Adaptive Optics Retinal Imaging in a Clinical Setting Using Long Stroke Wavefront

描述（由申请人提供）：SBIR第II阶段竞争性更新项目的主要目标是证明项目团队在第I阶段和第II阶段工作中设计和构建的独特自适应光学扫描激光检眼镜（AOSLO）的临床相关性。它具有闭环AO控制，自动补偿眼睛的像差，产生几乎衍射限制共焦视网膜图像。这在视网膜成像中特别有用，因为具有AO（~2 μ m）和不具有AO（~10 μ m）的可分辨特征尺寸的差异对应于包括许多视网膜最重要特征的尺寸的范围：视锥光感受器、神经纤维细胞、红细胞、白细胞、毛细血管和视网膜色素上皮细胞。因此，AOSLO应该能更好地了解视网膜功能和疾病。原型AOSLO采用了光学倍增器和定制开发的长行程变形镜，用于补偿高阶像差。这些独特的组件允许像差补偿成像，适用于90%的临床受试者，而无需使用额外的试验镜片。在第二阶段的工作中，AOSLO被证明可以实现卓越的视网膜图像分辨率和操作特性，使其非常适合临床使用。它使用长波长和低强度光源照明，使得许多对象可以成像而无需瞳孔扩张。它还包括一个光束转向系统，允许临床医生在视网膜上平移成像场，而不需要连续的受试者重新固定。使用AOSLO平台技术在临床环境中探索的创新成像技术包括个体血细胞跟踪、血流动力学成像和光感受器的蒙太奇映射。该项目将包括在原型AOSLO的成像、人体工程学和软件控制方面开发临床启发的增强功能。BMC将与临床研究中心合作评价AOSLO的临床有效性。观察性初步研究将在Joslin糖尿病中心的Beetham眼科研究所（BEI）进行。BEI研究的临床目的是评价AOSLO视网膜图像作为临床有用的视力替代品的能力。 在患有累及中心的糖尿病性黄斑水肿的眼睛中，并评估定量AOSLO图像指标与糖尿病性视网膜病变的视网膜疾病状态之间的相关性。

DESCRIPTION (provided by applicant): The principal objective for this SBIR Phase II Competitive Renewal project is to demonstrate clinical relevance of a unique Adaptive Optics Scanning Laser Ophthalmoscope (AOSLO) that the project team designed and built in Phase I and Phase II work. It features closed-loop AO control that automatically compensates for aberrations of the eye, yielding nearly diffraction-limited confocal retinal images. This is particularly useful in retinal imaging, since the difference in resolvable feature size with AO (~2¿m) and without AO (~10¿m) corresponds to a range that includes the size of many of the retina's most important features: cone photoreceptors, nerve fiber cells, erythrocytes, leukocytes, capillaries, and retinal pigment epithelial cells. As a result, the AOSLO should lead to a better understanding of retinal function and disease. The prototype AOSLO incorporates an optical doubler and custom-developed long-stroke deformable mirror for compensating higher order aberrations. Those unique components allow aberration- compensated imaging suitable for 90% of clinical subjects without the use of added trial lenses. In Phase II work, the AOSLO was demonstrated to achieve exceptional retinal image resolution and operational characteristics that make it well suited for clinical use. It uses long wavelength and low intensit source illumination, so that many subjects can be imaged without pupil dilation. It also includes a beam steering system that allows a clinician to translate the imaged field across the retina without requiring continual subject refixations. Innovative imaging techniques that will be explored in the clinical settings using this AOSLO platform technology include individual blood cell tracking, hemodynamic imaging, and montage mapping of photoreceptors. The project will include development of clinically inspired enhancements in imaging, ergonomics, and software control of the prototype AOSLO. BMC will collaborate with a clinical site in an evaluation of the clinical usefulness of the AOSLO. Observational pilot studies will be conducted at Beetham Eye Institute (BEI) of the Joslin Diabetes Center Clinical aims for the BEI study will be to evaluate the capability of AOSLO retinal images to serve as a clinically useful surrogates for visual acuity in eyes with center-involved diabetic macular edema, and to evaluate correlations between quantified AOSLO image metrics and the state of retinal disease in diabetic retinopathy.