SlideShare a Scribd company logo
1 of 33
Advances in Retinal Imaging of Achromatopsia Joseph Carroll, PhD Departments of Ophthalmology, Biophysics, and Cell Biology, Neurobiology, & Anatomy Medical College of Wisconsin Achromatopsia Convention August 2, 2011
Acknowledgements Medical College of Wisconsin Kim Stepien, MD Alf Dubra, PhD JungtaeRha, PhD Robert Cooper Adam Dubis Brett Schroeder Phyllis Summerfelt Chicago Lighthouse/UIC Gerald Fishman, MD Mohamed Genead, MD University of Washington Jay Neitz, PhD Maureen Neitz, PhD $$$$ - NIH EY017607, EY001931, Research to Prevent Blindness, E. Matilda Ziegler Foundation for the Blind,  Kirchgessner Foundation, Gene & Ruth Posner Foundation, RD & Linda Peters Foundation, Hope for Vision, Vision for Tomorrow Foundation, & Fight for Sight
Complex layered structure which is made up of different types of cells.    Picture from Webvision: The Organization of the Retina and Visual System
Webvision Ann Milam Fine & Yanoff (1979)
In achromatopsia, we are interested in studying photoreceptor structure – as this is likely to be helpful in the translation of gene-based therapies to the condition. Two imaging techniques have emerged that allow us to directly assess photoreceptor structure in patients with achromatopsia and other retinal disorders…
Optical Coherence Tomography
Adaptive Optics ,[object Object],[object Object]
Carroll et al., (2005)
Adaptive Optics Imaging 30 deg 3 deg 2 mm resolution
Imaging the Rod and Cone Mosaic Dubra, Sulai, Norris, Cooper, Dubis, Williams, Carroll(2011)
With the ability to resolve the entire photoreceptor mosaic, we can quantify different aspects of the rod and cone mosaics… Dubra, Sulai, Norris, Cooper, Dubis, Williams, Carroll(2011)
Recent success in retinal gene therapy indicate that it may be possible to restore cone function in individuals with ACHM and BCM: ,[object Object]
 cone function improved in dog and mouse models of congenital achromatopsia (Komáromyet al., 2010; Alexander et al., 2007),
trichromatic color vision achieved in a primate model of human dichromacy (Mancuso et al., 2009)A better understanding of photoreceptor structure is needed in order to assess the therapeutic potential in human patients with AHCM & BCM.
Achromatopsia ,[object Object]
Caused by defect in CNGA3, CNG3, GNAT2, or PDE6C.
 Affected individuals are thought to have no cone function (though see Nishiguchi, et al. 2005).
 Clinically presents very similarly to BCM.
 Histology data varies: from suggesting normal peripheral cones (Larsen, 1921), reduced numbers throughout (Harrison et al., 1960; Glickstein & Heath, 1975), or normal numbers in the fovea (Falls et al., 1965).
 OCT data suggests progressive loss of cone layers (Thiadens et al. 2010)…,[object Object]
Variable IS/OS Photoreceptor Structure Present in ACHM Geneadet al. (2011)
Foveal Hypoplasia Albinism ACHM
Assessing Cone Structure in ACHM Geneadet al. (2011)
Assessing Cone Structure in ACHM Geneadet al. (2011)
Variation in cone structure within individual retina.  Geneadet al. (2011)
ACHM: Imaging Summary ,[object Object]
 OCT reveals significant variation in the disruption of the IS/OS, and variable thinning of the ONL – suggesting variable degrees of photoreceptor loss.
 Imaging with AO reveals significant cone structure in most patients, with some even retaining both an inner and outer segment to the cone.  These cones are not functioning normally, but appear to be intact structurally, at least in part.
 Significant work remains:
 Examine differences across genotypes

More Related Content

What's hot

Focal choroidal excavation in eyes with central serous chorioretinopathy
Focal choroidal excavation in eyes with central serous chorioretinopathy Focal choroidal excavation in eyes with central serous chorioretinopathy
Focal choroidal excavation in eyes with central serous chorioretinopathy
Abdallah Ellabban
 
