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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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Das V, Zhang F, Bower AJ, Li J, Liu T, Aguilera N, Alvisio B, Liu Z, Hammer DX, Tam J. Revealing speckle obscured living human retinal cells with artificial intelligence assisted adaptive optics optical coherence tomography. COMMUNICATIONS MEDICINE 2024; 4:68. [PMID: 38600290 PMCID: PMC11006674 DOI: 10.1038/s43856-024-00483-1] [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: 04/18/2023] [Accepted: 03/13/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND In vivo imaging of the human retina using adaptive optics optical coherence tomography (AO-OCT) has transformed medical imaging by enabling visualization of 3D retinal structures at cellular-scale resolution, including the retinal pigment epithelial (RPE) cells, which are essential for maintaining visual function. However, because noise inherent to the imaging process (e.g., speckle) makes it difficult to visualize RPE cells from a single volume acquisition, a large number of 3D volumes are typically averaged to improve contrast, substantially increasing the acquisition duration and reducing the overall imaging throughput. METHODS Here, we introduce parallel discriminator generative adversarial network (P-GAN), an artificial intelligence (AI) method designed to recover speckle-obscured cellular features from a single AO-OCT volume, circumventing the need for acquiring a large number of volumes for averaging. The combination of two parallel discriminators in P-GAN provides additional feedback to the generator to more faithfully recover both local and global cellular structures. Imaging data from 8 eyes of 7 participants were used in this study. RESULTS We show that P-GAN not only improves RPE cell contrast by 3.5-fold, but also improves the end-to-end time required to visualize RPE cells by 99-fold, thereby enabling large-scale imaging of cells in the living human eye. RPE cell spacing measured across a large set of AI recovered images from 3 participants were in agreement with expected normative ranges. CONCLUSIONS The results demonstrate the potential of AI assisted imaging in overcoming a key limitation of RPE imaging and making it more accessible in a routine clinical setting.
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Affiliation(s)
- Vineeta Das
- National Eye Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Furu Zhang
- National Eye Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Andrew J Bower
- National Eye Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Joanne Li
- National Eye Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Tao Liu
- National Eye Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Nancy Aguilera
- National Eye Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Bruno Alvisio
- National Eye Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Zhuolin Liu
- Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, MD, 20993, USA
| | - Daniel X Hammer
- Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, MD, 20993, USA
| | - Johnny Tam
- National Eye Institute, National Institutes of Health, Bethesda, MD, 20892, USA.
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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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4
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Lindell M, Kar D, Sedova A, Kim YJ, Packer OS, Schmidt-Erfurth U, Sloan KR, Marsh M, Dacey DM, Curcio CA, Pollreisz A. Volumetric Reconstruction of a Human Retinal Pigment Epithelial Cell Reveals Specialized Membranes and Polarized Distribution of Organelles. Invest Ophthalmol Vis Sci 2023; 64:35. [PMID: 38133501 PMCID: PMC10746928 DOI: 10.1167/iovs.64.15.35] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/04/2023] [Indexed: 12/23/2023] Open
Abstract
Purpose Despite the centrality of the retinal pigment epithelium (RPE) in vision and retinopathy our picture of RPE morphology is incomplete. With a volumetric reconstruction of human RPE ultrastructure, we aim to characterize major membranous features including apical processes and their interactions with photoreceptor outer segments, basolateral infoldings, and the distribution of intracellular organelles. Methods A parafoveal retinal sample was acquired from a 21-year-old male organ donor. With serial block-face scanning electron microscopy, a tissue volume from the inner-outer segment junction to basal RPE was captured. Surface membranes and complete internal ultrastructure of an individual RPE cell were achieved with a combination of manual and automated segmentation methods. Results In one RPE cell, apical processes constitute 69% of the total cell surface area, through a dense network of over 3000 terminal branches. Single processes contact several photoreceptors. Basolateral infoldings facing the choriocapillaris resemble elongated filopodia and comprise 22% of the cell surface area. Membranous tubules and sacs of endoplasmic reticulum represent 20% of the cell body volume. A dense basal layer of mitochondria extends apically to partly overlap electron-dense pigment granules. Pores in the nuclear envelope form a distinct pattern of rows aligned with chromatin. Conclusions Specialized membranes at the apical and basal side of the RPE cell body involved in intercellular uptake and transport represent over 90% of the total surface area. Together with the polarized distribution of organelles within the cell body, these findings are relevant for retinal clinical imaging, therapeutic approaches, and disease pathomechanisms.
