Simultaneous visible light optical coherence tomography and near infrared OCT angiography in retinal pathologies: A case study

Simultaneous on-chip generation of violet, blue, cyan, green, yellow, orange, and red light from an octave-spanning infrared frequency comb

An integrated, multi-spectral visible-light source could significantly benefit technologies such as displays, medical imaging, spectroscopy, visible-light communications, and astrophysics. However, despite recent advances in chip-scale visible lasers, simultaneously generating light of all colors in a single chip has been challenging. Existing solutions are either not suitable for full chip-scale integration, or are fundamentally difficult to scale. Here we demonstrate the simultaneous on-chip generation of infrared, red, orange, yellow, green, cyan, blue, and violet light. Leveraging the low loss, low dispersion, and high density of modes of an adiabatic multimode silicon nitride (SiN) microresonator, we use a single infrared pump of moderate power (∼130 mW) to produce an octave-spanning infrared frequency comb that is then converted to different portions of the visible spectrum. We measure non-mode-locked combs and soliton steps corresponding to mode-locked states, making our comb generator suitable for applications that demand either low or high coherence. Since the required pump power is compatible with high-power lasers demonstrated in the same SiN platform, our multi-octave light generator can be fully integrated in a chip-scale form factor. We envision that such a light source will be a catalyst for the development and deployment of miniaturized multi-spectral technologies for quantum systems, medical imaging, displays, and spectroscopy.

Visible-light optical coherence tomography and its applications

Visible-light optical coherence tomography (vis-OCT) is an emerging OCT technology that uses visible rather than near-infrared illumination and is useful for pre-clinical and clinical imaging. It provides one-micron level axial resolution and distinct scattering and absorption contrast that enables oximetry but requires additional considerations in system implementation and practical settings. We review the development of vis-OCT and demonstrated applications. We also provide insights into prospects and possible technological improvements that may address current challenges.

Macular Oxygen Saturation in Glaucoma Using Retinal Oximetry of Visible Light Optical Coherence Tomography: A Pilot Study

Purpose

A cross-sectional pilot study to compare macular oxygen saturation (sO2) and associated clinical measurements between normal and glaucoma subjects and to evaluate whether macular sO2 can be a diagnostic metric for early-stage glaucoma.

Methods

Forty-eight eyes of 35 subjects from three groups were included: normal subjects (16 eyes, 10 subjects), suspect/pre-perimetric glaucoma (GS/PPG) subjects (17 eyes, 12 subjects), and perimetric glaucoma (PG) subjects (15 eyes, 13 subjects). We performed retinal oximetry of visible light optical coherence tomography (VIS-OCT) in macular vessels, with 512 × 256 sampling points over a 5 × 5 mm2 area. Zeiss Cirrus OCT scans and a 24-2 visual field test (VFT) were conducted. Statistical analysis was conducted.

Results

Significant differences were observed among the three groups for all VIS-OCT, Zeiss OCT, and VFT variables. As glaucoma severity increased, macular AsO2 (arterial sO2) and A-V sO2 (arteriovenous sO2 difference) decreased, whereas macular VsO2 (venous sO2) increased. Macular AsO2 and A-V sO2 were found to be statistically correlated with ganglion cell layer + inner plexiform layer (GCL+IPL) and circumpapillary retinal nerve fiber layer in all eyes, as well as in PG eyes. Within the PG group, a dominant correlation between AsO2 and ganglion cell layer + inner plexiform layer was observed in the more damaged lower hemifield.

Conclusions

Glaucoma subjects showed altered macular sO2, indicating reduced oxygen consumption. The sO2 measured by VIS-OCT could be a potential metric for early glaucoma diagnosis.

Translational Relevance

This study shows macular sO2 measurements via VIS-OCT could bridge advanced imaging technology and clinical glaucoma detection.

Quantitative Optical Imaging of Oxygen in Brain Vasculature

The intimate relationship between neuronal activity and cerebral oxygenation underpins fundamental brain functions like cognition, sensation, and motor control. Optical imaging offers a noninvasive approach to assess brain oxygenation and often serves as an indirect proxy for neuronal activity. However, deciphering neurovascular coupling─the intricate interplay between neuronal activity, blood flow, and oxygen delivery─necessitates independent, high spatial resolution, and high temporal resolution measurements of both microvasculature oxygenation and neuronal activation. This Perspective examines the established optical techniques employed for brain oxygen imaging, specifically functional near-infrared spectroscopy, photoacoustic imaging, optical coherence tomography, and two-photon phosphorescent lifetime microscopy, highlighting their fundamental principles, strengths, and limitations. Several other emerging optical techniques are also introduced. Finally, we discuss key technological challenges and future directions for quantitative optical oxygen imaging, paving the way for a deeper understanding of oxygen metabolism in the brain.

