Ultra high-speed swept source OCT imaging of the anterior segment of human eye at 200 kHz with adjustable imaging range

A simple computational model for scleral stiffness assessments via air-puff deformation OCT

Introduction: The mechanical properties of the sclera are related to its structural function, and changes to these properties are believed to contribute to pathologies such as myopia. Air-puff deformation imaging is a tool that uses an imaging system coupled with an air-puff excitation source to induce and measure deformation in a tissue in vivo. Typically used for the study of the cornea's mechanical properties and IOP, this tool has been proposed as a method to evaluate scleral stiffness. Methods: In this work, we present a computational model of the rabbit eye to assess scleral deformation under air-puff. Parametric studies were conducted to evaluate the effects of material properties, intraocular pressure, and other parameters on the deformation response. Output from the model was also compared to experimental measurements of air-puff deformation in rabbit eyes under varying IOP. Results: Central deformation response was found to be most influenced by material properties of the sclera (at site of air-puff and posterior), thickness, and IOP, whereas deformation profile was most influenced by material properties. Experimental and simulated IOP dependence were found to be similar (RMSE = 0.13 mm). Discussion: Scleral APDI could be a useful tool for quick in vivo assessment of scleral stiffness.

Comprehensive assessment of the anterior segment in refraction corrected OCT based on multitask learning

Anterior segment diseases are among the leading causes of irreversible blindness. However, a method capable of recognizing all important anterior segment structures for clinical diagnosis is lacking. By sharing the knowledge learned from each task, we proposed a fully automated multitask deep learning method that allows for simultaneous segmentation and quantification of all major anterior segment structures, including the iris, lens, cornea, as well as implantable collamer lens (ICL) and intraocular lens (IOL), and meanwhile for landmark detection of scleral spur and iris root in anterior segment OCT (AS-OCT) images. In addition, we proposed a refraction correction method to correct for the true geometry of the anterior segment distorted by light refraction during OCT imaging. 1251 AS-OCT images from 180 patients were collected and were used to train and test the model. Experiments demonstrated that our proposed network was superior to state-of-the-art segmentation and landmark detection methods, and close agreement was achieved between manually and automatically computed clinical parameters associated with anterior chamber, pupil, iris, ICL, and IOL. Finally, as an example, we demonstrated how our proposed method can be applied to facilitate the clinical evaluation of cataract surgery.

Patch-based CNN for corneal segmentation of AS-OCT images: Effect of the number of classes and image quality upon performance

Anterior segment optical coherence tomography (AS-OCT) is a fundamental ophthalmic imaging technique. AS-OCT images can be examined by experts and segmented to provide quantitative metrics that inform clinical decision making. Manual segmentation of these images is time-consuming and subjective, encouraging software developers in the field to automate segmentation procedures. Traditional programing segmentation approaches are being replaced by deep learning methods, which have shown state-of-the-art performance in AS-OCT image analysis. In this study, a method based on patch-based convolutional neural networks (CNN) was used to segment the three main boundaries of the cornea: the epithelium, Bowman's layer, and the endothelium. To assess the effect of the number of classes on performance, the model was designed as a patch-based boundary classifier using 4 and 8 classes. The effect of image quality was also assessed using different data distributions during the training process. While the Dice coefficient and probability revealed greater precision for the 8 class models, the boundary error metric indicated comparable performance. Additionally, for 8 class models, the image quality test had only a small negative effect on performance, which may be an indication of the robustness of the model and could also suggest that the data augmentation methods did not show significant improvement. These findings contribute to the development of automatic segmentation techniques for AS-OCT images, since patch-based methods have been largely unexplored in favor of other deep learning techniques. The overall performance of the proposed method is comparable to other well-established segmentation methods.

Requirements and limitations of imaging airway smooth muscle throughout the lung in vivo

Clinical visualization and quantification of the amount and distribution of airway smooth muscle (ASM) in the lungs of individuals with asthma has major implications for our understanding of airway wall remodeling as well as treatments targeted at the ASM. This paper theoretically investigates the feasibility of quantifying airway wall thickness (focusing on the ASM) throughout the lung in vivo by means of bronchoscopic polarization-sensitive optical coherence tomography (PS-OCT). Using extensive human biobank data from subjects with and without asthma in conjunction with a mathematical model of airway compliance, we define constraints that airways of various sizes pose to any endoscopic imaging technique and how this is impacted by physiologically relevant processes such as constriction, inflation and deflation. We identify critical PS-OCT system parameters and pinpoint parts of the airway tree that are conducive to successful quantification of ASM. We further quantify the impact of breathing and ASM contraction on the measurement error and recommend strategies for standardization and normalization.

The Development and Clinical Application of Innovative Optical Ophthalmic Imaging Techniques

The field of ophthalmic imaging has grown substantially over the last years. Massive improvements in image processing and computer hardware have allowed the emergence of multiple imaging techniques of the eye that can transform patient care. The purpose of this review is to describe the most recent advances in eye imaging and explain how new technologies and imaging methods can be utilized in a clinical setting. The introduction of optical coherence tomography (OCT) was a revolution in eye imaging and has since become the standard of care for a plethora of conditions. Its most recent iterations, OCT angiography, and visible light OCT, as well as imaging modalities, such as fluorescent lifetime imaging ophthalmoscopy, would allow a more thorough evaluation of patients and provide additional information on disease processes. Toward that goal, the application of adaptive optics (AO) and full-field scanning to a variety of eye imaging techniques has further allowed the histologic study of single cells in the retina and anterior segment. Toward the goal of remote eye care and more accessible eye imaging, methods such as handheld OCT devices and imaging through smartphones, have emerged. Finally, incorporating artificial intelligence (AI) in eye images has the potential to become a new milestone for eye imaging while also contributing in social aspects of eye care.

