Slitlamp Photography and Videography With High Magnifications

Yuan, Jing; Jiang, Hong; Mao, Xinjie; Ke, Bilian; Yan, Wentao; Cintrón-Colón, Héctor; Pérez, Víctor L.; Wang, Jianhua

doi:10.1097/icl.0000000000000148

Cited by 11 publications

(8 citation statements)

References 18 publications

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“…By shining a thin sheet of light into the eye, an in vivo stereoscopic evaluation of the pathological changes of the cornea, conjunctiva and other anterior segment tissues can be performed by SLB [9]. However, the limited magnification and poor spatial resolution of traditional SLB make it difficult to visualize more detailed pathological structures and perform accurate biometric measurements [10][11][12]. Fluorescein stain could stain stroma while leaving the intact epithelium with a specific fluorescein dye, thereby demarcating the location and area of the epithelial loss in ocular surface diseases, on a relative macro scale as well [13].…”

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confidence: 99%

“…Techniques like OCT angiography [29,30] have been applied to image the vessels of the anterior segment, but they could only provide morphological information and lack of the function of providing quantitative functional parameters, such as the blood flow velocity. To measure the blood flow velocity in bulbar conjunctival vessels and also evaluate their network complexity, our team has developed functional slit-lamp biomicroscopy to achieve conjunctival vessel network imaging as well as high-resolution conjunctival blood flow videography [10,31]. With customized software, images and videos can be processed to achieve morphological parameters such as vessel diameter and complexity, as well as functional parameters of blood flow velocity.…”

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Multi-modal Anterior Eye Imager Combining Ultra-High Resolution OCT and Microvascular Imaging for Structural and Functional Evaluation of the Human Eye

et al. 2020

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To establish complementary information for the diagnosis and evaluation of ocular surface diseases, we developed a multi-modal, non-invasive optical imaging platform by combining ultra-high resolution optical coherence tomography (UHR-OCT) with a microvascular imaging system based on slit-lamp biomicroscopy. Our customized UHR-OCT module achieves an axial resolution of ≈2.9 µm in corneal tissue with a broadband light source and an A-line acquisition rate of 24 kHz with a line array CCD camera. The microvascular imaging module has a lateral resolution of 3.5 µm under maximum magnification of ≈187.5× with an imaging rate of 60 frames/s, which is sufficient to image the conjunctival vessel network and record the movement trajectory of clusters of red blood cells. By combining the imaging optical paths of different modules, our customized multi-modal anterior eye imaging platform is capable of performing real-time cross-sectional UHR-OCT imaging of the anterior eye, conjunctival vessel network imaging, high-resolution conjunctival blood flow videography, fluorescein staining and traditional slit-lamp imaging on a single device. With self-developed software, a conjunctival vessel network image and blood flow videography were further analyzed to acquire quantitative morphological and hemodynamics parameters, including vessel fractal dimensions, blood flow velocity and vessel diameters. The ability of our multi-modal anterior eye imager to provide both structural and functional information for ophthalmic clinical applications was demonstrated on a healthy human subject and a keratitis patient. evaluation of ocular surface diseases, different imaging modalities are usually applied in ophthalmic clinics to provide multi-modal and multi-dimensional images [7,8].Slit-lamp biomicroscopy (SLB) is the gold standard for routine ophthalmic examinations. By shining a thin sheet of light into the eye, an in vivo stereoscopic evaluation of the pathological changes of the cornea, conjunctiva and other anterior segment tissues can be performed by SLB [9]. However, the limited magnification and poor spatial resolution of traditional SLB make it difficult to visualize more detailed pathological structures and perform accurate biometric measurements [10][11][12]. Fluorescein stain could stain stroma while leaving the intact epithelium with a specific fluorescein dye, thereby demarcating the location and area of the epithelial loss in ocular surface diseases, on a relative macro scale as well [13]. Developed in the 1990s, optical coherence tomography (OCT) has revolutionized the field of ophthalmology and vision science with its non-contact, non-invasive and high-resolution nature and become one of the prominent diagnostic tools in offering cross-sectional tissue imaging [14][15][16]. Applications of OCT for in vivo human eye imaging have been widely demonstrated in the literature [17][18][19][20][21][22][23][24][25][26][27][28]. With ever-improving techniques in broadband light sources, ultra-high resolution OCT (UHR-OCT) has achieved m...

