In vivo fluorescence imaging of primate retinal ganglion cells and retinal pigment epithelial cells

Fundus autofluorescence imaging: review and perspectives

Fundus autofluorescence (FAF) imaging is a novel imaging method that allows topographic mapping of lipofuscin distribution in the retinal pigment epithelium cell monolayer as well as of other fluorophores that may occur with disease in the outer retina and the subneurosensory space. Excessive accumulation of lipofuscin granules in the lysosomal compartment of retinal pigment epithelium cells represents a common downstream pathogenetic pathway in various hereditary and complex retinal diseases, including age-related macular degeneration. FAF imaging has been shown to be useful with regard to understanding of pathophysiologic mechanisms, diagnostics, phenotype-genotype correlation, identification of predictive markers for disease progression, and monitoring of novel therapies. FAF imaging gives information above and beyond that obtained by conventional imaging methods, such as fundus photography, fluorescein angiography, and optical coherence tomography. Its clinical value coupled with its simple, efficient, and noninvasive nature is increasingly appreciated. This review summarizes basic principles and FAF findings in various retinal diseases.

Light-induced retinal changes observed with high-resolution autofluorescence imaging of the retinal pigment epithelium

PURPOSE

Autofluorescence fundus imaging using an adaptive optics scanning laser ophthalmoscope (AOSLO) allows for imaging of individual retinal pigment epithelial (RPE) cells in vivo. In this study, the potential of retinal damage was investigated by using radiant exposure levels that are 2 to 150 times those used for routine imaging.

METHODS

Macaque retinas were imaged in vivo with a fluorescence AOSLO. The retina was exposed to 568- or 830-nm light for 15 minutes at various intensities over a square (1/2) degrees per side. Pre- and immediate postexposure images of the photoreceptors and RPE cells were taken over a 2 degrees field. Long-term AOSLO imaging was performed intermittently from 5 to 165 days after exposure. Exposures delivered over a uniform field were also investigated.

RESULTS

Exposures to 568-nm light caused an immediate decrease in autofluorescence of RPE cells. Follow-up imaging revealed either full recovery of autofluorescence or long-term damage in the RPE cells at the exposure. The outcomes of AOSLO exposures and uniform field exposures of equal average power were not significantly different. No effects from 830-nm exposures were observed.

CONCLUSIONS

The study revealed a novel change in RPE autofluorescence induced by 568-nm light exposure. Retinal damage occurred as a direct result of total average power, independent of the light-delivery

METHOD

Because the exposures were near or below permissible levels in laser safety standards, these results suggest that caution should be used with exposure of the retina to visible light and that the safety standards should be re-evaluated for these exposure conditions.

Characteristics of the human isoplanatic patch and implications for adaptive optics retinal imaging

Conventional adaptive optics enables correction of high-order aberrations of the eye, but only for a single retinal point. When imaging extended regions of the retina, aberrations increase away from this point and degrade image quality. The zone over which aberrations do not change significantly is called the "isoplanatic patch." Literature concerning the human isoplanatic patch is incomplete. We determine foveal isoplanatic patch characteristics by performing Hartmann-Shack aberrometry in 1 deg increments in 8 directions on 7 human eyes. Using these measurements, we establish the correction quality required to yield at least 80% of the potential patch size for a given eye. Single-point correction systems (conventional adaptive optics) and multiple-point correction systems (multiconjugate adaptive optics) are simulated. Results are compared to a model eye. Using the Marechal criterion for 555-nm light, average isoplanatic patch diameter for our subjects is 0.80+/-0.10 deg. The required order of aberration correction depends on desired image quality over the patch. For the more realistically achievable criterion of 0.1 mum root mean square (rms) wavefront error over a 6.0-mm pupil, correction to at least sixth order is recommended for all adaptive optics systems. The most important aberrations to target for a multiconjugate correction are defocus, astigmatism, and coma.

