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© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Adaptive optics-transscleral flood illumination (AO-TFI) is a novel imaging technique with potential for detecting retinal pigment epithelium (RPE) changes in dry age-related macular degeneration (AMD). This single-center prospective study evaluated its ability to visualize pathological features in AMD. AO-TFI images were acquired using the prototype Cellularis® camera over six 5 × 5° macular zones in patients with good fixation and no exudative changes. Conventional imaging modalities, including spectral-domain optical coherence tomography (OCT), color fundus photography and fundus autofluorescence, were used for comparison. AO-TFI images were correlated with OCT using a custom method (Fiji software, v. 2.9). Eleven eyes of nine patients (70 ± 8.3 years) with early (n = 5), intermediate (n = 1) and atrophic (n = 5) AMD were analyzed. AO-TFI identified relevant patterns in dry AMD. RPE cell visibility was impaired in affected eyes, but AO-TFI distinguished cuticular drusen with hyporeflective centers and bright edges, large ill-defined drusen and stage 3 subretinal drusenoid deposits as prominent hyperreflective spots. It provided superior resolution for small drusen compared to OCT and revealed crystalline structures and hyporeflective dots in atrophic regions. Atrophic borders remained isoreflective unless RPE displacement was absent, allowing precise delineation. These findings highlight AO-TFI’s potential as a sensitive imaging tool for characterizing early AMD and clinical research.

Details

Title
Adaptive Optics-Transscleral Flood Illumination Imaging of Retinal Pigment Epithelium in Dry Age-Related Macular Degeneration
Author
Kowalczuk, Laura 1   VIAFID ORCID Logo  ; Dornier Rémy 2   VIAFID ORCID Logo  ; Navarro, Aurélie 3 ; Jeunet Fanny 3 ; Moser Christophe 2 ; Behar-Cohen, Francine 4   VIAFID ORCID Logo  ; Mantel Irmela 3 

 Faculty of Biology and Medicine, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, 1004 Lausanne, Switzerland; [email protected] (L.K.); [email protected] (I.M.), Laboratory of Applied Photonic Devices (LAPD), School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland; [email protected] (R.D.); [email protected] (C.M.) 
 Laboratory of Applied Photonic Devices (LAPD), School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland; [email protected] (R.D.); [email protected] (C.M.) 
 Faculty of Biology and Medicine, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, 1004 Lausanne, Switzerland; [email protected] (L.K.); [email protected] (I.M.) 
 Centre de Recherche des Cordeliers, UPMC—Paris 6, INSERM U1138, Université Sorbonne Paris Cité, 75006 Paris, France, Assistance Publique Hôpitaux de Paris, Ophtalmopôle, Cochin Hospital, 75014 Paris, France, Hôpital Foch, Service D’ophtalmologie, 92150 Suresnes, France 
First page
633
Publication year
2025
Publication date
2025
Publisher
MDPI AG
e-ISSN
20734409
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3203186782
Copyright
© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.