Stacey S. Choi

Most of the high-order aberrations of the eye are not circularly symmetric. Hence, while it is well known that human vision is subject to cortically based orientation preference in cell tuning, the optics of the eye might also introduce some orientational anisotropy. We tested this idea by measuring contrast sensitivity at different orientations of sine-wave gratings when viewing through a closed-loop adaptive optics phoropter. Under aberration-corrected conditions, mean contrast sensitivity improved for all observers by a factor of 1.8× to 5×. The detectability of some orientations improved more than others. As expected, this orientation-specific effect varied between individuals. The sensitivity benefits were accurately predicted from MTF model simulations, demonstrating that the observed effects reflected the individual's pattern of high-order aberrations. In one observer, the orientation-specific effects were substantial: an improvement of 8× at one orientation and 2× in another orientation. The experiments confirm that, for conditions that are not diffraction limited, the optics of the eye introduce rotational asymmetry to the luminance distribution on the retina and that this impacts vision, inducing orientational anisotropy. These results suggest that the traditional view of meridional anisotropy having an entirely neural origin may be true for diffraction-limited pupils but that viewing through larger pupils introduces an additional orientation-specific optical component to this phenomenon.

Purpose. To study the integrity of inner and outer retinal layers in patients with various types of optic neuropathy by using high-resolution imaging modalities. methods. Three high-resolution imaging systems constructed at the University of California Davis were used to acquire retinal images from patients with optic neuropathy: (1) adaptive optics (AO)-flood–illuminated fundus camera, (2) high-resolution Fourier domain optical coherence tomography (FDOCT), and (3) adaptive optics-Fourier domain optical coherence tomography (AO-FDOCT). The AO fundus camera provides en face images of photoreceptors whereas cross-sectional images (B-scans) of the retina are obtained with both FDOCT and AO-FDOCT. From the volumetric FDOCT data sets, detailed thickness maps of a three-layer complex consisting of the nerve fiber (NF), ganglion cell (GC), and inner plexiform (IP) layers were created. The number of visible cones in the en face images of photoreceptors was then compared with visual sensitivity maps from Humphrey visual field (HVF; Carl Zeiss Meditec, Inc., Dublin, CA) testing, as well as FDOCT and AO-FDOCT images, including the thickness maps of the NF–GC–IP layer complex. Five types of optic neuropathy were studied: (1) optic neuritis with multiple sclerosis (MS), (2) idiopathic intracranial hypertension (pseudotumor cerebri), (3) nonarteritic anterior ischemic optic neuropathy (NAION), (4) optic nerve head drusen with NAION, and (5) systemic lupus erythematosus with MS and arthritis. results. With permanent visual field loss and thinning of the NF–GC–IP layer complex, cone photoreceptors showed structural changes, making them less reflective, which caused the appearance of dark spaces in the en face images (hence, reduced number of visible cones) and indistinct outer retinal layers in OCT images. However, when the visual field loss was only transient, with a normal NF–GC–IP layer complex, there were no detectable abnormalities in cone photoreceptors (i.e., they were densely packed and had distinct photoreceptor layering in the OCT images). conclusions. Cone photoreceptors show structural changes when there is permanent damage to overlying inner retinal layers. There was a positive relation between the thickness of the three-layer inner retinal complex, visual sensitivity, and integrity of the cone mosaic.

Advances in Fourier-domain optical coherence tomography (Fd-OCT) permit visualization of three-dimensional morphology of in-vivo retinal structures in a way that promises to revolutionize clinical and experimental imaging of the retina. The relevance of these advances will be further increased by the recent introduction of several commercial Fd-OCT instruments that can be used in clinical practice. However, due to some inherent limitations of current Fd-OCT technology (e.g., lack of spectroscopic information, inability to measure fluorescent signals), it is important to co-register Fd-OCT data with images obtained by other clinical imaging modalities such as fundus cameras and fluorescence angiography to create a more complete interpretation and representation of structures imaged. The co-registration between different imaging platforms becomes even more important if small retinal changes are monitored for early detection and treatment. Despite advances in volume acquisition speed with FD-OCT, eye/head motion artifacts can be still seen on acquired data. Additionally high-sampling density, large field-of-view (FOV) Fd-OCT volumes may also be needed for comparison with conventional imaging. In standard Fd-OCT systems, higher sampling density and larger imaging FOV (with constant sampling densities) lead to longer acquisition time which further increases eye/head motion artifacts. To overcome those problems, we tested 3D stitching of multiple, smaller retinal volumes which can be acquired in a less time (reduction of motion artifacts) and/or when stitched create a larger FOV representation of the retina. Custom visualization software that makes possible manual co-registration and simultaneous visualization of volumetric Fd-OCT data sets is described. Volumetric visualizations of healthy retinas with corresponding fundus pictures are presented followed by examples of retinal volumes of high sampling density that are created from multiple "standard" Fd-OCT volumes.

