Real-time measurement of in vitro flow by Fourier-domain color Doppler optical coherence tomography

Optical Flow-Based Full-Field Quantitative Blood-Flow Velocimetry Using Temporal Direction Filtering and Peak Interpolation

The quantitative measurement of the microvascular blood-flow velocity is critical to the early diagnosis of microvascular dysfunction, yet there are several challenges with the current quantitative flow velocity imaging techniques for the microvasculature. Optical flow analysis allows for the quantitative imaging of the blood-flow velocity with a high spatial resolution, using the variation in pixel brightness between consecutive frames to trace the motion of red blood cells. However, the traditional optical flow algorithm usually suffers from strong noise from the background tissue, and a significant underestimation of the blood-flow speed in blood vessels, due to the errors in detecting the feature points in optical images. Here, we propose a temporal direction filtering and peak interpolation optical flow method (TPIOF) to suppress the background noise, and improve the accuracy of the blood-flow velocity estimation. In vitro phantom experiments and in vivo animal experiments were performed to validate the improvements in our new method.

Low-Cost In Vivo Full-Range Optical Coherence Tomography Using a Voice Coil Motor

In this work, we demonstrated a novel and low-cost full-range optical coherence tomography (FROCT) method. In comparison with the off-pivot approach, which needs precise control of the deflecting distance and should be adjusted for different situations, our proposed method is more flexible without regulating the system itself. Different from the previous systems reported in the literature, which used a high-cost piezo-driven stage to introduce the phase modulation, our system utilizes a cost-effective voice coil motor for retrieving the complex-valued spectral signal. The complex-valued data, with a twofold increase in the accessible depth range, can be calculated using an algorithm based on the Hilbert transform and Dirac delta function. To confirm the effectivity of our method, both simulation and experiments were performed. In particular, for the in vivo experiment, we presented the FROCT result of a fingernail fold, demonstrating the availability of in vivo imaging. Since the key element of our system is a low-cost voice coil motor, which is flexible and more accessible for most of the clinics, we believe that it has great potential to be a clinical modality in the future.

Role of ocular blood flow in normal tension glaucoma

Background

Normal tension glaucoma (NTG) is a multifactorial disease in the pathogenesis of which intraocular pressure (IOP)-independent factors play a key role.

Main text

There is considerable evidence that impairment of the ocular blood flow (OBF) is involved both in the onset and progression of this disease. With the development of the hypothesis of OBF in NTG, various imaging techniques have been developed to evaluate the OBF and blood vessels. Moreover, vascular dysregulation, which is a main factor in Flammer syndrome, was frequently observed in NTG patients. Disturbed OBF leads to increased oxidative stress, which plays an important role in the pathogenesis of glaucomatous optic neuropathy. These results suggested that IOP-independent management may provide alternative treatment options for NTG patients.

Conclusions

In this review, we mainly focus on the mechanisms of the abnormal OBF in NTG.

Imaging the Retinal Vasculature

Advances in retinal imaging are enabling researchers and clinicians to make precise noninvasive measurements of the retinal vasculature in vivo. This includes measurements of capillary blood flow, the regulation of blood flow, and the delivery of oxygen, as well as mapping of perfused blood vessels. These advances promise to revolutionize our understanding of vascular regulation, as well as the management of retinal vascular diseases. This review provides an overview of imaging and optical measurements of the function and structure of the ocular vasculature. We include general characteristics of vascular systems with an emphasis on the eye and its unique status. The functions of vascular systems are discussed, along with physical principles governing flow and its regulation. Vascular measurement techniques based on reflectance and absorption are briefly introduced, emphasizing ways of generating contrast. One of the prime ways to enhance contrast within vessels is to use techniques sensitive to the motion of cells, allowing precise measurements of perfusion and blood velocity. Finally, we provide a brief introduction to retinal vascular diseases.

Phase-stabilized complex-decorrelation angiography

In this study, we developed a novel phase-stabilized complex-decorrelation (PSCD) optical coherence tomography (OCT) angiography (OCTA) method that can generate high quality OCTA images. This method has been validated using three different types of OCT systems and compared with conventional complex- and amplitude-based OCTA algorithms. Our results suggest that in combination with a pre-processing phase stabilization method, the PSCD method is insensitive to bulk motion phase shifts, less dependent on OCT reflectance than conventional complex methods and demonstrates extended dynamic range of flow signal, in contrast to other two methods.

Visualization of two-dimensional transverse blood flow direction using optical coherence tomography angiography

SIGNIFICANCE

Evaluation of vessel patency and blood flow direction is important in various medical situations, including diagnosis and monitoring of ischemic diseases, and image-guided vascular surgeries. While optical coherence tomography angiography (OCTA) is the most widely used functional extension of optical coherence tomography that visualizes three-dimensional vasculature, inability to provide information of blood flow direction is one of its limitations.

AIM

We demonstrate two-dimensional (2D) transverse blood flow direction imaging in en face OCTA.

APPROACH

A series of triangular beam scans for the fast axis was implemented in the horizontal direction for the first volume scan and in the vertical direction for the following volume scan, and the inter A-line OCTA was performed for the blood flow direction imaging while the stepwise pattern was used for each slow axis scan. The decorrelation differences between the forward and the backward inter A-line OCTA were calculated for the horizontal and the vertical fast axis scans, and the ratio of the horizontal and the vertical decorrelation differences was utilized to show the 2D transverse flow direction information.

RESULTS

OCTA flow direction imaging was verified using flow phantoms with various flow orientations and speeds, and we identified the flow speed range relative to the scan speed for reliable flow direction measurement. We demonstrated the visualization of 2D transverse blood flow orientations in mouse brain vascular networks in vivo.

CONCLUSIONS

The proposed OCTA imaging technique that provides information of 2D transverse flow direction can be utilized in various clinical applications and preclinical studies.