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Multi-modal Anterior Eye Imager Combining Ultra-High Resolution OCT and Microvascular Imaging for Structural and Functional Evaluation of the Human Eye

et al. 2020

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“…[ 9 ] It should be kept in mind that the cost of professional slit-lamp cameras ranges from upwards of USD 15,000. [ 5 16 ] Mounting CCD or other professional DSLR cameras can cost upwards of USD 1000 in addition to the cost of adapters,[ 5 ] and there is the additional cost of needing a computer and screen as well. In these cases, smartphones have been shown to be a more dependable and affordable alternative for anterior imaging, even in terms of picture quality at only a fraction of the cost of professional slit-lamp cameras.…”

Section: Discussionmentioning

confidence: 99%

A novel approach to anterior segment imaging with smartphones in the COVID-19 era

Dutt

Vadivel

Nagarajan

et al. 2021

Indian Journal of Ophthalmology

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Purpose: To report a novel, telemedicine-friendly, smartphone-based, wireless anterior segment device with instant photo-documentation ability in the COVID-19 era. Methods: Anterior Imaging Module (AIM) was constructed based on a 50/50 beam splitter design, to match the magnification drum optics of slit-lamps with a three-step or higher level of magnification. The design fills the smartphone sensor fully at the lowest magnification and matches the fixed focus of the slit-lamp. It comes with a smartphone for instant photo-documentation, an in-built software application for data-management and secure HIPAA compliant cloud storage, and a Bluetooth trigger for a one-tap image capture. The construction of the device is explained, and the optical resolution measured using U.S. air-force resolution test. AIM’s performance was characterized with traceability to internationally relevant performance standards for digital slit-lamps after image quality assessment through a pilot study. Results: Clinically useful anterior segment images were obtained with both diffuse and slit illumination at different magnification settings with the highest magnification (40X) resolution of 359 lines per cm and the lowest magnification (16X) resolution of 113 lines per cm. Conclusion: AIM is a novel, wireless, telemedicine-enabled design that digitizes existing, analog slit lamps with at least three-step magnification. The settings ensure the focus is determined purely by the position of the slit-lamp. Hence, the image viewed and captured on the smartphone is exactly what the clinician sees through the eyepiece. This helps in maintaining distance from the patient in the ongoing COVID-19 pandemic, as well.

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“…Once grafted, the same instruments used in clinic can be used to evaluate the grafted endothelium in the living animal in a non-invasive way, allowing to document its evolution over time. A slit lamp is an optical instrument that can be used to evaluate the three-dimensional anatomy of the anterior segment of the eye ( Yuan et al, 2015 ; Martin, 2018 ; Kaur and Gurnani, 2023 ). It can also be used to assess corneal transparency and thickness, as well as estimate inflammation levels in the anterior chamber, and signs of rejection ( Kaur and Gurnani, 2023 ).…”

Section: Tissue Engineering Of the Corneal Endotheliummentioning

confidence: 99%

Biomaterials used for tissue engineering of barrier-forming cell monolayers in the eye

Sasseville,

Karami,

Tchatchouang

et al. 2023

Front. Bioeng. Biotechnol.

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Cell monolayers that form a barrier between two structures play an important role for the maintenance of tissue functionality. In the anterior portion of the eye, the corneal endothelium forms a barrier that controls fluid exchange between the aqueous humor of the anterior chamber and the corneal stroma. This monolayer is central in the pathogenesis of Fuchs endothelial corneal dystrophy (FECD). FECD is a common corneal disease, in which corneal endothelial cells deposit extracellular matrix that increases the thickness of its basal membrane (Descemet’s membrane), and forms excrescences (guttae). With time, there is a decrease in endothelial cell density that generates vision loss. Transplantation of a monolayer of healthy corneal endothelial cells on a Descemet membrane substitute could become an interesting alternative for the treatment of this pathology. In the back of the eye, the retinal pigment epithelium (RPE) forms the blood-retinal barrier, controlling fluid exchange between the choriocapillaris and the photoreceptors of the outer retina. In the retinal disease dry age-related macular degeneration (dry AMD), deposits (drusen) form between the RPE and its basal membrane (Bruch’s membrane). These deposits hinder fluid exchange, resulting in progressive RPE cell death, which in turn generates photoreceptor cell death, and vision loss. Transplantation of a RPE monolayer on a Bruch’s membrane/choroidal stromal substitute to replace the RPE before photoreceptor cell death could become a treatment alternative for this eye disease. This review will present the different biomaterials that are proposed for the engineering of a monolayer of corneal endothelium for the treatment of FECD, and a RPE monolayer for the treatment of dry AMD.

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Slitlamp Photography and Videography With High Magnifications

Cited by 11 publications

References 18 publications

Multi-modal Anterior Eye Imager Combining Ultra-High Resolution OCT and Microvascular Imaging for Structural and Functional Evaluation of the Human Eye

Multi-modal Anterior Eye Imager Combining Ultra-High Resolution OCT and Microvascular Imaging for Structural and Functional Evaluation of the Human Eye

A novel approach to anterior segment imaging with smartphones in the COVID-19 era

Biomaterials used for tissue engineering of barrier-forming cell monolayers in the eye

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