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Borella Y, Danielsen N, Markle EM, Snyder VC, Lee DMW, Zhang M, Eller AW, Chhablani J, Paques M, Rossi EA. Are the Hypo-Reflective Clumps Associated With Age-Related Macular Degeneration in Adaptive Optics Ophthalmoscopy Autofluorescent? Invest Ophthalmol Vis Sci 2024; 65:28. [PMID: 39167400 PMCID: PMC11343010 DOI: 10.1167/iovs.65.10.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Accepted: 08/03/2024] [Indexed: 08/23/2024] Open
Abstract
Purpose Hypo-reflective clumps (HRCs) are structures associated with age-related macular degeneration (AMD) that were identified using flood-illumination adaptive optics ophthalmoscopy (FIAO) and hypothesized to be either macrophages that have accumulated melanin through the phagocytosis of retinal pigmented epithelial (RPE) cell organelles or transdifferentiated RPE cells. HRCs may be autofluorescent (AF) in the near infrared (NIR) but clinical NIR autofluorescence imaging lacks the resolution to answer this question definitively. Here, we used near infrared autofluorescence (NIRAF) imaging in fluorescence adaptive optics scanning laser ophthalmoscopy (AOSLO) to determine whether HRCs are AF. Methods Patients with AMD and HRCs underwent imaging with FIAO, optical coherence tomography (OCT), and multi-modal AOSLO (confocal, NIRAF, and non-confocal multi-offset detection using a fiber bundle). HRCs were segmented on FIAO and images, co-registered across modalities, and HRC morphometry and AF were quantified. Results Eight patients participated (mean age = 79 years, standard deviation [SD] = 5.7, range = 69-89 years, and 5 female patients). Most HRCs (86%, n = 153/178) were autofluorescent on AOSLO. HRC AF signal varied but most uniformly dark HRCs on FIAO showed corresponding AF on AOSLO, whereas heterogeneous HRCs showed a smaller AF area or no AF. Conclusions These findings are consistent with the hypothesis that HRCs contain AF RPE organelles. A small proportion of HRCs were not AF; these may represent macrophages that have not yet accumulated enough organelles to become AF. HRCs may have clinical significance but further study is needed to understand the interplay among HRCs, RPE cells, and macrophages, and their relationship to geographic atrophy (GA) progression in AMD.
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Affiliation(s)
- Ysé Borella
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
- Vision Institute, 15-20 National Ophthalmology Hospital, Clinical Investigation Center 1423 and Sorbonne University, Paris, France
| | - Natalie Danielsen
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
- Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, Pennsylvania, United States
| | - Evelyn M. Markle
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Valerie C. Snyder
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Daniel M. W. Lee
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
- Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, Pennsylvania, United States
| | - Min Zhang
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Andrew W. Eller
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Jay Chhablani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Michel Paques
- Vision Institute, 15-20 National Ophthalmology Hospital, Clinical Investigation Center 1423 and Sorbonne University, Paris, France
| | - Ethan A. Rossi
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
- Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, Pennsylvania, United States
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
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Govindahari V, Dornier R, Ferdowsi S, Moser C, Mantel I, Behar-Cohen F, Kowalczuk L. High-resolution adaptive optics-trans-scleral flood illumination (AO-TFI) imaging of retinal pigment epithelium (RPE) in central serous chorioretinopathy (CSCR). Sci Rep 2024; 14:13689. [PMID: 38871803 DOI: 10.1038/s41598-024-64524-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 06/10/2024] [Indexed: 06/15/2024] Open
Abstract
This study aims to correlate adaptive optics-transscleral flood illumination (AO-TFI) images of the retinal pigment epithelium (RPE) in central serous chorioretinopathy (CSCR) with standard clinical images and compare cell morphological features with those of healthy eyes. After stitching 125 AO-TFI images acquired in CSCR eyes (including 6 active CSCR, 15 resolved CSCR, and 3 from healthy contralateral), 24 montages were correlated with blue-autofluorescence, infrared and optical coherence tomography images. All 68 AO-TFI images acquired in pathological areas exhibited significant RPE contrast changes. Among the 52 healthy areas in clinical images, AO-TFI revealed a normal RPE mosaic in 62% of the images and an altered RPE pattern in 38% of the images. Morphological features of the RPE cells were quantified in 54 AO-TFI images depicting clinically normal areas (from 12 CSCR eyes). Comparison with data from 149 AO-TFI images acquired in 33 healthy eyes revealed significantly increased morphological heterogeneity. In CSCR, AO-TFI not only enabled high-resolution imaging of outer retinal alterations, but also revealed RPE abnormalities undetectable by all other imaging modalities. Further studies are required to estimate the prognosis value of these abnormalities. Imaging of the RPE using AO-TFI holds great promise for improving our understanding of the CSCR pathogenesis.
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Affiliation(s)
- Vishal Govindahari
- Department of Retina, Pushpagiri Eye Institute, Hyderabad, 500026, India
- INSERM UMRS 1138 From Physiopathology of Ocular Diseases to Clinical Developments, Centre de Recherche des Cordeliers, Université Pierre et Marie Curie - Paris 6, 75006, Paris, France
| | - Rémy Dornier
- Laboratory of Applied Photonic Devices (LAPD), School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), CH-1015, Lausanne, Switzerland
| | | | - Christophe Moser
- Laboratory of Applied Photonic Devices (LAPD), School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), CH-1015, Lausanne, Switzerland
| | - Irmela Mantel
- Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, CH-1004, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, CH-1005, Lausanne, Switzerland
| | - Francine Behar-Cohen
- INSERM UMRS 1138 From Physiopathology of Ocular Diseases to Clinical Developments, Centre de Recherche des Cordeliers, Université Pierre et Marie Curie - Paris 6, 75006, Paris, France
- Assistance Publique - Hôpitaux de Paris, Ophtalmopôle, Cochin Hospital, 75014, Paris, France
- Université Paris Cité, 75006, Paris, France
- Hôpital Foch, Suresnes, France
| | - Laura Kowalczuk
- Laboratory of Applied Photonic Devices (LAPD), School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), CH-1015, Lausanne, Switzerland.
- Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, CH-1004, Lausanne, Switzerland.