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Affiliation(s)
- Maximilian Lindell
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
| | - Deepayan Kar
- Department of Ophthalmology and Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Aleksandra Sedova
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
| | - Yeon Jin Kim
- Department of Biological Structure, University of Washington, Seattle, Washington, United States
| | - Orin S. Packer
- Department of Biological Structure, University of Washington, Seattle, Washington, United States
| | | | - Kenneth R. Sloan
- Department of Ophthalmology and Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Mike Marsh
- Object Research Systems, Montreal, Quebec, Canada
| | - Dennis M. Dacey
- Department of Biological Structure, University of Washington, Seattle, Washington, United States
| | - Christine A. Curcio
- Department of Ophthalmology and Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Andreas Pollreisz
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
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5
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Chen S, Abu-Qamar O, Kar D, Messinger JD, Hwang Y, Moult EM, Lin J, Baumal CR, Witkin A, Liang MC, Waheed NK, Curcio CA, Fujimoto JG. Ultrahigh resolution optical coherence tomography markers of normal aging and early age-related macular degeneration. OPHTHALMOLOGY SCIENCE 2023; 3:100277. [PMID: 36970115 PMCID: PMC10034509 DOI: 10.1016/j.xops.2023.100277] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 01/04/2023] [Accepted: 01/26/2023] [Indexed: 02/04/2023]
Abstract
Purpose Ultrahigh resolution spectral domain-OCT (UHR SD-OCT) enables in vivo visualization of micrometric structural markers which differentially associate with normal aging versus age-related macular degeneration (AMD). This study explores the hypothesis that UHR SD-OCT can detect and quantify sub-retinal pigment epithelium (RPE) deposits in early AMD, separating AMD pathology from normal aging. Design Prospective cross-sectional study. Participants A total of 53 nonexudative (dry) AMD eyes from 39 patients, and 63 normal eyes from 39 subjects. Methods Clinical UHR SD-OCT scans were performed using a high-density protocol. Exemplary high-resolution histology and transmission electron microscopy images were obtained from archive donor eyes. Three trained readers evaluated and labeled outer retina morphological features, including the appearance of a hyporeflective split within the RPE-RPE basal lamina (RPE-BL)-Bruch's membrane (BrM) complex on UHR brightness (B)-scans. A semi-automatic segmentation algorithm measured the thickness of the RPE-BL-BrM split/hyporeflective band. Main Outcome Measures Qualitative description of outer retinal morphological changes on UHR SD-OCT B-scans; the proportion of the RPE-BL-BrM complex with visible split (%) and the thickness of the resulting hyporeflective band (μm). Results In young normal eyes, UHR SD-OCT consistently revealed an RPE-BL-BrM split/hyporeflective band. Its visibility and thickness were less in eyes of advanced age. However, the split/hyporeflective band was again visible in early AMD eyes. Both qualitative reading and quantitative thickness measurements showed significantly elevated visibility and thickness of the RPE-BL-BrM split/hyporeflective in early AMD eyes compared to age-matched controls. Conclusions Our imaging results strongly support the hypothesis that appearance of the RPE-BL-BrM split/hyporeflective band in older subjects is dominated by the BL deposit, an indicator of early AMD well known from histology. Ultrahigh resolution SD-OCT can be used to investigate physiological aging as well as early AMD pathology in clinical imaging studies. Developing quantifiable markers associated with disease pathogenesis and progression can facilitate drug discovery, as well as reduce clinical trial times. Financial Disclosures Proprietary or commercial disclosure may be found after the references.
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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: 14] [Impact Index Per Article: 14.0] [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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7
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Liu Z, Zhang F, Zucca K, Agrawal A, Hammer DX. Ultrahigh-speed multimodal adaptive optics system for microscopic structural and functional imaging of the human retina. BIOMEDICAL OPTICS EXPRESS 2022; 13:5860-5878. [PMID: 36733751 PMCID: PMC9872887 DOI: 10.1364/boe.462594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 09/16/2022] [Accepted: 09/20/2022] [Indexed: 05/02/2023]
Abstract
We describe the design and performance of a multimodal and multifunctional adaptive optics (AO) system that combines scanning laser ophthalmoscopy (SLO) and optical coherence tomography (OCT) for simultaneous retinal imaging at 13.4 Hz. The high-speed AO-OCT channel uses a 3.4 MHz Fourier-domain mode-locked (FDML) swept source. The system achieves exquisite resolution and sensitivity for pan-macular and transretinal visualization of retinal cells and structures while providing a functional assessment of the cone photoreceptors. The ultra-high speed also enables wide-field scans for clinical usability and angiography for vascular visualization. The FDA FDML-AO system is a powerful platform for studying various retinal and neurological diseases for vision science research, retina physiology investigation, and biomarker development.
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Affiliation(s)
- Zhuolin Liu
- Center for Devices and Radiological Health
(CDRH), U. S. Food and Drug Administration (FDA), Silver Spring, Maryland 20993, USA
| | - Furu Zhang
- Center for Devices and Radiological Health
(CDRH), U. S. Food and Drug Administration (FDA), Silver Spring, Maryland 20993, USA
- Co-first author
| | - Kelvy Zucca
- Center for Devices and Radiological Health
(CDRH), U. S. Food and Drug Administration (FDA), Silver Spring, Maryland 20993, USA
| | - Anant Agrawal
- Center for Devices and Radiological Health
(CDRH), U. S. Food and Drug Administration (FDA), Silver Spring, Maryland 20993, USA
| | - Daniel X. Hammer
- Center for Devices and Radiological Health
(CDRH), U. S. Food and Drug Administration (FDA), Silver Spring, Maryland 20993, 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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Widespread subclinical cellular changes revealed across a neural-epithelial-vascular complex in choroideremia using adaptive optics. Commun Biol 2022; 5:893. [PMID: 36100689 PMCID: PMC9470576 DOI: 10.1038/s42003-022-03842-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/12/2022] [Indexed: 11/08/2022] Open
Abstract
AbstractChoroideremia is an X-linked, blinding retinal degeneration with progressive loss of photoreceptors, retinal pigment epithelial (RPE) cells, and choriocapillaris. To study the extent to which these layers are disrupted in affected males and female carriers, we performed multimodal adaptive optics imaging to better visualize the in vivo pathogenesis of choroideremia in the living human eye. We demonstrate the presence of subclinical, widespread enlarged RPE cells present in all subjects imaged. In the fovea, the last area to be affected in choroideremia, we found greater disruption to the RPE than to either the photoreceptor or choriocapillaris layers. The unexpected finding of patches of photoreceptors that were fluorescently-labeled, but structurally and functionally normal, suggests that the RPE blood barrier function may be altered in choroideremia. Finally, we introduce a strategy for detecting enlarged cells using conventional ophthalmic imaging instrumentation. These findings establish that there is subclinical polymegathism of RPE cells in choroideremia.
