Line-field parallel swept source MHz OCT for structural and functional retinal imaging

In vivo, contactless, cellular resolution imaging of the human cornea with Powell lens based line field OCT

Potentially blinding corneal diseases alter the morphology of the human cornea. At the early stages of disease development, these changes occur at the cellular level. The ability to visualize and quantify such changes can lead to early diagnostics of corneal pathologies, which is pivotal for the long-term preservation of vision. Here we present a Powell Lens-based Line-Field Optical Coherence Tomography system that combines high spatial resolution (2.4 μm × 2.2 μm × 1.7 μm (x × y × z)) in biological tissue, sufficient to resolve individual cells, high sensitivity (90.5 dB), sufficient to image the semi-transparent human cornea, and fast image acquisition rate (~ 2,400 fps), sufficient to suppress most involuntary eye motion artifacts and allow for contactless, in-vivo imaging of the cellular structure of the human cornea. Volumetric images acquired in-vivo from corneas of healthy subjects show epithelial, endothelial and keratocytes cells, as well as sub-basal and stromal nerves. The system's high axial resolution also allows for volumetric morphometry of the corneal endothelium, Descemet's membrane and the pre-Descemet's (Dua) layer.

Line-field confocal optical coherence tomography based on tandem interferometry with a focus-tunable lens

This article introduces an innovative line-field confocal optical coherence tomography (LC-OCT) system based on tandem interferometry, featuring a focus-tunable lens for dynamic focusing. The principle of tandem interferometry is first recalled, and an analytical expression of the interferometric signal detected is established in order to identify the influence of key experimental parameters. The LC-OCT system is based on a Linnik-type imaging interferometer with a focus-tunable lens for focus scanning, coupled to a Michelson-type compensating interferometer using a piezoelectric linear translation stage for coherence plane scanning. The system achieves axial and lateral image resolutions of approximately 1 µm over the entire imaging depth (400 µm), in line with conventional LC-OCT. Vertical section images (B-scans) of skin acquired at 14.3 fps reveal distinguishable structures within the epidermis and dermis. Using refocusing and stitching, images of a tissue phantom were obtained with an imaging depth superior to 1.4 mm. The system holds promise for LC-OCT miniaturization, along with enhanced imaging speed and extended imaging depth.

On-axis full-field swept-source optical coherence tomography for murine retinal imaging

A full-field swept-source optical coherence tomography (FF-SS-OCT) for in vivo murine retinal imaging is demonstrated. The on-axis FF-SS-OCT system was built in a Mach-Zehnder interferometer configuration employing a tunable laser source with an adjustable sweep rate and sweep range in conjunction with a fast 2D-CMOS camera. A large field retinal (coherent) illumination was accomplished using an imaging interface comprised of a short-focal length imaging lens and a contact lens. The magnification between the camera and retina (spatial sampling) was appropriately chosen to record the microscopic structural features of the retina in the image. A pupil stop was employed in the detection path to reject unwanted backscattering from the mouse eye and other sources and limit aberrations distorting the retinal images. In vivo mouse retinal imaging was performed at a sweep rate of 150 Hz to acquire volumes unaffected by the system vibrations, which predominated at lower frequencies. Operating the FF-SS-OCT at this speed yielded an effective axial scan rate of 20 million A-scans/s and a field of view of 820 × 410 µm (24.12° × 12.06°). High-quality retinal B-scans and enface images of the retina were obtained with the SS-FF-OCT, revealing all major retinal layers and vascular plexuses.

Line-field dynamic optical coherence tomography platform for volumetric assessment of biological tissues

Dynamic optical coherence tomography (dOCT) utilizes time-dependent signal intensity fluctuations to enhance contrast in OCT images and indirectly probe physiological processes in cells. Majority of the dOCT studies published so far are based on acquisition of 2D images (B-scans or C-scans) by utilizing point-scanning Fourier domain (spectral or swept-source) OCT or full-field OCT respectively, primarily due to limitations in the image acquisition rate. Here we introduce a novel, high-speed spectral domain line-field dOCT (SD-LF-dOCT) system and image acquisition protocols designed for fast, volumetric dOCT imaging of biological tissues. The imaging probe is based on an exchangeable afocal lens pair that enables selection of combinations of transverse resolution (from 1.1 µm to 6.4 µm) and FOV (from 250 × 250 µm2 to 1.4 × 1.4 mm2), suitable for different biomedical applications. The system offers axial resolution of ∼ 1.9 µm in biological tissue, assuming an average refractive index of 1.38. Maximum sensitivity of 90.5 dB is achieved for 3.5 mW optical imaging power at the tissue surface and maximum camera acquisition rate of 2,000 fps. Volumetric dOCT images acquired with the SD-LF-dOCT system from plant tissue (cucumber), animal tissue (mouse liver) and human prostate carcinoma spheroids allow for volumetric visualization of the tissues' cellular and sub-cellular structures and assessment of cellular motility.

Deep learning-based label-free imaging of lymphatics and aqueous veins in the eye using optical coherence tomography

We demonstrate an adaptation of deep learning for label-free imaging of the micro-scale lymphatic vessels and aqueous veins in the eye using optical coherence tomography (OCT). The proposed deep learning-based OCT lymphangiography (DL-OCTL) method was trained, validated and tested, using OCT scans (23 volumetric scans comprising 19,736 B-scans) from 11 fresh ex vivo porcine eyes with the corresponding vessel labels generated by a conventional OCT lymphangiography (OCTL) method based on thresholding with attenuation compensation. Compared to conventional OCTL, the DL-OCTL method demonstrates comparable results for imaging lymphatics and aqueous veins in the eye, with an Intersection over Union value of 0.79 ± 0.071 (mean ± standard deviation). In addition, DL-OCTL mitigates the imaging artifacts in conventional OCTL where the OCT signal modelling was corrupted by the tissue heterogeneity, provides ~ 10 times faster processing based on a rough comparison and does not require OCT-related knowledge for correct implementation as in conventional OCTL. With these favorable features, DL-OCTL promises to improve the practicality of OCTL for label-free imaging of lymphatics and aqueous veins for preclinical and clinical imaging applications.

Dynamic contrast optical coherence tomography (DyC-OCT) for label-free live cell imaging

Dynamic contrast optical coherence tomography (DyC-OCT), an emerging imaging method, utilizes fluctuation patterns in OCT signals to enhance contrast, thereby enabling non-invasive label-free volumetric live cell imaging. In this mini review, we explain the core concepts behind DyC-OCT image formation and its system configurations, serving as practical guidance for future DyC-OCT users. Subsequently, we explore its applications in delivering high-quality, contrast-enhanced images of cellular morphology, as well as in monitoring changes in cellular activity/viability assay experiments.

