Performance Analysis of Cone Detection Algorithms

Many algorithms have been proposed to help clinicians evaluate cone density and spacing, as these may be related to the onset of retinal diseases. However, there has been no rigorous comparison of the performance of these algorithms. In addition, the performance of such algorithms is typically determined by comparison with human observers. Here we propose a technique to simulate realistic images of the cone mosaic. We use the simulated images to test the performance of two popular cone detection algorithms and we introduce an algorithm which is used by astronomers to detect stars in astronomical images. We use Free Response Operating Characteristic (FROC) curves to evaluate and compare the performance of the three algorithms. This allows us to optimize the performance of each algorithm. We observe that performance is significantly enhanced by up-sampling the images. We investigate the effect of noise and image quality on cone mosaic parameters estimated using the different algorithms, finding that the estimated regularity is the most sensitive parameter. This paper was published in JOSA A and is made available as an electronic reprint with the permission of OSA. The paper can be found at the following URL on the OSA website: http://www.opticsinfobase.org/abstract.cfm?msid=224577. Systematic or multiple reproduction or distribution to multiple locations via electronic or other means is prohibited and is subject to penalties under law.Comment: 13 pages, 7 figures, 2 table

Repeatability of \u3cem\u3eIn Vivo\u3c/em\u3e Parafoveal Cone Density and Spacing Measurements

Purpose. To assess the repeatability and measurement error associated with cone density and nearest neighbor distance (NND) estimates in images of the parafoveal cone mosaic obtained with an adaptive optics scanning light ophthalmoscope (AOSLO).Methods. Twenty-one participants with no known ocular pathology were recruited. Four retinal locations, approximately 0.65[degrees] eccentricity from the center of fixation, were imaged 10 times in randomized order with an AOSLO. Cone coordinates in each image were identified using an automated algorithm (with or without manual correction) from which cone density and NND were calculated. Owing to naturally occurring fixational instability, the 10 images recorded from a given location did not overlap entirely. We thus analyzed each image set both before and after alignment.Results. Automated estimates of cone density on the unaligned image sets showed a coefficient of repeatability of 11,769 cones/mm2 (17.1%). The primary reason for this variability appears to be fixational instability, as aligning the 10 images to include the exact same retinal area results in an improved repeatability of 4358 cones/mm2 (6.4%) using completely automated cone identification software. Repeatability improved further by manually identifying cones missed by the automated algorithm, with a coefficient of repeatability of 1967 cones/mm2 (2.7%). NND showed improved repeatability and was generally insensitive to the undersampling by the automated algorithm.Conclusions. As our data were collected in a young, healthy population, this likely represents a best-case estimate for corresponding measurements in patients with retinal disease. Similar studies need to be carried out on other imaging systems (including those using different imaging modalities, wavefront correction technology, and/or image analysis software), as repeatability would be expected to be highly sensitive to initial image quality and the performance of cone identification algorithms. Separate studies addressing intersession repeatability and interobserver reliability are also needed

Suboptimal eye movements for seeing fine details.

Human eyes are never stable, even during attempts of maintaining gaze on a visual target. Considering transient response characteristics of retinal ganglion cells, a certain amount of motion of the eyes is required to efficiently encode information and to prevent neural adaptation. However, excessive motion of the eyes leads to insufficient exposure to the stimuli, which creates blur and reduces visual acuity. Normal miniature eye movements fall in between these extremes, but it is unclear if they are optimally tuned for seeing fine spatial details. We used a state-of-the-art retinal imaging technique with eye tracking to address this question. We sought to determine the optimal gain (stimulus/eye motion ratio) that corresponds to maximum performance in an orientation-discrimination task performed at the fovea. We found that miniature eye movements are tuned but may not be optimal for seeing fine spatial details

A two-step method for identifying photopigment opsin and rhodopsin gene sequences underlying human color vision phenotypes.