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Abstract
The eye, the photoreceptive organ used to perceive the external environment, is of great importance to humans. It has been proven that some diseases in humans are accompanied by fundus changes; therefore, the health status of people may be interpreted from retinal images. However, the human eye is not a perfect refractive system for the existence of ocular aberrations. These aberrations not only affect the ability of human visual discrimination and recognition, but restrict the observation of the fine structures of human eye and reduce the possibility of exploring the mechanisms of eye disease. Adaptive optics (AO) is a technique that corrects optical wavefront aberrations. Once integrated into ophthalmoscopes, AO enables retinal imaging at the cellular level. This paper illustrates the principle of AO in correcting wavefront aberrations in human eyes, and then reviews the applications and advances of AO in ophthalmology, including the adaptive optics fundus camera (AO-FC), the adaptive optics scanning laser ophthalmoscope (AO-SLO), the adaptive optics optical coherence tomography (AO-OCT), and their combined multimodal imaging technologies. The future development trend of AO in ophthalmology is also prospected.
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11
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Hazim RA, Williams DS. Microtubule Motor Transport of Organelles in a Specialized Epithelium: The RPE. Front Cell Dev Biol 2022; 10:852468. [PMID: 35309899 PMCID: PMC8930850 DOI: 10.3389/fcell.2022.852468] [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: 01/11/2022] [Accepted: 02/01/2022] [Indexed: 11/13/2022] Open
Abstract
The retinal pigment epithelium (RPE) is a uniquely polarized epithelium that lies adjacent to the photoreceptor cells in the retina, and is essential for photoreceptor function and viability. Two major motile organelles present in the RPE are the melanosomes, which are important for absorbing stray light, and phagosomes that result from the phagocytosis of the distal tips of the photoreceptor cilium, known as the photoreceptor outer segment (POS). These organelles are transported along microtubules, aligned with the apical-basal axis of the RPE. Although they undergo a directional migration, the organelles exhibit bidirectional movements, indicating both kinesin and dynein motor function in their transport. Apical melanosome localization requires dynein; it has been suggested that kinesin contribution might be complex with the involvement of more than one type of kinesin. POS phagosomes undergo bidirectional movements; roles of both plus- and minus-end directed motors appear to be important in the efficient degradation of phagosomes. This function is directly related to retinal health, with defects in motor proteins, or in the association of the phagosomes with the motors, resulting in retinal degenerative pathologies.
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Affiliation(s)
- Roni A. Hazim
- Department of Ophthalmology and Stein Eye Institute, Los Angeles, CA, United States
| | - David S. Williams
- Department of Ophthalmology and Stein Eye Institute, Los Angeles, CA, United States
- Department of Neurobiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
- Molecular Biology Institute, University of California, Los Angeles, Los Angeles, CA, United States
- Brain Research Institute, University of California, Los Angeles, Los Angeles, CA, United States
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12
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Cone photoreceptor dysfunction in retinitis pigmentosa revealed by optoretinography. Proc Natl Acad Sci U S A 2021; 118:2107444118. [PMID: 34795055 PMCID: PMC8617487 DOI: 10.1073/pnas.2107444118] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2021] [Indexed: 12/20/2022] Open
Abstract
Many blinding diseases afflict photoreceptors, specialized cells in the retina that capture and transduce light to initiate vision. Biomarkers that are sensitive to photoreceptor health are crucial for early detection and effective treatment monitoring of these diseases yet remain elusive. Here, we develop an optical biomarker, based on optoretinographic photoreceptor responses to light stimulation, that reflects the degree of dysfunction of individual cone photoreceptors in patients with retinitis pigmentosa (RP), the most common inherited retinal degenerative disease. Our results show that this biomarker may be beneficial for assessing the functionality of remaining retinal cells in RP patients and for assessing efficacy of treatments such as gene therapy and stem cell transplantation for RP and other diseases afflicting photoreceptors. Retinitis pigmentosa (RP) is the most common group of inherited retinal degenerative diseases, whose most debilitating phase is cone photoreceptor death. Perimetric and electroretinographic methods are the gold standards for diagnosing and monitoring RP and assessing cone function. However, these methods lack the spatial resolution and sensitivity to assess disease progression at the level of individual photoreceptor cells, where the disease originates and whose degradation causes vision loss. High-resolution retinal imaging methods permit visualization of human cone cells in vivo but have only recently achieved sufficient sensitivity to observe their function as manifested in the cone optoretinogram. By imaging with phase-sensitive adaptive optics optical coherence tomography, we identify a biomarker in the cone optoretinogram that characterizes individual cone dysfunction by stimulating cone cells with flashes of light and measuring nanometer-scale changes in their outer segments. We find that cone optoretinographic responses decrease with increasing RP severity and that even in areas where cone density appears normal, cones can respond differently than those in controls. Unexpectedly, in the most severely diseased patches examined, we find isolated cones that respond normally. Short-wavelength–sensitive cones are found to be more vulnerable to RP than medium- and long-wavelength–sensitive cones. We find that decreases in cone response and cone outer-segment length arise earlier in RP than changes in cone density but that decreases in response and length are not necessarily correlated within single cones.