Fine needle aspiration biopsy of ameloblastic carcinoma of the mandible a cas...
Fine needle aspiration biopsy of ameloblastic carcinoma of the mandible a cas...Fine needle aspiration biopsy of ameloblastic carcinoma of the mandible a cas...
Fine needle aspiration biopsy of ameloblastic carcinoma of the mandible a cas...
Quách Bảo Toàn
 
Fine needle aspiration findings in malignant ameloblastoma a case report and ...
Fine needle aspiration findings in malignant ameloblastoma a case report and ...Fine needle aspiration findings in malignant ameloblastoma a case report and ...
Fine needle aspiration findings in malignant ameloblastoma a case report and ...
Quách Bảo Toàn
 
Use of cone beam computed tomography in endodontics
Use of cone beam computed tomography in endodonticsUse of cone beam computed tomography in endodontics
Use of cone beam computed tomography in endodontics
Nielsen Pereira
 
Cone beam ct findings in a case of plexiform ameloblatoma
Cone beam ct findings in a case of plexiform ameloblatomaCone beam ct findings in a case of plexiform ameloblatoma
Cone beam ct findings in a case of plexiform ameloblatoma
Quách Bảo Toàn
 
SLIDE FINAL PAPER PALEMBANG
SLIDE FINAL PAPER PALEMBANGSLIDE FINAL PAPER PALEMBANG
SLIDE FINAL PAPER PALEMBANG
RSCM Jakarta
 

What's hot (19)

Focal choroidal excavation in eyes with central serous chorioretinopathy
Focal choroidal excavation in eyes with central serous chorioretinopathy Focal choroidal excavation in eyes with central serous chorioretinopathy
Focal choroidal excavation in eyes with central serous chorioretinopathy
 
Focal choroidal excavation in eyes with central serous chorioretinopathy
Focal choroidal excavation in eyes with central serous chorioretinopathyFocal choroidal excavation in eyes with central serous chorioretinopathy
Focal choroidal excavation in eyes with central serous chorioretinopathy
 
X-linked adrenoleukodystrophy: Radiological assessment
X-linked adrenoleukodystrophy: Radiological assessmentX-linked adrenoleukodystrophy: Radiological assessment
X-linked adrenoleukodystrophy: Radiological assessment
 
Fine needle aspiration biopsy of ameloblastic carcinoma of the mandible a cas...
Fine needle aspiration biopsy of ameloblastic carcinoma of the mandible a cas...Fine needle aspiration biopsy of ameloblastic carcinoma of the mandible a cas...
Fine needle aspiration biopsy of ameloblastic carcinoma of the mandible a cas...
 
Anterior segment and Corneal OCT review
Anterior segment and Corneal OCT reviewAnterior segment and Corneal OCT review
Anterior segment and Corneal OCT review
 
Fine needle aspiration findings in malignant ameloblastoma a case report and ...
Fine needle aspiration findings in malignant ameloblastoma a case report and ...Fine needle aspiration findings in malignant ameloblastoma a case report and ...
Fine needle aspiration findings in malignant ameloblastoma a case report and ...
 
Genetics in Ophthalmology
Genetics in OphthalmologyGenetics in Ophthalmology
Genetics in Ophthalmology
 
3D Cephalometrics and morphometrics /certified fixed orthodontic courses by ...
 3D Cephalometrics and morphometrics /certified fixed orthodontic courses by ... 3D Cephalometrics and morphometrics /certified fixed orthodontic courses by ...
3D Cephalometrics and morphometrics /certified fixed orthodontic courses by ...
 
use of Cbct in dental implant
use of Cbct  in dental implantuse of Cbct  in dental implant
use of Cbct in dental implant
 
Dentistry 1-1008
Dentistry 1-1008Dentistry 1-1008
Dentistry 1-1008
 
CBCT
CBCTCBCT
CBCT
 
Initial of primary bone tumour
Initial of primary bone tumourInitial of primary bone tumour
Initial of primary bone tumour
 
