 41 subjects were scanned with Cirrus
Coupland. Ophthalmology, University of Ottawa Eye Institute, Ottawa, ON, to measure peripapillary RNFL and macular ganglion cell-inner plexiform layer
Canada. (GCIPL) thicknesses thickness, and with RTVue to measure peripapillary RNFL
Purpose: SLO/OCT has been shown to be capable of imaging posterior pole folds. and macular ganglion cell complex (GCC). FPRs were calculated using the
This imaging modality however does not always accurately distinguish betwen devices‟ predefined criteria of abnormality and compared between devices.
choroidal, chorioretinal, and retinal folds. The purpose of this study is to evaluate Agreement between instruments and between RNFL and ganglion cell scans in
the ability of multispectral fundus imaging (MSI) to characterize posterior pole classifying subjects as normal or abnormal was assessed with kappa (κ) statistic.
folds in comparison to SLO/OCT. Results: All eyes had a 20/20 visual acuity and normal VF. For RNFL, the FPR
Methods: Patients with posterior pole folds on clinical exam were identified in the was 4.8% for average and ranged from 2.4% to 7.3% for quadrants on Cirrus, but
Neuro-Ophthalmology and Retina subspecialty clinics at the Ottawa Eye Institute. was 0% for all parameters on RTVue. The differences in FPR between devices
Three dimensional color and red-free fundus photographs of the disc-macula were were insignificant (all P>0.05). The FPR based on the presence of any abnormal
obtained using a retinal camera (Topcon TRC-50DX). OCT topographical T-Scans parameter was 19.2% on Cirrus and 0% on RTVue, P=0.002. Cirrus average,
of the central 29 degrees along with horizontal and vertical B-Scans through the minimum and hemispheric GCIPL were falsely positive in 12.2% to 17%. FPRs
macula were obtained (OPKO Spectral OCT/SLO™). MSI of the central 41 degree ranged from 9.7% to 14.6% for RTVue average, focal loss volume and hemispheric
field were obtained using wavelengths ranging from 450 nm to 900 nm and a GCC, with no significant differences compared to Cirrus GCIPL rates, all P>0.05.
stacked set of images from the retina through to the choroid was generated. The overall Cirrus FPR (36.5%) was significantly higher than that of RTVue
(Annidis Retinal Health Analyzer). Images were analyzed by staff Neuro- (14.6%), P=0.023. On Cirrus 33.3% of eyes with abnormal average GCIPL had
ophthalmologist, Clinical Electro-physiologist and Retina Specialist. Each set of abnormal average RNFL; no eye with abnormal average GCC had abnormal
images was graded for the presence or absence of folds and the layer of the folds. average RNFL on RTVue. The agreement between devices was fair (κ=0.34) for
Results: Thirteen eyes of ten patients with presumed folds on clinical examination ganglion cell and poor (κ=0) for RNFL scans. The agreement between peripapillary
were identified for this study. Five eyes demonstrated chorioretinal folds on both and macular scans in classifying subjects as false positive was poor both on Cirrus
SLO/OCT and MSI. Four eyes had retinal folds without choroidal folds on both (κ=0.13) and RTVue (κ=0).
SLO/OCT and MSI. Two eyes showed choroidal folds on both SLO/OCT and MSI. Conclusions: There are no differences in FPRs of average and individual quadrant
Another two eyes showed choroidal folds on MSI with no apparent folds on RNFL, and in FPRs of average and individual hemispheric macular ganglion cell
SLO/OCT. between Cirrus and RTVue. Overall FPRs of peripapillary and macular scans seem
Conclusions: SLO/OCT and MSI are valuable methods for examining posterior higher with Cirrus than RTVue. The agreement between RTVue and Cirrus for
pole folds. However SLO/OCT was not able to identify presence of posterior pole classifying subjects as false positive based on RNFL was poor. The classification
folds in all subjects. MSI is a useful adjunct to imaging these folds and determining agreement between macular ganglion cell and peripapillary RNFL scans was also
their anatomical location. This study represents the largest collection of SLO/OCT poor on both devices. The high FPR of OCT results in healthy myopic subjects may
and MSI data for patients with posterior pole folds. be a matter of concern during longitudinal monitoring of glaucoma.
Commercial Relationships: Rustum Karanjia, None; John M. Hamilton, Commercial Relationships: Jean-Claude Mwanza, None; Fouad E. Sayyad,
Annidis Health Systems Corp. (C); Brian C. Leonard, Annidis Health Systems None; Ahmad A. Aref, None; Donald L. Budenz, None
Corp. (C); Vivek Patel, None; Stuart G. Coupland, Annidis Health Systems Support: Research to Prevent Blindness
Corp. (C)
Support: University Medical Research Fund
Program Number: 796 Poster Board Number: D734
Presentation Time: 11:15 AM - 1:00 PM
Program Number: 794 Poster Board Number: D732 Assessment of Cirrus SD-OCT Registration in Patients with Neovascular Age-
Presentation Time: 11:15 AM - 1:00 PM related Macular Degeneration
Optical Coherence Tomography Study Of Vitreo-retinal Interactions In Shiri Zayit-Soudry1,2A, Paul F. Stetson3, Mary K. Durbin4, Neil M. Bressler2B.
Fuchs’ Uveitis 1Retina Division, University of California, San Francisco, San Francisco, CA;
Nadia Bouchenaki1,2, Marina Papadia2,3, Carl P. Herbort1,2. 1Memorial A. De ARetina Division, BOphthalmology, 2Wilmer Eye Institute, Baltimore, MD; 3Carl
Rothschild, Clinique Generale-Beaulieu, Geneva, Switzerland; 2Clinique Zeiss Meditec, Dublin, CA; 4R & D, Carl Zeiss Meditec, Inc, Dublin, CA.
Montchoisi, Centre for Ophtalmic Specialised Care, Lausanne, Switzerland; 3Eye Purpose: We aimed to evaluate automated and manual optical coherence
Clinic, Department of Neurosciences, Ophthalmology and Genetics, University of tomography (OCT) registration across visits in eyes with neovascular age-related
Genova, Italy. macular degeneration (AMD) receiving treatment in order to determine the rate of
Purpose: To evaluate an describe vitreo-retinal interactions by Optical Coherence successful automatic registration, rate of successful manual registration in cases of
Tomography (OCT) in Fuchs‟ uveitis. failed automatic registration, and quality of successful registration. We also
Methods: Retrospective study including 29 patients (31 eyes) with Fuchs‟ uveitis compared thickness values of manually registered scans to unregistered scans in
who underwent OCT evaluation. Vitreo-retinal interface was analyzed and cases of failed automatic registration.
morphological changes described and compared to the normal controlateral eye Methods: After IRB approval, Cirrus SD-OCT (Carl Zeiss Meditec Inc., Dublin,
(except 2 bilateral cases). CA) scans from 100 eyes with neovascular AMD were obtained at 3 different visits
Results: Vitreo-retinal modifications were seen on OCT in 90% of Fuchs‟ uveitis including baseline, 1 month after an anti-vascular endothelial growth factor
patients. The main vitreo-retinal interactions that could be described were : vitreous (VEGF) drug injection, and a third visit some time later. Automatic registration of
hyperreflective dots (45%), thickening of posterior hyaloid (38.7%), posterior each follow-up scan to the baseline scan was either successful or failed. Among
vitreous detachement (32.3%), vitreo-retinal traction (29%), epiretinal membrane cases of failed automated registration, manual registration was attempted. All cases
(25.8%). OCT examination was normal in 9.6% of cases. were graded for registration quality. For each case with failed automatic but
Conclusions: Vitreous involvement is a characteristic feature of Fuchs‟ uveitis successful manual registration, difference in percent thickness change between the

Copyright 2012 by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. For permission to reproduce any abstract, contact the ARVO Office at [email protected].
ARVO 2012 Annual Meeting Abstracts by Scientific Section/Group – Multidisciplinary Ophthalmic Imaging Group (MOI)

