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

项目摘要 光学相干断层扫描（OCT）独特地能够实现微米深度分辨率，同时对大的 3-三维（3D）体积。这使得3D成像和精确测量的前段， 眼睛，包括角膜、结膜、巩膜、前房、虹膜和晶状体透镜。眼前节 OCT已广泛应用于眼科。但一些高影响力的应用程序被阻止， 有限的速度、范围、渗透和疾病特异性算法。因此，具体目标是： (1)开发适用于前眼的高性能OCT。一种新型垂直腔面发射激光器 （VCSEL）将用于开发具有超高速，宽视场，长距离和高分辨率的OCT原型。 渗透。高速度和穿透力将允许虹膜肿瘤中的血管成像（血管造影术）。的 宽视野和长范围将能够实现从角膜顶点到 晶状体透镜的后表面，其将采用人工透镜（IOL）配方和定制巩膜 接触透镜设计达到新的精度水平。 (2)开展虹膜肿瘤的OCT血管造影（OCTA）。区分良性和恶性 肿瘤，包括致命的黑色素瘤，对于制定治疗方案以最大限度地减少对敏感眼睛的损害至关重要 组织和降低转移的风险。血管增多标志着肿瘤的恶性转化。的 拟议的高性能OCT原型将使OCTA在肿瘤中具有足够的穿透力， 表征肿瘤脉管系统和体积。新的软件算法将用于抑制运动， 投影和阴影伪影，分割组织边界，并计算定量血管密度， 弯曲度测量。该技术可用于评估其他地方的肿瘤血管生成。 (3)改进基于OCT的IOL屈光度公式。之前，我们开发了一种基于OCT的IOL配方， 改善近视LASIK术后白内障手术的屈光结果。我们现在建议进一步改进 基于OCT的IOL配方，以便它可以改善所有白内障手术的屈光结果， 选择散光矫正型和非散光矫正型IOL。远程OCT可以精确测量晶体透镜赤道面 位置，以改善IOL位置的预测，这是目前限制IOL位置准确性的关键变量。 IOL配方。高速OCT与光线追踪一起将实现更准确的净角膜功率， 散光测量，特别是在放射状角膜切开术后和LASIK术后的眼睛。 (4)通过宽视野OCT改善巩膜透镜的拟合。巩膜接触透镜在角膜上形成穹窿， 为角膜形状不规则的患者提供了一种重要的非手术选择， 眼表炎症巩膜透镜的主要限制是困难的试错拟合过程。 我们将使用宽视野OCT角巩膜地形图来改进初始试验透镜的选择和设计 先进的径向不对称巩膜透镜，其高度定制以适应受试者的眼表面。

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.