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Ni S, Liang GB, Ng R, Ostmo S, Jia Y, Chiang MF, Huang D, Skalet AH, Young BK, Campbell JP, Jian Y. Panretinal handheld OCT angiography for pediatric retinal imaging. BIOMEDICAL OPTICS EXPRESS 2024; 15:3412-3424. [PMID: 38855676 PMCID: PMC11161374 DOI: 10.1364/boe.520739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 06/11/2024]
Abstract
Comprehensive visualization of retina morphology is essential in the diagnosis and management of retinal diseases in pediatric populations. Conventional imaging techniques often face challenges in effectively capturing the peripheral retina, primarily due to the limitations in current optical designs, which lack the necessary field of view to characterize the far periphery. To address this gap, our study introduces a novel ultra-widefield optical coherence tomography angiography (OCTA) system. This system, specifically tailored for pediatric applications, incorporates an ultrahigh-speed 800 kHz swept-source laser. The system's innovative design achieves a 140° field of view while maintaining excellent optical performance. Over the last 15 months, we have conducted 379 eye examinations on 96 babies using this system. It demonstrates marked efficacy in the diagnosis of retinopathy of prematurity, providing detailed and comprehensive peripheral retinal angiography. The capabilities of the ultra-widefield handheld OCTA system in enhancing the clarity and thoroughness of retina vascularization assessments have significantly improved the precision of diagnoses and the customization of treatment strategies. Our findings underscore the system's potential to advance pediatric ophthalmology and broaden the scope of retinal imaging.
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Affiliation(s)
- Shuibin Ni
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - Guangru Ben Liang
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - Ringo Ng
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Susan Ostmo
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Yali Jia
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - Michael F. Chiang
- National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
- National Library of Medicine, National Institutes of Health, Bethesda, MD 20892, USA
| | - David Huang
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - Alison H. Skalet
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Radiation Medicine, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Benjamin K. Young
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - J. Peter Campbell
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Yifan Jian
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
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2
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Truzzi S, Manns F, Parel JM, Ruggeri M. Handheld contact-type OCT and color fundus system for retinal imaging. BIOMEDICAL OPTICS EXPRESS 2024; 15:2681-2696. [PMID: 38633089 PMCID: PMC11019701 DOI: 10.1364/boe.520735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/21/2024] [Accepted: 03/21/2024] [Indexed: 04/19/2024]
Abstract
We present proof of concept for a handheld contact-type system capable of simultaneous optical coherence tomography (OCT) imaging of the retina and wide-field digital fundus color photography. The study focuses on demonstrating the feasibility of the proposed approach, particularly for eventual use in pediatric patients during examination under anesthesia in the operating room and in the neonatal intensive care unit. Direct contact of the probe with the cornea allows the photographer to maintain a stable position during imaging, reducing motion artifacts in the OCT images. Additionally, it simplifies the alignment process and increases the field of view of the optics. By integrating OCT and fundus imaging into a single device, the proposed compact modular design eliminates the need for separate, space-consuming systems dedicated to each imaging modality.
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Affiliation(s)
- Stefano Truzzi
- Ophthalmic Biophysics Center, Bascom Palmer
Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Engineering “Enzo
Ferrari”, University of Modena and Reggio Emilia, Modena, Italy
| | - Fabrice Manns
- Ophthalmic Biophysics Center, Bascom Palmer
Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL, USA
| | - Jean-Marie Parel
- Ophthalmic Biophysics Center, Bascom Palmer
Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL, USA
- Brien Holden Vision Institute, Sydney, NSW, Australia
| | - Marco Ruggeri
- Ophthalmic Biophysics Center, Bascom Palmer
Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL, USA
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3
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Wijesingha N, Tsai WS, Keskin AM, Holmes C, Kazantzis D, Chandak S, Kubravi H, Sivaprasad S. Optical Coherence Tomography Angiography as a Diagnostic Tool for Diabetic Retinopathy. Diagnostics (Basel) 2024; 14:326. [PMID: 38337841 PMCID: PMC10855126 DOI: 10.3390/diagnostics14030326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 01/29/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
Diabetic retinopathy (DR) is the most common microvascular complication of diabetes mellitus, leading to visual impairment if left untreated. This review discusses the use of optical coherence tomography angiography (OCTA) as a diagnostic tool for the early detection and management of DR. OCTA is a fast, non-invasive, non-contact test that enables the detailed visualisation of the macular microvasculature in different plexuses. OCTA offers several advantages over fundus fluorescein angiography (FFA), notably offering quantitative data. OCTA is not without limitations, including the requirement for careful interpretation of artefacts and the limited region of interest that can be captured currently. We explore how OCTA has been instrumental in detecting early microvascular changes that precede clinical signs of DR. We also discuss the application of OCTA in the diagnosis and management of various stages of DR, including non-proliferative diabetic retinopathy (NPDR), proliferative diabetic retinopathy (PDR), diabetic macular oedema (DMO), diabetic macular ischaemia (DMI), and pre-diabetes. Finally, we discuss the future role of OCTA and how it may be used to enhance the clinical outcomes of DR.
