Optical section retinal imaging and wavefront sensing in diabetes.

PURPOSE: To investigate differences in higher-order ocular aberrations and in optical section retinal image resolution between healthy normal and diabetic subjects.

METHODS: An optical imaging system was established for combined retinal optical section imaging and wavefront sensing. A laser beam was expanded and focused to a point on the retina by the optics of the eye. For optical section retinal imaging, a cylindrical lens was placed in the path of the incident laser beam to form a focused line on the retina. Because of the angle between the incident laser and imaging path, an optical section image of the retina was captured. For wavefront sensing, a Shack-Hartmann aberrometer was incorporated in the imaging system. Twenty-two subjects with diabetes (average age, 52 +/- 12 years) and 13 normal subjects (average age, 47 +/- 9 years) were imaged. Retinal depth resolution was determined from the width of the laser line on the retina. Higher-order ocular aberrations were determined from the root mean square of the third to seventh Zernike terms, characterizing the wavefront aberration function. The data were analyzed statistically using Student's t-test and linear regression.

RESULTS: Higher-order ocular aberrations in diabetic subjects were significantly higher than in normal subjects (p=0.03). The retinal image depth resolution in diabetic subjects was significantly lower than in normal subjects (p <0.001). The retinal image depth resolution was inversely correlated with higher-order aberrations (r=-0.5; p=0.007; N=35).

CONCLUSIONS: The results demonstrate disease-related increases in higher-order ocular aberrations that influence retinal image resolution in diabetic eyes. This information is useful for designing high-resolution retinal imaging systems applicable for eyes with retinal disease.