Characterization of retinal pigment epithelium layer in healthy and diseased retinas with high-resolution adaptive optics transscleral flood illumination imaging.

IF 2.8 3区医学 Q1 OPHTHALMOLOGY

Acta Ophthalmologica Pub Date : 2025-10-07 DOI:10.1111/aos.70016

Leila Sara Eppenberger, Safa Mohanna, Sohrab Ferdowsi, Sonja Simon-Zoula, Oliver Pfäffli, Christoph Amstutz, Lucas M Bachmann, Michael A Thiel, Martin K Schmid

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引用次数: 0

Abstract

Purpose: The retinal pigment epithelium (RPE) is critical in the pathophysiology of retinal diseases, such as age-related macular degeneration. Adaptive optics transscleral flood illumination (AO-TFI) offers rapid, detailed morphometric characterization of the RPE layer. This study evaluated AO-TFI's efficacy and feasibility to detect clinically relevant morphological characteristics in a clinical setting.

Methods: A total of 230 participants, categorized by their central retinal health, underwent comprehensive examination including SD-OCT, fundus imaging and AO-TFI using the Cellularis® prototype 2.0. Image quality control and RPE layer quantification were performed with an AO-TFI-specific automated segmentation algorithm. Density and area of hyper- and hyporeflective regions in the RPE layer plane, and, if detectable, RPE cell density, were quantified. We hypothesized that the RPE cell density would be lower in diseased retinas than in healthy retinas. Imaging results of healthy participants were statistically compared to those of diseased eyes. Additionally, generalized linear and logistic regression mixed-effect models identified associations between ocular characteristics and imaging parameters.

Results: After quality evaluation, high-quality images from 200 subjects (87%) were selected and segmented. The number of hyperreflective regions and their mean surface area were significantly higher in diseased than in healthy eyes (68 ± 40/mm² vs. 51 ± 39/mm²; p < 0.001; 302 ± 196 μm² vs. 155 ± 55 μm²; p < 0.001). The RPE distinct mosaic pattern was more often visible in healthy retinas (n = 103 vs. n = 30, p < 0.0001). The mean RPE cell density was 6354 ± 695/mm², with comparable counts for healthy and diseased, 6327 ± 687/mm² vs. 6532 ± 725/mm² (p = 0.1).

Conclusion: AO-TFI detected differences between healthy and diseased eyes, indicating its potential as a promising clinical modality providing quantitative and qualitative insights into RPE layer dynamics.

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高分辨率自适应光学经巩膜泛光成像对健康和病变视网膜色素上皮层的表征。

目的：视网膜色素上皮（RPE）在视网膜疾病（如年龄相关性黄斑变性）的病理生理中起着关键作用。自适应光学经巩膜泛光照明（AO-TFI）提供了快速、详细的RPE层形态特征。本研究评估了AO-TFI在临床环境中检测临床相关形态学特征的有效性和可行性。方法：使用Cellularis®原型2.0对230名参与者进行了包括SD-OCT、眼底成像和AO-TFI在内的综合检查。采用ao - tfi特异性自动分割算法进行图像质量控制和RPE层量化。测量了RPE层平面上高反射区和低反射区的密度和面积，以及可检测到的RPE细胞密度。我们假设病变视网膜的RPE细胞密度低于健康视网膜。健康参与者的成像结果与患病参与者的成像结果进行统计比较。此外，广义线性和逻辑回归混合效应模型确定了眼部特征和成像参数之间的关联。结果：经过质量评估，选出200名受试者（87%）的高质量图像进行分割。病变眼的高反射区数量和平均表面积显著高于健康眼(68±40/mm2 vs. 51±39/mm2; p2 vs. 155±55 μm2; p2，健康眼和病变眼的高反射区数量相当，为6327±687/mm2 vs. 6532±725/mm2 （p = 0.1）。结论：AO-TFI检测到健康眼和病变眼之间的差异，表明其有潜力作为一种有前途的临床模式，为RPE层动力学提供定量和定性的见解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Ophthalmologica 医学-眼科学

CiteScore

7.60

自引率

5.90%

发文量

433

审稿时长

6 months

期刊介绍： Acta Ophthalmologica is published on behalf of the Acta Ophthalmologica Scandinavica Foundation and is the official scientific publication of the following societies: The Danish Ophthalmological Society, The Finnish Ophthalmological Society, The Icelandic Ophthalmological Society, The Norwegian Ophthalmological Society and The Swedish Ophthalmological Society, and also the European Association for Vision and Eye Research (EVER). Acta Ophthalmologica publishes clinical and experimental original articles, reviews, editorials, educational photo essays (Diagnosis and Therapy in Ophthalmology), case reports and case series, letters to the editor and doctoral theses.