In vivo time-lapse fluorescence imaging of individual retinal ganglion cells in mice

We have developed a technique that permits time-lapse imaging of retinal ganglion cells (RGCs), their dendritic arbors and their axons in mammals in vivo. This technique utilizes a standard confocal laser scanning microscope, transgenic mice that express yellow fluorescent protein (YFP) in a subset of RGCs and survival anesthesia techniques. The same individual RGCs with their dendritic arbors and axons were multiply imaged in vivo in both adult and juvenile mice. Additionally, the same RGC that was imaged in vivo could then be located and imaged in fixed retinal whole mount preparations. This novel technique has many potential applications.

No wavefront sensor adaptive optics system for compensation of primary aberrations by software analysis of a point source image. 2. Tests

The description of an adaptive optics (AO) system with no wavefront sensor to correct primary aberrations is presented. This system is based on closed loop software that iteratively analyzes a point source target image on the instrument focal plane and suitably modifies the AO device. The performed tests with a pull-only deformable mirror (DM) have shown that the system works very well, reaching an optimal focusing condition in a few seconds using standard components. Such a system can be conveniently applied in all the fields in which a not very fast optical adaptation is acceptable.

Large-field-of-view, modular, stabilized, adaptive-optics-based scanning laser ophthalmoscope

We describe the design and performance of an adaptive optics retinal imager that is optimized for use during dynamic correction for eye movements. The system incorporates a retinal tracker and stabilizer, a wide-field line scan scanning laser ophthalmoscope (SLO), and a high-resolution microelectromechanical-systems-based adaptive optics SLO. The detection system incorporates selection and positioning of confocal apertures, allowing measurement of images arising from different portions of the double pass retinal point-spread function (psf). System performance was excellent. The adaptive optics increased the brightness and contrast for small confocal apertures by more than 2x and decreased the brightness of images obtained with displaced apertures, confirming the ability of the adaptive optics system to improve the psf. The retinal image was stabilized to within 18 microm 90% of the time. Stabilization was sufficient for cross-correlation techniques to automatically align the images.

Maximum permissible exposures for ocular safety (ANSI 2000), with emphasis on ophthalmic devices

After discussing the rationale and assumptions of the ANSI Z136.1-2000 Standard for protection of the human eye from laser exposure, we present the concise formulation of the exposure limits expressed as maximum permissible radiant exposure (in J/cm(2)) for light overfilling the pupil. We then translate the Standard to a form that is more practical for typical ophthalmic devices or in vision research situations, implementing the special qualifications of the Standard. The safety limits are then expressed as radiant power (watts) entering the pupil of the eye. Exposure by repetitive pulses is also addressed, as this is frequently employed in ophthalmic applications. Examples are given that will familiarize potential users with this format.

In vivo fluorescent imaging of the mouse retina using adaptive optics

In vivo imaging of the mouse retina using visible and near infrared wavelengths does not achieve diffraction-limited resolution due to wavefront aberrations induced by the eye. Considering the pupil size and axial dimension of the eye, it is expected that unaberrated imaging of the retina would have a transverse resolution of 2 microm. Higher-order aberrations in retinal imaging of human can be compensated for by using adaptive optics. We demonstrate an adaptive optics system for in vivo imaging of fluorescent structures in the retina of a mouse, using a microelectromechanical system membrane mirror and a Shack-Hartmann wavefront sensor that detects fluorescent wavefront.

Multi-wavelength imaging with the adaptive optics scanning laser Ophthalmoscope

The adaptive optics scanning laser ophthalmoscope has been fitted with three light sources of different wavelengths to allow simultaneous or separate imaging with one, two or three wavelength combinations. The source wavelengths used are 532 nm, 658 nm and 840 nm. Typically the instrument is used in dual-frame mode, performing imaging at 840 nm and precisely coincident retinal stimulation in one of the visible wavelengths. Instrument set-up and single-detector image capture are described. Simultaneous multi-wavelength imaging in the living human retina is demonstrated. The chromatic aberrations of the human eye lead to lateral and axial shifts, as well as magnification differences in the image, from one wavelength to another. Measurement of these chromatic effects is described for instrument characterization purposes.