The Adaptive Optics Imaging Project: Background
Over the past 20 years, eye care has greatly benefited from advances in ocular imaging, which have allowed clinicians to study the microscopic structures of the eye in living patients approaching the detail formerly only seen in glass slides on the pathologist’s microscope. These enhanced views have aided earlier, more accurate diagnosis as well as the ability to monitor the outcomes of therapeutic interventions. With these advances came the recognition of the limitations of currently available clinical instruments due to the optical characteristics of the eye.
View Adaptive Optics Images and Videos
- Epiretinal Membrane
- Retinal Nerve Fiber Layer
- Retinal Pigment Epithelium
- Retinal Vasculature
There are many new therapeutic technologies in development which call for the next generation of imaging resolution and will require physicians to be able to study their patients’ retinas at a cellular level. These include stem cell therapies, gene transplant treatments, photoreceptor counting to monitor preservation and rescue, atrophy progression monitoring, and a variety of pharmaceutical trials which depend upon subtle changes over long periods of time.
The major limitation to consistently achieving cellular-level imaging has to do with the optical distortions inherent to the eye. In order to overcome this barrier, optical scientists have adopted a technique originally developed to allow astronomical telescopes to compensate for atmospheric distortions. This technique involves the use a special mirror that reads the distortions in the reflected light and modifies its surface to compensate or ‘adapt’ to the distortions and eliminate them. This Adaptive Optics technique is dynamic and improves the optical transmission of light sufficient to allow resolutions of 2 microns, which is10x the resolution otherwise achievable. In terms of clinical capabilities, this resolution provides the ability to detect and count the individual rods in the photoreceptor mosaic, which are 2.5 micron in diameter.
Adaptive Optics (AO) has been under development for the past 12 years but has been largely confined to academic centers with minimal exposure to real-world clinical subjects. To date there have been many publications describing the extraordinary views obtained and the potential to enhance our understanding of the critical clinical diseases we face each day. At the Infirmary we have made a strong commitment to advancing ocular imaging over the past 20 years and have been on the forefront of new developments in optical coherence tomography (OCT), scanning laser ophthalmoscopy (SLO), high resolution ultrasound, retinal blood flow imaging, macular pigment densitometry, retinal oximetry, and metabolic mapping. To further these efforts we surveyed a large number of research institutions in order to find a suitable partner, who would see the practical value of transitioning their technology to a major clinical center. We chose the researchers at the Medical College of Wisconsin in achieving the highest resolution in real patients with their Adaptive Optics Scanning Laser Ophthalmoscope (AOSLO).
NYEE Adaptive Optics Publications
A. Peer-reviewed publications