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13
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Pandiyan VP, Jiang X, Kuchenbecker JA, Sabesan R. Reflective mirror-based line-scan adaptive optics OCT for imaging retinal structure and function. BIOMEDICAL OPTICS EXPRESS 2021; 12:5865-5880. [PMID: 34692221 PMCID: PMC8515964 DOI: 10.1364/boe.436337] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/16/2021] [Accepted: 08/20/2021] [Indexed: 05/06/2023]
Abstract
Line-scan OCT incorporated with adaptive optics (AO) offers high resolution, speed, and sensitivity for imaging retinal structure and function in vivo. Here, we introduce its implementation with reflective mirror-based afocal telescopes, optimized for imaging light-induced retinal activity (optoretinography) and weak retinal reflections at the cellular scale. A non-planar optical design was followed based on previous recommendations with key differences specific to a line-scan geometry. The three beam paths fundamental to an OCT system -illumination/sample, detection, and reference- were modeled in Zemax optical design software to yield theoretically diffraction-limited performance over a 2.2 deg. field-of-view and 1.5 D vergence range at the eye's pupil. The performance for imaging retinal structure was exemplified by cellular-scale visualization of retinal ganglion cells, macrophages, foveal cones, and rods in human observers. The performance for functional imaging was exemplified by resolving the light-evoked optical changes in foveal cone photoreceptors where the spatial resolution was sufficient for cone spectral classification at an eccentricity 0.3 deg. from the foveal center. This enabled the first in vivo demonstration of reduced S-cone (short-wavelength cone) density in the human foveola, thus far observed only in ex vivo histological preparations. Together, the feasibility for high resolution imaging of retinal structure and function demonstrated here holds significant potential for basic science and translational applications.
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Affiliation(s)
- Vimal Prabhu Pandiyan
- Department of Ophthalmology, University of Washington School of Medicine, Seattle, WA 98109, USA
- Co-first authors with equal contribution
| | - Xiaoyun Jiang
- Department of Ophthalmology, University of Washington School of Medicine, Seattle, WA 98109, USA
- Co-first authors with equal contribution
| | - James A Kuchenbecker
- Department of Ophthalmology, University of Washington School of Medicine, Seattle, WA 98109, USA
| | - Ramkumar Sabesan
- Department of Ophthalmology, University of Washington School of Medicine, Seattle, WA 98109, USA
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14
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Cideciyan AV, Krishnan AK, Roman AJ, Sumaroka A, Swider M, Jacobson SG. Measures of Function and Structure to Determine Phenotypic Features, Natural History, and Treatment Outcomes in Inherited Retinal Diseases. Annu Rev Vis Sci 2021; 7:747-772. [PMID: 34255540 DOI: 10.1146/annurev-vision-032321-091738] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Inherited retinal diseases (IRDs) are at the forefront of innovative gene-specific treatments because of the causation by single genes, the availability of microsurgical access for treatment delivery, and the relative ease of quantitative imaging and vision measurement. However, it is not always easy to choose a priori, from scores of potential measures, an appropriate subset to evaluate efficacy outcomes considering the wide range of disease stages with different phenotypic features. This article reviews measurements of visual function and retinal structure that our group has used over the past three decades to understand the natural history of IRDs. We include measures of light sensitivity, retinal structure, mapping of natural fluorophores, evaluation of pupillary light reflex, and oculomotor control. We provide historical context and examples of applicability. We also review treatment trial outcomes using these measures of function and structure. Expected final online publication date for the Annual Review of Vision Science, Volume 7 is September 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Artur V Cideciyan
- Department of Ophthalmology, Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA;
| | - Arun K Krishnan
- Department of Ophthalmology, Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA;
| | - Alejandro J Roman
- Department of Ophthalmology, Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA;
| | - Alexander Sumaroka
- Department of Ophthalmology, Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA;
| | - Malgorzata Swider
- Department of Ophthalmology, Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA;
| | - Samuel G Jacobson
- Department of Ophthalmology, Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA;
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15
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Bower AJ, Liu T, Aguilera N, Li J, Liu J, Lu R, Giannini JP, Huryn LA, Dubra A, Liu Z, Hammer DX, Tam J. Integrating adaptive optics-SLO and OCT for multimodal visualization of the human retinal pigment epithelial mosaic. BIOMEDICAL OPTICS EXPRESS 2021; 12:1449-1466. [PMID: 33796365 PMCID: PMC7984802 DOI: 10.1364/boe.413438] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/29/2021] [Accepted: 01/31/2021] [Indexed: 05/03/2023]
