The use of retinal photography in non-ophthalmic settings and its potential for neurology

PubMed Central

Pérez, Mario A.; Bruce, Beau B.; Newman, Nancy J.; Biousse, Valérie

2012-01-01

Background Ocular fundus examination is an important element of the neurological examination. However, direct ophthalmoscopy is difficult to perform without pupillary dilation and requires extensive practice to accurately recognize optic nerve and retinal abnormalities. Recent studies have suggested that digital retinal photography can replace direct ophthalmoscopy in many settings. Review Summary Ocular fundus imaging is routinely used to document and monitor disease progression in ophthalmology. Advances in optical technology have made it easier to obtain high-quality retinal imaging, even without pupillary dilation. Retinal photography has a high sensitivity, specificity, and inter-/intra-examination agreement compared to in-person ophthalmologist examination, suggesting that photographs can be used in lieu of ophthalmoscopy in many clinical situations. Non-mydriatic retinal photography has recently gained relevance as a helpful tool for diagnosing neuro-ophthalmologic disorders in the emergency department. Additionally, several population-based studies have used retinal imaging to relate ophthalmic abnormalities to the risk of hypertension, renal dysfunction, cardiovascular mortality, subclinical and clinical stroke, and cognitive impairment. The possibility of telemedical consultation offered by digital retinal photography has already increased access to timely and accurate subspecialty care, particularly for underserved areas. Conclusion Retinal photography (even without pupillary dilation) has become increasingly available to medical fields outside of ophthalmology, allowing for faster and more accurate diagnosis of various ocular, neurologic and systemic disorders. The potential for telemedicine may provide the additional benefits of improving access to appropriate urgent consultation in both clinical and research settings. PMID:23114666

High-speed adaptive optics line scan confocal retinal imaging for human eye

PubMed Central

Wang, Xiaolin; Zhang, Yuhua

2017-01-01

Purpose Continuous and rapid eye movement causes significant intraframe distortion in adaptive optics high resolution retinal imaging. To minimize this artifact, we developed a high speed adaptive optics line scan confocal retinal imaging system. Methods A high speed line camera was employed to acquire retinal image and custom adaptive optics was developed to compensate the wave aberration of the human eye’s optics. The spatial resolution and signal to noise ratio were assessed in model eye and in living human eye. The improvement of imaging fidelity was estimated by reduction of intra-frame distortion of retinal images acquired in the living human eyes with frame rates at 30 frames/second (FPS), 100 FPS, and 200 FPS. Results The device produced retinal image with cellular level resolution at 200 FPS with a digitization of 512×512 pixels/frame in the living human eye. Cone photoreceptors in the central fovea and rod photoreceptors near the fovea were resolved in three human subjects in normal chorioretinal health. Compared with retinal images acquired at 30 FPS, the intra-frame distortion in images taken at 200 FPS was reduced by 50.9% to 79.7%. Conclusions We demonstrated the feasibility of acquiring high resolution retinal images in the living human eye at a speed that minimizes retinal motion artifact. This device may facilitate research involving subjects with nystagmus or unsteady fixation due to central vision loss. PMID:28257458

High-speed adaptive optics line scan confocal retinal imaging for human eye.

PubMed

Lu, Jing; Gu, Boyu; Wang, Xiaolin; Zhang, Yuhua

2017-01-01

Continuous and rapid eye movement causes significant intraframe distortion in adaptive optics high resolution retinal imaging. To minimize this artifact, we developed a high speed adaptive optics line scan confocal retinal imaging system. A high speed line camera was employed to acquire retinal image and custom adaptive optics was developed to compensate the wave aberration of the human eye's optics. The spatial resolution and signal to noise ratio were assessed in model eye and in living human eye. The improvement of imaging fidelity was estimated by reduction of intra-frame distortion of retinal images acquired in the living human eyes with frame rates at 30 frames/second (FPS), 100 FPS, and 200 FPS. The device produced retinal image with cellular level resolution at 200 FPS with a digitization of 512×512 pixels/frame in the living human eye. Cone photoreceptors in the central fovea and rod photoreceptors near the fovea were resolved in three human subjects in normal chorioretinal health. Compared with retinal images acquired at 30 FPS, the intra-frame distortion in images taken at 200 FPS was reduced by 50.9% to 79.7%. We demonstrated the feasibility of acquiring high resolution retinal images in the living human eye at a speed that minimizes retinal motion artifact. This device may facilitate research involving subjects with nystagmus or unsteady fixation due to central vision loss.

Motion detection and compensation in infrared retinal image sequences.

PubMed

Scharcanski, J; Schardosim, L R; Santos, D; Stuchi, A

2013-01-01

Infrared image data captured by non-mydriatic digital retinography systems often are used in the diagnosis and treatment of the diabetic macular edema (DME). Infrared illumination is less aggressive to the patient retina, and retinal studies can be carried out without pupil dilation. However, sequences of infrared eye fundus images of static scenes, tend to present pixel intensity fluctuations in time, and noisy and background illumination changes pose a challenge to most motion detection methods proposed in the literature. In this paper, we present a retinal motion detection method that is adaptive to background noise and illumination changes. Our experimental results indicate that this method is suitable for detecting retinal motion in infrared image sequences, and compensate the detected motion, which is relevant in retinal laser treatment systems for DME. Copyright © 2013 Elsevier Ltd. All rights reserved.

THE ACCURACY OF DIGITAL-VIDEO RETINAL IMAGING TO SCREEN FOR DIABETIC RETINOPATHY: AN ANALYSIS OF TWO DIGITAL-VIDEO RETINAL IMAGING SYSTEMS USING STANDARD STEREOSCOPIC SEVEN-FIELD PHOTOGRAPHY AND DILATED CLINICAL EXAMINATION AS REFERENCE STANDARDS

PubMed Central

Lawrence, Mary Gilbert

2004-01-01

ABSTRACT Purpose To evaluate the accuracy of two digital-video retinal imaging (DVRI) systems to detect diabetic retinopathy. Methods A prospective, masked, technology assessment was conducted for two DVRI systems at a tertiary care Veterans Affairs Medical Center. Group A (n = 151 patients) was imaged with a 640 × 480 resolution system and group B (n = 103 patients) with an 800 × 600 resolution system. Four retinal evaluations were performed on each patient: DVRI with undilated pupils using one imaging field (U-DVRI), DVRI with dilated pupils using three imaging fields (D-DVRI), dilated clinical examination, and Early Treatment Diabetic Retinopathy Study stereoscopic seven-field photography (ETDRS-P). Two analyses of accuracy were conducted, one using ETDRS-P as a “gold standard” (ETDRS-GS) and one using dilated clinical examination as a “gold standard” (C-GS). Results For group A, using the ETDRS-GS, sensitivities of U-DVRI and D-DVRI were 0.66 and 0.66; specificities of U-DVRI and D-DVRI were 0.66 and 0.86. Using the C-GS, sensitivities of U-DVRI and D-DVRI were 0.79 and 0.80; specificities of U-DVRI and D-DVRI were 0.68 and 0.85. For group B, using the ETDRS-GS, sensitivities of U-DVRI and D-DVRI were 0.76 and 0.85; specificities of U-DVRI and D-DVRI were 0.45 and 0.80. Using the C-GS, sensitivities of U-DVRI and D-DVRI were 0.81 and 0.87; specificities of U-DVRI and D-DVRI were 0.45 and 0.69. For both groups, dilation significantly improved specificities. Conclusions The 800 × 600 resolution DVRI system offers an accurate method of detecting diabetic retinopathy, provided there is adequate pupillary dilation and three retinal images are taken. DVRI technology may help facilitate retinal screenings of growing diabetic populations. PMID:15747766

Automatic Tortuosity-Based Retinopathy of Prematurity Screening System

NASA Astrophysics Data System (ADS)

Sukkaew, Lassada; Uyyanonvara, Bunyarit; Makhanov, Stanislav S.; Barman, Sarah; Pangputhipong, Pannet

Retinopathy of Prematurity (ROP) is an infant disease characterized by increased dilation and tortuosity of the retinal blood vessels. Automatic tortuosity evaluation from retinal digital images is very useful to facilitate an ophthalmologist in the ROP screening and to prevent childhood blindness. This paper proposes a method to automatically classify the image into tortuous and non-tortuous. The process imitates expert ophthalmologists' screening by searching for clearly tortuous vessel segments. First, a skeleton of the retinal blood vessels is extracted from the original infant retinal image using a series of morphological operators. Next, we propose to partition the blood vessels recursively using an adaptive linear interpolation scheme. Finally, the tortuosity is calculated based on the curvature of the resulting vessel segments. The retinal images are then classified into two classes using segments characterized by the highest tortuosity. For an optimal set of training parameters the prediction is as high as 100%.

Portable retinal imaging for eye disease screening using a consumer-grade digital camera

NASA Astrophysics Data System (ADS)

Barriga, Simon; Larichev, Andrey; Zamora, Gilberto; Soliz, Peter

2012-03-01

The development of affordable means to image the retina is an important step toward the implementation of eye disease screening programs. In this paper we present the i-RxCam, a low-cost, hand-held, retinal camera for widespread applications such as tele-retinal screening for eye diseases like diabetic retinopathy (DR), glaucoma, and age-related ocular diseases. Existing portable retinal imagers do not meet the requirements of a low-cost camera with sufficient technical capabilities (field of view, image quality, portability, battery power, and ease-of-use) to be distributed widely to low volume clinics, such as the offices of single primary care physicians serving rural communities. The i-RxCam uses a Nikon D3100 digital camera body. The camera has a CMOS sensor with 14.8 million pixels. We use a 50mm focal lens that gives a retinal field of view of 45 degrees. The internal autofocus can compensate for about 2D (diopters) of focusing error. The light source is an LED produced by Philips with a linear emitting area that is transformed using a light pipe to the optimal shape at the eye pupil, an annulus. To eliminate corneal reflex we use a polarization technique in which the light passes through a nano-wire polarizer plate. This is a novel type of polarizer featuring high polarization separation (contrast ratio of more than 1000) and very large acceptance angle (>45 degrees). The i-RxCam approach will yield a significantly more economical retinal imaging device that would allow mass screening of the at-risk population.

Retinal flavoprotein autofluorescence as a measure of retinal health.

PubMed

Elner, Susan G; Elner, Victor M; Field, Matthew G; Park, Seung; Heckenlively, John R; Petty, Howard R

2008-01-01

To establish that increased autofluorescence of mitochondrial flavoproteins, an indicator of mitochondrial oxidative stress, correlates with retinal cell dysfunction. Retinal flavoprotein autofluorescence (FA) was imaged in humans with a fundus camera modified with 467DF8-nm excitation and 535-nm emission filters and a back-illuminated, electron-multiplying, charge-coupled device camera interfaced with a computer equipped with customized image capture software. Multiple digital images, centered on the fovea, were obtained from each eye. Histograms of pixel intensities in grayscale units were analyzed for average intensity and average curve width. Adults with diabetes mellitus, age-related macular degeneration (ARMD), central serous retinopathy, and retinal dystrophies, as well as healthy control volunteers, were imaged. Monolayers of cultured human retinal pigment epithelial (HRPE) cells, HRPE cells exposed to sublethal doses of H2O2, and HRPE cells exposed to H2O2 in the presence of antioxidants were imaged for FA using fluorescent photomicroscopy. Control patients demonstrated low levels of retinal FA, which increased progressively with age. Diabetics without visible retinopathy demonstrated increased FA levels compared to control volunteers (P < .001). Diabetics with retinopathy demonstrated significantly higher FA values than those without retinopathy (P < .04). Patients with ARMD, central serous retinopathy, or retinal dystrophies also demonstrated significantly increased FA. Compared to control RPE cells, cells oxidatively stressed with H2O2 had significantly elevated FA (P < .05), which was prevented by antioxidants (P < .05). Retinal FA is significantly increased with age and diseases known to be mediated by oxidative stress. Retinal FA imaging may provide a novel, noninvasive method of assessing retinal health and retinal dysfunction prior to retinal cell death.

Digital Tracking and Control of Retinal Images

DTIC Science & Technology

1993-05-01

combination of Ketamine (35 mg/kg) and Rompan (5.9 mg/kg). The rabbit’s eye was then dilated with Atropine and a speculum inserted to open the eyelid. A...experiments 251 xviii Chapter 1 Introduction 1.1 Overview Dr. A.J. Welch, Dr. H. Grady Rylander III M.D., and associated researchers have worked toward the...obtain a high contrast image of the retina. Specifically, it is used to image microaneurysms associated with critical retinal diseases long before the

Statistical wiring of thalamic receptive fields optimizes spatial sampling of the retinal image

PubMed Central

Wang, Xin; Sommer, Friedrich T.; Hirsch, Judith A.

2014-01-01

Summary It is widely assumed that mosaics of retinal ganglion cells establish the optimal representation of visual space. However, relay cells in the visual thalamus often receive convergent input from several retinal afferents and, in cat, outnumber ganglion cells. To explore how the thalamus transforms the retinal image, we built a model of the retinothalamic circuit using experimental data and simple wiring rules. The model shows how the thalamus might form a resampled map of visual space with the potential to facilitate detection of stimulus position in the presence of sensor noise. Bayesian decoding conducted with the model provides support for this scenario. Despite its benefits, however, resampling introduces image blur, thus impairing edge perception. Whole-cell recordings obtained in vivo suggest that this problem is mitigated by arrangements of excitation and inhibition within the receptive field that effectively boost contrast borders, much like strategies used in digital image processing. PMID:24559681

DIAGNOcam--a Near Infrared Digital Imaging Transillumination (NIDIT) technology.

PubMed

Abdelaziz, Marwa; Krejci, Ivo

2015-01-01

In developed countries, clinical manifestation of carious lesions is changing: instead of dentists being confronted with wide-open cavities, more and more hidden caries are seen. For a long time, the focus of the research community was on finding a method for the detection of carious lesions without the need for radiographs. The research on Digital Imaging Fiber-Optic Transillumination (DIFOTI) has been an active domain. The scope of the present article is to describe a novel technology for caries diagnostics based on Near Infrared Digital Imaging Transillumination (NIDIT), and to give first examples of its clinical indications. In addition, the coupling of NIDIT with a head-mounted retinal image display (RID) to improve clinical workflow is presented. The novel NIDIT technology was shown to be useful as a diagnostic tool in several indications, including mainly the detection of proximal caries and, less importantly, for occlusal caries, fissures, and secondary decay around amalgam and composite restorations. The coupling of this technology with a head-mounted retinal image system allows for its very efficient implementation into daily practice.

Digital Tracking and Control of Retinal Images

DTIC Science & Technology

1993-01-01

induced retinal lesions are used to treat a variety of eye diseases such as diabetic retinopathy and retinal tears or breaks. Both the location and...one second and typical treatment for a disease such as diabetic retinopathy requires as many as 2000 lesions per eye. This type of tedious task is...Oxygenation and Laser Treatment in Patients with Diabetic Retinopathy ", American Journal of Ophthalmology, Volume 113, January 1992, pp 36 - 38. [21

Digital retinal imaging in a residency-based patient-centered medical home.

PubMed

Newman, Robert; Cummings, Doyle M; Doherty, Lisa; Patel, Nick R

2012-03-01

Diabetic retinopathy is the leading cause of blindness in adults in the United States, and early screening/treatment may preserve vision. This study examined the feasibility of using non-mydriatic digital retinal imaging (DRI) for retinopathy screening in a busy family medicine residency program at the point of care using a nurse-driven protocol. We compared the number of diabetics screened during a 1-year period before and after DRI protocol implementation. We also determined the prevalence of retinopathy, assessed patient satisfaction with the alternative screening process, and tracked ophthalmologic appointment compliance for patients referred because of abnormal screening results. Screening approximately doubled from 161 patients/year before the protocol to 330 patients/year after protocol implementation. However, DRI screening had no impact on ophthalmologic appointment compliance; only 58% of 153 patients referred for ophthalmologic evaluation because of positive screening findings completed their referral appointment. Seven cases needing urgent ophthalmologic treatment were identified. Satisfaction with primary care retinopathy screening was high. Use of a nurse-driven protocol for digital retinal imaging at the point of care dramatically improves rates of annual retinopathy screening in academic family medicine practice and can identify patients who require subspecialty referral. However, DRI screening does not improve visit compliance rates with ophthalmologists for evaluation and management.

The Accuracy and Reliability of Crowdsource Annotations of Digital Retinal Images

PubMed Central

Mitry, Danny; Zutis, Kris; Dhillon, Baljean; Peto, Tunde; Hayat, Shabina; Khaw, Kay-Tee; Morgan, James E.; Moncur, Wendy; Trucco, Emanuele; Foster, Paul J.

2016-01-01

Purpose Crowdsourcing is based on outsourcing computationally intensive tasks to numerous individuals in the online community who have no formal training. Our aim was to develop a novel online tool designed to facilitate large-scale annotation of digital retinal images, and to assess the accuracy of crowdsource grading using this tool, comparing it to expert classification. Methods We used 100 retinal fundus photograph images with predetermined disease criteria selected by two experts from a large cohort study. The Amazon Mechanical Turk Web platform was used to drive traffic to our site so anonymous workers could perform a classification and annotation task of the fundus photographs in our dataset after a short training exercise. Three groups were assessed: masters only, nonmasters only and nonmasters with compulsory training. We calculated the sensitivity, specificity, and area under the curve (AUC) of receiver operating characteristic (ROC) plots for all classifications compared to expert grading, and used the Dice coefficient and consensus threshold to assess annotation accuracy. Results In total, we received 5389 annotations for 84 images (excluding 16 training images) in 2 weeks. A specificity and sensitivity of 71% (95% confidence interval [CI], 69%–74%) and 87% (95% CI, 86%–88%) was achieved for all classifications. The AUC in this study for all classifications combined was 0.93 (95% CI, 0.91–0.96). For image annotation, a maximal Dice coefficient (∼0.6) was achieved with a consensus threshold of 0.25. Conclusions This study supports the hypothesis that annotation of abnormalities in retinal images by ophthalmologically naive individuals is comparable to expert annotation. The highest AUC and agreement with expert annotation was achieved in the nonmasters with compulsory training group. Translational Relevance The use of crowdsourcing as a technique for retinal image analysis may be comparable to expert graders and has the potential to deliver timely, accurate, and cost-effective image analysis. PMID:27668130

The Accuracy and Reliability of Crowdsource Annotations of Digital Retinal Images.

PubMed

Mitry, Danny; Zutis, Kris; Dhillon, Baljean; Peto, Tunde; Hayat, Shabina; Khaw, Kay-Tee; Morgan, James E; Moncur, Wendy; Trucco, Emanuele; Foster, Paul J

2016-09-01

Crowdsourcing is based on outsourcing computationally intensive tasks to numerous individuals in the online community who have no formal training. Our aim was to develop a novel online tool designed to facilitate large-scale annotation of digital retinal images, and to assess the accuracy of crowdsource grading using this tool, comparing it to expert classification. We used 100 retinal fundus photograph images with predetermined disease criteria selected by two experts from a large cohort study. The Amazon Mechanical Turk Web platform was used to drive traffic to our site so anonymous workers could perform a classification and annotation task of the fundus photographs in our dataset after a short training exercise. Three groups were assessed: masters only, nonmasters only and nonmasters with compulsory training. We calculated the sensitivity, specificity, and area under the curve (AUC) of receiver operating characteristic (ROC) plots for all classifications compared to expert grading, and used the Dice coefficient and consensus threshold to assess annotation accuracy. In total, we received 5389 annotations for 84 images (excluding 16 training images) in 2 weeks. A specificity and sensitivity of 71% (95% confidence interval [CI], 69%-74%) and 87% (95% CI, 86%-88%) was achieved for all classifications. The AUC in this study for all classifications combined was 0.93 (95% CI, 0.91-0.96). For image annotation, a maximal Dice coefficient (∼0.6) was achieved with a consensus threshold of 0.25. This study supports the hypothesis that annotation of abnormalities in retinal images by ophthalmologically naive individuals is comparable to expert annotation. The highest AUC and agreement with expert annotation was achieved in the nonmasters with compulsory training group. The use of crowdsourcing as a technique for retinal image analysis may be comparable to expert graders and has the potential to deliver timely, accurate, and cost-effective image analysis.

Comparison Study of Funduscopic Examination Using a Smartphone-Based Digital Ophthalmoscope and the Direct Ophthalmoscope.

PubMed

Wu, Amy Ruomei; Fouzdar-Jain, Samiksha; Suh, Donny W

2018-05-01

To assess the ease of use of the D-EYE digital ophthalmoscope (D-EYE Srl, Padova, Italy) in retinal screening against the conventional direct ophthalmoscope. The digital ophthalmoscope used comprised a smartphone equipped with a D-EYE lens that produces digital retinal images. Twenty-five medical students were given 30 minutes of instruction regarding how to use a direct ophthalmoscope and D-EYE digital ophthalmoscope by a pediatric ophthalmologist. Afterwards, they used two methods to view the fundus under dim light on two undilated volunteer participants under supervision of the pediatric ophthalmologist. Each student had to describe their findings and show the video taken from the smartphone to the pediatric ophthalmologist. Students also completed a survey rating their experience using each method. Ninety-two percent of the medical students preferred the D-EYE digital ophthalmoscope to the direct ophthalmoscope. Students were also able to identify the optic nerve and macula in a shorter amount of time and review the images to confirm their findings. Overall, the medical students showed a strong preference for the D-EYE digital ophthalmoscope that was statistically significant (P < .001). The D-EYE digital ophthalmoscope is a practical device that could be incorporated into medical education and clinical practice. Survey results revealed that most students preferred the D-EYE digital ophthalmoscope due to the recording features and larger image of the fundus. [J Pediatr Ophthalmol Strabismus. 2018;55(3):201-206.]. Copyright 2018, SLACK Incorporated.

Results of Automated Retinal Image Analysis for Detection of Diabetic Retinopathy from the Nakuru Study, Kenya.

PubMed

Hansen, Morten B; Abràmoff, Michael D; Folk, James C; Mathenge, Wanjiku; Bastawrous, Andrew; Peto, Tunde

2015-01-01

Digital retinal imaging is an established method of screening for diabetic retinopathy (DR). It has been established that currently about 1% of the world's blind or visually impaired is due to DR. However, the increasing prevalence of diabetes mellitus and DR is creating an increased workload on those with expertise in grading retinal images. Safe and reliable automated analysis of retinal images may support screening services worldwide. This study aimed to compare the Iowa Detection Program (IDP) ability to detect diabetic eye diseases (DED) to human grading carried out at Moorfields Reading Centre on the population of Nakuru Study from Kenya. Retinal images were taken from participants of the Nakuru Eye Disease Study in Kenya in 2007/08 (n = 4,381 participants [NW6 Topcon Digital Retinal Camera]). First, human grading was performed for the presence or absence of DR, and for those with DR this was sub-divided in to referable or non-referable DR. The automated IDP software was deployed to identify those with DR and also to categorize the severity of DR. The primary outcomes were sensitivity, specificity, and positive and negative predictive value of IDP versus the human grader as reference standard. Altogether 3,460 participants were included. 113 had DED, giving a prevalence of 3.3% (95% CI, 2.7-3.9%). Sensitivity of the IDP to detect DED as by the human grading was 91.0% (95% CI, 88.0-93.4%). The IDP ability to detect DED gave an AUC of 0.878 (95% CI 0.850-0.905). It showed a negative predictive value of 98%. The IDP missed no vision threatening retinopathy in any patients and none of the false negative cases met criteria for treatment. In this epidemiological sample, the IDP's grading was comparable to that of human graders'. It therefore might be feasible to consider inclusion into usual epidemiological grading.

A Morphological Hessian Based Approach for Retinal Blood Vessels Segmentation and Denoising Using Region Based Otsu Thresholding

PubMed Central

BahadarKhan, Khan; A Khaliq, Amir; Shahid, Muhammad

2016-01-01

Diabetic Retinopathy (DR) harm retinal blood vessels in the eye causing visual deficiency. The appearance and structure of blood vessels in retinal images play an essential part in the diagnoses of an eye sicknesses. We proposed a less computational unsupervised automated technique with promising results for detection of retinal vasculature by using morphological hessian based approach and region based Otsu thresholding. Contrast Limited Adaptive Histogram Equalization (CLAHE) and morphological filters have been used for enhancement and to remove low frequency noise or geometrical objects, respectively. The hessian matrix and eigenvalues approach used has been in a modified form at two different scales to extract wide and thin vessel enhanced images separately. Otsu thresholding has been further applied in a novel way to classify vessel and non-vessel pixels from both enhanced images. Finally, postprocessing steps has been used to eliminate the unwanted region/segment, non-vessel pixels, disease abnormalities and noise, to obtain a final segmented image. The proposed technique has been analyzed on the openly accessible DRIVE (Digital Retinal Images for Vessel Extraction) and STARE (STructured Analysis of the REtina) databases along with the ground truth data that has been precisely marked by the experts. PMID:27441646

Computer-based detection of diabetes retinopathy stages using digital fundus images.

PubMed

Acharya, U R; Lim, C M; Ng, E Y K; Chee, C; Tamura, T

2009-07-01

Diabetes mellitus is a heterogeneous clinical syndrome characterized by hyperglycaemia and the long-term complications are retinopathy, neuropathy, nephropathy, and cardiomyopathy. It is a leading cause of blindness. Diabetic retinopathy is the progressive pathological alterations in the retinal microvasculature, leading to areas of retinal nonperfusion, increased vascular permeability, and the pathological proliferation of retinal vessels. Hence, it is beneficial to have regular cost-effective eye screening for diabetes subjects. Nowadays, different stages of diabetes retinopathy are detected by retinal examination using indirect biomicroscopy by senior ophthalmologists. In this work, morphological image processing and support vector machine (SVM) techniques were used for the automatic diagnosis of eye health. In this study, 331 fundus images were analysed. Five groups were identified: normal retina, mild non-proliferative diabetic retinopathy, moderate non-proliferative diabetic retinopathy, severe non-proliferative diabetic retinopathy, and proliferative diabetic retinopathy. Four salient features blood vessels, microaneurysms, exudates, and haemorrhages were extracted from the raw images using image-processing techniques and fed to the SVM for classification. A sensitivity of more than 82 per cent and specificity of 86 per cent was demonstrated for the system developed.

Retinal imaging analysis based on vessel detection.

PubMed

Jamal, Arshad; Hazim Alkawaz, Mohammed; Rehman, Amjad; Saba, Tanzila

2017-07-01

With an increase in the advancement of digital imaging and computing power, computationally intelligent technologies are in high demand to be used in ophthalmology cure and treatment. In current research, Retina Image Analysis (RIA) is developed for optometrist at Eye Care Center in Management and Science University. This research aims to analyze the retina through vessel detection. The RIA assists in the analysis of the retinal images and specialists are served with various options like saving, processing and analyzing retinal images through its advanced interface layout. Additionally, RIA assists in the selection process of vessel segment; processing these vessels by calculating its diameter, standard deviation, length, and displaying detected vessel on the retina. The Agile Unified Process is adopted as the methodology in developing this research. To conclude, Retina Image Analysis might help the optometrist to get better understanding in analyzing the patient's retina. Finally, the Retina Image Analysis procedure is developed using MATLAB (R2011b). Promising results are attained that are comparable in the state of art. © 2017 Wiley Periodicals, Inc.

Automated detection and differentiation of drusen, exudates, and cotton-wool spots in digital color fundus photographs for diabetic retinopathy diagnosis.

PubMed

Niemeijer, Meindert; van Ginneken, Bram; Russell, Stephen R; Suttorp-Schulten, Maria S A; Abràmoff, Michael D

2007-05-01

To describe and evaluate a machine learning-based, automated system to detect exudates and cotton-wool spots in digital color fundus photographs and differentiate them from drusen, for early diagnosis of diabetic retinopathy. Three hundred retinal images from one eye of 300 patients with diabetes were selected from a diabetic retinopathy telediagnosis database (nonmydriatic camera, two-field photography): 100 with previously diagnosed bright lesions and 200 without. A machine learning computer program was developed that can identify and differentiate among drusen, (hard) exudates, and cotton-wool spots. A human expert standard for the 300 images was obtained by consensus annotation by two retinal specialists. Sensitivities and specificities of the annotations on the 300 images by the automated system and a third retinal specialist were determined. The system achieved an area under the receiver operating characteristic (ROC) curve of 0.95 and sensitivity/specificity pairs of 0.95/0.88 for the detection of bright lesions of any type, and 0.95/0.86, 0.70/0.93, and 0.77/0.88 for the detection of exudates, cotton-wool spots, and drusen, respectively. The third retinal specialist achieved pairs of 0.95/0.74 for bright lesions and 0.90/0.98, 0.87/0.98, and 0.92/0.79 per lesion type. A machine learning-based, automated system capable of detecting exudates and cotton-wool spots and differentiating them from drusen in color images obtained in community based diabetic patients has been developed and approaches the performance level of retinal experts. If the machine learning can be improved with additional training data sets, it may be useful for detecting clinically important bright lesions, enhancing early diagnosis, and reducing visual loss in patients with diabetes.

Image analysis in modern ophthalmology: from acquisition to computer assisted diagnosis and telemedicine

NASA Astrophysics Data System (ADS)

Marrugo, Andrés G.; Millán, María S.; Cristóbal, Gabriel; Gabarda, Salvador; Sorel, Michal; Sroubek, Filip

2012-06-01

Medical digital imaging has become a key element of modern health care procedures. It provides visual documentation and a permanent record for the patients, and most important the ability to extract information about many diseases. Modern ophthalmology thrives and develops on the advances in digital imaging and computing power. In this work we present an overview of recent image processing techniques proposed by the authors in the area of digital eye fundus photography. Our applications range from retinal image quality assessment to image restoration via blind deconvolution and visualization of structural changes in time between patient visits. All proposed within a framework for improving and assisting the medical practice and the forthcoming scenario of the information chain in telemedicine.

A Deep Learning Approach to Digitally Stain Optical Coherence Tomography Images of the Optic Nerve Head.

PubMed

Devalla, Sripad Krishna; Chin, Khai Sing; Mari, Jean-Martial; Tun, Tin A; Strouthidis, Nicholas G; Aung, Tin; Thiéry, Alexandre H; Girard, Michaël J A

2018-01-01

To develop a deep learning approach to digitally stain optical coherence tomography (OCT) images of the optic nerve head (ONH). A horizontal B-scan was acquired through the center of the ONH using OCT (Spectralis) for one eye of each of 100 subjects (40 healthy and 60 glaucoma). All images were enhanced using adaptive compensation. A custom deep learning network was then designed and trained with the compensated images to digitally stain (i.e., highlight) six tissue layers of the ONH. The accuracy of our algorithm was assessed (against manual segmentations) using the dice coefficient, sensitivity, specificity, intersection over union (IU), and accuracy. We studied the effect of compensation, number of training images, and performance comparison between glaucoma and healthy subjects. For images it had not yet assessed, our algorithm was able to digitally stain the retinal nerve fiber layer + prelamina, the RPE, all other retinal layers, the choroid, and the peripapillary sclera and lamina cribrosa. For all tissues, the dice coefficient, sensitivity, specificity, IU, and accuracy (mean) were 0.84 ± 0.03, 0.92 ± 0.03, 0.99 ± 0.00, 0.89 ± 0.03, and 0.94 ± 0.02, respectively. Our algorithm performed significantly better when compensated images were used for training (P < 0.001). Besides offering a good reliability, digital staining also performed well on OCT images of both glaucoma and healthy individuals. Our deep learning algorithm can simultaneously stain the neural and connective tissues of the ONH, offering a framework to automatically measure multiple key structural parameters of the ONH that may be critical to improve glaucoma management.

Comprehensive eye evaluation algorithm

NASA Astrophysics Data System (ADS)

Agurto, C.; Nemeth, S.; Zamora, G.; Vahtel, M.; Soliz, P.; Barriga, S.

2016-03-01

In recent years, several research groups have developed automatic algorithms to detect diabetic retinopathy (DR) in individuals with diabetes (DM), using digital retinal images. Studies have indicated that diabetics have 1.5 times the annual risk of developing primary open angle glaucoma (POAG) as do people without DM. Moreover, DM patients have 1.8 times the risk for age-related macular degeneration (AMD). Although numerous investigators are developing automatic DR detection algorithms, there have been few successful efforts to create an automatic algorithm that can detect other ocular diseases, such as POAG and AMD. Consequently, our aim in the current study was to develop a comprehensive eye evaluation algorithm that not only detects DR in retinal images, but also automatically identifies glaucoma suspects and AMD by integrating other personal medical information with the retinal features. The proposed system is fully automatic and provides the likelihood of each of the three eye disease. The system was evaluated in two datasets of 104 and 88 diabetic cases. For each eye, we used two non-mydriatic digital color fundus photographs (macula and optic disc centered) and, when available, information about age, duration of diabetes, cataracts, hypertension, gender, and laboratory data. Our results show that the combination of multimodal features can increase the AUC by up to 5%, 7%, and 8% in the detection of AMD, DR, and glaucoma respectively. Marked improvement was achieved when laboratory results were combined with retinal image features.

Portable, low-priced retinal imager for eye disease screening

NASA Astrophysics Data System (ADS)

Soliz, Peter; Nemeth, Sheila; VanNess, Richard; Barriga, E. S.; Zamora, Gilberto

2014-02-01

The objective of this project was to develop and demonstrate a portable, low-priced, easy to use non-mydriatic retinal camera for eye disease screening in underserved urban and rural locations. Existing portable retinal imagers do not meet the requirements of a low-cost camera with sufficient technical capabilities (field of view, image quality, portability, battery power, and ease-of-use) to be distributed widely to low volume clinics, such as the offices of single primary care physicians serving rural communities or other economically stressed healthcare facilities. Our approach for Smart i-Rx is based primarily on a significant departure from current generations of desktop and hand-held commercial retinal cameras as well as those under development. Our techniques include: 1) Exclusive use of off-the-shelf components; 2) Integration of retinal imaging device into low-cost, high utility camera mount and chin rest; 3) Unique optical and illumination designed for small form factor; and 4) Exploitation of autofocus technology built into present digital SLR recreational cameras; and 5) Integration of a polarization technique to avoid the corneal reflex. In a prospective study, 41 out of 44 diabetics were imaged successfully. No imaging was attempted on three of the subjects due to noticeably small pupils (less than 2mm). The images were of sufficient quality to detect abnormalities related to diabetic retinopathy, such as microaneurysms and exudates. These images were compared with ones taken non-mydriatically with a Canon CR-1 Mark II camera. No cases identified as having DR by expert retinal graders were missed in the Smart i-Rx images.

Multifractal geometry in analysis and processing of digital retinal photographs for early diagnosis of human diabetic macular edema.

PubMed

Tălu, Stefan

2013-07-01

The purpose of this paper is to determine a quantitative assessment of the human retinal vascular network architecture for patients with diabetic macular edema (DME). Multifractal geometry and lacunarity parameters are used in this study. A set of 10 segmented and skeletonized human retinal images, corresponding to both normal (five images) and DME states of the retina (five images), from the DRIVE database was analyzed using the Image J software. Statistical analyses were performed using Microsoft Office Excel 2003 and GraphPad InStat software. The human retinal vascular network architecture has a multifractal geometry. The average of generalized dimensions (Dq) for q = 0, 1, 2 of the normal images (segmented versions), is similar to the DME cases (segmented versions). The average of generalized dimensions (Dq) for q = 0, 1 of the normal images (skeletonized versions), is slightly greater than the DME cases (skeletonized versions). However, the average of D2 for the normal images (skeletonized versions) is similar to the DME images. The average of lacunarity parameter, Λ, for the normal images (segmented and skeletonized versions) is slightly lower than the corresponding values for DME images (segmented and skeletonized versions). The multifractal and lacunarity analysis provides a non-invasive predictive complementary tool for an early diagnosis of patients with DME.

Detection of Clinically Significant Retinopathy of Prematurity Using Wide-angle Digital Retinal Photography

PubMed Central

Chiang, Michael F.; Melia, Michele; Buffenn, Angela N.; Lambert, Scott R.; Recchia, Franco M.; Simpson, Jennifer L.; Yang, Michael B.

2013-01-01

Objective To evaluate the accuracy of detecting clinically significant retinopathy of prematurity (ROP) using wide-angle digital retinal photography. Methods Literature searches of PubMed and the Cochrane Library databases were conducted last on December 7, 2010, and yielded 414 unique citations. The authors assessed these 414 citations and marked 82 that potentially met the inclusion criteria. These 82 studies were reviewed in full text; 28 studies met inclusion criteria. The authors extracted from these studies information about study design, interventions, outcomes, and study quality. After data abstraction, 18 were excluded for study deficiencies or because they were superseded by a more recent publication. The methodologist reviewed the remaining 10 studies and assigned ratings of evidence quality; 7 studies were rated level I evidence and 3 studies were rated level III evidence. Results There is level I evidence from ≥5 studies demonstrating that digital retinal photography has high accuracy for detection of clinically significant ROP. Level III studies have reported high accuracy, without any detectable complications, from real-world operational programs intended to detect clinically significant ROP through remote site interpretation of wide-angle retinal photographs. Conclusions Wide-angle digital retinal photography has the potential to complement standard ROP care. It may provide advantages through objective documentation of clinical examination findings, improved recognition of disease progression by comparing previous photographs, and the creation of image libraries for education and research. Financial Disclosure(s) Proprietary or commercial disclosure may be found after the references. PMID:22541632

Fast vessel segmentation in retinal images using multi-scale enhancement and second-order local entropy

NASA Astrophysics Data System (ADS)

Yu, H.; Barriga, S.; Agurto, C.; Zamora, G.; Bauman, W.; Soliz, P.

2012-03-01

Retinal vasculature is one of the most important anatomical structures in digital retinal photographs. Accurate segmentation of retinal blood vessels is an essential task in automated analysis of retinopathy. This paper presents a new and effective vessel segmentation algorithm that features computational simplicity and fast implementation. This method uses morphological pre-processing to decrease the disturbance of bright structures and lesions before vessel extraction. Next, a vessel probability map is generated by computing the eigenvalues of the second derivatives of Gaussian filtered image at multiple scales. Then, the second order local entropy thresholding is applied to segment the vessel map. Lastly, a rule-based decision step, which measures the geometric shape difference between vessels and lesions is applied to reduce false positives. The algorithm is evaluated on the low-resolution DRIVE and STARE databases and the publicly available high-resolution image database from Friedrich-Alexander University Erlangen-Nuremberg, Germany). The proposed method achieved comparable performance to state of the art unsupervised vessel segmentation methods with a competitive faster speed on the DRIVE and STARE databases. For the high resolution fundus image database, the proposed algorithm outperforms an existing approach both on performance and speed. The efficiency and robustness make the blood vessel segmentation method described here suitable for broad application in automated analysis of retinal images.

Pain and stress assessment after retinopathy of prematurity screening examination: Indirect ophthalmoscopy versus digital retinal imaging

PubMed Central

2012-01-01

Background Increasingly, neonatal clinics seek to minimize painful experiences and stress for premature infants. Fundoscopy performed with a binocular indirect ophthalmoscope is the reference examination technique for screening of retinopathy of prematurity (ROP), and it is associated with pain and stress. Wide-field digital retinal imaging is a recent technique that should be evaluated for minimizing infant pain and stress. Methods The purpose of the study was to assess and compare the impact of using a binocular indirect ophthalmoscope (BIO), or wide-field digital retinal imaging (WFDRI) on pain and stress in infants undergoing ROP screening examination. This was a comparative evaluation study of two screening procedures. Ophthalmologic examinations (N = 70) were performed on 24 infants with both BIO and WFDRI. Pain assessments were performed with two specific neonatal scales (Crying, requires oxygen, increased vital signs, expression and sleeplessness, CRIES and, Premature infant pain profile, PIPP) just prior to the examination, and 30 seconds, 1 hour, and 24 hours later after ending the examination. Results Changes over time were significantly different between BIO and WFDRI with both scales (PIPP score, p = .007, and CRIES score, p = .001). Median PIPP score (interquartile interval) at baseline was 4 (3–5). At 30 seconds the score was 8 (6–9) for BIO and 6 (5–7) for WFDRI, respectively. The increase in PIPP score between baseline and 30 seconds was significantly lower with WFDRI (p = .006). The median increase in CRIES score from baseline to 30 seconds was 1 point lower for WFDRI than for BIO (p < .001). No significant difference in response remained at 1 hour or 24 hour assessments. Conclusions A transient short-term pain and stress response occurs with both BIO and WFDRI. Infants examined for screening of ROP with digital retinal imaging present less pain and stress at 30 seconds following completion of the exam when compared with binocular indirect ophthalmoscopy. PMID:22928523

Fundus Photography in the 21st Century--A Review of Recent Technological Advances and Their Implications for Worldwide Healthcare.

PubMed

Panwar, Nishtha; Huang, Philemon; Lee, Jiaying; Keane, Pearse A; Chuan, Tjin Swee; Richhariya, Ashutosh; Teoh, Stephen; Lim, Tock Han; Agrawal, Rupesh

2016-03-01

The introduction of fundus photography has impacted retinal imaging and retinal screening programs significantly. Fundus cameras play a vital role in addressing the cause of preventive blindness. More attention is being turned to developing countries, where infrastructure and access to healthcare are limited. One of the major limitations for tele-ophthalmology is restricted access to the office-based fundus camera. Recent advances in access to telecommunications coupled with introduction of portable cameras and smartphone-based fundus imaging systems have resulted in an exponential surge in available technologies for portable fundus photography. Retinal cameras in the near future would have to cater to these needs by featuring a low-cost, portable design with automated controls and digitalized images with Web-based transfer. In this review, we aim to highlight the advances of fundus photography for retinal screening as well as discuss the advantages, disadvantages, and implications of the various technologies that are currently available.

Fundus Photography in the 21st Century—A Review of Recent Technological Advances and Their Implications for Worldwide Healthcare

PubMed Central

Panwar, Nishtha; Huang, Philemon; Lee, Jiaying; Keane, Pearse A.; Chuan, Tjin Swee; Richhariya, Ashutosh; Teoh, Stephen; Lim, Tock Han

2016-01-01

Abstract Background: The introduction of fundus photography has impacted retinal imaging and retinal screening programs significantly. Literature Review: Fundus cameras play a vital role in addressing the cause of preventive blindness. More attention is being turned to developing countries, where infrastructure and access to healthcare are limited. One of the major limitations for tele-ophthalmology is restricted access to the office-based fundus camera. Results: Recent advances in access to telecommunications coupled with introduction of portable cameras and smartphone-based fundus imaging systems have resulted in an exponential surge in available technologies for portable fundus photography. Retinal cameras in the near future would have to cater to these needs by featuring a low-cost, portable design with automated controls and digitalized images with Web-based transfer. Conclusions: In this review, we aim to highlight the advances of fundus photography for retinal screening as well as discuss the advantages, disadvantages, and implications of the various technologies that are currently available. PMID:26308281

Near-infrared light-guided miniaturized indirect ophthalmoscopy for nonmydriatic wide-field fundus photography.

PubMed

Toslak, Devrim; Liu, Changgeng; Alam, Minhaj Nur; Yao, Xincheng

2018-06-01

A portable fundus imager is essential for emerging telemedicine screening and point-of-care examination of eye diseases. However, existing portable fundus cameras have limited field of view (FOV) and frequently require pupillary dilation. We report here a miniaturized indirect ophthalmoscopy-based nonmydriatic fundus camera with a snapshot FOV up to 67° external angle, which corresponds to a 101° eye angle. The wide-field fundus camera consists of a near-infrared light source (LS) for retinal guidance and a white LS for color retinal imaging. By incorporating digital image registration and glare elimination methods, a dual-image acquisition approach was used to achieve reflection artifact-free fundus photography.

Comparative study of the polaroid and digital non-mydriatic cameras in the detection of referrable diabetic retinopathy in Australia.

PubMed

Phiri, R; Keeffe, J E; Harper, C A; Taylor, H R

2006-08-01

To show that the non-mydriatic retinal camera (NMRC) using polaroid film is as effective as the NMRC using digital imaging in detecting referrable retinopathy. A series of patients with diabetes attending the eye out-patients department at the Royal Victorian Eye and Ear Hospital had single-field non-mydriatic fundus photographs taken using first a digital and then a polaroid camera. Dilated 30 degrees seven-field stereo fundus photographs were then taken of each eye as the gold standard. The photographs were graded in a masked fashion. Retinopathy levels were defined using the simplified Wisconsin Grading system. We used the kappa statistics for inter-reader and intrareader agreement and the generalized linear model to derive the odds ratio. There were 196 participants giving 325 undilated retinal photographs. Of these participants 111 (57%) were males. The mean age of the patients was 68.8 years. There were 298 eyes with all three sets of photographs from 154 patients. The digital NMRC had a sensitivity of 86.2%[95% confidence interval (CI) 65.8, 95.3], whilst the polaroid NMRC had a sensitivity of 84.1% (95% CI 65.5, 93.7). The specificities of the two cameras were identical at 71.2% (95% CI 58.8, 81.1). There was no difference in the ability of the polaroid and digital camera to detect referrable retinopathy (odds ratio 1.06, 95% CI 0.80, 1.40, P = 0.68). This study suggests that non-mydriatic retinal photography using polaroid film is as effective as digital imaging in the detection of referrable retinopathy in countries such as the USA and Australia or others that use the same criterion for referral.

Automated radial basis function neural network based image classification system for diabetic retinopathy detection in retinal images

NASA Astrophysics Data System (ADS)

Anitha, J.; Vijila, C. Kezi Selva; Hemanth, D. Jude

2010-02-01

Diabetic retinopathy (DR) is a chronic eye disease for which early detection is highly essential to avoid any fatal results. Image processing of retinal images emerge as a feasible tool for this early diagnosis. Digital image processing techniques involve image classification which is a significant technique to detect the abnormality in the eye. Various automated classification systems have been developed in the recent years but most of them lack high classification accuracy. Artificial neural networks are the widely preferred artificial intelligence technique since it yields superior results in terms of classification accuracy. In this work, Radial Basis function (RBF) neural network based bi-level classification system is proposed to differentiate abnormal DR Images and normal retinal images. The results are analyzed in terms of classification accuracy, sensitivity and specificity. A comparative analysis is performed with the results of the probabilistic classifier namely Bayesian classifier to show the superior nature of neural classifier. Experimental results show promising results for the neural classifier in terms of the performance measures.

Lesion detection in ultra-wide field retinal images for diabetic retinopathy diagnosis

NASA Astrophysics Data System (ADS)

Levenkova, Anastasia; Sowmya, Arcot; Kalloniatis, Michael; Ly, Angelica; Ho, Arthur

2018-02-01

Diabetic retinopathy (DR) leads to irreversible vision loss. Diagnosis and staging of DR is usually based on the presence, number, location and type of retinal lesions. Ultra-wide field (UWF) digital scanning laser technology provides an opportunity for computer-aided DR lesion detection. High-resolution UWF images (3078×2702 pixels) may allow detection of more clinically relevant retinopathy in comparison with conventional retinal images as UWF imaging covers a 200° retinal area, versus 45° by conventional cameras. Current approaches to DR diagnosis that analyze 7-field Early Treatment Diabetic Retinopathy Study (ETDRS) retinal images provide similar results to UWF imaging. However, in 40% of cases, more retinopathy was found outside the 7- field ETDRS fields by UWF and in 10% of cases, retinopathy was reclassified as more severe. The reason is that UWF images examine both the central retina and more peripheral regions. We propose an algorithm for automatic detection and classification of DR lesions such as cotton wool spots, exudates, microaneurysms and haemorrhages in UWF images. The algorithm uses convolutional neural network (CNN) as a feature extractor and classifies the feature vectors extracted from colour-composite UWF images using a support vector machine (SVM). The main contribution includes detection of four types of DR lesions in the peripheral retina for diagnostic purposes. The evaluation dataset contains 146 UWF images. The proposed method for detection of DR lesion subtypes in UWF images using two scenarios for transfer learning achieved AUC ≈ 80%. Data was split at the patient level to validate the proposed algorithm.

Multispectral fundus imaging for early detection of diabetic retinopathy

NASA Astrophysics Data System (ADS)

Beach, James M.; Tiedeman, James S.; Hopkins, Mark F.; Sabharwal, Yashvinder S.

1999-04-01

Functional imaging of the retina and associated structures may provide information for early assessment of risks of developing retinopathy in diabetic patients. Here we show results of retinal oximetry performed using multi-spectral reflectance imaging techniques to assess hemoglobin (Hb) oxygen saturation (OS) in blood vessels of the inner retina and oxygen utilization at the optic nerve in diabetic patients without retinopathy and early disease during experimental hyperglycemia. Retinal images were obtained through a fundus camera and simultaneously recorded at up to four wavelengths using image-splitting modules coupled to a digital camera. Changes in OS in large retinal vessels, in average OS in disk tissue, and in the reduced state of cytochrome oxidase (CO) at the disk were determined from changes in reflectance associated with the oxidation/reduction states of Hb and CO. Step to high sugar lowered venous oxygen saturation to a degree dependent on disease duration. Moderate increase in sugar produced higher levels of reduced CO in both the disk and surrounding tissue without a detectable change in average tissue OS. Results suggest that regulation of retinal blood supply and oxygen consumption are altered by hyperglycemia and that such functional changes are present before clinical signs of retinopathy.

Personality and Total Health Through Life Project Eye Substudy: Methodology and Baseline Retinal Features.

PubMed

Wijngaarden, Peter Van; Keel, Stuart; Hodgson, Lauren A B; Kumar, Dinesh K; Aliahmad, Behzad; Paim, Cistiane C; Kiely, Kim M; Cherbuin, Nicolas; Anstey, Kaarin J; Dirani, Mohamed

2017-01-01

To describe the methodology and present the retinal grading findings of an older sample of australians with well-defined indices of neurocognitive function in the Personality and total Health (PATH) through life project. A cross-sectional study. Three hundred twenty-six individuals from the PatH through life project were invited to participate. Participants completed a general questionnaire and 2-field, 45-degree nonmydriatic color digital retinal photography. Photographs were graded for retinal pathology according to established protocols. Two hundred fifty-four (77.9%) subjects, aged 72 to 78 years, agreed to participate in the eye substudy. gradable images of at least 1 eye were acquired in 211 of 254 subjects (83.1%). retinal photographic screening identified 1 or more signs of pathology in 130 of the 174 subjects (74.7%) with gradable images of both eyes. a total of 45 participants (17.7%) had self-reported diabetes and diabetic retinopathy was observed in 22 (48.9%) of these participants. This well-defined sample of older australians provides a unique opportunity to interrogate associations between retinal findings, including retinal vascular geometric parameters, and indices of neurocognitive function. Copyright 2017 Asia-Pacific Academy of Ophthalmology.

N-acetylcysteine and acute retinal laser lesions in the colubrid snake eye

NASA Astrophysics Data System (ADS)

Elliott, William R., III; Rentmeister-Bryant, Heike K.; Barsalou, Norman; Beer, Jeremy; Zwick, Harry

2004-07-01

This study examined the role of oxidative stress and the effect of a single dose treatment with N-Acetylcysteine (NAC) on the temporal development of acute laser-induced retinal injury. We used the snake eye/Scanning Laser Ophthalmoscope (SLO) model, an in vivo, non-invasive ocular imaging technique, which has the ability to image cellular retinal detail and allows for studying morphological changes of retinal injury over time. For this study 12 corn-snakes (Elaphe g. guttata) received 5 laser exposures per eye, followed by either a single dose of the antioxidant NAC (150mg/kg, IP in sterile saline) or placebo. Laser exposures were made with a Nd: VO4 DPSS, 532nm laser, coaxially aligned to the SLO. Shuttered pulses were 20msec x 50 mW; 1mJ each. Retinal images were taken using a Rodenstock cSLO and were digitally recorded at 1, 6, 24-hrs, and at 3-wks post-exposure. Lesions were assessed by two raters blind to the conditions of the study yielding measures of damaged area and counts of missing or damaged photoreceptors. Treated eyes showed a significant beneficial effect overall, and these results suggest that oxidative stress plays a role in laser-induced retinal injury. The use of NAC or a similar antioxidant shows promise as a therapeutic tool.

Automated Detection of Malarial Retinopathy in Digital Fundus Images for Improved Diagnosis in Malawian Children with Clinically Defined Cerebral Malaria.

PubMed

Joshi, Vinayak; Agurto, Carla; Barriga, Simon; Nemeth, Sheila; Soliz, Peter; MacCormick, Ian J; Lewallen, Susan; Taylor, Terrie E; Harding, Simon P

2017-02-15

Cerebral malaria (CM), a complication of malaria infection, is the cause of the majority of malaria-associated deaths in African children. The standard clinical case definition for CM misclassifies ~25% of patients, but when malarial retinopathy (MR) is added to the clinical case definition, the specificity improves from 61% to 95%. Ocular fundoscopy requires expensive equipment and technical expertise not often available in malaria endemic settings, so we developed an automated software system to analyze retinal color images for MR lesions: retinal whitening, vessel discoloration, and white-centered hemorrhages. The individual lesion detection algorithms were combined using a partial least square classifier to determine the presence or absence of MR. We used a retrospective retinal image dataset of 86 pediatric patients with clinically defined CM (70 with MR and 16 without) to evaluate the algorithm performance. Our goal was to reduce the false positive rate of CM diagnosis, and so the algorithms were tuned at high specificity. This yielded sensitivity/specificity of 95%/100% for the detection of MR overall, and 65%/94% for retinal whitening, 62%/100% for vessel discoloration, and 73%/96% for hemorrhages. This automated system for detecting MR using retinal color images has the potential to improve the accuracy of CM diagnosis.

Automated Detection of Malarial Retinopathy in Digital Fundus Images for Improved Diagnosis in Malawian Children with Clinically Defined Cerebral Malaria

NASA Astrophysics Data System (ADS)

Joshi, Vinayak; Agurto, Carla; Barriga, Simon; Nemeth, Sheila; Soliz, Peter; MacCormick, Ian J.; Lewallen, Susan; Taylor, Terrie E.; Harding, Simon P.

2017-02-01

Cerebral malaria (CM), a complication of malaria infection, is the cause of the majority of malaria-associated deaths in African children. The standard clinical case definition for CM misclassifies ~25% of patients, but when malarial retinopathy (MR) is added to the clinical case definition, the specificity improves from 61% to 95%. Ocular fundoscopy requires expensive equipment and technical expertise not often available in malaria endemic settings, so we developed an automated software system to analyze retinal color images for MR lesions: retinal whitening, vessel discoloration, and white-centered hemorrhages. The individual lesion detection algorithms were combined using a partial least square classifier to determine the presence or absence of MR. We used a retrospective retinal image dataset of 86 pediatric patients with clinically defined CM (70 with MR and 16 without) to evaluate the algorithm performance. Our goal was to reduce the false positive rate of CM diagnosis, and so the algorithms were tuned at high specificity. This yielded sensitivity/specificity of 95%/100% for the detection of MR overall, and 65%/94% for retinal whitening, 62%/100% for vessel discoloration, and 73%/96% for hemorrhages. This automated system for detecting MR using retinal color images has the potential to improve the accuracy of CM diagnosis.

Supervised retinal vessel segmentation from color fundus images based on matched filtering and AdaBoost classifier.

PubMed

Memari, Nogol; Ramli, Abd Rahman; Bin Saripan, M Iqbal; Mashohor, Syamsiah; Moghbel, Mehrdad

2017-01-01

The structure and appearance of the blood vessel network in retinal fundus images is an essential part of diagnosing various problems associated with the eyes, such as diabetes and hypertension. In this paper, an automatic retinal vessel segmentation method utilizing matched filter techniques coupled with an AdaBoost classifier is proposed. The fundus image is enhanced using morphological operations, the contrast is increased using contrast limited adaptive histogram equalization (CLAHE) method and the inhomogeneity is corrected using Retinex approach. Then, the blood vessels are enhanced using a combination of B-COSFIRE and Frangi matched filters. From this preprocessed image, different statistical features are computed on a pixel-wise basis and used in an AdaBoost classifier to extract the blood vessel network inside the image. Finally, the segmented images are postprocessed to remove the misclassified pixels and regions. The proposed method was validated using publicly accessible Digital Retinal Images for Vessel Extraction (DRIVE), Structured Analysis of the Retina (STARE) and Child Heart and Health Study in England (CHASE_DB1) datasets commonly used for determining the accuracy of retinal vessel segmentation methods. The accuracy of the proposed segmentation method was comparable to other state of the art methods while being very close to the manual segmentation provided by the second human observer with an average accuracy of 0.972, 0.951 and 0.948 in DRIVE, STARE and CHASE_DB1 datasets, respectively.

A Novel Image Recuperation Approach for Diagnosing and Ranking Retinopathy Disease Level Using Diabetic Fundus Image

PubMed Central

2015-01-01

Retinal fundus images are widely used in diagnosing and providing treatment for several eye diseases. Prior works using retinal fundus images detected the presence of exudation with the aid of publicly available dataset using extensive segmentation process. Though it was proved to be computationally efficient, it failed to create a diabetic retinopathy feature selection system for transparently diagnosing the disease state. Also the diagnosis of diseases did not employ machine learning methods to categorize candidate fundus images into true positive and true negative ratio. Several candidate fundus images did not include more detailed feature selection technique for diabetic retinopathy. To apply machine learning methods and classify the candidate fundus images on the basis of sliding window a method called, Diabetic Fundus Image Recuperation (DFIR) is designed in this paper. The initial phase of DFIR method select the feature of optic cup in digital retinal fundus images based on Sliding Window Approach. With this, the disease state for diabetic retinopathy is assessed. The feature selection in DFIR method uses collection of sliding windows to obtain the features based on the histogram value. The histogram based feature selection with the aid of Group Sparsity Non-overlapping function provides more detailed information of features. Using Support Vector Model in the second phase, the DFIR method based on Spiral Basis Function effectively ranks the diabetic retinopathy diseases. The ranking of disease level for each candidate set provides a much promising result for developing practically automated diabetic retinopathy diagnosis system. Experimental work on digital fundus images using the DFIR method performs research on the factors such as sensitivity, specificity rate, ranking efficiency and feature selection time. PMID:25974230

Diagnosing and ranking retinopathy disease level using diabetic fundus image recuperation approach.

PubMed

Somasundaram, K; Rajendran, P Alli

2015-01-01

Retinal fundus images are widely used in diagnosing different types of eye diseases. The existing methods such as Feature Based Macular Edema Detection (FMED) and Optimally Adjusted Morphological Operator (OAMO) effectively detected the presence of exudation in fundus images and identified the true positive ratio of exudates detection, respectively. These mechanically detected exudates did not include more detailed feature selection technique to the system for detection of diabetic retinopathy. To categorize the exudates, Diabetic Fundus Image Recuperation (DFIR) method based on sliding window approach is developed in this work to select the features of optic cup in digital retinal fundus images. The DFIR feature selection uses collection of sliding windows with varying range to obtain the features based on the histogram value using Group Sparsity Nonoverlapping Function. Using support vector model in the second phase, the DFIR method based on Spiral Basis Function effectively ranks the diabetic retinopathy disease level. The ranking of disease level on each candidate set provides a much promising result for developing practically automated and assisted diabetic retinopathy diagnosis system. Experimental work on digital fundus images using the DFIR method performs research on the factors such as sensitivity, ranking efficiency, and feature selection time.

Diagnosing and Ranking Retinopathy Disease Level Using Diabetic Fundus Image Recuperation Approach

PubMed Central

Somasundaram, K.; Alli Rajendran, P.

2015-01-01

Retinal fundus images are widely used in diagnosing different types of eye diseases. The existing methods such as Feature Based Macular Edema Detection (FMED) and Optimally Adjusted Morphological Operator (OAMO) effectively detected the presence of exudation in fundus images and identified the true positive ratio of exudates detection, respectively. These mechanically detected exudates did not include more detailed feature selection technique to the system for detection of diabetic retinopathy. To categorize the exudates, Diabetic Fundus Image Recuperation (DFIR) method based on sliding window approach is developed in this work to select the features of optic cup in digital retinal fundus images. The DFIR feature selection uses collection of sliding windows with varying range to obtain the features based on the histogram value using Group Sparsity Nonoverlapping Function. Using support vector model in the second phase, the DFIR method based on Spiral Basis Function effectively ranks the diabetic retinopathy disease level. The ranking of disease level on each candidate set provides a much promising result for developing practically automated and assisted diabetic retinopathy diagnosis system. Experimental work on digital fundus images using the DFIR method performs research on the factors such as sensitivity, ranking efficiency, and feature selection time. PMID:25945362

Benefit from NASA

NASA Image and Video Library

1985-01-01

The NASA imaging processing technology, an advanced computer technique to enhance images sent to Earth in digital form by distant spacecraft, helped develop a new vision screening process. The Ocular Vision Screening system, an important step in preventing vision impairment, is a portable device designed especially to detect eye problems in children through the analysis of retinal reflexes.

In vivo retinal imaging for fixational eye motion detection using a high-speed digital micromirror device (DMD)-based ophthalmoscope.

PubMed

Vienola, Kari V; Damodaran, Mathi; Braaf, Boy; Vermeer, Koenraad A; de Boer, Johannes F

2018-02-01

Retinal motion detection with an accuracy of 0.77 arcmin corresponding to 3.7 µm on the retina is demonstrated with a novel digital micromirror device based ophthalmoscope. By generating a confocal image as a reference, eye motion could be measured from consecutively measured subsampled frames. The subsampled frames provide 7.7 millisecond snapshots of the retina without motion artifacts between the image points of the subsampled frame, distributed over the full field of view. An ophthalmoscope pattern projection speed of 130 Hz enabled a motion detection bandwidth of 65 Hz. A model eye with a scanning mirror was built to test the performance of the motion detection algorithm. Furthermore, an in vivo motion trace was obtained from a healthy volunteer. The obtained eye motion trace clearly shows the three main types of fixational eye movements. Lastly, the obtained eye motion trace was used to correct for the eye motion in consecutively obtained subsampled frames to produce an averaged confocal image correct for motion artefacts.

In vivo retinal imaging for fixational eye motion detection using a high-speed digital micromirror device (DMD)-based ophthalmoscope

PubMed Central

Vienola, Kari V.; Damodaran, Mathi; Braaf, Boy; Vermeer, Koenraad A.; de Boer, Johannes F.

2018-01-01

Retinal motion detection with an accuracy of 0.77 arcmin corresponding to 3.7 µm on the retina is demonstrated with a novel digital micromirror device based ophthalmoscope. By generating a confocal image as a reference, eye motion could be measured from consecutively measured subsampled frames. The subsampled frames provide 7.7 millisecond snapshots of the retina without motion artifacts between the image points of the subsampled frame, distributed over the full field of view. An ophthalmoscope pattern projection speed of 130 Hz enabled a motion detection bandwidth of 65 Hz. A model eye with a scanning mirror was built to test the performance of the motion detection algorithm. Furthermore, an in vivo motion trace was obtained from a healthy volunteer. The obtained eye motion trace clearly shows the three main types of fixational eye movements. Lastly, the obtained eye motion trace was used to correct for the eye motion in consecutively obtained subsampled frames to produce an averaged confocal image correct for motion artefacts. PMID:29552396

Computer-aided diagnosis of retinopathy in retinal fundus images of preterm infants via quantification of vascular tortuosity

PubMed Central

Oloumi, Faraz; Rangayyan, Rangaraj M.; Ells, Anna L.

2016-01-01

Abstract. Retinopathy of prematurity (ROP), a disorder of the retina occurring in preterm infants, is the leading cause of preventable childhood blindness. An active phase of ROP that requires treatment is associated with the presence of plus disease, which is diagnosed clinically in a qualitative manner by visual assessment of the existence of a certain level of increase in the thickness and tortuosity of retinal vessels. The present study performs computer-aided diagnosis (CAD) of plus disease via quantitative measurement of tortuosity in retinal fundus images of preterm infants. Digital image processing techniques were developed for the detection of retinal vessels and measurement of their tortuosity. The total lengths of abnormally tortuous vessels in each quadrant and the entire image were then computed. A minimum-length diagnostic-decision-making criterion was developed to assess the diagnostic sensitivity and specificity of the values obtained. The area (Az) under the receiver operating characteristic curve was used to assess the overall diagnostic accuracy of the methods. Using a set of 19 retinal fundus images of preterm infants with plus disease and 91 without plus disease, the proposed methods provided an overall diagnostic accuracy of Az=0.98. Using the total length of all abnormally tortuous vessel segments in an image, our techniques are capable of CAD of plus disease with high accuracy without the need for manual selection of vessels to analyze. The proposed methods may be used in a clinical or teleophthalmological setting. PMID:28018938

Characterisation of human non-proliferative diabetic retinopathy using the fractal analysis

PubMed Central

Ţălu, Ştefan; Călugăru, Dan Mihai; Lupaşcu, Carmen Alina

2015-01-01

AIM To investigate and quantify changes in the branching patterns of the retina vascular network in diabetes using the fractal analysis method. METHODS This was a clinic-based prospective study of 172 participants managed at the Ophthalmological Clinic of Cluj-Napoca, Romania, between January 2012 and December 2013. A set of 172 segmented and skeletonized human retinal images, corresponding to both normal (24 images) and pathological (148 images) states of the retina were examined. An automatic unsupervised method for retinal vessel segmentation was applied before fractal analysis. The fractal analyses of the retinal digital images were performed using the fractal analysis software ImageJ. Statistical analyses were performed for these groups using Microsoft Office Excel 2003 and GraphPad InStat software. RESULTS It was found that subtle changes in the vascular network geometry of the human retina are influenced by diabetic retinopathy (DR) and can be estimated using the fractal geometry. The average of fractal dimensions D for the normal images (segmented and skeletonized versions) is slightly lower than the corresponding values of mild non-proliferative DR (NPDR) images (segmented and skeletonized versions). The average of fractal dimensions D for the normal images (segmented and skeletonized versions) is higher than the corresponding values of moderate NPDR images (segmented and skeletonized versions). The lowest values were found for the corresponding values of severe NPDR images (segmented and skeletonized versions). CONCLUSION The fractal analysis of fundus photographs may be used for a more complete undeTrstanding of the early and basic pathophysiological mechanisms of diabetes. The architecture of the retinal microvasculature in diabetes can be quantitative quantified by means of the fractal dimension. Microvascular abnormalities on retinal imaging may elucidate early mechanistic pathways for microvascular complications and distinguish patients with DR from healthy individuals. PMID:26309878

Characterisation of human non-proliferative diabetic retinopathy using the fractal analysis.

PubMed

Ţălu, Ştefan; Călugăru, Dan Mihai; Lupaşcu, Carmen Alina

2015-01-01

To investigate and quantify changes in the branching patterns of the retina vascular network in diabetes using the fractal analysis method. This was a clinic-based prospective study of 172 participants managed at the Ophthalmological Clinic of Cluj-Napoca, Romania, between January 2012 and December 2013. A set of 172 segmented and skeletonized human retinal images, corresponding to both normal (24 images) and pathological (148 images) states of the retina were examined. An automatic unsupervised method for retinal vessel segmentation was applied before fractal analysis. The fractal analyses of the retinal digital images were performed using the fractal analysis software ImageJ. Statistical analyses were performed for these groups using Microsoft Office Excel 2003 and GraphPad InStat software. It was found that subtle changes in the vascular network geometry of the human retina are influenced by diabetic retinopathy (DR) and can be estimated using the fractal geometry. The average of fractal dimensions D for the normal images (segmented and skeletonized versions) is slightly lower than the corresponding values of mild non-proliferative DR (NPDR) images (segmented and skeletonized versions). The average of fractal dimensions D for the normal images (segmented and skeletonized versions) is higher than the corresponding values of moderate NPDR images (segmented and skeletonized versions). The lowest values were found for the corresponding values of severe NPDR images (segmented and skeletonized versions). The fractal analysis of fundus photographs may be used for a more complete undeTrstanding of the early and basic pathophysiological mechanisms of diabetes. The architecture of the retinal microvasculature in diabetes can be quantitative quantified by means of the fractal dimension. Microvascular abnormalities on retinal imaging may elucidate early mechanistic pathways for microvascular complications and distinguish patients with DR from healthy individuals.

A dual-modal retinal imaging system with adaptive optics.

PubMed

Meadway, Alexander; Girkin, Christopher A; Zhang, Yuhua

2013-12-02

An adaptive optics scanning laser ophthalmoscope (AO-SLO) is adapted to provide optical coherence tomography (OCT) imaging. The AO-SLO function is unchanged. The system uses the same light source, scanning optics, and adaptive optics in both imaging modes. The result is a dual-modal system that can acquire retinal images in both en face and cross-section planes at the single cell level. A new spectral shaping method is developed to reduce the large sidelobes in the coherence profile of the OCT imaging when a non-ideal source is used with a minimal introduction of noise. The technique uses a combination of two existing digital techniques. The thickness and position of the traditionally named inner segment/outer segment junction are measured from individual photoreceptors. In-vivo images of healthy and diseased human retinas are demonstrated.

Simultaneous hand-held contact color fundus and SD-OCT imaging for pediatric retinal diseases (Conference Presentation)

NASA Astrophysics Data System (ADS)

Ruggeri, Marco; Hernandez, Victor; De Freitas, Carolina; Relhan, Nidhi; Silgado, Juan; Manns, Fabrice; Parel, Jean-Marie

2016-03-01

Hand-held wide-field contact color fundus photography is currently the standard method to acquire diagnostic images of children during examination under anesthesia and in the neonatal intensive care unit. The recent development of portable non-contact hand-held OCT retinal imaging systems has proved that OCT is of tremendous help to complement fundus photography in the management of pediatric patients. Currently, there is no commercial or research system that combines color wide-field digital fundus and OCT imaging in a contact-fashion. The contact of the probe with the cornea has the advantages of reducing motion experienced by the photographer during the imaging and providing fundus and OCT images with wider field of view that includes the periphery of the retina. In this study we produce proof of concept for a contact-type hand-held unit for simultaneous color fundus and OCT live view of the retina of pediatric patients. The front piece of the hand-held unit consists of a contact ophthalmoscopy lens integrating a circular light guide that was recovered from a digital fundus camera for pediatric imaging. The custom-made rear piece consists of the optics to: 1) fold the visible aerial image of the fundus generated by the ophthalmoscopy lens on a miniaturized level board digital color camera; 2) conjugate the eye pupil to the galvanometric scanning mirrors of an OCT delivery system. Wide-field color fundus and OCT images were simultaneously obtained in an eye model and sequentially obtained on the eye of a conscious 25 year-old human subject with healthy retina.

Use of Gabor filters and deep networks in the segmentation of retinal vessel morphology

NASA Astrophysics Data System (ADS)

Leopold, Henry A.; Orchard, Jeff; Zelek, John; Lakshminarayanan, Vasudevan

2017-02-01

The segmentation of retinal morphology has numerous applications in assessing ophthalmologic and cardiovascular disease pathologies. The early detection of many such conditions is often the most effective method for reducing patient risk. Computer aided segmentation of the vasculature has proven to be a challenge, mainly due to inconsistencies such as noise, variations in hue and brightness that can greatly reduce the quality of fundus images. Accurate fundus and/or retinal vessel maps give rise to longitudinal studies able to utilize multimodal image registration and disease/condition status measurements, as well as applications in surgery preparation and biometrics. This paper further investigates the use of a Convolutional Neural Network as a multi-channel classifier of retinal vessels using the Digital Retinal Images for Vessel Extraction database, a standardized set of fundus images used to gauge the effectiveness of classification algorithms. The CNN has a feed-forward architecture and varies from other published architectures in its combination of: max-pooling, zero-padding, ReLU layers, batch normalization, two dense layers and finally a Softmax activation function. Notably, the use of Adam to optimize training the CNN on retinal fundus images has not been found in prior review. This work builds on prior work of the authors, exploring the use of Gabor filters to boost the accuracy of the system to 0.9478 during post processing. The mean of a series of Gabor filters with varying frequencies and sigma values are applied to the output of the network and used to determine whether a pixel represents a vessel or non-vessel.

Automated segmentation of retinal blood vessels and identification of proliferative diabetic retinopathy

NASA Astrophysics Data System (ADS)

Jelinek, Herbert F.; Cree, Michael J.; Leandro, Jorge J. G.; Soares, João V. B.; Cesar, Roberto M.; Luckie, A.

2007-05-01

Proliferative diabetic retinopathy can lead to blindness. However, early recognition allows appropriate, timely intervention. Fluorescein-labeled retinal blood vessels of 27 digital images were automatically segmented using the Gabor wavelet transform and classified using traditional features such as area, perimeter, and an additional five morphological features based on the derivatives-of-Gaussian wavelet-derived data. Discriminant analysis indicated that traditional features do not detect early proliferative retinopathy. The best single feature for discrimination was the wavelet curvature with an area under the curve (AUC) of 0.76. Linear discriminant analysis with a selection of six features achieved an AUC of 0.90 (0.73-0.97, 95% confidence interval). The wavelet method was able to segment retinal blood vessels and classify the images according to the presence or absence of proliferative retinopathy.

In vivo wide-field multispectral scanning laser ophthalmoscopy–optical coherence tomography mouse retinal imager: longitudinal imaging of ganglion cells, microglia, and Müller glia, and mapping of the mouse retinal and choroidal vasculature

PubMed Central

Zhang, Pengfei; Zam, Azhar; Jian, Yifan; Wang, Xinlei; Li, Yuanpei; Lam, Kit S.; Burns, Marie E.; Sarunic, Marinko V.; Pugh, Edward N.; Zawadzki, Robert J.

2015-01-01

Abstract. Scanning laser ophthalmoscopy (SLO) and optical coherence tomography (OCT) provide complementary views of the retina, with the former collecting fluorescence data with good lateral but relatively low-axial resolution, and the latter collecting label-free backscattering data with comparable lateral but much higher axial resolution. To take maximal advantage of the information of both modalities in mouse retinal imaging, we have constructed a compact, four-channel, wide-field (∼50  deg) system that simultaneously acquires and automatically coregisters three channels of confocal SLO and Fourier domain OCT data. The scanner control system allows “zoomed” imaging of a region of interest identified in a wide-field image, providing efficient digital sampling and localization of cellular resolution features in longitudinal imaging of individual mice. The SLO is equipped with a “flip-in” spectrometer that enables spectral “fingerprinting” of fluorochromes. Segmentation of retina layers and en face display facilitate spatial comparison of OCT data with SLO fluorescence patterns. We demonstrate that the system can be used to image an individual retinal ganglion cell over many months, to simultaneously image microglia and Müller glia expressing different fluorochromes, to characterize the distinctive spatial distributions and clearance times of circulating fluorochromes with different molecular sizes, and to produce unequivocal images of the heretofore uncharacterized mouse choroidal vasculature. PMID:26677070

Validated System for Centralized Grading of Retinopathy of Prematurity: Telemedicine Approaches to Evaluating Acute-Phase Retinopathy of Prematurity (e-ROP) Study.

PubMed

Daniel, Ebenezer; Quinn, Graham E; Hildebrand, P Lloyd; Ells, Anna; Hubbard, G Baker; Capone, Antonio; Martin, E Revell; Ostroff, Candace P; Smith, Eli; Pistilli, Maxwell; Ying, Gui-Shuang

2015-06-01

Measurable competence derived from comprehensive and advanced training in grading digital images is critical in studies using a reading center to evaluate retinal fundus images from infants at risk for retinopathy of prematurity (ROP). Details of certification for nonphysician trained readers (TRs) have not yet been described. To describe a centralized system for grading ROP digital images by TRs in the Telemedicine Approaches to Evaluating Acute-Phase Retinopathy of Prematurity (e-ROP) Study. Multicenter observational cohort study conducted from July 1, 2010, to June 30, 2014. The TRs were trained by experienced ROP specialists and certified to detect ROP morphology in digital retinal images under supervision of an ophthalmologist reading center director. An ROP reading center was developed with standard hardware, secure Internet access, and customized image viewing software with an electronic grading form. A detailed protocol for grading was developed. Based on results of TR gradings, a computerized algorithm determined whether referral-warranted ROP (RW-ROP; defined as presence of plus disease, zone I ROP, and stage 3 or worse ROP) was present in digital images from infants with birth weight less than 1251 g enrolled from May 25, 2011, through October 31, 2013. Independent double grading was done by the TRs with adjudication of discrepant fields performed by the reading center director. Digital retinal images. Intragrader and intergrader variability and monitoring for temporal drift. Four TRs underwent rigorous training and certification. A total of 5520 image sets were double graded, with 24.5% requiring adjudication for at least 1 component of RW-ROP. For individual RW-ROP components, the adjudication rate was 3.9% for plus disease, 12.4% for zone I ROP, and 16.9% for stage 3 or worse ROP. The weighted κ for intergrader agreement (n = 80 image sets) was 0.72 (95% CI, 0.52-0.93) for RW-ROP, 0.57 (95% CI, 0.37-0.77) for plus disease, 0.43 (95% CI, 0.24-0.63) for zone I ROP, and 0.67 (95% CI, 0.47-0.88) for stage 3 or worse ROP. The weighted κ for grade-regrade agreement was 0.77 (95% CI, 0.57-0.97) for RW-ROP, 0.87 (95% CI, 0.67-1.00) for plus disease, 0.70 (95% CI, 0.51-0.90) for zone I ROP, and 0.77 (95% CI, 0.57-0.97) for stage 3 or worse ROP. These data suggest that the e-ROP system for training and certifying nonphysicians to grade ROP images under the supervision of a reading center director reliably detects potentially serious ROP with good intragrader and intergrader consistency and minimal temporal drift.

Comparison of low-light nonmydriatic digital imaging with 35-mm ETDRS seven-standard field stereo color fundus photographs and clinical examination.

PubMed

Silva, Paolo S; Walia, Saloni; Cavallerano, Jerry D; Sun, Jennifer K; Dunn, Cheri; Bursell, Sven-Erik; Aiello, Lloyd M; Aiello, Lloyd Paul

2012-09-01

To compare agreement between diagnosis of clinical level of diabetic retinopathy (DR) and diabetic macular edema (DME) derived from nonmydriatic fundus images using a digital camera back optimized for low-flash image capture (MegaVision) compared with standard seven-field Early Treatment Diabetic Retinopathy Study (ETDRS) photographs and dilated clinical examination. Subject comfort and image acquisition time were also evaluated. In total, 126 eyes from 67 subjects with diabetes underwent Joslin Vision Network nonmydriatic retinal imaging. ETDRS photographs were obtained after pupillary dilation, and fundus examination was performed by a retina specialist. There was near-perfect agreement between MegaVision and ETDRS photographs (κ=0.81, 95% confidence interval [CI] 0.73-0.89) for clinical DR severity levels. Substantial agreement was observed with clinical examination (κ=0.71, 95% CI 0.62-0.80). For DME severity level there was near-perfect agreement with ETDRS photographs (κ=0.92, 95% CI 0.87-0.98) and moderate agreement with clinical examination (κ=0.58, 95% CI 0.46-0.71). The wider MegaVision 45° field led to identification of nonproliferative changes in areas not imaged by the 30° field of ETDRS photos. Field area unique to ETDRS photographs identified proliferative changes not visualized with MegaVision. Mean MegaVision acquisition time was 9:52 min. After imaging, 60% of subjects preferred the MegaVision lower flash settings. When evaluated using a rigorous protocol, images captured using a low-light digital camera compared favorably with ETDRS photography and clinical examination for grading level of DR and DME. Furthermore, these data suggest the importance of more extensive peripheral images and suggest that utilization of wide-field retinal imaging may further improve accuracy of DR assessment.

Detection of amblyopia utilizing generated retinal reflexes

NASA Technical Reports Server (NTRS)

Kerr, J. H.; Hay, S. H.

1981-01-01

Investigation confirmed that GRR images can be consistently obtained and that these images contain information required to detect the optical inequality of one eye compared to the fellow eye. Digital analyses, electro-optical analyses, and trained observers were used to evaluate the GRR images. Two and three dimensional plots were made from the digital analyses results. These plotted data greatly enhanced the GRR image content, and it was possible for nontrained observers to correctly identify normal vs abnormal ocular status by viewing the plots. Based upon the criteria of detecting equality or inequality of ocular status of a person's eyes, the trained observer correctly identified the ocular status of 90% of the 232 persons who participated in this program.

Detection of hypertensive retinopathy using vessel measurements and textural features.

PubMed

Agurto, Carla; Joshi, Vinayak; Nemeth, Sheila; Soliz, Peter; Barriga, Simon

2014-01-01

Features that indicate hypertensive retinopathy have been well described in the medical literature. This paper presents a new system to automatically classify subjects with hypertensive retinopathy (HR) using digital color fundus images. Our method consists of the following steps: 1) normalization and enhancement of the image; 2) determination of regions of interest based on automatic location of the optic disc; 3) segmentation of the retinal vasculature and measurement of vessel width and tortuosity; 4) extraction of color features; 5) classification of vessel segments as arteries or veins; 6) calculation of artery-vein ratios using the six widest (major) vessels for each category; 7) calculation of mean red intensity and saturation values for all arteries; 8) calculation of amplitude-modulation frequency-modulation (AM-FM) features for entire image; and 9) classification of features into HR and non-HR using linear regression. This approach was tested on 74 digital color fundus photographs taken with TOPCON and CANON retinal cameras using leave-one out cross validation. An area under the ROC curve (AUC) of 0.84 was achieved with sensitivity and specificity of 90% and 67%, respectively.

Comparison of digital color fundus imaging and fluorescein angiographic findings for the early detection of diabetic retinopathy in young type 1 diabetic patients.

