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Ni S, Khan S, Jiménez-Villar A, Pennesi ME, Huang D, Jian Y, Chen S. Optical Assessment of Photoreceptor Function Over the Macula. Transl Vis Sci Technol 2024; 13:41. [PMID: 39186303 PMCID: PMC11361383 DOI: 10.1167/tvst.13.8.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 07/03/2024] [Indexed: 08/27/2024] Open
Abstract
Purpose The purpose of this study was to develop next-generation functional photoreceptor imaging using ultrahigh-speed swept-source optical coherence tomography (UHS-SS-OCT) and split-spectrum amplitude-decorrelation optoretinography (SSADOR) algorithm. The advancement enables rapid surveying of large retinal areas, promising non-contact, objective, and quantifiable measurements of macular visual function. Methods We designed and built a UHS-SS-OCT prototype instrument using a wavelength tunable laser with 1 MHz A-scan rate. The functional scanning protocol records 5 repeated volumes in 3 seconds. A flash pattern selectively exposes the imaged retina area. SSADOR quantifies photoreceptor light response by extracting optical coherence tomography (OCT) signal changes within the photoreceptor outer segment before and after the flash. Results The study prospectively enrolled 16 eyes from 8 subjects, demonstrating the ability to measure photoreceptor light response over a record field of view (3 × 3 mm2) with high topographical resolution (approximately 100 µm). The measured SSADOR signal corresponds to the flashed pattern, whose amplitude also correlates with flash strength, showing consistency and reproducibility across subjects. Conclusions The integration of high-performance UHS-SS-OCT and SSADOR enables characterizing photoreceptor function over a clinically meaningful field of view, while maintaining a workflow that can be integrated into routine clinical tests and trials. The new approach allows detecting changes in photoreceptor light response with high sensitivity and can detect small focal impairments. Translational Relevance This innovative advance can enable us to detect early photoreceptor abnormalities, as well as help to stage and monitor degenerative retinal diseases, potentially providing a surrogate visual function marker for retinal diseases and accelerating therapeutic development through a safe and efficient outcome endpoint.
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Affiliation(s)
- Shuibin Ni
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR, USA
| | - Shanjida Khan
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR, USA
| | | | - Mark E. Pennesi
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
| | - David Huang
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR, USA
| | - Yifan Jian
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR, USA
| | - Siyu Chen
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR, USA
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Ni S, Ng R, Huang D, Chen S, Young BK, Peter Campbell J, Jian Y. Non-mydriatic ultra-widefield diffraction-limited retinal imaging. OPTICS LETTERS 2024; 49:3902-3905. [PMID: 39008737 DOI: 10.1364/ol.525364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 06/20/2024] [Indexed: 07/17/2024]
Abstract
We demonstrate a new non-mydriatic ultra-widefield optical coherence tomography retinal imaging system, designed with custom optics to improve the imaging field of view, lateral resolution, and patient comfort. The key motivation is to address the challenge with conventional systems that require pupillary dilation, adding time, expense, discomfort, and medical risk to the examination of the retina. Our system provides an ultrawide 100° field of view (beam scanning angle at the scanning pivot point) and maintains a lateral resolution of 20 µm on the center. It also allows a generous working distance of 16 mm, 2-3 times longer than existing ultra-widefield OCT imaging systems. This advanced system was able to avoid iris vignetting artifacts without pharmacological dilation and ensure diffraction-limited ultra-widefield imaging under a generalized eye model. This enables a comprehensive evaluation of retina diseases, especially those affecting the peripheral regions.
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Watson JJ, Hecht R, Tao YK. Optimization of handheld spectrally encoded coherence tomography and reflectometry for point-of-care ophthalmic diagnostic imaging. JOURNAL OF BIOMEDICAL OPTICS 2024; 29:076006. [PMID: 39050778 PMCID: PMC11267400 DOI: 10.1117/1.jbo.29.7.076006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 06/28/2024] [Accepted: 07/08/2024] [Indexed: 07/27/2024]
Abstract
Significance Handheld optical coherence tomography (HH-OCT) systems enable point-of-care ophthalmic imaging in bedridden, uncooperative, and pediatric patients. Handheld spectrally encoded coherence tomography and reflectometry (HH-SECTR) combines OCT and spectrally encoded reflectometry (SER) to address critical clinical challenges in HH-OCT imaging with real-time en face retinal aiming for OCT volume alignment and volumetric correction of motion artifacts that occur during HH-OCT imaging. Aim We aim to enable robust clinical translation of HH-SECTR and improve clinical ergonomics during point-of-care OCT imaging for ophthalmic diagnostics. Approach HH-SECTR is redesigned with (1) optimized SER optical imaging for en face retinal aiming and retinal tracking for motion correction, (2) a modular aluminum form factor for sustained alignment and probe stability for longitudinal clinical studies, and (3) one-handed photographer-ergonomic motorized focus adjustment. Results We demonstrate an HH-SECTR imaging probe with micron-scale optical-optomechanical stability and use it for in vivo human retinal imaging and volumetric motion correction. Conclusions This research will benefit the clinical translation of HH-SECTR for point-of-care ophthalmic diagnostics.
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Affiliation(s)
- Jacob J. Watson
- Vanderbilt University, Department of Biomedical Engineering, Nashville, Tennessee, United States
| | - Rachel Hecht
- Vanderbilt University, Department of Biomedical Engineering, Nashville, Tennessee, United States
| | - Yuankai K. Tao
- Vanderbilt University, Department of Biomedical Engineering, Nashville, Tennessee, United States
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Burt SS, Woodward M, Ni S, Jackson J, Coyner AS, Ostmo SR, Liang G, Bayhaqi Y, Jia Y, Huang D, Chiang MF, Young BK, Jian Y, Campbell JP. Isolated Retinal Neovascularization in Retinopathy of Prematurity: Clinical Associations and Prognostic Implications. Ophthalmol Retina 2024:S2468-6530(24)00234-3. [PMID: 38735640 DOI: 10.1016/j.oret.2024.04.025] [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: 04/17/2024] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVE Isolated retinal neovascularization (IRNV) is a common finding in patients with stage 2 and 3 retinopathy of prematurity (ROP). This study aimed to further classify the clinical course and significance of these lesions (previously described as "popcorn" based on clinical appearance) in patients with ROP as visualized with ultrawidefield OCT (UWF-OCT). DESIGN Single center, retrospective case series. PARTICIPANTS Images were collected from 136 babies in the Oregon Health and Science University neonatal intensive care unit. METHODS A prototype UWF-OCT device captured en face scans (>140°), which were reviewed for the presence of IRNV along with standard zone, stage, and plus classification. In a cross-sectional analysis we compared demographics and the clinical course of eyes with and without IRNV. Longitudinally, we compared ROP severity using a clinician-assigned vascular severity score (VSS) and compared the risk of progression among eyes with and without IRNV using multivariable logistic regression. MAIN OUTCOME MEASURES Differences in clinical demographics and disease progression between patients with and without IRNV. RESULTS Of the 136 patients, 60 developed stage 2 or worse ROP during their disease course, 22 of whom had IRNV visualized on UWF-OCT (37%). On average, patients with IRNV had lower birth weights (BWs) (660.1 vs. 916.8 g, P = 0.001), gestational age (GA) (24.9 vs. 26.1 weeks, P = 0.01), and were more likely to present with ROP in zone I (63.4% vs. 15.8%, P < 0.001). They were also more likely to progress to stage 3 (68.2% vs. 13.2%, P < 0.001) and receive treatment (54.5% vs. 15.8%, P = 0.002). Eyes with IRNV had a higher peak VSS (5.61 vs. 3.73, P < 0.001) and averaged a higher VSS throughout their disease course. On multivariable logistic regression, IRNV was independently associated with progression to stage 3 (P = 0.02) and requiring treatment (P = 0.03), controlling for GA, BW, and initial zone 1 disease. CONCLUSIONS In this single center study, we found that IRNV occurs in higher risk babies and was an independent risk factor for ROP progression and treatment. These findings may have implications for OCT-based ROP classifications in the future. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Spencer S Burt
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon
| | - Mani Woodward
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon
| | - Shuibin Ni
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon
| | - John Jackson
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon
| | - Aaron S Coyner
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon
| | - Susan R Ostmo
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon
| | - Guangru Liang
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon
| | - Yakub Bayhaqi
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon
| | - Yali Jia
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon
| | - David Huang
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon
| | - Michael F Chiang
- National Eye Institute, National Institutes of Health, Bethesda, Maryland; National Library of Medicine, National Institutes of Health, Bethesda, Maryland
| | - Benjamin K Young
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon
| | - Yifan Jian
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon
| | - J Peter Campbell
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon.
