Applications of ultrahigh-speed long-range wide-field OCT in anterior eye diseases

项目总结 光学相干层析成像(OCT)是唯一能够实现微米深度分辨率的成像技术 三维(3D)体积。这使得在前段进行3D成像和精确测量成为可能 眼，包括角膜、结膜、巩膜、前房、虹膜和晶状体。前段 OCT已广泛应用于眼科。但一些影响较大的应用程序被 有限的速度、射程、渗透率和特定疾病的算法。因此，具体目标是： (1)研制超高性能的前眼OCT。一种新型垂直腔面发射激光器 (VCSEL)将用于开发超高速、宽视场、远距离、高功率的OCT样机。 穿透力。高速和穿透性将使虹膜肿瘤的血管成像(血管造影术)成为可能。这个 宽视场和远距离将使从角膜尖端到 晶状体的后表面，将采用人工晶状体(IOL)公式和定制巩膜 隐形眼镜设计将精确度提升到一个新的水平。 (2)发展虹膜肿瘤的OCT血管成像(OCTA)。辨别良恶性 肿瘤，包括致命的黑色素瘤，对于计划将对敏感眼睛的损害降至最低的治疗方案至关重要。 并降低转移的风险。血管增多标志着肿瘤的恶性转化。这个 拟议的超高性能OCT原型将使OCTA在肿瘤中具有足够的穿透性 肿瘤血管和体积的特征。新的软件算法将被用来抑制运动， 投影和阴影伪影，分割组织边界，并计算定量血管密度和 曲折测量。这项技术可能会对其他地方的肿瘤血管生成进行评估。 (3)改进基于OCT的人工晶状体屈光度公式。之前，我们开发了一种基于OCT的IOL公式 改善近视LASIK术后眼的白内障手术屈光状态。我们现在提议进一步改进 基于OCT的人工晶状体公式，因此它可以改善所有白内障手术的屈光状态，并被使用 选择Toric和Non-Toric IOL。远距离OCT可以精确测量赤道晶状体 位置以改善人工晶状体位置的预测，这是目前限制人工晶状体位置准确性的关键变量 人工晶状体公式。高速OCT与光线跟踪相结合，将使更准确的净角膜屈光度和 散光测量，特别是在放射状角膜切开术和远视LASIK术后。 (4)改进广场OCT对巩膜晶状体的配戴。巩膜隐形眼镜跳过角膜， 提供了一个重要的非手术选择，以恢复舒适和视力的患者不规则的角膜形状或 眼表发炎。巩膜晶状体的主要缺陷是难于反复试配。 我们将使用广视场OCT角巩膜地形图来改进初始试镜的选择和设计 先进的径向不对称巩膜镜片，高度根据受试者眼表定制。

PROJECT SUMMARY Optical coherence tomography (OCT) is uniquely able to achieve micron depth resolution while imaging a large 3-dimensional (3D) volume. This enables 3D imaging and precise measurements in the anterior segment of the eye, including the cornea, conjunctiva, sclera, anterior chamber, iris, and crystalline lens. Anterior segment OCT is already widely used in ophthalmology. But a number of high-impact applications were held back by limited speed, range, penetration, and disease-specific algorithms. Therefore the specific aims are to: (1) Develop ultrahigh performance OCT for anterior eye. A novel vertical-cavity surface-emitting laser (VCSEL) will be used to develop an OCT prototype with ultrahigh-speed, wide-field, long-range, and high- penetration. The high speed and penetration will allow blood vessel imaging (angiography) in iris tumors. The wide field and long range will enable accurate whole anterior-segment biometry from the apex of the cornea to the posterior surface of the crystalline lens, which will take intraocular lens (IOL) formulas and custom scleral contact lens design to a new level of accuracy. (2) Develop OCT angiography (OCTA) of iris tumors. Distinguishing between benign and malignant tumors, including deadly melanomas, is crucial for planning treatments that minimize damage to sensitive eye tissues and reduce the risk of metastasis. Increased vascularity marks malignant transformation in tumors. The proposed ultrahigh performance OCT prototype will enable OCTA in tumors with sufficient penetration to characterize both tumor vasculature and volume. Novel software algorithms will be used to suppress motion, projection, and shadow artifacts, segment tissue boundaries, and calculate quantitative vascular density and tortuosity measurements. The technology could be useful in the evaluation of tumor angiogenesis elsewhere. (3) Improve OCT-based IOL power formula. Previously we developed an OCT-based IOL formula that improved cataract surgery refractive outcome in post-myopic LASIK eyes. We now propose to further improve the OCT-based IOL formula so that it could improve refractive outcome in all cataract surgeries, and be used to select toric as well non-toric IOL. The long-range OCT can accurately measure the crystalline lens equatorial position to improve the prediction of IOL position, which is a crucial variable that currently limits the accuracy of IOL formulas. High-speed OCT together with ray-tracing will enable more accurate net corneal power and astigmatism measurements, especially in post-radial keratotomy and post-hyperopic LASIK eyes. (4) Improve scleral lens fitting with wide-field OCT. Scleral contact lens vaults over the cornea and offers an important nonsurgical option to restore comfort and vision to patients with irregular corneal shape or ocular surface inflammation. The primary limitation of scleral lens is the difficult trial-and-error fitting process. We will use wide-field OCT corneoscleral topography to improve the selection of the initial trial lens and design advanced radially asymmetric scleral lenses that are highly customized to the subject ocular surface.