PurposeTo present a detailed, reliable long range-PCR and sequencing (LR-PCR-Seq) procedure to identify human opsin gene sequences for variations in the long wavelength-sensitive (OPN1LW), medium wavelength-sensitive (OPN1MW), short wavelength-sensitive (OPN1SW), and rhodopsin (RHO) genes.MethodsColor vision was assessed for nine subjects using the Farnsworth-Munsell 100 hue test, Ishihara pseudoisochromatic plates, and the Rabin cone-contrast threshold procedure (ColorDX, Konan Medical). The color vision phenotypes were normal trichromacy (n = 3), potential tetrachromacy (n = 3), dichromacy (n = 2), and unexplained low color vision (n = 1). DNA was isolated from blood or saliva and LR-PCR amplified into individual products: OPN1LW (4,045 bp), OPN1MW (4,045 bp), OPN1SW (3,326 bp), and RHO (6,715 bp). Each product was sequenced using specific internal primer sets. Analysis was performed with Mutation Surveyor software.ResultsThe LR-PCR-Seq technique identified known single nucleotide polymorphisms (SNPs) in OPN1LW and OPN1MW gene codons (180, 230, 233, 277, and 285), as well as those for lesser studied codons (174, 178, 236, 274, 279, 298 and 309) in the OPN1LW and OPN1MW genes. Additionally, six SNP variants in the OPN1MW and OPN1LW genes not previously reported in the NCBI dbSNP database were identified. An unreported poly-T region within intron 5(c.36+126) of the rhodopsin gene was also found, and analysis showed it to be highly conserved in mammalian species.ConclusionsThis LR-PCR-Seq procedure (single PCR reaction per gene followed by sequencing) can identify exonic and intronic SNP variants in OPN1LW, OPN1MW, OPN1SW, and rhodopsin genes. There is no need for restriction enzyme digestion or multiple PCR steps that can introduce errors. Future studies will combine the LR-PCR-Seq with perceptual behavior measures, allowing for accurate correlations between opsin genotypes, retinal photopigment phenotypes, and color perception behaviors

Optical and visual characterization of multifocal contact lenses and multifocal intraocular lenses

