Retinal damage extends beyond the border of the detached retina in fovea-on retinal detachment

Purpose: The aim of this study was to investigate the preoperative and postoperative change in retinal sensitivity in relation to the distance to the retinal detachment (RD) in patients with fovea-on RD. Methods: We prospectively evaluated 13 patients with fovea-on RD and a healthy control eye. Preoperatively, OCT scans of the RD border and the macula were obtained. The RD border was highlighted on the SLO image. Microperimetry was used to assess the retinal sensitivity at the macula, the RD border and the retina around the RD border. At 6 weeks, 3 and 6 months postoperatively, follow-up examinations of OCT and microperimetry were performed in the study eye. Microperimetry was performed once in control eyes. Microperimetry data were overlaid on the SLO image. The shortest distance to the RD border was calculated for each sensitivity measurement. The change in retinal sensitivity was calculated as control-study. The relation between the change in retinal sensitivity and the distance to the RD border was assessed using a locally weighted scatterplot smoothing curve. Results: Preoperatively, the greatest loss in retinal sensitivity was 21 dB at 3° inside the RD which decreased linearly, through the RD border, and reached a plateau of 2 dB at 4°. For 6 weeks and 3 months postoperatively, the greatest retinal sensitivity loss remained at 3° inside the RD but was 4 dB and sensitivity loss decreased linearly to a plateau of 0 dB at 5° outside the RD. At 6 months postoperatively, the greatest sensitivity loss was 2 dB at 3° inside the RD, and decreased linearly to a plateau of 0 dB at 2° outside the RD. Conclusions: Retinal damage extends beyond the detached retina. Retinal sensitivity loss of the attached retina decreased drastically as the distance to the RD increased. Postoperative recovery occurred for both attached and detached retina.</p

A quadrature filter approach for registration accuracy assessment of fundus images

This paper presents a method to automatically assess the accuracy of image registration. It is applicable to images in which vessels are the main landmarks such as fundus images and angiography. The method simultaneously exploits not only the position, but also the intensity profile across the vasculatures. The accuracy measure is defined as the energy of the odd component of the 1D vessel profile in the difference image divided by the total energy of the corresponding vessels in the constituting images. Scale and orientation-selective quadrature filter banks have been employed to analyze the 1D signal profiles. Subsequently, the relative energy measure has been calibrated such that the measure translates to a spatial misalignment in pixels. The method was validated on a fundus image dataset from a diabetic retinopathy screening program at the Rotterdam Eye Hospital. An evaluation showed that the proposed measure assesses the registration accuracy with a bias of -0.1 pixels and a precision (standard deviation) of 0.9 pixels. The small Fourier footprint of the orientation selective quadrature filters makes the method robust against noise

LONGITUDINAL STUDY OFRPE65-ASSOCIATED INHERITED RETINAL DEGENERATIONS

Purpose: To study the disease course ofRPE65-associated inherited retinal degenerations (IRDs) as a function of the genotype, define a critical age for blindness, and identify potential modifiers. Methods: Forty-five patients with IRD from 33 families with biallelicRPE65mutations, 28 stemming from a genetic isolate. We collected retrospective data from medical charts. Coexisting variants in 108 IRD-associated genes were identified with Molecular Inversion Probe analysis. Results: Most patients were diagnosed within the first years of life. Daytime visual function ranged from near-normal to blindness in the first four decades and met WHO criteria for blindness for visual acuity and visual field in the fifth decade. p.(Thr368His) was the most common variant (54%). Intrafamilial variability and interfamilial variability in disease severity and progression were observed. Molecular Inversion Probe analysis confirmed allRPE65variants and identified one additional variant inLRATand one inEYSin two separate patients. Conclusion: All patients withRPE65-associated IRDs developed symptoms within the first year of life. Visual function in childhood and adolescence varied but deteriorated inevitably toward blindness after age 40. In this study, genotype was not predictive of clinical course. The variance in severity of disease could not be explained by double hits in other IRD genes

Transient Peripapillary Retinoschisis in Glaucomatous Eyes

Purpose. To investigate transient focal microcystic retinoschisis in glaucomatous eyes in images obtained with several imaging techniques used in daily glaucoma care. Methods. Images of 117 glaucoma patients and 91 healthy subjects participating in a large prospective follow-up study into glaucoma imaging were reviewed. Participants were measured with spectral domain optical coherence tomography (SD-OCT), scanning laser polarimetry (SLP), scanning laser tomography (SLT), and standard automated perimetry (SAP). The presence of a focal retinoschisis in SD-OCT was observed and correlated to SLP, SLT, and SAP measurements, both cross-sectionally and longitudinally. Results. Seven out of 117 glaucoma patients showed a transient, localised, peripapillary, heterogeneous microcystic schisis of the retinal nerve fiber layer (RNFL) and sometimes other retinal layers as well in SD-OCT. None of the healthy eyes showed this phenomenon nor did any of the other imaging techniques display it as detailed and consistently as did the SD-OCT. SAP showed a temporarily decreased focal retinal sensitivity during the retinoschisis and we found no signs of glaucomatous progression related to the retinoschisis. Conclusions. Transient microcystic retinoschisis appears to be associated with glaucomatous wedge defects in the RNFL. It was best observed with SD-OCT and it was absent in healthy eyes. We found no evidence that the retinoschisis predicted glaucomatous progression

Non-invasive in vivo angiography of the human eye with Doppler Optical Coherence Tomography

