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Rui Y, Zhang M, Lee DM, Snyder VC, Raghuraman R, Gofas-Salas E, Mecê P, Yadav S, Tiruveedhula P, Grieve K, Sahel JA, Errera MH, Rossi EA. Label-Free Imaging of Inflammation at the Level of Single Cells in the Living Human Eye. OPHTHALMOLOGY SCIENCE 2024; 4:100475. [PMID: 38881602 PMCID: PMC11179426 DOI: 10.1016/j.xops.2024.100475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 12/22/2023] [Accepted: 01/16/2024] [Indexed: 06/18/2024]
Abstract
Purpose Putative microglia were recently detected using adaptive optics ophthalmoscopy in healthy eyes. Here we evaluate the use of nonconfocal adaptive optics scanning light ophthalmoscopy (AOSLO) for quantifying the morphology and motility of presumed microglia and other immune cells in eyes with retinal inflammation from uveitis and healthy eyes. Design Observational exploratory study. Participants Twelve participants were imaged, including 8 healthy participants and 4 posterior uveitis patients recruited from the clinic of 1 of the authors (M.H.E.). Methods The Pittsburgh AOSLO imaging system was used with a custom-designed 7-fiber optical fiber bundle for simultaneous confocal and nonconfocal multioffset detection. The inner retina was imaged at several locations at multiple timepoints in healthy participants and uveitis patients to generate time-lapse images. Main Outcome Measures Microglia and macrophages were manually segmented from nonconfocal AOSLO images, and their morphological characteristics quantified (including soma size, diameter, and circularity). Cell soma motion was quantified across time for periods of up to 30 minutes and their speeds were calculated by measuring their displacement over time. Results A spectrum of cell morphologies was detected in healthy eyes from circular amoeboid cells to elongated cells with visible processes, resembling activated and ramified microglia, respectively. Average soma diameter was 16.1 ± 0.9 μm. Cell movement was slow in healthy eyes (0.02 μm/sec on average), but macrophage-like cells moved rapidly in some uveitis patients (up to 3 μm/sec). In an eye with infectious uveitis, many macrophage-like cells were detected; during treatment their quantity and motility decreased as vision improved. Conclusions In vivo adaptive optics ophthalmoscopy offers promise as a potentially powerful tool for detecting and monitoring inflammation and response to treatment at a cellular level in the living eye. Financial Disclosures Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Yuhua Rui
- Department of Ophthalmology, University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania
- Eye Center of Xiangya Hospital, Central South University Hunan Key Laboratory of Ophthalmology Changsha, Hunan, China
| | - Min Zhang
- Department of Ophthalmology, University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania
| | - Daniel M.W. Lee
- Department of Bioengineering, University of Pittsburgh Swanson School of Engineering Pittsburgh, Pennsylvania
| | - Valerie C. Snyder
- Department of Ophthalmology, University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania
| | - Rashmi Raghuraman
- Department of Ophthalmology, University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania
| | - Elena Gofas-Salas
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
- CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, Paris, France
| | - Pedro Mecê
- Institut Langevin, ESPCI Paris, Université PSL, CNRS, Paris, France
| | - Sanya Yadav
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | | - Kate Grieve
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
- CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, Paris, France
| | - José-Alain Sahel
- Department of Ophthalmology, University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania
| | - Marie-Hélène Errera
- Department of Ophthalmology, University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania
| | - Ethan A. Rossi
- Department of Ophthalmology, University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania
- Department of Bioengineering, University of Pittsburgh Swanson School of Engineering Pittsburgh, Pennsylvania
- McGowan Institute for Regenerative Medicine Pittsburgh, Pennsylvania
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Cui J, Villamil M, Schneider AC, Lawton PF, Young LK, Booth MJ, Smithson HE. Extended-period AOSLO imaging in the living human retina without pupil dilation: a feasibility study. BIOMEDICAL OPTICS EXPRESS 2024; 15:4995-5008. [PMID: 39296415 PMCID: PMC11407263 DOI: 10.1364/boe.531808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 07/21/2024] [Accepted: 07/22/2024] [Indexed: 09/21/2024]
Abstract
In vivo imaging using an adaptive optics scanning laser ophthalmoscope (AOSLO) is challenging, especially over extended periods. Pharmacological agents, administered as eye drops, are commonly used to dilate the pupil and paralyse accommodation, to improve image quality. However, they are contraindicated in some scenarios. Here, we evaluate the feasibility and reproducibility of performing AOSLO imaging without pharmacological pupil dilation over 1.5 hours with visual stimulation. Through statistical analysis and theoretical modelling using a dataset of retinal and pupil images collected from six healthy, young, near-emmetropic participants between the ages of 20-30 years, we validate that the retinal image quality does not change significantly with time in the experimental session (p = 0.33), and that pupil size has a strong effect on image quality but is not the only contributing factor.
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Affiliation(s)
- Jiahe Cui
- Department of Engineering Science, University of Oxford, Parks Road, Oxford OX1 3PJ, United Kingdom
| | - Maria Villamil
- Department of Experimental Psychology, University of Oxford, Anna Watts Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, United Kingdom
| | - Allie C Schneider
- Department of Experimental Psychology, University of Oxford, Anna Watts Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, United Kingdom
| | - Penelope F Lawton
- Faculty of Medical Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, United Kingdom
| | - Laura K Young
- Faculty of Medical Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, United Kingdom
| | - Martin J Booth
- Department of Engineering Science, University of Oxford, Parks Road, Oxford OX1 3PJ, United Kingdom
| | - Hannah E Smithson
- Department of Experimental Psychology, University of Oxford, Anna Watts Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, United Kingdom
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3
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Song H, Hang H, Li K, Rossi EA, Zhang J. LONGITUDINAL ADAPTIVE OPTICS SCANNING LASER OPHTHALMOSCOPY REVEALS REGIONAL VARIATION IN CONE AND ROD PHOTORECEPTOR LOSS IN STARGARDT DISEASE. Retina 2024; 44:1403-1412. [PMID: 38484106 PMCID: PMC11269039 DOI: 10.1097/iae.0000000000004104] [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: 04/12/2024]
Abstract
PURPOSE To investigate the temporal sequence of changes in the photoreceptor cell mosaic in patients with Stargardt disease type 1, using adaptive optics scanning laser ophthalmoscopy. METHODS Two brothers with genetically confirmed Stargardt disease type 1 underwent comprehensive eye exams, spectral-domain optical coherence tomography, fundus autofluorescence, and adaptive optics scanning laser ophthalmoscopy imaging 3 times over the course of 28 months. Confocal images of the cones and rods were obtained from the central fovea to 10° inferiorly. Photoreceptors were counted in sampling windows at 100- µ m intervals of 200 µ m × 200 µ m for cones and 50 µ m × 50 µ m for rods, using custom cell marking software with manual correction. Photoreceptor density and spacing were measured and compared across imaging sessions using one-way analysis of variance. RESULTS Adaptive optics scanning laser ophthalmoscopy revealed the younger brother had a 30% decline in foveal cone density after 8 months, followed by complete loss of foveal cones at 28 months; the older brother had no detectable foveal cones at baseline. In the peripheral macula, cone and rod spacings were greater than normal in both patients. The ratio of the cone spacing to rod spacing was greater than normal across all eccentricities, with a greater divergence closer to the foveal center. CONCLUSION Cone cell loss may be an early pathogenetic step in Stargardt disease. Adaptive optics scanning laser ophthalmoscopy provides the capability to track individual photoreceptor changes longitudinally in Stargardt disease.
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Affiliation(s)
- Hongxin Song
- Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and visual Sciences, National Engineering Research Center for Ophthalmology. Beijing, China
| | - Hui Hang
- Department of Ophthalmology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital. Nanjing, China
| | - Kaiwen Li
- Advanced Ophthalmology Laboratory (AOL), Robotrak Technologies, Nanjing, China
| | - Ethan A. Rossi
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jie Zhang
- Advanced Ophthalmology Laboratory (AOL), Robotrak Technologies, Nanjing, China
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4
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Zhang F, Kovalick K, Raghavendra A, Soltanian-Zadeh S, Farsiu S, Hammer DX, Liu Z. In vivo imaging of human retinal ganglion cells using optical coherence tomography without adaptive optics. BIOMEDICAL OPTICS EXPRESS 2024; 15:4675-4688. [PMID: 39346995 PMCID: PMC11427184 DOI: 10.1364/boe.533249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 06/21/2024] [Accepted: 06/25/2024] [Indexed: 10/01/2024]
Abstract
Retinal ganglion cells play an important role in human vision, and their degeneration results in glaucoma and other neurodegenerative diseases. Imaging these cells in the living human retina can greatly improve the diagnosis and treatment of glaucoma. However, owing to their translucent soma and tight packing arrangement within the ganglion cell layer (GCL), successful imaging has only been achieved with sophisticated research-grade adaptive optics (AO) systems. For the first time we demonstrate that GCL somas can be resolved and cell morphology can be quantified using non-AO optical coherence tomography (OCT) devices with optimal parameter configuration and post-processing.
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Affiliation(s)
- Furu Zhang
- Center for Devices and Radiological Health (CDRH), U.S. Food and Drug Administration, Silver Spring, MD 20993, USA
| | - Katherine Kovalick
- Center for Devices and Radiological Health (CDRH), U.S. Food and Drug Administration, Silver Spring, MD 20993, USA
| | - Achyut Raghavendra
- Center for Devices and Radiological Health (CDRH), U.S. Food and Drug Administration, Silver Spring, MD 20993, USA
| | | | - Sina Farsiu
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Daniel X. Hammer
- Center for Devices and Radiological Health (CDRH), U.S. Food and Drug Administration, Silver Spring, MD 20993, USA
| | - Zhuolin Liu
- Center for Devices and Radiological Health (CDRH), U.S. Food and Drug Administration, Silver Spring, MD 20993, USA
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De Bruyn H, Johnson M, Moretti M, Ahmed S, Mujat M, Akula JD, Glavan T, Mihalek I, Aslaksen S, Molday LL, Molday RS, Berkowitz BA, Fulton AB. The Surviving, Not Thriving, Photoreceptors in Patients with ABCA4 Stargardt Disease. Diagnostics (Basel) 2024; 14:1545. [PMID: 39061682 PMCID: PMC11275370 DOI: 10.3390/diagnostics14141545] [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: 05/31/2024] [Revised: 06/25/2024] [Accepted: 07/02/2024] [Indexed: 07/28/2024] Open
Abstract
Stargardt disease (STGD1), associated with biallelic variants in the ABCA4 gene, is the most common heritable macular dystrophy and is currently untreatable. To identify potential treatment targets, we characterized surviving STGD1 photoreceptors. We used clinical data to identify macular regions with surviving STGD1 photoreceptors. We compared the hyperreflective bands in the optical coherence tomographic (OCT) images that correspond to structures in the STGD1 photoreceptor inner segments to those in controls. We used adaptive optics scanning light ophthalmoscopy (AO-SLO) to study the distribution of cones and AO-OCT to evaluate the interface of photoreceptors and retinal pigment epithelium (RPE). We found that the profile of the hyperreflective bands differed dramatically between patients with STGD1 and controls. AO-SLOs showed patches in which cone densities were similar to those in healthy retinas and others in which the cone population was sparse. In regions replete with cones, there was no debris at the photoreceptor-RPE interface. In regions with sparse cones, there was abundant debris. Our results raise the possibility that pharmaceutical means may protect surviving photoreceptors and so mitigate vision loss in patients with STGD1.
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Affiliation(s)
- Hanna De Bruyn
- Department of Ophthalmology, Boston Children’s Hospital, Boston, MA 02115, USA; (H.D.B.)
| | - Megan Johnson
- Department of Ophthalmology, Visual and Anatomical Sciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Madelyn Moretti
- Department of Ophthalmology, Visual and Anatomical Sciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Saleh Ahmed
- Department of Ophthalmology, Visual and Anatomical Sciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Mircea Mujat
- Physical Sciences, Inc., 20 New England Business Center, Andover, MA 01810, USA;
| | - James D. Akula
- Department of Ophthalmology, Boston Children’s Hospital, Boston, MA 02115, USA; (H.D.B.)
- Department of Ophthalmology, Harvard Medical School, Boston, MA 02115, USA
| | - Tomislav Glavan
- Department of Molecular Medicine and Biotechnology, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Ivana Mihalek
- Department of Molecular Medicine and Biotechnology, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Sigrid Aslaksen
- Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Department of Clinical Science, University of Bergen, 5007 Bergen, Norway
- Department of Medical Genetics, Haukeland University Hospital, 5009 Bergen, Norway
| | - Laurie L. Molday
- Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Robert S. Molday
- Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Bruce A. Berkowitz
- Department of Ophthalmology, Visual and Anatomical Sciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Anne B. Fulton
- Department of Ophthalmology, Boston Children’s Hospital, Boston, MA 02115, USA; (H.D.B.)