Continuous spectral zooming for in vivo live 4D-OCT with MHz A-scan rates and long coherence

We present continuous three-dimensional spectral zooming in live 4D-OCT using a home-built FDML based OCT system with 3.28 MHz A-scan rate. Improved coherence characteristics of the FDML laser allow for imaging ranges up to 10 cm. For the axial spectral zoom feature, we switch between high resolution and long imaging range by adjusting the sweep range of our laser. We present a new imaging setup allowing for synchronized adjustments of the imaging range and lateral field of view during live OCT imaging. For this, a novel inline recalibration algorithm was implemented that enables numerical k-linearization of the raw OCT fringes for every frame instead of every volume. This is realized by acquiring recalibration data within the dead time of the raster scan at the turning points of the fast axis scanner. We demonstrate in vivo OCT images of fingers and hands at different resolution modes and show real three-dimensional zooming during live 4D-OCT. A three-dimensional spectral zooming feature for live 4D-OCT is expected to be a useful tool for a wide range of biomedical, scientific and research applications, especially in OCT guided surgery.

High speed, long range, deep penetration swept source OCT for structural and angiographic imaging of the anterior eye

This study reports the development of prototype swept-source optical coherence tomography (SS-OCT) technology for imaging the anterior eye. Advances in vertical-cavity surface-emitting laser (VCSEL) light sources, signal processing, optics and mechanical designs, enable a unique combination of high speed, long range, and deep penetration that addresses the challenges of anterior eye imaging. We demonstrate SS-OCT with a 325 kHz A-scan rate, 12.2 µm axial resolution (in air), and 15.5 mm depth range (in air) at 1310 nm wavelength. The ultrahigh 325 kHz A-scan rate not only facilitates biometry measurements by minimizing acquisition time and thus reducing motion, but also enables volumetric OCT for comprehensive structural analysis and OCT angiography (OCTA) for visualizing vasculature. The 15.5 mm (~ 11.6 mm in tissue) depth range spans all optical surfaces from the anterior cornea to the posterior lens capsule. The 1310 nm wavelength range enables structural OCT and OCTA deep in the sclera and through the iris. Achieving high speed and long range requires linearizing the VCSEL wavenumber sweep to efficiently utilize analog-to-digital conversion bandwidth. Dual channel recording of the OCT and calibration interferometer fringe signals, as well as sweep to sweep wavenumber compensation, is used to achieve invariant 12.2 µm (~ 9.1 µm in tissue) axial resolution and optimum point spread function throughout the depth range. Dynamic focusing using a tunable liquid lens extends the effective depth of field while preserving the lateral resolution. Improved optical and mechanical design, including parallax “split view” iris cameras and stable, ergonomic patient interface, facilitates accurate instrument positioning, reduces patient motion, and leads to improved imaging data yield and measurement accuracy. We present structural and angiographic OCT images of the anterior eye, demonstrating the unique imaging capabilities using representative scanning protocols which may be relevant to future research and clinical applications.

Optical coherence tomography

Optical coherence tomography (OCT) is a non-contact method for imaging the topological and internal microstructure of samples in three dimensions. OCT can be configured as a conventional microscope, as an ophthalmic scanner, or using endoscopes and small diameter catheters for accessing internal biological organs. In this Primer, we describe the principles underpinning the different instrument configurations that are tailored to distinct imaging applications and explain the origin of signal, based on light scattering and propagation. Although OCT has been used for imaging inanimate objects, we focus our discussion on biological and medical imaging. We examine the signal processing methods and algorithms that make OCT exquisitely sensitive to reflections as weak as just a few photons and that reveal functional information in addition to structure. Image processing, display and interpretation, which are all critical for effective biomedical imaging, are discussed in the context of specific applications. Finally, we consider image artifacts and limitations that commonly arise and reflect on future advances and opportunities.

Estimation of scleral mechanical properties from air-puff optical coherence tomography

We introduce a method to estimate the biomechanical properties of the porcine sclera in intact eye globes ex vivo, using optical coherence tomography that is coupled with an air-puff excitation source, and inverse optimization techniques based on finite element modeling. Air-puff induced tissue deformation was determined at seven different locations on the ocular globe, and the maximum apex deformation, the deformation velocity, and the arc-length during deformation were quantified. In the sclera, the experimental maximum deformation amplitude and the corresponding arc length were dependent on the location of air-puff excitation. The normalized temporal deformation profile of the sclera was distinct from that in the cornea, but similar in all tested scleral locations, suggesting that this profile is independent of variations in scleral thickness. Inverse optimization techniques showed that the estimated scleral elastic modulus ranged from 1.84 ± 0.30 MPa (equatorial inferior) to 6.04 ± 2.11 MPa (equatorial temporal). The use of scleral air-puff imaging holds promise for non-invasively investigating the structural changes in the sclera associated with myopia and glaucoma, and for monitoring potential modulation of scleral stiffness in disease or treatment.

Ultimate Spatial Resolution Realisation in Optical Frequency Domain Reflectometry with Equal Frequency Resampling

A method based on equal frequency resampling is proposed to suppress laser nonlinear frequency sweeping for the ultimate spatial resolution in optical frequency domain reflectometry. Estimation inaccuracy of the sweeping frequency distribution caused by the finite sampling rate in the auxiliary interferometer can be efficiently compensated by the equal frequency resampling method. With the sweeping range of 130 nm, a 12.1 µm spatial resolution is experimentally obtained. In addition, the sampling limitation of the auxiliary interferometer-based correction is discussed. With a 200 m optical path delay in the auxiliary interferometer, a 21.3 µm spatial resolution is realised at the 191 m fibre end. By employing the proposed resampling and a drawing tower FBG array to enhance the Rayleigh backscattering, a distributed temperature sensing over a 105 m fibre with a sensing resolution of 1 cm is achieved. The measured temperature uncertainty is limited to ±0.15 °C.

