Hand-held wide-field contact color fundus photography is currently the standard method to acquire diagnostic images of children during examination under anesthesia and in the neonatal intensive care unit. The recent development of portable non-contact hand-held OCT retinal imaging systems has proved that OCT is of tremendous help to complement fundus photography in the management of pediatric patients. Currently, there is no commercial or research system that combines color wide-field digital fundus and OCT imaging in a contact-fashion. The contact of the probe with the cornea has the advantages of reducing motion experienced by the photographer during the imaging and providing fundus and OCT images with wider field of view that includes the periphery of the retina. In this study we produce proof of concept for a contact-type hand-held unit for simultaneous color fundus and OCT live view of the retina of pediatric patients. The front piece of the hand-held unit consists of a contact ophthalmoscopy lens integrating a circular light guide that was recovered from a digital fundus camera for pediatric imaging. The custom-made rear piece consists of the optics to: 1) fold the visible aerial image of the fundus generated by the ophthalmoscopy lens on a miniaturized level board digital color camera; 2) conjugate the eye pupil to the galvanometric scanning mirrors of an OCT delivery system. Wide-field color fundus and OCT images were simultaneously obtained in an eye model and sequentially obtained on the eye of a conscious 25 year-old human subject with healthy retina.
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.
Little is known about the structural changes of the ciliary muscle with age and how it may contribute to presbyopia.
Optical coherence tomography (OCT) has been used to perform ciliary muscle biometry at different age and
accommodative states with low resolution and speed. Dynamic imaging and accurate biometry of the ciliary muscle
requires high-speed, high-resolution and correction of the OCT image distortions. We integrate an existing custom-made
Spectral Domain OCT (SD-OCT) platform working at 840nm for biometry of the human eye with a SD-OCT system
working at 1325nm that enables high-speed and high-resolution transscleral imaging of the ciliary muscle dynamically
during accommodation and we developed an algorithm to provide corrected thickness measurements of the ciliary
muscle.
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