Real-time line-field optical coherence tomography for cellular resolution imaging of biological tissue

A real-time line-field optical coherence tomography (LF-OCT) system is demonstrated with image acquisition rates of up to 5000 B-frames or 2.5 million A-lines per second for 500 A-lines per B-frame. The system uses a high-speed low-cost camera to achieve continuous data transfer rates required for real-time imaging, allowing the evaluation of future applications in clinical or intraoperative environments. The light source is an 840 nm super-luminescent diode. Leveraging parallel computing with GPU and high speed CoaXPress data transfer interface, we were able to acquire, process, and display OCT data with low latency. The studied system uses anamorphic beam shaping in the detector arm, optimizing the field of view and sensitivity for imaging biological tissue at cellular resolution. The lateral and axial resolution measured in air were 1.7 µm and 6.3 µm, respectively. Experimental results demonstrate real-time inspection of the trabecular meshwork and Schlemm's canal on ex vivo corneoscleral wedges and real-time imaging of endothelial cells of human subjects in vivo.

Feasibility of deep learning-based polarization-sensitive optical coherence tomography angiography for imaging cutaneous microvasculature

Polarization-sensitive optical coherence tomography (PS-OCT) measures the polarization states of the backscattered light from tissue that can improve angiography based on conventional optical coherence tomography (OCT). We present a feasibility study on PS-OCT integrated with deep learning for PS-OCT angiography (PS-OCTA) imaging of human cutaneous microvasculature. Two neural networks were assessed for PS-OCTA, including the residual dense network (RDN), which previously showed superior performance for angiography with conventional OCT and the upgraded grouped RDN (GRDN). We also investigated different protocols to process the multiple signal channels provided by the Jones matrices from the PS-OCT system to achieve optimal PS-OCTA performance. The training and testing of the deep learning-based PS-OCTA were performed using PS-OCT scans collected from 18 skin locations comprising 16,600 B-scan pairs. The results demonstrated a moderately improved performance of GRDN over RDN, and of the use of the combined signal from the Jones matrix elements over the separate use of the elements, as well as a similar image quality to that provided by speckle decorrelation angiography. GRDN-based PS-OCTA also showed ∼2-3 times faster processing and improved mitigation of tissue motion as compared to speckle decorrelation angiography, and enabled fully automatic processing. Deep learning-based PS-OCTA can be used for imaging cutaneous microvasculature, which may enable easy adoption of PS-OCTA for preclinical and clinical applications.

Rapid imaging and product screening with low-cost line-field Fourier domain optical coherence tomography

Fourier domain optical coherence tomography (FD-OCT) is a well-established imaging technique that provides high-resolution internal structure images of an object at a fast speed. Modern FD-OCT systems typically operate at speeds of 40,000-100,000 A-scans/s, but are priced at least tens of thousands of pounds. In this study, we demonstrate a line-field FD-OCT (LF-FD-OCT) system that achieves an OCT imaging speed of 100,000 A-scan/s at a hardware cost of thousands of pounds. We demonstrate the potential of LF-FD-OCT for biomedical and industrial imaging applications such as corneas, 3D printed electronics, and printed circuit boards.

Powell lens-based line-field spectral domain optical coherence tomography system for cellular resolution imaging of biological tissue

A Powell lens is used in a line-field spectral domain OCT (PL-LF-SD-OCT) system to generate a line-shaped imaging beam with almost uniform distribution of the optical power in the line direction. This design overcomes the severe sensitivity loss (∼10 dB) observed along the line length direction (B-scan) in LF-OCT systems based on cylindrical lens line generators. The PL-LF-SD-OCT system offers almost isotropic spatial resolution (Δx and Δy ∼2 µm, Δz ∼1.8 µm) in free space and sensitivity of ∼87 dB for 2.5 mW imaging power at 2,000 fps imaging rate with only ∼1.6 dB sensitivity loss along the line length. Images acquired with the PL-LF-SD-OCT system allow for visualization of the cellular and sub-cellular structure of biological tissues.

Resolution-enhanced OCT and expanded framework of information capacity and resolution in coherent imaging

Spatial resolution in conventional optical microscopy has traditionally been treated as a fixed parameter of the optical system. Here, we present an approach to enhance transverse resolution in beam-scanned optical coherence tomography (OCT) beyond its aberration-free resolution limit, without any modification to the optical system. Based on the theorem of invariance of information capacity, resolution-enhanced (RE)-OCT navigates the exchange of information between resolution and signal-to-noise ratio (SNR) by exploiting efficient noise suppression via coherent averaging and a simple computational bandwidth expansion procedure. We demonstrate a resolution enhancement of 1.5 × relative to the aberration-free limit while maintaining comparable SNR in silicone phantom. We show that RE-OCT can significantly enhance the visualization of fine microstructural features in collagen gel and ex vivo mouse brain. Beyond RE-OCT, our analysis in the spatial-frequency domain leads to an expanded framework of information capacity and resolution in coherent imaging that contributes new implications to the theory of coherent imaging. RE-OCT can be readily implemented on most OCT systems worldwide, immediately unlocking information that is beyond their current imaging capabilities, and so has the potential for widespread impact in the numerous areas in which OCT is utilized, including the basic sciences and translational medicine.

Enhanced medical diagnosis for dOCTors: a perspective of optical coherence tomography

SIGNIFICANCE

After three decades, more than 75,000 publications, tens of companies being involved in its commercialization, and a global market perspective of about USD 1.5 billion in 2023, optical coherence tomography (OCT) has become one of the fastest successfully translated imaging techniques with substantial clinical and economic impacts and acceptance.

AIM

Our perspective focuses on disruptive forward-looking innovations and key technologies to further boost OCT performance and therefore enable significantly enhanced medical diagnosis.

APPROACH

A comprehensive review of state-of-the-art accomplishments in OCT has been performed.

RESULTS

The most disruptive future OCT innovations include imaging resolution and speed (single-beam raster scanning versus parallelization) improvement, new implementations for dual modality or even multimodality systems, and using endogenous or exogenous contrast in these hybrid OCT systems targeting molecular and metabolic imaging. Aside from OCT angiography, no other functional or contrast enhancing OCT extension has accomplished comparable clinical and commercial impacts. Some more recently developed extensions, e.g., optical coherence elastography, dynamic contrast OCT, optoretinography, and artificial intelligence enhanced OCT are also considered with high potential for the future. In addition, OCT miniaturization for portable, compact, handheld, and/or cost-effective capsule-based OCT applications, home-OCT, and self-OCT systems based on micro-optic assemblies or photonic integrated circuits will revolutionize new applications and availability in the near future. Finally, clinical translation of OCT including medical device regulatory challenges will continue to be absolutely essential.

