A new detection scheme was developed for simultaneous multi-channel imaging that provides isotropic images of retinal structures, free of directionality artifacts. The arrangement consists of light collecting fibers that act as offset apertures. This fiber bundle configuration can be used to retrofit basically any existing AO-SLO platform. The channels can be combined to reveal additional structural and functional details and this kind of retinal imaging with cellular resolution is a valuable new tool for researchers and clinicians.
We developed a novel ophthalmic imaging platform that combines non-invasive measurements of retina/choroid structure and ocular blood flow based on optical coherence tomography (OCT) and wide-field semi-quantitative global flow visualization using line-scanning Doppler flowmetry (LSDF). The combination of these two imaging modalities within the same imaging platform enables comprehensive assessment of blood flow in retina and choroid and provides efficient characterization of blood flow in hemodynamic studies both in human volunteers and in small animals. The platform enables visualization of the entire posterior hemisphere vasculature, including vortex veins, using only light and without additional contrast agent in humans and rats.
The use of a Prosthetic Replacement of the Ocular Surface Environment (PROSE) device is a revolutionary treatment for military patients that have lost their eyelids due to 3rd degree facial burns and for civilians who suffer from a host of corneal diseases. However, custom manual fitting is often a protracted painful, inexact process that requires multiple fitting sessions. Training for new practitioners is a long process. Automated methods to measure the complete corneal and scleral topology would provide a valuable tool for both clinicians and PROSE device manufacturers and would help streamline the fitting process.
PSI has developed an ocular anterior-segment profiler based on Optical Coherence Tomography (OCT), which provides a 3D measure of the surface of the sclera and cornea. This device will provide topography data that will be used to expedite and improve the fabrication process for PROSE devices. OCT has been used to image portions of the cornea and sclera and to measure surface topology for smaller contact lenses [1-3]. However, current state-of-the-art anterior eye OCT systems can only scan about 16 mm of the eye’s anterior surface, which is not sufficient for covering the sclera around the cornea. In addition, there is no systematic method for scanning and aligning/stitching the full scleral/corneal surface and commercial segmentation software is not optimized for the PROSE application.
Although preliminary, our results demonstrate the capability of PSI’s approach to generate accurate surface plots over relatively large areas of the eye, which is not currently possible with any other existing platform. Testing the technology on human volunteers is currently underway at Boston Foundation for Sight.
AO has achieved success in a range of applications in ophthalmology where microstructures need to be identified,
counted, and mapped. Multiple images are averaged to improve the SNR or analyzed for temporal dynamics. For small
patches, image registration by cross-correlation is straightforward. 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 long strips are not simple displacements, averaging will actually degrade the images.
We have applied non-rigid registration that significantly improves the quality of processed images for mapping cones
and rods, and microvasculature in dark-field imaging. Local grid deformations account for local image stretching and
compression due to a number of causes. Individual blood cells can be traced along capillaries in high-speed imaging
(130 fps) and flow dynamics can be analyzed.
The performance of clinical confocal SLO and OCT imagers is limited by ocular aberrations. Adaptive optics (AO)
addresses this problem, but most research systems are large, complex, and less well suited to the clinical environment.
PSI's recently developed compact retinal imager is designed for rapid, automated generation of cone photoreceptor
density maps. The device has a compact foot-print suitable for clinical deployment. The system previously presented at
Photonics West and ARVO 2013 has been upgraded to include numerous new features that support clinical research
applications. These upgrades significantly enhance the capabilities of the imager, providing the clinician with
simultaneously-acquired (registered) en face photoreceptor images and AO-OCT retinal cross-sections.
We describe here Mueller matrix microscopy, an imaging technique for investigating the anisotropic properties of the refractive index in biological samples. Tissue properties probed by polarization are the anisotropic real and imaginary parts of the refractive index that modify the polarization. Physical Sciences Inc. has developed a robust polarization microscope that is capable of performing complete Mueller matrix imaging in both transmission and reflection configuration. The system’s capabilities are illustrated on biological samples.
