Invited Session V: The eye as a window to systemic and neurodegenerative health: Seeking Answers through a keyhole: Harnessing the Synergy of Dynamic OCT/OCT Angiography and Adaptive Optics SLO for Retinal Assessment of Systemic Disease.

The retina is our only non-invasive access to microworld of the body's capillaries and cellular activities. Leveraging the multimodal synergy of combining dynamic methods of OCT/OCTA, with Adaptive Optics SLO, clinicians have new opportunities to better appreciate some of the complexities of human disease. Serial OCTA imaging can reveal inconsistencies in retinal perfusion not appreciated on single images and can be used to measure activity status of sickle cell microvasculopathy. This approach facilitates earlier detection and immediate assessment of disease burden. AOSLO imaging provides cellular level resolution for confirmation of these OCTA events. En face OCT reflectance images which accompany OCTA studies offer a glimpse of the macrophage-like cellular activity above the retinal surface which responds to systemically instigated vascular events below. The complementary use of AOSLO to characterize morphology of these cells provides clues to their activation status and potential role in tissue maintenance and repair. Features of clinical OCT/OCTA interpreted by AOSLO imaging have the potential to become useful clinical biomarkers of disease activity and response to treatment.