- Faculty of Biology and Medicine, University of Lausanne, CH-1005, Lausanne, Switzerland.
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Gofas-Salas E, Lee DMW, Rondeau C, Grieve K, Rossi EA, Paques M, Gocho K. Comparison between Two Adaptive Optics Methods for Imaging of Individual Retinal Pigmented Epithelial Cells. Diagnostics (Basel) 2024; 14:768. [PMID: 38611681 PMCID: PMC11012195 DOI: 10.3390/diagnostics14070768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/18/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
The Retinal Pigment Epithelium (RPE) plays a prominent role in diseases such as age-related macular degeneration, but imaging individual RPE cells is challenging due to their high absorption and low autofluorescence emission. The RPE lies beneath the highly reflective photoreceptor layer (PR) and contains absorptive pigments, preventing direct backscattered light detection when the PR layer is intact. Here, we used near-infrared autofluorescence adaptive optics scanning laser ophthalmoscopy (NIRAF AOSLO) and transscleral flood imaging (TFI) in the same healthy eyes to cross-validate these approaches. Both methods revealed a consistent RPE mosaic pattern and appeared to reflect a distribution of fluorophores consistent with findings from histological studies. Interestingly, even in apparently healthy RPE, we observed dynamic changes over months, suggesting ongoing cellular activity or alterations in fluorophore distribution. These findings emphasize the value of NIRAF AOSLO and TFI in understanding RPE morphology and dynamics.
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Affiliation(s)
- Elena Gofas-Salas
- Department of Photonics, Institut de la Vision, INSERM, CNRS, Sorbonne Université, 17 rue Moreau, F-75012 Paris, France;
- CIC 1423, CHNO des Quinze-Vingts, INSERM-DGOS 28 rue de Charenton, F-75012 Paris, France; (M.P.); (K.G.)
| | - Daniel M. W. Lee
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA; (D.M.W.L.); (E.A.R.)
| | | | - Kate Grieve
- Department of Photonics, Institut de la Vision, INSERM, CNRS, Sorbonne Université, 17 rue Moreau, F-75012 Paris, France;
- CIC 1423, CHNO des Quinze-Vingts, INSERM-DGOS 28 rue de Charenton, F-75012 Paris, France; (M.P.); (K.G.)
| | - Ethan A. Rossi
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA; (D.M.W.L.); (E.A.R.)
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15260, USA
| | - Michel Paques
- CIC 1423, CHNO des Quinze-Vingts, INSERM-DGOS 28 rue de Charenton, F-75012 Paris, France; (M.P.); (K.G.)
| | - Kiyoko Gocho
- CIC 1423, CHNO des Quinze-Vingts, INSERM-DGOS 28 rue de Charenton, F-75012 Paris, France; (M.P.); (K.G.)
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Wang S, Li K, Yin Q, Ren J, Zhang J. Semi-supervised generative adversarial learning for denoising adaptive optics retinal images. BIOMEDICAL OPTICS EXPRESS 2024; 15:1437-1452. [PMID: 38495700 PMCID: PMC10942687 DOI: 10.1364/boe.511587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/28/2023] [Accepted: 01/24/2024] [Indexed: 03/19/2024]
Abstract
This study presents denoiseGAN, a novel semi-supervised generative adversarial network, for denoising adaptive optics (AO) retinal images. By leveraging both synthetic and real-world data, denoiseGAN effectively addresses various noise sources, including blur, motion artifacts, and electronic noise, commonly found in AO retinal imaging. Experimental results demonstrate that denoiseGAN outperforms traditional image denoising methods and the state-of-the-art conditional GAN model, preserving retinal cell structures and enhancing image contrast. Moreover, denoiseGAN aids downstream analysis, improving cell segmentation accuracy. Its 30% faster computational efficiency makes it a potential choice for real-time AO image processing in ophthalmology research and clinical practice.
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Affiliation(s)
- Shidan Wang
- Advanced Ophthalmology Laboratory (AOL), Robotrak Technologies, Nanjing, 210000, China
| | - Kaiwen Li
- Advanced Ophthalmology Laboratory (AOL), Robotrak Technologies, Nanjing, 210000, China
| | - Qi Yin
- Advanced Ophthalmology Laboratory (AOL), Robotrak Technologies, Nanjing, 210000, China
| | - Ji Ren
- Advanced Ophthalmology Laboratory (AOL), Robotrak Technologies, Nanjing, 210000, China
| | - Jie Zhang
- Advanced Ophthalmology Laboratory (AOL), Robotrak Technologies, Nanjing, 210000, China
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Vienola KV, Holmes JA, Glasso Z, Rossi EA. Head stabilization apparatus for high-resolution ophthalmic imaging. APPLIED OPTICS 2024; 63:940-944. [PMID: 38437390 PMCID: PMC11210293 DOI: 10.1364/ao.513801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/23/2023] [Indexed: 03/06/2024]
Abstract
Head movement must be stabilized to enable high-quality data collection from optical instrumentation such as eye trackers and ophthalmic imaging devices. Though critically important for imaging, head stabilization is often an afterthought in the design of advanced ophthalmic imaging systems, and experimental devices often adapt used and/or discarded equipment from clinical devices for this purpose. Alternatively, those seeking the most stable solution possible, including many users of adaptive optics ophthalmoscopy systems, utilize bite bars. Bite bars can provide excellent stability but are time consuming to fabricate, decreasing imaging efficiency, and uncomfortable for many patients, especially the elderly and/or those with prosthodontics such as dentures who may refuse participation in a study that requires one. No commercial vendors specifically offer head mount solutions for experimental ophthalmic imaging devices, resulting in nearly every custom device having a different solution for this commonly encountered problem. Parallelizing the head stabilization apparatus across different custom devices may improve standardization of experimental imaging systems for clinical trials and other multicenter investigations. Here we introduce a head mount design for ophthalmic imaging that is modular, adjustable, and customizable to the constraints of different experimental imaging configurations. The three points of head contact in our solution provide excellent stabilization across a range of head sizes and shapes from small children to adults, and the ease of adjustment afforded by our design minimizes the time to get participants stabilized and comfortable.
