Imaging ex vivo healthy and pathological human brain tissue with ultra-high-resolution optical coherence tomography

The ability of ultra-high-resolution optical coherence tomography (UHR OCT) to discriminate between healthy and pathological human brain tissue is examined by imaging ex vivo tissue morphology of various brain biopsies. Micrometer-scale OCT resolution (0.9x2 microm, axialxlateral) is achieved in biological tissue by interfacing a state-of-the-art Ti:Al2O3 laser (lambda(c)=800 nm, delta lambda=260 nm, and P(out)=120 mW exfiber) to a free-space OCT system utilizing dynamic focusing. UHR OCT images are acquired from both healthy brain tissue and various types of brain tumors including fibrous, athypical, and transitional meningioma and ganglioglioma. A comparison of the tomograms with standard hematoxylin and eosin (H&E) stained histological sections of the imaged biopsies demonstrates the ability of UHR OCT to visualize and identify morphological features such as microcalcifications (>20 microm), enlarged nuclei of tumor cells (approximately 8 to 15 microm), small cysts, and blood vessels, which are characteristic of neuropathologies and normally absent in healthy brain tissue.

Adaptive-optics ultrahigh-resolution optical coherence tomography

Merging of ultrahigh-resolution optical coherence tomography (UHR OCT) and adaptive optics (AO), resulting in high axial (3 microm) and improved transverse resolution (5-10 microm) is demonstrated for the first time to our knowledge in in vivo retinal imaging. A compact (300 mm x 300 mm) closed-loop AO system, based on a real-time Hartmann-Shack wave-front sensor operating at 30 Hz and a 37-actuator membrane deformable mirror, is interfaced to an UHR OCT system, based on a commercial OCT instrument, employing a compact Ti:sapphire laser with 130-nm bandwidth. Closed-loop correction of both ocular and system aberrations results in a residual uncorrected wave-front rms of 0.1 microm for a 3.68-mm pupil diameter. When this level of correction is achieved, OCT images are obtained under a static mirror configuration. By use of AO, an improvement of the transverse resolution of two to three times, compared with UHR OCT systems used so far, is obtained. A significant signal-to-noise ratio improvement of up to 9 dB in corrected compared with uncorrected OCT tomograms is also achieved.

Full range complex spectral optical coherence tomography technique in eye imaging

We demonstrate a new implementation of complex spectral optical coherence tomography (OCT) in biomedical imaging. By reconstruction of both amplitude and phase we are able to use the negative and positive optical path differences to get images of objects of considerable thickness. An accompanying reduction of coherent noise improves the quality of the images. The property of the complex spectral OCT that permits the measurement range to be increased and permits the simultaneous use of phase and amplitude in spectral systems was not described previously. To show the potential of this technique we measured an anterior chamber of a porcine eye in vitro.

Submicrometer axial resolution optical coherence tomography

Optical coherence tomography (OCT) with unprecedented submicrometer axial resolution achieved by use of a photonic crystal fiber in combination with a compact sub-10-fs Ti:sapphire laser (Femtolasers Produktions) is demonstrated for what the authors believe is the first time. The emission spectrum ranges from 550 to 950 nm (lambda(c)=725 nm , P(out)=27 mW) , resulting in a free-space axial OCT resolution of ~0.75 mum , corresponding to ~0.5 mum in biological tissue. Submicrometer-resolution OCT is demonstrated in vitro on human colorectal adenocarcinoma cells HT-29. This novel light source has great potential for development of spectroscopic OCT because its spectrum covers the absorption bands of several biological chromophores.

Differential phase measurements in low-coherence interferometry without 2pi ambiguity

Quantitative phase measurements by low-coherence interferometry and optical coherence tomography are restricted by the well-known 2pi ambiguity to path-length differences smaller than lambda/2 . We present a method that overcomes this ambiguity. Introducing a slight dispersion imbalance between reference and sample arms of the interferometer causes the short and long wavelengths of the source spectrum to separate within the interferometric signal. This causes the phase slope to vary within the signal. The phase-difference function between two adjacent sample beam components is calculated by subtraction of their phase functions obtained from phase-sensitive interferometric signal recording. Because of the dispersive effect, the phase difference varies across the interferometric signal. The slope of that phase difference is proportional to the optical path difference, without 2pi ambiguity.