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Affiliation(s)
- Naomi Wijesingha
- UCL Institute of Ophthalmology, London EC1V 9EL, UK;
- Moorfields Eye Hospital, London EC1V 2PD, UK; (W.-S.T.); (A.M.K.); (C.H.); (D.K.); (S.C.); (H.K.)
| | - Wei-Shan Tsai
- Moorfields Eye Hospital, London EC1V 2PD, UK; (W.-S.T.); (A.M.K.); (C.H.); (D.K.); (S.C.); (H.K.)
| | - Ayse Merve Keskin
- Moorfields Eye Hospital, London EC1V 2PD, UK; (W.-S.T.); (A.M.K.); (C.H.); (D.K.); (S.C.); (H.K.)
| | - Christopher Holmes
- Moorfields Eye Hospital, London EC1V 2PD, UK; (W.-S.T.); (A.M.K.); (C.H.); (D.K.); (S.C.); (H.K.)
| | - Dimitrios Kazantzis
- Moorfields Eye Hospital, London EC1V 2PD, UK; (W.-S.T.); (A.M.K.); (C.H.); (D.K.); (S.C.); (H.K.)
| | - Swati Chandak
- Moorfields Eye Hospital, London EC1V 2PD, UK; (W.-S.T.); (A.M.K.); (C.H.); (D.K.); (S.C.); (H.K.)
| | - Heena Kubravi
- Moorfields Eye Hospital, London EC1V 2PD, UK; (W.-S.T.); (A.M.K.); (C.H.); (D.K.); (S.C.); (H.K.)
| | - Sobha Sivaprasad
- UCL Institute of Ophthalmology, London EC1V 9EL, UK;
- Moorfields Eye Hospital, London EC1V 2PD, UK; (W.-S.T.); (A.M.K.); (C.H.); (D.K.); (S.C.); (H.K.)
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4
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Ni S, Nguyen TTP, Ng R, Woodward M, Ostmo S, Jia Y, Chiang MF, Huang D, Skalet AH, Campbell JP, Jian Y. Panretinal Optical Coherence Tomography. IEEE TRANSACTIONS ON MEDICAL IMAGING 2023; 42:3219-3228. [PMID: 37216244 PMCID: PMC10615839 DOI: 10.1109/tmi.2023.3278269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
We introduce a new concept of panoramic retinal (panretinal) optical coherence tomography (OCT) imaging system with a 140° field of view (FOV). To achieve this unprecedented FOV, a contact imaging approach was used which enabled faster, more efficient, and quantitative retinal imaging with measurement of axial eye length. The utilization of the handheld panretinal OCT imaging system could allow earlier recognition of peripheral retinal disease and prevent permanent vision loss. In addition, adequate visualization of the peripheral retina has a great potential for better understanding disease mechanisms regarding the periphery. To the best of our knowledge, the panretinal OCT imaging system presented in this manuscript has the widest FOV among all the retina OCT imaging systems and offers significant values in both clinical ophthalmology and basic vision science.
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5
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Wei F, Hagan K, Viehland C, Tao YK, Kuo AN, Izatt JA, Dhalla AH. Hybrid spiral scanning in a double-clad fiber-based handheld confocal scanning light ophthalmoscope. BIOMEDICAL OPTICS EXPRESS 2023; 14:5162-5181. [PMID: 37854550 PMCID: PMC10581785 DOI: 10.1364/boe.500608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 10/20/2023]
Abstract
High-speed, accessible, and robust in vivo imaging of the human retina is critical for screening of retinal pathologies, such as diabetic retinopathy, age-related macular degeneration, and others. Scanning light ophthalmoscopy (SLO) is a retinal imaging modality that produces digital, en face images of the human retina with superior image gradability rates when compared to the current standard of care in screening for these diseases, namely the flood-illumination handheld fundus camera (HFC). However, current-generation commercial SLO systems are mostly tabletop devices, limiting their accessibility and utility in screening applications. Moreover, most existing SLO systems use raster scan patterns, which are both inefficient and lead to undesired subject gaze drift when used with visible or pseudo-visible illumination. Non-raster scan patterns, especially spiral scanning as described herein, promise advantages in both scan efficiency and reduced subject eye motion. In this work, we introduce a novel "hybrid spiral" scan pattern and the associated hardware design and real-time image reconstruction techniques necessary for its implementation in an SLO system. Building upon this core hybrid spiral scanning SLO (HSS-SLO) technology, we go on to present a complete handheld HSS-SLO system, featuring a fiber-coupled portable patient interface which leverages a dual-clad fiber (DCF) to form a single-path optical topology, thus ensuring mechanically robust co-alignment of illumination and collection apertures, a necessity for a handheld system. The feasibility of HSS-SLO for handheld, in vivo imaging is demonstrated by imaging eight human volunteers.
