Document Detail


Selective cone photoreceptor injury in acute macular neuroretinopathy.
MedLine Citation:
PMID:  23615345     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate retinal structural and functional abnormalities in a patient with acute macular neuroretinopathy.
METHODS: An adaptive optics scanning light ophthalmoscope was used to image the photoreceptor mosaic and assess rod and cone structure. Spectral-domain optical coherence tomography was used to examine retinal lamination. Microperimetry was used to assess function across the macula.
RESULTS: Microperimetry showed reduced function of localized areas within retinal lesions corresponding to subjective scotomas. Spectral-domain optical coherence tomography imaging revealed attenuation of two outer retinal bands typically thought to reflect photoreceptor structure. Adaptive optics scanning light ophthalmoscope images of the photoreceptor mosaic revealed a heterogeneous presentation within these lesions. There were areas containing non-waveguiding cones and other areas of decreased cone density where the remaining rods had expanded to fill in the vacant space. Within these lesions, cone densities were shown to be significantly lower than eccentricity-matched areas of normal retina, as well as accepted histologic measurements. A 6-month follow-up revealed no change in rod or cone structure.
CONCLUSION: Imaging of acute macular neuroretinopathy using an adaptive optics scanning light ophthalmoscope shows a preferential disruption of cone photoreceptor structure within the region of decreased retinal sensitivity (as measured by microperimetry). Adaptive optics-based imaging tools provide a noninvasive way to assess photoreceptor structure at a level of detail that is not resolved by use of conventional spectral-domain optical coherence tomography or other clinical measures.
Authors:
Sean O Hansen; Robert F Cooper; Alfredo Dubra; Joseph Carroll; David V Weinberg
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Retina (Philadelphia, Pa.)     Volume:  33     ISSN:  1539-2864     ISO Abbreviation:  Retina (Philadelphia, Pa.)     Publication Date:  2013 Sep 
Date Detail:
Created Date:  2013-08-23     Completed Date:  2014-02-05     Revised Date:  2014-09-02    
Medline Journal Info:
Nlm Unique ID:  8309919     Medline TA:  Retina     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1650-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Female
Humans
Ophthalmoscopes*
Optic Nerve Diseases / diagnosis*,  physiopathology
Optical Imaging / instrumentation,  methods
Retina / physiopathology
Retinal Cone Photoreceptor Cells / pathology*
Retinal Diseases / diagnosis*,  physiopathology
Retinal Rod Photoreceptor Cells / cytology
Scotoma / diagnosis,  physiopathology
Tomography, Optical Coherence
Visual Acuity / physiology
Visual Field Tests
Visual Fields / physiology
Grant Support
ID/Acronym/Agency:
C06 RR016511/RR/NCRR NIH HHS; P30 EY001931/EY/NEI NIH HHS; R01 EY017607/EY/NEI NIH HHS; UL1 TR000055/TR/NCATS NIH HHS
Comments/Corrections

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