PubMed

Kapsala, Z; Anastasakis, A; Mamoulakis, D; Maniadaki, I; Tsilimbaris, M

2018-01-01

To compare the findings from digital 7-field color fundus (CF) photography and fundus fluorescein angiography (FFA) in young patients with diabetes mellitus (DM) type 1 without known diabetic retinopathy. In this prospective, observational cohort study, 54 type 1 diabetic patients were recruited. Participants had been diagnosed with diabetes mellitus (DM) for at least 6 years, had Best Corrected Visual Acuity of 20/25 or better and did not have any known retinal pathology. One hundred and seven eyes were analyzed. All patients underwent a complete ophthalmic examination in the Retina Service of a University Eye Clinic including digital CF imaging and FFA. The mean age of the patients was 18.6 years. Mean duration of DM was 11.3 years, and mean haemoglobin A1c (HbA1c) level was 8.6%. Of the 107 eyes, 8 eyes (7.5%) showed microvascular abnormalities on CF images, while FFA images revealed changes in 26 eyes (24.3%). Hence, 18 of the 26 eyes showing abnormalities on FFA did not show any abnormalities on CF images. Mean DM duration in the patient group with detectable microvascular changes was found to be significantly higher compared to patients without changes, while no difference in HbA1c levels, serum lipid levels or blood pressure was observed. Comparison of digital CF and FFA findings for the detection of diabetic microvascular changes in type 1 diabetic patients showed that FFA reveals more information about retinal vascular pathology for early detection of diabetic retinopathy. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

A Comprehensive Study of Retinal Vessel Classification Methods in Fundus Images

PubMed Central

Miri, Maliheh; Amini, Zahra; Rabbani, Hossein; Kafieh, Raheleh

2017-01-01

Nowadays, it is obvious that there is a relationship between changes in the retinal vessel structure and diseases such as diabetic, hypertension, stroke, and the other cardiovascular diseases in adults as well as retinopathy of prematurity in infants. Retinal fundus images provide non-invasive visualization of the retinal vessel structure. Applying image processing techniques in the study of digital color fundus photographs and analyzing their vasculature is a reliable approach for early diagnosis of the aforementioned diseases. Reduction in the arteriolar–venular ratio of retina is one of the primary signs of hypertension, diabetic, and cardiovascular diseases which can be calculated by analyzing the fundus images. To achieve a precise measuring of this parameter and meaningful diagnostic results, accurate classification of arteries and veins is necessary. Classification of vessels in fundus images faces with some challenges that make it difficult. In this paper, a comprehensive study of the proposed methods for classification of arteries and veins in fundus images is presented. Considering that these methods are evaluated on different datasets and use different evaluation criteria, it is not possible to conduct a fair comparison of their performance. Therefore, we evaluate the classification methods from modeling perspective. This analysis reveals that most of the proposed approaches have focused on statistics, and geometric models in spatial domain and transform domain models have received less attention. This could suggest the possibility of using transform models, especially data adaptive ones, for modeling of the fundus images in future classification approaches. PMID:28553578

An Unsupervised Approach for Extraction of Blood Vessels from Fundus Images.

PubMed

Dash, Jyotiprava; Bhoi, Nilamani

2018-04-26

Pathological disorders may happen due to small changes in retinal blood vessels which may later turn into blindness. Hence, the accurate segmentation of blood vessels is becoming a challenging task for pathological analysis. This paper offers an unsupervised recursive method for extraction of blood vessels from ophthalmoscope images. First, a vessel-enhanced image is generated with the help of gamma correction and contrast-limited adaptive histogram equalization (CLAHE). Next, the vessels are extracted iteratively by applying an adaptive thresholding technique. At last, a final vessel segmented image is produced by applying a morphological cleaning operation. Evaluations are accompanied on the publicly available digital retinal images for vessel extraction (DRIVE) and Child Heart And Health Study in England (CHASE_DB1) databases using nine different measurements. The proposed method achieves average accuracies of 0.957 and 0.952 on DRIVE and CHASE_DB1 databases respectively.

The design and integration of retinal CAD-SR to diabetes patient ePR system

NASA Astrophysics Data System (ADS)

Wu, Huiqun; Wei, Yufang; Liu, Brent J.; Shang, Yujuan; Shi, Lili; Jiang, Kui; Dong, Jiancheng

2017-03-01

Diabetic retinopathy (DR) is one of the serious complications of diabetes that could lead to blindness. Digital fundus camera is often used to detect retinal changes but the diagnosis relies too much on ophthalmologist's experience. Based on our previously developed algorithms for quantifying retinal vessels and lesions, we developed a computer aided detection-structured report (CAD-SR) template and implemented it into picture archiving and communication system (PACS). Furthermore, we mapped our CAD-SR into HL7 CDA to integrate CAD findings into diabetes patient electronic patient record (ePR) system. Such integration could provide more quantitative features from fundus image into ePR system, which is valuable for further data mining researches.

Validation of Smartphone Based Retinal Photography for Diabetic Retinopathy Screening.

PubMed

Rajalakshmi, Ramachandran; Arulmalar, Subramanian; Usha, Manoharan; Prathiba, Vijayaraghavan; Kareemuddin, Khaji Syed; Anjana, Ranjit Mohan; Mohan, Viswanathan

2015-01-01

To evaluate the sensitivity and specificity of "fundus on phone' (FOP) camera, a smartphone based retinal imaging system, as a screening tool for diabetic retinopathy (DR) detection and DR severity in comparison with 7-standard field digital retinal photography. Single-site, prospective, comparative, instrument validation study. 301 patients (602 eyes) with type 2 diabetes underwent standard seven-field digital fundus photography with both Carl Zeiss fundus camera and indigenous FOP at a tertiary care diabetes centre in South India. Grading of DR was performed by two independent retina specialists using modified Early Treatment of Diabetic Retinopathy Study grading system. Sight threatening DR (STDR) was defined by the presence of proliferative DR(PDR) or diabetic macular edema. The sensitivity, specificity and image quality were assessed. The mean age of the participants was 53.5 ±9.6 years and mean duration of diabetes 12.5±7.3 years. The Zeiss camera showed that 43.9% had non-proliferative DR(NPDR) and 15.3% had PDR while the FOP camera showed that 40.2% had NPDR and 15.3% had PDR. The sensitivity and specificity for detecting any DR by FOP was 92.7% (95%CI 87.8-96.1) and 98.4% (95%CI 94.3-99.8) respectively and the kappa (ĸ) agreement was 0.90 (95%CI-0.85-0.95 p<0.001) while for STDR, the sensitivity was 87.9% (95%CI 83.2-92.9), specificity 94.9% (95%CI 89.7-98.2) and ĸ agreement was 0.80 (95%CI 0.71-0.89 p<0.001), compared to conventional photography. Retinal photography using FOP camera is effective for screening and diagnosis of DR and STDR with high sensitivity and specificity and has substantial agreement with conventional retinal photography.

Portable Video/Digital Retinal Funduscope

NASA Technical Reports Server (NTRS)

Taylor, Gerald R.; Meehan, Richard; Hunter, Norwood; Caputo, Michael; Gibson, C. Robert

1991-01-01

Lightweight, inexpensive electronic and photographic instrument developed for detection, monitoring, and objective quantification of ocular/systemic disease or physiological alterations of retina, blood vessels, or other structures in anterior and posterior chambers of eye. Operated with little training. Functions with human or animal subject seated, recumbent, inverted, or in almost any other orientation; and in hospital, laboratory, field, or other environment. Produces video images viewed directly and/or digitized for simultaneous or subsequent analysis. Also equipped to produce photographs and/or fitted with adaptors to produce stereoscopic or magnified images of skin, nose, ear, throat, or mouth to detect lesions or diseases.

Telemedicine diagnosis of cytomegalovirus retinitis by nonophthalmologists.

PubMed

Yen, Michael; Ausayakhun, Somsanguan; Chen, Jenny; Ausayakhun, Sakarin; Jirawison, Choeng; Heiden, David; Holland, Gary N; Margolis, Todd P; Keenan, Jeremy D

2014-09-01

Cytomegalovirus (CMV) retinitis continues to be a leading cause of blindness in many developing countries. Telemedicine holds the potential to increase the number of people screened for CMV retinitis, but it is unclear whether nonophthalmologists could be responsible for interpreting fundus photographs captured in a telemedicine program. To determine the accuracy of nonophthalmologist photographic graders in diagnosing CMV retinitis from digital fundus photographs. Fifteen nonexpert graders each evaluated 182 mosaic retinal images taken from the eyes of patients with AIDS who were evaluated at the Ocular Infectious Diseases Clinic at Chiang Mai University in Chiang Mai, Thailand. Graders diagnosed each image as CMV retinitis present, CMV retinitis absent, or unknown. The results from each grader were compared with those of an indirect ophthalmoscopic examination from an experienced on-site ophthalmologist as well as with the consensus grade given by a panel of CMV retinitis experts. Relative to the on-site ophthalmologist, the sensitivity of remote CMV retinitis diagnosis by nonexpert graders ranged from 64.0% to 95.5% (mean, 84.1%; 95% CI, 78.6%-89.6%)), and the specificity ranged from 65.6% to 92.5% (mean, 82.3%; 95% CI, 76.6%-88.0%)). Agreement between nonexpert and expert graders was high: the mean sensitivity and specificity values of nonexpert diagnosis using expert consensus as the reference standard were 93.2% (95% CI, 90.6%-95.8%) and 88.4% (95% CI, 85.4%-91.1%), respectively. Mean intrarater reliability also was high (mean Cohen κ, 0.83; 95% CI, 0.78-0.87). The sensitivity and specificity of remote diagnosis of CMV retinitis by nonexpert graders was variable, although several nonexperts achieved a level of accuracy comparable to that of CMV retinitis experts. More intensive training and periodic evaluations would be required if nonexperts are to be used in clinical practice.

Ambulatory Aortic Stiffness Is Associated With Narrow Retinal Arteriolar Caliber in Hypertensives: The SAFAR Study.

PubMed

Aissopou, Evaggelia K; Argyris, Antoniοs A; Nasothimiou, Efthimia G; Konstantonis, George D; Tampakis, Kostas; Tentolouris, Nikolaos; Papathanassiou, Miltiadis; Theodossiadis, Panagiotis G; Papaioannou, Theodoros G; Stehouwer, Coen D A; Sfikakis, Petros P; Protogerou, Athanassios D

2016-05-01

Arterial stiffness measured under static conditions reclassifies significantly cardiovascular (CV) risk and associates with narrower retinal arterioles. However, arterial stiffness exhibits circadian variation, thus single static stiffness recordings do not correspond to the "usual" 24 hr, awake, and asleep average arterial stiffness. We aimed to test the hypothesis that ambulatory 24 hr, awake, and asleep aortic (a) pulse wave velocity (PWV) associate with retinal vessel calibers, independently of confounders and of static arterial stiffness, in hypertensive individuals free from diabetes and CV disease. Digital retinal images were obtained (181 individuals, age: 53.9±10.7 years, 55.2% men) and retinal vessel calibers were measured with validated software to determine central retinal arteriolar and venular equivalents (CRAE and CRVE, respectively); ambulatory (24 hr, awake, asleep) and static office aPWV were estimated by Mobil-O-Graph; and static office carotid to femoral (cf) PWV by SphygmoCor. Regression analysis performed in 320 gradable retinal images showed that, after adjustment for confounders: (i) ambulatory aPWV was significantly associated with narrower retinal arterioles but not with venules; (ii) asleep aPWV had stronger associations with CRAE than awake aPWV; (iii) both ambulatory aPWV and cfPWV were associated mutually independently with narrower retinal arterioles; aPWV introduction in the model of cfPWV, improved model's R2 (P = 0.012). Similar discriminatory ability of 24 hr aPWV and of cfPWV to detect the presence of retinal arteriolar narrowing was found. Ambulatory aPWV, estimated by an operator-independent method, provides additional information to cfPWV regarding the associations of arterial stiffness with the retinal vessel calibers. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

An image-processing strategy to extract important information suitable for a low-size stimulus pattern in a retinal prosthesis.

PubMed

Chen, Yili; Fu, Jixiang; Chu, Dawei; Li, Rongmao; Xie, Yaoqin

2017-11-27

A retinal prosthesis is designed to help the blind to obtain some sight. It consists of an external part and an internal part. The external part is made up of a camera, an image processor and an RF transmitter. The internal part is made up of an RF receiver, implant chip and microelectrode. Currently, the number of microelectrodes is in the hundreds, and we do not know the mechanism for using an electrode to stimulate the optic nerve. A simple hypothesis is that the pixels in an image correspond to the electrode. The images captured by the camera should be processed by suitable strategies to correspond to stimulation from the electrode. Thus, it is a question of how to obtain the important information from the image captured in the picture. Here, we use the region of interest (ROI), a useful algorithm for extracting the ROI, to retain the important information, and to remove the redundant information. This paper explains the details of the principles and functions of the ROI. Because we are investigating a real-time system, we need a fast processing ROI as a useful algorithm to extract the ROI. Thus, we simplified the ROI algorithm and used it in an outside image-processing digital signal processing (DSP) system of the retinal prosthesis. The results show that our image-processing strategies are suitable for a real-time retinal prosthesis and can eliminate redundant information and provide useful information for expression in a low-size image.

Instant electronic imaging systems are superior to Polaroid at detecting sight-threatening diabetic retinopathy.

PubMed

Ryder, R E; Kong, N; Bates, A S; Sim, J; Welch, J; Kritzinger, E E

1998-03-01

Polaroid photography in diabetic retinopathy screening allows instant image availability to enhance the results of ophthalmoscopy. Retinal cameras are now being developed which use video/digital imaging techniques to produce an instant enlarged retinal image on a computer monitor screen. We aimed to compare one such electronic imaging system, attached to a Canon CR5 45NM, with standard Polaroid retinal photography. Two hundred and thirteen eyes from 107 diabetic patients were photographed through dilated pupils by both systems in random order and the images were analysed blind. Diabetic retinopathy was present in 58 eyes of which 55/58 (95%) were detected on the electronic image and only 49/58 (84%) on the Polaroid. Of 34 eyes requiring ophthalmologist referral according to standard European criteria, 34/34 (100%) were detected on the electronic image and only 24/34 (71%) on the Polaroid. Side by side comparisons showed electronic imaging to be superior to Polaroid at lesion detection. Using linear analogue scales, the patients assessed the electronic imaging photographic flash as less uncomfortable than the Polaroid equivalent (p < 0.0001). Other advantages of electronic imaging include: ready storage of the images with other patient clinical data on the diabetes computerized register/database; potential for image enhancement and analysis using image analysis software and electronic transfer of images to ophthalmologist or general practitioner. Electronic imaging systems represent a potential major advance for the improvement of diabetic retinopathy screening.

Image analysis for microelectronic retinal prosthesis.

PubMed

Hallum, L E; Cloherty, S L; Lovell, N H

2008-01-01

By way of extracellular, stimulating electrodes, a microelectronic retinal prosthesis aims to render discrete, luminous spots-so-called phosphenes-in the visual field, thereby providing a phosphene image (PI) as a rudimentary remediation of profound blindness. As part thereof, a digital camera, or some other photosensitive array, captures frames, frames are analyzed, and phosphenes are actuated accordingly by way of modulated charge injections. Here, we present a method that allows the assessment of image analysis schemes for integration with a prosthetic device, that is, the means of converting the captured image (high resolution) to modulated charge injections (low resolution). We use the mutual-information function to quantify the amount of information conveyed to the PI observer (device implantee), while accounting for the statistics of visual stimuli. We demonstrate an effective scheme involving overlapping, Gaussian kernels, and discuss extensions of the method to account for shortterm visual memory in observers, and their perceptual errors of omission and commission.

Automatic detection of diabetic retinopathy features in ultra-wide field retinal images

NASA Astrophysics Data System (ADS)

Levenkova, Anastasia; Sowmya, Arcot; Kalloniatis, Michael; Ly, Angelica; Ho, Arthur

2017-03-01

Diabetic retinopathy (DR) is a major cause of irreversible vision loss. DR screening relies on retinal clinical signs (features). Opportunities for computer-aided DR feature detection have emerged with the development of Ultra-WideField (UWF) digital scanning laser technology. UWF imaging covers 82% greater retinal area (200°), against 45° in conventional cameras3 , allowing more clinically relevant retinopathy to be detected4 . UWF images also provide a high resolution of 3078 x 2702 pixels. Currently DR screening uses 7 overlapping conventional fundus images, and the UWF images provide similar results1,4. However, in 40% of cases, more retinopathy was found outside the 7-field ETDRS) fields by UWF and in 10% of cases, retinopathy was reclassified as more severe4 . This is because UWF imaging allows examination of both the central retina and more peripheral regions, with the latter implicated in DR6 . We have developed an algorithm for automatic recognition of DR features, including bright (cotton wool spots and exudates) and dark lesions (microaneurysms and blot, dot and flame haemorrhages) in UWF images. The algorithm extracts features from grayscale (green "red-free" laser light) and colour-composite UWF images, including intensity, Histogram-of-Gradient and Local binary patterns. Pixel-based classification is performed with three different classifiers. The main contribution is the automatic detection of DR features in the peripheral retina. The method is evaluated by leave-one-out cross-validation on 25 UWF retinal images with 167 bright lesions, and 61 other images with 1089 dark lesions. The SVM classifier performs best with AUC of 94.4% / 95.31% for bright / dark lesions.

Textureless Macula Swelling Detection with Multiple Retinal Fundus Images

DOE Office of Scientific and Technical Information (OSTI.GOV)

Giancardo, Luca; Meriaudeau, Fabrice; Karnowski, Thomas Paul

2010-01-01

Retinal fundus images acquired with non-mydriatic digital fundus cameras are a versatile tool for the diagnosis of various retinal diseases. Because of the ease of use of newer camera models and their relatively low cost, these cameras can be employed by operators with limited training for telemedicine or Point-of-Care applications. We propose a novel technique that uses uncalibrated multiple-view fundus images to analyse the swelling of the macula. This innovation enables the detection and quantitative measurement of swollen areas by remote ophthalmologists. This capability is not available with a single image and prone to error with stereo fundus cameras. Wemore » also present automatic algorithms to measure features from the reconstructed image which are useful in Point-of-Care automated diagnosis of early macular edema, e.g., before the appearance of exudation. The technique presented is divided into three parts: first, a preprocessing technique simultaneously enhances the dark microstructures of the macula and equalises the image; second, all available views are registered using non-morphological sparse features; finally, a dense pyramidal optical flow is calculated for all the images and statistically combined to build a naiveheight- map of the macula. Results are presented on three sets of synthetic images and two sets of real world images. These preliminary tests show the ability to infer a minimum swelling of 300 microns and to correlate the reconstruction with the swollen location.« less

Multimodal ophthalmic imaging using swept source spectrally encoded scanning laser ophthalmoscopy and optical coherence tomography

NASA Astrophysics Data System (ADS)

Malone, Joseph D.; El-Haddad, Mohamed T.; Tye, Logan A.; Majeau, Lucas; Godbout, Nicolas; Rollins, Andrew M.; Boudoux, Caroline; Tao, Yuankai K.

2016-03-01

Scanning laser ophthalmoscopy (SLO) and optical coherence tomography (OCT) benefit clinical diagnostic imaging in ophthalmology by enabling in vivo noninvasive en face and volumetric visualization of retinal structures, respectively. Spectrally encoding methods enable confocal imaging through fiber optics and reduces system complexity. Previous applications in ophthalmic imaging include spectrally encoded confocal scanning laser ophthalmoscopy (SECSLO) and a combined SECSLO-OCT system for image guidance, tracking, and registration. However, spectrally encoded imaging suffers from speckle noise because each spectrally encoded channel is effectively monochromatic. Here, we demonstrate in vivo human retinal imaging using a swept source spectrally encoded scanning laser ophthalmoscope and OCT (SSSESLO- OCT) at 1060 nm. SS-SESLO-OCT uses a shared 100 kHz Axsun swept source, shared scanner and imaging optics, and are detected simultaneously on a shared, dual channel high-speed digitizer. SESLO illumination and detection was performed using the single mode core and multimode inner cladding of a double clad fiber coupler, respectively, to preserve lateral resolution while improving collection efficiency and reducing speckle contrast at the expense of confocality. Concurrent en face SESLO and cross-sectional OCT images were acquired with 1376 x 500 pixels at 200 frames-per-second. Our system design is compact and uses a shared light source, imaging optics, and digitizer, which reduces overall system complexity and ensures inherent co-registration between SESLO and OCT FOVs. En face SESLO images acquired concurrent with OCT cross-sections enables lateral motion tracking and three-dimensional volume registration with broad applications in multivolume OCT averaging, image mosaicking, and intraoperative instrument tracking.

Inner Segment Remodeling and Mitochondrial Translocation in Cone Photoreceptors in Age-Related Macular Degeneration With Outer Retinal Tubulation.

PubMed

Litts, Katie M; Messinger, Jeffrey D; Freund, K Bailey; Zhang, Yuhua; Curcio, Christine A

2015-04-01

To quantify impressions of mitochondrial translocation in degenerating cones and to determine the nature of accumulated material in the subretinal space with apparent inner segment (IS)-like features by examining cone IS ultrastructure. Human donor eyes with advanced age-related macular degeneration (AMD) were screened for outer retinal tubulation (ORT) in macula-wide, high-resolution digital sections. Degenerating cones inside ORT (ORT cones) and outside ORT (non-ORT cones) from AMD eyes and unaffected cones in age-matched control eyes were imaged using transmission electron microscopy. The distances of mitochondria to the external limiting membrane (ELM), cone IS length, and cone IS width at the ELM were measured. Outer retinal tubulation and non-ORT cones lose outer segments (OS), followed by shortening of IS and mitochondria. In non-ORT cones, IS broaden. Outer retinal tubulation and non-ORT cone IS myoids become undetectable due to mitochondria redistribution toward the nucleus. Some ORT cones were found lacking IS and containing mitochondria in the outer fiber (between soma and ELM). Unlike long, thin IS mitochondria in control cones, ORT and non-ORT IS mitochondria are ovoid or reniform. Shed IS, some containing mitochondria, were found in the subretinal space. In AMD, macula cones exhibit loss of detectable myoid due to IS shortening in addition to OS loss, as described. Mitochondria shrink and translocate toward the nucleus. As reflectivity sources, translocating mitochondria may be detectable using in vivo imaging to monitor photoreceptor degeneration in retinal disorders. These results improve the knowledge basis for interpreting high-resolution clinical retinal imaging.

The Portable Dynamic Fundus Instrument: Uses in telemedicine and research

NASA Technical Reports Server (NTRS)

Hunter, Norwood; Caputo, Michael; Billica, Roger; Taylor, Gerald; Gibson, C. Robert; Manuel, F. Keith; Mader, Thomas; Meehan, Richard

1994-01-01

For years ophthalmic photographs have been used to track the progression of many ocular diseases such as macular degeneration and glaucoma as well as the ocular manifestations of diabetes, hypertension, and hypoxia. In 1987 a project was initiated at the Johnson Space Center (JSC) to develop a means of monitoring retinal vascular caliber and intracranial pressure during space flight. To conduct telemedicine during space flight operations, retinal images would require real-time transmissions from space. Film-based images would not be useful during in-flight operations. Video technology is beneficial in flight because the images may be acquired, recorded, and transmitted to the ground for rapid computer digital image processing and analysis. The computer analysis techniques developed for this project detected vessel caliber changes as small as 3 percent. In the field of telemedicine, the Portable Dynamic Fundus Instrument demonstrates the concept and utility of a small, self-contained video funduscope. It was used to record retinal images during the Gulf War and to transmit retinal images from the Space Shuttle Columbia during STS-50. There are plans to utilize this device to provide a mobile ophthalmic screening service in rural Texas. In the fall of 1993 a medical team in Boulder, Colorado, will transmit real-time images of the retina during remote consultation and diagnosis. The research applications of this device include the capability of operating in remote locations or small, confined test areas. There has been interest shown utilizing retinal imaging during high-G centrifuge tests, high-altitude chamber tests, and aircraft flight tests. A new design plan has been developed to incorporate the video instrumentation into face-mounted goggle. This design would eliminate head restraint devices, thus allowing full maneuverability to the subjects. Further development of software programs will broaden the application of the Portable Dynamic Fundus Instrument in telemedicine and medical research.

Ultra-widefield imaging for the management of pediatric retinal diseases.

PubMed

Kang, Kai B; Wessel, Matthew M; Tong, Jianping; D'Amico, Donald J; Chan, R V Paul

2013-01-01

To describe the utility of using ultra-widefield digital fundus photography and ultra-widefield fluorescein angiography (UWFA) in the pediatric patient population to evaluate peripheral retinal pathology and to manage Coats' disease and familial exudative vitreoretinopathy (FEVR). Retrospective review of pediatric retinal patients with FEVR or Coats' disease who underwent ultra-widefield fundus photography and UWFA. Eight patients were included in this case series. Five patients had the clinical diagnosis of FEVR, and two eyes of two patients with FEVR received UWFA-guided laser photocoagulation. Three patients were diagnosed as having Coats' disease and received UWFA-guided laser photocoagulation. Ultra-widefield fundus photography and UWFA can be used successfully as an outpatient procedure in the pediatric patient population without the necessity of examination under anesthesia and can aid the physician in the documentation and evaluation of peripheral retinal pathology. UWFA can also assist in directing laser photocoagulation in the treatment of pediatric retinal diseases. Copyright 2013, SLACK Incorporated.

Telemedicine screening for cytomegalovirus retinitis at the point of care for human immunodeficiency virus infection.

PubMed

Jirawison, Choeng; Yen, Michael; Leenasirimakul, Prattana; Chen, Jenny; Guadanant, Siripim; Kunavisarut, Paradee; Patikulsila, Direk; Watanachai, Nawat; Ausayakhun, Somsanguan; Heiden, David; Holland, Gary N; Margolis, Todd P; Keenan, Jeremy D

2015-02-01

Cytomegalovirus (CMV) retinitis is a leading cause of blindness in many developing countries, likely the result of inadequate screening. Telemedicine screening for CMV retinitis instituted at the point of care for human immunodeficiency virus (HIV) infection may allow for earlier detection. To determine the diagnostic accuracy of retinal photography in detecting CMV retinitis at the point of HIV care and to characterize the clinical manifestations of CMV retinitis detected through the screening program. We enrolled 103 participants from a population of 258 patients with HIV and a CD4 level of less than 100/μL treated at an HIV clinic in Thailand from June 2010 through June 2012. We captured mosaic fundus photographs through a dilated pupil using a digital fundus camera. An experienced on-site ophthalmologist masked to the results of the fundus images subsequently examined each eye with indirect ophthalmoscopy and recorded the clinical findings on a standardized form. Three remote graders evaluated each image for CMV retinitis. Fundus photography and indirect ophthalmoscopy. Sensitivity and specificity of telemedicine relative to indirect ophthalmoscopy for diagnosis of CMV retinitis and clinical features of CMV retinitis lesions. Sixteen patients (15.5%) were diagnosed as having CMV retinitis, of whom 5 (31%) had bilateral disease. Of the 21 eyes (10.2%) with CMV retinitis, 7 (33%) had visual symptoms. Retinitis lesions occupied less than 10% of the total retinal surface area in 13 of 21 eyes (62%) and did not involve the posterior pole (ie, zone 1) in 15 of 21 eyes (71%). Mean logMAR visual acuity in affected eyes was 0.41 (95% CI, 0.11-0.71; Snellen equivalent, 20/50 [95% CI, 20/25-20/100]). The mean sensitivity for the 3 remote graders in detecting CMV retinitis on fundus photography was 30.2% (95% CI, 10.5%-52.4%), and mean specificity was 99.1% (95% CI, 97.8%-100.0%). The CMV retinitis lesions missed by the remote graders (false-negative findings) were more likely to be small (P = .001) and located in the peripheral retina (P = .04). Patients undergoing screening at a clinic for HIV treatment had less extensive retinitis than patients in recent reports from an ophthalmology clinic. Retinal photography with the camera used in this study was not highly sensitive in detecting CMV retinitis but may identify disease with an immediate threat to vision. Improved accuracy will require a camera that can more easily image the peripheral retina.

Imaging of the peripheral retina

PubMed Central

Kernt, Marcus; Kampik, Anselm

2013-01-01

The technical progress of the recent years has revolutionized imaging in ophthalmology. Scanning laser ophthalmoscopy (SLO), digital angiography, optical coherence tomography (OCT), and detection of fundus autofluorescence (FAF) have fundamentally changed our understanding of numerous retinal and choroidal diseases. Besides the tremendous advances in macular diagnostics, there is more and more evidence that central pathologies are often directly linked to changes in the peripheral retina. This review provides a brief overview on current posterior segment imaging techniques with a special focus on the peripheral retina. PMID:24391370

The Role of Retinal Vascular Density as a Screening Tool for Ageing and Stroke.

PubMed

Sprödhuber, Andrea; Wolz, Johannes; Budai, Attila; Laumeier, Inga; Audebert, Heinrich J; Michelson, Georg

2018-06-06

To measure the density of retinal vessels from digitized fundus photographs in patients with recent stroke and age-matched controls. To investigate whether the parameter retinal vascular density (RVD) served as a quantitative marker for cerebrovascular events. Digitized fundus photographs of n = 158 subjects with stroke or transient ischemic attack within 1 year at the time of examination and n = 1,250 age-matched controls without any remarkable medical history were examined. Sex, hypertension, and diabetes were considered to be cofactors. Measurement of RVD was performed with a computer-aided image-analyzing program by segmenting automatically all visible retinal vessels and measuring areas of vessels in distinct circles around the optic disk. In controls RVD dwindles with increasing distance from the optic disk. RVD decreased significantly with age (p = 0.000). Stroke patients showed significantly lower values of RVD of -15% in comparison to age-matched controls. In old subjects, stroke in combination with hypertension is associated with a significant decreased RVD, and in middle-aged subjects diabetes and stroke are associated with a significant decreased RVD (p = 0.01). Age and stroke are significant risk factors for decreased RVD. Diabetes and arterial hypertension are additional significant risk factors in patients with stroke with respect to RVD. © 2018 S. Karger AG, Basel.

The Python pit organ: imaging and immunocytochemical analysis of an extremely sensitive natural infrared detector.

PubMed

Grace, M S; Church, D R; Kelly, C T; Lynn, W F; Cooper, T M

1999-01-01

The Python infrared-sensitive pit organ is a natural infrared imager that combines high sensitivity, ambient temperature function, microscopic dimensions, and self-repair. We are investigating the spectral sensitivity and signal transduction process in snake infrared-sensitive neurons, neither of which is understood. For example, it is unknown whether infrared receptor neurons function on a thermal or a photic mechanism. We imaged pit organs in living Python molurus and Python regius using infrared-sensitive digital video cameras. Pit organs were significantly more absorptive and/or emissive than surrounding tissues in both 3-5 microns and 8-12 microns wavelength ranges. Pit organs exhibited greater absorption/emissivity in the 8-12 microns range than in the 3-5 microns range. To directly test the relationship between photoreceptors and pit organ infrared-sensitive neurons, we performed immunocytochemistry using antisera directed against retinal photoreceptor opsins. Retinal photoreceptors were labeled with antisera specific for retinal opsins, but these antisera failed to label terminals of infrared-sensitive neurons in the pit organ. Infrared-receptive neurons were also distinguished from retinal photoreceptors on the basis of their calcium-binding protein content. These results indicate that the pit organ absorbs infrared radiation in two major atmospheric transmission windows, one of which (8-12 microns) matches emission of targeted prey, and that infrared receptors are biochemically distinct from retinal photoreceptors. These results also provide the first identification of prospective biochemical components of infrared signal transduction in pit organ receptor neurons.

Digital micromirror device based ophthalmoscope with concentric circle scanning.

PubMed

Damodaran, Mathi; Vienola, Kari V; Braaf, Boy; Vermeer, Koenraad A; de Boer, Johannes F

2017-05-01

Retinal imaging is demonstrated using a novel scanning light ophthalmoscope based on a digital micromirror device with 810 nm illumination. Concentric circles were used as scan patterns, which facilitated fixation by a human subject for imaging. An annular illumination was implemented in the system to reduce the background caused by corneal reflections and thereby to enhance the signal-to-noise ratio. A 1.9-fold increase in the signal-to-noise ratio was found by using an annular illumination aperture compared to a circular illumination aperture, resulting in a 5-fold increase in imaging speed and a better signal-to-noise ratio compared to our previous system. We tested the imaging performance of our system by performing non-mydriatic imaging on two subjects at a speed of 7 Hz with a maximum 20° (diameter) field of view. The images were shot noise limited and clearly show various anatomical features of the retina with high contrast.

Digital micromirror device based ophthalmoscope with concentric circle scanning

PubMed Central

Damodaran, Mathi; Vienola, Kari V.; Braaf, Boy; Vermeer, Koenraad A.; de Boer, Johannes F.

2017-01-01

Retinal imaging is demonstrated using a novel scanning light ophthalmoscope based on a digital micromirror device with 810 nm illumination. Concentric circles were used as scan patterns, which facilitated fixation by a human subject for imaging. An annular illumination was implemented in the system to reduce the background caused by corneal reflections and thereby to enhance the signal-to-noise ratio. A 1.9-fold increase in the signal-to-noise ratio was found by using an annular illumination aperture compared to a circular illumination aperture, resulting in a 5-fold increase in imaging speed and a better signal-to-noise ratio compared to our previous system. We tested the imaging performance of our system by performing non-mydriatic imaging on two subjects at a speed of 7 Hz with a maximum 20° (diameter) field of view. The images were shot noise limited and clearly show various anatomical features of the retina with high contrast. PMID:28663905

Detection of retinal lesions in diabetic retinopathy: comparative evaluation of 7-field digital color photography versus red-free photography.

PubMed

Venkatesh, Pradeep; Sharma, Reetika; Vashist, Nagender; Vohra, Rajpal; Garg, Satpal

2015-10-01

Red-free light allows better detection of vascular lesions as this wavelength is absorbed by hemoglobin; however, the current gold standard for the detection and grading of diabetic retinopathy remains 7-field color fundus photography. The goal of this study was to compare the ability of 7-field fundus photography using red-free light to detect retinopathy lesions with corresponding images captured using standard 7-field color photography. Non-stereoscopic standard 7-field 30° digital color fundus photography and 7-field 30° digital red-free fundus photography were performed in 200 eyes of 103 patients with various grades of diabetic retinopathy ranging from mild to moderate non-proliferative diabetic retinopathy to proliferative diabetic retinopathy. The color images (n = 1,400) were studied with corresponding red-free images (n = 1,400) by one retina consultant (PV) and two senior residents training in retina. The various retinal lesions [microaneurysms, hemorrhages, hard exudates, soft exudates, intra-retinal microvascular anomalies (IRMA), neovascularization of the retina elsewhere (NVE), and neovascularization of the disc (NVD)] detected by all three observers in each of the photographs were noted followed by determination of agreement scores using κ values (range 0-1). Kappa coefficient was categorized as poor (≤0), slight (0.01-0.20), fair (0.2 -0.40), moderate (0.41-0.60), substantial (0.61-0.80), and almost perfect (0.81-1). The number of lesions detected by red-free images alone was higher for all observers and all abnormalities except hard exudates. Detection of IRMA was especially higher for all observers with red-free images. Between image pairs, there was substantial agreement for detection of hard exudates (average κ = 0.62, range 0.60-0.65) and moderate agreement for detection of hemorrhages (average κ = 0.52, range 0.45-0.58), soft exudates (average κ = 0.51, range 0.42-0.61), NVE (average κ = 0.47, range 0.39-0.53), and NVD (average κ = 0.51, range 0.45-0.54). Fair agreement was noted for detection of microaneurysms (average κ = 0.29, range 0.20-0.39) and IRMA (average κ = 0.23, range 0.23-0.24). Inter-observer agreement with color images was substantial for hemorrhages (average κ = 0.72), soft exudates (average κ = 0.65), and NVD (average κ = 0.65); moderate for microaneurysms (average κ = 0.42), NVE (average κ = 0.44), and hard exudates (average κ = 0.59) and fair for IRMA (average κ = 0.21). Inter-observer agreement with red-free images was substantial for hard exudates (average κ = 0.63) and moderate for detection of hemorrhages (average κ = 0.56), SE (average κ = 0.60), IRMA (average κ = 0.50), NVE (average κ = 0.44), and NVD (average κ = 0.45). Digital red-free photography has a higher level of detection ability for all retinal lesions of diabetic retinopathy. More advanced grades of retinopathy are likely to be detected earlier with red-free imaging because of its better ability to detect IRMA, NVE, and NVD. Red-free monochromatic imaging of the retina is a more effective and less costly alternative for detection of vision-threatening diabetic retinopathy.

Comparison of digital imaging screening and indirect ophthalmoscopy for retinopathy of prematurity.

PubMed

Ezz El Din, Zahraa Mohamed; El Sada, Mohamed Ahmed; Ali, Aliaa Adel; Al Husseiny, Khalid; Yousef, Aly Abdel Rahman

2015-01-01

The aims of this study were to determine the incidence and severity of retinopathy of prematurity (ROP) using digital imaging screening, confirm findings by indirect opthalmoscopy, and document risk factors of ROP in the neonatal intensive care unit (NICU) of a large tertiary hospital in a developing country. This prospective cohort study included infants with gestational age (GA) ≤ 32 wk, birth weight (BW) ≤ 1,500 g, or older and heavier neonates who were critically ill. Two hundred twenty two eyes (111 infants) were screened with digital imaging (Ret-Cam) and indirect ophthalmoscopy until retinal vascularization was complete or the disease regressed. Perinatal risk factors for ROP were analyzed. The overall incidence of ROP was 18.9 %. The incidence of ROP requiring treatment was 5.4 % (12/222) of the total eyes screened. Lower GA and blood transfusion were independent risk factors associated with ROP by multivariate analysis (p = 0.001, OR = 0.562, 95 % CI = 0.395-0.802, and p = 0.027, OR = 6.11, 95 % CI = 1.22-30.44, respectively). Digital imaging facilitated timely screening and detection of ROP, and enabled transfer of images, allowing early intervention for patients who required treatment.

Holographic line field en-face OCT with digital adaptive optics in the retina in vivo.

PubMed

Ginner, Laurin; Schmoll, Tilman; Kumar, Abhishek; Salas, Matthias; Pricoupenko, Nastassia; Wurster, Lara M; Leitgeb, Rainer A

2018-02-01

We demonstrate a high-resolution line field en-face time domain optical coherence tomography (OCT) system using an off-axis holography configuration. Line field en-face OCT produces high speed en-face images at rates of up to 100 Hz. The high frame rate favors good phase stability across the lateral field-of-view which is indispensable for digital adaptive optics (DAO). Human retinal structures are acquired in-vivo with a broadband light source at 840 nm, and line rates of 10 kHz to 100 kHz. Structures of different retinal layers, such as photoreceptors, capillaries, and nerve fibers are visualized with high resolution of 2.8 µm and 5.5 µm in lateral directions. Subaperture based DAO is successfully applied to increase the visibility of cone-photoreceptors and nerve fibers. Furthermore, en-face Doppler OCT maps are generated based on calculating the differential phase shifts between recorded lines.

Validation of Smartphone Based Retinal Photography for Diabetic Retinopathy Screening

PubMed Central

Rajalakshmi, Ramachandran; Arulmalar, Subramanian; Usha, Manoharan; Prathiba, Vijayaraghavan; Kareemuddin, Khaji Syed; Anjana, Ranjit Mohan; Mohan, Viswanathan

2015-01-01

Aim To evaluate the sensitivity and specificity of “fundus on phone’ (FOP) camera, a smartphone based retinal imaging system, as a screening tool for diabetic retinopathy (DR) detection and DR severity in comparison with 7-standard field digital retinal photography. Design Single-site, prospective, comparative, instrument validation study. Methods 301 patients (602 eyes) with type 2 diabetes underwent standard seven-field digital fundus photography with both Carl Zeiss fundus camera and indigenous FOP at a tertiary care diabetes centre in South India. Grading of DR was performed by two independent retina specialists using modified Early Treatment of Diabetic Retinopathy Study grading system. Sight threatening DR (STDR) was defined by the presence of proliferative DR(PDR) or diabetic macular edema. The sensitivity, specificity and image quality were assessed. Results The mean age of the participants was 53.5 ±9.6 years and mean duration of diabetes 12.5±7.3 years. The Zeiss camera showed that 43.9% had non-proliferative DR(NPDR) and 15.3% had PDR while the FOP camera showed that 40.2% had NPDR and 15.3% had PDR. The sensitivity and specificity for detecting any DR by FOP was 92.7% (95%CI 87.8–96.1) and 98.4% (95%CI 94.3–99.8) respectively and the kappa (ĸ) agreement was 0.90 (95%CI-0.85–0.95 p<0.001) while for STDR, the sensitivity was 87.9% (95%CI 83.2–92.9), specificity 94.9% (95%CI 89.7–98.2) and ĸ agreement was 0.80 (95%CI 0.71–0.89 p<0.001), compared to conventional photography. Conclusion Retinal photography using FOP camera is effective for screening and diagnosis of DR and STDR with high sensitivity and specificity and has substantial agreement with conventional retinal photography. PMID:26401839

Image analysis of ocular fundus for retinopathy characterization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ushizima, Daniela; Cuadros, Jorge

2010-02-05

Automated analysis of ocular fundus images is a common procedure in countries as England, including both nonemergency examination and retinal screening of patients with diabetes mellitus. This involves digital image capture and transmission of the images to a digital reading center for evaluation and treatment referral. In collaboration with the Optometry Department, University of California, Berkeley, we have tested computer vision algorithms to segment vessels and lesions in ground-truth data (DRIVE database) and hundreds of images of non-macular centric and nonuniform illumination views of the eye fundus from EyePACS program. Methods under investigation involve mathematical morphology (Figure 1) for imagemore » enhancement and pattern matching. Recently, we have focused in more efficient techniques to model the ocular fundus vasculature (Figure 2), using deformable contours. Preliminary results show accurate segmentation of vessels and high level of true-positive microaneurysms.« less

Closed-loop optical stabilization and digital image registration in adaptive optics scanning light ophthalmoscopy

PubMed Central

Yang, Qiang; Zhang, Jie; Nozato, Koji; Saito, Kenichi; Williams, David R.; Roorda, Austin; Rossi, Ethan A.

2014-01-01

Eye motion is a major impediment to the efficient acquisition of high resolution retinal images with the adaptive optics (AO) scanning light ophthalmoscope (AOSLO). Here we demonstrate a solution to this problem by implementing both optical stabilization and digital image registration in an AOSLO. We replaced the slow scanning mirror with a two-axis tip/tilt mirror for the dual functions of slow scanning and optical stabilization. Closed-loop optical stabilization reduced the amplitude of eye-movement related-image motion by a factor of 10–15. The residual RMS error after optical stabilization alone was on the order of the size of foveal cones: ~1.66–2.56 μm or ~0.34–0.53 arcmin with typical fixational eye motion for normal observers. The full implementation, with real-time digital image registration, corrected the residual eye motion after optical stabilization with an accuracy of ~0.20–0.25 μm or ~0.04–0.05 arcmin RMS, which to our knowledge is more accurate than any method previously reported. PMID:25401030

Modulation of Retinal Arteriolar Central Reflection by APOE Genotype.

PubMed

Frost, Shaun; Bhuiyan, Alauddin; Offerman, David; Doecke, James D; Macaulay, S Lance; Sohrabi, Hamid R; Ames, David; Masters, Colin; Martins, Ralph N; Kanagasingam, Yogesan; Group, Aibl Research

2017-01-01

This study investigated the retinal arteriolar central reflex (CR, the central reflection observed in photographs of retinal vessels), which may provide information about micro-vascular health in the retina and also the brain, due to the homology between these vascular networks. The study also describes a novel computer based semi-automated technique that accurately quantifies retinal arteriolar CR and vessel width, and calculates the CR to vessel width ratio (CRR) from digital retinal photographs. Digital retinal photographs were collected from participants in the Australian Imaging, Biomarkers and Lifestyle study of ageing (AIBL), including 25 participants diagnosed with Alzheimer's disease (AD) (age 72.4 ± 7.5 yrs, 12 male, 13 female) and 123 elderly participants without dementia (cognitively normals: CN) (age 71.6 ± 5.6 yrs, 55 male, 68 female). Using a sub-cohort of 144 (22 AD, 122 CN) with the novel CRR measures, we identified significantly higher CRR levels in AD participants (mean CRR 0.253 (SD 0.04)) as compared with CN's (mean CRR 0.231 (SD 0.04), p = 0.025). Adjustment for APOE ε4 allele status however, reduced the significance (p = 0.081). CRR was significantly higher in APOE ε4 allele carriers (mean CRR 0.254 (SD 0.03) as compared with non-carriers (mean CRR 0.224 (SD 0.05), p < 0.0001). These data indicate that CRR is strongly linked to APOE ε4 status and exhibits a weaker, independent trend with AD diagnosis. The retina may be useful as a novel model for non-invasive monitoring of the effects of APOE ε4 on the central nervous system, particularly in cerebrovascular disease. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Analysis of normal human retinal vascular network architecture using multifractal geometry

PubMed Central

Ţălu, Ştefan; Stach, Sebastian; Călugăru, Dan Mihai; Lupaşcu, Carmen Alina; Nicoară, Simona Delia

2017-01-01

AIM To apply the multifractal analysis method as a quantitative approach to a comprehensive description of the microvascular network architecture of the normal human retina. METHODS Fifty volunteers were enrolled in this study in the Ophthalmological Clinic of Cluj-Napoca, Romania, between January 2012 and January 2014. A set of 100 segmented and skeletonised human retinal images, corresponding to normal states of the retina were studied. An automatic unsupervised method for retinal vessel segmentation was applied before multifractal analysis. The multifractal analysis of digital retinal images was made with computer algorithms, applying the standard box-counting method. Statistical analyses were performed using the GraphPad InStat software. RESULTS The architecture of normal human retinal microvascular network was able to be described using the multifractal geometry. The average of generalized dimensions (Dq) for q=0, 1, 2, the width of the multifractal spectrum (Δα=αmax − αmin) and the spectrum arms' heights difference (|Δf|) of the normal images were expressed as mean±standard deviation (SD): for segmented versions, D0=1.7014±0.0057; D1=1.6507±0.0058; D2=1.5772±0.0059; Δα=0.92441±0.0085; |Δf|= 0.1453±0.0051; for skeletonised versions, D0=1.6303±0.0051; D1=1.6012±0.0059; D2=1.5531±0.0058; Δα=0.65032±0.0162; |Δf|= 0.0238±0.0161. The average of generalized dimensions (Dq) for q=0, 1, 2, the width of the multifractal spectrum (Δα) and the spectrum arms' heights difference (|Δf|) of the segmented versions was slightly greater than the skeletonised versions. CONCLUSION The multifractal analysis of fundus photographs may be used as a quantitative parameter for the evaluation of the complex three-dimensional structure of the retinal microvasculature as a potential marker for early detection of topological changes associated with retinal diseases. PMID:28393036

Clinical Validation of a Smartphone-Based Adapter for Optic Disc Imaging in Kenya.

PubMed

Bastawrous, Andrew; Giardini, Mario Ettore; Bolster, Nigel M; Peto, Tunde; Shah, Nisha; Livingstone, Iain A T; Weiss, Helen A; Hu, Sen; Rono, Hillary; Kuper, Hannah; Burton, Matthew

2016-02-01

Visualization and interpretation of the optic nerve and retina are essential parts of most physical examinations. To design and validate a smartphone-based retinal adapter enabling image capture and remote grading of the retina. This validation study compared the grading of optic nerves from smartphone images with those of a digital retinal camera. Both image sets were independently graded at Moorfields Eye Hospital Reading Centre. Nested within the 6-year follow-up (January 7, 2013, to March 12, 2014) of the Nakuru Eye Disease Cohort in Kenya, 1460 adults (2920 eyes) 55 years and older were recruited consecutively from the study. A subset of 100 optic disc images from both methods were further used to validate a grading app for the optic nerves. Data analysis was performed April 7 to April 12, 2015. Vertical cup-disc ratio for each test was compared in terms of agreement (Bland-Altman and weighted κ) and test-retest variability. A total of 2152 optic nerve images were available from both methods (also 371 from the reference camera but not the smartphone, 170 from the smartphone but not the reference camera, and 227 from neither the reference camera nor the smartphone). Bland-Altman analysis revealed a mean difference of 0.02 (95% CI, -0.21 to 0.17) and a weighted κ coefficient of 0.69 (excellent agreement). The grades of an experienced retinal photographer were compared with those of a lay photographer (no health care experience before the study), and no observable difference in image acquisition quality was found. Nonclinical photographers using the low-cost smartphone adapter were able to acquire optic nerve images at a standard that enabled independent remote grading of the images comparable to those acquired using a desktop retinal camera operated by an ophthalmic assistant. The potential for task shifting and the detection of avoidable causes of blindness in the most at-risk communities makes this an attractive public health intervention.

Retinal identification based on an Improved Circular Gabor Filter and Scale Invariant Feature Transform.

PubMed

Meng, Xianjing; Yin, Yilong; Yang, Gongping; Xi, Xiaoming

2013-07-18

Retinal identification based on retinal vasculatures in the retina provides the most secure and accurate means of authentication among biometrics and has primarily been used in combination with access control systems at high security facilities. Recently, there has been much interest in retina identification. As digital retina images always suffer from deformations, the Scale Invariant Feature Transform (SIFT), which is known for its distinctiveness and invariance for scale and rotation, has been introduced to retinal based identification. However, some shortcomings like the difficulty of feature extraction and mismatching exist in SIFT-based identification. To solve these problems, a novel preprocessing method based on the Improved Circular Gabor Transform (ICGF) is proposed. After further processing by the iterated spatial anisotropic smooth method, the number of uninformative SIFT keypoints is decreased dramatically. Tested on the VARIA and eight simulated retina databases combining rotation and scaling, the developed method presents promising results and shows robustness to rotations and scale changes.

Retinal Identification Based on an Improved Circular Gabor Filter and Scale Invariant Feature Transform

PubMed Central

Meng, Xianjing; Yin, Yilong; Yang, Gongping; Xi, Xiaoming

2013-01-01

Retinal identification based on retinal vasculatures in the retina provides the most secure and accurate means of authentication among biometrics and has primarily been used in combination with access control systems at high security facilities. Recently, there has been much interest in retina identification. As digital retina images always suffer from deformations, the Scale Invariant Feature Transform (SIFT), which is known for its distinctiveness and invariance for scale and rotation, has been introduced to retinal based identification. However, some shortcomings like the difficulty of feature extraction and mismatching exist in SIFT-based identification. To solve these problems, a novel preprocessing method based on the Improved Circular Gabor Transform (ICGF) is proposed. After further processing by the iterated spatial anisotropic smooth method, the number of uninformative SIFT keypoints is decreased dramatically. Tested on the VARIA and eight simulated retina databases combining rotation and scaling, the developed method presents promising results and shows robustness to rotations and scale changes. PMID:23873409

Automatic screening and classification of diabetic retinopathy and maculopathy using fuzzy image processing.

PubMed

Rahim, Sarni Suhaila; Palade, Vasile; Shuttleworth, James; Jayne, Chrisina

2016-12-01

Digital retinal imaging is a challenging screening method for which effective, robust and cost-effective approaches are still to be developed. Regular screening for diabetic retinopathy and diabetic maculopathy diseases is necessary in order to identify the group at risk of visual impairment. This paper presents a novel automatic detection of diabetic retinopathy and maculopathy in eye fundus images by employing fuzzy image processing techniques. The paper first introduces the existing systems for diabetic retinopathy screening, with an emphasis on the maculopathy detection methods. The proposed medical decision support system consists of four parts, namely: image acquisition, image preprocessing including four retinal structures localisation, feature extraction and the classification of diabetic retinopathy and maculopathy. A combination of fuzzy image processing techniques, the Circular Hough Transform and several feature extraction methods are implemented in the proposed system. The paper also presents a novel technique for the macula region localisation in order to detect the maculopathy. In addition to the proposed detection system, the paper highlights a novel online dataset and it presents the dataset collection, the expert diagnosis process and the advantages of our online database compared to other public eye fundus image databases for diabetic retinopathy purposes.

Obtaining optic disc center and pixel region by automatic thresholding methods on morphologically processed fundus images.

PubMed

Marin, Diego; Gegundez-Arias, Manuel E; Suero, Angel; Bravo, Jose M

2015-02-01

Development of automatic retinal disease diagnosis systems based on retinal image computer analysis can provide remarkably quicker screening programs for early detection. Such systems are mainly focused on the detection of the earliest ophthalmic signs of illness and require previous identification of fundal landmark features such as optic disc (OD), fovea or blood vessels. A methodology for accurate center-position location and OD retinal region segmentation on digital fundus images is presented in this paper. The methodology performs a set of iterative opening-closing morphological operations on the original retinography intensity channel to produce a bright region-enhanced image. Taking blood vessel confluence at the OD into account, a 2-step automatic thresholding procedure is then applied to obtain a reduced region of interest, where the center and the OD pixel region are finally obtained by performing the circular Hough transform on a set of OD boundary candidates generated through the application of the Prewitt edge detector. The methodology was evaluated on 1200 and 1748 fundus images from the publicly available MESSIDOR and MESSIDOR-2 databases, acquired from diabetic patients and thus being clinical cases of interest within the framework of automated diagnosis of retinal diseases associated to diabetes mellitus. This methodology proved highly accurate in OD-center location: average Euclidean distance between the methodology-provided and actual OD-center position was 6.08, 9.22 and 9.72 pixels for retinas of 910, 1380 and 1455 pixels in size, respectively. On the other hand, OD segmentation evaluation was performed in terms of Jaccard and Dice coefficients, as well as the mean average distance between estimated and actual OD boundaries. Comparison with the results reported by other reviewed OD segmentation methodologies shows our proposal renders better overall performance. Its effectiveness and robustness make this proposed automated OD location and segmentation method a suitable tool to be integrated into a complete prescreening system for early diagnosis of retinal diseases. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

An exudate detection method for diagnosis risk of diabetic macular edema in retinal images using feature-based and supervised classification.

PubMed

Marin, D; Gegundez-Arias, M E; Ponte, B; Alvarez, F; Garrido, J; Ortega, C; Vasallo, M J; Bravo, J M

2018-01-10

The present paper aims at presenting the methodology and first results of a detection system of risk of diabetic macular edema (DME) in fundus images. The system is based on the detection of retinal exudates (Ex), whose presence in the image is clinically used for an early diagnosis of the disease. To do so, the system applies digital image processing algorithms to the retinal image in order to obtain a set of candidate regions to be Ex, which are validated by means of feature extraction and supervised classification techniques. The diagnoses provided by the system on 1058 retinographies of 529 diabetic patients at risk of having DME show that the system can operate at a level of sensitivity comparable to that of ophthalmological specialists: it achieved 0.9000 sensitivity per patient against 0.7733, 0.9133 and 0.9000 of several specialists, where the false negatives were mild clinical cases of the disease. In addition, the level of specificity reached by the system was 0.6939, high enough to screen about 70% of the patients with no evidence of DME. These values show that the system fulfils the requirements for its possible integration into a complete diabetic retinopathy pre-screening tool for the automated management of patients within a screening programme. Graphical Abstract Diagnosis system of risk of diabetic macular edema (DME) based on exudate (Ex) detection in fundus images.

Retinal oxygen saturation evaluation by multi-spectral fundus imaging

NASA Astrophysics Data System (ADS)

Khoobehi, Bahram; Ning, Jinfeng; Puissegur, Elise; Bordeaux, Kimberly; Balasubramanian, Madhusudhanan; Beach, James

2007-03-01

Purpose: To develop a multi-spectral method to measure oxygen saturation of the retina in the human eye. Methods: Five Cynomolgus monkeys with normal eyes were anesthetized with intramuscular ketamine/xylazine and intravenous pentobarbital. Multi-spectral fundus imaging was performed in five monkeys with a commercial fundus camera equipped with a liquid crystal tuned filter in the illumination light path and a 16-bit digital camera. Recording parameters were controlled with software written specifically for the application. Seven images at successively longer oxygen-sensing wavelengths were recorded within 4 seconds. Individual images for each wavelength were captured in less than 100 msec of flash illumination. Slightly misaligned images of separate wavelengths due to slight eye motion were registered and corrected by translational and rotational image registration prior to analysis. Numerical values of relative oxygen saturation of retinal arteries and veins and the underlying tissue in between the artery/vein pairs were evaluated by an algorithm previously described, but which is now corrected for blood volume from averaged pixels (n > 1000). Color saturation maps were constructed by applying the algorithm at each image pixel using a Matlab script. Results: Both the numerical values of relative oxygen saturation and the saturation maps correspond to the physiological condition, that is, in a normal retina, the artery is more saturated than the tissue and the tissue is more saturated than the vein. With the multi-spectral fundus camera and proper registration of the multi-wavelength images, we were able to determine oxygen saturation in the primate retinal structures on a tolerable time scale which is applicable to human subjects. Conclusions: Seven wavelength multi-spectral imagery can be used to measure oxygen saturation in retinal artery, vein, and tissue (microcirculation). This technique is safe and can be used to monitor oxygen uptake in humans. This work is original and is not under consideration for publication elsewhere.

DR HAGIS-a fundus image database for the automatic extraction of retinal surface vessels from diabetic patients.

PubMed

Holm, Sven; Russell, Greg; Nourrit, Vincent; McLoughlin, Niall

2017-01-01

A database of retinal fundus images, the DR HAGIS database, is presented. This database consists of 39 high-resolution color fundus images obtained from a diabetic retinopathy screening program in the UK. The NHS screening program uses service providers that employ different fundus and digital cameras. This results in a range of different image sizes and resolutions. Furthermore, patients enrolled in such programs often display other comorbidities in addition to diabetes. Therefore, in an effort to replicate the normal range of images examined by grading experts during screening, the DR HAGIS database consists of images of varying image sizes and resolutions and four comorbidity subgroups: collectively defined as the diabetic retinopathy, hypertension, age-related macular degeneration, and Glaucoma image set (DR HAGIS). For each image, the vasculature has been manually segmented to provide a realistic set of images on which to test automatic vessel extraction algorithms. Modified versions of two previously published vessel extraction algorithms were applied to this database to provide some baseline measurements. A method based purely on the intensity of images pixels resulted in a mean segmentation accuracy of 95.83% ([Formula: see text]), whereas an algorithm based on Gabor filters generated an accuracy of 95.71% ([Formula: see text]).

Deblurring adaptive optics retinal images using deep convolutional neural networks.

PubMed

Fei, Xiao; Zhao, Junlei; Zhao, Haoxin; Yun, Dai; Zhang, Yudong

2017-12-01

The adaptive optics (AO) can be used to compensate for ocular aberrations to achieve near diffraction limited high-resolution retinal images. However, many factors such as the limited aberration measurement and correction accuracy with AO, intraocular scatter, imaging noise and so on will degrade the quality of retinal images. Image post processing is an indispensable and economical method to make up for the limitation of AO retinal imaging procedure. In this paper, we proposed a deep learning method to restore the degraded retinal images for the first time. The method directly learned an end-to-end mapping between the blurred and restored retinal images. The mapping was represented as a deep convolutional neural network that was trained to output high-quality images directly from blurry inputs without any preprocessing. This network was validated on synthetically generated retinal images as well as real AO retinal images. The assessment of the restored retinal images demonstrated that the image quality had been significantly improved.

Deblurring adaptive optics retinal images using deep convolutional neural networks

PubMed Central

Fei, Xiao; Zhao, Junlei; Zhao, Haoxin; Yun, Dai; Zhang, Yudong

2017-01-01

The adaptive optics (AO) can be used to compensate for ocular aberrations to achieve near diffraction limited high-resolution retinal images. However, many factors such as the limited aberration measurement and correction accuracy with AO, intraocular scatter, imaging noise and so on will degrade the quality of retinal images. Image post processing is an indispensable and economical method to make up for the limitation of AO retinal imaging procedure. In this paper, we proposed a deep learning method to restore the degraded retinal images for the first time. The method directly learned an end-to-end mapping between the blurred and restored retinal images. The mapping was represented as a deep convolutional neural network that was trained to output high-quality images directly from blurry inputs without any preprocessing. This network was validated on synthetically generated retinal images as well as real AO retinal images. The assessment of the restored retinal images demonstrated that the image quality had been significantly improved. PMID:29296496

Infrared-laser-based fundus angiography

NASA Astrophysics Data System (ADS)

Klingbeil, Ulrich; Canter, Joseph M.; Lesiecki, Michael L.; Reichel, Elias

1994-06-01

Infrared fundus angiography, using the fluorescent dye indocyanine green (ICG), has shown great potential in delineating choroidal neovascularization (CNV) otherwise not detectable. A digital retinal imaging system containing a diode laser for illumination has been developed and optimized to perform high sensitivity ICG angiography. The system requires less power and generates less pseudo-fluorescence background than nonlaser devices. During clinical evaluation at three retinal centers more than 200 patients, the majority of which had age-related macular degeneration, were analyzed. Laser based ICG angiography was successful in outlining many of the ill-defined or obscure CNV as defined by fluorescein angiography. The procedure was not as successful with classic CNV. ICG angiograms were used to prepare and guide laser treatment.

Novel algorithm by low complexity filter on retinal vessel segmentation

NASA Astrophysics Data System (ADS)

Rostampour, Samad

2011-10-01

This article shows a new method to detect blood vessels in the retina by digital images. Retinal vessel segmentation is important for detection of side effect of diabetic disease, because diabetes can form new capillaries which are very brittle. The research has been done in two phases: preprocessing and processing. Preprocessing phase consists to apply a new filter that produces a suitable output. It shows vessels in dark color on white background and make a good difference between vessels and background. The complexity is very low and extra images are eliminated. The second phase is processing and used the method is called Bayesian. It is a built-in in supervision classification method. This method uses of mean and variance of intensity of pixels for calculate of probability. Finally Pixels of image are divided into two classes: vessels and background. Used images are related to the DRIVE database. After performing this operation, the calculation gives 95 percent of efficiency average. The method also was performed from an external sample DRIVE database which has retinopathy, and perfect result was obtained

Digital Quantification of Goldmann Visual Fields (GVF) as a Means for Genotype-Phenotype Comparisons and Detection of Progression in Retinal Degenerations

PubMed Central

Zahid, Sarwar; Peeler, Crandall; Khan, Naheed; Davis, Joy; Mahmood, Mahdi; Heckenlively, John; Jayasundera, Thiran

2015-01-01

Purpose To develop a reliable and efficient digital method to quantify planimetric Goldmann visual field (GVF) data to monitor disease course and treatment responses in retinal degenerative diseases. Methods A novel method to digitally quantify GVF using Adobe Photoshop CS3 was developed for comparison to traditional digital planimetry (Placom 45C digital planimeter; EngineerSupply, Lynchburg, Virginia, USA). GVFs from 20 eyes from 10 patients with Stargardt disease were quantified to assess the difference between the two methods (a total of 230 measurements per method). This quantification approach was also applied to 13 patients with X-linked retinitis pigmentosa (XLRP) with mutations in RPGR. Results Overall, measurements using Adobe Photoshop were more rapidly performed than those using conventional planimetry. Photoshop measurements also exhibited less inter- and intra-observer variability. GVF areas for the I4e isopter in patients with the same mutation in RPGR who were nearby in age had similar qualitative and quantitative areas. Conclusions Quantification of GVF using Adobe Photoshop is quicker, more reliable, and less-user dependent than conventional digital planimetry. It will be a useful tool for both retrospective and prospective studies of disease course as well as for monitoring treatment response in clinical trials for retinal degenerative diseases. PMID:24664690

Digital quantification of Goldmann visual fields (GVFs) as a means for genotype-phenotype comparisons and detection of progression in retinal degenerations.

PubMed

Zahid, Sarwar; Peeler, Crandall; Khan, Naheed; Davis, Joy; Mahmood, Mahdi; Heckenlively, John R; Jayasundera, Thiran

2014-01-01

To develop a reliable and efficient digital method to quantify planimetric Goldmann visual field (GVF) data to monitor disease course and treatment responses in retinal degenerative diseases. A novel method to digitally quantify GVFs using Adobe Photoshop CS3 was developed for comparison to traditional digital planimetry (Placom 45C digital planimeter; Engineer Supply, Lynchburg, Virginia, USA). GVFs from 20 eyes from 10 patients with Stargardt disease were quantified to assess the difference between the two methods (a total of 230 measurements per method). This quantification approach was also applied to 13 patients with X-linked retinitis pigmentosa (XLRP) with mutations in RPGR. Overall, measurements using Adobe Photoshop were more rapidly performed than those using conventional planimetry. Photoshop measurements also exhibited less inter- and intraobserver variability. GVF areas for the I4e isopter in patients with the same mutation in RPGR who were nearby in age had similar qualitative and quantitative areas. Quantification of GVFs using Adobe Photoshop is quicker, more reliable, and less user dependent than conventional digital planimetry. It will be a useful tool for both retrospective and prospective studies of disease course as well as for monitoring treatment response in clinical trials for retinal degenerative diseases.

Optic disc detection and boundary extraction in retinal images.

PubMed

Basit, A; Fraz, Muhammad Moazam

2015-04-10

With the development of digital image processing, analysis and modeling techniques, automatic retinal image analysis is emerging as an important screening tool for early detection of ophthalmologic disorders such as diabetic retinopathy and glaucoma. In this paper, a robust method for optic disc detection and extraction of the optic disc boundary is proposed to help in the development of computer-assisted diagnosis and treatment of such ophthalmic disease. The proposed method is based on morphological operations, smoothing filters, and the marker controlled watershed transform. Internal and external markers are used to first modify the gradient magnitude image and then the watershed transformation is applied on this modified gradient magnitude image for boundary extraction. This method has shown significant improvement over existing methods in terms of detection and boundary extraction of the optic disc. The proposed method has optic disc detection success rate of 100%, 100%, 100% and 98.9% for the DRIVE, Shifa, CHASE_DB1, and DIARETDB1 databases, respectively. The optic disc boundary detection achieved an average spatial overlap of 61.88%, 70.96%, 45.61%, and 54.69% for these databases, respectively, which are higher than currents methods.

Digital ocular fundus imaging: a review.

PubMed

Bernardes, Rui; Serranho, Pedro; Lobo, Conceição

2011-01-01

Ocular fundus imaging plays a key role in monitoring the health status of the human eye. Currently, a large number of imaging modalities allow the assessment and/or quantification of ocular changes from a healthy status. This review focuses on the main digital fundus imaging modality, color fundus photography, with a brief overview of complementary techniques, such as fluorescein angiography. While focusing on two-dimensional color fundus photography, the authors address the evolution from nondigital to digital imaging and its impact on diagnosis. They also compare several studies performed along the transitional path of this technology. Retinal image processing and analysis, automated disease detection and identification of the stage of diabetic retinopathy (DR) are addressed as well. The authors emphasize the problems of image segmentation, focusing on the major landmark structures of the ocular fundus: the vascular network, optic disk and the fovea. Several proposed approaches for the automatic detection of signs of disease onset and progression, such as microaneurysms, are surveyed. A thorough comparison is conducted among different studies with regard to the number of eyes/subjects, imaging modality, fundus camera used, field of view and image resolution to identify the large variation in characteristics from one study to another. Similarly, the main features of the proposed classifications and algorithms for the automatic detection of DR are compared, thereby addressing computer-aided diagnosis and computer-aided detection for use in screening programs. Copyright © 2011 S. Karger AG, Basel.

Evaluation of web-based annotation of ophthalmic images for multicentric clinical trials.

PubMed

Chalam, K V; Jain, P; Shah, V A; Shah, Gaurav Y

2006-06-01

An Internet browser-based annotation system can be used to identify and describe features in digitalized retinal images, in multicentric clinical trials, in real time. In this web-based annotation system, the user employs a mouse to draw and create annotations on a transparent layer, that encapsulates the observations and interpretations of a specific image. Multiple annotation layers may be overlaid on a single image. These layers may correspond to annotations by different users on the same image or annotations of a temporal sequence of images of a disease process, over a period of time. In addition, geometrical properties of annotated figures may be computed and measured. The annotations are stored in a central repository database on a server, which can be retrieved by multiple users in real time. This system facilitates objective evaluation of digital images and comparison of double-blind readings of digital photographs, with an identifiable audit trail. Annotation of ophthalmic images allowed clinically feasible and useful interpretation to track properties of an area of fundus pathology. This provided an objective method to monitor properties of pathologies over time, an essential component of multicentric clinical trials. The annotation system also allowed users to view stereoscopic images that are stereo pairs. This web-based annotation system is useful and valuable in monitoring patient care, in multicentric clinical trials, telemedicine, teaching and routine clinical settings.

Evaluation of the Retinal Vasculature in Hypertension and Chronic Kidney Disease in an Elderly Population of Irish Nuns.

PubMed

McGowan, Amy; Silvestri, Giuliana; Moore, Evelyn; Silvestri, Vittorio; Patterson, Christopher C; Maxwell, Alexander P; McKay, Gareth J

2015-01-01

Chronic kidney disease (CKD) and hypertension are global public health problems associated with considerable morbidity, premature mortality and attendant healthcare costs. Previous studies have highlighted that non-invasive examination of the retinal microcirculation can detect microvascular pathology that is associated with systemic disorders of the circulatory system such as hypertension. We examined the associations between retinal vessel caliber (RVC) and fractal dimension (DF), with both hypertension and CKD in elderly Irish nuns. Data from 1233 participants in the cross-sectional observational Irish Nun Eye Study (INES) were assessed from digital photographs with a standardized protocol using computer-assisted software. Multivariate regression analyses were used to assess associations with hypertension and CKD, with adjustment for age, body mass index (BMI), refraction, fellow eye RVC, smoking, alcohol consumption, ischemic heart disease (IHD), cerebrovascular accident (CVA), diabetes and medication use. In total, 1122 (91%) participants (mean age: 76.3 [range: 56-100] years) had gradable retinal images of sufficient quality for blood vessel assessment. Hypertension was significantly associated with a narrower central retinal arteriolar equivalent (CRAE) in a fully adjusted analysis (P = 0.002; effect size = -2.16 μm; 95% confidence intervals [CI]: -3.51, -0.81 μm). No significant associations between other retinal vascular parameters and hypertension or between any retinal vascular parameters and CKD were found. Individuals with hypertension have significantly narrower retinal arterioles which may afford an earlier opportunity for tailored prevention and treatment options to optimize the structure and function of the microvasculature, providing additional clinical utility. No significant associations between retinal vascular parameters and CKD were detected.

Paracentral acute middle maculopathy in nonischemic central retinal vein occlusion.

PubMed

Rahimy, Ehsan; Sarraf, David; Dollin, Michael L; Pitcher, John D; Ho, Allen C

2014-08-01

To better characterize a novel spectral-domain optical coherence tomography (OCT) presentation, termed paracentral acute middle maculopathy, to describe this finding in patients with nonischemic central retinal vein occlusion (CRVO), and to support a proposed pathogenesis of intermediate and deep retinal capillary ischemia. Retrospective observational case series. Clinical histories, high-resolution digital color imaging, red-free photography, fluorescein angiography, near-infrared reflectance, and spectral-domain OCT images of 484 patients with acute CRVO from 2 centers were evaluated for the presence of coexisting paracentral acute middle maculopathy. Of 484 patients diagnosed with CRVO, 25 (5.2%) demonstrated evidence of concurrent paracentral acute middle maculopathy. Patients averaged 51 years of age and presented with complaints of paracentral scotomas. All patients demonstrated hyper-reflective plaquelike lesions at the level of the inner nuclear layer by spectral-domain OCT and showed corresponding dark-gray lesions on near-infrared reflectance and perivenular deep retinal whitening on color fundus photography. There was no fluorescein angiographic correlate to these lesions. On follow-up spectral-domain OCT imaging, the lesions had resolved into areas of inner nuclear layer atrophy with persistence of scotomas. Paracentral acute middle maculopathy refers to characteristic hyper-reflective spectral-domain OCT lesions involving the middle layers of the retina at the level of the inner nuclear layer that may develop in response to ischemia of the intermediate and deep capillary plexuses. This series is the largest to describe this spectral-domain OCT finding to date, and it is the first to associate it with nonischemic CRVO. Copyright © 2014 Elsevier Inc. All rights reserved.

Snapshot hyperspectral retinal imaging using compact spectral resolving detector array.

PubMed

Li, Hao; Liu, Wenzhong; Dong, Biqin; Kaluzny, Joel V; Fawzi, Amani A; Zhang, Hao F

2017-06-01

Hyperspectral retinal imaging captures the light spectrum from each imaging pixel. It provides spectrally encoded retinal physiological and morphological information, which could potentially benefit diagnosis and therapeutic monitoring of retinal diseases. The key challenges in hyperspectral retinal imaging are how to achieve snapshot imaging to avoid motions between the images from multiple spectral bands, and how to design a compact snapshot imager suitable for clinical use. Here, we developed a compact, snapshot hyperspectral fundus camera for rodents using a novel spectral resolving detector array (SRDA), on which a thin-film Fabry-Perot cavity filter was monolithically fabricated on each imaging pixel. We achieved hyperspectral retinal imaging with 16 wavelength bands (460 to 630 nm) at 20 fps. We also demonstrated false-color vessel contrast enhancement and retinal oxygen saturation (sO 2 ) measurement through spectral analysis. This work could potentially bring hyperspectral retinal imaging from bench to bedside. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Computer-Assisted Digital Image Analysis of Plus Disease in Retinopathy of Prematurity.

PubMed

Kemp, Pavlina S; VanderVeen, Deborah K

2016-01-01

The objective of this study is to review the current state and role of computer-assisted analysis in diagnosis of plus disease in retinopathy of prematurity. Diagnosis and documentation of retinopathy of prematurity are increasingly being supplemented by digital imaging. The incorporation of computer-aided techniques has the potential to add valuable information and standardization regarding the presence of plus disease, an important criterion in deciding the necessity of treatment of vision-threatening retinopathy of prematurity. A review of literature found that several techniques have been published examining the process and role of computer aided analysis of plus disease in retinopathy of prematurity. These techniques use semiautomated image analysis techniques to evaluate retinal vascular dilation and tortuosity, using calculated parameters to evaluate presence or absence of plus disease. These values are then compared with expert consensus. The study concludes that computer-aided image analysis has the potential to use quantitative and objective criteria to act as a supplemental tool in evaluating for plus disease in the setting of retinopathy of prematurity.

Retinal imaging and image analysis.

PubMed

Abràmoff, Michael D; Garvin, Mona K; Sonka, Milan

2010-01-01

Many important eye diseases as well as systemic diseases manifest themselves in the retina. While a number of other anatomical structures contribute to the process of vision, this review focuses on retinal imaging and image analysis. Following a brief overview of the most prevalent causes of blindness in the industrialized world that includes age-related macular degeneration, diabetic retinopathy, and glaucoma, the review is devoted to retinal imaging and image analysis methods and their clinical implications. Methods for 2-D fundus imaging and techniques for 3-D optical coherence tomography (OCT) imaging are reviewed. Special attention is given to quantitative techniques for analysis of fundus photographs with a focus on clinically relevant assessment of retinal vasculature, identification of retinal lesions, assessment of optic nerve head (ONH) shape, building retinal atlases, and to automated methods for population screening for retinal diseases. A separate section is devoted to 3-D analysis of OCT images, describing methods for segmentation and analysis of retinal layers, retinal vasculature, and 2-D/3-D detection of symptomatic exudate-associated derangements, as well as to OCT-based analysis of ONH morphology and shape. Throughout the paper, aspects of image acquisition, image analysis, and clinical relevance are treated together considering their mutually interlinked relationships.

Retinal Imaging and Image Analysis

PubMed Central

Abràmoff, Michael D.; Garvin, Mona K.; Sonka, Milan

2011-01-01

Many important eye diseases as well as systemic diseases manifest themselves in the retina. While a number of other anatomical structures contribute to the process of vision, this review focuses on retinal imaging and image analysis. Following a brief overview of the most prevalent causes of blindness in the industrialized world that includes age-related macular degeneration, diabetic retinopathy, and glaucoma, the review is devoted to retinal imaging and image analysis methods and their clinical implications. Methods for 2-D fundus imaging and techniques for 3-D optical coherence tomography (OCT) imaging are reviewed. Special attention is given to quantitative techniques for analysis of fundus photographs with a focus on clinically relevant assessment of retinal vasculature, identification of retinal lesions, assessment of optic nerve head (ONH) shape, building retinal atlases, and to automated methods for population screening for retinal diseases. A separate section is devoted to 3-D analysis of OCT images, describing methods for segmentation and analysis of retinal layers, retinal vasculature, and 2-D/3-D detection of symptomatic exudate-associated derangements, as well as to OCT-based analysis of ONH morphology and shape. Throughout the paper, aspects of image acquisition, image analysis, and clinical relevance are treated together considering their mutually interlinked relationships. PMID:22275207

The New Pretender: A Large UK Case Series of Retinal Injuries in Children Secondary to Handheld Lasers.

PubMed

Raoof, Naz; Bradley, Patrick; Theodorou, Maria; Moore, Anthony T; Michaelides, Michel

2016-11-01

To characterize a large single-center series of retinal injuries in children secondary to handheld laser devices, with emphasis on potential prognostic factors. Retrospective case series. Sixteen children (24 eyes) with retinal injuries secondary to handheld lasers were identified from our electronic patient record system. Case notes, digital fundus photography, and spectral-domain optical coherence tomography images were reviewed. The mean age of affected children was 12.7 years (range 9-16 years), with 12 male and 4 female subjects. Mean follow up was 5.4 months (range 1-23 months). Five children (31%) were referred as suspected retinal dystrophies. The mean logMAR visual acuity at presentation was 0.30 (20/40) (range -0.20 [20/12.5] to 1.6 [20/800]). Eleven children (69%; 15 eyes) had "mild" injuries with focal retinal disruption confined to the photoreceptor and ellipsoid layers; such injuries were associated with a better prognosis, the mean visual acuity at presentation being 0.10 (20/25). "Moderate" injuries were seen in 3 eyes of 2 children, with retinal disruption confined to the outer retinal layer but diffuse rather than focal in nature. Three patients (4 eyes) had "severe" injuries, with subfoveal outer retinal architecture loss and overlying hyperreflective material in inner retinal layers. Retinal injuries secondary to handheld laser devices may be difficult to diagnose and are likely underreported. It is important that such data are in the public domain, so regulatory authorities recognize the importance of laser retinopathy as an avoidable cause of childhood visual impairment and take steps to minimize the incidence and impact of laser injuries. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

A survey on deep learning in medical image analysis.

PubMed

Litjens, Geert; Kooi, Thijs; Bejnordi, Babak Ehteshami; Setio, Arnaud Arindra Adiyoso; Ciompi, Francesco; Ghafoorian, Mohsen; van der Laak, Jeroen A W M; van Ginneken, Bram; Sánchez, Clara I

2017-12-01

Deep learning algorithms, in particular convolutional networks, have rapidly become a methodology of choice for analyzing medical images. This paper reviews the major deep learning concepts pertinent to medical image analysis and summarizes over 300 contributions to the field, most of which appeared in the last year. We survey the use of deep learning for image classification, object detection, segmentation, registration, and other tasks. Concise overviews are provided of studies per application area: neuro, retinal, pulmonary, digital pathology, breast, cardiac, abdominal, musculoskeletal. We end with a summary of the current state-of-the-art, a critical discussion of open challenges and directions for future research. Copyright © 2017 Elsevier B.V. All rights reserved.

MULTIMODAL IMAGING OF SYPHILITIC MULTIFOCAL RETINITIS.

PubMed

Curi, Andre L; Sarraf, David; Cunningham, Emmett T

2015-01-01

To describe multimodal imaging of syphilitic multifocal retinitis. Observational case series. Two patients developed multifocal retinitis after treatment of unrecognized syphilitic uveitis with systemic corticosteroids in the absence of appropriate antibiotic therapy. Multimodal imaging localized the foci of retinitis within the retina in contrast to superficial retinal precipitates that accumulate on the surface of the retina in eyes with untreated syphilitic uveitis. Although the retinitis resolved after treatment with systemic penicillin in both cases, vision remained poor in the patient with multifocal retinitis involving the macula. Treatment of unrecognized syphilitic uveitis with corticosteroids in the absence of antitreponemal treatment can lead to the development of multifocal retinitis. Multimodal imaging, and optical coherence tomography in particular, can be used to distinguish multifocal retinitis from superficial retinal precipitates or accumulations.

Is screening with digital imaging using one retinal view adequate?

PubMed

Herbert, H M; Jordan, K; Flanagan, D W

2003-05-01

To compare the detection of diabetic retinopathy from digital images with slit-lamp biomicroscopy, and to determine whether British Diabetic Association (BDA) screening criteria are attained (>80% sensitivity, >95% specificity, &<5% technical failure). Diabetics referred for screening were studied in a prospective fashion. A single 45 degrees fundus image was obtained using the nonmydriatic digital camera. Each patient subsequently underwent slit-lamp biomicroscopy and diabetic retinopathy grading by a consultant ophthalmologist. Diabetic retinopathy and maculopathy was graded according to the Early Treatment of Diabetic Retinopathy Study. A total of 145 patients (288 eyes) were identified for screening. Of these, 26% of eyes had diabetic retinopathy, and eight eyes (3%) had sight-threatening diabetic retinopathy requiring treatment. The sensitivity for detection of any diabetic retinopathy was 38% and the specificity 95%. There was a 4% technical failure rate. There were 42/288 false negatives and 10/288 false positives. Of the 42 false negatives, 18 represented diabetic maculopathy, 20 represented peripheral diabetic retinopathy and four eyes had both macular and peripheral changes. Three eyes in the false-negative group (1% of total eyes) had sight-threatening retinopathy. There was good concordance between the two consultants (79% agreement on slit-lamp biomicroscopy and 84% on digital image interpretation). The specificity value and technical failure rate compare favourably with BDA guidelines. The low sensitivity for detection of any retinopathy reflects failure to detect minimal maculopathy and retinopathy outside the 45 degrees image. This could be improved by an additional nasal image and careful evaluation of macular images with a low threshold for slit-lamp biomicroscopy if image quality is poor.

Imaging polarimetry and retinal blood vessel quantification at the epiretinal membrane

PubMed Central

Miura, Masahiro; Elsner, Ann E.; Cheney, Michael C.; Usui, Masahiko; Iwasaki, Takuya

2007-01-01

We evaluated a polarimetry method to enhance retinal blood vessels masked by the epiretinal membrane. Depolarized light images were computed by removing the polarization retaining light reaching the instrument and were compared with parallel polarized light images, average reflectance images, and the corresponding images at 514 nm. Contrasts were computed for retinal vessel profiles for arteries and veins. Contrasts were higher in the 514 nm images in normal eyes but higher in the depolarized light image in the eyes with epiretinal membranes. Depolarized light images were useful for examining the retinal vasculature in the presence of retinal disease. PMID:17429490

Simulated disparity and peripheral blur interact during binocular fusion.

PubMed

Maiello, Guido; Chessa, Manuela; Solari, Fabio; Bex, Peter J

2014-07-17

We have developed a low-cost, practical gaze-contingent display in which natural images are presented to the observer with dioptric blur and stereoscopic disparity that are dependent on the three-dimensional structure of natural scenes. Our system simulates a distribution of retinal blur and depth similar to that experienced in real-world viewing conditions by emmetropic observers. We implemented the system using light-field photographs taken with a plenoptic camera which supports digital refocusing anywhere in the images. We coupled this capability with an eye-tracking system and stereoscopic rendering. With this display, we examine how the time course of binocular fusion depends on depth cues from blur and stereoscopic disparity in naturalistic images. Our results show that disparity and peripheral blur interact to modify eye-movement behavior and facilitate binocular fusion, and the greatest benefit was gained by observers who struggled most to achieve fusion. Even though plenoptic images do not replicate an individual’s aberrations, the results demonstrate that a naturalistic distribution of depth-dependent blur may improve 3-D virtual reality, and that interruptions of this pattern (e.g., with intraocular lenses) which flatten the distribution of retinal blur may adversely affect binocular fusion. © 2014 ARVO.