A multifunctional line scanning ophthalmoscope (mLSO) was designed, constructed, and tested on human subjects. The mLSO could sequentially acquire wide-field, confocal, near-infrared reflectance, fluorescein angiography (FA), and indocyanine green angiography (ICGA) retinal images. The system also included a retinal tracker (RT) and a photodynamic therapy laser treatment port. The mLSO was tested in a pilot clinical study on human subjects with and without retinal disease. The instrument exhibited robust retinal tracking and high-contrast line scanning imaging. The FA and ICGA angiograms showed a similar appearance of hyper- and hypo-pigmented disease features and a nearly equivalent resolution of fine capillaries compared to a commercial flood-illumination fundus imager. An mLSO-based platform will enable researchers and clinicians to image human and animal eyes with a variety of modalities and deliver therapeutic beams from a single automated interface. This approach has the potential to improve patient comfort and reduce imaging session times, allowing clinicians to better diagnose, plan, and conduct patient procedures with improved outcomes.
Adaptive optics ophthalmic imaging systems that rely on a standalone wave-front sensor can be costly to build and
difficult for non-technical personnel to operate. As an alternative we present a simplified wavefront sensorless adaptive
optics laser scanning ophthalmoscope. This sensorless system is based on deterministic search algorithms that utilize the
image's spatial frequency as an optimization metric. We implement this algorithm on a NVIDIA video card to take
advantage of the graphics processing unit (GPU)'s parallel architecture to reduce algorithm computation times and
approach real-time correction.
We recently developed several versions of a multimodal adaptive optics (AO) retinal imager, which includes highresolution
scanning laser ophthalmoscopy (SLO) and Fourier domain optical coherence tomography (FDOCT) imaging
channels as well as an auxiliary wide-field line scanning ophthalmoscope (LSO). Some versions have also been
equipped with a fluorescence channel and a retinal tracker. We describe the performance of three key features of the
multimodal AO system including: simultaneous SLO/OCT imaging, which allows SLO/OCT co-registration; a small
animal imaging port, which adjusts the beam diameter at the pupil from 7.5 to 2.5 mm for use with small animals
ubiquitous in biological research or for extended depth-of-focus imaging in humans; and slow scan Doppler flowmetry
imaging using the wide field auxiliary LSO imaging channel. The systems are currently deployed in several
ophthalmology clinics and research laboratories and several investigations have commenced on patients with a variety
of retinal diseases and animals in vision research.
We developed a multimodal adaptive optics (AO) retinal imager for diagnosis of retinal diseases, including glaucoma, diabetic retinopathy (DR), age-related macular degeneration (AMD), and retinitis pigmentosa (RP). The development represents the first ever high performance AO system constructed that combines AO-corrected scanning laser ophthalmoscopy (SLO) and swept source Fourier domain optical coherence tomography (SSOCT) imaging modes in a
single compact clinical prototype platform. The SSOCT channel operates at a wavelength of 1 μm for increased penetration and visualization of the choriocapillaris and choroid, sites of major disease activity for DR and wet AMD.
The system is designed to operate on a broad clinical population with a dual deformable mirror (DM) configuration that
allows simultaneous low- and high-order aberration correction. The system also includes a wide field line scanning ophthalmoscope (LSO) for initial screening, target identification, and global orientation; an integrated retinal tracker (RT) to stabilize the SLO, OCT, and LSO imaging fields in the presence of rotational eye motion; and a high-resolution LCD-based fixation target for presentation to the subject of stimuli and other visual cues. The system was tested in a limited number of human subjects without retinal disease for performance optimization and validation. The system was able to resolve and quantify cone photoreceptors across the macula to within ~0.5 deg (~100-150 μm) of the fovea,
image and delineate ten retinal layers, and penetrate to resolve targets deep into the choroid. In addition to instrument
hardware development, analysis algorithms were developed for efficient information extraction from clinical imaging
sessions, with functionality including automated image registration, photoreceptor counting, strip and montage stitching, and segmentation. The system provides clinicians and researchers with high-resolution, high performance adaptive optics imaging to help guide therapies, develop new drugs, and improve patient outcomes.