unregistered and registered macular change map was calculated for each subfield. Commercial Relationships: Hyung Cho, None; Caio V. Regiatieri,
A difference greater than 10% was considered clinically relevant. None; Ahmad A. Alwassia, None; Jason Y. Zhang, None; Caroline Baumal,
Results: 142 (70%) of 200 paired images were registered automatically. Among None; Nadia Waheed, None; James G. Fujimoto, Carl Zeiss Meditech Inc. (F),
the 57 (29%) OCT pairs which failed automatic registration, manual registration Optovue Inc. (I); Jay S. Duker, Carl Zeiss Meditech Inc. (F), Optovue Inc. (F),
was successful in 55. Registration quality grades in cases of successful automatic Topcon Medical Systems Inc. (F)
registration were perfect or good in 55%, acceptable in 36%, and poor in 9%. Support: None
Among the 55 cases which required manual registration, the quality grades were
perfect or good in 38%, acceptable in 47%, and poor in 15%. The difference
Program Number: 798 Poster Board Number: D736
between “unregistered” and “manually registered” percent thickness change
Presentation Time: 11:15 AM - 1:00 PM
calculated for the central subfield was greater than 10% in 10 (18%) of the 55 cases
Retinal Nerve Fiber Layer Attenuation Maps Derived From Volumetric OCT
that required manual registration. Analysis of the inner and outer subfields showed
Data
a clinically relevant difference in 11 (20%) and 3 (5.4%) cases, respectively. Koenraad A. Vermeer1A, Josine van der Schoot1A,1B, Hans G. Lemij1B, Johannes F.
Conclusions: Our results suggest that automatic OCT registration succeeds in 70% De Boer2,1A. ARotterdam Ophthalmic Institute, BGlaucoma Service, 1Rotterdam Eye
(95% confidence interval [CI]: 65% to 78%) of paired images with neovascular Hospital, Rotterdam, The Netherlands; 2Physics And Astronomy, VU University,
AMD undergoing treatment. Subsequent manual registration appears to succeed in
Amsterdam, The Netherlands.
almost all which fail automatic registration. This information may be important
Purpose: To introduce and to evaluate the use of retinal pigment epithelial (RPE)
when OCT guides retreatment decisions in eyes with neovascular AMD.
normalized retinal nerve fiber layer (RNFL) attenuation coefficient maps, derived
Commercial Relationships: Shiri Zayit-Soudry, None; Paul F. Stetson, Carl
from optical coherence tomography (OCT) data.
Zeiss Meditec (E); Mary K. Durbin, Carl Zeiss Meditec (E); Neil M. Bressler,
Methods: Previously, the average OCT-signal of the RNFL was shown to provide
Alimera Sciences, Allergan USA, Bausch & Lomb Incorporated, Carl Zeiss
complementary data to thickness maps. However, quantitative interpretation of this
Medictec, Inc., ForSight Labs, LLC, Genentech, Inc., Lumenis, Inc., Notal Vision,
data is cumbersome, because it depends on the fluctuating strength of the incident
Novartis Pharma AG, Optovue, and Regeneron Phar (F)
beam and on the thickness of the layers (see figure, top row). We therefore derived
Support: Carl Zeiss Meditec Inc. Johns Hopkins University Retina Division
Research Fund. a model to locally calculate the RNFL attenuation coefficient (μatt). The model
incorporates reflectivity data from the RNFL, uses the RPE as a reference layer and
takes into account the thickness of the RNFL to adjust for attenuation of the
Program Number: 797 Poster Board Number: D735 incoming light beam in the RNFL. By using an automated segmentation algorithm,
Presentation Time: 11:15 AM - 1:00 PM the resulting μatt was calculated for every A-line and maps were produced. 10
Retinal Neovascularization Secondary to Proliferative Diabetic Retinopathy normal and 8 glaucomatous eyes were imaged on a Spectralis OCT device
Characterized by Spectral Domain Optical Coherence Tomography (Heidelberg Engineering, Germany). Each peri-papillary volumetric scan with a
Hyung Cho1, Caio V. Regiatieri2, Ahmad A. Alwassia1, Jason Y. Zhang1, Caroline field-of-view of 20° consisted of 193 B-scans (512 A-lines per B-scan, 5 times
Baumal1, Nadia Waheed1, James G. Fujimoto3, Jay S. Duker1. 1Ophthalmology, averaging).
Tufts-New England Eye Center, Boston, MA; 2Federal University of Sao Paulo, In addition to visual inspection of the resulting maps, the data was averaged to
Sao Paulo, Brazil; 3Massachusetts Institute of Technology, Cambridge, MA. produce a single mean RNFL attenuation coefficient per eye.
Purpose: To characterize retinal neovascularization and accompanying retinal and Results: All volumetric data sets were automatically segmented and RNFL
vitreal morphological changes in diabetic patients using high-resolution spectral attenuation coefficients were used. Examples of the resulting μatt-maps are shown
domain optical coherence tomography (SD-OCT). in the figure (middle row; normal (left) and glaucomatous (right)). The average μatt
Methods: A cross-sectional retrospective analysis was performed on 15 eyes of 13 was calculated for every eye and their distributions were plotted (see figure, bottom
nonconsecutive subjects with proliferative diabetic retinopathy that were seen row). The difference between the average μatt for healthy and glaucomatous eyes
between August 2011 and November 2011 at the New England Eye Center, was highly significant (Mann-Whitney test, P<0.01).
Boston, Massachusetts. When areas suspicious for neovascularization (NV) or Conclusions: We introduced the attenuation coefficient as a way to describe an
intraretinal microvascular abnormality (IRMA) was found on clinical exam, an optical property of the RNFL. Graphical, spatial maps were produced, showing
OCT image was obtained in the region of the abnormal blood vessels. relatively homogeneous coefficients for normal eyes and clearly pathological
Results: Characteristic changes of the vasculature, retina and vitreous were seen in patterns in glaucomatous eyes. The difference between normal and glaucomatous
the 15 eyes with diabetic neovascularization. On OCT, NV appears as eyes was highly significant, suggesting its use as a diagnostical tool. We have
hyperreflective loops of relatively homogenous hyperreflectivity with vessels shown that, in addition to morphological data, OCT data contains more information
projecting through the posterior hyaloid and into the vitreous (1d). IRMA lesions that is clinically useful, such as attenuation coefficient maps.
did not project into the vitreous (1c). Traction from NV with accompanying retinal
detachment was observed. The detached retina has lost its architectural
organization, and cystic spaces were present (2).
Conclusions: It is possible to image diabetic NV using SD-OCT and to visualize
the spectrum of retinal, retinal vascular and vitreal changes seen in these areas of
abnormal retinal vasculature. OCT may be useful to monitor subtle changes such as
progression of the neovascularization and traction on the retina over time.

Copyright 2012 by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. For permission to reproduce any abstract, contact the ARVO Office at [email protected].
ARVO 2012 Annual Meeting Abstracts by Scientific Section/Group – Multidisciplinary Ophthalmic Imaging Group (MOI)

Commercial Relationships: Koenraad A. Vermeer, OCT Attenuation was thinner (median, 2.1 µm) and present in more foveal (36.6%) than perifoveal
Coefficient (P); Josine van der Schoot, OCT Attenuation Coefficient (P); Hans G. (16.5%) locations.
Lemij, OCT Attenuation Coefficient (P); Johannes F. De Boer, OCT Technology Conclusions: SDD and BlinD prevalence in AMD eyes are both high. SDD‟s
(P) organized morphology, resembling lesions in adult vitelliform macular
Support: Stichting Combined Ophthalmic Research Rotterdam degeneration [4], plus its topography and impact on surrounding photoreceptors
imply specific processes of biogenesis. SDD‟s predominantly perifoveal, and
BlinD‟s predominantly foveal, locations suggest relationships with rod and cone
Program Number: 799 Poster Board Number: D737
topography, respectively. Perhaps differentiable aspects of rod and cone
Presentation Time: 11:15 AM - 1:00 PM
physiology, such as cholesterol homeostasis, contribute to lesion biogenesis, as
Retinal Nerve Fiber Layer And Ganglion Cell Complex Thickness Assessment
well as complement activation and other processes. References [1] Zweifel.
In Patients With Obstructive Sleep Apnea
Ophthalmology. 2010;117:303. [2] Curcio. IOVS 2011;52:3943. [3] Vogt. Exp Eye
Nataliya Semenova, Vladimir Akopyan. Department of ophthalmology, Lomonosov
Res. 2011;93:413. [4] Arnold. Eye.
Moscow State University, Medical School, Moscow, Russian Federation.
2003;17:717.
Purpose: To investigate the retinal nerve fiber layer (RNFL) and the macular
ganglion cell complex (GCC) in patients with obstructive sleep apnea (OSA) and
evaluate the relationship with the OSA severity.
Methods: This study included 43 previously untreated patients (86 eyes) with OSA
and 17 age- and sex-matched healthy controls that had no history of sleep-
disordered breathing. Patients with any conditions that can cause optic neuropathy
were excluded from the study. Participants with OSA were divided into three
groups on the basis of the apnea-hypopnea index (AHI): group I (mild OSA,
AHI=5-15) - 17 participants; group II (moderate OSA, AHI=16-30) - 11
participants; group III (severe OSA, AHI>30) - 15 participants. All the subjects
underwent polysomnography and complete ophthalmological examination
including perimetry (HFA II, Carl Zeiss Meditec Inc., USA), scanning laser
polarimetry (SLP; GDx VCC, Laser Diagnostic Technologies Inc., USA), optic
coherence tomography (OCT; RTVue-100 FD-OCT, Optovue Inc., USA). RNFL
thickness was measured in various segments using SLP and OCT. RNFL thickness
standard deviation and Nerve fiber index (NFI) were noted from SLP results. OCT
was used to obtain average GCC thickness, global and focal loss volume (GLV &
FLV).
Commercial Relationships: Christine A. Curcio, None; Jeffrey D. Messinger,
Results: There was no significant difference among the groups in terms of visual
None; Kenneth R. Sloan, None; Gerald McGwin, Jr., None; Nancy E.
acuity, IOP, MD and PSD perimetric indices. The patient and control groups
Medeiros, None; Richard F. Spaide, None
differed significantly in terms of average RNFL thickness, NFI, average GCC
Support: NEI EY06109, EyeSight Foundation of Alabama, Research to Prevent
thickness, GLV and FLV (Mann-Whitney test, p<0,01). There was a statistically
Blindness Inc., Macula Foundation
significant difference between NFI, GLV and FLV values of healthy and severe
OSA patients (Kruskal-Wallis test, p<0,01; Bonferroni-Dunn post hoc test,
p<0,05). Program Number: 801 Poster Board Number: D739
Conclusions: We supposed that episodes of OSA lead to nocturnal increase of Presentation Time: 11:15 AM - 1:00 PM
intracranial and intraocular pressure, transient hypoxemia and hypercapnia, which, Macular Volume Change By Spectral-domain Optical Coherence Tomography
in turn, may compromise optic nerve head perfusion and oxygenation, ultimately After Treatment With Bevacizumab in Exudative Macular Degeneration
leading to optic neuropathy. This study showed that OSA is associated with optic Joshua C. Priluck, K V. Chalam, Sandeep Grover. Ophthalmology, University of
neuropathy that could be revealed by OCT and SLP on the preperimetric stage. Florida College of Medicine, Jacksonville, FL.
Further studies of the effect of OSA treatment will clear up the role and Purpose: To evaluate the change in macular volume as well as macular thickness
contribution of apnea in pathogenesis of glaucoma and anterior ischemic optic by Spectral-domain optical coherence tomography (SD-OCT / Spectralis) in
neuropathy. patients with exudative age-related macular degeneration (AMD) in response to
Commercial Relationships: Nataliya Semenova, None; Vladimir Akopyan, treatment with intravitreal bevacizumab.
None Methods: This was a retrospective study where the patients with exudative AMD
Support: None who had been treated with intravitreal bevacizumab were identified. SD-OCT
recordings done at initial treatment and after at least 3 months of follow-up were
utilized for the measurements. Patients with diabetes or who underwent eye surgery
Program Number: 800 Poster Board Number: D738
during this period were excluded. Initial and final total macular volumes and
Presentation Time: 11:15 AM - 1:00 PM
central macular thickness (CMT) were recorded. Paired t-test was performed to
Subretinal Drusenoid Debris (SDD) Predominant In Perifovea, Basal Linear
analyze change in total macular volume and CMT for statistical significance.
Deposit (BlinD) Predominant In Fovea In Atrophic Age-related Macular
Results: 37 eyes of 35 patients were included in the study. The average initial
Degeneration (AMD)
Christine A. Curcio1, Jeffrey D. Messinger1, Kenneth R. Sloan2, Gerald McGwin, macular volume was 2.58 mm3 (+/- 0.52) and final was 2.35 mm3 (+/- 0.39) - the
Jr.1, Nancy E. Medeiros3, Richard F. Spaide4. 1Ophthalmology, Univ of Alabama change in volume was a decrease by 0.22 mm3 (+/- 0.46). Using a paired t-test the
at Birmingham, Birmingham, AL; 2Computer and Information Science, UAB, t-value was 0.0055, which is significant. The mean initial CMT was 377
Birmingham, AL; 3Ophthalmology, Retina Specialists-N Alabama, Huntsville, AL; micrometers (+/- 119) and final 327 micrometers (+/- 86.4) - the change in CMT
4Vitreous Retina Macula Consultants NY, New York, NY. was a decrease of 49.7 micrometers (+/- 108). Using a paired t-test the t-value was
0.0082, which is significant. The mean follow-up period ranged from 91 to 1372
Purpose: To characterize the morphology, prevalence, and topography of SDD, an
days with mean 493 days (+/-341) and median of 416 days.
extracellular, cholesterol-containing lesion that is a potential histological correlate
Conclusions: Patients with exudative AMD treated with bevacizumab not only
of reticular (pseudo-) drusen [1], and BlinD, a diffusely distributed, cholesterol-
show significantly reduced macular thickness but also 'total macular volume' after
rich, lesion that is specific to AMD (Figure).
treatment with intravitreal bevacizumab. Volumetric measurement of macular
Methods: Donor eyes with median death-to-preservation = 2:40 hr were post-fixed
thickness may be a useful additional tool in monitoring the treatment or course of
in osmium tannic acid paraphenylenediamine and prepared for macula-wide high-
the disease in exudative AMD.
resolution sections [2]. Study eyes, without exudative changes, exhibited
Commercial Relationships: Joshua C. Priluck, None; K. V. Chalam,
pigmentary disturbances ≥2A (scale modified from [3]) AND either drusen or
None; Sandeep Grover, None
continuous basal laminar deposits. Lesion morphologies and annotated thicknesses
Support: None
of chorioretinal layers were recorded at standard locations [2] in 2 horizontally
oriented sections that together included the fovea and nasal, temporal, and superior
perifovea (0.8-3 mm eccentricity). Program Number: 802 Poster Board Number: D740
Results: In these 21 eyes of 19 Caucasian donors (13 female, 6 male, 83.5 ± 7.7 Presentation Time: 11:15 AM - 1:00 PM
yr), SDD had two essential formations: isolated domes with caps of outer segment- Localization of Pigmentary Changes in Non-Neovascular Age Related
like material and confluent dollops punctuated by tufts of RPE apical processes, Macular Degeneration versus Pattern Dystrophy
both associated with photoreceptor perturbation. 18/21 eyes (85.7%) had Veena R. Raiji1, Florian M. Heussen2, Srinivas R. Sadda3. 1Ophthalmology,
measurable SDD and BlinD, respectively. SDD was thick (median, 9.4 µm) and Doheny Eye Institute, Los Angeles, CA; 2Doheny Eye Institute, Pasadena, CA;
present in more perifoveal (28.7%) than foveal (10.2%) sampling locations, BlinD 3Ophthalmology, Doheny Eye Institute - USC, Los Angeles, CA.