Simulated disparity and peripheral blur interact during binocular fusion

PubMed Central

Maiello, Guido; Chessa, Manuela; Solari, Fabio; Bex, Peter J

2014-01-01

We have developed a low-cost, practical gaze-contingent display in which natural images are presented to the observer with dioptric blur and stereoscopic disparity that are dependent on the three-dimensional structure of natural scenes. Our system simulates a distribution of retinal blur and depth similar to that experienced in real-world viewing conditions by emmetropic observers. We implemented the system using light-field photographs taken with a plenoptic camera which supports digital refocusing anywhere in the images. We coupled this capability with an eye-tracking system and stereoscopic rendering. With this display, we examine how the time course of binocular fusion depends on depth cues from blur and stereoscopic disparity in naturalistic images. Our results show that disparity and peripheral blur interact to modify eye-movement behavior and facilitate binocular fusion, and the greatest benefit was gained by observers who struggled most to achieve fusion. Even though plenoptic images do not replicate an individual's aberrations, the results demonstrate that a naturalistic distribution of depth-dependent blur may improve 3-D virtual reality, and that interruptions of this pattern (e.g., with intraocular lenses) which flatten the distribution of retinal blur may adversely affect binocular fusion. PMID:25034260

Assessment of Retinal Nerve Fiber Layer Using Optical Coherence Tomography and Scanning Laser Polarimetry in Progressive Glaucomatous Optic Neuropathy

PubMed Central

Sehi, Mitra; Greenfield, David S.

2006-01-01

Purpose To describe a case of progressive glaucomatous optic neuropathy using scanning laser polarimetry with fixed (SLP-FCC) and variable corneal compensation (SLP-VCC) and optical coherence tomography (OCT). Design Observational case report. Methods A 21-year-old male with juvenile primary open-angle glaucoma developed progression because of noncompliance with therapy. The patient underwent dilated stereoscopic examination and photography of the optic disk, standard automated perimetry (SAP), OCT, and SLP imaging with FCC and VCC at the baseline examination and after four years of follow-up. Results Optic disk, retinal nerve fiber layer (RNFL) atrophy, and SAP progression was observed. Reduction in mean RNFL thickness (average, superior, inferior) was 18, 18, and 27 microns (OCT); 22, 40, and 17 microns (SLP-FCC); and 6, 12, and 12 microns (SLP-VCC), respectively. Conclusions This case demonstrates that digital imaging of the peripapillary RNFL is capable of documentation and measurement of progressive glaucomatous RNFL atrophy. PMID:17157591

Patch-based automatic retinal vessel segmentation in global and local structural context.

PubMed

Cao, Shuoying; Bharath, Anil A; Parker, Kim H; Ng, Jeffrey

2012-01-01

In this paper, we extend our published work [1] and propose an automated system to segment retinal vessel bed in digital fundus images with enough adaptability to analyze images from fluorescein angiography. This approach takes into account both the global and local context and enables both vessel segmentation and microvascular centreline extraction. These tools should allow researchers and clinicians to estimate and assess vessel diameter, capillary blood volume and microvascular topology for early stage disease detection, monitoring and treatment. Global vessel bed segmentation is achieved by combining phase-invariant orientation fields with neighbourhood pixel intensities in a patch-based feature vector for supervised learning. This approach is evaluated against benchmarks on the DRIVE database [2]. Local microvascular centrelines within Regions-of-Interest (ROIs) are segmented by linking the phase-invariant orientation measures with phase-selective local structure features. Our global and local structural segmentation can be used to assess both pathological structural alterations and microemboli occurrence in non-invasive clinical settings in a longitudinal study.

Investigating the influence of chromatic aberration and optical illumination bandwidth on fundus imaging in rats

NASA Astrophysics Data System (ADS)

Li, Hao; Liu, Wenzhong; Zhang, Hao F.

2015-10-01

Rodent models are indispensable in studying various retinal diseases. Noninvasive, high-resolution retinal imaging of rodent models is highly desired for longitudinally investigating the pathogenesis and therapeutic strategies. However, due to severe aberrations, the retinal image quality in rodents can be much worse than that in humans. We numerically and experimentally investigated the influence of chromatic aberration and optical illumination bandwidth on retinal imaging. We confirmed that the rat retinal image quality decreased with increasing illumination bandwidth. We achieved the retinal image resolution of 10 μm using a 19 nm illumination bandwidth centered at 580 nm in a home-built fundus camera. Furthermore, we observed higher chromatic aberration in albino rat eyes than in pigmented rat eyes. This study provides a design guide for high-resolution fundus camera for rodents. Our method is also beneficial to dispersion compensation in multiwavelength retinal imaging applications.

Retinal vascular caliber, iris color, and age-related macular degeneration in the Irish Nun Eye Study.

PubMed

McGowan, Amy; Silvestri, Giuliana; Moore, Evelyn; Silvestri, Vittorio; Patterson, Christopher C; Maxwell, Alexander P; McKay, Gareth J

2014-12-18

To evaluate the relationship between retinal vascular caliber (RVC), iris color, and age-related macular degeneration (AMD) in elderly Irish nuns. Data from 1233 participants in the cross-sectional observational Irish Nun Eye Study were assessed from digital photographs with a standardized protocol using computer-assisted software. Macular images were graded according to the modified Wisconsin Age-related Maculopathy Grading System. Regression models were used to assess associations, adjusting for age, mean arterial blood pressure, body mass index, refraction, and fellow RVC. In total, 1122 (91%) participants had gradable retinal images of sufficient quality for vessel assessment (mean age: 76.3 years [range, 56-100 years]). In an unadjusted analysis, we found some support for a previous finding that individuals with blue iris color had narrower retinal venules compared to those with brown iris color (P < 0.05), but this was no longer significant after adjustment. Age-related macular degeneration status was categorized as no AMD, any AMD, and late AMD only. Individuals with any AMD (early or late AMD) had significantly narrower arterioles and venules compared to those with no AMD in an unadjusted analysis, but this was no longer significant after adjustment. A nonsignificant reduced risk of any AMD or late AMD only was observed in association with brown compared to blue iris color, in both unadjusted and adjusted analyses. Retinal vascular caliber was not significantly associated with iris color or early/late AMD after adjustment for confounders. A lower but nonsignificant AMD risk was observed in those with brown compared to blue iris color. Copyright 2015 The Association for Research in Vision and Ophthalmology, Inc.

Automated retinal image quality assessment on the UK Biobank dataset for epidemiological studies.

PubMed

Welikala, R A; Fraz, M M; Foster, P J; Whincup, P H; Rudnicka, A R; Owen, C G; Strachan, D P; Barman, S A

2016-04-01

Morphological changes in the retinal vascular network are associated with future risk of many systemic and vascular diseases. However, uncertainty over the presence and nature of some of these associations exists. Analysis of data from large population based studies will help to resolve these uncertainties. The QUARTZ (QUantitative Analysis of Retinal vessel Topology and siZe) retinal image analysis system allows automated processing of large numbers of retinal images. However, an image quality assessment module is needed to achieve full automation. In this paper, we propose such an algorithm, which uses the segmented vessel map to determine the suitability of retinal images for use in the creation of vessel morphometric data suitable for epidemiological studies. This includes an effective 3-dimensional feature set and support vector machine classification. A random subset of 800 retinal images from UK Biobank (a large prospective study of 500,000 middle aged adults; where 68,151 underwent retinal imaging) was used to examine the performance of the image quality algorithm. The algorithm achieved a sensitivity of 95.33% and a specificity of 91.13% for the detection of inadequate images. The strong performance of this image quality algorithm will make rapid automated analysis of vascular morphometry feasible on the entire UK Biobank dataset (and other large retinal datasets), with minimal operator involvement, and at low cost. Copyright © 2016 Elsevier Ltd. All rights reserved.

Clinical applications of three-dimensional tortuosity metrics

NASA Astrophysics Data System (ADS)

Dougherty, Geoff; Johnson, Michael J.

2007-03-01

The measurement of abnormal vascular tortuosity is important in the diagnosis of many diseases. Metrics based on three-dimensional (3-D) curvature, using approximate polynomial spline-fitting to "data balls" centered along the mid-line of the vessel, minimize digitization errors and give tortuosity values largely independent of the resolution of the imaging system. In order to establish their clinical validity we applied them to a number of clinical vascular systems, using both 2-D (standard angiograms and retinal images) and 3-D datasets (from computed tomography angiography (CTA) and magnetic resonance angiography (MRA)). Using the abdominal aortograms we found that the metrics correlated well with the ranking of an expert panel of three vascular surgeons. Both the mean curvature and the root-mean square curvature provided good discrimination between vessels of different tortuosity: and using a data ball size of one-quarter of the local vessel radius in the spline fitting gave consistent results. Tortuous retinal vessels resulting from retinitis or diabetes, but not from vasculitis, could be distinguished from normal vessels. Tortuosity values based on 3-D data sets gave higher values than their 2-D projections, and could easily be implemented in automatic measurement. They produced values sufficiently discriminating to assess the relative utility of arteries for endoluminal repair of aneurysms.

Retinal biometrics based on Iterative Closest Point algorithm.

PubMed

Hatanaka, Yuji; Tajima, Mikiya; Kawasaki, Ryo; Saito, Koko; Ogohara, Kazunori; Muramatsu, Chisako; Sunayama, Wataru; Fujita, Hiroshi

2017-07-01

The pattern of blood vessels in the eye is unique to each person because it rarely changes over time. Therefore, it is well known that retinal blood vessels are useful for biometrics. This paper describes a biometrics method using the Jaccard similarity coefficient (JSC) based on blood vessel regions in retinal image pairs. The retinal image pairs were rough matched by the center of their optic discs. Moreover, the image pairs were aligned using the Iterative Closest Point algorithm based on detailed blood vessel skeletons. For registration, perspective transform was applied to the retinal images. Finally, the pairs were classified as either correct or incorrect using the JSC of the blood vessel region in the image pairs. The proposed method was applied to temporal retinal images, which were obtained in 2009 (695 images) and 2013 (87 images). The 87 images acquired in 2013 were all from persons already examined in 2009. The accuracy of the proposed method reached 100%.

In Vivo Imaging of Retinal Hypoxia in a Model of Oxygen-Induced Retinopathy.

PubMed

Uddin, Md Imam; Evans, Stephanie M; Craft, Jason R; Capozzi, Megan E; McCollum, Gary W; Yang, Rong; Marnett, Lawrence J; Uddin, Md Jashim; Jayagopal, Ashwath; Penn, John S

2016-08-05

Ischemia-induced hypoxia elicits retinal neovascularization and is a major component of several blinding retinopathies such as retinopathy of prematurity (ROP), diabetic retinopathy (DR) and retinal vein occlusion (RVO). Currently, noninvasive imaging techniques capable of detecting and monitoring retinal hypoxia in living systems do not exist. Such techniques would greatly clarify the role of hypoxia in experimental and human retinal neovascular pathogenesis. In this study, we developed and characterized HYPOX-4, a fluorescence-imaging probe capable of detecting retinal-hypoxia in living animals. HYPOX-4 dependent in vivo and ex vivo imaging of hypoxia was tested in a mouse model of oxygen-induced retinopathy (OIR). Predicted patterns of retinal hypoxia were imaged by HYPOX-4 dependent fluorescence activity in this animal model. In retinal cells and mouse retinal tissue, pimonidazole-adduct immunostaining confirmed the hypoxia selectivity of HYPOX-4. HYPOX-4 had no effect on retinal cell proliferation as indicated by BrdU assay and exhibited no acute toxicity in retinal tissue as indicated by TUNEL assay and electroretinography (ERG) analysis. Therefore, HYPOX-4 could potentially serve as the basis for in vivo fluorescence-based hypoxia-imaging techniques, providing a tool for investigators to understand the pathogenesis of ischemic retinopathies and for physicians to address unmet clinical needs.

In Vivo Imaging of Retinal Hypoxia in a Model of Oxygen-Induced Retinopathy

PubMed Central

Uddin, Md. Imam; Evans, Stephanie M.; Craft, Jason R.; Capozzi, Megan E.; McCollum, Gary W.; Yang, Rong; Marnett, Lawrence J.; Uddin, Md. Jashim; Jayagopal, Ashwath; Penn, John S.

2016-01-01

Ischemia-induced hypoxia elicits retinal neovascularization and is a major component of several blinding retinopathies such as retinopathy of prematurity (ROP), diabetic retinopathy (DR) and retinal vein occlusion (RVO). Currently, noninvasive imaging techniques capable of detecting and monitoring retinal hypoxia in living systems do not exist. Such techniques would greatly clarify the role of hypoxia in experimental and human retinal neovascular pathogenesis. In this study, we developed and characterized HYPOX-4, a fluorescence-imaging probe capable of detecting retinal-hypoxia in living animals. HYPOX-4 dependent in vivo and ex vivo imaging of hypoxia was tested in a mouse model of oxygen-induced retinopathy (OIR). Predicted patterns of retinal hypoxia were imaged by HYPOX-4 dependent fluorescence activity in this animal model. In retinal cells and mouse retinal tissue, pimonidazole-adduct immunostaining confirmed the hypoxia selectivity of HYPOX-4. HYPOX-4 had no effect on retinal cell proliferation as indicated by BrdU assay and exhibited no acute toxicity in retinal tissue as indicated by TUNEL assay and electroretinography (ERG) analysis. Therefore, HYPOX-4 could potentially serve as the basis for in vivo fluorescence-based hypoxia-imaging techniques, providing a tool for investigators to understand the pathogenesis of ischemic retinopathies and for physicians to address unmet clinical needs. PMID:27491345

Color Retinal Image Enhancement Based on Luminosity and Contrast Adjustment.

PubMed

Zhou, Mei; Jin, Kai; Wang, Shaoze; Ye, Juan; Qian, Dahong

2018-03-01

Many common eye diseases and cardiovascular diseases can be diagnosed through retinal imaging. However, due to uneven illumination, image blurring, and low contrast, retinal images with poor quality are not useful for diagnosis, especially in automated image analyzing systems. Here, we propose a new image enhancement method to improve color retinal image luminosity and contrast. A luminance gain matrix, which is obtained by gamma correction of the value channel in the HSV (hue, saturation, and value) color space, is used to enhance the R, G, and B (red, green and blue) channels, respectively. Contrast is then enhanced in the luminosity channel of L * a * b * color space by CLAHE (contrast-limited adaptive histogram equalization). Image enhancement by the proposed method is compared to other methods by evaluating quality scores of the enhanced images. The performance of the method is mainly validated on a dataset of 961 poor-quality retinal images. Quality assessment (range 0-1) of image enhancement of this poor dataset indicated that our method improved color retinal image quality from an average of 0.0404 (standard deviation 0.0291) up to an average of 0.4565 (standard deviation 0.1000). The proposed method is shown to achieve superior image enhancement compared to contrast enhancement in other color spaces or by other related methods, while simultaneously preserving image naturalness. This method of color retinal image enhancement may be employed to assist ophthalmologists in more efficient screening of retinal diseases and in development of improved automated image analysis for clinical diagnosis.

Panoramic autofluorescence: highlighting retinal pathology.

PubMed

Slotnick, Samantha; Sherman, Jerome

2012-05-01

Recent technological advances in fundus autofluorescence (FAF) are providing new opportunities for insight into retinal physiology and pathophysiology. FAF provides distinctly different imaging information than standard photography or color separation. A review of the basis for this imaging technology is included to help the clinician understand how to interpret FAF images. Cases are presented to illustrate image interpretation. Optos, which manufactures equipment for simultaneous panoramic imaging, has recently outfitted several units with AF capabilities. Six cases are presented in which panoramic autofluorescent (PAF) images highlight retinal pathology, using Optos' Ultra-Widefield technology. Supportive imaging technologies, such as Optomap® images and spectral domain optical coherence tomography (SD-OCT), are used to assist in the clinical interpretation of retinal pathology detected on PAF. Hypofluorescent regions on FAF are identified to occur along with a disruption in the photoreceptors and/or retinal pigment epithelium, as borne out on SD-OCT. Hyperfluorescent regions on FAF occur at the advancing zones of retinal degeneration, indicating impending damage. PAF enables such inferences to be made in retinal areas which lie beyond the reach of SD-OCT imaging. PAF also enhances clinical pattern recognition over a large area and in comparison with the fellow eye. Symmetric retinal degenerations often occur with genetic conditions, such as retinitis pigmentosa, and may impel the clinician to recommend genetic testing. Autofluorescent ophthalmoscopy is a non-invasive procedure that can detect changes in metabolic activity at the retinal pigment epithelium before clinical ophthalmoscopy. Already, AF is being used as an adjunct technology to fluorescein angiography in cases of age-related macular degeneration. Both hyper- and hypoautofluorescent changes are indicative of pathology. Peripheral retinal abnormalities may precede central retinal impacts, potentially providing early signs for intervention before impacting visual acuity. The panoramic image enhances clinical pattern recognition over a large area and in comparison between eyes. Optos' Ultra-Widefield technology is capable of capturing high-resolution images of the peripheral retina without requiring dilation.

Detection of retinal changes from illumination normalized fundus images using convolutional neural networks

NASA Astrophysics Data System (ADS)

Adal, Kedir M.; van Etten, Peter G.; Martinez, Jose P.; Rouwen, Kenneth; Vermeer, Koenraad A.; van Vliet, Lucas J.

2017-03-01

Automated detection and quantification of spatio-temporal retinal changes is an important step to objectively assess disease progression and treatment effects for dynamic retinal diseases such as diabetic retinopathy (DR). However, detecting retinal changes caused by early DR lesions such as microaneurysms and dot hemorrhages from longitudinal pairs of fundus images is challenging due to intra and inter-image illumination variation between fundus images. This paper explores a method for automated detection of retinal changes from illumination normalized fundus images using a deep convolutional neural network (CNN), and compares its performance with two other CNNs trained separately on color and green channel fundus images. Illumination variation was addressed by correcting for the variability in the luminosity and contrast estimated from a large scale retinal regions. The CNN models were trained and evaluated on image patches extracted from a registered fundus image set collected from 51 diabetic eyes that were screened at two different time-points. The results show that using normalized images yield better performance than color and green channel images, suggesting that illumination normalization greatly facilitates CNNs to quickly and correctly learn distinctive local image features of DR related retinal changes.

Active eye-tracking for an adaptive optics scanning laser ophthalmoscope

PubMed Central

Sheehy, Christy K.; Tiruveedhula, Pavan; Sabesan, Ramkumar; Roorda, Austin

2015-01-01

We demonstrate a system that combines a tracking scanning laser ophthalmoscope (TSLO) and an adaptive optics scanning laser ophthalmoscope (AOSLO) system resulting in both optical (hardware) and digital (software) eye-tracking capabilities. The hybrid system employs the TSLO for active eye-tracking at a rate up to 960 Hz for real-time stabilization of the AOSLO system. AOSLO videos with active eye-tracking signals showed, at most, an amplitude of motion of 0.20 arcminutes for horizontal motion and 0.14 arcminutes for vertical motion. Subsequent real-time digital stabilization limited residual motion to an average of only 0.06 arcminutes (a 95% reduction). By correcting for high amplitude, low frequency drifts of the eye, the active TSLO eye-tracking system enabled the AOSLO system to capture high-resolution retinal images over a larger range of motion than previously possible with just the AOSLO imaging system alone. PMID:26203370

Sensitivity and specificity of Norwegian optometrists' evaluation of diabetic retinopathy in single-field retinal images - a cross-sectional experimental study.

PubMed

Sundling, Vibeke; Gulbrandsen, Pål; Straand, Jørund

2013-01-10

In the working age group, diabetic retinopathy is a leading cause of visual impairment. Regular eye examinations and early treatment of retinopathy can prevent visual loss, so screening for diabetic retinopathy is cost-effective. Dilated retinal digital photography with the additional use of ophthalmoscopy is the most effective and robust method of diabetic retinopathy screening. The aim of this study was to estimate the sensitivity and specificity of diabetic retinopathy screening when performed by Norwegian optometrists. This study employed a cross-sectional experimental design. Seventy-four optometrists working in private optometric practice were asked to screen 14 single-field retinal images for possible diabetic retinopathy. The screening was undertaken using a web-based visual identification and management of ophthalmological conditions (VIMOC) examination. The images used in the VIMOC examination were selected from a population survey and had been previously examined by two independent ophthalmologists. In order to establish a "gold standard", images were only chosen for use in the VIMOC examination if they had elicited diagnostic agreement between the two independent ophthalmologists. To reduce the possibility of falsely high specificity occurring by chance, half the presented images were of retinas that were not affected by diabetic retinopathy. Sensitivity and specificity for diabetic retinopathy was calculated with 95% confidence intervals (CIs). The mean (95%CI) sensitivity for identifying eyes with any diabetic retinopathy was 67% (62% to 72%). The mean (95%CI) specificity for identifying eyes without diabetic retinopathy was 84% (80% to 89%). The mean (95%CI) sensitivity for identifying eyes with mild non-proliferative diabetic retinopathy or moderate non-proliferative diabetes was 54% (47% to 61%) and 100%, respectively. Only four optometrists (5%) met the required standard of at least 80% sensitivity and 95% specificity that has been previously set for diabetic retinopathy screening programmes. The evaluation of retinal images for diabetic retinopathy by Norwegian optometrists does not meet the required screening standard of at least 80% sensitivity and 95% specificity. The introduction of measures to improve this situation could have implications for both formal optometric training and continuing optometric professional education.

Sensitivity and specificity of Norwegian optometrists’ evaluation of diabetic retinopathy in single-field retinal images – a cross-sectional experimental study

PubMed Central

2013-01-01

Background In the working age group, diabetic retinopathy is a leading cause of visual impairment. Regular eye examinations and early treatment of retinopathy can prevent visual loss, so screening for diabetic retinopathy is cost-effective. Dilated retinal digital photography with the additional use of ophthalmoscopy is the most effective and robust method of diabetic retinopathy screening. The aim of this study was to estimate the sensitivity and specificity of diabetic retinopathy screening when performed by Norwegian optometrists. Methods This study employed a cross-sectional experimental design. Seventy-four optometrists working in private optometric practice were asked to screen 14 single-field retinal images for possible diabetic retinopathy. The screening was undertaken using a web-based visual identification and management of ophthalmological conditions (VIMOC) examination. The images used in the VIMOC examination were selected from a population survey and had been previously examined by two independent ophthalmologists. In order to establish a “gold standard”, images were only chosen for use in the VIMOC examination if they had elicited diagnostic agreement between the two independent ophthalmologists. To reduce the possibility of falsely high specificity occurring by chance, half the presented images were of retinas that were not affected by diabetic retinopathy. Sensitivity and specificity for diabetic retinopathy was calculated with 95% confidence intervals (CIs). Results The mean (95%CI) sensitivity for identifying eyes with any diabetic retinopathy was 67% (62% to 72%). The mean (95%CI) specificity for identifying eyes without diabetic retinopathy was 84% (80% to 89%). The mean (95%CI) sensitivity for identifying eyes with mild non-proliferative diabetic retinopathy or moderate non-proliferative diabetes was 54% (47% to 61%) and 100%, respectively. Only four optometrists (5%) met the required standard of at least 80% sensitivity and 95% specificity that has been previously set for diabetic retinopathy screening programmes. Conclusions The evaluation of retinal images for diabetic retinopathy by Norwegian optometrists does not meet the required screening standard of at least 80% sensitivity and 95% specificity. The introduction of measures to improve this situation could have implications for both formal optometric training and continuing optometric professional education. PMID:23305337

Retinal microvascular network geometry and cognitive abilities in community-dwelling older people: The Lothian Birth Cohort 1936 study

PubMed Central

McGrory, Sarah; Taylor, Adele M; Kirin, Mirna; Corley, Janie; Pattie, Alison; Cox, Simon R; Dhillon, Baljean; Wardlaw, Joanna M; Doubal, Fergus N; Starr, John M; Trucco, Emanuele; MacGillivray, Thomas J; Deary, Ian J

2017-01-01

Aim To examine the relationship between retinal vascular morphology and cognitive abilities in a narrow-age cohort of community-dwelling older people. Methods Digital retinal images taken at age ∼73 years from 683 participants of the Lothian Birth Cohort 1936 (LBC1936) were analysed with Singapore I Vessel Assessment (SIVA) software. Multiple regression models were applied to determine cross-sectional associations between retinal vascular parameters and general cognitive ability (g), memory, processing speed, visuospatial ability, crystallised cognitive ability and change in IQ from childhood to older age. Results After adjustment for cognitive ability at age 11 years and cardiovascular risk factors, venular length-to-diameter ratio was nominally significantly associated with processing speed (β=−0.116, p=0.01) and g (β=−0.079, p=0.04). Arteriolar length-to-diameter ratio was associated with visuospatial ability (β=0.092, p=0.04). Decreased arteriolar junctional exponent deviation and increased arteriolar branching coefficient values were associated with less relative decline in IQ between childhood and older age (arteriolar junctional exponent deviation: β=−0.101, p=0.02; arteriolar branching coefficient: β=0.089, p=0.04). Data are presented as standardised β coefficients (β) reflecting change in cognitive domain score associated with an increase of 1 SD unit in retinal parameter. None of these nominally significant associations remained significant after correction for multiple statistical testing. Conclusions Retinal parameters contributed <1% of the variance in the majority of associations observed. Whereas retinal analysis may have potential for early detection of some types of age-related cognitive decline and dementia, our results present little evidence that retinal vascular features are associated with non-pathological cognitive ageing. PMID:28400371

SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY FINDINGS IN MACULA-INVOLVING CYTOMEGALOVIRUS RETINITIS.

PubMed

Gupta, Mrinali P; Patel, Sarju; Orlin, Anton; Marlow, Elizabeth; Chee, Ru-Ik; Nadelmann, Jennifer; Chan, R V Paul; DʼAmico, Donald J; Kiss, Szilard

2018-05-01

To evaluate the microstructural features of cytomegalovirus (CMV) retinitis by spectral domain optical coherence tomography (OCT). Subjects were patients with macula-involving CMV retinitis with OCT imaging. The leading edge of retinitis in the macula was identified based on fundus imaging, and OCT findings were longitudinally evaluated in three areas: within the area of active retinitis, at the leading edge of retinitis, and just beyond the leading edge of retinitis. Optical coherence tomography imaging of macular CMV retinitis identified vitreous cells in 10 eyes (100%), posterior vitreous detachment in four eyes (40%), broad-based vitreomacular traction in one eye (10%), epiretinal membrane in eight eyes (80%), and lamellar hole-associated epiretinal proliferation associated with an atrophic hole in one eye (10%). Retinal architectural disruption, disruption of inner retinal layers, disruption of the external limiting membrane, and ellipsoid zone abnormalities were noted within the area of retinitis in all eyes and decreased in frequency and severity at and beyond the leading edge of retinitis, although all 10 eyes (100%) exhibited one of these abnormalities, especially outer retinal microabnormalities, beyond the leading edge of retinitis. Microstructural abnormalities were frequently noted on OCT of CMV retinitis, including within the retina beyond the leading edge of retinitis identified by corresponding fundus imaging. Outer retinal abnormalities were noted more frequently than inner retinal abnormalities beyond the leading edge of retinitis. These findings provide insight into the effects of CMV retinitis on retinal microstructure and potentially on vision and highlight the potential utility of OCT for monitoring microprogression of macula-involving CMV retinitis.

Design of integrated eye tracker-display device for head mounted systems

NASA Astrophysics Data System (ADS)

David, Y.; Apter, B.; Thirer, N.; Baal-Zedaka, I.; Efron, U.

2009-08-01

We propose an Eye Tracker/Display system, based on a novel, dual function device termed ETD, which allows sharing the optical paths of the Eye tracker and the display and on-chip processing. The proposed ETD design is based on a CMOS chip combining a Liquid-Crystal-on-Silicon (LCoS) micro-display technology with near infrared (NIR) Active Pixel Sensor imager. The ET operation allows capturing the Near IR (NIR) light, back-reflected from the eye's retina. The retinal image is then used for the detection of the current direction of eye's gaze. The design of the eye tracking imager is based on the "deep p-well" pixel technology, providing low crosstalk while shielding the active pixel circuitry, which serves the imaging and the display drivers, from the photo charges generated in the substrate. The use of the ETD in the HMD Design enables a very compact design suitable for Smart Goggle applications. A preliminary optical, electronic and digital design of the goggle and its associated ETD chip and digital control, are presented.

Integrated scanning laser ophthalmoscopy and optical coherence tomography for quantitative multimodal imaging of retinal degeneration and autofluorescence

NASA Astrophysics Data System (ADS)

Issaei, Ali; Szczygiel, Lukasz; Hossein-Javaheri, Nima; Young, Mei; Molday, L. L.; Molday, R. S.; Sarunic, M. V.

2011-03-01

Scanning Laser Ophthalmoscopy (SLO) and Coherence Tomography (OCT) are complimentary retinal imaging modalities. Integration of SLO and OCT allows for both fluorescent detection and depth- resolved structural imaging of the retinal cell layers to be performed in-vivo. System customization is required to image rodents used in medical research by vision scientists. We are investigating multimodal SLO/OCT imaging of a rodent model of Stargardt's Macular Dystrophy which is characterized by retinal degeneration and accumulation of toxic autofluorescent lipofuscin deposits. Our new findings demonstrate the ability to track fundus autofluorescence and retinal degeneration concurrently.

Ridge-branch-based blood vessel detection algorithm for multimodal retinal images

NASA Astrophysics Data System (ADS)

Li, Y.; Hutchings, N.; Knighton, R. W.; Gregori, G.; Lujan, B. J.; Flanagan, J. G.

2009-02-01

Automatic detection of retinal blood vessels is important to medical diagnoses and imaging. With the development of imaging technologies, various modals of retinal images are available. Few of currently published algorithms are applied to multimodal retinal images. Besides, the performance of algorithms with pathologies is expected to be improved. The purpose of this paper is to propose an automatic Ridge-Branch-Based (RBB) detection algorithm of blood vessel centerlines and blood vessels for multimodal retinal images (color fundus photographs, fluorescein angiograms, fundus autofluorescence images, SLO fundus images and OCT fundus images, for example). Ridges, which can be considered as centerlines of vessel-like patterns, are first extracted. The method uses the connective branching information of image ridges: if ridge pixels are connected, they are more likely to be in the same class, vessel ridge pixels or non-vessel ridge pixels. Thanks to the good distinguishing ability of the designed "Segment-Based Ridge Features", the classifier and its parameters can be easily adapted to multimodal retinal images without ground truth training. We present thorough experimental results on SLO images, color fundus photograph database and other multimodal retinal images, as well as comparison between other published algorithms. Results showed that the RBB algorithm achieved a good performance.

Fast and automatic algorithm for optic disc extraction in retinal images using principle-component-analysis-based preprocessing and curvelet transform.

PubMed

Shahbeig, Saleh; Pourghassem, Hossein

2013-01-01

Optic disc or optic nerve (ON) head extraction in retinal images has widespread applications in retinal disease diagnosis and human identification in biometric systems. This paper introduces a fast and automatic algorithm for detecting and extracting the ON region accurately from the retinal images without the use of the blood-vessel information. In this algorithm, to compensate for the destructive changes of the illumination and also enhance the contrast of the retinal images, we estimate the illumination of background and apply an adaptive correction function on the curvelet transform coefficients of retinal images. In other words, we eliminate the fault factors and pave the way to extract the ON region exactly. Then, we detect the ON region from retinal images using the morphology operators based on geodesic conversions, by applying a proper adaptive correction function on the reconstructed image's curvelet transform coefficients and a novel powerful criterion. Finally, using a local thresholding on the detected area of the retinal images, we extract the ON region. The proposed algorithm is evaluated on available images of DRIVE and STARE databases. The experimental results indicate that the proposed algorithm obtains an accuracy rate of 100% and 97.53% for the ON extractions on DRIVE and STARE databases, respectively.

Vessel extraction in retinal images using automatic thresholding and Gabor Wavelet.

PubMed

Ali, Aziah; Hussain, Aini; Wan Zaki, Wan Mimi Diyana

2017-07-01

Retinal image analysis has been widely used for early detection and diagnosis of multiple systemic diseases. Accurate vessel extraction in retinal image is a crucial step towards a fully automated diagnosis system. This work affords an efficient unsupervised method for extracting blood vessels from retinal images by combining existing Gabor Wavelet (GW) method with automatic thresholding. Green channel image is extracted from color retinal image and used to produce Gabor feature image using GW. Both green channel image and Gabor feature image undergo vessel-enhancement step in order to highlight blood vessels. Next, the two vessel-enhanced images are transformed to binary images using automatic thresholding before combined to produce the final vessel output. Combining the images results in significant improvement of blood vessel extraction performance compared to using individual image. Effectiveness of the proposed method was proven via comparative analysis with existing methods validated using publicly available database, DRIVE.

C-reactive protein and chitinase 3-like protein 1 as biomarkers of spatial redistribution of retinal blood vessels on digital retinal photography in patients with diabetic retinopathy.

PubMed

Cekić, Sonja; Cvetković, Tatjana; Jovanović, Ivan; Jovanović, Predrag; Pesić, Milica; Stanković Babić, Gordana; Milenković, Svetislav; Risimić, Dijana

2014-08-20

The aim of the study was to investigate the correlation between the levels of C-reactive protein (CRP) and chitinase 3-like protein 1 (YKL-40) in blood samples with morpohometric parameters of retinal blood vessels in patients with diabetic retinopathy. Blood laboratory examination of 90 patients included the measurement of glycemia, HbA1C, total cholesterol, LDL-C, HDL-C, triglycerides and CRP. Levels of YKL-40 were detected and measured in serum by ELISA (Micro VueYKL-40 EIA Kit, Quidel Corporation, San Diego, USA). YKL-40 correlated positively with diameter and negatively with number of retinal blood vessels. The average number of the blood vessels per retinal zone was significantly higher in the group of patients with mild non-proliferative diabetic retinopathy than in the group with severe form in the optic disc and all five retinal zones. The average outer diameter of the evaluated retinal zones and optic disc vessels was significantly higher in the group with severe compared to the group with mild diabetic retinopathy. Morphological analysis of the retinal vessels on digital fundus photography and correlation with YKL-40 may be valuable for the follow-up of diabetic retinopathy.

Usher Syndrome

MedlinePlus

... or hearing loss and an eye disease called retinitis pigmentosa (RP) [re-tin-EYE-tis pig-men-TOE- ... 27. 6 Berson, E.L. (1998). Treatment of retinitis pigmentosa with vitamin A . Digital Journal of Ophthalmology, 4( ...

Ultra-widefield retinal imaging through a black intraocular lens.

PubMed

Yusuf, Imran H; Fung, Timothy H M; Patel, Chetan K

2015-09-01

To evaluate the feasibility of ultra-widefield retinal imaging in patients with near infrared (IR)-transmitting black intraocular lenses (IOLs). Oxford Eye Hospital, Oxford, United Kingdom. Laboratory evaluation of a diagnostic technology with interventional case report. The field of retinal imaging through a Morcher poly(methyl methacrylate) (PMMA) black IOL was determined in a purpose-built adult schematic model eye with the HRA2 Spectralis confocal scanning laser ophthalmoscope using standard imaging, Staurenghi retina lens-assisted imaging, and ultra-widefield noncontact imaging. Retinal imaging using each modality was then performed on a patient implanted with another Morcher PMMA black IOL model. Ultra-widefield noncontact imaging and lens-assisted imaging captured up to 150 degrees of field (versus 40 degrees with a standard confocal scanning laser ophthalmoscope). Ultra-widefield retinal images were successfully acquired in a patient eye with a black IOL. This study has identified the first ultra-widefield retinal imaging modalities for patients with near IR-transmitting black IOLs. Should larger studies confirm this finding, noncontact ultra-widefield confocal scanning laser ophthalmoscopy might be considered the gold standard imaging technique for retinal surveillance in patients with near IR-transmitting black IOLs. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

In vivo integrated photoacoustic ophthalmoscopy, optical coherence tomography, and scanning laser ophthalmoscopy for retinal imaging

NASA Astrophysics Data System (ADS)

Song, Wei; Zhang, Rui; Zhang, Hao F.; Wei, Qing; Cao, Wenwu

2012-12-01

The physiological and pathological properties of retina are closely associated with various optical contrasts. Hence, integrating different ophthalmic imaging technologies is more beneficial in both fundamental investigation and clinical diagnosis of several blinding diseases. Recently, photoacoustic ophthalmoscopy (PAOM) was developed for in vivo retinal imaging in small animals, which demonstrated the capability of imaging retinal vascular networks and retinal pigment epithelium (RPE) at high sensitivity. We combined PAOM with traditional imaging modalities, such as fluorescein angiography (FA), spectral-domain optical coherence tomography (SD-OCT), and auto-fluorescence scanning laser ophthalmoscopy (AF-SLO), for imaging rats and mice. The multimodal imaging system provided more comprehensive evaluation of the retina based on the complementary imaging contrast mechanisms. The high-quality retinal images show that the integrated ophthalmic imaging system has great potential in the investigation of blinding disorders.

Adaptive Optics Technology for High-Resolution Retinal Imaging

PubMed Central

Lombardo, Marco; Serrao, Sebastiano; Devaney, Nicholas; Parravano, Mariacristina; Lombardo, Giuseppe

2013-01-01

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. PMID:23271600

Denoising and segmentation of retinal layers in optical coherence tomography images

NASA Astrophysics Data System (ADS)

Dash, Puspita; Sigappi, A. N.

2018-04-01

Optical Coherence Tomography (OCT) is an imaging technique used to localize the intra-retinal boundaries for the diagnostics of macular diseases. Due to speckle noise, low image contrast and accurate segmentation of individual retinal layers is difficult. Due to this, a method for retinal layer segmentation from OCT images is presented. This paper proposes a pre-processing filtering approach for denoising and segmentation methods for segmenting retinal layers OCT images using graph based segmentation technique. These techniques are used for segmentation of retinal layers for normal as well as patients with Diabetic Macular Edema. The algorithm based on gradient information and shortest path search is applied to optimize the edge selection. In this paper the four main layers of the retina are segmented namely Internal limiting membrane (ILM), Retinal pigment epithelium (RPE), Inner nuclear layer (INL) and Outer nuclear layer (ONL). The proposed method is applied on a database of OCT images of both ten normal and twenty DME affected patients and the results are found to be promising.

Ultra-Widefield Steering-Based SD-OCT Imaging of the Retinal Periphery

PubMed Central

Choudhry, Netan; Golding, John; Manry, Matthew W.; Rao, Rajesh C.

2016-01-01

Objective To describe the spectral-domain optical coherence tomography (SD-OCT) features of peripheral retinal findings using an ultra-widefield (UWF) steering technique to image the retinal periphery. Design Observational study. Participants 68 patients (68 eyes) with 19 peripheral retinal features. Main Outcome Measures SD-OCT-based structural features. Methods Nineteen peripheral retinal features including: vortex vein, congenital hypertrophy of the retinal pigment epithelium (CHRPE), pars plana, ora serrata pearl, typical cystoid degeneration (TCD), cystic retinal tuft, meridional fold, lattice and cobblestone degeneration, retinal hole, retinal tear, rhegmatogenous retinal detachment (RRD), typical degenerative senile retinoschisis, peripheral laser coagulation scars, ora tooth, cryopexy scars (retinal tear and treated retinoblastoma scar), bone spicules, white without pressure, and peripheral drusen were identified by peripheral clinical examination. Near infrared (NIR) scanning laser ophthalmoscopy (SLO) images and SD-OCT of these entities were registered to UWF color photographs. Results SD-OCT resolved structural features of all peripheral findings. Dilated hyporeflective tubular structures within the choroid were observed in the vortex vein. Loss of retinal lamination, neural retinal attenuation, RPE loss or hypertrophy were seen in several entities including CHRPE, ora serrata pearl, TCD, cystic retinal tuft, meridional fold, lattice and cobblestone degenerations. Hyporeflective intraretinal spaces, indicating cystoid or schitic fluid, were seen in ora serrata pearl, ora tooth, TCD, cystic retinal tuft, meridional fold, retinal hole, and typical degenerative senile retinoschisis. The vitreoretinal interface, which often consisted of lamellae-like structures of the condensed cortical vitreous near or adherent to the neural retina, appeared clearly in most peripheral findings, confirming its association with many low-risk and vision-threatening pathologies such as lattice degeneration, meridional folds, retinal breaks, and RRDs. Conclusions UWF steering technique-based SD-OCT imaging of the retinal periphery is feasible with current commercially available devices, and provides detailed anatomical information of the peripheral retina, including benign and pathological entities, not previously imaged. This imaging technique may deepen our structural understanding of these entities, their potentially associated macular and systemic pathologies, and may influence decision-making in clinical practice, particularly in areas with teleretinal capabilities but poor access to retinal specialists. PMID:26992837

COMPARISON OF RETINAL PATHOLOGY VISUALIZATION IN MULTISPECTRAL SCANNING LASER IMAGING.

PubMed

Meshi, Amit; Lin, Tiezhu; Dans, Kunny; Chen, Kevin C; Amador, Manuel; Hasenstab, Kyle; Muftuoglu, Ilkay Kilic; Nudleman, Eric; Chao, Daniel; Bartsch, Dirk-Uwe; Freeman, William R

2018-03-16

To compare retinal pathology visualization in multispectral scanning laser ophthalmoscope imaging between the Spectralis and Optos devices. This retrospective cross-sectional study included 42 eyes from 30 patients with age-related macular degeneration (19 eyes), diabetic retinopathy (10 eyes), and epiretinal membrane (13 eyes). All patients underwent retinal imaging with a color fundus camera (broad-spectrum white light), the Spectralis HRA-2 system (3-color monochromatic lasers), and the Optos P200 system (2-color monochromatic lasers). The Optos image was cropped to a similar size as the Spectralis image. Seven masked graders marked retinal pathologies in each image within a 5 × 5 grid that included the macula. The average area with detected retinal pathology in all eyes was larger in the Spectralis images compared with Optos images (32.4% larger, P < 0.0001), mainly because of better visualization of epiretinal membrane and retinal hemorrhage. The average detection rate of age-related macular degeneration and diabetic retinopathy pathologies was similar across the three modalities, whereas epiretinal membrane detection rate was significantly higher in the Spectralis images. Spectralis tricolor multispectral scanning laser ophthalmoscope imaging had higher rate of pathology detection primarily because of better epiretinal membrane and retinal hemorrhage visualization compared with Optos bicolor multispectral scanning laser ophthalmoscope imaging.

Ultra-Widefield Steering-Based Spectral-Domain Optical Coherence Tomography Imaging of the Retinal Periphery.

PubMed

Choudhry, Netan; Golding, John; Manry, Matthew W; Rao, Rajesh C

2016-06-01

To describe the spectral-domain optical coherence tomography (SD OCT) features of peripheral retinal findings using an ultra-widefield (UWF) steering technique to image the retinal periphery. Observational study. A total of 68 patients (68 eyes) with 19 peripheral retinal features. Spectral-domain OCT-based structural features. Nineteen peripheral retinal features, including vortex vein, congenital hypertrophy of the retinal pigment epithelium, pars plana, ora serrata pearl, typical cystoid degeneration (TCD), cystic retinal tuft, meridional fold, lattice and cobblestone degeneration, retinal hole, retinal tear, rhegmatogenous retinal detachment, typical degenerative senile retinoschisis, peripheral laser coagulation scars, ora tooth, cryopexy scars (retinal tear and treated retinoblastoma scar), bone spicules, white without pressure, and peripheral drusen, were identified by peripheral clinical examination. Near-infrared scanning laser ophthalmoscopy images and SD OCT of these entities were registered to UWF color photographs. Spectral-domain OCT resolved structural features of all peripheral findings. Dilated hyporeflective tubular structures within the choroid were observed in the vortex vein. Loss of retinal lamination, neural retinal attenuation, retinal pigment epithelium loss, or hypertrophy was seen in several entities, including congenital hypertrophy of the retinal pigment epithelium, ora serrata pearl, TCD, cystic retinal tuft, meridional fold, lattice, and cobblestone degenerations. Hyporeflective intraretinal spaces, indicating cystoid or schitic fluid, were seen in ora serrata pearl, ora tooth, TCD, cystic retinal tuft, meridional fold, retinal hole, and typical degenerative senile retinoschisis. The vitreoretinal interface, which often consisted of lamellae-like structures of the condensed cortical vitreous near or adherent to the neural retina, appeared clearly in most peripheral findings, confirming its association with many low-risk and vision-threatening pathologies, such as lattice degeneration, meridional folds, retinal breaks, and rhegmatogenous retinal detachments. Ultra-widefield steering-based SD OCT imaging of the retinal periphery is feasible with current commercially available devices and provides detailed anatomic information of the peripheral retina, including benign and pathologic entities, not previously imaged. This imaging technique may deepen our structural understanding of these entities and their potentially associated macular and systemic pathologies, and may influence decision-making in clinical practice, particularly in areas with teleretinal capabilities but poor access to retinal specialists. Copyright © 2016 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Analysis of the chicken retina with an adaptive optics multiphoton microscope.

PubMed

Bueno, Juan M; Giakoumaki, Anastasia; Gualda, Emilio J; Schaeffel, Frank; Artal, Pablo

2011-06-01

The structure and organization of the chicken retina has been investigated with an adaptive optics multiphoton imaging microscope in a backward configuration. Non-stained flat-mounted retinal tissues were imaged at different depths, from the retinal nerve fiber layer to the outer segment, by detecting the intrinsic nonlinear fluorescent signal. From the stacks of images corresponding to the different retinal layers, volume renderings of the entire retina were reconstructed. The density of photoreceptors and ganglion cells layer were directly estimated from the images as a function of the retinal eccentricity. The maximum anatomical resolving power at different retinal eccentricities was also calculated. This technique could be used for a better characterization of retinal alterations during myopia development, and may be useful for visualization of retinal pathologies and intoxication during pharmacological studies.

Facts About Usher Syndrome

MedlinePlus

... or hearing loss and an eye disease called retinitis pigmentosa (RP). Deafness or hearing loss in Usher syndrome ... 27. 6 Berson, E.L. (1998). Treatment of retinitis pigmentosa with vitamin A . Digital Journal of Ophthalmology, 4( ...

Clinical applications of fundus autofluorescence in retinal disease.

PubMed

Yung, Madeline; Klufas, Michael A; Sarraf, David

2016-01-01

Fundus autofluorescence (FAF) is a non-invasive retinal imaging modality used in clinical practice to provide a density map of lipofuscin, the predominant ocular fluorophore, in the retinal pigment epithelium. Multiple commercially available imaging systems, including the fundus camera, the confocal scanning laser ophthalmoscope, and the ultra-widefield imaging device, are available to the clinician. Each offers unique advantages for evaluating various retinal diseases. The clinical applications of FAF continue to expand. It is now an essential tool for evaluating age related macular degeneration, macular dystrophies, retinitis pigmentosa, white dot syndromes, retinal drug toxicities, and various other retinal disorders. FAF may detect abnormalities beyond those detected on funduscopic exam, fluorescein angiography, or optical coherence tomography, and can be used to elucidate disease pathogenesis, form genotype-phenotype correlations, diagnose and monitor disease, and evaluate novel therapies. Given its ease of use, non-invasive nature, and value in characterizing retinal disease, FAF enjoys increasing clinical relevance. This review summarizes common ocular fluorophores, imaging modalities, and FAF findings for a wide spectrum of retinal disorders.

Retinal status analysis method based on feature extraction and quantitative grading in OCT images.

PubMed

Fu, Dongmei; Tong, Hejun; Zheng, Shuang; Luo, Ling; Gao, Fulin; Minar, Jiri

2016-07-22

Optical coherence tomography (OCT) is widely used in ophthalmology for viewing the morphology of the retina, which is important for disease detection and assessing therapeutic effect. The diagnosis of retinal diseases is based primarily on the subjective analysis of OCT images by trained ophthalmologists. This paper describes an OCT images automatic analysis method for computer-aided disease diagnosis and it is a critical part of the eye fundus diagnosis. This study analyzed 300 OCT images acquired by Optovue Avanti RTVue XR (Optovue Corp., Fremont, CA). Firstly, the normal retinal reference model based on retinal boundaries was presented. Subsequently, two kinds of quantitative methods based on geometric features and morphological features were proposed. This paper put forward a retinal abnormal grading decision-making method which was used in actual analysis and evaluation of multiple OCT images. This paper showed detailed analysis process by four retinal OCT images with different abnormal degrees. The final grading results verified that the analysis method can distinguish abnormal severity and lesion regions. This paper presented the simulation of the 150 test images, where the results of analysis of retinal status showed that the sensitivity was 0.94 and specificity was 0.92.The proposed method can speed up diagnostic process and objectively evaluate the retinal status. This paper aims on studies of retinal status automatic analysis method based on feature extraction and quantitative grading in OCT images. The proposed method can obtain the parameters and the features that are associated with retinal morphology. Quantitative analysis and evaluation of these features are combined with reference model which can realize the target image abnormal judgment and provide a reference for disease diagnosis.

Preparing Fresh Retinal Slices from Adult Zebrafish for Ex Vivo Imaging Experiments.

PubMed

Giarmarco, Michelle M; Cleghorn, Whitney M; Hurley, James B; Brockerhoff, Susan E

2018-05-09

The retina is a complex tissue that initiates and integrates the first steps of vision. Dysfunction of retinal cells is a hallmark of many blinding diseases, and future therapies hinge on fundamental understandings about how different retinal cells function normally. Gaining such information with biochemical methods has proven difficult because contributions of particular cell types are diminished in the retinal cell milieu. Live retinal imaging can provide a view of numerous biological processes on a subcellular level, thanks to a growing number of genetically encoded fluorescent biosensors. However, this technique has thus far been limited to tadpoles and zebrafish larvae, the outermost retinal layers of isolated retinas, or lower resolution imaging of retinas in live animals. Here we present a method for generating live ex vivo retinal slices from adult zebrafish for live imaging via confocal microscopy. This preparation yields transverse slices with all retinal layers and most cell types visible for performing confocal imaging experiments using perfusion. Transgenic zebrafish expressing fluorescent proteins or biosensors in specific retinal cell types or organelles are used to extract single-cell information from an intact retina. Additionally, retinal slices can be loaded with fluorescent indicator dyes, adding to the method's versatility. This protocol was developed for imaging Ca 2+ within zebrafish cone photoreceptors, but with proper markers it could be adapted to measure Ca 2+ or metabolites in Müller cells, bipolar and horizontal cells, microglia, amacrine cells, or retinal ganglion cells. The retinal pigment epithelium is removed from slices so this method is not suitable for studying that cell type. With practice, it is possible to generate serial slices from one animal for multiple experiments. This adaptable technique provides a powerful tool for answering many questions about retinal cell biology, Ca 2+ , and energy homeostasis.

A Web-based telemedicine system for diabetic retinopathy screening using digital fundus photography.

PubMed

Wei, Jack C; Valentino, Daniel J; Bell, Douglas S; Baker, Richard S

2006-02-01

The purpose was to design and implement a Web-based telemedicine system for diabetic retinopathy screening using digital fundus cameras and to make the software publicly available through Open Source release. The process of retinal imaging and case reviewing was modeled to optimize workflow and implement use of computer system. The Web-based system was built on Java Servlet and Java Server Pages (JSP) technologies. Apache Tomcat was chosen as the JSP engine, while MySQL was used as the main database and Laboratory of Neuro Imaging (LONI) Image Storage Architecture, from the LONI-UCLA, as the platform for image storage. For security, all data transmissions were carried over encrypted Internet connections such as Secure Socket Layer (SSL) and HyperText Transfer Protocol over SSL (HTTPS). User logins were required and access to patient data was logged for auditing. The system was deployed at Hubert H. Humphrey Comprehensive Health Center and Martin Luther King/Drew Medical Center of Los Angeles County Department of Health Services. Within 4 months, 1500 images of more than 650 patients were taken at Humphrey's Eye Clinic and successfully transferred to King/Drew's Department of Ophthalmology. This study demonstrates an effective architecture for remote diabetic retinopathy screening.

The Edge Detectors Suitable for Retinal OCT Image Segmentation

PubMed Central

Yang, Jing; Gao, Qian; Zhou, Sheng

2017-01-01

Retinal layer thickness measurement offers important information for reliable diagnosis of retinal diseases and for the evaluation of disease development and medical treatment responses. This task critically depends on the accurate edge detection of the retinal layers in OCT images. Here, we intended to search for the most suitable edge detectors for the retinal OCT image segmentation task. The three most promising edge detection algorithms were identified in the related literature: Canny edge detector, the two-pass method, and the EdgeFlow technique. The quantitative evaluation results show that the two-pass method outperforms consistently the Canny detector and the EdgeFlow technique in delineating the retinal layer boundaries in the OCT images. In addition, the mean localization deviation metrics show that the two-pass method caused the smallest edge shifting problem. These findings suggest that the two-pass method is the best among the three algorithms for detecting retinal layer boundaries. The overall better performance of Canny and two-pass methods over EdgeFlow technique implies that the OCT images contain more intensity gradient information than texture changes along the retinal layer boundaries. The results will guide our future efforts in the quantitative analysis of retinal OCT images for the effective use of OCT technologies in the field of ophthalmology. PMID:29065594

A Charge Coupled Device Imaging System For Ophthalmology

NASA Astrophysics Data System (ADS)

Rowe, R. Wanda; Packer, Samuel; Rosen, James; Bizais, Yves

1984-06-01

A digital camera system has been constructed for obtaining reflectance images of the fundus of the eye with monochromatic light. Images at wavelengths in the visible and near infrared regions of the spectrum are recorded by a charge-coupled device array and transferred to a computer. A variety of image processing operations are performed to restore the pictures, correct for distortions in the image formation process, and extract new and diagnostically useful information. The steps involved in calibrating the system to permit quantitative measurement of fundus reflectance are discussed. Three clinically important applications of such a quantitative system are addressed: the characterization of changes in the optic nerve arising from glaucoma, the diagnosis of choroidal melanoma through spectral signatures, and the early detection and improved management of diabetic retinopathy by measurement of retinal tissue oxygen saturation.

Analysis of the chicken retina with an adaptive optics multiphoton microscope

PubMed Central

Bueno, Juan M.; Giakoumaki, Anastasia; Gualda, Emilio J.; Schaeffel, Frank; Artal, Pablo

2011-01-01

The structure and organization of the chicken retina has been investigated with an adaptive optics multiphoton imaging microscope in a backward configuration. Non-stained flat-mounted retinal tissues were imaged at different depths, from the retinal nerve fiber layer to the outer segment, by detecting the intrinsic nonlinear fluorescent signal. From the stacks of images corresponding to the different retinal layers, volume renderings of the entire retina were reconstructed. The density of photoreceptors and ganglion cells layer were directly estimated from the images as a function of the retinal eccentricity. The maximum anatomical resolving power at different retinal eccentricities was also calculated. This technique could be used for a better characterization of retinal alterations during myopia development, and may be useful for visualization of retinal pathologies and intoxication during pharmacological studies. PMID:21698025

Imaging microscopic structures in pathological retinas using a flood-illumination adaptive optics retinal camera

NASA Astrophysics Data System (ADS)

Viard, Clément; Nakashima, Kiyoko; Lamory, Barbara; Pâques, Michel; Levecq, Xavier; Château, Nicolas

2011-03-01

This research is aimed at characterizing in vivo differences between healthy and pathological retinal tissues at the microscopic scale using a compact adaptive optics (AO) retinal camera. Tests were performed in 120 healthy eyes and 180 eyes suffering from 19 different pathological conditions, including age-related maculopathy (ARM), glaucoma and rare diseases such as inherited retinal dystrophies. Each patient was first examined using SD-OCT and infrared SLO. Retinal areas of 4°x4° were imaged using an AO flood-illumination retinal camera based on a large-stroke deformable mirror. Contrast was finally enhanced by registering and averaging rough images using classical algorithms. Cellular-resolution images could be obtained in most cases. In ARM, AO images revealed granular contents in drusen, which were invisible in SLO or OCT images, and allowed the observation of the cone mosaic between drusen. In glaucoma cases, visual field was correlated to changes in cone visibility. In inherited retinal dystrophies, AO helped to evaluate cone loss across the retina. Other microstructures, slightly larger in size than cones, were also visible in several retinas. AO provided potentially useful diagnostic and prognostic information in various diseases. In addition to cones, other microscopic structures revealed by AO images may also be of interest in monitoring retinal diseases.

Digital photorefraction

NASA Astrophysics Data System (ADS)

Costa, Manuel F. M.; Jorge, Jorge M.

1998-01-01

The early evaluation of the visual status of human infants is of a critical importance. It is of utmost importance to the development of the child's visual system that she perceives clear, focused, retinal images. Furthermore if the refractive problems are not corrected in due time amblyopia may occur. Photorefraction is a non-invasive clinical tool rather convenient for application to this kind of population. A qualitative or semi-quantitative information about refractive errors, accommodation, strabismus, amblyogenic factors and some pathologies (cataracts) can the easily obtained. The photorefraction experimental setup we established using new technological breakthroughs on the fields of imaging devices, image processing and fiber optics, allows the implementation of both the isotropic and eccentric photorefraction approaches. Essentially both methods consist on delivering a light beam into the eyes. It is refracted by the ocular media, strikes the retina, focusing or not, reflects off and is collected by a camera. The system is formed by one CCD color camera and a light source. A beam splitter in front of the camera's objective allows coaxial illumination and observation. An optomechanical system also allows eccentric illumination. The light source is a flash type one and is synchronized with the camera's image acquisition. The camera's image is digitized displayed in real time. Image processing routines are applied for image's enhancement and feature extraction.

Digital photorefraction

NASA Astrophysics Data System (ADS)

Costa, Manuel F.; Jorge, Jorge M.

1997-12-01

The early evaluation of the visual status of human infants is of a critical importance. It is of utmost importance to the development of the child's visual system that she perceives clear, focused, retinal images. Furthermore if the refractive problems are not corrected in due time amblyopia may occur. Photorefraction is a non-invasive clinical tool rather convenient for application to this kind of population. A qualitative or semi-quantitative information about refractive errors, accommodation, strabismus, amblyogenic factors and some pathologies (cataracts) can the easily obtained. The photorefraction experimental setup we established using new technological breakthroughs on the fields of imaging devices, image processing and fiber optics, allows the implementation of both the isotropic and eccentric photorefraction approaches. Essentially both methods consist on delivering a light beam into the eyes. It is refracted by the ocular media, strikes the retina, focusing or not, reflects off and is collected by a camera. The system is formed by one CCD color camera and a light source. A beam splitter in front of the camera's objective allows coaxial illumination and observation. An optomechanical system also allows eccentric illumination. The light source is a flash type one and is synchronized with the camera's image acquisition. The camera's image is digitized displayed in real time. Image processing routines are applied for image's enhancement and feature extraction.

Parental history of hypertension is associated with narrower retinal arteriolar caliber in young girls.

PubMed

Gopinath, Bamini; Baur, Louise A; Hardy, Louise L; Wang, Jie Jin; Teber, Erdahl; Wong, Tien Y; Mitchell, Paul

2011-09-01

We aimed to assess the associations between parental history of hypertension and indicators of cardiovascular risk (retinal vessel diameter, presence of obesity, and elevated blood pressure) in prepubertal children. There were 1739 (77.7% of those eligible) 6-year-old students (863 girls and 876 boys) who were examined from a random cluster sample of 34 Sydney schools. Parents completed questionnaires about their medical conditions, including whether they have/had hypertension. Retinal images were taken with a digital fundus camera, and retinal vessel caliber was quantified using computer software. Anthropometric (height, weight, percentage of body fat, and body mass index) and blood pressure measures were collected. There were 160 children (9.2%) with a positive parental history of hypertension (either biological mother and/or father). Children with a positive versus negative parental history of hypertension had significantly higher body mass index (16.8 versus 16.5 kg/m(2); P=0.04) and systolic blood pressure (101.3 versus 99.8 mm Hg; P=0.01). Girls with positive versus negative parental history of hypertension had significantly higher diastolic blood pressure (≈3.1 mm Hg; P=0.01) and narrower retinal arteriolar caliber (≈4.3 μm; P=0.0004). Positive parental history of hypertension was not associated with mean retinal vascular caliber among boys. We show that a positive parental history of hypertension in healthy prepubertal girls, but not boys, is associated with narrower retinal arteriolar vessels, likely conveying a predisposition to develop hypertension later in life. These findings may indicate the need for cardiovascular disease prevention measures starting early in life among offspring of hypertensive parents.

Fluorescence lifetime imaging ophthalmoscopy.

PubMed

Dysli, Chantal; Wolf, Sebastian; Berezin, Mikhail Y; Sauer, Lydia; Hammer, Martin; Zinkernagel, Martin S

2017-09-01

Imaging techniques based on retinal autofluorescence have found broad applications in ophthalmology because they are extremely sensitive and noninvasive. Conventional fundus autofluorescence imaging measures fluorescence intensity of endogenous retinal fluorophores. It mainly derives its signal from lipofuscin at the level of the retinal pigment epithelium. Fundus autofluorescence, however, can not only be characterized by the spatial distribution of the fluorescence intensity or emission spectrum, but also by a characteristic fluorescence lifetime function. The fluorescence lifetime is the average amount of time a fluorophore remains in the excited state following excitation. Fluorescence lifetime imaging ophthalmoscopy (FLIO) is an emerging imaging modality for in vivo measurement of lifetimes of endogenous retinal fluorophores. Recent reports in this field have contributed to our understanding of the pathophysiology of various macular and retinal diseases. Within this review, the basic concept of fluorescence lifetime imaging is provided. It includes technical background information and correlation with in vitro measurements of individual retinal metabolites. In a second part, clinical applications of fluorescence lifetime imaging and fluorescence lifetime features of selected retinal diseases such as Stargardt disease, age-related macular degeneration, choroideremia, central serous chorioretinopathy, macular holes, diabetic retinopathy, and retinal artery occlusion are discussed. Potential areas of use for fluorescence lifetime imaging ophthalmoscopy will be outlined at the end of this review. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

INVESTIGATION OF ENROFLOXACIN-ASSOCIATED RETINAL TOXICITY IN NONDOMESTIC FELIDS.

PubMed

Newkirk, Kim M; Beard, L Kathryn; Sun, Xiaocun; Ramsay, Edward C

2017-06-01

Enrofloxacin is known to cause retinal toxicity in domestic cats. The hallmark lesion of enrofloxacin-associated retinal toxicity in domestic cats is thinning of the outer nuclear layer of the retina. Enrofloxacin is commonly used to treat bacterial infections in nondomestic felids because of its action against a wide spectrum of bacteria and the ability for it to be given orally. No previous studies have investigated the potential retinal toxicity of enrofloxacin in nondomestic felids. This retrospective study evaluated 81 eyes from 14 lions ( Panthera leo ) and 33 tigers ( Panthera tigris ) that had been enucleated or collected postmortem. The thickness of the outer nuclear retina was assessed in two separate sites in each eye by counting the rows of nuclei and by using digital image analysis software to determine the area of the nuclei at each site. Medical records were reviewed to determine the enrofloxacin dose for each cat. Cats that had not received enrofloxacin (n = 11) were compared with treated animals (n = 36). The outer nuclear layer thickness or area in treated versus untreated cats was not significantly different. Additionally, no clinical blindness was reported in any of the cats. This study showed no evidence of enrofloxacin-associated thinning of the outer nuclear layer in the lions and tigers evaluated, suggesting that enrofloxacin can be used safely in these animals.

Color Doppler imaging of the retrobulbar vessels in diabetic retinopathy.

PubMed

Pauk-Domańska, Magdalena; Walasik-Szemplińska, Dorota

2014-03-01

Diabetes is a metabolic disease characterized by elevated blood glucose level due to impaired insulin secretion and activity. Chronic hyperglycemia leads to functional disorders of numerous organs and to their damage. Vascular lesions belong to the most common late complications of diabetes. Microangiopathic lesions can be found in the eyeball, kidneys and nervous system. Macroangiopathy is associated with coronary and peripheral vessels. Diabetic retinopathy is the most common microangiopathic complication characterized by closure of slight retinal blood vessels and their permeability. Despite intensive research, the pathomechanism that leads to the development and progression of diabetic retinopathy is not fully understood. The examinations used in assessing diabetic retinopathy usually involve imaging of the vessels in the eyeball and the retina. Therefore, the examinations include: fluorescein angiography, optical coherence tomography of the retina, B-mode ultrasound imaging, perimetry and digital retinal photography. There are many papers that discuss the correlations between retrobulbar circulation alterations and progression of diabetic retinopathy based on Doppler sonography. Color Doppler imaging is a non-invasive method enabling measurements of blood flow velocities in small vessels of the eyeball. The most frequently assessed vessels include: the ophthalmic artery, which is the first branch of the internal carotid artery, as well as the central retinal vein and artery, and the posterior ciliary arteries. The analysis of hemodynamic alterations in the retrobulbar vessels may deliver important information concerning circulation in diabetes and help to answer the question whether there is a relation between the progression of diabetic retinopathy and the changes observed in blood flow in the vessels of the eyeball. This paper presents the overview of literature regarding studies on blood flow in the vessels of the eyeball in patients with diabetic retinopathy.

Multimodal swept-source spectrally encoded scanning laser ophthalmoscopy and optical coherence tomography at 400 kHz

NASA Astrophysics Data System (ADS)

El-Haddad, Mohamed T.; Joos, Karen M.; Patel, Shriji N.; Tao, Yuankai K.

2017-02-01

Multimodal imaging systems that combine scanning laser ophthalmoscopy (SLO) and optical coherence tomography (OCT) have demonstrated the utility of concurrent en face and volumetric imaging for aiming, eye tracking, bulk motion compensation, mosaicking, and contrast enhancement. However, this additional functionality trades off with increased system complexity and cost because both SLO and OCT generally require dedicated light sources, galvanometer scanners, relay and imaging optics, detectors, and control and digitization electronics. We previously demonstrated multimodal ophthalmic imaging using swept-source spectrally encoded SLO and OCT (SS-SESLO-OCT). Here, we present system enhancements and a new optical design that increase our SS-SESLO-OCT data throughput by >7x and field-of-view (FOV) by >4x. A 200 kHz 1060 nm Axsun swept-source was optically buffered to 400 kHz sweep-rate, and SESLO and OCT were simultaneously digitized on dual input channels of a 4 GS/s digitizer at 1.2 GS/s per channel using a custom k-clock. We show in vivo human imaging of the anterior segment out to the limbus and retinal fundus over a >40° FOV. In addition, nine overlapping volumetric SS-SESLO-OCT volumes were acquired under video-rate SESLO preview and guidance. In post-processing, all nine SESLO images and en face projections of the corresponding OCT volumes were mosaicked to show widefield multimodal fundus imaging with a >80° FOV. Concurrent multimodal SS-SESLO-OCT may have applications in clinical diagnostic imaging by enabling aiming, image registration, and multi-field mosaicking and benefit intraoperative imaging by allowing for real-time surgical feedback, instrument tracking, and overlays of computationally extracted image-based surrogate biomarkers of disease.

Detection and classification of retinal lesions for grading of diabetic retinopathy.

PubMed

Usman Akram, M; Khalid, Shehzad; Tariq, Anam; Khan, Shoab A; Azam, Farooque

2014-02-01

Diabetic Retinopathy (DR) is an eye abnormality in which the human retina is affected due to an increasing amount of insulin in blood. The early detection and diagnosis of DR is vital to save the vision of diabetes patients. The early signs of DR which appear on the surface of the retina are microaneurysms, haemorrhages, and exudates. In this paper, we propose a system consisting of a novel hybrid classifier for the detection of retinal lesions. The proposed system consists of preprocessing, extraction of candidate lesions, feature set formulation, and classification. In preprocessing, the system eliminates background pixels and extracts the blood vessels and optic disc from the digital retinal image. The candidate lesion detection phase extracts, using filter banks, all regions which may possibly have any type of lesion. A feature set based on different descriptors, such as shape, intensity, and statistics, is formulated for each possible candidate region: this further helps in classifying that region. This paper presents an extension of the m-Mediods based modeling approach, and combines it with a Gaussian Mixture Model in an ensemble to form a hybrid classifier to improve the accuracy of the classification. The proposed system is assessed using standard fundus image databases with the help of performance parameters, such as, sensitivity, specificity, accuracy, and the Receiver Operating Characteristics curves for statistical analysis. Copyright © 2013 Elsevier Ltd. All rights reserved.

Oral-facial-digital syndrome type IX in a patient with Dandy-Walker malformation.

PubMed Central

Nagai, K; Nagao, M; Nagao, M; Yanai, S; Minagawa, K; Takahashi, Y; Takekoshi, Y; Ishizaka, A; Matsuzono, Y; Kobayashi, O; Itagaki, T

1998-01-01

We report a girl with oral, facial, and digital anomalies including multiple alveolar frenula, lobulated tongue with nodules, a posterior cleft palate, hypertelorism, a prominent forehead with a large anterior fontanelle, and postaxial polydactyly in both hands and the right foot, features compatible with the oral-facial-digital syndrome (OFDS). In addition, she had bilateral microphthalmia, optic disc coloboma, and retinal degeneration with partial detachment, thus establishing a diagnosis of OFDS type IX. Dandy-Walker malformation and retrobulbar cysts were observed on MRI. These additional malformations have not been reported in OFDS type IX. The frequent apnoeic spells which occurred immediately after birth were relieved after cystoperitoneal shunt implantation for hydrocephalus. Considering our case and previous reports of OFDS type IX, including two male sibs, a boy born to consanguineous parents, and three females, inheritance is probably autosomal recessive. Images PMID:9598735

Digital versus film stereo-photography for assessment of the optic nerve head in glaucoma and glaucoma suspect patients.

PubMed

Hasanreisoglu, Murat; Priel, Ethan; Naveh, Lili; Lusky, Moshe; Weinberger, Dov; Benjamini, Yoav; Gaton, Dan D

2013-03-01

One of the leading methods for optic nerve head assessment in glaucoma remains stereoscopic photography. This study compared conventional film and digital stereoscopy in the quantitative and qualitative assessment of the optic nerve head in glaucoma and glaucoma suspect patients. Fifty patients with glaucoma or suspected glaucoma underwent stereoscopic photography of the optic nerve head with a 35-mm color slide film and a digital camera. Photographs/images were presented in random order to 3 glaucoma specialists for independent analysis using a standardized assessment form. Findings for the following parameters were compared among assessors and between techniques: cup/disc (C/D) ratio, state of the optic rim, presence of peripapillary atrophy and appearance of the retinal nerve fiber layer, blood vessels, and lamina cribrosa. The film-based and image-based diagnoses (glaucoma yes/no) were compared as well. Despite high level of agreement across graders using the same method for the horizontal and vertical C/D ratio, (intraclass correlations 0.80 to 0.83), the agreement across graders was much lower for the other parameters using the same method. Similarly the agreement between the findings of the same grader using either method was high for horizontal and vertical C/D ratio, but low for the other parameters. The latter differences were reflected in the disagreement regarding the final diagnosis: The diagnoses differed by technique for each grader in 18% to 46% of eyes, resulting in 38.5% of eyes diagnosed with glaucoma by film photography that "lost" their diagnosis on the digital images, whereas 18.7% of eyes diagnosed as nonglaucomatous by film photography were considered to have glaucoma on the digital images. Although there is consistency between 35-mm film stereoscopy and digital stereoscopy in determining the cup/disc (C/D) ratio, in all other parameters large differences exist, leading to differences in diagnosis. Differences in capturing images between digital and film photography may lead to loss of information and misdiagnosis. Further studies are needed to determine the reliability of the new digital techniques.

Panretinal, high-resolution color photography of the mouse fundus.

PubMed

Paques, Michel; Guyomard, Jean-Laurent; Simonutti, Manuel; Roux, Michel J; Picaud, Serge; Legargasson, Jean-François; Sahel, José-Alain

2007-06-01

To analyze high-resolution color photographs of the mouse fundus. A contact fundus camera based on topical endoscopy fundus imaging (TEFI) was built. Fundus photographs of C57 and Balb/c mice obtained by TEFI were qualitatively analyzed. High-resolution digital imaging of the fundus, including the ciliary body, was routinely obtained. The reflectance and contrast of retinal vessels varied significantly with the amount of incident and reflected light and, thus, with the degree of fundus pigmentation. The combination of chromatic and spherical aberration favored blue light imaging, in term of both field and contrast. TEFI is a small, low-cost system that allows high-resolution color fundus imaging and fluorescein angiography in conscious mice. Panretinal imaging is facilitated by the presence of the large rounded lens. TEFI significantly improves the quality of in vivo photography of retina and ciliary process of mice. Resolution is, however, affected by chromatic aberration, and should be improved by monochromatic imaging.

A novel retinal vessel extraction algorithm based on matched filtering and gradient vector flow

NASA Astrophysics Data System (ADS)

Yu, Lei; Xia, Mingliang; Xuan, Li

2013-10-01

The microvasculature network of retina plays an important role in the study and diagnosis of retinal diseases (age-related macular degeneration and diabetic retinopathy for example). Although it is possible to noninvasively acquire high-resolution retinal images with modern retinal imaging technologies, non-uniform illumination, the low contrast of thin vessels and the background noises all make it difficult for diagnosis. In this paper, we introduce a novel retinal vessel extraction algorithm based on gradient vector flow and matched filtering to segment retinal vessels with different likelihood. Firstly, we use isotropic Gaussian kernel and adaptive histogram equalization to smooth and enhance the retinal images respectively. Secondly, a multi-scale matched filtering method is adopted to extract the retinal vessels. Then, the gradient vector flow algorithm is introduced to locate the edge of the retinal vessels. Finally, we combine the results of matched filtering method and gradient vector flow algorithm to extract the vessels at different likelihood levels. The experiments demonstrate that our algorithm is efficient and the intensities of vessel images exactly represent the likelihood of the vessels.

Retinal image restoration by means of blind deconvolution

NASA Astrophysics Data System (ADS)

Marrugo, Andrés G.; Šorel, Michal; Šroubek, Filip; Millán, María S.

2011-11-01

Retinal imaging plays a key role in the diagnosis and management of ophthalmologic disorders, such as diabetic retinopathy, glaucoma, and age-related macular degeneration. Because of the acquisition process, retinal images often suffer from blurring and uneven illumination. This problem may seriously affect disease diagnosis and progression assessment. Here we present a method for color retinal image restoration by means of multichannel blind deconvolution. The method is applied to a pair of retinal images acquired within a lapse of time, ranging from several minutes to months. It consists of a series of preprocessing steps to adjust the images so they comply with the considered degradation model, followed by the estimation of the point-spread function and, ultimately, image deconvolution. The preprocessing is mainly composed of image registration, uneven illumination compensation, and segmentation of areas with structural changes. In addition, we have developed a procedure for the detection and visualization of structural changes. This enables the identification of subtle developments in the retina not caused by variation in illumination or blur. The method was tested on synthetic and real images. Encouraging experimental results show that the method is capable of significant restoration of degraded retinal images.

Retinal Image Quality Assessment for Spaceflight-Induced Vision Impairment Study

NASA Technical Reports Server (NTRS)

Vu, Amanda Cadao; Raghunandan, Sneha; Vyas, Ruchi; Radhakrishnan, Krishnan; Taibbi, Giovanni; Vizzeri, Gianmarco; Grant, Maria; Chalam, Kakarla; Parsons-Wingerter, Patricia

2015-01-01

Long-term exposure to space microgravity poses significant risks for visual impairment. Evidence suggests such vision changes are linked to cephalad fluid shifts, prompting a need to directly quantify microgravity-induced retinal vascular changes. The quality of retinal images used for such vascular remodeling analysis, however, is dependent on imaging methodology. For our exploratory study, we hypothesized that retinal images captured using fluorescein imaging methodologies would be of higher quality in comparison to images captured without fluorescein. A semi-automated image quality assessment was developed using Vessel Generation Analysis (VESGEN) software and MATLAB® image analysis toolboxes. An analysis of ten images found that the fluorescein imaging modality provided a 36% increase in overall image quality (two-tailed p=0.089) in comparison to nonfluorescein imaging techniques.

Multimodal Imaging and Spatial Analysis of Ebola Retinal Lesions in 14 Survivors of Ebola Virus Disease.

PubMed

Steptoe, Paul J; Momorie, Fayiah; Fornah, Alimamy D; Komba, Sahr P; Emsley, Elizabeth; Scott, Janet T; Harding, Simon P; Vandy, Matthew J; Sahr, Foday; Beare, Nicholas A V; Semple, Malcolm G

2018-05-03

Differentiation between Ebola retinal lesions and other retinal pathologies in West Africa is important, and the pathogenesis of Ebola retinal disease remains poorly understood. To describe the appearance of Ebola virus disease (EVD) retinal lesions using multimodal imaging to enable inferences on potential pathogenesis. This prospective case series study was carried out at 34 Military Hospital in Freetown, Sierra Leone. Ophthalmological images were analyzed from 14 consecutively identified survivors of EVD of Sierra Leonean origin who had identified Ebola retinal lesions. Multimodal imaging findings including ultra-widefield scanning laser ophthalmoscopy, fundus autofluorescence, swept-source optical coherence tomography (OCT), Humphrey visual field analysis, and spatial analysis. The 14 study participants had a mean (SD) age of 37.1 (8.8) years; 6 (43%) were women. A total of 141 Ebola retinal lesions were observed in 22 of 27 eyes (81%) of these 14 survivors on ultra-widefield imaging. Of these, 41 lesions (29.1%) were accessible to OCT imaging. Retinal lesions were predominantly nonpigmented with a pale-gray appearance. Peripapillary lesions exhibited variable curvatures in keeping with the retinal nerve fiber layer projections. All lesions respected the horizontal raphe and spared the fovea. The OCT imaging demonstrated a V-shaped hyperreflectivity of the outer nuclear layer overlying discontinuities of the ellipsoid zone and interdigitation zone in the smaller lesions. Larger lesions caused a collapse of the retinal layers and loss of retinal thickness. Lesion shapes were variable, but sharp angulations were characteristic. Perilesional areas of dark without pressure (thinned ellipsoid zone hyporeflectivity) accompanied 125 of the 141 lesions (88.7%) to varying extents. We demonstrate OCT evidence of localized pathological changes at the level of the photoreceptors in small lesions among survivors of EVD with retinal lesions. The relevance of associated areas of dark without pressure remains undetermined.

Wide-field optical coherence tomography based microangiography for retinal imaging

PubMed Central

Zhang, Qinqin; Lee, Cecilia S.; Chao, Jennifer; Chen, Chieh-Li; Zhang, Thomas; Sharma, Utkarsh; Zhang, Anqi; Liu, Jin; Rezaei, Kasra; Pepple, Kathryn L.; Munsen, Richard; Kinyoun, James; Johnstone, Murray; Van Gelder, Russell N.; Wang, Ruikang K.

2016-01-01

Optical coherence tomography angiography (OCTA) allows for the evaluation of functional retinal vascular networks without a need for contrast dyes. For sophisticated monitoring and diagnosis of retinal diseases, OCTA capable of providing wide-field and high definition images of retinal vasculature in a single image is desirable. We report OCTA with motion tracking through an auxiliary real-time line scan ophthalmoscope that is clinically feasible to image functional retinal vasculature in patients, with a coverage of more than 60 degrees of retina while still maintaining high definition and resolution. We demonstrate six illustrative cases with unprecedented details of vascular involvement in retinal diseases. In each case, OCTA yields images of the normal and diseased microvasculature at all levels of the retina, with higher resolution than observed with fluorescein angiography. Wide-field OCTA technology will be an important next step in augmenting the utility of OCT technology in clinical practice. PMID:26912261

Wide-field optical coherence tomography based microangiography for retinal imaging

NASA Astrophysics Data System (ADS)

Zhang, Qinqin; Lee, Cecilia S.; Chao, Jennifer; Chen, Chieh-Li; Zhang, Thomas; Sharma, Utkarsh; Zhang, Anqi; Liu, Jin; Rezaei, Kasra; Pepple, Kathryn L.; Munsen, Richard; Kinyoun, James; Johnstone, Murray; van Gelder, Russell N.; Wang, Ruikang K.

2016-02-01

Optical coherence tomography angiography (OCTA) allows for the evaluation of functional retinal vascular networks without a need for contrast dyes. For sophisticated monitoring and diagnosis of retinal diseases, OCTA capable of providing wide-field and high definition images of retinal vasculature in a single image is desirable. We report OCTA with motion tracking through an auxiliary real-time line scan ophthalmoscope that is clinically feasible to image functional retinal vasculature in patients, with a coverage of more than 60 degrees of retina while still maintaining high definition and resolution. We demonstrate six illustrative cases with unprecedented details of vascular involvement in retinal diseases. In each case, OCTA yields images of the normal and diseased microvasculature at all levels of the retina, with higher resolution than observed with fluorescein angiography. Wide-field OCTA technology will be an important next step in augmenting the utility of OCT technology in clinical practice.

Wide-field optical coherence tomography based microangiography for retinal imaging.

PubMed

Zhang, Qinqin; Lee, Cecilia S; Chao, Jennifer; Chen, Chieh-Li; Zhang, Thomas; Sharma, Utkarsh; Zhang, Anqi; Liu, Jin; Rezaei, Kasra; Pepple, Kathryn L; Munsen, Richard; Kinyoun, James; Johnstone, Murray; Van Gelder, Russell N; Wang, Ruikang K

2016-02-25

Optical coherence tomography angiography (OCTA) allows for the evaluation of functional retinal vascular networks without a need for contrast dyes. For sophisticated monitoring and diagnosis of retinal diseases, OCTA capable of providing wide-field and high definition images of retinal vasculature in a single image is desirable. We report OCTA with motion tracking through an auxiliary real-time line scan ophthalmoscope that is clinically feasible to image functional retinal vasculature in patients, with a coverage of more than 60 degrees of retina while still maintaining high definition and resolution. We demonstrate six illustrative cases with unprecedented details of vascular involvement in retinal diseases. In each case, OCTA yields images of the normal and diseased microvasculature at all levels of the retina, with higher resolution than observed with fluorescein angiography. Wide-field OCTA technology will be an important next step in augmenting the utility of OCT technology in clinical practice.

Scattering angle resolved optical coherence tomography for in vivo murine retinal imaging

NASA Astrophysics Data System (ADS)

Gardner, Michael R.; Katta, Nitesh; McElroy, Austin; Baruah, Vikram; Rylander, H. G.; Milner, Thomas E.

2017-02-01

Optical coherence tomography (OCT) retinal imaging contributes to understanding central nervous system (CNS) diseases because the eye is an anatomical "window to the brain" with direct optical access to nonmylenated retinal ganglion cells. However, many CNS diseases are associated with neuronal changes beyond the resolution of standard OCT retinal imaging systems. Though studies have shown the utility of scattering angle resolved (SAR) OCT for particle sizing and detecting disease states ex vivo, a compact SAR-OCT system for in vivo rodent retinal imaging has not previously been reported. We report a fiber-based SAR-OCT system (swept source at 1310 nm +/- 65 nm, 100 kHz scan rate) for mouse retinal imaging with a partial glass window (center aperture) for angular discrimination of backscattered light. This design incorporates a dual-axis MEMS mirror conjugate to the ocular pupil plane and a high collection efficiency objective. A muring retina is imaged during euthanasia, and the proposed SAR-index is examined versus time. Results show a positive correlation between the SAR-index and the sub-cellular hypoxic response of neurons to isoflurane overdose during euthanasia. The proposed SAR-OCT design and image process technique offer a contrast mechanism able to detect sub-resolution neuronal changes for murine retinal imaging.