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Hanif AM, Jian Y, Young BK, Campbell JP. Implementation of optical coherence tomography in retinopathy of prematurity screening. Curr Opin Ophthalmol 2024; 35:252-259. [PMID: 38205941 PMCID: PMC11034813 DOI: 10.1097/icu.0000000000001030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
PURPOSE OF REVIEW In this review, we explore the investigational applications of optical coherence tomography (OCT) in retinopathy of prematurity (ROP), the insights they have delivered thus far, and key milestones for its integration into the standard of care. RECENT FINDINGS While OCT has been widely integrated into clinical management of common retinal diseases, its use in pediatric contexts has been undermined by limitations in ergonomics, image acquisition time, and field of view. Recently, investigational handheld OCT devices have been reported with advancements including ultra-widefield view, noncontact use, and high-speed image capture permitting real-time en face visualization. These developments are compelling for OCT as a more objective alternative with reduced neonatal stress compared to indirect ophthalmoscopy and/or fundus photography as a means of classifying and monitoring ROP. SUMMARY OCT may become a viable modality in management of ROP. Ongoing innovation surrounding handheld devices should aim to optimize patient comfort and image resolution in the retinal periphery. Future clinical investigations may seek to objectively characterize features of peripheral stage and explore novel biomarkers of disease activity.
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Affiliation(s)
- Adam M. Hanif
- Ophthalmology, Oregon Health & Science University, Portland, Oregon
| | - Yifan Jian
- Ophthalmology, Oregon Health & Science University, Portland, Oregon
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Ni S, Liang GB, Ng R, Ostmo S, Jia Y, Chiang MF, Huang D, Skalet AH, Young BK, Campbell JP, Jian Y. Panretinal handheld OCT angiography for pediatric retinal imaging. BIOMEDICAL OPTICS EXPRESS 2024; 15:3412-3424. [PMID: 38855676 PMCID: PMC11161374 DOI: 10.1364/boe.520739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 06/11/2024]
Abstract
Comprehensive visualization of retina morphology is essential in the diagnosis and management of retinal diseases in pediatric populations. Conventional imaging techniques often face challenges in effectively capturing the peripheral retina, primarily due to the limitations in current optical designs, which lack the necessary field of view to characterize the far periphery. To address this gap, our study introduces a novel ultra-widefield optical coherence tomography angiography (OCTA) system. This system, specifically tailored for pediatric applications, incorporates an ultrahigh-speed 800 kHz swept-source laser. The system's innovative design achieves a 140° field of view while maintaining excellent optical performance. Over the last 15 months, we have conducted 379 eye examinations on 96 babies using this system. It demonstrates marked efficacy in the diagnosis of retinopathy of prematurity, providing detailed and comprehensive peripheral retinal angiography. The capabilities of the ultra-widefield handheld OCTA system in enhancing the clarity and thoroughness of retina vascularization assessments have significantly improved the precision of diagnoses and the customization of treatment strategies. Our findings underscore the system's potential to advance pediatric ophthalmology and broaden the scope of retinal imaging.
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Affiliation(s)
- Shuibin Ni
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - Guangru Ben Liang
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - Ringo Ng
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Susan Ostmo
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Yali Jia
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - Michael F. Chiang
- National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
- National Library of Medicine, National Institutes of Health, Bethesda, MD 20892, USA
| | - David Huang
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - Alison H. Skalet
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Radiation Medicine, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Benjamin K. Young
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - J. Peter Campbell
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Yifan Jian
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
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Truzzi S, Manns F, Parel JM, Ruggeri M. Handheld contact-type OCT and color fundus system for retinal imaging. BIOMEDICAL OPTICS EXPRESS 2024; 15:2681-2696. [PMID: 38633089 PMCID: PMC11019701 DOI: 10.1364/boe.520735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/21/2024] [Accepted: 03/21/2024] [Indexed: 04/19/2024]
Abstract
We present proof of concept for a handheld contact-type system capable of simultaneous optical coherence tomography (OCT) imaging of the retina and wide-field digital fundus color photography. The study focuses on demonstrating the feasibility of the proposed approach, particularly for eventual use in pediatric patients during examination under anesthesia in the operating room and in the neonatal intensive care unit. Direct contact of the probe with the cornea allows the photographer to maintain a stable position during imaging, reducing motion artifacts in the OCT images. Additionally, it simplifies the alignment process and increases the field of view of the optics. By integrating OCT and fundus imaging into a single device, the proposed compact modular design eliminates the need for separate, space-consuming systems dedicated to each imaging modality.
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Affiliation(s)
- Stefano Truzzi
- Ophthalmic Biophysics Center, Bascom Palmer
Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Engineering “Enzo
Ferrari”, University of Modena and Reggio Emilia, Modena, Italy
| | - Fabrice Manns
- Ophthalmic Biophysics Center, Bascom Palmer
Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL, USA
| | - Jean-Marie Parel
- Ophthalmic Biophysics Center, Bascom Palmer
Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL, USA
- Brien Holden Vision Institute, Sydney, NSW, Australia
| | - Marco Ruggeri
- Ophthalmic Biophysics Center, Bascom Palmer
Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL, USA
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Ahronovich E, Shen JH, Vadakkan TJ, Prasad R, Joos KM, Simaan N. Five degrees-of-freedom mechanical arm with remote center of motion (RCM) device for volumetric optical coherence tomography (OCT) retinal imaging. BIOMEDICAL OPTICS EXPRESS 2024; 15:1150-1162. [PMID: 38404307 PMCID: PMC10890879 DOI: 10.1364/boe.505294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/21/2023] [Accepted: 12/10/2023] [Indexed: 02/27/2024]
Abstract
Handheld optical coherence tomography (HH-OCT) is gaining popularity for diagnosing retinal diseases in neonates (e.g. retinopathy of prematurity). Diagnosis accuracy is degraded by hand tremor and patient motion when using commercially available handheld retinal OCT probes. This work presents a low-cost arm designed to address ergonomic challenges of holding a commercial OCT probe and alleviating hand tremor. Experiments with a phantom eye show enhanced geometric uniformity and volumetric accuracy when obtaining OCT scans with our device compared to handheld imaging approaches. An in-vivo porcine volumetric image was also obtained with the mechanical arm demonstrating clinical deployability.
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Affiliation(s)
- Elan Ahronovich
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Jin-Hui Shen
- Vanderbilt Eye Institute, Vanderbilt University 2311 Pierce Avenue Nashville, TN 37232, USA
| | - Tegy J. Vadakkan
- Vanderbilt University Cell Imaging Shared Resources (CISR), Nashville, TN, USA
| | - Ratna Prasad
- Vanderbilt Eye Institute, Vanderbilt University 2311 Pierce Avenue Nashville, TN 37232, USA
| | - Karen M. Joos
- Vanderbilt Eye Institute, Vanderbilt University 2311 Pierce Avenue Nashville, TN 37232, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Nabil Simaan
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, USA
- Department of Computer Science, Vanderbilt University, Nashville, TN, USA
- Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University, Nashville, TN, USA
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Chen X, Imperio R, Viehland C, Patel PR, Tran-Viet D, Mangalesh S, Prakalapakorn SG, Freedman SF, Izatt JA, Toth CA. A pilot optical coherence tomography angiography classification of retinal neovascularization in retinopathy of prematurity. Sci Rep 2024; 14:568. [PMID: 38177160 PMCID: PMC10766630 DOI: 10.1038/s41598-023-49964-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 12/14/2023] [Indexed: 01/06/2024] Open
Abstract
Extraretinal neovascularization is a hallmark of treatment-requiring retinopathy of prematurity (ROP). Optical coherence tomography angiography (OCTA) offers vascular flow and depth information not available from indirect ophthalmoscopy and structural OCT, but OCTA is only commercially available as a tabletop device. In this study, we used an investigational handheld OCTA device to study the vascular flow in and around retinal neovascularization in seven preterm infants with treatment-requiring ROP and contrasted them to images of vascular flow in six infants of similar age without neovascular ROP. We showed stages of retinal neovascularization visible in preterm infants from 32 to 47 weeks postmenstrual age: Intraretinal neovascularization did not break through the internal limiting membrane; Subclinical neovascular buds arose from retinal vasculature with active flow through the internal limiting membrane; Flat neovascularization in aggressive ROP assumed a low-lying configuration compared to elevated extraretinal neovascular plaques; Regressed neovascularization following treatment exhibited decreased vascular flow within the preretinal tissue, but flow persisted in segments of retinal vessels elevated from their original intraretinal location. These findings enable a pilot classification of retinal neovascularization in eyes with ROP using OCTA, and may be helpful in detailed monitoring of disease progression, treatment response and predicting reactivation.
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Affiliation(s)
- Xi Chen
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, 27517, USA.