An automated algorithm for differentiating breast tissue types based on optical coherence tomography (OCT) data is presented. Eight parameters are derived from the OCT reflectivity profiles and their means and covariance matrices are calculated for each tissue type from a training set (48 samples) selected based on histological examination. A quadratic discrimination score is then used to assess the samples from a validation set. The algorithm results for a set of 89 breast tissue samples were correlated with the histological findings, yielding specificity and sensitivity of 0.88. If further perfected to work in real time and yield even higher sensitivity and specificity, this algorithm would be a valuable tool for biopsy guidance and could significantly increase procedure reliability by reducing both the number of nondiagnostic aspirates and the number of false negatives.
By increasing the speed and reducing the complexity of OCT systems, the parallel OCT system presented here will reduce the cost of high performance instruments while making them more widespread and easy to use. The instrument integrates line scanning with a swept source to achieve ultrahigh image speeds in a much simpler way. The swept source speed requirements are significantly relaxed. In a traditional OCT, a focused beam is scanned for image formation, while parallel OCT images simultaneously a full B-scan or a complete 3D cube. The system achieved ultrahigh scan speeds (98 kHz line rates and 160 fps), and was initially tested on various reflective and diffuse targets. The system demonstrates the potential for 3-D volumetric mapping of tissue at several volumes per second.
Subretinal neovascular membranes (SRNM) are a deleterious complication of laser eye injury and retinal diseases such as age-related macular degeneration (AMD), choroiditis, and myopic retinopathy. Photodynamic therapy (PDT) and anti-vascular endothelial growth factor (VEGF) drugs are approved treatment methods. PDT acts by selective dye accumulation, activation by laser light, and disruption and clotting of the new leaky vessels. However, PDT surgery is currently not image-guided, nor does it proceed in an efficient or automated manner. This may contribute to the high rate of re-treatment. We have developed a multimodal scanning laser ophthalmoscope (SLO) for automated diagnosis and image-guided treatment of SRNMs associated with AMD. The system combines line scanning laser ophthalmoscopy (LSLO), fluorescein angiography (FA), indocyanine green angiography (ICGA), PDT laser delivery, and retinal tracking in a compact, efficient platform. This paper describes the system hardware and software design, performance characterization, and automated patient imaging and treatment session procedures and algorithms. Also, we present initial imaging and tracking measurements on normal subjects and automated lesion demarcation and sizing analysis of previously acquired angiograms. Future pre-clinical testing includes line scanning angiography and PDT treatment of AMD subjects. The automated acquisition procedure, enhanced and expedited data post-processing, and innovative image visualization and interpretation tools provided by the multimodal retinal imager may eventually aid in the diagnosis, treatment, and prognosis of AMD and other retinal diseases.
We have developed a compact retinal imager that integrates adaptive optics (AO) into a line scanning laser ophthalmoscope (LSLO). The bench-top AO-LSLO instrument significantly reduces the size, complexity, and cost of research AOSLOs, for the purpose of moving adaptive optics imaging more rapidly into routine clinical use. The AO-LSLO produces high resolution retinal images with only one moving part and a significantly reduced instrument footprint and number of optical components. The AO-LSLO has a moderate field of view (5.5 deg), which allows montages of the macula or other targets to be obtained more quickly and efficiently. In a preliminary human subjects investigation, photoreceptors could be resolved and counted within ~0.5 mm of the fovea. Photoreceptor counts matched closely to previously reported histology. The capillaries surrounding the foveal avascular zone could be resolved, as well as cells flowing within them. Individual nerve fiber bundles could be resolved, especially near the optic nerve head, as well as other structures such as the lamina cribrosa. In addition to instrument design, fabrication, and testing, software algorithms were developed for automated image registration, cone counting, and montage stitching.
Adaptive optics (AO) is used to correct ocular aberrations primarily in the cornea, lens, and tear film of every eye.
