Compact Line Scanning Adaptive Optics Retinal Imager

紧凑型线扫描自适应光学视网膜成像仪

• 批准号: 7909611
• 负责人: DANIEL X HAMMER
• 金额: $ 46.45万
• 依托单位: PHYSICAL SCIENCES, INC
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-01 至 2012-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7909611
• 关键词: Academic Medical Centers; Age related macular degeneration; Algorithms; Biomedical Engineering; Bite; Blood capillaries; Caliber; Categories; Cell Death; Cell Density; Cells; Clinic; Clinical; Clinical Data; Clinical Research; Clinical Trials; Collaborations; Collection; Color; Computer software; Data; Detection; Development; Device or Instrument Development; Devices; Diabetic Retinopathy; Diagnostic; Disease; Disease Progression; Disorder by Site; Doctor of Medicine; Early Diagnosis; Edema; Elements; Engineering; Environment; Erythrocytes; Evaluation; Exudate; Eye; Flowmetry; Fundus; Generations; Goals; Head; Health; High Prevalence; Histology; Housing; Image; Image Analysis; Imaging Techniques; Individual; Investigation; Joystick; Laboratory Research; Lasers; Lateral; Learning; Left; Lesion; Leukocytes; Licensing; Manufacturer Name; Maps; Measures; Mechanics; Mediation; Medical Technology; Modification; Monitor; Nerve Fibers; Ophthalmologist; Ophthalmology; Ophthalmoscopes; Ophthalmoscopy; Optic Disk; Optical Coherence Tomography; Optics; Outcome; Output; Pathology; Patient Care; Patients; Performance; Pharmacotherapy; Phase; Photoreceptors; Pilot Projects; Positioning Attribute; Procedures; Process; Protocols documentation; Public Health; Radial; Recording of previous events; Reporting; Research; Research Ethics Committees; Research Personnel; Resolution; Resources; Retinal; Retinal Cone; Retinal Diseases; Retinal Dystrophy; Retinal Edemas; Retinitis Pigmentosa; Sales; Scanning; Scientist; Screening procedure; Site; Speed; Staging; Stream; Stroke; Structure; System; Techniques; Technology; Testing; Time; Tissues; Universities; Vision; adaptive optics; base; capillary; clinical application; commercialization; cost; density; design; detector; diabetic; eye center; fovea centralis; geographic atrophy; hemodynamics; human subject; image processing; image registration; imaging modality; improved; instrument; instrumentation; macula; macular drusen; macular edema; neovascular; operation; optical imaging; physical science; professor; programs; prototype; public health relevance; research clinical testing; sensor; statistics; systems research; tool; treatment strategy

DESCRIPTION (provided by applicant): Physical Sciences Inc. (PSI) has successfully completed a Phase I program demonstrating the feasibility of integrating adaptive optics (AO) into a line scanning laser ophthalmoscope (LSLO). The bench-top AO-LSLO instrument significantly reduces the size, complexity, and cost of research AOSLOs, for the purpose of moving adaptive optics imaging more quickly into routine clinical use. The AO-LSLO produces high resolution retinal images with only one moving part and a significantly reduced instrument footprint and number of optical components. The AO-LSLO has a moderate field of view (5.5 deg), which allows montages of the macula or other targets to be obtained more quickly and efficiently. In a preliminary human subjects investigation, photoreceptors could be resolved and counted to within ~0.5 mm of the fovea. Photoreceptor counts matched closely to previously reported histology. The capillaries surrounding the foveal avascular zone could be resolved, as well as cells flowing within them. Individual nerve fiber bundles could be resolved, especially near the optic nerve head, as well as other structures such as the lamina cribrosa. In addition to instrument design, fabrication, and testing, software algorithms were developed for automated image registration, cone counting, and montage stitching. In collaboration with ophthalmologists at Duke University Eye Center, we propose to continue instrument development and full clinical testing in Phase II. The AO-LSLO instrument will be refined and enhanced for clinical operation, including re-design of the optical layout for a smaller footprint, opto- mechanical design of a clinical package, modification of scanning hardware for automatic montaging, and upgrade of some components for improved performance. In addition, we will explore further reduction of hardware complexity with the implementation of wave front sensorless algorithms. The pilot clinical study at Duke will be conducted in three stages. The first stage will accomplish preliminary testing in a clinical environment. The second stage will include a repeatability study, image several different retinal diseases (Stargardt's, retinitis pigmentosa, etc.), and compare the AO-LSLO to other imaging modalities currently in routine clinical use. The third stage will explore the instrument's capabilities to image photoreceptors in dry age-related macular degeneration (AMD) at the margin of sites of geographic atrophy (GA) and in diabetic macula edema at sites of previous laser treatment. In particular we will characterize and quantify photoreceptor loss across these sites of disease or laser treatment and other inner retinal components. This study will determine if the AO-LSLO provides complementary information not currently available from other imaging modes. If successful, the Phase II program and subsequent Phase III commercial development will provide clinicians with high-resolution, high performance adaptive optics imaging at a cost comparable to other retinal imagers to help guide therapies and improve patient outcomes. PUBLIC HEALTH RELEVANCE: By making high-resolution ocular access more widespread, the proposed AO-LSLO instrument will bring adaptive optics technology into use by a greater number of clinicians and scientists. These researchers will, in turn, use this tool to increase our understanding of vision and its disruption by disease and to measure tissue effects of new drugs and therapies.