- Duke University Medical Center, 2351 Erwin Road, Box 3802, Durham, NC, 27710, USA.
| | - Ryan Imperio
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, 27517, USA
| | - Christian Viehland
- Department of Biomedical Engineering, Duke University, Durham, NC, 27517, USA
| | - Pujan R Patel
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, 27517, USA
| | - Du Tran-Viet
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, 27517, USA
| | - Shwetha Mangalesh
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, 27517, USA
| | - S Grace Prakalapakorn
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, 27517, USA
- Department of Pediatrics, Duke University Medical Center, Durham, NC, 27571, USA
| | - Sharon F Freedman
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, 27517, USA
- Department of Pediatrics, Duke University Medical Center, Durham, NC, 27571, USA
| | - Joseph A Izatt
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, 27517, USA
- Department of Biomedical Engineering, Duke University, Durham, NC, 27517, USA
| | - Cynthia A Toth
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, 27517, USA
- Department of Biomedical Engineering, Duke University, Durham, NC, 27517, USA
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Miao Y, Jung H, Hsu D, Song J, Ni S, Ma D, Jian Y, Makita S, Yasuno Y, Sarunic MV, Stephenson KAJ, Paton K, Mammo Z, Ju MJ. Polarization-Diversity Optical Coherence Tomography Assessment of Choroidal Nevi. Invest Ophthalmol Vis Sci 2023; 64:6. [PMID: 37930688 PMCID: PMC10629548 DOI: 10.1167/iovs.64.14.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 10/09/2023] [Indexed: 11/07/2023] Open
Abstract
Purpose The purpose of this study was to demonstrate the utility of polarization-diversity optical coherence tomography (PD-OCT), a noninvasive imaging technique with melanin-specific contrast, in the quantitative and qualitative assessment of choroidal nevi. Methods Nevi were imaged with a custom-built 55-degree field-of-view (FOV) 400 kHz PD-OCT system. Imaging features on PD-OCT were compared to those on fundus photography, auto-fluorescence, ultrasound, and non-PD-OCT images. Lesions were manually segmented for size measurement and metrics for objective assessment of melanin distributions were calculated, including degree of polarization uniformity (DOPU), attenuation coefficient, and melanin occupancy rate (MOR). Results We imaged 17 patients (mean age = 69.5 years, range = 37-90) with 11 pigmented, 3 non-pigmented, and 3 mixed pigmentation nevi. Nevi with full margin acquisition had an average longest basal diameter of 5.1 mm (range = 2.99-8.72 mm) and average height of 0.72 mm (range = 0.37 mm-2.09 mm). PD-OCT provided clear contrast of choroidal melanin content, distribution, and delineation of nevus margins for melanotic nevi. Pigmented nevi were found to have lower DOPU, higher attenuation coefficient, and higher MOR than non-pigmented lesions. Melanin content on PD-OCT was consistent with pigmentation on fundus in 15 of 17 nevi (88%). Conclusions PD-OCT allows objective assessment of choroidal nevi melanin content and distribution. In addition, melanin-specific contrast by PD-OCT enables clear nevus margin delineation and may improve serial growth surveillance. Further investigation is needed to determine the clinical significance and prognostic value of melanin characterization by PD-OCT in the evaluation of choroidal nevi.
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Affiliation(s)
- Yusi Miao
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Hoyoung Jung
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Destiny Hsu
- School of Engineering Science, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Jun Song
- School of Biomedical Engineering, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shuibin Ni
- Case Eye Institute, Oregon Health & Science University, Portland, Oregon, United States
| | - Da Ma
- Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
| | - Yifan Jian
- Case Eye Institute, Oregon Health & Science University, Portland, Oregon, United States
| | - Shuichi Makita
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Yoshiaki Yasuno
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Marinko V. Sarunic
- School of Engineering Science, Simon Fraser University, Burnaby, British Columbia, Canada
- Department of Medical Physics and Biomedical Engineering, University College London, London, England, United Kingdom
- Institute of Ophthalmology, University College London, London, England, United Kingdom
| | - Kirk A. J. Stephenson
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Katherine Paton
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Zaid Mammo
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Myeong Jin Ju
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
- School of Biomedical Engineering, University of British Columbia, Vancouver, British Columbia, Canada
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Hoyek S, Cruz NFSD, Patel NA, Al-Khersan H, Fan KC, Berrocal AM. Identification of novel biomarkers for retinopathy of prematurity in preterm infants by use of innovative technologies and artificial intelligence. Prog Retin Eye Res 2023; 97:101208. [PMID: 37611892 DOI: 10.1016/j.preteyeres.2023.101208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 08/25/2023]
Abstract
Retinopathy of prematurity (ROP) is a leading cause of preventable vision loss in preterm infants. While appropriate screening is crucial for early identification and treatment of ROP, current screening guidelines remain limited by inter-examiner variability in screening modalities, absence of local protocol for ROP screening in some settings, a paucity of resources and an increased survival of younger and smaller infants. This review summarizes the advancements and challenges of current innovative technologies, artificial intelligence (AI), and predictive biomarkers for the diagnosis and management of ROP. We provide a contemporary overview of AI-based models for detection of ROP, its severity, progression, and response to treatment. To address the transition from experimental settings to real-world clinical practice, challenges to the clinical implementation of AI for ROP are reviewed and potential solutions are proposed. The use of optical coherence tomography (OCT) and OCT angiography (OCTA) technology is also explored, providing evaluation of subclinical ROP characteristics that are often imperceptible on fundus examination. Furthermore, we explore several potential biomarkers to reduce the need for invasive procedures, to enhance diagnostic accuracy and treatment efficacy. Finally, we emphasize the need of a symbiotic integration of biologic and imaging biomarkers and AI in ROP screening, where the robustness of biomarkers in early disease detection is complemented by the predictive precision of AI algorithms.
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Affiliation(s)
- Sandra Hoyek
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Natasha F S da Cruz
- Bascom Palmer Eye Institute, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Nimesh A Patel
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Hasenin Al-Khersan
- Bascom Palmer Eye Institute, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Kenneth C Fan
- Bascom Palmer Eye Institute, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Audina M Berrocal
- Bascom Palmer Eye Institute, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA.
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12
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Ni S, Nguyen TTP, Ng R, Woodward M, Ostmo S, Jia Y, Chiang MF, Huang D, Skalet AH, Campbell JP, Jian Y. Panretinal Optical Coherence Tomography. IEEE TRANSACTIONS ON MEDICAL IMAGING 2023; 42:3219-3228. [PMID: 37216244 PMCID: PMC10615839 DOI: 10.1109/tmi.2023.3278269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
We introduce a new concept of panoramic retinal (panretinal) optical coherence tomography (OCT) imaging system with a 140° field of view (FOV). To achieve this unprecedented FOV, a contact imaging approach was used which enabled faster, more efficient, and quantitative retinal imaging with measurement of axial eye length. The utilization of the handheld panretinal OCT imaging system could allow earlier recognition of peripheral retinal disease and prevent permanent vision loss. In addition, adequate visualization of the peripheral retina has a great potential for better understanding disease mechanisms regarding the periphery. To the best of our knowledge, the panretinal OCT imaging system presented in this manuscript has the widest FOV among all the retina OCT imaging systems and offers significant values in both clinical ophthalmology and basic vision science.
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13
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Mangalesh S, Toth CA. Preterm infant retinal OCT markers of perinatal health and retinopathy of prematurity. Front Pediatr 2023; 11:1238193. [PMID: 37808559 PMCID: PMC10551634 DOI: 10.3389/fped.2023.1238193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 08/29/2023] [Indexed: 10/10/2023] Open
Abstract
The increasing survival of preterm infants has led to the importance of improving long-term outcomes associated with preterm birth. Antenatal and perinatal insults not only impact mortality, but also long-term disability. While in the intensive care nursery, preterm infants are also exposed to various stressors that lead to long-term cognitive deficits. It is therefore critical to identify early, low-stress, non-invasive biomarkers for preterm infant health. Optical coherence tomography (OCT) is a powerful imaging modality that has recently been adapted to the infant population and provides noninvasive, high-resolution, cross-sectional imaging of the infant eye at the bedside with low stress relative to conventional examination. In this review we delve into discussing the associations between preterm systemic health factors and OCT-based retinal findings and their potential contribution to the development of non-invasive biomarkers for infant health and for retinopathy of prematurity (ROP).
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Affiliation(s)
| | - Cynthia A. Toth
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, United States
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14
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He B, Zhang Y, Zhao L, Sun Z, Hu X, Kang Y, Wang L, Li Z, Huang W, Li Z, Xing G, Hua F, Wang C, Xue P, Zhang N. Robotic-OCT guided inspection and microsurgery of monolithic storage devices. Nat Commun 2023; 14:5701. [PMID: 37709753 PMCID: PMC10502073 DOI: 10.1038/s41467-023-41498-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 09/06/2023] [Indexed: 09/16/2023] Open
Abstract
Data recovery from monolithic storage devices (MSDs) is in high demand for legal or business purposes. However, the conventional data recovery methods are destructive, complicated, and time-consuming. We develop a robotic-arm-assisted optical coherence tomography (robotic-OCT) for non-destructive inspection of MSDs, offering ~7 μm lateral resolution, ~4 μm axial resolution and an adjustable field-of-view to accommodate various MSD sizes. Using a continuous scanning strategy, robotic-OCT achieves automated volumetric imaging of a micro-SD card in ~37 seconds, significantly faster than the traditional stop-and-stare scanning that typically takes tens of minutes. We also demonstrate the robotic-OCT-guided laser ablation as a microsurgical tool for targeted area removal with precision of ±10 μm and accuracy of ~50 μm, eliminating the need to remove the entire insulating layer and operator intervention, thus greatly improving the data recovery efficiency. This work has diverse potential applications in digital forensics, failure analysis, materials testing, and quality control.