Phase-stabilized complex-decorrelation angiography

In this study, we developed a novel phase-stabilized complex-decorrelation (PSCD) optical coherence tomography (OCT) angiography (OCTA) method that can generate high quality OCTA images. This method has been validated using three different types of OCT systems and compared with conventional complex- and amplitude-based OCTA algorithms. Our results suggest that in combination with a pre-processing phase stabilization method, the PSCD method is insensitive to bulk motion phase shifts, less dependent on OCT reflectance than conventional complex methods and demonstrates extended dynamic range of flow signal, in contrast to other two methods.

Imaging Motion: A Comprehensive Review of Optical Coherence Tomography Angiography

Optical coherence tomography (OCT) is a three-dimensional (3-D) optical imaging technology that provides noninvasive, micrometer resolution images of structural interiors within biological samples with an approximately 1 ~ 2 mm penetration depth. Over the last decades, advances in OCT have revolutionized biomedical imaging by demonstrating a potential of optical biopsy in preclinical and clinical settings. Recently, functional OCT imaging has shown a promise as angiography to visualize cell-perfused vasculatures in the tissue bed in vivo without requiring any exogenous contrast agents. This new technology termed OCT angiography (OCTA) possesses a unique imaging capability of delineating tissue morphology and blood or lymphatic vessels down to capillaries at real-time acquisition rates. For the past 10 years since 2007, OCTA has been proven to be a useful tool to identify disorder or dysfunction in tissue microcirculation from both experimental animal studies and clinical studies in ophthalmology and dermatology. In this section, we overview about OCTA including a basic principle of OCTA explained with simple optical physics, and its scan protocols and post-processing algorithms for acquisition of angiography. Then, potential and challenge of OCTA for clinical settings are shown with outcomes of human studies.

Multi-meridian corneal imaging of air-puff induced deformation for improved detection of biomechanical abnormalities

Corneal biomechanics play a fundamental role in the genesis and progression of corneal pathologies, such as keratoconus; in corneal remodeling after corneal surgery; and in affecting the measurement accuracy of glaucoma biomarkers, such as the intraocular pressure (IOP). Air-puff induced corneal deformation imaging reveals information highlighting normal and pathological corneal response to a non-contact mechanical excitation. However, current commercial systems are limited to monitoring corneal deformation only on one corneal meridian. Here, we present a novel custom-developed swept-source optical coherence tomography (SSOCT) system, coupled with a collinear air-puff excitation, capable of acquiring dynamic corneal deformation on multiple meridians. Backed by numerical simulations of corneal deformations, we propose two different scan patterns, aided by low coil impedance galvanometric scan mirrors that permit an appropriate compromise between temporal and spatial sampling of the corneal deformation profiles. We customized the air-puff module to provide an unobstructed SSOCT field of view and different peak pressures, air-puff durations, and distances to the eye. We acquired multi-meridian corneal deformation profiles (a) in healthy human eyes in vivo, (b) in porcine eyes ex vivo under varying controlled IOP, and (c) in a keratoconus-mimicking porcine eye ex vivo. We detected deformation asymmetries, as predicted by numerical simulations, otherwise missed on a single meridian that will substantially aid in corneal biomechanics diagnostics and pathology screening.

Age-Related Changes to the Three-Dimensional Full Shape of the Isolated Human Crystalline Lens

Purpose

Studying the full shape crystalline lens geometry is important to understand the changes undergone by the crystalline lens leading to presbyopia, cataract, or failure of emmetropization, and to aid in the design and selection of intraocular lenses and new strategies for correction. We used custom-developed three-dimensional (3-D) quantitative optical coherence tomography (OCT) to study age-related changes in the full shape of the isolated human crystalline lens.

Methods

A total of 103 ex vivo human isolated lenses from 87 subjects (age range, 0–56 years) were imaged using a 3-D spectral-domain OCT system. Lens models, constructed after segmentation of the surfaces and distortion correction, were used to automatically quantify central geometric parameters (lens thickness, radii of curvatures, and asphericities of anterior and posterior surfaces) and full shape parameters (lens volume, surface area, diameter, and equatorial plane position). Age-dependencies of these parameters were studied.

Results

Most of the measured parameters showed a biphasic behavior, statistically significantly increasing (radii of curvature, lens volume, surface area, diameter) or decreasing (asphericities, lens thickness) very fast in the first two decades of life, followed by a slow but significant increase after age 20 years (for all the parameters except for the posterior surface asphericity and the equatorial plane position, that remained constant).

Conclusions

Three-dimensional quantitative OCT allowed us to study the age-dependency of geometric parameters of the full isolated human crystalline lens. We found that most of the lens geometric parameters showed a biphasic behavior, changing rapidly before age 20 years and with a slower linear growth thereafter.

Anterior Segment Biometry During Accommodation and Effects of Cycloplegics by Swept-Source Optical Coherence Tomography

Purpose

We analyzed changes in the crystalline lens during accommodation and the effects of cycloplegics by swept-source anterior-segment optical coherence tomography (AS-OCT).

Materials and Methods

Twenty healthy volunteers (7 males and 13 females, aged 22–34 years), with no history of eye disease except for refractive errors, were recruited. Biometric parameters, including anterior chamber depth (ACD), lens thickness (LT), and anterior and posterior curvature of the lens (ACL and PCL), were measured using AS-OCT (CASIA2). The measurements were performed with or without an accommodative demand of 5.0 diopters (D). The same tests were repeated following the topical administration of 1% cyclopentolate or a compounding agent comprising 0.5% tropicamide and 0.5% phenylephrine.

Results

The AS-OCT system was capable of simultaneous visualization of all optical components of the anterior segment in a single frame. ACD, LAC, and LPC decreased and LT increased significantly during 5.0 D accommodative stimulation in both eyes. Both cyclopentolate and tropicamide/phenylephrine eyedrops led to deeper ACD, thinner LT, and flatter LAC. There were no significant differences in all lens parameters despite having 5.0 D accommodative stimulation in both eyes with cycloplegia.

Conclusion

Our results suggest that both tropicamide/phenylephrine and cyclopentolate eyedrops have enough cycloplegic effects in young adults.

