Detection of photoreceptor disruption by adaptive optics fundus imaging and Fourier-domain optical coherence tomography in eyes with occult macular dystrophy

Abstract

Yoshiyuki Kitaguchi1, Shunji Kusaka1, Tatsuo Yamaguchi2, Toshifumi Mihashi2, Takashi Fujikado11Department of Applied Visual Science, Osaka University Graduate School of Medicine, Osaka, Japan; 2Topcon Research Institute, Itabashi, JapanPurpose: To investigate the structural changes in the photoreceptors by adaptive optics (AO) fundus imaging and Fourier-domain optical coherence tomography (FD-OCT) in eyes with occult macular dystrophy (OMD).Design: Observational case reports.Methods: Eight eyes of four patients who were diagnosed with OMD were examined. All eyes had a complete ophthalmological examination. Multifocal electroretinograms (mfERGs) were recorded from all eyes. AO and FD-OCT images of foveal photoreceptors were obtained.Results: The best-corrected visual acuity (BCVA) of these eyes ranged from 20/20 to 20/200, and the ocular fundus was normal by conventional ocular examination in all eyes. The amplitudes of the mfERGs were decreased in the foveal area. The inner and outer segment (IS/OS) junction of the photoreceptors in the foveal area was disrupted. The IS/OS junction was intact in one eye with a BCVA of 20/20, and the outer segment layer between the IS/OS junction and retinal pigment epithelium of the FD-OCT images was identified only in the center of the fovea. The AO images showed patchy dark areas in all eyes, which indicated a disruption of the mosaic of bright spots in the fovea.Conclusion: Structural changes of photoreceptors in OMD patients were detected tangentially by FD-OCT and en face by AO.Keywords: Photoreceptors, OMD, images, retinal imaging