- Department of Ophthalmology, Harvard Medical School, Boston, MA 02115, USA
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6
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Ameln J, Saßmannshausen M, von der Emde L, Carmichael-Martins A, Holz FG, Ach T, Harmening WM. Assessment of local sensitivity in incomplete retinal pigment epithelium and outer retinal atrophy (iRORA) lesions in intermediate age-related macular degeneration (iAMD). BMJ Open Ophthalmol 2024; 9:e001638. [PMID: 38981710 PMCID: PMC11256035 DOI: 10.1136/bmjophth-2024-001638] [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: 01/18/2024] [Accepted: 06/17/2024] [Indexed: 07/11/2024] Open
Abstract
Lesions of incomplete retinal pigment epithelium and outer retinal atrophy (iRORA) are associated with disease progression in age-related macular degeneration. However, the corresponding functional impact of these precursor lesions is unknown.We present a cross-sectional study of four patients employing clinical-grade MAIA (stimulus size: 0.43°, ~125 µm) and adaptive optics scanning light ophthalmoscope (AOSLO, stimulus size 0.07°, ~20 µm) based microperimetry (MP) to assess the specific impact of iRORA lesions on retinal sensitivity.AOSLO imaging showed overall reduced photoreceptor reflectivity and patches of hyporeflective regions at drusen with interspersed hyper-reflective foci in iRORA regions. MAIA-MP yielded an average retinal sensitivity loss of -7.3±3.1 dB at iRORA lesions compared with the in-eye control. With AOSLO-MP, the corresponding sensitivity loss was 20.1±4.8 dB.We demonstrated that iRORA lesions are associated with a severe impairment in retinal sensitivity. Larger cohort studies will be necessary to validate our findings.
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Affiliation(s)
- Julius Ameln
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
| | | | - Leon von der Emde
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
| | | | - Frank G Holz
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
| | - Thomas Ach
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
| | - Wolf M Harmening
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
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7
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Torm MEW, Pircher M, Bonnin S, Johannesen J, Klefter ON, Schmidt MF, Frederiksen JL, Lefaudeux N, Andilla J, Valdes C, Loza-Alvarez P, Brea LS, De Jesus DA, Grieve K, Paques M, Larsen M, Gocho K. Detection of capillary abnormalities in early diabetic retinopathy using scanning laser ophthalmoscopy and optical coherence tomography combined with adaptive optics. Sci Rep 2024; 14:13450. [PMID: 38862584 PMCID: PMC11166634 DOI: 10.1038/s41598-024-63749-7] [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: 02/01/2024] [Accepted: 05/31/2024] [Indexed: 06/13/2024] Open
Abstract
This study tested if a high-resolution, multi-modal, multi-scale retinal imaging instrument can provide novel information about structural abnormalities in vivo. The study examined 11 patients with very mild to moderate non-proliferative diabetic retinopathy (NPDR) and 10 healthy subjects using fundus photography, optical coherence tomography (OCT), OCT angiography (OCTA), adaptive optics scanning laser ophthalmoscopy (AO-SLO), adaptive optics OCT and OCTA (AO-OCT(A)). Of 21 eyes of 11 patients, 11 had very mild NPDR, 8 had mild NPDR, 2 had moderate NPDR, and 1 had no retinopathy. Using AO-SLO, capillary looping, inflections and dilations were detected in 8 patients with very mild or mild NPDR, and microaneurysms containing hyperreflective granular elements were visible in 9 patients with mild or moderate NPDR. Most of the abnormalities were seen to be perfused in the corresponding OCTA scans while a few capillary loops appeared to be occluded or perfused at a non-detectable flow rate, possibly because of hypoperfusion. In one patient with moderate NPDR, non-perfused capillaries, also called ghost vessels, were identified by alignment of corresponding en face AO-OCT and AO-OCTA images. The combination of multiple non-invasive imaging methods could identify prominent microscopic abnormalities in diabetic retinopathy earlier and more detailed than conventional fundus imaging devices.
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Affiliation(s)
- Marie Elise Wistrup Torm
- Department of Ophthalmology, Center for Research in Eye Diseases, Rigshospitalet, Section 37, Valdemar Hansens Vej 13, 2600, Glostrup, Denmark.
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, Denmark.
| | - Michael Pircher
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Sophie Bonnin
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, 28 Rue de Charenton, 75012, Paris, France
- INSERM, CNRS, Institut de La Vision, Sorbonne Université, 17 Rue Moreau, 75012, Paris, France
- Foundation Rothschild Hospital, 25-29, Rue Manin, 75019, Paris, France
| | - Jesper Johannesen
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, Denmark
- Department of Pediatrics, Herlev-Gentofte Hospital, Borgmester Ib Juuls Vej 25C, Herlev, Denmark
- Department of Clinical Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, Herlev, Denmark
| | - Oliver Niels Klefter
- Department of Ophthalmology, Center for Research in Eye Diseases, Rigshospitalet, Section 37, Valdemar Hansens Vej 13, 2600, Glostrup, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, Denmark
| | - Mathias Falck Schmidt
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, Denmark
- Department of Neurology, Clinic of Optic Neuritis, The Danish Multiple Sclerosis Center (DMSC), Rigshospitalet, Valdemar Hansens Vej 13, Glostrup, Denmark
| | - Jette Lautrup Frederiksen
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, Denmark
- Department of Neurology, Clinic of Optic Neuritis, The Danish Multiple Sclerosis Center (DMSC), Rigshospitalet, Valdemar Hansens Vej 13, Glostrup, Denmark
| | | | - Jordi Andilla
- The Barcelona Institute of Science and Technology, ICFO-Institut de Ciencies Fotoniques, 08860, Castelldefels, Barcelona, Spain
| | - Claudia Valdes
- The Barcelona Institute of Science and Technology, ICFO-Institut de Ciencies Fotoniques, 08860, Castelldefels, Barcelona, Spain
| | - Pablo Loza-Alvarez
- The Barcelona Institute of Science and Technology, ICFO-Institut de Ciencies Fotoniques, 08860, Castelldefels, Barcelona, Spain
| | - Luisa Sanchez Brea
- Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Dr. Molewaterplein 40, Rotterdam, The Netherlands
- Department of Ophthalmology, Erasmus Medical Center, Dr. Molewaterplein 40, Rotterdam, The Netherlands
- The Rotterdam Eye Hospital, The Rotterdam Ophthalmic Institute, Schiedamse Vest 160, Rotterdam, The Netherlands
| | - Danilo Andrade De Jesus
- Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Dr. Molewaterplein 40, Rotterdam, The Netherlands
- Department of Ophthalmology, Erasmus Medical Center, Dr. Molewaterplein 40, Rotterdam, The Netherlands
- The Rotterdam Eye Hospital, The Rotterdam Ophthalmic Institute, Schiedamse Vest 160, Rotterdam, The Netherlands
| | - Kate Grieve
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, 28 Rue de Charenton, 75012, Paris, France
- INSERM, CNRS, Institut de La Vision, Sorbonne Université, 17 Rue Moreau, 75012, Paris, France
| | - Michel Paques
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, 28 Rue de Charenton, 75012, Paris, France
- INSERM, CNRS, Institut de La Vision, Sorbonne Université, 17 Rue Moreau, 75012, Paris, France
| | - Michael Larsen
- Department of Ophthalmology, Center for Research in Eye Diseases, Rigshospitalet, Section 37, Valdemar Hansens Vej 13, 2600, Glostrup, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, Denmark
| | - Kiyoko Gocho
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, 28 Rue de Charenton, 75012, Paris, France
- INSERM, CNRS, Institut de La Vision, Sorbonne Université, 17 Rue Moreau, 75012, Paris, France
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D'Angelo JC, Tiruveedhula P, Weber RJ, Arathorn DW, Roorda A. A paradoxical misperception of relative motion. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.04.596708. [PMID: 38895454 PMCID: PMC11185587 DOI: 10.1101/2024.06.04.596708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
Motion perception is considered a hyperacuity. The presence of a visual frame of reference to compute relative motion is necessary to achieve this sensitivity [Legge, Gordon E., and F. W. Campbell. "Displacement detection in human vision." Vision Research 21.2 (1981): 205-213.]. However, there is a special condition where humans are unable to accurately detect relative motion: images moving in a direction consistent with retinal slip where the motion is unnaturally amplified can, under some conditions, appear stable [Arathorn, David W., et al. "How the unstable eye sees a stable and moving world." Journal of Vision 13.10.22 (2013)]. In this study, we asked: Is world-fixed retinal image background content necessary for the visual system to compute the direction of eye motion to render in the percept images moving with amplified slip as stable? Or, are non-visual cues sufficient? Subjects adjusted the parameters of a stimulus moving in a random trajectory to match the perceived motion of images moving contingent to the retina. Experiments were done with and without retinal image background content. The perceived motion of stimuli moving with amplified retinal slip was suppressed in the presence of visual content; however, higher magnitudes of motion were perceived under conditions with no visual cues. Our results demonstrate that the presence of retinal image background content is essential for the visual system to compute its direction of motion. The visual content that might be thought to provide a strong frame of reference to detect amplified retinal slips, instead paradoxically drives the misperception of relative motion.
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Affiliation(s)
- Josephine C D'Angelo
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, CA 94720
| | - Pavan Tiruveedhula
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, CA 94720
| | - Raymond J Weber
- Electrical and Computer Engineering Department, Montana Sate University, Bozeman, MT 59717-3780
| | - David W Arathorn
- Electrical and Computer Engineering Department, Montana Sate University, Bozeman, MT 59717-3780
| | - Austin Roorda
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, CA 94720
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9
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Greene MJ, Boehm AE, Vanston JE, Pandiyan VP, Sabesan R, Tuten WS. Unique yellow shifts for small and brief stimuli in the central retina. J Vis 2024; 24:2. [PMID: 38833255 PMCID: PMC11156209 DOI: 10.1167/jov.24.6.2] [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: 10/31/2023] [Accepted: 05/01/2024] [Indexed: 06/06/2024] Open
Abstract
The spectral locus of unique yellow was determined for flashes of different sizes (<11 arcmin) and durations (<500 ms) presented in and near the fovea. An adaptive optics scanning laser ophthalmoscope was used to minimize the effects of higher-order aberrations during simultaneous stimulus delivery and retinal imaging. In certain subjects, parafoveal cones were classified as L, M, or S, which permitted the comparison of unique yellow measurements with variations in local L/M ratios within and between observers. Unique yellow shifted to longer wavelengths as stimulus size or duration was reduced. This effect is most pronounced for changes in size and more apparent in the fovea than in the parafovea. The observed variations in unique yellow are not entirely predicted from variations in L/M ratio and therefore implicate neural processes beyond photoreception.
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Affiliation(s)
- Maxwell J Greene
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, CA, USA
| | - Alexandra E Boehm
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, CA, USA
| | - John E Vanston
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, CA, USA
| | - Vimal P Pandiyan
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Ramkumar Sabesan
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - William S Tuten
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, CA, USA
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10
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Baez HC, LaPorta JM, Walker AD, Fischer WS, Hollar R, Patterson S, DiLoreto DA, Gullapalli V, McGregor JE. Inner limiting Membrane Peel Extends In vivo Calcium Imaging of Retinal Ganglion Cell Activity Beyond the Fovea in Non-Human Primate. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.02.597041. [PMID: 38854047 PMCID: PMC11160754 DOI: 10.1101/2024.06.02.597041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
High resolution retinal imaging paired with intravitreal injection of a viral vector coding for the calcium indicator GCaMP has enabled visualization of activity dependent calcium changes in retinal ganglion cells (RGCs) at single cell resolution in the living eye. The inner limiting membrane (ILM) is a barrier for viral vectors, restricting transduction to a ring of RGCs serving the fovea in both humans and non-human primates (NHP). We evaluate peeling the ILM prior to intravitreal injection as a strategy to expand calcium imaging beyond the fovea in the NHP eye in vivo. Five Macaca fascicularis eyes (age 3-10y; n=3 individuals; 2M, 1F) underwent vitrectomy and 5 to 6-disc diameter ILM peel centered on the fovea prior to intravitreal delivery of 7m8:SNCG:GCaMP8s. Calcium responses from RGCs were recorded using a fluorescence adaptive optics scanning laser ophthalmoscope. In all eyes GCaMP was expressed throughout the peeled area, representing a mean 8-fold enlargement in area of expression relative to a control eye. Calcium recordings were obtained up to 11 degrees from the foveal center. RGC responses were comparable to the fellow control eye and showed no significant decrease over the 6 months post ILM peel, suggesting that RGC function was not compromised by the surgical procedure. In addition, we demonstrate that activity can be recorded directly from the retinal nerve fiber layer. This approach will be valuable for a range of applications in visual neuroscience including pre-clinical evaluation of retinal function, detecting vision loss, and assessing the impact of therapeutic interventions.
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Affiliation(s)
- Hector C Baez
- Department of Biomedical Engineering, University of Rochester, Rochester, NY
- Center for Visual Science, University of Rochester, Rochester, NY
| | | | - Amber D Walker
- Center for Visual Science, University of Rochester, Rochester, NY
| | | | - Rachel Hollar
- Center for Visual Science, University of Rochester, Rochester, NY
- Department of Ophthalmology, Flaum Eye Institute, University of Rochester Medical Center, Rochester, NY
| | - Sara Patterson
- Center for Visual Science, University of Rochester, Rochester, NY
| | - David A DiLoreto
- Center for Visual Science, University of Rochester, Rochester, NY
- Department of Ophthalmology, Flaum Eye Institute, University of Rochester Medical Center, Rochester, NY
| | - Vamsi Gullapalli
- Department of Ophthalmology, Flaum Eye Institute, University of Rochester Medical Center, Rochester, NY
| | - Juliette E McGregor
- Center for Visual Science, University of Rochester, Rochester, NY
- Department of Ophthalmology, Flaum Eye Institute, University of Rochester Medical Center, Rochester, NY
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11
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Moon B, Linebach G, Yang A, Jenks SK, Rucci M, Poletti M, Rolland JP. High refresh rate display for natural monocular viewing in AOSLO psychophysics experiments. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.26.595808. [PMID: 38854135 PMCID: PMC11160679 DOI: 10.1101/2024.05.26.595808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
By combining an external display operating at 360 frames per second with an Adaptive Optics Scanning Laser Ophthalmoscope (AOSLO) for human foveal imaging, we demonstrate color stimulus delivery at high spatial and temporal resolution in AOSLO psychophysics experiments. A custom pupil relay enables viewing of the stimulus through a 3-mm effective pupil diameter and provides refractive error correction from -8 to +4 diopters. Performance of the assembled and aligned pupil relay was validated by measuring the wavefront error across the field of view and correction range, and the as-built Strehl ratio was 0.64 or better. High-acuity stimuli were rendered on the external display and imaged through the pupil relay to demonstrate that spatial frequencies up to 54 cycles per degree, corresponding to 20/11 visual acuity, are resolved. The completed external display was then used to render fixation markers across the field of view of the monitor, and a continuous retinal montage spanning 9.4 by 5.4 degrees of visual angle was acquired with the AOSLO. We conducted eye-tracking experiments during free-viewing and high-acuity tasks with polychromatic images presented on the external display. Sub-arcminute eye position uncertainty was achieved, enabling precise localization of the line of sight on the monitor while simultaneously imaging the fine structure of the human central fovea. This high refresh rate display overcomes the temporal, spectral, and field of view limitations of AOSLO-based stimulus presentation, enabling natural monocular viewing of stimuli in psychophysics experiments conducted with AOSLO.