Macular Oxygen Saturation in Glaucoma Using Retinal Oximetry of Visible Light Optical Coherence Tomography

Purpose

Oxygen saturation (sO2) plays a critical role in retinal pathophysiology, especially at the macula, which undergoes significant energy consumption. While macular damage has been suggested to be involved in early-stage glaucoma, there has been no report to date on non-invasive macular sO2 in glaucoma. Therefore, we conducted this study to compare macular sO2 associated with other clinical measurements between normal and glaucoma subjects and evaluate whether there are significant differences.

Method

This is a cross-sectional study. We used visible light optical coherence tomography (VIS-OCT) for retinal oximetry in perifoveal vessels. The subjects from groups of normal, suspect/pre-perimetric glaucoma (GS/PPG) and perimetric glaucoma (PG) were scanned using VIS-OCT in the macular region with a sampling density of 512×256 in an area of 5×5 mm2. 48 eyes (16 normal, 17 GS/PPG and 15 PG) were included for the analysis. For each eye, we measured the sO2 of arterioles (AsO2), venules (VsO2), and calculated the difference between arterioles and venules (A-V sO2=AsO2-VsO2), oxygen extraction (OE=(AsO2-VsO2)/AsO2 ×100%). Additionally, we included Zeiss Cirrus OCT scans and 24-2 visual field test (VFT) for clinical benchmark. One-way ANOVA was used to compare the differences among the three groups. Spearman correlation tests were used for correlation sO2 markers to standard metrics including the thickness of ganglion cell layer and inner plexiform layer (GCL+IPL), circumpapillary retinal nerve fiber layer (cpRNFL) and mean deviation (MD) in VFT.

Result

Significant differences were found among three groups for all VIS-OCT, Zeiss OCT, and VFT variables. Macular AsO2, A-V sO2, OE decreased, and VsO2 increased along with severity. Macular AsO2 and A-V sO2 were statistically correlated with GCL+IPL and cpRNFL in all eyes, as well as only PG eyes. Within PG eyes, the correlation between AsO2 and GCL+IPL is dominant in more damaged lower hemifield.

Conclusion

The GS/PPG and PG subjects had significantly higher macular VsO2, lower A-V sO2 and OE indicating less oxygen consumption. The sO2 measured by retinal oximetry of VIS-OCT can be a potential metric for the early diagnosis of glaucoma.

Deep learning network for parallel self-denoising and segmentation in visible light optical coherence tomography of the human retina

Visible light optical coherence tomography (VIS-OCT) of the human retina is an emerging imaging modality that uses shorter wavelengths in visible light range than conventional near-infrared (NIR) light. It provides one-micron level axial resolution to better separate stratified retinal layers, as well as microvascular oximetry. However, due to the practical limitation of laser safety and comfort, the permissible illumination power is much lower than NIR OCT, which can be challenging to obtain high-quality VIS-OCT images and subsequent image analysis. Therefore, improving VIS-OCT image quality by denoising is an essential step in the overall workflow in VIS-OCT clinical applications. In this paper, we provide the first VIS-OCT retinal image dataset from normal eyes, including retinal layer annotation and "noisy-clean" image pairs. We propose an efficient co-learning deep learning framework for parallel self-denoising and segmentation simultaneously. Both tasks synergize within the same network and improve each other's performance. The significant improvement of segmentation (2% higher Dice coefficient compared to segmentation-only process) for ganglion cell layer (GCL), inner plexiform layer (IPL) and inner nuclear layer (INL) is observed when available annotation drops to 25%, suggesting an annotation-efficient training. We also showed that the denoising model trained on our dataset generalizes well for a different scanning protocol.