Copyright 2012 by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. For permission to reproduce any abstract, contact the ARVO Office at [email protected].
ARVO 2012 Annual Meeting Abstracts by Scientific Section/Group – Multidisciplinary Ophthalmic Imaging Group (MOI)

Purpose: Pigmentary abnormalities have commonly been described in both non- Purpose: To analyze the occurrence of persistent retinal cystic structures over scars
neovacular age-related macular degeneration (NNVAMD) and pattern dystrophy and areas of chorioretinal atrophy in patients with exudative age-related macular
(PD). The purpose of our study is to describe the optical coherence tomography degeneration (AMD).
(OCT) correlates of these pigmentary abnormalities in these disorders. Methods: A retrospective case review identified 119 patients (238 eyes) with
Methods: We retrospectively reviewed the medical history and OCT findings of 50 exudative AMD treated with anti-vascular endothelial growth factor (VEGF)
eyes of 38 patients (32 with NNVAMD and 18 with PD) presenting to the Doheny agents. Patients were scanned using the Cirrus HD-OCT (Carl Zeiss Meditec,
Retina Centers. All patients underwent OCT imaging using a macular cube Dublin, California). The presence of fibrous scar formation and chorioretinal
protocol (512 x 128) with either a Topcon 3D-OCT 2000 or Zeiss Cirrus OCT. atrophy were determined by fundus photography and noted on OCT, and the
OCTs were graded by two experienced ophthalmologists, for a number of features presence, location, and persistence of cystic structures within the retina were
including the presence of pigment migration as evidenced by intraretinal documented.
hyperreflective foci (IHF), subretinal deposits, pigment epithelial detachment, Results: Scar formation detected on photographs was present in 42 of 238 eyes
integrity of the RPE band, RPE atrophy, and vitreoretinal interface abnormalities (17.6%). Eleven of the 42 eyes (26%) demonstrated retinal cysts overlying the
(e.g. epiretinal membrane). For those eyes with IHF, the number of individual B- scars on OCT. Chorioretinal atrophy was observed in 108 eyes (45.4%), 22 of
scans with IHF were quantified, and both the predominant retinal layer involved which had cystic structures overlying the atrophy on OCT. Most cysts were located
and the innermost extent of the IHF was determined. The largest hyperreflective in the outer retina (83.1% in patients with scar formation, 68.7% in patients with
focus was also measured using the caliper function as was the height of the largest atrophy) and located directly over the area of pathology. In the patients with
adjacent pigment epithelial detachment. scarring, 32 cysts in 10 eyes persisted over an average of 11.9 ± 5.5 months, despite
Results: We observed that 21 patients (65.6%) with NNVAMD and 13 patients 6 of these eyes receiving an average of 8 ± 4 injections with anti-VEGF agents. In
(72.2%) with PD had evidence of intraretinal hyperrefective foci (indicating the patients with chorioretinal atrophy, 17 cysts in 11 eyes persisted over 9.3 ± 4.6
pigment migration) and that 0 patients (0%) with NNVAMD and 11 patients months with 8 of these eyes undergoing an average of 12 ± 6 anti-VEGF injections.
(61.1%) with PD had evidence of subretinal deposits by OCT. For patients who had A total of 17 outer retinal tubulations were observed in 14 eyes, 7 associated with
IHF, the average number of individual scans with IHF was 12.3 in patients with scarring and 10 with atrophy.
NNVAMD and 3.92 in patients with PD (p-value 0.0018). The average level of Conclusions: Retinal cysts over fibrotic scars in patients with treated exudative
highest RPE migration was slightly above the outer plexiform layer in NNVAMD AMD are present in 26% of eyes and do not seem to be affected by further
patients and was between the outer nuclear and outer plexiform layers in PD treatment with anti-VEGF agents. These structures are unlikely to represent a sign
patients (p-value 0.17). The average height of the largest hyperreflective focus was of active choroidal neovascularization and their presence should not be an
70.4 microns in NNVAMD patients and 78.6 microns in PD patients (p-value indication for re-treatment.
0.336). The average logMAR visual acuity in patients with NNVAMD was 0.208 Commercial Relationships: Michelle C. Liang, None; Caio V. Regatieri,
and in patients with PD was 0.163 (p-value 0.26). None; Jason Y. Zhang, None; Ahmad A. Alwassia, None; Jay S. Duker, Alcon
Conclusions: Intraretinal hyperreflective foci/ pigment migration was common (C), Carl Zeiss Meditech (F), EMD Serono (C), Genentech (C), Hemera (I), Merck
both in eyes with NNVAMD and in eyes with PD. IHF in eyes with PD were less (C), Novartis (C), Ophthotech (C), OptiVue (F), Paloma Pharmaceuticals (S), QLT
extensive and did not migrate as great a distance from the RPE band. Conversely, (C), Thrombogenics (C), Topcon Medical Systems, Inc. (F)
subretinal deposits were more common in eyes with PD and appeared to co-localize Support: None
with the pigment abnormalities. These findings suggest that pigment abnormalities
in eyes with NNVAMD correspond to intraretinal pigment migration, whereas they
Program Number: 805 Poster Board Number: D743
correspond to the subretinal lesions in eyes with pattern dystrophy.
Presentation Time: 11:15 AM - 1:00 PM
Commercial Relationships: Veena R. Raiji, None; Florian M. Heussen,
Predictive Power Of Novel Biomarkers For Early Retinopathy Development
None; Srinivas R. Sadda, None
In The Diabetic Macula
Support: None Delia DeBuc1, Wei Gao1, Erika Tatrai2, Lenke Laurik2, Boglarka Varga2, Veronika
Olvedy2, Aniko Somogyi3, William E. Smiddy1, Gabor M. Somfai2. 1Bascom Palmer
Program Number: 803 Poster Board Number: D741 Eye Institute, University of Miami Miller School of Medicine, Miami, FL;
Presentation Time: 11:15 AM - 1:00 PM 2Department of Ophthalmology, Semmelweis University, Budapest, Hungary;
Revisiting Fluorescein Angiography in the Evaluation and Management of 3Department of Internal Medicine, Semmelweis University, Budapest, Hungary.
Neovascular Age-related Macular Degeneration Purpose: To assess the diagnostic power of novel biomarkers based on thickness,
Joshua Schliesser, Nancy Kunjukunju, Gary Gallimore, Felix N. Sabates. texture and optical measures of the backscattered signal from layered retinal
Ophthalmology, UMKC School of Medicine, Kansas City, MO. structures in diabetic eyes.
Purpose: Optical Coherence Tomography (OCT) has advanced in recent years. Methods: A total of 155 eligible eyes from 99 participants (74 healthy eyes (34±12
Due to the convenience of OCT, there has been a trend to move away from using yrs), 38 eyes with type 1 diabetes mellitus (DM) with no retinopathy (35±10 yrs)
fluorescein angiography (FA) as the primary diagnostic modality in neovascular and 43 eyes with mild diabetic retinopathy (MDR, 43±17 yrs) on biomicroscopy)
age-related macular degeneration (AMD). We propose to show that flourescein were included in the study. Diagnostic parameters, such as thickness, rough
angiography still has a necessary role in evaluation and treatment of AMD, dimension, contrast, reflectivity, total reflectance and layer index, were extracted
particularly during follow-up. from OCT images and evaluated to test their suitability as predictors of early
Methods: A retrospective chart review in a busy retina specialty clinic was diabetic retinopathy. ANOVA followed by Newman-Keuls post-hoc analyses were
performed to find patients with neovascular AMD. Spectral-domain OCT (SD- used to test for differences between groups (p <0.001 statistically significant).
OCT) and FA were evaluated. The SD-OCT and FA results were then compared. Receiver operating characteristic (ROC) curves were constructed to describe the
Results: We present three separate cases of neovascular AMD, in treated patients ability of each parameter to discriminate between MDR eyes with DM and healthy
who were considered stable. All three patients noted changes in their vision. These eyes. Discriminative diagnostic characteristics of the ROC curve, such as the c-
changes were initially evaluated with SD-OCT. There was no evidence of statistic, sensitivity, specificity, and positive likelihood ratio (PLR), were analyzed.
intraretinal or subretinal fluid on SD-OCT. Upon further evaluation all three were Results: The maximum discrimination (MD) value for the intraretinal thickness of
found to have active fluorescein leakage and treated accordingly. 0.87 for the OPL and 0.74 for the GCL+IPL complex was obtained at a thickness
Conclusions: A literature search was performed, and few studies compare OCT ≤ 38.14 µm and 75.43 µm, respectively. This implies there is an 87% (74%)
and FA in identifying active disease in neovascular AMD. These studies show that probability the diabetic subject will have an abnormal OPL (GCL+IPL) thickness.
OCT, particularly SD-OCT, is fairly sensitive at detecting intraretinal or subretinal At this value, the sensitivity for the OPL (GCL+IPL) is 89.2% (74.3%) with a
fluid; however, there is low specificity. OCT has added a great deal of convenience specificity of 79.10% (65.10%). The PLR for OPL (GCL+IPL) is 4.3 (2.1), which
for the patient and the physician. Although OCT has made great strides there is still increase the probability of early retinopathy development about 25% (15%),
room for improvement. Clinicians need to be careful not to solely rely on OCT for respectively. Similarly, the MD value for rough dimension of 0.90 for the
guidance in management of neovascular AMD particularly in treated disease. GCL+IPL complex was obtained at a value ≤ 1.67. At this value, the sensitivity for
Commercial Relationships: Joshua Schliesser, None; Nancy Kunjukunju, the GCL+IPL complex is 91.9% with a specificity of 81.4%. The PLR for
None; Gary Gallimore, None; Felix N. Sabates, None GCL+IPL complex is 4.9, which increase the probability of early retinopathy
Support: None development about 30%. Total reflectance and layer index also showed MD values
for all layers except RPE and INL (only for layer index) with an average PLR of
2.0, which increase the probability of early retinopathy development about 15%.
Program Number: 804 Poster Board Number: D742
Conclusions: In this study, the total reflectance, rough dimension, thickness and
Presentation Time: 11:15 AM - 1:00 PM
layer index displayed the most powerful diagnostic utility for detecting early
Persistent Retinal Cysts in Exudative Age-Related Macular Degeneration
changes in the diabetic retina. Our results showed that looking for abnormality in
Michelle C. Liang, Caio V. Regatieri, Jason Y. Zhang, Ahmad A. Alwassia, Jay S.
the GCL+IPL complex, OPL and OS could detect DR earlier. Compared to the
Duker. New England Eye Center, Tufts Medical Center, Boston, MA.
standard thickness measurements provided by OCT devices, the combination of