Improved prediction of intraocular lens power using partial coherence interferometry

PURPOSE

To evaluate the feasibility of using a new optical biometry technique, dual-beam partial coherence interferometry (PCI), to improve intraocular lens (IOL) power prediction in cataract surgery.

SETTING

Department of Ophthalmology, Vienna General Hospital, and Institute of Medical Physics, University of Vienna, Vienna, Austria.

METHODS

Preoperative axial length (AL) data obtained with PCI biometry and applanation ultrasound (US) biometry in 77 eyes of 51 patients was applied to 4 commonly used IOL power formulas. The refractive outcome and the mean absolute error (MAE) were calculated for each formula using both biometry methods. A linear multiple-regression model based on preoperative PCI biometry data was derived to predict the postoperative anterior chamber depth (ACD). The predictive power of this regression model was assessed by adding the predicted ACD to the SRK/T formula. Predicted residuals were calculated to evaluate the feasibility and stability of this modified IOL power formula.

RESULTS

Using PCI instead of US biometry significantly improved the refractive outcome with all 4 IOL power formulas. The Holladay I and SRK/T formulas yielded an MAE of 0.44 diopter (D) using PCI AL data and 0.56 D and 0.57 D, respectively, using US biometry data. The SRK/T formula combined with the PCI regression model for postoperative ACD prediction performed slightly better (MAE 0.42 D) than the conventional SRK/T formula alone. Predicted residuals revealed an MAE of 0.46 D, proving the predictive performance of the new formula.

CONCLUSIONS

Partial coherence interferometry biometry applied to several widely used IOL power formulas yielded significantly better IOL power prediction and therefore refractive outcome in cataract surgery than US biometry. Further improvement can be achieved by applying PCI to a modified SRK/T formula that predicts the postoperative ACD using PCI biometry data.

Quantitative differential phase measurement and imaging in transparent and turbid media by optical coherence tomography

Differential phase-contrast optical coherence tomography allows one to measure the path-length differences of two transversally separated beams in the nanometer range. We calculate these path-length differences from the phase functions of the interferometric signals. Pure phase objects consisting of chromium layers containing steps of approximately 100-200-nm height were imaged. Phase differences can be measured with a precision of +/-2 degrees , corresponding to a path-difference resolution of 2-3 nm. To investigate the influence of scattering, we imaged the phase objects through scattering layers with increasing scattering coefficients. The limit of phase imaging through these layers was at approximately 8-9 mean free path lengths thick (single pass).

Spectral measurement of absorption by spectroscopic frequency-domain optical coherence tomography

A new method of measurement that essentially combines Fourier-domain optical coherence tomography with spectroscopy is introduced. By use of a windowed Fourier transform it is possible to obtain, in addition to the object structure, spectroscopic information such as the absorption properties of materials. The feasibility of this new method for performing depth-resolved spectroscopy is demonstrated with a glass filter plate. The results are compared with theoretically calculated spectra by use of the well-known spectral characteristics of the light source and the filter plate.

Resolution-improved dual-beam and standard optical coherence tomography: a comparison

BACKGROUND

The purpose of the study was to demonstrate the improved axial resolution and longitudinal stability of dual-beam optical coherence tomography (OCT) in comparison to conventional OCT setups used in commercially available OCT instruments.

METHODS

The conventional OCT technique is based on an interferometric setup that is rather sensitive to axial eye motions. We have developed a special dual-beam OCT technique which eliminates the influence of axial eye motions. This is achieved by using the anterior corneal surface as the reference surface for the interferometric ranging. To improve the signal quality, the different wavefront curvatures of beams reflected at cornea and retina are matched by a diffractive optical element. To improve the axial resolution, a broadband synthesized light source with an effective bandwidth of 50 nm is used, and the group dispersion of the ocular media is compensated. Tomographic images were recorded in the fovea and the optic nerve head of healthy volunteers. For comparison purposes, approximately the same locations in the same eyes were imaged by a commercially available OCT instrument.