Among other applications, AO allows high lateral resolution images to be acquired with scanning laser ophthalmoscopy
(SLO) and optical coherence tomography (OCT). Spectral domain optical coherence tomography (SDOCT) is a high-speed
imaging technique that can acquire cross-sectional scans with micron-scale axial resolution at tens to hundreds of
kHz line rates. We present a compact clinical AO-SDOCT system that achieves micron-scale axial and lateral resolution
of retinal structures. The system includes a line scanning laser ophthalmscope (LSLO) for simultaneous wide-field
retinal viewing and selection of regions-of-interest. OCT and LSLO imaging and AO correction performance are
characterized. We present a case study of a single subject with hyper-reflective lesions associated with stable, resolved
central serous retinopathy to compare and contrast AO as applied to scanning laser ophthalmoscopy and optical
coherence tomography. The two imaging modes are found to be complementary in terms of information on structure
morphology. Both provide additional information lacking in the other. This preliminary finding points to the power of
combining SLO and SDOCT in a single research instrument for exploration of disease mechanisms, retinal cellular
architecture, and visual psychophysics.
Spectral domain optical coherence tomography (SDOCT) is a relatively new imaging technique that allows high-speed
cross-sectional scanning of retinal structures with little motion artifact. However, instrumentation for these systems is
not yet fast enough to collect high-density three-dimensional retinal maps free of the adverse effects of lateral eye
movements. Low coherence interferometry instruments must also contend with axial motion primarily from head
movements that shift the target tissue out of the coherence detection range. Traditional SDOCT instruments suffer from
inherent deficiencies that exacerbate the effect of depth motion, including limited range, depth-dependent signal
attenuation, and complex conjugate overlap. We present initial results on extension of our transverse retinal tracking
system to three-dimensions especially for SDOCT imagers. The design and principle of operation of two depth tracking
techniques, adaptive ranging (AR) and Doppler velocity (DV) tracking, are presented. We have integrated the threedimensional
tracking hardware into a hybrid line scanning laser ophthalmoscope (LSLO)/SDOCT imaging system.
Imaging and tracking performance was characterized by tests involving a limited number of human subjects. The hybrid
imager could switch between wide-field en-face confocal LSLO images, high-resolution cross-sectional OCT images,
and an interleaved mode of sequential LSLO and OCT images. With 3-D tracking, the RMS error for axial motion
decreased to <50 µm and for lateral motion decreased to <10 µm. The development of real-time tracking and SDOCT
image processing hardware is also discussed. Future implementation of 3-D tracking should increase the yield of usable
images and decrease the patient measurement time for clinical SDOCT systems.
In this paper we demonstrate the integration of two technologies, Line-Scanning Laser Ophthalmoscopy (LSLO) and
Spectral Domain Optical Coherence Tomography (SDOCT) into a single compact instrument that shares the same
imaging optics and line scan camera for both LSLO and OCT imaging. Co-registered high contrast wide-field en face
retinal LSLO and SDOCT images are obtained non-mydriatically with less than 600 microwatts of broadband
illumination at 15 frames/sec. The hybrid instrument can work in three different modes: LSLO mode, SDOCT mode,
and LSLO/SDOCT interleaved mode. This instrument could be useful in clinical ophthalmic diagnostics and emergency
medicine.
Ultrahigh axial resolution in adaptive optics - optical coherence tomography (AO-OCT) is fundamentally limited by the
intrinsic chromatic aberrations of the human eye. Variation in refractive index of the ocular media with wavelength
causes the spectral content of broadband light sources to focus at different depths in the retina for light entering the eye
and at the imaging detector for light exiting. This effect has not been previously reported for ultrahigh-resolution OCT
(without AO) likely because the effect is masked by the relatively long depth of focus dictated by the small pupils used
in these systems. With AO, the pupil size is much larger and depth of focus substantially narrower. As such the
chromatic aberrations of the eye can counteract the lateral resolution benefit of AO when used with broadband light
sources. To more fully tap the potential of AO-OCT, compensation of the eye's chromatic and monochromatic
aberrations must occur concurrently. One solution is to insert an achromatizing lens in front of the eye whose chromatic
aberrations are equal but opposite in sign to that of the eye. In this paper we evaluate the efficacy of a novel design that
uses a custom achromatizing lens placed near the fiber collimating optic. AO-OCT images are acquired on several
subjects with and without the achromatizing lens and in combination with two light sources of different spectral width.