A Neural Network Approach to Quantify Blood Flow from Retinal OCT Intensity Time-Series Measurements

Many diseases of the eye are associated with alterations in the retinal vasculature that are possibly preceded by undetected changes in blood flow. In this work, a robust blood flow quantification framework is presented based on optical coherence tomography (OCT) angiography imaging and deep learning. The analysis used a forward signal model to simulate OCT blood flow data for training of a neural network (NN). The NN was combined with pre- and post-processing steps to create an analysis framework for measuring flow rates from individual blood vessels. The framework’s accuracy was validated using both blood flow phantoms and human subject imaging, and across flow speed, vessel angle, hematocrit levels, and signal-to-noise ratio. The reported flow rate of the calibrated NN framework was measured to be largely independent of vessel angle, hematocrit levels, and measurement signal-to-noise ratio. In vivo retinal flow rate measurements were self-consistent across vascular branch points, and approximately followed a predicted power-law dependence on the vessel diameter. The presented OCT-based NN flow rate estimation framework addresses the need for a robust, deployable, and label-free quantitative retinal blood flow mapping technique.

Impact of atherosclerotic disease on cerebral microvasculature and tissue oxygenation in awake LDLR-/-hApoB+/+ transgenic mice

We explore cortical microvasculature changes during the progression of atherosclerosis using young and old transgenic atherosclerotic (ATX) mice with thinned-skull cranial window. In awake animals, exploiting intrinsic signal optical imaging, Doppler optical coherence tomography, and two-photon microscopy, we investigate how the progression of atherosclerotic disease affects the morphology and function of cortical microvasculature as well as baseline cerebral tissue oxygenation. Results show that aged ATX mice exhibited weaker hemodynamic response in the somatosensory cortex to whisker stimulation and that the diameter of their descending arterioles and associated mean blood flow decreased significantly compared with the young ATX group. Data from two-photon phosphorescence lifetime microscopy indicate that old ATX mice had lower and more heterogeneous partial pressure of oxygen ( PO 2 ) in cortical tissue than young ATX mice. In addition, hypoxic micropockets in cortical tissue were found in old, but not young, ATX mice. Capillary red blood cell (RBC) flux, RBC velocity, RBC velocity heterogeneity, hematocrit, and diameter were also measured using line scans with two-photon fluorescence microscopy. When compared with the young group, RBC flux, velocity, and hematocrit decreased and RBC velocity heterogeneity increased in old ATX mice, presumably due to disturbed blood supply from arterioles that were affected by atherosclerosis. Finally, dilation of capillaries in old ATX mice was observed, which suggests that capillaries play an active role in compensating for an oxygen deficit in brain tissue.

Longitudinal detection of retinal alterations by visible and near-infrared optical coherence tomography in a dexamethasone-induced ocular hypertension mouse model

The retina, as part of the central nervous system, has distinct anatomical and structural properties for its visual function. Light scattering spectroscopy, while widely used for tissue structural characterization and disease diagnosis, has been relatively unexplored in the living retina. Recently, we have developed a fiber-based visible and near-infrared optical coherence tomography system (vnOCT) for in vivo retinal imaging, to uniquely measure a spectroscopic marker (VN ratio) sensitive to nanoscale pathological changes. In the present study, we applied vnOCT in an animal model of glaucoma (dexamethasone-induced ocular hypertension mouse) and tested the capabilities of four optical markers, VN ratio, peripapillary retinal nerve fiber layer (RNFL) thickness, total retinal blood flow, and hemoglobin oxygen saturation ( sO 2 ), for the detection of retinal ganglion cell (RGC) damage in association with ocular hypertension. We found that RNFL-RGC VN ratio and arteriovenous (A-V) sO 2 are capable of detecting early retinal alteration in ocular hypertensive eyes, preceding measurable change of RNFL thickness. This study suggests a potential clinical application of vnOCT in early detection of glaucoma.

Optical coherence tomography in Optics Express [Invited]

Optical coherence tomography (OCT) is one of the most successful technologies in the history of biomedical optics. Optics Express played an important role in communicating groundbreaking technological achievements in the field of OCT, and, conversely, OCT papers are among the most frequently cited papers published in Optics Express. On the occasion of the 20th anniversary of the journal, this review analyzes the reasons for the success of OCT papers in Optics Express and discusses possible motivations for researchers to submit some of their best OCT papers to the journal.

Wide dynamic range high-speed three-dimensional quantitative OCT angiography with a hybrid-beam scan

We demonstrate a novel hybrid-beam scanning-based quantitative optical coherence tomography angiography (OCTA) that provides high-speed wide dynamic range blood flow speed imaging. The hybrid-beam scanning scheme enables multiple OCTA image acquisitions with a wide range of multiple time intervals simultaneously providing wide dynamic range blood flow speed imaging independent of the blood vessel orientation, which was quantified over a speed range of 0.6∼104  mm/s through the blood flow phantom experiments. A fully automated high-speed hybrid-beam scanning-based quantitative OCTA system demonstrates visualization of blood flow speeds in various vessels from the main arteries to capillaries in a 4  mm×4  mm area (1024 A-lines × 512 B-scans) in vivo in 20 s, showing its potential as a useful imaging tool for various biomedical applications.

ASSESSMENT OF RETINAL BLOOD FLOW IN DIABETIC RETINOPATHY USING DOPPLER FOURIER-DOMAIN OPTICAL COHERENCE TOMOGRAPHY

PURPOSE

To evaluate retinal blood flow measurements in normal eyes and eyes with varying levels of diabetic retinopathy (DR) using Doppler Fourier-domain optical coherence tomography (FD-OCT).

METHODS

Twenty-two eyes of 19 subjects, 10 with severe nonproliferative DR (NPDR) and 12 with proliferative DR (PDR), were compared with 44 eyes of 40 healthy control subjects. All eyes were scanned by RTvue FD-OCT. Color disk photographs and cube/volume scans of the optic nerve head were obtained. Doppler OCT scans and accessory imaging data were imported into Doppler OCT of Retinal Circulation grading software to calculate TRBF and vascular parameters (e.g., venous and arterial cross-sectional area). Measurements were compared between cases and controls using independent t-tests.