Copyright 2012 by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. For permission to reproduce any abstract, contact the ARVO Office at [email protected].
ARVO 2012 Annual Meeting Abstracts by Scientific Section/Group – Multidisciplinary Ophthalmic Imaging Group (MOI)

thickness, texture and optical measurements were significantly better at visualization.
discriminating MDR eyes from healthy normal and DM eyes. Conclusions: The present prototype real-time, 3-dimensional optical coherence
Commercial Relationships: Delia DeBuc, US 61/139,082 (P); Wei Gao, tomography imaging system allows for the performance of basic microsurgical
None; Erika Tatrai, None; Lenke Laurik, None; Boglarka Varga, maneuvers using the OCT viewing environment as the primary source of visual
None; Veronika Olvedy, None; Aniko Somogyi, None; William E. Smiddy, information.
None; Gabor M. Somfai, None Commercial Relationships: Peter L. Gehlbach, None; Yong Huang, None; Jin
Support: NIH/NEI-EY020607; JDRF 2007-727, NIH Center Core Grant U. Kang, None
P30EY014801, Research to Prevent Blindness Unrestricted Grant, Department of Support: RO1 EY021540-01A1
Defense (DOD- Grant#W81XWH-09-1-0675)
Program Number: 808 Poster Board Number: D746
Program Number: 806 Poster Board Number: D744 Presentation Time: 11:15 AM - 1:00 PM
Presentation Time: 11:15 AM - 1:00 PM Pathological Visualization Of Henle’S Fiber Layer Using Spectral Domain
Attenuation Of Nerve Fiber And Ganglion Cell Layer In The Macular Area In Optical Coherence Tomography
Leber’S Hereditary Optic Neuropathy Micol Alkabes, Francesco Pichi, Andrea Lembo, Paolo Nucci. University Eye
Norihiro Yamada1, Shoji Kishi2. 1Ophthalmology, Gunma University School of Clinic, San Giuseppe Hospital, Milan, Italy.
Medicine, Maebashi-City, Japan; 2Ophthalmology, Gunma University Medical Purpose: Despite advances in SD-OCT hardware and software, Henle‟s fiber layer
Library, Maebashi-shi, Japan. (HFL) physiological visualization remains elusive, likely because of the inability to
Purpose: Leber‟s hereditary optic neuropathy (LHON) is caused by a point distinguish a change in reflectivity at the interface between the HFL and the outer
mutation of the mitochondrial gene, whose primary lesion is considered to be nuclear layer (ONL). The aim of this study is to describe HFL appearance in
retinal ganglion cells. We report four cases of LHON whose nerve fiber layer and different pathologies.
ganglion cell in the macular area is attenuated. Methods: Observational case series. 47 patients with different pathologies
Methods: Case 1: A 33-year-old man presented decreased vision and central underwent SD-OCT examination with a 6-mm line horizontal scan. 9 patients
scotoma. At first visit, his best corrected visual acuity (BCVA) was 0.8 in right and (19.1%) had central serous choriorethinopathy (CSC), 15 (31.9%) had macular
1.2 in left eye with bilateral central scotoma. His BCVA progressively declined and edema, 2 (4.2%) presented with a macular star secondary to neuroretinitis, and 21
became 0.15 in right and 0.08 in left eye 2 months after the initial visit. LHON was (44.7%) had drusen in dry age-related macular degeneration. The scans were
diagnosed by the G11778A point mutation of mitochondrial gene. On Spectral performed with the beam centered in the pupil; the measurement beam was then
domain optical coherence tomography (SD-OCT), nerve fiver layer and ganglion tilted nasally or temporally so that the incident angle of the measurement beam was
cell layer was attenuated, which resulted in swallowing of foveal pit. Case 2: A 17- perpendicular to the HFL.
year-old boy presented decreased vision with central scotoma in his left eye. Results: Hyperreflectivity could be imaged in the ONL and OPL in areas of a
Goldmann perimeter showed central scotoma and enlargement of blind spot in his detached neurosensory retina using SD-OCT in patients with acute central serous
left eye. His BCVA was 1.2 in right and 0.05 in left eye at first visit. He has a chorioretinopathy and that hyperreflectivity represents retinal maladjustment. In
family history of LHON. His BCVA declined to 0.2 and 0.08 one month after. CSC, macular elevation resulting from subretinal fluid causes the detached retina to
Mitochondrial gene showed the G11778A point mutation. SD-OCT showed tilt toward the fovea, which results in strong backscattering from HFL. In patients
attenuation of nerve fiber layer and ganglion cell layer. Case 3: A 14-year-old boy with macular edema, OCT imaging has suggested that there is less retinal swelling
was treated as bilateral optic neuritis with steroid pulse. At his first visit, BCVA in HFL than in the enlarged ONL with low reflectivity.The HFL thickness can
was 0.08 in right and 0.04 in left eye. He had a point mutation of G11778A. SD- increase greatly with fluid accumulation and early microcystic changes. Moreover,
OCT revealed thinning of nerve fiber layer and ganglion cell layer in the macular Henle‟s fibers were found to be „„standing up‟‟ to allow for this swelling.
area. Case 4: A 62-year-old man was treated as right optic neuritis with steroid Backscattering is thus likely to decrease not only because of fluid accumulation in
pulse. His BCVA declined to 0.06 and 0.07 11 months after. Mitochondrial gene the HFL but also because of changes in the running direction of Henle fibers. In
showed the G11778A point mutation. SD-OCT showed attenuation of nerve fiber patients with macular star formation in neuroretinitis HFL is oriented radially about
layer and ganglion cell layer. the fovea and is indirectly visible ophthalmoscopically and directly by SD-OCT
Results: All 4 cases of LHON showed thinning of nerve fiber layer and ganglion examination. Diffuse hyperreflectivity accompanying drusen has been commented
cell layer in a 6 mm scan of macular area in SD-OCT. on previously and the anatomic location of hyperreflectivity attributed to drusen
Conclusions: The OCT finding correlated with a previously reported pathological corresponds to HFL, and its intensity can be seen to vary substantially with pupil
report of LHON. entry position, due to an optical effect.
Commercial Relationships: Norihiro Yamada, None; Shoji Kishi, None Conclusions: Reflectivity changes are caused by alterations in the normal
Support: None geometry of the retina, where pigment epithelial detachment, drusen, or subretinal
fluid alters the angle of the cone of light reflecting from HFL. Optical changes in
HFL are introduced by these protuberances by elevating and changing the
Program Number: 807 Poster Board Number: D745
orientation of its fibers relative to the pupil such that different segments of HFL
Presentation Time: 11:15 AM - 1:00 PM
may appear to be hyporeflective and hyperreflective overlying a single
3-D Image Guided Retinal Surgery Using Real-Time High-Speed Fourier-
deformation.
Domain Optical Coherence Tomography
Peter L. Gehlbach1, Yong Huang2, Jin U. Kang2. 1Ophthalmology, Johns Hopkins Commercial Relationships: Micol Alkabes, None; Francesco Pichi,
Wilmer Eye Inst, Baltimore, MD; 2Electrical and Computer Engineering, Johns None; Andrea Lembo, None; Paolo Nucci, None
Support: None
Hopkins University, Baltimore, MD.
Purpose: To demonstrate an innovative microsurgical approach using a real-time,
3-dimensional optical coherence tomography imaging system to perform 3-D Program Number: 809 Poster Board Number: D747
image guided basic microsurgical procedures. Presentation Time: 11:15 AM - 1:00 PM
Methods: A novel microsurgical imaging system based on a Fourier-Domain OCT Fixation Behavior Characteristics In Different Retinal Diseases
(FD-OCT) integrated with a CPU-GPU heterogeneous computing architecture Carmela Carnevale1A, Serena Salvatore1B, Yu-hui Huang2, Pasquale Plateroti3,
capable of OCT image processing and displaying at the maximum processing speed Serena Fragiotta4, Roberto Grenga1A. AUOC B Ophthalmology, BOphthalmology,
of approximately 252,000 A-scans/second based on NUFFT and 10 1University La Sapienza of Rome, Rome, Italy; 2Ophthalmology, University of
volumes/second for complex conjugate free FD-OCT was used to provide real-time Illinois, Chicago, IL; 3Ophthalmology, University La Sapienza of Rome,
3-D video imaging of the surgical site and tool tips while basic surgical maneuvers Sant'Andrea Hospital, Italy; 4University La Sapienza of Rome, Latina, Italy.
were performed in ex vivo bovine eyes. The imaged site size was Purpose: To evaluate fixation behavior in patients with retinitis pigmentosa (RP)
3mm×3mm×3mm (Width × Length × Depth) sampled by 160×80×1024 pixels and and diabetic retinopathy (DR) using the MP-1 microperimeter (Nidek
was rendered to the surgeon with top, front-side and back-side views by a ray Technologies,Italy).
casting method. Two basic maneuvers were repeatedly performed and successfully Methods: Thirty healthy people (group A), 26 people with RP (group B), and 28
confirmed: retinal vessel isolation with micro-pick confirmed by retinal vessel people with DR (group C) were assessed. Groups were paired by age and gender.
isolation with suture; subretinal cannulation with delivery of fluid confirmed by BCVA, retinal sensitivity within central 2 and 4 degrees were evaluated. Fixation
subretinal cannulation with delivery of air. score, central 2 and 4 degrees values and bivariate contour ellipse area (BCEA)
Results: Using the 3-D surgical OCT viewing environment as the primary source were obtained from the MP-1. Statistical analysis was performed with Student‟s t-
of visualization, we were able to successfully perform and repeat the prototypical test. Values < 0.05 were considered significant. Pearson‟s correlation coefficient
microsurgical maneuvers described using the retina as a model system. For each was calculated for comparisons.
procedure there is a learning curve related to working predominantly in a 3-D OCT Results: Fixation within the 2° diameter circle was 93.53±5.97% for group A,
image environment. The data consists of video frames of all key steps. In all cases 82.00±23.31 for group B (p<0.05), and 78.13±21.61 for group C (p<0.05). Fixation
the OCT viewing environment was referenced to direct photography and or direct within the 4° diameter circle was 97.93±2.99% for group A, 93.00±14.42 for group

