Human graft cornea and laser incisions imaging with micrometer scale resolution full-field optical coherence tomography

Optical coherence tomography modeling incorporating scattering, absorption, and multiple reflections

A direct scattering optical coherence tomography forward model was developed to simulate A-scans for both idealized and real light sources on an arbitrary given sample structure. Previous models neglected absorption, scattering, and multiple reflections at interfacial layers, and so two extended models were developed to investigate the impact of these processes. The first model uses the Beer-Lambert law to incorporate both absorption and scattering optical processes, and the second model uses a recursive form to model multiple reflections. These models were tested on a structure representative of a multilayered skin sample. The results show that the absorption and scattering processes have significant impact on the height of the peaks in the simulated A-scans. Conversely, the incorporation of multiple reflections has very little impact on the height of these peaks. Neither of the above processes has any impact on the locations of the A-scan peaks, which are associated with the sample interfaces between layers.

Characterization of Corneal Donor Tissue Lesions by Anterior Segment Optical Coherence Tomography Compared With Eye Bank Technician Slit-Lamp Examination

PURPOSE

To compare anterior segment spectral-domain optical coherence tomography (OCT) with eye bank technician slit-lamp examination (SLE) in characterizing lesions in donor corneas.

METHODS

Twenty-nine donor corneas identified by eye bank technicians to have opacities or lesions potentially representing pathologic findings affecting the stroma were evaluated through the use of technician SLE, SLE photography, and OCT. Technicians were tasked with describing the lesion, estimating the lesion depth, and photographing their SLE findings. A masked grader evaluated the OCT images and measured the lesion depth using customized software. The lesions identified on OCT were then compared with those identified on SLE.

RESULTS

A total of 37 lesions were detected on SLE; 25 of the 37 lesions identified on SLE were matched to a lesion on OCT. SLE and OCT depth measurements were statistically significantly different (P = 0.0042, mean difference 4.8% ± 6.5%), and OCT graded lesions as slightly deeper. Of the 12 out of the 37 lesions that were noted on SLE (but not identified on OCT), these included 2 central and paracentral anterior stromal lesions (OCT showed loose epithelium), 5 peripheral anterior stromal lesions, and 5 corneas with LASIK.

CONCLUSIONS

Our study highlights both advantages and limitations of OCT compared with technician SLE in the evaluation of donor corneal tissue. Although OCT may miss some peripheral lesions and LASIK scars that are identifiable on SLE, OCT's depth resolution is helpful in differentiating whether shallow anterior opacities actually extend deeper into the stroma or are confined superficially to the epithelium.

New parameters in assessment of human donor corneal stroma

PURPOSE

To provide quantitative parameters for assessment of human donor corneal stroma by imaging stromal features of diseased and normal human corneas with full-field optical coherence microscopy (FFOCM), using confocal microscopy (CM) and histology as reference techniques.

METHODS

Bowman's layer (BL) thickness and keratocyte density were assessed ex vivo in 23 human donor corneas and 27 human pathological corneas (keratoconus and other corneal disorders) with FFOCM, CM and histology. Stromal backscattering was assessed with FFOCM. Additionally, 10 normal human corneas were assessed in vivo with CM.

RESULTS

In FFOCM, the logarithm of the normalized stromal reflectivity was a linear function of stromal depth (R²  = 0.95) in human donor corneas. Compared with keratoconus corneas, human donor corneas featured higher BL thickness (p = 0.0014) with lower coefficient of variation (BL-COV; p = 0.0002), and linear logarithmic stromal reflectivity with depth (higher R² , p = 0.0001). Compared with other corneal disorders, human donor corneas featured lower BL-COV (p = 0.012) and higher R² (p = 0.0001). Using the 95% confidence limits of the human donor cornea group, BL thickness < 6.5 μm (sensitivity, 57%; specificity, 100%), BL-COV > 18.6% (79%; 100%) and R²  < 0.94 (93%; 71%) were revealed as indictors of abnormal cornea. In CM, keratocyte density decreased with stromal depth (r = -0.56). The mean overall keratocyte density (cells/mm² ) was 205 in human donor corneas, 244 in keratoconus, 176 in other corneal disorders and 386 in normal corneas.

CONCLUSION

Full-field optical coherence microscopy (FFOCM) provides precise and reliable parameters for non-invasive assessment of human donor corneal stroma during storage, enabling detection of stromal disorders that could impair the results of keratoplasty.

Femtosecond laser bone ablation with a high repetition rate fiber laser source

Femtosecond laser pulses can be used to perform very precise cutting of material, including biological samples from subcellular organelles to large areas of bone, through plasma-mediated ablation. The use of a kilohertz regenerative amplifier is usually needed to obtain the pulse energy required for ablation. This work investigates a 5 megahertz compact fiber laser for near-video rate imaging and ablation in bone. After optimization of ablation efficiency and reduction in autofluorescence, the system is demonstrated for the in vivo study of bone regeneration. Image-guided creation of a bone defect and longitudinal evaluation of cellular injury response in the defect provides insight into the bone regeneration process.

