High-resolution in-vivo human retinal imaging using full-field OCT with optical stabilization of axial motion

Influence of static and dynamic ocular aberrations on full-field optical coherence tomography for in vivo high-resolution retinal imaging

Under spatially incoherent illumination, time-domain full-field optical coherence tomography (FFOCT) offers the possibility to achieve in vivo retinal imaging at cellular resolution over a wide field of view. Such performance is possible, albeit there is the presence of ocular aberrations even without the use of classical adaptive optics. While the effect of aberrations in FFOCT has been debated these past years, mostly on low-order and static aberrations, we present, for the first time to our knowledge, a method enabling a quantitative study of the effect of statistically representative static and dynamic ocular aberrations on FFOCT image metrics, such as SNR, resolution, and image similarity. While we show that ocular aberrations can decrease FFOCT SNR and resolution by up to 14 dB and fivefold, we take advantage of such quantification to discuss different possible compromises between performance gain and adaptive optics complexity and speed, to optimize both sensor-based and sensorless FFOCT high-resolution retinal imaging.

Head stabilization apparatus for high-resolution ophthalmic imaging

Head movement must be stabilized to enable high-quality data collection from optical instrumentation such as eye trackers and ophthalmic imaging devices. Though critically important for imaging, head stabilization is often an afterthought in the design of advanced ophthalmic imaging systems, and experimental devices often adapt used and/or discarded equipment from clinical devices for this purpose. Alternatively, those seeking the most stable solution possible, including many users of adaptive optics ophthalmoscopy systems, utilize bite bars. Bite bars can provide excellent stability but are time consuming to fabricate, decreasing imaging efficiency, and uncomfortable for many patients, especially the elderly and/or those with prosthodontics such as dentures who may refuse participation in a study that requires one. No commercial vendors specifically offer head mount solutions for experimental ophthalmic imaging devices, resulting in nearly every custom device having a different solution for this commonly encountered problem. Parallelizing the head stabilization apparatus across different custom devices may improve standardization of experimental imaging systems for clinical trials and other multicenter investigations. Here we introduce a head mount design for ophthalmic imaging that is modular, adjustable, and customizable to the constraints of different experimental imaging configurations. The three points of head contact in our solution provide excellent stabilization across a range of head sizes and shapes from small children to adults, and the ease of adjustment afforded by our design minimizes the time to get participants stabilized and comfortable.

Optical tomography in a single camera frame using fringe-encoded deep-learning full-field OCT

Optical coherence tomography is a valuable tool for in vivo examination thanks to its superior combination of axial resolution, field-of-view and working distance. OCT images are reconstructed from several phases that are obtained by modulation/multiplexing of light wavelength or optical path. This paper shows that only one phase (and one camera frame) is sufficient for en face tomography. The idea is to encode a high-frequency fringe patterns into the selected layer of the sample using low-coherence interferometry. These patterns can then be efficiently extracted with a high-pass filter enhanced via deep learning networks to create the tomographic full-field OCT view. This brings 10-fold improvement in imaging speed, considerably reducing the phase errors and incoherent light artifacts related to in vivo movements. Moreover, this work opens a path for low-cost tomography with slow consumer cameras. Optically, the device resembles the conventional time-domain full-field OCT without incurring additional costs or a field-of-view/resolution reduction. The approach is validated by imaging in vivo cornea in human subjects. Open-source and easy-to-follow codes for data generation/training/inference with U-Net/Pix2Pix networks are provided to be used in a variety of image-to-image translation tasks.

Bond-selective full-field optical coherence tomography

Optical coherence tomography (OCT) is a label-free, non-invasive 3D imaging tool widely used in both biological research and clinical diagnosis. Conventional OCT modalities can only visualize specimen tomography without chemical information. Here, we report a bond-selective full-field OCT (BS-FF-OCT), in which a pulsed mid-infrared laser is used to modulate the OCT signal through the photothermal effect, achieving label-free bond-selective 3D sectioned imaging of highly scattering samples. We first demonstrate BS-FF-OCT imaging of 1 µm PMMA beads embedded in agarose gel. Next, we show 3D hyperspectral imaging of up to 75 µm of polypropylene fiber mattress from a standard surgical mask. We then demonstrate BS-FF-OCT imaging on biological samples, including cancer cell spheroids and C. elegans. Using an alternative pulse timing configuration, we finally demonstrate the capability of BS-FF-OCT on imaging a highly scattering myelinated axons region in a mouse brain tissue slice.