Copyright 2012 by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. For permission to reproduce any abstract, contact the ARVO Office at [email protected].
ARVO 2012 Annual Meeting Abstracts by Scientific Section/Group – Multidisciplinary Ophthalmic Imaging Group (MOI)

B (0.11) and 95.13±4.91 for groups C (0.6). Retinal sensitivity within the 2°was Methods: Horizontal line scans through the fovea of 30 healthy controls, 11
17.66±2.37dB for group A, 14.47±5.06 dB for group B (0.13), and 14.54±6.06 for patients with Stargardt disease (STGD), 8 with retinitis pigmentosa (RP), 7 with
group C (0.2). Retinal sensitivity within the 4° was 18.05±1.41dB for group A, achromatopsia (ACHM), 7 with choroideremia (CHM), and 7 with age-related
14.55±4.95 for group B (0.7), and 15.69±4.23 for group C (0.4). BCEA which macular degeneration (AMD) were obtained with fdOCT (Spectralis, Heidelberg).
contained 99% fixation points was 11.11±10.55 degree sq. for group A, All patients showed regions with and without ISe preservation. Two bands [ISe
20.91±33.28for group B (0.002), and 16.25±14.37for group C (0.001). BCVA was band and outer limiting membrane (OLM)] and 3 layers [outer nuclear layer
0 ±0.96,0 ±1.14, and 0±0.94 logMAR respectively. A significant correlation was (ONL), inner nuclear (IN) layer and retinal ganglion cell layer plus inner plexiform
found between BCVA and BCEA (r= 0.99) for all groups. layer (RGC+)] were segmented with a computer-aided manual procedure [4]. The
Conclusions: Although a significant difference was found between fixation ISe and the OLM bands were divided into segments 3 pixels (11.7 υm) in depth and
behavior within the 2° diameter circles in all groups, the only fixation parameter 10 pixels (60.1 υm) in width. The 3 layers were divided into segments 10 pixels
that correlated with BCVA was BCEA, which could differentiate subtle changes in wide. The relative intensity of each segment was determined by dividing the
macular function. Thus, we recommend BCEA to be used to quantify fixation segment‟s average intensity by the average intensity of a local region ±45 pixels
stability when using MP-1. wide and extending from the RNFL/RGC border to Bruch‟s membrane.
Commercial Relationships: Carmela Carnevale, None; Serena Salvatore, Results: When the ISe was present, the patient‟s mean relative ISe intensity was
None; Yu-hui Huang, None; Pasquale Plateroti, None; Serena Fragiotta, typically within the normal 95% CI limits for all disease groups except for ACHM.
None; Roberto Grenga, None In addition, for all diseases, the relative intensities of the RGC+ and IN layers were
Support: None within normal limits whether or not the ISe was present. In contrast, the ONL
intensities were typically above normal limits when the ISe was absent [STGD:
11/11 (11 of 11 patients), RP: 8/8, ACHM: 5/7, CHM: 7/7, AMD: 6/7], and within
Program Number: 810 Poster Board Number: D748
normal limits when the ISe was present (STGD: 7/11 RP: 8/8, ACHM: 5/7, CHM:
Presentation Time: 11:15 AM - 1:00 PM
7/7, AMD: 7/7). In all ACHM and AMD patients, the OLM was more intense in
High Resolution Optical Coherence Tomography Imaging of Selective Retina
regions where the ISe was absent, but within normal limits in regions with an ISe.
Therapy Laser Lesions in the Retinal Pigment Epithelium
Patrick Steiner1A,2, Christoph Meier2, Carsten Framme1A, Sebastian Wolf1A, Jens H. Conclusions: The intensity of outer retinal layers can be less than (e.g. ISe) or
Kowal1A,1B. ADepartment of Ophthalmology, BARTORG Center Ophthalmic greater than (e.g. OLM, ONL) normal in patients with outer retinal disease. Further,
Technologies, 1University of Bern, Bern, Switzerland; 2OptoLab, Berne University the intensity can depend upon whether the region is severely affected (ISe absent)
or not (ISe present). In some cases, the variations in ONL intensity appeared to be
of Applied Sciences, Biel, Switzerland.
due to pigment migration and/or a splitting of the outer plexiform layer, while the
Purpose: Recently, a new approach to conventional photocoagulation, the selective
reason for the greater intensity of the OLM is not clear. 1. Spaide & Curcio. Retina
retina therapy (SRT), has been introduced for treatment of diabetic retinopathy,
2011. 2. Birch DG, Wen et al. IOVS 2011. 3. Hood DC, Zhang et al. IOVS 2011. 4.
age-related maculopathy and a variety of other eye diseases. The SRT confines the
Hood DC, Lin et al. IOVS 2009.
induced laser lesions to the retinal pigment epithelium (RPE) layer, leaving the
Commercial Relationships: Rithambara Ramachandran, None; Xian Zhang,
neural retina unaffected. However, with the dose of energy applied during SRT, the
None; Kirsten G. Locke, None; Vivienne C. Greenstein, None; David G. Birch,
lesions remain ophthalmologically invisible due to the absence of denaturized
None; Donald C. Hood, None
tissue close to the retinal surface. To guarantee the repeatable and reliable therapy
Support: NIH grant RO1-09076
and dosimetry control during treatment necessary for a wider acceptance of the
therapy, new imaging techniques need to be evaluated towards their capabilities to
visualize the laser lesions during the therapy. Program Number: 812 Poster Board Number: D750
Methods: In this manuscript, we evaluate the feasibility of optical coherence Presentation Time: 11:15 AM - 1:00 PM
tomography (OCT) as a method for therapy monitoring. OCT represents a non- Evaluation Of Retinal Pigment Epithelium/Bruch's Membrane Complex
invasive high-resolution imaging modality with a variety of fields of application, Thickness In Early Age Related Maculopathy Using Optical Coherence
predominantly in ophthalmology. A self-designed, high-resolution FD-OCT system Tomography
was used to image dissected retina samples before and after SRT treatment. The Michael Karampelas, Pearse Keane, Dawn Sim, Adnan Tufail, Jonathan Dowler.
samples were taken from fresh pig eyes with detached anterior segment, placed in a Medical Retina, Moorfields Eye Hospital, London, United Kingdom.
sample cell and irradiated with the SRT laser with varying pulse energies within the Purpose: To compare retinal pigment epithelium/Bruch‟s membrane (RPE/BM)
range used for treatment. Whenever possible, the samples were stored on ice and complex thickness in patients with early age related maculopathy (ARM) and in
covered with PBS to prevent from unwanted cell death. age-matched healthy controls using spectral-domain optical coherence tomography
Results: From the irradiated samples, 10 x 10 x 3 mm C-Scan volumes with a (SD-OCT).
lateral resolution of 20 µm and an axial resolution of 2.3 µm in tissue were Methods: This is a retrospective,non-interventional,cross-sectional study. Analysis
recorded. The processed scans show the potentially of high-resolution OCT to of SD-OCT datasets from 10 eyes of 10 consecutive patients with early ARM and
visualize SRT laser lesions in the RPE layer. The results show a good agreement 10 eyes from 10 normal age-matched controls was performed. The RPE/BM
between OCT scans and microscopic images with clearly visible laser lesions if complex band was manually segmented using custom image analysis software. In
sufficient energy is applied. areas of drusenoid pigment epithelium detachment in which BM was visible, RPE
Conclusions: We were able to show that OCT is a feasible technique for the detect and BM were measured separately and then added. RPE/BM complex thickness
ion of SRT lesions in the RPE layer. The resolving power of the OCT system was calculated in the 9 Early Treatment Diabetic Retinopathy Study (ETDRS)
proved to be sufficient to reliably detect the induced lesions under laboratory subfields.
conditions, thus making it a promising approach for SRT therapy monitoring. The Results: Mean patient age was 72.1 years (range: 58-83) in both groups. In the
incorporation of OCT into the treatment system and automation of therapy control group, mean RPE/BM thickness in the central (9), 1-4 and 5-8 subfields
monitoring could greatly increase the proliferation of the SRT technique. was 23.7±2.3 µm, 21.8±2.1 µm and 22.6±1.9 µm respectively. In the ARM group,
The authors would like to thank the Dr. Werner Jackstaedt foundation in mean RPE/BM thickness in the central (9), 1-4 and 5-8 subfields was 34.1±7.5 µm,
Wuppertal, Germany, for the generous financial support of this ongoing study. 30.6±7.3 µm and 33.2±5.7 µm respectively. Central subfield RPE/BM thickness
Commercial Relationships: Patrick Steiner, None; Christoph Meier, was positively correlated with age (r=0.729, p=0.017) in the control group, but not
None; Carsten Framme, None; Sebastian Wolf, None; Jens H. Kowal, None in the ARM group (r=0.218, p=0.545). Comparison of the thickness between
Support: None ETDRS zones for each group, revealed statistically significant difference only
between the 1-4 and 5-8 zones in the control group (p=0.006). RPE/BM was
significantly thicker in the ARM group compared with the age-matched controls in
Program Number: 811 Poster Board Number: D749
all ETDRS subfields (p=0.01 - central subfield, p=0.02 - subfields 1-4, p=0.00 -
Presentation Time: 11:15 AM - 1:00 PM
subfields 5-8).
The Intensity of Outer Retinal Layers Seen on Frequency Domain OCT in
Conclusions: This study demonstrated that RPE/BM thickness can be measured by
Patients with Outer Retinal Disease
Rithambara Ramachandran1A, Xian Zhang1A, Kirsten G. Locke2, Vivienne C. SD-OCT and that it is significantly higher in patients with early ARM compared to
Greenstein1B, David G. Birch2, Donald C. Hood1A,1B. APsychology, age-matched normal controls. Our ARM group consisted of patients with bilateral
BOphthalmology, 1Columbia University, New York, NY; 2Retina Foundation of early ARM (n=5) and patients with early ARM in one eye and wet age related
macular degeneration (AMD) in the fellow eye (n=5), but comparison of RPE/BM
Southwest, Dallas, TX.
thickness between those two subgroups did not reveal any statistically significant
Purpose: On frequency domain optical coherence tomography (fdOCT) scans, the
difference. A larger cohort will be required in order to investigate the possible role
inner segment ellipsoid (ISe) band (aka inner segment/outer segment border) [1] is
of RPE/BM thickness as a risk factor in developing wet AMD.
present [2], but less intense [3] in patients with achromatopsia and cone dystrophy.
Commercial Relationships: Michael Karampelas, None; Pearse Keane,
Here we examine the intensity of 5 retinal layers/bands in both reasonably healthy
None; Dawn Sim, None; Adnan Tufail, Allergan , GSK , Neuronsystems ,
regions (with ISe band) and in severely affected regions (without ISe band) of
Novartis, Thrombogenics (C); Jonathan Dowler, None
patients with outer retinal disease.