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Affiliation(s)
- Franklin Wei
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
- Department of Electrical and Computer Engineering, Duke University, Durham, NC 27708, USA
| | - Kristen Hagan
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Christian Viehland
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Yuankai K. Tao
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, USA
| | - Anthony N. Kuo
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
- Department of Ophthalmology, Duke University Medical Center, Durham, NC 27708, USA
| | - Joseph A. Izatt
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
- Department of Electrical and Computer Engineering, Duke University, Durham, NC 27708, USA
- Department of Ophthalmology, Duke University Medical Center, Durham, NC 27708, USA
| | - Al-Hafeez Dhalla
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
- Department of Ophthalmology, Duke University Medical Center, Durham, NC 27708, USA
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6
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Ong J, Zarnegar A, Corradetti G, Singh SR, Chhablani J. Advances in Optical Coherence Tomography Imaging Technology and Techniques for Choroidal and Retinal Disorders. J Clin Med 2022; 11:jcm11175139. [PMID: 36079077 PMCID: PMC9457394 DOI: 10.3390/jcm11175139] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/27/2022] [Accepted: 08/28/2022] [Indexed: 11/16/2022] Open
Abstract
Optical coherence tomography (OCT) imaging has played a pivotal role in the field of retina. This light-based, non-invasive imaging modality provides high-quality, cross-sectional analysis of the retina and has revolutionized the diagnosis and management of retinal and choroidal diseases. Since its introduction in the early 1990s, OCT technology has continued to advance to provide quicker acquisition times and higher resolution. In this manuscript, we discuss some of the most recent advances in OCT technology and techniques for choroidal and retinal diseases. The emerging innovations discussed include wide-field OCT, adaptive optics OCT, polarization sensitive OCT, full-field OCT, hand-held OCT, intraoperative OCT, at-home OCT, and more. The applications of these rising OCT systems and techniques will allow for a closer monitoring of chorioretinal diseases and treatment response, more robust analysis in basic science research, and further insights into surgical management. In addition, these innovations to optimize visualization of the choroid and retina offer a promising future for advancing our understanding of the pathophysiology of chorioretinal diseases.
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Affiliation(s)
- Joshua Ong
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Arman Zarnegar
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Giulia Corradetti
- Department of Ophthalmology, Doheny Eye Institute, Los Angeles, CA 90095, USA
- Stein Eye Institute, David Geffen School of Medicine at the University of California, Los Angeles, CA 90033, USA
| | | | - Jay Chhablani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
- Correspondence:
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7
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Alexopoulos P, Madu C, Wollstein G, Schuman JS. The Development and Clinical Application of Innovative Optical Ophthalmic Imaging Techniques. Front Med (Lausanne) 2022; 9:891369. [PMID: 35847772 PMCID: PMC9279625 DOI: 10.3389/fmed.2022.891369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/23/2022] [Indexed: 11/22/2022] Open
Abstract
The field of ophthalmic imaging has grown substantially over the last years. Massive improvements in image processing and computer hardware have allowed the emergence of multiple imaging techniques of the eye that can transform patient care. The purpose of this review is to describe the most recent advances in eye imaging and explain how new technologies and imaging methods can be utilized in a clinical setting. The introduction of optical coherence tomography (OCT) was a revolution in eye imaging and has since become the standard of care for a plethora of conditions. Its most recent iterations, OCT angiography, and visible light OCT, as well as imaging modalities, such as fluorescent lifetime imaging ophthalmoscopy, would allow a more thorough evaluation of patients and provide additional information on disease processes. Toward that goal, the application of adaptive optics (AO) and full-field scanning to a variety of eye imaging techniques has further allowed the histologic study of single cells in the retina and anterior segment. Toward the goal of remote eye care and more accessible eye imaging, methods such as handheld OCT devices and imaging through smartphones, have emerged. Finally, incorporating artificial intelligence (AI) in eye images has the potential to become a new milestone for eye imaging while also contributing in social aspects of eye care.