Blood flow rate estimation in optic disc capillaries and vessels using Doppler optical coherence tomography with 3D fast phase unwrapping

The retinal volumetric flow rate contains useful information not only for ophthalmology but also for the diagnosis of common civilization diseases such as diabetes, Alzheimer's disease, or cerebrovascular diseases. Non-invasive optical methods for quantitative flow assessment, such as Doppler optical coherence tomography (OCT), have certain limitations. One is the phase wrapping that makes simultaneous calculations of the flow in all human retinal vessels impossible due to a very large span of flow velocities. We demonstrate that three-dimensional Doppler OCT combined with three-dimensional four Fourier transform fast phase unwrapping (3D 4FT FPU) allows for the calculation of the volumetric blood flow rate in real-time by the implementation of the algorithms in a graphics processing unit (GPU). The additive character of the flow at the furcations is proven using a microfluidic device with controlled flow rates as well as in the retinal veins bifurcations imaged in the optic disc area of five healthy volunteers. We show values of blood flow rates calculated for retinal capillaries and vessels with diameters in the range of 12-150 µm. The potential of quantitative measurement of retinal blood flow volume includes noninvasive detection of carotid artery stenosis or occlusion, measuring vascular reactivity and evaluation of vessel wall stiffness.

Corneal pulsation and biomechanics during induced ocular pulse. An ex-vivo pilot study

The purpose of this study was to ascertain the relationships between the amplitude of the corneal pulse (CP) signal and the parameters of corneal biomechanics during ex-vivo intraocular pressure (IOP) elevation experiments on porcine eyes with artificially induced ocular pulse cycles. Two experiments were carried out using porcine eyes. In the first one, a selected eye globe was subjected to three IOP levels (15, 30 and 45 mmHg), where changes in physical ocular pulse amplitude were controlled by infusion/withdrawal volumes (ΔV). In the second experiment, six eyes were subjected to IOP from 15 mmHg to 45 mmHg in steps of 5 mmHg with a constant ΔV, where corneal deformation parameters were measured using Corvis ST. In both experiments, at each IOP, the CP and IOP signals were acquired synchronically using a non-contact ultrasonic distance sensor and a pressure transmitter, respectively. Based on the amplitudes of the CP and IOP signals ocular pulse based corneal rigidity index (OPCRI) was calculated. Results indicate positive correlations between ΔV and the physical ocular pulse amplitude, and between ΔV and the corneal pulse amplitude (both p < 0.001). OPCRI was found to increase with elevated IOP. Furthermore, IOP statistically significantly differentiated changes in OPCRI, the amplitudes of CP and IOP signals and in most of the corneal deformation parameters (p < 0.05). The partial correlation analysis, with IOP as a control variable, revealed a significant correlation between the length of the flattened cornea during the first applanation (A1L) and the corneal pulse amplitude (p = 0.002), and between A1L and OPCRI (p = 0.003). In conclusion, this study proved that natural corneal pulsations, detected with a non-contact ultrasonic technique, reflect pressure-volume dynamics and can potentially be utilized to assess stiffness of the cornea. The proposed new rigidity index could be a simple approach to estimating corneal rigidity.

Ultrahigh-resolution anterior segment optical coherence tomography for analysis of corneal microarchitecture during wound healing

PURPOSE

To employ ultrahigh-resolution (UHR) optical coherence tomography (OCT) for investigation of the early wound healing process in corneal epithelium.

METHODS

A custom-built UHR-OCT system assessed epithelial healing in human keratoconic cornea after epi-off crosslinking (CXL) procedure and a wound healing model in rabbits with iatrogenic corneal injury. 3D OCT data sets enhanced obtaining epithelial thickness maps and evaluation of reepithelization stage. Accompanying changes in deeper corneal microarchitecture were analysed.

RESULTS

The mean central corneal thickness in 40 eyes with keratoconus at baseline was 482.7 ± 38.2 μm, while mean central epithelial thickness (CET) was 43.8 ± 6.4 μm. At the final visit 20 ± 5 days post-CXL procedure, CET was 35.0 ± 5.8 μm, significantly thinner after reepithelization (p < 0.001). Surgical success was assessed at the final visit through the demarcation line (DL), identified at 43.7 ± 13.5% stromal depth. In rabbits, the mean CET in 20 eyes at baseline was 35.9 ± 2.6 μm. In rabbits that revealed complete wound closure (10/20 eyes) at the last study day at 72 hr, CET was significantly thinner compared to baseline (30.4 ± 2.8 μm versus 35.4 ± 2.9 μm, p = 0.005). An intra-stromal landmark indicating early keratocyte apoptosis was measured at 30.0 ± 5.1% stromal depth. Epithelial thickness maps showed the time-course of corneal healing.

CONCLUSION

Ultrahigh-resolution (UHR)-OCT provided precise assessment of epithelial wound and its healing by 3D-mapping. In addition, microarchitectural changes in the cornea in early phases of epithelial healing were revealed.

Observation of treated iris neovascularization by swept-source-based en-face anterior-segment optical coherence tomography angiography

We evaluated regression of iris neovascularization (INV) using en-face anterior-segment optical coherence tomography angiography (AS-OCTA) after anti-vascular endothelial growth factor (VEGF) therapy. Seven consecutive eyes with INV were examined before and after anti-VEGF therapy, and all AS-OCTA scans were obtained using a swept-source OCTA system with an anterior-segment lens adapter. Slit-lamp microscopy photography and anterior indocyanine green angiography also were performed. Quantitative analyses of the vascular density, vascular lacunarity, and fractal dimension on AS-OCTA images were performed. AS-OCTA visualized the INV as signals around the pupillary margin, which corresponded to the vasculature confirmed by slit-lamp microscopy. After anti-VEGF drug injection, regression of INV was observed by AS-OCTA in all eyes (100%). The vascular density decreased and vascular lacunarity increased significantly after anti-VEGF therapy. This pilot study demonstrated the ability of AS-OCTA not only to detect but also to evaluate INV. Further study is warranted to improve the algorithm for delineating the iris vasculature to decrease artifacts.

