title: Wavefront error correction with adaptive optics in diabetic retinopathy.
abstract: OBJECTIVE
  To determine the effects of diabetic retinopathy (DR), increased foveal thickness (FT), and adaptive optics (AO) on wavefront aberrations and Shack-Hartmann (SH) image quality.
  
  
  METHODS
  Shack-Hartmann aberrometry and wavefront error correction were performed with a bench-top AO retinal imaging system in 10 healthy control and 19 DR subjects. Spectral domain optical coherence tomography was performed and central FT was measured. Based on the FT data in the control group, subjects in the DR group were categorized into two subgroups: those with normal FT and those with increased FT. Shack-Hartmann image quality was assessed based on spot areas, and high-order (HO) root mean square (RMS) and total RMS were calculated.
  
  
  RESULTS
  There was a significant effect of DR on HO and total RMS (p = 0.01), and RMS decreased significantly after AO correction (p < 0.001). Shack-Hartmann spot area was significantly affected by DR (p < 0.001), but it did not change after AO correction (p = 0.6). High-order RMS, total RMS, and SH spot area were higher in DR subjects both before and after AO correction. In DR subgroups, HO and total RMS decreased significantly after AO correction (p < 0.001), whereas the effect of increased FT on HO and total RMS was not significant (p ≥ 0.7). There were no significant effects of increased FT and AO on SH spot area (p = 0.9).
  
  
  CONCLUSIONS
  Diabetic retinopathy subjects had higher wavefront aberrations and less compact SH spots, likely attributable to pathological changes in the ocular optics. Wavefront aberrations were significantly reduced by AO, although AO performance was suboptimal in DR subjects as compared with control subjects.
authors.affiliation: *MD, MPH †MS ‡MD §BS ∥PhD Department of Ophthalmology and Visual Sciences University of Illinois at Chicago Chicago, Illinois (all authors).
authors.forename: Ali Kord
authors.initials: AK
authors.lastname: Valeshabad
authors.forename: Justin
authors.initials: J
authors.lastname: Wanek
authors.forename: Patricia
authors.initials: P
authors.lastname: Grant
authors.forename: Jennifer I
authors.initials: JI
authors.lastname: Lim
authors.forename: Felix Y
authors.initials: FY
authors.lastname: Chau
authors.forename: Ruth
authors.initials: R
authors.lastname: Zelkha
authors.forename: Nicole
authors.initials: N
authors.lastname: Camardo
authors.forename: Mahnaz
authors.initials: M
authors.lastname: Shahidi
mesh_terms: D057128:Aberrometry; D000328:Adult; D057108:Corneal Wavefront Aberration / Q000503:physiopathology* / Q000628:therapy*; D003930:Diabetic Retinopathy / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055095:Optics and Photonics; D011446:Prospective Studies; D012160:Retina / Q000503:physiopathology; D041623:Tomography, Optical Coherence
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