RESULTS

Compared to the standard OCT technique, the dual-beam OCT images show considerably improved axial resolution. Especially in tomograms recorded at the fovea, dual-beam OCT resolves microstructural details that are not visible in the standard OCT images. Furthermore, the axial stability of dual-beam OCT enables the recording of exact geometrical contours of fundus layers.

CONCLUSIONS

Dual-beam OCT is able to provide structural information on the ocular fundus that is not obtained with standard OCT. The long recording times of our instrument limit the transverse resolution to 100-150 microm at present.

Polarization-sensitive optical coherence tomography of dental structures

Optical coherence tomography (OCT) has been developed during the last 10 years as a new noninvasive imaging tool and has been applied to diagnose different ocular and skin diseases. This technique has been modified for cross-sectional imaging of dental structures. In this first preliminary study the technique was applied to obtain tomographic images of extracted sound and decayed human teeth in order to evaluate its possible diagnostic potential for dental applications. Classical OCT images based on reflectivity measurements and phase retardation images using polarization-sensitive OCT were recorded. It was demonstrated that polarization-sensitive OCT can provide additional information which is probably related to the mineralization status and/or the scattering properties of the dental material. One of the attractive features of OCT is that it uses near-infrared light instead of ionizing radiation. Furthermore, high transversal and depth resolution on the order of 10 microm can be obtained. Present limitations, e.g. the limited penetration depth, and possible solutions are discussed.

Changes in intraocular lens position after neodymium: YAG capsulotomy

PURPOSE

To quantify changes in intraocular lens (IOL) position caused by neodymium: YAG (Nd:YAG) capsulotomy with 3 IOL styles.

SETTING

Department of Ophthalmology, University of Vienna, Austria.

METHODS

In a prospective study, anterior chamber depth (ACD) was measured by dualbeam partial coherence interferometry (PCI) in 32 pseudophakic eyes of 32 patients with posterior capsule opacification before and immediately after planned capsulotomy under mydriasis. Patients were divided into 3 groups with the following IOL styles: 1-piece poly(methyl methacrylate) (PMMA), 3-piece foldable, and plate haptic.

RESULTS

The capsulotomy induced a backward IOL movement in all 32 eyes (mean 25 microns; range 9 to 55 microns). It was more pronounced in eyes with plate-haptic IOLs than in those with the other styles. Precision of ACD measurement by PCI was 4 microns. Changes in ACD correlated significantly with capsulotomy size but not with preoperative lens-capsule distance.

CONCLUSION

Capsulotomy caused a backward movement of the IOL, which was more pronounced with plate-haptic IOLs than with 1-piece PMMA and 3-piece foldable IOLs. Since the magnitude of IOL movement in this study population was small, a hyperopic shift in refraction after capsulotomy will usually be small and not clinically relevant.

Differential phase contrast in optical coherence tomography

We report on a modification of optical coherence tomography (OCT) that allows one to measure small phase differences between beams traversing adjacent areas of a specimen. The sample beam of a polarization-sensitive low-coherence interferometer is split by a Wollaston prism into two components that traverse the object along closely spaced paths. After reflection at the various sample surfaces, the beams are recombined at the Wollaston prism. Any phase difference encountered between the two beams is converted into a change of polarization state of the recombined beam. This change is measured, and the resulting signals are converted to differential phase-contrast OCT images. The first images obtained from simple test objects allowed us to determine path-difference gradients with a resolution of the order of 5 x 10(-5) .

Dispersion effects in partial coherence interferometry: implications for intraocular ranging

In nondispersive media, the minimum distance that can be resolved by partial coherence interferometry (PCI) and optical coherence tomography (OCT) is inversely proportional to the source spectral bandwidth. Dispersion tends to increase the signal width and to degrade the resolution. We analyze the situation for PCI ranging and OCT imaging of ocular structures. It can be shown that for each ocular segment an optimum source bandwidth yielding optimum resolution exists. If the resolution is to be improved beyond this point, the group dispersion of the ocular media has to be compensated. With the use of a dispersion compensating element, and employing a broadband superluminescent diode, we demonstrate a resolution of 5 μm in the retina of both a model eye and a human eye in vivo. This is an improvement by a factor of 2-3 as compared to currently used instruments. © 1999 Society of Photo-Optical Instrumentation Engineers.