RESULTS

Mean TRBF was 44.98 ± 9.80 (range: 30.18-64.58) µL/minute for normal eyes, 35.80 ± 10.48 (range: 20.69-49.56) µL/minute for eyes with severe NPDR, and 34.79 ± 10.61 (range: 16.77-48.9) µL/minute for eyes with PDR. Mean TRBF was significantly lower in eyes with severe NPDR (P = 0.01) and PDR (P = 0.003) than in normal eyes.

CONCLUSION

Total retinal blood flow was significantly lower in eyes with severe NPDR and PDR compared with normal eyes. Retinal blood flow determined by Doppler OCT may be a useful parameter for evaluating patients with DR.

Oblique scanning laser microscopy for simultaneously volumetric structural and molecular imaging using only one raster scan

Multi-modal three dimensional (3D) optical imaging combining both structural sensitivity and molecular specificity is highly desirable in biomedical research. In this paper, we present a method termed oblique scanning laser microscopy (OSLM) to combine optical coherence tomography (OCT), for simultaneously volumetric structural and molecular imaging with cellular resolution in all three dimensions. Conventional 3D laser scanning fluorescence microscopy requires repeated optical sectioning to create z-stacks in depth. Here, the use of an obliquely scanning laser eliminates the z-stacking process, then allows highly efficient 3D OCT and fluorescence imaging by using only one raster scan. The current setup provides ~3.6 × 4.2 × 6.5 μm resolution in fluorescence imaging, ~7 × 7 × 3.5 μm in OCT in three dimensions, and the current speed of imaging is up to 100 frames per second (fps) over a volume about 0.8 × 1 × 0.5 mm³. We demonstrate several mechanisms for molecular imaging, including intrinsically expressed GFP fluorescence, autofluorescence from Flavin proteins, and exogenous antibody-conjugated dyes. We also demonstrate potential applications in imaging human intestinal organoids (HIOs), colon mucosa, and retina.

Can OCT Angiography Be Made a Quantitative Blood Measurement Tool?

Optical Coherence Tomography Angiography (OCTA) refers to a powerful class of OCT scanning protocols and algorithms that selectively enhance the imaging of blood vessel lumens, based mainly on the motion and scattering of red blood cells (RBCs). Though OCTA is widely used in clinical and basic science applications for visualization of perfused blood vessels, OCTA is still primarily a qualitative tool. However, more quantitative hemodynamic information would better delineate disease mechanisms, and potentially improve the sensitivity for detecting early stages of disease. Here, we take a broader view of OCTA in the context of microvascular hemodynamics and light scattering. Paying particular attention to the unique challenges presented by capillaries versus larger supplying and draining vessels, we critically assess opportunities and challenges in making OCTA a quantitative tool.

Evaluating ocular blood flow

Studies have shown that vascular impairment plays an important role in the etiology and pathogenesis of various ocular diseases including glaucoma, age-related macular degeneration, diabetic retinopathy, and retinal venous occlusive disease. Thus, qualitative and quantitative assessment of ocular blood flow (BF) is a topic of interest for early disease detection, diagnosis, and management. Owing to the rapid improvement in technology, there are several invasive and noninvasive techniques available for evaluating ocular BF, with each of these techniques having their own limitations and advantages. This article reviews these important techniques, with a particular focus on Doppler Fourier domain optical coherence tomography (OCT) and OCT-angiography.

Quantitative depth-resolved microcirculation imaging with optical coherence tomography angiography (Part Ι): Blood flow velocity imaging

The research goal of the microvascular network imaging with OCT angiography is to achieve depth-resolved blood flow and vessel imaging in vivo in the clinical management of patents. In this review, we review the main phenomena that have been explored in OCT to image the blood flow velocity vector and the vessels of the microcirculation within living tissues. Parameters that limit the accurate measurements of blood flow velocity are then considered. Finally, initial clinical diagnosis applications and future developments of OCT flow images are discussed.

TOWARD QUANTITATIVE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY: Visualizing Blood Flow Speeds in Ocular Pathology Using Variable Interscan Time Analysis

PURPOSE

Currently available optical coherence tomography angiography systems provide information about blood flux but only limited information about blood flow speed. The authors develop a method for mapping the previously proposed variable interscan time analysis (VISTA) algorithm into a color display that encodes relative blood flow speed.

METHODS

Optical coherence tomography angiography was performed with a 1,050 nm, 400 kHz A-scan rate, swept source optical coherence tomography system using a 5 repeated B-scan protocol. Variable interscan time analysis was used to compute the optical coherence tomography angiography signal from B-scan pairs having 1.5 millisecond and 3.0 milliseconds interscan times. The resulting VISTA data were then mapped to a color space for display.

RESULTS

The authors evaluated the VISTA visualization algorithm in normal eyes (n = 2), nonproliferative diabetic retinopathy eyes (n = 6), proliferative diabetic retinopathy eyes (n = 3), geographic atrophy eyes (n = 4), and exudative age-related macular degeneration eyes (n = 2). All eyes showed blood flow speed variations, and all eyes with pathology showed abnormal blood flow speeds compared with controls.

CONCLUSION

The authors developed a novel method for mapping VISTA into a color display, allowing visualization of relative blood flow speeds. The method was found useful, in a small case series, for visualizing blood flow speeds in a variety of ocular diseases and serves as a step toward quantitative optical coherence tomography angiography.

Dermoscopy guided dark-field multi-functional optical coherence tomography

Dermoscopy is a skin surface microscopic technique allowing specular reflection free observation of the skin, and has been used to examine pigmented skin lesions. However, dermoscopy has limitations in providing depth information due to lack of 3D resolution. In order to overcome the limitations, we developed dermoscopy guided multi-functional optical coherence tomography (MF-OCT) providing both high-contrast superficial information and depth-resolved structural, birefringent, and vascular information of the skin simultaneously. Dermoscopy and MF-OCT were combined by using a dichroic mirror, and dark-field configuration was adapted for MF-OCT to reduce specular reflection. After characterization, dermoscopy guided MF-OCT was applied to several human skin lesions such as the scar, port-wine stain (PWS) as well as the normal skin for demonstration. Various features of the scar and PWS were elucidated by both dermoscopy and MF-OCT. Dermoscopy guided MF-OCT may be useful for evaluation and treatment monitoring of skin lesions in clinical applications.