CONCLUSIONS

With its exquisite non-invasive, micrometer resolution depth sectioning capability, OCT has especially revolutionized ophthalmic diagnosis and hence is the fastest adopted imaging technology in the history of ophthalmology. Nonetheless, OCT has not been completely exploited and has substantial growth potential-in academics as well as in industry. This applies not only to the ophthalmic application field, but also especially to the original motivation of OCT to enable optical biopsy, i.e., the in situ imaging of tissue microstructure with a resolution approaching that of histology but without the need for tissue excision.

Compressive sensing for polarization sensitive optical coherence tomography

In this report, we report on the implementation of compressive sensing (CS) and sparse sampling in polarization sensitive optical coherence tomography (PS-OCT) to reduce the number of B-scans (frames consisting of an array of A-scans, where each represents a single depth profile of reflections) required for effective volumetric (3D dataset composed of an array of B-scans) PS-OCT measurements (i.e. OCT intensity, and phase retardation) reconstruction. Sparse sampling of PS-OCT is achieved through randomization of step sizes along the slow-axis of PS-OCT imaging, covering the same spatial ranges as those with equal slow-axis step sizes, but with a reduced number of B-scans. Tested on missing B-scan rates of 25%, 50% and 75%, we found CS could reconstruct reasonably good (as evidenced by a correlation coefficient >0.6) PS-OCT measurements with a maximum reduced B-scan rate of 50%, thereby accelerating and doubling the rate of volumetric PS-OCT measurements.

Flexible A-scan rate MHz-OCT: efficient computational downscaling by coherent averaging

In order to realize adjustable A-scan rates of fast optical coherence tomography (OCT) systems, we investigate averaging of OCT image data acquired with a MHz-OCT system based on a Fourier Domain Mode Locked (FDML) laser. Increased system sensitivity and image quality can be achieved with the same system at the cost of lower imaging speed. Effectively, the A-scan rate can be reduced in software by a freely selectable factor. We demonstrate a detailed technical layout of the strategies necessary to achieve efficient coherent averaging. Since there are many new challenges specific to coherent averaging in swept source MHz-OCT, we analyze them point by point and describe the appropriate solutions. We prove that coherent averaging is possible at MHz OCT-speed without special interferometer designs or digital phase stabilization. We find, that in our system up to ∼100x coherent averaging is possible while achieving a sensitivity increase close to the ideal values. This corresponds to a speed reduction from 3.3 MHz to 33 kHz and a sensitivity gain of 20 dB. We show an imaging comparison between coherent and magnitude averaging of a human finger knuckle joint in vivo with 121 dB sensitivity for the coherent case. Further, the benefits of computational downscaling in low sensitivity MHz-OCT systems are analyzed.

High-speed adaptive optics line-scan OCT for cellular-resolution optoretinography

Optoretinography-the non-invasive, optical imaging of light-induced functional activity in the retina-stands to provide a critical biomarker for testing the safety and efficacy of new therapies as well as their rapid translation to the clinic. Optical phase change in response to light, as readily accessible in phase-resolved OCT, offers a path towards all-optical imaging of retinal function. However, typical human eye motion adversely affects phase stability. In addition, recording fast light-induced retinal events necessitates high-speed acquisition. Here, we introduce a high-speed line-scan spectral domain OCT with adaptive optics (AO), aimed at volumetric imaging and phase-resolved acquisition of retinal responses to light. By virtue of parallel acquisition of an entire retinal cross-section (B-scan) in a single high-speed camera frame, depth-resolved tomograms at speeds up to 16 kHz were achieved with high sensitivity and phase stability. To optimize spectral and spatial resolution, an anamorphic detection paradigm was introduced, enabling improved light collection efficiency and signal roll-off compared to traditional methods. The benefits in speed, resolution and sensitivity were exemplified in imaging nanometer-millisecond scale light-induced optical path length changes in cone photoreceptor outer segments. With 660 nm stimuli, individual cone responses readily segregated into three clusters, corresponding to long, middle, and short-wavelength cones. Recording such optoretinograms on spatial scales ranging from individual cones, to 100 µm-wide retinal patches offers a robust and sensitive biomarker for cone function in health and disease.

Estimation and compensation of phase errors induced by axial bulk motion of a sample in wavelength-sweeping parallel Fourier domain OCT

We report a new, to the best of our knowledge, approach to correct image blurring due to the axial bulk motion of a sample in wavelength-sweeping Fourier domain parallel optical coherence tomography (OCT). This approach can estimate phase errors changing rapidly in time through direct measurements of the apparent axial shift during the sampling interval using common phase changes in parallel detection without additional hardware. To demonstrate the performance of the proposed algorithm, a single reflection and scattering sample were imaged with wavelength-sweeping parallel OCT implemented by scanning a spectrally dispersed line-field along the line direction. In addition, we quantitatively demonstrated that even a small axial movement of the sample could cause serious image blur at a high nonlinear degree of movement.

In vivo imaging of the human cornea with high-speed and high-resolution Fourier-domain full-field optical coherence tomography

Corneal evaluation in ophthalmology necessitates cellular-resolution and fast imaging techniques that allow for accurate diagnoses. Currently, the fastest volumetric imaging technique is Fourier-domain full-field optical coherence tomography (FD-FF-OCT), which uses a fast camera and a rapidly tunable laser source. Here, we demonstrate high-resolution, high-speed, non-contact corneal volumetric imaging in vivo with FD-FF-OCT that can acquire a single 3D volume with a voxel rate of 7.8 GHz. The spatial coherence of the laser source was suppressed to prevent it from focusing on a spot on the retina, and therefore, exceeding the maximum permissible exposure (MPE). The inherently volumetric nature of FD-FF-OCT data enabled flattening of curved corneal layers. The acquired FD-FF-OCT images revealed corneal cellular structures, such as epithelium, stroma and endothelium, as well as subbasal and mid-stromal nerves.