High-speed OCT-based ocular biometer combined with an air-puff system for determination of induced retraction-free eye dynamics

We demonstrate a swept source OCT-based ocular biometer integrated with an air-puff stimulus to study the reaction of the eye to mechanical stimulation in vivo. The system enables simultaneous measurement of the stimulus strength and high-speed imaging of the eye dynamics along the visual axis. We characterize the stimulus and perform optimization of the data acquisition for a proper interpretation of the results. Access to the dynamics of axial eye length allows for a determination of the eye retraction, which is used to correct the air-puff induced displacement of ocular structures. We define the parameters to quantify the reaction of the eye to the air puff and determine their reproducibility in a group of healthy subjects. We observe the corneal deformation process and axial wobbling of the crystalline lens. OCT biometer combined with the air puff is the first instrument with the potential to provide comprehensive information on the biomechanics of ocular components.

Developments in Contact Lens Imaging: New Applications of Optical Coherence Tomography

Optical coherence tomography (OCT) is a high-speed and non-contact optical imaging technology widely used for noninvasive cross-sectional imaging of biological objects. Two main OCT technologies have been developed: time domain and Fourier domain technologies. The latter can be further divided into spectral domain OCT, which uses a broadband light source and a spectrometer as a detector, and swept source OCT, which employs a quickly-rotating laser source. Advances in OCT technology have made it one of the most helpful devices in ophthalmic practice. Fourier OCT has revolutionized imaging of the posterior segment of the eye, as well as of anterior structures and has enhanced the ability to diagnose and manage patients. It provides high-resolution information about the tear film, contact lens (CL), a qualitative and quantitative assessment of the anterior eye that is important in contact lens fitting, and allows possible eye surface changes while wearing contact lenses to be monitored. Potential swept source OCT technology applications include industrial processes of lens design and quality control. In this paper, we describe clinical applications and outline a variety of multifunctional uses of OCT in the field of refractive error correction with contact lenses.

Ultrafast discrete swept source based on dual chirped combs for microscopic imaging

An inertial-free, ultrafast frequency comb source based on two chirped optical frequency combs (OFCs) is proposed and experimentally demonstrated. The high linearity frequency sweeping is realized by the Vernier effect between the two OFCs rather than any mechanical motion component, so that good stability and reliability are ensured and no recalibration or resampling process is required. Swept rate up to 1 MHz is realized while keeping a narrow instantaneous linewidth of 0.03 nm, thanks to the extra-cavity frequency sweeping method. The wavelength step is proportional to the swept rate (3.8 pm at 10 kHz), and can be tuned by changing the repetition rate difference between the two OFCs. This swept source is applied for high-speed wavelength encoded imaging and achieves 4.4-μm spatial resolution at a 329-kHz frame rate. Compared with the traditional time-stretch microscopy, the signal acquisition bandwidth decreased from 3.8 GHz to below 90 MHz to achieve the same spatial resolution. Furthermore, the exposure time for a specific wavelength is much longer due to the discrete sweeping feature, which is a benefit for higher sensitivity. This discrete swept source provided a promising low-cost option for high-speed biomedical imaging systems and high-accuracy spectroscopy.

Compressed sensing-enabled phase-sensitive swept-source optical coherence tomography

Here we present a novel phase-sensitive swept-source optical coherence tomography (PhS-SS-OCT) system. The simultaneously recorded calibration signal, which is commonly used in SS-OCT to stabilize the phase, is randomly sub-sampled during the acquisition, and it is later reconstructed based on the Compressed Sensing (CS) theory. We first mathematically investigated the method, and verified it through computer simulations. We then conducted a vibrational frequency test and a flow velocity measurement in phantoms to demonstrate the system's capability of handling phase-sensitive tasks. The proposed scheme shows excellent phase stability with greatly discounted data bandwidth compared with conventional procedures. We further showcased the usefulness of the system in biological samples by detecting the blood flow in ex vivo swine left marginal artery. The proposed system is compatible with most of the existing SS-OCT systems and could be a preferred solution for future high-speed phase-sensitive applications.

In Vivo and Ex Vivo Microscopy: Moving Toward the Integration of Optical Imaging Technologies Into Pathology Practice

The traditional surgical pathology assessment requires tissue to be removed from the patient, then processed, sectioned, stained, and interpreted by a pathologist using a light microscope. Today, an array of alternate optical imaging technologies allow tissue to be viewed at high resolution, in real time, without the need for processing, fixation, freezing, or staining. Optical imaging can be done in living patients without tissue removal, termed in vivo microscopy, or also in freshly excised tissue, termed ex vivo microscopy. Both in vivo and ex vivo microscopy have tremendous potential for clinical impact in a wide variety of applications. However, in order for these technologies to enter mainstream clinical care, an expert will be required to assess and interpret the imaging data. The optical images generated from these imaging techniques are often similar to the light microscopic images that pathologists already have expertise in interpreting. Other clinical specialists do not have this same expertise in microscopy, therefore, pathologists are a logical choice to step into the developing role of microscopic imaging expert. Here, we review the emerging technologies of in vivo and ex vivo microscopy in terms of the technical aspects and potential clinical applications. We also discuss why pathologists are essential to the successful clinical adoption of such technologies and the educational resources available to help them step into this emerging role.