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12
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Kortuem FC, Kempf M, Merle DA, Kuehlewein L, Pohl L, Reith M, Jung R, Ott S, Stingl K, Stingl K. A morphometric analysis of the retinal arterioles with adaptive optics imaging in RPE65-associated retinal dystrophy after treatment with voretigene neparvovec. Acta Ophthalmol 2024; 102:e358-e366. [PMID: 37715554 DOI: 10.1111/aos.15765] [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: 04/18/2023] [Revised: 07/03/2023] [Accepted: 08/29/2023] [Indexed: 09/17/2023]
Abstract
PURPOSE To investigate the changes in retinal arterial architecture after treatment with voretigene neparvovec in patients with retinal dystrophy caused by bi-allelic mutations in the RPE65 gene. METHODS Sixteen eyes treated with voretigene neparvovec at the University Eye Clinic in Tuebingen, Germany, underwent adaptive optics ophthalmoscopy (AO) imaging at baseline and 2 weeks, 1, 3, 6 and 12 months after treatment. Follow-up was performed in six eyes of four patients. For each eye, five different positions at arterial vessels were selected and the wall-to-lumen ratio (WLR), the lumen diameter (LD) and the wall cross-sectional area (WCSA) were measured by the manufacturer's software over the observational period. RESULTS Vast retinal atrophy dominated all gained AO images. WLR fluctuated in the observation period without statistically significant change. LD and WCSA changed significantly after 2 weeks from the baseline examination and returned to values similar to baseline thereafter. There were no signs of inflammation such as macrophages or perivascular accumulated fluid visible. CONCLUSION AO imaging of the retinal vessels in RPE65-associated retinal dystrophies (IRD) is challenging. There was no change in the retinal arterial vasculature over the observation period of 12 months that would indicate inflammatory changes. Decrease of the LD and WCSA shortly after treatment might be caused by the perioperative prednisolone intake. AO of retinal vessels can be used as a diagnostic module to complement monitoring the disease and effects of genetic treatments if the acquisition is possible in selected cases.
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Affiliation(s)
- Friederike C Kortuem
- Center for Ophthalmology, University Eye Hospital, University of Tübingen, Tübingen, Germany
| | - Melanie Kempf
- Center for Ophthalmology, University Eye Hospital, University of Tübingen, Tübingen, Germany
- Center for Rare Eye Diseases, University of Tübingen, Tübingen, Germany
| | - David A Merle
- Center for Ophthalmology, University Eye Hospital, University of Tübingen, Tübingen, Germany
- Center for Ophthalmology, Institute for Ophthalmic Research, University of Tübingen, Tübingen, Germany
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
| | - Laura Kuehlewein
- Center for Ophthalmology, University Eye Hospital, University of Tübingen, Tübingen, Germany
- Center for Ophthalmology, Institute for Ophthalmic Research, University of Tübingen, Tübingen, Germany
| | - Lisa Pohl
- Center for Ophthalmology, University Eye Hospital, University of Tübingen, Tübingen, Germany
| | - Milda Reith
- Center for Ophthalmology, University Eye Hospital, University of Tübingen, Tübingen, Germany
| | - Ronja Jung
- Center for Ophthalmology, University Eye Hospital, University of Tübingen, Tübingen, Germany
| | - Saskia Ott
- Center for Ophthalmology, University Eye Hospital, University of Tübingen, Tübingen, Germany
| | - Krunoslav Stingl
- Center for Ophthalmology, University Eye Hospital, University of Tübingen, Tübingen, Germany
- Center for Rare Eye Diseases, University of Tübingen, Tübingen, Germany
| | - Katarina Stingl
- Center for Ophthalmology, University Eye Hospital, University of Tübingen, Tübingen, Germany
- Center for Rare Eye Diseases, University of Tübingen, Tübingen, Germany
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13
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Channa R, Wolf RM, Simo R, Brigell M, Fort P, Curcio C, Lynch S, Verbraak F, Abramoff MD. A New Approach to Staging Diabetic Eye Disease: Staging of Diabetic Retinal Neurodegeneration and Diabetic Macular Edema. OPHTHALMOLOGY SCIENCE 2024; 4:100420. [PMID: 38284099 PMCID: PMC10818256 DOI: 10.1016/j.xops.2023.100420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/29/2023] [Accepted: 10/23/2023] [Indexed: 01/30/2024]
Abstract
Topic The goal of this review was to summarize the current level of evidence on biomarkers to quantify diabetic retinal neurodegeneration (DRN) and diabetic macular edema (DME). Clinical relevance With advances in retinal diagnostics, we have more data on patients with diabetes than ever before. However, the staging system for diabetic retinal disease is still based only on color fundus photographs and we do not have clear guidelines on how to incorporate data from the relatively newer modalities into clinical practice. Methods In this review, we use a Delphi process with experts to identify the most promising modalities to identify DRN and DME. These included microperimetry, full-field flash electroretinogram, spectral-domain OCT, adaptive optics, and OCT angiography. We then used a previously published method of determining the evidence level to complete detailed evidence grids for each modality. Results Our results showed that among the modalities evaluated, the level of evidence to quantify DRN and DME was highest for OCT (level 1) and lowest for adaptive optics (level 4). Conclusion For most of the modalities evaluated, prospective studies are needed to elucidate their role in the management and outcomes of diabetic retinal diseases. Financial Disclosures Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Roomasa Channa
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin
| | - Risa M. Wolf
- Department of Pediatric Endocrinology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Rafael Simo
- Division of Endocrinology, Vall d’Hebron University Hospital, CIBERDEM, Barcelona, Spain
| | | | - Patrice Fort
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan
| | - Christine Curcio
- Department of Ophthalmology, University of Alabama, Birmingham, Alabama
| | | | - Frank Verbraak
- Department of Ophthalmology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Michael D. Abramoff
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa
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Hu Y, Yin H, Li M, Bai T, He L, Hu Z, Xia Y, Wang Z. Design and Simulation of a 19-Electrode MEMS Piezoelectric Thin-Film Micro-Deformable Mirror for Ophthalmology. MICROMACHINES 2024; 15:539. [PMID: 38675350 PMCID: PMC11052033 DOI: 10.3390/mi15040539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024]
Abstract
This study presents a numerical simulation-based investigation of a MEMS (micro-electromechanical systems)technology-based deformable mirror employing a piezoelectric film for fundus examination in adaptive optics. Compared to the classical equal-area electrode arrangement model, we optimize the electrode array for higher-order aberrations. The optimized model centralizes electrodes around the mirror center, which realizes low-voltage driving with high-accuracy correction. The optimized models exhibited commendable correction abilities, achieving a unidirectional displacement of 5.74 μm with a driven voltage of 15 V. The voltage-displacement relationship demonstrated high linearity at 0.99. Furthermore, the deformable mirror's influence matrix was computed, aligning with the Zernike standard surface shape of the order 1-3. To quantify aberration correction capabilities, fitting residuals for both models were calculated. The results indicate an average removal of 96.8% of aberrations to the human eye. This underscores that the optimized model outperforms the classical model in correcting high-order aberrations.
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Affiliation(s)
- Yisen Hu
- School of Mechanical Engineering, Sichuan University, Chengdu 610065, China; (Y.H.); (M.L.); (T.B.); (L.H.)
- Key Laboratory of Radiation Physics and Technology of Ministry of Education, Institute of Nuclear Science and Technology, Sichuan University, Chengdu 610064, China;
| | - Hongbo Yin
- Med+X Center for Manufacturing, West China Hospital, Sichuan University, Chengdu 610041, China;
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Maoying Li
- School of Mechanical Engineering, Sichuan University, Chengdu 610065, China; (Y.H.); (M.L.); (T.B.); (L.H.)
| | - Tianyu Bai
- School of Mechanical Engineering, Sichuan University, Chengdu 610065, China; (Y.H.); (M.L.); (T.B.); (L.H.)
- Med+X Center for Manufacturing, West China Hospital, Sichuan University, Chengdu 610041, China;
| | - Liang He
- School of Mechanical Engineering, Sichuan University, Chengdu 610065, China; (Y.H.); (M.L.); (T.B.); (L.H.)
- Med+X Center for Manufacturing, West China Hospital, Sichuan University, Chengdu 610041, China;
| | - Zhimin Hu
- Key Laboratory of Radiation Physics and Technology of Ministry of Education, Institute of Nuclear Science and Technology, Sichuan University, Chengdu 610064, China;
| | - Yuanlin Xia
- School of Mechanical Engineering, Sichuan University, Chengdu 610065, China; (Y.H.); (M.L.); (T.B.); (L.H.)
- Med+X Center for Manufacturing, West China Hospital, Sichuan University, Chengdu 610041, China;
| | - Zhuqing Wang
- School of Mechanical Engineering, Sichuan University, Chengdu 610065, China; (Y.H.); (M.L.); (T.B.); (L.H.)
- Med+X Center for Manufacturing, West China Hospital, Sichuan University, Chengdu 610041, China;
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Warr E, Grieshop J, Cooper RF, Carroll J. The effect of sampling window size on topographical maps of foveal cone density. FRONTIERS IN OPHTHALMOLOGY 2024; 4:1348950. [PMID: 38984138 PMCID: PMC11182112 DOI: 10.3389/fopht.2024.1348950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 03/13/2024] [Indexed: 07/11/2024]
Abstract
Purpose To characterize the effect of sampling window size on maps of foveal cone density derived from adaptive optics scanning light ophthalmoscope (AOSLO) images of the cone mosaic. Methods Forty-four AOSLO-derived montages of the foveal cone mosaic (300 x 300µm) were used for this study (from 44 individuals with normal vision). Cone photoreceptor coordinates were semi-automatically identified by one experienced grader. From these coordinates, cone density matrices across each foveal montage were derived using 10 different sampling window sizes containing 5, 10, 15, 20, 40, 60, 80, 100, 150, or 200 cones. For all 440 density matrices, we extracted the location and value of peak cone density (PCD), the cone density centroid (CDC) location, and cone density at the CDC. Results Across all window sizes, PCD values were larger than those extracted at the CDC location, though the difference between these density values decreased as the sampling window size increased (p<0.0001). Overall, both PCD (r=-0.8099, p=0.0045) and density at the CDC (r=-0.7596, p=0.0108) decreased with increasing sampling window size. This reduction was more pronounced for PCD, with a 27.8% lower PCD value on average when using the 200-cone versus the 5-cone window (compared to only a 3.5% reduction for density at the CDC between these same window sizes). While the PCD and CDC locations did not occur at the same location within a given montage, there was no significant relationship between this PCD-CDC offset and sampling window size (p=0.8919). The CDC location was less variable across sampling windows, with an average per-participant 95% confidence ellipse area across the 10 window sizes of 47.56µm² (compared to 844.10µm² for the PCD location, p<0.0001). Conclusion CDC metrics appear more stable across varying sampling window sizes than PCD metrics. Understanding how density values change according to the method used to sample the cone mosaic may facilitate comparing cone density data across different studies.
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Affiliation(s)
- Emma Warr
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Jenna Grieshop
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, United States
- Joint Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI, United States
| | - Robert F Cooper
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, United States
- Joint Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI, United States
| | - Joseph Carroll
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, United States
- Joint Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI, United States
- Department of Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, WI, United States
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16
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Daich Varela M, Dixit M, Kalitzeos A, Michaelides M. Adaptive Optics Retinal Imaging in RDH12-Associated Early Onset Severe Retinal Dystrophy. Invest Ophthalmol Vis Sci 2024; 65:9. [PMID: 38466282 PMCID: PMC10929749 DOI: 10.1167/iovs.65.3.9] [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: 10/11/2023] [Accepted: 12/03/2023] [Indexed: 03/12/2024] Open
Abstract
Purpose RDH12 is among the most common genes found in individuals with early-onset severe retinal (EOSRD). Adaptive optics scanning light ophthalmoscopy (AOSLO) enables resolution of individual rod and cone photoreceptors in the retina. This study presents the first AOSLO imaging of individuals with RDH12-associated EOSRD. Methods Case series of patients who attended Moorfields Eye Hospital (London, UK). Spectral-domain optical coherence tomography, near-infrared reflectance (NIR), and blue autofluorescence imaging were analyzed. En face image sequences of photoreceptors were recorded using either of two AOSLO modalities. Cross-sectional analysis was undertaken for seven patients and longitudinal analysis for one patient. Results Nine eyes from eight patients are presented in this case series. The mean age at the time of the assessment was 11.2 ± 6.5 years of age (range 7-29). A subfoveal continuous ellipsoid zone (EZ) line was present in eight eyes. Posterior pole AOSLO revealed patches of cone mosaics. Average cone densities at regions of interest 0.5° to the fovea ranged from 12,620 to 23,660 cells/mm2, whereas intercell spacing ranged from 7.0 to 9.7 µm. Conclusions This study demonstrates that AOSLO can provide useful high-quality images in patients with EOSRD, even during childhood, with nystagmus, and early macular atrophy. Cones at the posterior pole can appear as scattered islands or, possibly later in life, as a single subfoveal conglomerate. Detailed image analysis suggests that retinal pigment epithelial stress and dysfunction may be the initial step toward degeneration, with NIR being a useful tool to assess retinal well-being in RDH12-associated EOSRD.