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Affiliation(s)
- Bin He
- Institute of Forensic Science, Ministry of Public Security, 100038, Beijing, China
- State Key Laboratory of Low-dimensional Quantum Physics and Department of Physics, Tsinghua University and Beijing Advanced Innovation Center for Structural Biology, 100084, Beijing, China
| | - Yuxin Zhang
- Institute of Forensic Science, Ministry of Public Security, 100038, Beijing, China
- State Key Laboratory of Low-dimensional Quantum Physics and Department of Physics, Tsinghua University and Beijing Advanced Innovation Center for Structural Biology, 100084, Beijing, China
| | - Lu Zhao
- Institute of Forensic Science, Ministry of Public Security, 100038, Beijing, China
| | - Zhenwen Sun
- Institute of Forensic Science, Ministry of Public Security, 100038, Beijing, China
| | - Xiyuan Hu
- School of Computer Science and Engineering, Nanjing University of Science and Technology, 210094, Nanjing, China
| | - Yanrong Kang
- Institute of Forensic Science, Ministry of Public Security, 100038, Beijing, China
| | - Lei Wang
- Institute of Forensic Science, Ministry of Public Security, 100038, Beijing, China
| | - Zhihui Li
- Institute of Forensic Science, Ministry of Public Security, 100038, Beijing, China
| | - Wei Huang
- Institute of Forensic Science, Ministry of Public Security, 100038, Beijing, China
| | - Zhigang Li
- Institute of Forensic Science, Ministry of Public Security, 100038, Beijing, China
| | - Guidong Xing
- Institute of Forensic Science, Ministry of Public Security, 100038, Beijing, China
| | - Feng Hua
- Institute of Forensic Science, Ministry of Public Security, 100038, Beijing, China
| | - Chengming Wang
- State Key Laboratory of Low-dimensional Quantum Physics and Department of Physics, Tsinghua University and Beijing Advanced Innovation Center for Structural Biology, 100084, Beijing, China
| | - Ping Xue
- State Key Laboratory of Low-dimensional Quantum Physics and Department of Physics, Tsinghua University and Beijing Advanced Innovation Center for Structural Biology, 100084, Beijing, China.
| | - Ning Zhang
- Institute of Forensic Science, Ministry of Public Security, 100038, Beijing, China.
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15
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Hormel TT, Jia Y. OCT angiography and its retinal biomarkers [Invited]. BIOMEDICAL OPTICS EXPRESS 2023; 14:4542-4566. [PMID: 37791289 PMCID: PMC10545210 DOI: 10.1364/boe.495627] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/13/2023] [Accepted: 07/13/2023] [Indexed: 10/05/2023]
Abstract
Optical coherence tomography angiography (OCTA) is a high-resolution, depth-resolved imaging modality with important applications in ophthalmic practice. An extension of structural OCT, OCTA enables non-invasive, high-contrast imaging of retinal and choroidal vasculature that are amenable to quantification. As such, OCTA offers the capability to identify and characterize biomarkers important for clinical practice and therapeutic research. Here, we review new methods for analyzing biomarkers and discuss new insights provided by OCTA.
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Affiliation(s)
- Tristan T. Hormel
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Yali Jia
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon, USA
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16
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Kvopka M, Chan W, Lake SR, Durkin S, Taranath D. Fundus fluorescein angiography imaging of retinopathy of prematurity in infants: A review. Surv Ophthalmol 2023; 68:849-860. [PMID: 37211096 DOI: 10.1016/j.survophthal.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 05/11/2023] [Accepted: 05/15/2023] [Indexed: 05/23/2023]
Abstract
Fluorescein angiography in retinopathy of prematurity is increasingly utilized over the past decade. The development of ultra-wide-field imaging combined with fluorescein angiography has allowed improved visualization of the peripheral retinal vasculature. Patient cooperation in the pediatric population is particularly challenging, but hand-held digital retinal photography has shown promise and can visualize the infant retina without the need for anesthesia and intravenous access. Many features of retinopathy of prematurity and its response to laser and anti-VEGF treatment can be either exclusively or better visualized on fluorescein angiography compared to indirect ophthalmoscopy or color fundus photography. Disease treatment is gradually shifting from laser photocoagulation to intravitreal anti-VEGF agents, the latter being associated with late-onset vision-threatening sequelae. The role of fluorescein angiography in retinopathy of prematurity monitoring will continue to increase with the longer follow-up required and different clinical behavior seen with anti-VEGF treatment. We highlight the utility, safety, and importance of fluorescein angiography in the diagnosis, treatment, and follow-up of retinopathy of prematurity.
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Affiliation(s)
- Michael Kvopka
- Department of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia.
| | - WengOnn Chan
- Department of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia; Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Australia; Machine Learning Division, Ophthalmic Research Laboratory, University of Adelaide, Australia
| | - Stewart R Lake
- Department of Ophthalmology, Division of Surgery, Flinders Medical Centre, Adelaide. Australia
| | - Shane Durkin
- Department of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
| | - Deepa Taranath
- Department of Ophthalmology, Division of Surgery, Flinders Medical Centre, Adelaide. Australia
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17
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Chang YH, Chen CY, Kuo WC. Handheld common-path swept-source optical coherence tomography angiography. OPTICS LETTERS 2023; 48:3913-3916. [PMID: 37527081 DOI: 10.1364/ol.488786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 07/03/2023] [Indexed: 08/03/2023]
Abstract
This study develops a handheld optical coherence tomography angiography (OCTA) system that uses a high-speed (200 kHz) swept laser with a dual-reference common-path configuration for stable and fast imaging. The common-path design automatically avoids polarization and dispersion mismatches by using one circulator as the primary system element, ensuring a cost-effective and compact design for handheld probe use. With its stable envelope (i.e., sub-µm shifts) and phase variation (corresponding to nm changes in axial displacement), the minimum detectable flow velocity is ∼ 0.08 mm/s in our experiment, which gives the common-path setup a high potential for application in a handheld OCTA system for clinical skin screening. In vivo skin structures and microvasculature networks on the dorsum of the hand and cheek of a healthy human are imaged successfully.
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18
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Kubsad D, Ohan MA, Wu JG, Cabrera MT. Vitreoretinal biomarkers of retinopathy of prematurity using handheld optical coherence tomography: a review. Front Pediatr 2023; 11:1191174. [PMID: 37325353 PMCID: PMC10264674 DOI: 10.3389/fped.2023.1191174] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/16/2023] [Indexed: 06/17/2023] Open
Abstract
Retinopathy of prematurity (ROP) is caused by abnormal retinal vascularization in premature infants that has the potential for severe long-term vision impairment. Recent advancements in handheld optical coherence tomography (OCT) have enabled noninvasive, high-resolution, cross-sectional imaging of the infant eye at the bedside. The use of handheld OCT devices in the diagnosis of ROP in premature infants has furthered our understanding of disease state and progression. This review discusses the known and novel biomarkers of ROP severity in premature infants identified through handheld OCT and potential for future directions.
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Affiliation(s)
- Deepika Kubsad
- University of Washington School of Medicine, Seattle, WA, United States
| | - Masis A. Ohan
- University of Washington School of Medicine, Seattle, WA, United States
| | - Jolan G. Wu
- Department of Ophthalmology, University of Washington, Seattle, WA, United States
| | - Michelle T. Cabrera
- Department of Ophthalmology, University of Washington, Seattle, WA, United States
- Division of Ophthalmology, Seattle Children's Hospital, Seattle, WA, United States
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19
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Macher J, Porter RS, Levin AV. Ophthalmic imaging in abusive head trauma. CHILD ABUSE & NEGLECT 2023; 139:106106. [PMID: 36867971 DOI: 10.1016/j.chiabu.2023.106106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/31/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Ophthalmic imaging plays an increasingly important role the evaluation of abusive head trauma, however these imaging modalities may be unfamiliar to non-ophthalmologists. OBJECTIVE To provide pediatricians and child abuse pediatric professionals with background on ophthalmic imaging techniques in the context of suspected abuse, as well as information on commercial options and costs for those interested in augmenting their ophthalmic imaging capabilities. METHODS We performed a review of the ophthalmic imaging literature for fundus photography, ocular coherence tomography, fluorescein angiography, ocular ultrasound, computed tomography, magnetic resonance imaging and postmortem imaging. We also contacted individual vendors for equipment pricing information. RESULTS For each ophthalmic imaging modality, we demonstrate its role in the evaluation of abusive head trauma including indications, potential findings, sensitivity and specificity of findings for abuse, and commercial options. CONCLUSIONS Ophthalmic imaging is an important supportive component of the evaluation for abusive head trauma. When used in conjunction with clinical examination, ophthalmic imaging can improve diagnostic accuracy, support documentation, and possibly improve communication in medicolegal contexts.
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Affiliation(s)
- Jared Macher
- University of Rochester School of Medicine, Rochester, NY, USA.
| | - Randall S Porter
- Anesthesiology and Perioperative Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | - Alex V Levin
- University of Rochester School of Medicine, Rochester, NY, USA; Pediatric Ophthalmology and Ocular Genetics, Flaum Eye Institute, Rochester, NY, USA; Clinical Genetics, Golisano Children's Hospital, Rochester, NY, USA.