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Affiliation(s)
- Kari V. Vienola
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - John A. Holmes
- Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, PA 15213, USA
| | - Zolten Glasso
- Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, PA 15213, USA
| | - Ethan A. Rossi
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, 15213, USA
- Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, PA 15213, USA
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
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Luo D, Xiong X, Chen W, Huang R. Design of two-dimensional piezoelectric laser scanner system for precision laser beam steering. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2023; 94:105003. [PMID: 37791864 DOI: 10.1063/5.0138139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 09/18/2023] [Indexed: 10/05/2023]
Abstract
In this work, a large aperture two-dimensional (2D) piezoelectric laser scanner system with an onboard sensor to detect the scanner's deflection angle has been designed and prototyped. The proposed 2D laser scanner is driven using three amplified piezoelectric actuators assembled in an equilateral triangle configuration to provide structural stability and compactness. To overcome the nonlinearity that derives from the hysteresis effect of the piezoelectric actuators, the tip-tilt principle and the control schemes of the 2D scanner are analyzed and compared. Thanks to the combination of onboard sensing of the deflection angle of the scanner with the closed-loop control capability, this 2D scanner's features include a large aperture and high accuracy. The experimental results demonstrate that closed-loop control achieves higher control accuracy than the open-loop control approach, leading to a reduction in the relative error from 2%-4% to ∼0.5%, while the deflection angle tracking accuracy lies approximately within the 40 μrad range.
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Affiliation(s)
- Dong Luo
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, 518055 Shenzhen, China
| | - Xiaogang Xiong
- School of Mechanical Engineering and Automation, Harbin Institute of Technology (Shenzhen), Shenzhen 518055, China
| | - Wei Chen
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, 518055 Shenzhen, China
| | - Ruining Huang
- School of Mechanical Engineering and Automation, Harbin Institute of Technology (Shenzhen), Shenzhen 518055, China
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Morgan JIW, Chui TYP, Grieve K. Twenty-five years of clinical applications using adaptive optics ophthalmoscopy [Invited]. BIOMEDICAL OPTICS EXPRESS 2023; 14:387-428. [PMID: 36698659 PMCID: PMC9841996 DOI: 10.1364/boe.472274] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/22/2022] [Accepted: 11/27/2022] [Indexed: 05/02/2023]
Abstract
Twenty-five years ago, adaptive optics (AO) was combined with fundus photography, thereby initiating a new era in the field of ophthalmic imaging. Since that time, clinical applications of AO ophthalmoscopy to investigate visual system structure and function in both health and disease abound. To date, AO ophthalmoscopy has enabled visualization of most cell types in the retina, offered insight into retinal and systemic disease pathogenesis, and been integrated into clinical trials. This article reviews clinical applications of AO ophthalmoscopy and addresses remaining challenges for AO ophthalmoscopy to become fully integrated into standard ophthalmic care.
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Affiliation(s)
- Jessica I. W. Morgan
- Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA 19104, USA
- Center for Advanced Retinal and Ocular Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA
- Contributed equally
| | - Toco Y. P. Chui
- Department of Ophthalmology, The New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA
- Contributed equally
| | - Kate Grieve
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, and CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, 28 rue de Charenton, F-75012 Paris, France
- Contributed equally
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Vienola KV, Lejoyeux R, Gofas-Salas E, Snyder VC, Zhang M, Dansingani KK, Sahel JA, Chhablani J, Rossi EA. Autofluorescent hyperreflective foci on infrared autofluorescence adaptive optics ophthalmoscopy in central serous chorioretinopathy. Am J Ophthalmol Case Rep 2022; 28:101741. [PMID: 36345414 PMCID: PMC9636439 DOI: 10.1016/j.ajoc.2022.101741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/12/2022] [Accepted: 10/22/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose To test the hypothesis that hyperreflective foci in central serous chorioretinopathy (CSCR) are autofluorescent and may represent macrophages that have engulfed outer retinal fluorophores from the retinal pigment epithelium (RPE) and photoreceptors. Methods Enrolled subjects underwent spectral domain and swept-source optical coherence tomography, adaptive optics flood-illumination, and adaptive optics scanning laser ophthalmoscopy (AOSLO), including near-infrared autofluorescence (AO-IRAF). For the AO-IRAF imaging, retinal fluorophores were excited using 795 nm light and collected in an emission band from 814 to 850 nm. Results In 2 of 3 eyes, a hyperautofluorescent signal was detected with an elliptical shape and punctate, granular aspects surrounded by a hypoautofluorescent halo. The size of these structures in the active case was measured to be 17 ± 4 μm in diameter, with at least 45 individual hyperautofluorescent foci identified from the AO-IRAF montage in the active stage of patient 2. In the asymptomatic case there were fewer structures visible (∼10) and their size was smaller (11 ± 4 μm). These hyper-AF foci were colocalized with hyperreflective foci on OCT and visible in simultaneously acquired confocal AOSLO images in active stage. The hyperautofluorescent foci in the patient with active CSCR disappeared coincident with clinical resolution. Conclusion and importance We show here the first AO-IRAF images from patients with CSCR, demonstrating hyper-autofluorescent punctate foci, colocalized with hyper-reflective foci on confocal AOSLO images and in OCT. The autofluorescence of these foci may be driven by the accumulation of photoreceptor and RPE fluorophores within macrophages during the active stage of the disease.