Label-free biomedical optical imaging

Label-free optical imaging employs natural and nondestructive approaches for the visualisation of biomedical samples for both biological assays and clinical diagnosis. Currently, this field revolves around multiple broad technology-oriented communities, each with a specific focus on a particular modality despite the existence of shared challenges and applications. As a result, biologists or clinical researchers who require label-free imaging are often not aware of the most appropriate modality to use. This manuscript presents a comprehensive review of and comparison among different label-free imaging modalities and discusses common challenges and applications. We expect this review to facilitate collaborative interactions between imaging communities, push the field forward and foster technological advancements, biophysical discoveries, as well as clinical detection, diagnosis, and monitoring of disease.

High dynamic range 3D motion tracking using circular scans with optical coherence tomography

Motion artifacts, from such sources as heartbeats, respiration, or peristalsis, often degrade microscopic images or videos of live subjects. We have developed a method using circular optical coherence tomography (OCT) scans to track the transverse and axial motion of biological samples at speeds ranging from several micrometers per second to several centimeters per second. We achieve fast and high-precision measurements of the magnitude and direction of the sample's motion by adaptively controlling the circular scan pattern settings and applying interframe and intraframe analyses. These measurements are the basis of active motion compensation via feedback control for future in vivo microscopic and macroscopic imaging applications.

Interface self-referenced dynamic full-field optical coherence tomography

Dynamic full-field optical coherence tomography (D-FFOCT) has recently emerged as an invaluable live label-free and non-invasive imaging modality able to image subcellular biological structures and their metabolic activity within complex 3D samples. However, D-FFOCT suffers from fringe artefacts when imaging near reflective surfaces and is highly sensitive to vibrations. Here, we present interface Self-Referenced (iSR) D-FFOCT, an alternative configuration to D-FFOCT that takes advantage of the presence of the sample coverslip in between the sample and the objective by using it as a defocused reference arm, thus avoiding the aforementioned artefacts. We demonstrate the ability of iSR D-FFOCT to image 2D fibroblast cell cultures, which are among the flattest mammalian cells.

Time-domain full-field optical coherence tomography (TD-FF-OCT) in ophthalmic imaging

Ocular imaging plays an irreplaceable role in the evaluation of eye diseases. Developing cellular-resolution ophthalmic imaging technique for more accurate and effective diagnosis and pathogenesis analysis of ocular diseases is a hot topic in the cross-cutting areas of ophthalmology and imaging. Currently, ocular imaging with traditional optical coherence tomography (OCT) is limited in lateral resolution and thus can hardly resolve cellular structures. Conventional OCT technology obtains ultra-high resolution at the expense of a certain imaging range and cannot achieve full field of view imaging. In the early years, Time-domain full-field OCT (TD-FF-OCT) has been mainly used for ex vivo ophthalmic tissue studies, limited by the low speed and low full-well capacity of existing two-dimensional (2D) cameras. The recent improvements in system design opened new imaging possibilities for in vivo applications thanks to its distinctive optical properties of TD-FF-OCT such as a spatial resolution almost insensitive to aberrations, and the possibility to control the curvature of the optical slice. This review also attempts to look at the future directions of TD-FF-OCT evolution, for example, the potential transfer of the functional-imaging dynamic TD-FF-OCT from the ex vivo into in vivo use and its expected benefit in basic and clinical ophthalmic research. Through non-invasive, wide-field, and cellular-resolution imaging, TD-FF-OCT has great potential to be the next-generation imaging modality to improve our understanding of human eye physiology and pathology.