Hematocrit dependence of flow signal in optical coherence tomography angiography

The hematocrit dependence of flow signal (split-spectrum amplitude decorrelation angiography-SSADA decorrelation value) was investigated in this paper. Based on the normalized field temporal correlation function and concentration dependent particle scattering properties, the relationship between hematocrit and flow signal was analytically derived. Experimental verification of the relationship was performed with custom-designed microfluidic chips and human blood with 45%, 40% and 32% hematocrit. It was found that, in large flow channels and blood vessels, the normal hematocrit is near the decorrelation saturation point and therefore a change in hematocrit has little effect on the SSADA decorrelation value (flow signal). However, in narrow channels in the capillary size range, the effective hematocrit (adjusted for the overlap between OCT beam and channel) is in the range of 6.7-9.5% and therefore variation in hematocrit does significantly affect the flow signal.

Evaluating anesthetic protocols for functional blood flow imaging in the rat eye

The purpose of this study is to evaluate the suitability of five different anesthetic protocols (isoflurane, isoflurane–xylazine, pentobarbital, ketamine–xylazine, and ketamine–xylazine–vecuronium) for functional blood flow imaging in the rat eye. Total retinal blood flow was measured at a series of time points using an ultrahigh-speed Doppler OCT system. Additionally, each anesthetic protocol was qualitatively evaluated according to the following criteria: (1) time-stability of blood flow, (2) overall rate of blood flow, (3) ocular immobilization, and (4) simplicity. We observed that different anesthetic protocols produced markedly different blood flows. Different anesthetic protocols also varied with respect to the four evaluated criteria. These findings suggest that the choice of anesthetic protocol should be carefully considered when designing and interpreting functional blood flow studies in the rat eye.

Structural and Functional Evaluations for the Early Detection of Glaucoma

The early detection of glaucoma is imperative in order to preserve functional vision. Structural and functional methods are utilized to detect and monitor glaucomatous damage and the vision loss it causes. The relationship between these detection measures is complex and differs between individuals, especially in early glaucoma. Using both measures together is advised in order to ensure the highest probability of glaucoma detection, and new testing methods are continuously developed with the goals of earlier disease detection and improvement of disease monitoring. The purpose of this review is to explore the relationship between structural and functional glaucoma detection and discuss important technological advances for early glaucoma detection.

Real-time Functional Analysis of Inertial Microfluidic Devices via Spectral Domain Optical Coherence Tomography

We report the application of spectral-domain optical coherence tomography (SD-OCT) technology that enables real-time functional analysis of sorting microparticles and cells in an inertial microfluidic device. We demonstrated high-speed, high-resolution acquisition of cross-sectional images at a frame rate of 350 Hz, with a lateral resolution of 3 μm and an axial resolution of 1 μm within the microfluidic channel filled with water. We analyzed the temporal sequence of cross-sectional SD-OCT images to determine the position and diameter of microspheres in a spiral microfluidic channel under various flow rates. We used microspheres with known diameters to validate the sub-micrometer precision of the particle size analysis based on a scattering model of spherical microparticles. An additional investigation of sorting live HT-29 cells in the spiral microfluidic channel indicated that the distribution of cells within in the microchannel has a close correspondence with the cells’ size distribution. The label-free real-time imaging and analysis of microscale particles in flow offers robustness for practical applications with live cells and allows us to better understand the mechanisms of particle separations in microfluidic sorting systems.

Fourier phase in Fourier-domain optical coherence tomography

Phase of an electromagnetic wave propagating through a sample-of-interest is well understood in the context of quantitative phase imaging in transmission-mode microscopy. In the past decade, Fourier-domain optical coherence tomography has been used to extend quantitative phase imaging to the reflection-mode. Unlike transmission-mode electromagnetic phase, however, the origin and characteristics of reflection-mode Fourier phase are poorly understood, especially in samples with a slowly varying refractive index. In this paper, the general theory of Fourier phase from first principles is presented, and it is shown that Fourier phase is a joint estimate of subresolution offset and mean spatial frequency of the coherence-gated sample refractive index. It is also shown that both spectral-domain phase microscopy and depth-resolved spatial-domain low-coherence quantitative phase microscopy are special cases of this general theory. Analytical expressions are provided for both, and simulations are presented to explain and support the theoretical results. These results are further used to show how Fourier phase allows the estimation of an axial mean spatial frequency profile of the sample, along with depth-resolved characterization of localized optical density change and sample heterogeneity. Finally, a Fourier phase-based explanation of Doppler optical coherence tomography is also provided.

Measuring absolute microvascular blood flow in cortex using visible-light optical coherence tomography

Understanding regulating mechanisms of cerebral blood flow (CBF) is important for clinical diagnosis and biomedical researches. We demonstrate here that phase sensitive Doppler optical coherence tomography is able to measure absolute CBF in mouse visual cortex in vivo when working in the visible-light spectral range. Both temporal and spatial profile of regional CBF variations can be resolved. We further assessed the accuracy of our method by in vitro experiments, which showed great consistency between the measured values and controlled ones. Finally, we enhanced the contrast of blood vessels to generate an angiogram showing great details of mouse cortical microvasculature.

Blood flow velocity vector field reconstruction from dual-beam bidirectional Doppler OCT measurements in retinal veins

In this paper, we demonstrate the possibility to reconstruct the actual blood flow velocity vector field in retinal microvessels from dual-beam bidirectional Doppler optical coherence tomography measurements. First, for a better understanding of measured phase patterns, several flow situations were simulated on the basis of the known dual beam measurement geometry. We were able to extract the vector field parameters that determine the measured phase pattern, allowing for the development of an algorithm to reconstruct the velocity vector field from measured phase data. In a next step, measurements were performed at a straight vessel section and at a venous convergence; the obtained phase data were evaluated by means of the new approach. For the straight vessel section, the reconstructed flow velocity vector field yielded a parabolic flow. For the venous convergence, however, the reconstructed vector field deviated from a parabolic profile, but was in very good accordance with the simulated vector field for the given vessel geometry. The proposed algorithm allows predictions of the velocity vector field. Moreover, the algorithm is also sensitive to directional changes of the flow velocity as small as <1°, thereby offering insight in the flow characteristics of the non-Newtonian fluid blood in microvessels.