Phase-stability optimization of swept-source optical coherence tomography

Phase-resolved imaging of swept-source optical coherence tomography (SS-OCT) is subject to phase measurement instabilities involved with the sweep variation of a frequency-swept source. In general, optically generated timing references are utilized to track the variations imposed on OCT signals. But they might not be accurately synchronized due to relative time delays. In this research, we investigated the impact of the signal delays on the timing instabilities and the consequent deviations of the measured phases. We considered two types of timing signals utilized in a popular digitizer operation mode: a sweep trigger from a fiber Bragg grating (FBG) that initiates a series of signal sampling actions clocked by an auxiliary Mach-Zehnder interferometer (MZI) signal. We found that significant instabilities were brought by the relative delays through incoherent timing corrections and timing collisions between the timing references. The best-to-worst ratio of the measured phase errors was higher than 200 while only the signal delays varied. Noise-limited phase stability was achieved with a wide dynamic range of OCT signals above 50 dB in optimized delays. This demonstrated that delay optimization is very effective in phase stabilization of SS-OCT.

Comparison of anterior segment optical coherence tomography findings in acanthamoeba keratitis and herpetic epithelial keratitis

This study is to investigate the characteristic features of Acanthamoeba keratitis (AK) that differentiating it from herpetic epithelial keratitis (HEK) using anterior segment optical coherence tomography (AS-OCT). Medical records of three eyes of each AK and herpetic keratitis who had AS-OCT examination were reviewed in this study. Slit-lamp biomicroscopy and AS-OCT was performed on the initial visit and on every follow-up visits in all patients. In all three AK cases, reflective bands in the corneal stroma that correspond to the area of radial keratoneuritis were observed. The depth of the reflective bands varied in each case. After AK treatment, slit-lamp biomicroscopy confirmed that radial keratoneuritis had resolved and AS-OCT confirmed that reflective bands in the corneal stroma had also disappeared in all patients. Unlike the AS-OCT results found in AK, highly reflective HEK lesions were observed only in the subepithelial area, not in the stroma. AS-OCT seems to be helpful analyzing the specific depth of the lesion which enables to distinguish AK from HEK.

Long scan depth optical coherence tomography on imaging accommodation: impact of enhanced axial resolution, signal-to-noise ratio and speed

BACKGROUND

Spectral domain optical coherence tomography (SD-OCT) was a useful tool to study accommodation in human eye, but the maximum image depth is limited due to the decreased signal-to-noise ratio (SNR). In this study, improving optical resolutions, speeds and the SNR were achieved by custom built SD-OCT, and the evaluation of the impact of the improvement during accommodation was investigated.

METHODS

Three systems with different spectrometer designs, including two Charge Coupled Device (CCD) cameras and one Complementary Metal-Oxide-Semiconductor Transistor (CMOS) camera, were tested. We measured the point spread functions of a mirror at different positions to obtain the axial resolution and the SNR of three OCT systems powered with a light source with a 50 nm bandwidth, centered at a wavelength of 840 nm. Two normal subjects, aged 26 and 47, respectively, and one 75-year-old patient with an intraocular lens implanted were imaged.

RESULTS

The results indicated that spectrometers using cameras with 4096 camera pixels optimized the axial resolutions, due to the use of the full spectrum provided by the light source. The CCD camera system with 4096 pixels had the highest SNR and the best image quality. The system with the CMOS camera with 4096 pixels had the highest speed but had a compromised SNR compared to the CCD camera with 4096 pixels.

CONCLUSIONS

Using these three OCT systems, we imaged the anterior segment of the human eye before and after accommodation, which showed similar results among the different systems. The system using the CMOS camera with an ultra-long scan depth, high resolution and high scan speed exhibited the best overall performance and therefore was recommended for imaging real-time accommodation.

Quantitative shadow compensated optical coherence tomography of choroidal vasculature

Conventionally rendered optical coherence tomography (OCT) images of the posterior segment contain shadows which influence the visualization of deep structures such as the choroid. The purpose of this study was to determine whether OCT shadow compensation (SC) alters the appearance of the choroid and the apparent choroidal vascularity index (CVI), an OCT-derived estimated ratio of luminal to total choroidal volume. All scans were shadow compensated using a previously published algorithm, binarized using a novel validated algorithm and extracted binarized choroid to estimate CVI. On 27 raw swept-source OCT volume-scans of healthy subjects, the effect of SC on CVI was established both qualitatively and quantitatively. In shadow compensated scans, the choroid was visualized with greater brightness than the neurosensory retina and the masking of deep tissues by retinal blood vessels was greatly reduced. Among study subjects, significant mean difference in CVI of -0.13 was observed between raw and shadow compensated scans. Conventionally acquired OCT underestimates both choroidal reflectivity and calculated CVI. Quantitative analysis based on subjective grading demonstrated that SC increased the contrast between stromal and luminal regions and are in agreement with true tissue regions. This study is warranted to determine the effects of SC on CVI in diseased eyes.

Group refractive index quantification using a Fourier domain short coherence Sagnac interferometer

The group refractive index is important in length calibration of Fourier domain interferometers by transparent transfer standards. We demonstrate accurate group refractive index quantification using a Fourier domain short coherence Sagnac interferometer. Because of a justified linear length calibration function, the calibration constants cancel out in the evaluation of the group refractive index, which is then obtained accurately from two uncalibrated lengths. Measurements of two standard thickness coverslips revealed group indices of 1.5426±0.0042 and 1.5434±0.0046, with accuracies quoted at the 95% confidence level. This agreed with the dispersion data of the coverslip manufacturer and therefore validates our method. Our method provides a sample specific and accurate group refractive index quantification using the same Fourier domain interferometer that is to be calibrated for the length. This reduces significantly the requirements of the calibration transfer standard.

In vivo high resolution human corneal imaging using full-field optical coherence tomography

We present the first full-field optical coherence tomography (FFOCT) device capable of in vivo imaging of the human cornea. We obtained images of the epithelial structures, Bowman's layer, sub-basal nerve plexus (SNP), anterior and posterior stromal keratocytes, stromal nerves, Descemet's membrane and endothelial cells with visible nuclei. Images were acquired with a high lateral resolution of 1.7 µm and relatively large field-of-view of 1.26 mm x 1.26 mm - a combination, which, to the best of our knowledge, has not been possible with other in vivo human eye imaging methods. The latter together with a contactless operation, make FFOCT a promising candidate for becoming a new tool in ophthalmic diagnostics.

