Adaptive Optics Retinal Imaging – Clinical Opportunities and Challenges

Abstract

The array of therapeutic options available to clinicians for treating retinal disease is expanding. With these advances comes the need for better understanding of the etiology of these diseases on a cellular level as well as improved non-invasive tools for identifying the best candidates for given therapies and monitoring the efficacy of those therapies. While spectral domain optical coherence tomography (SD-OCT) offers a widely available tool for clinicians to assay the living retina, it suffers from poor lateral resolution due to the eye’s monochromatic aberrations. Adaptive optics (AO) is a technique to compensate for the eye’s aberrations and provide nearly diffraction-limited resolution. The result is the ability to visualize the living retina with cellular resolution. While AO is unquestionably a powerful research tool, many clinicians remain undecided on the clinical potential of AO imaging – putting many at a crossroads with respect to adoption of this technology. This review will briefly summarize the current state of AO retinal imaging, discuss current as well as future clinical applications of AO retinal imaging, and finally provide some discussion of research needs to facilitate more widespread clinical use.

Mobile Virtual Reality for Ophthalmic Image Display and Diagnosis

“…Adaptive optics now allows for visualization of the retina on the cellular level, providing images too large to be practically displayed using a computer monitor. 4 This enhanced visualization at a cellular level may also accelerate nanotechnology applications, which act on the molecular level of single cellular structures. We feel the use of virtual displays for such applications has great potential for use in research and in the clinic.…”

Serum levels of lipid metabolites in age‐related macular degeneration

“…At its final stage, there are a reduced number of photoreceptor cells and cells in the retinal pigmented epithelium that are essential for photoreceptor function and survival. Imaging techniques such as Abbreviations: 5-HETE, 5-hydroxy-6E,8Z,11Z,14Z-eicosatetraenoic acid; 8-HETE, 8-hydroxy-5Z,9E,11Z,14Z-eicosatetraenoic acid; 9-HETE, 9-hydroxy-5Z,7E,11Z,14Z-eicosatetraenoic; 9-HODE, 9-hydroxy-10E,12Z-octadecadienoic acid; 11-HETE, 11-hydroxy-5Z,8Z,12E,14Z-eicosatetraenoic acid; 12-HETE, 12-hydroxy-5Z,8Z,10E,14Z-eicosatetraenoic acid; 13-HODE, (continued on next page) scanning laser ophthalmoscopy and optical coherent tomography have revolutionized current ophthalmology, improving the diagnosis of retinal diseases, monitoring their progression, evaluating treatment options, and dramatically advancing in vivo retinal research (11)(12)(13)(14)(15)(16)(17). However, by the time structural changes are observed in the retina with current methodology, the pathology is already well established.…”

Registration of adaptive optics corrected retinal nerve fiber layer (RNFL) images

“…Adding AO to imaging systems such as flood-illuminated ophthalmoscopes, Scanning Laser Ophthalmoscopes (SLO) and OCT devices has recently allowed researchers to identify individual nerve fiber bundles, providing high-resolution images of both the RNFL and ONH [1,2,9,[12][13][14][15]. In this work, sequences of RNFL images are obtained using a commercial AO-assisted flood illumination device.…”

“…In recent years, ophthalmic devices have been integrated with adaptive optics (AO) technology to provide high resolution retinal images that reveal retinal microstructures. Highly accurate and reliable image processing techniques are necessary for the development of automated diagnostic tools that will facilitate the use of AO retinal imaging technology in regular clinical practice [1,2].…”