Cone beam
Cone beamCone beam
Cone beam
 
Use of cone beam computed tomography in endodontics
Use of cone beam computed tomography in endodonticsUse of cone beam computed tomography in endodontics
Use of cone beam computed tomography in endodontics
 
Cone beam ct findings in a case of plexiform ameloblatoma
Cone beam ct findings in a case of plexiform ameloblatomaCone beam ct findings in a case of plexiform ameloblatoma
Cone beam ct findings in a case of plexiform ameloblatoma
 
SLIDE FINAL PAPER PALEMBANG
SLIDE FINAL PAPER PALEMBANGSLIDE FINAL PAPER PALEMBANG
SLIDE FINAL PAPER PALEMBANG
 
Aadr poster saha_v1
Aadr poster saha_v1Aadr poster saha_v1
Aadr poster saha_v1
 
Multimodal evaluation of macular function in age related macular
Multimodal evaluation of macular function in age related macularMultimodal evaluation of macular function in age related macular
Multimodal evaluation of macular function in age related macular
 
Gender Discrimination based on the Thermal Signature of the Face and the Exte...
Gender Discrimination based on the Thermal Signature of the Face and the Exte...Gender Discrimination based on the Thermal Signature of the Face and the Exte...
Gender Discrimination based on the Thermal Signature of the Face and the Exte...
 

Similar to Dr. Carroll: Advances in Retinal Imaging of Achromatopsia

Dome shaped macular configuration - 2 years
Dome shaped macular configuration - 2 yearsDome shaped macular configuration - 2 years
Dome shaped macular configuration - 2 years
Abdallah Ellabban
 
Osteogenesis Imperfecta
Osteogenesis ImperfectaOsteogenesis Imperfecta
Osteogenesis Imperfecta
Paudel Sushil
 
Early detection of glaucoma through retinal nerve fiber layer analysis using ...
Early detection of glaucoma through retinal nerve fiber layer analysis using ...Early detection of glaucoma through retinal nerve fiber layer analysis using ...
Early detection of glaucoma through retinal nerve fiber layer analysis using ...
eSAT Publishing House
 
Anterior segment imaging: ultrasound biomicroscopy
Anterior segment imaging: ultrasound biomicroscopyAnterior segment imaging: ultrasound biomicroscopy
Anterior segment imaging: ultrasound biomicroscopy
Patricia Chirinos
 
LASIK Surgery is Safe in the Long-Term
LASIK Surgery is Safe in the Long-TermLASIK Surgery is Safe in the Long-Term
LASIK Surgery is Safe in the Long-Term
London Vision Clinic
 
Huge ameloblastoma of jaw a case report
Huge ameloblastoma of jaw a case reportHuge ameloblastoma of jaw a case report
Huge ameloblastoma of jaw a case report
Quách Bảo Toàn
 

Similar to Dr. Carroll: Advances in Retinal Imaging of Achromatopsia (20)

3D Tomgraphic features in dome shaped macula by swept source OCT
3D Tomgraphic features in dome shaped macula by swept source OCT3D Tomgraphic features in dome shaped macula by swept source OCT
3D Tomgraphic features in dome shaped macula by swept source OCT
 
App ca1 paula
App ca1 paulaApp ca1 paula
App ca1 paula
 
Dome shaped macula
Dome shaped macula Dome shaped macula
Dome shaped macula
 
Dome shaped macula in High myopia - Swept-source Optical coherence tomograph...
Dome shaped macula  in High myopia - Swept-source Optical coherence tomograph...Dome shaped macula  in High myopia - Swept-source Optical coherence tomograph...
Dome shaped macula in High myopia - Swept-source Optical coherence tomograph...
 
Glaucoma
GlaucomaGlaucoma
Glaucoma
 
Cavernous Malformation of the Optic Chiasm with Multiples Cerebral Cavernous ...
Cavernous Malformation of the Optic Chiasm with Multiples Cerebral Cavernous ...Cavernous Malformation of the Optic Chiasm with Multiples Cerebral Cavernous ...
Cavernous Malformation of the Optic Chiasm with Multiples Cerebral Cavernous ...
 