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Affiliation(s)
- Kari V. Vienola
- University of Pittsburgh, Department of Ophthalmology, School of Medicine, 4200 Fifth Ave, Pittsburgh, PA, USA
- Corresponding author. Laboratory of Biophysics, Institute of Biomedicine University of Turku Tykistönkatu 6A, Turku, Finland.
| | - Raphael Lejoyeux
- University of Pittsburgh, Department of Ophthalmology, School of Medicine, 4200 Fifth Ave, Pittsburgh, PA, USA
- Rothschild Foundation Hospital, 29 rue Manin, Paris, France
| | - Elena Gofas-Salas
- University of Pittsburgh, Department of Ophthalmology, School of Medicine, 4200 Fifth Ave, Pittsburgh, PA, USA
| | - Valerie C. Snyder
- University of Pittsburgh, Department of Ophthalmology, School of Medicine, 4200 Fifth Ave, Pittsburgh, PA, USA
| | - Min Zhang
- University of Pittsburgh, Department of Ophthalmology, School of Medicine, 4200 Fifth Ave, Pittsburgh, PA, USA
| | - Kunal K. Dansingani
- University of Pittsburgh, Department of Ophthalmology, School of Medicine, 4200 Fifth Ave, Pittsburgh, PA, USA
| | - José-Alain Sahel
- University of Pittsburgh, Department of Ophthalmology, School of Medicine, 4200 Fifth Ave, Pittsburgh, PA, USA
| | - Jay Chhablani
- University of Pittsburgh, Department of Ophthalmology, School of Medicine, 4200 Fifth Ave, Pittsburgh, PA, USA
| | - Ethan A. Rossi
- University of Pittsburgh, Department of Ophthalmology, School of Medicine, 4200 Fifth Ave, Pittsburgh, PA, USA
- University of Pittsburgh, Department of Bioengineering, Swanson School of Engineering, Pittsburgh, PA, USA
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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Kowalczuk L, Dornier R, Kunzi M, Iskandar A, Misutkova Z, Gryczka A, Navarro A, Jeunet F, Mantel I, Behar-Cohen F, Laforest T, Moser C. In Vivo Retinal Pigment Epithelium Imaging using Transscleral Optical Imaging in Healthy Eyes. OPHTHALMOLOGY SCIENCE 2022; 3:100234. [PMID: 36545259 PMCID: PMC9762198 DOI: 10.1016/j.xops.2022.100234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 11/05/2022]
Abstract
Objective To image healthy retinal pigment epithelial (RPE) cells in vivo using Transscleral OPtical Imaging (TOPI) and to analyze statistics of RPE cell features as a function of age, axial length (AL), and eccentricity. Design Single-center, exploratory, prospective, and descriptive clinical study. Participants Forty-nine eyes (AL: 24.03 ± 0.93 mm; range: 21.9-26.7 mm) from 29 participants aged 21 to 70 years (37.1 ± 13.3 years; 19 men, 10 women). Methods Retinal images, including fundus photography and spectral-domain OCT, AL, and refractive error measurements were collected at baseline. For each eye, 6 high-resolution RPE images were acquired using TOPI at different locations, one of them being imaged 5 times to evaluate the repeatability of the method. Follow-up ophthalmic examination was repeated 1 to 3 weeks after TOPI to assess safety. Retinal pigment epithelial images were analyzed with a custom automated software to extract cell parameters. Statistical analysis of the selected high-contrast images included calculation of coefficient of variation (CoV) for each feature at each repetition and Spearman and Mann-Whitney tests to investigate the relationship between cell features and eye and subject characteristics. Main Outcome Measures Retinal pigment epithelial cell features: density, area, center-to-center spacing, number of neighbors, circularity, elongation, solidity, and border distance CoV. Results Macular RPE cell features were extracted from TOPI images at an eccentricity of 1.6° to 16.3° from the fovea. For each feature, the mean CoV was < 4%. Spearman test showed correlation within RPE cell features. In the perifovea, the region in which images were selected for all participants, longer AL significantly correlated with decreased RPE cell density (R Spearman, Rs = -0.746; P < 0.0001) and increased cell area (Rs = 0.668; P < 0.0001), without morphologic changes. Aging was also significantly correlated with decreased RPE density (Rs = -0.391; P = 0.036) and increased cell area (Rs = 0.454; P = 0.013). Lower circular, less symmetric, more elongated, and larger cells were observed in those > 50 years. Conclusions The TOPI technology imaged RPE cells in vivo with a repeatability of < 4% for the CoV and was used to analyze the influence of physiologic factors on RPE cell morphometry in the perifovea of healthy volunteers. Financial Disclosures Proprietary or commercial disclosure may be found after the references.
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Key Words
- AF, autofluorescence
- AL, axial length
- AO, adaptive optics
- Adaptive Optics Transscleral Flood Illumination
- BCVA, best-corrected visual acuity
- CCS, center-to-center spacing
- CoV, coefficient of variation
- D, diopters
- FOV, field of view
- Healthy volunteers
- High resolution retinal imaging
- IOP, intraocular pressure
- NIR, near-infrared
- PRL, preferred retinal locus
- QC, quality criterion
- RE, refractive error
- RPE, retinal pigment epithelium
- Retinal Pigment Epithelium
- SD, standard deviation
- SLO, scanning laser ophthalmoscope
- TOPI, transscleral optical imaging
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Affiliation(s)
- Laura Kowalczuk
- Laboratory of Applied Photonic Devices, School of Engineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland,Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland,Jules-Gonin Eye Hospital, Fondation Asile des aveugles, Lausanne, Switzerland,Correspondence: Laura Kowalczuk, PhD, École Polytechnique Fédérale de Lausanne, School of Engineering, Institute of Electrical and Micro-engineering, Laboratory of Applied Photonics Devices, BM 4127, Station 17, CH-1015, Lausanne, Switzerland.
