目标:高放大率模块(HMM™,海德堡工程,海德堡,德国)成像是一种新颖的技术,设计用于在细胞水平上可视化视网膜。为了评估基于HMM™的指标作为未来试验终点的潜力,我们评估了结构HMM™锥指标之间的相关性,谱域OCT(SD-OCT,海德堡工程,海德堡,德国)和微视野检查的视网膜敏感性(MP,MAIA,CenterVue,帕多瓦,意大利)在健康受试者和p。(Arg142Trp)PRPH2相关的中央乳晕脉络膜营养不良(CACD)患者中。
方法:我们在复合HMM™图像上投影了默认的10°MP网格,并执行了自动圆锥密度(CD),位于3°和5°视网膜偏心率的刺激下的细胞间距离(ICD)和最近邻距离(NND)分析。我们在SD-OCT上手动测量了绝对和相对暗点的受试者内视网膜外厚度,位于局灶性萎缩之外。
结果:我们包括15名CACD患者和5名健康受试者。我们发现在距中央凹3°偏心率时,HMM™指标和MP灵敏度的中强相关性。我们发现绝对暗点位置的外视网膜在统计学上显着变薄(p=0.000003,单样本t检验),作为相对暗点位置的外部视网膜厚度。有趣的是,这些区域的HMM™度量没有显著差异。
结论:我们发现,在健康受试者和CACD患者中,HMM™成像的结构光感受器指标与MP的视网膜敏感性之间存在显著相关性。多模式方法,结合SD-OCT,MP和HMM™成像,允许视网膜感光体完整性和恢复电位的详细映射,在未来的临床试验中可以作为生物标志物的重要数据。
OBJECTIVE: High Magnification Module (HMM™, Heidelberg Engineering, Heidelberg, Germany) imaging is a novel technique, designed to visualize the retina at a cellular level. To assess the potential of HMM™-based metrics as endpoints for future trials, we evaluated correlations between structural HMM™ cone metrics, spectral-domain OCT (SD-OCT, Heidelberg Engineering, Heidelberg, Germany) and retinal sensitivity on microperimetry (MP, MAIA, CenterVue, Padova, Italy) in healthy subjects and p.(Arg142Trp) PRPH2-associated Central Areolar Choroidal Dystrophy (CACD) patients.
METHODS: We projected a default 10° MP grid on composite HMM™ images and performed automated cone density (CD), intercell distance (ICD) and nearest neighbour distance (NND) analysis at stimuli located at 3° and 5° retinal eccentricity. We manually measured intrasubject outer retinal thickness on SD-OCT in absolute and relative scotomas, located outside of focal atrophy.
RESULTS: We included 15 CACD patients and five healthy subjects. We found moderate-to-strong correlations of HMM™ metrics and MP sensitivity at 3° eccentricity from the fovea. We found the outer retina at the locations of absolute scotomas to be statistically significant thinner (p = 0.000003, one-sample t-test), as the outer retinal thickness at locations of relative scotomas. Interestingly, HMM™ metrics of these areas did not differ significantly.
CONCLUSIONS: We found significant correlations between structural photoreceptors metrics on HMM™ imaging and retinal sensitivity on MP in healthy subjects and CACD patients. A multimodal approach, combining SD-OCT, MP and HMM™ imaging, allows for detailed mapping of retinal photoreceptor integrity and restitution potential, important data that could serve as biomarkers in future clinical trials.