Effect of fixational eye movements in corneal topography measurements with optical coherence tomography

There is an increasing interest in applying optical coherence tomography (OCT) to quantify the topography of ocular structures. However, in its most usual configuration, OCT data is acquired sequentially while a beam is scanned through the region of interest, and the presence of fixational eye movements can affect the accuracy of the technique. Several scan patterns and motion correction algorithms have been proposed to minimize this effect, but there is no consensus on the ideal parameters to obtain a correct topography. We have acquired corneal OCT images with raster and radial patterns, and modeled the data acquisition in the presence of eye movements. The simulations replicate the experimental variability in shape (radius of curvature and Zernike polynomials), corneal power, astigmatism, and calculated wavefront aberrations. The variability of the Zernike modes is highly dependent on the scan pattern, with higher variability in the direction of the slow scan axis. The model can be a useful tool to design motion correction algorithms and to determine the variability with different scan patterns.

Contactless, autonomous robotic alignment of optical coherence tomography for in vivo evaluation of diseased retinas

During the COVID-19 pandemic, an emphasis was placed on contactless, physical distancing and improved telehealth; contrariwise, standard-of-care ophthalmic imaging of patients required present, trained personnel. Here, we introduce contactless, autonomous robotic alignment of optical coherence tomography (RAOCT) for in vivo imaging of retinal disease and compare measured retinal thickness and diagnostic readability to technician operated clinical OCT. In a powered study, we found no statistically significant difference in retinal thickness in both healthy and diseased retinas (p > 0.7) or across a variety of demographics (gender, race, and age) between RAOCT and clinical OCT. In a secondary study, a retina specialist labeled a given volume as normal/abnormal. Compared to the clinical diagnostic label, sensitivity/specificity for RAOCT were equal or improved over clinical OCT. Contactless, autonomous RAOCT, that improves upon current clinical OCT, could play a role in both ophthalmic care and non-ophthalmic settings that would benefit from improved eye care.

Advances in Optical Coherence Tomography Imaging Technology and Techniques for Choroidal and Retinal Disorders

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.

Label free optical transmission tomography for biosystems: intracellular structures and dynamics

There is an increasing need for label free methods that could reveal intracellular structures and dynamics. In this context, we develop a new optical tomography method working in transmission - full-field optical transmission tomography (FF-OTT). The method can measure the forward scattering signals and reveals the time-dependent metabolic signals in living cells. FF-OTT is a common path interferometer taking advantage of the Gouy phase shift - a π phase shift that the light wave experiences around the focus. By modulating the position of the focus one can alter the phase of the scattered light. Demodulation of images with different phases rejects the background and enhances the light from the depth-of-field, thus producing an optical section. We test FF-OTT by imaging single-cell diatoms and ex vivo biological samples. In fresh samples, we show that the intracellular motions create visible intensity fluctuations in FF-OTT so that the method is able to reveal a metabolic dynamic contrast. FF-OTT was found to be an efficient label free technique that can be readily implemented thanks to a robust common-path speckle-free interferometer design using an incoherent light source.

Characterization and Analysis of Retinal Axial Motion at High Spatiotemporal Resolution and Its Implication for Real-Time Correction in Human Retinal Imaging

High-resolution ophthalmic imaging devices including spectral-domain and full-field optical coherence tomography (SDOCT and FFOCT) are adversely affected by the presence of continuous involuntary retinal axial motion. Here, we thoroughly quantify and characterize retinal axial motion with both high temporal resolution (200,000 A-scans/s) and high axial resolution (4.5 μm), recorded over a typical data acquisition duration of 3 s with an SDOCT device over 14 subjects. We demonstrate that although breath-holding can help decrease large-and-slow drifts, it increases small-and-fast fluctuations, which is not ideal when motion compensation is desired. Finally, by simulating the action of an axial motion stabilization control loop, we show that a loop rate of 1.2 kHz is ideal to achieve 100% robust clinical in-vivo retinal imaging.

Comparison of Cone Mosaic Metrics From Images Acquired With the SPECTRALIS High Magnification Module and Adaptive Optics Scanning Light Ophthalmoscopy

Purpose

To compare cone mosaic metrics derived from adaptive optics scanning light ophthalmoscopy (AOSLO) images with those derived from Heidelberg Engineering SPECTRALIS High Magnification Module (HMM) images.

Methods

Participants with contiguous cone mosaics had HMM imaging performed at locations superior and temporal to the fovea. These images were registered and averaged offline and then aligned to split-detection AOSLO images; 200 × 200-µm regions of interest were extracted from both modalities. Cones were semi-automatically identified by two graders to provide estimates of cone density and spacing.