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20
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Turner M, Ou Y. At-Home Glaucoma Monitoring: Is it Ready for Prime Time? Ophthalmol Glaucoma 2023; 6:117-120. [PMID: 36184483 DOI: 10.1016/j.ogla.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/28/2022] [Accepted: 08/11/2022] [Indexed: 10/14/2022]
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21
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Wakabayashi T, Patel SN, Campbell JP, Chang EY, Nudleman ED, Yonekawa Y. Advances in retinopathy of prematurity imaging. Saudi J Ophthalmol 2022; 36:243-250. [PMID: 36276248 PMCID: PMC9583355 DOI: 10.4103/sjopt.sjopt_20_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 02/06/2022] [Accepted: 02/07/2022] [Indexed: 11/18/2022] Open
Abstract
Retinopathy of prematurity (ROP) remains the leading cause of childhood blindness worldwide. Recent advances in ROP imaging have significantly improved our understanding of the pathogenesis and pathophysiological course of ROP including the acute phase, regression, reactivation, and late complications, known as adult ROP. Recent progress includes various contact and noncontact wide-field imaging devices for fundus imaging, smartphone-based fundus photography, wide-field fluorescein angiography, handheld optical coherence tomography (OCT) devices for wide-field en face OCT images, and OCT angiography. Images taken by those devices were incorporated in the recently updated guidelines of ROP, the International Classification of Retinopathy of Prematurity, Third Edition (ICROP3). ROP imaging has also allowed the real-world adoption of telemedicine- and artificial intelligence (AI)-based screening. Recent study demonstrated proof of concept that AI has a high diagnostic performance for the detection of ROP in a real-world screening. Here, we summarize the recent advances in ROP imaging and their application for screening, diagnosis, and management of ROP.
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Affiliation(s)
- Taku Wakabayashi
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Samir N. Patel
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - J. P. Campbell
- Department of Ophthalmology, Oregon Health and Science University, Portland, Oregon, USA
| | | | - Eric D. Nudleman
- Department of Ophthalmology, Shiley Eye Institute, University of California, San Diego, California, USA
| | - Yoshihiro Yonekawa
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania, USA,Address for correspondence: Dr. Yoshihiro Yonekawa, Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania, USA. E-mail:
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22
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Nguyen TTP, Ni S, Ostmo S, Rajagopalan A, Coyner AS, Woodward M, Chiang MF, Jia Y, Huang D, Campbell JP, Jian Y. Association of Optical Coherence Tomography-Measured Fibrovascular Ridge Thickness and Clinical Disease Stage in Retinopathy of Prematurity. JAMA Ophthalmol 2022; 140:2797385. [PMID: 36227622 PMCID: PMC9562098 DOI: 10.1001/jamaophthalmol.2022.4173] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/18/2022] [Indexed: 11/30/2022]
Abstract
Importance Accurate diagnosis of retinopathy of prematurity (ROP) is essential to provide timely treatment and reduce the risk of blindness. However, the components of an ROP examination are subjective and qualitative. Objective To evaluate whether optical coherence tomography (OCT)-derived retinal thickness measurements at the vascular-avascular junction are associated with clinical diagnosis of ROP stage. Design, Setting, and Participants This cross-sectional longitudinal study compared OCT-based ridge thickness calculated from OCT B-scans by a masked examiner to the clinical diagnosis of 2 masked examiners using both traditional stage classifications and a more granular continuous scale at the neonatal intensive care unit (NICU) of Oregon Health & Science University (OHSU) Hospital. Infants who met ROP screening criteria in the OHSU NICU between June 2021 and April 2022 and had guardian consent were included. One OCT volume and en face image per patient per eye showing at least 1 to 2 clock hours of ridge were included in the final analysis. Main Outcomes and Measures Comparison of OCT-derived ridge thickness to the clinical diagnosis of ROP stage using an ordinal and continuous scale. Repeatability was assessed using 20 repeated examinations from the same visit and compared using intraclass correlation coefficient (ICC) and coefficient of variation (CV). Comparison of ridge thickness with ordinal categories was performed using generalized estimating equations and with continuous stage using Spearman correlation. Results A total of 128 separate OCT eye examinations from 50 eyes of 25 patients were analyzed. The ICC was 0.87 with a CV of 7.0%. Higher ordinal disease classification was associated with higher axial ridge thickness on OCT, with mean (SD) thickness measurements of 264.2 (11.2) μm (P < .001), 334.2 (11.4) μm (P < .001), and 495.0 (32.2) μm (P < .001) for stages 1, 2, and 3, respectively and with continuous stage labels (ρ = 0.739, P < .001). Conclusions and Relevance These results suggest that OCT-based quantification of peripheral stage in ROP may be an objective and quantitative biomarker that may be useful for clinical diagnosis and longitudinal monitoring and may have implications for disease classification in the future.
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Affiliation(s)
| | - Shuibin Ni
- Casey Eye Institute, Oregon Health & Science University, Portland
- Department of Biomedical Engineering, Oregon Health & Science University, Portland
| | - Susan Ostmo
- Casey Eye Institute, Oregon Health & Science University, Portland
| | | | - Aaron S. Coyner
- Casey Eye Institute, Oregon Health & Science University, Portland
| | - Mani Woodward
- Casey Eye Institute, Oregon Health & Science University, Portland
| | - Michael F. Chiang
- National Eye Institute, National Institutes of Health, Bethesda, Maryland
| | - Yali Jia
- Casey Eye Institute, Oregon Health & Science University, Portland
- Department of Biomedical Engineering, Oregon Health & Science University, Portland
| | - David Huang
- Casey Eye Institute, Oregon Health & Science University, Portland
- Department of Biomedical Engineering, Oregon Health & Science University, Portland
| | | | - Yifan Jian
- Casey Eye Institute, Oregon Health & Science University, Portland
- Department of Biomedical Engineering, Oregon Health & Science University, Portland
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He Y, Chen X, Tsui I, Vajzovic L, Sadda SR. Insights into the developing fovea revealed by imaging. Prog Retin Eye Res 2022; 90:101067. [PMID: 35595637 DOI: 10.1016/j.preteyeres.2022.101067] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 04/21/2022] [Accepted: 04/24/2022] [Indexed: 11/17/2022]
Abstract
Early development of the fovea has been documented by histological studies over the past few decades. However, structural distortion due to sample processing and the paucity of high-quality post-mortem tissue has limited the effectiveness of this approach. With the continuous progress in high-resolution non-invasive imaging technology, most notably optical coherence tomography (OCT) and OCT angiography (OCT-A), in vivo visualization of the developing retina has become possible. Combining the information from histologic studies with this novel imaging information has provided a more complete and accurate picture of retinal development, and in particular the developing fovea. Advances in neonatal care have increased the survival rate of extremely premature infants. However, with enhanced survival there has been an attendant increase in retinal developmental complications. Several key abnormalities, including a thickening of the inner retina at the foveal center, a shallower foveal pit, a smaller foveal avascular zone, and delayed development of the photoreceptors have been described in preterm infants when compared to full-term infants. Notably these abnormalities, which are consistent with a partial arrest of foveal development, appear to persist into later childhood and adulthood in these eyes of individuals born prematurely. Understanding normal foveal development is vital to interpreting these pathologic findings associated with prematurity. In this review, we first discuss the various advanced imaging technologies that have been adapted for imaging the infant eye. We then review the key events and steps in the development of the normal structure of the fovea and contrast structural features in normal and preterm retina from infancy to childhood. Finally, we discuss the development of the perifoveal retinal microvasculature and highlight future opportunities to expand our understanding of the developing fovea.
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Affiliation(s)
- Ye He
- Department of Ophthalmology, University of California - Los Angeles, Los Angeles, CA, USA; Doheny Eye Institute, Pasadena, CA, USA; Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, China
| | - Xi Chen
- Department of Ophthalmology, Duke Eye Center, Duke University, Durham, NC, USA
| | - Irena Tsui
- Department of Ophthalmology, University of California - Los Angeles, Los Angeles, CA, USA; Doheny Eye Institute, Pasadena, CA, USA
| | - Lejla Vajzovic
- Department of Ophthalmology, Duke Eye Center, Duke University, Durham, NC, USA
| | - Srinivas R Sadda
- Department of Ophthalmology, University of California - Los Angeles, Los Angeles, CA, USA; Doheny Eye Institute, Pasadena, CA, USA.