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Affiliation(s)
- Malena Daich Varela
- Moorfields Eye Hospital, London, United Kingdom
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Mira Dixit
- Moorfields Eye Hospital, London, United Kingdom
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Angelos Kalitzeos
- Moorfields Eye Hospital, London, United Kingdom
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Michel Michaelides
- Moorfields Eye Hospital, London, United Kingdom
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
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17
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Lee S, Choi SS, Meleppat RK, Zawadzki RJ, Doble N. High-speed, phase contrast retinal and blood flow imaging using an adaptive optics partially confocal multi-line ophthalmoscope. BIOMEDICAL OPTICS EXPRESS 2024; 15:1815-1830. [PMID: 38495707 PMCID: PMC10942708 DOI: 10.1364/boe.507449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/18/2023] [Accepted: 01/14/2024] [Indexed: 03/19/2024]
Abstract
High-speed, phase contrast retinal and blood flow imaging using an adaptive optics partially confocal multi-line ophthalmosocope (AO-pcMLO) is described. It allows for simultaneous confocal and phase contrast imaging with various directional multi-line illumination by using a single 2D camera and a digital micromirror device (DMD). Both vertical and horizontal line illumination directions were tested, for photoreceptor and vascular imaging. The phase contrast imaging provided improved visualization of retinal structures such as cone inner segments, vessel walls and red blood cells with images being acquired at frame rates up to 500 Hz. Blood flow velocities of small vessels (<40 µm in diameter) were measured using kymographs for capillaries and cross-correlation between subsequent images for arterioles or venules. Cardiac-related pulsatile patterns were observed with normal resting heart-beat rate, and instantaneous blood flow velocities from 0.7 to 20 mm/s were measured.
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Affiliation(s)
- Soohyun Lee
- College of Optometry, The Ohio State University, 338 West 10th Avenue, Columbus, Ohio 43210, USA
| | - Stacey S. Choi
- College of Optometry, The Ohio State University, 338 West 10th Avenue, Columbus, Ohio 43210, USA
- Department of Ophthalmology and Visual Sciences, Havener Eye Institute, The Ohio State University, 915 Olentangy River Road, Suite 5000, Ohio 43212, USA
| | - Ratheesh K. Meleppat
- UC Davis Eye Center, Department of Ophthalmology and Vision Science, University of California, Davis, 4860 Y Street, Suite 2400, Sacramento, California 95817, USA
- UC Davis EyePod Small Animal Ocular Imaging Laboratory, Department of Cell Biology and Human Anatomy, University of California, Davis, 4320 Tupper Hall, Davis, California 95616, USA
| | - Robert J. Zawadzki
- UC Davis Eye Center, Department of Ophthalmology and Vision Science, University of California, Davis, 4860 Y Street, Suite 2400, Sacramento, California 95817, USA
- UC Davis EyePod Small Animal Ocular Imaging Laboratory, Department of Cell Biology and Human Anatomy, University of California, Davis, 4320 Tupper Hall, Davis, California 95616, USA
| | - Nathan Doble
- College of Optometry, The Ohio State University, 338 West 10th Avenue, Columbus, Ohio 43210, USA
- Department of Ophthalmology and Visual Sciences, Havener Eye Institute, The Ohio State University, 915 Olentangy River Road, Suite 5000, Ohio 43212, USA
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Luo T, Gilbert RN, Sapoznik KA, Walker BR, Burns SA. Automatic montaging of adaptive optics SLO retinal images based on graph theory. BIOMEDICAL OPTICS EXPRESS 2024; 15:1021-1037. [PMID: 38404321 PMCID: PMC10890876 DOI: 10.1364/boe.505013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/15/2024] [Accepted: 01/15/2024] [Indexed: 02/27/2024]
Abstract
We present a fully automatic montage pipeline for adaptive optics SLO retinal images. It contains a flexible module to estimate the translation between pairwise images. The user can change modules to accommodate the alignment of the dataset using the most appropriate alignment technique, provided that it estimates the translation between image pairs and provides a quantitative confidence metric for the match between 0 and 1. We use these pairwise comparisons and associated metrics to construct a graph where nodes represent frames and edges represent the overlap relations. We use a small diameter spanning tree to determine the best pairwise alignment for each image based on the entire set of image relations. The final stage of the pipeline is a blending module that uses dynamic programming to improve the smoothness of the transition between frames. Data sets ranging from 26 to 119 images were obtained from individuals aged 24 to 81 years with a mix of visually normal control eyes and eyes with glaucoma or diabetes. The resulting automatically generated montages were qualitatively and quantitatively compared to results from semi-automated alignment. Data sets were specifically chosen to include both high quality and medium quality data. The results obtained from the automatic method are comparable or better than results obtained by an experienced operator performing semi-automated montaging. For the plug-in pairwise alignment module, we tested a technique that utilizes SIFT + RANSAC, Normalized cross-correlation (NCC) and a combination of the two. This pipeline produces consistent results not only on outer retinal layers, but also on inner retinal layers such as a nerve fiber layer or images of the vascular complexes, even when images are not of excellent quality.
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Affiliation(s)
- Ting Luo
- School of Optometry, Indiana University, 800 E. Atwater Ave, Bloomington, IN 47405, USA
| | - Robert N. Gilbert
- School of Optometry, Indiana University, 800 E. Atwater Ave, Bloomington, IN 47405, USA
| | - Kaitlyn A. Sapoznik
- School of Optometry, Indiana University, 800 E. Atwater Ave, Bloomington, IN 47405, USA
- College of Optometry, University of Houston, 4401 Martin Luther King Blvd, Houston, TX 77204, USA
| | - Brittany R. Walker
- School of Optometry, Indiana University, 800 E. Atwater Ave, Bloomington, IN 47405, USA
| | - Stephen A. Burns
- School of Optometry, Indiana University, 800 E. Atwater Ave, Bloomington, IN 47405, USA
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Moon B, Poletti M, Roorda A, Tiruveedhula P, Liu SH, Linebach G, Rucci M, Rolland JP. Alignment, calibration, and validation of an adaptive optics scanning laser ophthalmoscope for high-resolution human foveal imaging. APPLIED OPTICS 2024; 63:730-742. [PMID: 38294386 PMCID: PMC11062499 DOI: 10.1364/ao.504283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/26/2023] [Indexed: 02/01/2024]
Abstract
In prior art, advances in adaptive optics scanning laser ophthalmoscope (AOSLO) technology have enabled cones in the human fovea to be resolved in healthy eyes with normal vision and low to moderate refractive errors, providing new insight into human foveal anatomy, visual perception, and retinal degenerative diseases. These high-resolution ophthalmoscopes require careful alignment of each optical subsystem to ensure diffraction-limited imaging performance, which is necessary for resolving the smallest foveal cones. This paper presents a systematic and rigorous methodology for building, aligning, calibrating, and testing an AOSLO designed for imaging the cone mosaic of the central fovea in humans with cellular resolution. This methodology uses a two-stage alignment procedure and thorough system testing to achieve diffraction-limited performance. Results from retinal imaging of healthy human subjects under 30 years of age with refractive errors of less than 3.5 diopters using either 680 nm or 840 nm light show that the system can resolve cones at the very center of the fovea, the region where the cones are smallest and most densely packed.
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Affiliation(s)
- Benjamin Moon
- The Institute of Optics, University of Rochester, Rochester, NY 14627, USA
- Center for Visual Science, University of Rochester, Rochester, NY 14627, USA
| | - Martina Poletti
- Center for Visual Science, University of Rochester, Rochester, NY 14627, USA
- Department of Brain and Cognitive Sciences, University of Rochester, Rochester, NY 14627, USA
- Department of Neuroscience, University of Rochester, Rochester, NY 14627, USA
| | - Austin Roorda
- Herbert Wertheim School of Optometry and Vision Science, University of California Berkeley, Berkeley, CA 94720, USA
| | - Pavan Tiruveedhula
- Herbert Wertheim School of Optometry and Vision Science, University of California Berkeley, Berkeley, CA 94720, USA
| | - Soh Hang Liu
- The Institute of Optics, University of Rochester, Rochester, NY 14627, USA
- Center for Visual Science, University of Rochester, Rochester, NY 14627, USA
| | - Glory Linebach
- The Institute of Optics, University of Rochester, Rochester, NY 14627, USA
- Center for Visual Science, University of Rochester, Rochester, NY 14627, USA
| | - Michele Rucci
- Center for Visual Science, University of Rochester, Rochester, NY 14627, USA
- Department of Brain and Cognitive Sciences, University of Rochester, Rochester, NY 14627, USA
| | - Jannick P. Rolland
- The Institute of Optics, University of Rochester, Rochester, NY 14627, USA
- Center for Visual Science, University of Rochester, Rochester, NY 14627, USA
- Department of Biomedical Engineering, University of Rochester, Rochester, NY 14627, USA
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20
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Mujat M, Sampani K, Patel AH, Zambrano R, Sun JK, Wollstein G, Ferguson RD, Schuman JS, Iftimia N. Motion Contrast, Phase Gradient, and Simultaneous OCT Images Assist in the Interpretation of Dark-Field Images in Eyes with Retinal Pathology. Diagnostics (Basel) 2024; 14:184. [PMID: 38248061 PMCID: PMC10814023 DOI: 10.3390/diagnostics14020184] [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: 12/02/2023] [Revised: 01/04/2024] [Accepted: 01/08/2024] [Indexed: 01/23/2024] Open
Abstract
The cellular-level visualization of retinal microstructures such as blood vessel wall components, not available with other imaging modalities, is provided with unprecedented details by dark-field imaging configurations; however, the interpretation of such images alone is sometimes difficult since multiple structural disturbances may be present in the same time. Particularly in eyes with retinal pathology, microstructures may appear in high-resolution retinal images with a wide range of sizes, sharpnesses, and brightnesses. In this paper we show that motion contrast and phase gradient imaging modalities, as well as the simultaneous acquisition of depth-resolved optical coherence tomography (OCT) images, provide additional insight to help understand the retinal neural and vascular structures seen in dark-field images and may enable improved diagnostic and treatment plans.
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Affiliation(s)
- Mircea Mujat
- Physical Sciences, Inc., 20 New England Business Center, Andover, MA 01810, USA; (A.H.P.); (R.D.F.); (N.I.)
| | - Konstantina Sampani
- Beetham Eye Institute, Joslin Diabetes Center, Boston, MA 02115, USA; (K.S.); (J.K.S.)
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Ankit H. Patel
- Physical Sciences, Inc., 20 New England Business Center, Andover, MA 01810, USA; (A.H.P.); (R.D.F.); (N.I.)
| | - Ronald Zambrano
- Department of Ophthalmology, New York University School of Medicine, New York, NY 10017, USA; (R.Z.); (G.W.)
| | - Jennifer K. Sun
- Beetham Eye Institute, Joslin Diabetes Center, Boston, MA 02115, USA; (K.S.); (J.K.S.)
- Department of Ophthalmology, Harvard Medical School, Boston, MA 02115, USA
| | - Gadi Wollstein
- Department of Ophthalmology, New York University School of Medicine, New York, NY 10017, USA; (R.Z.); (G.W.)
| | - R. Daniel Ferguson
- Physical Sciences, Inc., 20 New England Business Center, Andover, MA 01810, USA; (A.H.P.); (R.D.F.); (N.I.)
| | | | - Nicusor Iftimia
- Physical Sciences, Inc., 20 New England Business Center, Andover, MA 01810, USA; (A.H.P.); (R.D.F.); (N.I.)
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21
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Britten-Jones AC, Thai L, Flanagan JPM, Bedggood PA, Edwards TL, Metha AB, Ayton LN. Adaptive optics imaging in inherited retinal diseases: A scoping review of the clinical literature. Surv Ophthalmol 2024; 69:51-66. [PMID: 37778667 DOI: 10.1016/j.survophthal.2023.09.006] [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: 03/09/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/03/2023]
Abstract
Adaptive optics (AO) imaging enables direct, objective assessments of retinal cells. Applications of AO show great promise in advancing our understanding of the etiology of inherited retinal disease (IRDs) and discovering new imaging biomarkers. This scoping review systematically identifies and summarizes clinical studies evaluating AO imaging in IRDs. Ovid MEDLINE and EMBASE were searched on February 6, 2023. Studies describing AO imaging in monogenic IRDs were included. Study screening and data extraction were performed by 2 reviewers independently. This review presents (1) a broad overview of the dominant areas of research; (2) a summary of IRD characteristics revealed by AO imaging; and (3) a discussion of methodological considerations relating to AO imaging in IRDs. From 140 studies with AO outcomes, including 2 following subretinal gene therapy treatments, 75% included fewer than 10 participants with AO imaging data. Of 100 studies that included participants' genetic diagnoses, the most common IRD genes with AO outcomes are CNGA3, CNGB3, CHM, USH2A, and ABCA4. Confocal reflectance AO scanning laser ophthalmoscopy was the most reported imaging modality, followed by flood-illuminated AO and split-detector AO. The most common outcome was cone density, reported quantitatively in 56% of studies. Future research areas include guidelines to reduce variability in the reporting of AO methodology and a focus on functional AO techniques to guide the development of therapeutic interventions.