Wide-field Ophthalmic Space-Division Multiplexing Optical Coherence Tomography

High-speed ophthalmic optical coherence tomography systems are of interest because they allow rapid, motion-free, and wide-field retinal imaging. Space-division multiplexing optical coherence tomography (SDM-OCT) is a high-speed imaging technology which takes advantage of the long coherence length of microelectromechanical vertical cavity surface emitting laser (MEMs VCSEL) sources to multiplex multiple images along a single imaging depth. We demonstrate wide-field retinal OCT imaging, acquired at an effective A-scan rate of 800,000 A-scans/sec with volumetric images covering up to 12.5 mm × 7.4 mm on the retina acquired in less than 1 second. A clinical feasibility study was conducted to compare the ophthalmic SDM-OCT with commercial OCT systems, illustrating the high-speed capability of SDM-OCT in a clinical setting.

Mirau-based line-field confocal optical coherence tomography

Line-field confocal optical coherence tomography (LC-OCT) is an imaging technique in which A-scans are acquired in parallel through line illumination with a broadband laser and line detection with a line-scan camera. B-scan imaging at high spatial resolution is achieved by dynamic focusing in a Linnik interferometer. This paper presents an LC-OCT device based on a custom-designed Mirau interferometer that offers similar spatial resolution and detection sensitivity. The device has the advantage of being more compact and lighter. In vivo imaging of human skin with a resolution of 1.3 µm × 1.1 µm (lateral × axial) is demonstrated over a field of 0.9 mm × 0.4 mm (lateral × axial) at 12 frames per second.

Dual-mode line-field confocal optical coherence tomography for ultrahigh-resolution vertical and horizontal section imaging of human skin in vivo

Line-field confocal optical coherence tomography (LC-OCT) is a recently introduced technique for ultrahigh-resolution vertical section (B-scan) imaging of human skin in vivo. This work presents a new implementation of the LC-OCT technique to obtain horizontal section images (C-scans) in addition to B-scans. C-scan imaging is achieved with this dual-mode LC-OCT system using a mirror galvanometer for lateral scanning along with a piezoelectric chip for modulation of the interferometric signal. A quasi-identical spatial resolution of ∼ 1 µm is measured for both B-scans and C-scans. The images are acquired in both modes at a rate of 10 frames per second. The horizontal field of view of the C-scans is 1.2 × 0.5 mm², identical to the vertical field of view of the B-scans. The user can switch between the two modes by clicking a button. In vivo cellular-resolution imaging of human skin is demonstrated in both B-scan and C-scan modes, with the possibility to navigate within the skin tissues in real time.

Synchronized, concurrent optical coherence tomography and videostroboscopy for monitoring vocal fold morphology and kinematics

Voice disorders affect a large number of adults in the United States, and their clinical evaluation heavily relies on laryngeal videostroboscopy, which captures the medial-lateral and anterior-posterior motion of the vocal folds using stroboscopic sampling. However, videostroboscopy does not provide direct visualization of the superior-inferior movement of the vocal folds, which yields important clinical insight. In this paper, we present a novel technology that complements videostroboscopic findings by adding the ability to image the coronal plane and visualize the superior-inferior movement of the vocal folds. The technology is based on optical coherence tomography, which is combined with videostroboscopy within the same endoscopic probe to provide spatially and temporally co-registered images of the mucosal wave motion, as well as vocal folds subsurface morphology. We demonstrate the capability of the rigid endoscopic probe, in a benchtop setting, to characterize the complex movement and subsurface structure of the aerodynamically driven excised larynx models within the 50 to 200 Hz phonation range. Our preliminary results encourage future development of this technology with the goal of its use for in vivo laryngeal imaging.

Live video rate volumetric OCT imaging of the retina with multi-MHz A-scan rates

Surgical microscopes are vital tools for ophthalmic surgeons. The recent development of an integrated OCT system for the first time allows to look at tissue features below the surface. Hence, these systems can drastically improve the quality and reduce the risk of surgical interventions. However, current commercial OCT-enhanced ophthalmic surgical microscopes provide only one additional cross sectional view to the standard microscope image and feature a low update rate. To present volumetric data at a high update rate, much faster OCT systems than the ones applied in today's surgical microscopes need to be developed. We demonstrate live volumetric retinal OCT imaging, which may provide a sufficiently large volume size (330x330x595 Voxel) and high update frequency (24.2 Hz) such that the surgeon may even purely rely on the OCT for certain surgical maneuvers. It represents a major technological step towards the possible application of OCT-only surgical microscopes in the future which would be much more compact thus enabling many additional minimal invasive applications. We show that multi-MHz A-scan rates are essential for such a device. Additionally, advanced phase-based OCT techniques require 3D OCT volumes to be detected with a stable optical phase. These techniques can provide additional functional information of the retina. Up to now, classical OCT was to slow for this, so our system can pave the way to holographic OCT with a traditional confocal flying spot approach. For the first time, we present point scanning volumetric OCT imaging of the posterior eye with up to 191.2 Hz volume rate. We show that this volume rate is high enough to enable a sufficiently stable optical phase to a level, where remaining phase errors can be corrected. Applying advanced post processing concepts for numerical refocusing or computational adaptive optics should be possible in future with such a system.

Live video rate volumetric OCT imaging of the retina with multi-MHz A-scan rates

Surgical microscopes are vital tools for ophthalmic surgeons. The recent development of an integrated OCT system for the first time allows to look at tissue features below the surface. Hence, these systems can drastically improve the quality and reduce the risk of surgical interventions. However, current commercial OCT-enhanced ophthalmic surgical microscopes provide only one additional cross sectional view to the standard microscope image and feature a low update rate. To present volumetric data at a high update rate, much faster OCT systems than the ones applied in today's surgical microscopes need to be developed. We demonstrate live volumetric retinal OCT imaging, which may provide a sufficiently large volume size (330x330x595 Voxel) and high update frequency (24.2 Hz) such that the surgeon may even purely rely on the OCT for certain surgical maneuvers. It represents a major technological step towards the possible application of OCT-only surgical microscopes in the future which would be much more compact thus enabling many additional minimal invasive applications. We show that multi-MHz A-scan rates are essential for such a device. Additionally, advanced phase-based OCT techniques require 3D OCT volumes to be detected with a stable optical phase. These techniques can provide additional functional information of the retina. Up to now, classical OCT was to slow for this, so our system can pave the way to holographic OCT with a traditional confocal flying spot approach. For the first time, we present point scanning volumetric OCT imaging of the posterior eye with up to 191.2 Hz volume rate. We show that this volume rate is high enough to enable a sufficiently stable optical phase to a level, where remaining phase errors can be corrected. Applying advanced post processing concepts for numerical refocusing or computational adaptive optics should be possible in future with such a system.