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24
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Ong J, Zarnegar A, Corradetti G, Singh SR, Chhablani J. Advances in Optical Coherence Tomography Imaging Technology and Techniques for Choroidal and Retinal Disorders. J Clin Med 2022; 11:jcm11175139. [PMID: 36079077 PMCID: PMC9457394 DOI: 10.3390/jcm11175139] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/27/2022] [Accepted: 08/28/2022] [Indexed: 11/16/2022] Open
Abstract
Optical coherence tomography (OCT) imaging has played a pivotal role in the field of retina. This light-based, non-invasive imaging modality provides high-quality, cross-sectional analysis of the retina and has revolutionized the diagnosis and management of retinal and choroidal diseases. Since its introduction in the early 1990s, OCT technology has continued to advance to provide quicker acquisition times and higher resolution. In this manuscript, we discuss some of the most recent advances in OCT technology and techniques for choroidal and retinal diseases. The emerging innovations discussed include wide-field OCT, adaptive optics OCT, polarization sensitive OCT, full-field OCT, hand-held OCT, intraoperative OCT, at-home OCT, and more. The applications of these rising OCT systems and techniques will allow for a closer monitoring of chorioretinal diseases and treatment response, more robust analysis in basic science research, and further insights into surgical management. In addition, these innovations to optimize visualization of the choroid and retina offer a promising future for advancing our understanding of the pathophysiology of chorioretinal diseases.
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Affiliation(s)
- Joshua Ong
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Arman Zarnegar
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Giulia Corradetti
- Department of Ophthalmology, Doheny Eye Institute, Los Angeles, CA 90095, USA
- Stein Eye Institute, David Geffen School of Medicine at the University of California, Los Angeles, CA 90033, USA
| | | | - Jay Chhablani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
- Correspondence:
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25
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Nguyen TTP, Ni S, Liang G, Khan S, Wei X, Skalet A, Ostmo S, Chiang MF, Jia Y, Huang D, Jian Y, Campbell JP. Widefield Optical Coherence Tomography in Pediatric Retina: A Case Series of Intraoperative Applications Using a Prototype Handheld Device. Front Med (Lausanne) 2022; 9:860371. [PMID: 35860728 PMCID: PMC9289179 DOI: 10.3389/fmed.2022.860371] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 06/15/2022] [Indexed: 11/18/2022] Open
Abstract
Optical coherence tomography (OCT) has changed the standard of care for diagnosis and management of macular diseases in adults. Current commercially available OCT systems, including handheld OCT for pediatric use, have a relatively narrow field of view (FOV), which has limited the potential application of OCT to retinal diseases with primarily peripheral pathology, including many of the most common pediatric retinal conditions. More broadly, diagnosis of all types of retinal detachment (exudative, tractional, and rhegmatogenous) may be improved with OCT-based assessment of retinal breaks, identification of proliferative vitreoretinopathy (PVR) membranes, and the pattern of subretinal fluid. Intraocular tumors both benign and malignant often occur outside of the central macula and may be associated with exudation, subretinal and intraretinal fluid, and vitreoretinal traction. The development of wider field OCT systems thus has the potential to improve the diagnosis and management of myriad diseases in both adult and pediatric retina. In this paper, we present a case series of pediatric patients with complex vitreoretinal pathology undergoing examinations under anesthesia (EUA) using a portable widefield (WF) swept-source (SS)-OCT device.
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Affiliation(s)
- Thanh-Tin P. Nguyen
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
| | - Shuibin Ni
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, United States
| | - Guangru Liang
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, United States
| | - Shanjida Khan
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, United States
| | - Xiang Wei
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, United States
| | - Alison Skalet
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR, United States
- Department of Radiation Medicine, Oregon Health and Science University, Portland, OR, United States
- Department of Dermatology, Oregon Health and Science University, Portland, OR, United States
| | - Susan Ostmo
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
| | - Michael F. Chiang
- National Eye Institute, National Institutes of Health, Bethesda, MD, United States
| | - Yali Jia
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, United States
| | - David Huang
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, United States
| | - Yifan Jian
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, United States
| | - J. Peter Campbell
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
- *Correspondence: J. Peter Campbell,
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26
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Alexopoulos P, Madu C, Wollstein G, Schuman JS. The Development and Clinical Application of Innovative Optical Ophthalmic Imaging Techniques. Front Med (Lausanne) 2022; 9:891369. [PMID: 35847772 PMCID: PMC9279625 DOI: 10.3389/fmed.2022.891369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/23/2022] [Indexed: 11/22/2022] Open
Abstract
The field of ophthalmic imaging has grown substantially over the last years. Massive improvements in image processing and computer hardware have allowed the emergence of multiple imaging techniques of the eye that can transform patient care. The purpose of this review is to describe the most recent advances in eye imaging and explain how new technologies and imaging methods can be utilized in a clinical setting. The introduction of optical coherence tomography (OCT) was a revolution in eye imaging and has since become the standard of care for a plethora of conditions. Its most recent iterations, OCT angiography, and visible light OCT, as well as imaging modalities, such as fluorescent lifetime imaging ophthalmoscopy, would allow a more thorough evaluation of patients and provide additional information on disease processes. Toward that goal, the application of adaptive optics (AO) and full-field scanning to a variety of eye imaging techniques has further allowed the histologic study of single cells in the retina and anterior segment. Toward the goal of remote eye care and more accessible eye imaging, methods such as handheld OCT devices and imaging through smartphones, have emerged. Finally, incorporating artificial intelligence (AI) in eye images has the potential to become a new milestone for eye imaging while also contributing in social aspects of eye care.
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Affiliation(s)
- Palaiologos Alexopoulos
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Chisom Madu
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Gadi Wollstein
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, United States
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY, United States
- Center for Neural Science, College of Arts & Science, New York University, New York, NY, United States
| | - Joel S. Schuman
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, United States
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY, United States
- Center for Neural Science, College of Arts & Science, New York University, New York, NY, United States
- Department of Electrical and Computer Engineering, NYU Tandon School of Engineering, Brooklyn, NY, United States
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27
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Deng X, Liu K, Zhu T, Guo D, Yin X, Yao L, Ding Z, Ye J, Li P. Dynamic inverse SNR-decorrelation OCT angiography with GPU acceleration. BIOMEDICAL OPTICS EXPRESS 2022; 13:3615-3628. [PMID: 35781971 PMCID: PMC9208597 DOI: 10.1364/boe.459632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/12/2022] [Accepted: 05/22/2022] [Indexed: 05/02/2023]
Abstract
Dynamic OCT angiography (OCTA) is an attractive approach for monitoring stimulus-evoked hemodynamics; however, a 4D (3D space and time) dataset requires a long acquisition time and has a large data size, thereby posing a great challenge to data processing. This study proposed a GPU-based real-time data processing pipeline for dynamic inverse SNR-decorrelation OCTA (ID-OCTA), offering a measured line-process rate of 133 kHz for displaying OCT and OCTA cross-sections in real time. Real-time processing enabled automatic optimization of angiogram quality, which improved the vessel SNR, contrast-to-noise ratio, and connectivity by 14.37, 14.08, and 9.76%, respectively. Furthermore, motion-contrast 4D angiographic imaging of stimulus-evoked hemodynamics was achieved within a single trail in the mouse retina. Consequently, a flicker light stimulus evoked an apparent dilation of the retinal arterioles and venules and an elevation of the decorrelation value in the retinal plexuses. Therefore, GPU ID-OCTA enables real-time and high-quality angiographic imaging and is particularly suitable for hemodynamic studies.
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Affiliation(s)
- Xiaofeng Deng
- State Key Laboratory of Modern Optical
Instrumentation, College of Optical Science and
Engineering, Zhejiang University, Hangzhou 310027,
China
- These authors contributed equally to this
work
| | - Kaiyuan Liu
- State Key Laboratory of Modern Optical
Instrumentation, College of Optical Science and
Engineering, Zhejiang University, Hangzhou 310027,
China
- These authors contributed equally to this
work
| | - Tiepei Zhu
- Eye center of the Second Affiliated
Hospital, College of Medicine, Zhejiang
University, Hangzhou, Zhejiang 310003, China
| | - Dayou Guo
- State Key Laboratory of Modern Optical
Instrumentation, College of Optical Science and
Engineering, Zhejiang University, Hangzhou 310027,
China
| | - Xiaoting Yin
- State Key Laboratory of Modern Optical
Instrumentation, College of Optical Science and
Engineering, Zhejiang University, Hangzhou 310027,
China
| | - Lin Yao
- State Key Laboratory of Modern Optical
Instrumentation, College of Optical Science and
Engineering, Zhejiang University, Hangzhou 310027,
China
| | - Zhihua Ding
- State Key Laboratory of Modern Optical
Instrumentation, College of Optical Science and
Engineering, Zhejiang University, Hangzhou 310027,
China
| | - Juan Ye
- Eye center of the Second Affiliated
Hospital, College of Medicine, Zhejiang
University, Hangzhou, Zhejiang 310003, China
| | - Peng Li
- State Key Laboratory of Modern Optical
Instrumentation, College of Optical Science and
Engineering, Zhejiang University, Hangzhou 310027,
China
- Jiaxing Key Laboratory of
Photonic Sensing & Intelligent Imaging, Jiaxing
314000, China
- Intelligent Optics &
Photonics Research Center, Jiaxing Research Institute, Zhejiang
University, Jiaxing 314000, China
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28
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Sampson DM, Dubis AM, Chen FK, Zawadzki RJ, Sampson DD. Towards standardizing retinal optical coherence tomography angiography: a review. LIGHT, SCIENCE & APPLICATIONS 2022; 11:63. [PMID: 35304441 PMCID: PMC8933532 DOI: 10.1038/s41377-022-00740-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 02/01/2022] [Accepted: 02/14/2022] [Indexed: 05/11/2023]
Abstract
The visualization and assessment of retinal microvasculature are important in the study, diagnosis, monitoring, and guidance of treatment of ocular and systemic diseases. With the introduction of optical coherence tomography angiography (OCTA), it has become possible to visualize the retinal microvasculature volumetrically and without a contrast agent. Many lab-based and commercial clinical instruments, imaging protocols and data analysis methods and metrics, have been applied, often inconsistently, resulting in a confusing picture that represents a major barrier to progress in applying OCTA to reduce the burden of disease. Open data and software sharing, and cross-comparison and pooling of data from different studies are rare. These inabilities have impeded building the large databases of annotated OCTA images of healthy and diseased retinas that are necessary to study and define characteristics of specific conditions. This paper addresses the steps needed to standardize OCTA imaging of the human retina to address these limitations. Through review of the OCTA literature, we identify issues and inconsistencies and propose minimum standards for imaging protocols, data analysis methods, metrics, reporting of findings, and clinical practice and, where this is not possible, we identify areas that require further investigation. We hope that this paper will encourage the unification of imaging protocols in OCTA, promote transparency in the process of data collection, analysis, and reporting, and facilitate increasing the impact of OCTA on retinal healthcare delivery and life science investigations.