Abstract
In vivo imaging of human retinal pigment epithelial (RPE) cells has been demonstrated through multiple adaptive optics (AO)-based modalities. However, whether consistent and complete information regarding the cellular structure of the RPE mosaic is obtained across these modalities remains uncertain due to limited comparisons performed in the same eye. Here, an imaging platform combining multimodal AO-scanning light ophthalmoscopy (AO-SLO) with AO-optical coherence tomography (AO-OCT) is developed to make a side-by-side comparison of the same RPE cells imaged across four modalities: AO-darkfield, AO-enhanced indocyanine green (AO-ICG), AO-infrared autofluorescence (AO-IRAF), and AO-OCT. Co-registered images were acquired in five subjects, including one patient with choroideremia. Multimodal imaging provided multiple perspectives of the RPE mosaic that were used to explore variations in RPE cell contrast in a subject-, location-, and even cell-dependent manner. Estimated cell-to-cell spacing and density were found to be consistent both across modalities and with normative data. Multimodal images from a patient with choroideremia illustrate the benefit of using multiple modalities to infer the cellular structure of the RPE mosaic in an affected eye, in which disruptions to the RPE mosaic may locally alter the signal strength, visibility of individual RPE cells, or even source of contrast in unpredictable ways.
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Affiliation(s)
- Andrew J. Bower
- National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Tao Liu
- National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Nancy Aguilera
- National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Joanne Li
- National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Jianfei Liu
- National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Rongwen Lu
- National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - John P. Giannini
- National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Laryssa A. Huryn
- National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Alfredo Dubra
- Department of Ophthalmology, Stanford University, Palo Alto, CA 94303, USA
| | - Zhuolin Liu
- Center for Devices and Radiological Health (CDRH), U.S. Food and Drug Administration, 10903 New Hampshire Ave, Silver Spring, MD 20993, USA
| | - Daniel X. Hammer
- Center for Devices and Radiological Health (CDRH), U.S. Food and Drug Administration, 10903 New Hampshire Ave, Silver Spring, MD 20993, USA
| | - Johnny Tam
- National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
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16
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Kurokawa K, Crowell JA, Do N, Lee JJ, Miller DT. Multi-reference global registration of individual A-lines in adaptive optics optical coherence tomography retinal images. JOURNAL OF BIOMEDICAL OPTICS 2021; 26:JBO-200266R. [PMID: 33410310 PMCID: PMC7787477 DOI: 10.1117/1.jbo.26.1.016001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 12/10/2020] [Indexed: 05/18/2023]
Abstract
SIGNIFICANCE Adaptive optics optical coherence tomography (AO-OCT) technology enables non-invasive, high-resolution three-dimensional (3D) imaging of the retina and promises earlier detection of ocular disease. However, AO-OCT data are corrupted by eye-movement artifacts that must be removed in post-processing, a process rendered time-consuming by the immense quantity of data. AIM To efficiently remove eye-movement artifacts at the level of individual A-lines, including those present in any individual reference volume. APPROACH We developed a registration method that cascades (1) a 3D B-scan registration algorithm with (2) a global A-line registration algorithm for correcting torsional eye movements and image scaling and generating global motion-free coordinates. The first algorithm corrects 3D translational eye movements to a single reference volume, accelerated using parallel computing. The second algorithm combines outputs of multiple runs of the first algorithm using different reference volumes followed by an affine transformation, permitting registration of all images to a global coordinate system at the level of individual A-lines. RESULTS The 3D B-scan algorithm estimates and corrects 3D translational motions with high registration accuracy and robustness, even for volumes containing microsaccades. Averaging registered volumes improves our image quality metrics up to 22 dB. Implementation in CUDA™ on a graphics processing unit registers a 512 × 512 × 512 volume in only 10.6 s, 150 times faster than MATLAB™ on a central processing unit. The global A-line algorithm minimizes image distortion, improves regularity of the cone photoreceptor mosaic, and supports enhanced visualization of low-contrast retinal cellular features. Averaging registered volumes improves our image quality up to 9.4 dB. It also permits extending the imaging field of view (∼2.1 × ) and depth of focus (∼5.6 × ) beyond what is attainable with single-reference registration. CONCLUSIONS We can efficiently correct eye motion in all 3D at the level of individual A-lines using a global coordinate system.