Results

Thirty participants with contiguous cone mosaics were imaged (10 males, 20 females; age range, 11-67 years). Image quality varied, and 80% of our participants had analyzable HMM images. The intergrader intraclass correlation coefficients for cone metrics were good for both modalities (0.688-0.757 for HMM; 0.805-0.836 for AOSLO). Cone density estimates from HMM images were lower by 2661 cones/mm2 (24.1%) on average compared to AOSLO-derived estimates. Accordingly, HMM estimates of cone spacing were increased on average compared to AOSLO.

Conclusions

The cone mosaic can be visualized in vivo using the SPECTRALIS HMM, although image quality is variable and imaging is not successful in every individual. Metrics extracted from HMM images can differ from those from AOSLO, although excellent agreement is possible in individuals with excellent optical quality and precise co-registration between modalities.

Translational Relevance

Emerging non-adaptive optics-based photoreceptor imaging is more clinically accessible than adaptive optics techniques and has potential to expand high-resolution imaging in a clinical environment.

Present Application and Perspectives of Organoid Imaging Technology

An organoid is a miniaturized and simplified in vitro model with a similar structure and function to a real organ. In recent years, the use of organoids has increased explosively in the field of growth and development, disease simulation, drug screening, cell therapy, etc. In order to obtain necessary information, such as morphological structure, cell function and dynamic signals, it is necessary and important to directly monitor the culture process of organoids. Among different detection technologies, imaging technology is a simple and convenient choice and can realize direct observation and quantitative research. In this review, the principle, advantages and disadvantages of imaging technologies that have been applied in organoids research are introduced. We also offer an overview of prospective technologies for organoid imaging. This review aims to help biologists find appropriate imaging techniques for different areas of organoid research, and also contribute to the development of organoid imaging systems.

Optical phase modulation by natural eye movements: application to time-domain FF-OCT image retrieval

Eye movements are commonly seen as an obstacle to high-resolution ophthalmic imaging. In this context we study the natural axial movements of the in vivo human eye and show that they can be used to modulate the optical phase and retrieve tomographic images via time-domain full-field optical coherence tomography (TD-FF-OCT). This approach opens a path to a simplified ophthalmic TD-FF-OCT device, operating without the usual piezo motor-camera synchronization. The device demonstrates in vivo human corneal images under the different image retrieval schemes (2-phase and 4-phase) and different exposure times (3.5 ms, 10 ms, 20 ms). Data on eye movements, acquired with a spectral-domain OCT with axial eye tracking (180 B-scans/s), are used to study the influence of ocular motion on the probability of capturing high-signal tomographic images without phase washout. The optimal combinations of camera acquisition speed and amplitude of piezo modulation are proposed and discussed.

Partial-field illumination ophthalmoscope: improving the contrast of a camera-based retinal imager

Effective and accurate in vivo diagnosis of retinal pathologies requires high performance imaging devices, combining a large field of view and the ability to discriminate the ballistic signal from the diffuse background in order to provide a highly contrasted image of the retinal structures. Here, we have implemented the partial-field illumination ophthalmoscope, a patterned illumination modality, integrated to a high pixel rate adaptive optics full-field microscope. This non-invasive technique enables us to mitigate the low signal-to-noise ratio, intrinsic of full-field ophthalmoscopes, by partially illuminating the retina with complementary patterns to reconstruct a wide-field image. This new, to the best of our knowledge, modality provides an image contrast spanning from the full-field to the confocal contrast, depending on the pattern size. As a result, it offers various trade-offs in terms of contrast and acquisition speed, guiding the users towards the most efficient system for a particular clinical application.

Multimodal retinal imaging to detect and understand Alzheimer's and Parkinson's disease

Retinal neurodegeneration and visual dysfunctions have been reported in a majority of Alzheimer's and Parkinson's patients, and, in light of the quest for novel biomarkers for these neurodegenerative proteinopathies, the retina has been receiving increasing attention as an organ for diagnosing, monitoring, and understanding disease. Thinning of retinal layers, abnormalities in vasculature, and protein deposition can be imaged at unprecedented resolution, which offers a unique systems biology view on the cellular and molecular changes underlying these pathologies. It makes the retina not only a promising target for biomarker development, but it also suggests that novel fundamental insights into the pathophysiology of Alzheimer's and Parkinson's disease can be obtained by studying the retina-brain axis.