The combination of the achromatizing lens and broadband light source yielded the sharpest images of the retina and the
smallest speckle.
Scanning laser ophthalmoscopy (SLO) is a powerful imaging tool with specialized applications limited to research and ophthalmology clinics due in part to instrument size, cost, and complexity. Conversely, low-cost retinal imaging devices have limited capabilities in screening, detection, and diagnosis of diseases. To fill the niche between these two, a hand-held, nonmydriatic line-scanning laser ophthalmoscope (LSLO) is designed, constructed, and tested on normal human subjects. The LSLO has only one moving part and uses a novel optical approach to produce wide-field confocal fundus images. Imaging modes include multiwavelength illumination and live stereoscopic imaging with a split aperture. Image processing and display functions are controlled with two stacked prototype compact printed circuit boards. With near shot-noise limited performance, the digital LSLO camera requires low illumination power (<500 µW) at near-infrared wavelengths. The line-scanning principle of operation is examined in comparison to SLO and other imaging modes. The line-scanning approach produces high-contrast confocal images with nearly the same performance as a flying-spot SLO. The LSLO may significantly enhance SLO utility for routine use by ophthalmologists, optometrists, general practitioners, and also emergency medical personnel and technicians in the field for retinal disease detection and other diverse applications.
Active image stabilization for an adaptive optics scanning laser ophthalmoscope (AOSLO) was developed and tested in
human subjects. The tracking device, a high speed, closed-loop optical servo which uses retinal features as tracking target, is separate from AOSLO optical path. The tracking system and AOSLO beams are combined via a dichroic beam
splitter in front of the eye. The primary tracking system galvanometer mirrors follow the motion of the eye. The AOSLO raster is stabilized by a secondary set of galvanometer mirrors in the AOSLO optical train which are "slaved"
to the primary mirrors with fixed scaling factors to match the angular gains of the optical systems. The AO system (at
830 nm) uses a MEMS-based deformable mirror (Boston Micromachines Inc.) for wave-front correction. The third
generation retinal tracking system achieves a bandwidth of greater than 1 kHz allowing acquisition of stabilized AO
images with an accuracy of <10 μm. However, such high tracking bandwidth, required for tracking saccades, results in
finite tracking position noise which is evident in AOSLO images. By means of filtering algorithms, the AOSLO raster is
made to follow the eye accurately with reduced tracking noise artifacts. The system design includes simultaneous presentation of non-AO, wide-field (~40 deg) live reference image captured with a line scanning laser ophthalmoscope
(LSLO) typically operating from 900 to 940nm. High-magnification (1-2 deg) AOSLO retinal scans easily positioned
on the retina in a drag-and-drop manner. Normal adult human volunteers were tested to optimize the tracking
instrumentation and to characterize AOSLO imaging performance. Automatic blink detection and tracking re-lock,
enabling reacquisition without operator intervention, were also tested. The tracking-enhanced AOSLO may become a
useful tool for eye research and for early detection and treatment of retinal diseases.
Precise targeting of retinal structures including retinal pigment epithelial cells, feeder vessels, ganglion cells, photoreceptors, and other cells important for light transduction may enable earlier disease intervention with laser therapies and advanced methods for vision studies. A novel imaging system based upon scanning laser ophthalmoscopy (SLO) with adaptive optics (AO) and active image stabilization was designed, developed, and tested in humans and animals. An additional port allows delivery of aberration-corrected therapeutic/stimulus laser sources. The system design includes simultaneous presentation of non-AO, wide-field (~40 deg) and AO, high-magnification (1-2 deg) retinal scans easily positioned anywhere on the retina in a drag-and-drop manner. The AO optical design achieves an error of <0.45 waves (at 800 nm) over ±6 deg on the retina. A MEMS-based deformable mirror (Boston Micromachines Inc.) is used for wave-front correction. The third generation retinal tracking system achieves a bandwidth of greater than 1 kHz allowing acquisition of stabilized AO images with an accuracy of ~10 μm. Normal adult human volunteers and animals with previously-placed lesions (cynomolgus monkeys) were tested to optimize the tracking instrumentation and to characterize AO imaging performance. Ultrafast laser pulses were delivered to monkeys to characterize the ability to precisely place lesions and stimulus beams. Other advanced features such as real-time image averaging, automatic highresolution mosaic generation, and automatic blink detection and tracking re-lock were also tested. The system has the potential to become an important tool to clinicians and researchers for early detection and treatment of retinal diseases.