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Affiliation(s)
- Kazuhiro Kurokawa
- Indiana University, School of Optometry, Bloomington, Indiana, United States
| | - James A. Crowell
- Indiana University, School of Optometry, Bloomington, Indiana, United States
| | - Nhan Do
- Purdue School of Engineering and Technology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, United States
- Google, Mountain View, California, United States
| | - John J. Lee
- Purdue School of Engineering and Technology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, United States
| | - Donald T. Miller
- Indiana University, School of Optometry, Bloomington, Indiana, United States
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17
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Akyol E, Hagag AM, Sivaprasad S, Lotery AJ. Adaptive optics: principles and applications in ophthalmology. Eye (Lond) 2021; 35:244-264. [PMID: 33257798 PMCID: PMC7852593 DOI: 10.1038/s41433-020-01286-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 10/19/2020] [Accepted: 11/04/2020] [Indexed: 12/26/2022] Open
Abstract
This is a comprehensive review of the principles and applications of adaptive optics (AO) in ophthalmology. It has been combined with flood illumination ophthalmoscopy, scanning laser ophthalmoscopy, as well as optical coherence tomography to image photoreceptors, retinal pigment epithelium (RPE), retinal ganglion cells, lamina cribrosa and the retinal vasculature. In this review, we highlight the clinical studies that have utilised AO to understand disease mechanisms. However, there are some limitations to using AO in a clinical setting including the cost of running an AO imaging service, the time needed to scan patients, the lack of normative databases and the very small size of area imaged. However, it is undoubtedly an exceptional research tool that enables visualisation of the retina at a cellular level.
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Affiliation(s)
- Engin Akyol
- Faculty of Medicine, University of Southampton, Southampton, SO17 1BJ, UK
| | - Ahmed M Hagag
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, EC1V 2PD, UK
- UCL Institute of Ophthalmology, London, EC1V 9EL, UK
| | - Sobha Sivaprasad
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, EC1V 2PD, UK
- UCL Institute of Ophthalmology, London, EC1V 9EL, UK
| | - Andrew J Lotery
- Faculty of Medicine, University of Southampton, Southampton, SO17 1BJ, UK.
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18
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Wynne N, Carroll J, Duncan JL. Promises and pitfalls of evaluating photoreceptor-based retinal disease with adaptive optics scanning light ophthalmoscopy (AOSLO). Prog Retin Eye Res 2020; 83:100920. [PMID: 33161127 DOI: 10.1016/j.preteyeres.2020.100920] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/28/2020] [Accepted: 10/31/2020] [Indexed: 12/15/2022]
Abstract
Adaptive optics scanning light ophthalmoscopy (AOSLO) allows visualization of the living human retina with exquisite single-cell resolution. This technology has improved our understanding of normal retinal structure and revealed pathophysiological details of a number of retinal diseases. Despite the remarkable capabilities of AOSLO, it has not seen the widespread commercial adoption and mainstream clinical success of other modalities developed in a similar time frame. Nevertheless, continued advancements in AOSLO hardware and software have expanded use to a broader range of patients. Current devices enable imaging of a number of different retinal cell types, with recent improvements in stimulus and detection schemes enabling monitoring of retinal function, microscopic structural changes, and even subcellular activity. This has positioned AOSLO for use in clinical trials, primarily as exploratory outcome measures or biomarkers that can be used to monitor disease progression or therapeutic response. AOSLO metrics could facilitate patient selection for such trials, to refine inclusion criteria or to guide the choice of therapy, depending on the presence, absence, or functional viability of specific cell types. Here we explore the potential of AOSLO retinal imaging by reviewing clinical applications as well as some of the pitfalls and barriers to more widespread clinical adoption.
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Affiliation(s)
- Niamh Wynne
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Joseph Carroll
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA; Department of Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA; Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jacque L Duncan
- Department of Ophthalmology, University of California, San Francisco, CA, USA.
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19
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Miller DT, Kurokawa K. Cellular-Scale Imaging of Transparent Retinal Structures and Processes Using Adaptive Optics Optical Coherence Tomography. Annu Rev Vis Sci 2020; 6:115-148. [PMID: 32609578 PMCID: PMC7864592 DOI: 10.1146/annurev-vision-030320-041255] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
High-resolution retinal imaging is revolutionizing how scientists and clinicians study the retina on the cellular scale. Its exquisite sensitivity enables time-lapse optical biopsies that capture minute changes in the structure and physiological processes of cells in the living eye. This information is increasingly used to detect disease onset and monitor disease progression during early stages, raising the possibility of personalized eye care. Powerful high-resolution imaging tools have been in development for more than two decades; one that has garnered considerable interest in recent years is optical coherence tomography enhanced with adaptive optics. State-of-the-art adaptive optics optical coherence tomography (AO-OCT) makes it possible to visualize even highly transparent cells and measure some of their internal processes at all depths within the retina, permitting reconstruction of a 3D view of the living microscopic retina. In this review, we report current AO-OCT performance and its success in visualizing and quantifying these once-invisible cells in human eyes.