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Affiliation(s)
- Palaiologos Alexopoulos
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Chisom Madu
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Gadi Wollstein
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, United States
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY, United States
- Center for Neural Science, College of Arts & Science, New York University, New York, NY, United States
| | - Joel S. Schuman
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, United States
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY, United States
- Center for Neural Science, College of Arts & Science, New York University, New York, NY, United States
- Department of Electrical and Computer Engineering, NYU Tandon School of Engineering, Brooklyn, NY, United States
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8
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Rico-Jimenez JJ, Hu D, Tang EM, Oguz I, Tao YK. Real-time OCT image denoising using a self-fusion neural network. BIOMEDICAL OPTICS EXPRESS 2022; 13:1398-1409. [PMID: 35415003 PMCID: PMC8973187 DOI: 10.1364/boe.451029] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/20/2022] [Accepted: 02/06/2022] [Indexed: 06/07/2023]
Abstract
Optical coherence tomography (OCT) has become the gold standard for ophthalmic diagnostic imaging. However, clinical OCT image-quality is highly variable and limited visualization can introduce errors in the quantitative analysis of anatomic and pathologic features-of-interest. Frame-averaging is a standard method for improving image-quality, however, frame-averaging in the presence of bulk-motion can degrade lateral resolution and prolongs total acquisition time. We recently introduced a method called self-fusion, which reduces speckle noise and enhances OCT signal-to-noise ratio (SNR) by using similarity between from adjacent frames and is more robust to motion-artifacts than frame-averaging. However, since self-fusion is based on deformable registration, it is computationally expensive. In this study a convolutional neural network was implemented to offset the computational overhead of self-fusion and perform OCT denoising in real-time. The self-fusion network was pretrained to fuse 3 frames to achieve near video-rate frame-rates. Our results showed a clear gain in peak SNR in the self-fused images over both the raw and frame-averaged OCT B-scans. This approach delivers a fast and robust OCT denoising alternative to frame-averaging without the need for repeated image acquisition. Real-time self-fusion image enhancement will enable improved localization of OCT field-of-view relative to features-of-interest and improved sensitivity for anatomic features of disease.
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Affiliation(s)
- Jose J. Rico-Jimenez
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, USA
| | - Dewei Hu
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN 37235 USA, USA
| | - Eric M. Tang
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, USA
| | - Ipek Oguz
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN 37235 USA, USA
| | - Yuankai K. Tao
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, USA
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9
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Tang EM, El-Haddad MT, Patel SN, Tao YK. Automated instrument-tracking for 4D video-rate imaging of ophthalmic surgical maneuvers. BIOMEDICAL OPTICS EXPRESS 2022; 13:1471-1484. [PMID: 35414968 PMCID: PMC8973184 DOI: 10.1364/boe.450814] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/07/2022] [Accepted: 02/09/2022] [Indexed: 05/11/2023]
Abstract
Intraoperative image-guidance provides enhanced feedback that facilitates surgical decision-making in a wide variety of medical fields and is especially useful when haptic feedback is limited. In these cases, automated instrument-tracking and localization are essential to guide surgical maneuvers and prevent damage to underlying tissue. However, instrument-tracking is challenging and often confounded by variations in the surgical environment, resulting in a trade-off between accuracy and speed. Ophthalmic microsurgery presents additional challenges due to the nonrigid relationship between instrument motion and instrument deformation inside the eye, image field distortion, image artifacts, and bulk motion due to patient movement and physiological tremor. We present an automated instrument-tracking method by leveraging multimodal imaging and deep-learning to dynamically detect surgical instrument positions and re-center imaging fields for 4D video-rate visualization of ophthalmic surgical maneuvers. We are able to achieve resolution-limited tracking accuracy at varying instrument orientations as well as at extreme instrument speeds and image defocus beyond typical use cases. As proof-of-concept, we perform automated instrument-tracking and 4D imaging of a mock surgical task. Here, we apply our methods for specific applications in ophthalmic microsurgery, but the proposed technologies are broadly applicable for intraoperative image-guidance with high speed and accuracy.