Multi-functional angiographic OFDI using frequency-multiplexed dual-beam illumination

Detection of blood flow inside the tissue sample can be achieved by measuring the local change of complex signal over time in angiographic optical coherence tomography (OCT). In conventional angiographic OCT, the transverse displacement of the imaging beam during the time interval between a pair of OCT signal measurements must be significantly reduced to minimize the noise due to the beam scanning-induced phase decorrelation at the expense of the imaging speed. Recent introduction of dual-beam scan method either using polarization encoding or two identical imaging systems in spectral-domain (SD) OCT scheme shows potential for high-sensitivity vasculature imaging without suffering from spurious phase noise caused by the beam scanning-induced spatial decorrelation. In this paper, we present multi-functional angiographic optical frequency domain imaging (OFDI) using frequency-multiplexed dual-beam illumination. This frequency multiplexing scheme, utilizing unique features of OFDI, provides spatially separated dual imaging beams occupying distinct electrical frequency bands that can be demultiplexed in the frequency domain processing. We demonstrate the 3D multi-functional imaging of the normal mouse skin in the dorsal skin fold chamber visualizing distinct layer structures from the intensity imaging, information about mechanical integrity from the polarization-sensitive imaging, and depth-resolved microvasculature from the angiographic imaging that are simultaneously acquired and automatically co-registered.

Measurement of retinal blood flow in normal Chinese-American subjects by Doppler Fourier-domain optical coherence tomography

PURPOSE

To measure total retinal blood flow (TRBF) in normal, healthy Chinese Americans by using semi-automated analysis of Doppler Fourier-domain optical coherence tomography (FD-OCT) scans.

METHODS

Two hundred sixty-six normal, healthy Chinese-American participants (266 eyes) were enrolled from The Chinese American Eye Study. All participants underwent complete ophthalmic examination, including best-corrected visual acuity, indirect ophthalmoscopy, and Doppler FD-OCT imaging, using the circumpapillary double circular scan protocol. Total retinal blood flow and other vascular parameters (e.g., venous and arterial cross-sectional area and their velocities) were calculated by using Doppler OCT of Retinal Circulation software. Associations between TRBF and other clinical parameters were assessed by using bivariate correlations and linear regression.

RESULTS

The mean age of study participants was 57.40 ± 5.60 (range, 50-82) years. The mean TRBF was 49.34 ± 10.08 (range, 27.17-78.08, 95% confidence interval: 25.98-69.10) μL/min. The mean venous area was 0.0548 (±0.0084) mm(2). Superior retinal hemispheric blood flow (25.50 ± 6.62 μL/min) was slightly greater than inferior retinal hemispheric blood flow (23.84 ± 7.19 μL/min, P = 0.008). The mean flow velocity was 15.16 ± 3.12 mm/s. There was a weak but significant negative correlation between TRBF and age (r = -0.15, P = 0.012). No significant correlation was found between TRBF and axial length (r = 0.11, P = 0.08). Retinal blood flow was not significantly correlated with any other clinical parameters, including body mass index, systolic blood pressure, diastolic blood pressure, and intraocular pressure.

CONCLUSIONS

Normal Doppler OCT-derived total retinal blood values in a Chinese-American population showed considerable variability, some of which was explained by age. These observations should help design future studies evaluating TRBF in populations with eye disease.

Optical coherence Doppler tomography for quantitative cerebral blood flow imaging

Optical coherence Doppler tomography (ODT) is a promising neurotechnique that permits 3D imaging of the cerebral blood flow (CBF) network; however, quantitative CBF velocity (CBFv) imaging remains challenging. Here we present a simple phase summation method to enhance slow capillary flow detection sensitivity without sacrificing dynamic range for fast flow and vessel tracking to improve angle correction for absolute CBFv quantification. Flow phantom validation indicated that the CBFv quantification accuracy increased from 15% to 91% and the coefficient of variation (CV) decreased 9.3-fold; in vivo mouse brain validation showed that CV decreased 4.4-/10.8- fold for venular/arteriolar flows. ODT was able to identify cocaine-elicited microischemia and quantify CBFv disruption in branch vessels and capillaries that otherwise would have not been possible.

Measurement of the total retinal blood flow using dual beam Fourier-domain Doppler optical coherence tomography with orthogonal detection planes

We present a system capable of measuring the total retinal blood flow using a combination of dual beam Fourier-domain Doppler optical coherence tomography with orthogonal detection planes and a fundus camera-based retinal vessel analyzer. Our results show a high degree of conformity of venous and arterial flows, which corroborates the validity of the measurements. In accordance with Murray's law, the log-log regression coefficient between vessel diameter and blood flow was found to be ~3. The blood's velocity scaled linearly with the vessel diameter at higher diameters (> 60 µm), but showed a clear divergence from the linear dependence at lower diameters. Good agreement with literature data and the large range and high measurement sensitivity point to a high potential for further investigations.

