Visualization of Photoreceptors in Birdshot Chorioretinopathy Using Adaptive Optics Scanning Laser Ophthalmoscopy: A Pilot Study

Abstract

Purpose: Adaptive optics scanning laser ophthalmoscopy (AOSLO) allows en face visualization of specific layers of the retina. This pilot study evaluated the ability of AOSLO to visualize photoreceptor integrity in patients with birdshot chorioretinopathy (BCR).

Method: A total of 16 consecutive patients with HLA-A29+ BCR were imaged using the prototype Apaeros retinal imaging system. Images of high quality were aligned with infrared reflectance photos and correlated with spectral domain optical coherence tomography (SD-OCT).

Results: Images of four eyes of three patients were of sufficient quality to allow posterior pole montage and point-to-point correlation with SD-OCT. Areas of photoreceptor disruption on SD-OCT were seen as patchy areas of loss on AOSLO, whereas areas of intact interdigitation zone and inner segment/outer segment junction correlated with normal appearing photoreceptors on AOSLO.

Conclusions: Using AOSLO, we found one instance of subclinical photoreceptor disruption not seen on SD-OCT. Ultimately, there are unique challenges associated with imaging BCR patients using AOSLO.

Keywords:

• Adaptive optics scanning laser ophthalmoscope
• birdshot chorioretinopathy
• OCT
• photoreceptors

ACKNOWLEDGMENTS

The authors wish to acknowledge Dr. Stephen A. Burns who offered expertise in adaptive optics imaging and data processing and Boston Micromachines Corporation for providing the Apaeros AOSLO instrument and providing imaging support.

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. The authors have no proprietary interest in the subject of this manuscript.

Funding

DAG and AAF were supported by departmental unrestricted grant from Research to Prevent Blindness (NY). The funding agencies had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Additional information

Funding

DAG and AAF were supported by departmental unrestricted grant from Research to Prevent Blindness (NY). The funding agencies had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.