Copyright 2012 by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. For permission to reproduce any abstract, contact the ARVO Office at [email protected].
ARVO 2012 Annual Meeting Abstracts by Scientific Section/Group – Multidisciplinary Ophthalmic Imaging Group (MOI)

Support: National Institute of Health Research funding award to Moorfields Eye The pRNFL parameter with the largest AUC was the inferior (0.724) followed by
Hospital NHS Foundation Trust & UCL Institute of Ophthalmology as a Specialist average (0.724) and superior (0.618). The GCC parameter with the largest AUC
Biomedical Research Centre for Ophthalmology was the inferior (0.735), followed by average (0.703) and superior (0.631). No
significant difference was found between the parameters with larger AUCs from
pRNFL and GCC analysis (P=0.63). Using the normative database, the pRNFL
Program Number: 813 Poster Board Number: D751
analysis had sensitivity of 64.86% and specificity of 80.95% while the GCC
Presentation Time: 11:15 AM - 1:00 PM
analysis had a sensitivity of 59.46% and specificity of 80.95%. The combination of
Information On Neuronal Ageing From OCT Evaluation Of The Retina
Rui Bernardes1A,2, Torcato Santos1A,2, Pedro Serranho2,3, Melissa R. Horne4, Mary the pRNFL and the GCC analysis increased the sensitivity to 78.37% at the cost of
K. Durbin5, José Cunha-Vaz1,2. ACNTM, 1Association for Innovation and specificity (73.01%).
Biomedical Research on Light and Image, Coimbra, Portugal; 2Institute of Conclusions: While evaluating patients with normal IOP and large optic disc
cupping, SD-OCT was useful to differentiate those with (NTG) and without
Biomedical Research in Light and Image, Faculty of Medicine, University of
Coimbra, Coimbra, Portugal; 3Mathematics Section, Department of Science and glaucoma (LPC). Although the diagnostic ability of the pRNFL and the GCC scans
Technology, Open University, Lisbon, Portugal; 4OCT Imaging, Carl Zeiss were similar, these parameters yielded an increase in sensitivity when combined.
Meditec Inc, Dublin, CA; 5R & D, Carl Zeiss Meditec, Inc, Dublin, CA. Commercial Relationships: Tiago S. Prata, None; Mauro T. Leite, None; Luisa
Trancoso, None; Fabio N. Kanadani, None; Rafael Furlanetto, None
Purpose: To identify ageing changes in the human retinal tissue.
Support: None
Methods: Sixty-eight eyes from 41 healthy volunteers were noninvansively imaged
using the high-definition optical coherence tomography Cirrus HD-OCT (Carl
Zeiss Meditec, Dublin, CA, USA) to collect data from the eye fundus. Because Program Number: 815 Poster Board Number: D753
OCT is sensitive to changes in refractive index, changes over time in the refractive Presentation Time: 11:15 AM - 1:00 PM
index may translate into changes in the reflectivity observed in OCT data between 3D Modeling To Characterize Lamina Cribrosa Pore Geometry Using In Vivo
the inner limiting membrane and retinal pigment epithelium. OCT intensity Images From Normal And Glaucomatous Eyes
distribution was analyzed both in the linear and logarithmic spaces and fits of Nripun Sredar1A, Kevin M. Ivers1B, Hope M. Queener1B, George Zouridakis1A,
known mathematical functions used to compute a set of 51 features describing the Jason Porter1B. AComputer Science, BCollege of Optometry, 1University of
data. Functions were designed to account for differences in signal intensity across Houston, Houston, TX.
the eye rather than depending on absolute reflectivity. Data features were grouped Purpose: En face adaptive optics scanning laser ophthalmoscope (AOSLO) images
by the age of respective eye in group A (age < 40 yrs, n=33, 29.5±4.3 yrs), group B of the anterior lamina cribrosa surface (ALCS) represent a 2D projected view of a
(40 ≤ age < 60 yrs, n=22, 50.1±6.2 yrs) and group C (age ≥ 60 yrs, n=13, 67.5±6.5 3D surface. Laminar pore parameters calculated from these 2D images do not best
yrs). A support vector machine (SVM) classification algorithm was used for the represent the native 3D geometry. Using images acquired in living eyes, we
classification of eyes in one of the groups and the leave-one-out approach was used modeled the ALCS in 3D and transformed 2D AOSLO images onto the 3D surface
for the validation. to better characterize laminar pores.
Results: Using the entire set of eyes available, 33, 22 and 13, respectively group A, Methods: AOSLO images of the ALCS were acquired in vivo in the control and
B and C, eyes were correctly classified (overall) in 79.4% of the cases. Using a glaucomatous eyes of a rhesus monkey with unilateral experimental glaucoma and
subset of 13 eyes in each group, group A (age < 40 yrs, 28.7±4.6 yrs), group B (40 were used to calculate laminar pore areas. Spectral domain optical coherence
≤ age < 60 yrs, 50.0±6.2 yrs) and group C (age ≥ 60 yrs, 67.5±6.5 yrs), the overall tomography (SDOCT) [Spectralis HRA+OCT] cross-sectional radial scans (20°
correct classification is of 84.6% of the eyes. field, 48 B-scans) of the optic nerve head were acquired in both eyes. The ALCS
Conclusions: The results suggest the presence of signs of the ageing process within was manually marked in SDOCT B-scans using a custom MATLAB program. A
the human retina that can be noninvasively detected by the HD-OCT. These thin plate spline was fit to the marked points to model the ALCS in 3D. After
findings open novel perspectives of using the eye as a window to changes in age- registering and projecting the 2D AOSLO images onto the 3D surface, the surface
related neuronal diseases using well known low-cost technologies as HD-OCT. was tessellated into a 3D triangular mesh. The 3D surface area of a given pore was
Commercial Relationships: Rui Bernardes, None; Torcato Santos, calculated by adding the area of the individual triangles that formed the surface
None; Pedro Serranho, None; Melissa R. Horne, Carl Zeiss Meditec Inc (E); within the pore‟s boundary. The differences in the area of corresponding pores in
Mary K. Durbin, Carl Zeiss Meditec, Inc (E); José Cunha-Vaz, None the 2D and 3D images from living eyes were compared.
Support: Fundação para a Ciência e a Tecnologia (FCT) under the research project Results: This modeling method was validated using synthetic data (surfaces and
PTDC/SAU-BEB/103151/2008 and program COMPETE (FCOMP-01-0124- objects of known geometry). For example, a circular pore projected onto a
FEDER-010930) hemisphere resulted in a transformed surface area within 0.7% of the theoretical
Clinical Trial: http://www.clinicaltrials.gov, NCT01220804 value. In the monkey with experimental glaucoma, the mean ALCS heights in
control and glaucomatous eyes were 193.1 μm and 361.7 μm, respectively,
indicating a more severely sloped ALCS in the glaucoma eye. The root mean
Program Number: 814 Poster Board Number: D752
square (RMS) errors in fitting a thin plate spline to the marked ALCS points in the
Presentation Time: 11:15 AM - 1:00 PM
control and glaucomatous eyes were 10 μm and 9.4 μm, respectively. Mean pore
Eyes with Large Optic Disc Cupping and Normal Intraocular Pressure:
areas in the 2D and corresponding 3D images were 1,158 ± 976 μm2 vs. 1,205 ±
Ability of Spectral-Domain Optical Coherence Tomography to Discriminate
1004 μm2 in the control eye and 1,488 ± 1123 μm2 vs. 1,645 ± 1243 μm2 in the
those with and without Glaucoma
Tiago S. Prata1,2, Mauro T. Leite1, Luisa Trancoso2, Fabio N. Kanadani1, Rafael glaucomatous eye, respectively. The mean increase in pore area after 3D
Furlanetto1. 1Ophthalmology, Federal University of Sao Paulo, Sao Paulo, Brazil; transformation was 4% (46.8 ± 32.1 μm2) in the control eye and 10.5% (156.9 ±
2Glaucoma Unit, Hospital Medicina dos Olhos, Sao Paulo, Brazil. 133.9 μm2) in the glaucoma eye.
Conclusions: The thin plate spline can accurately fit laminar surfaces with
Purpose: To evaluate the ability of spectral-domain optic coherence tomography
different slopes (as indicated by the equally low RMS fitting errors measured in the
(SD-OCT) to differentiate eyes with large physiological optic disc cupping (LPC)
control and glaucoma eyes). The larger increase in mean laminar pore area in the
from eyes with normal-tension glaucoma (NTG).
glaucomatous eye after 3D transformation is reflective of its more steeply curved
Methods: Thirty-seven eyes from 24 individuals with NTG and 63 eyes from 33
ALCS (compared to the control eye). This 3D transformation and tessellation
individuals with LPC were included in this observational case-control study. To be
method can potentially be used to better understand 3D changes in laminar pore
included, glaucomatous eyes had to have untreated intraocular pressure (IOP)<21
geometry in glaucoma.
mmHg and reproducible glaucomatous visual field (VF) defects. Eyes with LPC
Commercial Relationships: Nripun Sredar, None; Kevin M. Ivers, None; Hope
required normal VF testing and at least 2 years of follow-up with no evidence of
M. Queener, None; George Zouridakis, None; Jason Porter, None
progressive optic neuropathy prior to the imaging session. Also, they were required
Support: NIH Grants R01 EY021783 and P30 EY07551
to have IOP<21mmHg and no previous history of IOP-lowering medications.
Parapapillary retinal nerve fiber layer (pRNFL; average, inferior and superior) and
macular ganglion cell complex thicknesses (GCC; average, inferior, superior) were Program Number: 816 Poster Board Number: D754
obtained using the RTVue SD-OCT. Age-adjusted areas under receiver operating Presentation Time: 11:15 AM - 1:00 PM
characteristic curves (AUCs) were calculated and compared. To account for the SDOCT Thickness and Volume Measurements of various Retinal Layers in
potential correlation between eyes, the cluster of data for the study subject was Patients with Autosomal Dominant Optic Atrophy due to OPA1 mutations
considered as the unit of resampling when calculating standard errors. In addition, Tina Ristau1A, Andrea M. Schild1B, Julia Fricke1B, Antje Neugebauer1B, Bernd
the ability of the normative database for the detection of glaucoma was evaluated. Kirchhof1B, Srinivas R. Sadda2, Sandra Liakopoulos1A. ACologne Image Reading
Eyes were considered abnormal if they had at least two borderline (P<0.05, color- Center, Department of Ophthalmology, BDepartment of Ophthalmology,
coded in yellow) or one abnormal (P<0.01%, color-coded in red) sectors (average, 1University of Cologne, Cologne, Germany; 2Doheny Image Reading Center,
superior and inferior) on either pRNFL or GCC analysis. Doheny Eye Institute, Los Angeles, CA.
Results: Patients with NTG were on average older (52.5y vs 41.2y; P=0.007) Purpose: To specify thickness values of various retinal layers on spectral domain
compared to individuals with LPC and had an average VF MD of -2.75dB (±2.4). OCT (SDOCT) volume scans in patients with Autosomal Dominant Optic Atrophy