描述（由申请人提供）：Physical Sciences Inc. (PSI)成功完成了第一阶段的计划，证明了自适应光学（AO）集成到线扫描激光检眼镜（LSLO）的可行性。台式AO-LSLO仪器显著降低了研究AOSLO的尺寸、复杂性和成本，目的是将自适应光学成像更快地应用于常规临床。AO-LSLO仅使用一个移动部件即可生成高分辨率视网膜图像，并显著减少了仪器占用空间和光学元件数量。AO-LSLO具有中等视野（5.5度），可更快速有效地获得黄斑或其他目标的蒙太奇。在初步的人类受试者研究中，可以分辨光感受器并计数到中央凹的约0.5 mm内。光感受器计数与之前报道的组织学结果密切匹配。中心凹无血管区周围的毛细血管以及其中流动的细胞可以被分辨。可以分辨单个神经纤维束，特别是在视神经头附近，以及其他结构，如筛板。除了仪器设计、制造和测试之外，还开发了用于自动图像配准、锥体计数和蒙太奇拼接的软件算法。 我们与杜克大学眼科中心的眼科医生合作，建议在第二阶段继续进行仪器开发和全面的临床测试。AO-LSLO仪器将针对临床操作进行改进和增强，包括重新设计光学布局以减小占地面积、临床包装的光学机械设计、修改扫描硬件以实现自动剪辑以及升级部分组件以提高性能。此外，我们将探索进一步降低硬件复杂性的波前传感器算法的实施。杜克的初步临床研究将分三个阶段进行。第一阶段将在临床环境中完成初步测试。第二阶段将包括重复性研究，成像几种不同的视网膜疾病（Stargardt's，视网膜色素变性等），并将AO-LSLO与目前常规临床使用的其他成像模式进行比较。第三阶段将探索该仪器对地图状萎缩（GA）边缘的干性年龄相关性黄斑变性（AMD）和先前激光治疗部位的糖尿病黄斑水肿中的光感受器成像的能力。特别是，我们将描述和量化这些疾病或激光治疗部位和其他内部视网膜成分的感光细胞损失。本研究将确定AO-LSLO是否提供目前其他成像模式无法提供的补充信息。如果成功，第二阶段计划和随后的第三阶段商业开发将为临床医生提供高分辨率，高性能的自适应光学成像，其成本与其他视网膜成像仪相当，以帮助指导治疗并改善患者的预后。 公共卫生相关性：通过使高分辨率的眼部访问更加广泛，拟议的AO-LSLO仪器将使自适应光学技术被更多的临床医生和科学家使用。反过来，这些研究人员将利用这一工具来增加我们对视力及其被疾病破坏的理解，并测量新药和疗法的组织效应。