Characterization of In Vivo Retinal Lesions of Diabetic Retinopathy Using Adaptive Optics Scanning Laser Ophthalmoscopy

Table 1

Diabetic retinopathy lesion characteristics on AOSLO and SDOCT imaging modalities.

Lesion type	Size range (μm)	Appearance on AOSLO imaging		Increased reflectivity	Longitudinal follow-up	Shadowing of cones	Detectable in SDOCT (%)	Blood flow visible on AOSLO imaging
		Confocal	Multiply scattered light
Microaneurysms ()	46–168	Round/oval lesions with dark, thickened vessel walls	Better defined vessel walls than in confocal imaging	46% intraluminal 35% vessel wall	No	Yes	58	Feeder vessels and intraluminal blood flow
IRMA ()	69–360	Distinct convoluted vessel formation	Better defined vessel walls than in confocal imaging	No	No	Yes	90	Feeder vessels and intraluminal blood flow
NV ()	283–1406	Distinct convoluted vessel formation	Sharply defined vessel walls, distinction to fibrotic tissue, perfused and nonperfused vessels	No	Yes, under treatment of 0.3 ranibizumab	Yes	100	Feeder vessels and intraluminal blood flow, nonperfused vascular channels
Hemorrhages ()	52–234	Dark homogenous patches	Dark homogenous patches, same information as in confocal imaging	No	No	Yes	No	n/a
CWS ()	432–954	RNFL striation pattern disrupted, hyperreflective, fluffy	Less RNFL reflectivity	Yes	No	No	100	n/a
HE ()	27–745	Highly reflective distinct granular patches	Highly reflective distinct granular patches, same information as in confocal imaging	Yes	Yes, under treatment of 0.3 ranibizumab	Yes	91	n/a
Cysts ()	72–1086	Blurred dark shadows	Clear delineation of cyst boundaries and wall structures	No	No	Inconsistent	100	n/a

AOSLO: adaptive optics scanning laser ophthalmoscopy; SDOCT: spectral domain optical coherence tomography; IRMA: intraretinal microvascular abnormalities; NV: neovascularization; CWS: cotton wool spot; RNFL: retinal nerve fiber layer; HE: hard exudates.