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Affiliation(s)
- Danuta M Sampson
- Surrey Biophotonics, Centre for Vision, Speech and Signal Processing and School of Biosciences and Medicine, The University of Surrey, Guildford, GU2 7XH, UK.
| | - Adam M Dubis
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Trust and UCL Institute of Ophthalmology, London, EC1V 2PD, UK
| | - Fred K Chen
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Nedlands, Western Australia, 6009, Australia
- Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, 6000, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, 3002, Australia
| | - Robert J Zawadzki
- Department of Ophthalmology & Vision Science, University of California Davis, Sacramento, CA, 95817, USA
| | - David D Sampson
- Surrey Biophotonics, Advanced Technology Institute, School of Physics and School of Biosciences and Medicine, University of Surrey, Guildford, Surrey, GU2 7XH, UK
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29
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Miao Y, Song J, Hsu D, Ng R, Jian Y, Sarunic MV, Ju MJ. Numerical calibration method for a multiple spectrometer-based OCT system. BIOMEDICAL OPTICS EXPRESS 2022; 13:1685-1701. [PMID: 35414988 PMCID: PMC8973183 DOI: 10.1364/boe.450942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/14/2022] [Accepted: 02/17/2022] [Indexed: 06/14/2023]
Abstract
The present paper introduces a numerical calibration method for the easy and practical implementation of multiple spectrometer-based spectral-domain optical coherence tomography (SD-OCT) systems. To address the limitations of the traditional hardware-based spectrometer alignment across more than one spectrometer, we applied a numerical spectral calibration algorithm where the pixels corresponding to the same wavelength in each unit are identified through spatial- and frequency-domain interferometric signatures of a mirror sample. The utility of dual spectrometer-based SD-OCT imaging is demonstrated through in vivo retinal imaging at two different operation modes with high-speed and dual balanced acquisitions, respectively, in which the spectral alignment is critical to achieve improved retinal image data without any artifacts caused by misalignment of the spectrometers.
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Affiliation(s)
- Yusi Miao
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Jun Song
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Destiny Hsu
- School of Engineering Science, Simon Fraser University, Burnaby, BC, Canada
| | - Ringo Ng
- School of Engineering Science, Simon Fraser University, Burnaby, BC, Canada
| | - Yifan Jian
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon 97239, USA
| | - Marinko V. Sarunic
- School of Engineering Science, Simon Fraser University, Burnaby, BC, Canada
- Institute of Ophthalmology, University College London, London, UK
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Myeong Jin Ju
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, BC, Canada
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
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30
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Zhang L, Dong R, Zawadzki RJ, Zhang P. Volumetric data analysis enabled spatially resolved optoretinogram to measure the functional signals in the living retina. JOURNAL OF BIOPHOTONICS 2022; 15:e202100252. [PMID: 34817116 PMCID: PMC8901551 DOI: 10.1002/jbio.202100252] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 10/21/2021] [Accepted: 11/22/2021] [Indexed: 05/05/2023]
Abstract
Optoretinogram, a technique in which optical coherence tomography (OCT) is used to measure retinal functions in response to a visible light stimulus, can be a potentially useful tool to quantify retinal health alterations. Existing experimental studies on animals have focused on measuring the global retinal response by transversally averaging 3D data across the retina, which minimizes the spatial resolution of the signals, and limits the signal-to-noise ratio because only central B-scans are collected and analyzed. These problems were addressed in this study by collecting volumetric data to probe functional signals and developing an improved 3D registration approach to align such series-acquired OCT volumes. These data were then divided into small blocks and subject to a spatiotemporal analysis, whose results confirmed the spatial-dependence of functional signals. By further averaging, the overall measurement accuracies for the position and the scattering signals were estimated to be approximately 30 nm and 1.1 %, respectively. With improved accuracy, this method revealed certain novel functional signals that have not been previously reported. In conclusion, this work provides a powerful tool to monitor retinal local and global functional changes in aging, diseased, or treated rodent eyes.
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Affiliation(s)
- Lijie Zhang
- School of Optoelectronic Engineering and Instrumentation Science, Dalian University of Technology, 116024, China
| | - Rongyao Dong
- School of Optoelectronic Engineering and Instrumentation Science, Dalian University of Technology, 116024, China
| | - Robert J. Zawadzki
- UC Davis Eye-Pod Small Animals Ocular Imaging Laboratory, Department of Cell Biology and Human Anatomy, University of California Davis, Davis, California, 95616, United States
- UC Davis Eye Center, Department of Ophthalmology & Vision Science, University of California Davis, Sacramento, California, 95817, United States
| | - Pengfei Zhang
- School of Optoelectronic Engineering and Instrumentation Science, Dalian University of Technology, 116024, China
- UC Davis Eye-Pod Small Animals Ocular Imaging Laboratory, Department of Cell Biology and Human Anatomy, University of California Davis, Davis, California, 95616, United States
- Correspondence: Pengfei Zhang, Dalian University of Technology, 116024, China,
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31
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Scruggs BA, Ni S, Nguyen TTP, Ostmo S, Chiang MF, Jia Y, Huang D, Jian Y, Campbell JP. Peripheral OCT Assisted by Scleral Depression in Retinopathy of Prematurity. OPHTHALMOLOGY SCIENCE 2022; 2:100094. [PMID: 35128508 PMCID: PMC8813034 DOI: 10.1016/j.xops.2021.100094] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/16/2021] [Accepted: 12/13/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To determine whether handheld widefield optical coherence tomography (OCT) can be used to document retinopathy of prematurity (ROP) stage while using scleral depression to improve peripheral views. DESIGN Prospective observational study. PARTICIPANTS Consecutive neonates admitted to the neonatal intensive care unit (NICU) in a single academic medical center who also met criteria for ROP screening and consented for research imaging. METHODS Scleral depression was combined with widefield OCT using an investigational 400-kHz, 55-degree field of view handheld OCT during routine ROP screening from October 28, 2020 to March 03, 2021. MAIN OUTCOME MEASURES Acquisition of en face and B-scan imaging of the peripheral retina to objectively assess early vitreoretinal pathology, including the demarcation between vascularized and anterior avascular retina, the presence of early ridge formation, and small neovascular tufts. RESULTS Various stages of ROP were detected using a rapid acquisition OCT system. In one neonate, serial OCT imaging over a five-week period demonstrated accumulation of neovascular tufts with progression to stage 3 ROP with extraretinal fibrovascular proliferation along the ridge. Videography of this technique is included in this report for instructional purposes. CONCLUSIONS Serial examinations using widefield OCT and scleral depression is feasible and may improve detection and documentation of ROP disease progression. Earlier detection of ROP-related proliferation may prevent vitreoretinal traction, retinal detachment, and blindness.
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Affiliation(s)
- Brittni A. Scruggs
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon
| | - Shuibin Ni
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon
| | - Thanh-Tin P. Nguyen
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon
| | - Susan Ostmo
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon
| | - Michael F. Chiang
- National Eye Institute, National Institutes of Health, Bethesda, Maryland
| | - Yali Jia
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon
| | - David Huang
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon
| | - Yifan Jian
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon
| | - J. Peter Campbell
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon
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32
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Ni S, Khan S, Nguyen TTP, Ng R, Lujan BJ, Tan O, Huang D, Jian Y. Volumetric directional optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2022; 13:950-961. [PMID: 35284155 PMCID: PMC8884206 DOI: 10.1364/boe.447882] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/14/2022] [Accepted: 01/14/2022] [Indexed: 06/14/2023]
Abstract
Photoreceptor loss and resultant thinning of the outer nuclear layer (ONL) is an important pathological feature of retinal degenerations and may serve as a useful imaging biomarker for age-related macular degeneration. However, the demarcation between the ONL and the adjacent Henle's fiber layer (HFL) is difficult to visualize with standard optical coherence tomography (OCT). A dedicated OCT system that can precisely control and continuously and synchronously update the imaging beam entry points during scanning has not been realized yet. In this paper, we introduce a novel imaging technology, Volumetric Directional OCT (VD-OCT), which can dynamically adjust the incident beam on the pupil without manual adjustment during a volumetric OCT scan. We also implement a customized spoke-circular scanning pattern to observe the appearance of HFL with sufficient optical contrast in continuous cross-sectional scans through the entire volume. The application of VD-OCT for retinal imaging to exploit directional reflectivity properties of tissue layers has the potential to allow for early identification of retinal diseases.