Measurement of retinal blood flow in the rat by combining Doppler Fourier-domain optical coherence tomography with fundus imaging

A wide variety of ocular diseases are associated with abnormalities in ocular circulation. As such, there is considerable interest in techniques for quantifying retinal blood flow, among which Doppler optical coherence tomography (OCT) may be the most promising. We present an approach to measure retinal blood flow in the rat using a new optical system that combines the measurement of blood flow velocities via Doppler Fourier-domain optical coherence tomography and the measurement of vessel diameters using a fundus camera-based technique. Relying on fundus images for extraction of retinal vessel diameters instead of OCT images improves the reliability of the technique. The system was operated with an 841-nm superluminescent diode and a charge-coupled device camera that could be operated at a line rate of 20 kHz. We show that the system is capable of quantifying the response of 100% oxygen breathing on the retinal blood flow. In six rats, we observed a decrease in retinal vessel diameters of 13.2% and a decrease in retinal blood velocity of 42.6%, leading to a decrease in retinal blood flow of 56.7%. Furthermore, in four rats, the response of retinal blood flow during stimulation with diffuse flicker light was assessed. Retinal vessel diameter and blood velocity increased by 3.4% and 28.1%, respectively, leading to a relative increase in blood flow of 36.2%. The presented technique shows much promise to quantify early changes in retinal blood flow during provocation with various stimuli in rodent models of ocular diseases in rats.

Absolute retinal blood flow measurement with a dual-beam Doppler optical coherence tomography

PURPOSE

To test the capability of a novel dual-beam Doppler optical coherence tomography (OCT) technique for simultaneous in vivo measurement of the Doppler angle and, thus, the absolute retinal blood velocity and the retinal flow rate, without the influence of motion artifacts.

METHODS

A novel dual-beam Doppler spectral domain OCT (SD-OCT) was developed. The two probing beams are separated with a controllable distance along an arbitrary direction, both of which are controlled by two independent 2D optical scanners. Two sets of optical Doppler tomography (ODT) images are acquired simultaneously. The Doppler angle of each blood vessel segment is calculated from the relative coordinates of the centers of the blood vessel in the two corresponding ODT images. The absolute blood flow velocity and the volumetric blood flow rate can then be calculated. To measure the total retinal blood flow, we used a circular scan pattern centered at the optic disc to obtain two sets of concentric OCT/ODT images simultaneously.

RESULTS

We imaged two normal human subjects at ages of 48 and 34 years. The total retinal blood flow rates of the two human subjects were calculated to be 47.01 μL/min (older subject) and 51.37 μL/min (younger subject), respectively. Results showed that the performance of this imaging system is immune to eye movement, since the two sets of ODT images were acquired simultaneously.

CONCLUSIONS

The dual-beam OCT/ODT system is successful in measuring the absolute retinal blood velocity and the volumetric flow rate. The advantage of the technique is that the two sets of ODT images used for the calculation are acquired simultaneously, which eliminates the influence of eye motion and ensures the accuracy of the calculated hemodynamic parameters.

Phase-variance optical coherence tomography: a technique for noninvasive angiography

PURPOSE

Phase-variance optical coherence tomography (PV-OCT) provides volumetric imaging of the retinal vasculature without the need for intravenous injection of a fluorophore. We compare images from PV-OCT and fluorescein angiography (FA) for normal individuals and patients with age-related macular degeneration (AMD) and diabetic retinopathy.

DESIGN

This is an evaluation of a diagnostic technology.

PARTICIPANTS

Four patients underwent comparative retinovascular imaging using FA and PV-OCT. Imaging was performed on 1 normal individual, 1 patient with dry AMD, 1 patient with exudative AMD, and 1 patient with nonproliferative diabetic retinopathy.

METHODS

Fluorescein angiography imaging was performed using a Topcon Corp (Tokyo, Japan) (TRC-50IX) camera with a resolution of 1280 (H) × 1024 (V) pixels. The PV-OCT images were generated by software data processing of the entire cross-sectional image from consecutively acquired B-scans. Bulk axial motion was calculated and corrected for each transverse location, reducing the phase noise introduced from eye motion. Phase variance was calculated through the variance of the motion-corrected phase changes acquired within multiple B-scans at the same position. Repeating these calculations over the entire volumetric scan produced a 3-dimensional PV-OCT representation of the vasculature.

MAIN OUTCOME MEASURES

Feasibility of rendering retinal and choroidal microvasculature using PV-OCT was compared qualitatively with FA, the current gold standard for retinovascular imaging.

RESULTS

Phase-variance OCT noninvasively rendered a 2-dimensional depth color-coded vasculature map of the retinal and choroidal vasculature. The choriocapillaris was imaged with better resolution of microvascular detail using PV-OCT. Areas of geographic atrophy and choroidal neovascularization imaged by FA were depicted by PV-OCT. Regions of capillary nonperfusion from diabetic retinopathy were shown by both imaging techniques; there was not complete correspondence between microaneurysms shown on FA and PV-OCT images.

CONCLUSIONS

Phase-variance OCT yields high-resolution imaging of the retinal and choroidal microvasculature that compares favorably with FA.

Mesoscopic fluorescence molecular tomography of reporter genes in bioprinted thick tissue

Three-dimensional imaging of thick tissue constructs is one of the main challenges in the field of tissue engineering and regenerative medicine. Optical methods are the most promising as they offer noninvasive, fast, and inexpensive solutions. Herein, we report the use of mesoscopic fluorescence molecular tomography (MFMT) to image function and structure of thick bioprinted tissue hosted in a 3-mm-thick bioreactor. Collagen-based tissue assembled in this study contains two vascular channels formed by green fluorescent protein- and mCherry-expressing cells. Transfected live cell imaging enables us to image function, whereas Flash Red fluorescent bead perfusion into the vascular channel allows us to image structure. The MFMT optical reconstructions are benchmarked with classical microscopy techniques. MFMT and wide-field fluorescence microscopy data match within 92% in area and 84% in location, validating the accuracy of MFMT reconstructions. Our results demonstrate that MFMT is a well-suited imaging modality for fast, longitudinal, functional imaging of thick, and turbid tissue engineering constructs.