Evaluating changes of blood flow in retina, choroid, and outer choroid in rats in response to elevated intraocular pressure by 1300 nm swept-source OCT

We report the development of a 1300 nm swept-source optical coherence tomography (SS-OCT) system specifically designed to perform OCT imaging and optical microangiography (OMAG) in rat eyes in vivo and its use in evaluating the effects of intraocular pressure (IOP) elevation on ocular circulation. The swept laser is operated in single longitude mode with a 90 nm bandwidth centered at 1300 nm and 200 kHz A-line rate, providing remarkable sensitivity fall-off performance along the imaging depth, a larger field of view of 2.5 × 2.5 mm2 (approximately 35°), and more time-efficient imaging acquisition. The advantage of the SS-OCT/OMAG is highlighted by an increased imaging depth of the entire posterior thickness of optic nerve head (ONH) and its surrounding vascular anatomy, to include, for the first time in vivo, the vasculature at the scleral opening, allowing visualization of the circle of Zinn-Haller and posterior ciliary arteries (PCAs). Furthermore, the capillary-level resolution angiograms achieved at the retinal and choroidal layers over a larger field of view enable a significantly improved quantification of the response of vascular area density (VAD) to elevated IOP. The results indicate that reduction in perfusion of the choroid in response to elevated IOP is delayed compared to that seen in the retina; while choroidal VAD doesn't reach 50% of baseline until ~70 mmHg, the same effect is seen for the retinal VAD at ~60 mmHg. The superior image quality offered by SS-OCT may allow more comprehensive investigation of IOP-related ocular perfusion changes and their pathological roles in glaucomatous optic nerve damage.

Line-field confocal time-domain optical coherence tomography with dynamic focusing

A time-domain optical coherence tomography technique is introduced for high-resolution B-scan imaging in real-time. The technique is based on a two-beam interference microscope with line illumination and line detection using a broadband spatially coherent light source and a line-scan camera. Multiple (2048) A-scans are acquired in parallel by scanning the sample depth while adjusting the focus. Quasi-isotropic spatial resolution of 1.3 µm × 1.1 µm (lateral × axial) is achieved. In vivo cellular-level resolution imaging of human skin is demonstrated at 10 frames per second with a penetration depth of ∼500 µm.

In vivo laser Doppler holography of the human retina

The eye offers a unique opportunity for the non-invasive exploration of cardiovascular diseases. Optical angiography in the retina requires sensitive measurements, which hinders conventional full-field laser Doppler imaging schemes. To overcome this limitation, we used digital holography to perform laser Doppler perfusion imaging of human retina with near-infrared light. Two imaging channels with a slow and a fast CMOS camera were used simultaneously for real-time narrowband measurements, and offline wideband measurements, respectively. The beat frequency spectrum of optical interferograms recorded with the fast (up to 75 kHz) CMOS camera was analyzed by short-time Fourier transformation. Power Doppler images drawn from the Doppler power spectrum density qualitatively revealed blood flow in retinal vessels over 512 × 512 pixels covering 2.4 × 2.4 mm² on the retina with a temporal resolution down to 1.6 ms. The sensitivity to lateral motion as well as the requirements in terms of sampling frequency are discussed.

Feasibility of correlation mapping optical coherence tomography angiographic technique using a 200 kHz vertical-cavity surface-emitting laser source for in vivo microcirculation imaging applications

Optical coherence tomography (OCT) angiography is a well-established in vivo imaging technique to assess the overall vascular morphology of tissues and is an emerging field of research for the assessment of blood flow dynamics and functional parameters such as oxygen saturation. In this study, we present a modified scanning-based correlation mapping OCT using a 200 kHz high-speed swept-source OCT system operating at 1300 nm and demonstrate its wide field-imaging capability in ocular angiographic studies.

Volumetric optical coherence microscopy with a high space-bandwidth-time product enabled by hybrid adaptive optics

Optical coherence microscopy (OCM) is a promising modality for high resolution imaging, but has limited ability to capture large-scale volumetric information about dynamic biological processes with cellular resolution. To enhance the throughput of OCM, we implemented a hybrid adaptive optics (hyAO) approach that combines computational adaptive optics with an intentionally aberrated imaging beam generated via hardware adaptive optics. Using hyAO, we demonstrate the depth-equalized illumination and collection ability of an astigmatic beam compared to a Gaussian beam for cellular-resolution imaging. With this advantage, we achieved volumetric OCM with a higher space-bandwidth-time product compared to Gaussian-beam acquisition that employed focus-scanning across depth. HyAO was also used to perform volumetric time-lapse OCM imaging of cellular dynamics over a 1mm × 1mm × 1mm field-of-view with 2 μm isotropic spatial resolution and 3-minute temporal resolution. As hyAO is compatible with both spectral-domain and swept-source beam-scanning OCM systems, significant further improvements in absolute volumetric throughput are possible by use of ultrahigh-speed swept sources.

In vivo super-resolution imaging of transient retinal phototropism evoked by oblique light stimulation

Rod-dominated transient retinal phototropism (TRP) has been observed in freshly isolated retinas, promising a noninvasive biomarker for objective assessment of retinal physiology. However, in vivo mapping of TRP is challenging due to its subcellular signal magnitude and fast time course. We report here a virtually structured detection-based super-resolution ophthalmoscope to achieve subcellular spatial resolution and millisecond temporal resolution for in vivo imaging of TRP. Spatiotemporal properties of in vivo TRP were characterized corresponding to variable light intensity stimuli, confirming that TRP is tightly correlated with early stages of phototransduction.

Spectrally encoded coherence tomography and reflectometry: Simultaneous en face and cross-sectional imaging at 2 gigapixels per second

Non-invasive biological imaging is crucial for understanding in vivo structure and function. Optical coherence tomography (OCT) and reflectance confocal microscopy are two of the most widely used optical modalities for exogenous contrast-free, high-resolution, three-dimensional imaging in non-fluorescent scattering tissues. However, sample motion remains a critical barrier to raster-scanned acquisition and reconstruction of wide-field anatomically accurate volumetric datasets. We introduce spectrally encoded coherence tomography and reflectometry (SECTR), a high-speed, multimodality system for simultaneous OCT and spectrally encoded reflectance (SER) imaging. SECTR utilizes a robust system design consisting of shared optical relays, scanning mirrors, swept laser and digitizer to achieve the fastest reported in vivo multimodal imaging rate of 2 gigapixels per second. Our optical design and acquisition scheme enable spatiotemporally co-registered acquisition of OCT cross-sections simultaneously with en face SER images for multivolumetric mosaicking. Complementary axial and lateral translation and rotation are extracted from OCT and SER data, respectively, for full volumetric estimation of sample motion with micron spatial and millisecond temporal resolution.