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Affiliation(s)
- Donald T Miller
- School of Optometry, Indiana University, Bloomington, Indiana 47405, USA; ,
| | - Kazuhiro Kurokawa
- School of Optometry, Indiana University, Bloomington, Indiana 47405, USA; ,
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20
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Shirazi MF, Brunner E, Laslandes M, Pollreisz A, Hitzenberger CK, Pircher M. Visualizing human photoreceptor and retinal pigment epithelium cell mosaics in a single volume scan over an extended field of view with adaptive optics optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2020; 11:4520-4535. [PMID: 32923061 PMCID: PMC7449740 DOI: 10.1364/boe.393906] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 07/13/2020] [Accepted: 07/17/2020] [Indexed: 05/18/2023]
Abstract
Using adaptive optics optical coherence tomography, human photoreceptors and retinal pigment epithelium (RPE) cells are typically visualized on a small field of view of ∼1° to 2°. In addition, volume averaging is required for visualizing the RPE cell mosaic. To increase the imaging area, we introduce a lens based spectral domain AO-OCT system that shows low aberrations within an extended imaging area of 4°×4° while maintaining a high (theoretical) transverse resolution (at >7 mm pupil diameter) in the order of 2 µm. A new concept for wavefront sensing is introduced that uses light mainly originating from the RPE layer and yields images of the RPE cell mosaic in a single volume acquisition. The capability of the instrument for in vivo imaging is demonstrated by visualizing various cell structures within the posterior retinal layers over an extended field of view.
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Affiliation(s)
- Muhammad Faizan Shirazi
- Center for Medical Physics and Biomedical
Engineering, Medical University of Vienna, Waehringer Guertel 18-20,
A-1090 Vienna, Austria
| | - Elisabeth Brunner
- Center for Medical Physics and Biomedical
Engineering, Medical University of Vienna, Waehringer Guertel 18-20,
A-1090 Vienna, Austria
| | - Marie Laslandes
- ALPAO 727 rue Aristide Bergès 38330
Montbonnot-Saint-Martin, France
| | - Andreas Pollreisz
- Department of Ophthalmology and Optometry,
Medical University of Vienna, Vienna, Waehringer Guertel 18-20, A-1090
Vienna, Austria
| | - Christoph K. Hitzenberger
- Center for Medical Physics and Biomedical
Engineering, Medical University of Vienna, Waehringer Guertel 18-20,
A-1090 Vienna, Austria
| | - Michael Pircher
- Center for Medical Physics and Biomedical
Engineering, Medical University of Vienna, Waehringer Guertel 18-20,
A-1090 Vienna, Austria
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21
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Pollreisz A, Neschi M, Sloan KR, Pircher M, Mittermueller T, Dacey DM, Schmidt-Erfurth U, Curcio CA. Atlas of Human Retinal Pigment Epithelium Organelles Significant for Clinical Imaging. Invest Ophthalmol Vis Sci 2020; 61:13. [PMID: 32648890 PMCID: PMC7425708 DOI: 10.1167/iovs.61.8.13] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 04/27/2020] [Indexed: 02/07/2023] Open
Abstract
Purpose To quantify organelles impacting imaging in the cell body and intact apical processes of human retinal pigment epithelium (RPE), including melanosomes, lipofuscin-melanolipofuscin (LM), mitochondria, and nuclei. Methods A normal perifovea of a 21-year-old white male was preserved after rapid organ recovery. An aligned image stack was generated using serial block-face scanning electron microscopy and was annotated by expert readers (TrakEM, ImageJ). Acquired measures included cell body and nuclear volume (n = 17); organelle count in apical processes (n = 17) and cell bodies (n = 8); distance of cell body organelles along a normalized apical-basal axis (n = 8); and dimensions of organelle-bounding boxes in apical processes in selected subsamples of cell bodies and apical processes. Results In 2661 sections through 17 cells, apical processes contained 65 ± 24 melanosomes in mononucleate (n = 15) and 131 ± 28 in binucleate cells (n = 2). Cell bodies contained 681 ± 153 LM and 734 ± 170 mitochondria. LM was excluded from the basal quartile, and mitochondria from the apical quartile. Lengths of melanosomes, LM, and mitochondria, respectively were 2305 ± 528, 1320 ± 574, and 1195 ± 294 nm. The ratio of cell body to nucleus volume was 4.6 ± 0.4. LM and mitochondria covered 75% and 63%, respectively, of the retinal imaging plane. Conclusions Among RPE signal sources for optical coherence tomography, LM and mitochondria are the most numerous reflective cell body organelles. These and our published data show that most melanosomes are in apical processes. Overlapping LM and previously mitochondria cushions may support multiple reflective bands in cell bodies. This atlas of subcellular reflectivity sources can inform development of advanced optical coherence tomography technologies.
