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AO imaging can be a powerful clinical tool for detecting photoreceptor degeneration at a cellular level that might be overlooked through conventional structural assessments, such as spectral-domain optical coherence tomography (SD-OCT). Therefore, AO imaging has gained significant interest in the study of photoreceptor degeneration, one of the most common causes of inherited blindness. Growing evidence supports that AO imaging may be useful for diagnosing early-stage retinal dystrophy before it becomes apparent on fundus examination or conventional retinal imaging. In addition, serial AO imaging may detect structural disease progression in early-stage disease over a shorter period compared to SD-OCT. Although AO imaging is gaining popularity as a structural endpoint in clinical trials, the results should be interpreted with caution due to several pitfalls, including the lack of standardized imaging and image analysis protocols, frequent ocular comorbidities that affect image quality, and significant interindividual variation of normal values. Herein, we summarize the current state-of-the-art AO imaging and review its potential applications, limitations, and pitfalls in patients with inherited retinal diseases.<\/jats:p>","DOI":"10.3390\/diagnostics13142413","type":"journal-article","created":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T21:21:46Z","timestamp":1689801706000},"page":"2413","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Pearls and Pitfalls of Adaptive Optics Ophthalmoscopy in Inherited Retinal Diseases"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1868-4845","authenticated-orcid":false,"given":"Helia","family":"Ashourizadeh","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Fakhri","sequence":"additional","affiliation":[{"name":"Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Sciences, Shahid Beheshti University of Medical Sciences, Tehran 16666, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1788-7352","authenticated-orcid":false,"given":"Kiana","family":"Hassanpour","sequence":"additional","affiliation":[{"name":"Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Sciences, Shahid Beheshti University of Medical Sciences, Tehran 16666, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Masoudi","sequence":"additional","affiliation":[{"name":"Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sattar","family":"Jalali","sequence":"additional","affiliation":[{"name":"Department of Physics, Central Tehran Branch, Islamic Azad University, Tehran 19558, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6716-6406","authenticated-orcid":false,"given":"Danial","family":"Roshandel","sequence":"additional","affiliation":[{"name":"Centre for Ophthalmology and Visual Science, The University of Western Australia, Nedlands, WA 6009, Australia"},{"name":"Ocular Tissue Engineering Laboratory, Lions Eye Institute, Nedlands, WA 6009, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2809-9930","authenticated-orcid":false,"given":"Fred K.","family":"Chen","sequence":"additional","affiliation":[{"name":"Centre for Ophthalmology and Visual Science, The University of Western Australia, Nedlands, WA 6009, Australia"},{"name":"Ocular Tissue Engineering Laboratory, Lions Eye Institute, Nedlands, WA 6009, Australia"},{"name":"Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC 3002, Australia"},{"name":"Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC 3010, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2884","DOI":"10.1364\/JOSAA.14.002884","article-title":"Supernormal vision and high-resolution retinal imaging through adaptive optics","volume":"14","author":"Liang","year":"1997","journal-title":"J. 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