Invest Ophthalmol Vis Sci
January 2025
Purpose: To assess the preferential sites of retinal capillary occlusion at the parafovea in patients with sickle cell disease (SCD) using optical coherence tomography angiography (OCT-A).
Methods: OCT-A scans from 107 patients with SCD and 51 race-matched unaffected controls were obtained using a commercial spectral domain-OCT system. At least eight sequential 3 × 3 mm scans centered at the fovea were acquired and averaged for image analysis.
Cone photoreceptor inner segments visualized in non-confocal split-detection adaptive optics scanning light ophthalmoscope (AOSLO) images appear as obliquely illuminated domes with bright and dark opposing regions. Previously, the pairing of these bright and dark regions for automated photoreceptor identification has necessitated complex algorithms. Here we demonstrate how the merging of split-detection images captured with a non-confocal quadrant light detection scheme allows automated cone identification using simple, open-source image processing tools, while also improving accuracy in both normal and pathologic retinas.
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