Optical Coherence Tomography in Multiple Sclerosis
Optical Coherence Tomography in Multiple SclerosisOptical Coherence Tomography in Multiple Sclerosis
Optical Coherence Tomography in Multiple Sclerosis
 
Radiographic aids in dx of periodontol ds part b
Radiographic aids in dx of periodontol ds part bRadiographic aids in dx of periodontol ds part b
Radiographic aids in dx of periodontol ds part b
 
Dome shaped macular configuration - 2 years
Dome shaped macular configuration - 2 yearsDome shaped macular configuration - 2 years
Dome shaped macular configuration - 2 years
 
FOCAL CHOROIDAL EXCAVATION IN EYES WITH CENTRAL SEROUS ‎CHORIORETINOPATHY ‎
FOCAL CHOROIDAL EXCAVATION IN EYES WITH CENTRAL SEROUS ‎CHORIORETINOPATHY ‎FOCAL CHOROIDAL EXCAVATION IN EYES WITH CENTRAL SEROUS ‎CHORIORETINOPATHY ‎
FOCAL CHOROIDAL EXCAVATION IN EYES WITH CENTRAL SEROUS ‎CHORIORETINOPATHY ‎
 
Osteogenesis Imperfecta
Osteogenesis ImperfectaOsteogenesis Imperfecta
Osteogenesis Imperfecta
 
Cochlear malformations
Cochlear malformationsCochlear malformations
Cochlear malformations
 
Early detection of glaucoma through retinal nerve fiber layer analysis using ...
Early detection of glaucoma through retinal nerve fiber layer analysis using ...Early detection of glaucoma through retinal nerve fiber layer analysis using ...
Early detection of glaucoma through retinal nerve fiber layer analysis using ...
 
Early detection of glaucoma through retinal nerve fiber layer analysis using ...
Early detection of glaucoma through retinal nerve fiber layer analysis using ...Early detection of glaucoma through retinal nerve fiber layer analysis using ...
Early detection of glaucoma through retinal nerve fiber layer analysis using ...
 
craniofacial microsomia
craniofacial microsomiacraniofacial microsomia
craniofacial microsomia
 
Cornea and Lens Histopathology Refractive Surgery Cataracts High Myopia
Cornea and Lens Histopathology Refractive Surgery Cataracts High MyopiaCornea and Lens Histopathology Refractive Surgery Cataracts High Myopia
Cornea and Lens Histopathology Refractive Surgery Cataracts High Myopia
 
Anterior segment imaging: ultrasound biomicroscopy
Anterior segment imaging: ultrasound biomicroscopyAnterior segment imaging: ultrasound biomicroscopy
Anterior segment imaging: ultrasound biomicroscopy
 
LASIK Surgery is Safe in the Long-Term
LASIK Surgery is Safe in the Long-TermLASIK Surgery is Safe in the Long-Term
LASIK Surgery is Safe in the Long-Term
 
Zomc Fracture
Zomc FractureZomc Fracture
Zomc Fracture
 
Huge ameloblastoma of jaw a case report
Huge ameloblastoma of jaw a case reportHuge ameloblastoma of jaw a case report
Huge ameloblastoma of jaw a case report
 

Recently uploaded

Difference Between Skeletal Smooth and Cardiac Muscles
Difference Between Skeletal Smooth and Cardiac MusclesDifference Between Skeletal Smooth and Cardiac Muscles
Difference Between Skeletal Smooth and Cardiac Muscles
MedicoseAcademics
 
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
Sheetaleventcompany
 
💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...
💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...
💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...
Sheetaleventcompany
 
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
Sheetaleventcompany
 
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
Sheetaleventcompany
 

Recently uploaded (20)

Circulatory Shock, types and stages, compensatory mechanisms
Circulatory Shock, types and stages, compensatory mechanismsCirculatory Shock, types and stages, compensatory mechanisms
Circulatory Shock, types and stages, compensatory mechanisms
 
Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...
Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...
Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...
 