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Affiliation(s)
- Shuibin Ni
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon 97239, USA
| | - Shanjida Khan
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon 97239, USA
| | - Thanh-Tin P. Nguyen
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon 97239, USA
| | - Ringo Ng
- School of Engineering Science, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada
| | - Brandon J. Lujan
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon 97239, USA
| | - Ou Tan
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon 97239, USA
| | - David Huang
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon 97239, USA
| | - Yifan Jian
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon 97239, USA
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33
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Garg I, Katz R, Lu Y, Miller JB. Remote Imaging Capture with Widefield Swept-Source OCT Angiography During the COVID-19 Pandemic. Clin Ophthalmol 2022; 16:477-486. [PMID: 35557997 PMCID: PMC9089192 DOI: 10.2147/opth.s352503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 02/11/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose The COVID-19 pandemic has had a widespread impact on the health sector worldwide, both in the clinical and research subsector. This has necessitated for the invention of protocols compliant with social distancing policies to efficiently tackle the current needs. Our aim is to describe a novel remote imaging technique, which helped us continue our research with widefield swept-source optical coherence tomography angiography (WF SS-OCTA). Patients and Methods As a part of this cross-sectional observational study from August 2020 to September 2020 at Massachusetts Eye and Ear (MEE), we used our institute approved remote desktop, outside of MEE, to gain full access to the on-site WF SS-OCTA device in the imaging room for the purpose of remote imaging. With only the patient being in the imaging room, effective communication was established via video conferencing on an encrypted tablet computer device for the entire procedure. Results We imaged four patients with various retinal pathologies, aged 32–69 years. All images obtained were of high quality and signal strength (median score 9/10 for both) and all patients reported a highly satisfactory, comfortable, and safe experience amidst the COVID-19 pandemic. Conclusion This novel method is better for remote imaging compared to the previously described techniques as it is time and cost effective, requires limited resources without compromising the image quality or patient satisfaction and adheres to the various guidelines for infection control, most importantly social distancing. As a paradigm shift, this can also be employed in future for setups with limited staff like busy emergency departments or a rural setup with limited access or difficult commute, in the “new-normal” era.
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Affiliation(s)
- Itika Garg
- Harvard Retinal Imaging Lab, Boston, MA, USA
- Retina Service, Massachusetts Eye and Ear Infirmary, Boston, MA, USA
| | - Raviv Katz
- Harvard Retinal Imaging Lab, Boston, MA, USA
| | - Yifan Lu
- Harvard Retinal Imaging Lab, Boston, MA, USA
- Retina Service, Massachusetts Eye and Ear Infirmary, Boston, MA, USA
| | - John B Miller
- Harvard Retinal Imaging Lab, Boston, MA, USA
- Retina Service, Massachusetts Eye and Ear Infirmary, Boston, MA, USA
- Correspondence: John B Miller, Tel +1 617 573-3750, Fax +1 617 573-3698, Email
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34
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Nguyen TTP, Ni S, Khan S, Wei X, Ostmo S, Chiang MF, Jia Y, Huang D, Jian Y, Campbell JP. Advantages of Widefield Optical Coherence Tomography in the Diagnosis of Retinopathy of Prematurity. Front Pediatr 2022; 9:797684. [PMID: 35118032 PMCID: PMC8806029 DOI: 10.3389/fped.2021.797684] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/21/2021] [Indexed: 12/13/2022] Open
Abstract
Recent advances in portable optical coherence tomography (OCT) and OCT angiography (OCTA) have resulted in wider fields of view (FOV) and shorter capture times, further expanding the potential clinical role of OCT technology in the diagnosis and management of retinopathy of prematurity (ROP). Using a prototype, handheld OCT device, retinal imaging was obtained in non-sedated infants in the neonatal intensive care unit (NICU) as well as sedated infants in the operating room of Oregon Health & Science University (OHSU) Hospital. In this observational study, we provide an overview of potential advantages of OCT-based disease assessment in ROP. We observed that next-generation OCT imaging (a) may be sufficient for objective diagnosis and zone/stage/plus disease categorization, (b) allows for minimally-invasive longitudinal monitoring of disease progression and post-treatment course, (c) provides three-dimensional mapping of the vitreoretinal interface, and (d) with OCTA, enables dye-free visualization of normal and pathologic vascular development.
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Affiliation(s)
- Thanh-Tin P. Nguyen
- School of Medicine, Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
| | - Shuibin Ni
- School of Medicine, Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
- Department of Biomedical Engineering, Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
| | - Shanjida Khan
- School of Medicine, Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
- Department of Biomedical Engineering, Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
| | - Xiang Wei
- School of Medicine, Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
- Department of Biomedical Engineering, Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
| | - Susan Ostmo
- School of Medicine, Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
| | - Michael F. Chiang
- School of Medicine, Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
- National Eye Institute, National Institutes of Health, Bethesda, MD, United States
| | - Yali Jia
- School of Medicine, Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
- Department of Biomedical Engineering, Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
| | - David Huang
- School of Medicine, Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
- Department of Biomedical Engineering, Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
| | - Yifan Jian
- School of Medicine, Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
- Department of Biomedical Engineering, Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
| | - J. Peter Campbell
- School of Medicine, Casey Eye Institute, Oregon Health and Science University, Portland, OR, United States
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35
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Rank EA, Agneter A, Schmoll T, Leitgeb RA, Drexler W. Miniaturizing optical coherence tomography. TRANSLATIONAL BIOPHOTONICS 2022. [DOI: 10.1002/tbio.202100007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Elisabet A. Rank
- Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria
| | - Anja Agneter
- Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria
| | - Tilman Schmoll
- Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria
- Carl Zeiss Meditec, Inc. Dublin California USA
| | - Rainer A. Leitgeb
- Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria
| | - Wolfgang Drexler
- Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria
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36
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Ni S, Nguyen TTP, Ng R, Khan S, Ostmo S, Jia Y, Chiang MF, Huang D, Campbell JP, Jian Y. 105° field of view non-contact handheld swept-source optical coherence tomography. OPTICS LETTERS 2021; 46:5878-5881. [PMID: 34851913 PMCID: PMC10443941 DOI: 10.1364/ol.443672] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 11/03/2021] [Indexed: 06/13/2023]
Abstract
We demonstrate a handheld swept-source optical coherence tomography (OCT) system with a 400 kHz vertical-cavity surface-emitting laser (VCSEL) light source, a non-contact approach, and an unprecedented single shot 105° field of view (FOV). We also implemented a spiral scanning pattern allowing real-time visualization with improved scanning efficiency. To the best of our knowledge, this is the widest FOV achieved in a portable non-contact OCT retinal imaging system to date. Improvements to the FOV may aid the evaluation of retinal diseases such as retinopathy of prematurity, where important vitreoretinal changes often occur in the peripheral retina.
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Affiliation(s)
- Shuibin Ni
- Casey Eye Institute, Oregon Health & Science
University, Portland, Oregon 97239, USA
| | - Thanh-Tin P. Nguyen
- Casey Eye Institute, Oregon Health & Science
University, Portland, Oregon 97239, USA
| | - Ringo Ng
- School of Engineering Science, Simon Fraser University,
Burnaby, British Columbia V5A 1S6, Canada
| | - Shanjida Khan
- Casey Eye Institute, Oregon Health & Science
University, Portland, Oregon 97239, USA
- Department of Biomedical Engineering, Oregon Health &
Science University, Portland, Oregon 97239, USA
| | - Susan Ostmo
- Casey Eye Institute, Oregon Health & Science
University, Portland, Oregon 97239, USA
| | - Yali Jia
- Casey Eye Institute, Oregon Health & Science
University, Portland, Oregon 97239, USA
- Department of Biomedical Engineering, Oregon Health &
Science University, Portland, Oregon 97239, USA
| | - Michael F. Chiang
- National Eye Institute, National Institutes of Health,
Bethesda, Maryland 20892, USA
| | - David Huang
- Casey Eye Institute, Oregon Health & Science
University, Portland, Oregon 97239, USA
- Department of Biomedical Engineering, Oregon Health &
Science University, Portland, Oregon 97239, USA
| | - J. Peter Campbell
- Casey Eye Institute, Oregon Health & Science
University, Portland, Oregon 97239, USA
| | - Yifan Jian
- Casey Eye Institute, Oregon Health & Science
University, Portland, Oregon 97239, USA
- Department of Biomedical Engineering, Oregon Health &
Science University, Portland, Oregon 97239, USA
| |
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