title: In vivo adaptive optics microvascular imaging in diabetic patients without clinically severe diabetic retinopathy.
abstract: We used a confocal adaptive optics scanning laser ophthalmoscope (AOSLO) to image the retina of subjects with non-proliferative diabetic retinopathy (NPDR). To improve visualization of different retinal features, the size and alignment of the confocal aperture were varied. The inner retinal layers contained clearly visualized retinal vessels. In diabetic subjects there was extensive capillary remodeling despite the subjects having only mild or moderate NPDR. Details of the retinal microvasculature were readily imaged with a larger confocal aperture. Hard exudates were observed with the AOSLO in all imaging modes. Photoreceptor layer images showed regions of bright cones and dark areas, corresponding in location to overlying vascular abnormalities and retinal edema. Clinically undetected intraretinal vessel remodeling and varying blood flow patterns were found. Perifoveal capillary diameters were larger in the diabetic subjects (p<0.01), and small arteriolar walls were thickened, based on wall to lumen measurements (p<.05). The results suggest that existing clinical classifications based on lower magnification clinical assessment may not adequately measure key vascular differences among individuals with NPDR.
authors.affiliation: School of Optometry, Indiana University, 800 E. Atwater Ave, Bloomington, IN, 47405, USA.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Burns
authors.affiliation: School of Optometry, Indiana University, 800 E. Atwater Ave, Bloomington, IN, 47405, USA.
authors.forename: Ann E
authors.initials: AE
authors.lastname: Elsner
authors.affiliation: School of Optometry, Indiana University, 800 E. Atwater Ave, Bloomington, IN, 47405, USA.
authors.forename: Toco Y
authors.initials: TY
authors.lastname: Chui
authors.affiliation: School of Optometry, Indiana University, 800 E. Atwater Ave, Bloomington, IN, 47405, USA.
authors.forename: Dean A
authors.initials: DA
authors.lastname: Vannasdale
authors.affiliation: School of Optometry, Indiana University, 800 E. Atwater Ave, Bloomington, IN, 47405, USA.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Clark
authors.affiliation: School of Optometry, Indiana University, 800 E. Atwater Ave, Bloomington, IN, 47405, USA.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Gast
authors.affiliation: School of Optometry, Indiana University, 800 E. Atwater Ave, Bloomington, IN, 47405, USA.
authors.forename: Victor E
authors.initials: VE
authors.lastname: Malinovsky
authors.affiliation: Eugene and Marilyn Glick Eye Institute, Department of Ophthalmology, Indiana University School of Medicine, 1160 West Michigan Street, Indianapolis, IN 46202, USA.
authors.forename: Anh-Danh T
authors.initials: AD
authors.lastname: Phan
keywords: (170.3880) Medical and biological imaging; (170.4460) Ophthalmic optics and devices; (170.4470) Ophthalmology