Advanced multi-contrast Jones matrix optical coherence tomography for Doppler and polarization sensitive imaging

An advanced version of Jones matrix optical coherence tomography (JMT) is demonstrated for Doppler and polarization sensitive imaging of the posterior eye. JMT is capable of providing localized flow tomography by Doppler detection and investigating the birefringence property of tissue through a three-dimensional (3-D) Jones matrix measurement. Owing to an incident polarization multiplexing scheme based on passive optical components, this system is stable, safe in a clinical environment, and cost effective. Since the properties of this version of JMT provide intrinsic compensation for system imperfection, the system is easy to calibrate. Compared with the previous version of JMT, this advanced JMT achieves a sufficiently long depth measurement range for clinical cases of posterior eye disease. Furthermore, a fine spectral shift compensation method based on the cross-correlation of calibration signals was devised for stabilizing the phase of OCT, which enables a high sensitivity Doppler OCT measurement. In addition, a new theory of JMT which integrates the Jones matrix measurement, Doppler measurement, and scattering measurement is presented. This theory enables a sensitivity-enhanced scattering OCT and high-sensitivity Doppler OCT. These new features enable the application of this system to clinical cases. A healthy subject and a geographic atrophy patient were measured in vivo, and simultaneous imaging of choroidal vasculature and birefringence structures are demonstrated.

Quantitative lateral and axial flow imaging with optical coherence microscopy and tomography

Optical coherence tomography (OCT) and optical coherence microscopy (OCM) allow the acquisition of quantitative three-dimensional axial flow by estimating the Doppler shift caused by moving scatterers. Measuring the velocity of red blood cells is currently the principal application of these methods. In many biological tissues, blood flow is often perpendicular to the optical axis, creating the need for a quantitative measurement of lateral flow. Previous work has shown that lateral flow can be measured from the Doppler bandwidth, albeit only for simplified optical systems. In this work, we present a generalized model to analyze the influence of relevant OCT/OCM system parameters such as light source spectrum, numerical aperture and beam geometry on the Doppler spectrum. Our analysis results in a general framework relating the mean and variance of the Doppler frequency to the axial and lateral flow velocity components. Based on this model, we present an optimized acquisition protocol and algorithm to reconstruct quantitative measurements of lateral and axial flow from the Doppler spectrum for any given OCT/OCM system. To validate this approach, Doppler spectrum analysis is employed to quantitatively measure flow in a capillary with both extended focus OCM and OCT.

Optical coherence tomography--current and future applications

PURPOSE OF REVIEW

Optical coherence tomography (OCT) has revolutionized the clinical practice of ophthalmology. It is a noninvasive imaging technique that provides high-resolution, cross-sectional images of the retina, retinal nerve fiber layer and the optic nerve head. This review discusses the present applications of the commercially available spectral-domain OCT (SD-OCT) systems in the diagnosis and management of retinal diseases, with particular emphasis on choroidal imaging. Future directions of OCT technology and their potential clinical uses are discussed.

RECENT FINDINGS

Analysis of the choroidal thickness in healthy eyes and disease states such as age-related macular degeneration, central serous chorioretinopathy, diabetic retinopathy and inherited retinal dystrophies has been successfully achieved using SD-OCT devices with software improvements. Future OCT innovations such as longer-wavelength OCT systems including the swept-source technology, along with Doppler OCT and en-face imaging, may improve the detection of subtle microstructural changes in chorioretinal diseases by improving imaging of the choroid.

SUMMARY

Advances in OCT technology provide for better understanding of pathogenesis, improved monitoring of progression and assistance in quantifying response to treatment modalities in diseases of the posterior segment of the eye. Further improvements in both hardware and software technologies should further advance the clinician's ability to assess and manage chorioretinal diseases.

Response of retinal blood flow to systemic hyperoxia as measured with dual-beam bidirectional Doppler Fourier-domain optical coherence tomography

PURPOSE

There is a long-standing interest in the study of retinal blood flow in humans. In the recent years techniques have been established to measure retinal perfusion based on optical coherence tomography (OCT). In the present study we used a technique called dual-beam bidirectional Doppler Fourier-domain optical coherence tomography (FD-OCT) to characterize the effects of 100% oxygen breathing on retinal blood flow. These data were compared to data obtained with a laser Doppler velocimeter (LDV).

METHODS

10 healthy subjects were studied on 2 study days. On one study day the effect of 100% oxygen breathing on retinal blood velocities was studied using dual-beam bidirectional Doppler FD-OCT. On the second study day the effect of 100% oxygen breathing on retinal blood velocities was assessed by laser Doppler velocimetry (LDV). Retinal vessel diameters were measured on both study days using a commercially available Dynamic Vessel Analyzer. Retinal blood flow was calculated based on retinal vessel diameters and red blood cell velocity.

RESULTS

As expected, breathing of pure oxygen induced a pronounced reduction in retinal vessel diameters, retinal blood velocities and retinal blood flow on both study days (p<0.001). Blood velocity data correlated well between the two methods applied under both baseline as well as under hyperoxic conditions (r = 0.98 and r = 0.75, respectively). Data as obtained with OCT were, however, slightly higher.

CONCLUSION

A good correlation was found between red blood cell velocity as measured with dual-beam bidirectional Doppler FD-OCT and red blood cell velocity assessed by the laser Doppler method. Dual-beam bidirectional Doppler FD-OCT is a promising approach for studying retinal blood velocities in vivo.

Choroidal imaging using spectral-domain optical coherence tomography

BACKGROUND

A structurally and functionally normal choroidal vasculature is essential for retinal function. Therefore, a precise clinical understanding of choroidal morphology should be important for understanding many retinal and choroidal diseases.

METHODS

PUBMED (http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed) was used for most of the literature search for this article. The criterion for inclusion of an article in the references for this review was that it included materials about both the clinical and the basic properties of choroidal imaging using spectral-domain optical coherence tomography.

RESULTS

Recent reports show successful examination and accurate measurement of choroidal thickness in normal and pathologic states using spectral-domain optical coherence tomography systems. This review focuses on the principles of the new technology that make choroidal imaging using optical coherence tomography possible and on the changes that subsequently have been documented to occur in the choroid in various diseases. Additionally, it outlines future directions in choroidal imaging.

CONCLUSION

Optical coherence tomography is now proven to be an effective noninvasive tool to evaluate the choroid and to detect choroidal changes in pathologic states. Additionally, choroidal evaluation using optical coherence tomography can be used as a parameter for diagnosis and follow-up.

