title: Adaptive optics imaging of geographic atrophy.
abstract: OBJECTIVE
  To report the findings of en face adaptive optics (AO) near infrared (NIR) reflectance fundus flood imaging in eyes with geographic atrophy (GA).
  
  
  METHODS
  Observational clinical study of AO NIR fundus imaging was performed in 12 eyes of nine patients with GA, and in seven controls using a flood illumination camera operating at 840 nm, in addition to routine clinical examination. To document short term and midterm changes, AO imaging sessions were repeated in four patients (mean interval between sessions 21 days; median follow up 6 months).
  
  
  RESULTS
  As compared with scanning laser ophthalmoscope imaging, AO NIR imaging improved the resolution of the changes affecting the RPE. Multiple hyporeflective clumps were seen within and around GA areas. Time-lapse imaging revealed micrometric-scale details of the emergence and progression of areas of atrophy as well as the complex kinetics of some hyporeflective clumps. Such dynamic changes were observed within as well as outside atrophic areas.
  
  
  CONCLUSIONS
  in eyes affected by GA, AO nir imaging allows high resolution documentation of the extent of RPE damage. this also revealed that a complex, dynamic process of redistribution of hyporeflective clumps throughout the posterior pole precedes and accompanies the emergence and progression of atrophy. therefore, these clumps are probably also a biomarker of rpe damage. AO NIR imaging may, therefore, be of interest to detect the earliest stages, to document the retinal pathology and to monitor the progression oF GA. (ClinicalTrials.gov number, NCT01546181.).
authors.affiliation: Clinical Investigation Center 503, Centre Hospitalier National des Quinze-Vingts, Institute National de la Santé, et de la Recherche Médicale (INSERM) and Université Pierre et Marie Curie-Paris6, Paris, France.
authors.forename: Kiyoko
authors.initials: K
authors.lastname: Gocho
authors.forename: Valérie
authors.initials: V
authors.lastname: Sarda
authors.forename: Sabrina
authors.initials: S
authors.lastname: Falah
authors.forename: José-Alain
authors.initials: JA
authors.lastname: Sahel
authors.forename: Florian
authors.initials: F
authors.lastname: Sennlaub
authors.forename: Mustapha
authors.initials: M
authors.lastname: Benchaboune
authors.forename: Martine
authors.initials: M
authors.lastname: Ullern
authors.forename: Michel
authors.initials: M
authors.lastname: Paques
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005654:Fundus Oculi; D057092:Geographic Atrophy / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy / Q000379:methods*; D055213:Retinal Pigment Epithelium / Q000473:pathology* / Q000503:physiopathology; D019265:Spectroscopy, Near-Infrared / Q000379:methods*; D059008:Time-Lapse Imaging
keywords: adaptive optics; geographic atrophy; infrared imaging; retinal pigment epithelium