Evidence of outer retinal changes in glaucoma patients as revealed by ultrahigh-resolution in vivo retinal imaging.
AIMS; It is well established that glaucoma results in a thinning of the inner retina. To investigate whether the outer retina is also involved, ultrahigh-resolution retinal imaging techniques were utilised.


METHODS
Eyes from 10 glaucoma patients (25-78 years old), were imaged using three research-grade instruments: (1) ultrahigh-resolution Fourier-domain optical coherence tomography (UHR-FD-OCT), (2) adaptive optics (AO) UHR-FD-OCT and (3) AO-flood illuminated fundus camera (AO-FC). UHR-FD-OCT and AO-UHR-FD-OCT B-scans were examined for any abnormalities in the retinal layers. On some patients, cone density measurements were made from the AO-FC en face images. Correlations between retinal structure and visual sensitivity were measured by Humphrey visual-field (VF) testing made at the corresponding retinal locations.


RESULTS
All three in vivo imaging modalities revealed evidence of outer retinal changes along with the expected thinning of the inner retina in glaucomatous eyes with VF loss. AO-UHR-FD-OCT images identified the exact location of structural changes within the cone photoreceptor layer with the AO-FC en face images showing dark areas in the cone mosaic at the same retinal locations with reduced visual sensitivity.


CONCLUSIONS
Losses in cone density along with expected inner retinal changes were demonstrated in well-characterised glaucoma patients with VF loss.
Department of Ophthalmology & Vision Science, University of California Davis, Sacramento, California, USA. chois@neco.edu
Stacey S
SS
Choi
Robert J
RJ
Zawadzki
Michele C
MC
Lim
James D
JD
Brandt
John L
JL
Keltner
Nathan
N
Doble
John S
JS
Werner
D000328:Adult; D000368:Aged; D000465:Algorithms; D000704:Analysis of Variance; D003941:Diagnostic Techniques, Ophthalmological / Q000592:standards*; D005260:Female; D005901:Glaucoma / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000473:pathology*