Spectrally encoded coherence tomography and reflectometry: Simultaneous en face and cross-sectional imaging at 2 gigapixels per second

Non-invasive biological imaging is crucial for understanding in vivo structure and function. Optical coherence tomography (OCT) and reflectance confocal microscopy are two of the most widely used optical modalities for exogenous contrast-free, high-resolution, three-dimensional imaging in non-fluorescent scattering tissues. However, sample motion remains a critical barrier to raster-scanned acquisition and reconstruction of wide-field anatomically accurate volumetric datasets. We introduce spectrally encoded coherence tomography and reflectometry (SECTR), a high-speed, multimodality system for simultaneous OCT and spectrally encoded reflectance (SER) imaging. SECTR utilizes a robust system design consisting of shared optical relays, scanning mirrors, swept laser and digitizer to achieve the fastest reported in vivo multimodal imaging rate of 2 gigapixels per second. Our optical design and acquisition scheme enable spatiotemporally co-registered acquisition of OCT cross-sections simultaneously with en face SER images for multivolumetric mosaicking. Complementary axial and lateral translation and rotation are extracted from OCT and SER data, respectively, for full volumetric estimation of sample motion with micron spatial and millisecond temporal resolution.

Ultrahigh-speed line-scan SD-OCT for four-dimensional in vivo imaging of small animal models

We report an ultrahigh-speed and high-resolution line-scan spectral-domain optical coherence tomography (SD-OCT) system that integrates a number of mechanisms for improving image quality. The illumination uniformity is significantly improved by the use of a Powell lens; Phase stepping and differential reconstruction are combined to suppress autocorrelation artifacts; Nonlocal means (NLM) is employed to enhance the signal to noise ratio while minimizing motion artifacts. The system is capable of acquiring cross-sectional images at more than 3,500 B-scans per second with sensitivities between 70dB and 90dB. The high B-scan rate enables image post-processing with nonlocal means, an advanced noise reduction algorithm that affords enhanced morphological details and reduced motion artifacts. The achieved axial and lateral resolutions are 2.0 and 6.2 microns, respectively. We have used this system to acquire four-dimensional (three-dimensional space and one-dimensional time) imaging data from live chicken embryos at up to 40 volumes per second. Dynamic cardiac tissue deformation and blood flow could be clearly visualized at high temporal and spatial resolutions, providing valuable information for understanding the mechanical and fluid dynamic properties of the developing cardiac system.

Holographic line field en-face OCT with digital adaptive optics in the retina in vivo

We demonstrate a high-resolution line field en-face time domain optical coherence tomography (OCT) system using an off-axis holography configuration. Line field en-face OCT produces high speed en-face images at rates of up to 100 Hz. The high frame rate favors good phase stability across the lateral field-of-view which is indispensable for digital adaptive optics (DAO). Human retinal structures are acquired in-vivo with a broadband light source at 840 nm, and line rates of 10 kHz to 100 kHz. Structures of different retinal layers, such as photoreceptors, capillaries, and nerve fibers are visualized with high resolution of 2.8 µm and 5.5 µm in lateral directions. Subaperture based DAO is successfully applied to increase the visibility of cone-photoreceptors and nerve fibers. Furthermore, en-face Doppler OCT maps are generated based on calculating the differential phase shifts between recorded lines.

as-PSOCT: Volumetric microscopic imaging of human brain architecture and connectivity

Polarization sensitive optical coherence tomography (PSOCT) with serial sectioning has enabled the investigation of 3D structures in mouse and human brain tissue samples. By using intrinsic optical properties of back-scattering and birefringence, PSOCT reliably images cytoarchitecture, myeloarchitecture and fiber orientations. In this study, we developed a fully automatic serial sectioning polarization sensitive optical coherence tomography (as-PSOCT) system to enable volumetric reconstruction of human brain samples with unprecedented sample size and resolution. The 3.5 μm in-plane resolution and 50 μm through-plane voxel size allow inspection of cortical layers that are a single-cell in width, as well as small crossing fibers. We show the abilities of as-PSOCT in quantifying layer thicknesses of the cerebellar cortex and creating microscopic tractography of intricate fiber networks in the subcortical nuclei and internal capsule regions, all based on volumetric reconstructions. as-PSOCT provides a viable tool for studying quantitative cytoarchitecture and myeloarchitecture and mapping connectivity with microscopic resolution in the human brain.

Long ranging swept-source optical coherence tomography-based angiography outperforms its spectral-domain counterpart in imaging human skin microcirculations

There is an increasing demand for imaging tools in clinical dermatology that can perform in vivo wide-field morphological and functional examination from surface to deep tissue regions at various skin sites of the human body. The conventional spectral-domain optical coherence tomography-based angiography (SD-OCTA) system is difficult to meet these requirements due to its fundamental limitations of the sensitivity roll-off, imaging range as well as imaging speed. To mitigate these issues, we demonstrate a swept-source OCTA (SS-OCTA) system by employing a swept source based on a vertical cavity surface-emitting laser. A series of comparisons between SS-OCTA and SD-OCTA are conducted. Benefiting from the high system sensitivity, long imaging range, and superior roll-off performance, the SS-OCTA system is demonstrated with better performance in imaging human skin than the SD-OCTA system. We show that the SS-OCTA permits remarkable deep visualization of both structure and vasculature (up to ∼2  mm penetration) with wide field of view capability (up to 18×18  mm2), enabling a more comprehensive assessment of the morphological features as well as functional blood vessel networks from the superficial epidermal to deep dermal layers. It is expected that the advantages of the SS-OCTA system will provide a ground for clinical translation, benefiting the existing dermatological practice.

