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

描述（由申请人提供）：SBIR第二期竞争性更新项目的主要目标是证明项目团队在第一期和第二期工作中设计和制造的独特的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，产生几乎衍射有限的共聚焦视网膜图像。这在视网膜成像中特别有用，因为有AO（~2¿m）和没有AO（~10¿m）的可分辨特征尺寸的差异对应于一个范围，包括视网膜许多最重要的特征的大小：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应该导致对视网膜功能和疾病的更好理解。原型AOSLO集成了一个光学倍频器和定制开发的长行程可变形镜，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被证明能够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，因此可以在不扩大瞳孔的情况下对许多对象成像。它还包括一个光束控制系统，允许临床医生在视网膜上转换成像场，而不需要持续的受试者固定。创新的成像技术，将在临床环境中探索使用这种AOSLO平台技术，包括个体血细胞跟踪，血流动力学成像和蒙太奇映射的光感受器。该项目将包括开发临床启发增强成像，人体工程学和原型AOSLO的软件控制。BMC将与一家临床机构合作，评估AOSLO的临床应用价值。观察性试点研究将在Joslin糖尿病中心的Beetham眼科研究所（BEI）进行，BEI临床研究的目的是评估AOSLO视网膜图像作为临床上有用的视力替代指标的能力

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. PUBLIC HEALTH RELEVANCE: 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 and that is specifically for use in a clinical setting. The instruments will be placed at a leading ophthalmology center where they will be used to quantify and report on the clinical utility of the unprecedented, high resolution in vivo images of the human retina provided by the AOSLO.