Digital holographic high-speed 3D imaging for the vibrometry of fast-occurring phenomena

Digital holography allows production of high-speed three-dimensional images at rates over 100,000 frames per second; however, simultaneously obtaining suitable performance and levels of accuracy using digital holography is difficult. This problem prevents high-speed three-dimensional imaging from being used for vibrometry. In this paper, we propose and test a digital holography method that can produce vibration measurements. The method is based on single-shot phase-shifting interferometry. Herein, we imaged the surface of a loudspeaker diaphragm and measured its displacement due to the vibrations produced by a frequency sweep signal. We then analyzed the frequency of the experimental data and confirmed that the frequency spectra inferred from the reconstructed images agreed well with the spectra produced by the sound recorded by a microphone. This method can be used for measuring vibrations with three-dimensional imaging for loudspeakers, microelectromechanical systems, surface acoustic wave filters, and biological tissues and organs.

Highly phase-stable 200 kHz swept-source optical coherence tomography based on KTN electro-optic deflector

The rapid advance in swept-source optical coherence tomography (SS-OCT) technology has enabled exciting new applications in elastography, angiography, and vibrometry, where both high temporal resolution and phase stability are highly sought-after. In this paper, we present a 200 kHz SS-OCT system centered at 1321 nm by using an electro-optically tuned swept source. The proposed system's performance was fully characterized, and it possesses superior phase stability (0.0012% scanning variability and <1 ns timing jitter) that is promising for many phase-sensitive imaging applications. Biological experiments were demonstrated within ex vivo human tracheobronchial ciliated epithelium where both the ciliary motion and ciliary beat frequency were successfully extracted.

Wide-field high-speed space-division multiplexing optical coherence tomography using an integrated photonic device

Space-division multiplexing optical coherence tomography (SDM-OCT) is a recently developed parallel OCT imaging method in order to achieve multi-fold speed improvement. However, the assembly of fiber optics components used in the first prototype system was labor-intensive and susceptible to errors. Here, we demonstrate a high-speed SDM-OCT system using an integrated photonic chip that can be reliably manufactured with high precisions and low per-unit cost. A three-layer cascade of 1 × 2 splitters was integrated in the photonic chip to split the incident light into 8 parallel imaging channels with ~3.7 mm optical delay in air between each channel. High-speed imaging (~1s/volume) of porcine eyes ex vivo and wide-field imaging (~18.0 × 14.3 mm²) of human fingers in vivo were demonstrated with the chip-based SDM-OCT system.

Phase-noise analysis of swept-source optical coherence tomography systems

We propose a new model to characterize the phase noise in swept-source optical coherence tomography (SS-OCT). The new model explicitly incorporates scanning variability, timing jitter, and sample location in addition to intensity noise (shot noise). The model was analyzed and validated by using both Monte Carlo methods and experiments. We suggest that the proposed model can be used as a guideline for future SS-OCT experimental designs.

Ultrahigh-resolution OCT imaging of the human cornea

We present imaging of corneal pathologies using optical coherence tomography (OCT) with high resolution. To this end, an ultrahigh-resolution spectral domain OCT (UHR-OCT) system based on a broad bandwidth Ti:sapphire laser is employed. With a central wavelength of 800 nm, the imaging device allows to acquire OCT data at the central, paracentral and peripheral cornea as well as the limbal region with 1.2 µm x 20 µm (axial x lateral) resolution at a rate of 140 000 A-scans/s. Structures of the anterior segment of the eye, not accessible with commercial OCT systems, are visualized. These include corneal nerves, limbal palisades of Vogt as well as several corneal pathologies. Cases such as keratoconus and Fuchs's endothelial dystrophy as well as infectious changes caused by diseases like Acanthamoeba keratitis and scarring after herpetic keratitis are presented. We also demonstrate the applicability of our system to visualize epithelial erosion and intracorneal foreign body after corneal trauma as well as chemical burns. Finally, results after Descemet's membrane endothelial keratoplasty (DMEK) are imaged. These clinical cases show the potential of UHR-OCT to help in clinical decision-making and follow-up. Our results and experience indicate that UHR-OCT of the cornea is a promising technique for the use in clinical practice, but can also help to gain novel insight in the physiology and pathophysiology of the human cornea.

In vivo three-dimensional imaging of human corneal nerves using Fourier-domain optical coherence tomography

We have employed Fourier-domain optical coherence tomography (FD-OCT) to achieve corneal nerve imaging, which could be useful in surgical planning and refractive surgery. Because the three-dimensional (3-D) images of the corneal nerves were acquired in vivo, unintentional movement of the subject during the measurement led to imaging artifacts. These artifacts were compensated for with a series of signal processing techniques, namely realigning A-scan images to flatten the boundary and cross-correlating adjacent B-scan images. To overcome the undesirably large signal from scattering at the corneal surface and iris, volume rendering and maximum intensity projections were performed with only the data taken in the stromal region of the cornea, which is located between 200 and 500???m from the corneal surface. The 3-D volume imaging of a 10×10??mm2 area took 9.8 s, which is slightly shorter than the normal tear breakup time. This allowed us to image the branched and threadlike corneal nerve bundles within the human eye. The experimental results show that FD-OCT systems have the potential to be useful in clinical investigations of corneal nerves and by minimizing nerve injury during clinical or surgical procedures.

Spectrometer calibration for spectroscopic Fourier domain optical coherence tomography

We propose a simple and robust procedure for Fourier domain optical coherence tomography (FdOCT) that allows to linearize the detected FdOCT spectra to wavenumber domain and, at the same time, to determine the wavelength of light for each point of detected spectrum. We show that in this approach it is possible to use any measurable physical quantity that has linear dependency on wavenumber and can be extracted from spectral fringes. The actual values of the measured quantity have no importance for the algorithm and do not need to be known at any stage of the procedure. As example we calibrate a spectral OCT spectrometer using Doppler frequency. The technique of spectral calibration can be in principle adapted to of all kind of Fourier domain OCT devices.

