High-Resolution En Face OCT of the RPE in Geographic Atrophy Captures Patterns Resembling Fundus Autofluorescence
- 1New England Eye Center, Tufts Medical Center, School of Medicine, Boston, Massachusetts, United States
- 2Department of Electrical Engineering and Computer Science, and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States
- 3Pattern Recognition Lab, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
Abstract
Purpose: Fundus autofluorescence (FAF) identifies distinct hyperautofluorescent (hyperAF) patterns at the margins of geographic atrophy (GA) that predict progression. We investigated whether high-resolution en face optical coherence tomography (OCT) could reveal corresponding reflectivity patterns within the retinal pigment epithelium (RPE).
Methods: In this cross-sectional case series, eyes with GA were imaged using commercial green excitation FAF and a prototype high-resolution OCT (2.7 µm axial resolution). Six consecutively acquired OCT volumes were computationally motion-corrected and fused. En face linear-scale OCT images of the RPE were generated by averaging signals within a slab (5.4–11.7 µm anterior to the RPE posterior boundary) corresponding to the RPE cell body. FAF and OCT images were registered, and the spatial correspondence between FAF hyperAF and OCT RPE hyper-reflectivity was assessed qualitatively and quantitatively.
Results: Eight eyes of six patients were analyzed. En face OCT of the RPE enabled visualization of reflectivity patterns mirroring established FAF phenotypes, including patchy, diffuse, and banded patterns. Of 94 hyperAF features identified on FAF, 82 (87%) exhibited corresponding hyper-reflectivity on OCT. Conversely, 82 of 121 OCT RPE hyper-reflective features (68%) corresponded to hyperAF on FAF, whereas 39 were OCT-only; 31 of these OCT-only features (80%) were located within the central 3-mm region where macular pigment attenuates visible light.
Conclusions: High-resolution en face OCT captures reflectivity patterns in the RPE that correspond to prognostic FAF patterns in GA. Integrating this surrogate for prognostic FAF markers with established OCT outer retinal and vascular biomarkers offers the potential for a more comprehensive assessment of GA progression risk.
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BibTeX
@article{hassan2026highresolution,
title = {{High-Resolution En Face OCT of the RPE in Geographic Atrophy Captures Patterns Resembling Fundus Autofluorescence}},
author = {Abdul Rhman Hassan and Yunchan Hwang and Stefan B. Ploner and Fatima Babiker and Peter Y. Zhao and Andre J. Witkin and Michelle C. Liang and Wenke Karbole and Andreas Maier and James G. Fujimoto and Nadia K. Waheed},
journal = {Investigative Ophthalmology \& Visual Science},
year = {2026},
month = oct,
doi = {10.1167/iovs.67.12.74},
url = {https://doi.org/10.1167/iovs.67.12.74},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - High-Resolution En Face OCT of the RPE in Geographic Atrophy Captures Patterns Resembling Fundus Autofluorescence
AU - Abdul Rhman Hassan
AU - Yunchan Hwang
AU - Stefan B. Ploner
AU - Fatima Babiker
AU - Peter Y. Zhao
AU - Andre J. Witkin
AU - Michelle C. Liang
AU - Wenke Karbole
AU - Andreas Maier
AU - James G. Fujimoto
AU - Nadia K. Waheed
PY - 2026
DA - 2026/10/28
JO - Investigative Ophthalmology & Visual Science
DO - 10.1167/iovs.67.12.74
UR - https://doi.org/10.1167/iovs.67.12.74
AB - Purpose: Fundus autofluorescence (FAF) identifies distinct hyperautofluorescent (hyperAF) patterns at the margins of geographic atrophy (GA) that predict progression. We investigated whether high-resolution en face optical coherence tomography (OCT) could reveal corresponding reflectivity patterns within the retinal pigment epithelium (RPE). Methods: In this cross-sectional case series, eyes with GA were imaged using commercial green excitation FAF and a prototype high-resolution OCT (2.7 µm axial resolution). Six consecutively acquired OCT volumes were computationally motion-corrected and fused. En face linear-scale OCT images of the RPE were generated by averaging signals within a slab (5.4–11.7 µm anterior to the RPE posterior boundary) corresponding to the RPE cell body. FAF and OCT images were registered, and the spatial correspondence between FAF hyperAF and OCT RPE hyper-reflectivity was assessed qualitatively and quantitatively. Results: Eight eyes of six patients were analyzed. En face OCT of the RPE enabled visualization of reflectivity patterns mirroring established FAF phenotypes, including patchy, diffuse, and banded patterns. Of 94 hyperAF features identified on FAF, 82 (87%) exhibited corresponding hyper-reflectivity on OCT. Conversely, 82 of 121 OCT RPE hyper-reflective features (68%) corresponded to hyperAF on FAF, whereas 39 were OCT-only; 31 of these OCT-only features (80%) were located within the central 3-mm region where macular pigment attenuates visible light. Conclusions: High-resolution en face OCT captures reflectivity patterns in the RPE that correspond to prognostic FAF patterns in GA. Integrating this surrogate for prognostic FAF markers with established OCT outer retinal and vascular biomarkers offers the potential for a more comprehensive assessment of GA progression risk.
SN - 0146-0404
SN - 1552-5783
ER -