Vision is presented and universally accepted as the most precious of the human senses.lt is structured in three main parts: the optical system {eye), the photo-sensor {eye's retina), and the data processor (brain). If one of them is affected by any disease or dysfunction, vision will be terrible or even nonexistent One of the most common dysfunction is presbyopia.lt i s an age-related disorder that is undergone by all the population s ince their mid-late-40s and it is consists in the loss of the ability to focus near objects (accommodation). A huge number of possible corrections of it can be easily found. On one hand, there are temporary corrections ,as progressive spectacle tenses or multifocal contact tenses. On the other hand, permanent corrections as multifocal i ntraocular lenses, multifocal cornea! ablation, accommodating intraocular tenses, monovision systems, or scleral modifications are also applied to correct presbyopia. Another age-related dysfunction is cataract. Cataract is the opacification of the crystalline fens and decreases the quality of the visual function. Consequently, it is one of the leading visual impairments in adults over 60 years old, affecting the half of the adults aged between 75-85 years old. The only possible solution far cataract is the extraction of the opacified fibers of the crystalline lens and the replacement of them with an intraocular lens by surgery. Due to the fact that all the patients affected by an age-related cataract are also affected by presbyopia it is totally understandable that a number of patients choose mulltifocal introcular lens to substitute their crystalline tenses .This way, only one surgery is needed to salve both age-related dysfunctions. Usually, young presbyopes choose a temporary correction as a first option to correct presbyopia. Some presbyopia corrections are based on the simultaneous vision principie, as, far example, multifocal contact or intraocular lenses. The optical design of these kind of lenses is very complex. Consequently, It is characterization is also difficult When these lenses were launched into the market, it was only possible to characterize optical quality before the implantation or the adaptation of them (characterization in vitro) and the visual quality after the surgery or the clinical adaptation was performed (characterization) .M. present and thanks to the technological advances, different new commercial instruments that are to perform characterization in vivo of the visual quality before the implantation or the adaptation of simultaneous vis ion tenses. They are based on the simulation of the vision that these tenses give to the implanted eye. Some experimental prototypes and commercial aberrometers or double­ pass systems have used to perform an optical quality characterization in vivo, but some issues have been reported. Taking into account all this information, the main goal of this thesis is the design and the assembly of a new open-field double-pass system with asymmetric focus that is suitable to characterize invivo optical quality in patients implanted or adapted with multifocal intraocular or contact lenses. In order to achieve this aim, different studies and processes were carried out Review of presbyopia corrections and the characterization of them (Clinical study about objective over-refraction wearing multifocal contact lenses); Verification of the suitability of one commerciat simulator (Clinical study with the commercial simulator VirtlOL (10lens S.l.)); Design and assembly of the double-pass system with asymmetric focus (Opto-mechanical design/ Validation of all the elements included in the system/ Optical validation of the system); Programming of the softwares to manage the system; Validation of the new prototype (Two clinical studies characterizing eyes implanted with multifocal introcular tenses by using the new system were done).La visió és entesa i, universalment acceptada, com el sentit humà més valorat .Aquesta esta estructurada en tres parts principals: el sistema òptic (l'ull), el fot-sensor (la retina ocular) iel processador (el cervell). Si una d'aquestes parts es veu afectada per una disfunció o malaltia, la visió pot arribar a ser de molt baixa qualitat i, fins hi tot, inexistent Una de les disfuncions més comunes és la presbícia. La presbícia és una disfunció lligada a l'edat que pateix tota lla població a partir dels 40 anys, aproximadament. Consisteix en la pèrdua de la capacitat d'enfocar objectes propers (acomodació). Actualment, es troba un ampli nombre de possibles correccions. Per una banda, tenim les correccions temporals, com ulleres o lents de contacte progressives, i, per l'altre, correccions permanents, com lents intraoculars multifocals , ablacions corneals multifocals, lents intraoculars acomodatives, sistemes de monovisió, o modificacions esclerals, entre altres. Una altre disfunció associada a l'edat és la cataracta, la qual crea la opacificació del cristal·lí impedint una visió nítida. Conseqüentment, la cataracta és una de la deficiències visuals més estesa a partir dels 60 anys, afectant a la meitat de la població entre els 75 i els 85 anys . La única solució per eliminar les cataractes és eliminant les fibres opacificades i substituir-les per una lent intraocular quirúrgicament. Donat que tots els pacients amb cataractes són, a la vegada, prèsbites, està justificat que un nombre de pacients decideixi implantar-se lents intraoculars multifocals per substituir el seu cristal·lí. D'aquesta manera es solucionen dues degeneracions associades a l'edat en una sola cirurgia. Els joves prèsbites acostumen a optar per correccions prèsbites temporals, mentre que molts dels prèsbites amb cataractes opten per solucions permanents. Algunes de les correccions de la presbícia, com les lents de contacte o intraoculars multifocals , estan basades en el principi de visió simultània. Els dissenys òptics d'aquest tipus de lents són molt complexos, cosa que fa que la seva caracterització sigui molt complicada. Quan aquestes lents van aparèixer al mercat, només era possible caracteritzar-les òpticament abans de la seva implantació o adaptació de manera in vitro, i de caracteritzar-les visualment després de la seva adaptació o implantació de manera in vivo. Actualment, i gracies a tots els avenços tecnològics, diferents instruments clínics han estat desenvolupats per realitzar mesures de les qualitats visuals abans de la seva implantació. Tots ells, es basen en simular-li al pacient la visió que tindria després de ser implantat. Per un altre cantó, alguns prototips experimentals iaberrometres o sistemes de doble-pas comercials han estat utilitzats per dur a terme la caracterització de la qualitat in vim en pacients implantats o adaptats amb sistemes multifocals, pero diferents problemes han estat plantejats. Tenint en compte tota aquesta informació, el principal objectiu d'aquesta tesi ha estat la de dissenyar i muntar un nou sistema de doble-pas d'enfocament asimètric de camp obert que fos capaç de fer una caracterització de la qualitat òptica in vivo de pacients implantats o adaptats amb lents de contacte o intraoculars multifocals. I per arribar a aquest objectiu, s'han dut a terme els següents passos: Revisió de les correccions per a la presbícia i caracterització d'elles (Estudi clínic de la sobre-refracció objectiva de pacients adaptats amb lents de contacte multifocals); Validació de la capacitat de mesura d'un simulador comercial (Estudi clínic amb el simulador comercial VirtlOL (1OLens S.L); Disseny i muntatge del sistema de doble-pas amb enfocament asimètric (Disseny opto-mecànic/ Validació de tots els components del sistema/ Validació òptica del sistema); Programació dels programes informàtics que gestionen el sistema i processenPostprint (published version

