The expansion of wavefront-sensing techniques redefined the meaning of refractive error in clinical ophthalmology. Clinical aberrometers provide detailed measurements of the eye's wavefront aberration. The distribution and contribution of each higher-order aberration to the overall wavefront aberration in the individual eye can now be accurately determined and predicted. Using corneal or ocular wavefront sensors, studies have measured the interindividual and age-related changes in the wavefront aberration in the normal population with the goal of optimizing refractive surgery outcomes for the individual. New objective optical-quality metrics would lead to better use and interpretation of newly available information on aberrations in the eye. However, the first metrics introduced, based on sets of Zernike polynomials, is not completely suitable to depict visual quality because they do not directly relate to the quality of the retinal image. Thus, several approaches to describe the real, complex optical performance of human eyes have been implemented. These include objective metrics that quantify the quality of the optical wavefront in the plane of the pupil (ie, pupil-plane metrics) and others that quantify the quality of the retinal image (ie, image-plane metrics). These metrics are derived by wavefront aberration information from the individual eye. This paper reviews the more recent knowledge of the wavefront aberration in human eyes and discusses the image-quality and optical-quality metrics and predictors that are now routinely calculated by wavefront-sensor software to describe the optical and image quality in the individual eye.

Adaptive optics (AO) is a technology used to improve the performance of optical systems by reducing the effects of optical aberrations. The direct visualization of the photoreceptor cells, capillaries and nerve fiber bundles represents the major benefit of adding AO to retinal imaging. Adaptive optics is opening a new frontier for clinical research in ophthalmology, providing new information on the early pathological changes of the retinal microstructures in various retinal diseases. We have reviewed AO technology for retinal imaging, providing information on the core components of an AO retinal camera. The most commonly used wavefront sensing and correcting elements are discussed. Furthermore, we discuss current applications of AO imaging to a population of healthy adults and to the most frequent causes of blindness, including diabetic retinopathy, age-related macular degeneration and glaucoma. We conclude our work with a discussion on future clinical prospects for AO retinal imaging.

The use of multiple and complementary metric descriptors allows for a more detailed description of packing distribution and preferred arrangement of cone photoreceptors across the parafoveal retina.

Copper is an essential transition metal ion for the function of key metabolic enzymes, but its uncontrolled redox reactivity is source of reactive oxygen species. Therefore a network of transporters strictly controls the trafficking of copper in living systems. Deficit, excess, or aberrant coordination of copper are conditions that may be detrimental, especially for neuronal cells, which are particularly sensitive to oxidative stress. Indeed, the genetic disturbances of copper homeostasis, Menkes' and Wilson's diseases, are associated with neurodegeneration. Furthermore, copper interacts with the proteins that are the hallmarks of neurodegenerative disorders, such as Alzheimer's disease, Parkinson's disease, prion diseases, and familial amyotrophic lateral sclerosis. In all cases, copper-mediated oxidative stress is linked to mitochondrial dysfunction, which is a common feature of neurodegeneration. In particular we recently demonstrated that in copper deficiency, mitochondrial function is impaired due to decreased activity of cytochrome c oxidase, leading to production of reactive oxygen species, which in turn triggers mitochondria-mediated apoptotic neurodegeneration.

At microscale level, the mechanical response of the most anterior stroma is complex and nonlinear. The microstructure (fibers' packing, number of cross-links, water content) and the combination of elastic (collagen fibers) and viscous (matrix) components of the tissue influence the type of viscoelastic response. Efforts in modeling the biomechanics of human corneal tissue at micrometric level are needed.

No author has a financial or proprietary interest in any material or method mentioned.

Cone density follows a symmetrical distribution between fellow eyes. A systematic distribution of parafoveal cones between fellow eyes may provide an anatomical basis for the involvement of the photoreceptor layer in the first step of binocular spatial sampling.

A subtle decrease of parafoveal cone density was found in DM1 patients in comparison with age-matched control subjects via high-resolution adaptive optics retinal imaging. The cone density decline was moderately associated with a disturbance in the glucose metabolism.