Copyright 2012 by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. For permission to reproduce any abstract, contact the ARVO Office at [email protected].
ARVO 2012 Annual Meeting Abstracts by Scientific Section/Group – Multidisciplinary Ophthalmic Imaging Group (MOI)

(ADOA) associated with OPA-1 mutations compared to healthy controls. Volumetric SDOCT Imaging of Pigment Epithelial Detachments in the HiPED
Methods: SDOCT Volume scans (3x3mm) of 7 right eyes of patients with newly Study
diagnosed ADOA and OPA-1 mutation and of 7 right eyes of healthy controls Jan Kristine T. Bayabo1,2, Anne E. Fung2, John W. Kitchens3, Brandon G. Busbee4,
matching in age, gender and refractive error were retrospectively collected. Mean Brandon J. Lujan1. 1School of Optometry, University of California, Berkeley,
age was 25 for ADOA patients and 26 for controls (range 4-48 years). Visual acuity Berkeley, CA; 2Ophthalmology, California Pacific Medical Center - Pacific Eye
ranged from 20/400 to 20/40 (mean 0.7 logMAR) in ADOA patients, all controls Associates, San Francisco, CA; 3Ophthalmology, Retina Associates of Kentucky,
had 20/20 vision. SDOCT volume scans were quantitatively analyzed using Lexington, KY; 4Centennial Professional Plaza, Tennessee Retina, PC, Nashville,
computer-assisted manual grading software (3D-OCTOR). Mean thickness values TN.
for the central subfield of the ETDRS grid (FCS, 1 mm diameter) and ETDRS Purpose: Spectral domain optical coherence tomography (SDOCT) was used to
subfields 5-8 (inner circle, 3 mm diameter) were calculated for the spaces: acquire volumetric datasets from a cohort of patients with wet age-related macular
neurosensory retina, retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), a degeneration (AMD) and persistent retinal pigment epithelial detachment (PED).
combined space of inner and outer plexiform layer and inner nuclear layer We sought to quantify PED metrics and compare their utility as a novel endpoint to
(IPL+INL+OPL) and outer nuclear layer (ONL). Thickness values of patients and established metrics.
controls were compared using Mann-Whitney-Rank-Sum-Test. Methods: The High Dose Ranibizumab for Persistent PED in Neovascular AMD
Results: Mean retinal thickness was 319.50 µm (for inner circle) and 246.51 µm (HiPED) study enrolled patients with persistent PED following 6+ previous
(for FCS) in healthy controls, compared to 255.67 µm (for inner circle) and 213.76 standard-dose anti-vascular endothelial growth factor intravitreal injections. Visual
µm (for FCS) in ADOA patients. ADOA patients showed statistically significant acuity (VA) at entry ranged from 20/32 - 20/100. Cirrus SD-OCT cube scans were
lower retinal thickness values than healthy controls, and this was even more evident obtained monthly with standard office protocols. Using software version 6.0, an
for the inner circle compared to the FCS (p<0.01 for FCS, p<0.001 for inner circle). automated algorithm generated segmentations of the ILM, the RPE, and inferred
Subanalysis of retinal layers revealed that RNFL thickness (p<0.001 for FCS and physiologic RPE. Datasets were excluded if the algorithm failed at any time point.
for inner circle) as well as GCL thickness (p<0.001 for FCS and for inner circle) Measurements of the central subfield thickness (CST), macular cube volume,
measurements were significantly lower in patients with ADOA. However, there average macular cube thickness, and PED area and volume were obtained.
was no difference in ONL thickness values as well as in IPL+INL+OPL thickness Correlations between these metrics and VA were calculated.
values between both groups. Results: 35 patients received either 2mg intravitreal ranibizumab monthly (Group
Conclusions: The RNFL as well as the GCL were significantly thinner in patients 1) or 2mg x 3 months followed by PRN therapy for persistent disease activity by
with ADOA due to OPA1 mutations compared to healthy controls. All other retinal SDOCT (Group 2). 7 patient SDOCT datasets (20%) were excluded due to failed
layers showed no difference between both groups. These findings may help to segmentation. Baseline characteristics of the remaining 28 patients: CST ranged
identify patients with possible hereditary optic neuropathy, before genetic analysis from 179um to 499um, (mean 271.96um), macular cube volume ranged from
confirms the diagnosis. 8.40mm3 to 12.70mm3 (mean 9.79 mm3). Within a 5mm of the fovea, PED area
Commercial Relationships: Tina Ristau, None; Andrea M. Schild, None; Julia ranged from 1.20mm2 to 10.50mm2 (mean 5.01mm2) and PED volume ranged from
Fricke, None; Antje Neugebauer, None; Bernd Kirchhof, None; Srinivas R. 0.06mm3 to 1.68mm3 (mean 0.60mm3). Mean change from baseline for PED area at
Sadda, Carl Zeiss Meditec, Optovue Inc. (F), Heidelberg Engineering (C), Topcon 6 months (n=9) decreased by 0.94 mm2 and PED volume decreased by 0.17 mm3,
Medical Systems (P, R); Sandra Liakopoulos, Heidelberg Engineering (R) while VA increased by +7.6 letters. A weak correlation between PED volume and
Support: None VA was found in these 9 patients (r = -0.15).
Conclusions: An automated algorithm for SDOCT measurements of PED area and
volume in the Cirrus HD-OCT 6.0 software was accurate in 80% of wet AMD
Program Number: 817 Poster Board Number: D755
patients in the HiPED Study. In this cohort of patients, persistent decrease in PED
Presentation Time: 11:15 AM - 1:00 PM
area and volume as well as macular thickness occurred with repeated 2mg
Repeatability Of Retinal Macular Thickness Measurements In Healthy
ranibizumab injections, and each was weakly correlated with gradual gain in VA.
Subjects And Diabetic Patients With Clinically Significant Macular Edema:
Commercial Relationships: Jan Kristine T. Bayabo, None; Anne E. Fung,
Evaluation Of The Follow-up System Of Spectralis Optical Coherence
Genentech (C), Santen (C); John W. Kitchens, Genentech (C); Brandon G.
Tomography
Marco Lupidi1, Tito Fiore1, Barbara Iaccheri1, Anna Caricato1, Alessio Busbee, Akorn (C), Genentech (C), Synergetics (C); Brandon J. Lujan, Carl Zeiss
Cerquaglia1, Daniela Fruttini2, Silvia Manes1, Marsela Menkulazi1, Carlo Cagini1. Meditec, Inc. (F, C, R), Genentech (C)
1Ophthalmology, Eye Clinic, University of Perugia, Perugia, Italy; 2Economic, Support: NIH K12 EY017269, The Struckman Family Trust
Clinical Trial: http://www.clinicaltrials.gov, NCT01189019
Financial and Statistical, University of Perugia, Perugia, Italy.
Purpose: To compare the repeatability of OCT Spectralis retinal thickness (RT)
measurements in healthy subjects and diabetic patients with clinical significant Program Number: 819 Poster Board Number: D757
macular edema (CSME) with or without the use of the follow-up system. Presentation Time: 11:15 AM - 1:00 PM
Methods: Fourteen eyes of 14 healthy subjects and twenty eyes of 20 diabetic High Resolution Optical Coherence Tomography Retinal and Choroidal
patients with CSME were included in the study. Repeatability and intrasession Findings in Ocular Toxoplasmosis
correlation coefficients were tested with 20 x 15 degree raster scans consisting of Michaella Goldstein, Zohar Habot-Wilner, Anat Loewenstein, Dafna Goldenberg.
19 high-resolution line scans (15 frames per scan) that were repeated three times by Ophthalmology, Tel Aviv Medical Center, Tel Aviv, Israel.
1 experienced examiner. The first scan was set as the reference scan, the second Purpose: To demonstrate the different retinal and choroidal morphological
and third scan were the follow-up scans and were respectively performed with and characteristics on SD Optical Coherence Tomography (OCT) in ocular
without the use of the follow-up mode. toxoplasmosis.
Results: The means and standard deviations for the central foveal subfield (CSF) in Methods: Case series of patients presented with ocular toxoplasmosis from August
healthy subjects and diabetic patients were respectively 298 ± 25 μm and 393 ± 113 2009 were included in the study. All patients underwent a detailed ophthalmic
μm. The absolute change in RT with and without the use of the follow-up mode examination, fundus color photography and Spectralis SD-OCT imaging at
was respectively in healthy subjects 0.29 ± 2.23 μm and 3.29 ± 12 μm, and in presentation and during follow-up. OCT scans were directed to the pathological
diabetic patients with CSME 1.05 ± 3.82 μm and 5.8 ± 23.29 μm. Particularly in retinal and choroidal areas that were demonstrated in the clinical examination.
diabetic patients, examining the CSF, coefficient of repeatability was respectively Results: Sixteen eyes (13 patients) were included. Eleven active lesions were
less and more than 2% with and without using the follow-up mode, and difference demonstrated in 9 eyes (8 patients) and 25 chorioretinal scars were demonstrated in
between obtained measurement was statistically significant (p<0.05) when 12 eyes (10 patients). The active lesion demonstrated retinal thickening, disruption
comparing data acquired with and without follow-up mode. and hyper-reflectivity of the retinal layers. During follow-up the retina became
Conclusions: These preliminary results support the hypothesis that the follow-up thinner and a scar formation was noted. Hyper-reflective deposits were noted on the
system improves the repeatability either in healthy subjects, or in diabetic patients. posterior hyaloid, within the vitreo-retinal interface and in the inner retina layres.
The wider improvement of the repeatability observed in diabetic patients compared Those deposits fade with time. Vitritis could be demonstrated as multiple hyper-
to healthy subjects when using the follow-up system could be related to the poor reflective dots in the vitreous cavity during the active phase, which resolved during
patient fixation or eye movement in patients with CSME. follow-up. Choroidal findings included significant thickening returning to normal
Commercial Relationships: Marco Lupidi, None; Tito Fiore, None; Barbara thickness when scars were formed.OCT findings of the chorioretinal scars
Iaccheri, None; Anna Caricato, None; Alessio Cerquaglia, None; Daniela demonstrated sharply demarcated borders, thinning of neurosensory retina, ELM &
Fruttini, None; Silvia Manes, None; Marsela Menkulazi, None; Carlo Cagini, IS/OS junction interruption, disorganization of the retinal layers and RPE changes.
None The choriocapillaries demonstrated a specific pattern with a significant
Support: None hypereflectivity. In addition, the posterior hyaloid was thickened and partially
detached over the toxoplasma scar. The OCT retinal and choroidal features
remained unchanged during the follow up.
Program Number: 818 Poster Board Number: D756
Conclusions: SD-OCT is a useful tool in the diagnosis and follow-up of patients
Presentation Time: 11:15 AM - 1:00 PM