Wavefront sensorless adaptive optics optical coherence tomography for in vivo retinal imaging in mice

PubMed Central

Jian, Yifan; Xu, Jing; Gradowski, Martin A.; Bonora, Stefano; Zawadzki, Robert J.; Sarunic, Marinko V.

2014-01-01

We present wavefront sensorless adaptive optics (WSAO) Fourier domain optical coherence tomography (FD-OCT) for in vivo small animal retinal imaging. WSAO is attractive especially for mouse retinal imaging because it simplifies optical design and eliminates the need for wavefront sensing, which is difficult in the small animal eye. GPU accelerated processing of the OCT data permitted real-time extraction of image quality metrics (intensity) for arbitrarily selected retinal layers to be optimized. Modal control of a commercially available segmented deformable mirror (IrisAO Inc.) provided rapid convergence using a sequential search algorithm. Image quality improvements with WSAO OCT are presented for both pigmented and albino mouse retinal data, acquired in vivo. PMID:24575347

Automatic Detection of Diabetic Retinopathy and Age-Related Macular Degeneration in Digital Fundus Images

PubMed Central

Barriga, E. Simon; Murray, Victor; Nemeth, Sheila; Crammer, Robert; Bauman, Wendall; Zamora, Gilberto; Pattichis, Marios S.; Soliz, Peter

2011-01-01

Purpose. To describe and evaluate the performance of an algorithm that automatically classifies images with pathologic features commonly found in diabetic retinopathy (DR) and age-related macular degeneration (AMD). Methods. Retinal digital photographs (N = 2247) of three fields of view (FOV) were obtained of the eyes of 822 patients at two centers: The Retina Institute of South Texas (RIST, San Antonio, TX) and The University of Texas Health Science Center San Antonio (UTHSCSA). Ground truth was provided for the presence of pathologic conditions, including microaneurysms, hemorrhages, exudates, neovascularization in the optic disc and elsewhere, drusen, abnormal pigmentation, and geographic atrophy. The algorithm was used to report on the presence or absence of disease. A detection threshold was applied to obtain different values of sensitivity and specificity with respect to ground truth and to construct a receiver operating characteristic (ROC) curve. Results. The system achieved an average area under the ROC curve (AUC) of 0.89 for detection of DR and of 0.92 for detection of sight-threatening DR (STDR). With a fixed specificity of 0.50, the system's sensitivity ranged from 0.92 for all DR cases to 1.00 for clinically significant macular edema (CSME). Conclusions. A computer-aided algorithm was trained to detect different types of pathologic retinal conditions. The cases of hard exudates within 1 disc diameter (DD) of the fovea (surrogate for CSME) were detected with very high accuracy (sensitivity = 1, specificity = 0.50), whereas mild nonproliferative DR was the most challenging condition (sensitivity= 0.92, specificity = 0.50). The algorithm was also tested on images with signs of AMD, achieving a performance of AUC of 0.84 (sensitivity = 0.94, specificity = 0.50). PMID:21666234

Automatic detection of diabetic retinopathy and age-related macular degeneration in digital fundus images.

PubMed

Agurto, Carla; Barriga, E Simon; Murray, Victor; Nemeth, Sheila; Crammer, Robert; Bauman, Wendall; Zamora, Gilberto; Pattichis, Marios S; Soliz, Peter

2011-07-29

To describe and evaluate the performance of an algorithm that automatically classifies images with pathologic features commonly found in diabetic retinopathy (DR) and age-related macular degeneration (AMD). Retinal digital photographs (N = 2247) of three fields of view (FOV) were obtained of the eyes of 822 patients at two centers: The Retina Institute of South Texas (RIST, San Antonio, TX) and The University of Texas Health Science Center San Antonio (UTHSCSA). Ground truth was provided for the presence of pathologic conditions, including microaneurysms, hemorrhages, exudates, neovascularization in the optic disc and elsewhere, drusen, abnormal pigmentation, and geographic atrophy. The algorithm was used to report on the presence or absence of disease. A detection threshold was applied to obtain different values of sensitivity and specificity with respect to ground truth and to construct a receiver operating characteristic (ROC) curve. The system achieved an average area under the ROC curve (AUC) of 0.89 for detection of DR and of 0.92 for detection of sight-threatening DR (STDR). With a fixed specificity of 0.50, the system's sensitivity ranged from 0.92 for all DR cases to 1.00 for clinically significant macular edema (CSME). A computer-aided algorithm was trained to detect different types of pathologic retinal conditions. The cases of hard exudates within 1 disc diameter (DD) of the fovea (surrogate for CSME) were detected with very high accuracy (sensitivity = 1, specificity = 0.50), whereas mild nonproliferative DR was the most challenging condition (sensitivity = 0.92, specificity = 0.50). The algorithm was also tested on images with signs of AMD, achieving a performance of AUC of 0.84 (sensitivity = 0.94, specificity = 0.50).

Detecting the optic disc boundary in digital fundus images using morphological, edge detection, and feature extraction techniques.

PubMed

Aquino, Arturo; Gegundez-Arias, Manuel Emilio; Marin, Diego

2010-11-01

Optic disc (OD) detection is an important step in developing systems for automated diagnosis of various serious ophthalmic pathologies. This paper presents a new template-based methodology for segmenting the OD from digital retinal images. This methodology uses morphological and edge detection techniques followed by the Circular Hough Transform to obtain a circular OD boundary approximation. It requires a pixel located within the OD as initial information. For this purpose, a location methodology based on a voting-type algorithm is also proposed. The algorithms were evaluated on the 1200 images of the publicly available MESSIDOR database. The location procedure succeeded in 99% of cases, taking an average computational time of 1.67 s. with a standard deviation of 0.14 s. On the other hand, the segmentation algorithm rendered an average common area overlapping between automated segmentations and true OD regions of 86%. The average computational time was 5.69 s with a standard deviation of 0.54 s. Moreover, a discussion on advantages and disadvantages of the models more generally used for OD segmentation is also presented in this paper.

Enface Thickness Mapping and Reflectance Imaging of Retinal Layers in Diabetic Retinopathy.

PubMed

Francis, Andrew W; Wanek, Justin; Lim, Jennifer I; Shahidi, Mahnaz

2015-01-01

To present a method for image segmentation and generation of enface thickness maps and reflectance images of retinal layers in healthy and diabetic retinopathy (DR) subjects. High density spectral domain optical coherence tomography (SDOCT) images were acquired in 10 healthy and 4 DR subjects. Customized image analysis software identified 5 retinal cell layer interfaces and generated thickness maps and reflectance images of the total retina (TR), inner retina (IR), outer retina (OR), and the inner segment ellipsoid (ISe) band. Thickness maps in DR subjects were compared to those of healthy subjects by generating deviation maps which displayed retinal locations with thickness below, within, and above the normal 95% confidence interval. In healthy subjects, TR and IR thickness maps displayed the foveal depression and increased thickness in the parafoveal region. OR and ISe thickness maps showed increased thickness at the fovea, consistent with normal retinal anatomy. In DR subjects, thickening and thinning in localized regions were demonstrated on TR, IR, OR, and ISe thickness maps, corresponding to retinal edema and atrophy, respectively. TR and OR reflectance images showed reduced reflectivity in regions of increased thickness. Hard exudates appeared as hyper-reflective spots in IR reflectance images and casted shadows on the deeper OR and ISe reflectance images. The ISe reflectance image clearly showed the presence of focal laser scars. Enface thickness mapping and reflectance imaging of retinal layers is a potentially useful method for quantifying the spatial and axial extent of pathologies due to DR.

Enface Thickness Mapping and Reflectance Imaging of Retinal Layers in Diabetic Retinopathy

PubMed Central

Francis, Andrew W.; Wanek, Justin; Lim, Jennifer I.; Shahidi, Mahnaz

2015-01-01

Purpose To present a method for image segmentation and generation of enface thickness maps and reflectance images of retinal layers in healthy and diabetic retinopathy (DR) subjects. Methods High density spectral domain optical coherence tomography (SDOCT) images were acquired in 10 healthy and 4 DR subjects. Customized image analysis software identified 5 retinal cell layer interfaces and generated thickness maps and reflectance images of the total retina (TR), inner retina (IR), outer retina (OR), and the inner segment ellipsoid (ISe) band. Thickness maps in DR subjects were compared to those of healthy subjects by generating deviation maps which displayed retinal locations with thickness below, within, and above the normal 95% confidence interval. Results In healthy subjects, TR and IR thickness maps displayed the foveal depression and increased thickness in the parafoveal region. OR and ISe thickness maps showed increased thickness at the fovea, consistent with normal retinal anatomy. In DR subjects, thickening and thinning in localized regions were demonstrated on TR, IR, OR, and ISe thickness maps, corresponding to retinal edema and atrophy, respectively. TR and OR reflectance images showed reduced reflectivity in regions of increased thickness. Hard exudates appeared as hyper-reflective spots in IR reflectance images and casted shadows on the deeper OR and ISe reflectance images. The ISe reflectance image clearly showed the presence of focal laser scars. Conclusions Enface thickness mapping and reflectance imaging of retinal layers is a potentially useful method for quantifying the spatial and axial extent of pathologies due to DR. PMID:26699878

Objective and expert-independent validation of retinal image registration algorithms by a projective imaging distortion model.

PubMed

Lee, Sangyeol; Reinhardt, Joseph M; Cattin, Philippe C; Abràmoff, Michael D

2010-08-01

Fundus camera imaging of the retina is widely used to diagnose and manage ophthalmologic disorders including diabetic retinopathy, glaucoma, and age-related macular degeneration. Retinal images typically have a limited field of view, and multiple images can be joined together using an image registration technique to form a montage with a larger field of view. A variety of methods for retinal image registration have been proposed, but evaluating such methods objectively is difficult due to the lack of a reference standard for the true alignment of the individual images that make up the montage. A method of generating simulated retinal images by modeling the geometric distortions due to the eye geometry and the image acquisition process is described in this paper. We also present a validation process that can be used for any retinal image registration method by tracing through the distortion path and assessing the geometric misalignment in the coordinate system of the reference standard. The proposed method can be used to perform an accuracy evaluation over the whole image, so that distortion in the non-overlapping regions of the montage components can be easily assessed. We demonstrate the technique by generating test image sets with a variety of overlap conditions and compare the accuracy of several retinal image registration models. Copyright 2010 Elsevier B.V. All rights reserved.

Automated detection of red lesions from digital colour fundus photographs.

PubMed

Jaafar, Hussain F; Nandi, Asoke K; Al-Nuaimy, Waleed

2011-01-01

Earliest signs of diabetic retinopathy, the major cause of vision loss, are damage to the blood vessels and the formation of lesions in the retina. Early detection of diabetic retinopathy is essential for the prevention of blindness. In this paper we present a computer-aided system to automatically identify red lesions from retinal fundus photographs. After pre-processing, a morphological technique was used to segment red lesion candidates from the background and other retinal structures. Then a rule-based classifier was used to discriminate actual red lesions from artifacts. A novel method for blood vessel detection is also proposed to refine the detection of red lesions. For a standarised test set of 219 images, the proposed method can detect red lesions with a sensitivity of 89.7% and a specificity of 98.6% (at lesion level). The performance of the proposed method shows considerable promise for detection of red lesions as well as other types of lesions.

The effect of baicalin in a mouse model of retinopathy of prematurity

PubMed Central

Jo, Hyoung; Jung, Sang Hoon; Yim, Hye Bin; Lee, Sung Jin; Kang, Kui Dong

2015-01-01

Baicalin is a flavonoid derived from the dried root of Scutellaria baicalensis. In this study, oxygen-induced retinopathy was used to characterize the anti-angiogenic properties of baicalin in mice. Pups were exposed to a hyperbaric oxygen environment to induce retinal angiogenesis and were subjected to intraperitoneal injection of baicalin. Avascular area, neovascular tufts, and neovascular lumens were quantified from digital images. Compared to the vehicle, baicalin clearly reduced the central avascular zone and the number of neovascular tufts and lumens. High-dose baicalin (10 mg/kg) significantly reduced the expression of matrix metalloproteinase-2 (MMP-2), MMP-9, angiotensin II, and vascular endothelial growth factor (VEGF). These results show that baicalin is a powerful antiangiogenic compound that attenuates new vessel formation in the retina after systemic administration, and is a candidate substance for therapeutic inhibition of retinal angiogenesis. [BMB Reports 2015; 48(5): 271-276] PMID:25154719

Role of VEGF Inhibition in the Treatment of Retinopathy of Prematurity.

PubMed

Eldweik, Luai; Mantagos, Iason S

2016-01-01

Retinopathy of prematurity (ROP) is a potentially blinding disease characterized by retinal neovascularization, which eventually can lead to tractional retinal detachment. Improvements have been made regarding the management of retinopathy of prematurity (ROP) since it was described in the Cryotherapy for Retinopathy of Prematurity study. A more appropriate time for therapeutic intervention was defined by the Early Treatment for Retinopathy of Prematurity (ETROP) trial. Advances in screening strategies with the use of digital imaging systems are now available. All of this and the use of laser photocoagulation and vitreoretinal surgery have contributed to significant increases in favorable outcomes and decreases in child blindness secondary to ROP. Recently the use of vascular endothelial growth factor (VEGF) inhibitors has been introduced to the armamentarium for the treatment of ROP. The purpose of this review article is to evaluate the role of VEGF inhibition in the treatment of ROP.

Feature-Based Retinal Image Registration Using D-Saddle Feature

PubMed Central

Hasikin, Khairunnisa; A. Karim, Noor Khairiah; Ahmedy, Fatimah

2017-01-01

Retinal image registration is important to assist diagnosis and monitor retinal diseases, such as diabetic retinopathy and glaucoma. However, registering retinal images for various registration applications requires the detection and distribution of feature points on the low-quality region that consists of vessels of varying contrast and sizes. A recent feature detector known as Saddle detects feature points on vessels that are poorly distributed and densely positioned on strong contrast vessels. Therefore, we propose a multiresolution difference of Gaussian pyramid with Saddle detector (D-Saddle) to detect feature points on the low-quality region that consists of vessels with varying contrast and sizes. D-Saddle is tested on Fundus Image Registration (FIRE) Dataset that consists of 134 retinal image pairs. Experimental results show that D-Saddle successfully registered 43% of retinal image pairs with average registration accuracy of 2.329 pixels while a lower success rate is observed in other four state-of-the-art retinal image registration methods GDB-ICP (28%), Harris-PIIFD (4%), H-M (16%), and Saddle (16%). Furthermore, the registration accuracy of D-Saddle has the weakest correlation (Spearman) with the intensity uniformity metric among all methods. Finally, the paired t-test shows that D-Saddle significantly improved the overall registration accuracy of the original Saddle. PMID:29204257

A Machine Learning Ensemble Classifier for Early Prediction of Diabetic Retinopathy.

PubMed

S K, Somasundaram; P, Alli

2017-11-09

The main complication of diabetes is Diabetic retinopathy (DR), retinal vascular disease and it leads to the blindness. Regular screening for early DR disease detection is considered as an intensive labor and resource oriented task. Therefore, automatic detection of DR diseases is performed only by using the computational technique is the great solution. An automatic method is more reliable to determine the presence of an abnormality in Fundus images (FI) but, the classification process is poorly performed. Recently, few research works have been designed for analyzing texture discrimination capacity in FI to distinguish the healthy images. However, the feature extraction (FE) process was not performed well, due to the high dimensionality. Therefore, to identify retinal features for DR disease diagnosis and early detection using Machine Learning and Ensemble Classification method, called, Machine Learning Bagging Ensemble Classifier (ML-BEC) is designed. The ML-BEC method comprises of two stages. The first stage in ML-BEC method comprises extraction of the candidate objects from Retinal Images (RI). The candidate objects or the features for DR disease diagnosis include blood vessels, optic nerve, neural tissue, neuroretinal rim, optic disc size, thickness and variance. These features are initially extracted by applying Machine Learning technique called, t-distributed Stochastic Neighbor Embedding (t-SNE). Besides, t-SNE generates a probability distribution across high-dimensional images where the images are separated into similar and dissimilar pairs. Then, t-SNE describes a similar probability distribution across the points in the low-dimensional map. This lessens the Kullback-Leibler divergence among two distributions regarding the locations of the points on the map. The second stage comprises of application of ensemble classifiers to the extracted features for providing accurate analysis of digital FI using machine learning. In this stage, an automatic detection of DR screening system using Bagging Ensemble Classifier (BEC) is investigated. With the help of voting the process in ML-BEC, bagging minimizes the error due to variance of the base classifier. With the publicly available retinal image databases, our classifier is trained with 25% of RI. Results show that the ensemble classifier can achieve better classification accuracy (CA) than single classification models. Empirical experiments suggest that the machine learning-based ensemble classifier is efficient for further reducing DR classification time (CT).

3D Reconstruction of the Retinal Arterial Tree Using Subject-Specific Fundus Images

NASA Astrophysics Data System (ADS)

Liu, D.; Wood, N. B.; Xu, X. Y.; Witt, N.; Hughes, A. D.; Samcg, Thom

Systemic diseases, such as hypertension and diabetes, are associated with changes in the retinal microvasculature. Although a number of studies have been performed on the quantitative assessment of the geometrical patterns of the retinal vasculature, previous work has been confined to 2 dimensional (2D) analyses. In this paper, we present an approach to obtain a 3D reconstruction of the retinal arteries from a pair of 2D retinal images acquired in vivo. A simple essential matrix based self-calibration approach was employed for the "fundus camera-eye" system. Vessel segmentation was performed using a semi-automatic approach and correspondence between points from different images was calculated. The results of 3D reconstruction show the centreline of retinal vessels and their 3D curvature clearly. Three-dimensional reconstruction of the retinal vessels is feasible and may be useful in future studies of the retinal vasculature in disease.

Automated measurement of retinal blood vessel tortuosity

NASA Astrophysics Data System (ADS)

Joshi, Vinayak; Reinhardt, Joseph M.; Abramoff, Michael D.

2010-03-01

Abnormalities in the vascular pattern of the retina are associated with retinal diseases and are also risk factors for systemic diseases, especially cardiovascular diseases. The three-dimensional retinal vascular pattern is mostly formed congenitally, but is then modified over life, in response to aging, vessel wall dystrophies and long term changes in blood flow and pressure. A characteristic of the vascular pattern that is appreciated by clinicians is vascular tortuosity, i.e. how curved or kinked a blood vessel, either vein or artery, appears along its course. We developed a new quantitative metric for vascular tortuosity, based on the vessel's angle of curvature, length of the curved vessel over its chord length (arc to chord ratio), number of curvature sign changes, and combined these into a unidimensional metric, Tortuosity Index (TI). In comparison to other published methods this method can estimate appropriate TI for vessels with constant curvature sign and vessels with equal arc to chord ratios, as well. We applied this method to a dataset of 15 digital fundus images of 8 patients with Facioscapulohumeral muscular dystrophy (FSHD), and to the other publically available dataset of 60 fundus images of normal cases and patients with hypertensive retinopathy, of which the arterial and venous tortuosities have also been graded by masked experts (ophthalmologists). The method produced exactly the same rank-ordered list of vessel tortuosity (TI) values as obtained by averaging the tortuosity grading given by 3 ophthalmologists for FSHD dataset and a list of TI values with high ranking correlation with the ophthalmologist's grading for the other dataset. Our results show that TI has potential to detect and evaluate abnormal retinal vascular structure in early diagnosis and prognosis of retinopathies.

Association of consumption of dairy products and meat with retinal vessel calibers in subjects at increased cardiovascular risk.

PubMed

Karatzi, K; Aissopou, E K; Tsirimiagou, C; Fatmeli, E; Sfikakis, P P; Protogerou, A D

2016-08-01

Association of dairy products and meat consumption with macrocirculation is previously described, but such association with microcirculation is poorly investigated. We aimed to test the hypothesis that the consumption of high- and low-fat dairy products as well as red, white, and processed meat is associated with retinal vessel calibers in adults at an increased risk of cardiovascular disease (CVD). In consecutive subjects (n = 181, age: 51.3 ± 12.4 years, 51.4% women) without CVD and diabetes mellitus but with increased CVD risk, we obtained digital left and right retinal images. These images were assessed with validated software to determine central retinal arteriolar and venular equivalents and the arteriolar to venular ratio (CRAE, CRVE, and AVR, respectively). The consumption of dairy products and meat was assessed through 24-h recalls in all volunteers. After adjustment for potential confounders, the following findings were obtained: (i) low-fat milk and yogurt were positively associated with CRAE (b=0.145, p=0.031 left; b=0.141, p=0.038 right) and inversely associated with CRVE (b=-0.155, p=0.026 left; b=-0.146, p=0.041 right); (ii) low-fat cheese was positively associated with CRAE (b=0.164, p=0.011 left and b=0.155, p=0.017 right); and (iii) red meat was inversely associated with CRAE (b=-0.143, p=0.032 left; b=-0.114, p=0.050 right). High-fat milk, yogurt, and cheese or white and processed meat were not found to be associated with retinal vessel calibers. High consumption of low-fat milk, yogurt, and cheese and low consumption of red meat could be beneficial for retinal microvascular health. Prospective studies are needed to verify these findings. Copyright © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Survey on diagnosis of diseases from retinal images

NASA Astrophysics Data System (ADS)

Das, Sneha; Malathy, C.

2018-04-01

Retina is a thin membranous layer of tissue that occupies at the back of the eye which provides central vision needed for daily routines. Identifying retinal diseases at the early stage is a challenging task since healthy retina is required for central vision. Several retinal diseases affect the eye such as retinal tear, retinal detachment, glaucoma, macular hole and macular degeneration etc. These maladies will encounter a secondary growth in the close future as the age of the person increases. A survey is made which tells about the diagnosis of the retinal diseases from the retinal images using machine learning techniques.

Automated analysis of retinal imaging using machine learning techniques for computer vision.

PubMed

De Fauw, Jeffrey; Keane, Pearse; Tomasev, Nenad; Visentin, Daniel; van den Driessche, George; Johnson, Mike; Hughes, Cian O; Chu, Carlton; Ledsam, Joseph; Back, Trevor; Peto, Tunde; Rees, Geraint; Montgomery, Hugh; Raine, Rosalind; Ronneberger, Olaf; Cornebise, Julien

2016-01-01

There are almost two million people in the United Kingdom living with sight loss, including around 360,000 people who are registered as blind or partially sighted. Sight threatening diseases, such as diabetic retinopathy and age related macular degeneration have contributed to the 40% increase in outpatient attendances in the last decade but are amenable to early detection and monitoring. With early and appropriate intervention, blindness may be prevented in many cases. Ophthalmic imaging provides a way to diagnose and objectively assess the progression of a number of pathologies including neovascular ("wet") age-related macular degeneration (wet AMD) and diabetic retinopathy. Two methods of imaging are commonly used: digital photographs of the fundus (the 'back' of the eye) and Optical Coherence Tomography (OCT, a modality that uses light waves in a similar way to how ultrasound uses sound waves). Changes in population demographics and expectations and the changing pattern of chronic diseases creates a rising demand for such imaging. Meanwhile, interrogation of such images is time consuming, costly, and prone to human error. The application of novel analysis methods may provide a solution to these challenges. This research will focus on applying novel machine learning algorithms to automatic analysis of both digital fundus photographs and OCT in Moorfields Eye Hospital NHS Foundation Trust patients. Through analysis of the images used in ophthalmology, along with relevant clinical and demographic information, DeepMind Health will investigate the feasibility of automated grading of digital fundus photographs and OCT and provide novel quantitative measures for specific disease features and for monitoring the therapeutic success.

Adaptive-optics SLO imaging combined with widefield OCT and SLO enables precise 3D localization of fluorescent cells in the mouse retina.

PubMed

Zawadzki, Robert J; Zhang, Pengfei; Zam, Azhar; Miller, Eric B; Goswami, Mayank; Wang, Xinlei; Jonnal, Ravi S; Lee, Sang-Hyuck; Kim, Dae Yu; Flannery, John G; Werner, John S; Burns, Marie E; Pugh, Edward N

2015-06-01

Adaptive optics scanning laser ophthalmoscopy (AO-SLO) has recently been used to achieve exquisite subcellular resolution imaging of the mouse retina. Wavefront sensing-based AO typically restricts the field of view to a few degrees of visual angle. As a consequence the relationship between AO-SLO data and larger scale retinal structures and cellular patterns can be difficult to assess. The retinal vasculature affords a large-scale 3D map on which cells and structures can be located during in vivo imaging. Phase-variance OCT (pv-OCT) can efficiently image the vasculature with near-infrared light in a label-free manner, allowing 3D vascular reconstruction with high precision. We combined widefield pv-OCT and SLO imaging with AO-SLO reflection and fluorescence imaging to localize two types of fluorescent cells within the retinal layers: GFP-expressing microglia, the resident macrophages of the retina, and GFP-expressing cone photoreceptor cells. We describe in detail a reflective afocal AO-SLO retinal imaging system designed for high resolution retinal imaging in mice. The optical performance of this instrument is compared to other state-of-the-art AO-based mouse retinal imaging systems. The spatial and temporal resolution of the new AO instrumentation was characterized with angiography of retinal capillaries, including blood-flow velocity analysis. Depth-resolved AO-SLO fluorescent images of microglia and cone photoreceptors are visualized in parallel with 469 nm and 663 nm reflectance images of the microvasculature and other structures. Additional applications of the new instrumentation are discussed.

Fast detection of the main anatomical structures in digital retinal images based on intra- and inter-structure relational knowledge.

PubMed

Molina-Casado, José M; Carmona, Enrique J; García-Feijoó, Julián

2017-10-01

The anatomical structure detection in retinal images is an open problem. However, most of the works in the related literature are oriented to the detection of each structure individually or assume the previous detection of a structure which is used as a reference. The objective of this paper is to obtain simultaneous detection of the main retinal structures (optic disc, macula, network of vessels and vascular bundle) in a fast and robust way. We propose a new methodology oriented to accomplish the mentioned objective. It consists of two stages. In an initial stage, a set of operators is applied to the retinal image. Each operator uses intra-structure relational knowledge in order to produce a set of candidate blobs that belongs to the desired structure. In a second stage, a set of tuples is created, each of which contains a different combination of the candidate blobs. Next, filtering operators, using inter-structure relational knowledge, are used in order to find the winner tuple. A method using template matching and mathematical morphology is implemented following the proposed methodology. A success is achieved if the distance between the automatically detected blob center and the actual structure center is less than or equal to one optic disc radius. The success rates obtained in the different public databases analyzed were: MESSIDOR (99.33%, 98.58%, 97.92%), DIARETDB1 (96.63%, 100%, 97.75%), DRIONS (100%, n/a, 100%) and ONHSD (100%, 98.85%, 97.70%) for optic disc (OD), macula (M) and vascular bundle (VB), respectively. Finally, the overall success rate obtained in this study for each structure was: 99.26% (OD), 98.69% (M) and 98.95% (VB). The average time of processing per image was 4.16 ± 0.72 s. The main advantage of the use of inter-structure relational knowledge was the reduction of the number of false positives in the detection process. The implemented method is able to simultaneously detect four structures. It is fast, robust and its detection results are competitive in relation to other methods of the recent literature. Copyright © 2017 Elsevier B.V. All rights reserved.

Active learning approach for detection of hard exudates, cotton wool spots, and drusen in retinal images

NASA Astrophysics Data System (ADS)

Sánchez, Clara I.; Niemeijer, Meindert; Kockelkorn, Thessa; Abràmoff, Michael D.; van Ginneken, Bram

2009-02-01

Computer-aided Diagnosis (CAD) systems for the automatic identification of abnormalities in retinal images are gaining importance in diabetic retinopathy screening programs. A huge amount of retinal images are collected during these programs and they provide a starting point for the design of machine learning algorithms. However, manual annotations of retinal images are scarce and expensive to obtain. This paper proposes a dynamic CAD system based on active learning for the automatic identification of hard exudates, cotton wool spots and drusen in retinal images. An uncertainty sampling method is applied to select samples that need to be labeled by an expert from an unlabeled set of 4000 retinal images. It reduces the number of training samples needed to obtain an optimum accuracy by dynamically selecting the most informative samples. Results show that the proposed method increases the classification accuracy compared to alternative techniques, achieving an area under the ROC curve of 0.87, 0.82 and 0.78 for the detection of hard exudates, cotton wool spots and drusen, respectively.

LONGITUDINAL STRUCTURAL CHANGES IN LATE-ONSET RETINAL DEGENERATION.

PubMed

Cukras, Catherine; Flamendorf, Jason; Wong, Wai T; Ayyagari, Radha; Cunningham, Denise; Sieving, Paul A

2016-12-01

To characterize longitudinal structural changes in early stages of late-onset retinal degeneration to investigate pathogenic mechanisms. Two affected siblings, both with a S163R missense mutation in the causative gene C1QTNF5, were followed for 8+ years. Color fundus photos, fundus autofluorescence images, near-infrared reflectance fundus images, and spectral domain optical coherence tomography scans were acquired during follow-up. Both patients, aged 45 and 50 years, had good visual acuities (>20/20) in the context of prolonged dark adaptation. Baseline color fundus photography demonstrated yellow-white, punctate lesions in the temporal macula that correlated with a reticular pattern on fundus autofluorescence and near-infrared reflectance imaging. Baseline spectral domain optical coherence tomography imaging revealed subretinal deposits that resemble reticular pseudodrusen described in age-related macular degeneration. During follow-up, these affected areas developed confluent thickening of the retinal pigment epithelial layer and disruption of the ellipsoid zone of photoreceptors before progressing to overt retinal pigment epithelium and outer retinal atrophy. Structural changes in early stages of late-onset retinal degeneration, revealed by multimodal imaging, resemble those of reticular pseudodrusen observed in age-related macular degeneration and other retinal diseases. Longitudinal follow-up of these lesions helps elucidate their progression to frank atrophy and may lend insight into the pathogenic mechanisms underlying diverse retinal degenerations.

[Computer graphic display of retinal examination results. Software improving the quality of documenting fundus changes].

PubMed

Jürgens, Clemens; Grossjohann, Rico; Czepita, Damian; Tost, Frank

2009-01-01

Graphic documentation of retinal examination results in clinical ophthalmological practice is often depicted using pictures or in handwritten form. Popular software products used to describe changes in the fundus do not vary much from simple graphic programs that enable to insert, scale and edit basic graphic elements such as: a circle, rectangle, arrow or text. Displaying the results of retinal examinations in a unified way is difficult to achieve. Therefore, we devised and implemented modern software tools for this purpose. A computer program enabling to quickly and intuitively form graphs of the fundus, that can be digitally archived or printed was created. Especially for the needs of ophthalmological clinics, a set of standard digital symbols used to document the results of retinal examinations was developed and installed in a library of graphic symbols. These symbols are divided into the following categories: preoperative, postoperative, neovascularization, retinopathy of prematurity. The appropriate symbol can be selected with a click of the mouse and dragged-and-dropped on the canvas of the fundus. Current forms of documenting results of retinal examinations are unsatisfactory, due to the fact that they are time consuming and imprecise. Unequivocal interpretation is difficult or in some cases impossible. Using the developed computer program a sketch of the fundus can be created much more quickly than by hand drawing. Additionally the quality of the medica documentation using a system of well described and standardized symbols will be enhanced. (1) Graphic symbols used to document the results of retinal examinations are a part of everyday clinical practice. (2) The designed computer program will allow quick and intuitive graphical creation of fundus sketches that can be either digitally archived or printed.

Comparison of the effectiveness of three retinal camera technologies for malarial retinopathy detection in Malawi

NASA Astrophysics Data System (ADS)

Soliz, Peter; Nemeth, Sheila C.; Barriga, E. Simon; Harding, Simon P.; Lewallen, Susan; Taylor, Terrie E.; MacCormick, Ian J.; Joshi, Vinayak S.

2016-03-01

The purpose of this study was to test the suitability of three available camera technologies (desktop, portable, and iphone based) for imaging comatose children who presented with clinical symptoms of malaria. Ultimately, the results of the project would form the basis for a design of a future camera to screen for malaria retinopathy (MR) in a resource challenged environment. The desktop, portable, and i-phone based cameras were represented by the Topcon, Pictor Plus, and Peek cameras, respectively. These cameras were tested on N=23 children presenting with symptoms of cerebral malaria (CM) at a malaria clinic, Queen Elizabeth Teaching Hospital in Malawi, Africa. Each patient was dilated for binocular indirect ophthalmoscopy (BIO) exam by an ophthalmologist followed by imaging with all three cameras. Each of the cases was graded according to an internationally established protocol and compared to the BIO as the clinical ground truth. The reader used three principal retinal lesions as markers for MR: hemorrhages, retinal whitening, and vessel discoloration. The study found that the mid-priced Pictor Plus hand-held camera performed considerably better than the lower price mobile phone-based camera, and slightly the higher priced table top camera. When comparing the readings of digital images against the clinical reference standard (BIO), the Pictor Plus camera had sensitivity and specificity for MR of 100% and 87%, respectively. This compares to a sensitivity and specificity of 87% and 75% for the i-phone based camera and 100% and 75% for the desktop camera. The drawback of all the cameras were their limited field of view which did not allow complete view of the periphery where vessel discoloration occurs most frequently. The consequence was that vessel discoloration was not addressed in this study. None of the cameras offered real-time image quality assessment to ensure high quality images to afford the best possible opportunity for reading by a remotely located specialist.

The effect of JPEG compression on automated detection of microaneurysms in retinal images

NASA Astrophysics Data System (ADS)

Cree, M. J.; Jelinek, H. F.

2008-02-01

As JPEG compression at source is ubiquitous in retinal imaging, and the block artefacts introduced are known to be of similar size to microaneurysms (an important indicator of diabetic retinopathy) it is prudent to evaluate the effect of JPEG compression on automated detection of retinal pathology. Retinal images were acquired at high quality and then compressed to various lower qualities. An automated microaneurysm detector was run on the retinal images of various qualities of JPEG compression and the ability to predict the presence of diabetic retinopathy based on the detected presence of microaneurysms was evaluated with receiver operating characteristic (ROC) methodology. The negative effect of JPEG compression on automated detection was observed even at levels of compression sometimes used in retinal eye-screening programmes and these may have important clinical implications for deciding on acceptable levels of compression for a fully automated eye-screening programme.

GCaMP expression in retinal ganglion cells characterized using a low-cost fundus imaging system

NASA Astrophysics Data System (ADS)

Chang, Yao-Chuan; Walston, Steven T.; Chow, Robert H.; Weiland, James D.

2017-10-01

Objective. Virus-transduced, intracellular-calcium indicators are effective reporters of neural activity, offering the advantage of cell-specific labeling. Due to the existence of an optimal time window for the expression of calcium indicators, a suitable tool for tracking GECI expression in vivo following transduction is highly desirable. Approach. We developed a noninvasive imaging approach based on a custom-modified, low-cost fundus viewing system that allowed us to monitor and characterize in vivo bright-field and fluorescence images of the mouse retina. AAV2-CAG-GCaMP6f was injected into a mouse eye. The fundus imaging system was used to measure fluorescence at several time points post injection. At defined time points, we prepared wholemount retina mounted on a transparent multielectrode array and used calcium imaging to evaluate the responsiveness of retinal ganglion cells (RGCs) to external electrical stimulation. Main results. The noninvasive fundus imaging system clearly resolves individual (RGCs and axons. RGC fluorescence intensity and the number of observable fluorescent cells show a similar rising trend from week 1 to week 3 after viral injection, indicating a consistent increase of GCaMP6f expression. Analysis of the in vivo fluorescence intensity trend and in vitro neurophysiological responsiveness shows that the slope of intensity versus days post injection can be used to estimate the optimal time for calcium imaging of RGCs in response to external electrical stimulation. Significance. The proposed fundus imaging system enables high-resolution digital fundus imaging in the mouse eye, based on off-the-shelf components. The long-term tracking experiment with in vitro calcium imaging validation demonstrates the system can serve as a powerful tool monitoring the level of genetically-encoded calcium indicator expression, further determining the optimal time window for following experiment.

Multimodal imaging in a case of bilateral outer retinitis associated with mumps infection.

PubMed

Kahloun, Rim; Ben Amor, Hager; Ksiaa, Imen; Zina, Sourour; Jelliti, Bechir; Ben Yahia, Salim; Khairallah, Moncef

2018-02-01

To report the results of multimodal imaging of acute outer retinitis associated to mumps infection. A patient with mumps-associated outer retinitis evaluated by color fundus photography, spectral domain optical coherence tomography (SD-OCT), optical coherence tomography angiography, fundus autofluorescence (FAF), fluorescein angiography (FA), and indocyanine green angiography (ICGA). We report a case of a 12-year-old boy who developed bilateral outer retinitis related to mumps. Ophthalmoscopy showed confluent areas of outer retinitis involving the posterior pole and the periphery with a centrifugal gyrate pattern. SD-OCT revealed a marked disorganization of the outer retinal layers with multiple highly reflective spicules. FA shows diffuse late hyperfluorescence with optic disk staining. ICGA shows macular and peripheral hyperfluorescent lesions with a geographical pattern in the late phases. The patient was treated with acyclovir and oral prednisone. Four weeks after presentation visual acuity remained unchanged, and retinal changes seen at the acute phase had resolved leading to extensive retinal atrophy and optic disk pallor. SD-OCT showed atrophy of the retinal pigment epithelial and outer retinal layers. FAF revealed scattered hyperautofluorescent lesions. Electrophysiology showed generalized retinal dysfunction. Mumps infection should be considered in the differential diagnosis of bilateral necrotizing outer retinitis in children and young adults. A multimodal imaging approach may help distinguish mumps-associated retinitis from other causes of viral retinitis and facilitate appropriate management.

Plenoptic Ophthalmoscopy: A Novel Imaging Technique.

PubMed

Adam, Murtaza K; Aenchbacher, Weston; Kurzweg, Timothy; Hsu, Jason

2016-11-01

This prospective retinal imaging case series was designed to establish feasibility of plenoptic ophthalmoscopy (PO), a novel mydriatic fundus imaging technique. A custom variable intensity LED array light source adapter was created for the Lytro Gen1 light-field camera (Lytro, Mountain View, CA). Initial PO testing was performed on a model eye and rabbit fundi. PO image acquisition was then performed on dilated human subjects with a variety of retinal pathology and images were subjected to computational enhancement. The Lytro Gen1 light-field camera with custom LED array captured fundus images of eyes with diabetic retinopathy, age-related macular degeneration, retinal detachment, and other diagnoses. Post-acquisition computational processing allowed for refocusing and perspective shifting of retinal PO images, resulting in improved image quality. The application of PO to image the ocular fundus is feasible. Additional studies are needed to determine its potential clinical utility. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:1038-1043.]. Copyright 2016, SLACK Incorporated.

[Reliability of retinal imaging screening in retinopathy of prematurity].

PubMed

Navarro-Blanco, C; Peralta-Calvo, J; Pastora-Salvador, N; Alvarez-Rementería, L; Chamorro, E; Sánchez-Ramos, C

2014-09-01

The retinopathy of prematurity (ROP) is a potentially avoidable cause of blindness in children. The advances in neonatal care make the survival of extremely premature infants, who show a greater incidence of the disease, possible. The aim of the study is to evaluate the reliability of ROP screening using retinography imaging with the RetCam 3 wide-angle camera and also study the variability of ROP diagnosis depending on the evaluator. The indirect ophthalmoscopy exam was performed by a Pediatric ROP-Expert Ophthalmologist. The same ophthalmologist and a technician specialized in digital image capture took retinal images using the RetCam 3 wide-angle camera. A total of 30 image sets were analyzed by 3 masked groups: group A (8 ophthalmologists), group B (5 experts in vision), and group C (2 ROP-expert ophthalmologists). According to the diagnosis using indirect ophthalmoscopy, the sensitivity (26-93), Kappa (0.24-0.80), and the percent agreement were statistically significant in group C for the diagnosis of ROP Type 1. In the diagnosis of ROP Type 1+Type 2, Kappa (0.17-0.33) and the percent agreement (58-90) were statistically significant, with higher values in group C. The diagnosis, carried out by ROP-expert ophthalmologists, using the wide-angle camera RetCam 3 has proved to be a reliable method. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Retinal imaging using adaptive optics technology☆

PubMed Central

Kozak, Igor

2014-01-01

Adaptive optics (AO) is a technology used to improve the performance of optical systems by reducing the effect of wave front distortions. Retinal imaging using AO aims to compensate for higher order aberrations originating from the cornea and the lens by using deformable mirror. The main application of AO retinal imaging has been to assess photoreceptor cell density, spacing, and mosaic regularity in normal and diseased eyes. Apart from photoreceptors, the retinal pigment epithelium, retinal nerve fiber layer, retinal vessel wall and lamina cribrosa can also be visualized with AO technology. Recent interest in AO technology in eye research has resulted in growing number of reports and publications utilizing this technology in both animals and humans. With the availability of first commercially available instruments we are making transformation of AO technology from a research tool to diagnostic instrument. The current challenges include imaging eyes with less than perfect optical media, formation of normative databases for acquired images such as cone mosaics, and the cost of the technology. The opportunities for AO will include more detailed diagnosis with description of some new findings in retinal diseases and glaucoma as well as expansion of AO into clinical trials which has already started. PMID:24843304

WIDEFIELD SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY IMAGING OF PERIPHERAL ROUND RETINAL HOLES WITH OR WITHOUT RETINAL DETACHMENT.

PubMed

Casswell, Edward J; Abou Ltaif, Sleiman; Carr, Thomas; Keane, Pearse A; Charteris, David G; Wickham, Louisa

2018-03-02

To describe the widefield spectral-domain optical coherence tomography features of peripheral round retinal holes, with or without associated retinal detachment (RD). Retrospective, observational study of 28 eyes with peripheral round retinal holes, with and without RD. Patients underwent imaging with a widefield 50-degree spectral-domain optical coherence tomography (Heidelberg Engineering, Germany) and Optos ultra-widefield imaging systems (Optos, United Kingdom). Vitreous attachment at the site of the retinal hole was detected in 27/28 (96.4%) cases. Cases were split into three groups: RHs with RD (n = 12); RHs with subretinal fluid (n = 5), and flat RHs (n = 11), with minimal or no subretinal fluid. 91.6% retinal holes associated with subretinal fluid or RD had vitreous attachment at the site of the hole. Eighty percent had vitreous attachment at both edges of the retinal hole, in a U-shape configuration, which appeared to exert traction. By contrast, flat retinal holes had visible vitreous attachment only at one edge of the retinal hole in 45.4%. Vitreous attachment was commonly seen at the site of round retinal holes. Vitreous attachment at both edges of the retinal hole in a U-shape configuration was more commonly seen at holes associated with subretinal fluid or RD.

Imaging of retinal and choroidal vascular tumours

PubMed Central

Heimann, H; Jmor, F; Damato, B

2013-01-01

The most common intraocular vascular tumours are choroidal haemangiomas, vasoproliferative tumours, and retinal haemangioblastomas. Rarer conditions include cavernous retinal angioma and arteriovenous malformations. Options for ablating the tumour include photodynamic therapy, argon laser photocoagulation, trans-scleral diathermy, cryotherapy, anti-angiogenic agents, plaque radiotherapy, and proton beam radiotherapy. Secondary effects are common and include retinal exudates, macular oedema, epiretinal membranes, retinal fibrosis, as well as serous and tractional retinal detachment, which are treated using standard methods (ie, intravitreal anti-angiogenic agents or steroids as well as vitreoretinal procedures, such as epiretinal membrane peeling and release of retinal traction). The detection, diagnosis, and monitoring of vascular tumours and their complications have improved considerably thanks to advances in imaging. These include spectral domain and enhanced depth imaging optical coherence tomography (SD-OCT and EDI-OCT, respectively), wide-angle photography and angiography as well as wide-angle fundus autofluorescence. Such novel imaging has provided new diagnostic clues and has profoundly influenced therapeutic strategies so that vascular tumours and secondary effects are now treated concurrently instead of sequentially, enhancing any opportunities for conserving vision and the eye. In this review, we describe how SD-OCT, EDI-OCT, autofluorescence, wide-angle photography and wide-angle angiography have facilitated the evaluation of eyes with the more common vascular tumours, that is, choroidal haemangioma, retinal vasoproliferative tumours, and retinal haemangioblastoma. PMID:23196648

[Fundus Autofluorescence Imaging].

PubMed

Schmitz-Valckenberg, S

2015-09-01

Fundus autofluorescence (FAF) imaging allows for non-invasive mapping of changes at the level of the retinal pigment epithelium/photoreceptor complex and of alterations of macular pigment distribution. This imaging method is based on the visualisation of intrinsic fluorophores and may be easily and rapidly used in routine patient care. Main applications include degenerative disorders of the outer retina such as age-related macular degeneration, hereditary and acquired retinal diseases. FAF imaging is particularly helpful for differential diagnosis, detection and extent of involved retinal areas, structural-functional correlations and monitoring of changes over time. Recent developments include - in addition to the original application of short wavelength light for excitation ("blue" FAF imaging) - the use of other wavelength ranges ("green" or "near-infrared" FAF imaging), widefield imaging for visualisation of peripheral retinal areas and quantitative FAF imaging. Georg Thieme Verlag KG Stuttgart · New York.

Retinopathy screening in patients with type 1 diabetes diagnosed in young age using a non-mydriatic digital stereoscopic retinal imaging.

PubMed

Minuto, N; Emmanuele, V; Vannati, M; Russo, C; Rebora, C; Panarello, S; Pistorio, A; Lorini, R; d'Annunzio, G

2012-04-01

Diabetic retinopathy seriously impairs patients' quality of life, since it represents the first cause of blindness in industrialized countries. To estimate prevalence of retinopathy in young Type 1 diabetes patients using a non-mydriatic digital stereoscopic retinal imaging (NMDSRI), and to evaluate the impact of socio-demographic, clinical, and metabolic variables. In 247 young patients glycated hemoglobin (HbA1c), gender, age, pubertal stage, presence of diabetic ketoacidosis (DKA), HLA-DQ heterodimers of susceptibility for Type 1 diabetes, and β-cell autoimmunity at clinical onset were considered. At retinopathy screening, we evaluated age, disease duration, pubertal stage, body mass index (BMI-SDS), insulin requirement, HbA1c levels, other autoimmune diseases, diabetes-related complications, serum concentrations of cholesterol and triglycerides, systolic and diastolic blood pressure. Retinopathy was found in 26/247 patients: 25 showed background retinopathy, and 1 had a sight-threatening retinopathy. A significant relationship between retinopathy and female gender (p=0.01), duration of disease ≥15 yr (p<0.0001), serum triglycerides levels >65 mg/dl (p=0.012) and mean HbA1c ≥7.5% or >9% (p=0.0014) were found at the multivariate logistic analysis. Metabolic control is the most important modifiable factor and promotion of continuous educational process to reach a good metabolic control is a cornerstone to prevent microangiopathic complications. Symptoms appear when the complication is already established; a screening program with an early diagnosis is mandatory to prevent an irreversible damage.

Functional Imaging of Retinal Photoreceptors and Inner Neurons Using Stimulus-Evoked Intrinsic Optical Signals

PubMed Central

Yao, Xin-Cheng; Li, Yi-Chao

2013-01-01

Retinal development is a dynamic process both anatomically and functionally. High-resolution imaging and dynamic monitoring of photoreceptors and inner neurons can provide important information regarding the structure and function of the developing retina. In this chapter, we describe intrinsic optical signal (IOS) imaging as a high spatiotemporal resolution method for functional study of living retinal tissues. IOS imaging is based on near infrared (NIR) light detection of stimulus-evoked transient change of inherent optical characteristics of the cells. With no requirement for exogenous biomarkers, IOS imaging is totally noninvasive for functional mapping of stimulus-evoked spatiotemporal dynamics of the photoreceptors and inner retinal neurons. PMID:22688714

Real-time blind deconvolution of retinal images in adaptive optics scanning laser ophthalmoscopy

NASA Astrophysics Data System (ADS)

Li, Hao; Lu, Jing; Shi, Guohua; Zhang, Yudong

2011-06-01

With the use of adaptive optics (AO), the ocular aberrations can be compensated to get high-resolution image of living human retina. However, the wavefront correction is not perfect due to the wavefront measure error and hardware restrictions. Thus, it is necessary to use a deconvolution algorithm to recover the retinal images. In this paper, a blind deconvolution technique called Incremental Wiener filter is used to restore the adaptive optics confocal scanning laser ophthalmoscope (AOSLO) images. The point-spread function (PSF) measured by wavefront sensor is only used as an initial value of our algorithm. We also realize the Incremental Wiener filter on graphics processing unit (GPU) in real-time. When the image size is 512 × 480 pixels, six iterations of our algorithm only spend about 10 ms. Retinal blood vessels as well as cells in retinal images are restored by our algorithm, and the PSFs are also revised. Retinal images with and without adaptive optics are both restored. The results show that Incremental Wiener filter reduces the noises and improve the image quality.

In vivo fluorescence imaging of primate retinal ganglion cells and retinal pigment epithelial cells

NASA Astrophysics Data System (ADS)

Gray, Daniel C.; Merigan, William; Wolfing, Jessica I.; Gee, Bernard P.; Porter, Jason; Dubra, Alfredo; Twietmeyer, Ted H.; Ahamd, Kamran; Tumbar, Remy; Reinholz, Fred; Williams, David R.

2006-08-01

The ability to resolve single cells noninvasively in the living retina has important applications for the study of normal retina, diseased retina, and the efficacy of therapies for retinal disease. We describe a new instrument for high-resolution, in vivo imaging of the mammalian retina that combines the benefits of confocal detection, adaptive optics, multispectral, and fluorescence imaging. The instrument is capable of imaging single ganglion cells and their axons through retrograde transport in ganglion cells of fluorescent dyes injected into the monkey lateral geniculate nucleus (LGN). In addition, we demonstrate a method involving simultaneous imaging in two spectral bands that allows the integration of very weak signals across many frames despite inter-frame movement of the eye. With this method, we are also able to resolve the smallest retinal capillaries in fluorescein angiography and the mosaic of retinal pigment epithelium (RPE) cells with lipofuscin autofluorescence.

Method and system for assigning a confidence metric for automated determination of optic disc location

DOEpatents

Karnowski, Thomas P [Knoxville, TN; Tobin, Jr., Kenneth W.; Muthusamy Govindasamy, Vijaya Priya [Knoxville, TN; Chaum, Edward [Memphis, TN

2012-07-10

A method for assigning a confidence metric for automated determination of optic disc location that includes analyzing a retinal image and determining at least two sets of coordinates locating an optic disc in the retinal image. The sets of coordinates can be determined using first and second image analysis techniques that are different from one another. An accuracy parameter can be calculated and compared to a primary risk cut-off value. A high confidence level can be assigned to the retinal image if the accuracy parameter is less than the primary risk cut-off value and a low confidence level can be assigned to the retinal image if the accuracy parameter is greater than the primary risk cut-off value. The primary risk cut-off value being selected to represent an acceptable risk of misdiagnosis of a disease having retinal manifestations by the automated technique.

Evaluation of a system for automatic detection of diabetic retinopathy from color fundus photographs in a large population of patients with diabetes.

PubMed

Abràmoff, Michael D; Niemeijer, Meindert; Suttorp-Schulten, Maria S A; Viergever, Max A; Russell, Stephen R; van Ginneken, Bram

2008-02-01

To evaluate the performance of a system for automated detection of diabetic retinopathy in digital retinal photographs, built from published algorithms, in a large, representative, screening population. We conducted a retrospective analysis of 10,000 consecutive patient visits, specifically exams (four retinal photographs, two left and two right) from 5,692 unique patients from the EyeCheck diabetic retinopathy screening project imaged with three types of cameras at 10 centers. Inclusion criteria included no previous diagnosis of diabetic retinopathy, no previous visit to ophthalmologist for dilated eye exam, and both eyes photographed. One of three retinal specialists evaluated each exam as unacceptable quality, no referable retinopathy, or referable retinopathy. We then selected exams with sufficient image quality and determined presence or absence of referable retinopathy. Outcome measures included area under the receiver operating characteristic curve (number needed to miss one case [NNM]) and type of false negative. Total area under the receiver operating characteristic curve was 0.84, and NNM was 80 at a sensitivity of 0.84 and a specificity of 0.64. At this point, 7,689 of 10,000 exams had sufficient image quality, 4,648 of 7,689 (60%) were true negatives, 59 of 7,689 (0.8%) were false negatives, 319 of 7,689 (4%) were true positives, and 2,581 of 7,689 (33%) were false positives. Twenty-seven percent of false negatives contained large hemorrhages and/or neovascularizations. Automated detection of diabetic retinopathy using published algorithms cannot yet be recommended for clinical practice. However, performance is such that evaluation on validated, publicly available datasets should be pursued. If algorithms can be improved, such a system may in the future lead to improved prevention of blindness and vision loss in patients with diabetes.

In vivo imaging of the mouse model of X-linked juvenile retinoschisis with fourier domain optical coherence tomography.

PubMed

Xu, Jing; Molday, Laurie L; Molday, Robert S; Sarunic, Marinko V

2009-06-01

The purpose of this study was to investigate Fourier domain optical coherence tomography (FD OCT) as a noninvasive tool for retinal imaging in the Rs1h-knockout mouse (model for X-linked juvenile retinoschisis). A prototype spectrometer-based FD OCT system was used in combination with a custom optical beam-scanning platform. Images of the retinas from wild-type and Rs1h-knockout mice were acquired noninvasively with FD OCT with the specimen anesthetized. At the completion of the noninvasive FD OCT imaging, invasive retinal cross-sectional images (histology) were acquired from a nearby region for comparison to the FD OCT images. The retinal layers were identifiable in the FD OCT images, permitting delineation and thickness measurement of the outer nuclear layer (ONL). During FD OCT in vivo imaging of the Rs1h-knockout mouse, holes were observed in the inner nuclear layer (INL), and retinal cell disorganization was observed as a change in the backscattering intensity profile. Comparison of the ONL measurements acquired noninvasively with FD OCT to measurements taken using histology at nearby locations showed a degeneration of roughly 30% of the ONL by the age of 2 months in Rs1h-knockout mice relative to wild-type. FD OCT was demonstrated to be effective for noninvasive imaging of retinal degeneration and observation of retinal holes in Rs1h-knockout mice.

Use of OCTA, FA, and Ultra-Widefield Imaging in Quantifying Retinal Ischemia: A Review.

PubMed

Or, Chris; Sabrosa, Almyr S; Sorour, Osama; Arya, Malvika; Waheed, Nadia

2018-01-01

As ischemia remains a key prognostic factor in the management of various diseases including diabetic retinopathy, an increasing amount of research has been dedicated to its quantification as a potential biomarker. Advancements in the quantification of retinal ischemia have been made with the imaging modalities of fluorescein angiography (FA), ultra-widefield imaging (UWF), and optical coherence tomography angiography (OCTA), with each imaging modality offering certain benefits over the others. FA remains the gold standard in assessing the extent of ischemia. UWF imaging has allowed for the assessment of peripheral ischemia via FA. It is, however, OCTA that offers the best visualization of retinal vasculature with its noninvasive depth-resolved imaging and therefore has the potential to become a mainstay in the assessment of retinal ischemia. The primary purpose of this article is to review the use of FA, UWF, and OCTA to quantify retinal ischemia and the various methods described in the literature by which this is achieved. Copyright 2018 Asia-Pacific Academy of Ophthalmology.

Ultrahigh resolution retinal imaging by visible light OCT with longitudinal achromatization

PubMed Central

Chong, Shau Poh; Zhang, Tingwei; Kho, Aaron; Bernucci, Marcel T.; Dubra, Alfredo; Srinivasan, Vivek J.

2018-01-01

Chromatic aberrations are an important design consideration in high resolution, high bandwidth, refractive imaging systems that use visible light. Here, we present a fiber-based spectral/Fourier domain, visible light OCT ophthalmoscope corrected for the average longitudinal chromatic aberration (LCA) of the human eye. Analysis of complex speckles from in vivo retinal images showed that achromatization resulted in a speckle autocorrelation function that was ~20% narrower in the axial direction, but unchanged in the transverse direction. In images from the improved, achromatized system, the separation between Bruch’s membrane (BM), the retinal pigment epithelium (RPE), and the outer segment tips clearly emerged across the entire 6.5 mm field-of-view, enabling segmentation and morphometry of BM and the RPE in a human subject. Finally, cross-sectional images depicted distinct inner retinal layers with high resolution. Thus, with chromatic aberration compensation, visible light OCT can achieve volume resolutions and retinal image quality that matches or exceeds ultrahigh resolution near-infrared OCT systems with no monochromatic aberration compensation. PMID:29675296

Retinal imaging as a source of biomarkers for diagnosis, characterization and prognosis of chronic illness or long-term conditions

PubMed Central

Trucco, E; Cameron, J R; Dhillon, B; Houston, J G; van Beek, E J R

2014-01-01

The black void behind the pupil was optically impenetrable before the invention of the ophthalmoscope by von Helmholtz over 150 years ago. Advances in retinal imaging and image processing, especially over the past decade, have opened a route to another unexplored landscape, the retinal neurovascular architecture and the retinal ganglion pathways linking to the central nervous system beyond. Exploiting these research opportunities requires multidisciplinary teams to explore the interface sitting at the border between ophthalmology, neurology and computing science. It is from the detail and depth of retinal phenotyping that novel metrics and candidate biomarkers are likely to emerge. Confirmation that in vivo retinal neurovascular measures are predictive of microvascular change in the brain and other organs is likely to be a major area of research activity over the next decade. Unlocking this hidden potential within the retina requires integration of structural and functional data sets, that is, multimodal mapping and longitudinal studies spanning the natural history of the disease process. And with further advances in imaging, it is likely that this area of retinal research will remain active and clinically relevant for many years to come. Accordingly, this review looks at state-of-the-art retinal imaging and its application to diagnosis, characterization and prognosis of chronic illness or long-term conditions. PMID:24936979

Mobile, Multi-modal, Label-Free Imaging Probe Analysis of Choroidal Oximetry and Retinal Hypoxia

DTIC Science & Technology

2015-10-01

eyes and image choroidal vessels/capillaries using CARS intravital microscopy Subtask 3: Measure oxy-hemoglobin levels in PBI test and control eyes...AWARD NUMBER: W81XWH-14-1-0537 TITLE: Mobile, Multi-modal, Label-Free Imaging Probe Analysis of Choroidal Oximetry and Retinal Hypoxia...4. TITLE AND SUBTITLE Mobile, Multimodal, Label-Free Imaging Probe Analysis of Choroidal Oximetry and Retinal Hypoxia 5a. CONTRACT NUMBER W81XWH

User-guided segmentation for volumetric retinal optical coherence tomography images

PubMed Central

Yin, Xin; Chao, Jennifer R.; Wang, Ruikang K.

2014-01-01

Abstract. Despite the existence of automatic segmentation techniques, trained graders still rely on manual segmentation to provide retinal layers and features from clinical optical coherence tomography (OCT) images for accurate measurements. To bridge the gap between this time-consuming need of manual segmentation and currently available automatic segmentation techniques, this paper proposes a user-guided segmentation method to perform the segmentation of retinal layers and features in OCT images. With this method, by interactively navigating three-dimensional (3-D) OCT images, the user first manually defines user-defined (or sketched) lines at regions where the retinal layers appear very irregular for which the automatic segmentation method often fails to provide satisfactory results. The algorithm is then guided by these sketched lines to trace the entire 3-D retinal layer and anatomical features by the use of novel layer and edge detectors that are based on robust likelihood estimation. The layer and edge boundaries are finally obtained to achieve segmentation. Segmentation of retinal layers in mouse and human OCT images demonstrates the reliability and efficiency of the proposed user-guided segmentation method. PMID:25147962

User-guided segmentation for volumetric retinal optical coherence tomography images.

PubMed

Yin, Xin; Chao, Jennifer R; Wang, Ruikang K

2014-08-01

Despite the existence of automatic segmentation techniques, trained graders still rely on manual segmentation to provide retinal layers and features from clinical optical coherence tomography (OCT) images for accurate measurements. To bridge the gap between this time-consuming need of manual segmentation and currently available automatic segmentation techniques, this paper proposes a user-guided segmentation method to perform the segmentation of retinal layers and features in OCT images. With this method, by interactively navigating three-dimensional (3-D) OCT images, the user first manually defines user-defined (or sketched) lines at regions where the retinal layers appear very irregular for which the automatic segmentation method often fails to provide satisfactory results. The algorithm is then guided by these sketched lines to trace the entire 3-D retinal layer and anatomical features by the use of novel layer and edge detectors that are based on robust likelihood estimation. The layer and edge boundaries are finally obtained to achieve segmentation. Segmentation of retinal layers in mouse and human OCT images demonstrates the reliability and efficiency of the proposed user-guided segmentation method.

High quality optical microangiography of ocular microcirculation and measurement of total retinal blood flow in mouse eye

NASA Astrophysics Data System (ADS)

Zhi, Zhongwei; Yin, Xin; Dziennis, Suzan; Alpers, Charles E.; Wang, Ruikang K.

2013-03-01

Visualization and measurement of retinal blood flow (RBF) is important to the diagnosis and management of different eye diseases, including diabetic retinopathy. Optical microangiography (OMAG) is developed for generating 3D dynamic microcirculation image and later refined into ultra-high sensitive OMAG (UHS-OMAG) for true capillary vessels imaging. Here, we present the application of OMAG imaging technique for visualization of depth-resolved vascular network within retina and choroid as well as measurement of total retinal blood flow in mice. A fast speed spectral domain OCT imaging system at 820nm with a line scan rate of 140 kHz was developed to image mouse posterior eye. By applying UHS-OMAG scanning protocol and processing algorithm, we achieved true capillary level imaging of retina and choroid vasculature in mouse eye. The vascular pattern within different retinal layers and choroid was presented. An en face Doppler OCT approach [1] without knowing Doppler angle was adopted for the measurement of total retinal blood flow. The axial blood flow velocity is measured in an en face plane by raster scanning and the flow is calculated by integrating over the vessel area of the central retinal artery.

Retinal Structure of Birds of Prey Revealed by Ultra-High Resolution Spectral-Domain Optical Coherence Tomography

PubMed Central

Ruggeri, Marco; Major, James C.; McKeown, Craig; Knighton, Robert W.; Puliafito, Carmen A.

2010-01-01

Purpose. To reveal three-dimensional (3-D) information about the retinal structures of birds of prey in vivo. Methods. An ultra-high resolution spectral-domain optical coherence tomography (SD-OCT) system was built for in vivo imaging of retinas of birds of prey. The calibrated imaging depth and axial resolution of the system were 3.1 mm and 2.8 μm (in tissue), respectively. 3-D segmentation was performed for calculation of the retinal nerve fiber layer (RNFL) map. Results. High-resolution OCT images were obtained of the retinas of four species of birds of prey: two diurnal hawks (Buteo platypterus and Buteo brachyurus) and two nocturnal owls (Bubo virginianus and Strix varia). These images showed the detailed retinal anatomy, including the retinal layers and the structure of the deep and shallow foveae. The calculated thickness map showed the RNFL distribution. Traumatic injury to one bird's retina was also successfully imaged. Conclusions. Ultra-high resolution SD-OCT provides unprecedented high-quality 2-D and 3-D in vivo visualization of the retinal structures of birds of prey. SD-OCT is a powerful imaging tool for vision research in birds of prey. PMID:20554605

The retinal funduscope demonstration project

NASA Technical Reports Server (NTRS)

Wilhelm, Jim

1994-01-01

A lightweight, relatively inexpensive electronic and photographic instrument has been re-developed for the detection, monitoring, and objective quantification of ocular/ systemic disease or physiological alterations of the retina, blood vessels, or other structures in the anterior and posterior chambers of the eye. The instrument can be operated with little training. It can function with a human or animal subject seated, recumbent, inverted, or in almost any other orientation; and in a hospital, laboratory, field, or other environment. The instrument produces video images that can be viewed directly and/or digitized for simultaneous or subsequent analysis. It can also be equipped to produce photographs and/or fitted with adaptors to produce stereoscopic or magnified images ot the skin, nose, ear, throat, or mouth to detect lesions or diseases.

Computer-aided diagnosis based on enhancement of degraded fundus photographs.

PubMed

Jin, Kai; Zhou, Mei; Wang, Shaoze; Lou, Lixia; Xu, Yufeng; Ye, Juan; Qian, Dahong

2018-05-01

Retinal imaging is an important and effective tool for detecting retinal diseases. However, degraded images caused by the aberrations of the eye can disguise lesions, so that a diseased eye can be mistakenly diagnosed as normal. In this work, we propose a new image enhancement method to improve the quality of degraded images. A new method is used to enhance degraded-quality fundus images. In this method, the image is converted from the input RGB colour space to LAB colour space and then each normalized component is enhanced using contrast-limited adaptive histogram equalization. Human visual system (HVS)-based fundus image quality assessment, combined with diagnosis by experts, is used to evaluate the enhancement. The study included 191 degraded-quality fundus photographs of 143 subjects with optic media opacity. Objective quality assessment of image enhancement (range: 0-1) indicated that our method improved colour retinal image quality from an average of 0.0773 (variance 0.0801) to an average of 0.3973 (variance 0.0756). Following enhancement, area under curves (AUC) were 0.996 for the glaucoma classifier, 0.989 for the diabetic retinopathy (DR) classifier, 0.975 for the age-related macular degeneration (AMD) classifier and 0.979 for the other retinal diseases classifier. The relatively simple method for enhancing degraded-quality fundus images achieves superior image enhancement, as demonstrated in a qualitative HVS-based image quality assessment. This retinal image enhancement may, therefore, be employed to assist ophthalmologists in more efficient screening of retinal diseases and the development of computer-aided diagnosis. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Comparison of the depth of an optic nerve head obtained using stereo retinal images and HRT

NASA Astrophysics Data System (ADS)

Nakagawa, Toshiaki; Hayashi, Yoshinori; Hatanaka, Yuji; Aoyama, Akira; Hara, Takeshi; Kakogawa, Masakatsu; Fujita, Hiroshi; Yamamoto, Tetsuya

2007-03-01

The analysis of the optic nerve head (ONH) in the retinal fundus is important for the early detection of glaucoma. In this study, we investigate an automatic reconstruction method for producing the 3-D structure of the ONH from a stereo retinal image pair; the depth value of the ONH measured by using this method was compared with the measurement results determined from the Heidelberg Retina Tomograph (HRT). We propose a technique to obtain the depth value from the stereo image pair, which mainly consists of four steps: (1) cutout of the ONH region from the retinal images, (2) registration of the stereo pair, (3) disparity detection, and (4) depth calculation. In order to evaluate the accuracy of this technique, the shape of the depression of an eyeball phantom that had a circular dent as generated from the stereo image pair and used to model the ONH was compared with a physically measured quantity. The measurement results obtained when the eyeball phantom was used were approximately consistent. The depth of the ONH obtained using the stereo retinal images was in accordance with the results obtained using the HRT. These results indicate that the stereo retinal images could be useful for assessing the depth of the ONH for the diagnosis of glaucoma.

Photoreceptor counting and montaging of en-face retinal images from an adaptive optics fundus camera

PubMed Central

Xue, Bai; Choi, Stacey S.; Doble, Nathan; Werner, John S.

2008-01-01

A fast and efficient method for quantifying photoreceptor density in images obtained with an en-face flood-illuminated adaptive optics (AO) imaging system is described. To improve accuracy of cone counting, en-face images are analyzed over extended areas. This is achieved with two separate semiautomated algorithms: (1) a montaging algorithm that joins retinal images with overlapping common features without edge effects and (2) a cone density measurement algorithm that counts the individual cones in the montaged image. The accuracy of the cone density measurement algorithm is high, with >97% agreement for a simulated retinal image (of known density, with low contrast) and for AO images from normal eyes when compared with previously reported histological data. Our algorithms do not require spatial regularity in cone packing and are, therefore, useful for counting cones in diseased retinas, as demonstrated for eyes with Stargardt’s macular dystrophy and retinitis pigmentosa. PMID:17429482

Image quality classification for DR screening using deep learning.

PubMed

FengLi Yu; Jing Sun; Annan Li; Jun Cheng; Cheng Wan; Jiang Liu

2017-07-01

The quality of input images significantly affects the outcome of automated diabetic retinopathy (DR) screening systems. Unlike the previous methods that only consider simple low-level features such as hand-crafted geometric and structural features, in this paper we propose a novel method for retinal image quality classification (IQC) that performs computational algorithms imitating the working of the human visual system. The proposed algorithm combines unsupervised features from saliency map and supervised features coming from convolutional neural networks (CNN), which are fed to an SVM to automatically detect high quality vs poor quality retinal fundus images. We demonstrate the superior performance of our proposed algorithm on a large retinal fundus image dataset and the method could achieve higher accuracy than other methods. Although retinal images are used in this study, the methodology is applicable to the image quality assessment and enhancement of other types of medical images.

Photoreceptor counting and montaging of en-face retinal images from an adaptive optics fundus camera

NASA Astrophysics Data System (ADS)

Xue, Bai; Choi, Stacey S.; Doble, Nathan; Werner, John S.

2007-05-01

A fast and efficient method for quantifying photoreceptor density in images obtained with an en-face flood-illuminated adaptive optics (AO) imaging system is described. To improve accuracy of cone counting, en-face images are analyzed over extended areas. This is achieved with two separate semiautomated algorithms: (1) a montaging algorithm that joins retinal images with overlapping common features without edge effects and (2) a cone density measurement algorithm that counts the individual cones in the montaged image. The accuracy of the cone density measurement algorithm is high, with >97% agreement for a simulated retinal image (of known density, with low contrast) and for AO images from normal eyes when compared with previously reported histological data. Our algorithms do not require spatial regularity in cone packing and are, therefore, useful for counting cones in diseased retinas, as demonstrated for eyes with Stargardt's macular dystrophy and retinitis pigmentosa.

An automated retinal imaging method for the early diagnosis of diabetic retinopathy.

PubMed

Franklin, S Wilfred; Rajan, S Edward

2013-01-01

Diabetic retinopathy is a microvascular complication of long-term diabetes and is the major cause for eyesight loss due to changes in blood vessels of the retina. Major vision loss due to diabetic retinopathy is highly preventable with regular screening and timely intervention at the earlier stages. Retinal blood vessel segmentation methods help to identify the successive stages of such sight threatening diseases like diabetes. To develop and test a novel retinal imaging method which segments the blood vessels automatically from retinal images, which helps the ophthalmologists in the diagnosis and follow-up of diabetic retinopathy. This method segments each image pixel as vessel or nonvessel, which in turn, used for automatic recognition of the vasculature in retinal images. Retinal blood vessels were identified by means of a multilayer perceptron neural network, for which the inputs were derived from the Gabor and moment invariants-based features. Back propagation algorithm, which provides an efficient technique to change the weights in a feed forward network, is utilized in our method. Quantitative results of sensitivity, specificity and predictive values were obtained in our method and the measured accuracy of our segmentation algorithm was 95.3%, which is better than that presented by state-of-the-art approaches. The evaluation procedure used and the demonstrated effectiveness of our automated retinal imaging method proves itself as the most powerful tool to diagnose diabetic retinopathy in the earlier stages.

Ultra-wide-field angiography improves the detection and classification of diabetic retinopathy.

PubMed

Wessel, Matthew M; Aaker, Grant D; Parlitsis, George; Cho, Minhee; D'Amico, Donald J; Kiss, Szilárd

2012-04-01

To evaluate patients with diabetic retinopathy using ultra-wide-field fluorescein angiography and to compare the visualized retinal pathology with that seen on an overly of conventional 7 standard field (7SF) imaging. Two hundred and eighteen eyes of 118 diabetic patients who underwent diagnostic fluorescein angiography using the Optos Optomap Panoramic 200A imaging system were included. The visualized area of the retina, retinal nonperfusion, retinal neovascularization, and panretinal photocoagulation were quantified by two independent masked graders. The respective areas identified on the ultra-wide-field fluorescein angiography image were compared with an overly of a modified 7SF image as outlined in the Early Treatment Diabetic Retinopathy Study. Ultra-wide-field fluorescein angiograms imaging, on average, demonstrated 3.2 times more total retinal surface area than 7SF. When compared with 7SF, ultra-wide-field fluorescein angiography showed 3.9 times more nonperfusion (P < 0.001), 1.9 times more neovascularization (P = 0.036), and 3.8 times more panretinal photocoagulation (P < 0.001). In 22 eyes (10%), ultra-wide-field fluorescein angiography demonstrated retinal pathology (including nonperfusion and neovascularization) not evident in an 7SF overly. Compared with conventional 7SF imaging, ultra-wide-field fluorescein angiography reveals significantly more retinal vascular pathology in patients with diabetic retinopathy. Improved retinal visualization may alter the classification of diabetic retinopathy and may therefore influence follow-up and treatment of these patients.

Three-dimensional retinal imaging with high-speed ultrahigh-resolution optical coherence tomography.

PubMed

Wojtkowski, Maciej; Srinivasan, Vivek; Fujimoto, James G; Ko, Tony; Schuman, Joel S; Kowalczyk, Andrzej; Duker, Jay S

2005-10-01

To demonstrate high-speed, ultrahigh-resolution, 3-dimensional optical coherence tomography (3D OCT) and new protocols for retinal imaging. Ultrahigh-resolution OCT using broadband light sources achieves axial image resolutions of approximately 2 microm compared with standard 10-microm-resolution OCT current commercial instruments. High-speed OCT using spectral/Fourier domain detection enables dramatic increases in imaging speeds. Three-dimensional OCT retinal imaging is performed in normal human subjects using high-speed ultrahigh-resolution OCT. Three-dimensional OCT data of the macula and optic disc are acquired using a dense raster scan pattern. New processing and display methods for generating virtual OCT fundus images; cross-sectional OCT images with arbitrary orientations; quantitative maps of retinal, nerve fiber layer, and other intraretinal layer thicknesses; and optic nerve head topographic parameters are demonstrated. Three-dimensional OCT imaging enables new imaging protocols that improve visualization and mapping of retinal microstructure. An OCT fundus image can be generated directly from the 3D OCT data, which enables precise and repeatable registration of cross-sectional OCT images and thickness maps with fundus features. Optical coherence tomography images with arbitrary orientations, such as circumpapillary scans, can be generated from 3D OCT data. Mapping of total retinal thickness and thicknesses of the nerve fiber layer, photoreceptor layer, and other intraretinal layers is demonstrated. Measurement of optic nerve head topography and disc parameters is also possible. Three-dimensional OCT enables measurements that are similar to those of standard instruments, including the StratusOCT, GDx, HRT, and RTA. Three-dimensional OCT imaging can be performed using high-speed ultrahigh-resolution OCT. Three-dimensional OCT provides comprehensive visualization and mapping of retinal microstructures. The high data acquisition speeds enable high-density data sets with large numbers of transverse positions on the retina, which reduces the possibility of missing focal pathologies. In addition to providing image information such as OCT cross-sectional images, OCT fundus images, and 3D rendering, quantitative measurement and mapping of intraretinal layer thickness and topographic features of the optic disc are possible. We hope that 3D OCT imaging may help to elucidate the structural changes associated with retinal disease as well as improve early diagnosis and monitoring of disease progression and response to treatment.

Detection of retinal nerve fiber layer defects on retinal fundus images for early diagnosis of glaucoma

NASA Astrophysics Data System (ADS)

Muramatsu, Chisako; Hayashi, Yoshinori; Sawada, Akira; Hatanaka, Yuji; Hara, Takeshi; Yamamoto, Tetsuya; Fujita, Hiroshi

2010-01-01

Retinal nerve fiber layer defect (NFLD) is a major sign of glaucoma, which is the second leading cause of blindness in the world. Early detection of NFLDs is critical for improved prognosis of this progressive, blinding disease. We have investigated a computerized scheme for detection of NFLDs on retinal fundus images. In this study, 162 images, including 81 images with 99 NFLDs, were used. After major blood vessels were removed, the images were transformed so that the curved paths of retinal nerves become approximately straight on the basis of ellipses, and the Gabor filters were applied for enhancement of NFLDs. Bandlike regions darker than the surrounding pixels were detected as candidates of NFLDs. For each candidate, image features were determined and the likelihood of a true NFLD was determined by using the linear discriminant analysis and an artificial neural network (ANN). The sensitivity for detecting the NFLDs was 91% at 1.0 false positive per image by using the ANN. The proposed computerized system for the detection of NFLDs can be useful to physicians in the diagnosis of glaucoma in a mass screening.

Medical Image Segmentation using the HSI color space and Fuzzy Mathematical Morphology

NASA Astrophysics Data System (ADS)

Gasparri, J. P.; Bouchet, A.; Abras, G.; Ballarin, V.; Pastore, J. I.

2011-12-01

Diabetic retinopathy is the most common cause of blindness among the active population in developed countries. An early ophthalmologic examination followed by proper treatment can prevent blindness. The purpose of this work is develop an automated method for segmentation the vasculature in retinal images in order to assist the expert in the evolution of a specific treatment or in the diagnosis of a potential pathology. Since the HSI space has the ability to separate the intensity of the intrinsic color information, its use is recommended for the digital processing images when they are affected by lighting changes, characteristic of the images under study. By the application of color filters, is achieved artificially change the tone of blood vessels, to better distinguish them from the bottom. This technique, combined with the application of fuzzy mathematical morphology tools as the Top-Hat transformation, creates images of the retina, where vascular branches are markedly enhanced over the original. These images provide the visualization of blood vessels by the specialist.

Quantitative Analysis of Mouse Retinal Layers Using Automated Segmentation of Spectral Domain Optical Coherence Tomography Images

PubMed Central

Dysli, Chantal; Enzmann, Volker; Sznitman, Raphael; Zinkernagel, Martin S.

2015-01-01

Purpose Quantification of retinal layers using automated segmentation of optical coherence tomography (OCT) images allows for longitudinal studies of retinal and neurological disorders in mice. The purpose of this study was to compare the performance of automated retinal layer segmentation algorithms with data from manual segmentation in mice using the Spectralis OCT. Methods Spectral domain OCT images from 55 mice from three different mouse strains were analyzed in total. The OCT scans from 22 C57Bl/6, 22 BALBc, and 11 C3A.Cg-Pde6b+Prph2Rd2/J mice were automatically segmented using three commercially available automated retinal segmentation algorithms and compared to manual segmentation. Results Fully automated segmentation performed well in mice and showed coefficients of variation (CV) of below 5% for the total retinal volume. However, all three automated segmentation algorithms yielded much thicker total retinal thickness values compared to manual segmentation data (P < 0.0001) due to segmentation errors in the basement membrane. Conclusions Whereas the automated retinal segmentation algorithms performed well for the inner layers, the retinal pigmentation epithelium (RPE) was delineated within the sclera, leading to consistently thicker measurements of the photoreceptor layer and the total retina. Translational Relevance The introduction of spectral domain OCT allows for accurate imaging of the mouse retina. Exact quantification of retinal layer thicknesses in mice is important to study layers of interest under various pathological conditions. PMID:26336634

Cone photoreceptor definition on adaptive optics retinal imaging

PubMed Central

Muthiah, Manickam Nick; Gias, Carlos; Chen, Fred Kuanfu; Zhong, Joe; McClelland, Zoe; Sallo, Ferenc B; Peto, Tunde; Coffey, Peter J; da Cruz, Lyndon

2014-01-01

Aims To quantitatively analyse cone photoreceptor matrices on images captured on an adaptive optics (AO) camera and assess their correlation to well-established parameters in the retinal histology literature. Methods High resolution retinal images were acquired from 10 healthy subjects, aged 20–35 years old, using an AO camera (rtx1, Imagine Eyes, France). Left eye images were captured at 5° of retinal eccentricity, temporal to the fovea for consistency. In three subjects, images were also acquired at 0, 2, 3, 5 and 7° retinal eccentricities. Cone photoreceptor density was calculated following manual and automated counting. Inter-photoreceptor distance was also calculated. Voronoi domain and power spectrum analyses were performed for all images. Results At 5° eccentricity, the cone density (cones/mm2 mean±SD) was 15.3±1.4×103 (automated) and 13.9±1.0×103 (manual) and the mean inter-photoreceptor distance was 8.6±0.4 μm. Cone density decreased and inter-photoreceptor distance increased with increasing retinal eccentricity from 2 to 7°. A regular hexagonal cone photoreceptor mosaic pattern was seen at 2, 3 and 5° of retinal eccentricity. Conclusions Imaging data acquired from the AO camera match cone density, intercone distance and show the known features of cone photoreceptor distribution in the pericentral retina as reported by histology, namely, decreasing density values from 2 to 7° of eccentricity and the hexagonal packing arrangement. This confirms that AO flood imaging provides reliable estimates of pericentral cone photoreceptor distribution in normal subjects. PMID:24729030

Feature-based pairwise retinal image registration by radial distortion correction

NASA Astrophysics Data System (ADS)

Lee, Sangyeol; Abràmoff, Michael D.; Reinhardt, Joseph M.

2007-03-01

Fundus camera imaging is widely used to document disorders such as diabetic retinopathy and macular degeneration. Multiple retinal images can be combined together through a procedure known as mosaicing to form an image with a larger field of view. Mosaicing typically requires multiple pairwise registrations of partially overlapped images. We describe a new method for pairwise retinal image registration. The proposed method is unique in that the radial distortion due to image acquisition is corrected prior to the geometric transformation. Vessel lines are detected using the Hessian operator and are used as input features to the registration. Since the overlapping region is typically small in a retinal image pair, only a few correspondences are available, thus limiting the applicable model to an afine transform at best. To recover the distortion due to curved-surface of retina and lens optics, a combined approach of an afine model with a radial distortion correction is proposed. The parameters of the image acquisition and radial distortion models are estimated during an optimization step that uses Powell's method driven by the vessel line distance. Experimental results using 20 pairs of green channel images acquired from three subjects with a fundus camera confirmed that the afine model with distortion correction could register retinal image pairs to within 1.88+/-0.35 pixels accuracy (mean +/- standard deviation) assessed by vessel line error, which is 17% better than the afine-only approach. Because the proposed method needs only two correspondences, it can be applied to obtain good registration accuracy even in the case of small overlap between retinal image pairs.

Filling in the retinal image

NASA Technical Reports Server (NTRS)

Larimer, James; Piantanida, Thomas

1990-01-01

The optics of the eye form an image on a surface at the back of the eyeball called the retina. The retina contains the photoreceptors that sample the image and convert it into a neural signal. The spacing of the photoreceptors in the retina is not uniform and varies with retinal locus. The central retinal field, called the macula, is densely packed with photoreceptors. The packing density falls off rapidly as a function of retinal eccentricity with respect to the macular region and there are regions in which there are no photoreceptors at all. The retinal regions without photoreceptors are called blind spots or scotomas. The neural transformations which convert retinal image signals into percepts fills in the gaps and regularizes the inhomogeneities of the retinal photoreceptor sampling mosaic. The filling-in mechamism plays an important role in understanding visual performance. The filling-in mechanism is not well understood. A systematic collaborative research program at the Ames Research Center and SRI in Menlo Park, California, was designed to explore this mechanism. It was shown that the perceived fields which are in fact different from the image on the retina due to filling-in, control some aspects of performance and not others. Researchers have linked these mechanisms to putative mechanisms of color coding and color constancy.

