Ryan P. McNabb

Doppler velocity detection limitations in spectrometer-based versus swept-source optical coherence tomography

Recent advances in Doppler techniques have enabled high sensitivity imaging of biological flow to measure blood velocities and vascular perfusion. Here we compare spectrometer-based and wavelength-swept Doppler OCT implementations theoretically and experimentally, characterizing the lower and upper observable velocity limits in each configuration. We specifically characterize the washout limit for Doppler OCT, the velocity at which signal degradation results in loss of flow information, which is valid for both quantitative and qualitative flow imaging techniques. We also clearly differentiate the washout effect from the separate phenomenon of phase wrapping. We demonstrate that the maximum detectable Doppler velocity is determined by the fringe washout limit and not phase wrapping. Both theory and experimental results from phantom flow data and retinal blood flow data demonstrate the superiority of the swept-source technique for imaging vessels with high flow rates.

Fast Acquisition and Reconstruction of Optical Coherence Tomography Images via Sparse Representation

In this paper, we present a novel technique, based on compressive sensing principles, for reconstruction and enhancement of multi-dimensional image data. Our method is a major improvement and generalization of the multi-scale sparsity based tomographic denoising (MSBTD) algorithm we recently introduced for reducing speckle noise. Our new technique exhibits several advantages over MSBTD, including its capability to simultaneously reduce noise and interpolate missing data. Unlike MSBTD, our new method does not require an a priori high-quality image from the target imaging subject and thus offers the potential to shorten clinical imaging sessions. This novel image restoration method, which we termed sparsity based simultaneous denoising and interpolation (SBSDI), utilizes sparse representation dictionaries constructed from previously collected datasets. We tested the SBSDI algorithm on retinal spectral domain optical coherence tomography images captured in the clinic. Experiments showed that the SBSDI algorithm qualitatively and quantitatively outperforms other state-of-the-art methods.

Robust automatic segmentation of corneal layer boundaries in SDOCT images using graph theory and dynamic programming.

Segmentation of anatomical structures in corneal images is crucial for the diagnosis and study of anterior segment diseases. However, manual segmentation is a time-consuming and subjective process. This paper presents an automatic approach for segmenting corneal layer boundaries in Spectral Domain Optical Coherence Tomography images using graph theory and dynamic programming. Our approach is robust to the low-SNR and different artifact types that can appear in clinical corneal images. We show that our method segments three corneal layer boundaries in normal adult eyes more accurately compared to an expert grader than a second grader—even in the presence of significant imaging outliers.

Piezoelectric scanning mirrors for endoscopic optical coherence tomography

A novel piezoelectric scanning mirror design for endoscopic optical coherence tomography (OCT) is presented. OCT is an interferometric technique providing microscopic tomographic sectioning of biological samples with mm-range penetration capability in tissue and is suited for integration with endoscopes using fiber-based light delivery to the sample. The piezoelectric scanning mirror was designed to provide wide-range rapid forwarding-looking scanning of the optical beam at the distal end of a compact catheter. The optical scanner provides a large ratio of mirror aperture to device size with rectangular mirror sizes ranging from 600 µm × 840 µm to 840 µm × 1600 µm. Static angular displacements up to ±7° (mechanical angle) were demonstrated and resonance frequencies of hundreds of Hz (and up to 1–2 kHz) were measured, depending on the mirror size. The imaging capability of the piezoelectric scanner was demonstrated using a bench-top spectrometer-based Fourier-domain OCT system.