Hyperglycemia-induced abnormalities in rat and human corneas: the potential of second harmonic generation microscopy

Background

Second Harmonic Generation (SHG) microscopy recently appeared as an efficient optical imaging technique to probe unstained collagen-rich tissues like cornea. Moreover, corneal remodeling occurs in many diseases and precise characterization requires overcoming the limitations of conventional techniques. In this work, we focus on diabetes, which affects hundreds of million people worldwide and most often leads to diabetic retinopathy, with no early diagnostic tool. This study then aims to establish the potential of SHG microscopy for in situ detection and characterization of hyperglycemia-induced abnormalities in the Descemet’s membrane, in the posterior cornea.

Methodology/Principal Findings

We studied corneas from age-matched control and Goto-Kakizaki rats, a spontaneous model of type 2 diabetes, and corneas from human donors with type 2 diabetes and without any diabetes. SHG imaging was compared to confocal microscopy, to histology characterization using conventional staining and transmitted light microscopy and to transmission electron microscopy. SHG imaging revealed collagen deposits in the Descemet’s membrane of unstained corneas in a unique way compared to these gold standard techniques in ophthalmology. It provided background-free images of the three-dimensional interwoven distribution of the collagen deposits, with improved contrast compared to confocal microscopy. It also provided structural capability in intact corneas because of its high specificity to fibrillar collagen, with substantially larger field of view than transmission electron microscopy. Moreover, in vivo SHG imaging was demonstrated in Goto-Kakizaki rats.

Conclusions/Significance

Our study shows unambiguously the high potential of SHG microscopy for three-dimensional characterization of structural abnormalities in unstained corneas. Furthermore, our demonstration of in vivo SHG imaging opens the way to long-term dynamical studies. This method should be easily generalized to other structural remodeling of the cornea and SHG microscopy should prove to be invaluable for in vivo corneal pathological studies.

Label-Free, Longitudinal Visualization of PDT Response In Vitro with Optical Coherence Tomography

A major challenge in creating and optimizing therapeutics in the fight against cancer is visualizing and understanding the microscale spatiotemporal treatment response dynamics that occur in patients. This is especially true for photodynamic therapy (PDT), where therapeutic optimization relies on understanding the interplay between factors such as photosensitizer localization and uptake, in addition to light dose and delivery rate. In vitro 3D culture systems that recapitulate many of the biological features of human disease are powerful platforms for carrying out detailed studies on PDT response and resistance. Current techniques for visualizing these models, however, often lack accuracy due to the perturbative nature of the sample preparation, with light attenuation complicating the study of intact models. Optical coherence tomography (OCT) is an ideal method for the long-term, non-perturbative study of in vitro models and their response to PDT. Monitoring the response of 3D models to PDT by time-lapse OCT methods promises to provide new perspectives and open the way to cancer treatment methodologies that can be translated towards the clinic.

Light scattering from edematous human corneal grafts' microstructure: experimental study and electromagnetic modelization

Along with the lens, the cornea is the only transparent tissue in the human body. However, the development of an edema involves structural disturbances increasing light scattering and leading to the opacification of the cornea. Several mechanisms of transparency loss have been studied in the literature, but the whole phenomenon is complex and the part played by each scatterer is still unclear. We propose here to study human corneal grafts combining microscopic OCT imagery with far-field measurement of the scattered light in the reflected half-space. We introduce afterwards numerical calculations based on electromagnetic equations solved with first order approximation to link the observed microscopic-scale structural modifications with the intensity level of the scattered light, and to try and quantify the relationship between them.

In vivo structural imaging of the cornea by polarization-resolved second harmonic microscopy

The transparency and mechanical strength of the cornea are related to the highly organized three-dimensional distribution of collagen fibrils. It is of great interest to develop specific and contrasted in vivo imaging tools to probe these collagenous structures, which is not available yet. Second Harmonic Generation (SHG) microscopy is a unique tool to reveal fibrillar collagen within unstained tissues, but backward SHG images of cornea fail to reveal any spatial features due to the nanometric diameter of stromal collagen fibrils. To overcome this limitation, we performed polarization-resolved SHG imaging, which is highly sensitive to the sub-micrometer distribution of anisotropic structures. Using advanced data processing, we successfully retrieved the orientation of the collagenous fibrils at each depth of human corneas, even in backward SHG homogenous images. Quantitative information was also obtained about the submicrometer heterogeneities of the fibrillar collagen distribution by measuring the SHG anisotropy. All these results were consistent with numerical simulation of the polarization-resolved SHG response of cornea. Finally, we performed in vivo SHG imaging of rat corneas and achieved structural imaging of corneal stroma without any labeling. Epi-detected polarization-resolved SHG imaging should extend to other organs and become a new diagnosis tool for collagen remodeling.

Interfaces detection after corneal refractive surgery by low coherence optical interferometry

The detection of refractive corneal surgery by LASIK, during the storage of corneas in Eye Banks will become a challenge when the numerous operated patients will arrive at the age of cornea donation. The subtle changes of corneal structure and refraction are highly suspected to negatively influence clinical results in recipients of such corneas. In order to detect LASIK cornea interfaces we developed a low coherence interferometry technique using a broadband continuum source. Real time signal recording, without moving any optical elements and without need of a Fourier Transform operation, combined with good measurement resolution is the main asset of this interferometer. The associated numerical processing is based on a method initially used in astronomy and offers an optimal correlation signal without the necessity to image the whole cornea that is time consuming. The detection of corneal interfaces - both outer and inner surface and the buried interface corresponding to the surgical wound - is then achieved directly by the innovative combination of interferometry and this original numerical process.