- Pinhas A, Dubow M, Shah N, Chui TY, Scoles D, Sulai YN, Weitz R, Walsh JB, Carroll J, Dubra A, Rosen RB. In vivo imaging of human retinal microvasculature using adaptive optics scanning light ophthalmoscope fluorescein angiography. Biomed Opt Express 2013;4:1305-1317. PMID: 24009994
- Dubow M, Pinhas A, Shah N, Cooper RF, Gan A, Gentile RC, Hendrix VL, Sulai YN, Carroll J, Chui TY, Walsh J, Weitz R, Dubra A, Rosen RB. Classification of Human Retinal Microaneurysms using Adaptive Optics Scanning Light Ophthalmoscope Fluorescein Angiography. Invest Ophthalmol Vis Sci 2014. PMID: 24425852
- Chui TY, Dubow M, Pinhas A, Shah N, Gan A, Weitz R, Sulai YN, Dubra A, RB Rosen. Comparison of adaptive optics scanning light ophthalmoscopic fluorescein angiography and offset pinhole imaging. Biomed Opt Express 2014;5:1173-1189
- Flatter JA, Cooper RF, Dubow MJ, Pinhas A, Singh RS, Kapur R, Shah N, Walsh, RD, Hong SH, Weinberg DV, Stepien KE, Wirostko WJ, Robison S, Dubra A, Rosen RB, Connor TB Jr, Carroll J. OUTER RETINAL STRUCTURE AFTER CLOSED-GLOBE BLUNT OCULAR
- Pinhas A, Razeen M, Dubow M, Gan A, Chui TY, Shah N, Mehta M, Gentile RC, Weitz R, Walsh J, Sulai YN, Carroll J, Dubra A, Rosen RB. Assessment of Perfused Foveal Microvascular Density and Identification of Nonperfused Capillaries in Healthy and Vasculopathic Eyes. Invest Ophthalmol Vis Sci 2014. 2014 Nov 20;55(12):8056-66. PMID: 25414179
- Chen MF, Chui TY, Alhadeff P, Rosen RB, Ritch R, Dubra A, Hood DC. Adaptive optics imaging of healthy and abnormal regions of retinal nerve fiber bundles of patients with glaucoma. Invest Ophthalmol Vis Sci. 2015 Jan 8;56(1):674-81. PMID: 25574048
- Hood DC, Chen MF, Lee D, Epstein B, Alhadeff P, Rosen RB, Ritch R, Dubra A, Chui TYP. Adaptive Optics Imaging of Peripapillary Nerve Fiber Bundles: Implications for Glaucomatous Damage Seen on Circumpapillary OCT Scans. Translational Vision Science & Technology, In press.
B. Conference abstracts
The Association for Research in Vision and Ophthalmology – 2015 ARVO Annual Meeting
- Rosen, Richard B. Changes over time in retinal vessels in patients with early diabetes. Mechanisms of vision loss in early diabetes: Connecting new findings from retinal imaging and functional techniques in patients to basic models - Minisymposium. ARVO Meeting Abstracts. Denver, CO, May, 2015
- Rosen, Richard B; Choudhury, Nadim; Menon, Nikhil; Pinhas, Alexander; Dubra, Alfredo; Chui, Toco Y. Visualization of Multiple Retinal Capillary Beds using Offset Pinhole Adaptive Optics Scanning Light Ophthalmoscopy. ARVO Meeting Abstracts. Denver, CO, May, 2015
- Chui, Toco Y.; Menon, Nikhil; Choudhury, Nadim; Pinhas, Alexander; Dubow, Michael; Shah, Nishit; Dubra, Alfredo; Rosen, Rosen. Imaging of Periarteriolar Capillary Free Zone using Offset Pinhole Adaptive Optics Scanning Light Ophthalmoscopy. ARVO Meeting Abstracts. Denver, CO, May, 2015
- Menon, Nikhil; Choudhury, Nadim; Chui, Toco Y.; Pinhas, Alexander; Sulai, Yusufu N.; Dubra, Alfredo; Rosen, Richard B. In vivo retinal vascular wall imaging in patients with diabetic retinopathy using non-confocal Split Detection Adaptive Optics Scanning Light Ophthalmoscopy. ARVO Meeting Abstracts. Denver, CO, May, 2015
- Choudhury, Nadim; Menon, Nikhil; Gan, Alexander; Razeen, Moataz M.; Pinhas, Alexander; Shah, Nishit; Gentile, Ronald C.; Chui, Toco Y.; Dubra, Alfredo; Rosen, Richard B. In vivo imaging of human retinal microvasculature in sickle cell retinopathy using adaptive optics scanning light ophthalmoscope fluorescein angiography and offset pinhole imaging. ARVO Meeting Abstracts. Denver, CO, May, 2015