Optical Coherence Tomography Accurately Measures Corneal Power Change from Laser Refractive Surgery

PURPOSE To determine the ability of motion-corrected optical coherence tomography (OCT) to measure the corneal refractive power change due to LASIK. DESIGN Evaluation of a diagnostic test or technology in a cohort. SUBJECTS A total of 70 eyes from 37 subjects undergoing LASIK were measured preoperatively. A total of 39 eyes from 22 subjects were measured postoperatively and completed the study. METHODS Consecutive patients undergoing LASIK at the Duke Eye Center who consented to participate were imaged with Placido-ring topography, Scheimpflug photography, and OCT on the day of their surgery. Patients were then reimaged with the same imaging systems at the postoperative month 3 visit. Change in preoperative to postoperative corneal refractive power as measured by each of the imaging modalities was compared with the preoperative to postoperative change in manifest refraction (MRx) using the t test with generalized estimating equations. MAIN OUTCOME MEASURES Corneal refractive power change due to LASIK as measured by Placido-ring topography, Scheimpflug photography, and OCT compared with the MRx change vertexed to the corneal plane. The change in MRx should correspond to the change in the corneal refractive power from LASIK and was considered the reference measurement. RESULTS In 22 individuals (39 eyes) returning after LASIK, we found no significant difference between the clinically measured pre- to post-LASIK change in MRx and both Scheimpflug photography (P = 0.714) and OCT (P = 0.216). In contrast, keratometry values from Placido-ring topography were found to be significantly different from the measured refractive change (P < 0.001). In addition, of the 3 imaging modalities, OCT recorded the smallest mean absolute difference from the reference measurement with the least amount of variability. CONCLUSIONS Motion-corrected OCT more accurately measures the change in corneal refractive power due to laser refractive surgery than other currently available clinical devices. By offering accurate corneal refractive power measurements in normal and surgically modified subjects, OCT offers a compelling alternative to current clinical devices for determining corneal refractive power.

Correction of Ocular Shape in Retinal Optical Coherence Tomography and Effect on Current Clinical Measures

PURPOSE To address the misrepresentation of the eye in retinal optical coherence tomography (OCT) images and to examine the effect of this misrepresentation on retinal thickness measurements. DESIGN Prospective case series. METHODS Five subjects with recent orbital magnetic resonance imaging (MRI) scans and normal eye examinations were consented from the clinics of the Duke Eye Center. Each subject had both eyes imaged using a retinal spectral-domain OCT system and ocular biometry measured. Two types of individualized optical models of the subject eyes-numerical and analytical-were used to determine the spatial paths of the OCT A-scans. These paths were used to reorient the A-scans in the associated retinal OCT images and generate corrected images. Using curvature as a general measure of shape, the radii of curvature of the retinal pigment epithelium in the original and corrected OCT images were compared to the ocular radii of curvature in the MRI images. Differences between the retinal thickness maps derived from the original and corrected OCT images were then determined. RESULTS The retinal curvatures were substantially flatter in the original OCT than in the MRI images (mean paired difference: 52.8 ± 41.8 mm, P < .001). Correcting the OCT images decreased the paired differences between OCT and MRI (numerical: 1.6 ± 2.3 mm, P = .091; analytical: 1.9 ± 4.3 mm, P = .278). Retinal thickness measurements between the corrected and uncorrected images differed, with a root mean square difference of 5.61 μm over the entire 6-mm extent of the image; this difference was greater peripherally (6.02 μm) than centrally (2.54 μm). CONCLUSIONS Optically based algorithms can be used to correct the shape of the retina as represented in OCT; this correction makes OCT more consistent with other clinical imaging techniques. Resultant retinal thickness maps were minimally affected by the change in shape. Ocular shape correction should be considered in future development of posterior segment OCT-based morphologic measurements.

Distributed scanning volumetric SDOCT for motion corrected corneal biometry

We present a method, termed distributed scanning OCT (DSOCT), which reduces the effects of patient motion on corneal biometry utilizing current-generation clinically available spectral domain optical coherence tomography (SDOCT) systems. We first performed a pilot study of the power spectrum of normal patient axial eye motion based on repeated (M-mode) SDOCT. Using DSOCT to reduce the effects of patient motion, we conducted a preliminary patient study comparing the measured anterior and posterior corneal curvatures and the calculated corneal power to both corneal topography and Scheimpflug photography in normal subjects. The repeatability for the measured radius of curvature of both anterior and posterior surfaces as well as calculated corneal refractive power using DSOCT was comparable to those of both topography and Scheimpflug photography.

