Daniel Pascual

Optical distortion correction in Optical Coherence Tomography for quantitative ocular anterior segment by three-dimensional imaging

A method for three-dimensional 3-D optical distortion (refraction) correction on anterior segment Optical Coherence Tomography (OCT) images has been developed. The method consists of 3-D ray tracing through the different surfaces, following denoising, segmentation of the surfaces, Delaunay representation of the surfaces, and application of fan distortion correction. The correction has been applied theoretically to realistic computer eye models, and experimentally to OCT images of: an artificial eye with a Polymethyl Methacrylate (PMMA) cornea and an intraocular lens (IOL), an enucleated porcine eye, and a human eye in vivo obtained from two OCT laboratory set-ups (time domain and spectral). Data are analyzed in terms of surface radii of curvature and asphericity. Comparisons are established between the reference values for the surfaces (nominal values in the computer model; non-contact profilometric measurements for the artificial eye; Scheimpflug imaging for the real eyes in vivo and vitro). The results from the OCT data were analyzed following the conventional approach of dividing the optical path by the refractive index, after application of 2-D optical correction, and 3-D optical correction (in all cases after fan distortion correction). The application of 3-D optical distortion correction increased significantly both the accuracy of the radius of curvature estimates and particularly asphericity of the surfaces, with respect to conventional methods of OCT image analysis. We found that the discrepancies of the radii of curvature estimates from 3-D optical distortion corrected OCT images are less than 1% with respect to nominal values. Optical distortion correction in 3-D is critical for quantitative analysis of OCT anterior segment imaging, and allows accurate topography of the internal surfaces of the eye.

Dynamic OCT measurement of corneal deformation by an air puff in normal and cross-linked corneas

A new technique is presented for the non-invasive imaging of the dynamic response of the cornea to an air puff inducing a deformation. A spectral OCT instrument combined with an air tonometer in a non-collinear configuration was used to image the corneal deformation over full corneal cross-sections, as well as to obtain high speed measurements of the temporal evolution of the corneal apex. The entire deformation process can be dynamically visualized. A quantitative analysis allows direct extraction of several deformation parameters, such as amplitude, diameter and volume of the maximum deformation, as well as duration and speed of the increasing deformation period and the recovery period. The potential of the technique is demonstrated on porcine corneas in vitro under constant IOP for several conditions (untreated, after riboflavin instillation and under cross-linking with ultraviolet light), as well as on human corneas in vivo. The new technique has proved very sensitive to detect differences in the deformation parameters across conditions. We have confirmed non-invasively that Riboflavin and UV-cross-linking induce changes in the corneal biomechanical properties. Those differences appear to be the result of changes in constituent properties of the cornea, and not a consequence of changes in corneal thickness, geometry or IOP. These measurements are a first step for the estimation of the biomechanical properties of corneal tissue, at an individual level and in vivo, to improve diagnosis and prognosis of diseases and treatments involving changes in the biomechanical properties of the cornea.

Corneal Viscoelastic Properties from Finite-Element Analysis of In Vivo Air-Puff Deformation

Biomechanical properties are an excellent health marker of biological tissues, however they are challenging to be measured in-vivo. Non-invasive approaches to assess tissue biomechanics have been suggested, but there is a clear need for more accurate techniques for diagnosis, surgical guidance and treatment evaluation. Recently air-puff systems have been developed to study the dynamic tissue response, nevertheless the experimental geometrical observations lack from an analysis that addresses specifically the inherent dynamic properties. In this study a viscoelastic finite element model was built that predicts the experimental corneal deformation response to an air-puff for different conditions. A sensitivity analysis reveals significant contributions to corneal deformation of intraocular pressure and corneal thickness, besides corneal biomechanical properties. The results show the capability of dynamic imaging to reveal inherent biomechanical properties in vivo. Estimates of corneal biomechanical parameters will contribute to the basic understanding of corneal structure, shape and integrity and increase the predictability of corneal surgery.

