Abstract
SummaryDuring dry age‐related macular degeneration (ARMD), adaptive optics (AO) en face flood imaging improves the resolution of drusens and of pigmentary changes and hence of the progression of atrophic lesions. In addition, AO revealed the presence of numerous migrating hyporeflective clumps, which are most likely melanin‐loaded cells (MLCs). Time‐lapse imaging demonstrates a high kinetic activity of these MLCs, that appear to migrate subretinally because the photoreceptors are visible over them. The linear velocity of MLCs peakee at ~1 µm/day, hence they can be tracked only if there is a short ionterval of time between imaging sessions. As many adjacent MLCs are seen to migrate in opposite direction, there appears to be no migrating scheme. Such subretinal migration of MLCs occurs throughout the posterior pole, in atrophic as well as in nonatrophic areas. It is likely that these MLCs correspond to the hyperreflective dots reported by optical coherence tomography. The nature of these cells and their role in the process of ARMD remains to be clarified. Nevertheless, we believe that this finding may have important consequences for the understanding and monitoring of dry ARMD, as well as for the validation of experimental models of ARMD.
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