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Longitudinal adaptive optics fluorescence microscopy reveals cellular mosaicism in patients
HaeWon Jung, Jianfei Liu, Tao Liu, Aman George, Margery G. Smelkinson, Sarah Cohen, Ruchi Sharma, Owen Schwartz, Arvydas Maminishkis, Kapil Bharti, Catherine Cukras, Laryssa A. Huryn, Brian P. Brooks, Robert Fariss, Johnny Tam
HaeWon Jung, Jianfei Liu, Tao Liu, Aman George, Margery G. Smelkinson, Sarah Cohen, Ruchi Sharma, Owen Schwartz, Arvydas Maminishkis, Kapil Bharti, Catherine Cukras, Laryssa A. Huryn, Brian P. Brooks, Robert Fariss, Johnny Tam
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Resource and Technical Advance Ophthalmology

Longitudinal adaptive optics fluorescence microscopy reveals cellular mosaicism in patients

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Abstract

The heterogeneity of individual cells in a tissue has been well characterized, largely using ex vivo approaches that do not permit longitudinal assessments of the same tissue over long periods of time. We demonstrate a potentially novel application of adaptive optics fluorescence microscopy to visualize and track the in situ mosaicism of retinal pigment epithelial (RPE) cells directly in the human eye. After a short, dynamic period during which RPE cells take up i.v.-administered indocyanine green (ICG) dye, we observed a remarkably stable heterogeneity in the fluorescent pattern that gradually disappeared over a period of days. This pattern could be robustly reproduced with a new injection and follow-up imaging in the same eye out to at least 12 months, which enabled longitudinal tracking of RPE cells. Investigation of ICG uptake in primary human RPE cells and in a mouse model of ICG uptake alongside human imaging corroborated our findings that the observed mosaicism is an intrinsic property of the RPE tissue. We demonstrate a potentially novel application of fluorescence microscopy to detect subclinical changes to the RPE, a technical advance that has direct implications for improving our understanding of diseases such as oculocutaneous albinism, late-onset retinal degeneration, and Bietti crystalline dystrophy.

Authors

HaeWon Jung, Jianfei Liu, Tao Liu, Aman George, Margery G. Smelkinson, Sarah Cohen, Ruchi Sharma, Owen Schwartz, Arvydas Maminishkis, Kapil Bharti, Catherine Cukras, Laryssa A. Huryn, Brian P. Brooks, Robert Fariss, Johnny Tam

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Figure 2

Dynamic establishment of heterogeneous pattern.

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Dynamic establishment of heterogeneous pattern.
The same retinal regions...
The same retinal regions imaged at different time points, corrected for eye motion, registered together, and normalized for intensity (based on histogram stretching) following indocyanine green (ICG) dye administration, in human subjects. (A) The AO-ICG exhibits spatial dynamics until about 5 minutes, after which the heterogeneous pattern stabilizes. Black subpanels indicate missing data sequences (i.e., not acquired or unusable data). In S7R, the solid black outline represents some cells starting bright and ending dim; others start dim and end bright. In S10L, the dotted outline represents that, although the large majority of cells reached stability after about 5 minutes, there was 1 region that showed a diminished fluorescence after 45 minutes. (B) Relative AO-ICG fluorescence change (%) measured in cells over time. Intensities at each time point were normalized to the average fluorescence intensity of the ROI, and then the percent change in intensity from 1 time point relative to the previous time point was calculated. In the case of missing data denoted by black boxes in (A), data is plotted as the average of neighboring values, except for S6L, where it was not possible to reliably calculate the time change for the first minute (dotted box) . Gray vertical bar indicates 5 minute time point at which the heterogeneous pattern is established. The mean and 1 SD are shown in black solid and dotted lines, respectively. The increase in variance at the t > 45 minute time point is likely due to a weaker SNR, which would lead to a greater degree of intensity normalization (histogram stretching). (C) The AO-ICG signal persists for days following injection (n = 3 eyes) but gets progressively weaker and is barely visible after 4 days. Scale bars: 50 μm.

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