In vivo imaging of human retinal microvasculature using adaptive optics scanning light ophthalmoscope fluorescein angiography

Pinhas, Alexander; Dubow, Michael; Shah, Nishit; Chui, Toco Y. P.; Scoles, Drew; Sulai, Yusufu N.; Weitz, Rishard; Walsh, J. B.; Carroll, Joseph; Dubra, Alfredo; Rosen, Richard B.

doi:10.1364/boe.4.001305

Cited by 74 publications

(63 citation statements)

References 57 publications

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“…13,29–31 The systems are housed at the Medical College of Wisconsin and the New York Eye & Ear Infirmary, and are based on the same optical design. A 796 nm superluminescent diode was used for reflectance retinal imaging, with two fields of view used to acquire videos subtending either 1 x 1° or 1.75 x 1.75°.…”

Section: Methodsmentioning

confidence: 99%

Outer Retinal Structure After Closed-Globe Blunt Ocular Trauma

Flatter

Cooper

Dubow

et al. 2014

Retina

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Purpose To evaluate outer retinal structural abnormalities in patients with visual deficits following closed globe blunt ocular trauma (cgBOT). Methods Nine subjects with visual complaints following cgBOT were examined between 1 month post-trauma and 6 years post-trauma. Spectral domain optical coherence tomography (SD-OCT) was used to assess outer retinal architecture, while adaptive optics scanning light ophthalmoscopy (AOSLO) was used to analyze photoreceptor mosaic integrity. Results Visual deficits ranged from central scotomas to decreased visual acuity. SD-OCT defects included focal foveal photoreceptor lesions, variable attenuation of the interdigitation zone, and mottling of the outer segment band, with one subject having normal outer retinal structure. AOSLO revealed disruption of the photoreceptor mosaic in all subjects, variably manifesting as foveal focal discontinuities, perifoveal hyporeflective cones, and paracentral regions of selective cone loss. Conclusions We observe persistent outer retinal disruption in subjects with visual complaints following cgBOT, albeit to a variable degree. AOSLO imaging allows assessment of photoreceptor structure at a level of detail not resolvable using SD-OCT or other current clinical imaging tools. Multimodal imaging appears useful for revealing the cause of visual complaints in patients following cgBOT. Future studies are needed to better understand how photoreceptor structure changes longitudinally in response to various trauma.

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Section: Methodsmentioning

confidence: 99%

Outer Retinal Structure After Closed-Globe Blunt Ocular Trauma

Flatter

Cooper

Dubow

et al. 2014

Retina

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“…[8][9][10][11][12] In vivo fluorescein angiography can resolve individual capillaries close to the vitreoretinal interface, yet does not provide reliable observation of deeper microvessels or of connecting vessels even in confocal mode. [13][14][15] The recent advent of in vivo imaging systems allowing segmentation of microvessel layers, such as adaptive optics ophthalmoscopy 1 4 or angio-optical coherence tomography (OCTA), [15][16][17][18][19][20][21][22] renewed the interest in the tridimensional disposition of human retinal microvessels. However, the yet limited resolution of OCTA impairs the analysis of the relationship between the layers.…”

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confidence: 99%

The 3D Retinal Capillary Circulation in Pigs Reveals a Predominant Serial Organization

Fouquet

Vacca

Sennlaub

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To establish a model of the retinal capillary circulation in pigs, which in many aspects is close to the human retina.METHODS. Using high density confocal microscopy image stacks of immunolabeled porcine retinal whole mounts, microvessels close to the optic nerve head were traced in three dimensions. The direction of flow of individual capillaries was deduced from their arteriolar and/or venous connections.RESULTS. From major arteries, second-order arteries traversed the nerve fiber layer and resolved exclusively into the superficial vascular plexus (SVP), which dichotomized the blood flow between radial peripapillary capillaries (RPCs) on one side and the intermediate (IVP) and deep vascular plexus (DVP) on the other. Each RPC was supplied by one or several capillaries from the SVP and drained to the IVP or DVP. The DVP was a mosaic of approximately 300 to 600 lm wide anastomotic watersheds, each drained by one or two venules connected to major veins. A presumptive direction of flow could be determined for >90% of capillaries. These results suggest a model of the capillary circulation in which the three microvessel layers are serially organized with RPCs are in parallel between the SVP and IVP or DVP.CONCLUSIONS. In the peripapillary retina of pigs, microvascular layers have a serial arrangement, with RPCs emerging from the SVP and draining to the IVP or DVP; hence, connected in parallel of this scheme. The bulk of flow, therefore, traverses the SVP and DVP successively. This organization contributes to the higher oxygen saturation in the SVP and RPCs than in the DVP. Physiopathologic implications of this model regarding retinal diseases are discussed.

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“…Rosen et al have successfully combined AOSLO and FA in order to further increase the imaging resolution and signal to noise ratio [32][33][34], which could help to address some of the image processing challenges previously discussed. In such systems, a blue channel (~488nm) light source was added for the fluorescein excitation, while maintaining the capability correcting the ophthalmic aberrations from the cornea and lens to reach theoretical limited imaging performance.…”

Section: Discussionmentioning

confidence: 99%

Computational fluid dynamics assisted characterization of parafoveal hemodynamics in normal and diabetic eyes using adaptive optics scanning laser ophthalmoscopy

Bernabéu¹,

Lammer²,

Cai³

et al. 2016

Biomed. Opt. Express

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Diabetic retinopathy (DR) is the leading cause of visual loss in working-age adults worldwide. Previous studies have found hemodynamic changes in the diabetic eyes, which precede clinically evident pathological alterations of the retinal microvasculature. There is a pressing need for new methods to allow greater understanding of these early hemodynamic changes that occur in DR. In this study, we propose a noninvasive method for the assessment of hemodynamics around the fovea (a region of the eye of paramount importance for vision). The proposed methodology combines adaptive optics scanning laser ophthalmoscopy and computational fluid dynamics modeling. We compare results obtained with this technique with in vivo measurements of blood flow based on blood cell aggregation tracking. Our results suggest that parafoveal hemodynamics, such as capillary velocity, wall shear stress, and capillary perfusion pressure can be noninvasively and reliably characterized with this method in both healthy and diabetic retinopathy patients.

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In vivo imaging of human retinal microvasculature using adaptive optics scanning light ophthalmoscope fluorescein angiography

Cited by 74 publications

References 57 publications

Outer Retinal Structure After Closed-Globe Blunt Ocular Trauma

Outer Retinal Structure After Closed-Globe Blunt Ocular Trauma

The 3D Retinal Capillary Circulation in Pigs Reveals a Predominant Serial Organization

Computational fluid dynamics assisted characterization of parafoveal hemodynamics in normal and diabetic eyes using adaptive optics scanning laser ophthalmoscopy

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