Wide-field optical model of the human eye with asymmetrically tilted and decentered lens that reproduces measured ocular aberrations

Eye models are valuable tools that can help delineate the role of anatomical parameters on visual performance and guide the design of advanced ophthalmic instrumentation. We propose an optically accurate wide-field schematic eye that reproduces the complete aberration profile of the human eye across a wide visual field. The optical performance of the schematic eye is based on experimentally measured wavefront aberrations taken with a four mm pupil for the central 80° of the horizontal meridian (101 eyes) and 50° of the vertical meridian (10 eyes). Across the entire field of view, our model shows excellent agreement with the measured data both comprehensively and for low-order and high-order aberrations. In comparison to previous eye models, our schematic eye excels at reproducing the aberrations of the retinal periphery. Also unlike previous models, tilt and decentering of the gradient refractive index crystalline lens, which arose naturally through the optimization process, permits our model to mimic the asymmetries of real human eyes while remaining both anatomically and optically correct. Finally, we outline a robust reverse building eye modeling technique that is capable of predicting trends beyond those defined explicitly in the optimization routine. Our proposed model may aid in the design of wide-field imaging instrumentation, including optical coherence tomography, scanning laser ophthalmoscopy, fluorescence imaging, and fundus photography, and it has the potential to provide further insights in the study and understanding of the peripheral optics of the human eye.

Wide field of view swept-source optical coherence tomography for peripheral retinal disease

Background/aims To assess peripheral retinal lesions and the posterior pole in single widefield optical coherence tomography (OCT) volumes. Methods A wide field of view (FOV) swept-source OCT (WFOV SSOCT) system was developed using a commercial swept-source laser and a custom sample arm consisting of two indirect ophthalmic lenses. Twenty-seven subjects with peripheral lesions (choroidal melanomas, choroidal naevi, sclerochoroidal calcification, retinitis pigmentosa, diabetic retinopathy, retinoschisis and uveitis) were imaged with the WFOV SSOCT. Volumes were taken in primary gaze. Using the optic nerve to fovea distance as a reference measurement, comparisons were made between the lateral FOV of the WFOV SSOCT, current generation spectral-domain OCT (SDOCT) and widefield scanning laser ophthalmoscopy (SLO) of the same eyes. Results Peripheral pathologies were captured with WFOV SSOCT in 26 of the 27 subjects. The one not captured was in the far nasal periphery and was not seen in the primary gaze volume. Posterior pole associated pathologies were captured in all subjects. Current generation SDOCT had a mean lateral FOV of 2.08±0.21 optic nerve to fovea distance units, WFOV SSOCT had an FOV of 4.62±0.62 units and SLO had an FOV of 9.35±1.02 units. Conclusions WFOV OCT can be used to examine both peripheral retinal pathology and the posterior pole within a single volume acquisition. SLO had the greatest FOV, but does not provide depth information. Future studies using widefield OCT systems will help further delineate the role of WFOV OCT to quantitatively assess and monitor peripheral retinal disease in three dimensions.

Complete 360° circumferential gonioscopic optical coherence tomography imaging of the iridocorneal angle

Clinically, gonioscopy is used to provide en face views of the ocular angle. The angle has been imaged with optical coherence tomography (OCT) through the corneoscleral limbus but is currently unable to image the angle from within the ocular anterior chamber. We developed a novel gonioscopic OCT system that images the angle circumferentially from inside the eye through a custom, radially symmetric, gonioscopic contact lens. We present, to our knowledge, the first 360° circumferential volumes (two normal subjects, two subjects with pathology) of peripheral iris and iridocorneal angle structures obtained via an internal approach not typically available in the clinic.