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Affiliation(s)
- Alexis Ceecee Britten-Jones
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia; Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia.
| | - Lawrence Thai
- Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Jeremy P M Flanagan
- Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Phillip A Bedggood
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Thomas L Edwards
- Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Andrew B Metha
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Lauren N Ayton
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia; Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
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22
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Ayubi GA, Dubra A. Robust real-time estimation of non-uniform angular velocity and sub-pixel jitter in images captured with resonant scanners. OPTICS EXPRESS 2023; 31:44199-44211. [PMID: 38178497 DOI: 10.1364/oe.512233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 12/05/2023] [Indexed: 01/06/2024]
Abstract
Images captured with resonant scanners are affected by angular velocity fluctuations that result in image distortion and by poor synchronization between scanning and light detection that creates jitter between image rows. We previously demonstrated that both problems can be mitigated in post-processing by recording the scanner orientation in synchrony with the image capture, followed by data resampling [Opt. Express30, 112 (2022)10.1364/OE.446162]. Here we introduce more robust algorithms for estimation of both angular velocity fluctuation and jitter in the presence of random and deterministic noise. We also show linearization of the scanner oscillation model to reduce calculation times by two orders of magnitude, reaching 65,000 jitter estimations per second when using 2,800 samples per image row, and 500,000 when using only 500 samples, easily supporting real-time generation of jitter-corrected images.
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23
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Schmetterer L, Scholl H, Garhöfer G, Janeschitz-Kriegl L, Corvi F, Sadda SR, Medeiros FA. Endpoints for clinical trials in ophthalmology. Prog Retin Eye Res 2023; 97:101160. [PMID: 36599784 DOI: 10.1016/j.preteyeres.2022.101160] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 12/22/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023]
Abstract
With the identification of novel targets, the number of interventional clinical trials in ophthalmology has increased. Visual acuity has for a long time been considered the gold standard endpoint for clinical trials, but in the recent years it became evident that other endpoints are required for many indications including geographic atrophy and inherited retinal disease. In glaucoma the currently available drugs were approved based on their IOP lowering capacity. Some recent findings do, however, indicate that at the same level of IOP reduction, not all drugs have the same effect on visual field progression. For neuroprotection trials in glaucoma, novel surrogate endpoints are required, which may either include functional or structural parameters or a combination of both. A number of potential surrogate endpoints for ophthalmology clinical trials have been identified, but their validation is complicated and requires solid scientific evidence. In this article we summarize candidates for clinical endpoints in ophthalmology with a focus on retinal disease and glaucoma. Functional and structural biomarkers, as well as quality of life measures are discussed, and their potential to serve as endpoints in pivotal trials is critically evaluated.
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Affiliation(s)
- Leopold Schmetterer
- Singapore Eye Research Institute, Singapore; SERI-NTU Advanced Ocular Engineering (STANCE), Singapore; Academic Clinical Program, Duke-NUS Medical School, Singapore; School of Chemistry, Chemical Engineering and Biotechnology, Nanyang Technological University, Singapore; Department of Clinical Pharmacology, Medical University Vienna, Vienna, Austria; Center for Medical Physics and Biomedical Engineering, Medical University Vienna, Vienna, Austria; Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland.
| | - Hendrik Scholl
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland; Department of Ophthalmology, University of Basel, Basel, Switzerland
| | - Gerhard Garhöfer
- Department of Clinical Pharmacology, Medical University Vienna, Vienna, Austria
| | - Lucas Janeschitz-Kriegl
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland; Department of Ophthalmology, University of Basel, Basel, Switzerland
| | - Federico Corvi
- Eye Clinic, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Italy
| | - SriniVas R Sadda
- Doheny Eye Institute, Los Angeles, CA, USA; Department of Ophthalmology, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
| | - Felipe A Medeiros
- Vision, Imaging and Performance Laboratory, Department of Ophthalmology, Duke Eye Center, Duke University, Durham, NC, USA
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24
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Toledo-Cortés S, Dubis AM, González FA, Müller H. Deep Density Estimation for Cone Counting and Diagnosis of Genetic Eye Diseases From Adaptive Optics Scanning Light Ophthalmoscope Images. Transl Vis Sci Technol 2023; 12:25. [PMID: 37982767 PMCID: PMC10668615 DOI: 10.1167/tvst.12.11.25] [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: 03/09/2023] [Accepted: 10/02/2023] [Indexed: 11/21/2023] Open
Abstract
Purpose Adaptive optics scanning light ophthalmoscope (AOSLO) imaging offers a microscopic view of the living retina, holding promise for diagnosing and researching eye diseases like retinitis pigmentosa and Stargardt's disease. The technology's clinical impact of AOSLO hinges on early detection through automated analysis tools. Methods We introduce Cone Density Estimation (CoDE) and CoDE for Diagnosis (CoDED). CoDE is a deep density estimation model for cone counting that estimates a density function whose integral is equal to the number of cones. CoDED is an integration of CoDE with deep image classifiers for diagnosis. We use two AOSLO image datasets to train and evaluate the performance of cone density estimation and classification models for retinitis pigmentosa and Stargardt's disease. Results Bland-Altman plots show that CoDE outperforms state-of-the-art models for cone density estimation. CoDED reported an F1 score of 0.770 ± 0.04 for disease classification, outperforming traditional convolutional networks. Conclusions CoDE shows promise in classifying the retinitis pigmentosa and Stargardt's disease cases from a single AOSLO image. Our preliminary results suggest the potential role of analyzing patterns in the retinal cellular mosaic to aid in the diagnosis of genetic eye diseases. Translational Relevance Our study explores the potential of deep density estimation models to aid in the analysis of AOSLO images. Although the initial results are encouraging, more research is needed to fully realize the potential of such methods in the treatment and study of genetic retinal pathologies.
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Affiliation(s)
- Santiago Toledo-Cortés
- Department of TI and Process Optimization, Faculty of Engineering, Universidad de La Sabana Campus Puente del Común km 7, Chía, Colombia
- MindLab Research Group, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Adam M. Dubis
- Moorfields Eye Hospital NHS Foundation Trust, London, Institute of Ophthalmology, University College London, London, UK
- Global Business School for Health, University College London, London, UK
| | - Fabio A. González
- MindLab Research Group, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Henning Müller
- Institute of Information Systems, HES-SO (University of Applied Sciences and Arts Western Switzerland), Sierre, Switzerland
- Medical Faculty, University of Geneva, Switzerland
- The Sense research and innovation center, Sion and Lausanne, Switzerland
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25
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Doyle HK, Herbeck SR, Boehm AE, Vanston JE, Ng R, Tuten WS, Roorda A. Boosting 2-photon vision with adaptive optics. J Vis 2023; 23:4. [PMID: 37801322 PMCID: PMC10561787 DOI: 10.1167/jov.23.12.4] [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: 05/25/2023] [Accepted: 09/05/2023] [Indexed: 10/07/2023] Open
Abstract
The 2-photon effect in vision occurs when two photons of the same wavelength are absorbed by cone photopigment in the retina and create a visual sensation matching the appearance of light close to half their wavelength. This effect is especially salient for infrared light, where humans are mostly insensitive to 1-photon isomerizations and thus any perception is dominated by 2-photon isomerizations. This phenomenon can be made more readily visible using short-pulsed lasers, which increase the likelihood of 2-photon excitation by making photon arrivals at the retina more concentrated in time. Adaptive optics provides another avenue for enhancing the 2-photon effect by focusing light more tightly at the retina, thereby increasing the spatial concentration of incident photons. This article makes three contributions. First, we demonstrate through color-matching experiments that an adaptive optics correction can provide a 25-fold increase in the luminance of the 2-photon effect-a boost equivalent to reducing pulse width by 96%. Second, we provide image-based evidence that the 2-photon effect occurs at the photoreceptor level. Third, we use our results to compute the specifications for a system that could utilize 2-photon vision and adaptive optics to image and stimulate the retina using a single infrared wavelength and reach luminance levels comparable to conventional displays.
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Affiliation(s)
- Hannah K Doyle
- Department of Electrical Engineering and Computer Sciences, University of California Berkeley, Berkeley, CA, USA
| | - Sofie R Herbeck
- Department of Electrical Engineering and Computer Sciences, University of California Berkeley, Berkeley, CA, USA
| | - Alexandra E Boehm
- Herbert Wertheim School of Optometry and Vision Science, University of California Berkeley, Berkeley, CA, USA
| | - John E Vanston
- Herbert Wertheim School of Optometry and Vision Science, University of California Berkeley, Berkeley, CA, USA
| | - Ren Ng
- Department of Electrical Engineering and Computer Sciences, University of California Berkeley, Berkeley, CA, USA
| | - William S Tuten
- Herbert Wertheim School of Optometry and Vision Science, University of California Berkeley, Berkeley, CA, USA
| | - Austin Roorda
- Herbert Wertheim School of Optometry and Vision Science, University of California Berkeley, Berkeley, CA, USA
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26
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Krafft L, Senée P, Gofas E, Thouvenin O, Atlan M, Paques M, Meimon S, Mecê P. Multimodal high-resolution retinal imaging using a camera-based DMD-integrated adaptive optics flood-illumination ophthalmoscope. OPTICS LETTERS 2023; 48:3785-3788. [PMID: 37450750 DOI: 10.1364/ol.495515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023]
Abstract
We demonstrate the feasibility of a multimodal adaptive optics flood-illumination ophthalmoscope, able to provide both bright-field and dark-field images (such as phase contrast). The multimodality was made possible by integrating a digital micromirror device (DMD) at the illumination path to project a sequence of complementary high-resolution patterns into the retina. Through a versatile post-processing method that digitally selects backscattered or multiply scattered photons, we were able: (1) to achieve up to four-fold contrast increase of bright-field images when imaging the photoreceptor mosaic and nerve fibers; and (2) to visualize translucent retinal features such as capillaries, red blood cells, vessel walls, ganglion cells, and photoreceptor inner segments through phase contrast.
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27
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Mujat M, Akula JD, Fulton AB, Ferguson RD, Iftimia N. Non-Rigid Registration for High-Resolution Retinal Imaging. Diagnostics (Basel) 2023; 13:2285. [PMID: 37443679 PMCID: PMC10341150 DOI: 10.3390/diagnostics13132285] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/30/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023] Open
Abstract
Adaptive optics provides improved resolution in ophthalmic imaging when retinal microstructures need to be identified, counted, and mapped. In general, multiple images are averaged to improve the signal-to-noise ratio or analyzed for temporal dynamics. Image registration by cross-correlation is straightforward for small patches; however, larger images require more sophisticated registration techniques. Strip-based registration has been used successfully for photoreceptor mosaic alignment in small patches; however, if the deformations along strips are not simple displacements, averaging can degrade the final image. We have applied a non-rigid registration technique that improves the quality of processed images for mapping cones over large image patches. In this approach, correction of local deformations compensates for local image stretching, compressing, bending, and twisting due to a number of causes. The main result of this procedure is improved definition of retinal microstructures that can be better identified and segmented. Derived metrics such as cone density, wall-to-lumen ratio, and quantification of structural modification of blood vessel walls have diagnostic value in many retinal diseases, including diabetic retinopathy and age-related macular degeneration, and their improved evaluations may facilitate early diagnostics of retinal diseases.
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Affiliation(s)
- Mircea Mujat
- Physical Sciences, Inc., 20 New England Business Center, Andover, MA 01810, USA; (R.D.F.); (N.I.)
| | - James D. Akula
- Department of Ophthalmology, Boston Children’s Hospital, Boston, MA 02115, USA; (J.D.A.); (A.B.F.)
- Department of Ophthalmology, Harvard Medical School, Boston, MA 02115, USA
| | - Anne B. Fulton
- Department of Ophthalmology, Boston Children’s Hospital, Boston, MA 02115, USA; (J.D.A.); (A.B.F.)
- Department of Ophthalmology, Harvard Medical School, Boston, MA 02115, USA
| | - R. Daniel Ferguson
- Physical Sciences, Inc., 20 New England Business Center, Andover, MA 01810, USA; (R.D.F.); (N.I.)
| | - Nicusor Iftimia
- Physical Sciences, Inc., 20 New England Business Center, Andover, MA 01810, USA; (R.D.F.); (N.I.)