Optical and visual characterization of multifocal contact lenses and multifocal intraocular lenses

Vision is presented and universally accepted as the most precious of the human senses.lt is structured in three main parts: the optical system {eye), the photo-sensor {eye's retina), and the data processor (brain). If one of them is affected by any disease or dysfunction, vision will be terrible or even nonexistent One of the most common dysfunction is presbyopia.lt i s an age-related disorder that is undergone by all the population s ince their mid-late-40s and it is consists in the loss of the ability to focus near objects (accommodation). A huge number of possible corrections of it can be easily found. On one hand, there are temporary corrections ,as progressive spectacle tenses or multifocal contact tenses. On the other hand, permanent corrections as multifocal i ntraocular lenses, multifocal cornea! ablation, accommodating intraocular tenses, monovision systems, or scleral modifications are also applied to correct presbyopia. Another age-related dysfunction is cataract. Cataract is the opacification of the crystalline fens and decreases the quality of the visual function. Consequently, it is one of the leading visual impairments in adults over 60 years old, affecting the half of the adults aged between 75-85 years old. The only possible solution far cataract is the extraction of the opacified fibers of the crystalline lens and the replacement of them with an intraocular lens by surgery. Due to the fact that all the patients affected by an age-related cataract are also affected by presbyopia it is totally understandable that a number of patients choose mulltifocal introcular lens to substitute their crystalline tenses .This way, only one surgery is needed to salve both age-related dysfunctions. Usually, young presbyopes choose a temporary correction as a first option to correct presbyopia. Some presbyopia corrections are based on the simultaneous vision principie, as, far example, multifocal contact or intraocular lenses. The optical design of these kind of lenses is very complex. Consequently, It is characterization is also difficult When these lenses were launched into the market, it was only possible to characterize optical quality before the implantation or the adaptation of them (characterization in vitro) and the visual quality after the surgery or the clinical adaptation was performed (characterization) .M. present and thanks to the technological advances, different new commercial instruments that are to perform characterization in vivo of the visual quality before the implantation or the adaptation of simultaneous vis ion tenses. They are based on the simulation of the vision that these tenses give to the implanted eye. Some experimental prototypes and commercial aberrometers or double­ pass systems have used to perform an optical quality characterization in vivo, but some issues have been reported. Taking into account all this information, the main goal of this thesis is the design and the assembly of a new open-field double-pass system with asymmetric focus that is suitable to characterize invivo optical quality in patients implanted or adapted with multifocal intraocular or contact lenses. In order to achieve this aim, different studies and processes were carried out Review of presbyopia corrections and the characterization of them (Clinical study about objective over-refraction wearing multifocal contact lenses); Verification of the suitability of one commerciat simulator (Clinical study with the commercial simulator VirtlOL (10lens S.l.)); Design and assembly of the double-pass system with asymmetric focus (Opto-mechanical design/ Validation of all the elements included in the system/ Optical validation of the system); Programming of the softwares to manage the system; Validation of the new prototype (Two clinical studies characterizing eyes implanted with multifocal introcular tenses by using the new system were done).La visió és entesa i, universalment acceptada, com el sentit humà més valorat .Aquesta esta estructurada en tres parts principals: el sistema òptic (l'ull), el fot-sensor (la retina ocular) iel processador (el cervell). Si una d'aquestes parts es veu afectada per una disfunció o malaltia, la visió pot arribar a ser de molt baixa qualitat i, fins hi tot, inexistent Una de les disfuncions més comunes és la presbícia. La