| | - Rémy Dornier
- Laboratory of Applied Photonic Devices, School of Engineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Mathieu Kunzi
- Laboratory of Applied Photonic Devices, School of Engineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Antonio Iskandar
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland,Jules-Gonin Eye Hospital, Fondation Asile des aveugles, Lausanne, Switzerland
| | - Zuzana Misutkova
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland,Jules-Gonin Eye Hospital, Fondation Asile des aveugles, Lausanne, Switzerland
| | - Aurélia Gryczka
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland,Jules-Gonin Eye Hospital, Fondation Asile des aveugles, Lausanne, Switzerland
| | - Aurélie Navarro
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland,Jules-Gonin Eye Hospital, Fondation Asile des aveugles, Lausanne, Switzerland
| | - Fanny Jeunet
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland,Jules-Gonin Eye Hospital, Fondation Asile des aveugles, Lausanne, Switzerland
| | - Irmela Mantel
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland,Jules-Gonin Eye Hospital, Fondation Asile des aveugles, Lausanne, Switzerland
| | - Francine Behar-Cohen
- Centre de Recherche des Cordeliers, Université Pierre et Marie Curie, Paris, France,INSERM U1138, USPC, Université de Paris-Cité, Sorbonne Université, Paris, France,Assistance Publique - Hôpitaux de Paris, Ophtalmopôle, Cochin Hospital, Paris, France,Université Paris Cité, Paris, France,Hôpital Foch, Suresnes, France
| | - Timothé Laforest
- Laboratory of Applied Photonic Devices, School of Engineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Christophe Moser
- Laboratory of Applied Photonic Devices, School of Engineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
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10
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Vienola KV, Zhang M, Snyder VC, Dansingani KK, Sahel JA, Rossi EA. Near infrared autofluorescence imaging of retinal pigmented epithelial cells using 663 nm excitation. Eye (Lond) 2022; 36:1878-1883. [PMID: 34462582 PMCID: PMC9499940 DOI: 10.1038/s41433-021-01754-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 08/03/2021] [Accepted: 08/18/2021] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Fundus autofluorescence (AF) using adaptive optics scanning laser ophthalmoscopy (AOSLO) enables morphometric analysis of individual retinal pigmented epithelial (RPE) cells. However, only a few excitation wavelengths in the visible and near-infrared have been evaluated. Visible light excitation (<600 nm) presents additional safety hazards and is uncomfortable for patients. Near-infrared excitation (>700 nm) overcomes those problems but introduces others, including decreased AF signal and cone signatures that obscure RPE structure. Here we investigated the use of an intermediate wavelength, 663 nm, for excitation and compared it to 795 nm. METHODS Subjects were imaged using AOSLO equipped with a detection channel to collect AF emission between 814 and 850 nm. Two light sources (663 and 795 nm) were used to excite the retinal fluorophores. We recorded 90 s videos and registered them with custom software to integrate AF images for analysis. RESULTS We imaged healthy eyes and an eye with pattern dystrophy. Similar AF microstructures were detected with each excitation source, despite ~4 times lower excitation power with 663 nm. The signal-to-noise values showed no meaningful difference between 663 nm and 795 nm excitation and a similar trend was observed for image contrast between the two excitation wavelengths. CONCLUSIONS Lower light levels can be used with shorter wavelength excitation to achieve comparable images of the microstructure of the RPE as have been obtained using higher light levels at longer wavelengths. Further experiments are needed to fully characterize AF across spectrum and determine the optimal excitation and emission bandwidths that balance efficiency, patient comfort, and efficacy.
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Affiliation(s)
- Kari V Vienola
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
- Department of Ophthalmology and Vision Science, University of California Davis, Sacramento, CA, USA.
| | - Min Zhang
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Valerie C Snyder
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kunal K Dansingani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - José-Alain Sahel
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ethan A Rossi
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, PA, USA
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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11
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von der Emde L, Vaisband M, Hasenauer J, Bourauel L, Bermond K, Saßmannshausen M, Heintzmann R, Holz FG, Curcio CA, Sloan KR, Ach T. Histologic Cell Shape Descriptors for the Retinal Pigment Epithelium in Age-Related Macular Degeneration: A Comparison to Unaffected Eyes. Transl Vis Sci Technol 2022; 11:19. [PMID: 35984669 PMCID: PMC9419462 DOI: 10.1167/tvst.11.8.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 07/16/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose Phenotype alterations of the retinal pigment epithelium (RPE) are a main characteristic of age-related macular degeneration (AMD). Individual RPE cell shape descriptors may help to delineate healthy from AMD-affected cells in early disease stages. Methods Twenty-two human RPE flatmounts (7 eyes with AMD [early, 3; geographic atrophy, 1; neovascular, 3); 15 unaffected eyes [8 aged ≤51 years; 7 aged >80 years)] were imaged at the fovea, perifovea, and near periphery (predefined sample locations) using a laser-scanning confocal fluorescence microscope. RPE cell boundaries were manually marked with computer assistance. For each cell, 11 shape descriptors were calculated and correlated with donor age, cell autofluorescence (AF) intensity, and retinal location. Statistical analysis was performed using an ensemble classifier based on logistic regression. Results In AMD, RPE was altered at all locations (most pronounced at the fovea), with area, solidity, and form factor being the most discriminatory descriptors. In the unaffected macula, aging had no significant effect on cell shape factors; however, with increasing distance to the fovea, area, solidity, and convexity increased while form factor decreased. Reduced AF in AMD was significantly associated with decreased roundness and solidity. Conclusions AMD results in an altered RPE with enlarged and deformed cells that could precede clinically visible lesions and thus serve as early biomarkers for AMD onset. Our data may also help guide the interpretation of RPE morphology in in vivo studies utilizing high-resolution single-cell imaging. Translational Relevance Our histologic RPE cell shape data have the ability to identify robust biomarkers for the early detection of AMD-affected cells, which also could serve as a basis for automated segmentation of RPE sheets.
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Affiliation(s)
- Leon von der Emde
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
| | - Marc Vaisband
- University of Bonn, Life & Medical Sciences Institute, Bonn, Germany
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center; Salzburg Cancer Research Institute–Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR); Paracelsus Medical University, Salzburg, Austria, Cancer Cluster Salzburg, Austria
| | - Jan Hasenauer
- University of Bonn, Life & Medical Sciences Institute, Bonn, Germany
- Helmholtz Center Munich- German Research Center for Environmental Health, Institute of Computational Biology, Neuherberg, Germany
| | - Leonie Bourauel
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
| | - Katharina Bermond
- Department of Ophthalmology, Ludwigshafen Hospital, Ludwigshafen, Germany
| | | | - Rainer Heintzmann
- Leibniz Institute of Photonic Technology, Jena, Germany
- Institute of Physical Chemistry and Abbe Center of Photonics, Friedrich-Schiller University Jena, Jena, Germany
| | - Frank G. Holz
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
| | - Christine A. Curcio
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, AL, USA
| | - Kenneth R. Sloan
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, AL, USA
| | - Thomas Ach
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
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12
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Kellner S, Weinitz S, Farmand G, Kellner U. Nahinfrarot-Autofluoreszenz: klinische Anwendung und diagnostische Relevanz. AUGENHEILKUNDE UP2DATE 2022. [DOI: 10.1055/a-1810-1314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
ZusammenfassungDie Nahinfrarot-Autofluoreszenz (NIA) ist ein nicht-invasives Verfahren zur Untersuchung des retinalen Pigmentepithels (RPE) basierend auf der Darstellung des antioxidativen Schutzfaktors
Melanin in den RPE-Zellen. Die NIA verbessert die Früherkennung chorioretinaler Erkrankungen, da bei vielen dieser Erkrankungen mit der NIA Strukturveränderungen des RPE nachweisbar sind,
bevor sich in anderen Untersuchungen Krankheitszeichen erkennen lassen.