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Affiliation(s)
- Eric M. Tang
- Vanderbilt University, Department of Biomedical Engineering, Nashville, TN 37232, USA
| | - Mohamed T. El-Haddad
- Vanderbilt University, Department of Biomedical Engineering, Nashville, TN 37232, USA
| | - Shriji N. Patel
- Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Yuankai K. Tao
- Vanderbilt University, Department of Biomedical Engineering, Nashville, TN 37232, USA
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10
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Rank EA, Agneter A, Schmoll T, Leitgeb RA, Drexler W. Miniaturizing optical coherence tomography. TRANSLATIONAL BIOPHOTONICS 2022. [DOI: 10.1002/tbio.202100007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Elisabet A. Rank
- Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria
| | - Anja Agneter
- Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria
| | - Tilman Schmoll
- Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria
- Carl Zeiss Meditec, Inc. Dublin California USA
| | - Rainer A. Leitgeb
- Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria
| | - Wolfgang Drexler
- Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria
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11
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Ortiz P, Draelos M, Viehland C, Qian R, McNabb RP, Kuo AN, Izatt JA. Robotically aligned optical coherence tomography with 5 degree of freedom eye tracking for subject motion and gaze compensation. BIOMEDICAL OPTICS EXPRESS 2021; 12:7361-7376. [PMID: 35003839 PMCID: PMC8713666 DOI: 10.1364/boe.443537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/21/2021] [Accepted: 10/26/2021] [Indexed: 05/04/2023]
Abstract
Optical coherence tomography (OCT) has revolutionized diagnostics in ophthalmology. However, OCT requires a trained operator and patient cooperation to carefully align a scanner with the subject's eye and orient it in such a way that it images a desired region of interest at the retina. With the goal of automating this process of orienting and aligning the scanner, we developed a robot-mounted OCT scanner that automatically aligned with the pupil while matching its optical axis with the target region of interest at the retina. The system used two 3D cameras for face tracking and three high-resolution 2D cameras for pupil and gaze tracking. The tracking software identified 5 degrees of freedom for robot alignment and ray aiming through the ocular pupil: 3 degrees of translation (x, y, z) and 2 degrees of orientation (yaw, pitch). We evaluated the accuracy, precision, and range of our tracking system and demonstrated imaging performance on free-standing human subjects. Our results demonstrate that the system stabilized images and that the addition of gaze tracking and aiming allowed for region-of-interest specific alignment at any gaze orientation within a 28° range.
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Affiliation(s)
- Pablo Ortiz
- Department of Biomedical Engineering,
Duke University, Durham, NC 27708, USA
| | - Mark Draelos
- Department of Biomedical Engineering,
Duke University, Durham, NC 27708, USA
| | - Christian Viehland
- Department of Biomedical Engineering,
Duke University, Durham, NC 27708, USA
| | - Ruobing Qian
- Department of Biomedical Engineering,
Duke University, Durham, NC 27708, USA
| | - Ryan P. McNabb
- Department of Ophthalmology,
Duke University, Durham, NC 27708, USA
| | - Anthony N. Kuo
- Department of Biomedical Engineering,
Duke University, Durham, NC 27708, USA
- Department of Ophthalmology,
Duke University, Durham, NC 27708, USA
| | - Joseph A. Izatt
- Department of Biomedical Engineering,
Duke University, Durham, NC 27708, USA
- Department of Ophthalmology,
Duke University, Durham, NC 27708, USA
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12
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Ni S, Nguyen TTP, Ng R, Khan S, Ostmo S, Jia Y, Chiang MF, Huang D, Campbell JP, Jian Y. 105° field of view non-contact handheld swept-source optical coherence tomography. OPTICS LETTERS 2021; 46:5878-5881. [PMID: 34851913 PMCID: PMC10443941 DOI: 10.1364/ol.443672] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 11/03/2021] [Indexed: 06/13/2023]
Abstract
We demonstrate a handheld swept-source optical coherence tomography (OCT) system with a 400 kHz vertical-cavity surface-emitting laser (VCSEL) light source, a non-contact approach, and an unprecedented single shot 105° field of view (FOV). We also implemented a spiral scanning pattern allowing real-time visualization with improved scanning efficiency. To the best of our knowledge, this is the widest FOV achieved in a portable non-contact OCT retinal imaging system to date. Improvements to the FOV may aid the evaluation of retinal diseases such as retinopathy of prematurity, where important vitreoretinal changes often occur in the peripheral retina.
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Affiliation(s)
- Shuibin Ni
- Casey Eye Institute, Oregon Health & Science
University, Portland, Oregon 97239, USA
| | - Thanh-Tin P. Nguyen
- Casey Eye Institute, Oregon Health & Science
University, Portland, Oregon 97239, USA
| | - Ringo Ng
- School of Engineering Science, Simon Fraser University,
Burnaby, British Columbia V5A 1S6, Canada
| | - Shanjida Khan
- Casey Eye Institute, Oregon Health & Science
University, Portland, Oregon 97239, USA
- Department of Biomedical Engineering, Oregon Health &
Science University, Portland, Oregon 97239, USA
| | - Susan Ostmo
- Casey Eye Institute, Oregon Health & Science
University, Portland, Oregon 97239, USA
| | - Yali Jia
- Casey Eye Institute, Oregon Health & Science
University, Portland, Oregon 97239, USA
- Department of Biomedical Engineering, Oregon Health &
Science University, Portland, Oregon 97239, USA
| | - Michael F. Chiang
- National Eye Institute, National Institutes of Health,
Bethesda, Maryland 20892, USA
| | - David Huang
- Casey Eye Institute, Oregon Health & Science
University, Portland, Oregon 97239, USA
- Department of Biomedical Engineering, Oregon Health &
Science University, Portland, Oregon 97239, USA
| | - J. Peter Campbell
- Casey Eye Institute, Oregon Health & Science
University, Portland, Oregon 97239, USA
| | - Yifan Jian
- Casey Eye Institute, Oregon Health & Science
University, Portland, Oregon 97239, USA
- Department of Biomedical Engineering, Oregon Health &
Science University, Portland, Oregon 97239, USA
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Tang EM, Tao YK. Modeling and optimization of galvanometric point-scanning temporal dynamics. BIOMEDICAL OPTICS EXPRESS 2021; 12:6701-6716. [PMID: 34858675 PMCID: PMC8606146 DOI: 10.1364/boe.430586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 09/21/2021] [Accepted: 09/27/2021] [Indexed: 05/02/2023]
Abstract
Galvanometers are ubiquitous in point-scanning applications in optical imaging, display, ranging, manufacturing, and therapeutic technologies. However, galvanometer performance is constrained by finite response times related to mirror size and material properties. We present a model-driven approach for optimizing galvanometer response characteristics by tuning the parameters of the closed-loop galvanometer controller and demonstrate settling time reduction by over 50%. As an imaging proof-of-concept, we implement scan waveforms that take advantage of the optimized galvanometer frequency response to increase linear field-of-view, signal-to-noise ratio, contrast-to-noise ratio, and speed. The hardware methods presented may be directly implemented on galvanometer controllers without the need for specialized equipment and used in conjunction with customized scan waveforms to further optimize scanning performance.