We describe a compact MEMS-based adaptive optics (AO) optical coherence tomography (OCT) system with improved AO performance and ease of clinical use. A typical AO system consists of a Shack-Hartmann wavefront sensor and a deformable mirror that measures and corrects the ocular and system aberrations. Because of limitations on current deformable mirror technologies, the amount of real-time ocular-aberration compensation is restricted and small in previous AO-OCT instruments. In this instrument, we incorporate an optical apparatus to correct the spectacle aberrations of the patients such as myopia, hyperopia and astigmatism. This eliminates the tedious process of using trial lenses in clinical imaging. Different amount of spectacle aberration compensation was achieved by motorized stages and automated with the AO computer for ease of clinical use. In addition, the compact AO-OCT was optimized to have minimum system aberrations to reduce AO registration errors and improve AO performance.

We have combined methods from volume visualization and data analysis to support better diagnosis and treatment of human retinal diseases. Many diseases can be identified by abnormalities in the thicknesses of various retinal layers captured using optical coherence tomography (OCT). We used a support vector machine (SVM) to perform semi-automatic segmentation of retinal layers for subsequent analysis including a comparison of layer thicknesses to known healthy parameters. We have extended and generalized an older SVM approach to support better performance in a clinical setting through performance enhancements and graceful handling of inherent noise in OCT data by considering statistical characteristics at multiple levels of resolution. The addition of the multi-resolution hierarchy extends the SVM to have "global awareness". A feature, such as a retinal layer, can therefore be modeled within the SVM as a combination of statistical characteristics across all levels; thus capturing high- and low-frequency information. We have compared our semi-automatically generated segmentations to manually segmented layers for verification purposes. Our main goals were to provide a tool that could (i) be used in a clinical setting; (ii) operate on noisy OCT data; and (iii) isolate individual or multiple retinal layers in both healthy and disease cases that contain structural deformities.

The ability to obtain true three-dimensional (3D) morphology of the retinal structures is essential for future clinical and experimental studies. It becomes especially critical if the measurements acquired with different instruments need to be compared, or precise volumetric data are needed for monitoring and treatment of retinal disease. On the other hand, it is well understood that optical coherence tomography (OCT) images are distorted by several factors. Only limited work has been performed to eliminate these problems in ophthalmic retinal imaging, perhaps because they are less evident in the more common 2D representation mode of time-domain OCT. With recent progress in imaging speed of Fourier domain - OCT (Fd-OCT) techniques, however, 3D OCT imaging is more frequently being used, thereby exposing problems that have been ignored previously. In this paper we propose possible solutions to minimize and compensate for artifacts caused by subject eye and head motion, and distortions caused by the geometry of the scanning optics. The first is corrected by cross-correlation based B-scan registration techniques; the second is corrected by incorporating the geometry of the scanning beam into custom volume rendering software. Retinal volumes of optical nerve head (ONH) and foveal regions of healthy volunteer, with and without corrections, are presented. Finally, some common factors that may lead to increased distortions of the ophthalmic OCT image such as refractive error or position of the subject's head are discussed.

Purpose. To relate in vivo microscopic retinal changes to visual function in patients who have various forms of retinal dystrophy. methods. The UC Davis Adaptive Optics (AO) fundus camera was used to acquire in vivo retinal images at the cellular level. Visual function tests consisting of visual fields, multifocal electroretinography (mfERG), and contrast sensitivity were measured in all subjects by using stimuli that were coincident with areas imaged. Five patients with different forms of retinal dystrophy and three control subjects were recruited. Cone densities were quantified for all retinal images. results. In all images of diseased retinas, there were extensive areas of dark space between groups of photoreceptors, where no cone photoreceptors were evident. These irregular features were not seen in healthy retinas, but were apparent in patients with retinal dystrophy. There were significant correlations between functional vision losses and the extent to which these irregularities, quantified by cone density, occurred in retinal images. conclusions. AO fundus imaging is a reliable technique for assessing and quantifying the changes in the photoreceptor layer as disease progresses. Furthermore, this technique can be useful in cases where visual function tests provide borderline or ambiguous results, as it allows visualization of individual photoreceptors.

Adaptive optics-optical coherence tomography (AO-OCT) has the potential to improve lateral resolution for OCT retinal imaging. Several reports have already described the successful combination of AO with a scanning confocal Fourier-domain OCT instrument to permit real-time three-dimensional (3D) imaging with high resolution (in all three dimensions). One of the key components that sets the performance limit of AO is the wavefront corrector. Several different wavefront correctors have been used in AO-OCT systems so far. In this paper we compare two commercially available wavefront correctors: an AOptix Bimorph deformable mirror (DM) and a Boston Micromachines Micro- Electro Mechanical System (MEMS) DM (used for the first time in an AO-OCT system). To simplify the analysis, we tested their performance for the correction of low-amplitude high-order aberrations (with minimal defocus and astigmatism). Results were obtained with an AO-OCT instrument constructed at UC Davis that combines state-of-the-art Fourier-domain OCT and an AO design to allow simultaneous testing of both mirrors without the need to modify the optical system.