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13
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Kellner S, Weinitz S, Farmand G, Kellner U. [Near-infrared Fundus Autofluorescence: Clinical Application and Diagnostic Relevance]. Klin Monbl Augenheilkd 2022; 239:1059-1076. [PMID: 35609811 DOI: 10.1055/a-1857-1387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Near-infrared autofluorescence (NIA) is a non-invasive retinal imaging technique for examination of the retinal pigment epithelium (RPE) based on the autofluorescence of melanin. Melanin has several functions within the RPE cells, in one of them it serves as a protective antioxidative factor within the RPE cells and is involved in the phagocytosis of photoreceptor outer segments. Disorders that affect the photoreceptor-RPE complex result in alterations of RPE cells which are detectable by alterations of NIA. Therefore, NIA allows to detect early alterations in inherited and acquired chorioretinal disorders, frequently prior to ophthalmoscopical visualisation and often prior to alterations in lipofuscin associated fundus autofluorescence (FAF) or optical coherence tomography (OCT). Although NIA and FAF relate to disorders affecting the RPE, findings between both imaging methods differ and the area involved has been demonstrated to be larger in NIA compared to FAF in several disorders (e.g., age-related macular degeneration, retinitis pigmentosa, ABCA4-gene associated Stargardt disease and cone-rod dystrophy, light damage), indicating that NIA detects earlier alterations compared to FAF. In addition, due to the absence of blue-light filtering which limits foveal visualisation in FAF, foveal alterations can be much better detected using NIA. A reduced subfoveal NIA intensity is the earliest sign of autosomal dominant BEST1-associated disease, when FAF and OCT are still normal. In other disorders, a normal subfoveal NIA intensity is associated with good visual acuity. This review summarizes the present knowledge on NIA and demonstrates biomarkers for various chorioretinal disorders.
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14
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Baraas RC, Pedersen HR, Knoblauch K, Gilson SJ. Human Foveal Cone and RPE Cell Topographies and Their Correspondence With Foveal Shape. Invest Ophthalmol Vis Sci 2022; 63:8. [PMID: 35113142 PMCID: PMC8819292 DOI: 10.1167/iovs.63.2.8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Purpose To characterize the association between foveal shape and cone and retinal pigment epithelium (RPE) cell topographies in healthy humans. Methods Multimodal adaptive scanning light ophthalmoscopy and optical coherence tomography (OCT) were used to acquire images of foveal cones, RPE cells, and retinal layers in eyes of 23 healthy participants with normal foveas. Distributions of cone and RPE cell densities were fitted with nonlinear mixed-effects models. A linear mixed-effects model was used to examine the relationship between cone and RPE inter-cell distances and foveal shape as obtained from the OCT scans of retinal thickness. Results The best-fit model to the cone densities was a power function with a nasal–temporal asymmetry. There was a significant linear relationship among cone and RPE cell spacing, foveal shape, and foveal cell topography. The model predictions of the central 10° show that the contributions of both the cones and RPE cells are necessary to account for foveal shape. Conclusions The results indicate that there is a strong relationship between cone and RPE cell spacing and the shape of the human adolescent and adult fovea. This finding adds to the existing evidence of the critical role that the RPE serves in fetal foveal development and through adolescence, possibly via the imposition of constraints on the number and distribution of foveal cones.
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Affiliation(s)
- Rigmor C Baraas
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Hilde R Pedersen
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Kenneth Knoblauch
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway.,Stem Cell and Brain Research Institute, INSERM U1208, Bron, France.,Université de Lyon, Lyon, France
| | - Stuart J Gilson
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
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15
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Gofas-Salas E, Rui Y, Mecê P, Zhang M, Snyder VC, Vienola KV, Lee DMW, Sahel JA, Grieve K, Rossi EA. Design of a radial multi-offset detection pattern for in vivo phase contrast imaging of the inner retina in humans. BIOMEDICAL OPTICS EXPRESS 2022; 13:117-132. [PMID: 35154858 PMCID: PMC8803027 DOI: 10.1364/boe.441808] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 11/15/2021] [Accepted: 11/21/2021] [Indexed: 05/06/2023]
Abstract
Previous work has shown that multi-offset detection in adaptive optics scanning laser ophthalmoscopy (AOSLO) can be used to image transparent cells such as retinal ganglion cells (RGCs) in monkeys and humans. Though imaging in anesthetized monkeys with high light levels produced high contrast images of RGCs, images from humans failed to reach the same contrast due to several drawbacks in the previous dual-wavelength multi-offset approach. Our aim here was to design and build a multi-offset detection pattern for humans at safe light levels that could reveal transparent cells in the retinal ganglion cell layer with a contrast and acquisition time approaching results only previously obtained in monkeys. Here, we present a new single-wavelength solution that allows for increased light power and eliminates problematic chromatic aberrations. Then, we demonstrate that a radial multi-offset detection pattern with an offset distance of 8-10 Airy Disk Diameter (ADD) is optimal to detect photons multiply scattered in all directions from weakly reflective retinal cells thereby enhancing their contrast. This new setup and image processing pipeline led to improved imaging of inner retinal cells, including the first images of microglia with multi-offset imaging in AOSLO.