High-resolution optical coherence tomography, autofluorescence, and infrared reflectance imaging in Sjögren reticular dystrophy.

PubMed

Schauwvlieghe, Pieter-Paul; Torre, Kara Della; Coppieters, Frauke; Van Hoey, Anneleen; De Baere, Elfride; De Zaeytijd, Julie; Leroy, Bart P; Brodie, Scott E

2013-01-01

To describe the phenotype of three cases of Sjögren reticular dystrophy in detail, including high-resolution optical coherence tomography, autofluorescence imaging, and near-infrared reflectance imaging. Two unrelated teenagers were independently referred for ophthalmologic evaluation. Both underwent a full ophthalmologic workup, including electrophysiologic and extensive imaging with spectral-domain optical coherence tomography, autofluorescence imaging, and near-infrared reflectance imaging. In addition, mutation screening of ABCA4, PRPH2, and the mitochondrial tRNA gene was performed in Patient 1. Subsequently, the teenage sister of Patient 2 was examined. Strikingly similar phenotypes were present in these three patients. Fundoscopy showed bilateral foveal pigment alterations, and a lobular network of deep retinal, pigmented deposits throughout the posterior pole, tapering toward the midperiphery, with relative sparing of the immediate perifoveal macula and peripapillary area. This network is mildly to moderately hyperautofluorescent on autofluorescence and bright on near-infrared reflectance imaging. Optical coherence tomography showed abnormalities of the retinal pigment epithelium-Bruch membrane complex, photoreceptor outer segments, and photoreceptor inner/outer segment interface. The results of retinal function test were entirely normal. No molecular cause was detected in Patient 1. Imaging suggested that the lobular network of deep retinal deposits in Sjögren reticular dystrophy is the result of accumulation of both pigment and lipofuscin between photoreceptors and retinal pigment epithelium, as well as within the retinal pigment epithelium.

Automatic retinal interest evaluation system (ARIES).

PubMed

Yin, Fengshou; Wong, Damon Wing Kee; Yow, Ai Ping; Lee, Beng Hai; Quan, Ying; Zhang, Zhuo; Gopalakrishnan, Kavitha; Li, Ruoying; Liu, Jiang

2014-01-01

In recent years, there has been increasing interest in the use of automatic computer-based systems for the detection of eye diseases such as glaucoma, age-related macular degeneration and diabetic retinopathy. However, in practice, retinal image quality is a big concern as automatic systems without consideration of degraded image quality will likely generate unreliable results. In this paper, an automatic retinal image quality assessment system (ARIES) is introduced to assess both image quality of the whole image and focal regions of interest. ARIES achieves 99.54% accuracy in distinguishing fundus images from other types of images through a retinal image identification step in a dataset of 35342 images. The system employs high level image quality measures (HIQM) to perform image quality assessment, and achieves areas under curve (AUCs) of 0.958 and 0.987 for whole image and optic disk region respectively in a testing dataset of 370 images. ARIES acts as a form of automatic quality control which ensures good quality images are used for processing, and can also be used to alert operators of poor quality images at the time of acquisition.

Retinal amyloid pathology and proof-of-concept imaging trial in Alzheimer’s disease

PubMed Central

Koronyo, Yosef; Biggs, David; Barron, Ernesto; Boyer, David S.; Pearlman, Joel A.; Au, William J.; Kile, Shawn J.; Blanco, Austin; Fuchs, Dieu-Trang; Frautschy, Sally; Cole, Gregory M.; Miller, Carol A.; Hinton, David R.; Verdooner, Steven R.; Black, Keith L.

2017-01-01

BACKGROUND. Noninvasive detection of Alzheimer’s disease (AD) with high specificity and sensitivity can greatly facilitate identification of at-risk populations for earlier, more effective intervention. AD patients exhibit a myriad of retinal pathologies, including hallmark amyloid β-protein (Aβ) deposits. METHODS. Burden, distribution, cellular layer, and structure of retinal Aβ plaques were analyzed in flat mounts and cross sections of definite AD patients and controls (n = 37). In a proof-of-concept retinal imaging trial (n = 16), amyloid probe curcumin formulation was determined and protocol was established for retinal amyloid imaging in live patients. RESULTS. Histological examination uncovered classical and neuritic-like Aβ deposits with increased retinal Aβ42 plaques (4.7-fold; P = 0.0063) and neuronal loss (P = 0.0023) in AD patients versus matched controls. Retinal Aβ plaque mirrored brain pathology, especially in the primary visual cortex (P = 0.0097 to P = 0.0018; Pearson’s r = 0.84–0.91). Retinal deposits often associated with blood vessels and occurred in hot spot peripheral regions of the superior quadrant and innermost retinal layers. Transmission electron microscopy revealed retinal Aβ assembled into protofibrils and fibrils. Moreover, the ability to image retinal amyloid deposits with solid-lipid curcumin and a modified scanning laser ophthalmoscope was demonstrated in live patients. A fully automated calculation of the retinal amyloid index (RAI), a quantitative measure of increased curcumin fluorescence, was constructed. Analysis of RAI scores showed a 2.1-fold increase in AD patients versus controls (P = 0.0031). CONCLUSION. The geometric distribution and increased burden of retinal amyloid pathology in AD, together with the feasibility to noninvasively detect discrete retinal amyloid deposits in living patients, may lead to a practical approach for large-scale AD diagnosis and monitoring. FUNDING. National Institute on Aging award (AG044897) and The Saban and The Marciano Family Foundations. PMID:28814675

Morphology and Topography of Retinal Pericytes in the Living Mouse Retina Using In Vivo Adaptive Optics Imaging and Ex Vivo Characterization

PubMed Central

Schallek, Jesse; Geng, Ying; Nguyen, HoanVu; Williams, David R.

2013-01-01

Purpose. To noninvasively image retinal pericytes in the living eye and characterize NG2-positive cell topography and morphology in the adult mouse retina. Methods. Transgenic mice expressing fluorescent pericytes (NG2, DsRed) were imaged using a two-channel, adaptive optics scanning laser ophthalmoscope (AOSLO). One channel imaged vascular perfusion with near infrared light. A second channel simultaneously imaged fluorescent retinal pericytes. Mice were also imaged using wide-field ophthalmoscopy. To confirm in vivo imaging, five eyes were enucleated and imaged in flat mount with conventional fluorescent microscopy. Cell topography was quantified relative to the optic disc. Results. We observed strong DsRed fluorescence from NG2-positive cells. AOSLO revealed fluorescent vascular mural cells enveloping all vessels in the living retina. Cells were stellate on larger venules, and showed banded morphology on arterioles. NG2-positive cells indicative of pericytes were found on the smallest capillaries of the retinal circulation. Wide-field SLO enabled quick assessment of NG2-positive distribution, but provided insufficient resolution for cell counts. Ex vivo microscopy showed relatively even topography of NG2-positive capillary pericytes at eccentricities more than 0.3 mm from the optic disc (515 ± 94 cells/mm2 of retinal area). Conclusions. We provide the first high-resolution images of retinal pericytes in the living animal. Subcellular resolution enabled morphological identification of NG2-positive cells on capillaries showing classic features and topography of retinal pericytes. This report provides foundational basis for future studies that will track and quantify pericyte topography, morphology, and function in the living retina over time, especially in the progression of microvascular disease. PMID:24150762

Retinitis Pigmentosa Sine Pigmento Mimicking a Chiasm Disease.

PubMed

Pellegrini, Francesco; Prosdocimo, Giovanni; Romano, Francesco; Interlandi, Emanuela

2017-08-01

A 75-year-old woman presented to her ophthalmologist complaining of visual loss for several years. The ophthalmic examination was remarkable for a bitemporal visual field defect. Magnetic resonance imaging (MRI) scan of the brain was normal without evidence of chiasm compression. Neuro-ophthalmic examination was consistent with a retinal rather than a chiasmal disease. Retinal multimodal imaging helped in the correct diagnosis of retinitis pigmentosa, later confirmed by genetic testing.

Paintings, photographs, and computer graphics are calculated appearances

NASA Astrophysics Data System (ADS)

McCann, John

2012-03-01

Painters reproduce the appearances they see, or visualize. The entire human visual system is the first part of that process, providing extensive spatial processing. Painters have used spatial techniques since the Renaissance to render HDR scenes. Silver halide photography responds to the light falling on single film pixels. Film can only mimic the retinal response of the cones at the start of the visual process. Film cannot mimic the spatial processing in humans. Digital image processing can. This talk studies three dramatic visual illusions and uses the spatial mechanisms found in human vision to interpret their appearances.

Improving the blind restoration of retinal images by means of point-spread-function estimation assessment

NASA Astrophysics Data System (ADS)

Marrugo, Andrés. G.; Millán, María. S.; Å orel, Michal; Kotera, Jan; Å roubek, Filip

2015-01-01

Retinal images often suffer from blurring which hinders disease diagnosis and progression assessment. The restoration of the images is carried out by means of blind deconvolution, but the success of the restoration depends on the correct estimation of the point-spread-function (PSF) that blurred the image. The restoration can be space-invariant or space-variant. Because a retinal image has regions without texture or sharp edges, the blind PSF estimation may fail. In this paper we propose a strategy for the correct assessment of PSF estimation in retinal images for restoration by means of space-invariant or space-invariant blind deconvolution. Our method is based on a decomposition in Zernike coefficients of the estimated PSFs to identify valid PSFs. This significantly improves the quality of the image restoration revealed by the increased visibility of small details like small blood vessels and by the lack of restoration artifacts.

Integrated photoacoustic microscopy, optical coherence tomography, and fluorescence microscopy for multimodal chorioretinal imaging

NASA Astrophysics Data System (ADS)

Tian, Chao; Zhang, Wei; Nguyen, Van Phuc; Huang, Ziyi; Wang, Xueding; Paulus, Yannis M.

2018-02-01

Current clinical available retinal imaging techniques have limitations, including limited depth of penetration or requirement for the invasive injection of exogenous contrast agents. Here, we developed a novel multimodal imaging system for high-speed, high-resolution retinal imaging of larger animals, such as rabbits. The system integrates three state-of-the-art imaging modalities, including photoacoustic microscopy (PAM), optical coherence tomography (OCT), and fluorescence microscopy (FM). In vivo experimental results of rabbit eyes show that the PAM is able to visualize laser-induced retinal burns and distinguish individual eye blood vessels using a laser exposure dose of 80 nJ, which is well below the American National Standards Institute (ANSI) safety limit 160 nJ. The OCT can discern different retinal layers and visualize laser burns and choroidal detachments. The novel multi-modal imaging platform holds great promise in ophthalmic imaging.

Fluorocoxib A enables targeted detection of cyclooxygenase-2 in laser-induced choroidal neovascularization

NASA Astrophysics Data System (ADS)

Uddin, Md. Jashim; Moore, Chauca E.; Crews, Brenda C.; Daniel, Cristina K.; Ghebreselasie, Kebreab; McIntyre, J. Oliver; Marnett, Lawrence J.; Jayagopal, Ashwath

2016-09-01

Ocular angiogenesis is a blinding complication of age-related macular degeneration and other retinal vascular diseases. Clinical imaging approaches to detect inflammation prior to the onset of neovascularization in these diseases may enable early detection and timely therapeutic intervention. We demonstrate the feasibility of a previously developed cyclooxygenase-2 (COX-2) targeted molecular imaging probe, fluorocoxib A, for imaging retinal inflammation in a mouse model of laser-induced choroidal neovascularization. This imaging probe exhibited focal accumulation within laser-induced neovascular lesions, with minimal detection in proximal healthy tissue. The selectivity of the probe for COX-2 was validated in vitro and by in vivo retinal imaging with nontargeted 5-carboxy-X-rhodamine dye, and by blockade of the COX-2 active site with nonfluorescent celecoxib prior to injection of fluorocoxib A. Fluorocoxib A can be utilized for imaging COX-2 expression in vivo for further validation as an imaging biomarker in retinal diseases.

Ocular screening tests of elementary school children

NASA Technical Reports Server (NTRS)

Richardson, J.

1983-01-01

This report presents an analysis of 507 abnormal retinal reflex images taken of Huntsville kindergarten and first grade students. The retinal reflex images were obtained by using an MSFC-developed Generated Retinal Reflex Image System (GRRIS) photorefractor. The system uses a 35 mm camera with a telephoto lens with an electronic flash attachment. Slide images of the eyes were examined for abnormalities. Of a total of 1835 students screened for ocular abnormalities, 507 were found to have abnormal retinal reflexes. The types of ocular abnormalities detected were hyperopia, myopia, astigmatism, esotropia, exotropia, strabismus, and lens obstuctions. The report shows that the use of the photorefractor screening system is an effective low-cost means of screening school children for abnormalities.

In vivo imaging of the Mouse Model of X-Linked Juvenile Retinoschisis Using Fourier Domain Optical Coherence Tomography

PubMed Central

Xu, Jing; Molday, Laurie L.; Molday, Robert S.; Sarunic, Marinko V.

2009-01-01

Purpose The purpose of this study is to investigate Fourier Domain Optical Coherence Tomography (FD OCT) as a non-invasive tool for retinal imaging in the Rs1h knockout mouse (model for X-linked Juvenile Retinoschisis). Methods A prototype spectrometer based FD OCT system was used in combination with a custom optical beam-scanning platform. Images of the retinas from wild type and Rs1h knockout mice were acquired non-invasively using FD OCT with the specimen anesthetized. At the completion of the non-invasive FD OCT imaging, invasive retinal cross sectional images (histology) were acquired from a nearby region for comparison to the FD OCT images. Results The retinal layers could be identified in the FD OCT images, permitting delineation and thickness measurement of the outer nuclear layer (ONL). During FD OCT in vivo imaging of the Rs1h knockout mouse, holes were observed in the inner nuclear layer (INL) and retinal cell disorganization was observed as a change in the backscattering intensity profile. Comparison of the ONL measurements acquired non-invasively using FD OCT to measurements taken using histology at nearby locations showed a degeneration of roughly thirty percent of the ONL by the age of two months in Rs1h knockout mice relative to wild type. Conclusions FD OCT has been demonstrated for non-invasive imaging of retinal degeneration and observation of retinal holes in Rs1h knockout mice. PMID:19182246

Automated detection of the retinal from OCT spectral domain images of healthy eyes

NASA Astrophysics Data System (ADS)

Giovinco, Gaspare; Savastano, Maria Cristina; Ventre, Salvatore; Tamburrino, Antonello

2015-06-01

Optical coherence tomography (OCT) has become one of the most relevant diagnostic tools for retinal diseases. Besides being a non-invasive technique, one distinguished feature is its unique capability of providing (in vivo) cross-sectional view of the retinal. Specifically, OCT images show the retinal layers. From the clinical point of view, the identification of the retinal layers opens new perspectives to study the correlation between morphological and functional aspects of the retinal tissue. The main contribution of this paper is a new method/algorithm for the automated segmentation of cross-sectional images of the retina of healthy eyes, obtained by means of spectral domain optical coherence tomography (SD-OCT). Specifically, the proposed segmentation algorithm provides the automated detection of different retinal layers. Tests on experimental SD-OCT scans performed by three different instruments/manufacturers have been successfully carried out and compared to a manual segmentation made by an independent ophthalmologist, showing the generality and the effectiveness of the proposed method.

Evaluation of patient suitability for a retinal prosthesis using structural and functional tests of inner retinal integrity

NASA Astrophysics Data System (ADS)

Huang, Qiuhen; Chowdhury, Vivek; Coroneo, Minas Theodore

2009-06-01

The purpose of this study was to assess inner retinal structure and function in patients with retinitis pigmentosa (RP) using optical coherence tomography (OCT) imaging of the retina, and electrical stimulation of the retina with a contact lens electrode. OCT images of 17 RP patients were acquired at the macula and at four quadrants of the peripheral retina in both eyes. Analysis was made of the residual inner retinal thickness and nerve fibre layer thickness in RP patients, and this was compared to normal controls. Eight of these patients further underwent contact lens electrical stimulation of one eye and thresholds for phosphene perception were obtained. OCT imaging showed a significant amount of inner retinal preservation in the peripheral retina and the macula of RP patients despite severe visual acuity and visual field loss. Phosphene thresholds were obtained across the range of pulse durations tested but were much higher than those obtained in normal controls. Phosphene thresholds in RP patients moderately correlated with inner retinal thicknesses as measured by OCT. Preservation of inner retinal structure in patients with RP and the responsiveness of these eyes to electrical stimulation suggest adequate inner retinal preservation for a retinal prosthesis to be successful.

Concurrent OCT imaging of stimulus evoked retinal neural activation and hemodynamic responses

NASA Astrophysics Data System (ADS)

Son, Taeyoon; Wang, Benquan; Lu, Yiming; Chen, Yanjun; Cao, Dingcai; Yao, Xincheng

2017-02-01

It is well established that major retinal diseases involve distortions of the retinal neural physiology and blood vascular structures. However, the details of distortions in retinal neurovascular coupling associated with major eye diseases are not well understood. In this study, a multi-modal optical coherence tomography (OCT) imaging system was developed to enable concurrent imaging of retinal neural activity and vascular hemodynamics. Flicker light stimulation was applied to mouse retinas to evoke retinal neural responses and hemodynamic changes. The OCT images were acquired continuously during the pre-stimulation, light-stimulation, and post-stimulation phases. Stimulus-evoked intrinsic optical signals (IOSs) and hemodynamic changes were observed over time in blood-free and blood regions, respectively. Rapid IOSs change occurred almost immediately after stimulation. Both positive and negative signals were observed in adjacent retinal areas. The hemodynamic changes showed time delays after stimulation. The signal magnitudes induced by light stimulation were observed in blood regions and did not show significant changes in blood-free regions. These differences may arise from different mechanisms in blood vessels and neural tissues in response to light stimulation. These characteristics agreed well with our previous observations in mouse retinas. Further development of the multimodal OCT may provide a new imaging method for studying how retinal structures and metabolic and neural functions are affected by age-related macular degeneration (AMD), glaucoma, diabetic retinopathy (DR), and other diseases, which promises novel noninvasive biomarkers for early disease detection and reliable treatment evaluations of eye diseases.

Color Doppler imaging of retinal diseases.

PubMed

Dimitrova, Galina; Kato, Satoshi

2010-01-01

Color Doppler imaging (CDI) is a widely used method for evaluating ocular circulation that has been used in a number of studies on retinal diseases. CDI assesses blood velocity parameters by using ultrasound waves. In ophthalmology, these assessments are mainly performed on the retrobulbar blood vessels: the ophthalmic, the central retinal, and the short posterior ciliary arteries. In this review, we discuss CDI use for the assessment of retinal diseases classified into the following: vascular diseases, degenerations, dystrophies, and detachment. The retinal vascular diseases that have been investigated by CDI include diabetic retinopathy, retinal vein occlusions, retinal artery occlusions, ocular ischemic conditions, and retinopathy of prematurity. Degenerations and dystrophies included in this review are age-related macular degeneration, myopia, and retinitis pigmentosa. CDI has been used for the differential diagnosis of retinal detachment, as well as the evaluation of retrobulbar circulation in this condition. CDI is valuable for research and is a potentially useful diagnostic tool in the clinical setting.

Laser speckle imaging of rat retinal blood flow with hybrid temporal and spatial analysis method

NASA Astrophysics Data System (ADS)

Cheng, Haiying; Yan, Yumei; Duong, Timothy Q.

2009-02-01

Noninvasive monitoring of blood flow in retinal circulation will reveal the progression and treatment of ocular disorders, such as diabetic retinopathy, age-related macular degeneration and glaucoma. A non-invasive and direct BF measurement technique with high spatial-temporal resolution is needed for retinal imaging. Laser speckle imaging (LSI) is such a method. Currently, there are two analysis methods for LSI: spatial statistics LSI (SS-LSI) and temporal statistical LSI (TS-LSI). Comparing these two analysis methods, SS-LSI has higher signal to noise ratio (SNR) and TSLSI is less susceptible to artifacts from stationary speckle. We proposed a hybrid temporal and spatial analysis method (HTS-LSI) to measure the retinal blood flow. Gas challenge experiment was performed and images were analyzed by HTS-LSI. Results showed that HTS-LSI can not only remove the stationary speckle but also increase the SNR. Under 100% O2, retinal BF decreased by 20-30%. This was consistent with the results observed with laser Doppler technique. As retinal blood flow is a critical physiological parameter and its perturbation has been implicated in the early stages of many retinal diseases, HTS-LSI will be an efficient method in early detection of retina diseases.

Retinitis Pigmentosa Sine Pigmento Mimicking a Chiasm Disease

PubMed Central

Pellegrini, Francesco; Prosdocimo, Giovanni; Romano, Francesco; Interlandi, Emanuela

2017-01-01

ABSTRACT A 75-year-old woman presented to her ophthalmologist complaining of visual loss for several years. The ophthalmic examination was remarkable for a bitemporal visual field defect. Magnetic resonance imaging (MRI) scan of the brain was normal without evidence of chiasm compression. Neuro-ophthalmic examination was consistent with a retinal rather than a chiasmal disease. Retinal multimodal imaging helped in the correct diagnosis of retinitis pigmentosa, later confirmed by genetic testing. PMID:29344059

Optimization of the open-loop liquid crystal adaptive optics retinal imaging system

NASA Astrophysics Data System (ADS)

Kong, Ningning; Li, Chao; Xia, Mingliang; Li, Dayu; Qi, Yue; Xuan, Li

2012-02-01

An open-loop adaptive optics (AO) system for retinal imaging was constructed using a liquid crystal spatial light modulator (LC-SLM) as the wavefront compensator. Due to the dispersion of the LC-SLM, there was only one illumination source for both aberration detection and retinal imaging in this system. To increase the field of view (FOV) for retinal imaging, a modified mechanical shutter was integrated into the illumination channel to control the size of the illumination spot on the fundus. The AO loop was operated in a pulsing mode, and the fundus was illuminated twice by two laser impulses in a single AO correction loop. As a result, the FOV for retinal imaging was increased to 1.7-deg without compromising the aberration detection accuracy. The correction precision of the open-loop AO system was evaluated in a closed-loop configuration; the residual error is approximately 0.0909λ (root-mean-square, RMS), and the Strehl ratio ranges to 0.7217. Two subjects with differing rates of myopia (-3D and -5D) were tested. High-resolution images of capillaries and photoreceptors were obtained.

Imaging Retinal Vascular Changes in the Mouse Model of Oxygen-Induced Retinopathy

PubMed Central

Furtado, João M.; Davies, Michael H.; Choi, Dongseok; Lauer, Andreas K.; Appukuttan, Binoy; Bailey, Steven T.; Rahman, Hassan T.; Payne, John F.; Stempel, Andrew J.; Mohs, Kathleen; Powers, Michael R.; Yeh, Steven; Smith, Justine R.

2012-01-01

Purpose Oxygen-induced retinopathy in the mouse is the standard experimental model of retinopathy of prematurity. Assessment of the pathology involves in vitro analysis of retinal vaso-obliteration and retinal neovascularization. The authors studied the clinical features of oxygen-induced retinopathy in vivo using topical endoscopy fundus imaging (TEFI), in comparison to standard investigations, and evaluated a system for grading these features. Methods Postnatal day (P)7 mice were exposed to 75% oxygen for five days to induce retinopathy or maintained in room air as controls. Retinal vascular competence was graded against standard photographs by three masked graders. Retinal photographs were obtained at predetermined ages using TEFI. Postmortem, retinal vaso-obliteration was measured in whole mounts with labeled vasculature, and retinal neovascularization was quantified in hematoxylin- and eosin-stained ocular cross sections. Results Fundus photography by TEFI was possible from P15, when retinal vascular incompetence, including dilatation and tortuosity, was significant in mice with oxygen-induced retinopathy in comparison to controls. Vascular incompetence peaked in severity at P17 and persisted through P25. Comparison with in vitro analyses indicated that vascular changes were most severe after retinal avascularity had begun to decrease in area, and coincident with the maximum of retinal neovascularization. A weighted Fleiss-Cohen kappa indicated good intra- and interobserver agreement for a 5-point grading system. Conclusions Topical endoscopy fundus imaging demonstrates retinal vascular incompetence in mice with oxygen-induced retinopathy. The technique complements standard postmortem analysis for following the course of the model. Translational Relevance Topical endoscopy fundus imaging has application in the evaluation of novel biologic drugs for retinopathy of prematurity. PMID:24049705

Wide-field fundus imaging with trans-palpebral illumination.

PubMed

Toslak, Devrim; Thapa, Damber; Chen, Yanjun; Erol, Muhammet Kazim; Paul Chan, R V; Yao, Xincheng

2017-01-28

In conventional fundus imaging devices, transpupillary illumination is used for illuminating the inside of the eye. In this method, the illumination light is directed into the posterior segment of the eye through the cornea and passes the pupillary area. As a result of sharing the pupillary area for the illumination beam and observation path, pupil dilation is typically necessary for wide-angle fundus examination, and the field of view is inherently limited. An alternative approach is to deliver light from the sclera. It is possible to image a wider retinal area with transcleral-illumination. However, the requirement of physical contact between the illumination probe and the sclera is a drawback of this method. We report here trans-palpebral illumination as a new method to deliver the light through the upper eyelid (palpebra). For this study, we used a 1.5 mm diameter fiber with a warm white LED light source. To illuminate the inside of the eye, the fiber illuminator was placed at the location corresponding to the pars plana region. A custom designed optical system was attached to a digital camera for retinal imaging. The optical system contained a 90 diopter ophthalmic lens and a 25 diopter relay lens. The ophthalmic lens collected light coming from the posterior of the eye and formed an aerial image between the ophthalmic and relay lenses. The aerial image was captured by the camera through the relay lens. An adequate illumination level was obtained to capture wide angle fundus images within ocular safety limits, defined by the ISO 15004-2: 2007 standard. This novel trans-palpebral illumination approach enables wide-angle fundus photography without eyeball contact and pupil dilation.

Retinal Image Quality During Accommodation

PubMed Central

López-Gil, N.; Martin, J.; Liu, T.; Bradley, A.; Díaz-Muñoz, D.; Thibos, L.

2013-01-01

Purpose We asked if retinal image quality is maximum during accommodation, or sub-optimal due to accommodative error, when subjects perform an acuity task. Methods Subjects viewed a monochromatic (552nm), high-contrast letter target placed at various viewing distances. Wavefront aberrations of the accommodating eye were measured near the endpoint of an acuity staircase paradigm. Refractive state, defined as the optimum target vergence for maximising retinal image quality, was computed by through-focus wavefront analysis to find the power of the virtual correcting lens that maximizes visual Strehl ratio. Results Despite changes in ocular aberrations and pupil size during binocular viewing, retinal image quality and visual acuity typically remain high for all target vergences. When accommodative errors lead to sub-optimal retinal image quality, acuity and measured image quality both decline. However, the effect of accommodation errors of on visual acuity are mitigated by pupillary constriction associated with accommodation and binocular convergence and also to binocular summation of dissimilar retinal image blur. Under monocular viewing conditions some subjects displayed significant accommodative lag that reduced visual performance, an effect that was exacerbated by pharmacological dilation of the pupil. Conclusions Spurious measurement of accommodative error can be avoided when the image quality metric used to determine refractive state is compatible with the focusing criteria used by the visual system to control accommodation. Real focusing errors of the accommodating eye do not necessarily produce a reliably measurable loss of image quality or clinically significant loss of visual performance, probably because of increased depth-of-focus due to pupil constriction. When retinal image quality is close to maximum achievable (given the eye’s higher-order aberrations), acuity is also near maximum. A combination of accommodative lag, reduced image quality, and reduced visual function may be a useful sign for diagnosing functionally-significant accommodative errors indicating the need for therapeutic intervention. PMID:23786386

Retinal image quality during accommodation.

PubMed

López-Gil, Norberto; Martin, Jesson; Liu, Tao; Bradley, Arthur; Díaz-Muñoz, David; Thibos, Larry N

2013-07-01

We asked if retinal image quality is maximum during accommodation, or sub-optimal due to accommodative error, when subjects perform an acuity task. Subjects viewed a monochromatic (552 nm), high-contrast letter target placed at various viewing distances. Wavefront aberrations of the accommodating eye were measured near the endpoint of an acuity staircase paradigm. Refractive state, defined as the optimum target vergence for maximising retinal image quality, was computed by through-focus wavefront analysis to find the power of the virtual correcting lens that maximizes visual Strehl ratio. Despite changes in ocular aberrations and pupil size during binocular viewing, retinal image quality and visual acuity typically remain high for all target vergences. When accommodative errors lead to sub-optimal retinal image quality, acuity and measured image quality both decline. However, the effect of accommodation errors of on visual acuity are mitigated by pupillary constriction associated with accommodation and binocular convergence and also to binocular summation of dissimilar retinal image blur. Under monocular viewing conditions some subjects displayed significant accommodative lag that reduced visual performance, an effect that was exacerbated by pharmacological dilation of the pupil. Spurious measurement of accommodative error can be avoided when the image quality metric used to determine refractive state is compatible with the focusing criteria used by the visual system to control accommodation. Real focusing errors of the accommodating eye do not necessarily produce a reliably measurable loss of image quality or clinically significant loss of visual performance, probably because of increased depth-of-focus due to pupil constriction. When retinal image quality is close to maximum achievable (given the eye's higher-order aberrations), acuity is also near maximum. A combination of accommodative lag, reduced image quality, and reduced visual function may be a useful sign for diagnosing functionally-significant accommodative errors indicating the need for therapeutic intervention. © 2013 The Authors Ophthalmic & Physiological Optics © 2013 The College of Optometrists.

Detection of retinal nerve fiber layer defects in retinal fundus images using Gabor filtering

NASA Astrophysics Data System (ADS)

Hayashi, Yoshinori; Nakagawa, Toshiaki; Hatanaka, Yuji; Aoyama, Akira; Kakogawa, Masakatsu; Hara, Takeshi; Fujita, Hiroshi; Yamamoto, Tetsuya

2007-03-01

Retinal nerve fiber layer defect (NFLD) is one of the most important findings for the diagnosis of glaucoma reported by ophthalmologists. However, such changes could be overlooked, especially in mass screenings, because ophthalmologists have limited time to search for a number of different changes for the diagnosis of various diseases such as diabetes, hypertension and glaucoma. Therefore, the use of a computer-aided detection (CAD) system can improve the results of diagnosis. In this work, a technique for the detection of NFLDs in retinal fundus images is proposed. In the preprocessing step, blood vessels are "erased" from the original retinal fundus image by using morphological filtering. The preprocessed image is then transformed into a rectangular array. NFLD regions are observed as vertical dark bands in the transformed image. Gabor filtering is then applied to enhance the vertical dark bands. False positives (FPs) are reduced by a rule-based method which uses the information of the location and the width of each candidate region. The detected regions are back-transformed into the original configuration. In this preliminary study, 71% of NFLD regions are detected with average number of FPs of 3.2 per image. In conclusion, we have developed a technique for the detection of NFLDs in retinal fundus images. Promising results have been obtained in this initial study.

Comparison of Nondiabetic Retinal Findings Identified With Nonmydriatic Fundus Photography vs Ultrawide Field Imaging in an Ocular Telehealth Program.

PubMed

Silva, Paolo S; Cavallerano, Jerry D; Haddad, Nour Maya N; Tolls, Dorothy; Thakore, Komal; Patel, Bina; Sehizadeh, Mina; Tolson, Ann M; Sun, Jennifer K; Aiello, Lloyd Paul

2016-03-01

Ultrawide field imaging (UWFI) is increasingly being used in teleophthalmology settings. Given the greater area of the retina imaged, we evaluated the ability of UWFI vs nonmydriatic fundus photography (NMFP) to detect nondiabetic retinal findings in a teleophthalmology program. We conducted a retrospective single-center comparative cohort study from January 1, 2011, to June 30, 2013, imaging 3864 and 3971 consecutive teleophthalmology patients (7728 and 7942 eyes) using NMFP and UWFI, respectively. Standard diabetic retinopathy evaluation and nondiabetic findings were compared between the 2 imaging modalities. In patients without diabetic retinopathy (2243 by NMFP and 2252 by UWFI), the rate of identification of nondiabetic findings by NMFP (451 patients [20.1%]) and UWFI (490 [21.8%]) were comparable (P = .19). Ultrawide field imaging increased the identification of choroidal nevi by 27% (406 eyes [5.3%] by NMFP vs 545 eyes [6.9%] by UWFI; P < .001) and chorioretinal atrophy or scarring by 116% (50 eyes [0.6%] by NMFP vs 101 eyes [1.3%] by UWFI; P < .001). No peripheral retinal findings were identified with NMFP, while UWFI detected 25 retinal tears (0.3%; P < .001), 54 lattice and peripheral degenerations (0.7%; P < .001), and 142 cases of vitreous detachment or floaters (1.8%; P < .001). Data analysis was performed from November 1, 2013, to May 1, 2014. In eyes without diabetic retinopathy, approximately 20% may have ocular findings identified on retinal imaging, which emphasizes the role of retinal imaging in patients with diabetes mellitus type 1 and type 2 regardless of the severity of retinopathy. In this cohort, UWFI increased the identification of peripheral retinal and vitreous pathologic findings.

MULTIMODAL IMAGING OF MOSAIC RETINOPATHY IN CARRIERS OF HEREDITARY X-LINKED RECESSIVE DISEASES.

PubMed

Wu, An-Lun; Wang, Jung-Pan; Tseng, Yun-Ju; Liu, Laura; Kang, Yu-Chuan; Chen, Kuan-Jen; Chao, An-Ning; Yeh, Lung-Kun; Chen, Tun-Lu; Hwang, Yih-Shiou; Wu, Wei-Chi; Lai, Chi-Chun; Wang, Nan-Kai

2018-05-01

To investigate the clinical features in carriers of X-linked retinitis pigmentosa, X-linked ocular albinism, and choroideremia (CHM) using multimodal imaging and to assess their diagnostic value in these three mosaic retinopathies. We prospectively examined 14 carriers of 3 X-linked recessive disorders (X-linked retinitis pigmentosa, X-linked ocular albinism, and CHM). Details of abnormalities of retinal morphology were evaluated using fundus photography, fundus autofluorescence (FAF) imaging, and spectral domain optical coherence tomography. In six X-linked retinitis pigmentosa carriers, fundus appearance varied from unremarkable to the presence of tapetal-like reflex and pigmentary changes. On FAF imaging, all carriers exhibited a bright radial reflex against a dark background. By spectral domain optical coherence tomography, loss of the ellipsoid zone in the macula was observed in 3 carriers (50%). Regarding the retinal laminar architecture, 4 carriers (66.7%) showed thinning of the outer nuclear layer and a dentate appearance of the outer plexiform layer. All five X-linked ocular albinism carriers showed a characteristic mud-splatter patterned fundus, dark radial streaks against a bright background on FAF imaging, and a normal-appearing retinal structure by spectral domain optical coherence tomography imaging. Two of the 3 CHM carriers (66.7%) showed a diffuse moth-eaten appearance of the fundus, and all 3 showed irregular hyper-FAF and hypo-FAF spots throughout the affected area. In the CHM carriers, the structural changes observed by spectral domain optical coherence tomography imaging were variable. Our findings in an Asian cohort suggest that FAF imaging is a practical diagnostic test for differentiating X-linked retinitis pigmentosa, X-linked ocular albinism, and CHM carriers. Wide-field FAF is an easy and helpful adjunct to testing for the correct diagnosis and identification of lyonization in carriers of these three mosaic retinopathies.

Cone photoreceptor definition on adaptive optics retinal imaging.

PubMed

Muthiah, Manickam Nick; Gias, Carlos; Chen, Fred Kuanfu; Zhong, Joe; McClelland, Zoe; Sallo, Ferenc B; Peto, Tunde; Coffey, Peter J; da Cruz, Lyndon

2014-08-01

To quantitatively analyse cone photoreceptor matrices on images captured on an adaptive optics (AO) camera and assess their correlation to well-established parameters in the retinal histology literature. High resolution retinal images were acquired from 10 healthy subjects, aged 20-35 years old, using an AO camera (rtx1, Imagine Eyes, France). Left eye images were captured at 5° of retinal eccentricity, temporal to the fovea for consistency. In three subjects, images were also acquired at 0, 2, 3, 5 and 7° retinal eccentricities. Cone photoreceptor density was calculated following manual and automated counting. Inter-photoreceptor distance was also calculated. Voronoi domain and power spectrum analyses were performed for all images. At 5° eccentricity, the cone density (cones/mm(2) mean±SD) was 15.3±1.4×10(3) (automated) and 13.9±1.0×10(3) (manual) and the mean inter-photoreceptor distance was 8.6±0.4 μm. Cone density decreased and inter-photoreceptor distance increased with increasing retinal eccentricity from 2 to 7°. A regular hexagonal cone photoreceptor mosaic pattern was seen at 2, 3 and 5° of retinal eccentricity. Imaging data acquired from the AO camera match cone density, intercone distance and show the known features of cone photoreceptor distribution in the pericentral retina as reported by histology, namely, decreasing density values from 2 to 7° of eccentricity and the hexagonal packing arrangement. This confirms that AO flood imaging provides reliable estimates of pericentral cone photoreceptor distribution in normal subjects. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Hybrid tracking and control system for computer-aided retinal surgery

NASA Astrophysics Data System (ADS)

Ferguson, R. D.; Wright, Cameron H. G.; Rylander, Henry G., III; Welch, Ashley J.; Barrett, Steven F.

1996-05-01

We describe initial experimental results of a new hybrid digital and analog design for retinal tracking and laser beam control. Initial results demonstrate tracking rates which exceed the equivalent of 50 degrees per second in the eye, with automatic lesion pattern creation and robust loss of lock detection. Robotically assisted laser surgery to treat conditions such as diabetic retinopathy, macular degeneration, and retinal tears can now be realized under clinical conditions with requisite safety using standard video hardware and inexpensive optical components.

Automatic segmentation of pigment deposits in retinal fundus images of Retinitis Pigmentosa.

PubMed

Brancati, Nadia; Frucci, Maria; Gragnaniello, Diego; Riccio, Daniel; Di Iorio, Valentina; Di Perna, Luigi

2018-06-01

Retinitis Pigmentosa is an eye disease that presents with a slow loss of vision and then evolves until blindness results. The automatic detection of the early signs of retinitis pigmentosa acts as a great support to ophthalmologists in the diagnosis and monitoring of the disease in order to slow down the degenerative process. A large body of literature is devoted to the analysis of Retinitis Pigmentosa. However, all the existing approaches work on Optical Coherence Tomography (OCT) data, while hardly any attempts have been made working on fundus images. Fundus image analysis is a suitable tool in daily practice for an early detection of retinal diseases and the monitoring of their progression. Moreover, the fundus camera represents a low-cost and easy-access diagnostic system, which can be employed in resource-limited regions and countries. The fundus images of a patient suffering from retinitis pigmentosa are characterized by an attenuation of the vessels, a waxy disc pallor and the presence of pigment deposits. Considering that several methods have been proposed for the analysis of retinal vessels and the optic disk, this work focuses on the automatic segmentation of the pigment deposits in the fundus images. The image distortions are attenuated by applying a local pre-processing. Next, a watershed transformation is carried out to produce homogeneous regions. Working on regions rather than on pixels makes the method very robust to the high variability of pigment deposits in terms of color and shape, so allowing the detection even of small pigment deposits. The regions undergo a feature extraction procedure, so that a region classification process is performed by means of an outlier detection analysis and a rule set. The experiments have been performed on a dataset of images of patients suffering from retinitis pigmentosa. Although the images present a high variability in terms of color and illumination, the method provides a good performance in terms of sensitivity, specificity, accuracy and the F-measure, whose values are 74.43, 98.44, 97.90, 59.04, respectively. Copyright © 2018 Elsevier Ltd. All rights reserved.

Three-dimensional image reconstruction of macula from stratus optical coherence tomography (OCT) for diagnosis of macular degeneration

NASA Astrophysics Data System (ADS)

Arinilhaq; Widita, R.

2016-03-01

Diagnosis of macular degeneration using a Stratus OCT with a fast macular thickness map (FMTM) method produced six B-scan images of macula from different angles. The images were converted into a retinal thickness chart to be evaluated by normal distribution percentile of data so that it can be classified as normal thickness of macula or as experiencing abnormality (e.g. thickening and thinning). Unfortunately, the diagnostic images only represent the retinal thickness in several areas of the macular region. Thus, this study is aims to obtain the entire retinal thickness in the macula area from Status OCT's output images. Basically, the volumetric image is obtained by combining each of the six images. Reconstruction consists of a series of processes such as pre-processing, segmentation, and interpolation. Linear interpolation techniques are used to fill the empty pixels in reconstruction matrix. Based on the results, this method is able to provide retinal thickness maps on the macula surface and the macula 3D image. Retinal thickness map can display the macula area which experienced abnormalities. The macula 3D image can show the layers of tissue in the macula that is abnormal. The system built cannot replace ophthalmologist in decision making in term of diagnosis.

Novel method for edge detection of retinal vessels based on the model of the retinal vascular network and mathematical morphology

NASA Astrophysics Data System (ADS)

Xu, Lei; Zheng, Xiaoxiang; Zhang, Hengyi; Yu, Yajun

1998-09-01

Accurate edge detection of retinal vessels is a prerequisite for quantitative analysis of subtle morphological changes of retinal vessels under different pathological conditions. A novel method for edge detection of retinal vessels is presented in this paper. Methods: (1) Wavelet-based image preprocessing. (2) The signed edge detection algorithm and mathematical morphological operation are applied to get the approximate regions that contain retinal vessels. (3) By convolving the preprocessed image with a LoG operator only on the detected approximate regions of retinal vessels, followed by edges refining, clear edge maps of the retinal vessels are fast obtained. Results: A detailed performance evaluation together with the existing techniques is given to demonstrate the strong features of our method. Conclusions: True edge locations of retinal vessels can be fast detected with continuous structures of retinal vessels, less non- vessel segments left and insensitivity to noise. The method is also suitable for other application fields such as road edge detection.

Alterations in Retinal Layer Thickness and Reflectance at Different Stages of Diabetic Retinopathy by En Face Optical Coherence Tomography

PubMed Central

Wanek, Justin; Blair, Norman P.; Chau, Felix Y.; Lim, Jennifer I.; Leiderman, Yannek I.; Shahidi, Mahnaz

2016-01-01

Purpose This article reports a method for en face optical coherence tomography (OCT) imaging and quantitative assessment of alterations in both thickness and reflectance of individual retinal layers at different stages of diabetic retinopathy (DR). Methods High-density OCT raster volume scans were acquired in 29 diabetic subjects divided into no DR (NDR) or non-proliferative DR (NPDR) groups and 22 control subjects (CNTL). A customized image segmentation method identified eight retinal layer interfaces and generated en face thickness maps and reflectance images for nerve fiber layer (NFL), ganglion cell and inner plexiform layers (GCLIPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), photoreceptor outer segment layer (OSL), and retinal pigment epithelium (RPE). Mean thickness and intensity values were calculated in nine macular subfields for each retinal layer. Results En face thickness maps and reflectance images of retinal layers in CNTL subjects corresponded to normal retinal anatomy. Total retinal thickness correlated negatively with age in nasal subfields (R ≤−0.31; P ≤ 0.03, N = 51). In NDR subjects, NFL and OPL thickness were decreased (P = 0.05), and ONL thickness was increased (P = 0.04) compared to CNTL. In NPDR subjects, GCLIPL thickness was increased in perifoveal subfields (P < 0.05) and INL intensity was higher in all macular subfields (P = 0.04) compared to CNTL. Conclusions Depth and spatially resolved retinal thickness and reflectance measurements are potential biomarkers for assessment and monitoring of DR. PMID:27409491

Automatic Detection of Optic Disc in Retinal Image by Using Keypoint Detection, Texture Analysis, and Visual Dictionary Techniques

PubMed Central

Bayır, Şafak

2016-01-01

With the advances in the computer field, methods and techniques in automatic image processing and analysis provide the opportunity to detect automatically the change and degeneration in retinal images. Localization of the optic disc is extremely important for determining the hard exudate lesions or neovascularization, which is the later phase of diabetic retinopathy, in computer aided eye disease diagnosis systems. Whereas optic disc detection is fairly an easy process in normal retinal images, detecting this region in the retinal image which is diabetic retinopathy disease may be difficult. Sometimes information related to optic disc and hard exudate information may be the same in terms of machine learning. We presented a novel approach for efficient and accurate localization of optic disc in retinal images having noise and other lesions. This approach is comprised of five main steps which are image processing, keypoint extraction, texture analysis, visual dictionary, and classifier techniques. We tested our proposed technique on 3 public datasets and obtained quantitative results. Experimental results show that an average optic disc detection accuracy of 94.38%, 95.00%, and 90.00% is achieved, respectively, on the following public datasets: DIARETDB1, DRIVE, and ROC. PMID:27110272

Retinal image quality assessment based on image clarity and content

NASA Astrophysics Data System (ADS)

Abdel-Hamid, Lamiaa; El-Rafei, Ahmed; El-Ramly, Salwa; Michelson, Georg; Hornegger, Joachim

2016-09-01

Retinal image quality assessment (RIQA) is an essential step in automated screening systems to avoid misdiagnosis caused by processing poor quality retinal images. A no-reference transform-based RIQA algorithm is introduced that assesses images based on five clarity and content quality issues: sharpness, illumination, homogeneity, field definition, and content. Transform-based RIQA algorithms have the advantage of considering retinal structures while being computationally inexpensive. Wavelet-based features are proposed to evaluate the sharpness and overall illumination of the images. A retinal saturation channel is designed and used along with wavelet-based features for homogeneity assessment. The presented sharpness and illumination features are utilized to assure adequate field definition, whereas color information is used to exclude nonretinal images. Several publicly available datasets of varying quality grades are utilized to evaluate the feature sets resulting in area under the receiver operating characteristic curve above 0.99 for each of the individual feature sets. The overall quality is assessed by a classifier that uses the collective features as an input vector. The classification results show superior performance of the algorithm in comparison to other methods from literature. Moreover, the algorithm addresses efficiently and comprehensively various quality issues and is suitable for automatic screening systems.

Automated and simultaneous fovea center localization and macula segmentation using the new dynamic identification and classification of edges model.

PubMed

Onal, Sinan; Chen, Xin; Satamraju, Veeresh; Balasooriya, Maduka; Dabil-Karacal, Humeyra

2016-07-01

Detecting the position of retinal structures, including the fovea center and macula, in retinal images plays a key role in diagnosing eye diseases such as optic nerve hypoplasia, amblyopia, diabetic retinopathy, and macular edema. However, current detection methods are unreliable for infants or certain ethnic populations. Thus, a methodology is proposed here that may be useful for infants and across ethnicities that automatically localizes the fovea center and segments the macula on digital fundus images. First, dark structures and bright artifacts are removed from the input image using preprocessing operations, and the resulting image is transformed to polar space. Second, the fovea center is identified, and the macula region is segmented using the proposed dynamic identification and classification of edges (DICE) model. The performance of the method was evaluated using 1200 fundus images obtained from the relatively large, diverse, and publicly available Messidor database. In 96.1% of these 1200 cases, the distance between the fovea center identified manually by ophthalmologists and automatically using the proposed method remained within 0 to 8 pixels. The dice similarity index comparing the manually obtained results with those of the model for macula segmentation was 96.12% for these 1200 cases. Thus, the proposed method displayed a high degree of accuracy. The methodology using the DICE model is unique and advantageous over previously reported methods because it simultaneously determines the fovea center and segments the macula region without using any structural information, such as optic disc or blood vessel location, and it may prove useful for all populations, including infants.

Restoration of retinal images with space-variant blur.

PubMed

Marrugo, Andrés G; Millán, María S; Sorel, Michal; Sroubek, Filip

2014-01-01

Retinal images are essential clinical resources for the diagnosis of retinopathy and many other ocular diseases. Because of improper acquisition conditions or inherent optical aberrations in the eye, the images are often degraded with blur. In many common cases, the blur varies across the field of view. Most image deblurring algorithms assume a space-invariant blur, which fails in the presence of space-variant (SV) blur. In this work, we propose an innovative strategy for the restoration of retinal images in which we consider the blur to be both unknown and SV. We model the blur by a linear operation interpreted as a convolution with a point-spread function (PSF) that changes with the position in the image. To achieve an artifact-free restoration, we propose a framework for a robust estimation of the SV PSF based on an eye-domain knowledge strategy. The restoration method was tested on artificially and naturally degraded retinal images. The results show an important enhancement, significant enough to leverage the images' clinical use.

Landmark matching based retinal image alignment by enforcing sparsity in correspondence matrix.

PubMed

Zheng, Yuanjie; Daniel, Ebenezer; Hunter, Allan A; Xiao, Rui; Gao, Jianbin; Li, Hongsheng; Maguire, Maureen G; Brainard, David H; Gee, James C

2014-08-01

Retinal image alignment is fundamental to many applications in diagnosis of eye diseases. In this paper, we address the problem of landmark matching based retinal image alignment. We propose a novel landmark matching formulation by enforcing sparsity in the correspondence matrix and offer its solutions based on linear programming. The proposed formulation not only enables a joint estimation of the landmark correspondences and a predefined transformation model but also combines the benefits of the softassign strategy (Chui and Rangarajan, 2003) and the combinatorial optimization of linear programming. We also introduced a set of reinforced self-similarities descriptors which can better characterize local photometric and geometric properties of the retinal image. Theoretical analysis and experimental results with both fundus color images and angiogram images show the superior performances of our algorithms to several state-of-the-art techniques. Copyright © 2013 Elsevier B.V. All rights reserved.

The application of retinal fundus camera imaging in dementia: A systematic review.

PubMed

McGrory, Sarah; Cameron, James R; Pellegrini, Enrico; Warren, Claire; Doubal, Fergus N; Deary, Ian J; Dhillon, Baljean; Wardlaw, Joanna M; Trucco, Emanuele; MacGillivray, Thomas J

2017-01-01

The ease of imaging the retinal vasculature, and the evolving evidence suggesting this microvascular bed might reflect the cerebral microvasculature, presents an opportunity to investigate cerebrovascular disease and the contribution of microvascular disease to dementia with fundus camera imaging. A systematic review and meta-analysis was carried out to assess the measurement of retinal properties in dementia using fundus imaging. Ten studies assessing retinal properties in dementia were included. Quantitative measurement revealed significant yet inconsistent pathologic changes in vessel caliber, tortuosity, and fractal dimension. Retinopathy was more prevalent in dementia. No association of age-related macular degeneration with dementia was reported. Inconsistent findings across studies provide tentative support for the application of fundus camera imaging as a means of identifying changes associated with dementia. The potential of fundus image analysis in differentiating between dementia subtypes should be investigated using larger well-characterized samples. Future work should focus on refining and standardizing methods and measurements.

Longitudinal in vivo imaging of retinal gliosis in a diabetic mouse model.

PubMed

Kumar, Saravana; Zhuo, Lang

2010-10-01

In this study, we visualize and quantify retinal gliosis in vivo for monitoring early diabetic retinopathy (DR) in a transgenic mouse model. Onset of diabetes was triggered via intraperitoneal injection of streptozotocin (STZ) into transgenic F1 hybrid (FVB/N × C57BL/6J) mice expressing green fluorescent protein (GFP) under the control of glial fibrillary acidic protein (GFAP) promoter. Retinal glial cells are imaged once pre-STZ treatment followed by weekly post-STZ imaging for five weeks using a confocal scanning laser ophthalmoscope. Mice develop diabetes one week after STZ induction as confirmed from the high blood glucose levels (>13.9 mmol/L). A significant increase is observed in the GFAP-GFP transgene expression from astrocytic cell bodies and processes as early as week 5 for the STZ-treated mice. Retinal astrocytes also undergo hyperplasia progressively from week 0 to 5. This precedes any structural abnormalities to the retinal vasculature. Immunohistochemistry (IHC) on retinal sections as well as quantitative RT-PCR of endogenous and transgene GFAP mRNA supports our in vivo observation. Our in vivo data correlates with clinical reports with regards to retinal gliosis-related inflammatory response during early diabetic retinopathy. This opens up the possibility of using in vivo molecular imaging of retinal glial cells as a platform for monitoring the efficacy of anti-DR drug candidates which intervene at an early stage.

Simultaneous three wavelength imaging with a scanning laser ophthalmoscope.

PubMed

Reinholz, F; Ashman, R A; Eikelboom, R H

1999-11-01

Various imaging properties of scanning laser ophthalmoscopes (SLO) such as contrast or depth discrimination, are superior to those of the traditional photographic fundus camera. However, most SLO are monochromatic whereas photographic systems produce colour images, which inherently contain information over a broad wavelength range. An SLO system has been modified to allow simultaneous three channel imaging. Laser light sources in the visible and infrared spectrum were concurrently launched into the system. Using different wavelength triads, digital fundus images were acquired at high frame rates. Favourable wavelengths combinations were established and high contrast, true (red, green, blue) or false (red, green, infrared) colour images of the retina were recorded. The monochromatic frames which form the colour image exhibit improved distinctness of different retinal structures such as the nerve fibre layer, the blood vessels, and the choroid. A multi-channel SLO combines the advantageous imaging properties of a tunable, monochrome SLO with the benefits and convenience of colour ophthalmoscopy. The options to modify parameters such as wavelength, intensity, gain, beam profile, aperture sizes, independently for every channel assign a high degree of versatility to the system. Copyright 1999 Wiley-Liss, Inc.

Integrated Photoacoustic Ophthalmoscopy and Spectral-domain Optical Coherence Tomography

PubMed Central

Jiao, Shuliang; Zhang, Hao F.

2013-01-01

Both the clinical diagnosis and fundamental investigation of major ocular diseases greatly benefit from various non-invasive ophthalmic imaging technologies. Existing retinal imaging modalities, such as fundus photography1, confocal scanning laser ophthalmoscopy (cSLO)2, and optical coherence tomography (OCT)3, have significant contributions in monitoring disease onsets and progressions, and developing new therapeutic strategies. However, they predominantly rely on the back-reflected photons from the retina. As a consequence, the optical absorption properties of the retina, which are usually strongly associated with retinal pathophysiology status, are inaccessible by the traditional imaging technologies. Photoacoustic ophthalmoscopy (PAOM) is an emerging retinal imaging modality that permits the detection of the optical absorption contrasts in the eye with a high sensitivity4-7 . In PAOM nanosecond laser pulses are delivered through the pupil and scanned across the posterior eye to induce photoacoustic (PA) signals, which are detected by an unfocused ultrasonic transducer attached to the eyelid. Because of the strong optical absorption of hemoglobin and melanin, PAOM is capable of non-invasively imaging the retinal and choroidal vasculatures, and the retinal pigment epithelium (RPE) melanin at high contrasts 6,7. More importantly, based on the well-developed spectroscopic photoacoustic imaging5,8 , PAOM has the potential to map the hemoglobin oxygen saturation in retinal vessels, which can be critical in studying the physiology and pathology of several blinding diseases 9 such as diabetic retinopathy and neovascular age-related macular degeneration. Moreover, being the only existing optical-absorption-based ophthalmic imaging modality, PAOM can be integrated with well-established clinical ophthalmic imaging techniques to achieve more comprehensive anatomic and functional evaluations of the eye based on multiple optical contrasts6,10 . In this work, we integrate PAOM and spectral-domain OCT (SD-OCT) for simultaneously in vivo retinal imaging of rat, where both optical absorption and scattering properties of the retina are revealed. The system configuration, system alignment and imaging acquisition are presented. PMID:23354081

Peripapillary nerve fiber layer thickness measurement reproducibility using optical coherence tomography.

PubMed

Villain, Max A; Greenfield, David S

2003-01-01

To assess reproducibility of quadrantic and clock hour sectors of retinal nerve fiber layer thickness in normal eyes using optical coherence tomography. Normal eyes of healthy volunteers meeting eligibility criteria were imaged by two inexperienced operators. Six 360 degrees circular scans with a diameter of 3.4 mm centered on the optic disc were obtained during each scanning session, and a baseline image was formed using 3 high-quality images defined by the software. Images were obtained on three different days within a 4-week period. Variance and coefficient of variation (CV) were calculated for quadrantic and retinal nerve fiber layer clock hour sectors obtained from the baseline image. Five normal eyes were scanned. Intraoperator reproducibility was high. The mean (+/- SD) CV for total retinal nerve fiber layer thickness was 5.3 +/- 3.82% and 4.33 +/- 3.7% for operators 1 and 2, respectively. Interoperator reproducibility was good with statistically similar variance for all quadrantic and clock hour retinal nerve fiber layer parameters (P = .42 to .99). The nasal retinal nerve fiber layer was the most variable sector for both operators (mean CV: 10.42% and 7.83% for operators 1 and 2, respectively). Differences in mean total, nasal, temporal, and superior retinal nerve fiber layer thickness were not statistically significant between operators for all eyes; however, for inferior retinal nerve fiber layer thickness, there was a significant (P = .0007) difference between operators in one eye. Peripapillary retinal nerve fiber layer thickness assessments using optical coherence tomography have good intraoperator and interoperator reproducibility. Inexperienced operators can generate useful measurement data with acceptable levels of variance.

OPTICAL COHERENCE TOMOGRAPHY FINDINGS IN CYTOMEGALOVIRUS RETINITIS: A Longitudinal Study.

PubMed

Invernizzi, Alessandro; Agarwal, Aniruddha; Ravera, Vittoria; Oldani, Marta; Staurenghi, Giovanni; Viola, Francesco

2018-01-01

To evaluate the vitreal, retinal, and choroidal features using spectral domain optical coherence tomography (SD-OCT) in eyes affected by cytomegalovirus (CMV) retinitis. Patients diagnosed with either active or inactive CMV retinitis were included in the study. Complete ophthalmic examination, serial color fundus photography, and SD-OCT (with and without enhanced depth imaging function) were performed for all the subjects at baseline and follow-up visits. The SD-OCT images were analyzed by two independent graders to evaluate the structural changes in areas of CMV retinitis. Prevalence data for vitreal, retinal, and choroidal SD-OCT features were collected. Twelve eyes from 9 patients (6 males, mean age: 52.7 ± 10.3 years) were enrolled. Nine eyes were diagnosed with active CMV retinitis at baseline. Active disease SD-OCT characteristic findings included nebulous vitritis (100%), posterior hyaloid thickening (83.3%), epiretinal membrane (100%), and retinal swelling (100%). Two distinct patterns of chorioretinal involvement were observed in active retinitis: 1) full-thickness retinitis (Full thickness retinitis) (n = 7 eyes) with choriocapillaris alterations and retinal pigment epithelial thickening and 2) cavernous retinitis (n = 3 eyes) characterized by inner retinal hyperreflectivity, large empty spaces in outer nuclear layer, and bridges of retinal tissue but retinal pigment epithelium and choriocapillaris sparing. Patients with cavernous retinitis develop retinal detachment during follow-up. Eyes with Full thickness retinitis developed choriocapillaris atrophy and choroidal thinning and retinal scars as the lesions healed. There are two distinct patterns of chorioretinal involvement in CMV retinitis. SD-OCT is a useful tool in the diagnosis, management, and prediction of the outcome of CMV retinitis.

Use of ultra-wide-field retinal imaging in the management of active Behçet retinal vasculitis.

PubMed

Mesquida, Marina; Llorenç, Victor; Fontenla, José Ramón; Navarro, Manuel Javier; Adán, Alfredo

2014-10-01

Retinal vasculitis (RV) is an important component of Behçet disease. It may be difficult to detect either clinically or with conventional retinal imaging. The role of ultra-wide-field (UWF) retinal imaging was assessed in the diagnosis and management of RV associated with Behçet disease. A total of 38 eyes of 20 patients with active RV associated to Behçet disease underwent UWF imaging with the Optos scanning laser ophthalmoscope, fundus autofluorescence, and/or fluorescein angiography. This study determined the UWF findings and percentage of patients in whom this imaging modality assisted in diagnosing the extent of vasculitis, planning treatment, and monitoring disease activity. Optos UWF imaging assisted in diagnosing and quantifying the extent of RV in 16 patients (80%), planning medical treatment or laser photocoagulation in 13 of 20 patients (65%), and enhanced disease monitoring in 11 of 20 patients (55%). UWF fluorescein angiography revealed vasculitis not clinically evident in 28 of 33 eyes (84.8%). Predominant angiographic findings were diffuse vascular leakage (75.7%), peripheral retinal nonperfusion (66.7%), optic disk leakage (63.6%), macular leakage (30.3%), and macular edema (27.3%). Eighteen patients (34 eyes) underwent UWF fundus autofluorescence, showing multiple hyperfluorescent spots in retinal periphery in 28 eyes (82.3%). Ultra-wide-field imaging is a valuable tool in the management of patients with RV associated to Behçet disease and can be used for the diagnosis, treatment, and follow-up. Additional studies, including longitudinal evaluations, are needed to elucidate whether these findings or the subsequent management alterations may improve patients' outcomes.

Retinopathy of prematurity: An update on screening and management

PubMed Central

Jefferies, Ann L

2016-01-01

Retinopathy of prematurity is a proliferative disorder of the developing retinal blood vessels in preterm infants. The present practice point reviews new information regarding screening and management for retinopathy of prematurity, including the role of risk factors in screening, optimal scheduling for screening examinations, pain management, digital retinal photography and antivascular endothelial growth factor therapy. PMID:27095887

Reliability and Agreement Between Metrics of Cone Spacing in Adaptive Optics Images of the Human Retinal Photoreceptor Mosaic.

PubMed

Giannini, Daniela; Lombardo, Giuseppe; Mariotti, Letizia; Devaney, Nicholas; Serrao, Sebastiano; Lombardo, Marco

2017-06-01

To assess reliability and agreement among three metrics used to evaluate the distribution of cell distances in adaptive optics (AO) images of the cone mosaic. Using an AO flood illumination retinal camera, we acquired images of the cone mosaic in 20 healthy subjects and 12 patients with retinal diseases. The three spacing metrics studied were the center-to-center spacing (Scc), the local cone spacing (LCS), and the density recovery profile distance (DRPD). Each metric was calculated in sampling areas of different sizes (64 × 64 μm and 204 × 204 μm) across the parafovea. Both Scc and LCS were able to discriminate between healthy subjects and patients with retinal diseases; DRPD did not reliably detect any abnormality in the distribution of cell distances in patients with retinal diseases. The agreement between Scc and LCS was high in healthy subjects (intraclass correlation coefficient [ICC] ≥ 0.79) and moderate in patients with retinal diseases (ICC ≤ 0.51). The DRPD had poor agreement with Scc (ICC ≤ 0.47) and LCS (ICC ≤ 0.37). The correlation between the spacing metrics of the two sampling areas was greater in healthy subjects than in patients with retinal diseases. The Scc and LCS provided interchangeable estimates of cone distance in AO retinal images of healthy subjects but could not be used interchangeably when investigating retinal diseases with significant cell reflectivity loss (≥30%). The DRPD was unreliable for describing cell distance in a human retinal cone mosaic and did not correlate with Scc and LCS. Caution is needed when comparing spacing metrics evaluated in sampling areas of different sizes.

Fundus autofluorescence applications in retinal imaging

PubMed Central

Gabai, Andrea; Veritti, Daniele; Lanzetta, Paolo

2015-01-01

Fundus autofluorescence (FAF) is a relatively new imaging technique that can be used to study retinal diseases. It provides information on retinal metabolism and health. Several different pathologies can be detected. Peculiar AF alterations can help the clinician to monitor disease progression and to better understand its pathogenesis. In the present article, we review FAF principles and clinical applications. PMID:26139802

New clinical opportunities for retinal vascular imaging: adaptive optics to OCT angiography

NASA Astrophysics Data System (ADS)

Rosen, Richard; Chui, Toco; Weitz, Rishard; Dubra, Alfredo; Carroll, Joseph; Garcia, Patricia; Pinhas, Alexander; Scripsema, Nicole; Mo, Shelley; Agemy, Steven; Krawitz, Brian

2018-03-01

As techniques of retinal imaging have evolved, anatomic features that were only assessable in the laboratory have become available in the clinic for patient care. The retinal capillaries were initially described on microscope sections in the pathology laboratory. As optical methods have advanced these features have become part of the routine clinical landscape inspected daily by physicians. This paper briefly traces the evolution of these techniques and shows how they fit into the modern diagnostic armamentarium of ophthalmic retinal care.

Test-retest reliability of retinal oxygen saturation measurement.

PubMed

O'Connell, Rachael A; Anderson, Andrew J; Hosking, Sarah L; Batcha, Abrez H; Bui, Bang V

2014-06-01

To determine intrasession and intersession repeatability of retinal vessel oxygen saturation from the Oxymap Retinal Oximeter using a whole image-based analysis technique and so determine optimal analysis parameters to reduce variability. Ten fundus oximetry images were acquired through dilated pupils from 18 healthy participants (aged 22 to 38) using the Oxymap Retinal Oximeter T1. A further 10 images were obtained 1 to 2 weeks later from each individual. Analysis was undertaken for subsets of images to determine the number of images needed to return a stable coefficient of variation (CoV). Intrasession and intersession variability were quantified by evaluating the CoV and establishing the 95% limits of agreement using Bland and Altman analysis. Retinal oxygenation was derived from the distribution of oxygenation values from all vessels of a given width in an image or set of images, as described by Paul et al. in 2013. Grouped in 10-μm-wide bins, oxygen saturation varied significantly for both arteries and veins (p < 0.01). Between 110 and 150 μm, arteries had the least variability between individuals, with average CoVs less than 5% whose confidence intervals did not overlap with the greater than 10% average CoVs for veins across the same range. Bland and Altman analysis showed that there was no bias within or between recording sessions and that the 95% limits of agreement were generally lower in arteries. Retinal vessel oxygen saturation measurements show variability within and between clinical sessions when the whole image is used, which we believe more accurately reflects the true variability in Oxymap images than previous studies on select image segments. Averaging data from vessels 100 to 150 μm in width may help to minimize such variability.

Investigation of alterations in multifractality in optical coherence tomographic images of in vivo human retina

NASA Astrophysics Data System (ADS)

Das, Nandan Kumar; Mukhopadhyay, Sabyasachi; Ghosh, Nirmalya; Chhablani, Jay; Richhariya, Ashutosh; Divakar Rao, Kompalli; Sahoo, Naba Kishore

2016-09-01

Optical coherence tomography (OCT) enables us to monitor alterations in the thickness of the retinal layer as disease progresses in the human retina. However, subtle morphological changes in the retinal layers due to early disease progression often may not lead to detectable alterations in the thickness. OCT images encode depth-dependent backscattered intensity distribution arising due to the depth distributions of the refractive index from tissue microstructures. Here, such depth-resolved refractive index variations of different retinal layers were analyzed using multifractal detrended fluctuation analysis, a special class of multiresolution analysis tools. The analysis extracted and quantified microstructural multifractal information encoded in normal as well as diseased human retinal OCT images acquired in vivo. Interestingly, different layers of the retina exhibited different degrees of multifractality in a particular retina, and the individual layers displayed consistent multifractal trends in healthy retinas of different human subjects. In the retinal layers of diabetic macular edema (DME) subjects, the change in multifractality manifested prominently near the boundary of the DME as compared to the normal retinal layers. The demonstrated ability to quantify depth-resolved information on multifractality encoded in OCT images appears promising for the early diagnosis of diseases of the human eye, which may also prove useful for detecting other types of tissue abnormalities from OCT images.

Longitudinal Structural changes in Late-onset Retinal Degeneration

PubMed Central

Cukras, Catherine; Flamendorf, Jason; Wong, Wai T; Ayyagari, Radha; Cunningham, Denise; Sieving, Paul A.

2016-01-01

Purpose To characterize longitudinal structural changes in early stages of late-onset retinal degeneration (L-ORD) to investigate pathogenic mechanisms. Methods Two affected siblings, both with a S163R missense mutation in the causative gene C1QTNF5, were followed for 8+ years. Color fundus photos, fundus autofluorescence (FAF) images, near infrared reflectance (NIR-R) fundus images, and spectral domain optical coherence tomography (SD-OCT) scans were acquired during follow-up. Results Both patients, aged 45 and 50 years, had good visual acuities (> 20/20 OU) in the context of prolonged dark adaptation. Baseline color fundus photography demonstrated yellow-white, punctate lesions in the temporal macula that correlated with a reticular pattern on FAF and NIR-R imaging. Baseline SD-OCT imaging revealed subretinal deposits that resemble reticular pseudodrusen (RPD) described in age-related macular degeneration (AMD). During follow-up, these affected areas developed confluent thickening of the retinal pigment epithelial (RPE) layer and disruption of the ellipsoid zone of photoreceptors before progressing to overt RPE and outer retinal atrophy. Conclusions Structural changes in early stage L-ORD revealed by multimodal imaging resemble those of RPD observed in AMD and other retinal diseases. Longitudinal follow-up of these lesions helps elucidate their progression to frank atrophy and may lend insight into the pathogenic mechanisms underlying diverse retinal degenerations. PMID:27388725

Lens-based wavefront sensorless adaptive optics swept source OCT

NASA Astrophysics Data System (ADS)

Jian, Yifan; Lee, Sujin; Ju, Myeong Jin; Heisler, Morgan; Ding, Weiguang; Zawadzki, Robert J.; Bonora, Stefano; Sarunic, Marinko V.

2016-06-01

Optical coherence tomography (OCT) has revolutionized modern ophthalmology, providing depth resolved images of the retinal layers in a system that is suited to a clinical environment. Although the axial resolution of OCT system, which is a function of the light source bandwidth, is sufficient to resolve retinal features at a micrometer scale, the lateral resolution is dependent on the delivery optics and is limited by ocular aberrations. Through the combination of wavefront sensorless adaptive optics and the use of dual deformable transmissive optical elements, we present a compact lens-based OCT system at an imaging wavelength of 1060 nm for high resolution retinal imaging. We utilized a commercially available variable focal length lens to correct for a wide range of defocus commonly found in patient’s eyes, and a novel multi-actuator adaptive lens for aberration correction to achieve near diffraction limited imaging performance at the retina. With a parallel processing computational platform, high resolution cross-sectional and en face retinal image acquisition and display was performed in real time. In order to demonstrate the system functionality and clinical utility, we present images of the photoreceptor cone mosaic and other retinal layers acquired in vivo from research subjects.

Toward automatic phenotyping of retinal images from genetically determined mono- and dizygotic twins using amplitude modulation-frequency modulation methods

NASA Astrophysics Data System (ADS)

Soliz, P.; Davis, B.; Murray, V.; Pattichis, M.; Barriga, S.; Russell, S.

2010-03-01

This paper presents an image processing technique for automatically categorize age-related macular degeneration (AMD) phenotypes from retinal images. Ultimately, an automated approach will be much more precise and consistent in phenotyping of retinal diseases, such as AMD. We have applied the automated phenotyping to retina images from a cohort of mono- and dizygotic twins. The application of this technology will allow one to perform more quantitative studies that will lead to a better understanding of the genetic and environmental factors associated with diseases such as AMD. A method for classifying retinal images based on features derived from the application of amplitude-modulation frequency-modulation (AM-FM) methods is presented. Retinal images from identical and fraternal twins who presented with AMD were processed to determine whether AM-FM could be used to differentiate between the two types of twins. Results of the automatic classifier agreed with the findings of other researchers in explaining the variation of the disease between the related twins. AM-FM features classified 72% of the twins correctly. Visual grading found that genetics could explain between 46% and 71% of the variance.

Comparison of amplitude-decorrelation, speckle-variance and phase-variance OCT angiography methods for imaging the human retina and choroid

PubMed Central

Gorczynska, Iwona; Migacz, Justin V.; Zawadzki, Robert J.; Capps, Arlie G.; Werner, John S.

2016-01-01

We compared the performance of three OCT angiography (OCTA) methods: speckle variance, amplitude decorrelation and phase variance for imaging of the human retina and choroid. Two averaging methods, split spectrum and volume averaging, were compared to assess the quality of the OCTA vascular images. All data were acquired using a swept-source OCT system at 1040 nm central wavelength, operating at 100,000 A-scans/s. We performed a quantitative comparison using a contrast-to-noise (CNR) metric to assess the capability of the three methods to visualize the choriocapillaris layer. For evaluation of the static tissue noise suppression in OCTA images we proposed to calculate CNR between the photoreceptor/RPE complex and the choriocapillaris layer. Finally, we demonstrated that implementation of intensity-based OCT imaging and OCT angiography methods allows for visualization of retinal and choroidal vascular layers known from anatomic studies in retinal preparations. OCT projection imaging of data flattened to selected retinal layers was implemented to visualize retinal and choroidal vasculature. User guided vessel tracing was applied to segment the retinal vasculature. The results were visualized in a form of a skeletonized 3D model. PMID:27231598

A robust technique based on VLM and Frangi filter for retinal vessel extraction and denoising.

PubMed

Khan, Khan Bahadar; Khaliq, Amir A; Jalil, Abdul; Shahid, Muhammad

2018-01-01

The exploration of retinal vessel structure is colossally important on account of numerous diseases including stroke, Diabetic Retinopathy (DR) and coronary heart diseases, which can damage the retinal vessel structure. The retinal vascular network is very hard to be extracted due to its spreading and diminishing geometry and contrast variation in an image. The proposed technique consists of unique parallel processes for denoising and extraction of blood vessels in retinal images. In the preprocessing section, an adaptive histogram equalization enhances dissimilarity between the vessels and the background and morphological top-hat filters are employed to eliminate macula and optic disc, etc. To remove local noise, the difference of images is computed from the top-hat filtered image and the high-boost filtered image. Frangi filter is applied at multi scale for the enhancement of vessels possessing diverse widths. Segmentation is performed by using improved Otsu thresholding on the high-boost filtered image and Frangi's enhanced image, separately. In the postprocessing steps, a Vessel Location Map (VLM) is extracted by using raster to vector transformation. Postprocessing steps are employed in a novel way to reject misclassified vessel pixels. The final segmented image is obtained by using pixel-by-pixel AND operation between VLM and Frangi output image. The method has been rigorously analyzed on the STARE, DRIVE and HRF datasets.

Brightness-preserving fuzzy contrast enhancement scheme for the detection and classification of diabetic retinopathy disease.

PubMed

Datta, Niladri Sekhar; Dutta, Himadri Sekhar; Majumder, Koushik

2016-01-01

The contrast enhancement of retinal image plays a vital role for the detection of microaneurysms (MAs), which are an early sign of diabetic retinopathy disease. A retinal image contrast enhancement method has been presented to improve the MA detection technique. The success rate on low-contrast noisy retinal image analysis shows the importance of the proposed method. Overall, 587 retinal input images are tested for performance analysis. The average sensitivity and specificity are obtained as 95.94% and 99.21%, respectively. The area under curve is found as 0.932 for the receiver operating characteristics analysis. The classifications of diabetic retinopathy disease are also performed here. The experimental results show that the overall MA detection method performs better than the current state-of-the-art MA detection algorithms.

Noninvasive Quantification of Retinal Microglia Using Widefield Autofluorescence Imaging.

PubMed

Kokona, Despina; Schneider, Nadia; Giannakaki-Zimmermann, Helena; Jovanovic, Joel; Ebneter, Andreas; Zinkernagel, Martin

2017-04-01

To validate widefield autofluorescence (AF) in vivo imaging of the retina in mice expressing green fluorescent protein (gfp) in microglia, and to monitor retinal microglia reconstitution in vivo after lethal irradiation and bone marrow transplantation. Transgenic Cx3cr1gfp/gfp and wildtype Balb/c mice were used in this study. A confocal scanning laser ophthalmoscope was used for AF imaging with a 55° and a widefield 102° lens. Intrasession reproducibility was assessed for each lens. To investigate reconstitution in vivo, bone marrow from Cx3cr1gfp/gfp mice was used to rescue lethally irradiated wildtype mice. Data were compared to confocal microscopy of retinal flat mounts. Both the 55° and the 102° lens produced high resolution images of retinal microglia with similar microglia density. However, compared to the 55° lens, the widefield 102° lens captured approximately 3.6 times more microglia cells (1515 ± 123 cells versus 445 ± 76 cells [mean ± SD], for 102° and 55°, respectively, P < 0.001). No statistical difference in the number of gfp positive cells within corresponding areas was observed within the same imaging session. Imaging of microglia reconstitution showed a similar time course compared to flat mount preparations with an excellent correlation between microglia cell numbers in AF and gfp-stained flat mounts (R = 0.92, P < 0.0001). Widefield AF imaging of mice with gfp expressing microglia can be used to quantify retinal microglia. In vivo microglia counts corresponded very well with ex vivo counts on retinal flat mounts. As such, AF imaging can largely replace ex vivo quantification.

Automated detection of retinal layers from OCT spectral-domain images of healthy eyes

NASA Astrophysics Data System (ADS)

Giovinco, Gaspare; Savastano, Maria Cristina; Ventre, Salvatore; Tamburrino, Antonello

2015-12-01

Optical coherence tomography (OCT) has become one of the most relevant diagnostic tools for retinal diseases. Besides being a non-invasive technique, one distinguished feature is its unique capability of providing (in vivo) cross-sectional view of the retina. Specifically, OCT images show the retinal layers. From the clinical point of view, the identification of the retinal layers opens new perspectives to study the correlation between morphological and functional aspects of the retinal tissue. The main contribution of this paper is a new method/algorithm for the automated segmentation of cross-sectional images of the retina of healthy eyes, obtained by means of spectral-domain optical coherence tomography (SD-OCT). Specifically, the proposed segmentation algorithm provides the automated detection of different retinal layers. Tests on experimental SD-OCT scans performed by three different instruments/manufacturers have been successfully carried out and compared to a manual segmentation made by an independent ophthalmologist, showing the generality and the effectiveness of the proposed method.

Large-field-of-view, modular, stabilized, adaptive-optics-based scanning laser ophthalmoscope.

PubMed

Burns, Stephen A; Tumbar, Remy; Elsner, Ann E; Ferguson, Daniel; Hammer, Daniel X

2007-05-01

We describe the design and performance of an adaptive optics retinal imager that is optimized for use during dynamic correction for eye movements. The system incorporates a retinal tracker and stabilizer, a wide-field line scan scanning laser ophthalmoscope (SLO), and a high-resolution microelectromechanical-systems-based adaptive optics SLO. The detection system incorporates selection and positioning of confocal apertures, allowing measurement of images arising from different portions of the double pass retinal point-spread function (psf). System performance was excellent. The adaptive optics increased the brightness and contrast for small confocal apertures by more than 2x and decreased the brightness of images obtained with displaced apertures, confirming the ability of the adaptive optics system to improve the psf. The retinal image was stabilized to within 18 microm 90% of the time. Stabilization was sufficient for cross-correlation techniques to automatically align the images.

Probabilistic retinal vessel segmentation

NASA Astrophysics Data System (ADS)

Wu, Chang-Hua; Agam, Gady

2007-03-01

Optic fundus assessment is widely used for diagnosing vascular and non-vascular pathology. Inspection of the retinal vasculature may reveal hypertension, diabetes, arteriosclerosis, cardiovascular disease and stroke. Due to various imaging conditions retinal images may be degraded. Consequently, the enhancement of such images and vessels in them is an important task with direct clinical applications. We propose a novel technique for vessel enhancement in retinal images that is capable of enhancing vessel junctions in addition to linear vessel segments. This is an extension of vessel filters we have previously developed for vessel enhancement in thoracic CT scans. The proposed approach is based on probabilistic models which can discern vessels and junctions. Evaluation shows the proposed filter is better than several known techniques and is comparable to the state of the art when evaluated on a standard dataset. A ridge-based vessel tracking process is applied on the enhanced image to demonstrate the effectiveness of the enhancement filter.

Large Field of View, Modular, Stabilized, Adaptive-Optics-Based Scanning Laser Ophthalmoscope

PubMed Central

Burns, Stephen A.; Tumbar, Remy; Elsner, Ann E.; Ferguson, Daniel; Hammer, Daniel X.

2007-01-01

We describe the design and performance of an adaptive optics retinal imager that is optimized for use during dynamic correction for eye movements. The system incorporates a retinal tracker and stabilizer, a wide field line scan Scanning Laser Ophthalmocsope (SLO), and a high resolution MEMS based adaptive optics SLO. The detection system incorporates selection and positioning of confocal apertures, allowing measurement of images arising from different portions of the double pass retinal point spread function (psf). System performance was excellent. The adaptive optics increased the brightness and contrast for small confocal apertures by more than 2x, and decreased the brightness of images obtained with displaced apertures, confirming the ability of the adaptive optics system to improve the pointspread function. The retinal image was stabilized to within 18 microns 90% of the time. Stabilization was sufficient for cross-correlation techniques to automatically align the images. PMID:17429477

Spectral domain optical coherence tomography imaging in optic disk pit associated with outer retinal dehiscence

PubMed Central

Wong, Chee Wai; Wong, Doric; Mathur, Ranjana

2014-01-01

A 37-year-old Bangladeshi male presented with an inferotemporal optic disk pit and serous macular detachment in the left eye. Imaging with spectral domain optical coherence tomography (OCT) revealed a multilayer macular schisis pattern with a small subfoveal outer retinal dehiscence. This case illustrates a rare phenotype of optic disk maculopathy with macular schisis and a small outer retinal layer dehiscence. Spectral domain OCT was a useful adjunct in delineating the retinal layers in optic disk pit maculopathy, and revealed a small area of outer retinal layer dehiscence that could only have been detected on high-resolution OCT. PMID:25349471

Adaptive optics two-photon excited fluorescence lifetime imaging ophthalmoscopy of exogenous fluorophores in mice.

PubMed

Feeks, James A; Hunter, Jennifer J

2017-05-01

In vivo cellular scale fluorescence lifetime imaging of the mouse retina has the potential to be a sensitive marker of retinal cell health. In this study, we demonstrate fluorescence lifetime imaging of extrinsic fluorophores using adaptive optics fluorescence lifetime imaging ophthalmoscopy (AOFLIO). We recorded AOFLIO images of inner retinal cells labeled with enhanced green fluorescent protein (EGFP) and capillaries labeled with fluorescein. We demonstrate that AOFLIO can be used to differentiate spectrally overlapping fluorophores in the retina. With further refinements, AOFLIO could be used to assess retinal health in early stages of degeneration by utilizing lifetime-based sensors or even fluorophores native to the retina.

In vivo optical imaging of amblyopia: Digital subtraction autofluorescence and split-spectrum amplitude-decorrelation angiography.