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14
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Leitgeb R, Placzek F, Rank E, Krainz L, Haindl R, Li Q, Liu M, Andreana M, Unterhuber A, Schmoll T, Drexler W. Enhanced medical diagnosis for dOCTors: a perspective of optical coherence tomography. JOURNAL OF BIOMEDICAL OPTICS 2021; 26:JBO-210150-PER. [PMID: 34672145 PMCID: PMC8528212 DOI: 10.1117/1.jbo.26.10.100601] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 09/23/2021] [Indexed: 05/17/2023]
Abstract
SIGNIFICANCE After three decades, more than 75,000 publications, tens of companies being involved in its commercialization, and a global market perspective of about USD 1.5 billion in 2023, optical coherence tomography (OCT) has become one of the fastest successfully translated imaging techniques with substantial clinical and economic impacts and acceptance. AIM Our perspective focuses on disruptive forward-looking innovations and key technologies to further boost OCT performance and therefore enable significantly enhanced medical diagnosis. APPROACH A comprehensive review of state-of-the-art accomplishments in OCT has been performed. RESULTS The most disruptive future OCT innovations include imaging resolution and speed (single-beam raster scanning versus parallelization) improvement, new implementations for dual modality or even multimodality systems, and using endogenous or exogenous contrast in these hybrid OCT systems targeting molecular and metabolic imaging. Aside from OCT angiography, no other functional or contrast enhancing OCT extension has accomplished comparable clinical and commercial impacts. Some more recently developed extensions, e.g., optical coherence elastography, dynamic contrast OCT, optoretinography, and artificial intelligence enhanced OCT are also considered with high potential for the future. In addition, OCT miniaturization for portable, compact, handheld, and/or cost-effective capsule-based OCT applications, home-OCT, and self-OCT systems based on micro-optic assemblies or photonic integrated circuits will revolutionize new applications and availability in the near future. Finally, clinical translation of OCT including medical device regulatory challenges will continue to be absolutely essential. CONCLUSIONS With its exquisite non-invasive, micrometer resolution depth sectioning capability, OCT has especially revolutionized ophthalmic diagnosis and hence is the fastest adopted imaging technology in the history of ophthalmology. Nonetheless, OCT has not been completely exploited and has substantial growth potential-in academics as well as in industry. This applies not only to the ophthalmic application field, but also especially to the original motivation of OCT to enable optical biopsy, i.e., the in situ imaging of tissue microstructure with a resolution approaching that of histology but without the need for tissue excision.
