In an effort to meet the need of imaging technology that reliably measure the dynamics of accommodation, we developed a swept source OCT system for imaging and biometry of the crystalline lens dynamics at high sampling rates (~100 Hz). Preliminary data suggests that high sampling rates improve detection of lens micro-fluctuations during accommodation and that sampling rates higher than 40 Hz might be needed to fully capture crystalline lens dynamics. Long term, the information acquired with the system will improve our understanding of the mechanism of accommodation and enable to design and evaluate new procedures to restore accommodation.
Anatomical changes of the growing crystalline lens influence its refractive development, including power and spherical aberration. We have recently developed a new instrument that characterizes both the optical and biometric properties of the lens in-vitro by merging Ray-Tracing Aberrometry (RTA) with three-dimensional OCT imaging. In this abstract, we describe the application of the RTA to the measurement of lens spherical aberration.
Experiments were performed on 54 isolated human lenses (age: 0.25 to 56 years). The system was programmed to sequentially deliver the probing beam through the lens using a raster scan pattern of 13 × 13 transversal positions spaced 0.5 mm apart. Exit rays were imaged after exiting the tissue chamber at 9 different axial positions (ΔZ = 0 mm to 8 mm) in 1 mm intervals. A total of 1,521 spot images were acquired per lens. All data was automatically analyzed using custom software we developed in MATLAB. Exit ray slopes over a 6 mm pupil were used to determine Zernike wavefront coefficients up to the sixth order. The 4th order Zernike coefficient Z[4,0] was used to measure primary spherical aberration (SA). The results suggest that spherical aberration of the growing lens becomes more negative before adulthood and less negative after around age 30. The data is consistent with results from in-vivo studies that suggest the lens spherical aberration becomes less negative in older lenses (>30 years).
Purpose: To objectively quantify dynamic changes in lens shape during accommodation using two-dimensional OCT images
Methods: In-vivo responses to an accommodative step stimulus of three subjects (aged 22, 39, and 45) were captured using a custom-made extended-depth SD-OCT system operating at 840 nm following an IRB-approved protocol (Ruggeri et al. 2012). Subjects focused on a visual accommodation target designed to produce an adjustable step stimulus of accommodation. Accommodative responses to 2-D and 4-D stimuli were captured ~1.5s before and ~4.5s after stimulation. Lens thickness, anterior curvature, and posterior curvature were measured using a newly-developed algorithm (validated using a calibration sphere). Dynamic changes in lens thickness and curvature were then fitted with an exponential model to produce time dependent constants.
Results: All calibration OCT images were automatically analyzed in under 2 seconds. A radius of 7.793mm ± 0.051mm was calculated resulting in a difference of 2.4μm from the reported nominal value of the calibration sphere. Anterior lens radius decreased over time in all subjects. Radius of the posterior lens experienced a slight increase for all subjects.
Conclusion: This study demonstrates the feasibility of quantifying the dynamic changes in lens curvature and thickness during accommodation using extended-depth OCT combined with a step accommodation stimulus and an automated segmentation algorithm.
Purpose: To determine the dynamic interaction between ciliary muscle and lens during accommodation and disaccommodation through synchronous imaging of ciliary muscle and lens response to pulse stimulus
Methods: The ciliary muscle and lens were imaged simultaneously in a 33 year old subject responding to a 4D pulse stimulus (accommodative stimulus at 1.7 s, disaccommodative stimulus at 7.7 s) using an existing imaging system (Ruggeri et al, 2016) consisting of an Anterior Segment Optical Coherence Tomography system, Ciliary Muscle Optical Coherence Tomography system, and custom-built accommodation module. OCT images were recorded at an effective frame rate of 13.0 frames per second for a total scan time of 11.5 s.
An automated segmentation algorithm was applied to images of the anterior segment to detect the boundaries of the cornea and lens, from which lens thickness was extracted. Segmentation of the ciliary muscle was performed manually and then corrected for distortion due to refraction of the beam to obtain measurements of thicknesses at the apex and fixed distances from the scleral spur.
Results: The dynamic biometric response to a pulse stimulus at 4D was determined for both the ciliary muscle and lens, suggesting the ciliary muscle and lens interact differently in accommodation and disaccommodation.
Conclusions: The study introduces new data and analyses of the ciliary muscle and lens interaction during a complete accommodative response from the relaxed to the accommodated state and back, providing insight into the interplay between individual elements in the accommodative system and how their relationships may change with age.
Age-related changes in the crystalline lens shape and refractive index gradient produce changes in dioptric power and high-order aberrations that influence the optics of the whole eye and contribute to a decrease in overall visual quality. Despite their key role, the changes in lens shape and refractive index gradient with age and accommodation and their effects on high-order aberrations are still not well understood. The goal of this project was to develop a combined laser ray tracing (LRT) and optical coherence tomography (OCT) system to measure high-order aberrations, shape and refractive index gradient in non-human primate and human lenses. A miniature motorized lens stretching system was built to enable imaging and aberrometry of the lens during simulated accommodation. A positioning system was also built to enable on- and off-axis OCT imaging and aberrometry for characterization of the peripheral defocus of the lens. We demonstrated the capability of the LRT-OCT system to produce OCT images and aberration measurements of crystalline lens with age and accommodation in vitro. In future work, the information acquired with the LRT-OCT system will be used to develop an accurate age-dependent lens model to predict the role of the lens in the development of refractive error and aberrations of the whole eye.
The purpose of this project is to design and evaluate a system that will enable objective assessment of the optical accommodative response in real-time while acquiring axial biometric information. The system combines three sub-systems which were integrated and mounted on a joystick x-y-z adjustable modified slit-lamp base to facilitate alignment and data acquisition: (1) a Shack-Hartmann wavefront sensor for dynamic refraction measurement, provided software calculates sphere, cylinder and axis values, (2) an extended-depth Optical Coherence Tomography (OCT) system using an optical switch records high-resolution cross-sectional images across the length of the eye, from which, dynamic axial biometry (corneal thickness, anterior chamber depth, crystalline lens thickness and vitreous depth) can be extracted, and (3) a modified dual-channel accommodation stimulus unit based on the Badal optometer for providing a step change in accommodative stimulus. The prototypal system is capable of taking simultaneous measurements of both the optical and the mechanical response of lens accommodation. These measurements can provide insight into correlating changes in lens shape with changes in lens power and ocular refraction and ultimately provide a more comprehensive understanding of accommodation, presbyopia and an objective assessment of presbyopia correction techniques.
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