PubMed

Guo, Lei; Tao, Jun; Xia, Fan; Yang, Zhi; Ma, Xiaoli; Hua, Rui

2016-09-01

Amblyopia is a visual impairment that is attributed to either abnormal binocular interactions or visual deprivation. The retina and choroids have been shown to be involved in the development of amblyopia. The purpose of this study was to investigate the retinal and choroidal microstructural abnormalities of amblyopia using digital subtraction autofluorescence and split-spectrum amplitude-decorrelation angiography (SSADA) approaches. This prospective study included 44 eyes of 22 patients with unilateral amblyopia. All patients who received indirect ophthalmoscopy, combined depth imaging spectral domain optical coherence tomography (OCT), SSADA-OCT, and macular blue light (BL-) and near-infrared (NIR-) autofluorescences underwent pupil dilation. The subfoveal choroidal thickness (SFCT) was measured. BL- and NIR-autofluorescences were determined for all patients and used to generate subtraction images with ImageJ software. The superficial, deep layers of the retina, and inner choroid layer were required for SSADA-OCT. For the normal eyes, a regularly increasing signal was observed in the central macula based on the subtraction images. In contrast, a decreased signal for the central patch or a reduced peak was detected in 16 of 22 amblyopic eyes (72.7%). The mean SFCT of the amblyopic eyes was greater than that of the fellow normal eyes (399.25 ± 4.944 µm vs. 280.58 ± 6.491 µm, respectively, P < 0.05). SSADA-OCT revealed a normal choroidal capillary network in all fellow normal eyes. However, 18 of 22 amblyopic eyes (86.4%) exhibited a blurry choroidal capillary network, and 15 of 22 amblyopic eyes (68.2%) displayed a dark atrophic patch. This is the first report of amblyopia using SSADA-OCT and digital subtraction images of autofluorescence. The mechanistic relationship of a thicker choroid and choroidal capillary atrophy with amblyopia remains to be described. The digital subtraction image confirmed the changes in the microstructure of the amblyopic retina as a supplementary approach to detect the progression of amblyopia. Lasers Surg. Med. 48:660-667, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Structural analysis of retinal photoreceptor ellipsoid zone and postreceptor retinal layer associated with visual acuity in patients with retinitis pigmentosa by ganglion cell analysis combined with OCT imaging

PubMed Central

Liu, Guodong; Li, Hui; Liu, Xiaoqiang; Xu, Ding; Wang, Fang

2016-01-01

Abstract The aim of this study was to examine changes in photoreceptor ellipsoid zone (EZ) and postreceptor retinal layer in retinitis pigmentosa (RP) patients by ganglion cell analysis (GCA) combined with optical coherence tomography (OCT) imaging to evaluate the structure–function relationships between retinal layer changes and best corrected visual acuity (BCVA). Sixty-eight eyes of 35 patients with RP and 65 eyes of 35 normal controls were analyzed in the study. The average length of EZ was 911.1 ± 208.8 μm in RP patients, which was shortened with the progression of the disease on the OCT images. The average ganglion cell–inner plexiform layer thickness (GCIPLT) was 54.7 ± 18.9 μm in RP patients, while in normal controls it was 85.6 ± 6.8 μm. The GCIPLT in all quarters became significantly thinner along with outer retinal thinning. There was a significantly positive correlation between BCVA and EZ (r = −0.7622, P < 0.001) and GCIPLT (r = −0.452, P < 0.001). Therefore, we assess the retinal layer changes from a new perspective in RP patients, which suggests that EZ and GCIPLT obtained by GCA combined with OCT imaging are the direct and valid indicators to diagnosis and predict the pathological process of RP. PMID:28033301

Retinal Oximetry Discovers Novel Biomarkers in Retinal and Brain Diseases.

PubMed

Stefánsson, Einar; Olafsdottir, Olof Birna; Einarsdottir, Anna Bryndis; Eliasdottir, Thorunn Scheving; Eysteinsson, Thor; Vehmeijer, Wouter; Vandewalle, Evelien; Bek, Toke; Hardarson, Sveinn Hakon

2017-05-01

Biomarkers for several eye and brain diseases are reviewed, where retinal oximetry may help confirm diagnosis or measure severity of disease. These include diabetic retinopathy, central retinal vein occlusion (CRVO), retinitis pigmentosa, glaucoma, and Alzheimer's disease. Retinal oximetry is based on spectrophotometric fundus imaging and measures oxygen saturation in retinal arterioles and venules in a noninvasive, quick, safe manner. Retinal oximetry detects changes in oxygen metabolism, including those that result from ischemia or atrophy. In diabetic retinopathy, venous oxygen saturation increases and arteriovenous difference decreases. Both correlate with diabetic retinopathy severity as conventionally classified on fundus photographs. In CRVO, vein occlusion causes hypoxia, which is measured directly by retinal oximetry to confirm the diagnosis and measure severity. In both diseases, the change in oxygen levels is a consequence of disturbed blood flow with resulting tissue hypoxia and vascular endothelial growth factor (VEGF) production. In atrophic diseases, such as retinitis pigmentosa and glaucoma, retinal oxygen consumption is reduced and this is detected by retinal oximetry. Retinal oximetry correlates with visual field damage and retinal atrophy. It is an objective metabolic measure of the degree of retinal atrophy. Finally, the retina is part of the central nervous system tissue and reflects central nervous system diseases. In Alzheimer's disease, a change in retinal oxygen metabolism has been discovered. Retinal oximetry is a novel, noninvasive technology that opens the field of metabolic imaging of the retina. Biomarkers in metabolic, ischemic, and atrophic diseases of the retina and central nervous system have been discovered.

Improving Access to Eye Care: Teleophthalmology in Alberta, Canada

PubMed Central

Ng, ManCho; Nathoo, Nawaaz; Rudnisky, Chris J.; Tennant, Matthew T. S.

2009-01-01

Backround Diabetic retinopathy in Alberta and throughout Canada is common, with a prevalence up to 40% in people with diabetes. Unfortunately, due to travel distance, time, and expense, a third of patients with diabetes do not receive annual dilated eye examinations by ophthalmologists, despite universal health care access. In an effort to improve access, a teleophthalmology program was developed to overcome barriers to eye care. Prior to clinical implementation, teleophthalmology technology was clinically validated for the identification of treatable levels of diabetic retinopathy. Method Patients undergoing a teleophthalmology assessment underwent stereoscopic digital retinal photographs following pupillary dilation. Digital images were then packaged into an encrypted password-protected compressed file for uploading onto a secure server. Images were digitally unpackaged for review as a stereoscopic digital slide show and graded with a modified Early Treatment Diabetic Retinopathy Study algorithm. Reports were then generated automatically as a PDF file and sent back to the referring physician. Results Teleophthalmology programs in Alberta have assessed more than 5500 patients (9016 visits) to date. Nine hundred thirty patients have been referred for additional testing or treatment. Approximately 2% of teleophthalmology assessments have required referral for in-person examination due to ungradable image sets, most commonly due to cataract, corneal drying, or asteroid hyalosis. Conclusions In Alberta and throughout Canada, many patients with diabetes do not receive an annual dilated eye examination. Teleophthalmology is beneficial because patients can be assessed within their own communities. This decreases the time to treatment, allows treated patients to be followed remotely, and prevents unnecessary referrals. Health care costs may be reduced by the introduction of comprehensive teleophthalmology examinations by enabling testing and treatment to be planned prior to the patient's first visit. PMID:20144360

Improving access to eye care: teleophthalmology in Alberta, Canada.

PubMed

Ng, Mancho; Nathoo, Nawaaz; Rudnisky, Chris J; Tennant, Matthew T S

2009-03-01

Diabetic retinopathy in Alberta and throughout Canada is common, with a prevalence up to 40% in people with diabetes. Unfortunately, due to travel distance, time, and expense, a third of patients with diabetes do not receive annual dilated eye examinations by ophthalmologists, despite universal health care access. In an effort to improve access, a teleophthalmology program was developed to overcome barriers to eye care. Prior to clinical implementation, teleophthalmology technology was clinically validated for the identification of treatable levels of diabetic retinopathy. Patients undergoing a teleophthalmology assessment underwent stereoscopic digital retinal photographs following pupillary dilation. Digital images were then packaged into an encrypted password-protected compressed file for uploading onto a secure server. Images were digitally unpackaged for review as a stereoscopic digital slide show and graded with a modified Early Treatment Diabetic Retinopathy Study algorithm. Reports were then generated automatically as a PDF file and sent back to the referring physician. Teleophthalmology programs in Alberta have assessed more than 5500 patients (9016 visits) to date. Nine hundred thirty patients have been referred for additional testing or treatment. Approximately 2% of teleophthalmology assessments have required referral for in-person examination due to ungradable image sets, most commonly due to cataract, corneal drying, or asteroid hyalosis. In Alberta and throughout Canada, many patients with diabetes do not receive an annual dilated eye examination. Teleophthalmology is beneficial because patients can be assessed within their own communities. This decreases the time to treatment, allows treated patients to be followed remotely, and prevents unnecessary referrals. Health care costs may be reduced by the introduction of comprehensive teleophthalmology examinations by enabling testing and treatment to be planned prior to the patient's first visit. (c) 2009 Diabetes Technology Society.

A novel method for retinal optic disc detection using bat meta-heuristic algorithm.

PubMed

Abdullah, Ahmad S; Özok, Yasa Ekşioğlu; Rahebi, Javad

2018-05-09

Normally, the optic disc detection of retinal images is useful during the treatment of glaucoma and diabetic retinopathy. In this paper, the novel preprocessing of a retinal image with a bat algorithm (BA) optimization is proposed to detect the optic disc of the retinal image. As the optic disk is a bright area and the vessels that emerge from it are dark, these facts lead to the selected segments being regions with a great diversity of intensity, which does not usually happen in pathological regions. First, in the preprocessing stage, the image is fully converted into a gray image using a gray scale conversion, and then morphological operations are implemented in order to remove dark elements such as blood vessels, from the images. In the next stage, a bat algorithm (BA) is used to find the optimum threshold value for the optic disc location. In order to improve the accuracy and to obtain the best result for the segmented optic disc, the ellipse fitting approach was used in the last stage to enhance and smooth the segmented optic disc boundary region. The ellipse fitting is carried out using the least square distance approach. The efficiency of the proposed method was tested on six publicly available datasets, MESSIDOR, DRIVE, DIARETDB1, DIARETDB0, STARE, and DRIONS-DB. The optic disc segmentation average overlaps and accuracy was in the range of 78.5-88.2% and 96.6-99.91% in these six databases. The optic disk of the retinal images was segmented in less than 2.1 s per image. The use of the proposed method improved the optic disc segmentation results for healthy and pathological retinal images in a low computation time. Graphical abstract ᅟ.

Blood vessel segmentation in modern wide-field retinal images in the presence of additive Gaussian noise.

PubMed

Asem, Morteza Modarresi; Oveisi, Iman Sheikh; Janbozorgi, Mona

2018-07-01

Retinal blood vessels indicate some serious health ramifications, such as cardiovascular disease and stroke. Thanks to modern imaging technology, high-resolution images provide detailed information to help analyze retinal vascular features before symptoms associated with such conditions fully develop. Additionally, these retinal images can be used by ophthalmologists to facilitate diagnosis and the procedures of eye surgery. A fuzzy noise reduction algorithm was employed to enhance color images corrupted by Gaussian noise. The present paper proposes employing a contrast limited adaptive histogram equalization to enhance illumination and increase the contrast of retinal images captured from state-of-the-art cameras. Possessing directional properties, the multistructure elements method can lead to high-performance edge detection. Therefore, multistructure elements-based morphology operators are used to detect high-quality image ridges. Following this detection, the irrelevant ridges, which are not part of the vessel tree, were removed by morphological operators by reconstruction, attempting also to keep the thin vessels preserved. A combined method of connected components analysis (CCA) in conjunction with a thresholding approach was further used to identify the ridges that correspond to vessels. The application of CCA can yield higher efficiency when it is locally applied rather than applied on the whole image. The significance of our work lies in the way in which several methods are effectively combined and the originality of the database employed, making this work unique in the literature. Computer simulation results in wide-field retinal images with up to a 200-deg field of view are a testimony of the efficacy of the proposed approach, with an accuracy of 0.9524.

A level-set method for pathology segmentation in fluorescein angiograms and en face retinal images of patients with age-related macular degeneration

NASA Astrophysics Data System (ADS)

Mohammad, Fatimah; Ansari, Rashid; Shahidi, Mahnaz

2013-03-01

The visibility and continuity of the inner segment outer segment (ISOS) junction layer of the photoreceptors on spectral domain optical coherence tomography images is known to be related to visual acuity in patients with age-related macular degeneration (AMD). Automatic detection and segmentation of lesions and pathologies in retinal images is crucial for the screening, diagnosis, and follow-up of patients with retinal diseases. One of the challenges of using the classical level-set algorithms for segmentation involves the placement of the initial contour. Manually defining the contour or randomly placing it in the image may lead to segmentation of erroneous structures. It is important to be able to automatically define the contour by using information provided by image features. We explored a level-set method which is based on the classical Chan-Vese model and which utilizes image feature information for automatic contour placement for the segmentation of pathologies in fluorescein angiograms and en face retinal images of the ISOS layer. This was accomplished by exploiting a priori knowledge of the shape and intensity distribution allowing the use of projection profiles to detect the presence of pathologies that are characterized by intensity differences with surrounding areas in retinal images. We first tested our method by applying it to fluorescein angiograms. We then applied our method to en face retinal images of patients with AMD. The experimental results included demonstrate that the proposed method provided a quick and improved outcome as compared to the classical Chan-Vese method in which the initial contour is randomly placed, thus indicating the potential to provide a more accurate and detailed view of changes in pathologies due to disease progression and treatment.

Automatic detection of the macula in retinal fundus images using seeded mode tracking approach.

PubMed

Wong, Damon W K; Liu, Jiang; Tan, Ngan-Meng; Yin, Fengshou; Cheng, Xiangang; Cheng, Ching-Yu; Cheung, Gemmy C M; Wong, Tien Yin

2012-01-01

The macula is the part of the eye responsible for central high acuity vision. Detection of the macula is an important task in retinal image processing as a landmark for subsequent disease assessment, such as for age-related macula degeneration. In this paper, we have presented an approach to automatically determine the macula centre in retinal fundus images. First contextual information on the image is combined with a statistical model to obtain an approximate macula region of interest localization. Subsequently, we propose the use of a seeded mode tracking technique to locate the macula centre. The proposed approach is tested on a large dataset composed of 482 normal images and 162 glaucoma images from the ORIGA database and an additional 96 AMD images. The results show a ROI detection of 97.5%, and 90.5% correct detection of the macula within 1/3DD from a manual reference, which outperforms other current methods. The results are promising for the use of the proposed approach to locate the macula for the detection of macula diseases from retinal images.

Reconstruction 3-dimensional image from 2-dimensional image of status optical coherence tomography (OCT) for analysis of changes in retinal thickness

DOE Office of Scientific and Technical Information (OSTI.GOV)

Arinilhaq,; Widita, Rena

2014-09-30

Optical Coherence Tomography is often used in medical image acquisition to diagnose that change due easy to use and low price. Unfortunately, this type of examination produces a two-dimensional retinal image of the point of acquisition. Therefore, this study developed a method that combines and reconstruct 2-dimensional retinal images into three-dimensional images to display volumetric macular accurately. The system is built with three main stages: data acquisition, data extraction and 3-dimensional reconstruction. At data acquisition step, Optical Coherence Tomography produced six *.jpg images of each patient were further extracted with MATLAB 2010a software into six one-dimensional arrays. The six arraysmore » are combined into a 3-dimensional matrix using a kriging interpolation method with SURFER9 resulting 3-dimensional graphics of macula. Finally, system provides three-dimensional color graphs based on the data distribution normal macula. The reconstruction system which has been designed produces three-dimensional images with size of 481 × 481 × h (retinal thickness) pixels.« less

GDx-MM: An imaging Mueller matrix retinal polarimeter

NASA Astrophysics Data System (ADS)

Twietmeyer, Karen Marie

2007-12-01

Retinal diseases are a major cause of blindness worldwide. Although widely studied, disease mechanisms are not completely understood, and diagnostic tests may not detect disease early enough for timely intervention. The goal of this research is to contribute to research for more sensitive diagnostic tests that might use the interaction of polarized light with retinal tissue to detect subtle changes in the microstructure. This dissertation describes the GDx-MM, a scanning laser polarimeter which measures a complete 16-element Mueller matrix image of the retina. This full polarization signature may provide new comparative information on the structure of healthy and diseased retinal tissue by highlighting depolarizing structures as well as structures with varying magnitudes and orientations of retardance and diattenuation. The three major components of this dissertation are: (1) Development of methods for polarimeter optimization and error analysis; (2) Design, optimization, assembly, calibration, and validation of the GDx-MM polarimeter; and (3) Analysis of data for several human subjects. Development involved modifications to a Laser Diagnostics GDx, a commercially available scanning laser ophthalmoscope with incomplete polarization capability. Modifications included installation of polarization components, development of a data acquisition system, and implementation of algorithms to convert raw data into polarization parameter images. Optimization involved visualization of polarimeter state trajectories on the Poincare sphere and a condition number analysis of the instrument matrix. Retinal images are collected non-invasively at 20 mum resolution over a 15° visual field in four seconds. Validation of the polarimeter demonstrates a polarimetric measurement accuracy of approximately +/- 5%. Retinal polarization data was collected on normal human subjects at the University of Arizona and at Indiana University School of Optometry. Calculated polarization parameter images reveal properties of the tissue microstructure. For example, retardance images indicate nerve fiber layer thickness and orientation, and depolarization images (uniform for these normal subjects), are predicted to indicate regions of disease-related tissue disruption. This research demonstrates a method for obtaining a full polarization signature of the retina in one measurement using a polarimetrically optimized instrument, and provides a step toward the use of complete retinal imaging polarimetry in the diagnosis and monitoring of retinal disease.

Automated Detection of Microaneurysms Using Scale-Adapted Blob Analysis and Semi-Supervised Learning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Adal, Kedir M.; Sidebe, Desire; Ali, Sharib

2014-01-07

Despite several attempts, automated detection of microaneurysm (MA) from digital fundus images still remains to be an open issue. This is due to the subtle nature of MAs against the surrounding tissues. In this paper, the microaneurysm detection problem is modeled as finding interest regions or blobs from an image and an automatic local-scale selection technique is presented. Several scale-adapted region descriptors are then introduced to characterize these blob regions. A semi-supervised based learning approach, which requires few manually annotated learning examples, is also proposed to train a classifier to detect true MAs. The developed system is built using onlymore » few manually labeled and a large number of unlabeled retinal color fundus images. The performance of the overall system is evaluated on Retinopathy Online Challenge (ROC) competition database. A competition performance measure (CPM) of 0.364 shows the competitiveness of the proposed system against state-of-the art techniques as well as the applicability of the proposed features to analyze fundus images.« less

Retinal vasculature classification using novel multifractal features

NASA Astrophysics Data System (ADS)

Ding, Y.; Ward, W. O. C.; Duan, Jinming; Auer, D. P.; Gowland, Penny; Bai, L.

2015-11-01

Retinal blood vessels have been implicated in a large number of diseases including diabetic retinopathy and cardiovascular diseases, which cause damages to retinal blood vessels. The availability of retinal vessel imaging provides an excellent opportunity for monitoring and diagnosis of retinal diseases, and automatic analysis of retinal vessels will help with the processes. However, state of the art vascular analysis methods such as counting the number of branches or measuring the curvature and diameter of individual vessels are unsuitable for the microvasculature. There has been published research using fractal analysis to calculate fractal dimensions of retinal blood vessels, but so far there has been no systematic research extracting discriminant features from retinal vessels for classifications. This paper introduces new methods for feature extraction from multifractal spectra of retinal vessels for classification. Two publicly available retinal vascular image databases are used for the experiments, and the proposed methods have produced accuracies of 85.5% and 77% for classification of healthy and diabetic retinal vasculatures. Experiments show that classification with multiple fractal features produces better rates compared with methods using a single fractal dimension value. In addition to this, experiments also show that classification accuracy can be affected by the accuracy of vessel segmentation algorithms.

Retinal Vasculitis

PubMed Central

Rosenbaum, James T.; Sibley, Cailin H.; Lin, Phoebe

2016-01-01

Purpose of review Ophthalmologists and rheumatologists frequently miscommunicate in consulting on patients with retinal vasculitis. This report seeks to establish a common understanding of the term, retinal vasculitis, and to review recent papers on this diagnosis. Recent findings 1) The genetic basis of some rare forms of retinal vascular disease have recently been described. Identified genes include CAPN5, TREX1, and TNFAIP3; 2) Behçet’s disease is a systemic illness that is very commonly associated with occlusive retinal vasculitis; 3) retinal imaging including fluorescein angiography and other newer imaging modalities has proven crucial to the identification and characterization of retinal vasculitis and its complications; 4) although monoclonal antibodies to IL-17A or IL-1 beta failed in trials for Behçet’s disease, antibodies to TNF alpha, either infliximab or adalimumab, have demonstrated consistent benefit in managing this disease. Interferon treatment and B cell depletion therapy via rituximab may be beneficial in certain types of retinal vasculitis. Summary Retinal vasculitis is an important entity for rheumatologists to understand. Retinal vasculitis associated with Behçet’s disease responds to monoclonal antibodies that neutralize TNF, but the many other forms of non-infectious retinal vasculitis may require alternate therapeutic management. PMID:26945335

Microscope-Integrated Optical Coherence Tomography Angiography in the Operating Room in Young Children With Retinal Vascular Disease.

PubMed

Chen, Xi; Viehland, Christian; Carrasco-Zevallos, Oscar M; Keller, Brenton; Vajzovic, Lejla; Izatt, Joseph A; Toth, Cynthia A

2017-05-01

Intraoperative optical coherence tomography (OCT) has gained traction as an important adjunct for clinical decision making during vitreoretinal surgery, and OCT angiography (OCTA) has provided novel insights in clinical evaluation of retinal diseases. To date, these two technologies have not been applied in combination to evaluate retinal vascular disease in the operating suite. To conduct microscope-integrated, swept-source OCTA (MIOCTA) in children with retinal vascular disease. In this case report analysis, OCT imaging in pediatric patients, MIOCTA images were obtained during examination under anesthesia from a young boy with a history of idiopathic vitreous hemorrhage and a female infant with familial exudative vitreoretinopathy. Side-by-side comparison of research MIOCT angiograms and clinically indicated fluorescein angiograms. In 2 young children with retinal vascular disease, the MIOCTA images showed more detailed vascular patterns than were visible on the fluorescein angiograms although within a more posterior field of view. The MIOCTA system allowed visualization of small pathological retinal vessels in the retinal periphery that were obscured in the fluorescein angiograms by fluorescein staining from underlying, preexisting laser scars. This is the first report to date of the use of MIOCTA in the operating room for young children with retinal vascular disease. Further optimization of this system may allow noninvasive detailed evaluation of retinal vasculature during surgical procedures and in patients who could not cooperate with in-office examinations.

Ultrahigh-speed ultrahigh-resolution adaptive optics: optical coherence tomography system for in-vivo small animal retinal imaging

NASA Astrophysics Data System (ADS)

Jian, Yifan; Xu, Jing; Zawadzki, Robert J.; Sarunic, Marinko V.

2013-03-01

Small animal models of human retinal diseases are a critical component of vision research. In this report, we present an ultrahigh-resolution ultrahigh-speed adaptive optics optical coherence tomography (AO-OCT) system for small animal retinal imaging (mouse, fish, etc.). We adapted our imaging system to different types of small animals in accordance with the optical properties of their eyes. Results of AO-OCT images of small animal retinas acquired with AO correction are presented. Cellular structures including nerve fiber bundles, capillary networks and detailed double-cone photoreceptors are visualized.

Measurement of retinal blood flow in the rat by combining Doppler Fourier-domain optical coherence tomography with fundus imaging

NASA Astrophysics Data System (ADS)

Werkmeister, René M.; Vietauer, Martin; Knopf, Corinna; Fürnsinn, Clemens; Leitgeb, Rainer A.; Reitsamer, Herbert; Gröschl, Martin; Garhöfer, Gerhard; Vilser, Walthard; Schmetterer, Leopold

2014-10-01

A wide variety of ocular diseases are associated with abnormalities in ocular circulation. As such, there is considerable interest in techniques for quantifying retinal blood flow, among which Doppler optical coherence tomography (OCT) may be the most promising. We present an approach to measure retinal blood flow in the rat using a new optical system that combines the measurement of blood flow velocities via Doppler Fourier-domain optical coherence tomography and the measurement of vessel diameters using a fundus camera-based technique. Relying on fundus images for extraction of retinal vessel diameters instead of OCT images improves the reliability of the technique. The system was operated with an 841-nm superluminescent diode and a charge-coupled device camera that could be operated at a line rate of 20 kHz. We show that the system is capable of quantifying the response of 100% oxygen breathing on the retinal blood flow. In six rats, we observed a decrease in retinal vessel diameters of 13.2% and a decrease in retinal blood velocity of 42.6%, leading to a decrease in retinal blood flow of 56.7%. Furthermore, in four rats, the response of retinal blood flow during stimulation with diffuse flicker light was assessed. Retinal vessel diameter and blood velocity increased by 3.4% and 28.1%, respectively, leading to a relative increase in blood flow of 36.2%;. The presented technique shows much promise to quantify early changes in retinal blood flow during provocation with various stimuli in rodent models of ocular diseases in rats.

Combined Central Retinal Vein and Branch Retinal Artery Occlusion Post Intense Physical Activity.

PubMed

Coca, Mircea; Tecle, Nahom; Amde, Wendewessen; Mehta, Ankur

2017-08-23

We report a case of combined central retinal vein occlusion and branch retinal artery occlusion. A previously healthy 47-year-old male presented with decreased vision in the right eye after completing a half marathon. A fundus exam and retinal imaging revealed a combined central retinal vein and branch retinal artery occlusion. In the present report, we review the literature and discuss the possible mechanisms behind combined retinal vessel occlusions. To our knowledge, this is the first reported case of combined central retinal vein occlusion and branch retinal artery occlusion following intense exercise.

Combined Central Retinal Vein and Branch Retinal Artery Occlusion Post Intense Physical Activity

PubMed Central

Tecle, Nahom; Amde, Wendewessen; Mehta, Ankur

2017-01-01

We report a case of combined central retinal vein occlusion and branch retinal artery occlusion. A previously healthy 47-year-old male presented with decreased vision in the right eye after completing a half marathon. A fundus exam and retinal imaging revealed a combined central retinal vein and branch retinal artery occlusion. In the present report, we review the literature and discuss the possible mechanisms behind combined retinal vessel occlusions. To our knowledge, this is the first reported case of combined central retinal vein occlusion and branch retinal artery occlusion following intense exercise. PMID:29067224

Adaptive optics retinal imaging: emerging clinical applications.

PubMed

Godara, Pooja; Dubis, Adam M; Roorda, Austin; Duncan, Jacque L; Carroll, Joseph

2010-12-01

The human retina is a uniquely accessible tissue. Tools like scanning laser ophthalmoscopy and spectral domain-optical coherence tomography provide clinicians with remarkably clear pictures of the living retina. Although the anterior optics of the eye permit such non-invasive visualization of the retina and associated pathology, the same optics induce significant aberrations that obviate cellular-resolution imaging in most cases. Adaptive optics (AO) imaging systems use active optical elements to compensate for aberrations in the optical path between the object and the camera. When applied to the human eye, AO allows direct visualization of individual rod and cone photoreceptor cells, retinal pigment epithelium cells, and white blood cells. AO imaging has changed the way vision scientists and ophthalmologists see the retina, helping to clarify our understanding of retinal structure, function, and the etiology of various retinal pathologies. Here, we review some of the advances that were made possible with AO imaging of the human retina and discuss applications and future prospects for clinical imaging.

Morphometric analysis of small arteries in the human retina using adaptive optics imaging: relationship with blood pressure and focal vascular changes

PubMed Central

Koch, Edouard; Rosenbaum, David; Brolly, Aurélie; Sahel, José-Alain; Chaumet-Riffaud, Philippe; Girerd, Xavier; Rossant, Florence; Paques, Michel

2014-01-01

Objectives: The wall-to-lumen ratio (WLR) of retinal arteries is a recognized surrogate of end-organ damage due to aging and/or arterial hypertension. However, parietal morphometry remains difficult to assess in vivo. Recently, it was shown that adaptive optics retinal imaging can resolve parietal structures of retinal arterioles in humans in vivo. Here, using adaptive optics retinal imaging, we investigated the variations of parietal thickness of small retinal arteries with blood pressure and focal vascular damage. Methods: Adaptive optics imaging of the superotemporal retinal artery was done in 49 treatment-naive individuals [mean age (±SD) 44.9 years (±14); mean systolic pressure 132 mmHg (±22)]. Semi-automated segmentation allowed extracting parietal thickness and lumen diameter. In a distinct cohort, adaptive optics images of arteriovenous nicking (AVN; n = 12) and focal arteriolar narrowing (FAN; n = 10) were also analyzed qualitatively and quantitatively. Results: In the cohort of treatment-naive individuals, by multiple regression taking into account age, body mass index, mean, systolic, diastolic and pulse blood pressure, the WLR was found positively correlated to mean blood pressure and age which in combination accounted for 43% of the variability of WLR. In the cohort of patients with focal vascular damage, neither FANs or AVNs showed evidence of parietal growth; instead, at sites of FANs, decreased outer diameter suggestive of vasoconstriction was consistently found, while at sites of AVNs venous narrowing could be seen in the absence of arteriovenous contact. Conclusion: High resolution imaging of retinal vessels by adaptive optics allows quantitative microvascular phenotyping, which may contribute to a better understanding and management of hypertensive retinopathy. PMID:24406779

In vivo imaging of microscopic structures in the rat retina

PubMed Central

Geng, Ying; Greenberg, Kenneth P.; Wolfe, Robert; Gray, Daniel C.; Hunter, Jennifer J.; Dubra, Alfredo; Flannery, John G.; Williams, David R.; Porter, Jason

2010-01-01

Purpose The ability to resolve single retinal cells in rodents in vivo has applications in rodent models of the visual system and retinal disease. We have characterized the performance of a fluorescence adaptive optics scanning laser ophthalmoscope (fAOSLO) that provides cellular and subcellular imaging of rat retina in vivo. Methods Green fluorescent protein (eGFP) was expressed in retinal ganglion cells of normal Sprague Dawley rats via intravitreal injections of adeno-associated viral vectors. Simultaneous reflectance and fluorescence retinal images were acquired using the fAOSLO. fAOSLO resolution was characterized by comparing in vivo images with subsequent imaging of retinal sections from the same eyes using confocal microscopy. Results Retinal capillaries and eGFP-labeled ganglion cell bodies, dendrites, and axons were clearly resolved in vivo with adaptive optics (AO). AO correction reduced the total root mean square wavefront error, on average, from 0.30 μm to 0.05 μm (1.7-mm pupil). The full width at half maximum (FWHM) of the average in vivo line-spread function (LSF) was ∼1.84 μm, approximately 82% greater than the FWHM of the diffraction-limited LSF. Conclusions With perfect aberration compensation, the in vivo resolution in the rat eye could be ∼2× greater than that in the human eye due to its large numerical aperture (∼0.43). While the fAOSLO corrects a substantial fraction of the rat eye's aberrations, direct measurements of retinal image quality reveal some blur beyond that expected from diffraction. Nonetheless, subcellular features can be resolved, offering promise for using AO to investigate the rodent eye in vivo with high resolution. PMID:19578019

Retinal Optical Coherence Tomography Imaging

NASA Astrophysics Data System (ADS)

Drexler, Wolfgang; Fujimoto, James G.

The eye is essentially transparent, transmitting light with only minimal optical attenuation and scattering providing easy optical access to the anterior segment as well as the retina. For this reason, ophthalmic and especially retinal imaging has been not only the first but also most successful clinical application for optical coherence tomography (OCT). This chapter focuses on the development of OCT technology for retinal imaging. OCT has significantly improved the potential for early diagnosis, understanding of retinal disease pathogenesis, as well as monitoring disease progression and response to therapy. Development of ultrabroad bandwidth light sources and high-speed detection techniques has enabled significant improvements in ophthalmic OCT imaging performance, demonstrating the potential of three-dimensional, ultrahigh-resolution OCT (UHR OCT) to perform noninvasive optical biopsy of the living human retina, i.e., the in vivo visualization of microstructural, intraretinal morphology in situ approaching the resolution of conventional histopathology. Significant improvements in axial resolution and speed not only enable three-dimensional rendering of retinal volumes but also high-definition, two-dimensional tomograms, topographic thickness maps of all major intraretinal layers, as well as volumetric quantification of pathologic intraretinal changes. These advances in OCT technology have also been successfully applied in several animal models of retinal pathologies. The development of light sources emitting at alternative wavelengths, e.g., around #1,060 nm, not only enabled three-dimensional OCT imaging with enhanced choroidal visualization but also improved OCT performance in cataract patients due to reduced scattering losses in this wavelength region. Adaptive optics using deformable mirror technology, with unique high stroke to correct higher-order ocular aberrations, with specially designed optics to compensate chromatic aberration of the human eye, in combination with three-dimensional UHR OCT, recently enabled in vivo cellular resolution retinal imaging.

Morphometric analysis of small arteries in the human retina using adaptive optics imaging: relationship with blood pressure and focal vascular changes.

PubMed

Koch, Edouard; Rosenbaum, David; Brolly, Aurélie; Sahel, José-Alain; Chaumet-Riffaud, Philippe; Girerd, Xavier; Rossant, Florence; Paques, Michel

2014-04-01

The wall-to-lumen ratio (WLR) of retinal arteries is a recognized surrogate of end-organ damage due to aging and/or arterial hypertension. However, parietal morphometry remains difficult to assess in vivo. Recently, it was shown that adaptive optics retinal imaging can resolve parietal structures of retinal arterioles in humans in vivo. Here, using adaptive optics retinal imaging, we investigated the variations of parietal thickness of small retinal arteries with blood pressure and focal vascular damage. Adaptive optics imaging of the superotemporal retinal artery was done in 49 treatment-naive individuals [mean age (±SD) 44.9 years (±14); mean systolic pressure 132  mmHg (±22)]. Semi-automated segmentation allowed extracting parietal thickness and lumen diameter. In a distinct cohort, adaptive optics images of arteriovenous nicking (AVN; n = 12) and focal arteriolar narrowing (FAN; n = 10) were also analyzed qualitatively and quantitatively. In the cohort of treatment-naive individuals, by multiple regression taking into account age, body mass index, mean, systolic, diastolic and pulse blood pressure, the WLR was found positively correlated to mean blood pressure and age which in combination accounted for 43% of the variability of WLR. In the cohort of patients with focal vascular damage, neither FANs or AVNs showed evidence of parietal growth; instead, at sites of FANs, decreased outer diameter suggestive of vasoconstriction was consistently found, while at sites of AVNs venous narrowing could be seen in the absence of arteriovenous contact. High resolution imaging of retinal vessels by adaptive optics allows quantitative microvascular phenotyping, which may contribute to a better understanding and management of hypertensive retinopathy.

The Diabetic Retinopathy Screening Workflow: Potential for Smartphone Imaging.

PubMed

Bolster, Nigel M; Giardini, Mario E; Bastawrous, Andrew

2015-11-23

Complications of diabetes mellitus, namely diabetic retinopathy and diabetic maculopathy, are the leading cause of blindness in working aged people. Sufferers can avoid blindness if identified early via retinal imaging. Systematic screening of the diabetic population has been shown to greatly reduce the prevalence and incidence of blindness within the population. Many national screening programs have digital fundus photography as their basis. In the past 5 years several techniques and adapters have been developed that allow digital fundus photography to be performed using smartphones. We review recent progress in smartphone-based fundus imaging and discuss its potential for integration into national systematic diabetic retinopathy screening programs. Some systems have produced promising initial results with respect to their agreement with reference standards. However further multisite trialling of such systems' use within implementable screening workflows is required if an evidence base strong enough to affect policy change is to be established. If this were to occur national diabetic retinopathy screening would, for the first time, become possible in low- and middle-income settings where cost and availability of trained eye care personnel are currently key barriers to implementation. As diabetes prevalence and incidence is increasing sharply in these settings, the impact on global blindness could be profound. © 2015 Diabetes Technology Society.

NOVEL PRERETINAL HAIR PIN-LIKE VESSEL IN RETINAL ASTROCYTIC HAMARTOMA WITH VITREOUS HEMORRHAGE.

PubMed

Soeta, Megumi; Arai, Yusuke; Takahashi, Hidenori; Fujino, Yujiro; Tanabe, Tatsuro; Inoue, Yuji; Kawashima, Hidetoshi

2018-01-01

To report a case of retinal astrocytic hamartoma with vitreous hemorrhage and a hair pin-like vessel adhering to a posterior vitreous membrane. A 33-year-old man with a retinal astrocytic hamartoma presented with vitreous hemorrhage 5 times. Multimodal imaging, including fundus photography, fluorescein angiography, optical coherence tomography, and B-mode ultrasonography. Multimodal imaging demonstrated a novel hair pin-like vessel that adhered to the posterior vitreous membrane. Some cases of retinal astrocytic hamartoma with vitreous hemorrhage may be related to structure abnormalities of tumor vessels.

Retinal vascular imaging in early life: insights into processes and risk of cardiovascular disease

PubMed Central

Li, Ling‐Jun; Ikram, Mohammad Kamran

2015-01-01

Abstract Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally. In recent years, studies have shown that the origins of CVD may be traced to vascular and metabolic processes in early life. Retinal vascular imaging is a new technology that allows detailed non‐invasive in vivo assessment and monitoring of the microvasculature. In this systematic review, we described the application of retinal vascular imaging in children and adolescents, and we examined the use of retinal vascular imaging in understanding CVD risk in early life. We reviewed all publications with quantitative retinal vascular assessment in two databases: PubMed and Scopus. Early life CVD risk factors were classified into four groups: birth risk factors, environmental risk factors, systemic risk factors and conditions linked to future CVD development. Retinal vascular changes were associated with lower birth weight, shorter gestational age, low‐fibre and high‐sugar diet, lesser physical activity, parental hypertension history, childhood hypertension, childhood overweight/obesity, childhood depression/anxiety and childhood type 1 diabetes mellitus. In summary, there is increasing evidence supporting the view that structural changes in the retinal microvasculature are associated with CVD risk factors in early life. Thus, the retina is a useful site for pre‐clinical assessment of microvascular processes that may underlie the future development of CVD in adulthood. PMID:26435039

Blood flow velocity in monocular retinoblastoma assessed by color doppler

PubMed Central

Bonanomi, Maria Teresa B C; Saito, Osmar C; de Lima, Patricia Picciarelli; Bonanomi, Roberta Chizzotti; Chammas, Maria Cristina

2015-01-01

OBJECTIVE: To analyze the flow of retrobulbar vessels in retinoblastoma by color Doppler imaging. METHODS: A prospective study of monocular retinoblastoma treated by enucleation between 2010 and 2014. The examination comprised fundoscopy, magnetic resonance imaging, ultrasonography and color Doppler imaging. The peak blood velocities in the central retinal artery and central retinal vein of tumor-containing eyes (tuCRAv and tuCRVv, respectively) were assessed. The velocities were compared with those for normal eyes (nlCRAv and nlCRVv) and correlated with clinical and pathological findings. Tumor dimensions in the pathological sections were compared with those in magnetic resonance imaging and ultrasonography and were correlated with tuCRAv and tuCRVv. In tumor-containing eyes, the resistivity index in the central retinal artery and the pulse index in the central retinal vein were studied in relation to all variables. RESULTS: Eighteen patients were included. Comparisons between tuCRAv and nlCRAv and between tuCRVv and nlCRVv revealed higher velocities in tumor-containing eyes (p<0.001 for both), with a greater effect in the central retinal artery than in the central retinal vein (p=0.024). Magnetic resonance imaging and ultrasonography measurements were as reliable as pathology assessments (p=0.675 and p=0.375, respectively). A positive relationship was found between tuCRAv and the tumor volume (p=0.027). The pulse index in the central retinal vein was lower in male patients (p=0.017) and in eyes with optic nerve invasion (p=0.0088). CONCLUSIONS: TuCRAv and tuCRVv are higher in tumor-containing eyes than in normal eyes. Magnetic resonance imaging and ultrasonography measurements are reliable. The tumor volume is correlated with a higher tuCRAv and a reduced pulse in the central retinal vein is correlated with male sex and optic nerve invasion. PMID:26735219

Automated feature extraction in color retinal images by a model based approach.

PubMed

Li, Huiqi; Chutatape, Opas

2004-02-01

Color retinal photography is an important tool to detect the evidence of various eye diseases. Novel methods to extract the main features in color retinal images have been developed in this paper. Principal component analysis is employed to locate optic disk; A modified active shape model is proposed in the shape detection of optic disk; A fundus coordinate system is established to provide a better description of the features in the retinal images; An approach to detect exudates by the combined region growing and edge detection is proposed. The success rates of disk localization, disk boundary detection, and fovea localization are 99%, 94%, and 100%, respectively. The sensitivity and specificity of exudate detection are 100% and 71%, correspondingly. The success of the proposed algorithms can be attributed to the utilization of the model-based methods. The detection and analysis could be applied to automatic mass screening and diagnosis of the retinal diseases.

Association of Retinopathy and Retinal Microvascular Abnormalities With Stroke and Cerebrovascular Disease.

PubMed

Hughes, Alun D; Falaschetti, Emanuela; Witt, Nicholas; Wijetunge, Sumangali; Thom, Simon A McG; Tillin, Therese; Aldington, Steve J; Chaturvedi, Nish

2016-11-01

Abnormalities of the retinal circulation may be associated with cerebrovascular disease. We investigated associations between retinal microvascular abnormalities and (1) strokes and subclinical cerebral infarcts and (2) cerebral white matter lesions in a UK-based triethnic population-based cohort. A total of 1185 participants (age, 68.8±6.1 years; 77% men) underwent retinal imaging and cerebral magnetic resonance imaging. Cerebral infarcts and white matter hyperintensities were identified on magnetic resonance imaging, retinopathy was graded, and retinal vessels were measured. Higher retinopathy grade (odds ratio [OR], 1.40 [95% confidence interval (95% CI), 1.16-1.70]), narrower arteriolar diameter (OR, 0.98 [95% CI, 0.97-0.99]), fewer symmetrical arteriolar bifurcations (OR, 0.84 [95% CI, 0.75-0.95]), higher arteriolar optimality deviation (OR, 1.16 [95% CI, 1.00-1.34]), and more tortuous venules (OR, 1.20 [95% CI, 1.09-1.32]) were associated with strokes/infarcts and white matter hyperintensities. Associations with quantitative retinal microvascular measures were independent of retinopathy. Abnormalities of the retinal microvasculature are independently associated with stroke, cerebral infarcts, and white matter lesions. © 2016 American Heart Association, Inc.

Multimodal adaptive optics for depth-enhanced high-resolution ophthalmic imaging

NASA Astrophysics Data System (ADS)

Hammer, Daniel X.; Mujat, Mircea; Iftimia, Nicusor V.; Lue, Niyom; Ferguson, R. Daniel

2010-02-01

We developed a multimodal adaptive optics (AO) retinal imager for diagnosis of retinal diseases, including glaucoma, diabetic retinopathy (DR), age-related macular degeneration (AMD), and retinitis pigmentosa (RP). The development represents the first ever high performance AO system constructed that combines AO-corrected scanning laser ophthalmoscopy (SLO) and swept source Fourier domain optical coherence tomography (SSOCT) imaging modes in a single compact clinical prototype platform. The SSOCT channel operates at a wavelength of 1 μm for increased penetration and visualization of the choriocapillaris and choroid, sites of major disease activity for DR and wet AMD. The system is designed to operate on a broad clinical population with a dual deformable mirror (DM) configuration that allows simultaneous low- and high-order aberration correction. The system also includes a wide field line scanning ophthalmoscope (LSO) for initial screening, target identification, and global orientation; an integrated retinal tracker (RT) to stabilize the SLO, OCT, and LSO imaging fields in the presence of rotational eye motion; and a high-resolution LCD-based fixation target for presentation to the subject of stimuli and other visual cues. The system was tested in a limited number of human subjects without retinal disease for performance optimization and validation. The system was able to resolve and quantify cone photoreceptors across the macula to within ~0.5 deg (~100-150 μm) of the fovea, image and delineate ten retinal layers, and penetrate to resolve targets deep into the choroid. In addition to instrument hardware development, analysis algorithms were developed for efficient information extraction from clinical imaging sessions, with functionality including automated image registration, photoreceptor counting, strip and montage stitching, and segmentation. The system provides clinicians and researchers with high-resolution, high performance adaptive optics imaging to help guide therapies, develop new drugs, and improve patient outcomes.

Adaptive optics fundus images of cone photoreceptors in the macula of patients with retinitis pigmentosa.

PubMed

Tojo, Naoki; Nakamura, Tomoko; Fuchizawa, Chiharu; Oiwake, Toshihiko; Hayashi, Atsushi

2013-01-01

The purpose of this study was to examine cone photoreceptors in the macula of patients with retinitis pigmentosa using an adaptive optics fundus camera and to investigate any correlations between cone photoreceptor density and findings on optical coherence tomography and fundus autofluorescence. We examined two patients with typical retinitis pigmentosa who underwent ophthalmological examination, including measurement of visual acuity, and gathering of electroretinographic, optical coherence tomographic, fundus autofluorescent, and adaptive optics fundus images. The cone photoreceptors in the adaptive optics images of the two patients with retinitis pigmentosa and five healthy subjects were analyzed. An abnormal parafoveal ring of high-density fundus autofluorescence was observed in the macula in both patients. The border of the ring corresponded to the border of the external limiting membrane and the inner segment and outer segment line in the optical coherence tomographic images. Cone photoreceptors at the abnormal parafoveal ring were blurred and decreased in the adaptive optics images. The blurred area corresponded to the abnormal parafoveal ring in the fundus autofluorescence images. Cone densities were low at the blurred areas and at the nasal and temporal retina along a line from the fovea compared with those of healthy controls. The results for cone spacing and Voronoi domains in the macula corresponded with those for the cone densities. Cone densities were heavily decreased in the macula, especially at the parafoveal ring on high-density fundus autofluorescence in both patients with retinitis pigmentosa. Adaptive optics images enabled us to observe in vivo changes in the cone photoreceptors of patients with retinitis pigmentosa, which corresponded to changes in the optical coherence tomographic and fundus autofluorescence images.

Comparison of retinal vessel measurements using adaptive optics scanning laser ophthalmoscopy and optical coherence tomography.

PubMed

Arichika, Shigeta; Uji, Akihito; Ooto, Sotaro; Muraoka, Yuki; Yoshimura, Nagahisa

2016-05-01

We compared adaptive optics scanning laser ophthalmoscopy (AOSLO) and optical coherence tomography (OCT) vessel caliber measurements. AOSLO videos were acquired from 28 volunteers with healthy eyes. Artery measurements were made 0.5-1 disc diameters away from the optic disc margin. Individual segmented retinal arterial caliber was measured in synchronization with cardiac pulsation and averaged to obtain final horizontal retinal arterial caliber (ACH) and horizontal retinal arterial lumen (ALH). All OCT images were obtained with the Spectralis OCT, a spectral-domain OCT system. Vertical retinal arterial caliber (ACV) and vertical retinal arterial lumen (ALV) were measured on the same artery measured with AOSLO. Measurements made with the two imaging systems were compared. Average ACH, measured with AOSLO, was 123.4 ± 11.2 and average ALH was 101.8 ± 10.2 µm. Average ACV, measured with OCT, was 125.5 ± 11.4 and average ALV was 99.1 ± 10.6 µm. Both arterial caliber (r = 0.767, p < 0.0001) and arterial lumen (r = 0.81, p < 0.0001) measurements were significantly correlated between imaging modalities. Additionally, ACH and ACV were not significantly different (p = 0.16). However, ALH measurements were significantly higher than ALV measurements (p = 0.03). Vessel measurements made with AOSLO and OCT were well correlated. Moreover, plasma is visible and distinguishable from the retinal vessel wall in AOSLO images but not in OCT images. Therefore, AOSLO may measure vessel width more precisely than OCT.

Adaptive optics two-photon excited fluorescence lifetime imaging ophthalmoscopy of exogenous fluorophores in mice

PubMed Central

Feeks, James A.; Hunter, Jennifer J.

2017-01-01

In vivo cellular scale fluorescence lifetime imaging of the mouse retina has the potential to be a sensitive marker of retinal cell health. In this study, we demonstrate fluorescence lifetime imaging of extrinsic fluorophores using adaptive optics fluorescence lifetime imaging ophthalmoscopy (AOFLIO). We recorded AOFLIO images of inner retinal cells labeled with enhanced green fluorescent protein (EGFP) and capillaries labeled with fluorescein. We demonstrate that AOFLIO can be used to differentiate spectrally overlapping fluorophores in the retina. With further refinements, AOFLIO could be used to assess retinal health in early stages of degeneration by utilizing lifetime-based sensors or even fluorophores native to the retina. PMID:28663886

[Evaluation of fundus autofluorescence in hereditary retinal diseases using Heidelberg Retina Angiograph2].

PubMed

Côco, Monique; Baba, Natalia Tamie; Sallum, Juliana Maria Ferraz

2007-01-01

To define characteristics of the fundus autofluorescence examination, verifying usefulness in the diagnosis and care of hereditary retinal diseases. 28 patients, adults, divided equally into four groups with diagnoses of Stargardt macular dystrophy, cone dystrophy, retinitis pigmentosa and healthy volunteers for the establishment of the normality pattern. An average of nine images with the filter for fluorescein angiography was obtained for the formation of the image autofluorescence using Heidelberg Retina Angiograph2. The images of each group of patients were analyzed to verify common characteristics. The fundus autofluorescence of healthy volunteers showed the foveal area darker than the surrounding retina. The images of Stargardt macular dystrophy, in general, presented an oval central lesion, with reduced autofluorescence. The main alterations of the autofluorescence in patients with cone dystrophy were reduced foveal autofluorescence with a parafoveal ring of increased autofluorescence. In general, the images of retinitis pigmentosa showed outlying pigments with reduced autofluorescence, and of the foveal area, in some cases disorganization or reduced autofluorescence. The study showed the existence of patterns of fundus autofluorescence in the hereditary retinal diseases that allow the diagnosis and better interpretation of the pathogenesis of these diseases.

Quantitative Multispectral Analysis Of Discrete Subcellular Particles By Digital Imaging Fluorescence Microscopy (DIFM)

NASA Astrophysics Data System (ADS)

Dorey, C. K.; Ebenstein, David B.

1988-10-01

Subcellular localization of multiple biochemical markers is readily achieved through their characteristic autofluorescence or through use of appropriately labelled antibodies. Recent development of specific probes has permitted elegant studies in calcium and pH in living cells. However, each of these methods measured fluorescence at one wavelength; precise quantitation of multiple fluorophores at individual sites within a cell has not been possible. Using DIFM, we have achieved spectral analysis of discrete subcellular particles 1-2 gm in diameter. The fluorescence emission is broken into narrow bands by an interference monochromator and visualized through the combined use of a silicon intensified target (SIT) camera, a microcomputer based framegrabber with 8 bit resolution, and a color video monitor. Image acquisition, processing, analysis and display are under software control. The digitized image can be corrected for the spectral distortions induced by the wavelength dependent sensitivity of the camera, and the displayed image can be enhanced or presented in pseudocolor to facilitate discrimination of variation in pixel intensity of individual particles. For rapid comparison of the fluorophore composition of granules, a ratio image is produced by dividing the image captured at one wavelength by that captured at another. In the resultant ratio image, a granule which has a fluorophore composition different from the majority is selectively colored. This powerful system has been utilized to obtain spectra of endogenous autofluorescent compounds in discrete cellular organelles of human retinal pigment epithelium, and to measure immunohistochemically labelled components of the extracellular matrix associated with the human optic nerve.

Retinal Imaging Techniques for Diabetic Retinopathy Screening

PubMed Central

Goh, James Kang Hao; Cheung, Carol Y.; Sim, Shaun Sebastian; Tan, Pok Chien; Tan, Gavin Siew Wei; Wong, Tien Yin

2016-01-01

Due to the increasing prevalence of diabetes mellitus, demand for diabetic retinopathy (DR) screening platforms is steeply increasing. Early detection and treatment of DR are key public health interventions that can greatly reduce the likelihood of vision loss. Current DR screening programs typically employ retinal fundus photography, which relies on skilled readers for manual DR assessment. However, this is labor-intensive and suffers from inconsistency across sites. Hence, there has been a recent proliferation of automated retinal image analysis software that may potentially alleviate this burden cost-effectively. Furthermore, current screening programs based on 2-dimensional fundus photography do not effectively screen for diabetic macular edema (DME). Optical coherence tomography is becoming increasingly recognized as the reference standard for DME assessment and can potentially provide a cost-effective solution for improving DME detection in large-scale DR screening programs. Current screening techniques are also unable to image the peripheral retina and require pharmacological pupil dilation; ultra-widefield imaging and confocal scanning laser ophthalmoscopy, which address these drawbacks, possess great potential. In this review, we summarize the current DR screening methods using various retinal imaging techniques, and also outline future possibilities. Advances in retinal imaging techniques can potentially transform the management of patients with diabetes, providing savings in health care costs and resources. PMID:26830491

Retinal Imaging Techniques for Diabetic Retinopathy Screening.

PubMed

Goh, James Kang Hao; Cheung, Carol Y; Sim, Shaun Sebastian; Tan, Pok Chien; Tan, Gavin Siew Wei; Wong, Tien Yin

2016-02-01

Due to the increasing prevalence of diabetes mellitus, demand for diabetic retinopathy (DR) screening platforms is steeply increasing. Early detection and treatment of DR are key public health interventions that can greatly reduce the likelihood of vision loss. Current DR screening programs typically employ retinal fundus photography, which relies on skilled readers for manual DR assessment. However, this is labor-intensive and suffers from inconsistency across sites. Hence, there has been a recent proliferation of automated retinal image analysis software that may potentially alleviate this burden cost-effectively. Furthermore, current screening programs based on 2-dimensional fundus photography do not effectively screen for diabetic macular edema (DME). Optical coherence tomography is becoming increasingly recognized as the reference standard for DME assessment and can potentially provide a cost-effective solution for improving DME detection in large-scale DR screening programs. Current screening techniques are also unable to image the peripheral retina and require pharmacological pupil dilation; ultra-widefield imaging and confocal scanning laser ophthalmoscopy, which address these drawbacks, possess great potential. In this review, we summarize the current DR screening methods using various retinal imaging techniques, and also outline future possibilities. Advances in retinal imaging techniques can potentially transform the management of patients with diabetes, providing savings in health care costs and resources. © 2016 Diabetes Technology Society.

High-Resolution In Vivo Imaging of Regimes of Laser Damage to the Primate Retina

PubMed Central

Pocock, Ginger M.; Oliver, Jeffrey W.; Specht, Charles S.; Estep, J. Scot; Noojin, Gary D.; Schuster, Kurt; Rockwell, Benjamin A.

2014-01-01

Purpose. To investigate fundamental mechanisms of regimes of laser induced damage to the retina and the morphological changes associated with the damage response. Methods. Varying grades of photothermal, photochemical, and photomechanical retinal laser damage were produced in eyes of eight cynomolgus monkeys. An adaptive optics confocal scanning laser ophthalmoscope and spectral domain optical coherence tomographer were combined to simultaneously collect complementary in vivo images of retinal laser damage during and following exposure. Baseline color fundus photography was performed to complement high-resolution imaging. Monkeys were perfused with 10% buffered formalin and eyes were enucleated for histological analysis. Results. Laser energies for visible retinal damage in this study were consistent with previously reported damage thresholds. Lesions were identified in OCT images that were not visible in direct ophthalmoscopic examination or fundus photos. Unique diagnostic characteristics, specific to each damage regime, were identified and associated with shape and localization of lesions to specific retinal layers. Previously undocumented retinal healing response to blue continuous wave laser exposure was recorded through a novel experimental methodology. Conclusion. This study revealed increased sensitivity of lesion detection and improved specificity to the laser of origin utilizing high-resolution imaging when compared to traditional ophthalmic imaging techniques in the retina. PMID:24891943

Effect of pharmacologically induced retinal degeneration on retinal autofluorescence lifetimes in mice.

PubMed

Dysli, Chantal; Dysli, Muriel; Zinkernagel, Martin S; Enzmann, Volker

2016-12-01

Fluorescence lifetime imaging ophthalmoscopy (FLIO) was used to investigate retinal autofluorescence lifetimes in mouse models of pharmacologically induced retinal degeneration over time. Sodium iodate (NaIO 3 , 35 mg/kg intravenously) was used to induce retinal pigment epithelium (RPE) degeneration with subsequent loss of photoreceptors (PR) whereas N-methyl-N-nitrosourea (MNU, 45 mg/kg intraperitoneally) was employed for degeneration of the photoreceptor cell layer alone. All mice were measured at day 3, 7, 14, and 28 after the respective injection of NaIO 3 , MNU or NaCl (control). Fluorescence lifetime imaging was performed using a fluorescence lifetime imaging ophthalmoscope (Heidelberg Engineering, Heidelberg, Germany). Fluorescence was excited at 473 nm and fluorescence lifetimes were measured in a short and a long spectral channel (498-560 nm and 560-720 nm). Corresponding optical coherence tomography (OCT) images were consecutively acquired and histology was performed at the end of the experiments. Segmentation of OCT images and histology verified the cell type-specific degeneration process over time. Retinal autofluorescence lifetimes increased from day 3 to day 28 in mice after NaIO 3 treatment. Finally, at day 28, fluorescence lifetimes were prolonged by 8% in the short and 61% in the long spectral channel compared to control animals (p = 0.21 and p = 0.004, respectively). In mice after MNU treatment, the mean retinal autofluorescence lifetimes were already decreased at day 3 and retinal lifetimes were finally shortened by 27% in the short and 51% in the long spectral channel at day 28 (p = 0.0028). In conclusion, degeneration of the RPE with subsequent photoreceptor degeneration by NaIO 3 lead to longer mean fluorescence lifetimes of the retina compared to control mice, whereas during specific degeneration of the photoreceptor layer induced by MNU shorter lifetimes were measured. Therefore, short retinal fluorescence lifetimes may originate from the RPE and may be modified by the overlaying retinal layers. Copyright © 2016 Elsevier Ltd. All rights reserved.

The neurovascular relation in oxygen-induced retinopathy.

PubMed

Akula, James D; Mocko, Julie A; Benador, Ilan Y; Hansen, Ronald M; Favazza, Tara L; Vyhovsky, Tanya C; Fulton, Anne B

2008-01-01

Longitudinal studies in rat models of retinopathy of prematurity (ROP) have demonstrated that abnormalities of retinal vasculature and function change hand-in-hand. In the developing retina, vascular and neural structures are under cooperative molecular control. In this study of rats with oxygen-induced retinopathy (OIR) models of ROP, mRNA expression of vascular endothelial growth factor (VEGF), semaphorin (Sema), and their neuropilin receptor (NRP) were examined during the course of retinopathy to evaluate their roles in the observed neurovascular congruency. Oxygen exposures designed to induce retinopathy were delivered to Sprague-Dawley rat pups (n=36) from postnatal day (P) 0 to P14 or from P7 to P14. Room-air-reared controls (n=18) were also studied. Sensitivities of the rod photoreceptors (S(rod)) and the postreceptor cells (Sm) were derived from electroretinographic (ERG) records. Arteriolar tortuosity, T(A), was derived from digital fundus images using Retinal Image multi-Scale Analysis (RISA) image analysis software. mRNA expression of VEGF(164), semaphorin IIIA (Sema3A), and neuropilin-1 (NRP-1) was evaluated by RT-PCR of retinal extracts. Tests were performed at P15-P16, P18-P19, and P25-P26. Relations among ERG, RISA, and PCR parameters were evaluated using linear regression on log transformed data. Sm was low and T(A) was high at young ages, then both resolved by P25-P26. VEGF(164) and Sema3A mRNA expression were also elevated early and decreased with age. Low Sm was significantly associated with high VEGF(164) and Sema3A expression. Low S(rod) was also significantly associated with high VEGF(164). S(rod) and Sm were both correlated with T(A). NRP-1 expression was little affected by OIR. The postreceptor retina appears to mediate the vascular abnormalities that characterize OIR. Because of the relationships revealed by these data, early treatment that targets the neural retina may mitigate the effects of ROP.

The neurovascular relation in oxygen-induced retinopathy

PubMed Central

Akula, James D.; Mocko, Julie A.; Benador, Ilan Y.; Hansen, Ronald M.; Favazza, Tara L.; Vyhovsky, Tanya C.

2008-01-01

Purpose Longitudinal studies in rat models of retinopathy of prematurity (ROP) have demonstrated that abnormalities of retinal vasculature and function change hand-in-hand. In the developing retina, vascular and neural structures are under cooperative molecular control. In this study of rats with oxygen-induced retinopathy (OIR) models of ROP, mRNA expression of vascular endothelial growth factor (VEGF), semaphorin (Sema), and their neuropilin receptor (NRP) were examined during the course of retinopathy to evaluate their roles in the observed neurovascular congruency. Methods Oxygen exposures designed to induce retinopathy were delivered to Sprague-Dawley rat pups (n=36) from postnatal day (P) 0 to P14 or from P7 to P14. Room-air-reared controls (n=18) were also studied. Sensitivities of the rod photoreceptors (Srod) and the postreceptor cells (Sm) were derived from electroretinographic (ERG) records. Arteriolar tortuosity, TA, was derived from digital fundus images using Retinal Image multi-Scale Analysis (RISA) image analysis software. mRNA expression of VEGF164, semaphorin IIIA (Sema3A), and neuropilin-1 (NRP-1) was evaluated by RT–PCR of retinal extracts. Tests were performed at P15–P16, P18–P19, and P25–P26. Relations among ERG, RISA, and PCR parameters were evaluated using linear regression on log transformed data. Results Sm was low and TA was high at young ages, then both resolved by P25–P26. VEGF164 and Sema3A mRNA expression were also elevated early and decreased with age. Low Sm was significantly associated with high VEGF164 and Sema3A expression. Low Srod was also significantly associated with high VEGF164. Srod and Sm were both correlated with TA. NRP-1 expression was little affected by OIR. Conclusions The postreceptor retina appears to mediate the vascular abnormalities that characterize OIR. Because of the relationships revealed by these data, early treatment that targets the neural retina may mitigate the effects of ROP. PMID:19112532

The role of fundus autofluorescence in late-onset retinitis pigmentosa (LORP) diagnosis.

PubMed

Lee, Tamara J; Hwang, John C; Chen, Royce W S; Lima, Luiz H; Wang, Nan-Kai; Tosi, Joaquin; Freund, K Bailey; Yannuzzi, Lawrence A; Tsang, Stephen H

2014-09-01

To demonstrate the utility and characteristics of fundus autofluorescence in late-onset retinitis pigmentosa. Observational case series. Patients diagnosed with late-onset retinitis pigmentosa were identified retrospectively in an institutional setting. Twelve eyes of six patients were identified and medical records were reviewed. All patients presented with slowly progressive peripheral field loss and initial clinical examination revealed only subtle retinal changes. There was a notable lack of intraretinal pigment migration in all patients. Five out of six patients underwent magnetic resonance imaging of the brain to rule out intracranial processes and all were referred from another ophthalmologist for further evaluation. Fundus autofluorescence was ultimately employed in all patients and revealed more extensive retinal pathology than initially appreciated on clinical examination. Fundus autofluorescence directed the workup toward a retinal etiology in all cases and led to the eventual diagnosis of late-onset retinitis pigmentosa through electroretinogram testing. Fundus autofluorescence may be a more sensitive marker for retinal pathology than stereo fundus biomicroscopy alone in late-onset retinitis pigmentosa. Early use of fundus autofluorescence imaging in the evaluation of patients with subtle retinal lesions and complaints of peripheral field loss may be an effective strategy for timely and cost-efficient diagnosis.

The Dept. of Energy Artificial Retina project

ScienceCinema

None

2017-12-09

LLNL has assisted in the development of the first long-term retinal prosthesis - called an artificial retina - that can function for years inside the harsh biological environment of the eye. This work has been done in collaboration with four national laboratories (Argonne, Los Alamos, Oak Ridge and Sandia), four universities (the California Institute of Technology, the Doheny Eye Institute at USC, North Carolina State University and the University of California, Santa Cruz), an industrial partner (Second Sight® Medical Products Inc. of Sylmar, Calif.) and the U.S. Department of Energy. With this device, application-specific integrated circuits transform digital images from a camera into electric signals in the eye that the brain uses to create a visual image. In clinical trials, patients with vision loss were able to successfully identify objects, increase mobility and detect movement using the artificial retina.

Virtual Averaging Making Nonframe-Averaged Optical Coherence Tomography Images Comparable to Frame-Averaged Images.

PubMed

Chen, Chieh-Li; Ishikawa, Hiroshi; Wollstein, Gadi; Bilonick, Richard A; Kagemann, Larry; Schuman, Joel S

2016-01-01

Developing a novel image enhancement method so that nonframe-averaged optical coherence tomography (OCT) images become comparable to active eye-tracking frame-averaged OCT images. Twenty-one eyes of 21 healthy volunteers were scanned with noneye-tracking nonframe-averaged OCT device and active eye-tracking frame-averaged OCT device. Virtual averaging was applied to nonframe-averaged images with voxel resampling and adding amplitude deviation with 15-time repetitions. Signal-to-noise (SNR), contrast-to-noise ratios (CNR), and the distance between the end of visible nasal retinal nerve fiber layer (RNFL) and the foveola were assessed to evaluate the image enhancement effect and retinal layer visibility. Retinal thicknesses before and after processing were also measured. All virtual-averaged nonframe-averaged images showed notable improvement and clear resemblance to active eye-tracking frame-averaged images. Signal-to-noise and CNR were significantly improved (SNR: 30.5 vs. 47.6 dB, CNR: 4.4 vs. 6.4 dB, original versus processed, P < 0.0001, paired t -test). The distance between the end of visible nasal RNFL and the foveola was significantly different before (681.4 vs. 446.5 μm, Cirrus versus Spectralis, P < 0.0001) but not after processing (442.9 vs. 446.5 μm, P = 0.76). Sectoral macular total retinal and circumpapillary RNFL thicknesses showed systematic differences between Cirrus and Spectralis that became not significant after processing. The virtual averaging method successfully improved nontracking nonframe-averaged OCT image quality and made the images comparable to active eye-tracking frame-averaged OCT images. Virtual averaging may enable detailed retinal structure studies on images acquired using a mixture of nonframe-averaged and frame-averaged OCT devices without concerning about systematic differences in both qualitative and quantitative aspects.

Virtual Averaging Making Nonframe-Averaged Optical Coherence Tomography Images Comparable to Frame-Averaged Images

PubMed Central

Chen, Chieh-Li; Ishikawa, Hiroshi; Wollstein, Gadi; Bilonick, Richard A.; Kagemann, Larry; Schuman, Joel S.

2016-01-01

Purpose Developing a novel image enhancement method so that nonframe-averaged optical coherence tomography (OCT) images become comparable to active eye-tracking frame-averaged OCT images. Methods Twenty-one eyes of 21 healthy volunteers were scanned with noneye-tracking nonframe-averaged OCT device and active eye-tracking frame-averaged OCT device. Virtual averaging was applied to nonframe-averaged images with voxel resampling and adding amplitude deviation with 15-time repetitions. Signal-to-noise (SNR), contrast-to-noise ratios (CNR), and the distance between the end of visible nasal retinal nerve fiber layer (RNFL) and the foveola were assessed to evaluate the image enhancement effect and retinal layer visibility. Retinal thicknesses before and after processing were also measured. Results All virtual-averaged nonframe-averaged images showed notable improvement and clear resemblance to active eye-tracking frame-averaged images. Signal-to-noise and CNR were significantly improved (SNR: 30.5 vs. 47.6 dB, CNR: 4.4 vs. 6.4 dB, original versus processed, P < 0.0001, paired t-test). The distance between the end of visible nasal RNFL and the foveola was significantly different before (681.4 vs. 446.5 μm, Cirrus versus Spectralis, P < 0.0001) but not after processing (442.9 vs. 446.5 μm, P = 0.76). Sectoral macular total retinal and circumpapillary RNFL thicknesses showed systematic differences between Cirrus and Spectralis that became not significant after processing. Conclusion The virtual averaging method successfully improved nontracking nonframe-averaged OCT image quality and made the images comparable to active eye-tracking frame-averaged OCT images. Translational Relevance Virtual averaging may enable detailed retinal structure studies on images acquired using a mixture of nonframe-averaged and frame-averaged OCT devices without concerning about systematic differences in both qualitative and quantitative aspects. PMID:26835180

Integrated adaptive optics optical coherence tomography and adaptive optics scanning laser ophthalmoscope system for simultaneous cellular resolution in vivo retinal imaging

PubMed Central

Zawadzki, Robert J.; Jones, Steven M.; Pilli, Suman; Balderas-Mata, Sandra; Kim, Dae Yu; Olivier, Scot S.; Werner, John S.

2011-01-01

We describe an ultrahigh-resolution (UHR) retinal imaging system that combines adaptive optics Fourier-domain optical coherence tomography (AO-OCT) with an adaptive optics scanning laser ophthalmoscope (AO-SLO) to allow simultaneous data acquisition by the two modalities. The AO-SLO subsystem was integrated into the previously described AO-UHR OCT instrument with minimal changes to the latter. This was done in order to ensure optimal performance and image quality of the AO- UHR OCT. In this design both imaging modalities share most of the optical components including a common AO-subsystem and vertical scanner. One of the benefits of combining Fd-OCT with SLO includes automatic co-registration between two acquisition channels for direct comparison between retinal structures imaged by both modalities (e.g., photoreceptor mosaics or microvasculature maps). Because of differences in the detection scheme of the two systems, this dual imaging modality instrument can provide insight into retinal morphology and potentially function, that could not be accessed easily by a single system. In this paper we describe details of the components and parameters of the combined instrument, including incorporation of a novel membrane magnetic deformable mirror with increased stroke and actuator count used as a single wavefront corrector. We also discuss laser safety calculations for this multimodal system. Finally, retinal images acquired in vivo with this system are presented. PMID:21698028

Extracting and compensating dispersion mismatch in ultrahigh-resolution Fourier domain OCT imaging of the retina

PubMed Central

Choi, WooJhon; Baumann, Bernhard; Swanson, Eric A.; Fujimoto, James G.

2012-01-01

We present a numerical approach to extract the dispersion mismatch in ultrahigh-resolution Fourier domain optical coherence tomography (OCT) imaging of the retina. The method draws upon an analogy with a Shack-Hartmann wavefront sensor. By exploiting mathematical similarities between the expressions for aberration in optical imaging and dispersion mismatch in spectral / Fourier domain OCT, Shack-Hartmann principles can be extended from the two-dimensional paraxial wavevector space (or the x-y plane in the spatial domain) to the one-dimensional wavenumber space (or the z-axis in the spatial domain). For OCT imaging of the retina, different retinal layers, such as the retinal nerve fiber layer (RNFL), the photoreceptor inner and outer segment junction (IS/OS), or all the retinal layers near the retinal pigment epithelium (RPE) can be used as point source beacons in the axial direction, analogous to point source beacons used in conventional two-dimensional Shack-Hartman wavefront sensors for aberration characterization. Subtleties regarding speckle phenomena in optical imaging, which affect the Shack-Hartmann wavefront sensor used in adaptive optics, also occur analogously in this application. Using this approach and carefully suppressing speckle, the dispersion mismatch in spectral / Fourier domain OCT retinal imaging can be successfully extracted numerically and used for numerical dispersion compensation to generate sharper, ultrahigh-resolution OCT images. PMID:23187353

Prevalence of diabetic retinopathy in Peruvian patients with type 2 diabetes: results of a hospital-based retinal telescreening program.

PubMed

Villena, Jaime E; Yoshiyama, Christian A; Sánchez, Javier E; Hilario, Nélida L; Merin, Lawrence M

2011-11-01

To estimate the prevalence of diabetic retinopathy (DR) in patients with type 2 diabetes and to determine any association with clinical factors. This hospital-based screening project was designed to prospectively detect the presence of DR in patients with type 2 diabetes by grading images acquired with a digital retinal camera. Of 1 311 patients screened, appropriate retinal images were obtained in 1 222 subjects (93.2%). DR was detected in 282 patients (23.1%) [95% confidence interval (CI): 20.71-25.44]; 249 patients (20.4%) (95% CI: 18.1-22.6) had nonproliferative DR and 33 (2.7%) (95% CI: 1.8-3.6) had proliferative DR. In 32 patients (11.3%), DR was unilateral. The frequency of DR was the same in both sexes. Prevalence of blindness was twice as frequent in patients with DR as in those without it (9.4% and 4.6%, respectively) (P = 0.001). The frequency of DR at diagnosis was 3.5% and it increased with the duration of diabetes. DR was more frequent in patients with arterial hypertension, macrovascular or microvascular complications, and hemoglobin A1c (HbA1c) > 7.0% and in those treated with insulin or sulfonylureas. It was less prevalent in those with HbA1c < 7.0%, with greater body mass index, and who had been treated with metformin. The prevalence of DR in these patients with type 2 diabetes was 23.1%. Nonproliferative retinopathy accounted for 77.0% of cases. Although less prevalent than in a previous report, it doubled the frequency of blindness in the people affected. A national screening DR program should be considered in order to detect this prevalent condition early and treat it in a timely fashion.

The Role of Retinal Imaging and Portable Screening Devices in Tele-ophthalmology Applications for Diabetic Retinopathy Management.

PubMed

DeBuc, Delia Cabrera

2016-12-01

In the years since its introduction, retinal imaging has transformed our capability to visualize the posterior pole of the eye. Increasing practical advances in mobile technology, regular monitoring, and population screening for diabetic retinopathy management offer the opportunity for further development of cost-effective applications through remote assessment of the diabetic eye using portable retinal cameras, smart-phone-based devices and telemedicine networks. Numerous retinal imaging methods and mobile technologies in tele-ophthalmology applications have been reported for diabetic retinopathy screening and management. They provide several advantages of automation, sensitivity, specificity, portability, and miniaturization for the development of point-of-care diagnostics for eye complications in diabetes. The aim of this paper is to review the role of retinal imaging and mobile technologies in tele-ophthalmology applications for diabetic retinopathy screening and management. At large, although improvements in current technology and telemedicine services are still needed, telemedicine has demonstrated to be a worthy tool to support health caregivers in the effective management and prevention of diabetes and its complications.

Assessing blood vessel perfusion and vital signs through retinal imaging photoplethysmography.

PubMed

Hassan, Harnani; Jaidka, Sheila; Dwyer, Vincent M; Hu, Sijung

2018-05-01

One solution to the global challenge of increasing ocular disease is a cost-effective technique for rapid screening and assessment. Current ophthalmic imaging techniques, e.g. scanning and ocular blood flow systems, are expensive, complex to operate and utilize invasive contrast agents during assessment. The work presented here demonstrates a simple retinal imaging photoplethysmography (iPPG) system with the potential to provide screening, diagnosis, monitoring and assessment that is non-invasive, painless and radiationless. Time series of individual retinal blood vessel images, captured with an eye fundus camera, are processed using standard filtering, amplitude demodulation and principle component analysis (PCA) methods to determine the values of the heart rate (HR) and respiration rate (RR), which are in compliance with simultaneously obtained measurements using commercial pulse oximetry. It also seems possible that some information on the dynamic changes in oxygen saturation levels ( SpO 2 ) in a retinal blood vessel may also be obtained. As a consequence, the retinal iPPG modality system demonstrates a potential avenue for rapid ophthalmic screening, and even early diagnosis, against ocular disease without the need for fluorescent or contrast agents.

Optical aberrations, retinal image quality and eye growth: Experimentation and modeling

NASA Astrophysics Data System (ADS)

Tian, Yibin

2007-12-01

Retinal image quality is important for normal eye growth. Optical aberrations are of interest for two reasons: first, they degrade retinal images; second, they might provide some cues to defocus. Higher than normal ocular aberrations have been previously associated with human myopia. However, these studies were cross-sectional in design, and only reported aberrations in terms of root mean square (RMS) errors of Zernike coefficients, a poor metric of optical quality. This dissertation presents results from investigations of ocular optical aberrations, retinal image quality and eye growth in chicks and humans. A number of techniques were utilized, including Shack-Hartmann aberrometry, high-frequency A-scan ultrasonography, ciliary nerve section (CNX), photorefractive keratectomy (PRK) as well as computer simulations and modeling. A technique to extract light scatter information from Shack-Hartmann images was also developed. The main findings of the dissertation are summarized below. In young chicks, most ocular aberrations decreased with growth in both normal and CNX eyes, and there were diurnal fluctuations in some aberrations. Modeling suggested active reduction in higher order aberrations (HOAs) during early development. Although CNX eyes manifested greater than normal HOAs, they showed near normal growth. Retinal image degradation varied greatly among individual eyes post-PRK in young chicks. Including light scatter information into analyses of retinal image quality better estimated the latter. Albino eyes showed more severe retinal image degradation than normal eyes, due to increased optical aberrations and light scatter, but their growth was similar to those of normal eyes, implying that they are relatively insensitive to retina image quality. Although the above results questioned the influence of optical aberrations on early ocular growth, some optical quality metrics, derived from optical aberrations data, could predict how much the eyes of young chicks subsequently elongated. The performance of some focus measures was very poor when non-defocus aberrations exceeded a certain level; presumably, these non-defocus aberrations might interfere with the eye's ability to interpret defocus. In anisomyopic human adults, more myopic eyes had larger anterior and vitreous chambers, greater astigmatism, and more positive spherical aberration. However, compared to isometropes, only interocular differences in spherical equivalent refractive errors were significantly increased.

Intra-retinal segmentation of optical coherence tomography images using active contours with a dynamic programming initialization and an adaptive weighting strategy

NASA Astrophysics Data System (ADS)

Gholami, Peyman; Roy, Priyanka; Kuppuswamy Parthasarathy, Mohana; Ommani, Abbas; Zelek, John; Lakshminarayanan, Vasudevan

2018-02-01

Retinal layer shape and thickness are one of the main indicators in the diagnosis of ocular diseases. We present an active contour approach to localize intra-retinal boundaries of eight retinal layers from OCT images. The initial locations of the active contour curves are determined using a Viterbi dynamic programming method. The main energy function is a Chan-Vese active contour model without edges. A boundary term is added to the energy function using an adaptive weighting method to help curves converge to the retinal layer edges more precisely, after evolving of curves towards boundaries, in final iterations. A wavelet-based denoising method is used to remove speckle from OCT images while preserving important details and edges. The performance of the proposed method was tested on a set of healthy and diseased eye SD-OCT images. The experimental results, compared between the proposed method and the manual segmentation, which was determined by an optometrist, indicate that our method has obtained an average of 95.29%, 92.78%, 95.86%, 87.93%, 82.67%, and 90.25% respectively, for accuracy, sensitivity, specificity, precision, Jaccard Index, and Dice Similarity Coefficient over all segmented layers. These results justify the robustness of the proposed method in determining the location of different retinal layers.

An Approach to Evaluate Blurriness in Retinal Images with Vitreous Opacity for Cataract Diagnosis

PubMed Central

Xu, Liang

2017-01-01

Cataract is one of the leading causes of blindness in the world's population. A method to evaluate blurriness for cataract diagnosis in retinal images with vitreous opacity is proposed in this paper. Three types of features are extracted, which include pixel number of visible structures, mean contrast between vessels and background, and local standard deviation. To avoid the wrong detection of vitreous opacity as retinal structures, a morphological method is proposed to detect and remove such lesions from retinal visible structure segmentation. Based on the extracted features, a decision tree is trained to classify retinal images into five grades of blurriness. The proposed approach was tested using 1355 clinical retinal images, and the accuracies of two-class classification and five-grade grading compared with that of manual grading are 92.8% and 81.1%, respectively. The kappa value between automatic grading and manual grading is 0.74 in five-grade grading, in which both variance and P value are less than 0.001. Experimental results show that the grading difference between automatic grading and manual grading is all within 1 grade, which is much improvement compared with that of other available methods. The proposed grading method provides a universal measure of cataract severity and can facilitate the decision of cataract surgery. PMID:29065620

Mixture model-based clustering and logistic regression for automatic detection of microaneurysms in retinal images

NASA Astrophysics Data System (ADS)

Sánchez, Clara I.; Hornero, Roberto; Mayo, Agustín; García, María

2009-02-01

Diabetic Retinopathy is one of the leading causes of blindness and vision defects in developed countries. An early detection and diagnosis is crucial to avoid visual complication. Microaneurysms are the first ocular signs of the presence of this ocular disease. Their detection is of paramount importance for the development of a computer-aided diagnosis technique which permits a prompt diagnosis of the disease. However, the detection of microaneurysms in retinal images is a difficult task due to the wide variability that these images usually present in screening programs. We propose a statistical approach based on mixture model-based clustering and logistic regression which is robust to the changes in the appearance of retinal fundus images. The method is evaluated on the public database proposed by the Retinal Online Challenge in order to obtain an objective performance measure and to allow a comparative study with other proposed algorithms.

Vessel Segmentation in Retinal Images Using Multi-scale Line Operator and K-Means Clustering.

PubMed

Saffarzadeh, Vahid Mohammadi; Osareh, Alireza; Shadgar, Bita

2014-04-01

Detecting blood vessels is a vital task in retinal image analysis. The task is more challenging with the presence of bright and dark lesions in retinal images. Here, a method is proposed to detect vessels in both normal and abnormal retinal fundus images based on their linear features. First, the negative impact of bright lesions is reduced by using K-means segmentation in a perceptive space. Then, a multi-scale line operator is utilized to detect vessels while ignoring some of the dark lesions, which have intensity structures different from the line-shaped vessels in the retina. The proposed algorithm is tested on two publicly available STARE and DRIVE databases. The performance of the method is measured by calculating the area under the receiver operating characteristic curve and the segmentation accuracy. The proposed method achieves 0.9483 and 0.9387 localization accuracy against STARE and DRIVE respectively.

Characterisation of Feature Points in Eye Fundus Images

NASA Astrophysics Data System (ADS)

Calvo, D.; Ortega, M.; Penedo, M. G.; Rouco, J.

The retinal vessel tree adds decisive knowledge in the diagnosis of numerous opthalmologic pathologies such as hypertension or diabetes. One of the problems in the analysis of the retinal vessel tree is the lack of information in terms of vessels depth as the image acquisition usually leads to a 2D image. This situation provokes a scenario where two different vessels coinciding in a point could be interpreted as a vessel forking into a bifurcation. That is why, for traking and labelling the retinal vascular tree, bifurcations and crossovers of vessels are considered feature points. In this work a novel method for these retinal vessel tree feature points detection and classification is introduced. The method applies image techniques such as filters or thinning to obtain the adequate structure to detect the points and sets a classification of these points studying its environment. The methodology is tested using a standard database and the results show high classification capabilities.

