Classification of Human Retinal Microaneurysms Using Adaptive Optics Scanning Light Ophthalmoscope Fluorescein Angiography

Authors

Michael Dubow, New York Icahn School of Medicine at Mount Sinai
Alexander Pinhas, New York Icahn School of Medicine at Mount Sinai
Nishit Shah, New York Eye and Ear InfirmaryFollow
Robert F. Cooper, Marquette University
Alexander Gan, New York Eye and Ear Infirmary
Ronald C. Gentile, New York Eye and Ear Infirmary
Vernon Hendrix, New York Eye and Ear Infirmary
Yusufu N. Sulai, University of RochesterFollow
Joseph Carroll, Marquette University
Toco Y.P. Chui, New York Eye and Ear Infirmary
Joseph B. Walsh, New York Eye and Ear Infirmary
Rishard Weitz, New York Eye and Ear Infirmary
Alfredo Dubra, Marquette University
Richard B. Rosen, New York Eye and Ear Infirmary

Document Type

Article

Language

eng

Format of Original

11 p.

Publication Date

3-2014

Publisher

Association for Research in Vision and Opthalmology

Source Publication

Investigative Ophthalmology & Visual Science

Source ISSN

0146-0404

Original Item ID

doi: 10.1167/iovs.13-13122

Abstract

Purpose.

Microaneurysms (MAs) are considered a hallmark of retinal vascular disease, yet what little is known about them is mostly based upon histology, not clinical observation. Here, we use the recently developed adaptive optics scanning light ophthalmoscope (AOSLO) fluorescein angiography (FA) to image human MAs in vivo and to expand on previously described MA morphologic classification schemes.

Methods.

Patients with vascular retinopathies (diabetic, hypertensive, and branch and central retinal vein occlusion) were imaged with reflectance AOSLO and AOSLO FA. Ninety-three MAs, from 14 eyes, were imaged and classified according to appearance into six morphologic groups: focal bulge, saccular, fusiform, mixed, pedunculated, and irregular. The MA perimeter, area, and feret maximum and minimum were correlated to morphology and retinal pathology. Select MAs were imaged longitudinally in two eyes.

Results.

Adaptive optics scanning light ophthalmoscope fluorescein angiography imaging revealed microscopic features of MAs not appreciated on conventional images. Saccular MAs were most prevalent (47%). No association was found between the type of retinal pathology and MA morphology (P = 0.44). Pedunculated and irregular MAs were among the largest MAs with average areas of 4188 and 4116 μm², respectively. Focal hypofluorescent regions were noted in 30% of MAs and were more likely to be associated with larger MAs (3086 vs. 1448 μm², P = 0.0001).

Conclusions.

Retinal MAs can be classified in vivo into six different morphologic types, according to the geometry of their two-dimensional (2D) en face view. Adaptive optics scanning light ophthalmoscope fluorescein angiography imaging of MAs offers the possibility of studying microvascular change on a histologic scale, which may help our understanding of disease progression and treatment response.

Comments

Accepted version. Investigative Ophthalmology & Visual Science, Vol. 55, No. 3 (March 2014): 1299-1309. DOI. © 2014 Association for Research in Vision and Ophthalmology. Used with permission.

Recommended Citation

Dubow, Michael; Pinhas, Alexander; Shah, Nishit; Cooper, Robert F.; Gan, Alexander; Gentile, Ronald C.; Hendrix, Vernon; Sulai, Yusufu N.; Carroll, Joseph; Chui, Toco Y.P.; Walsh, Joseph B.; Weitz, Rishard; Dubra, Alfredo; and Rosen, Richard B., "Classification of Human Retinal Microaneurysms Using Adaptive Optics Scanning Light Ophthalmoscope Fluorescein Angiography" (2014). Biomedical Engineering Faculty Research and Publications. 302.
https://epublications.marquette.edu/bioengin_fac/302