presbícia és una disfunció lligada a l'edat que pateix tota lla població a partir dels 40 anys, aproximadament. Consisteix en la pèrdua de la capacitat d'enfocar objectes propers (acomodació). Actualment, es troba un ampli nombre de possibles correccions. Per una banda, tenim les correccions temporals, com ulleres o lents de contacte progressives, i, per l'altre, correccions permanents, com lents intraoculars multifocals , ablacions corneals multifocals, lents intraoculars acomodatives, sistemes de monovisió, o modificacions esclerals, entre altres. Una altre disfunció associada a l'edat és la cataracta, la qual crea la opacificació del cristal·lí impedint una visió nítida. Conseqüentment, la cataracta és una de la deficiències visuals més estesa a partir dels 60 anys, afectant a la meitat de la població entre els 75 i els 85 anys . La única solució per eliminar les cataractes és eliminant les fibres opacificades i substituir-les per una lent intraocular quirúrgicament. Donat que tots els pacients amb cataractes són, a la vegada, prèsbites, està justificat que un nombre de pacients decideixi implantar-se lents intraoculars multifocals per substituir el seu cristal·lí. D'aquesta manera es solucionen dues degeneracions associades a l'edat en una sola cirurgia. Els joves prèsbites acostumen a optar per correccions prèsbites temporals, mentre que molts dels prèsbites amb cataractes opten per solucions permanents. Algunes de les correccions de la presbícia, com les lents de contacte o intraoculars multifocals , estan basades en el principi de visió simultània. Els dissenys òptics d'aquest tipus de lents són molt complexos, cosa que fa que la seva caracterització sigui molt complicada. Quan aquestes lents van aparèixer al mercat, només era possible caracteritzar-les òpticament abans de la seva implantació o adaptació de manera in vitro, i de caracteritzar-les visualment després de la seva adaptació o implantació de manera in vivo. Actualment, i gracies a tots els avenços tecnològics, diferents instruments clínics han estat desenvolupats per realitzar mesures de les qualitats visuals abans de la seva implantació. Tots ells, es basen en simular-li al pacient la visió que tindria després de ser implantat. Per un altre cantó, alguns prototips experimentals iaberrometres o sistemes de doble-pas comercials han estat utilitzats per dur a terme la caracterització de la qualitat in vim en pacients implantats o adaptats amb sistemes multifocals, pero diferents problemes han estat plantejats. Tenint en compte tota aquesta informació, el principal objectiu d'aquesta tesi ha estat la de dissenyar i muntar un nou sistema de doble-pas d'enfocament asimètric de camp obert que fos capaç de fer una caracterització de la qualitat òptica in vivo de pacients implantats o adaptats amb lents de contacte o intraoculars multifocals. I per arribar a aquest objectiu, s'han dut a terme els següents passos: Revisió de les correccions per a la presbícia i caracterització d'elles (Estudi clínic de la sobre-refracció objectiva de pacients adaptats amb lents de contacte multifocals); Validació de la capacitat de mesura d'un simulador comercial (Estudi clínic amb el simulador comercial VirtlOL (1OLens S.L); Disseny i muntatge del sistema de doble-pas amb enfocament asimètric (Disseny opto-mecànic/ Validació de tots els components del sistema/ Validació òptica del sistema); Programació dels programes informàtics que gestionen el sistema i processe

Deep Learning in Cardiology

The medical field is creating large amount of data that physicians are unable to decipher and use efficiently. Moreover, rule-based expert systems are inefficient in solving complicated medical tasks or for creating insights using big data. Deep learning has emerged as a more accurate and effective technology in a wide range of medical problems such as diagnosis, prediction and intervention. Deep learning is a representation learning method that consists of layers that transform the data non-linearly, thus, revealing hierarchical relationships and structures. In this review we survey deep learning application papers that use structured data, signal and imaging modalities from cardiology. We discuss the advantages and limitations of applying deep learning in cardiology that also apply in medicine in general, while proposing certain directions as the most viable for clinical use.Comment: 27 pages, 2 figures, 10 table