Updates in ophthalmic imaging of the posterior segment


Denver, Colo.—Three recent studies presented this week at the Association for Research in Vision and Ophthalmology (ARVO) 2022 Annual Meeting in Denver, Colo. discuss exciting new ways to image the posterior segment of the eyes. One study uses a retinal camera prototype for transscleral optical imaging. Another study examines 2D ultra-widefield Optomap images and the last study assesses a different type of relationship: retinal fractal dimension and schizophrenia.

Latest optics camera successful in imaging essential retinal cells

Researchers from EarlySight SA, École Polytechnique Fédérale de Lausanne (EPFL), University of Lausanne, Jules-Gonin Eye Hospital in Switzerland, as well as the Université Pierre et Marie Curie - Paris 6 and Cochin Hospital in France evaluated the efficacy and replicability of the Transscleral Optical Imaging (TOI) technology in imaging retinal pigment epithelium (RPE) cells and wanted to define healthy RPE cells.

They examined 49 eyes from patients above 18 years old that presented with normal fundus check with a new retinal camera prototype for TOI. They found the TOI was safe, efficient, and “repeatable in vivo imaging of human RPE cells.” They also saw a relationship between subject and cell characteristics, which could suggest “modification of cell number, size and shape with increasing age.”

The lead researcher, Sonja Simon-Zoula, PhD said “the study we performed paves the way for establishing a normative database to characterize human retinal pigment epithelium (RPE) cells in vivo. Since RPE impairment is associated with many retinal diseases, such as age-related macular degeneration, the technology would allow identification of cell-level disease biomarkers at early stage and improve the overall management of retinal diseases.”

  • Abstract title: Human retinal pigment epithelium cells can be imaged in vivo with a novel adaptive optics camera using transscleral illumination
  • Presentation start/end time: Sunday, May 1, 5:15 – 7:15pm MDT
  • Location: Poster Hall (Denver Convention Center/Virtual)
  • Also available on the virtual meeting site at beginning on May 1
  • Abstract Number: F0303

Measuring tumor thickness with advanced imaging

Choroidal melanoma (CM) is the most common primary intraocular malignant tumor and it arises from benign choroidal nevi. Increased tumor thickness is an established risk factor for choroidal nevus (CN) transformation into CM, so establishing tumor thickness is a crucial step in working up pigmented choroidal lesions. Presently, the most dependable method for measuring tumor thickness is the B-scan ultrasonography, but it has limitations, primarily accessibility. Lead researcher Michael Yu, MD, and a team of scientists from Stanford University and the University of Illinois at Chicago correlated tumor thickness to tumor hyperintensity on green-channel ultra-widefield Optomap images.

Yu and his team evaluated 141 patients with pigmented choroidal lesions, who underwent extensive clinical examination, UWF imaging, and standardized ultrasonography. For each tumor, the green-channel hyperintensity was matched to its thickness as measured by ultrasonography. The team reported a “linear correlation coefficient for tumor thickness to [green-channel tumor hyperintensity]” of 0.85, signifying a strong positive association between tumor brightness on green-channel Optomap image and tumor thickness.

Their findings showed that choroidal tumor thickness could be reliably estimated, in a majority of cases, using only 2D UWF images in place of ultrasonography. Yu happily expressed, “We're pleased to present at ARVO 2022 a novel way to estimate tumor thickness using only 2D images captured by Optos machines. Given that these machines are widely used in the optometric setting and national screening pathways, with further development, there is potential that implementation of this technique could lead to improved screening of pigmented choroidal lesions and, by extension, more accurate and timely referrals."

  • Abstract title: A Novel Approach to Estimating Choroidal Lesion Thickness Using 2D Optomap Images
  • Presentation start/end time: Tuesday, May 3, 1:17 – 1:34pm MT
  • Location: 205/207 (Denver Convention Center)
  • Also available on the virtual meeting site at beginning May 11
  • Abstract Number: 2665

Schizophrenia, retinal blood vessels, and diabetes

Chronic, severe mental disorders, such as schizophrenia, can be associated with neurovascular impairment and cardiovascular morbidity. This is because such disorders affect the blood vessels around the brain, including retinal blood vessels. Similar to a tree, the branching of retinal blood vessels exhibit a repeating motif on an every-magnifying scale. This self-similarity can be measured using fractal dimension. A way to measure the complexity of this branching is fractal dimension (FD): intuitively, the higher the dimension, the more complex the branching is. Retinal FD has been shown to be associated with neurovascular pathology.

Researchers Moorfields Eye Hospital NHS Foundation Trust, University College London, the University Hospitals Birmingham NHS Foundation Trust, and the University of Dundee in the United Kingdom assessed the relationship between schizophrenia and retinal FD and examined the effect of other comorbidities on this relationship. They ran a hospital-based retrospective cohort study at a tertiary ophthalmic institution and the retinal dimension was obtained from a software named Vessel Assessment and Measurement Platform for Images of the Retina (VAMPIRE). Of the 96,995 patients, 676 of them had schizophrenia. They assessed the association between retinal FD and schizophrenia adjusting for sex, age, diabetes mellitus and hypertension. This was a part of a big retrospective study called AlzEye, led by Siegfried Wagner and Pearse Keane at Moorfields, set up to investigate the relationship between ophthalmic signatures of systemic diseases.

Timing Liu, BA and team found that patients with schizophrenia were younger and more likely to be diabetic, however, there wasn’t a significant difference in hypertension distribution or sex. Adjusting for hypertension, age, sex, schizophrenia remained associated with reduced retinal FD in patients with diabetes.

Liu said “In this study, we found that patients with schizophrenia have reduced fractal dimension of their retinal vessels than patients without schizophrenia if they have diabetes mellitus. In other words, patients with schizophrenia, who also have diabetes, have altered retinal vasculature. Since looking at retinal blood vessels is low-cost, it can be done cheaply and may serve as a potential tool for population screening and early detection of systemic diseases.”

  • Abstract title: Association between retinal fractal dimension and schizophrenia
  • Presentation start/end time: Sunday, May 1, 5:15 – 7:15pm MT
  • Location: Virtual (
  • Abstract Number: 1057 – F0304


The Association for Research in Vision and Ophthalmology (ARVO) is the largest eye and vision research organization in the world. Members include approximately 10,000 eye and vision researchers from over 75 countries. ARVO advances research worldwide into understanding the visual system and preventing, treating and curing its disorders. Learn more at

The 2022 ARVO Annual Meeting will take place in Denver, Colo. from May 1 – 4 and virtually May 11 - 12. The Meeting is the premiere gathering of nearly 10,000 eye and vision researchers from around the world. During the Meeting, 4,800 abstracts will be presented on the latest basic and translational research in eye and vision science.

All abstracts accepted for presentation at the ARVO Annual Meeting represent previously unpublished data and conclusions. This research may be proprietary or may have been submitted for journal publication. Embargo policy: Journalists must seek approval from the presenter(s) before reporting data from paper or poster presentations. Press releases or stories on information presented at the ARVO Annual Meeting may not be released or published until the following embargo dates:

  • May 1: Official launch of presentations of all posters (both presented in-person and virtually)
  • Rolling basis: Paper session, Symposia, Minisymposia, Cross-sectional Groups, and invited speaker sessions that have specific presentation times will be embargoed until the end of those individual time slots.


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Jenniffer Scherhaufer