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Affiliation(s)
- Elena Gofas-Salas
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh 15106, USA
- Denotes that each of these authors contributed equally to this work
| | - Yuhua Rui
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh 15106, USA
- Eye center of Xiangya Hospital, Central South University, Hunan Key Laboratory of Ophthalmology, Changsha, Hunan 401302, China
- Denotes that each of these authors contributed equally to this work
| | - Pedro Mecê
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh 15106, USA
| | - Min Zhang
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh 15106, USA
| | - Valerie C. Snyder
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh 15106, USA
| | - Kari V. Vienola
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh 15106, USA
| | - Daniel M. W. Lee
- Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh 15106, USA
| | - José-Alain Sahel
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh 15106, USA
| | | | - Ethan A. Rossi
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh 15106, USA
- Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh 15106, USA
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh 15106, USA
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16
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Vienola KV, Dansingani KK, Eller AW, Martel JN, Snyder VC, Rossi EA. Multimodal Imaging of Torpedo Maculopathy With Fluorescence Adaptive Optics Imaging of Individual Retinal Pigmented Epithelial Cells. Front Med (Lausanne) 2021; 8:769308. [PMID: 34957148 PMCID: PMC8698897 DOI: 10.3389/fmed.2021.769308] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/08/2021] [Indexed: 12/03/2022] Open
Abstract
Torpedo maculopathy (TM) is a rare congenital defect of the retinal pigment epithelium (RPE). The RPE is often evaluated clinically using fundus autofluorescence (AF), a technique that visualizes RPE structure at the tissue level from the intrinsic AF of RPE fluorophores. TM lesions typically emit little or no AF, but this macroscopic assessment is unable to resolve the RPE cells, leaving the organization of the RPE cell mosaic in TM unknown. We used fluorescence adaptive optics scanning laser ophthalmoscopy (AOSLO) to show here for the first time the microscopic cellular-level structural alterations to the RPE cell mosaic in TM that underlie the tissue-level changes seen in conventional clinical imaging. We evaluated two patients with TM using conventional clinical imaging techniques and adaptive optics (AO) infrared autofluorescence (IRAF) in AOSLO. Confocal AOSLO revealed relatively normal cones outside the TM lesion but altered cone appearance within it and along its margins in both patients. We quantified cone topography and RPE cell morphometry from the fovea to the margin of the lesion in case 1 and found cone density to be within the normal range across the locations imaged. However, RPE morphometric analysis revealed disrupted RPE cells outside the margin of the lesion; the mean RPE cell area was greater than two standard deviations above the normative range up to approximately 1.5 mm from the lesion margin. Similar morphometric changes were seen to individual RPE cells in case 2. Multi-modal imaging with AOSLO reveals that RPE cells are abnormal in TM well beyond the margins of the characteristic TM lesion boundary defined with conventional clinical imaging. Since the TM fovea appears to be fully formed, with normal cone packing, it is possible that the congenital RPE defect in TM occurs relatively late in retinal development. This work demonstrates how cellular level imaging of the RPE can provide new insight into RPE pathologies, particularly for rare conditions such as TM.
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Affiliation(s)
- Kari V Vienola
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kunal K Dansingani
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Andrew W Eller
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Joseph N Martel
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Valerie C Snyder
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Ethan A Rossi
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States.,Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, PA, United States.,McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, United States
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17
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Rossi EA, Norberg N, Eandi C, Chaumette C, Kapoor S, Le L, Snyder VC, Martel JN, Gautier J, Gocho K, Dansingani KK, Chhablani J, Arleo A, Mrejen S, Sahel JA, Grieve K, Paques M. A New Method for Visualizing Drusen and Their Progression in Flood-Illumination Adaptive Optics Ophthalmoscopy. Transl Vis Sci Technol 2021; 10:19. [PMID: 34928325 PMCID: PMC8709936 DOI: 10.1167/tvst.10.14.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Drusen are dynamic sub-RPE deposits that are risk factors for late-stage age-related macular degeneration (AMD). Here we show a new imaging method using flood-illumination adaptive optics (FIAO) that reveal drusen with high contrast and resolution. Methods A fovea-centered 4° × 4° FIAO image and eight surrounding images with gaze displaced by ±2° vertically and horizontally were acquired. Clinical color fundus and spectral-domain optical coherence tomography were acquired for clinical grading and comparison. Custom software registered overlapping FIAO images and fused the data statistically to generate a fovea-centered 4° × 4° gaze-dependent image. Our dataset included 15 controls (aged 31-72) and 182 eyes from 104 AMD patients (aged 56-92), graded as either normal aging (n = 7), and early (n = 12), intermediate (n = 108) and late AMD (n = 42); 27 had subretinal drusenoid deposits (SDDs), and 83 were imaged longitudinally. Results No gaze varying structures were detected in young eyes. In aging eyes with no evidence of age-related changes, putative drusen <20 µm in diameter were visible. Gaze-dependent images revealed more drusen and many smaller drusen than visible in color fundus images. Longitudinal images showed expansion and fusion of drusen. SDDs were lower contrast, and RPE atrophy did not yield a consistent signal. Conclusions Gaze-dependent imaging in a commercially available FIAO fundus camera combined with image registration and postprocessing permits visualization of drusen and their progression with high contrast and resolution. Translational Relevance This new technique offers promise as a robust and sensitive method to detect, map, quantify, and monitor the dynamics of drusen in aging and AMD.
