Original articleHigh-Resolution Imaging of the Photoreceptor Layer in Epiretinal Membrane Using Adaptive Optics Scanning Laser Ophthalmoscopy
Section snippets
Materials and Methods
All investigations adhered to the tenets of the Declaration of Helsinki, and the study was approved by the institutional review board and the ethics committee at Kyoto University Graduate School of Medicine. The nature of the study and its possible consequences were explained to study candidates, after which written informed consent was obtained from all who participated.
Results
On AO-SLO images in 24 (96%) of the 25 eyes with ERM, many thin, straight hyporeflective lines in the cone mosaic were observed (Figs 2 and 3 [available at http://aaojournal.org]; Fig 4). These lines, which we describe as “microfolds,” were not seen in any normal eyes (Fig 1).
The microfolds appeared in localized clusters, with the microfolds in each cluster aligned almost in parallel. Each microfold was approximately 5 to 20 μm wide, which was narrower than the 50-μm or wider retinal folds seen
Discussion
Although vision changes due to metamorphopsia are a major symptom in patients with ERM, the structural abnormalities that underlie the vision disturbance remain unknown. A previous study using binocular correspondence perimetry8 attributed the vision changes to retinal or photoreceptor displacement, whereas other studies suggested that vision changes could be due to clinical findings, such as folds of the internal limiting membrane or the ERM, displacement of vessels toward the fovea, abnormal
Acknowledgments
The authors thank the imaging specialists of Kyoto University OCT Reading Center (Mayumi Yoshida and Akiko Hirata) for evaluating AO-SLO images.
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Manuscript no. 2010-124.
Financial Disclosure(s): The author(s) have made the following disclosure(s): Masanori Hangai and Nagahisa Yoshimura are paid members of the advisory boards of Topcon and NIDEK. Susumu Oshima is an employee of NIDEK. Takashi Inoue is an employee of Hamamatsu Photonics.
Supported in part by the New Energy and Industrial Technology Development Organization (NEDO; P05002), Kawasaki, Japan.