Twenty-five years of optical coherence tomography: the paradigm shift in sensitivity and speed provided by Fourier domain OCT [Invited]

Optical coherence tomography (OCT) has become one of the most successful optical technologies implemented in medicine and clinical practice mostly due to the possibility of non-invasive and non-contact imaging by detecting back-scattered light. OCT has gone through a tremendous development over the past 25 years. From its initial inception in 1991 [Science254, 1178 (1991)] it has become an indispensable medical imaging technology in ophthalmology. Also in fields like cardiology and gastro-enterology the technology is envisioned to become a standard of care. A key contributor to the success of OCT has been the sensitivity and speed advantage offered by Fourier domain OCT. In this review paper the development of FD-OCT will be revisited, providing a single comprehensive framework to derive the sensitivity advantage of both SD- and SS-OCT. We point out the key aspects of the physics and the technology that has enabled a more than 2 orders of magnitude increase in sensitivity, and as a consequence an increase in the imaging speed without loss of image quality. This speed increase provided a paradigm shift from point sampling to comprehensive 3D in vivo imaging, whose clinical impact is still actively explored by a large number of researchers worldwide.

Evaluating the Effects of Riboflavin/UV-A and Rose-Bengal/Green Light Cross-Linking of the Rabbit Cornea by Noncontact Optical Coherence Elastography

Purpose

The purpose of this study was to use noncontact optical coherence elastography (OCE) to evaluate and compare changes in biomechanical properties that occurred in rabbit cornea in situ after corneal collagen cross-linking by either of two techniques: ultraviolet-A (UV-A)/riboflavin or rose-Bengal/green light.

Methods

Low-amplitude (≤10 μm) elastic waves were induced in mature rabbit corneas by a focused air pulse. Elastic wave propagation was imaged by a phase-stabilized swept source OCE (PhS-SSOCE) system. Corneas were then cross-linked by either of two methods: UV-A/riboflavin (UV-CXL) or rose-Bengal/green light (RGX). Phase velocities of the elastic waves were fitted to a previously developed modified Rayleigh-Lamb frequency equation to obtain the viscoelasticity of the corneas before and after the cross-linking treatments. Micro-scale depth-resolved phase velocity distribution revealed the depth-wise heterogeneity of both cross-linking techniques.

Results

Under standard treatment settings, UV-CXL significantly increased the stiffness of the corneas by ∼47% (P < 0.05), but RGX did not produce statistically significant increases. The shear viscosities were unaffected by either cross-linking technique. The depth-wise phase velocities showed that UV-CXL affected the anterior ∼34% of the corneas, whereas RGX affected only the anterior ∼16% of the corneas.

Conclusions

UV-CXL significantly strengthens the cornea, whereas RGX does not, and the effects of cross-linking by UV-CXL reach deeper into the cornea than cross-linking effects of RGX under similar conditions.

Reduction of frame rate in full-field swept-source optical coherence tomography by numerical motion correction [Invited]

Full-field swept-source optical coherence tomography (FF-SS-OCT) was recently shown to allow new and exciting applications for imaging the human eye that were previously not possible using current scanning OCT systems. However, especially when using cameras that do not acquire data with hundreds of kHz frame rate, uncorrected phase errors due to axial motion of the eye lead to a drastic loss in image quality of the reconstructed volumes. Here we first give a short overview of recent advances in techniques and applications of parallelized OCT and finally present an iterative and statistical algorithm that estimates and corrects motion-induced phase errors in the FF-SS-OCT data. The presented algorithm is in many aspects adopted from the phase gradient autofocus (PGA) method, which is frequently used in synthetic aperture radar (SAR). Following this approach, the available phase errors can be estimated based on the image information that remains in the data, and no parametrization with few degrees of freedom is required. Consequently, the algorithm is capable of compensating even strong motion artifacts. Efficacy of the algorithm was tested on simulated data with motion containing varying frequency components. We show that even in strongly blurred data, the actual image information remains intact, and the algorithm can identify the phase error and correct it. Furthermore, we use the algorithm to compensate real phase error in FF-SS-OCT imaging of the human retina. Acquisition rates can be reduced by a factor of three (from 60 to 20 kHz frame rate) with an image quality that is even higher compared to uncorrected volumes recorded at the maximum acquisition rate. The presented algorithm for axial motion correction decreases the high requirements on the camera frame rate and thus brings FF-SS-OCT closer to clinical applications.

Ultra-fast line-field low coherence holographic elastography using spatial phase shifting

Optical coherence elastography (OCE) is an emerging technique for quantifying tissue biomechanical properties. Generally, OCE relies on point-by-point scanning. However, long acquisition times make point-by-point scanning unfeasible for clinical use. Here we demonstrate a noncontact single shot line-field low coherence holography system utilizing an automatic Hilbert transform analysis based on a spatial phase shifting technique. Spatio-temporal maps of elastic wave propagation were acquired with only one air-pulse excitation and used to quantify wave velocity and sample mechanical properties at a line rate of 200 kHz. Results obtained on phantoms were correlated with data from mechanical testing. Finally, the stiffness of porcine cornea at different intraocular pressures was also quantified in situ.

High-speed OCT light sources and systems [Invited]

Imaging speed is one of the most important parameters that define the performance of optical coherence tomography (OCT) systems. During the last two decades, OCT speed has increased by over three orders of magnitude. New developments in wavelength-swept lasers have repeatedly been crucial for this development. In this review, we discuss the historical evolution and current state of the art of high-speed OCT systems, with focus on wavelength swept light sources and swept source OCT systems.

Wide field and highly sensitive angiography based on optical coherence tomography with akinetic swept source

Wide-field vascular visualization in bulk tissue that is of uneven surface is challenging due to the relatively short ranging distance and significant sensitivity fall-off for most current optical coherence tomography angiography (OCTA) systems. We report a long ranging and ultra-wide-field OCTA (UW-OCTA) system based on an akinetic swept laser. The narrow instantaneous linewidth of the swept source with its high phase stability, combined with high-speed detection in the system enable us to achieve long ranging (up to 46 mm) and almost negligible system sensitivity fall-off. To illustrate these advantages, we compare the basic system performances between conventional spectral domain OCTA and UW-OCTA systems and their functional imaging of microvascular networks in living tissues. In addition, we show that the UW-OCTA is capable of different depth-ranging of cerebral blood flow within entire brain in mice, and providing unprecedented blood perfusion map of human finger in vivo. We believe that the UW-OCTA system has promises to augment the existing clinical practice and explore new biomedical applications for OCT imaging.

