BACKGROUND: There have been reports that by compensating for ocular aberrations using adaptive optical systems it may be possible to improve the resolution of clinical retinal imaging systems beyond what is now possible. To develop such a system to observe eyes with retinal disease, understanding of ocular wavefront aberrations in individuals with retinal disease is required. METHODS: Eighty-two eyes of 66 patients with macular disease (epiretinal membrane, macular edema, macular hole, etc.) and 85 eyes of 51 patients without retinal disease were studied. Using a ray-tracing wavefront device, each eye was scanned at both small and large pupil apertures, and Zernike coefficients up to the sixth order were acquired. RESULTS: In phakic eyes, third-order root mean square errors in the macular disease group were statistically greater than in the control group, an average of 12% for 5-mm and 31% for 3-mm scan diameters (P < 0.021). In pseudophakic eyes, there was also an elevation of third-order root mean square, on average 57% for 5-mm and 51% for 3-mm scan diameters (P < 0.031). CONCLUSION: Higher-order wavefront aberrations in eyes with macular disease were greater than in control eyes without disease. This study suggests that such aberrations may result from irregular or multiple reflecting retinal surfaces. Modifications in wavefront sensor technology will be needed to accurately determine wavefront aberration and allow correction using adaptive optics in eyes with macular irregularities.
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