Partial coherence interferometry: a novel approach to biometry in cataract surgery

PURPOSE

To compare biometry performed by an enhanced version of dual beam partial coherence interferometry and applanation ultrasound in a prospective study of 85 cataract eyes to improve refractive outcome of cataract surgery due to a more accurate calculation of intraocular lens power.

METHODS

The SRK II formula using ultrasound biometry data was employed. Three months after surgery, partial coherence interferometry biometry was repeated and refractive outcome was determined. Preoperative partial coherence interferometry biometry data were used to determine the refractive power of the intraocular lenses retrospectively and to calculate the possible refractive outcome.

RESULTS

Precision of partial coherence interferometry biometry was more than 10 times better than that of ultrasound. Therefore, the possible mean absolute error for postoperative refraction achieved with partial coherence interferometry biometry was 0.49 diopters (compared with 0.67 diopters with ultrasound biometry), resulting in an improvement of 27%. Axial eye length measured with the two techniques differed by a mean of 460 microm. The difference in lens thickness measured with partial coherence interferometry and ultrasound significantly correlated with cataract grade. A mean shortening of 120 microm of axial eye length following cataract surgery was also detected by partial coherence interferometry.

CONCLUSIONS

The enhanced version of partial coherence interferometry offers biometry with unprecedented precision (<10 microm) and resolution (approximately 12 microm), therefore improving the refractive outcome in cataract surgery. This noninvasive technique provides a high degree of comfort for the patient, with no need for local anesthesia or pupil dilation and minimized risk of corneal infection.

Eye elongation during accommodation in humans: differences between emmetropes and myopes

PURPOSE

The pathophysiology and pathogenesis of myopia are still a matter of controversy. Exaggerated longitudinal eye growth is assumed to play an important role in the development of myopia. A significant correlation between refraction and amount of near-work has been reported. However, current knowledge of changes of axial eye length with accommodation is limited because clinical ultrasound biometry does not provide the precision and resolution required to thoroughly investigate these phenomena.

METHODS

Partial coherence interferometry (PCI), a noninvasive biometric technique, uses laser light with short coherence length in combination with interferometry to achieve precision in the micrometer to submicrometer range and resolution of 10 microm. In the present study this technique was used to investigate axial eye length changes in 11 emmetropic and 12 myopic eyes during monocular fixation at the far and near point. In 7 subjects, the contralateral eye has also been measured to investigate interocular differences in eye elongation.

RESULTS

All investigated eyes elongated during accommodation. This elongation was more pronounced in emmetropes than in myopes (P < 0.001). Mean accommodation-induced eye elongations of 12.7 microm (range, 8.6-19.2 microm) and 5.2 microm (range, 2.1-9.5 microm), corresponding to a dioptric change of approximately -0.036 D and -0.015 D, were obtained for emmetropes and myopes. No significant difference in accommodative amplitudes between groups (5.1 +/- 1.2 D [range, 3.8-7.1 D] versus 4.1 +/- 2.0 D [range, 1.0-7.1 D]; P = 0.14) was detected. No significant interocular difference in accommodation-induced eye elongation was revealed (P = 0.86). Also, a mean backward movement of the posterior lens pole of 38 microm (range, 9-107 microm) was observed in both study groups.

CONCLUSIONS

The detected eye elongation can be explained by the accommodation-induced contraction of the ciliary muscle, which results in forward and inward pulling of the choroid, thus decreasing the circumference of the sclera, and leads to an elongation of the axial eye length. Finally, it was demonstrated that PCI, in contrast to clinical ultrasound, is capable of characterizing eye length changes during accommodation in humans.

Accurate determination of effective lens position and lens-capsule distance with 4 intraocular lenses

PURPOSE

To measure effective lens position (ELP) of 4 intraocular lenses (IOLs) using high precision and high resolution dual-beam partial coherence interferometry (PCI) and to assess the tendency of these IOLs to produce a lens-capsule distance (LCD), a possible risk factor for posterior capsule opacification.

