Adaptive optics (AO)-enhanced imaging of the retina is now reaching a level of technical maturity which fosters its expanding use in research and clinical centers in the world. By achieving wavelength-limited resolution it did not only allow a better observation of retinal substructures already visible by other means, it also broke anatomical frontiers such as individual photoreceptors or vessel walls. The clinical applications of AO-enhanced imaging has been slower than that of optical coherence tomography because of the combination of technical complexity, costs and the paucity of interpretative scheme of complex data. In several diseases, AO-enhanced imaging has already proven to provide added clinical value and quantitative biomarkers. Here, we will review some of the clinical applications of AO-enhanced en face imaging, and trace perspectives to improve its clinical pertinence in these applications. An interesting perspective is to document cell motion through time-lapse imaging such as during agerelated macular degeneration. In arterial hypertension, the possibility to measure parietal thickness and perform fine morphometric analysis is of interest for monitoring patients. In the near future, implementation of novel approaches and multimodal imaging, including in particular optical coherence tomography, will undoubtedly expand our imaging capabilities. Tackling the technical, scientific and medical challenges offered by high resolution imaging are likely to contribute to our rethinking of many retinal diseases, and, most importantly, may find applications in other areas of medicine.