Difference Between Skeletal Smooth and Cardiac Muscles
Difference Between Skeletal Smooth and Cardiac MusclesDifference Between Skeletal Smooth and Cardiac Muscles
Difference Between Skeletal Smooth and Cardiac Muscles
 
Cardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their RegulationCardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their Regulation
 
❤️Call Girl Service In Chandigarh☎️9814379184☎️ Call Girl in Chandigarh☎️ Cha...
❤️Call Girl Service In Chandigarh☎️9814379184☎️ Call Girl in Chandigarh☎️ Cha...❤️Call Girl Service In Chandigarh☎️9814379184☎️ Call Girl in Chandigarh☎️ Cha...
❤️Call Girl Service In Chandigarh☎️9814379184☎️ Call Girl in Chandigarh☎️ Cha...
 
Independent Bangalore Call Girls (Adult Only) 💯Call Us 🔝 7304373326 🔝 💃 Escor...
Independent Bangalore Call Girls (Adult Only) 💯Call Us 🔝 7304373326 🔝 💃 Escor...Independent Bangalore Call Girls (Adult Only) 💯Call Us 🔝 7304373326 🔝 💃 Escor...
Independent Bangalore Call Girls (Adult Only) 💯Call Us 🔝 7304373326 🔝 💃 Escor...
 
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
 
Low Cost Call Girls Bangalore {9179660964} ❤️VVIP NISHA Call Girls in Bangalo...
Low Cost Call Girls Bangalore {9179660964} ❤️VVIP NISHA Call Girls in Bangalo...Low Cost Call Girls Bangalore {9179660964} ❤️VVIP NISHA Call Girls in Bangalo...
Low Cost Call Girls Bangalore {9179660964} ❤️VVIP NISHA Call Girls in Bangalo...
 
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
 
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service AvailableCall Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
 
💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...
💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...
💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...
 
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
 
Ahmedabad Call Girls Book Now 9630942363 Top Class Ahmedabad Escort Service A...
Ahmedabad Call Girls Book Now 9630942363 Top Class Ahmedabad Escort Service A...Ahmedabad Call Girls Book Now 9630942363 Top Class Ahmedabad Escort Service A...
Ahmedabad Call Girls Book Now 9630942363 Top Class Ahmedabad Escort Service A...
 
Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...
Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...
Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...
 
Call Girls Shahdol Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Shahdol Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Shahdol Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Shahdol Just Call 8250077686 Top Class Call Girl Service Available
 
💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...
💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...
💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...
 
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
 
(RIYA)🎄Airhostess Call Girl Jaipur Call Now 8445551418 Premium Collection Of ...
(RIYA)🎄Airhostess Call Girl Jaipur Call Now 8445551418 Premium Collection Of ...(RIYA)🎄Airhostess Call Girl Jaipur Call Now 8445551418 Premium Collection Of ...
(RIYA)🎄Airhostess Call Girl Jaipur Call Now 8445551418 Premium Collection Of ...
 
Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...
Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...
Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...
 