SETTING

Department of Ophthalmology, Vienna General Hospital; Institute of Medical Physics, University of Vienna, Austria.

METHODS

In a retrospective study, PCI was used to measure ELP and LCD in 139 pseudophakic eyes of 110 patients with 4 IOLs: acrylic 3-piece IOL (AcrySof MA60BM); silicone 3-piece IOL without a capsular tension ring (PhacoFlex SI30) and with a capsular tension ring (PhacoFlex SI30 and Morcher Type 14); silicone plate-haptic IOL (Staar AA4203VF); and a hydrogel plate-haptic IOL (logel 1103).

RESULTS

The ELP and LCD were determined with a precision of approximately 3 to 4 microns. An LCD was detected in 21% eyes with the AcrySof, 20% of eyes with the SI30 without a capsular tension ring, 10% of eyes with a capsular tension ring, 21% of eyes with the Staar, and 17% of eyes with the logel. The LCDs detected by PCI, but not by slitlamp examination, were significantly smaller than those detected by both.

CONCLUSION

The amount of LCD detected by PCI was approximately the same with all IOL types (approximately 20%) except the PhacoFlex SI30 with a capsular tension ring (10%).

High precision biometry of pseudophakic eyes using partial coherence interferometry

PURPOSE

To investigate the applicability of the scanning version of dual-beam partial coherence interferometry (PCI) for measuring the anterior segment and axial length of pseudophakic eyes in a clinical setting and to determine the achievable precision with this biometry technique.

SETTING

Department of Ophthalmology, Vienna General Hospital, and Institute of Medical Physics, University of Vienna, Austria.

METHODS

Partial coherence interferometry was performed in 39 pseudophakic eyes of 39 patients after implantation of a foldable acrylic intraocular lens (IOL).

RESULTS

Effective lens position (ELP), IOL thickness and lens-capsule distance (LCD) were determined with a precision of 2 to 3 microns; corneal thickness and axial eye length, with a precision of 0.8 and 5.0 microns, respectively. The mean ELP of the IOL was 4.093 mm +/- 0.290 (SD). In 7 eyes (18%), a positive LCD of 68 +/- 40 microns was detected with PCI. Mean corneal thickness was 526.4 +/- 31.5 microns; mean IOL thickness, 791.5 +/- 40.2 microns; and mean axial length, 23.388 +/- 0.824 mm.

CONCLUSION

The scanning version of PCI enables high precision (< or = 5 microns) and high resolution (approximately 12 microns) biometry of pseudophakic eyes that is better than conventional ultrasound by a factor of more than 20. For the first time, positive LCD, a possible risk factor for posterior capsule opacification, could be detected and quantified. Furthermore, this technique offers a high degree of comfort for the patient since it is a noncontact method with no need for local anesthesia or pupil dilation and has a reduced risk of corneal infection.

Dual beam optical coherence tomography: signal identification for ophthalmologic diagnosis

The dual beam version of optical coherence topography can be used for noninvasive, high-resolution imaging of the human eye fundus, enabling in vivo visualization of retinal morphology as well as accurate quantification of the thickness profiles of its layers. Interferometric fundus signals-optical A-scans-and retinal tomograms of patients with glaucoma, diabetic retinopathy, and age-related macular degeneration are compared with those of healthy, normal subjects to elucidate the origin of the signal peaks detected and to investigate and interpret the retinal microstructures contained in the cross-sectional images. © 1998 Society of Photo-Optical Instrumentation Engineers.

Signal and resolution enhancements in dual beam optical coherence tomography of the human eye

In the past 10 years, a dual beam version of partial coherence interferometry has been developed for measuring intraocular distances in vivo with a precision on the order of 0.3 to 3 μm. Two improvements of this technology are described. A special diffractive optical element allows matching of the wavefronts of the divergent beam reflected at the cornea and the parallel beam reflected at the retina and collimated by the optic system of the eye. In this way, the power of the light oscillations of the interfering beams incident on the photodetector is increased and the signal-to-noise ratio of in vivo measurements to the human retina is improved by 20 to 25 dB. By using a synthesized light source consisting of two spectrally displaced superluminescent diodes with an effective bandwidth of 50 nm, and by compensating for the dispersive effects of the ocular media, it was possible to record the first optical coherence tomogram of the retina of a human eye in vivo with an axial resolution of ∼6 to 7 μm. This is a twofold improvement over the current technology. © 1998 Society of Photo-Optical Instrumentation Engineers.