- Pinhas A, Razeen M, Danias T, Menon N, Choudhury N, Field M, Panarelli J, Rosen, RB. Macular Mitochondrial Flavoprotein Autofluorescence in Eyes with Primary Open Angle Glaucoma. ARVO Meeting Abstracts. Denver, CO, May, 2015
- E. Smith, Toco Yuen Ping Chui, Ching-Lung Chen, J. Carroll, A. Dubra, Cooper R, R. Rosen, D.C. Hood, V.C. Greenstein. Analysis of the Photoreceptor Mosaic Within, On and Outside the Borders of Hyperautofluorescent Rings in Retinitis Pigmentosa Using Adaptive Optics Scanning Light Ophthalmoscopy. ARVO Meeting Abstracts. Denver, CO, May, 2015
- Lee, Dongwon; Chen, Monica; Chui, Toco Y.; Epstein, Benjamin; Ritch, Robert; Rosen, Richard B.; Dubra, Alfredo; Hood, Donald C. Adaptive Optics Imaging of Peripapillary Nerve Fiber Bundles: Implications for Glaucomatous Damage Seen on Circumpapillary OCT Scans. ARVO Meeting Abstracts. Denver, CO, May, 2015
- Maria A. Mavrommatis; Brad Fortune; Juan Reynaud; Monica Chen; Ramachandran, Rithu; Ritch, Robert; Rosen, Richard B; Dubra, Alfred; Chui, Toco Y; Hood, Donald C. Glaucomatous Damage of the Retinal Nerve Fiber Layer Can Be Better Visualized with En-Face OCT Imaging than with Typical OCT Thickness Maps. ARVO Meeting Abstracts. Denver, CO, May, 2015
- Ramamirtham, Ramkumar; Soni, Garima; Akula, James D; Swanson, Emily A; Favazza, Tara L; Mujat, Mircea; Ferguson, R D; Chui, Toco Y; Moskowitz, Anne; Fulton, Anne B. Extrafoveal Cone Packing Density and Geometry in Retinopathy of Prematurity (ROP). ARVO Meeting Abstracts. Denver, CO, May, 2015
- Gast T; Xiao F, Gens JS, Sawides L, Chui TYP, Glazier J, Burns SA. A Compucell3D Model of Diabetic Maculopathy Applicable to Individual Patients. ARVO Meeting Abstracts. Denver, CO, May, 2015
- Agemy, Steven; Lee, Jessica; Garcia Patricia; Hsiao Yi-Sing; Chui, Toco Y; Rosen, Richard B. Quantitative Analysis of Capillary Network Density in Diabetic Retinopathy Using Optical Coherence Tomography with Split-Spectrum Amplitudinal Decorrelation Angiography. ARVO Meeting Abstracts. Denver, CO, May, 2015
2015 ISIE/ ARVO Imaging Conference
- Nadim Choudhury, Nikhil Menon, Eric Cheang, Alexander Pinhas, Toco Y Chui, Alfredo Dubra, Richard Rosen. Quantitative Analysis of Foveal Capillary Tortuosity in Patients with Retinopathy using Adaptive Optics Scanning Light Ophthalmoscope Fluorescein Angiography. ARVO Imaging Conference. Denver, CO, May, 2015.
- Nikhil Menon, Nadim Choudhury, Toco Y Chui, Alfredo Dubra, Richard B Rosen. Characterizing the Perifoveal Intercapillary Region: Towards a Better Understanding of Foveal Vasculature Development in Healthy Human Subjects. ARVO Imaging Conference. Denver, CO, May, 2015.
- Donald C. Hood; Brad Fortune; Maria Mavrommatis; Juan Reynaud; Rithu Ramachandran; Robert Ritch; Richard Rosen; Alfredo Dubra; Hassan Muhammad; Toco Chui. Local details of glaucomatous damage seen on AO-SLO images can be detected in en-face images derived from swept-source OCT scans. ARVO Imaging Conference. Denver, CO, May, 2015.
- Richard B. Rosen; Steven Agemy; Patricia Garcia; Toco Chui; Chirag Shah. Quantitative Retinal Vascular Perfusion Density Mapping of Diabetic and Normal Subjects Utilizing Optical Coherence Tomography Angiography. ARVO Imaging Conference. Denver, CO, May, 2015.