Copyright 2012 by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. For permission to reproduce any abstract, contact the ARVO Office at [email protected].
ARVO 2012 Annual Meeting Abstracts by Scientific Section/Group – Multidisciplinary Ophthalmic Imaging Group (MOI)

with ocular toxoplasmosis and provides a better understanding of the pathogenesis vascular leakage. Interestingly, OCT exposed involvement of the inner retinal
of the disease. layers as well as the contiguous vitreous forming a firework pattern, not seen in the
Commercial Relationships: Michaella Goldstein, None; Zohar Habot-Wilner, clinical examination.
None; Anat Loewenstein, None; Dafna Goldenberg, None Conclusions: Some of the changes in the macula of newborn patients caused by
Support: None retinal pathology evaluated by OCT imaging have not been previously described.
This imaging technology reveals clinical and sub-clinical macular changes that aid
in the understanding of neonatal retina pathology.
Program Number: 820 Poster Board Number: D758
Commercial Relationships: Rosa E. Martinez, None; Fernando Schoonewolff,
Presentation Time: 11:15 AM - 1:00 PM
None; Virgilio Morales-Canton, None; Jans Fromow-Guerra, None; Gerardo
Using Oct To Identify The Presence Of Silicone Oil Emulsion In The Retina
Garcia-Aguirre, None; Veronica Giordano, None; Maria A. Martinez-
Following Vitreoretinal Surgery With Silicone Oil Tamponade
Castellanos, None
Sidath E. Liyanage, Marie-Helene Errera, Paul M. Sullivan. Moorfields Eye
Support: None
Hospital, London, United Kingdom.
Purpose: To describe the use of spectral-domain optical coherence tomography
(OCT) to identify silicone oil emulsion in a series of patients following temporary Program Number: 822 Poster Board Number: D760
silicone oil tamponade. Presentation Time: 11:15 AM - 1:00 PM
Methods: Spectral-domain OCT was used to identify silicone oil emulsion in a Sd Oct Macular Findings In Patients Treated With Hydroxychloroquine
series of patients following vitreoretinal surgery using temporary silicone oil Shiri Shulman, zohar Habot-Wilner, Michaela Goldstein, Meira Neudorfer, Dafna
tamponade. Nine eyes of nine patients who had undergone vitrectomy and silicone Goldenberg. Ophthalmology, Tel Aviv Medical Center, Tel-Aviv, Israel.
oil tamponade were studied retrospectively using OCT. Each eye was monitored Purpose: Hydroxychloroquine (Plaquinil) is widely used in the treatment of
during the postoperative period by clinical examination and using both time and rheumatic diseases, and its prolonged use may be associated with irreversible
spectral-domain OCT. In vitro, anterior segment spectral-domain OCT images were macular a toxicity. Our purpose was to evaluate the sensitivity and specificity of
acquired of model eyes in which emulsified silicone oil had been injected in routine SD OCT exam in the follow up of patients treated with Plaquinil.
anterior chamber. Methods: Prospective case series. Patients treated with Plaquinil for systemic
Results: Nine patients with silicone oil emulsion secondary to a retinal detachment disorders such as Systemic Lupus erythematosis (SLE) and Rheumatoid Arthritis
(8 patients) or macular hole surgery (1 patient).The mean age of patients was 57 (RA) underwent an ophthalmological examination. Demographic data including the
years (range, 50-76 years). Eight eyes had undergone silicone oil tamponade for systemic disease and medications, as well as the duration of plaquinil use, daily
retinal detachment and one for full thickness macular hole. In eight eyes, the OCT dosage and cumulative dosage were collected.
examination was carried out after silicone oil removal (mean 11.8 ± 13.6 months, All patients underwent a complete ophthalmologic examination, including
range 1.75- 40 months) and in one eye the OCT examination was carried with the biomicroscopic examination, Humphry 10-2 visual field test, spectralis SD OCT
oil in situ. On OCT, all eyes showed either silicone oil droplets intraretinally or macular imaging.
underneath an epiretinal membrane (ERM). The emulsion was seen as hyper- Results: Thirty two patients were included in the study. . There were 4 men and 28
reflective, spherical droplets with both time and spectral-domain OCT modalities. women . The mean age was 55.7 years (range 19-83 ). The most common diagnosis
Anterior segment studies of silicone oil emulsification confirmed that the was SLE in 17 patients. The mean duration of plaquinil use was 5.3 years (range 2-
configuration of this sheen mimics that of a silicone oil hyperoleum seen with 10 years) and the mean cumulative dose was 864.6 gr.
spectral-domain OCTs. In 11 patients (34%) all screening tests were normal.
Conclusions: Spectral-domain OCT is a useful method of identifying silicone oil 7 patients (21.8% ) had fundus changes suspicious of plaquinil toxicity in
emulsion both intraretinally and underneath ERMs, as defined by the presence of biomicroscopic examination and 9 patients (28%) had parafoveal scotomata in
hyper-reflective spherical bodies. Further studies are required to determine the visual field test. .
incidence, clinicopathological and functional significance of silicone emulsion in 11 patients (34%) had OCT findings . 8 patients had non specific OCT changes
the retina associated with vitrectomy and silicone oil including retinal pigment epithelial (RPE) irregularities, Pigment epithelial
tamponade. detachment (PED) drusen, and Epiretinal membranes, and 3 patients had changes
suggestive of plaquinil toxicity demonstrating perifoveal thinning or complete loss
of the inner-outer segment layer of the photorecptor. .
Allt these 3 patients had both visual field defects and mild perifoveal RPE changes
on fundus examination.
Conclusions: In patients treated with Plaquinil visual field testing and fundus
examination are highly sensitive but non specific screening tool . SD OCT is a
sensitive and specific modality and should be included in the routine follow up of
these patients.
Commercial Relationships: Shiri Shulman, None; zohar Habot-Wilner,
Commercial Relationships: Sidath E. Liyanage, None; Marie-Helene Errera, None; Michaela Goldstein, None; Meira Neudorfer, None; Dafna Goldenberg,
None; Paul M. Sullivan, None None
Support: None Support: None
Program Number: 821 Poster Board Number: D759 Program Number: 823 Poster Board Number: D761
Presentation Time: 11:15 AM - 1:00 PM Presentation Time: 11:15 AM - 1:00 PM
Evaluation of Macular Changes in Neonatal Retinal Pathology Using Spectral Pericentral Ganglion Cell Layer Thickness Decreases with Age in Normal
Domain Optical Coherence Tomography Eyes as Measured by Spectral-Domain Optical Coherence Tomography
Rosa E. Martinez, Fernando Schoonewolff, Virgilio Morales-Canton, Jans Nazli Demirkaya1A, Hille W. van Dijk1A, Reinier O. Schlingemann1A, Michael D.
Fromow-Guerra, Gerardo Garcia-Aguirre, Veronica Giordano, Maria A. Abramoff2,3, Mona K. Garvin2, Milan Sonka2,3, Frank D. Verbraak1A,1B.
Martinez-Castellanos. Retina and Vitreous, Asociacion Para Evitar la Ceguera en AOphthalmology, BBiomedical Engineering and Physics, 1Academic Medical
Mexico, Universidad Nacional Autonoma de Mexico, Mexico. Center, Amsterdam, The Netherlands; 2Electrical and Computer Engineering, The
Purpose: To report macular changes in retinal neonatal pathology assessed by University of Iowa, Iowa City, IA; 3Ophthalmology and Visual Sciences, The
spectral domain optical coherence tomography (OCT). University of Iowa Hospital and Clinics, Iowa, IA.
Methods: Newborn infants with systemic pathology and suspected retinal disease Purpose: To determine the effect of age on individual retinal layer thicknesses in
underwent full eye exam using indirect ophthalmoscopy. Retinal images were healthy subjects measured by Spectral-Domain Optical Coherence Tomography.
acquired using Retcam II (Clarity Medical Systems, Pleasanton, CA). OCT images Methods: Eighty-four healthy subjects with an age ranging between 18 and 70
were taken using iVue spectral domain technology (Optovue, Inc., Fremont, CA) years were examined with Spectral-Domain Optical Coherence Tomography (SD-
under topical anesthesia. OCT, Topcon, Marck II). Mean layer thickness was calculated for 7 retinal layers,
Results: Eight infants (10 eyes) were screened, 4 eyes showed abnormal foveal in the central area (region 1 of the 9 ETDRS regions), in the pericentral area
changes. In a patient diagnosed with shaken baby syndrome and a macular (ETDRS regions 2 to 5), and the peripheral area (ETDRS region 6 to 9) following
hemorrhage, OCT demonstrated a dome shape elevation in the foveal area due to a automated segmentation using a custom made algorithm, which uses a fully three-
sub-internal limiting membrane hemorrhage. A second case had intraretinal dimensional graph search approach. To avoid the influence of confounders like
hemorrhages due to aggressive reanimation maneuvers; OCT revealed a macular gender and axial length we calculated for each layer in each area the ratio Mean
hemorrhagic retinoschisis. A patient with neonatal candida endophthalmitis Layer Thickness/ Total Retinal Thickness (Mean LT/Mean Total RT). The Pearson
developed white “cotton ball” lesions in the retina in close proximity to the macular correlation test was performed for each retinal layer to determine the relationship
area. Retinal angiography showed late staining of these lesions and peripheral between age and the ratio Mean LT/Mean Total RT.

Copyright 2012 by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. For permission to reproduce any abstract, contact the ARVO Office at [email protected].