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Affiliation(s)
- Ethan A Rossi
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, PA, USA.,McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Nathaniel Norberg
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France and CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, 28 rue de Charenton, F-75012 Paris, France
| | - Chiara Eandi
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France and CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, 28 rue de Charenton, F-75012 Paris, France.,Department of Surgical Science, University of Torino, Turin, Italy
| | - Celine Chaumette
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France and CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, 28 rue de Charenton, F-75012 Paris, France
| | - Saloni Kapoor
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Laura Le
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Valerie C Snyder
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Joseph N Martel
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Josselin Gautier
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France and CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, 28 rue de Charenton, F-75012 Paris, France
| | - Kiyoko Gocho
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France and CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, 28 rue de Charenton, F-75012 Paris, France
| | - Kunal K Dansingani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jay Chhablani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Angelo Arleo
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France and CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, 28 rue de Charenton, F-75012 Paris, France
| | - Sarah Mrejen
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France and CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, 28 rue de Charenton, F-75012 Paris, France
| | - José-Alain Sahel
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France and CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, 28 rue de Charenton, F-75012 Paris, France
| | - Kate Grieve
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France and CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, 28 rue de Charenton, F-75012 Paris, France
| | - Michel Paques
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France and CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, 28 rue de Charenton, F-75012 Paris, France
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18
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Fujita A, Amari T, Ueda K, Azuma K, Inoue T, Komatsu K, Yamamoto M, Aoki N, Yamanari M, Sugiyama S, Aihara M, Kato S, Obata R. Three-Dimensional Distribution Of Fundus Depolarization and Associating Factors Measured Using Polarization-Sensitive Optical Coherence Tomography. Transl Vis Sci Technol 2021; 10:30. [PMID: 34003915 PMCID: PMC7900852 DOI: 10.1167/tvst.10.2.30] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Purpose To investigate the three-dimensional distribution and associating demographic factors of depolarization, using polarization-sensitive optical coherence tomography (PS-OCT), to evaluate melanin pigmentation in the retinal pigment epithelium (RPE) and choroid in healthy eyes. Methods In total, 39 unaffected healthy eyes of 39 subjects were examined using a PS-OCT clinical prototype. The degree of depolarization, expressed as the polarimetric entropy, was assessed in the RPE, the superficial and the total choroid layer, especially in the center, the inner, or the outer areas centered at the fovea. The values and their association with the demographic data were analyzed. Near-infrared fundus autofluorescence (NIRAF) was also used, in the same manner, for the comparison. Twenty-eight of 39 eyes were measured twice to evaluate intrasession repeatability. Results Both the polarimetric entropy in the RPE and the gray level in NIRAF, decreased from the center to the periphery (P < 0.001). The polarimetric entropy in the RPE was significantly associated with age in each area (P ≤ 0.001). In the RPE and the superficial choroid, the polarimetric entropy was negatively associated with axial length in each area (P ≤ 0.002). The intraclass correlation coefficient of the polarimetric entropy in the same session was excellent in each area of the RPE, superficial choroid, or total choroid layer (0.94–0.98). Conclusions The distribution of fundus melanin pigment-related depolarization was evaluated using PS-OCT. The depolarization was associated with the subjects’ demographic data, such as age or axial length. Translational Relevance The presented information in healthy eyes provides an essential basis for the investigation into a variety of chorioretinal pathologies.
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Affiliation(s)
- Asahi Fujita
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan.,Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
| | - Tatsuaki Amari
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan.,Eguchi Eye Hospital, Hakodate, Japan
| | - Kohei Ueda
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
| | - Keiko Azuma
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
| | - Tatsuya Inoue
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan.,Department of Ophthalmology, Yokohama City University Medical Center, Yokohama, Japan
| | - Kayoko Komatsu
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
| | - Motoshi Yamamoto
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
| | | | | | | | - Makoto Aihara
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
| | - Satoshi Kato
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
| | - Ryo Obata
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
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19
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Zhang M, Gofas-Salas E, Leonard BT, Rui Y, Snyder VC, Reecher HM, Mecê P, Rossi EA. Strip-based digital image registration for distortion minimization and robust eye motion measurement from scanned ophthalmic imaging systems. BIOMEDICAL OPTICS EXPRESS 2021; 12:2353-2372. [PMID: 33996234 PMCID: PMC8086453 DOI: 10.1364/boe.418070] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/13/2021] [Accepted: 03/16/2021] [Indexed: 05/22/2023]
Abstract
Retinal image-based eye motion measurement from scanned ophthalmic imaging systems, such as scanning laser ophthalmoscopy, has allowed for precise real-time eye tracking at sub-micron resolution. However, the constraints of real-time tracking result in a high error tolerance that is detrimental for some eye motion measurement and imaging applications. We show here that eye motion can be extracted from image sequences when these constraints are lifted, and all data is available at the time of registration. Our approach identifies and discards distorted frames, detects coarse motion to generate a synthetic reference frame and then uses it for fine scale motion tracking with improved sensitivity over a larger area. We demonstrate its application here to tracking scanning laser ophthalmoscopy (TSLO) and adaptive optics scanning light ophthalmoscopy (AOSLO), and show that it can successfully capture most of the eye motion across each image sequence, leaving only between 0.1-3.4% of non-blink frames untracked, while simultaneously minimizing image distortions induced from eye motion. These improvements will facilitate precise measurement of fixational eye movements (FEMs) in TSLO and longitudinal tracking of individual cells in AOSLO.
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Affiliation(s)
- Min Zhang
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
- Denotes that each of these authors contributed equally to this work
| | - Elena Gofas-Salas
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
- Denotes that each of these authors contributed equally to this work
| | - Bianca T Leonard
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Yuhua Rui
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
- Eye center of Xiangya Hospital, Central South University; Hunan Key Laboratory of Ophthalmology; Changsha, Hunan 410008, China
| | - Valerie C Snyder
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Hope M Reecher
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Pedro Mecê
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Ethan A Rossi
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
- Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, PA 15261, USA
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
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Akondi V, Kowalski B, Burns SA, Dubra A. Dynamic distortion in resonant galvanometric optical scanners. OPTICA 2020; 7:1506-1513. [PMID: 34368405 PMCID: PMC8345821 DOI: 10.1364/optica.405187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
High-speed optical systems are revolutionizing biomedical imaging in microscopy, DNA sequencing, and flow cytometry, as well as numerous other applications, including data storage, display technologies, printing, and autonomous vehicles. These systems often achieve the necessary imaging or sensing speed through the use of resonant galvanometric optical scanners. Here, we show that the optical performance of these devices suffers due to the dynamic mirror distortion that arises from the variation in torque with angular displacement. In one of two scanners tested, these distortions result in a variation of signal-to-noise (Strehl) ratio by an order of magnitude across the field of view, degrading transverse resolution by more than a factor of 2. This mirror distortion could be mitigated through the use of stiffer materials, such as beryllium or silicon carbide, at the expense of surface roughness, as these cannot be polished to the same degree of smoothness as common optical glasses. The repeatability of the dynamic distortion indicates that computational and optical corrective methods are also possible.
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Affiliation(s)
- Vyas Akondi
- Byers Eye Institute, Stanford University, Palo Alto, California 94303, USA
- Corresponding author:
| | | | - Stephen A. Burns
- Indiana University School of Optometry, Bloomington, Indiana 47405, USA
| | - Alfredo Dubra
- Byers Eye Institute, Stanford University, Palo Alto, California 94303, USA
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