A New Method for Visualizing Drusen and Their Progression in Flood-Illumination Adaptive Optics Ophthalmoscopy

• DOI: 10.1167/tvst.10.14.19
• Publication Date: 2021-12-20T16:31:04Z
• Authors: Ethan A. Rossi; Nathaniel Norberg; Chiara Eandi; Celine Chaumette; Saloni Kapoor; Laura Le; Valerie C. Snyder; Joseph N. Martel; Josselin Gautier; Kiyoko Gocho; Kunal K. Dansingani; Jay Chhablani; Angelo Arleo; Sarah Mrejen; José-Alain Sahel; Kate Grieve; Michel Paques
• Keywords: Drusen; Fundus (uterus); Scanning laser ophthalmoscopy

Drusen are dynamic sub-RPE deposits that risk factors for late-stage age-related macular degeneration (AMD). Here we show a new imaging method using flood-illumination adaptive optics (FIAO) reveal drusen with high contrast and resolution. A fovea-centered 4° × FIAO image eight surrounding images gaze displaced by ±2° vertically horizontally were acquired. Clinical color fundus spectral-domain optical coherence tomography acquired clinical grading comparison. Custom software registered overlapping fused the data statistically to generate gaze-dependent image. Our dataset included 15 controls (aged 31-72) 182 eyes from 104 AMD patients 56-92), graded as either normal aging (n = 7), early 12), intermediate 108) late 42); 27 had subretinal drusenoid (SDDs), 83 imaged longitudinally. No varying structures detected in young eyes. In no evidence of changes, putative <20 µm diameter visible. Gaze-dependent revealed more many smaller than visible images. Longitudinal showed expansion fusion drusen. SDDs lower contrast, RPE atrophy did not yield consistent signal. commercially available camera combined registration postprocessing permits visualization their progression This technique offers promise robust sensitive detect, map, quantify, monitor dynamics AMD.