Investigation of dispersion effects in ocular media by multiple wavelength partial coherence interferometry

We report on quantitative measurements of group refractive indices and group dispersion in water and in human ocular media such as the cornea, the aqueous humor, the lens, artificial intraocular lenses, as well as a total value averaged over the media along the axial eye length of normal subjects and pseudophakic patients in vivo using dual beam partial coherence interferometry. Different optical thickness values due to the dispersion of the cornea are demonstrated using two spectrally displaced light sources. The displacement can be used to indirectly calculate the group dispersion of the human cornea in the spectral region between 810 nm and 860 nm. If the object under investigation is dispersive, resolution is limited due to a broadening of the detected signals. This broadening increases with group dispersion, i.e., the extent to which the group refractive index of the medium varies with wavelength and thickness of the tissue under investigation as well as with the spectral bandwidth of the light source. Measurements of the group dispersion in the cornea, lens and vitreous of pseudophakic and normal human eyes, show that the cornea and the lens are more dispersive than water-by a factor of about 5 and 2, respectively-in the investigated spectral region. The cornea is approximately threefold more dispersive than the human crystalline lens, the aqueous humor is less dispersive than water and the group dispersion of all ocular components together, averaged over the axial length of normal and pseudophakic eyes, was only slightly higher compared to that of water. Since the highly dispersive cornea and lens together have only a thickness of about one sixth of that of the axial eye length, it seems that their contribution to the group dispersive effect along the whole axial eye length is only small.

Biometric investigation of changes in the anterior eye segment during accommodation

Non-invasive biometry of the anterior structures of the human eye can be performed with unprecedented precision of 8-10 microns and a resolution of approximately 9 microns by partial coherence interferometry, which has the potential to assess the effect of cycloplegia on the ocular components of the anterior eye segment, to further improve the precision to 1-2 microns by the use of these agents and to quantify the amount of residual accommodations in different states of cycloplegia. In addition, the anterior chamber depth, the thickness of the crystalline lens, their changes during accommodation, as well as the movement of the anterior and posterior lens pole during accommodation can be quantified objectively and accurately to investigate the mechanism of accommodation.

Wavelength-tuning interferometry of intraocular distances

We describe basic principles of wavelength-tuning interferometry and demonstrate its application in ophthalmology. The advantage of this technique compared with conventional low-coherence interferometry ranging is the simultaneous measurement of the object structure without the need for a moving reference mirror. Shifting the wavelength of an external-cavity tunable laser diode causes intensity oscillations in the interference pattern of light beams remitted from the intraocular structure. A Fourier transform of the corresponding wave-number-dependent photodetector signal yields the distribution of the scattering potential along the light beam illuminating the eye. We use an external interferometer to linearize the wave-number axis. We obtain high resolution in a model eye by slow tuning over a wide wavelength range. With lower resolution we demonstrate the simultaneous measurement of anterior segment length, vitreous chamber depth, and axial eye length in human eyes in vivo with data-acquisition times in the millisecond range.

Submicrometer precision biometry of the anterior segment of the human eye

PURPOSE

To demonstrate the feasibility of measuring the anterior structures of the human eye by partial coherence interferometry and to determine its precision for eyes under normal and cycloplegic conditions.

METHODS

The dual-beam version of partial coherence interferometry, a recently developed noninvasive optical ranging technique, enables high resolution measurements of several intraocular distances with unprecedented precision. A modified, more sensitive scanning version of this technique was used to assess the central and peripheral corneal thickness, the anterior chamber depth, and the lens thickness of 20 healthy, emmetropic to moderately myopic eyes. Furthermore the anterior structures of three eyes were measured under cycloplegia (1% cyclopentolate) to investigate the influence on the precision of this technique after suppression of residual accommodations.

