Abstract
The purpose of the present study was to evaluate the intraretinal migration of the retinal pigment epithelium (RPE) cells in age-related macular degeneration (AMD) using polarimetry. We evaluated 155 eyes at various AMD stages. Depolarized light images were computed using a polarization-sensitive scanning laser ophthalmoscope (PS-SLO), and the degree of polarization uniformity was calculated using polarization-sensitive optical coherence tomography (OCT). Each polarimetry image was compared with the corresponding autofluorescence (AF) images at 488 nm (SW-AF) and at 787 nm (NIR-AF). Intraretinal RPE migration was defined by the presence of depolarization at intraretinal hyperreflective foci on PS-SLO and PS-OCT images, and by the presence of hyper-AF on both NIR-AF and SW-AF images. RPE migration was detected in 52 of 155 eyes (33.5%) and was observed in drusenoid pigment epithelial detachment (PED) and serous PED with significantly higher frequencies than in other groups (P = 0.015). The volume of the migrated RPE cluster in serous PED was significantly correlated with the volume of the PED (R2 = 0.26; P = 0.011). Overall, our results showed that intraretinal RPE migrations occurred in various AMD stages, and that they occurred more commonly in eyes with serous and drusenoid PED.
Highlights
In most developed countries, age-related macular degeneration (AMD) remains a leading cause of severe visual loss in older patients[1]
We investigated the presence of intraretinal retinal pigment epithelium (RPE) migration in AMD using PS-optical coherence tomography (OCT), polarization-sensitive scanning laser ophthalmoscope (PS-SLO), near infrared wavelength AF imaging (NIR-AF), and short wavelength AF imaging (SW-AF)
When the Polarization-sensitive optical coherence tomography (PS-OCT) cross-sectional degree of polarization uniformity (DOPU) images were plotted as pseudocolor, there were focal color changes that emphasized depolarization consistent with RPE changes, and the hyperreflective foci (HRF) could be localized within specific retinal layers in some eyes (Figs 1d, 2d, and 3d), but not in others (Fig. 4d)
Summary
Age-related macular degeneration (AMD) remains a leading cause of severe visual loss in older patients[1]. The presence of depolarization at HRF locations does not necessarily indicate the presence of intraretinal RPE migration To overcome this limitation, we combined polarimetry imaging with autofluorescence (AF) imaging. Hyper-AF in near infrared wavelength AF imaging (NIR-AF; excitation 788 nm, emission > 800 nm) is thought to originate from melanin or melanolipofuscin in the RPE, from melanin in melanocytes, or from melanin-containing inflammatory cells[40, 41]. We investigated the presence of intraretinal RPE migration in AMD using PS-OCT, PS-SLO, NIR-AF, and SW-AF. We correlated these imaging findings with the presence of pathophysiological markers of AMD
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