Noninvasive two-photon fluorescence microscopy imaging of mouse retina and RPE through the pupil of the eye

PubMed Central

Palczewska, Grazyna; Dong, Zhiqian; Golczak, Marcin; Hunter, Jennifer J.; Williams, David R.; Alexander, Nathan S.; Palczewski, Krzysztof

2014-01-01

Two-photon excitation microscopy (TPM) can image retinal molecular processes in vivo. Intrinsically fluorescent retinyl esters in sub-cellular structures called retinosomes are an integral part of the visual chromophore regeneration pathway. Fluorescent condensation products of all–trans–retinal accumulate in the eye with age and are also associated with age-related macular degeneration (AMD). Here we report repetitive, dynamic imaging of these compounds in live mice, through the pupil of the eye. Leveraging advanced adaptive optics we developed a data acquisition algorithm that permitted the identification of retinosomes and condensation products in the retinal pigment epithelium (RPE) by their characteristic localization, spectral properties, and absence in genetically modified or drug-treated mice. This imaging approach has the potential to detect early molecular changes in retinoid metabolism that trigger light and AMD-induced retinal defects and to assess the effectiveness of treatments for these conditions. PMID:24952647

In vivo optical coherence tomography of stimulus-evoked intrinsic optical signals in mouse retinas

NASA Astrophysics Data System (ADS)

Wang, Benquan; Lu, Yiming; Yao, Xincheng

2016-09-01

Intrinsic optical signal (IOS) imaging promises a noninvasive method for advanced study and diagnosis of eye diseases. Before pursuing clinical applications, it is essential to understand anatomic and physiological sources of retinal IOSs and to establish the relationship between IOS distortions and eye diseases. The purpose of this study was designed to demonstrate the feasibility of in vivo IOS imaging of mouse models. A high spatiotemporal resolution spectral domain optical coherence tomography (SD-OCT) was employed for depth-resolved retinal imaging. A custom-designed animal holder equipped with ear bar and bite bar was used to minimize eye movements. Dynamic OCT imaging revealed rapid IOS from the photoreceptor's outer segment immediately after the stimulation delivery, and slow IOS changes were observed from inner retinal layers. Comparative photoreceptor IOS and electroretinography recordings suggested that the fast photoreceptor IOS may be attributed to the early stage of phototransduction before the hyperpolarization of retinal photoreceptor.

Optical Coherence Tomography Findings in Endogenous Fungal Chorioretinitis, Retinitis, and Endophthalmitis.

PubMed

Stephens, John D; Adam, Murtaza K; Todorich, Bohzo; Faia, Lisa J; Garg, Sunir; Dunn, James P; Mehta, Sonia

2017-11-01

To describe spectral-domain optical coherence tomography (SD-OCT) findings in eyes with endogenous fungal chorioretinitis and endophthalmitis. Retrospective, observational case series of subjects at Wills Eye Hospital and William Beaumont Hospital were identified by screening OCT billing data and cross-referencing with patient charts. Clinical and imaging data were collected for each patient and reviewed. Twelve eyes of seven consecutive patients were identified, demonstrating two patterns of posterior ocular involvement: chorioretinal infiltration and superficial retinal/retinal vascular infiltration without choroidal involvement. Six of 12 eyes had follow-up imaging performed after antifungal treatment, which demonstrated decreased size of choroidal and/or retinal infiltrates. All patients with follow-up imaging had anatomic improvement by OCT of the lesions with treatment. In the future, OCT imaging may provide a method to assess therapeutic response and prognosis for visual recovery in patients with endogenous fungal ocular disease. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:894-901.]. Copyright 2017, SLACK Incorporated.

Superpixel guided active contour segmentation of retinal layers in OCT volumes

NASA Astrophysics Data System (ADS)

Bai, Fangliang; Gibson, Stuart J.; Marques, Manuel J.; Podoleanu, Adrian

2018-03-01

Retinal OCT image segmentation is a precursor to subsequent medical diagnosis by a clinician or machine learning algorithm. In the last decade, many algorithms have been proposed to detect retinal layer boundaries and simplify the image representation. Inspired by the recent success of superpixel methods for pre-processing natural images, we present a novel framework for segmentation of retinal layers in OCT volume data. In our framework, the region of interest (e.g. the fovea) is located using an adaptive-curve method. The cell layer boundaries are then robustly detected firstly using 1D superpixels, applied to A-scans, and then fitting active contours in B-scan images. Thereafter the 3D cell layer surfaces are efficiently segmented from the volume data. The framework was tested on healthy eye data and we show that it is capable of segmenting up to 12 layers. The experimental results imply the effectiveness of proposed method and indicate its robustness to low image resolution and intrinsic speckle noise.

Automated identification of cone photoreceptors in adaptive optics retinal images.

PubMed

Li, Kaccie Y; Roorda, Austin

2007-05-01

In making noninvasive measurements of the human cone mosaic, the task of labeling each individual cone is unavoidable. Manual labeling is a time-consuming process, setting the motivation for the development of an automated method. An automated algorithm for labeling cones in adaptive optics (AO) retinal images is implemented and tested on real data. The optical fiber properties of cones aided the design of the algorithm. Out of 2153 manually labeled cones from six different images, the automated method correctly identified 94.1% of them. The agreement between the automated and the manual labeling methods varied from 92.7% to 96.2% across the six images. Results between the two methods disagreed for 1.2% to 9.1% of the cones. Voronoi analysis of large montages of AO retinal images confirmed the general hexagonal-packing structure of retinal cones as well as the general cone density variability across portions of the retina. The consistency of our measurements demonstrates the reliability and practicality of having an automated solution to this problem.

Angiography with a multifunctional line scanning ophthalmoscope

PubMed Central

Ferguson, R. Daniel; Patel, Ankit H.; Vazquez, Vanessa; Husain, Deeba

2012-01-01

Abstract. A multifunctional line scanning ophthalmoscope (mLSO) was designed, constructed, and tested on human subjects. The mLSO could sequentially acquire wide-field, confocal, near-infrared reflectance, fluorescein angiography (FA), and indocyanine green angiography (ICGA) retinal images. The system also included a retinal tracker (RT) and a photodynamic therapy laser treatment port. The mLSO was tested in a pilot clinical study on human subjects with and without retinal disease. The instrument exhibited robust retinal tracking and high-contrast line scanning imaging. The FA and ICGA angiograms showed a similar appearance of hyper- and hypo-pigmented disease features and a nearly equivalent resolution of fine capillaries compared to a commercial flood-illumination fundus imager. An mLSO-based platform will enable researchers and clinicians to image human and animal eyes with a variety of modalities and deliver therapeutic beams from a single automated interface. This approach has the potential to improve patient comfort and reduce imaging session times, allowing clinicians to better diagnose, plan, and conduct patient procedures with improved outcomes. PMID:22463040

Characteristics of eyes with inner retinal cleavage.

PubMed

Hwang, Young Hoon; Kim, Yong Yeon; Kim, Hwang Ki; Sohn, Yong Ho

2015-02-01

Inner retinal cleavage can be misdiagnosed as a glaucomatous retinal nerve fiber layer (RNFL) defect. This study was performed to characterize eyes with inner retinal cleavage. Inner retinal cleavage is defined as the appearance of a dark spindle-shaped space between the nerve fibers. Patients who presented at our institution with inner retinal cleavage were enrolled in the study. All participants were evaluated by fundus examination, visual field testing with standard automated perimetry, and optical coherence tomography (OCT) imaging. A total of 15 eyes of 11 subjects with inner retinal cleavage were included in the study. The median age of the subjects was 57 years (age range, 30-67 years). In each case, inner retinal cleavage was located adjacent to retinal blood vessels. Tissue bridging the cleavage area was observed in ten eyes. Six eyes had epiretinal membranes (ERMs), two eyes had glaucoma, and one eye had ERM in addition to glaucoma. Six eyes with inner retinal cleavage without combined ocular abnormalities had highly myopic refractive error (-6.50 to -8.50 diopters). Cross-sectional OCT images of the areas of inner retinal cleavage demonstrated defects with irregular margins and empty spaces in the inner layers of the retina. During the follow-up period, no eye showed changes in inner retinal layer cleavage or visual field sensitivity. Inner retinal cleavage was found in eyes with high myopia or ERMs. Inner retinal cleavage was associated with structural changes distinct from those associated with glaucomatous RNFL defects.

Robust adaptive optics systems for vision science

NASA Astrophysics Data System (ADS)

Burns, S. A.; de Castro, A.; Sawides, L.; Luo, T.; Sapoznik, K.

2018-02-01

Adaptive Optics (AO) is of growing importance for understanding the impact of retinal and systemic diseases on the retina. While AO retinal imaging in healthy eyes is now routine, AO imaging in older eyes and eyes with optical changes to the anterior eye can be difficult and requires a control and an imaging system that is resilient when there is scattering and occlusion from the cornea and lens, as well as in the presence of irregular and small pupils. Our AO retinal imaging system combines evaluation of local image quality of the pupil, with spatially programmable detection. The wavefront control system uses a woofer tweeter approach, combining an electromagnetic mirror and a MEMS mirror and a single Shack Hartmann sensor. The SH sensor samples an 8 mm exit pupil and the subject is aligned to a region within this larger system pupil using a chin and forehead rest. A spot quality metric is calculated in real time for each lenslet. Individual lenslets that do not meet the quality metric are eliminated from the processing. Mirror shapes are smoothed outside the region of wavefront control when pupils are small. The system allows imaging even with smaller irregular pupils, however because the depth of field increases under these conditions, sectioning performance decreases. A retinal conjugate micromirror array selectively directs mid-range scatter to additional detectors. This improves detection of retinal capillaries even when the confocal image has poorer image quality that includes both photoreceptors and blood vessels.

Laser-induced retinal damage thresholds for annular retinal beam profiles

NASA Astrophysics Data System (ADS)

Kennedy, Paul K.; Zuclich, Joseph A.; Lund, David J.; Edsall, Peter R.; Till, Stephen; Stuck, Bruce E.; Hollins, Richard C.

2004-07-01

The dependence of retinal damage thresholds on laser spot size, for annular retinal beam profiles, was measured in vivo for 3 μs, 590 nm pulses from a flashlamp-pumped dye laser. Minimum Visible Lesion (MVL)ED50 thresholds in rhesus were measured for annular retinal beam profiles covering 5, 10, and 20 mrad of visual field; which correspond to outer beam diameters of roughly 70, 160, and 300 μm, respectively, on the primate retina. Annular beam profiles at the retinal plane were achieved using a telescopic imaging system, with the focal properties of the eye represented as an equivalent thin lens, and all annular beam profiles had a 37% central obscuration. As a check on experimental data, theoretical MVL-ED50 thresholds for annular beam exposures were calculated using the Thompson-Gerstman granular model of laser-induced thermal damage to the retina. Threshold calculations were performed for the three experimental beam diameters and for an intermediate case with an outer beam diameter of 230 μm. Results indicate that the threshold vs. spot size trends, for annular beams, are similar to the trends for top hat beams determined in a previous study; i.e., the threshold dose varies with the retinal image area for larger image sizes. The model correctly predicts the threshold vs. spot size trends seen in the biological data, for both annular and top hat retinal beam profiles.

Incremental retinal-defocus theory of myopia development--schematic analysis and computer simulation.

PubMed

Hung, George K; Ciuffreda, Kenneth J

2007-07-01

Previous theories of myopia development involved subtle and complex processes such as the sensing and analyzing of chromatic aberration, spherical aberration, spatial gradient of blur, or spatial frequency content of the retinal image, but they have not been able to explain satisfactorily the diverse experimental results reported in the literature. On the other hand, our newly proposed incremental retinal-defocus theory (IRDT) has been able to explain all of these results. This theory is based on a relatively simple and direct mechanism for the regulation of ocular growth. It states that a time-averaged decrease in retinal-image defocus area decreases the rate of release of retinal neuromodulators, which decreases the rate of retinal proteoglycan synthesis with an associated decrease in scleral structural integrity. This increases the rate of scleral growth, and in turn the eye's axial length, which leads to myopia. Our schematic analysis has provided a clear explanation for the eye's ability to grow in the appropriate direction under a wide range of experimental conditions. In addition, the theory has been able to explain how repeated cycles of nearwork-induced transient myopia leads to repeated periods of decreased retinal-image defocus, whose cumulative effect over an extended period of time results in an increase in axial growth that leads to permanent myopia. Thus, this unifying theory forms the basis for understanding the underlying retinal and scleral mechanisms of myopia development.

MULTIMODAL IMAGING IN VORTEX VEIN VARICES.

PubMed

Veronese, Chiara; Staurenghi, Giovanni; Pellegrini, Marco; Maiolo, Chiara; Primavera, Laura; Morara, Mariachiara; Armstrong, Grayson W; Ciardella, Antonio P

2017-03-22

The aim of this study is to describe the clinical presentation of vortex vein varices with multimodal imaging. The authors carried out a retrospective case series of eight patients (7 female, 1 male) with an average age of 60.2 years (min 8, max 84, median 68.5) presenting with vortex vein varices. All patients were evaluated at the Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy and at Luigi Sacco Hospital, University of Milan, Milan, Italy. Patients underwent complete ophthalmologic examinations, including best corrected visual acuity, intraocular pressure, anterior segment, and fundus examination. Imaging studies, including fundus color photography, near-infrared reflectance imaging, fundus autofluorescence, fluorescein angiography, indocyanine green angiography, and spectral-domain enhanced depth imaging optical coherence tomography were also performed. Ultra-widefield fluorescein angiography and ultra-widefield indocyanine angiography using the Heidelberg Retina Angiograph and the Staurenghi 230 SLO Retina Lens were used to demonstrate the disappearance of all retinal lesions when pressure was applied to the globe. All eight cases initially presented to the emergency room. One patient presented secondary to trauma, two patients presented for suspected hemangioma, whereas the other five were referred to the authors' hospitals for suspected retinal lesions. On examination, retinal abnormalities were identified in all 8 patients, with 7 (87.5%) oculus dexter and 1 (12.5%) oculus sinister, and with 1 (12.5%) inferotemporally, 3 (37.5%) superonasally, 3 (37.5%) inferonasally, and 1 (12.5%) inferiorly. Fundus color photography showed an elevated lesion in seven patients and a nonelevated red lesion in one patient. In all patients, near-infrared reflectance imaging showed a hyporeflective lesion in the periphery of the retina. Fundus autofluorescence identified round hypofluorescent rings surrounding weakly hyperfluorescent lesions in all patients. On fluorescein angiography, all lesions were initially hyperfluorescent with a hypofluorescent ring, with the lesion becoming hyperfluorescent after injection of dye. Indocyanine green angiography demonstrated dilation of the vortex vein ampullae in all patients. Spectral-domain enhanced depth imaging optical coherence tomography demonstrated dilated choroidal vessels and a hyporeflective cavity without subretinal fluid in all patients. Ultra-widefield fluorescein angiography and ultra-widefield indocyanine angiography demonstrated disappearance of all retinal lesions when pressure was applied to the globe. Findings are consistent with the diagnosis of vortex vein varix in all eight patients, with six patients (75%) exhibiting a single varix and two patients (25%) exhibiting a double varix. The diagnosis of vortex vein varices can be confirmed through clinical examination through the use of digital pressure to the globe during ophthalmoscopic examination. Adjunctive multimodal imaging (fundus color photography, near-infrared reflectance imaging, fundus autofluorescence, fluorescein angiography, indocyanine angiography, and spectral-domain enhanced depth imaging optical coherence tomography) was useful in the diagnosis of vortex vein varices in the authors' clinical cases. However, in more challenging clinical cases, the authors' novel use of the ultra-widefield contact lens for application of ocular pressure with a resulting resolution of the varix proved to be a useful and easy diagnostic imaging method for confirming the presence of vortex vein varices.

Classification of Human Retinal Microaneurysms Using Adaptive Optics Scanning Light Ophthalmoscope Fluorescein Angiography

PubMed Central

Dubow, Michael; Pinhas, Alexander; Shah, Nishit; Cooper, Robert F.; Gan, Alexander; Gentile, Ronald C.; Hendrix, Vernon; Sulai, Yusufu N.; Carroll, Joseph; Chui, Toco Y. P.; Walsh, Joseph B.; Weitz, Rishard; Dubra, Alfredo; Rosen, Richard B.

2014-01-01

Purpose. Microaneurysms (MAs) are considered a hallmark of retinal vascular disease, yet what little is known about them is mostly based upon histology, not clinical observation. Here, we use the recently developed adaptive optics scanning light ophthalmoscope (AOSLO) fluorescein angiography (FA) to image human MAs in vivo and to expand on previously described MA morphologic classification schemes. Methods. Patients with vascular retinopathies (diabetic, hypertensive, and branch and central retinal vein occlusion) were imaged with reflectance AOSLO and AOSLO FA. Ninety-three MAs, from 14 eyes, were imaged and classified according to appearance into six morphologic groups: focal bulge, saccular, fusiform, mixed, pedunculated, and irregular. The MA perimeter, area, and feret maximum and minimum were correlated to morphology and retinal pathology. Select MAs were imaged longitudinally in two eyes. Results. Adaptive optics scanning light ophthalmoscope fluorescein angiography imaging revealed microscopic features of MAs not appreciated on conventional images. Saccular MAs were most prevalent (47%). No association was found between the type of retinal pathology and MA morphology (P = 0.44). Pedunculated and irregular MAs were among the largest MAs with average areas of 4188 and 4116 μm2, respectively. Focal hypofluorescent regions were noted in 30% of MAs and were more likely to be associated with larger MAs (3086 vs. 1448 μm2, P = 0.0001). Conclusions. Retinal MAs can be classified in vivo into six different morphologic types, according to the geometry of their two-dimensional (2D) en face view. Adaptive optics scanning light ophthalmoscope fluorescein angiography imaging of MAs offers the possibility of studying microvascular change on a histologic scale, which may help our understanding of disease progression and treatment response. PMID:24425852

High resolution multimodal clinical ophthalmic imaging system

PubMed Central

Mujat, Mircea; Ferguson, R. Daniel; Patel, Ankit H.; Iftimia, Nicusor; Lue, Niyom; Hammer, Daniel X.

2010-01-01

We developed a multimodal adaptive optics (AO) retinal imager which is the first to combine high performance AO-corrected scanning laser ophthalmoscopy (SLO) and swept source Fourier domain optical coherence tomography (SSOCT) imaging modes in a single compact clinical prototype platform. Such systems are becoming ever more essential to vision research and are expected to prove their clinical value for diagnosis of retinal diseases, including glaucoma, diabetic retinopathy (DR), age-related macular degeneration (AMD), and retinitis pigmentosa. The SSOCT channel operates at a wavelength of 1 µm for increased penetration and visualization of the choriocapillaris and choroid, sites of major disease activity for DR and wet AMD. This AO system is designed for use in clinical populations; a dual deformable mirror (DM) configuration allows simultaneous low- and high-order aberration correction over a large range of refractions and ocular media quality. The system also includes a wide field (33 deg.) line scanning ophthalmoscope (LSO) for initial screening, target identification, and global orientation, an integrated retinal tracker (RT) to stabilize the SLO, OCT, and LSO imaging fields in the presence of lateral eye motion, and a high-resolution LCD-based fixation target for presentation of visual cues. The system was tested in human subjects without retinal disease for performance optimization and validation. We were able to resolve and quantify cone photoreceptors across the macula to within ~0.5 deg (~100-150 µm) of the fovea, image and delineate ten retinal layers, and penetrate to resolve features deep into the choroid. The prototype presented here is the first of a new class of powerful flexible imaging platforms that will provide clinicians and researchers with high-resolution, high performance adaptive optics imaging to help guide therapies, develop new drugs, and improve patient outcomes. PMID:20589021

Meaning of visualizing retinal cone mosaic on adaptive optics images.

PubMed

Jacob, Julie; Paques, Michel; Krivosic, Valérie; Dupas, Bénédicte; Couturier, Aude; Kulcsar, Caroline; Tadayoni, Ramin; Massin, Pascale; Gaudric, Alain

2015-01-01

To explore the anatomic correlation of the retinal cone mosaic on adaptive optics images. Retrospective nonconsecutive observational case series. A retrospective review of the multimodal imaging charts of 6 patients with focal alteration of the cone mosaic on adaptive optics was performed. Retinal diseases included acute posterior multifocal placoid pigment epitheliopathy (n = 1), hydroxychloroquine retinopathy (n = 1), and macular telangiectasia type 2 (n = 4). High-resolution retinal images were obtained using a flood-illumination adaptive optics camera. Images were recorded using standard imaging modalities: color and red-free fundus camera photography; infrared reflectance scanning laser ophthalmoscopy, fluorescein angiography, indocyanine green angiography, and spectral-domain optical coherence tomography (OCT) images. On OCT, in the marginal zone of the lesions, a disappearance of the interdigitation zone was observed, while the ellipsoid zone was preserved. Image recording demonstrated that such attenuation of the interdigitation zone co-localized with the disappearance of the cone mosaic on adaptive optics images. In 1 case, the restoration of the interdigitation zone paralleled that of the cone mosaic after a 2-month follow-up. Our results suggest that the interdigitation zone could contribute substantially to the reflectance of the cone photoreceptor mosaic. The absence of cones on adaptive optics images does not necessarily mean photoreceptor cell death. Copyright © 2015 Elsevier Inc. All rights reserved.

Application of morphological bit planes in retinal blood vessel extraction.

PubMed

Fraz, M M; Basit, A; Barman, S A

2013-04-01

The appearance of the retinal blood vessels is an important diagnostic indicator of various clinical disorders of the eye and the body. Retinal blood vessels have been shown to provide evidence in terms of change in diameter, branching angles, or tortuosity, as a result of ophthalmic disease. This paper reports the development for an automated method for segmentation of blood vessels in retinal images. A unique combination of methods for retinal blood vessel skeleton detection and multidirectional morphological bit plane slicing is presented to extract the blood vessels from the color retinal images. The skeleton of main vessels is extracted by the application of directional differential operators and then evaluation of combination of derivative signs and average derivative values. Mathematical morphology has been materialized as a proficient technique for quantifying the retinal vasculature in ocular fundus images. A multidirectional top-hat operator with rotating structuring elements is used to emphasize the vessels in a particular direction, and information is extracted using bit plane slicing. An iterative region growing method is applied to integrate the main skeleton and the images resulting from bit plane slicing of vessel direction-dependent morphological filters. The approach is tested on two publicly available databases DRIVE and STARE. Average accuracy achieved by the proposed method is 0.9423 for both the databases with significant values of sensitivity and specificity also; the algorithm outperforms the second human observer in terms of precision of segmented vessel tree.

In Vivo Confocal Intrinsic Optical Signal Identification of Localized Retinal Dysfunction

PubMed Central

Zhang, Qiu-Xiang; Lu, Rong-Wen; Curcio, Christine A.; Yao, Xin-Cheng

2012-01-01

Purpose. The purposes of this study were to investigate the physiological mechanism of stimulus-evoked fast intrinsic optical signals (IOSs) recorded in dynamic confocal imaging of the retina, and to demonstrate the feasibility of in vivo confocal IOS mapping of localized retinal dysfunctions. Methods. A rapid line-scan confocal ophthalmoscope was constructed to achieve in vivo confocal IOS imaging of frog (Rana pipiens) retinas at cellular resolution. In order to investigate the physiological mechanism of confocal IOS, comparative IOS and electroretinography (ERG) measurements were made using normal frog eyes activated by variable-intensity stimuli. A dynamic spatiotemporal filtering algorithm was developed to reject the contamination of hemodynamic changes on fast IOS recording. Laser-injured frog eyes were employed to test the potential of confocal IOS mapping of localized retinal dysfunctions. Results. Comparative IOS and ERG experiments revealed a close correlation between the confocal IOS and retinal ERG, particularly the ERG a-wave, which has been widely used to evaluate photoreceptor function. IOS imaging of laser-injured frog eyes indicated that the confocal IOS could unambiguously detect localized (30 μm) functional lesions in the retina before a morphological abnormality is detectable. Conclusions. The confocal IOS predominantly results from retinal photoreceptors, and can be used to map localized photoreceptor lesion in laser-injured frog eyes. We anticipate that confocal IOS imaging can provide applications in early detection of age-related macular degeneration, retinitis pigmentosa, and other retinal diseases that can cause pathological changes in the photoreceptors. PMID:23150616

Teleretinal Imaging to Screen for Diabetic Retinopathy in the Veterans Health Administration

PubMed Central

Cavallerano, Anthony A.; Conlin, Paul R.

2008-01-01

Diabetes is the leading cause of adult vision loss in the United States and other industrialized countries. While the goal of preserving vision in patients with diabetes appears to be attainable, the process of achieving this goal poses a formidable challenge to health care systems. The large increase in the prevalence of diabetes presents practical and logistical challenges to providing quality care to all patients with diabetes. Given this challenge, the Veterans Health Administration (VHA) is increasingly using information technology as a means of improving the efficiency of its clinicians. The VHA has taken advantage of a mature computerized patient medical record system by integrating a program of digital retinal imaging with remote image interpretation (teleretinal imaging) to assist in providing eye care to the nearly 20% of VHA patients with diabetes. We describe this clinical pathway for accessing patients with diabetes in ambulatory care settings, evaluating their retinas for level of diabetic retinopathy with a teleretinal imaging system, and prioritizing their access into an eye and health care program in a timely and appropriate manner. PMID:19885175

Enhanced retinal vasculature imaging with a rapidly configurable aperture

PubMed Central

Sapoznik, Kaitlyn A.; Luo, Ting; de Castro, Alberto; Sawides, Lucie; Warner, Raymond L.; Burns, Stephen A.

2018-01-01

In adaptive optics scanning laser ophthalmoscope (AOSLO) systems, capturing multiply scattered light can increase the contrast of the retinal microvasculature structure, cone inner segments, and retinal ganglion cells. Current systems generally use either a split detector or offset aperture approach to collect this light. We tested the ability of a spatial light modulator (SLM) as a rapidly configurable aperture to use more complex shapes to enhance the contrast of retinal structure. Particularly, we varied the orientation of a split detector aperture and explored the use of a more complex shape, the half annulus, to enhance the contrast of the retinal vasculature. We used the new approach to investigate the influence of scattering distance and orientation on vascular imaging. PMID:29541524

A novel method for segmentation of Infrared Scanning Laser Ophthalmoscope (IR-SLO) images of retina.

PubMed

Ajaz, Aqsa; Aliahmad, Behzad; Kumar, Dinesh K

2017-07-01

Retinal vessel segmentation forms an essential element of automatic retinal disease screening systems. The development of multimodal imaging system with IR-SLO and OCT could help in studying the early stages of retinal disease. The advantages of IR-SLO to examine the alterations in the structure of retina and direct correlation with OCT can be useful for assessment of various diseases. This paper presents an automatic method for segmentation of IR-SLO fundus images based on the combination of morphological filters and image enhancement techniques. As a first step, the retinal vessels are contrasted using morphological filters followed by background exclusion using Contrast Limited Adaptive Histogram Equalization (CLAHE) and Bilateral filtering. The final segmentation is obtained by using Isodata technique. Our approach was tested on a set of 26 IR-SLO images and results were compared to two set of gold standard images. The performance of the proposed method was evaluated in terms of sensitivity, specificity and accuracy. The system has an average accuracy of 0.90 for both the sets.

The Diabetic Retinopathy Screening Workflow

PubMed Central

Bolster, Nigel M.; Giardini, Mario E.; Bastawrous, Andrew

2015-01-01

Complications of diabetes mellitus, namely diabetic retinopathy and diabetic maculopathy, are the leading cause of blindness in working aged people. Sufferers can avoid blindness if identified early via retinal imaging. Systematic screening of the diabetic population has been shown to greatly reduce the prevalence and incidence of blindness within the population. Many national screening programs have digital fundus photography as their basis. In the past 5 years several techniques and adapters have been developed that allow digital fundus photography to be performed using smartphones. We review recent progress in smartphone-based fundus imaging and discuss its potential for integration into national systematic diabetic retinopathy screening programs. Some systems have produced promising initial results with respect to their agreement with reference standards. However further multisite trialling of such systems’ use within implementable screening workflows is required if an evidence base strong enough to affect policy change is to be established. If this were to occur national diabetic retinopathy screening would, for the first time, become possible in low- and middle-income settings where cost and availability of trained eye care personnel are currently key barriers to implementation. As diabetes prevalence and incidence is increasing sharply in these settings, the impact on global blindness could be profound. PMID:26596630

An improved arteriovenous classification method for the early diagnostics of various diseases in retinal image.

PubMed

Xu, Xiayu; Ding, Wenxiang; Abràmoff, Michael D; Cao, Ruofan

2017-04-01

Retinal artery and vein classification is an important task for the automatic computer-aided diagnosis of various eye diseases and systemic diseases. This paper presents an improved supervised artery and vein classification method in retinal image. Intra-image regularization and inter-subject normalization is applied to reduce the differences in feature space. Novel features, including first-order and second-order texture features, are utilized to capture the discriminating characteristics of arteries and veins. The proposed method was tested on the DRIVE dataset and achieved an overall accuracy of 0.923. This retinal artery and vein classification algorithm serves as a potentially important tool for the early diagnosis of various diseases, including diabetic retinopathy and cardiovascular diseases. Copyright © 2017 Elsevier B.V. All rights reserved.

Acute progressive paravascular placoid neuroretinopathy with negative-type electroretinography in paraneoplastic retinopathy.

PubMed

Chen, Fred K; Chew, Avenell L; Zhang, Dan; Chen, Shang-Chih; Chelva, Enid; Chandrasekera, Erandi; Koay, Eleanor M H; Forrester, John; McLenachan, Samuel

2017-06-01

Paraneoplastic retinopathy can be the first manifestation of systemic malignancy. A subset of paraneoplastic retinopathy is characterized by negative-type electroretinography (ERG) without fundus abnormality. Here we describe the multimodal imaging and clinico-pathological correlation of a unique case of acute progressive paravascular placoid neuroretinopathy with suspected retinal depolarizing bipolar cell dysfunction preceding the diagnosis of metastatic small cell carcinoma of the prostate. ERG was performed according to the International Society for Clinical Electrophysiology of Vision standards. Imaging modalities included near-infrared reflectance, blue-light autofluorescence, fluorescein and indocyanine green angiographies, spectral domain optical coherence tomography, ultra-widefield colour and green-light autofluorescence imaging, microperimetry and adaptive optics imaging. Patient serum was screened for anti-retinal antibodies using western blotting. Immunostaining and histological analyses were performed on sections from human retinal tissues and a patient prostate biopsy. Serial multimodal retinal imaging, microperimetry and adaptive optics photography demonstrated a paravascular distribution of placoid lesions characterized by hyper-reflectivity within the outer nuclear layer resembling type 2 acute macular neuroretinopathy. There was no visible lesion within the inner nuclear layer despite electronegative-type ERG. Six months later, the patient presented with metastatic small cell carcinoma of the prostate. Tumour cells were immunopositive for glyceraldehyde-3-phosphate dehydrogenase, enolase and recoverin as well as neuroendocrine markers. The patient's serum reacted to cytoplasmic and nuclear antigens in the prostate biopsy and in human retina. Anti-retinal antibodies against several antigens were detected by both commercial and in-house western blots. A spectrum of autoreactive anti-retinal antibodies is associated with a unique phenotype of acute progressive paravascular placoid neuroretinopathy resulting in degeneration of photoreceptor cells, inner retinal dysfunction and classic electronegative ERG in paraneoplastic retinopathy. Detailed clinical, functional and immunological phenotyping of paraneoplastic retinopathy illustrated the complex mechanism of paraneoplastic syndrome.

Integration of a Spectral Domain Optical Coherence Tomography System into a Surgical Microscope for Intraoperative Imaging

PubMed Central

Ehlers, Justis P.; Tao, Yuankai K.; Farsiu, Sina; Maldonado, Ramiro; Izatt, Joseph A.

2011-01-01

Purpose. To demonstrate an operating microscope-mounted spectral domain optical coherence tomography (MMOCT) system for human retinal and model surgery imaging. Methods. A prototype MMOCT system was developed to interface directly with an ophthalmic surgical microscope, to allow SDOCT imaging during surgical viewing. Nonoperative MMOCT imaging was performed in an Institutional Review Board–approved protocol in four healthy volunteers. The effect of surgical instrument materials on MMOCT imaging was evaluated while performing retinal surface, intraretinal, and subretinal maneuvers in cadaveric porcine eyes. The instruments included forceps, metallic and polyamide subretinal needles, and soft silicone-tipped instruments, with and without diamond dusting. Results. High-resolution images of the human retina were successfully obtained with the MMOCT system. The optical properties of surgical instruments affected the visualization of the instrument and the underlying retina. Metallic instruments (e.g., forceps and needles) showed high reflectivity with total shadowing below the instrument. Polyamide material had a moderate reflectivity with subtotal shadowing. Silicone instrumentation showed moderate reflectivity with minimal shadowing. Summed voxel projection MMOCT images provided clear visualization of the instruments, whereas the B-scans from the volume revealed details of the interactions between the tissues and the instrumentation (e.g., subretinal space cannulation, retinal elevation, or retinal holes). Conclusions. High-quality retinal imaging is feasible with an MMOCT system. Intraoperative imaging with model eyes provides high-resolution depth information including visualization of the instrument and intraoperative tissue manipulation. This study demonstrates a key component of an interactive platform that could provide enhanced information for the vitreoretinal surgeon. PMID:21282565

Integration of a spectral domain optical coherence tomography system into a surgical microscope for intraoperative imaging.

PubMed

Ehlers, Justis P; Tao, Yuankai K; Farsiu, Sina; Maldonado, Ramiro; Izatt, Joseph A; Toth, Cynthia A

2011-05-16

To demonstrate an operating microscope-mounted spectral domain optical coherence tomography (MMOCT) system for human retinal and model surgery imaging. A prototype MMOCT system was developed to interface directly with an ophthalmic surgical microscope, to allow SDOCT imaging during surgical viewing. Nonoperative MMOCT imaging was performed in an Institutional Review Board-approved protocol in four healthy volunteers. The effect of surgical instrument materials on MMOCT imaging was evaluated while performing retinal surface, intraretinal, and subretinal maneuvers in cadaveric porcine eyes. The instruments included forceps, metallic and polyamide subretinal needles, and soft silicone-tipped instruments, with and without diamond dusting. High-resolution images of the human retina were successfully obtained with the MMOCT system. The optical properties of surgical instruments affected the visualization of the instrument and the underlying retina. Metallic instruments (e.g., forceps and needles) showed high reflectivity with total shadowing below the instrument. Polyamide material had a moderate reflectivity with subtotal shadowing. Silicone instrumentation showed moderate reflectivity with minimal shadowing. Summed voxel projection MMOCT images provided clear visualization of the instruments, whereas the B-scans from the volume revealed details of the interactions between the tissues and the instrumentation (e.g., subretinal space cannulation, retinal elevation, or retinal holes). High-quality retinal imaging is feasible with an MMOCT system. Intraoperative imaging with model eyes provides high-resolution depth information including visualization of the instrument and intraoperative tissue manipulation. This study demonstrates a key component of an interactive platform that could provide enhanced information for the vitreoretinal surgeon.

RETINAL DEEP CAPILLARY ISCHEMIA ASSOCIATED WITH AN OCCLUDED CONGENITAL RETINAL MACROVESSEL.

PubMed

Hasegawa, Taiji; Ogata, Nahoko

2017-01-01

To report the case of a patient with an occluded congenital retinal macrovessel accompanied by retinal deep capillary ischemia. A 38-year-old woman presented with a 2-day history of a paracentral scotoma of her right eye. Fundus photograph showed a dilated congenital retinal macrovessel with arteriovenous anastomosis, an intravascular white region indicating the thrombus at arteriovenous anastomotic region, and an area of retinal whitening temporal to the fovea. The spectral domain optical coherence tomography images through the area of retinal whitening showed a thickening and highly reflectivity at the level of the inner nuclear layer, which is likely due to the deep capillary ischemia. After 6 weeks, spectral domain optical coherence tomography images through the same area demonstrated a thinning and atrophy of only the inner nuclear layer, and the patient's paracentral scotoma persisted. Acute capillary hemodynamic changes caused deep capillary ischemia. The spectral domain optical coherence tomography showed a highly reflective lesion at the level of the inner nuclear layer in the acute phase.

A new approach to optic disc detection in human retinal images using the firefly algorithm.

PubMed

Rahebi, Javad; Hardalaç, Fırat

2016-03-01

There are various methods and algorithms to detect the optic discs in retinal images. In recent years, much attention has been given to the utilization of the intelligent algorithms. In this paper, we present a new automated method of optic disc detection in human retinal images using the firefly algorithm. The firefly intelligent algorithm is an emerging intelligent algorithm that was inspired by the social behavior of fireflies. The population in this algorithm includes the fireflies, each of which has a specific rate of lighting or fitness. In this method, the insects are compared two by two, and the less attractive insects can be observed to move toward the more attractive insects. Finally, one of the insects is selected as the most attractive, and this insect presents the optimum response to the problem in question. Here, we used the light intensity of the pixels of the retinal image pixels instead of firefly lightings. The movement of these insects due to local fluctuations produces different light intensity values in the images. Because the optic disc is the brightest area in the retinal images, all of the insects move toward brightest area and thus specify the location of the optic disc in the image. The results of implementation show that proposed algorithm could acquire an accuracy rate of 100 % in DRIVE dataset, 95 % in STARE dataset, and 94.38 % in DiaRetDB1 dataset. The results of implementation reveal high capability and accuracy of proposed algorithm in the detection of the optic disc from retinal images. Also, recorded required time for the detection of the optic disc in these images is 2.13 s for DRIVE dataset, 2.81 s for STARE dataset, and 3.52 s for DiaRetDB1 dataset accordingly. These time values are average value.

A Review of Algorithms for Segmentation of Optical Coherence Tomography from Retina

PubMed Central

Kafieh, Raheleh; Rabbani, Hossein; Kermani, Saeed

2013-01-01

Optical coherence tomography (OCT) is a recently established imaging technique to describe different information about the internal structures of an object and to image various aspects of biological tissues. OCT image segmentation is mostly introduced on retinal OCT to localize the intra-retinal boundaries. Here, we review some of the important image segmentation methods for processing retinal OCT images. We may classify the OCT segmentation approaches into five distinct groups according to the image domain subjected to the segmentation algorithm. Current researches in OCT segmentation are mostly based on improving the accuracy and precision, and on reducing the required processing time. There is no doubt that current 3-D imaging modalities are now moving the research projects toward volume segmentation along with 3-D rendering and visualization. It is also important to develop robust methods capable of dealing with pathologic cases in OCT imaging. PMID:24083137

In vivo thickness and birefringence determination of the human retinal nerve fiber layer using polarization-sensitive optical coherence tomography.

PubMed

Cense, B; Chen, T C; de Boer, J F

2006-01-01

Thinning of the retinal nerve fiber layer and changes in retinal nerve fiber layer birefringence may both precede clinically detectable glaucomatous vision loss. We present in vivo thickness and depth-resolved birefringence measurements of the human retinal nerve fiber layer (RNFL) by use of polarization-sensitive optical coherence tomography (PS-OCT). Using a fiber-based PS-OCT setup real-time images of the human retina in vivo were recorded, co-registered with retinal video images of the location of PS-OCT scans. PS-OCT scans around the optic nerve head (ONH) of two healthy young volunteers were made using 10 concentric circles of increasing radius. Both the mean retinal nerve fiber layer thickness and mean retinal nerve fiber birefringence for each of 48 sectors on a circle were determined. The retinal nerve fiber layer thickness and birefringence varied as a function of sector around the ONH. Measured double pass phase retardation per unit depth values around the ONH range between 0.10 and 0.35 degrees/microm. The retinal nerve fiber layer becomes thinner with increasing distance from the ONH. In contrast, the birefringence does not vary significantly with increasing distance from the ONH.

High-Resolution Images of Retinal Structure in Patients with Choroideremia

PubMed Central

Syed, Reema; Sundquist, Sanna M.; Ratnam, Kavitha; Zayit-Soudry, Shiri; Zhang, Yuhua; Crawford, J. Brooks; MacDonald, Ian M.; Godara, Pooja; Rha, Jungtae; Carroll, Joseph; Roorda, Austin; Stepien, Kimberly E.; Duncan, Jacque L.

2013-01-01

Purpose. To study retinal structure in choroideremia patients and carriers using high-resolution imaging techniques. Methods. Subjects from four families (six female carriers and five affected males) with choroideremia (CHM) were characterized with best-corrected visual acuity (BCVA), kinetic and static perimetry, full-field electroretinography, and fundus autofluorescence (FAF). High-resolution macular images were obtained with adaptive optics scanning laser ophthalmoscopy (AOSLO) and spectral domain optical coherence tomography (SD-OCT). Coding regions of the CHM gene were sequenced. Results. Molecular analysis of the CHM gene identified a deletion of exons 9 to 15 in family A, a splice site mutation at position 79+1 of exon 1 in family B, deletion of exons 6 to 8 in family C, and a substitution at position 106 causing a premature stop in family D. BCVA ranged from 20/16 to 20/63 in carriers and from 20/25 to 5/63 in affected males. FAF showed abnormalities in all subjects. SD-OCT showed outer retinal layer loss, outer retinal tubulations at the margin of outer retinal loss, and inner retinal microcysts. Patchy cone loss was present in two symptomatic carriers. In two affected males, cone mosaics were disrupted with increased cone spacing near the fovea but more normal cone spacing near the edge of atrophy. Conclusions. High-resolution retinal images in CHM carriers and affected males demonstrated RPE and photoreceptor cell degeneration. As both RPE and photoreceptor cells were affected, these cell types may degenerate simultaneously in CHM. These findings provide insight into the effect of CHM mutations on macular retinal structure, with implications for the development of treatments for CHM. (ClinicalTrials.gov number, NCT00254605.) PMID:23299470

High-resolution images of retinal structure in patients with choroideremia.

PubMed

Syed, Reema; Sundquist, Sanna M; Ratnam, Kavitha; Zayit-Soudry, Shiri; Zhang, Yuhua; Crawford, J Brooks; MacDonald, Ian M; Godara, Pooja; Rha, Jungtae; Carroll, Joseph; Roorda, Austin; Stepien, Kimberly E; Duncan, Jacque L

2013-02-01

To study retinal structure in choroideremia patients and carriers using high-resolution imaging techniques. Subjects from four families (six female carriers and five affected males) with choroideremia (CHM) were characterized with best-corrected visual acuity (BCVA), kinetic and static perimetry, full-field electroretinography, and fundus autofluorescence (FAF). High-resolution macular images were obtained with adaptive optics scanning laser ophthalmoscopy (AOSLO) and spectral domain optical coherence tomography (SD-OCT). Coding regions of the CHM gene were sequenced. Molecular analysis of the CHM gene identified a deletion of exons 9 to 15 in family A, a splice site mutation at position 79+1 of exon 1 in family B, deletion of exons 6 to 8 in family C, and a substitution at position 106 causing a premature stop in family D. BCVA ranged from 20/16 to 20/63 in carriers and from 20/25 to 5/63 in affected males. FAF showed abnormalities in all subjects. SD-OCT showed outer retinal layer loss, outer retinal tubulations at the margin of outer retinal loss, and inner retinal microcysts. Patchy cone loss was present in two symptomatic carriers. In two affected males, cone mosaics were disrupted with increased cone spacing near the fovea but more normal cone spacing near the edge of atrophy. High-resolution retinal images in CHM carriers and affected males demonstrated RPE and photoreceptor cell degeneration. As both RPE and photoreceptor cells were affected, these cell types may degenerate simultaneously in CHM. These findings provide insight into the effect of CHM mutations on macular retinal structure, with implications for the development of treatments for CHM. (ClinicalTrials.gov number, NCT00254605.).

Alterations of the tunica vasculosa lentis in the rat model of retinopathy of prematurity.

PubMed

Favazza, Tara L; Tanimoto, Naoyuki; Munro, Robert J; Beck, Susanne C; Garcia Garrido, Marina; Seide, Christina; Sothilingam, Vithiyanjali; Hansen, Ronald M; Fulton, Anne B; Seeliger, Mathias W; Akula, James D

2013-08-01

To study the relationship between retinal and tunica vasculosa lentis (TVL) disease in retinopathy of prematurity (ROP). Although the clinical hallmark of ROP is abnormal retinal blood vessels, the vessels of the anterior segment, including the TVL, are also altered. ROP was induced in Long-Evans pigmented and Sprague Dawley albino rats; room-air-reared (RAR) rats served as controls. Then, fluorescein angiographic images of the TVL and retinal vessels were serially obtained with a scanning laser ophthalmoscope near the height of retinal vascular disease, ~20 days of age, and again at 30 and 64 days of age. Additionally, electroretinograms (ERGs) were obtained prior to the first imaging session. The TVL images were analyzed for percent coverage of the posterior lens. The tortuosity of the retinal arterioles was determined using Retinal Image multiScale Analysis (Gelman et al. in Invest Ophthalmol Vis Sci 46:4734-4738, 2005). In the youngest ROP rats, the TVL was dense, while in RAR rats, it was relatively sparse. By 30 days, the TVL in RAR rats had almost fully regressed, while in ROP rats, it was still pronounced. By the final test age, the TVL had completely regressed in both ROP and RAR rats. In parallel, the tortuous retinal arterioles in ROP rats resolved with increasing age. ERG components indicating postreceptoral dysfunction, the b-wave, and oscillatory potentials were attenuated in ROP rats. These findings underscore the retinal vascular abnormalities and, for the first time, show abnormal anterior segment vasculature in the rat model of ROP. There is delayed regression of the TVL in the rat model of ROP. This demonstrates that ROP is a disease of the whole eye.

Alterations of the Tunica Vasculosa Lentis in the Rat Model of Retinopathy of Prematurity

PubMed Central

Favazza, Tara L; Tanimoto, Naoyuki; Munro, Robert J.; Beck, Susanne C.; Garrido, Marina G.; Seide, Christina; Sothilingam, Vithiyanjali; Hansen, Ronald M.; Fulton, Anne B.; Seeliger, Mathias W.; Akula, James D

2013-01-01

Purpose To study the relation between retinal and tunica vasculosa lentis (TVL) disease in ROP. Although the clinical hallmark of retinopathy of prematurity (ROP) is abnormal retinal blood vessels, the vessels of the anterior segment, including the TVL, are also altered. Methods ROP was induced in Long Evans pigmented and Sprague-Dawley albino rats; room-air-reared (RAR) rats served as controls. Then, fluorescein angiographic images of the TVL and retinal vessels were serially obtained with a scanning laser ophthalmoscope (SLO) near the height of retinal vascular disease, ∼20 days-of-age, and again at 30 and 64 days-of-age. Additionally, electroretinograms (ERGs) were obtained prior to the first imaging session. The TVL images were analyzed for percent coverage of the posterior lens. The tortuosity of the retinal arterioles was determined using Retinal Image multiScale Analysis (RISA; Gelman et al., 2005). Results In the youngest ROP rats, the TVL was dense, while in RAR rats, it was relatively sparse. By 30 days, the TVL in RAR rats had almost fully regressed, while in ROP rats it was still pronounced. By the final test age, the TVL had completely regressed in both ROP and RAR rats. In parallel, the tortuous retinal arterioles in ROP rats resolved with increasing age. ERG components indicating postreceptoral dysfunction, the b-wave and oscillatory potentials (OPs), were attenuated in ROP rats. Conclusions These findings underscore the retinal vascular abnormalities and, for the first time, show abnormal anterior segment vasculature in the rat model of ROP. There is delayed regression of the TVL in the rat model of ROP. This demonstrates that ROP is a disease of the whole eye. PMID:23748796

Retinal optical coherence tomography at 1 μm with dynamic focus control and axial motion tracking

NASA Astrophysics Data System (ADS)

Cua, Michelle; Lee, Sujin; Miao, Dongkai; Ju, Myeong Jin; Mackenzie, Paul J.; Jian, Yifan; Sarunic, Marinko V.

2016-02-01

High-resolution optical coherence tomography (OCT) retinal imaging is important to noninvasively visualize the various retinal structures to aid in better understanding of the pathogenesis of vision-robbing diseases. However, conventional OCT systems have a trade-off between lateral resolution and depth-of-focus. In this report, we present the development of a focus-stacking OCT system with automatic focus optimization for high-resolution, extended-focal-range clinical retinal imaging by incorporating a variable-focus liquid lens into the sample arm optics. Retinal layer tracking and selection was performed using a graphics processing unit accelerated processing platform for focus optimization, providing real-time layer-specific en face visualization. After optimization, multiple volumes focused at different depths were acquired, registered, and stitched together to yield a single, high-resolution focus-stacked dataset. Using this system, we show high-resolution images of the retina and optic nerve head, from which we extracted clinically relevant parameters such as the nerve fiber layer thickness and lamina cribrosa microarchitecture.

Retinal optical coherence tomography at 1 μm with dynamic focus control and axial motion tracking.

PubMed

Cua, Michelle; Lee, Sujin; Miao, Dongkai; Ju, Myeong Jin; Mackenzie, Paul J; Jian, Yifan; Sarunic, Marinko V

2016-02-01

High-resolution optical coherence tomography (OCT) retinal imaging is important to noninvasively visualize the various retinal structures to aid in better understanding of the pathogenesis of vision-robbing diseases. However, conventional OCT systems have a trade-off between lateral resolution and depth-of-focus. In this report, we present the development of a focus-stacking OCT system with automatic focus optimization for high-resolution, extended-focal-range clinical retinal imaging by incorporating a variable-focus liquid lens into the sample arm optics. Retinal layer tracking and selection was performed using a graphics processing unit accelerated processing platform for focus optimization, providing real-time layer-specific en face visualization. After optimization, multiple volumes focused at different depths were acquired, registered, and stitched together to yield a single, high-resolution focus-stacked dataset. Using this system, we show high-resolution images of the retina and optic nerve head, from which we extracted clinically relevant parameters such as the nerve fiber layer thickness and lamina cribrosa microarchitecture.

Multimodal ophthalmic imaging using handheld spectrally encoded coherence tomography and reflectometry (SECTR)

NASA Astrophysics Data System (ADS)

Leeburg, Kelsey C.; El-Haddad, Mohamed T.; Malone, Joseph D.; Terrones, Benjamin D.; Tao, Yuankai K.

2018-02-01

Scanning laser ophthalmoscopy (SLO) provides high-speed, noninvasive en face imaging of the retinal fundus. Optical coherence tomography (OCT) is the current "gold-standard" for ophthalmic diagnostic imaging and enables depth-resolved visualization of ophthalmic structures and image-based surrogate biomarkers of disease. We present a compact optical and mechanical design for handheld spectrally encoded coherence tomography and reflectometry (SECTR) for multimodality en face spectrally encoded reflectometry (SER) and cross-sectional OCT imaging. We custom-designed a double-pass telecentric scan lens, which halves the size of 4-f optical relays and allowed us to reduce the footprint of our SECTR scan-head by a factor of >2.7x (volume) over our previous design. The double-pass scan lens was optimized for diffraction-limited performance over a +/-10° scan field. SECTR optics and optomechanics were combined in a compact rapid-prototyped enclosure with dimensions 87 x 141.8 x 137 mm (w x h x d). SECTR was implemented using a custom-built 400 kHz 1050 nm swept-source. OCT and SER were simultaneously digitized on dual input channels of a 4 GS/s digitizer at 1.4 GS/s per channel. In vivo human en face SER and cross-sectional OCT images were acquired at 350 fps. OCT volumes of 1000 B-scans were acquired in 2.86 s. We believe clinical translation of our compact handheld design will benefit point-of-care ophthalmic diagnostics in patients who are unable to be imaged on conventional slit-lamp based systems, such as infants and the bedridden. When combined with multi-volumetric registration methods, handheld SECTR will have advantages in motion-artifact free imaging over existing handheld technologies.

A Method for En Face OCT Imaging of Subretinal Fluid in Age-Related Macular Degeneration

PubMed Central

Mohammad, Fatimah; Wanek, Justin; Zelkha, Ruth; Lim, Jennifer I.; Chen, Judy; Shahidi, Mahnaz

2014-01-01

Purpose. The purpose of the study is to report a method for en face imaging of subretinal fluid (SRF) due to age-related macular degeneration (AMD) based on spectral domain optical coherence tomography (SDOCT). Methods. High density SDOCT imaging was performed at two visits in 4 subjects with neovascular AMD and one healthy subject. En face OCT images of a retinal layer anterior to the retinal pigment epithelium were generated. Validity, repeatability, and utility of the method were established. Results. En face OCT images generated by manual and automatic segmentation were nearly indistinguishable and displayed similar regions of SRF. En face OCT images displayed uniform intensities and similar retinal vascular patterns in a healthy subject, while the size and appearance of a hypopigmented fibrotic scar in an AMD subject were similar at 2 visits. In AMD subjects, dark regions on en face OCT images corresponded to reduced or absent light reflectance due to SRF. On en face OCT images, a decrease in SRF areas with treatment was demonstrated and this corresponded with a reduction in the central subfield retinal thickness. Conclusion. En face OCT imaging is a promising tool for visualization and monitoring of SRF area due to disease progression and treatment. PMID:25478209

Automatic detection of retinal anatomy to assist diabetic retinopathy screening.

PubMed

Fleming, Alan D; Goatman, Keith A; Philip, Sam; Olson, John A; Sharp, Peter F

2007-01-21

Screening programmes for diabetic retinopathy are being introduced in the United Kingdom and elsewhere. These require large numbers of retinal images to be manually graded for the presence of disease. Automation of image grading would have a number of benefits. However, an important prerequisite for automation is the accurate location of the main anatomical features in the image, notably the optic disc and the fovea. The locations of these features are necessary so that lesion significance, image field of view and image clarity can be assessed. This paper describes methods for the robust location of the optic disc and fovea. The elliptical form of the major retinal blood vessels is used to obtain approximate locations, which are refined based on the circular edge of the optic disc and the local darkening at the fovea. The methods have been tested on 1056 sequential images from a retinal screening programme. Positional accuracy was better than 0.5 of a disc diameter in 98.4% of cases for optic disc location, and in 96.5% of cases for fovea location. The methods are sufficiently accurate to form an important and effective component of an automated image grading system for diabetic retinopathy screening.

Automatic detection of retinal anatomy to assist diabetic retinopathy screening

NASA Astrophysics Data System (ADS)

Fleming, Alan D.; Goatman, Keith A.; Philip, Sam; Olson, John A.; Sharp, Peter F.

2007-01-01

Screening programmes for diabetic retinopathy are being introduced in the United Kingdom and elsewhere. These require large numbers of retinal images to be manually graded for the presence of disease. Automation of image grading would have a number of benefits. However, an important prerequisite for automation is the accurate location of the main anatomical features in the image, notably the optic disc and the fovea. The locations of these features are necessary so that lesion significance, image field of view and image clarity can be assessed. This paper describes methods for the robust location of the optic disc and fovea. The elliptical form of the major retinal blood vessels is used to obtain approximate locations, which are refined based on the circular edge of the optic disc and the local darkening at the fovea. The methods have been tested on 1056 sequential images from a retinal screening programme. Positional accuracy was better than 0.5 of a disc diameter in 98.4% of cases for optic disc location, and in 96.5% of cases for fovea location. The methods are sufficiently accurate to form an important and effective component of an automated image grading system for diabetic retinopathy screening.

The Role of Fundus Autofluorescence in Late-Onset Retinitis Pigmentosa (LORP) Diagnosis

PubMed Central

Lee, Tamara J.; Hwang, John C.; Chen, Royce W. S.; Lima, Luiz H.; Wang, Nan-Kai; Tosi, Joaquin; Freund, K. Bailey; Yannuzzi, Lawrence A.; Tsang, Stephen H.

2015-01-01

Purpose To demonstrate the utility and characteristics of fundus autofluorescence in late-onset retinitis pigmentosa. Methods Observational case series. Patients diagnosed with late-onset retinitis pigmentosa were identified retrospectively in an institutional setting. Twelve eyes of six patients were identified and medical records were reviewed. Results All patients presented with slowly progressive peripheral field loss and initial clinical examination revealed only subtle retinal changes. There was a notable lack of intraretinal pigment migration in all patients. Five out of six patients underwent magnetic resonance imaging of the brain to rule out intracranial processes and all were referred from another ophthalmologist for further evaluation. Fundus autofluorescence was ultimately employed in all patients and revealed more extensive retinal pathology than initially appreciated on clinical examination. Fundus autofluorescence directed the workup toward a retinal etiology in all cases and led to the eventual diagnosis of late-onset retinitis pigmentosa through electroretinogram testing. Conclusion Fundus autofluorescence may be a more sensitive marker for retinal pathology than stereo fundus biomicroscopy alone in late-onset retinitis pigmentosa. Early use of fundus autofluorescence imaging in the evaluation of patients with subtle retinal lesions and complaints of peripheral field loss may be an effective strategy for timely and cost-efficient diagnosis. PMID:23899229

Retinal vascular and structural changes are associated with amyloid burden in the elderly: ophthalmic biomarkers of preclinical Alzheimer's disease.

PubMed

Golzan, S Mojtaba; Goozee, Kathryn; Georgevsky, Dana; Avolio, Alberto; Chatterjee, Pratishtha; Shen, Kaikai; Gupta, Vivek; Chung, Roger; Savage, Greg; Orr, Carolyn F; Martins, Ralph N; Graham, Stuart L

2017-03-01

Retinal imaging may serve as an alternative approach to monitor brain pathology in Alzheimer's disease (AD). In this study, we investigated the association between retinal vascular and structural changes and cerebral amyloid-β (Aβ) plaque load in an elderly cohort. We studied a total of 101 participants, including 73 elderly subjects (79 ± 5 years, 22 male) with no clinical diagnosis of AD but reporting some subjective memory change and an additional 28 subjects (70 ± 9 years, 16 male) with clinically established AD. Following a complete dilated ocular examination, the amplitude of retinal vascular pulsations and dynamic response, retinal nerve fibre layer thickness and retinal ganglion cell layer (RGCL) thickness were determined in all patients. Systemic blood pressure and carotid-to-femoral pulse wave velocity were measured. The elderly cohort also underwent magnetic resonance imaging and 18 F-florbetaben (FBB)-positron emission tomographic amyloid imaging to measure neocortical Aβ standardised uptake value ratio (SUVR), and this was used to characterise a 'preclinical' group (SUVR >1.4). The mean FBB neocortical SUVR was 1.35 ± 0.3. The amplitude of retinal venous pulsations correlated negatively with the neocortical Aβ scores (p < 0.001), whereas the amplitude of retinal arterial pulsations correlated positively with neocortical Aβ scores (p < 0.01). RGCL thickness was significantly lower in the clinical AD group (p < 0.05). The correlation between retinal vascular changes and Aβ plaque load supports the possibility of a vascular component to AD. Dynamic retinal vascular parameters may provide an additional inexpensive tool to aid in the preclinical assessment of AD.

Long-term changes in retinal contrast sensitivity in chicks from frosted occluders and drugs: relations to myopia?

PubMed

Diether, S; Schaeffel, F

1999-07-01

Experiments in animal models have shown that the retinal analyzes the image to identify the position of the plane of focus and fine-tunes the growth of the underlying sclera. It is fundamental to the understanding of the development of refractive errors to know which image features are processed. Since the position of the image plane fluctuates continuously with accommodative status and viewing distance, a meaningful control of refractive development can only occur by an averaging procedure with a long time constant. As a candidate for a retinal signal for enhanced eye growth and myopia we propose the level of contrast adaptation which varies with the average amount of defocus. Using a behavioural paradigm, we have found in chickens (1) that contrast adaptation (CA, here referred to as an increase in contrast sensitivity) occurs at low spatial frequencies (0.2 cyc/deg) already after 1.5 h of wearing frosted goggles which cause deprivation myopia, (2) that CA also occurs with negative lenses (-7.4D) and positive lenses (+6.9D) after 1.5 h, at least if accommodation is paralyzed and, (3) that CA occurs at a retinal level or has, at least, a retinal component. Furthermore, we have studied the effects of atropine and reserpine, which both suppress myopia development, on CA. Quisqualate, which causes retinal degeneration but leaves emmetropization functional, was also tested. We found that both atropine and reserpine increase contrast sensitivity to a level where no further CA could be induced by frosted goggles. Quisqualate increased only the variability of refractive development and of contrast sensitivity. Taken together, CA occurring during extended periods of defocus is a possible candidate for a retinal error signal for myopia development. However, the situation is complicated by the fact that there must be a second image processing mode generating a powerful inhibitory growth signal if the image is in front of the retina, even with poor images (Diether, S., & Schaeffel, F. (1999).

The Relationship of Retinal Vessel Geometric Characteristics to the Incidence and Progression of Diabetic Retinopathy.

PubMed

Klein, Ronald; Lee, Kristine E; Danforth, Lorraine; Tsai, Michael Y; Gangnon, Ronald E; Meuer, Stacy E; Wong, Tien Y; Cheung, Carol Y; Klein, Barbara E K

2018-05-17

To examine the relationships of retinal vessel geometric characteristics (RVGCs) to the incidence and progression of diabetic retinopathy (DR). Observational, prospective cohort study. Nine hundred ninety-six persons with type 1 diabetes mellitus (T1DM) and 1370 persons with type 2 diabetes mellitus (T2DM) seen at a baseline examination who were eligible for follow-up examinations at subsequent 5-year intervals. A total of 3846 person-interval data from these follow-up examinations are the basis for the analyses. Diabetic retinopathy and macular edema were assessed by grading of 30° stereoscopic color fundus photographs. Retinal vessel geometric characteristics were assessed using the Singapore I Vessel Assessment program from a digitized copy of 1 of the field 1 fundus photographs obtained at baseline and follow-up. The 5-year incidence of any DR, progression of DR, and incidence of proliferative diabetic retinopathy (PDR) and clinically significant macular edema (CSME) in right eyes. Incident DR occurred in 45%, progression in 32%, PDR in 10%, and CSME in 5%. While adjusting for glycated hemoglobin, duration of diabetes, and other factors, retinal arteriolar simple tortuosity was associated significantly with the incidence of any DR (odds ratio [OR], 1.17; 95% confidence interval [CI], 1.01-1.35). Retinal venular branching angle was associated significantly with progression of DR (OR, 1.18; 95% CI, 1.03-1.36), retinal venular curvature tortuosity was associated significantly with the incidence of PDR (OR, 1.15; 95% CI, 1.01-1.30), and retinal venular branching angle (OR, 1.41; 95% CI, 1.10-1.82) was associated significantly with the incidence of CSME. There were no significant associations of other RVGCs with any of the DR outcomes in the full multivariate model. Inclusion of all possible RVGCs did not improve the predictive value of the models that already included retinal vessel diameter and baseline DR severity level. Retinal vessel geometric characteristics of the retinal venules were associated with progression of DR; however, most of the RVGCs measured from digitized fundus photographs added little to the assessment of risk of incidence and progression of DR when other risk factors were considered in T1DM and T2DM. Copyright © 2018 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Profile and Determinants of Retinal Optical Intensity in Normal Eyes with Spectral Domain Optical Coherence Tomography.

PubMed

Chen, Binyao; Gao, Enting; Chen, Haoyu; Yang, Jianling; Shi, Fei; Zheng, Ce; Zhu, Weifang; Xiang, Dehui; Chen, Xinjian; Zhang, Mingzhi

2016-01-01

To investigate the profile and determinants of retinal optical intensity in normal subjects using 3D spectral domain optical coherence tomography (SD OCT). A total of 231 eyes from 231 healthy subjects ranging in age from 18 to 80 years were included and underwent a 3D OCT scan. Forty-four eyes were randomly chosen to be scanned by two operators for reproducibility analysis. Distribution of optical intensity of each layer and regions specified by the Early Treatment of Diabetic Retinopathy Study (ETDRS) were investigated by analyzing the OCT raw data with our automatic graph-based algorithm. Univariate and multivariate analyses were performed between retinal optical intensity and sex, age, height, weight, spherical equivalent (SE), axial length, image quality, disc area and rim/disc area ratio (R/D area ratio). For optical intensity measurements, the intraclass correlation coefficient of each layer ranged from 0.815 to 0.941, indicating good reproducibility. Optical intensity was lowest in the central area of retinal nerve fiber layer, ganglion cell layer, inner plexiform layer, inner nuclear layer, outer plexiform layer and photoreceptor layer, except for the retinal pigment epithelium (RPE). Optical intensity was positively correlated with image quality in all retinal layers (0.553<β<0.851, p<0.01), and negatively correlated with age in most retinal layers (-0.362<β<-0.179, p<0.01), except for the RPE (β = 0.456, p<0.01), outer nuclear layer and photoreceptor layer (p>0.05). There was no relationship between retinal optical intensity and sex, height, weight, SE, axial length, disc area and R/D area ratio. There was a specific pattern of distribution of retinal optical intensity in different regions. The optical intensity was affected by image quality and age. Image quality can be used as a reference for normalization. The effect of age needs to be taken into consideration when using OCT for diagnosis.

Early screening of an infant's visual system

NASA Astrophysics Data System (ADS)

Costa, Manuel F. M.; Jorge, Jorge M.

1999-06-01

It is of utmost importance to the development of the child's visual system that she perceives clear focused retinal images. Furthermore if the refractive problems are not corrected in due time amblyopia may occur--myopia and hyperopia can only cause important problems in the future when they are significantly large, however for the astigmatism (rather frequent in infants) and anisometropia the problems tend to be more stringent. The early evaluation of the visual status of human infants is thus of critical importance. Photorefraction is a convenient technique for this kind of subjects. Essentially a light beam is delivered into the eyes. It is refracted by the ocular media, strikes the retina, focusing or not, reflects off and is collected by a camera. The photorefraction setup we established using new technological breakthroughs on the fields of imaging devices, digital image processing and fiber optics, allows a fast noninvasive evaluation of children visual status (refractive errors, accommodation, strabismus, ...). Results of the visual screening of a group of risk' child descents of blinds or amblyopes will be presented.

Live-cell imaging: new avenues to investigate retinal regeneration

PubMed Central

Lahne, Manuela; Hyde, David R.

2017-01-01

Sensing and responding to our environment requires functional neurons that act in concert. Neuronal cell loss resulting from degenerative diseases cannot be replaced in humans, causing a functional impairment to integrate and/or respond to sensory cues. In contrast, zebrafish (Danio rerio) possess an endogenous capacity to regenerate lost neurons. Here, we will focus on the processes that lead to neuronal regeneration in the zebrafish retina. Dying retinal neurons release a damage signal, tumor necrosis factor α, which induces the resident radial glia, the Müller glia, to reprogram and re-enter the cell cycle. The Müller glia divide asymmetrically to produce a Müller glia that exits the cell cycle and a neuronal progenitor cell. The arising neuronal progenitor cells undergo several rounds of cell divisions before they migrate to the site of damage to differentiate into the neuronal cell types that were lost. Molecular and immunohistochemical studies have predominantly provided insight into the mechanisms that regulate retinal regeneration. However, many processes during retinal regeneration are dynamic and require live-cell imaging to fully discern the underlying mechanisms. Recently, a multiphoton imaging approach of adult zebrafish retinal cultures was developed. We will discuss the use of live-cell imaging, the currently available tools and those that need to be developed to advance our knowledge on major open questions in the field of retinal regeneration. PMID:28966629

Live-cell imaging: new avenues to investigate retinal regeneration.

PubMed

Lahne, Manuela; Hyde, David R

2017-08-01

Sensing and responding to our environment requires functional neurons that act in concert. Neuronal cell loss resulting from degenerative diseases cannot be replaced in humans, causing a functional impairment to integrate and/or respond to sensory cues. In contrast, zebrafish ( Danio rerio ) possess an endogenous capacity to regenerate lost neurons. Here, we will focus on the processes that lead to neuronal regeneration in the zebrafish retina. Dying retinal neurons release a damage signal, tumor necrosis factor α, which induces the resident radial glia, the Müller glia, to reprogram and re-enter the cell cycle. The Müller glia divide asymmetrically to produce a Müller glia that exits the cell cycle and a neuronal progenitor cell. The arising neuronal progenitor cells undergo several rounds of cell divisions before they migrate to the site of damage to differentiate into the neuronal cell types that were lost. Molecular and immunohistochemical studies have predominantly provided insight into the mechanisms that regulate retinal regeneration. However, many processes during retinal regeneration are dynamic and require live-cell imaging to fully discern the underlying mechanisms. Recently, a multiphoton imaging approach of adult zebrafish retinal cultures was developed. We will discuss the use of live-cell imaging, the currently available tools and those that need to be developed to advance our knowledge on major open questions in the field of retinal regeneration.

78 FR 24756 - Government-Owned Inventions; Availability for Licensing

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-26

...; Availability for Licensing AGENCY: National Institutes of Health, Public Health Service, HHS. ACTION: Notice... chelators. Potential Commercial Applications: Cancer imaging. PET imaging. ImmunoPET. Competitive Advantages... crucial role in retinal physiology by forming a blood- retinal barrier and closely interacting with...

Optical Coherence Tomography for Retinal Surgery: Perioperative Analysis to Real-Time Four-Dimensional Image-Guided Surgery.

PubMed

Carrasco-Zevallos, Oscar M; Keller, Brenton; Viehland, Christian; Shen, Liangbo; Seider, Michael I; Izatt, Joseph A; Toth, Cynthia A

2016-07-01

Magnification of the surgical field using the operating microscope facilitated profound innovations in retinal surgery in the 1970s, such as pars plana vitrectomy. Although surgical instrumentation and illumination techniques are continually developing, the operating microscope for vitreoretinal procedures has remained essentially unchanged and currently limits the surgeon's depth perception and assessment of subtle microanatomy. Optical coherence tomography (OCT) has revolutionized clinical management of retinal pathology, and its introduction into the operating suite may have a similar impact on surgical visualization and treatment. In this article, we review the evolution of OCT for retinal surgery, from perioperative analysis to live volumetric (four-dimensional, 4D) image-guided surgery. We begin by briefly addressing the benefits and limitations of the operating microscope, the progression of OCT technology, and OCT applications in clinical/perioperative retinal imaging. Next, we review intraoperative OCT (iOCT) applications using handheld probes during surgical pauses, two-dimensional (2D) microscope-integrated OCT (MIOCT) of live surgery, and volumetric MIOCT of live surgery. The iOCT discussion focuses on technological advancements, applications during human retinal surgery, translational difficulties and limitations, and future directions.

Optical Coherence Tomography for Retinal Surgery: Perioperative Analysis to Real-Time Four-Dimensional Image-Guided Surgery

PubMed Central

Carrasco-Zevallos, Oscar M.; Keller, Brenton; Viehland, Christian; Shen, Liangbo; Seider, Michael I.; Izatt, Joseph A.; Toth, Cynthia A.

2016-01-01

Magnification of the surgical field using the operating microscope facilitated profound innovations in retinal surgery in the 1970s, such as pars plana vitrectomy. Although surgical instrumentation and illumination techniques are continually developing, the operating microscope for vitreoretinal procedures has remained essentially unchanged and currently limits the surgeon's depth perception and assessment of subtle microanatomy. Optical coherence tomography (OCT) has revolutionized clinical management of retinal pathology, and its introduction into the operating suite may have a similar impact on surgical visualization and treatment. In this article, we review the evolution of OCT for retinal surgery, from perioperative analysis to live volumetric (four-dimensional, 4D) image-guided surgery. We begin by briefly addressing the benefits and limitations of the operating microscope, the progression of OCT technology, and OCT applications in clinical/perioperative retinal imaging. Next, we review intraoperative OCT (iOCT) applications using handheld probes during surgical pauses, two-dimensional (2D) microscope-integrated OCT (MIOCT) of live surgery, and volumetric MIOCT of live surgery. The iOCT discussion focuses on technological advancements, applications during human retinal surgery, translational difficulties and limitations, and future directions. PMID:27409495

Quantification of the progression of CMV infection as observed from retinal angiograms in patients with AIDS

NASA Astrophysics Data System (ADS)

Brahmi, Djamel; Cassoux, Nathalie; Serruys, Camille; Giron, Alain; Lehoang, Phuc; Fertil, Bernard

1999-05-01

To support ophthalmologists in their daily routine and enable the quantitative assessment of progression of Cytomegalovirus infection as observed on series of retinal angiograms, a methodology allowing an accurate comparison of retinal borders has been developed. In order to evaluate accuracy of borders, ophthalmologists have been asked to repeatedly outline boundaries between infected and noninfected areas. As a matter of fact, accuracy of drawing relies on local features such as contrast, quality of image, background..., all factors which make the boundaries more or less perceptible from one part of an image to another. In order to directly estimate accuracy of retinal border from image analysis, an artificial neural network (a succession of unsupervised and supervised neural networks) has been designed to correlate accuracy of drawing (as calculated form ophthalmologists' hand-outlines) with local features of the underlying image. Our method has been applied to the quantification of CMV retinitis. It is shown that accuracy of border is properly predicted and characterized by a confident envelope that allows, after a registration phase based on fixed landmarks such as vessel forks, to accurately assess the evolution of CMV infection.

Retinal Structure Measurements as Inclusion Criteria for Stem Cell-Based Therapies of Retinal Degenerations.

PubMed

Jacobson, Samuel G; Matsui, Rodrigo; Sumaroka, Alexander; Cideciyan, Artur V

2016-04-01

We reviewed and illustrated the most optimal retinal structural measurements to make in stem cell clinical trials. Optical coherence tomography (OCT) and autofluorescence (AF) imaging were used to evaluate patients with severe visual loss from nonsyndromic and syndromic retinitis pigmentosa (RP), ABCA4-Stargardt disease, and nonneovascular age-related macular degeneration (AMD). Outer nuclear layer (ONL), rod outer segment (ROS) layer, inner retina, ganglion cell layer (GCL), and nerve fiber layer (NFL) thicknesses were quantified. All patients had severely reduced visual acuities. Retinitis pigmentosa patients had limited visual fields; maculopathy patients had central scotomas with retained peripheral function. For the forms of RP illustrated, there was detectable albeit severely reduced ONL across the scanned retina, and normal or hyperthick GCL and NFL. Maculopathy patients had no measurable ONL centrally; it became detectable with eccentricity. Some maculopathy patients showed unexpected GCL losses. Autofluorescence imaging illustrated central losses of RPE integrity. A hypothetical scheme to relate patient data with different phases of retinal remodeling in animal models of retinal degeneration was presented. Stem cell science is advancing, but it is not too early to open the discussion of criteria for patient selection and monitoring. Available clinical tools, such as OCT and AF imaging, can provide inclusion/exclusion criteria and robust objective outcomes. Accepting that early trials may not lead to miraculous cures, we should be prepared to know why-scientifically and clinically-so we can improve subsequent trials. We also must determine if retinal remodeling is an impediment to efficacy.

Toward high-resolution optoelectronic retinal prosthesis

NASA Astrophysics Data System (ADS)

Palanker, Daniel; Huie, Philip; Vankov, Alexander; Asher, Alon; Baccus, Steven

2005-04-01

It has been already demonstrated that electrical stimulation of retina can produce visual percepts in blind patients suffering from macular degeneration and retinitis pigmentosa. Current retinal implants provide very low resolution (just a few electrodes), while several thousand pixels are required for functional restoration of sight. We present a design of the optoelectronic retinal prosthetic system that can activate a retinal stimulating array with pixel density up to 2,500 pix/mm2 (geometrically corresponding to a visual acuity of 20/80), and allows for natural eye scanning rather than scanning with a head-mounted camera. The system operates similarly to "virtual reality" imaging devices used in military and medical applications. An image from a video camera is projected by a goggle-mounted infrared LED-LCD display onto the retina, activating an array of powered photodiodes in the retinal implant. Such a system provides a broad field of vision by allowing for natural eye scanning. The goggles are transparent to visible light, thus allowing for simultaneous utilization of remaining natural vision along with prosthetic stimulation. Optical control of the implant allows for simple adjustment of image processing algorithms and for learning. A major prerequisite for high resolution stimulation is the proximity of neural cells to the stimulation sites. This can be achieved with sub-retinal implants constructed in a manner that directs migration of retinal cells to target areas. Two basic implant geometries are described: perforated membranes and protruding electrode arrays. Possibility of the tactile neural stimulation is also examined.

Screening retinal transplants with Fourier-domain OCT

NASA Astrophysics Data System (ADS)

Rao, Bin

2009-02-01

Transplant technologies have been studied for the recovery of vision loss from retinitis pigmentosa (RP) and age-related macular degeneration (AMD). In several rodent retinal degeneration models and in patients, retinal progenitor cells transplanted as layers to the subretinal space have been shown to restore or preserve vision. The methods for evaluation of transplants are expensive considering the large amount of animals. Alternatively, time-domain Stratus OCT was previously shown to be able to image the morphological structure of transplants to some extent, but could not clearly identify laminated transplants. The efficacy of screening retinal transplants with Fourier-domain OCT was studied on 37 S334ter line 3 rats with retinal degeneration 6-67 days after transplant surgery. The transplants were morphologically categorized as no transplant, detachment, rosettes, small laminated area and larger laminated area with both Fourier-domain OCT and histology. The efficacy of Fourier-domain OCT in screening retinal transplants was evaluated by comparing the categorization results with OCT and histology. Additionally, 4 rats were randomly selected for multiple OCT examinations (1, 5, 9, 14 and 21days post surgery) in order to determine the earliest image time of OCT examination since the transplanted tissue may need some time to show its tendency of growing. Finally, we demonstrated the efficacy of Fourier-domain OCT in screening retinal transplants in early stages and determined the earliest imaging time for OCT. Fourier-domain OCT makes itself valuable in saving resource spent on animals with unsuccessful transplants.

Age-Related Alterations in the Retinal Microvasculature, Microcirculation, and Microstructure.

PubMed

Wei, Yantao; Jiang, Hong; Shi, Yingying; Qu, Dongyi; Gregori, Giovanni; Zheng, Fang; Rundek, Tatjana; Wang, Jianhua

2017-07-01

To characterize age-related alterations in the retinal microcirculation, microvascular network, and microstructure in healthy subjects. Seventy-four healthy subjects aged from 18 to 82 years were recruited and divided into four age groups (G1 with age <35 years, G2 with age 35 ∼ 49 years, G3 with age 50 ∼ 64 years, and G4 with age ≥65 years). Custom ultra-high resolution optical coherence tomography (UHR-OCT) was used to acquire six intraretinal layers of the macula. OCT angiography (OCTA) was used to image the retinal microvascular network. The retinal blood flow velocity (BFV) was measured using a Retinal Function Imager (RFI). Compared to G1, G2 had significant thinning of the retinal nerve fiber layer (RNFL) (P < 0.05), while G3 had thinning of the RNFL and ganglion cell and inner plexiform layer (GCIPL) (P < 0.05), in addition to thickening of the outer plexiform layer (OPL) and photoreceptor layer (PR) (P < 0.05). G4 had loss in retinal vessel density, thinning in RNFL and GCIPL, and decrease in venular BFV, in addition to thickening of the OPL and PR (P < 0.05). Age was negatively related to retinal vessel densities, the inner retinal layers, and venular BFV (P < 0.05). By contrast, age was positively related to OPL and PR (P < 0.05). During aging, decreases in retinal vessel density, inner retinal layer thickness, and venular BFV were evident and impacted each other as observed by simultaneous changes in multiple retinal components.

Retinal vessel enhancement based on the Gaussian function and image fusion

NASA Astrophysics Data System (ADS)

Moraru, Luminita; Obreja, Cristian Dragoş

2017-01-01

The Gaussian function is essential in the construction of the Frangi and COSFIRE (combination of shifted filter responses) filters. The connection of the broken vessels and an accurate extraction of the vascular structure is the main goal of this study. Thus, the outcome of the Frangi and COSFIRE edge detection algorithms are fused using the Dempster-Shafer algorithm with the aim to improve detection and to enhance the retinal vascular structure. For objective results, the average diameters of the retinal vessels provided by Frangi, COSFIRE and Dempster-Shafer fusion algorithms are measured. These experimental values are compared to the ground truth values provided by manually segmented retinal images. We prove the superiority of the fusion algorithm in terms of image quality by using the figure of merit objective metric that correlates the effects of all post-processing techniques.

Improving image segmentation performance and quantitative analysis via a computer-aided grading methodology for optical coherence tomography retinal image analysis.

PubMed

Debuc, Delia Cabrera; Salinas, Harry M; Ranganathan, Sudarshan; Tátrai, Erika; Gao, Wei; Shen, Meixiao; Wang, Jianhua; Somfai, Gábor M; Puliafito, Carmen A

2010-01-01

We demonstrate quantitative analysis and error correction of optical coherence tomography (OCT) retinal images by using a custom-built, computer-aided grading methodology. A total of 60 Stratus OCT (Carl Zeiss Meditec, Dublin, California) B-scans collected from ten normal healthy eyes are analyzed by two independent graders. The average retinal thickness per macular region is compared with the automated Stratus OCT results. Intergrader and intragrader reproducibility is calculated by Bland-Altman plots of the mean difference between both gradings and by Pearson correlation coefficients. In addition, the correlation between Stratus OCT and our methodology-derived thickness is also presented. The mean thickness difference between Stratus OCT and our methodology is 6.53 microm and 26.71 microm when using the inner segment/outer segment (IS/OS) junction and outer segment/retinal pigment epithelium (OS/RPE) junction as the outer retinal border, respectively. Overall, the median of the thickness differences as a percentage of the mean thickness is less than 1% and 2% for the intragrader and intergrader reproducibility test, respectively. The measurement accuracy range of the OCT retinal image analysis (OCTRIMA) algorithm is between 0.27 and 1.47 microm and 0.6 and 1.76 microm for the intragrader and intergrader reproducibility tests, respectively. Pearson correlation coefficients demonstrate R(2)>0.98 for all Early Treatment Diabetic Retinopathy Study (ETDRS) regions. Our methodology facilitates a more robust and localized quantification of the retinal structure in normal healthy controls and patients with clinically significant intraretinal features.

Improving image segmentation performance and quantitative analysis via a computer-aided grading methodology for optical coherence tomography retinal image analysis

NASA Astrophysics Data System (ADS)

Cabrera Debuc, Delia; Salinas, Harry M.; Ranganathan, Sudarshan; Tátrai, Erika; Gao, Wei; Shen, Meixiao; Wang, Jianhua; Somfai, Gábor M.; Puliafito, Carmen A.