Contactless optical coherence tomography of the eyes of freestanding individuals with a robotic scanner

Clinical systems for optical coherence tomography (OCT) are used routinely to diagnose and monitor patients with a range of ocular diseases. They are large tabletop instruments operated by trained staff, and require mechanical stabilization of the head of the patient for positioning and motion reduction. Here we report the development and performance of a robot-mounted OCT scanner for the autonomous contactless imaging, at safe distances, of the eyes of freestanding individuals without the need for operator intervention or head stabilization. The scanner uses robotic positioning to align itself with the eye to be imaged, as well as optical active scanning to locate the pupil and to attenuate physiological eye motion. We show that the scanner enables the acquisition of OCT volumetric datasets, comparable in quality to those of clinical tabletop systems, that resolve key anatomic structures relevant for the management of common eye conditions. Robotic OCT scanners may enable the diagnosis and monitoring of patients with eye conditions in non-specialist clinics.

Towards distortion-free imaging of the eye

The high power of the eye and optical components used to image it result in "static" distortion, remaining constant across acquired retinal images. In addition, raster-based systems sample points or lines of the image over time, suffering from "dynamic" distortion due to the constant motion of the eye. We recently described an algorithm which corrects for the latter problem but is entirely blind to the former. Here, we describe a new procedure termed "DIOS" (Dewarp Image by Oblique Shift) to remove static distortion of arbitrary type. Much like the dynamic correction method, it relies on locating the same tissue in multiple frames acquired as the eye moves through different gaze positions. Here, the resultant maps of pixel displacement are used to form a sparse system of simultaneous linear equations whose solution gives the common warp seen by all frames. We show that the method successfully handles torsional movement of the eye. We also show that the output of the previously described dynamic correction procedure may be used as input for this new procedure, recovering an image of the tissue that is, in principle, a faithful replica free of any type of distortion. The method could be extended beyond ocular imaging, to any kind of imaging system in which the image can move or be made to move across the detector.

Analysis of the impact of optical aberrations in en-face full-field OCT microscopy

Optical coherence tomography (OCT) is a powerful technique for cross-sectioning imaging. However, the lateral resolution may be degraded by optical aberrations originating from the sample or the setup. We present an extensive quantitative study of the impact of aberrations in time-domain en-face full-field OCT (FFOCT). Using an adaptive optics loop integrated in an FFOCT setup, a deformable mirror is used to introduce low-order calibrated aberrations. The experimental analysis of both the line spread functions (SF) and the complex object images has allowed us to measure the loss in contrast and the impact on lateral spatial resolution. We demonstrate that the frequency content of FFOCT image spectra in terms of signal-to-noise ratio and cutoff frequency is degraded by aberrations but remains much higher than in conventional incoherent images. Line SF profiles in conventional imaging display widening, whereas in FFOCT they display oscillations, leading to the possible perception of preserved resolution. Nevertheless, for complex objects, the aberration image blurring is strong due to the convolution process by the point SF, resulting in a significant filtering of the image spatial spectrum.

Adaptive-glasses time-domain FFOCT for wide-field high-resolution retinal imaging with increased SNR

The highest three-dimensional (3D) resolution possible in in vivo retinal imaging is achieved by combining optical coherence tomography (OCT) and adaptive optics. However, this combination brings important limitations, such as small field-of-view and complex, cumbersome systems, preventing so far the translation of this technology from the research lab to clinics. In this Letter, we mitigate these limitations by combining our compact time-domain full-field OCT (FFOCT) with a multi-actuator adaptive lens positioned just in front of the eye, in a technique we call the adaptive-glasses wavefront sensorless approach. Through this approach, we demonstrate that ocular aberrations can be corrected, increasing the FFOCT signal-to-noise ratio (SNR) and enabling imaging of different retinal layers with a 3D cellular resolution over a 5^∘×5^∘ field-of-view, without apparent anisoplanatism.