A novel instrument for real-time in vivo measurement of blood composition is presented. Two optical technologies are combined in this instrument: spectral domain low coherence interferometry (SD-LCI) and retinal tracking. Retinal tracking is used to stabilize the LCI beam on vessels. SD-LCI is used to get depth-reflectivity profiles within the vessels. Multiple signals are rapidly acquired, averaged and processed. Differences in the slopes of the depth reflectivity profiles for different subjects correspond to the difference in the scattering coefficient, which is proportional to the concentration of red blood cells per cubic mm of blood (hematocrit). Preliminary measurements on several healthy volunteers show a good correlation with the normal range of the hematocrit.
We have designed, developed, and tested a three-dimensional tracking and imaging system that uses a novel optical layout to acquire both en-face confocal images by scanning laser imaging (e.g. scanning laser ophthalmoscopy, SLO) and high-resolution depth sections by optical coherence tomography (OCT). The present application for this system is retinal imaging. The instrument is capable of sequentially collecting OCT and SLO images with the simple articulation of an optic affixed to a flip-mount. In addition, we have extended our mature transverse tracking system for full three-dimensional motion stabilization. The tracking component employs an innovative optical and electronic design that encodes transverse and depth tracking information on a single beam. We have demonstrated en face SLO imaging with a resolution of ~25 μm and depth-resolved OCT imaging with a resolution of ~10 μm. On artificial targets, transverse tracking was robust up to 1 m/s with a bandwidth of ~1 kHz and depth tracking was robust up to a velocity of ~15 cm/sec, a range of ~1 mm, and a bandwidth of a few hundred Hz. The details of the instrument, including optical and electronic design, are discussed. The system has the potential to provide clinicians and researchers with a wide variety of diagnostic information for the early detection and treatment of retinal diseases.
A retinal tracker was integrated into a third-generation commercial clinical optical coherence tomography system (Stratus OCT) manufactured by Carl Zeiss Meditec Inc. (CZMI). The instrument, called tracking optical coherence tomography (TOCT), uses a secondary sensing beam in a confocal reflectometer and steering mirrors to compensate eye motion with a closed loop bandwidth of 1 kHz and a lateral accuracy of less than 15 μm. Imaging and tracking control systems have been integrated into a single platform and user interface in order to admit new imaging capabilities and considerable simplification in acquisition of clinical data. The system was configured to acquire three-dimensional retinal OCT maps through all subject eye movements and blinks.
An active, hardware-based retinal tracker is integrated with a clinical optical coherence tomography (OCT) system to investigate the effects of stabilization on acquisition of high-resolution retinal sections. The prototype retinal tracker locks onto common fundus features, detects transverse eye motion via changes in feature reflectance, and positions the OCT diagnostic beam to fixed coordinates on the retina with mirrors driven by a feedback control loop. The system is tested in a full clinical protocol on subjects with normal and glaucomatous eyes. Experimental analysis software is developed to coalign and coadd multiple fundus and OCT images and to extract quantitative information on the location of structures in the images. Tracking is highly accurate and reproducible on all but one subject, resulting in the ability to scan the same retinal location continually over long periods of time. The results show qualitative improvement in 97% of coadded OCT scans and a reduction in the variance of the position of the optic disc cup edge to less than 1 pixel (<60 µm). The tracking system can be easily configured for use in research on ultra-high-resolution OCT systems for advanced image modalities. For example, tracking will enable very high density 3-D scans of the retina, which are susceptible to eye motion artifacts even for new high-speed systems.
