High Performance Multimodal Adaptive Optics Retinal Imaging

高性能多模态自适应光学视网膜成像

• 批准号: 8135335
• 负责人: R DANIEL FERGUSON
• 金额: $ 70.04万
• 依托单位: PHYSICAL SCIENCES, INC
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-05-01 至 2014-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8135335
• 关键词: Age related macular degeneration; Age-Years; Algorithms; Area; Atrophic; Biochemical; Blindness; Blood Vessels; Blood capillaries; Bruch' s basal membrane structure; Cell Death; Cells; Characteristics; Choroid; Clinical; Clinical Trials; Collaborations; Coupled; Cues; Databases; Degenerative Disorder; Development; Device or Instrument Development; Diabetic Retinopathy; Diagnosis; Disease; Disease Progression; Disorder by Site; Drusen; Dyes; Equipment; Evaluation; Eye; Genetic; Glaucoma; Government; Human; Image; Imagery; Imaging Device; Inherited; Investigation; Lasers; Learning; Licensing; Light; Lighting; Lipofuscin; Manufacturer Name; Marketing; Measurement; Measures; Medical center; Microaneurysm; Modification; Motion; Nature; Nerve Fibers; Ophthalmologist; Ophthalmoscopes; Ophthalmoscopy; Optic Disk; Optical Coherence Tomography; Optics; Outcome; Patients; Penetration; Performance; Persons; Pharmaceutical Preparations; Pharmacotherapy; Phase; Photoreceptors; Population; Price; Production; Public Health; Reporting; Reproducibility; Research; Research Personnel; Resolution; Retinal; Retinal Cone; Retinal Degeneration; Retinal Diseases; Retinitis Pigmentosa; Sales; Scanning; Scientist; Screening procedure; Signal Transduction; Site; Small Business Innovation Research Grant; Source; Staging; Stimulus; Stroke; System; Technology; Testing; Time; Tissues; Universities; Validation; Vascular Diseases; Vision; Visit; Visual; adaptive optics; arm; base; capillary; clinically relevant; commercialization; cost; design; eye center; fovea centralis; ganglion cell; geographic atrophy; human subject; image registration; improved; insight; instrument; interest; macula; neovascularization; neuronal cell body; operation; optical imaging; physical science; product development; programs; prototype; public health relevance; research clinical testing; retinal nerve fiber layer; sample fixation; therapy development; tool

DESCRIPTION (provided by applicant): Physical Sciences Inc. (PSI) has successfully completed a Phase I program to develop a multimodal adaptive optics (AO) retinal imager for diagnosis of retinal diseases, including glaucoma, diabetic retinopathy (DR), age-related macular degeneration (AMD), and retinitis pigmentosa (RP). The development represents the first ever high performance AO system constructed that combines AO- corrected scanning laser ophthalmoscopy (SLO) and swept source Fourier domain optical coherence tomography (SSOCT) imaging modes in a single compact clinical prototype platform. The SSOCT channel operates at a wavelength of 1 5m for increased penetration and visualization of the choriocapillaris and choroid, sites of major disease activity for DR and wet AMD. The system is designed to operate on a broad clinical population with a dual deformable mirror (DM) configuration that allows simultaneous low- and high- order aberration correction. The system also includes a wide field line scanning ophthalmoscope (LSO) for initial screening, target identification, and global orientation; an integrated retinal tracker (RT) to stabilize the SLO, OCT, and LSO imaging fields in the presence of rotational eye motion; and a high-resolution LCD-based fixation target for presentation to the subject of stimuli and other visual cues. The system was tested in a limited number of human subjects without retinal disease for performance optimization and validation. The system was able to resolve and quantify cone photoreceptors across the macula to within ~0.5 deg (~100-150 5m) of the fovea, image and delineate ten retinal layers, and penetrate to resolve targets deep into the choroid. In addition to instrument hardware development, analysis algorithms were developed for efficient information extraction from clinical imaging sessions, with functionality including automated image registration, photoreceptor counting, strip and montage stitching, and segmentation. In collaboration with ophthalmologists and researchers at University of Pittsburgh Medical Center (UPMC) Eye Center, we propose to continue instrument development and full clinical testing in Phase II. The multimodal AO instrument will be refined and enhanced for clinical operation, including upgrades of the retinal tracker and synchronization hardware. In addition, we will outfit the instrument with a piezo-driven reference mirror for measurement of power Doppler signals from fine retinal capillaries. The system will be installed at UPMC for a two-stage clinical trial including initial validation in subjects without retinal disease and tests in subjects with glaucoma, DR, AMD, and RP. The study will demonstrate that the multimodal AO system provides structural and flow information not currently available from any other commercially- available imager. If successful, the Phase II program and subsequent Phase III commercial development will provide clinicians with high-resolution, high performance adaptive optics imaging to help guide therapies, develop new drugs, and improve patient outcomes. PUBLIC HEALTH RELEVANCE: By making high-resolution ocular access more widespread, the proposed high performance multimodal AO 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)已成功完成第一阶段计划，开发一种多模式自适应光学（AO）视网膜成像仪，用于诊断视网膜疾病，包括青光眼、糖尿病视网膜病变（DR）、年龄相关性黄斑变性（AMD）和视网膜色素变性（RP）。该开发代表了第一个高性能AO系统，该系统将AO校正扫描激光检眼镜（SLO）和扫频源傅立叶域光学相干断层扫描（SSOCT）成像模式结合在一个紧凑的临床原型平台中。SSOCT通道在15 m的波长下操作，用于增加脉络膜毛细血管和脉络膜的穿透和可视化，脉络膜毛细血管和脉络膜是DR和湿性AMD的主要疾病活动部位。该系统设计用于广泛的临床人群，具有双变形镜（DM）配置，允许同时进行低阶和高阶像差校正。该系统还包括用于初始筛选、目标识别和全局定向的宽场线扫描检眼镜（LSO）;用于在存在旋转眼球运动的情况下稳定SLO、OCT和LSO成像场的集成视网膜跟踪器（RT）;以及用于向受试者呈现刺激和其他视觉提示的基于高分辨率LCD的注视目标。该系统在有限数量的没有视网膜疾病的人类受试者中进行了测试，以进行性能优化和验证。该系统能够分辨和量化黄斑中心凹~0.5度（~100-150 5 m）范围内的锥体光感受器，成像和描绘10个视网膜层，并穿透以分辨深入脉络膜的目标。除了仪器硬件开发外，还开发了分析算法，用于从临床成像会话中有效提取信息，其功能包括自动图像配准、感光器计数、条带和蒙太奇拼接以及分割。 在匹兹堡大学医学中心（UPMC）眼科中心的眼科医生和研究人员的合作下，我们建议在第二阶段继续进行仪器开发和全面的临床测试。多模式AO仪器将进行改进和增强，用于临床操作，包括升级视网膜跟踪器和同步硬件。此外，我们将配备一个压电驱动的参考镜的仪器，用于测量功率多普勒信号从精细的视网膜毛细血管。该系统将安装在UPMC进行两阶段临床试验，包括在无视网膜疾病的受试者中进行初始验证，以及在青光眼、DR、AMD和RP受试者中进行测试。该研究将证明，多模式AO系统提供的结构和流动信息目前无法从任何其他市售成像仪。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，以帮助指导治疗，开发新药，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通路更加广泛，所提出的高性能多模式AO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。