Spectral phase-based automatic calibration scheme for swept source-based optical coherence tomography systems

The automatic calibration in Fourier-domain optical coherence tomography (FD-OCT) systems allows for high resolution imaging with precise depth ranging functionality in many complex imaging scenarios, such as microsurgery. However, the accuracy and speed of the existing automatic schemes are limited due to the functional approximations and iterative operations used in their procedures. In this paper, we present a new real-time automatic calibration scheme for swept source-based optical coherence tomography (SS-OCT) systems. The proposed automatic calibration can be performed during scanning operation and does not require an auxiliary interferometer for calibration signal generation and an additional channel for its acquisition. The proposed method makes use of the spectral component corresponding to the sample surface reflection as the calibration signal. The spectral phase function representing the non-linear sweeping characteristic of the frequency-swept laser source is determined from the calibration signal. The phase linearization with improved accuracy is achieved by normalization and rescaling of the obtained phase function. The fractional-time indices corresponding to the equidistantly spaced phase intervals are estimated directly from the resampling function and are used to resample the OCT signals. The proposed approach allows for precise calibration irrespective of the path length variation induced by the non-planar topography of the sample or galvo scanning. The conceived idea was illustrated using an in-house-developed SS-OCT system by considering the specular reflection from a mirror and other test samples. It was shown that the proposed method provides high-performance calibration in terms of axial resolution and sensitivity without increasing computational and hardware complexity.

Multimodal optical coherence tomography and fluorescence lifetime imaging with interleaved excitation sources for simultaneous endogenous and exogenous fluorescence

Multimodal imaging probes a variety of tissue properties in a single image acquisition by merging complimentary imaging technologies. Exploiting synergies amongst the data, algorithms can be developed that lead to better tissue characterization than could be accomplished by the constituent imaging modalities taken alone. The combination of optical coherence tomography (OCT) with fluorescence lifetime imaging microscopy (FLIM) provides access to detailed tissue morphology and local biochemistry. The optical system described here merges 1310 nm swept-source OCT with time-domain FLIM having excitation at 355 and 532 nm. The pulses from 355 and 532 nm lasers have been interleaved to enable simultaneous acquisition of endogenous and exogenous fluorescence signals, respectively. The multimodal imaging system was validated using tissue phantoms. Nonspecific tagging with Alexa Flour 532 in a Watanbe rabbit aorta and active tagging of the LOX-1 receptor in human coronary artery, demonstrate the capacity of the system for simultaneous acquisition of OCT, endogenous FLIM, and exogenous FLIM in tissues.

High-speed spectral calibration by complex FIR filter in phase-sensitive optical coherence tomography

Swept-laser sources offer a number of advantages for Phase-sensitive Optical Coherence Tomography (PhOCT). However, inter- and intra-sweep variability leads to calibration errors that adversely affect phase sensitivity. While there are several approaches to overcoming this problem, our preferred method is to simply calibrate every sweep of the laser. This approach offers high accuracy and phase stability at the expense of a substantial processing burden. In this approach, the Hilbert phase of the interferogram from a reference interferometer provides the instantaneous wavenumber of the laser, but is computationally expensive. Fortunately, the Hilbert transform may be approximated by a Finite Impulse-Response (FIR) filter. Here we explore the use of several FIR filter based Hilbert transforms for calibration, explicitly considering the impact of filter choice on phase sensitivity and OCT image quality. Our results indicate that the complex FIR filter approach is the most robust and accurate among those considered. It provides similar image quality and slightly better phase sensitivity than the traditional FFT-IFFT based Hilbert transform while consuming fewer resources in an FPGA implementation. We also explored utilizing the Hilbert magnitude of the reference interferogram to calculate an ideal window function for spectral amplitude calibration. The ideal window function is designed to carefully control sidelobes on the axial point spread function. We found that after a simple chromatic correction, calculating the window function using the complex FIR filter and the reference interferometer gave similar results to window functions calculated using a mirror sample and the FFT-IFFT Hilbert transform. Hence, the complex FIR filter can enable accurate and high-speed calibration of the magnitude and phase of spectral interferograms.

Spectral domain optical coherence tomography with balanced detection using single line-scan camera and optical delay line

We propose a spectral domain optical coherence tomography (SD-OCT) system that uses a single line-scan detection scheme for balanced detection. Two phase-opposed spectra, generated by two optical fiber couplers, were detected by using a spectrometer with fast optical switching. A 2.69 km optical fiber was introduced to provide a proper time delay to prevent phase errors caused by the difference in measurement time between the two opposing spectra and unstable output voltages for controlling the galvano-scanner. Hence, a phase difference of π was obtained between the spectra over the sample depth without a phase error, which improved sensitivity by approximately 6 dB compared to that of conventional SD-OCT. We directly showed and compared the OCT images before and after applying the proposed balanced detection method in a phantom and in vivo sample.

Laser optomechanics

Cavity optomechanics explores the interaction between optical field and mechanical motion. So far, this interaction has relied on the detuning between a passive optical resonator and an external pump laser. Here, we report a new scheme with mutual coupling between a mechanical oscillator supporting the mirror of a laser and the optical field generated by the laser itself. The optically active cavity greatly enhances the light-matter energy transfer. In this work, we use an electrically-pumped vertical-cavity surface-emitting laser (VCSEL) with an ultra-light-weight (130 pg) high-contrast-grating (HCG) mirror, whose reflectivity spectrum is designed to facilitate strong optomechanical coupling, to demonstrate optomechanically-induced regenerative oscillation of the laser optomechanical cavity. We observe >550 nm self-oscillation amplitude of the micromechanical oscillator, two to three orders of magnitude larger than typical, and correspondingly a 23 nm laser wavelength sweep. In addition to its immediate applications as a high-speed wavelength-swept source, this scheme also offers a new approach for integrated on-chip sensors.