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Affiliation(s)
- Andreas Pollreisz
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
| | - Martina Neschi
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
| | - Kenneth R. Sloan
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
- Department of Computer Science, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Michael Pircher
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | | | - Dennis M. Dacey
- Department of Biologic Structure, University of Washington, Seattle, Washington, United States
| | | | - Christine A. Curcio
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
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22
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Vienola KV, Zhang M, Snyder VC, Sahel JA, Dansingani KK, Rossi EA. Microstructure of the retinal pigment epithelium near-infrared autofluorescence in healthy young eyes and in patients with AMD. Sci Rep 2020; 10:9561. [PMID: 32533046 PMCID: PMC7293312 DOI: 10.1038/s41598-020-66581-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 05/21/2020] [Indexed: 01/18/2023] Open
Abstract
Retinal pigmented epithelial (RPE) cells are essential for maintaining normal visual function, especially in their role in the visual cycle, and are thought to be one of the first cell classes affected by age-related macular degeneration (AMD). Clinical imaging systems routinely evaluate the structure of the RPE at the tissue level, but cellular level information may provide valuable RPE biomarkers of health, aging and disease. In this exploratory study, participants were imaged with 795 nm excitation in adaptive optics scanning laser ophthalmoscopy (AOSLO) to observe the microstructure of the near-infrared autofluorescence (AO-IRAF) from the RPE layer in healthy retinas and patients with AMD. The expected hexagonal mosaic of RPE cells was only sometimes seen in normal eyes, while AMD patients exhibited highly variable patterns of altered AO-IRAF. In some participants, AO-IRAF structure corresponding to cones was observed, as we have demonstrated previously. In some AMD patients, marked alterations in the pattern of AO-IRAF could be seen even in areas where the RPE appeared relatively normal in clinical imaging modalities, such as spectral domain optical coherence tomography (SD-OCT). AO-IRAF imaging using AOSLO offers promise for better detection and understanding of early RPE changes in the course of AMD, potentially before clinical signs appear.
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Affiliation(s)
- Kari V Vienola
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA.
| | - Min Zhang
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - Valerie C Snyder
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - José-Alain Sahel
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - Kunal K Dansingani
- 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, 15213, USA
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23
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Lakkaraju A, Umapathy A, Tan LX, Daniele L, Philp NJ, Boesze-Battaglia K, Williams DS. The cell biology of the retinal pigment epithelium. Prog Retin Eye Res 2020; 78:100846. [PMID: 32105772 PMCID: PMC8941496 DOI: 10.1016/j.preteyeres.2020.100846] [Citation(s) in RCA: 185] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 02/19/2020] [Accepted: 02/23/2020] [Indexed: 02/07/2023]
Abstract
The retinal pigment epithelium (RPE), a monolayer of post-mitotic polarized epithelial cells, strategically situated between the photoreceptors and the choroid, is the primary caretaker of photoreceptor health and function. Dysfunction of the RPE underlies many inherited and acquired diseases that cause permanent blindness. Decades of research have yielded valuable insight into the cell biology of the RPE. In recent years, new technologies such as live-cell imaging have resulted in major advancement in our understanding of areas such as the daily phagocytosis and clearance of photoreceptor outer segment tips, autophagy, endolysosome function, and the metabolic interplay between the RPE and photoreceptors. In this review, we aim to integrate these studies with an emphasis on appropriate models and techniques to investigate RPE cell biology and metabolism, and discuss how RPE cell biology informs our understanding of retinal disease.
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Affiliation(s)
- Aparna Lakkaraju
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, USA
| | - Ankita Umapathy
- Department of Ophthalmology and Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Neurobiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Li Xuan Tan
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, USA
| | - Lauren Daniele
- Department of Biochemistry, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Nancy J Philp
- Department of Pathology, Anatomy and Cell Biology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Kathleen Boesze-Battaglia
- Department of Biochemistry, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David S Williams
- Department of Ophthalmology and Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Neurobiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
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Kurokawa K, Crowell JA, Zhang F, Miller DT. Suite of methods for assessing inner retinal temporal dynamics across spatial and temporal scales in the living human eye. NEUROPHOTONICS 2020; 7:015013. [PMID: 32206680 PMCID: PMC7070771 DOI: 10.1117/1.nph.7.1.015013] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 02/17/2020] [Indexed: 05/08/2023]
Abstract
Significance: There are no label-free imaging descriptors related to physiological activity of inner retinal cells in the living human eye. A major reason is that inner retinal neurons are highly transparent and reflect little light, making them extremely difficult to visualize and quantify. Aim: To measure physiologically-induced optical changes of inner retinal cells despite their challenging optical properties. Approach: We developed an imaging method based on adaptive optics and optical coherence tomography (AO-OCT) and a suite of postprocessing algorithms, most notably a new temporal correlation method. Results: We captured the temporal dynamics of entire inner retinal layers, of specific tissue types, and of individual cells across three different timescales from fast (seconds) to extremely slow (one year). Time correlation analysis revealed significant differences in time constant (up to 0.4 s) between the principal layers of the inner retina with the ganglion cell layer (GCL) being the most dynamic. At the cellular level, significant differences were found between individual GCL somas. The mean time constant of the GCL somas ( 0.69 ± 0.17 s ) was ∼ 30 % smaller than that of nerve fiber bundles and inner plexiform layer synapses and processes. Across longer durations, temporal speckle contrast and time-lapse imaging revealed motion of macrophage-like cells (over minutes) and GCL neuron loss and remodeling (over one year). Conclusions: Physiological activity of inner retinal cells is now measurable in the living human eye.
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Affiliation(s)
- Kazuhiro Kurokawa
- Indiana University, School of Optometry, Bloomington, Indiana, United States
| | - James A. Crowell
- Indiana University, School of Optometry, Bloomington, Indiana, United States
| | - Furu Zhang
- Indiana University, School of Optometry, Bloomington, Indiana, United States
| | - Donald T. Miller
- Indiana University, School of Optometry, Bloomington, Indiana, United States
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