Real time, high-speed image stabilization with a retinal tracking scanning laser ophthalmoscope (TSLO) enables new approaches to established diagnostics. Large dynamic range, wide-field stabilized Doppler flowmetry imaging was demonstrated in initial human subject testing with a large frequency range and up to 40 deg fields of view. The retinal tracking system uses a confocal reflectometer with a closed loop optical servo system to lock onto features in the ocular fundus. The fundus imaging method is a quasi-confocal line-scanning laser ophthalmoscope (LSLO). By locking to the retina and performing a slow scan of the laser line imager taking up to 30 seconds, frequency-resolved retinal perfusion and vascular flow images were obtained. The tracking system and auto-relock algorithms after blinks allowed the full image to be captured free of eye motion artifacts. Image cubes comprised of 512 by 512 spatial pixels by 512 or more temporal pixels were captured with a line rate of up to 20 kHz. The line sensor integrates, as opposed to conventional SLO flowmeters, thus minimizing aliasing that contributes to velocity errors. Fast Fourier Transform (FFT) power spectra at each image pixel were computed. Image reconstruction accuracy was typically better than one pixel width. Doppler frequency resolution from 14 Hz to 3.675 kHz was demonstrated in this work. Pulsatile flow effects were observed. Normal adult subjects and patients were tested with or without mydriasis to characterize flow imaging performance.
Scanning laser ophthalmoscopy is a powerful research tool with specialized but, to date, limited use in ophthalmic clinics due in part to the size, cost, and complexity of instruments. Conversely, low-cost retinal imaging devices have limited capabilities in screening, detection, and diagnosis of diseases. To fill the niche between these two, a low-cost, hand-held, line-scanning laser ophthalmoscope (LSLO) was designed, constructed, and tested on normal human subjects. The LSLO has only one moving part, multiple imaging modes, and uses low-cost but highly sensitive complimentary metal oxide semiconductor (CMOS) linear arrays for imaging with a detector dynamic range of 12-bits. The line-scanning approach produces high contrast quasi-confocal images with nearly the same performance as a flying-spot SLO. Imaging modes include simultaneous dual wavelength illumination and live stereoscopic imaging with a split aperture. Image processing and display functions are controlled with two stacked prototype compact printed circuit boards using field-programmable gated arrays (FPGA) and other digital electronic elements. With near shot-noise limited performance, the digital LSLO camera requires low illumination power (~ 100 μW) at near-infrared wavelengths. Wide field fundus images with several imaging modes have been obtained from several human subjects. The LSLO will significantly enhance confocal scanning laser ophthalmoscopy for routine use by ophthalmologist, optometrists, general practitioners and also non-specialized emergency medical personnel and technicians in the field for retinal disease detection and other diverse applications.
The effectiveness of image stabilization with a retinal tracker in
a multi-function, compact scanning laser ophthalmoscope (TSLO) was
demonstrated in initial human subject tests. The retinal tracking
system uses a confocal reflectometer with a closed loop optical
servo system to lock onto features in the fundus. The system is
modular to allow configuration for many research and clinical
applications, including hyperspectral imaging, multifocal
electroretinography (MFERG), perimetry, quantification of macular
and photo-pigmentation, imaging of neovascularization and other
subretinal structures (drusen, hyper-, and hypo-pigmentation), and
endogenous fluorescence imaging. Optical hardware features include
dual wavelength imaging and detection, integrated monochromator,
higher-order motion control, and a stimulus source. The system
software consists of a real-time feedback control algorithm and a
user interface. Software enhancements include automatic bias
correction, asymmetric feature tracking, image averaging,
automatic track re-lock, and acquisition and logging of
uncompressed images and video files. Normal adult subjects were
tested without mydriasis to optimize the tracking instrumentation
and to characterize imaging performance. The retinal tracking
system achieves a bandwidth of greater than 1 kHz, which permits
tracking at rates that greatly exceed the maximum rate of motion
of the human eye. The TSLO stabilized images in all test subjects
during ordinary saccades up to 500 °/sec with an inter-frame
accuracy better than 0.05 °. Feature lock was maintained for
minutes despite subject eye blinking. Successful frame averaging
allowed image acquisition with decreased noise in low-light
applications. The retinal tracking system significantly enhances
the imaging capabilities of the scanning laser ophthalmoscope.