Introduction Optical coherence tomography (OCT) uses laser interferometry for non-invasive cross-sectional imaging of tissues with micrometer resolution. This technology is therefore ideal to visualize the micro-structures of the human retina and choroid in vivo. Additionally blood flow can be detected from Doppler frequency shifts in the OCT signal over time, which are caused by moving particles in flowing blood. In this study we investigated if these Doppler shifts can be used to create angiograms of the retina and choroid. Methods An experimental OCT system was constructed based on a 1040 nm swept laser source. A healthy volunteer was imaged over a retinal area of 6.0 × 7.9 mm 2 (20º × 26º). Doppler shifts were evaluated by measuring each location twice and were calculated from phase changes within the OCT signals. Angiograms of the vasculature were created by integration of the phase changes over depth. Results The retinal angiogram (Fig. 1(A)) shows blood vessels (in white) down to the capillary level and visualizes clearly the avascular zone of the fovea and the entrance and exit of vessels through the optic disc. The choroidal angiogram (Fig. 1(B)) shows a dense network of large vessels below the retina. Conclusions Doppler OCT can produce high-resolution angiograms of the retina and choroid

Parallel scanning laser ophthalmoscope (PSLO) for high-speed retinal imaging

Purpose High-speed imaging of the retina is crucial for obtaining high quality images in the presence of eye motion. To improve the speed of traditional scanners, a high-speed ophthalmic device is presented using a digital micro-mirror device (DMD) for confocal imaging with multiple simultaneous spots. Methods The PSLO consists of three parts: an illumination, an imaging and a detector arm (Fig. 1). The DMD is uniformly illuminated with a near-infrared (850 nm) LED. The separation between ON positioned mirror elements was made large enough to eliminate cross-talk between neighboring virtual pinholes, and therefore allowed multi-spot confocal imaging across the whole field of view (FOV). The DMD is programmed to project series of shifted point pattern configurations, effectively scanning the spots over the sample surface. The DMD was imaged onto a sample and the returning light was tapped of via a beam-splitter and imaged on a CMOS camera. Multiple point illuminated frames are combined to form one confocal wide-field image. As a proof of principle images of a resolution target were acquired with the PSLO system. Results The resolution target was imaged with a pattern with virtual pinhole size of 2x2 mirrors and the separation between two pinholes was 4 mirror elements. Figure 1B shows the results for combining 9 illumination patterns to form the final image. Conclusions It is possible to create wide-field confocal images with the PSLO system. In theory the DMD can achieve higher frame rates than traditional scanner-based systems by illuminating the sample with multiple spots. In retinal imaging, such a setup will provide better images because higher imaging speeds reduce motion artifacts

Parallel line scanning ophthalmoscope for retinal imaging

Purpose: To visualize retinal structures using a newly developed parallel line scanning ophthalmoscope (PLSO). Methods: A PLSO was built using a digital micromirror device (DMD) instead of traditional scanning mirrors to scan lines over the field of view (FOV). The DMD consists of 912 × 1140 micromirrors which can be individually switched on/off based on a programmed binary pattern. By switching on multiple (parallel) two-element wide lines in the DMD, the corresponding lines on the retina are imaged on a CMOS camera. After acquisition of each frame, the micromirrors are turned off and the mirrors for the next set of adjacent lines are turned on. This is repeated until the whole FOV is imaged. Confocal images are generated from the data by subtracting the maximum and minimum intensity values for each pixel in the sequence. The fovea and optic nerve head (ONH) of a healthy subject were imaged using 10º × 10º FOV at 100 Hz with 7 parallel lines resulting in a full image frame rate of 1.4 fps. The images were acquired through a dark-adapted pupil without any dilatation. The acquired data were processed, as mentioned earlier, into confocal images; but also non-confocal images were obtained by averaging all frames. Results: Figure 1A shows the imaged areas. In the non-confocal images (Fig. 1B&C), the corneal scattering is dominant and makes the retinal structures covered in haze. In the confocal images (Fig. 1D&E), confocality and contrast are improved. The foveal avascular zone and smaller blood vessels are visible in the fovea image (Fig. 1D). Also the quality of the ONH image is improved and many of the main features can be distinguished such as small blood vessels (Fig. 1E). Conclusions: The PLSO provided high contrast images of the fovea and ONH and detailed retinal structures could be observed. The DMD eliminates moving parts from the system and exposure time for each frame is potentially shorter than in full-field imaging, which reduces intra-frame motion. In retinal imaging, such a setup will provide better images because higher imaging speeds reduce motion artifacts

In vivo retinal imaging for fixational eye motion detection using a high-speed digital micromirror device (DMD)-based ophthalmoscope

Retinal motion detection with an accuracy of 0.77 arcmin corresponding to 3.7 µm on the retina is demonstrated with a novel digital micromirror device based ophthalmoscope. By generating a confocal image as a reference, eye motion could be measured from consecutively measured subsampled frames. The subsampled frames provide 7.7 millisecond snapshots of the retina without motion artifacts between the image points of the subsampled frame, distributed over the full field of view. An ophthalmoscope pattern projection speed of 130 Hz enabled a motion detection bandwidth of 65 Hz. A model eye with a scanning mirror was built to test the performance of the motion detection algorithm. Furthermore, an in vivo motion trace was obtained from a healthy volunteer. The obtained eye motion trace clearly shows the three main types of fixational eye movements. Lastly, the obtained eye motion trace was used to correct for the eye motion in consecutively obtained subsampled frames to produce an averaged confocal image correct for motion artefacts