Visual performance with real-life tasks under adaptive-optics ocular aberration correction.

We measured the effect of the correction of the natural aberrations of the eye by means of adaptive optics on the subjects performance on three different visual tasks: subjective sharpness assessment of natural images, familiar face recognition, and facial expression recognition. Images were presented through a dedicated psychophysical channel and viewed through an electromagnetic deformable mirror. Experiments were performed on 17 normal subjects. Ocular aberrations (astigmatism and higher order aberrations) were reduced on average from 0.366 +/- 0.154 to 0.101 +/- 0.055 mum for a 5-mm pupil diameter. On average, subjects considered to be sharper 84 +/- 14% of the images viewed under AO correction, and there was a significant correlation between the amount of corrected aberrations and the percentage of images that the subject considered sharper when observed under AO-corrected aberrations. In all eyes (except one), AO correction improved familiar face recognition, by a factor of x1.13 +/- 0.12 on average. However, AO correction did not improve systematically facial expression recognition.

Contribution of the gradient refractive index and shape to the crystalline lens spherical aberration and astigmatism

The optical properties of the crystalline lens are determined by its shape and refractive index distribution. However, to date, those properties have not been measured together in the same lens, and therefore their relative contributions to optical aberrations are not fully understood. The shape, the optical path difference, and the focal length of ten porcine lenses (age around 6 months) were measured in vitro using Optical Coherence Tomography and laser ray tracing. The 3D Gradient Refractive Index distribution (GRIN) was reconstructed by means of an optimization method based on genetic algorithms. The optimization method searched for the parameters of a 4-variable GRIN model that best fits the distorted posterior surface of the lens in 18 different meridians. Spherical aberration and astigmatism of the lenses were estimated using computational ray tracing, with the reconstructed GRIN lens and an equivalent homogeneous refractive index. For all lenses the posterior radius of curvature was systematically steeper than the anterior one, and the conic constant of both the anterior and posterior positive surfaces was positive. In average, the measured focal length increased with increasing pupil diameter, consistent with a crystalline lens negative spherical aberration. The refractive index of nucleus and surface was reconstructed to an average value of 1.427 and 1.364, respectively, for 633 nm. The results of the GRIN reconstruction showed a wide distribution of the index in all lens samples. The GRIN shifted spherical aberration towards negative values when compared to a homogeneous index. A negative spherical aberration with GRIN was found in 8 of the 10 lenses. The presence of GRIN also produced a decrease in the total amount of lens astigmatism in most lenses, while the axis of astigmatism was only little influenced by the presence of GRIN. To our knowledge, this study is the first systematic experimental study of the relative contribution of geometry and GRIN to the aberrations in a mammal lens.

Portable simultaneous vision device to simulate multifocal corrections

Multifocal lenses are increasingly used solutions for presbyopia, the age-related loss of crystalline lens focus ability. These lenses work by the principle of simultaneous vision, superimposing focused and defocused images on the retina. Providing the experience of simultaneous vision to a patient before permanent implantation of a multifocal lens is a recognized unmet need to increase the patient’s confidence and optimize the lens selection. We developed a hand-held, see-through multifocal vision simulator based on temporal multiplexing of a tunable lens. The device was calibrated and validated using focimetry and Hartmann–Shack aberrometry revealing high reproducibility of the through-focus multifocal energy distribution and high optical quality. We measured visual acuity and perceptual quality on nine cyclopeged patients with three monofocal, two bifocal, and two trifocal corrections with different far/intermediate/near energy distributions simulated using the device. Visual performance and perceptual quality with multifocal corrections varied across patients, although they were more uniform across distances than monofocal corrections. Among the bifocal and trifocal designs, a trifocal with more energy at far was the most frequently identified as providing better quality. The simultaneous vision simulator proved a promising compact tool to study visual performance with multifocal corrections and to select the lens design best suited for each patient, alternative to costly and bulky adaptive optics based devices.