A new system for robotically assisted retinal surgery requires real-time signal processing of the reflectance signal from small targets on the retina. Laser photocoagulation is used extensively by ophthalmologists to treat retinal disorders such as diabetic retinopathy and retinal breaks. Currently, the procedure is performed manually and suffers from several drawbacks which a computer-assisted system could alleviate. Such a system is under development that will rapidly and safely place multiple therapeutic lesions at desired locations on the retina in a mater of seconds. This system provides real- time, motion-stabilized lesion placement for typical clinical irradiation times. A reflectance signal from a small target on the retina is used to derive high-speed tracking corrections to compensate for patient eye movement by adjusting the laser pointing angles. Another reflectance signal from a different small target on the retina is used to derive information to control the laser irradiation time which allows consistent lesion formation over any part of the retina. This paper describes the electro-optical system which dynamically measures the two reflectance signals, determines the appropriate reflectance parameters in real time, and controls laser pointing and irradiation time to meet the stated requirements.
KEYWORDS: Eye, Analog electronics, Retina, Confocal microscopy, Optical tracking, Reflectometry, Reflectivity, In vivo imaging, Laser coagulation, Argon ion lasers
We describe initial in vivo experimental results of a new hybrid digital and analog design for retinal tracking and laser beam control. An overview of the design is given. The results show in vivo tracking rates which exceed the equivalent of 38 degrees per second in the eye, with automated lesion pattern creation. Robotically-assisted laser surgery to treat conditions such as diabetic retinopathy and retinal breaks may soon be realized under clinical conditions with requisite safety using standard video hardware and inexpensive optical components based on this design.
The initial experimental results of a new hybrid digital and analog design for retinal tracking and laser beam control are described. The results demonstrate tracking rates that exceed the equivalent of 60 deg per second in the eye, with automatic creation of lesion patterns and robust loss of lock detection. Robotically assisted laser surgery to treat conditions such as diabetic retinopathy and retinal tears can soon be realized under clinical conditions with requisite safety using standard video hardware and inexpensive optical components.
Shadowgraphic holography allows imaging of small particles over a 180 degree field of view and with a large depth of field. The cylindrical holography technique developed by Hough and Gustafson has been modified to allow holograms of small hypervelocity impact generated simulated space debris particles to be successfully made by using a subnanosecond laser pulse length. The use of very short (135 ps) laser pulses with a corresponding short coherence length (4 cm) frees the motion of small high speed particles. With this system, shadowgraphic holograms of aluminum projectiles impacting aluminum and graphic epoxy plates have been achieved at hypervelocity. Results of these tests as well as low speed proof of concept tests are presented.
We describe initial experimental results of a new hybrid digital and analog design for retinal tracking and laser beam control. Initial results demonstrate tracking rates which exceed the equivalent of 50 degrees per second in the eye, with automatic lesion pattern creation and robust loss of lock detection. Robotically assisted laser surgery to treat conditions such as diabetic retinopathy, macular degeneration, and retinal tears can now be realized under clinical conditions with requisite safety using standard video hardware and inexpensive optical components.
Laser-induced photocoagulation is used routinely to treat a variety of retinal disorders. In this procedure, absorption by the retina and choroid of focused laser light creates thermal lesions that provide the therapeutic effect. The treatment endpoint is determined by the ophthalmoscopical visibility of the coagulation resulting from the increased diffuse reflectivity of the fundus at the lesion site. To date, it is impossible, prior to treatment, to predict the effectiveness of a specific dosage of laser radiation -- the result can be assessed only after the exposure, and only subjectively. To avoid side effects like hemorrhage, macular pucker, and post-coagulative retinal detachments that can result from excessive local heating, a device for automatically controlling the laser exposure parameters is needed. Preliminary research aimed toward development of such a device has now been completed. The technique employs a simple electro-optical detector to monitor the changing reflectivity of the lesion during the laser exposure, and couples that information to a microcontroller which automatically adjusts the laser exposure parameters. The first results of a clinically realistic device are reported.
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