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Affiliation(s)
- Rainer Leitgeb
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, Vienna, Austria
- Medical University of Vienna, Christian Doppler Laboratory OPTRAMED, Vienna, Austria
| | - Fabian Placzek
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, Vienna, Austria
| | - Elisabet Rank
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, Vienna, Austria
| | - Lisa Krainz
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, Vienna, Austria
| | - Richard Haindl
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, Vienna, Austria
| | - Qian Li
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, Vienna, Austria
| | - Mengyang Liu
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, Vienna, Austria
| | - Marco Andreana
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, Vienna, Austria
| | - Angelika Unterhuber
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, Vienna, Austria
| | - Tilman Schmoll
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, Vienna, Austria
- Carl Zeiss Meditec, Inc., Dublin, California, United States
| | - Wolfgang Drexler
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, Vienna, Austria
- Address all correspondence to Wolfgang Drexler,
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15
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Hu D, Cui C, Li H, Larson KE, Tao YK, Oguz I. LIFE: A Generalizable Autodidactic Pipeline for 3D OCT-A Vessel Segmentation. MEDICAL IMAGE COMPUTING AND COMPUTER-ASSISTED INTERVENTION : MICCAI ... INTERNATIONAL CONFERENCE ON MEDICAL IMAGE COMPUTING AND COMPUTER-ASSISTED INTERVENTION 2021; 12901:514-524. [PMID: 34950935 PMCID: PMC8692169 DOI: 10.1007/978-3-030-87193-2_49] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Optical coherence tomography (OCT) is a non-invasive imaging technique widely used for ophthalmology. It can be extended to OCT angiography (OCT-A), which reveals the retinal vasculature with improved contrast. Recent deep learning algorithms produced promising vascular segmentation results; however, 3D retinal vessel segmentation remains difficult due to the lack of manually annotated training data. We propose a learning-based method that is only supervised by a self-synthesized modality named local intensity fusion (LIF). LIF is a capillary-enhanced volume computed directly from the input OCT-A. We then construct the local intensity fusion encoder (LIFE) to map a given OCT-A volume and its LIF counterpart to a shared latent space. The latent space of LIFE has the same dimensions as the input data and it contains features common to both modalities. By binarizing this latent space, we obtain a volumetric vessel segmentation. Our method is evaluated in a human fovea OCT-A and three zebrafish OCT-A volumes with manual labels. It yields a Dice score of 0.7736 on human data and 0.8594 ± 0.0275 on zebrafish data, a dramatic improvement over existing unsupervised algorithms.
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Affiliation(s)
- Dewei Hu
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, USA
| | - Can Cui
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, USA
| | - Hao Li
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, USA
| | - Kathleen E Larson
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Yuankai K Tao
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Ipek Oguz
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, USA
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16
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Ni S, Wei X, Ng R, Ostmo S, Chiang MF, Huang D, Jia Y, Campbell JP, Jian Y. High-speed and widefield handheld swept-source OCT angiography with a VCSEL light source. BIOMEDICAL OPTICS EXPRESS 2021; 12:3553-3570. [PMID: 34221678 PMCID: PMC8221946 DOI: 10.1364/boe.425411] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/14/2021] [Accepted: 05/17/2021] [Indexed: 05/18/2023]
Abstract
Optical coherence tomography (OCT) and OCT angiography (OCTA) enable noninvasive structural and angiographic imaging of the eye. Portable handheld OCT/OCTA systems are required for imaging patients in the supine position. Examples include infants in the neonatal intensive care unit (NICU) and operating room (OR). The speed of image acquisition plays a pivotal role in acquiring high-quality OCT/OCTA images, particularly with the handheld system, since both the operator hand tremor and subject motion can cause significant motion artifacts. In addition, having a large field of view and the ability of real-time data visualization are critical elements in rapid disease screening, reducing imaging time, and detecting peripheral retinal pathologies. The arrangement of optical components is less flexible in the handheld system due to the limitation of size and weight. In this paper, we introduce a 400-kHz, 55-degree field of view handheld OCT/OCTA system that has overcome many technical challenges as a portable OCT system as well as a high-speed OCTA system. We demonstrate imaging premature infants with retinopathy of prematurity (ROP) in the NICU, a patient with incontinentia pigmenti (IP), and a patient with X-linked retinoschisis (XLRS) in the OR using our handheld OCT system. Our design may have the potential for improving the diagnosis of retinal diseases and help provide a practical guideline for designing a flexible and portable OCT system.
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Affiliation(s)
- Shuibin Ni
- Casey Eye Institute, Oregon Health and Science University, Portland, OR 97239, USA
| | - Xiang Wei
- Casey Eye Institute, Oregon Health and Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - Ringo Ng
- Department of Engineering Science, Simon Fraser University, Burnaby, Canada
| | - Susan Ostmo
- Casey Eye Institute, Oregon Health and Science University, Portland, OR 97239, USA
| | - Michael F. Chiang
- National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - David Huang
- Casey Eye Institute, Oregon Health and Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - Yali Jia
- Casey Eye Institute, Oregon Health and Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - J. Peter Campbell
- Casey Eye Institute, Oregon Health and Science University, Portland, OR 97239, USA
| | - Yifan Jian
- Casey Eye Institute, Oregon Health and Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
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17
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Ringel MJ, Tang EM, Tao YK. Advances in multimodal imaging in ophthalmology. Ther Adv Ophthalmol 2021; 13:25158414211002400. [PMID: 35187398 PMCID: PMC8855415 DOI: 10.1177/25158414211002400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 02/23/2021] [Indexed: 12/12/2022] Open
Abstract
Multimodality ophthalmic imaging systems aim to enhance the contrast, resolution, and functionality of existing technologies to improve disease diagnostics and therapeutic guidance. These systems include advanced acquisition and post-processing methods using optical coherence tomography (OCT), combined scanning laser ophthalmoscopy and OCT systems, adaptive optics, surgical guidance, and photoacoustic technologies. Here, we provide an overview of these ophthalmic imaging systems and their clinical and basic science applications.