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28
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Xu P, Jiang YY, Morgan JIW. Cone Photoreceptor Morphology in Choroideremia Assessed Using Non-Confocal Split-Detection Adaptive Optics Scanning Light Ophthalmoscopy. Invest Ophthalmol Vis Sci 2023; 64:36. [PMID: 37504961 PMCID: PMC10383007 DOI: 10.1167/iovs.64.10.36] [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: 04/06/2023] [Accepted: 07/10/2023] [Indexed: 07/29/2023] Open
Abstract
Purpose Choroideremia (CHM) is an X-linked inherited retinal degeneration causing loss of the photoreceptors, retinal pigment epithelium, and choriocapillaris, although patients typically retain a central island of relatively preserved, functioning retina until late-stage disease. Here, we investigate cone photoreceptor morphology within the retained retinal island by examining cone inner segment area, density, circularity, and intercone space. Methods Using a custom-built, multimodal adaptive optics scanning light ophthalmoscope, nonconfocal split-detection images of the photoreceptor mosaic were collected at 1°, 2°, and 4° temporal to the fovea from 13 CHM and 12 control subjects. Cone centers were manually identified, and cone borders were segmented. A custom MATLAB script was used to extract area and circularity for each cone and calculate the percentage of intercone space in each region of interest. Bound cone density was also calculated. An unbalanced two-way ANOVA and Bonferroni post hoc tests were used to assess statistical differences between the CHM and control groups and along retinal eccentricity. Results Cone density was lower in the CHM group than in the control group (P < 0.001) and decreased with eccentricity from the fovea (P < 0.001). CHM cone inner segments were larger in area (P < 0.001) and more circular (P = 0.042) than those of the controls. Intercone space in CHM was also higher than in the controls (P < 0.001). Conclusions Cone morphology is altered in CHM compared to control, even within the centrally retained, functioning retinal area. Further studies are required to determine whether such morphology is a precursor to cone degeneration.
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Affiliation(s)
- Peiluo Xu
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Yu You Jiang
- Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
- Center for Advanced Retinal and Ocular Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Jessica I. W. Morgan
- Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
- Center for Advanced Retinal and Ocular Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, United States
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29
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Li B, Zhu L, Li B, Feng W, Lian X, Ji X. Efficient framework of solving time-gated reflection matrix for imaging through turbid medium. OPTICS EXPRESS 2023; 31:15461-15473. [PMID: 37157647 DOI: 10.1364/oe.488257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Imaging through turbid medium is a long pursuit in many research fields, such as biomedicine, astronomy and automatic vehicle, in which the reflection matrix-based method is a promising solution. However, the epi-detection geometry suffers from round-trip distortion and it is challenging to isolate the input and output aberrations in non-ideal cases due to system imperfections and measurement noises. Here, we present an efficient framework based on single scattering accumulation together with phase unwrapping that can accurately separate input and output aberrations from the noise-affected reflection matrix. We propose to only correct the output aberration while suppressing the input aberration by incoherent averaging. The proposed method is faster in convergence and more robust against noise, avoiding precise and tedious system adjustments. In both simulations and experiments, we demonstrate the diffraction-limited resolution capability under optical thickness beyond 10 scattering mean free paths, showing the potential of applications in neuroscience and dermatology.
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30
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Vanston JE, Boehm AE, Tuten WS, Roorda A. It's not easy seeing green: The veridical perception of small spots. J Vis 2023; 23:2. [PMID: 37133838 PMCID: PMC10166115 DOI: 10.1167/jov.23.5.2] [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: 11/16/2022] [Accepted: 03/26/2023] [Indexed: 05/04/2023] Open
Abstract
When single cones are stimulated with spots of 543-nm light presented against a white background, subjects report percepts that vary between predominately red, white, and green. However, light of the same spectral composition viewed over a large field under normal viewing conditions looks invariably green and highly saturated. It remains unknown what stimulus parameters are most important for governing the color appearance in the transition between these two extreme cases. The current study varied the size, intensity and retinal motion of stimuli presented in an adaptive optics scanning laser ophthalmoscope. Stimuli were either stabilized on target locations or allowed to drift across the retina with the eye's natural motion. Increasing both stimulus size and intensity led to higher likelihoods that monochromatic spots of light were perceived as green, whereas only higher intensities led to increases in perceived saturation. The data also show an interaction between size and intensity, suggesting that the balance between magnocellular and parvocellular activation may be critical factors for color perception. Surprisingly, under the range of conditions tested, color appearance did not depend on whether stimuli were stabilized. Sequential activation of many cones does not appear to drive hue and saturation perception as effectively as simultaneous activation of many cones.
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Affiliation(s)
- John Erik Vanston
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, CA, USA
| | - Alexandra E Boehm
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, CA, USA
| | - William S Tuten
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, CA, USA
| | - Austin Roorda
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, CA, USA
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31
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Muchuchuti S, Viriri S. Retinal Disease Detection Using Deep Learning Techniques: A Comprehensive Review. J Imaging 2023; 9:84. [PMID: 37103235 PMCID: PMC10145952 DOI: 10.3390/jimaging9040084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/02/2023] [Accepted: 04/07/2023] [Indexed: 04/28/2023] Open
Abstract
Millions of people are affected by retinal abnormalities worldwide. Early detection and treatment of these abnormalities could arrest further progression, saving multitudes from avoidable blindness. Manual disease detection is time-consuming, tedious and lacks repeatability. There have been efforts to automate ocular disease detection, riding on the successes of the application of Deep Convolutional Neural Networks (DCNNs) and vision transformers (ViTs) for Computer-Aided Diagnosis (CAD). These models have performed well, however, there remain challenges owing to the complex nature of retinal lesions. This work reviews the most common retinal pathologies, provides an overview of prevalent imaging modalities and presents a critical evaluation of current deep-learning research for the detection and grading of glaucoma, diabetic retinopathy, Age-Related Macular Degeneration and multiple retinal diseases. The work concluded that CAD, through deep learning, will increasingly be vital as an assistive technology. As future work, there is a need to explore the potential impact of using ensemble CNN architectures in multiclass, multilabel tasks. Efforts should also be expended on the improvement of model explainability to win the trust of clinicians and patients.
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Affiliation(s)
| | - Serestina Viriri
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Durban 4001, South Africa
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32
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Sabesan R, Grieve K, Hammer DX, Ji N, Marcos S. Introduction to the Feature Issue on Adaptive Optics for Biomedical Applications. BIOMEDICAL OPTICS EXPRESS 2023; 14:1772-1776. [PMID: 37078031 PMCID: PMC10110319 DOI: 10.1364/boe.488044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Indexed: 05/03/2023]
Abstract
The guest editors introduce a feature issue commemorating the 25th anniversary of adaptive optics in biomedical research.
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Affiliation(s)
- Ramkumar Sabesan
- Department of Ophthalmology, University of Washington School of Medicine, Seattle, WA, USA
| | - Kate Grieve
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, and CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, 28 rue de Charenton, F-75012 Paris, France
| | - Daniel X. Hammer
- Center for Devices and Radiological Health (CDRH), U. S. Food and Drug Administration (FDA), Silver Spring, MD 20993, USA
| | - Na Ji
- Department of Physics, Department of Molecular & Cellular Biology, University of California, Berkeley, CA 94720, USA
| | - Susana Marcos
- Visual Optics and Biophotonics Laboratory, Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Calle Serrano 121, Madrid, 28006, Spain
- Center for Visual Sciences; The Institute of Optics and Flaum Eye Institute, University of Rochester, Rochester, NY 14642, USA
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Wang X, Sadda SR, Ip MS, Sarraf D, Zhang Y. In Vivo Longitudinal Measurement of Cone Photoreceptor Density in Intermediate Age-Related Macular Degeneration. Am J Ophthalmol 2023; 248:60-75. [PMID: 36436549 PMCID: PMC10038851 DOI: 10.1016/j.ajo.2022.11.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 11/14/2022] [Accepted: 11/16/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate cone photoreceptor density in clinically unremarkable retinal regions in patients with age-related macular degeneration (AMD) using adaptive optics scanning laser ophthalmoscopy (AOSLO). DESIGN Prospective case series with normal comparison group. METHODS Ten eyes of 7 patients with intermediate AMD were studied, including 4 with predominantly subretinal drusenoid deposits (SDD) and 3 without SDD. Macular regions with a clinical absence of AMD-associated lesions were identified by cone packing structure on AOSLO and optical coherence tomography. Cone density was measured in 1174 clinically unremarkable regions within the central subfield (CSF), the inner (IR), and outer rings (OR) of the Early Treatment Diabetic Retinopathy Study grid over 39.6 ± 3.3 months and compared with age-matched normal values obtained in 17 participants. RESULTS Cone density decreased at 98.3% of the examined locations over time in the eyes with AMD. In the CSF, IR, and OR, cones declined by -255 ± 135, -133 ± 45, and -59 ± 24 cones/degree2/year, respectively, in eyes with SDD, and by -212 ± 89, -83 ± 37, and -27 ± 18 cones/degree2/year, respectively, in eyes without SDD. The percentage of retinal loci with cone density lower than normal (Z score < -2) increased over the follow-up: from 42% at the baseline to 80% at the last visit in eyes with SDD and from 31% to 70% in eyes without SDD. CONCLUSIONS AOSLO revealed cone photoreceptor loss in regions that appear otherwise unremarkable clinically. These findings may help explain the loss of mesopic sensitivity reported in these areas in eyes with intermediate AMD.
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Affiliation(s)
- Xiaolin Wang
- From the Doheny Eye Institute (X.W., S.R.S., M.I., Y.Z.), Pasadena, California
| | - SriniVas R Sadda
- From the Doheny Eye Institute (X.W., S.R.S., M.I., Y.Z.), Pasadena, California; Department of Ophthalmology, University of California-Los Angeles (S.R.S., M.I., D.S., Y.Z.), Los Angeles, California
| | - Michael S Ip
- From the Doheny Eye Institute (X.W., S.R.S., M.I., Y.Z.), Pasadena, California; Department of Ophthalmology, University of California-Los Angeles (S.R.S., M.I., D.S., Y.Z.), Los Angeles, California
| | - David Sarraf
- Department of Ophthalmology, University of California-Los Angeles (S.R.S., M.I., D.S., Y.Z.), Los Angeles, California; Stein Eye Institute (David Sarraf), Los Angeles, California, USA
| | - Yuhua Zhang
- From the Doheny Eye Institute (X.W., S.R.S., M.I., Y.Z.), Pasadena, California; Department of Ophthalmology, University of California-Los Angeles (S.R.S., M.I., D.S., Y.Z.), Los Angeles, California.
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Lee B, Jeong S, Lee J, Kim TS, Braaf B, Vakoc BJ, Oh WY. Wide-Field Three-Dimensional Depth-Invariant Cellular-Resolution Imaging of the Human Retina. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2023; 19:e2203357. [PMID: 36642824 PMCID: PMC10023497 DOI: 10.1002/smll.202203357] [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] [Received: 05/31/2022] [Revised: 12/02/2022] [Indexed: 06/17/2023]
Abstract
Three-dimensional (3D) cellular-resolution imaging of the living human retina over a large field of view will bring a great impact in clinical ophthalmology, potentially finding new biomarkers for early diagnosis and improving the pathophysiological understanding of ocular diseases. While hardware-based and computational adaptive optics (AO) optical coherence tomography (OCT) have been developed to achieve cellular-resolution retinal imaging, these approaches support limited 3D imaging fields, and their high cost and intrinsic hardware complexity limit their practical utility. Here, this work demonstrates 3D depth-invariant cellular-resolution imaging of the living human retina over a 3 × 3 mm field of view using the first intrinsically phase-stable multi-MHz retinal swept-source OCT and novel computational defocus and aberration correction methods. Single-acquisition imaging of photoreceptor cells, retinal nerve fiber layer, and retinal capillaries is presented across unprecedented imaging fields. By providing wide-field 3D cellular-resolution imaging in the human retina using a standard point-scan architecture routinely used in the clinic, this platform proposes a strategy for expanded utilization of high-resolution retinal imaging in both research and clinical settings.
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Affiliation(s)
- ByungKun Lee
- Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
- KI for Health Science and Technology, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
| | - Sunhong Jeong
- Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
- KI for Health Science and Technology, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
| | - Joosung Lee
- Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
- KI for Health Science and Technology, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
| | - Tae Shik Kim
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston 02140, USA
| | - Boy Braaf
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston 02140, USA
| | - Benjamin J. Vakoc
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston 02140, USA
| | - Wang-Yuhl Oh
- Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
- KI for Health Science and Technology, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
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35
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Williams DR, Burns SA, Miller DT, Roorda A. Evolution of adaptive optics retinal imaging [Invited]. BIOMEDICAL OPTICS EXPRESS 2023; 14:1307-1338. [PMID: 36950228 PMCID: PMC10026580 DOI: 10.1364/boe.485371] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 02/02/2023] [Indexed: 05/02/2023]
Abstract
This review describes the progress that has been achieved since adaptive optics (AO) was incorporated into the ophthalmoscope a quarter of a century ago, transforming our ability to image the retina at a cellular spatial scale inside the living eye. The review starts with a comprehensive tabulation of AO papers in the field and then describes the technological advances that have occurred, notably through combining AO with other imaging modalities including confocal, fluorescence, phase contrast, and optical coherence tomography. These advances have made possible many scientific discoveries from the first maps of the topography of the trichromatic cone mosaic to exquisitely sensitive measures of optical and structural changes in photoreceptors in response to light. The future evolution of this technology is poised to offer an increasing array of tools to measure and monitor in vivo retinal structure and function with improved resolution and control.
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Affiliation(s)
- David R. Williams
- The Institute of Optics and the Center for
Visual Science, University of Rochester,
Rochester NY, USA
| | - Stephen A. Burns
- School of Optometry, Indiana
University at Bloomington, Bloomington IN, USA
| | - Donald T. Miller
- School of Optometry, Indiana
University at Bloomington, Bloomington IN, USA
| | - Austin Roorda
- Herbert Wertheim School of Optometry and
Vision Science, University of California at Berkeley, Berkeley CA, USA
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36
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Lee S, Choi SS, Meleppat RK, Zawadzki RJ, Doble N. Programmable, high-speed, adaptive optics partially confocal multi-spot ophthalmoscope using a digital micromirror device. OPTICS LETTERS 2023; 48:791-794. [PMID: 36723590 PMCID: PMC10422682 DOI: 10.1364/ol.480688] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 01/01/2023] [Indexed: 06/18/2023]
Abstract
A high-speed, adaptive optics partially confocal multi-spot ophthalmoscope (AO-pcMSO) using a digital micromirror device (DMD) in the illumination channel and a fast 2D CMOS camera is described. The camera is synchronized with the DMD allowing projection of multiple, simultaneous AO-corrected spots onto the human retina. Spatial filtering on each raw retinal image before reconstruction works as an array virtual pinholes. A frame acquisition rate of 250 fps is achieved by applying this parallel projection scheme. The contrast improves by 2-3 fold when compared to a standard flood illumination architecture. Partially confocal images of the human retina show cone and rod photoreceptors over a range of retinal eccentricities.
