Adaptive optics parallel confocal scanning ophthalmoscope (AO-PCSO)

描述（由申请人提供）：视网膜相关性黄斑变性（AMD）是发达国家50岁或以上人群失明的主要原因。最突出的临床和组织学损伤涉及视网膜色素上皮（RPE）、布鲁赫膜和脉络膜毛细血管;但正是光感受器的变性、功能障碍和死亡导致视力丧失。解剖学和功能研究已经发现，在RPE/布鲁赫膜复合体中的疾病进展到晚期AMD之前，发生感光细胞变性和损失。尽管视锥细胞变性是视杆细胞死亡的继发性改变，但视锥细胞的丧失才是导致视力障碍的主要原因。因此，在临床环境中检测早期视锥细胞变性对于预防视力丧失至关重要。视锥内段变宽和畸形的退化过程中，我们假设，扩大和变形的旁视锥可以作为一个早期的临床体征，用于诊断AMD。高分辨率和高保真度的视网膜成像可能有助于识别这些迹象。 活体人眼中细胞尺度的视网膜图像只能通过自适应光学（AO）辅助检眼镜来实现。但目前的AO视网膜成像受到图像采集速度不足和图像保真度不足的阻碍。在本申请中，我们将开发一种高速、高分辨率的AO并行共焦扫描检眼镜（AO-PCSO），以便于在早期阶段诊断AMD。 本应用中开发的仪器是面向“真实世界”患者的。AO-PCSO超越了目前的AO视网膜成像模式，显著提高了数据收集效率和图像保真度。该应用打破了AMD研究的障碍，通过提供视网膜变性疾病的细胞诊断，寻求将当前的临床实践范式从宏观尺度转变为微观尺度。这项研究的成功将显著提高我们在AMD发病时诊断AMD的能力和我们对疾病进展的了解。高速图像采集是共焦视网膜成像的一个标志性进展;它不仅对老年受试者的成像很重要，而且对涉及早发性视网膜疾病儿童的研究也同样重要。

DESCRIPTION (provided by applicant): Age-related macular degeneration (AMD) is the leading cause of blindness in people 50 years of age or older in the developed world. The most prominent clinical and histological damage involves retinal pigment epithelium (RPE), Bruch's membrane, and choriocapillaris; but it is the degeneration, dysfunction, and death of photoreceptors that accounts for the vision loss. Anatomical and functional studies have found that photoreceptor degeneration and loss occur before disease in the RPE/Bruch's membrane complex progresses to late AMD. Although the cone photoreceptor degeneration is secondary to rod death, it is the cone loss that causes major visual handicap. As such detecting early cone degeneration in a clinical setting is strategically critical to prevent vision loss. Cone inner segments become widened and misshapen during the degeneration; we hypothesize that enlargement and deformation of the parafoveal cones could be used as an early clinical sign for the diagnosis of AMD. Identifying these signs may be facilitated by high-resolution and high-fidelity retinal imaging. The cellular scale retinal image in the living human eye can only be achieved by adaptive optics (AO) assisted ophthalmoscopy. But current AO retinal imaging is hampered by insufficient image acquisition speed and inadequate image fidelity. In this application, we will develop a high- speed, high-resolution AO parallel confocal scanning ophthalmoscope (AO-PCSO) to facilitate diagnosis of AMD at an earlier stage. The instrument developed in this application is 'real-world' patient oriented. The AO-PCSO exceeds current AO retinal imaging modalities with significantly improved data collection efficiency and image fidelity. This application breaks the barrier to the study of AMD, seeking to shift current clinical practice paradigms from macro-scale to micro-scale by providing cellular diagnosis of retinal degenerative disease. The success of this research will significantly improve our ability to diagnose AMD at its onset and our knowledge of disease progression. High-speed image acquisition is a signature advance in confocal retinal imaging; it is not only important for imaging the elderly subjects but also equally important for studies involving children with early onset retinal disease.