Imaging human macular pigments with visible light optical coherence tomography and superluminescent diodes

We demonstrate superluminescent diodes (SLDs) for visible light optical coherence tomography (OCT) of the human retina. SLDs are less costly than supercontinuum sources and have lower intrinsic excess noise, enabling imaging closer to the shot noise limit. While single SLDs are not broadband, they provide power concentrated at specific wavelengths relevant to retinal function. As a new, to the best of our knowledge, application, we image human macular pigments (MPs), which are thought to both aid vision and protect against advanced age-related macular degeneration. Using the unique depth-resolved capabilities of OCT, we localize MPs in depth to Henle's fibers beneath the foveal pit in the living human retina. Our approach reduces the cost of visible light OCT to nearly that of near-infrared (NIR) OCT while also providing information about clinically relevant MPs which cannot be measured in the NIR.

Visible Light Optical Coherence Tomography Reveals the Relationship of the Myoid and Ellipsoid to Band 2 in Humans

Purpose

We employ visible light optical coherence tomography (OCT) to investigate the relationship between the myoid, ellipsoid, and band 2 in the living human retina. Rather than refute existing theories, we aim to reveal new bands and better delineate the structures at hand.

Methods

An upgraded spectral/Fourier domain visible light OCT prototype, with 1.0-µm axial resolution, imaged 13 eyes of 13 young adult human subjects (23–40 years old) without a history of ocular pathology. The external limiting membrane (band 1) and band 2 edges were segmented. Reflectivity was examined along the inner segment (IS), defined as extending from band 1 to the band 2 center, and within band 2 itself.

Results

Images highlight a nearly continuously resolved extrafoveal internal limiting membrane, the peripheral single-cell thick ganglion cell layer, and the peripheral photoreceptor axonal fiber layer, a peripheral division of band 2 into bands 2a and 2b, and a reflectivity-based division of the IS into “m” and “e” zones.

Discussion

Topography and transverse intensity variations of the outermost band 2b suggest an association with rods. The “m” and “e” zone border is consistent with the myoid–ellipsoid boundary, even recapitulating the well-documented distribution of mitochondria throughout the IS at the foveal center. Theories of outer retinal reflectivity in OCT must adequately explain these observations.

Translational Relevance

Findings support that band 2 does partially overlap with the ellipsoid in transversally averaged OCT images due to photoreceptor IS length dispersion but argue that the inner ellipsoid must be inner to band 2, as suggested by prior quantitative measurements.

The Development and Clinical Application of Innovative Optical Ophthalmic Imaging Techniques

The field of ophthalmic imaging has grown substantially over the last years. Massive improvements in image processing and computer hardware have allowed the emergence of multiple imaging techniques of the eye that can transform patient care. The purpose of this review is to describe the most recent advances in eye imaging and explain how new technologies and imaging methods can be utilized in a clinical setting. The introduction of optical coherence tomography (OCT) was a revolution in eye imaging and has since become the standard of care for a plethora of conditions. Its most recent iterations, OCT angiography, and visible light OCT, as well as imaging modalities, such as fluorescent lifetime imaging ophthalmoscopy, would allow a more thorough evaluation of patients and provide additional information on disease processes. Toward that goal, the application of adaptive optics (AO) and full-field scanning to a variety of eye imaging techniques has further allowed the histologic study of single cells in the retina and anterior segment. Toward the goal of remote eye care and more accessible eye imaging, methods such as handheld OCT devices and imaging through smartphones, have emerged. Finally, incorporating artificial intelligence (AI) in eye images has the potential to become a new milestone for eye imaging while also contributing in social aspects of eye care.

A Baseline Study of Oxygen Saturation in Parafoveal Vessels Using Visible Light Optical Coherence Tomography

The retinal macula is at the center of our visual field, and thus pathological damage in the macula significantly impacts an individual's quality of life. The parafoveal vessels form the inner retina provide oxygen perfusion, and the measurement of parafoveal oxygen saturation (sO₂) can evaluate macular metabolism and provide pathophysiological insight. In this paper, for the first time, we present a baseline study of microvascular oxygen saturation (sO₂) in perifoveal macular region using visible light optical coherence tomography (VIS-OCT) on normal eyes. The arterial and venous sO₂ from all eyes was 92.1 ± 7.1 (vol %) and 48.4 ± 5.0 (vol %) (mean ± SD), respectively. Arteriovenous sO₂ difference was 43.8 ± 9.5 (vol %). Marginal correlation was found between venous sO₂ and intraocular pressure (IOP) among eyes. No significant correlation was found between sO₂ and vessel topological features, including length, diameter, and distance to fovea. This baseline study could serve as a benchmark for the future sO₂ investigation of retinal macular pathologies.