Simultaneous multimodal ophthalmic imaging using swept-source spectrally encoded scanning laser ophthalmoscopy and optical coherence tomography

Scanning laser ophthalmoscopy (SLO) benefits diagnostic imaging and therapeutic guidance by allowing for high-speed en face imaging of retinal structures. When combined with optical coherence tomography (OCT), SLO enables real-time aiming and retinal tracking and provides complementary information for post-acquisition volumetric co-registration, bulk motion compensation, and averaging. However, multimodality SLO-OCT systems generally require dedicated light sources, scanners, relay optics, detectors, and additional digitization and synchronization electronics, which increase system complexity. Here, we present a multimodal ophthalmic imaging system using swept-source spectrally encoded scanning laser ophthalmoscopy and optical coherence tomography (SS-SESLO-OCT) for in vivo human retinal imaging. SESLO reduces the complexity of en face imaging systems by multiplexing spatial positions as a function of wavelength. SESLO image quality benefited from single-mode illumination and multimode collection through a prototype double-clad fiber coupler, which optimized scattered light throughput and reduce speckle contrast while maintaining lateral resolution. Using a shared 1060 nm swept-source, shared scanner and imaging optics, and a shared dual-channel high-speed digitizer, we acquired inherently co-registered en face retinal images and OCT cross-sections simultaneously at 200 frames-per-second.

Development of a first-generation miniature multiple reference optical coherence tomography imaging device

Multiple reference optical coherence tomography (MR-OCT) is a technology ideally suited to low-cost, compact OCT imaging. This modality is an extension of time-domain OCT with the addition of a partial mirror in front of the reference mirror. This enables extended, simultaneous depth scanning with the relatively short scan range of a miniature voice coil motor on which the scanning mirror is mounted. This work details early stage development of the first iteration of a miniature MR-OCT device. This iteration utilizes a fiber-coupled input from an off-board superluminescent diode. The dimensions of the module are 40 × 57 ?? mm . Off-the-shelf miniature optical components, voice coil motors, and photodetectors are used, with the complexity of design depending on the specific application. The photonic module can be configured as either polarized or nonpolarized and can include balanced detection. The results shown in this work are from the nonpolarized device. The system was characterized through measurement of the input spectrum, axial resolution, and signal-to-noise ratio. Typical B-scans of static and in vivo samples are shown, which illustrate the potential applications for such a technology.

Spectrally encoded common-path fiber-optic-based parallel optical coherence tomography

We demonstrate a fiber-optic-based parallel optical coherence tomography (OCT) using spectrally encoded extended illumination with a common-path handheld probe, where the flexibility and robustness of the system are significantly improved, which is critical in the clinical environment. To the best of our knowledge, we present the first parallel OCT based on fiber optics including a fiber coupler with a sensitivity of 94 dB, which is comparable to that of point-scanning OCT. We also investigated the effect of the phase stability of the fiber-based interferometry on the parallel OCT system by comparing the common-path OCT with two-arm OCT. Using the homemade common-path handheld probe based on a Mirau interferometer, the phase stability was 32 times better than that of the two-arm OCT. The axial resolution of the common-path OCT was measured as 5.1±0.3  μm. To demonstrate the in vivo imaging performance of the fiber-optic-based parallel OCT, human skin was imaged.

Non-contact single shot elastography using line field low coherence holography

Optical elastic wave imaging is a powerful technique that can quantify local biomechanical properties of tissues. However, typically long acquisition times make this technique unfeasible for clinical use. Here, we demonstrate non-contact single shot elastographic holography using a line-field interferometer integrated with an air-pulse delivery system. The propagation of the air-pulse induced elastic wave was imaged in real time, and required a single excitation for a line-scan measurement. Results on tissue-mimicking phantoms and chicken breast muscle demonstrated the feasibility of this technique for accurate assessment of tissue biomechanical properties with an acquisition time of a few milliseconds using parallel acquisition.

High-resolution extended source optical coherence tomography

High resolution optical coherence tomography (OCT) is capable of providing detailed tissue microstructures that are critical for disease diagnosis, yet its sensitivity is usually degraded since the system key components are typically not working at their respective center wavelengths. We developed a novel imaging system that achieves enhanced sensitivity without axial resolution degradation by the use of a spectrally encoded extended source (SEES) technique; it allows larger sample power without exceeding the maximum permissible exposure (MPE). In this study, we demonstrate a high-resolution extended source (HRES) OCT system, which is capable of providing a transverse resolution of 4.4 µm and an axial resolution of 2.1 µm in air with the SEES technique. We first theoretically show a sensitivity advantage of 6-dB of the HRES-OCT over that of its point source counterpart using numerical simulations, and then experimentally validate the applicability of the SEES technique to high-resolution OCT (HR-OCT) by comparing the HRES-OCT with an equivalent point-source system. In the HRES-OCT system, a dispersive prism was placed in the infinity space of the sample arm optics to spectrally extend the visual angle (angular subtense) of the light source to 10.3 mrad. This extended source allowed ~4 times larger MPE than its point source counterpart, which results in an enhancement of ~6 dB in sensitivity. Specifically, to solve the unbalanced dispersion between the sample and the reference arm optics, we proposed easy and efficient methods for system calibration and dispersion correction, respectively. With a maximum scanning speed reaching up to 60K A-lines/s, we further conducted imaging experiments with HRES-OCT using the human fingertip in vivo and the swine eye tissues ex vivo. Results demonstrate that the HRES-OCT is able to achieve significantly larger penetration depth than its conventional point source OCT counterpart.

A widefield fluorescence microscope with a linear image sensor for image cytometry of biospecimens: Considerations for image quality optimization

Linear image sensors have been widely used in numerous research and industry applications to provide continuous imaging of moving objects. Here, we present a widefield fluorescence microscope with a linear image sensor used to image translating objects for image cytometry. First, a calibration curve was characterized for a custom microfluidic chamber over a span of volumetric pump rates. Image data were also acquired using 15 μm fluorescent polystyrene spheres on a slide with a motorized translation stage in order to match linear translation speed with line exposure periods to preserve the image aspect ratio. Aspect ratios were then calculated after imaging to ensure quality control of image data. Fluorescent beads were imaged in suspension flowing through the microfluidics chamber being pumped by a mechanical syringe pump at 16 μl min(-1) with a line exposure period of 150 μs. The line period was selected to acquire images of fluorescent beads with a 40 dB signal-to-background ratio. A motorized translation stage was then used to transport conventional glass slides of stained cellular biospecimens. Whole blood collected from healthy volunteers was stained with 0.02% (w/v) proflavine hemisulfate was imaged to highlight leukocyte morphology with a 1.56 mm × 1.28 mm field of view (1540 ms total acquisition time). Oral squamous cells were also collected from healthy volunteers and stained with 0.01% (w/v) proflavine hemisulfate to demonstrate quantifiable subcellular features and an average nuclear to cytoplasmic ratio of 0.03 (n = 75), with a resolution of 0.31 μm pixels(-1).