Kilohertz retinal FF-SS-OCT and flood imaging with hardware-based adaptive optics

A retinal imaging system was designed for full-field (FF) swept-source (SS) optical coherence tomography (OCT) with cellular resolution. The system incorporates a real-time adaptive optics (AO) subsystem and a very high-speed CMOS sensor, and is capable of acquiring volumetric images of the retina at rates up to 1 kHz. While digital aberration correction (DAC) is an attractive potential alternative to AO, it has not yet been shown to provide resolution allowing visualization of cones in the fovea, where early detection of functional deficits is most critical. Here we demonstrate that FF-SS-OCT with hardware AO permits resolution of foveal cones, imaged at eccentricities of 1° and 2°, with volume rates adequate to measure light-evoked changes in photoreceptors. With the reference arm blocked, the system can operate as a kilohertz AO flood illumination fundus camera with adjustable temporal coherence and is expected to allow measurement of light-evoked changes caused by common path interference in photoreceptor outer segments (OS). In this paper, we describe the system's optical design, characterize its performance, and demonstrate its ability to produce images of the human photoreceptor mosaic.

Coherence gate shaping for wide field high-resolution in vivo retinal imaging with full-field OCT

Allying high-resolution with a large field-of-view (FOV) is of great importance in the fields of biology and medicine, but it is particularly challenging when imaging non-flat living samples such as the human retina. Indeed, high-resolution is normally achieved with adaptive optics (AO) and scanning methods, which considerably reduce the useful FOV and increase the system complexity. An alternative technique is time-domain full-field optical coherence tomography (FF-OCT), which has already shown its potential for in-vivo high-resolution retinal imaging. Here, we introduce coherence gate shaping for FF-OCT, to optically shape the coherence gate geometry to match the sample curvature, thus achieving a larger FOV than previously possible. Using this instrument, we obtained high-resolution images of living human photoreceptors close to the foveal center without AO and with a 1 mm × 1 mm FOV in a single shot. This novel advance enables the extraction of photoreceptor-based biomarkers with ease and spatiotemporal monitoring of individual photoreceptors. We compare our findings with AO-assisted ophthalmoscopes, highlighting the potential of FF-OCT, as a compact system, to become a routine clinical imaging technique.

Optical Incoherence Tomography: a method to generate tomographic retinal cross-sections with non-interferometric adaptive optics ophthalmoscopes

We present Optical Incoherence Tomography (OIT): a completely digital method to generate tomographic retinal cross-sections from en-face through-focus image stacks acquired by non-interferometric imaging systems, such as en-face adaptive optics (AO)-ophthalmoscopes. We demonstrate that OIT can be applied to different imaging modalities using back-scattered light, including systems without inherent optical sectioning and, for the first time, multiply-scattered light, revealing a distinctive cross-sectional view of the retina. The axial dimension of OIT cross-sections is given in terms of focus position rather than optical path, as in OCT. We explore this property to guide focus position in cases where the user is "blind" focusing, allowing precise plane selection for en-face imaging of retinal pigment epithelium, the vascular plexuses and translucent retinal neurons, such as photoreceptor inner segments and retinal ganglion cells, using respectively autofluorescence, motion contrast and split detection techniques.

In vivo imaging of the human cornea with high-speed and high-resolution Fourier-domain full-field optical coherence tomography

Corneal evaluation in ophthalmology necessitates cellular-resolution and fast imaging techniques that allow for accurate diagnoses. Currently, the fastest volumetric imaging technique is Fourier-domain full-field optical coherence tomography (FD-FF-OCT), which uses a fast camera and a rapidly tunable laser source. Here, we demonstrate high-resolution, high-speed, non-contact corneal volumetric imaging in vivo with FD-FF-OCT that can acquire a single 3D volume with a voxel rate of 7.8 GHz. The spatial coherence of the laser source was suppressed to prevent it from focusing on a spot on the retina, and therefore, exceeding the maximum permissible exposure (MPE). The inherently volumetric nature of FD-FF-OCT data enabled flattening of curved corneal layers. The acquired FD-FF-OCT images revealed corneal cellular structures, such as epithelium, stroma and endothelium, as well as subbasal and mid-stromal nerves.