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Affiliation(s)
- Morgan J. Ringel
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Eric M. Tang
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Yuankai K. Tao
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA
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Sheng A, Lin L, Zhu J, Zhuang J, Li J, Chang L, Cheng H. Micro/nanodevices for assessment and treatment in stomatology and ophthalmology. MICROSYSTEMS & NANOENGINEERING 2021; 7:11. [PMID: 33532080 PMCID: PMC7844113 DOI: 10.1038/s41378-021-00238-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/19/2020] [Accepted: 12/09/2020] [Indexed: 05/09/2023]
Abstract
Micro/nanodevices have been widely applied for the real-time monitoring of intracellular activities and the delivery of exogenous substances in the past few years. This review focuses on miniaturized micro/nanodevices for assessment and treatment in stomatology and ophthalmology. We first summarize the recent progress in this field by examining the available materials and fabrication techniques, device design principles, mechanisms, and biosafety aspects of micro/nanodevices. Following a discussion of biochemical sensing technology from the cellular level to the tissue level for disease assessment, we then summarize the use of microneedles and other micro/nanodevices in the treatment of oral and ocular diseases and conditions, including oral cancer, eye wrinkles, keratitis, and infections. Along with the identified key challenges, this review concludes with future directions as a small fraction of vast opportunities, calling for joint efforts between clinicians and engineers with diverse backgrounds to help facilitate the rapid development of this burgeoning field in stomatology and ophthalmology.
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Affiliation(s)
- An’an Sheng
- The Institute of Single Cell Engineering, Beijing Advanced Innovation Center for Biomedical Engineering; School of Biological Science and Medical Engineering, Beihang University, 100191 Beijing, China
- Department of Stomatology, Xiang’An Hospital of Xiamen University, 361100 Xiamen, China
- School of Stomatology, North China University of Science and Technology, 063210 Tangshan, China
| | - Long Lin
- The Institute of Single Cell Engineering, Beijing Advanced Innovation Center for Biomedical Engineering; School of Biological Science and Medical Engineering, Beihang University, 100191 Beijing, China
- Institute of Plastic Machinery and Plastic Engineering, School of Mechanical and Electrical Engineering, Beijing University of Chemical Technology, 100029 Beijing, China
| | - Jia Zhu
- Department of Engineering Science and Mechanics, Pennsylvania State University, University Park, PA 16802 USA
| | - Jian Zhuang
- Institute of Plastic Machinery and Plastic Engineering, School of Mechanical and Electrical Engineering, Beijing University of Chemical Technology, 100029 Beijing, China
| | - Jian Li
- Department of Stomatology, Xiang’An Hospital of Xiamen University, 361100 Xiamen, China
| | - Lingqian Chang
- The Institute of Single Cell Engineering, Beijing Advanced Innovation Center for Biomedical Engineering; School of Biological Science and Medical Engineering, Beihang University, 100191 Beijing, China
- School of Biomedical Engineering, Research and Engineering Center of Biomedical Materials, Anhui Medical University, 230032 Hefei, China
| | - Huanyu Cheng
- Department of Engineering Science and Mechanics, Pennsylvania State University, University Park, PA 16802 USA
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Pavlatos E, Huang D, Li Y. Eye motion correction algorithm for OCT-based corneal topography. BIOMEDICAL OPTICS EXPRESS 2020; 11:7343-7356. [PMID: 33409001 PMCID: PMC7747916 DOI: 10.1364/boe.412209] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 05/30/2023]
Abstract
With its sequential image acquisition, OCT-based corneal topography is often susceptible to measurement errors due to eye motion. We have developed a novel algorithm to detect eye motion and minimize its impact on OCT topography maps. We applied the eye motion correction algorithm to corneal topographic scans acquired using a 70 kHz spectral-domain OCT device. OCT corneal topographic measurements were compared to those from a rotating Scheimpflug camera topographer. The motion correction algorithm provided a 2-4 fold improvement in the repeatability of OCT topography and its agreement with the standard Scheimpflug topographer. The repeatability of OCT Zernike-based corneal mean power, cardinal astigmatism, and oblique astigmatism after motion detection was 0.14 D, 0.28 D, and 0.24 D, respectively. The average differences between the two devices were 0.19 D for simulated keratometry-based corneal mean power, 0.23 D for cardinal astigmatism, and 0.25 D for oblique astigmatism. Our eye motion detection method can be applied to any OCT device, and it therefore represents a powerful tool for improving OCT topography.
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