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Affiliation(s)
- Soohyun Lee
- College of Optometry, The Ohio State University, 338 West 10th Avenue, Columbus, OH 43221
| | - Stacey S. Choi
- College of Optometry, The Ohio State University, 338 West 10th Avenue, Columbus, OH 43221
- Department of Ophthalmology and Visual Science, Havener Eye Institute, The Ohio State University, 915 Olentangy River Road Suite 5000, OH 43212
| | - Ratheesh K. Meleppat
- UC Davis Eye Center, Department of Ophthalmology and Vision Science, University of California Davis, 4860 Y Street, Suite 2400, Sacramento, CA 95817
- UC Davis EyePod Small Animal Ocular Imaging Laboratory, Department of Cell Biology and Human Anatomy, University of California Davis, 4320 Tupper Hall, Davis, CA 95616
| | - Robert J. Zawadzki
- UC Davis Eye Center, Department of Ophthalmology and Vision Science, University of California Davis, 4860 Y Street, Suite 2400, Sacramento, CA 95817
- UC Davis EyePod Small Animal Ocular Imaging Laboratory, Department of Cell Biology and Human Anatomy, University of California Davis, 4320 Tupper Hall, Davis, CA 95616
| | - Nathan Doble
- College of Optometry, The Ohio State University, 338 West 10th Avenue, Columbus, OH 43221
- Department of Ophthalmology and Visual Science, Havener Eye Institute, The Ohio State University, 915 Olentangy River Road Suite 5000, OH 43212
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Hirji SH. Measure of Visual Function. Methods Mol Biol 2023; 2560:145-151. [PMID: 36481892 DOI: 10.1007/978-1-0716-2651-1_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This chapter describes various methods of the assessment of visual function used for assessing disease progression and treatment response in patients with retinitis pigmentosa (RP). These methods include full-field stimulus testing (FST), near-infrared autofluorescence (NIR-AF), quantitative fundus autofluorescence (qAF), and quantitative near-infrared autofluorescence (qNIR-AF). This chapter will also outline the protocol for adaptive optics (AO) imaging of RP patients and cover how each of these methods is used for RP patients, with details including the expected findings, as evidenced by recent literature.
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Affiliation(s)
- Sitara H Hirji
- Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York, NY, USA.
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38
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Morgan JIW, Chui TYP, Grieve K. Twenty-five years of clinical applications using adaptive optics ophthalmoscopy [Invited]. BIOMEDICAL OPTICS EXPRESS 2023; 14:387-428. [PMID: 36698659 PMCID: PMC9841996 DOI: 10.1364/boe.472274] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/22/2022] [Accepted: 11/27/2022] [Indexed: 05/02/2023]
Abstract
Twenty-five years ago, adaptive optics (AO) was combined with fundus photography, thereby initiating a new era in the field of ophthalmic imaging. Since that time, clinical applications of AO ophthalmoscopy to investigate visual system structure and function in both health and disease abound. To date, AO ophthalmoscopy has enabled visualization of most cell types in the retina, offered insight into retinal and systemic disease pathogenesis, and been integrated into clinical trials. This article reviews clinical applications of AO ophthalmoscopy and addresses remaining challenges for AO ophthalmoscopy to become fully integrated into standard ophthalmic care.
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Affiliation(s)
- Jessica I. W. Morgan
- Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA 19104, USA
- Center for Advanced Retinal and Ocular Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA
- Contributed equally
| | - Toco Y. P. Chui
- Department of Ophthalmology, The New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA
- Contributed equally
| | - Kate Grieve
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, and CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, 28 rue de Charenton, F-75012 Paris, France
- Contributed equally
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39
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Vienola KV, Lejoyeux R, Gofas-Salas E, Snyder VC, Zhang M, Dansingani KK, Sahel JA, Chhablani J, Rossi EA. Autofluorescent hyperreflective foci on infrared autofluorescence adaptive optics ophthalmoscopy in central serous chorioretinopathy. Am J Ophthalmol Case Rep 2022; 28:101741. [PMID: 36345414 PMCID: PMC9636439 DOI: 10.1016/j.ajoc.2022.101741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/12/2022] [Accepted: 10/22/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose To test the hypothesis that hyperreflective foci in central serous chorioretinopathy (CSCR) are autofluorescent and may represent macrophages that have engulfed outer retinal fluorophores from the retinal pigment epithelium (RPE) and photoreceptors. Methods Enrolled subjects underwent spectral domain and swept-source optical coherence tomography, adaptive optics flood-illumination, and adaptive optics scanning laser ophthalmoscopy (AOSLO), including near-infrared autofluorescence (AO-IRAF). For the AO-IRAF imaging, retinal fluorophores were excited using 795 nm light and collected in an emission band from 814 to 850 nm. Results In 2 of 3 eyes, a hyperautofluorescent signal was detected with an elliptical shape and punctate, granular aspects surrounded by a hypoautofluorescent halo. The size of these structures in the active case was measured to be 17 ± 4 μm in diameter, with at least 45 individual hyperautofluorescent foci identified from the AO-IRAF montage in the active stage of patient 2. In the asymptomatic case there were fewer structures visible (∼10) and their size was smaller (11 ± 4 μm). These hyper-AF foci were colocalized with hyperreflective foci on OCT and visible in simultaneously acquired confocal AOSLO images in active stage. The hyperautofluorescent foci in the patient with active CSCR disappeared coincident with clinical resolution. Conclusion and importance We show here the first AO-IRAF images from patients with CSCR, demonstrating hyper-autofluorescent punctate foci, colocalized with hyper-reflective foci on confocal AOSLO images and in OCT. The autofluorescence of these foci may be driven by the accumulation of photoreceptor and RPE fluorophores within macrophages during the active stage of the disease.
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Affiliation(s)
- Kari V. Vienola
- University of Pittsburgh, Department of Ophthalmology, School of Medicine, 4200 Fifth Ave, Pittsburgh, PA, USA
- Corresponding author. Laboratory of Biophysics, Institute of Biomedicine University of Turku Tykistönkatu 6A, Turku, Finland.
| | - Raphael Lejoyeux
- University of Pittsburgh, Department of Ophthalmology, School of Medicine, 4200 Fifth Ave, Pittsburgh, PA, USA
- Rothschild Foundation Hospital, 29 rue Manin, Paris, France
| | - Elena Gofas-Salas
- University of Pittsburgh, Department of Ophthalmology, School of Medicine, 4200 Fifth Ave, Pittsburgh, PA, USA
| | - Valerie C. Snyder
- University of Pittsburgh, Department of Ophthalmology, School of Medicine, 4200 Fifth Ave, Pittsburgh, PA, USA
| | - Min Zhang
- University of Pittsburgh, Department of Ophthalmology, School of Medicine, 4200 Fifth Ave, Pittsburgh, PA, USA
| | - Kunal K. Dansingani
- University of Pittsburgh, Department of Ophthalmology, School of Medicine, 4200 Fifth Ave, Pittsburgh, PA, USA
| | - José-Alain Sahel
- University of Pittsburgh, Department of Ophthalmology, School of Medicine, 4200 Fifth Ave, Pittsburgh, PA, USA
| | - Jay Chhablani
- University of Pittsburgh, Department of Ophthalmology, School of Medicine, 4200 Fifth Ave, Pittsburgh, PA, USA
| | - Ethan A. Rossi
- University of Pittsburgh, Department of Ophthalmology, School of Medicine, 4200 Fifth Ave, Pittsburgh, PA, USA
- University of Pittsburgh, Department of Bioengineering, Swanson School of Engineering, Pittsburgh, PA, USA
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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40
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Warner RL, Brainard DH, Morgan JIW. Repeatability and reciprocity of the cone optoretinogram. BIOMEDICAL OPTICS EXPRESS 2022; 13:6561-6573. [PMID: 36589578 PMCID: PMC9774868 DOI: 10.1364/boe.471990] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 11/08/2022] [Accepted: 11/08/2022] [Indexed: 05/02/2023]
Abstract
Optoretinography has enabled noninvasive visualization of physiological changes in cone photoreceptors exposed to light. Understanding the cone optoretinogram in healthy subjects is essential for establishing it as a biomarker for cone function in disease. Here, we measure the population cone intensity optoretinogram in healthy adults, for multiple irradiance/duration combinations of visible stimuli with equal energy. We study the within and between session repeatability and reciprocity of the ORG in five healthy subjects. We find the cone optoretinogram exhibits equivalent amplitudes for equal-energy stimuli. We also find good within-subject repeatability, which allows us to show differences across the five subjects.
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Affiliation(s)
- R. L. Warner
- Scheie Eye Institute, Department of
Ophthalmology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - D. H. Brainard
- Psychology Department, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - J. I. W. Morgan
- Scheie Eye Institute, Department of
Ophthalmology, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Center for Advanced Retinal and Ocular
Therapeutics, University of Pennsylvania,
Philadelphia, PA, 19104, USA
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41
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Mozaffari S, Feroldi F, LaRocca F, Tiruveedhula P, Gregory PD, Park BH, Roorda A. Retinal imaging using adaptive optics optical coherence tomography with fast and accurate real-time tracking. BIOMEDICAL OPTICS EXPRESS 2022; 13:5909-5925. [PMID: 36733754 PMCID: PMC9872892 DOI: 10.1364/boe.467634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/11/2022] [Accepted: 10/04/2022] [Indexed: 05/02/2023]
Abstract
One of the main obstacles in high-resolution 3-D retinal imaging is eye motion, which causes blur and distortion artifacts that require extensive post-processing to be corrected. Here, an adaptive optics optical coherence tomography (AOOCT) system with real-time active eye motion correction is presented. Correction of ocular aberrations and of retinal motion is provided by an adaptive optics scanning laser ophthalmoscope (AOSLO) that is optically and electronically combined with the AOOCT system. We describe the system design and quantify its performance. The AOOCT system features an independent focus adjustment that allows focusing on different retinal layers while maintaining the AOSLO focus on the photoreceptor mosaic for high fidelity active motion correction. The use of a high-quality reference frame for eye tracking increases revisitation accuracy between successive imaging sessions, allowing to collect several volumes from the same area. This system enables spatially targeted retinal imaging as well as volume averaging over multiple imaging sessions with minimal correction of motion in post processing.
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Affiliation(s)
- Sanam Mozaffari
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Fabio Feroldi
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Francesco LaRocca
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Pavan Tiruveedhula
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Patrick D. Gregory
- Department of Bioengineering, University of California, Riverside, CA 92521, USA
| | - B. Hyle Park
- Department of Bioengineering, University of California, Riverside, CA 92521, USA
| | - Austin Roorda
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, CA 94720, USA
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42
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Liu Z, Zhang F, Zucca K, Agrawal A, Hammer DX. Ultrahigh-speed multimodal adaptive optics system for microscopic structural and functional imaging of the human retina. BIOMEDICAL OPTICS EXPRESS 2022; 13:5860-5878. [PMID: 36733751 PMCID: PMC9872887 DOI: 10.1364/boe.462594] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 09/16/2022] [Accepted: 09/20/2022] [Indexed: 05/02/2023]
Abstract
We describe the design and performance of a multimodal and multifunctional adaptive optics (AO) system that combines scanning laser ophthalmoscopy (SLO) and optical coherence tomography (OCT) for simultaneous retinal imaging at 13.4 Hz. The high-speed AO-OCT channel uses a 3.4 MHz Fourier-domain mode-locked (FDML) swept source. The system achieves exquisite resolution and sensitivity for pan-macular and transretinal visualization of retinal cells and structures while providing a functional assessment of the cone photoreceptors. The ultra-high speed also enables wide-field scans for clinical usability and angiography for vascular visualization. The FDA FDML-AO system is a powerful platform for studying various retinal and neurological diseases for vision science research, retina physiology investigation, and biomarker development.
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Affiliation(s)
- Zhuolin Liu
- Center for Devices and Radiological Health
(CDRH), U. S. Food and Drug Administration (FDA), Silver Spring, Maryland 20993, USA
| | - Furu Zhang
- Center for Devices and Radiological Health
(CDRH), U. S. Food and Drug Administration (FDA), Silver Spring, Maryland 20993, USA
- Co-first author
| | - Kelvy Zucca
- Center for Devices and Radiological Health
(CDRH), U. S. Food and Drug Administration (FDA), Silver Spring, Maryland 20993, USA
| | - Anant Agrawal
- Center for Devices and Radiological Health
(CDRH), U. S. Food and Drug Administration (FDA), Silver Spring, Maryland 20993, USA
| | - Daniel X. Hammer
- Center for Devices and Radiological Health
(CDRH), U. S. Food and Drug Administration (FDA), Silver Spring, Maryland 20993, USA
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43
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Bastelica P, Labbé A, El Maftouhi A, Hamard P, Paques M, Baudouin C. Rôle de la lame criblée dans la pathogenèse du glaucome. Une revue de la littérature. J Fr Ophtalmol 2022; 45:952-966. [DOI: 10.1016/j.jfo.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 03/23/2022] [Indexed: 11/24/2022]
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44
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Zhou M, Doble N, Choi SS, Jin T, Xu C, Parthasarathy S, Ramnath R. Using deep learning for the automated identification of cone and rod photoreceptors from adaptive optics imaging of the human retina. BIOMEDICAL OPTICS EXPRESS 2022; 13:5082-5097. [PMID: 36425636 PMCID: PMC9664895 DOI: 10.1364/boe.470071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/13/2022] [Accepted: 08/16/2022] [Indexed: 05/02/2023]
Abstract
Adaptive optics imaging has enabled the enhanced in vivo retinal visualization of individual cone and rod photoreceptors. Effective analysis of such high-resolution, feature rich images requires automated, robust algorithms. This paper describes RC-UPerNet, a novel deep learning algorithm, for identifying both types of photoreceptors, and was evaluated on images from central and peripheral retina extending out to 30° from the fovea in the nasal and temporal directions. Precision, recall and Dice scores were 0.928, 0.917 and 0.922 respectively for cones, and 0.876, 0.867 and 0.870 for rods. Scores agree well with human graders and are better than previously reported AI-based approaches.