RESULTS

The mean geometric precision (standard deviation) of the measurement of the central corneal thickness was 0.29 micron (range, 0.22 micron to 0.38 micron) and 0.43 micron (range, 0.27 micron to 0.56 micron) for the peripheral corneal thickness at a distance 2 mm from its apex. The precision for measuring the anterior chamber depth and the lens thickness for fixation at infinity was 8.7 microns (range, 3.9 microns to 16.8 microns) and 8.9 microns (rang, 2.9 microns to 14.4 microns) for noncycloplegic eyes and 1.9 microns (range, 1.7 microns to 2 microns) and 1.4 microns (range, 0.7 micron to 1.8 microns) for cycloplegic eyes, respectively.

CONCLUSIONS

The dual-beam partial coherence interferometry enables fast, noninvasive, submicrometer precision biometry of the anterior segment of the eye. The precision of determining the anterior chamber depth and the lens thickness is more than one order of magnitude better than that of the currently used ultrasound and optical techniques, and it can be improved by a factor of 5 by using cycloplegia.

The effect of systemic nitric oxide-synthase inhibition on ocular fundus pulsations in man

There is experimental evidence that endothelium derived nitric oxide is involved in the regulation of ocular vascular tone. The purpose of this study was to investigate the effects of NO-synthase inhibition by N-monomethyl-L-arginine (L-NMMA) on ocular fundus pulsations in young healthy volunteers. Three milligrams per kilograms L-NMMA were administered i.v. over 5 minutes. Protocol 1: Measurements of blood pressure, pulse rate, fundus pulsation amplitude, NO-exhalation, and cardiac output were performed at baseline and 10, 30, 60, 90, 150, and 300 minutes after L-NMMA infusion (n = 8). Fundus pulsation amplitude, which has been shown to estimate the pulsatile component of the choroidal blood flow, was recorded with a recently developed laser interferometer. Protocol 2: Measurements of blood pressure, pulse rate, fundus pulsation amplitude, NO-exhalation, and blood flow velocity in the ophthalmic artery were performed in a randomized, placebo controlled cross over study (n = 10). Ten minutes after L-NMMA administration fundus pulsation amplitude decreased by 23 +/- 2% (protocol 1) and 19 +/- 1% (protocol 2, P < 0.01 each), cardiac output by 12 +/- 2% (P < 0.01), and exhaled NO by 55 +/- 6% (protocol 1) and 41 +/- 6% (protocol 2, P < 0.01 each). All parameters returned to baseline values within the 300 minutes observation period, with a faster recovery of fundus pulsation amplitude than of cardiac output and exhaled NO. Blood pressure, pulse rate, and ophthalmic artery blood flow velocity showed only minor changes during and after administration of L-NMMA. Our results suggest that systemic NO-synthase inhibition reduces pulsatile choroidal and most likely total choroidal blood flow in humans. The recovery of vascular tone in choroidal vessels seems to be different from the cardiovascular response. Our findings indicate that reduced fundus pulsations after L-NMMA are caused by systemic factors as well as by local reactions of the choroidal vasculature.

Effect of isoproterenol, phenylephrine, and sodium nitroprusside on fundus pulsations in healthy volunteers

AIMS/BACKGROUND

Recently a laser interferometric method for topical measurement of fundus pulsations has been developed. Fundus pulsations in the macular region are caused by the inflow and outflow of blood into the choroid. The purpose of this work was to study the influence of a peripheral vasoconstricting (the alpha 1 adrenoceptor agonist phenylephrine), a predominantly positive inotropic (the non-specific beta adrenoceptor agonist isoproterenol), and a non-specific vasodilating (sodium nitroprusside) model drug on ocular fundus pulsations to determine reproducibility and sensitivity of the method.

METHODS

In a double masked randomised crossover study the drugs were administered in stepwise increasing doses to 10 male and nine female healthy volunteers. Systemic haemodynamic variables and fundus pulsations were measured at all infusion steps.