2010-07-01

We demonstrate quantitative analysis and error correction of optical coherence tomography (OCT) retinal images by using a custom-built, computer-aided grading methodology. A total of 60 Stratus OCT (Carl Zeiss Meditec, Dublin, California) B-scans collected from ten normal healthy eyes are analyzed by two independent graders. The average retinal thickness per macular region is compared with the automated Stratus OCT results. Intergrader and intragrader reproducibility is calculated by Bland-Altman plots of the mean difference between both gradings and by Pearson correlation coefficients. In addition, the correlation between Stratus OCT and our methodology-derived thickness is also presented. The mean thickness difference between Stratus OCT and our methodology is 6.53 μm and 26.71 μm when using the inner segment/outer segment (IS/OS) junction and outer segment/retinal pigment epithelium (OS/RPE) junction as the outer retinal border, respectively. Overall, the median of the thickness differences as a percentage of the mean thickness is less than 1% and 2% for the intragrader and intergrader reproducibility test, respectively. The measurement accuracy range of the OCT retinal image analysis (OCTRIMA) algorithm is between 0.27 and 1.47 μm and 0.6 and 1.76 μm for the intragrader and intergrader reproducibility tests, respectively. Pearson correlation coefficients demonstrate R2>0.98 for all Early Treatment Diabetic Retinopathy Study (ETDRS) regions. Our methodology facilitates a more robust and localized quantification of the retinal structure in normal healthy controls and patients with clinically significant intraretinal features.

A tool for computer-aided diagnosis of retinopathy of prematurity

NASA Astrophysics Data System (ADS)

Zhao, Zheen; Wallace, David K.; Freedman, Sharon F.; Aylward, Stephen R.

2008-03-01

In this paper we present improvements to a software application, named ROPtool, that aids in the timely and accurate detection and diagnosis of retinopathy of prematurity (ROP). ROP occurs in 68% of infants less than 1251 grams at birth, and it is a leading cause of blindness for prematurely born infants. The standard of care for its diagnosis is the subjective assessment of retinal vessel dilation and tortuosity. There is significant inter-observer variation in those assessments. ROPtool analyzes retinal images, extracts user-selected blood vessels from those images, and quantifies the tortuosity of those vessels. The presence of ROP is then gauged by comparing the tortuosity of an infant's retinal vessels with measures made from a clinical-standard image of severely tortuous retinal vessels. The presence of such tortuous retinal vessels is referred to as 'plus disease'. In this paper, a novel metric of tortuosity is proposed. From the ophthalmologist's point of view, the new metric is an improvement from our previously published algorithm, since it uses smooth curves instead of straight lines to simulate 'normal vessels'. Another advantage of the new ROPtool is that minimal user interactions are required. ROPtool utilizes a ridge traversal algorithm to extract retinal vessels. The algorithm reconstructs connectivity along a vessel automatically. This paper supports its claims by reporting ROC curves from a pilot study involving 20 retinal images. The areas under two ROC curves, from two experts in ROP, using the new metric to diagnose 'tortuosity sufficient for plus disease', varied from 0.86 to 0.91.

Spectral imaging technique for retinal perfusion detection using confocal scanning laser ophthalmoscopy

NASA Astrophysics Data System (ADS)

Rasta, Seyed Hossein; Manivannan, Ayyakkannu; Sharp, Peter F.

2012-11-01

To evaluate retinal perfusion in the human eye, a dual-wavelength confocal scanning laser ophthalmoscope (cSLO) was developed that provides spectral imaging of the fundus using a combination of red (670 nm) and near-infrared (810 nm) wavelengths. The image of the ocular fundus was analyzed to find out if quantitative measurements of the reflectivity of tissue permit assessment of the oxygen perfusion of tissue. We explored problems that affect the reproducibility of patient measurements such as non-uniformity errors on the image. For the first time, an image processing technique was designed and used to minimize the errors of oxygen saturation measurements by illumination correction in retina wide field by increasing SNR. Retinal images were taken from healthy and diabetic retinopathy eyes using the cSLO with a confocal aperture of 100 μm. The ratio image (RI) of red/IR, as oxygen saturation (SO2) index, was calculated for normal eyes. The image correction technique improved the reproducibility of the measurements. Average RI intensity variation of healthy retina tissue was determined within a range of about 5.5%. The capability of the new technique to discriminate oxygenation levels of retinal artery and vein was successfully demonstrated and showed good promise in the diagnosis of the perfused retina.

Noninvasive imaging of the human rod photoreceptor mosaic using a confocal adaptive optics scanning ophthalmoscope

PubMed Central

Dubra, Alfredo; Sulai, Yusufu; Norris, Jennifer L.; Cooper, Robert F.; Dubis, Adam M.; Williams, David R.; Carroll, Joseph

2011-01-01

The rod photoreceptors are implicated in a number of devastating retinal diseases. However, routine imaging of these cells has remained elusive, even with the advent of adaptive optics imaging. Here, we present the first in vivo images of the contiguous rod photoreceptor mosaic in nine healthy human subjects. The images were collected with three different confocal adaptive optics scanning ophthalmoscopes at two different institutions, using 680 and 775 nm superluminescent diodes for illumination. Estimates of photoreceptor density and rod:cone ratios in the 5°–15° retinal eccentricity range are consistent with histological findings, confirming our ability to resolve the rod mosaic by averaging multiple registered images, without the need for additional image processing. In one subject, we were able to identify the emergence of the first rods at approximately 190 μm from the foveal center, in agreement with previous histological studies. The rod and cone photoreceptor mosaics appear in focus at different retinal depths, with the rod mosaic best focus (i.e., brightest and sharpest) being at least 10 μm shallower than the cones at retinal eccentricities larger than 8°. This study represents an important step in bringing high-resolution imaging to bear on the study of rod disorders. PMID:21750765

Characterization of the optic disc in retinal imagery using a probabilistic approach

NASA Astrophysics Data System (ADS)

Tobin, Kenneth W., Jr.; Chaum, Edward; Govindasamy, V. P.; Karnowski, Thomas P.; Sezer, Omer

2006-03-01

The application of computer based image analysis to the diagnosis of retinal disease is rapidly becoming a reality due to the broad-based acceptance of electronic imaging devices throughout the medical community and through the collection and accumulation of large patient histories in picture archiving and communications systems. Advances in the imaging of ocular anatomy and pathology can now provide data to diagnose and quantify specific diseases such as diabetic retinopathy (DR). Visual disability and blindness have a profound socioeconomic impact upon the diabetic population and DR is the leading cause of new blindness in working-age adults in the industrialized world. To reduce the impact of diabetes on vision loss, robust automation is required to achieve productive computer-based screening of large at-risk populations at lower cost. Through this research we are developing automation methods for locating and characterizing important structures in the human retina such as the vascular arcades, optic nerve, macula, and lesions. In this paper we present results for the automatic detection of the optic nerve using digital red-free fundus photography. Our method relies on the accurate segmentation of the vasculature of the retina along with spatial probability distributions describing the luminance across the retina and the density, average thickness, and average orientation of the vasculature in relation to the position of the optic nerve. With these features and other prior knowledge, we predict the location of the optic nerve in the retina using a two-class, Bayesian classifier. We report 81% detection performance on a broad range of red-free fundus images representing a population of over 345 patients with 19 different pathologies associated with DR.

Light and portable novel device for diabetic retinopathy screening.

PubMed

Ting, Daniel S W; Tay-Kearney, Mei Ling; Kanagasingam, Yogesan

2012-01-01

To validate the use of an economical portable multipurpose ophthalmic imaging device, EyeScan (Ophthalmic Imaging System, Sacramento, CA, USA), for diabetic retinopathy screening. Evaluation of a diagnostic device. One hundred thirty-six (272 eyes) were recruited from diabetic retinopathy screening clinic of Royal Perth Hospital, Western Australia, Australia. All patients underwent three-field (optic disc, macular and temporal view) mydriatic retinal digital still photography captured by EyeScan and FF450 plus (Carl Zeiss Meditec, North America) and were subsequently examined by a senior consultant ophthalmologist using the slit-lamp biomicroscopy (reference standard). All retinal images were interpreted by a consultant ophthalmologist and a medical officer. The sensitivity, specificity and kappa statistics of EyeScan and FF450 plus with reference to the slit-lamp examination findings by a senior consultant ophthalmologist. For detection of any grade of diabetic retinopathy, EyeScan had a sensitivity and specificity of 93 and 98%, respectively (ophthalmologist), and 92 and 95%, respectively (medical officer). In contrast, FF450 plus images had a sensitivity and specificity of 95 and 99%, respectively (ophthalmologist), and 92 and 96%, respectively (medical officer). The overall kappa statistics for diabetic retinopathy grading for EyeScan and FF450 plus were 0.93 and 0.95 for ophthalmologist and 0.88 and 0.90 for medical officer, respectively. Given that the EyeScan requires minimal training to use and has excellent diagnostic accuracy in screening for diabetic retinopathy, it could be potentially utilized by the primary eye care providers to widely screen for diabetic retinopathy in the community. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.

Eye-pupil displacement and prediction: effects on residual wavefront in adaptive optics retinal imaging

PubMed Central

Kulcsár, Caroline; Raynaud, Henri-François; Garcia-Rissmann, Aurea

2016-01-01

This paper studies the effect of pupil displacements on the best achievable performance of retinal imaging adaptive optics (AO) systems, using 52 trajectories of horizontal and vertical displacements sampled at 80 Hz by a pupil tracker (PT) device on 13 different subjects. This effect is quantified in the form of minimal root mean square (rms) of the residual phase affecting image formation, as a function of the delay between PT measurement and wavefront correction. It is shown that simple dynamic models identified from data can be used to predict horizontal and vertical pupil displacements with greater accuracy (in terms of average rms) over short-term time horizons. The potential impact of these improvements on residual wavefront rms is investigated. These results allow to quantify the part of disturbances corrected by retinal imaging systems that are caused by relative displacements of an otherwise fixed or slowy-varying subject-dependent aberration. They also suggest that prediction has a limited impact on wavefront rms and that taking into account PT measurements in real time improves the performance of AO retinal imaging systems. PMID:27231607

Automatic optimization high-speed high-resolution OCT retinal imaging at 1μm

NASA Astrophysics Data System (ADS)

Cua, Michelle; Liu, Xiyun; Miao, Dongkai; Lee, Sujin; Lee, Sieun; Bonora, Stefano; Zawadzki, Robert J.; Mackenzie, Paul J.; Jian, Yifan; Sarunic, Marinko V.

2015-03-01

High-resolution OCT retinal imaging is important in providing visualization of various retinal structures to aid researchers in better understanding the pathogenesis of vision-robbing diseases. However, conventional optical coherence tomography (OCT) systems have a trade-off between lateral resolution and depth-of-focus. In this report, we present the development of a focus-stacking optical coherence tomography (OCT) system with automatic optimization for high-resolution, extended-focal-range clinical retinal imaging. A variable-focus liquid lens was added to correct for de-focus in real-time. A GPU-accelerated segmentation and optimization was used to provide real-time layer-specific enface visualization as well as depth-specific focus adjustment. After optimization, multiple volumes focused at different depths were acquired, registered, and stitched together to yield a single, high-resolution focus-stacked dataset. Using this system, we show high-resolution images of the ONH, from which we extracted clinically-relevant parameters such as the nerve fiber layer thickness and lamina cribrosa microarchitecture.

Rapid and coordinated processing of global motion images by local clusters of retinal ganglion cells.

PubMed

Matsumoto, Akihiro; Tachibana, Masao

2017-01-01

Even when the body is stationary, the whole retinal image is always in motion by fixational eye movements and saccades that move the eye between fixation points. Accumulating evidence indicates that the brain is equipped with specific mechanisms for compensating for the global motion induced by these eye movements. However, it is not yet fully understood how the retina processes global motion images during eye movements. Here we show that global motion images evoke novel coordinated firing in retinal ganglion cells (GCs). We simultaneously recorded the firing of GCs in the goldfish isolated retina using a multi-electrode array, and classified each GC based on the temporal profile of its receptive field (RF). A moving target that accompanied the global motion (simulating a saccade following a period of fixational eye movements) modulated the RF properties and evoked synchronized and correlated firing among local clusters of the specific GCs. Our findings provide a novel concept for retinal information processing during eye movements.

Quantitative Assessment of Retinopathy Using Multi-parameter Image Analysis

PubMed Central

Ghanian, Zahra; Staniszewski, Kevin; Jamali, Nasim; Sepehr, Reyhaneh; Wang, Shoujian; Sorenson, Christine M.; Sheibani, Nader; Ranji, Mahsa

2016-01-01

A multi-parameter quantification method was implemented to quantify retinal vascular injuries in microscopic images of clinically relevant eye diseases. This method was applied to wholemount retinal trypsin digest images of diabetic Akita/+, and bcl-2 knocked out mice models. Five unique features of retinal vasculature were extracted to monitor early structural changes and retinopathy, as well as quantifying the disease progression. Our approach was validated through simulations of retinal images. Results showed fewer number of cells (P = 5.1205e-05), greater population ratios of endothelial cells to pericytes (PCs) (P = 5.1772e-04; an indicator of PC loss), higher fractal dimension (P = 8.2202e-05), smaller vessel coverage (P = 1.4214e-05), and greater number of acellular capillaries (P = 7.0414e-04) for diabetic retina as compared to normal retina. Quantification using the present method would be helpful in evaluating physiological and pathological retinopathy in a high-throughput and reproducible manner. PMID:27186534

Adaptation to Skew Distortions of Natural Scenes and Retinal Specificity of Its Aftereffects

PubMed Central

Habtegiorgis, Selam W.; Rifai, Katharina; Lappe, Markus; Wahl, Siegfried

2017-01-01

Image skew is one of the prominent distortions that exist in optical elements, such as in spectacle lenses. The present study evaluates adaptation to image skew in dynamic natural images. Moreover, the cortical levels involved in skew coding were probed using retinal specificity of skew adaptation aftereffects. Left and right skewed natural image sequences were shown to observers as adapting stimuli. The point of subjective equality (PSE), i.e., the skew amplitude in simple geometrical patterns that is perceived to be unskewed, was used to quantify the aftereffect of each adapting skew direction. The PSE, in a two-alternative forced choice paradigm, shifted toward the adapting skew direction. Moreover, significant adaptation aftereffects were obtained not only at adapted, but also at non-adapted retinal locations during fixation. Skew adaptation information was transferred partially to non-adapted retinal locations. Thus, adaptation to skewed natural scenes induces coordinated plasticity in lower and higher cortical areas of the visual pathway. PMID:28751870

Analysis of retinal capillaries in patients with type 1 diabetes and nonproliferative diabetic retinopathy using adaptive optics imaging.

PubMed

Lombardo, Marco; Parravano, Mariacristina; Serrao, Sebastiano; Ducoli, Pietro; Stirpe, Mario; Lombardo, Giuseppe

2013-09-01

To illustrate a noninvasive method to analyze the retinal capillary lumen caliber in patients with Type 1 diabetes. Adaptive optics imaging of the retinal capillaries were acquired in two parafoveal regions of interest in eyes with nonproliferative diabetic retinopathy and unaffected controls. Measures of the retinal capillary lumen caliber were quantified using an algorithm written in Matlab by an independent observer in a masked manner. Comparison of the adaptive optics images with red-free and color wide fundus retinography images was also assessed. Eight eyes with nonproliferative diabetic retinopathy (eight patients, study group), no macular edema, and preserved visual acuity and eight control eyes (eight healthy volunteers; control group) were analyzed. The repeatability of capillary lumen caliber measurements was 0.22 μm (3.5%) with the 95% confidence interval between 0.12 and 0.31 μm in the study group. It was 0.30 μm (4.1%) with the 95% confidence interval between 0.16 and 0.43 μm in the control group. The average capillary lumen caliber was significantly narrower in eyes with nonproliferative diabetic retinopathy (6.27 ± 1.63 μm) than in the control eyes (7.31 ± 1.59 μm, P = 0.002). The authors demonstrated a noninvasive method to analyze, with micrometric scale of resolution, the lumen of retinal capillaries. The parafoveal capillaries were narrower in patients with Type 1 diabetes and nonproliferative diabetic retinopathy than in healthy subjects, showing the potential capability of adaptive optics imaging to detect pathologic variations of the retinal microvascular structures in vaso-occlusive diseases.

Digital Museum of Retinal Ganglion Cells with Dense Anatomy and Physiology.

PubMed

Bae, J Alexander; Mu, Shang; Kim, Jinseop S; Turner, Nicholas L; Tartavull, Ignacio; Kemnitz, Nico; Jordan, Chris S; Norton, Alex D; Silversmith, William M; Prentki, Rachel; Sorek, Marissa; David, Celia; Jones, Devon L; Bland, Doug; Sterling, Amy L R; Park, Jungman; Briggman, Kevin L; Seung, H Sebastian

2018-05-17

When 3D electron microscopy and calcium imaging are used to investigate the structure and function of neural circuits, the resulting datasets pose new challenges of visualization and interpretation. Here, we present a new kind of digital resource that encompasses almost 400 ganglion cells from a single patch of mouse retina. An online "museum" provides a 3D interactive view of each cell's anatomy, as well as graphs of its visual responses. The resource reveals two aspects of the retina's inner plexiform layer: an arbor segregation principle governing structure along the light axis and a density conservation principle governing structure in the tangential plane. Structure is related to visual function; ganglion cells with arbors near the layer of ganglion cell somas are more sustained in their visual responses on average. Our methods are potentially applicable to dense maps of neuronal anatomy and physiology in other parts of the nervous system. Copyright © 2018 Elsevier Inc. All rights reserved.

Association of parental blood pressure with retinal microcirculatory abnormalities indicative of endothelial dysfunction in children.

PubMed

Islam, Muhammad; Jafar, Tazeen H; Bux, Rasool; Hashmi, Shiraz; Chaturvedi, Nish; Hughes, Alun D

2014-03-01

Microcirculatory abnormalities precede the onset of hypertension and may explain its familial nature. We examined the relationship between parental blood pressure (BP) and offspring retinal microvasculature in Pakistani trios [father, mother, and child (aged 9-14 years)]. This is a substudy of a population-based trial of BP reduction. Data were available on 358 normotensive, and 410 offspring of at least one hypertensive parent. Retinal vessel characteristics were measured from digital images. Multivariable linear regression models were built to assess the associations between maternal and paternal BP and offspring retinal microvasculature. Optimality deviation was greatest in offspring of two hypertensive parents, compared with those with one or no hypertensive parent (P=0.030 for trend). Paternal SBP and DBP were each significantly associated with optimality deviation in offspring (P=0.023 and P=0.006, respectively). This relationship persisted after accounting for offspring cardiovascular risk factors [increase in optimality deviation (95% confidence interval, CI) 0.0053 (0.0001-0.0106, P=0.047) and 0.0109 (0.0025-0.0193, P=0.011), for each 10 mmHg increase in paternal SBP and DBP, respectively]. Maternal DBP was inversely associated with offspring arteriovenous ratio -0.0102 (-0.0198 to -0.0007, P=0.035). Microvascular endothelial dysfunction in children is associated with increasing levels of parental hypertension. The association with paternal BP is independent of other cardiovascular risk factors, including the child's BP. Higher maternal DBP is associated with evidence of arteriolar narrowing in offspring. These early microcirculatory changes may help explain familial predisposition to hypertension in people of Pakistani origin at an early age. :

Adaptive optics with pupil tracking for high resolution retinal imaging

PubMed Central

Sahin, Betul; Lamory, Barbara; Levecq, Xavier; Harms, Fabrice; Dainty, Chris

2012-01-01

Adaptive optics, when integrated into retinal imaging systems, compensates for rapidly changing ocular aberrations in real time and results in improved high resolution images that reveal the photoreceptor mosaic. Imaging the retina at high resolution has numerous potential medical applications, and yet for the development of commercial products that can be used in the clinic, the complexity and high cost of the present research systems have to be addressed. We present a new method to control the deformable mirror in real time based on pupil tracking measurements which uses the default camera for the alignment of the eye in the retinal imaging system and requires no extra cost or hardware. We also present the first experiments done with a compact adaptive optics flood illumination fundus camera where it was possible to compensate for the higher order aberrations of a moving model eye and in vivo in real time based on pupil tracking measurements, without the real time contribution of a wavefront sensor. As an outcome of this research, we showed that pupil tracking can be effectively used as a low cost and practical adaptive optics tool for high resolution retinal imaging because eye movements constitute an important part of the ocular wavefront dynamics. PMID:22312577

Adaptive optics with pupil tracking for high resolution retinal imaging.

PubMed

Sahin, Betul; Lamory, Barbara; Levecq, Xavier; Harms, Fabrice; Dainty, Chris

2012-02-01

Adaptive optics, when integrated into retinal imaging systems, compensates for rapidly changing ocular aberrations in real time and results in improved high resolution images that reveal the photoreceptor mosaic. Imaging the retina at high resolution has numerous potential medical applications, and yet for the development of commercial products that can be used in the clinic, the complexity and high cost of the present research systems have to be addressed. We present a new method to control the deformable mirror in real time based on pupil tracking measurements which uses the default camera for the alignment of the eye in the retinal imaging system and requires no extra cost or hardware. We also present the first experiments done with a compact adaptive optics flood illumination fundus camera where it was possible to compensate for the higher order aberrations of a moving model eye and in vivo in real time based on pupil tracking measurements, without the real time contribution of a wavefront sensor. As an outcome of this research, we showed that pupil tracking can be effectively used as a low cost and practical adaptive optics tool for high resolution retinal imaging because eye movements constitute an important part of the ocular wavefront dynamics.

Design of a high-resolution optoelectronic retinal prosthesis.

PubMed

Palanker, Daniel; Vankov, Alexander; Huie, Phil; Baccus, Stephen

2005-03-01

It has been demonstrated that electrical stimulation of the retina can produce visual percepts in blind patients suffering from macular degeneration and retinitis pigmentosa. However, current retinal implants provide very low resolution (just a few electrodes), whereas at least several thousand pixels would be required for functional restoration of sight. This paper presents the design of an optoelectronic retinal prosthetic system with a stimulating pixel density of up to 2500 pix mm(-2) (corresponding geometrically to a maximum visual acuity of 20/80). Requirements on proximity of neural cells to the stimulation electrodes are described as a function of the desired resolution. Two basic geometries of sub-retinal implants providing required proximity are presented: perforated membranes and protruding electrode arrays. To provide for natural eye scanning of the scene, rather than scanning with a head-mounted camera, the system operates similar to 'virtual reality' devices. An image from a video camera is projected by a goggle-mounted collimated infrared LED-LCD display onto the retina, activating an array of powered photodiodes in the retinal implant. The goggles are transparent to visible light, thus allowing for the simultaneous use of remaining natural vision along with prosthetic stimulation. Optical delivery of visual information to the implant allows for real-time image processing adjustable to retinal architecture, as well as flexible control of image processing algorithms and stimulation parameters.

Design of a high-resolution optoelectronic retinal prosthesis

NASA Astrophysics Data System (ADS)

Palanker, Daniel; Vankov, Alexander; Huie, Phil; Baccus, Stephen

2005-03-01

It has been demonstrated that electrical stimulation of the retina can produce visual percepts in blind patients suffering from macular degeneration and retinitis pigmentosa. However, current retinal implants provide very low resolution (just a few electrodes), whereas at least several thousand pixels would be required for functional restoration of sight. This paper presents the design of an optoelectronic retinal prosthetic system with a stimulating pixel density of up to 2500 pix mm-2 (corresponding geometrically to a maximum visual acuity of 20/80). Requirements on proximity of neural cells to the stimulation electrodes are described as a function of the desired resolution. Two basic geometries of sub-retinal implants providing required proximity are presented: perforated membranes and protruding electrode arrays. To provide for natural eye scanning of the scene, rather than scanning with a head-mounted camera, the system operates similar to 'virtual reality' devices. An image from a video camera is projected by a goggle-mounted collimated infrared LED-LCD display onto the retina, activating an array of powered photodiodes in the retinal implant. The goggles are transparent to visible light, thus allowing for the simultaneous use of remaining natural vision along with prosthetic stimulation. Optical delivery of visual information to the implant allows for real-time image processing adjustable to retinal architecture, as well as flexible control of image processing algorithms and stimulation parameters.

Computer-aided diagnostic detection system of venous beading in retinal images

NASA Astrophysics Data System (ADS)

Yang, Ching-Wen; Ma, DyeJyun; Chao, ShuennChing; Wang, ChuinMu; Wen, Chia-Hsien; Lo, ChienShun; Chung, Pau-Choo; Chang, Chein-I.

2000-05-01

The detection of venous beading in retinal images provides an early sign of diabetic retinopathy and plays an important role as a preprocessing step in diagnosing ocular diseases. We present a computer-aided diagnostic system to automatically detect venous beading of blood vessels. It comprises of two modules, referred to as the blood vessel extraction module and the venus beading detection module. The former uses a bell-shaped Gaussian kernel with 12 azimuths to extract blood vessels while the latter applies a neural network-based shape cognitron to detect venous beading among the extracted blood vessels for diagnosis. Both modules are fully computer-automated. To evaluate the proposed system, 61 retinal images (32 beaded and 29 normal images) are used for performance evaluation.

Spectral domain optical coherence tomography imaging of retinal diseases in Singapore.

PubMed

Singh, Mandeep; Chee, Caroline K L

2009-01-01

In this retrospective case series, the authors reviewed cases of patients with macular disorders whose eyes had been imaged using spectral domain optical coherence tomography (SD-OCT) (Cirrus HD-OCT; Carl Zeiss Meditec, Inc., Dublin, CA). SD-OCT images were obtained from patients with a variety of ocular conditions attending a tertiary retinal clinic in Singapore from August 2007 to December 2007, according to standardized protocols. Images of 428 eyes from 301 patients were reviewed. Ocular diagnoses included diabetic macular edema, exudative age-related macular degeneration, central serous chorioretinopathy, cystoid macular edema, retinal vein and artery occlusions, infective chorioretinitis, and others. The authors present four cases of particular interest to illustrate how SD-OCT was useful in complementing the clinician's assessment of macular disease.

Stabilized high-accuracy correction of ocular aberrations with liquid crystal on silicon spatial light modulator in adaptive optics retinal imaging system.

PubMed

Huang, Hongxin; Inoue, Takashi; Tanaka, Hiroshi

2011-08-01

We studied the long-term optical performance of an adaptive optics scanning laser ophthalmoscope that uses a liquid crystal on silicon spatial light modulator to correct ocular aberrations. The system achieved good compensation of aberrations while acquiring images of fine retinal structures, excepting during sudden eye movements. The residual wavefront aberrations collected over several minutes in several situations were statistically analyzed. The mean values of the root-mean-square residual wavefront errors were 23-30 nm, and for around 91-94% of the effective time the errors were below the Marechal criterion for diffraction limited imaging. The ability to axially shift the imaging plane to different retinal depths was also demonstrated.

Retinal image mosaicing using the radial distortion correction model

NASA Astrophysics Data System (ADS)

Lee, Sangyeol; Abràmoff, Michael D.; Reinhardt, Joseph M.

2008-03-01

Fundus camera imaging can be used to examine the retina to detect disorders. Similar to looking through a small keyhole into a large room, imaging the fundus with an ophthalmologic camera allows only a limited view at a time. Thus, the generation of a retinal montage using multiple images has the potential to increase diagnostic accuracy by providing larger field of view. A method of mosaicing multiple retinal images using the radial distortion correction (RADIC) model is proposed in this paper. Our method determines the inter-image connectivity by detecting feature correspondences. The connectivity information is converted to a tree structure that describes the spatial relationships between the reference and target images for pairwise registration. The montage is generated by cascading pairwise registration scheme starting from the anchor image downward through the connectivity tree hierarchy. The RADIC model corrects the radial distortion that is due to the spherical-to-planar projection during retinal imaging. Therefore, after radial distortion correction, individual images can be properly mapped onto a montage space by a linear geometric transformation, e.g. affine transform. Compared to the most existing montaging methods, our method is unique in that only a single registration per image is required because of the distortion correction property of RADIC model. As a final step, distance-weighted intensity blending is employed to correct the inter-image differences in illumination encountered when forming the montage. Visual inspection of the experimental results using three mosaicing cases shows our method can produce satisfactory montages.

Early simultaneous fundus autofluorescence and optical coherence tomography features after pars plana vitrectomy for primary rhegmatogenous retinal detachment.

PubMed

Dell'Omo, Roberto; Mura, Marco; Lesnik Oberstein, Sarit Y; Bijl, Heico; Tan, H Stevie

2012-04-01

To describe fundus autofluorescence and optical coherence tomography (OCT) features of the macula after pars plana vitrectomy for rhegmatogenous retinal detachment. Thirty-three eyes of 33 consecutive patients with repaired rhegmatogenous retinal detachment with or without the involvement of the macula were prospectively investigated with simultaneous fundus autofluorescence and OCT imaging using the Spectralis HRA+OCT (Heidelberg Engineering, Heidelberg, Germany) within a few weeks after the operation. Fundus autofluorescence imaging of the macula showed lines of increased and decreased autofluorescence in 19 cases (57.6%). On OCT, these lines corresponded to the following abnormalities: outer retinal folds, inner retinal folds, and skip reflectivity abnormalities of the photoreceptor inner segment/outer segment band. Other OCT findings, not related to abnormal lines on fundus autofluorescence, consisted of disruption of photoreceptor inner segment/outer segment band and collection of intraretinal or subretinal fluid. The presence of outer retinal folds significantly related to metamorphopsia but did not relate to poor postoperative visual acuity. Partial-thickness retinal folds occur commonly after vitrectomy for rhegmatogenous retinal detachment repair and may represent an important anatomical substrate for postoperative metamorphopsia. Fundus autofluorescence and OCT are both sensitive techniques for the detection of these abnormalities.

Effects of GH/IGF-I Axis on Retinal Vascular Morphology: Retinal Vascular Characteristics in a Clinical Setting with Severe IGF-I Deficiency.

PubMed

Sekeroglu, Hande Taylan; Kadayıfcılar, Sibel; Kasım, Burcu; Arslan, Umut; Ozon, Alev

2016-01-01

The purpose of this study was to assess retinal vascular characteristics of patients with Laron syndrome (LS) as a genetic model of IGF-I deficiency before and after rhIGF1/IGFBP3 treatment and to compare them with healthy controls. A total of 28 subjects (11 LS, and 17 controls) were enrolled. Patients with LS received combined rhIGF1/rhIGFBP3 1-2 mg/kg/d in a single dose and digital fundus imaging was performed. The number of branching points and tortuosity of retinal vessels were studied. Pre- and post-treatment findings were compared with each other and with controls. The number of branching points was significantly lower in patients with LS in comparison to controls (12.73 ± 3.41, and 17.47 ± 5.82 respectively, p = 0.012). This difference persisted after treatment (12.09 ± 2.66 post-treatment LS versus controls, p = 0.017). Tortuosity indices of nasal arteries (NA) were significantly less in LS than that of controls (upper NA 1.07 ± 0.04 and 1.12 ± 0.06 respectively p = 0.022; lower NA 1.07 ± 0.03 and 1.13 ± 0.07 respectively, p = 0.004). This difference also persisted following treatment (p < 0.05). Remaining vessels did not differ in tortuosity index. There was no significant difference of tortuosity index and number of branching points before and after treatment in patients with LS. Retinal vascular development may be adversely affected in the setting of severe IGF-I deficiency confirming a major role for GH/IGF-I axis during retinal vascular development in humans antenatally. Resolution of IGF-I deficiency following birth using rhIGF1, however, may not reverse these changes, suggesting that IGF-I may be necessary but insufficient by itself for postnatal angiogenesis.

Automatic detection of diabetic retinopathy using an artificial neural network: a screening tool.

PubMed

Gardner, G G; Keating, D; Williamson, T H; Elliott, A T

1996-11-01

To determine if neural networks can detect diabetic features in fundus images and compare the network against an ophthalmologist screening a set of fundus images. 147 diabetic and 32 normal images were captured from a fundus camera, stored on computer, and analysed using a back propagation neural network. The network was trained to recognise features in the retinal image. The effects of digital filtering techniques and different network variables were assessed. 200 diabetic and 101 normal images were then randomised and used to evaluate the network's performance for the detection of diabetic retinopathy against an ophthalmologist. Detection rates for the recognition of vessels, exudates, and haemorrhages were 91.7%, 93.1%, and 73.8% respectively. When compared with the results of the ophthalmologist, the network achieved a sensitivity of 88.4% and a specificity of 83.5% for the detection of diabetic retinopathy. Detection of vessels, exudates, and haemorrhages was possible, with success rates dependent upon preprocessing and the number of images used in training. When compared with the ophthalmologist, the network achieved good accuracy for the detection of diabetic retinopathy. The system could be used as an aid to the screening of diabetic patients for retinopathy.

Automated Diagnosis of Glaucoma Using Empirical Wavelet Transform and Correntropy Features Extracted From Fundus Images.

PubMed

Maheshwari, Shishir; Pachori, Ram Bilas; Acharya, U Rajendra

2017-05-01

Glaucoma is an ocular disorder caused due to increased fluid pressure in the optic nerve. It damages the optic nerve and subsequently causes loss of vision. The available scanning methods are Heidelberg retinal tomography, scanning laser polarimetry, and optical coherence tomography. These methods are expensive and require experienced clinicians to use them. So, there is a need to diagnose glaucoma accurately with low cost. Hence, in this paper, we have presented a new methodology for an automated diagnosis of glaucoma using digital fundus images based on empirical wavelet transform (EWT). The EWT is used to decompose the image, and correntropy features are obtained from decomposed EWT components. These extracted features are ranked based on t value feature selection algorithm. Then, these features are used for the classification of normal and glaucoma images using least-squares support vector machine (LS-SVM) classifier. The LS-SVM is employed for classification with radial basis function, Morlet wavelet, and Mexican-hat wavelet kernels. The classification accuracy of the proposed method is 98.33% and 96.67% using threefold and tenfold cross validation, respectively.

Automated detection of microaneurysms using scale-adapted blob analysis and semi-supervised learning.

PubMed

Adal, Kedir M; Sidibé, Désiré; Ali, Sharib; Chaum, Edward; Karnowski, Thomas P; Mériaudeau, Fabrice

2014-04-01

Despite several attempts, automated detection of microaneurysm (MA) from digital fundus images still remains to be an open issue. This is due to the subtle nature of MAs against the surrounding tissues. In this paper, the microaneurysm detection problem is modeled as finding interest regions or blobs from an image and an automatic local-scale selection technique is presented. Several scale-adapted region descriptors are introduced to characterize these blob regions. A semi-supervised based learning approach, which requires few manually annotated learning examples, is also proposed to train a classifier which can detect true MAs. The developed system is built using only few manually labeled and a large number of unlabeled retinal color fundus images. The performance of the overall system is evaluated on Retinopathy Online Challenge (ROC) competition database. A competition performance measure (CPM) of 0.364 shows the competitiveness of the proposed system against state-of-the art techniques as well as the applicability of the proposed features to analyze fundus images. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Mapping by VESGEN of Blood Vessels in the Retinas of Astronauts Pre- and Post-Flight to the ISS

NASA Technical Reports Server (NTRS)

Parsons-Wingerter, P.; Vyas, R. J.; Murray, M. C.; Predovic, M.; Lim, S.; Vizzeri, G.; Taibbi, G.; Mason, S. S.; Zanello, S. B.; Young, M.

2017-01-01

Research by NASA [1] established that significant risks for visual and ocular impairments associated with increased intracranial pressure (VIIP) are incurred by microgravity spaceflight, especially long-duration missions. It is well established in physiology and pathology that a fundamental role of the microvasculature is to mediate fluid transfers and remodel actively in response to environmental, immune and other stresses. We therefore hypothesize that remodeling of retinal blood vessels necessarily occurs during accommodation of microgravity-induced fluid shifts prior to subsequent development of visual and ocular impairments. Potential contributions of retinal vascular remodeling to VIIP etiology are therefore being investigated by NASA's innovative VESsel GENeration Analysis (VESGEN) software for two studies: (1) U.S. crew members before and after ISS missions, and (2) head-down tilt in human subjects before and after 70 days of bed rest. We anticipate that results of the two studies will be complete by the Investigators Workshop (January 22, 2017). METHODS: For the 2013 NASA NRA award, we are concluding the analysis of 30 degree infrared (IR) Heidelberg Spectralis images of retinal blood vessels by VESGEN (patents pending), a mature, automated software developed as a translational and basic vascular research discovery tool, particularly for retinal vascular disease. Subjects of our retrospective study include eight ISS crew members monitored for routine occupational surveillance pre- and post-flight, who provided their study consents to NASAs Lifetime Surveillance of Astronaut Health (LSAH) in coordination with approval of the VESGEN retrospective study protocol by NASAs Institutional Review Board (IRB). The ophthalmic retinal images (average image resolution, approximately 5.6 microns per pixel) are blinded as to pre and post ISS status until the second portion of our study, when VESGEN results will be correlated with other ophthalmic and medical findings for the crew members. Due to image resolution challenges, a novel Matlab tool was developed for aligning pre and post images, and comparing (querying) the two images for differences in the morphology of small vessels. RESULTS: During the past year, LSAH approved the release of all astronaut retinal images to our study for VESGEN analysis. Substantial progress on the initial blinded portion of the study is in place. We anticipate that VESGEN analysis of the 32 Spectralis IR retinal images will be complete for presentation at the 2017 IWS meeting. CONCLUSIONS: Modified retinal vascular patterning may offer early-stage predictions of ocular changes resulting in decreased visual acuity for the VIIP syndrome. Novel insights provided by VESGEN into progressively pathological and blinding vascular remodeling in the human retina currently help to guide other NIH- and NASA-supported therapeutic studies of retinal disease and modeling of the VIIP risk. Results of our vascular investigation of the retinas of astronauts pre- and post-flight may help advance the understanding of both healthy and pathological adaptations to fluid shifts in microgravity associated with the VIIP syndrome. Preliminary results indicate that imaging of higher resolution, such as the new OCT angiography (OCT-A) technology, will be required to determine conclusively the role of the smaller retinal and choroidal vessels in VIIP etiology.

Wide-field fundus autofluorescence imaging to evaluate retinal function in patients with retinitis pigmentosa.

PubMed

Ogura, Shuntaro; Yasukawa, Tsutomu; Kato, Aki; Usui, Hideaki; Hirano, Yoshio; Yoshida, Munenori; Ogura, Yuichiro

2014-11-01

To study the correlation between the visual fields (VF) and wide-field fundus autofluorescence (FAF) in patients with retinitis pigmentosa (RP). Retrospective, observational, consecutive case series. Twenty-four eyes of 12 patients diagnosed with RP were enrolled. The VFs measured by Goldmann perimetry and wide-field FAF images were compared for each eye. The relationship between the areas of hypoautofluorescence on the wide-field FAF images and scotoma on Goldmann perimetry were evaluated. The VF and FAF images in the central 60 degrees were trimmed and superimposed to calculate the percentage agreement between the hypoautofluorescence and the scotomas and between the isoautofluorescence and hyperautofluorescence and the remaining VFs. The areas of hypoautofluorescence on the FAF images were correlated significantly (R = 0.86, P < .001) with the areas of the VF defects on Goldmann perimetry. The mean percentage agreement between the hypoautofluorescence and the scotomas was 91.0% ± 7.7% and that of the isoautofluorescence and hyperautofluorescence with the remaining VFs was 84.5% ± 7.4%. The areas of geographic hypoautofluorescence with or without hyperautofluorescent bands reflected the VF defects, while nummular or mottled hypoautofluorescence without VF defects was seen in 7 eyes. These results suggested that wide-field FAF imaging is useful to evaluate the remaining retinal function in patients with RP. Abnormal fundus autofluorescence precedes loss of retinal function and is helpful for monitoring disease progression. Copyright © 2014 Elsevier Inc. All rights reserved.

Retinal microvascular network alterations: potential biomarkers of cerebrovascular and neural diseases.

PubMed

Cabrera DeBuc, Delia; Somfai, Gabor Mark; Koller, Akos

2017-02-01

Increasing evidence suggests that the conditions of retinal microvessels are indicators to a variety of cerebrovascular, neurodegenerative, psychiatric, and developmental diseases. Thus noninvasive visualization of the human retinal microcirculation offers an exceptional opportunity for the investigation of not only the retinal but also cerebral microvasculature. In this review, we show how the conditions of the retinal microvessels could be used to assess the conditions of brain microvessels because the microvascular network of the retina and brain share, in many aspects, standard features in development, morphology, function, and pathophysiology. Recent techniques and imaging modalities, such as optical coherence tomography (OCT), allow more precise visualization of various layers of the retina and its microcirculation, providing a "microscope" to brain microvessels. We also review the potential role of retinal microvessels in the risk identification of cerebrovascular and neurodegenerative diseases. The association between vision problems and cerebrovascular and neurodegenerative diseases, as well as the possible role of retinal microvascular imaging biomarkers in cerebrovascular and neurodegenerative screening, their potentials, and limitations, are also discussed. Copyright © 2017 the American Physiological Society.

Hyperspectral imaging for the detection of retinal disease

NASA Astrophysics Data System (ADS)

Harvey, Andrew R.; Lawlor, Joanne; McNaught, Andrew I.; Williams, John W.; Fletcher-Holmes, David W.

2002-11-01

Hyperspectral imaging (HSI) shows great promise for the detection and classification of several diseases, particularly in the fields of "optical biopsy" as applied to oncology, and functional retinal imaging in ophthalmology. In this paper, we discuss the application of HSI to the detection of retinal diseases and technological solutions that address some of the fundamental difficulties of spectral imaging within the eye. HSI of the retina offers a route to non-invasively deduce biochemical and metabolic processes within the retina. For example it shows promise for the mapping of retinal blood perfusion using spectral signatures of oxygenated and deoxygenated hemoglobin. Compared with other techniques using just a few spectral measurements, it offers improved classification in the presence of spectral cross-contamination by pigments and other components within the retina. There are potential applications for this imaging technique in the investigation and treatment of the eye complications of diabetes, and other diseases involving disturbances to the retinal, or optic-nerve-head circulation. It is well known that high-performance HSI requires high signal-to-noise ratios (SNR) whereas the application of any imaging technique within the eye must cope with the twin limitations of the small numerical aperture provided by the entrance pupil to the eye and the limit on the radiant power at the retina. We advocate the use of spectrally-multiplexed spectral imaging techniques (the traditional filter wheel is a traditional example). These approaches enable a flexible approach to spectral imaging, with wider spectral range, higher SNRs and lower light intensity at the retina than could be achieved using a Fourier-transform (FT) approach. We report the use of spectral imaging to provide calibrated spectral albedo images of healthy and diseased retinas and the use of this data for screening purposes. These images clearly demonstrate the ability to distinguish between oxygenated and deoxygenated hemoglobin using spectral imaging and this shows promise for the early detection of various retinopathies.

Optical Coherence Tomography Angiography of Retinal Cavernous Hemangioma.

PubMed

Pierro, Luisa; Marchese, Alessandro; Gagliardi, Marco; Bandello, Francesco

2017-08-01

Retinal cavernous hemangioma is a rare, benign, retinal tumor characterized by angiomatous proliferation of vessels within the inner retina or the optic disc.1 Here we report a case of retinal cavernous hemangioma on the margin of the optic disc in the right eye of a 61-year-old asymptomatic female. The lesion was studied with multimodal imaging which included structural optical coherence tomography, fluorescein angiography, blue fundus auto-fluorescence, optical coherence tomography angiography (OCTA) (DRI OCT Triton; Topcon, Tokyo, Japan) and visual field examination. Blood circulation inside retinal cavernous hemangioma lesion is typically low-stagnant.2 However, OCTA demonstrated blood flow inside the lesion, illustrating its vascular circulation.3 Visual field was within the normal limits, except from a slight enlargement of the blind spot. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:684-685.]. Copyright 2017, SLACK Incorporated.

Comparison of conventional color fundus photography and multicolor imaging in choroidal or retinal lesions.

PubMed

Muftuoglu, Ilkay Kilic; Gaber, Raouf; Bartsch, Dirk-Uwe; Meshi, Amit; Goldbaum, Michael; Freeman, William R

2018-04-01

Our purpose was to compare the characteristics of the retinal and choroidal lesions including choroidal nevus, choroidal melanoma and congenital hypertrophy of the retina pigment epithelium using conventional color fundus photography (CFP) and multicolor imaging (MCI). The paired images of patients with retinal or choroidal lesions were assessed for the visibility of lesion's border, halo and drusen using a grading scale (0-2). The area of the lesion was measured on both imaging modalities. The same grading was also done on the individual color channels of MCI for a further evaluation. Thirty-three eyes of 33 patients were included. There were no significant differences in the mean border, drusen and halo visibility scores between the two imaging modalities (p = 0.12, p = 0.70, p = 0.35). However, the mean area of the lesion was significantly smaller on MCI than that on CFP (14.9±3.3 versus 18.7±3.4 mm 2 , p = 0.01). The appearance of choroidal and/ or retinal lesions on MCI may be different than that on CFP. Though MCI can provide similar information with CFP for the features of retinal and/ or choroidal lesions including border, halo and drusen; the infrared light reflection on MCI underestimates the extent of the choroidal lesion by 33%.

Optical Coherence Tomography Angiography and Ultra-Widefield Optical Coherence Tomography in a Child With Incontinentia Pigmenti.

PubMed

Kim, Sang Jin; Yang, Jianlong; Liu, Gangjun; Huang, David; Campbell, J Peter

2018-04-01

Incontinentia pigmenti (IP) is a rare X-linked dominant disorder that can cause retinal nonperfusion, neovascularization, and retinal detachment. Evaluation of the peripheral retinal vasculature and appropriate treatment can reduce the risk of blindness. The authors report the use of a handheld prototype optical coherence tomography angiography (OCTA) and ultra-widefield OCT (UWF-OCT) during exam under anesthesia of a 2-year-old with a history of severe early onset IP. UWF-OCT and OCTA may be used as noninvasive imaging modalities for IP and similar retinal vascular disorders in supine young children. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:273-275.]. Copyright 2018, SLACK Incorporated.

Optic disc detection using ant colony optimization

NASA Astrophysics Data System (ADS)

Dias, Marcy A.; Monteiro, Fernando C.

2012-09-01

The retinal fundus images are used in the treatment and diagnosis of several eye diseases, such as diabetic retinopathy and glaucoma. This paper proposes a new method to detect the optic disc (OD) automatically, due to the fact that the knowledge of the OD location is essential to the automatic analysis of retinal images. Ant Colony Optimization (ACO) is an optimization algorithm inspired by the foraging behaviour of some ant species that has been applied in image processing for edge detection. Recently, the ACO was used in fundus images to detect edges, and therefore, to segment the OD and other anatomical retinal structures. We present an algorithm for the detection of OD in the retina which takes advantage of the Gabor wavelet transform, entropy and ACO algorithm. Forty images of the retina from DRIVE database were used to evaluate the performance of our method.

Ultrahigh-speed non-invasive widefield angiography

NASA Astrophysics Data System (ADS)

Blatter, Cedric; Klein, Thomas; Grajciar, Branislav; Schmoll, Tilman; Wieser, Wolfgang; Andre, Raphael; Huber, Robert; Leitgeb, Rainer A.

2012-07-01

Retinal and choroidal vascular imaging is an important diagnostic benefit for ocular diseases such as age-related macular degeneration. The current gold standard for vessel visualization is fluorescence angiography. We present a potential non-invasive alternative to image blood vessels based on functional Fourier domain optical coherence tomography (OCT). For OCT to compete with the field of view and resolution of angiography while maintaining motion artifacts to a minimum, ultrahigh-speed imaging has to be introduced. We employ Fourier domain mode locking swept source technology that offers high quality imaging at an A-scan rate of up to 1.68 MHz. We present retinal angiogram over ˜48 deg acquired in a few seconds in a single recording without the need of image stitching. OCT at 1060 nm allows for high penetration in the choroid and efficient separate characterization of the retinal and choroidal vascularization.

Tracking scanning laser ophthalmoscope (TSLO)

NASA Astrophysics Data System (ADS)

Hammer, Daniel X.; Ferguson, R. Daniel; Magill, John C.; White, Michael A.; Elsner, Ann E.; Webb, Robert H.

2003-07-01

The effectiveness of image stabilization with a retinal tracker in a multi-function, compact scanning laser ophthalmoscope (TSLO) was demonstrated in initial human subject tests. The retinal tracking system uses a confocal reflectometer with a closed loop optical servo system to lock onto features in the fundus. The system is modular to allow configuration for many research and clinical applications, including hyperspectral imaging, multifocal electroretinography (MFERG), perimetry, quantification of macular and photo-pigmentation, imaging of neovascularization and other subretinal structures (drusen, hyper-, and hypo-pigmentation), and endogenous fluorescence imaging. Optical hardware features include dual wavelength imaging and detection, integrated monochromator, higher-order motion control, and a stimulus source. The system software consists of a real-time feedback control algorithm and a user interface. Software enhancements include automatic bias correction, asymmetric feature tracking, image averaging, automatic track re-lock, and acquisition and logging of uncompressed images and video files. Normal adult subjects were tested without mydriasis to optimize the tracking instrumentation and to characterize imaging performance. The retinal tracking system achieves a bandwidth of greater than 1 kHz, which permits tracking at rates that greatly exceed the maximum rate of motion of the human eye. The TSLO stabilized images in all test subjects during ordinary saccades up to 500 deg/sec with an inter-frame accuracy better than 0.05 deg. Feature lock was maintained for minutes despite subject eye blinking. Successful frame averaging allowed image acquisition with decreased noise in low-light applications. The retinal tracking system significantly enhances the imaging capabilities of the scanning laser ophthalmoscope.

Retinal blood vessel segmentation using fully convolutional network with transfer learning.

PubMed

Jiang, Zhexin; Zhang, Hao; Wang, Yi; Ko, Seok-Bum

2018-04-26

Since the retinal blood vessel has been acknowledged as an indispensable element in both ophthalmological and cardiovascular disease diagnosis, the accurate segmentation of the retinal vessel tree has become the prerequisite step for automated or computer-aided diagnosis systems. In this paper, a supervised method is presented based on a pre-trained fully convolutional network through transfer learning. This proposed method has simplified the typical retinal vessel segmentation problem from full-size image segmentation to regional vessel element recognition and result merging. Meanwhile, additional unsupervised image post-processing techniques are applied to this proposed method so as to refine the final result. Extensive experiments have been conducted on DRIVE, STARE, CHASE_DB1 and HRF databases, and the accuracy of the cross-database test on these four databases is state-of-the-art, which also presents the high robustness of the proposed approach. This successful result has not only contributed to the area of automated retinal blood vessel segmentation but also supports the effectiveness of transfer learning when applying deep learning technique to medical imaging. Copyright © 2018 Elsevier Ltd. All rights reserved.

Multispectral scanning laser ophthalmoscopy combined with optical coherence tomography for simultaneous in vivo mouse retinal imaging

NASA Astrophysics Data System (ADS)

Zhang, Pengfei; Zam, Azhar; Jian, Yifan; Wang, Xinlei; Burns, Marie E.; Sarunic, Marinko V.; Pugh, Edward N.; Zawadzki, Robert J.

2015-03-01

A compact, non-invasive multi-modal system has been developed for in vivo mouse retina imaging. It is configured for simultaneously detecting green and red fluorescent protein signals with scanning laser ophthalmoscopy (SLO) back-scattered light from the SLO illumination beam, and depth information about different retinal layers by means of Optical Coherence Tomography (OCT). Simultaneous assessment of retinal characteristics with different modalities can provide a wealth of information about the structural and functional changes in the retinal neural tissue and chorio-retinal vasculature in vivo. Additionally, simultaneous acquisition of multiple channels facilitates analysis of the data of different modalities by automatic temporal and structural co-registration. As an example of the instrument's performance we imaged the retina of a mouse with constitutive expression of GFP in microglia cells (Cx3cr1GFP/+), and which also expressed the red fluorescent protein mCherry in Müller glial cells by means of adeno-associated virus delivery (AAV2) of an mCherry cDNA driven by the GFAP (glial fibrillary acid protein) promoter.

Automated method for identification and artery-venous classification of vessel trees in retinal vessel networks.

PubMed

Joshi, Vinayak S; Reinhardt, Joseph M; Garvin, Mona K; Abramoff, Michael D

2014-01-01

The separation of the retinal vessel network into distinct arterial and venous vessel trees is of high interest. We propose an automated method for identification and separation of retinal vessel trees in a retinal color image by converting a vessel segmentation image into a vessel segment map and identifying the individual vessel trees by graph search. Orientation, width, and intensity of each vessel segment are utilized to find the optimal graph of vessel segments. The separated vessel trees are labeled as primary vessel or branches. We utilize the separated vessel trees for arterial-venous (AV) classification, based on the color properties of the vessels in each tree graph. We applied our approach to a dataset of 50 fundus images from 50 subjects. The proposed method resulted in an accuracy of 91.44% correctly classified vessel pixels as either artery or vein. The accuracy of correctly classified major vessel segments was 96.42%.

Choroidal Involvement in Acute Posterior Multifocal Placoid Pigment Epitheliopathy.

PubMed

Mrejen, Sarah; Sarraf, David; Chexal, Saradha; Wald, Kenneth; Freund, K Bailey

2016-01-01

To evaluate choroidal involvement in acute posterior multifocal placoid pigment epitheliopathy (APMPPE). Retrospective study in five eyes of three patients evaluated through multimodal imaging, including enhanced-depth imaging optical coherence tomography (OCT), ultra-wide field color photography, fundus autofluorescence, and fluorescein angiography (FA). Choroidal thickness and structure were evaluated on OCT. During the acute phase, choroidal OCT showed choroidal thickening and a lucency at the level of the inner choroid. Subclinical lesions detected in the retinal periphery using wide-field retinal imaging were isoautofluorescent and corresponded to choriocapillaris filling-defects on FA. At final follow-up, all patients showed resolution of choroidal thickening and the inner choroidal lucency, as well as the disappearance of subclinical lesions. These results suggest a transient ischemic choroiditis in APMPPE that may lead to secondary permanent retinal pigment epithelium damage in the posterior pole but not in the retinal periphery. Copyright 2016, SLACK Incorporated.

Oscillating fluid lens in coherent retinal projection displays for extending depth of focus

NASA Astrophysics Data System (ADS)

von Waldkirch, extending depth of focus M.; Lukowicz, P.; Troster, G.

2005-09-01

See-through head-mounted displays, which allow to overlay virtual information over the user's real view, suffer normally from a limited depth of focus (DOF). To overcome this problem we discuss in this paper the use of a fast oscillating, variable-focus lens in a retinal projection display. The evaluation is based on a schematic eye model and on the partial coherence simulation tool SPLAT which allows us to calculate the projected retinal images of a text target. Objective image quality criteria demonstrate that the use of an oscillating lens is promising provided that partially coherent illumination light is used. In this case, psychometric measurements reveal that the depth of focus for reading text can be extended by a factor of up to 2.2. For fully coherent and incoherent illumination, however, the retinal images suffer from structural and contrast degradation effects, respectively.

Imaging retinal progenitor lineages in developing zebrafish embryos.

PubMed

Jusuf, Patricia; Harris, William A; Poggi, Lucia

2013-03-01

In this protocol, we describe how to make and analyze four dimensional (4D) movies of retinal lineage in the zebrafish embryo in vivo. 4D consists of three spatial dimensions (3D) reconstructed from stacks of confocal planes plus one time dimension. Our imaging is performed on transgenic cells that express fluorescent proteins under the control of cell-specific promoters or on cells that transiently express such reporters in specific retinal cell progenitors. An important aspect of lineage tracing is the ability to follow individual cells as they undergo multiple cell divisions, final migration, and differentiation. This may mean many hours of 4D imaging, requiring that cells be kept healthy and maintained under conditions suitable for normal development. The longest movies we have made are ∼50 h. By analyzing these movies, we can see when a specific cell was born and who its sister was, allowing us to reconstruct its retinal lineages in vivo.

Retinal vascular imaging technology to monitor disease severity and complications in type 1 diabetes mellitus: A systematic review.

PubMed

Kee, Ae Ra; Wong, Tien Yin; Li, Ling-Jun

2017-02-01

Type 1 diabetes mellitus (T1DM) is a major disease affecting a large number of young patients. In the recent years, retinal vascular imaging has provided an objective assessment of vascular health in patients with T1DM. Our study aimed to review the current literature on retinal vascular parameters in young patients with T1DM in order to understand the following: (i) How retinal vessels are affected in T1DM (ii) How such vascular changes can be predictive of future diabetic microvascular complications METHODS: We performed a systematic review and extracted relevant data from 17 articles. We found significant correlations between retinal vessel changes and diabetes-related risk factors (eg, hypertension, hyperlipidemia, and obesity), diabetes-related features (eg, diabetes duration and glycemic control), and diabetes-related microvascular complications (eg, diabetic retinopathy, nephropathy, and neuropathy). Our findings suggest that retinal microvasculature is associated with both disease severity and complications in young patients with T1DM. © 2016 John Wiley & Sons Ltd.

Age-Related Alterations in the Retinal Microvasculature, Microcirculation, and Microstructure

PubMed Central

Wei, Yantao; Jiang, Hong; Shi, Yingying; Qu, Dongyi; Gregori, Giovanni; Zheng, Fang; Rundek, Tatjana; Wang, Jianhua

2017-01-01

Purpose To characterize age-related alterations in the retinal microcirculation, microvascular network, and microstructure in healthy subjects. Methods Seventy-four healthy subjects aged from 18 to 82 years were recruited and divided into four age groups (G1 with age <35 years, G2 with age 35 ∼ 49 years, G3 with age 50 ∼ 64 years, and G4 with age ≥65 years). Custom ultra-high resolution optical coherence tomography (UHR-OCT) was used to acquire six intraretinal layers of the macula. OCT angiography (OCTA) was used to image the retinal microvascular network. The retinal blood flow velocity (BFV) was measured using a Retinal Function Imager (RFI). Results Compared to G1, G2 had significant thinning of the retinal nerve fiber layer (RNFL) (P < 0.05), while G3 had thinning of the RNFL and ganglion cell and inner plexiform layer (GCIPL) (P < 0.05), in addition to thickening of the outer plexiform layer (OPL) and photoreceptor layer (PR) (P < 0.05). G4 had loss in retinal vessel density, thinning in RNFL and GCIPL, and decrease in venular BFV, in addition to thickening of the OPL and PR (P < 0.05). Age was negatively related to retinal vessel densities, the inner retinal layers, and venular BFV (P < 0.05). By contrast, age was positively related to OPL and PR (P < 0.05). Conclusions During aging, decreases in retinal vessel density, inner retinal layer thickness, and venular BFV were evident and impacted each other as observed by simultaneous changes in multiple retinal components. PMID:28744554

Application of Image Intensifier Technology to the Military, Scientific, Industrial, Educational, and Medical Communities.

DTIC Science & Technology

1980-05-30

afflicted with Retinitis Pigmentosa , commonly called night blindness. People who suffer from this are virtually blind in absence of normal room light...image intensification 5. Low light ophthalmological surgery 6. Retinitis Pigmentosa patients 7. Mine rescue and first aid 8. TV microscopy 9

Ultra-wide-field autofluorescence imaging in non-traumatic rhegmatogenous retinal detachment

PubMed Central

Witmer, M T; Cho, M; Favarone, G; Paul Chan, R V; D'Amico, D J; Kiss, S

2012-01-01

Purpose Rhegmatogenous retinal detachment (RRD) affects the function of the retina before and after surgical repair. We investigated ultra-wide-field autofluorescence (UAF) abnormalities in patients with acute RRD to improve our understanding of the functional changes in the retina before and after surgery. Methods In this retrospective study, we present the UAF imaging findings of 16 patients with acute, non-traumatic RRD. Imaging was obtained with the Optos 200 Tx (Optos) in 14 eyes preoperatively and in 12 eyes postoperatively. Twelve eyes had RRDs that involved the macula (group A), whereas four eyes had macula-sparing RRDs (group B). Results All patients (100%) with bullous retinal detachments demonstrated hypofluorescence over the area of retinal detachment. A hyperfluorescent leading edge (HLE) to the retinal detachment was observed preoperatively in 100% of eyes in group A and 75% of eyes in group B. Preoperative UAF through the fovea of group A eyes was normal (30%), hypofluorescent (50%) or hyperfluorescent (20%). In all patients with a HLE preoperatively, the HLE resolved by the 1-month postoperative visit. A residual line of demarcation remained in 8 of the 12 eyes (67%). In group A eyes, postoperative granular autofluorescent changes were present in four of the nine (44%) eyes, and were associated with worse preoperative (P=0.04) and postoperative (P=0.09) visual acuity. Conclusion UAF imaging reveals abnormalities in RRDs that allow excellent demarcation of the extent of the retinal detachment and assist in preoperative characterization of the detachment and postoperative counselling. PMID:22722489

In vivo imaging of the retinal pigment epithelial cells

NASA Astrophysics Data System (ADS)

Morgan, Jessica Ijams Wolfing

The retinal pigment epithelial (RPE) cells form an important layer of the retina because they are responsible for providing metabolic support to the photoreceptors. Techniques to image the RPE layer include autofluorescence imaging with a scanning laser ophthalmoscope (SLO). However, previous studies were unable to resolve single RPE cells in vivo. This thesis describes the technique of combining autofluorescence, SLO, adaptive optics (AO), and dual-wavelength simultaneous imaging and registration to visualize the individual cells in the RPE mosaic in human and primate retina for the first time in vivo. After imaging the RPE mosaic non-invasively, the cell layer's structure and regularity were characterized using quantitative metrics of cell density, spacing, and nearest neighbor distances. The RPE mosaic was compared to the cone mosaic, and RPE imaging methods were confirmed using histology. The ability to image the RPE mosaic led to the discovery of a novel retinal change following light exposure; 568 nm exposures caused an immediate reduction in autofluorescence followed by either full recovery or permanent damage in the RPE layer. A safety study was conducted to determine the range of exposure irradiances that caused permanent damage or transient autofluorescence reductions. Additionally, the threshold exposure causing autofluorescence reduction was determined and reciprocity of radiant exposure was confirmed. Light exposures delivered by the AOSLO were not significantly different than those delivered by a uniform source. As all exposures tested were near or below the permissible light levels of safety standards, this thesis provides evidence that the current light safety standards need to be revised. Finally, with the retinal damage and autofluorescence reduction thresholds identified, the methods of RPE imaging were modified to allow successful imaging of the individual cells in the RPE mosaic while still ensuring retinal safety. This thesis has provided a highly sensitive method for studying the in vivo morphology of individual RPE cells in normal, diseased, and damaged retinas. The methods presented here also will allow longitudinal studies for tracking disease progression and assessing treatment efficacy in human patients and animal models of retinal diseases affecting the RPE.

Automated intraretinal segmentation of SD-OCT images in normal and age-related macular degeneration eyes

PubMed Central

de Sisternes, Luis; Jonna, Gowtham; Moss, Jason; Marmor, Michael F.; Leng, Theodore; Rubin, Daniel L.

2017-01-01

This work introduces and evaluates an automated intra-retinal segmentation method for spectral-domain optical coherence (SD-OCT) retinal images. While quantitative assessment of retinal features in SD-OCT data is important, manual segmentation is extremely time-consuming and subjective. We address challenges that have hindered prior automated methods, including poor performance with diseased retinas relative to healthy retinas, and data smoothing that obscures image features such as small retinal drusen. Our novel segmentation approach is based on the iterative adaptation of a weighted median process, wherein a three-dimensional weighting function is defined according to image intensity and gradient properties, and a set of smoothness constraints and pre-defined rules are considered. We compared the segmentation results for 9 segmented outlines associated with intra-retinal boundaries to those drawn by hand by two retinal specialists and to those produced by an independent state-of-the-art automated software tool in a set of 42 clinical images (from 14 patients). These images were obtained with a Zeiss Cirrus SD-OCT system, including healthy, early or intermediate AMD, and advanced AMD eyes. As a qualitative evaluation of accuracy, a highly experienced third independent reader blindly rated the quality of the outlines produced by each method. The accuracy and image detail of our method was superior in healthy and early or intermediate AMD eyes (98.15% and 97.78% of results not needing substantial editing) to the automated method we compared against. While the performance was not as good in advanced AMD (68.89%), it was still better than the manual outlines or the comparison method (which failed in such cases). We also tested our method’s performance on images acquired with a different SD-OCT manufacturer, collected from a large publicly available data set (114 healthy and 255 AMD eyes), and compared the data quantitatively to reference standard markings of the internal limiting membrane and inner boundary of retinal pigment epithelium, producing a mean unsigned positioning error of 6.04 ± 7.83µm (mean under 2 pixels). Our automated method should be applicable to data from different OCT manufacturers and offers detailed layer segmentations in healthy and AMD eyes. PMID:28663874

A cascade model of information processing and encoding for retinal prosthesis.

PubMed

Pei, Zhi-Jun; Gao, Guan-Xin; Hao, Bo; Qiao, Qing-Li; Ai, Hui-Jian

2016-04-01

Retinal prosthesis offers a potential treatment for individuals suffering from photoreceptor degeneration diseases. Establishing biological retinal models and simulating how the biological retina convert incoming light signal into spike trains that can be properly decoded by the brain is a key issue. Some retinal models have been presented, ranking from structural models inspired by the layered architecture to functional models originated from a set of specific physiological phenomena. However, Most of these focus on stimulus image compression, edge detection and reconstruction, but do not generate spike trains corresponding to visual image. In this study, based on state-of-the-art retinal physiological mechanism, including effective visual information extraction, static nonlinear rectification of biological systems and neurons Poisson coding, a cascade model of the retina including the out plexiform layer for information processing and the inner plexiform layer for information encoding was brought forward, which integrates both anatomic connections and functional computations of retina. Using MATLAB software, spike trains corresponding to stimulus image were numerically computed by four steps: linear spatiotemporal filtering, static nonlinear rectification, radial sampling and then Poisson spike generation. The simulated results suggested that such a cascade model could recreate visual information processing and encoding functionalities of the retina, which is helpful in developing artificial retina for the retinally blind.

Automated detection of retinal whitening in malarial retinopathy

NASA Astrophysics Data System (ADS)

Joshi, V.; Agurto, C.; Barriga, S.; Nemeth, S.; Soliz, P.; MacCormick, I.; Taylor, T.; Lewallen, S.; Harding, S.

2016-03-01

Cerebral malaria (CM) is a severe neurological complication associated with malarial infection. Malaria affects approximately 200 million people worldwide, and claims 600,000 lives annually, 75% of whom are African children under five years of age. Because most of these mortalities are caused by the high incidence of CM misdiagnosis, there is a need for an accurate diagnostic to confirm the presence of CM. The retinal lesions associated with malarial retinopathy (MR) such as retinal whitening, vessel discoloration, and hemorrhages, are highly specific to CM, and their detection can improve the accuracy of CM diagnosis. This paper will focus on development of an automated method for the detection of retinal whitening which is a unique sign of MR that manifests due to retinal ischemia resulting from CM. We propose to detect the whitening region in retinal color images based on multiple color and textural features. First, we preprocess the image using color and textural features of the CMYK and CIE-XYZ color spaces to minimize camera reflex. Next, we utilize color features of the HSL, CMYK, and CIE-XYZ channels, along with the structural features of difference of Gaussians. A watershed segmentation algorithm is used to assign each image region a probability of being inside the whitening, based on extracted features. The algorithm was applied to a dataset of 54 images (40 with whitening and 14 controls) that resulted in an image-based (binary) classification with an AUC of 0.80. This provides 88% sensitivity at a specificity of 65%. For a clinical application that requires a high specificity setting, the algorithm can be tuned to a specificity of 89% at a sensitivity of 82%. This is the first published method for retinal whitening detection and combining it with the detection methods for vessel discoloration and hemorrhages can further improve the detection accuracy for malarial retinopathy.

Automatic detection and recognition of multiple macular lesions in retinal optical coherence tomography images with multi-instance multilabel learning

NASA Astrophysics Data System (ADS)

Fang, Leyuan; Yang, Liumao; Li, Shutao; Rabbani, Hossein; Liu, Zhimin; Peng, Qinghua; Chen, Xiangdong

2017-06-01

Detection and recognition of macular lesions in optical coherence tomography (OCT) are very important for retinal diseases diagnosis and treatment. As one kind of retinal disease (e.g., diabetic retinopathy) may contain multiple lesions (e.g., edema, exudates, and microaneurysms) and eye patients may suffer from multiple retinal diseases, multiple lesions often coexist within one retinal image. Therefore, one single-lesion-based detector may not support the diagnosis of clinical eye diseases. To address this issue, we propose a multi-instance multilabel-based lesions recognition (MIML-LR) method for the simultaneous detection and recognition of multiple lesions. The proposed MIML-LR method consists of the following steps: (1) segment the regions of interest (ROIs) for different lesions, (2) compute descriptive instances (features) for each lesion region, (3) construct multilabel detectors, and (4) recognize each ROI with the detectors. The proposed MIML-LR method was tested on 823 clinically labeled OCT images with normal macular and macular with three common lesions: epiretinal membrane, edema, and drusen. For each input OCT image, our MIML-LR method can automatically identify the number of lesions and assign the class labels, achieving the average accuracy of 88.72% for the cases with multiple lesions, which better assists macular disease diagnosis and treatment.

Real-time acquisition and display of flow contrast using speckle variance optical coherence tomography in a graphics processing unit.

PubMed

Xu, Jing; Wong, Kevin; Jian, Yifan; Sarunic, Marinko V

2014-02-01

In this report, we describe a graphics processing unit (GPU)-accelerated processing platform for real-time acquisition and display of flow contrast images with Fourier domain optical coherence tomography (FDOCT) in mouse and human eyes in vivo. Motion contrast from blood flow is processed using the speckle variance OCT (svOCT) technique, which relies on the acquisition of multiple B-scan frames at the same location and tracking the change of the speckle pattern. Real-time mouse and human retinal imaging using two different custom-built OCT systems with processing and display performed on GPU are presented with an in-depth analysis of performance metrics. The display output included structural OCT data, en face projections of the intensity data, and the svOCT en face projections of retinal microvasculature; these results compare projections with and without speckle variance in the different retinal layers to reveal significant contrast improvements. As a demonstration, videos of real-time svOCT for in vivo human and mouse retinal imaging are included in our results. The capability of performing real-time svOCT imaging of the retinal vasculature may be a useful tool in a clinical environment for monitoring disease-related pathological changes in the microcirculation such as diabetic retinopathy.

Comparison of ultra-widefield fluorescein angiography with the Heidelberg Spectralis(®) noncontact ultra-widefield module versus the Optos(®) Optomap(®).

PubMed

Witmer, Matthew T; Parlitsis, George; Patel, Sarju; Kiss, Szilárd

2013-01-01

To compare ultra-widefield fluorescein angiography imaging using the Optos(®) Optomap(®) and the Heidelberg Spectralis(®) noncontact ultra-widefield module. Five patients (ten eyes) underwent ultra-widefield fluorescein angiography using the Optos(®) panoramic P200Tx imaging system and the noncontact ultra-widefield module in the Heidelberg Spectralis(®) HRA+OCT system. The images were obtained as a single, nonsteered shot centered on the macula. The area of imaged retina was outlined and quantified using Adobe(®) Photoshop(®) C5 software. The total area and area within each of four visualized quadrants was calculated and compared between the two imaging modalities. Three masked reviewers also evaluated each quadrant per eye (40 total quadrants) to determine which modality imaged the retinal vasculature most peripherally. Optos(®) imaging captured a total retinal area averaging 151,362 pixels, ranging from 116,998 to 205,833 pixels, while the area captured using the Heidelberg Spectralis(®) was 101,786 pixels, ranging from 73,424 to 116,319 (P = 0.0002). The average area per individual quadrant imaged by Optos(®) versus the Heidelberg Spectralis(®) superiorly was 32,373 vs 32,789 pixels, respectively (P = 0.91), inferiorly was 24,665 vs 26,117 pixels, respectively (P = 0.71), temporally was 47,948 vs 20,645 pixels, respectively (P = 0.0001), and nasally was 46,374 vs 22,234 pixels, respectively (P = 0.0001). The Heidelberg Spectralis(®) was able to image the superior and inferior retinal vasculature to a more distal point than was the Optos(®), in nine of ten eyes (18 of 20 quadrants). The Optos(®) was able to image the nasal and temporal retinal vasculature to a more distal point than was the Heidelberg Spectralis(®), in ten of ten eyes (20 of 20 quadrants). The ultra-widefield fluorescein angiography obtained with the Optos(®) and Heidelberg Spectralis(®) ultra-widefield imaging systems are both excellent modalities that provide views of the peripheral retina. On a single nonsteered image, the Optos(®) Optomap(®) covered a significantly larger total retinal surface area, with greater image variability, than did the Heidelberg Spectralis(®) ultra-widefield module. The Optos(®) captured an appreciably wider view of the retina temporally and nasally, albeit with peripheral distortion, while the ultra-widefield Heidelberg Spectralis(®) module was able to image the superior and inferior retinal vasculature more peripherally. The clinical significance of these findings as well as the area imaged on steered montaged images remains to be determined.

Challenges and advantages in wide-field optical coherence tomography angiography imaging of the human retinal and choroidal vasculature at 1.7-MHz A-scan rate

NASA Astrophysics Data System (ADS)

Poddar, Raju; Migacz, Justin V.; Schwartz, Daniel M.; Werner, John S.; Gorczynska, Iwona

2017-10-01

We present noninvasive, three-dimensional, depth-resolved imaging of human retinal and choroidal blood circulation with a swept-source optical coherence tomography (OCT) system at 1065-nm center wavelength. Motion contrast OCT imaging was performed with the phase-variance OCT angiography method. A Fourier-domain mode-locked light source was used to enable an imaging rate of 1.7 MHz. We experimentally demonstrate the challenges and advantages of wide-field OCT angiography (OCTA). In the discussion, we consider acquisition time, scanning area, scanning density, and their influence on visualization of selected features of the retinal and choroidal vascular networks. The OCTA imaging was performed with a field of view of 16 deg (5 mm×5 mm) and 30 deg (9 mm×9 mm). Data were presented in en face projections generated from single volumes and in en face projection mosaics generated from up to 4 datasets. OCTA imaging at 1.7 MHz A-scan rate was compared with results obtained from a commercial OCTA instrument and with conventional ophthalmic diagnostic methods: fundus photography, fluorescein, and indocyanine green angiography. Comparison of images obtained from all methods is demonstrated using the same eye of a healthy volunteer. For example, imaging of retinal pathology is presented in three cases of advanced age-related macular degeneration.

Imaging of the optic nerve and retinal nerve fiber layer: an essential part of glaucoma diagnosis and monitoring.

PubMed

Kotowski, Jacek; Wollstein, Gadi; Ishikawa, Hiroshi; Schuman, Joel S

2014-01-01

Because glaucomatous damage is irreversible early detection of structural changes in the optic nerve head and retinal nerve fiber layer is imperative for timely diagnosis of glaucoma and monitoring of its progression. Significant improvements in ocular imaging have been made in recent years. Imaging techniques such as optical coherence tomography, scanning laser polarimetry and confocal scanning laser ophthalmoscopy rely on different properties of light to provide objective structural assessment of the optic nerve head, retinal nerve fiber layer and macula. In this review, we discuss the capabilities of these imaging modalities pertinent for diagnosis of glaucoma and detection of progressive glaucomatous damage and provide a review of the current knowledge on the clinical performance of these technologies. Copyright © 2014 Elsevier Inc. All rights reserved.

Roi Detection and Vessel Segmentation in Retinal Image

NASA Astrophysics Data System (ADS)

Sabaz, F.; Atila, U.

2017-11-01

Diabetes disrupts work by affecting the structure of the eye and afterwards leads to loss of vision. Depending on the stage of disease that called diabetic retinopathy, there are sudden loss of vision and blurred vision problems. Automated detection of vessels in retinal images is a useful study to diagnose eye diseases, disease classification and other clinical trials. The shape and structure of the vessels give information about the severity of the disease and the stage of the disease. Automatic and fast detection of vessels allows for a quick diagnosis of the disease and the treatment process to start shortly. ROI detection and vessel extraction methods for retinal image are mentioned in this study. It is shown that the Frangi filter used in image processing can be successfully used in detection and extraction of vessels.

Adaptive optics ophthalmoscopy: results and applications.

PubMed

Pallikaris, A

2005-01-01

The living human eye's optical aberrations set a limit to retinal imaging in the clinical setting. Progress in the field of adaptive optics has offered unique solutions to this problem. The purpose of this review is to summarize the most recent advances in adaptive optics ophthalmoscopy. Adaptive optics technology has been combined with flood illumination imaging, confocal scanning laser ophthalmoscopy, and optical coherence tomography for the high resolution imaging of the retina. The advent of adaptive optics technology has provided the technical platform for the compensation of the eye's aberration and made possible the observation of single cones, small capillaries, nerve fibers, and leukocyte dynamics as well as the ultrastructure of the optic nerve head lamina cribrosa in vivo. Detailed imaging of retinal infrastructure provides valuable information for the study of retinal physiology and pathology.

Platform-Independent Cirrus and Spectralis Thickness Measurements in Eyes with Diabetic Macular Edema Using Fully Automated Software

PubMed Central

Willoughby, Alex S.; Chiu, Stephanie J.; Silverman, Rachel K.; Farsiu, Sina; Bailey, Clare; Wiley, Henry E.; Ferris, Frederick L.; Jaffe, Glenn J.

2017-01-01

Purpose We determine whether the automated segmentation software, Duke Optical Coherence Tomography Retinal Analysis Program (DOCTRAP), can measure, in a platform-independent manner, retinal thickness on Cirrus and Spectralis spectral domain optical coherence tomography (SD-OCT) images in eyes with diabetic macular edema (DME) under treatment in a clinical trial. Methods Automatic segmentation software was used to segment the internal limiting membrane (ILM), inner retinal pigment epithelium (RPE), and Bruch's membrane (BM) in SD-OCT images acquired by Cirrus and Spectralis commercial systems, from the same eye, on the same day during a clinical interventional DME trial. Mean retinal thickness differences were compared across commercial and DOCTRAP platforms using intraclass correlation (ICC) and Bland-Altman plots. Results The mean 1 mm central subfield thickness difference (standard error [SE]) comparing segmentation of Spectralis images with DOCTRAP versus HEYEX was 0.7 (0.3) μm (0.2 pixels). The corresponding values comparing segmentation of Cirrus images with DOCTRAP versus Cirrus software was 2.2 (0.7) μm. The mean 1 mm central subfield thickness difference (SE) comparing segmentation of Cirrus and Spectralis scan pairs with DOCTRAP using BM as the outer retinal boundary was −2.3 (0.9) μm compared to 2.8 (0.9) μm with inner RPE as the outer boundary. Conclusions DOCTRAP segmentation of Cirrus and Spectralis images produces validated thickness measurements that are very similar to each other, and very similar to the values generated by the corresponding commercial software in eyes with treated DME. Translational Relevance This software enables automatic total retinal thickness measurements across two OCT platforms, a process that is impractical to perform manually. PMID:28180033

Fundus autofluorescence imaging in dry AMD: 2014 Jules Gonin lecture of the Retina Research Foundation.

PubMed

Holz, Frank G; Steinberg, Julia S; Göbel, Arno; Fleckenstein, Monika; Schmitz-Valckenberg, Steffen

2015-01-01

Fundus autofluorescence (FAF) imaging allows for topographic mapping of intrisnic fluorophores in the retinal pigment epithelial cell monolayer, as well as mapping of other fluorophores that may occur with disease in the outer retina and the sub-neurosensory space. FAF imaging provides information not obtainable with other imaging modalities. Near-infrared fundus autofluorescence images can also be obtained in vivo, and may be largely melanin-derived. FAF imaging has been shown to be useful in a wide spectrum of macular and retinal diseases. The scope of applications now includes identification of diseased RPE in macular/retinal diseases, elucidating pathophysiological mechanisms, identification of early disease stages, refined phenotyping, identification of prognostic markers for disease progression, monitoring disease progression in the context of both natural history and interventional therapeutic studies, and objective assessment of luteal pigment distribution and density as well as RPE melanin distribution. Here, we review the use of FAF imaging in various phenotypic manifestations of dry AMD.

Imaging polarimetry in patients with neovascular age-related macular degeneration

PubMed Central

Elsner, Ann E.; Weber, Anke; Cheney, Michael C.; VanNasdale, Dean A.; Miura, Masahiro

2007-01-01

Imaging polarimetry was used to examine different components of neovascular membranes in age-related macular degeneration. Retinal images were acquired with a scanning laser polarimeter. An innovative pseudo-color scale, based on cardinal directions of color, displayed two types of image information: relative phases and magnitudes of birefringence. Membranes had relative phase changes that did not correspond to anatomical structures in reflectance images. Further, membrane borders in depolarized light images had significantly higher contrasts than those in reflectance images. The retinal birefringence in neovascular membranes indicates optical activity consistent with molecular changes rather than merely geometrical changes. PMID:17429494

Murine fundus fluorescein angiography: An alternative approach using a handheld camera.

PubMed

Ehrenberg, Moshe; Ehrenberg, Scott; Schwob, Ouri; Benny, Ofra

2016-07-01

In today's modern pharmacologic approach to treating sight-threatening retinal vascular disorders, there is an increasing demand for a compact, mobile, lightweight and cost-effective fluorescein fundus camera to document the effects of antiangiogenic drugs on laser-induced choroidal neovascularization (CNV) in mice and other experimental animals. We have adapted the use of the Kowa Genesis Df Camera to perform Fundus Fluorescein Angiography (FFA) in mice. The 1 kg, 28 cm high camera has built-in barrier and exciter filters to allow digital FFA recording to a Compact Flash memory card. Furthermore, this handheld unit has a steady Indirect Lens Holder that firmly attaches to the main unit, that securely holds a 90 diopter lens in position, in order to facilitate appropriate focus and stability, for photographing the delicate central murine fundus. This easily portable fundus fluorescein camera can effectively record exceptional central retinal vascular detail in murine laser-induced CNV, while readily allowing the investigator to adjust the camera's position according to the variable head and eye movements that can randomly occur while the mouse is optimally anesthetized. This movable image recording device, with efficiencies of space, time, cost, energy and personnel, has enabled us to accurately document the alterations in the central choroidal and retinal vasculature following induction of CNV, implemented by argon-green laser photocoagulation and disruption of Bruch's Membrane, in the experimental murine model of exudative macular degeneration. Copyright © 2016 Elsevier Ltd. All rights reserved.

Retinal cell imaging in myopic chickens using adaptive optics multiphoton microscopy.

PubMed

Bueno, Juan M; Palacios, Raquel; Giakoumaki, Anastasia; Gualda, Emilio J; Schaeffel, Frank; Artal, Pablo

2014-03-01

Abnormal eye growth induced by visual deprivation can modify the structure and density of the retinal cells. We have used an adaptive optics multiphoton microscope to image photoreceptors (PRs) and ganglion cells (GCs) at different retinal locations in unstained retinas of chicken eyes with about 10D of myopia and their normal-sighted fellow eyes. In all samples, the local averaged inter-PR distance increased with eccentricity. No significant differences in PR density were found between control and myopic eyes. GC density declined in myopic eyes compared to control eyes and the inter-cell distance increased. In normal eyes, the size of the GC cell bodies increased approximately two-fold between the area centralis and the peripheral retina. In myopic eyes, this trend was preserved but the GC bodies were larger at each retinal location, compared to control eyes. Obviously, GC morphology is changing when the retinal area is enlarged in myopic eyes.