Effect of NO synthase inhibition on retinal vessel reaction to isometric exercise in healthy humans

PURPOSE

It has been shown that retinal blood flow is autoregulated, meaning that flow is independent of perfusion pressure within a certain range. We tested the hypothesis that nitric oxide (NO) synthase inhibition alters the response of retinal arterial and venous vessels during isometric exercise.

METHODS

In this study, nine healthy subjects were included. Each subject received the NO synthase inhibitor Ng-monomethyl-l-Arginine (l-NMMA, the α-receptor agonist phenylephrine or placebo intravenously on three study days. Retinal vessel diameter was assessed with the retinal vessel analyser (RVA), at baseline and during a squatting period of 6-7 min in absence or presence of l-NMMA, phenylephrine or placebo.

RESULTS

Mean arterial pressure (MAP) and pulse rate (PR) increased significantly during all pretreatment squatting periods (p < 0.001) Retinal venous and arterial diameters showed a continuous decrease during squatting (p < 0.001). Phenylephrine increased MAP and PR but did not alter the retinal vessel diameter response to squatting. Administration of l-NMMA lead to a significant decrease in venous diameter before isometric exercise (p = 0.004). In addition, the retinal venous diameter response during administration of the NO synthase inhibitor was less pronounced than during phenylephrine or placebo (p < 0.001).

CONCLUSION

Our study confirms that NO plays an important role in the control of retinal vascular tone at rest. In addition, the present data indicate a role of NO in retinal autoregulation, because the response of retinal venous diameters was altered after NO synthase inhibition. The nature of involvement, however, appears to be complex and requires further studies.

Measurement of pulsatile total blood flow in the human and rat retina with ultrahigh speed spectral/Fourier domain OCT

We present an approach to measure pulsatile total retinal arterial blood flow in humans and rats using ultrahigh speed Doppler OCT. The axial blood velocity is measured in an en face plane by raster scanning and the flow is calculated by integrating over the vessel area, without the need to measure the Doppler angle. By measuring flow at the central retinal artery, the scan area can be very small. Combined with ultrahigh speed, this approach enables high volume acquisition rates necessary for pulsatile total flow measurement without modification in the OCT system optics. A spectral domain OCT system at 840nm with an axial scan rate of 244kHz was used for this study. At 244kHz the nominal axial velocity range that could be measured without phase wrapping was ±37.7mm/s. By repeatedly scanning a small area centered at the central retinal artery with high volume acquisition rates, pulsatile flow characteristics, such as systolic, diastolic, and mean total flow values, were measured. Real-time Doppler C-scan preview is proposed as a guidance tool to enable quick and easy alignment necessary for large scale studies. Data processing for flow calculation can be entirely automatic using this approach because of the simple and robust algorithm. Due to the rapid volume acquisition rate and the fact that the measurement is independent of Doppler angle, this approach is inherently less sensitive to involuntary eye motion. This method should be useful for investigation of small animal models of ocular diseases as well as total blood flow measurements in human patients in the clinic.

The role of spectral-domain OCT in the diagnosis and management of neovascular age-related macular degeneration

Spectral-domain optical coherence tomography (SD-OCT) has emerged as the ancillary examination of choice to assist the diagnosis and management of neovascular age-related macular degeneration (AMD). SD-OCT provides more detailed images of intraretinal, subretinal, and subretinal pigment epithelium fluid when compared to time-domain technology, leading to higher and earlier detection rates of neovascular AMD activity. Improvements in image analysis and acquisition speed make it important for decision-making in the diagnosis and treatment of this disease. However, this new technology needs to be validated for its role in the improvement of visual outcomes in the context of anti-angiogenic therapy.

High-penetration swept source Doppler optical coherence angiography by fully numerical phase stabilization

A high-penetration swept-source optical coherence tomography (HP-SS-OCT) system based on a 1-μm short cavity laser is developed. Doppler OCT processing is applied, along with a custom-made numerical phase stabilization algorithm; this process does not require additional calibration hardware. Thus, our phase stabilization method is simple and can be employed in a variety of SS-OCT systems. The bidirectional blood flow and vasculature in the deep choroid was successfully imaged via two Doppler modes that use different time intervals for Doppler processing. En face projection image of squared power of Doppler shift is compared to ICGA, and the utility of our method is verified.

Flicker-induced changes in retinal blood flow assessed by Doppler optical coherence tomography

We used Doppler Fourier-domain optical coherence tomography (OCT) to investigate flicker-induced changes of total retinal blood flow. Total retinal blood flow was measured by summing flows in veins imaged in double-circular scans around the optic disc. In 3 healthy volunteers, total retinal blood flow was measured before and 10-15 seconds after 30 seconds of flicker stimulation. The average blood flow increased 22.2% (p = 0.002). The total venous and arterial vessel cross-sectional area increased 11.3% (p < 0.001) and +2.7% (p = 0.28) respectively. The average venous and arterial flow velocity were calculated indirectly by dividing total retinal blood flow by total venous and arterial cross-sectional areas. They also increased by 8.8% (p = 0.046) and 18.3% (p = 0.004), respectively. These results show that human retinal blood flow increases after visible flicker stimulation, and this could be measured with OCT.

Flicker-induced changes in retinal blood flow assessed by Doppler optical coherence tomography

We used Doppler Fourier-domain optical coherence tomography (OCT) to investigate flicker-induced changes of total retinal blood flow. Total retinal blood flow was measured by summing flows in veins imaged in double-circular scans around the optic disc. In 3 healthy volunteers, total retinal blood flow was measured before and 10-15 seconds after 30 seconds of flicker stimulation. The average blood flow increased 22.2% (p = 0.002). The total venous and arterial vessel cross-sectional area increased 11.3% (p < 0.001) and +2.7% (p = 0.28) respectively. The average venous and arterial flow velocity were calculated indirectly by dividing total retinal blood flow by total venous and arterial cross-sectional areas. They also increased by 8.8% (p = 0.046) and 18.3% (p = 0.004), respectively. These results show that human retinal blood flow increases after visible flicker stimulation, and this could be measured with OCT.