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Affiliation(s)
- Mengxi Zhou
- The Ohio State University, Department of Computer Science and Engineering, 2015 Neil Ave., Columbus, OH 43210, USA
| | - Nathan Doble
- The Ohio State University, College of Optometry, 338 W 10th Ave., Columbus, OH 43210, USA
- The Ohio State University, Department of Ophthalmology and Visual Science, Havener Eye Institute, 915 Olentangy River Road, Columbus, OH 43212, USA
| | - Stacey S. Choi
- The Ohio State University, College of Optometry, 338 W 10th Ave., Columbus, OH 43210, USA
- The Ohio State University, Department of Ophthalmology and Visual Science, Havener Eye Institute, 915 Olentangy River Road, Columbus, OH 43212, USA
| | - Tianyu Jin
- The Ohio State University, Department of Computer Science and Engineering, 2015 Neil Ave., Columbus, OH 43210, USA
| | - Chenwei Xu
- The Ohio State University, Department of Statistics, 127 Pomerene Hall, 1760 Neil Ave, Columbus, OH 43212, USA
| | - Srinivasan Parthasarathy
- The Ohio State University, Department of Computer Science and Engineering, 2015 Neil Ave., Columbus, OH 43210, USA
| | - Rajiv Ramnath
- The Ohio State University, Department of Computer Science and Engineering, 2015 Neil Ave., Columbus, OH 43210, USA
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45
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Vienola KV, Zhang M, Snyder VC, Dansingani KK, Sahel JA, Rossi EA. Near infrared autofluorescence imaging of retinal pigmented epithelial cells using 663 nm excitation. Eye (Lond) 2022; 36:1878-1883. [PMID: 34462582 PMCID: PMC9499940 DOI: 10.1038/s41433-021-01754-0] [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: 09/20/2020] [Revised: 08/03/2021] [Accepted: 08/18/2021] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Fundus autofluorescence (AF) using adaptive optics scanning laser ophthalmoscopy (AOSLO) enables morphometric analysis of individual retinal pigmented epithelial (RPE) cells. However, only a few excitation wavelengths in the visible and near-infrared have been evaluated. Visible light excitation (<600 nm) presents additional safety hazards and is uncomfortable for patients. Near-infrared excitation (>700 nm) overcomes those problems but introduces others, including decreased AF signal and cone signatures that obscure RPE structure. Here we investigated the use of an intermediate wavelength, 663 nm, for excitation and compared it to 795 nm. METHODS Subjects were imaged using AOSLO equipped with a detection channel to collect AF emission between 814 and 850 nm. Two light sources (663 and 795 nm) were used to excite the retinal fluorophores. We recorded 90 s videos and registered them with custom software to integrate AF images for analysis. RESULTS We imaged healthy eyes and an eye with pattern dystrophy. Similar AF microstructures were detected with each excitation source, despite ~4 times lower excitation power with 663 nm. The signal-to-noise values showed no meaningful difference between 663 nm and 795 nm excitation and a similar trend was observed for image contrast between the two excitation wavelengths. CONCLUSIONS Lower light levels can be used with shorter wavelength excitation to achieve comparable images of the microstructure of the RPE as have been obtained using higher light levels at longer wavelengths. Further experiments are needed to fully characterize AF across spectrum and determine the optimal excitation and emission bandwidths that balance efficiency, patient comfort, and efficacy.
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Affiliation(s)
- Kari V Vienola
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
- Department of Ophthalmology and Vision Science, University of California Davis, Sacramento, CA, USA.
| | - Min Zhang
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Valerie C Snyder
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kunal K Dansingani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - José-Alain Sahel
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ethan A Rossi
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, PA, USA
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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46
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Li K, Yin Q, Ren J, Song H, Zhang J. Automatic quantification of cone photoreceptors in adaptive optics scanning light ophthalmoscope images using multi-task learning. BIOMEDICAL OPTICS EXPRESS 2022; 13:5187-5201. [PMID: 36425624 PMCID: PMC9664876 DOI: 10.1364/boe.471426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/27/2022] [Accepted: 08/31/2022] [Indexed: 05/02/2023]
Abstract
Adaptive optics scanning light ophthalmoscope (AO-SLO) can directly image the cone photoreceptor mosaic in the living human retina, which offers a potentially great tool to detect cone-related ocular pathologies by quantifying the changes in the cone mosaic. However, manual quantification is very time-consuming and automation is highly desirable. In this paper, we developed a fully automatic method based on multi-task learning to identify and quantify cone photoreceptors. By including cone edges in the labels as the third dimension of the classification, our method provided more accurate and reliable results than the two previously reported methods. We trained and validated our network in an open data set consisting of over 200,000 cones, and achieved a 99.20% true positive rate, 0.71% false positive rate, and 99.24% Dice's coefficient on the test set consisting of 44,634 cones. All are better than the reported methods. In addition, the reproducibility of all three methods was also tested and compared, and the result showed the performance of our method was generally closer to the gold standard. Bland-Altman plots show that our method was more stable and accurate than the other two methods. Then ablation experiment was further done, and the result shows that multi-task learning is essential to achieving accurate quantifications. Finally, our method was also extended to segment the cones to extract the size information. Overall, the method proposed here demonstrated great performance in terms of accuracy and reliability, which can be used to efficiently quantify the subtle changes associated with the progression of many diseases affecting cones.
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Affiliation(s)
- Kaiwen Li
- Advanced Ophthalmology Laboratory (AOL), Robotrak Technologies, Nanjing, 210000, China
| | - Qi Yin
- Advanced Ophthalmology Laboratory (AOL), Robotrak Technologies, Nanjing, 210000, China
| | - Ji Ren
- Advanced Ophthalmology Laboratory (AOL), Robotrak Technologies, Nanjing, 210000, China
| | - Hongxin Song
- Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100005, China
| | - Jie Zhang
- Advanced Ophthalmology Laboratory (AOL), Robotrak Technologies, Nanjing, 210000, China
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Human cone elongation responses can be explained by photoactivated cone opsin and membrane swelling and osmotic response to phosphate produced by RGS9-catalyzed GTPase. Proc Natl Acad Sci U S A 2022; 119:e2202485119. [PMID: 36122241 PMCID: PMC9522364 DOI: 10.1073/pnas.2202485119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Optical coherence tomography has established that human cone photoreceptor outer segments elongate in response to stimuli bleaching large fractions of their visual pigment. Elongation responses are completely described over their 200-fold bleaching range as the sum of two exponentially rising components differing 13-fold in time constants and 4-fold in light sensitivity. Bleaching measurements of individual cones with adaptive optics scanning laser ophthalmoscopy (SLO) suggest that component 2 arises from cone opsin and disk membrane swelling triggered by photoactivation. Application of a model of phototransduction suggests that component 1 corresponds to free phosphate generated by regulator of G-protein signaling 9 (RGS9)-catalyzed hydrolysis of guanosine triphosphate (GTP) in the α-subunit of G protein complexed with phosphodiesterase. Human cone outer segment (COS) length changes in response to stimuli bleaching up to 99% of L- and M-cone opsins were measured with high resolution, phase-resolved optical coherence tomography (OCT). Responses comprised a fast phase (∼5 ms), during which COSs shrink, and two slower phases (1.5 s), during which COSs elongate. The slower components saturated in amplitude (∼425 nm) and initial rate (∼3 nm ms−1) and are well described over the 200-fold bleaching range as the sum of two exponentially rising functions with time constants of 80 to 90 ms (component 1) and 1,000 to 1,250 ms (component 2). Measurements with adaptive optics reflection densitometry revealed component 2 to be linearly related to cone pigment bleaching, and the hypothesis is proposed that it arises from cone opsin and disk membrane swelling triggered by isomerization and rate-limited by chromophore hydrolysis and its reduction to membrane-localized all-trans retinol. The light sensitivity and kinetics of component 1 suggested that the underlying mechanism is an osmotic response to an amplified soluble by-product of phototransduction. The hypotheses that component 1 corresponds to G-protein subunits dissociating from the membrane, metabolites of cyclic guanosine monophosphate (cGMP) hydrolysis, or by-products of activated guanylate cyclase are rejected, while the hypothesis that it corresponds to phosphate produced by regulator of G-protein signaling 9 (RGS9)-catalyzed hydrolysis of guanosine triphosphate (GTP) in G protein–phosphodiesterase complexes was found to be consistent with the results. These results provide a basis for the assessment with optoretinography of phototransduction in individual cone photoreceptors in health and during disease progression and therapeutic interventions.
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Nanegrungsunk O, Patikulsila D, Sadda SR. Ophthalmic imaging in diabetic retinopathy: A review. Clin Exp Ophthalmol 2022; 50:1082-1096. [PMID: 36102668 PMCID: PMC10088017 DOI: 10.1111/ceo.14170] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/01/2022] [Accepted: 09/09/2022] [Indexed: 11/30/2022]
Abstract
Retinal imaging has been a key tool in the diagnosis, evaluation, management and documentation of diabetic retinopathy (DR) and diabetic macular oedema (DMO) for many decades. Imaging technologies have rapidly evolved over the last few decades, yielding images with higher resolution and contrast with less time, effort and invasiveness. While many retinal imaging technologies provide detailed insight into retinal structure such as colour reflectance photography and optical coherence tomography (OCT), others such as fluorescein or OCT angiography and oximetry provide dynamic and functional information. Many other novel imaging technologies are in development and are poised to further enhance our evaluation of patients with DR.
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Affiliation(s)
- Onnisa Nanegrungsunk
- Doheny Imaging Reading Center Doheny Eye Institute Pasadena California USA
- David Geffen School of Medicine University of California‐Los Angeles Los Angeles California USA
- Retina Division, Department of Ophthalmology Chiang Mai University Chiang Mai Thailand
| | - Direk Patikulsila
- Retina Division, Department of Ophthalmology Chiang Mai University Chiang Mai Thailand
| | - Srinivas R. Sadda
- Doheny Imaging Reading Center Doheny Eye Institute Pasadena California USA
- David Geffen School of Medicine University of California‐Los Angeles Los Angeles California USA
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Pham AT, Onghanseng N, Halim MS, Ormaechea MS, Hassan M, Akhavanrezayat A, Uludag G, Tran ANT, Razeen MM, Sredar N, Dubra A, Nguyen QD. Reflectance adaptive optics findings in a patient with Vogt-Koyanagi-Harada disease. Am J Ophthalmol Case Rep 2022; 27:101660. [PMID: 35880207 PMCID: PMC9307596 DOI: 10.1016/j.ajoc.2022.101660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 05/25/2022] [Accepted: 07/10/2022] [Indexed: 11/22/2022] Open
Abstract
Purpose To describe the reflectance adaptive optics scanning laser ophthalmoscopy (AOSLO) findings in different stages of Vogt-Koyanagi-Harada (VKH) disease and correlate them to visual gain post treatment. Confocal (cAOSLO) and non-confocal split-detector AOSLO (sdAOSLO) were used to assess longitudinally the status of the photoreceptors in a patient with VKH managed on corticosteroid and immunomodulatory therapy. Observation A 32-year-old Japanese American female presented with a 2-week history of blurred vision in both eyes (OU) and worsening headache previously diagnosed as a case of VKH and treated with high dose oral prednisone. At the time of presentation, though vision was improving, and frank serous retinal detachments were absent, spectral domain optical coherence tomography (SD-OCT) showed presence of residual subretinal fluid with disruption of the photoreceptor inner segments and outer segments (IS/OS) involving OU. The photoreceptor mosaic at the foveal center appeared very sparse with large areas devoid of visible photoreceptors on cAOSLO, in agreement with the SD-OCT data. sdAOSLO imaging over the same location shows a higher number of contiguous photoreceptors. After imaging, the patient was started on mycophenolate mofetil as steroid-sparing long-term therapy. Three months later, visual acuity improved to 20/20 OU, and SD-OCT showed almost complete resolution of subretinal fluid with significant improvement of the IS/OS SD-OCT signal, OU. cAOSLO imaging revealed a contiguous photoreceptor mosaic without gaps and of normal appearance. Conclusions and Importance VKH patients may demonstrate transient photoreceptor abnormalities on SD-OCT and cAOSLO imaging. sdAOSLO imaging revealed intact photoreceptor segments in areas that appeared as voids on cAOSLO, which later showed structural recovery on SD-OCT and cAOSLO. Therefore, sdAOSLO may predict potential for improvement in patients wherein there appears to be photoreceptor loss in cAOSLO and/or SD-OCT.
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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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