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
 

Dr. Carroll: Advances in Retinal Imaging of Achromatopsia

  • 1. Advances in Retinal Imaging of Achromatopsia Joseph Carroll, PhD Departments of Ophthalmology, Biophysics, and Cell Biology, Neurobiology, & Anatomy Medical College of Wisconsin Achromatopsia Convention August 2, 2011
  • 2. Acknowledgements Medical College of Wisconsin Kim Stepien, MD Alf Dubra, PhD JungtaeRha, PhD Robert Cooper Adam Dubis Brett Schroeder Phyllis Summerfelt Chicago Lighthouse/UIC Gerald Fishman, MD Mohamed Genead, MD University of Washington Jay Neitz, PhD Maureen Neitz, PhD $$$$ - NIH EY017607, EY001931, Research to Prevent Blindness, E. Matilda Ziegler Foundation for the Blind, Kirchgessner Foundation, Gene & Ruth Posner Foundation, RD & Linda Peters Foundation, Hope for Vision, Vision for Tomorrow Foundation, & Fight for Sight
  • 3. Complex layered structure which is made up of different types of cells. Picture from Webvision: The Organization of the Retina and Visual System
  • 4.
  • 5. Webvision Ann Milam Fine & Yanoff (1979)
  • 6.
  • 7. In achromatopsia, we are interested in studying photoreceptor structure – as this is likely to be helpful in the translation of gene-based therapies to the condition. Two imaging techniques have emerged that allow us to directly assess photoreceptor structure in patients with achromatopsia and other retinal disorders…
  • 9.
  • 10. Carroll et al., (2005)
  • 11. Adaptive Optics Imaging 30 deg 3 deg 2 mm resolution
  • 12. Imaging the Rod and Cone Mosaic Dubra, Sulai, Norris, Cooper, Dubis, Williams, Carroll(2011)
  • 13. With the ability to resolve the entire photoreceptor mosaic, we can quantify different aspects of the rod and cone mosaics… Dubra, Sulai, Norris, Cooper, Dubis, Williams, Carroll(2011)
  • 14.
  • 15. cone function improved in dog and mouse models of congenital achromatopsia (Komáromyet al., 2010; Alexander et al., 2007),
  • 16. trichromatic color vision achieved in a primate model of human dichromacy (Mancuso et al., 2009)A better understanding of photoreceptor structure is needed in order to assess the therapeutic potential in human patients with AHCM & BCM.
  • 17.
  • 18. Caused by defect in CNGA3, CNG3, GNAT2, or PDE6C.
  • 19. Affected individuals are thought to have no cone function (though see Nishiguchi, et al. 2005).
  • 20. Clinically presents very similarly to BCM.
  • 21. Histology data varies: from suggesting normal peripheral cones (Larsen, 1921), reduced numbers throughout (Harrison et al., 1960; Glickstein & Heath, 1975), or normal numbers in the fovea (Falls et al., 1965).
  • 22.
  • 23. Variable IS/OS Photoreceptor Structure Present in ACHM Geneadet al. (2011)
  • 25. Assessing Cone Structure in ACHM Geneadet al. (2011)
  • 26. Assessing Cone Structure in ACHM Geneadet al. (2011)
  • 27.
  • 28. Variation in cone structure within individual retina. Geneadet al. (2011)
  • 29.
  • 30. OCT reveals significant variation in the disruption of the IS/OS, and variable thinning of the ONL – suggesting variable degrees of photoreceptor loss.
  • 31. Imaging with AO reveals significant cone structure in most patients, with some even retaining both an inner and outer segment to the cone. These cones are not functioning normally, but appear to be intact structurally, at least in part.
  • 33. Examine differences across genotypes
  • 34. Examine longitudinal cone loss in these conditions
  • 35.
  • 36.
  • 38. JC0184 JC0183 JC0118 ID# 13 yrs 16 yrs 31 yrs AGE 20/100 20/80 20/60 BCVA AXIAL LENGTH mm (OD) 24.85 25.65 25.83
  • 40. JC_0183 JC_0184 Curcio et al. (1991) 2,626 cones/mm2 4,116 cones/mm2 2,000 – 5,000 cones/mm2 S-Cone Free Zone - Data is consistent with the S-cone free zone being variable in size (Williams et al., 1981; de Monasterioet al., 1985; Norket al., 1990; Curcio et al., 1991). - Residual packing density of S-cones may contribute to phenotypic heterogeneity.
  • 41. Peripheral BCM Mosaic Rods begin to appear. Large, bright S cones no longer visible, rather cones appear dark (inner segment). Fewer in number than AHCM.
  • 42.
  • 43. BCM has thinner ONL than ACHM
  • 44. S-cone free zone visible in BCM, not ACHM
  • 45. No foveal hypoplasia seen in BCM
  • 46. As genetic testing can often be inconclusive and expensive, use of high resolution imaging to guide genetic testing may be helpful.
  • 47.
  • 48. Continued development of hardware that will allow more routine imaging of the retina in patients with nystagmus.
  • 49. Need for better software for more robust analysis of retinal images – still evolving.
  • 50. Need to expand access to high-resolution imaging tools.
  • 51. All of this requires commitment and investment from funding agencies, researchers, and patients alike.