RESULTS

Fundus pulsation increased during infusion of isoproterenol with statistical significance versus baseline at the lowest dose of 0.1 microgram/min. Neither peripheral vasoconstriction nor peripheral vasodilatation affected the ocular fundus pulsations.

CONCLUSIONS

Measurements of fundus pulsations is a highly reproducible method in healthy subjects with low ametropy. Changes of local pulsatile ocular blood flow were detectable with our method following the infusion of isoproterenol. As systemic pharmacological vasodilatation or vasoconstriction did not change fundus pulsations, further experimental work has to be done to evaluate the sensitivity of the laser interferometric fundus pulsation measurement in various eye diseases.

A randomized, placebo-controlled, double-blind crossover study of the effect of pentoxifylline on ocular fundus pulsations

PURPOSE

To estimate the short-term effects of pentoxifylline on ocular blood flow in healthy volunteers.

METHODS

In ten healthy subjects, either 200 or 400 mg of pentoxifylline or placebo was administered intravenously over 90 minutes in a randomized, double-blind, placebo-controlled, three-way crossover study design. Noninvasive measurements of blood pressure, pulse rate, flow variables in the radial artery, ocular fundus pulsations, and whole blood viscosity and filterability were performed at baseline and at 30-minute intervals until four hours after the start of drug infusion. Ocular fundus pulsation amplitude, which has been shown to estimate the pulsatile component of the ocular blood flow, was recorded with a laser interferometer in the macula, the optic disk, and a peripheral region.

RESULTS

Fundus pulsation amplitude significantly increased after infusion of pentoxifylline, with maximum effect 150 to 180 minutes after the start of the infusion. This effect was dose-dependent and more pronounced in the macula (+17%, P < .001 vs baseline, after 200 mg; and +27%, P < .001 vs baseline, after 400 mg of pentoxifylline) and the peripheral region (+14%, P < .001; and +26%, P < .001) than in the optic disk (+11%, P < .002; and +13%, P < .001). Viscosity but not filterability of whole blood dose-dependently decreased. Peak systolic flow velocity in the radial artery decreased after infusion of 400 mg of pentoxifylline. Blood pressure and pulse rate were unchanged during the observation period.

CONCLUSIONS

These findings demonstrate that pentoxifylline increases pulsatile ocular blood flow in healthy volunteers. Our results support the possibility that pentoxifylline could be used therapeutically in several eye diseases, such as diabetic retinopathy.

The effect of hyperoxia and hypercapnia on fundus pulsations in the macular and optic disc region in healthy young men

The purpose of this study was to investigate the influence of hyperoxia and hypercapnia on fundus pulsations in the macular and optic disc region and determine a potential autoregulative capacity of the choroid under these conditions. In a randomized cross-over study 100% O2 and a mixture of 5% CO2 with air was inhaled for 10 min by ten healthy male volunteers on different study days. Fundus pulsations were measured with a recently described laser interferometer. These results were compared to changes in systemic haemodynamics and Doppler-sonographic measurements of the radial artery. The fundus pulsation amplitude significantly decreased during hyperoxia and significantly increased during hypercapnia. These effects on fundus pulsations were stronger in the optic disc region than in the macular region. The systemic parameters showed only minor changes. Hence the amplitudes of fundus pulsations measured during hyperoxia and hypercapnia are assumed to be a consequence of metabolic autoregulative mechanisms. This autoregulative capacity is greater in the optic disc region than in the macular region, implying that the fundus pulsation amplitude in the papilla is influenced by both the choroidal and the retinal circulation.

Comparison of non-invasive methods for the assessment of haemodynamic drug effects in healthy male and female volunteers: sex differences in cardiovascular responsiveness

1. The study was performed to determine the sensitivity and short-term and day-to-day variability of a novel technique based on laser interferometry of ocular fundus pulsations and of non-invasive methods for the quantification of haemodynamic drug effects. An additional aim was to assess sex differences in haemodynamic responsiveness to cardiovascular drugs in male and female healthy volunteers. 2. Ten males and nine females (age range 20-33 years) were studied in a double-blind, randomized, cross-over trial. Simultaneous measurements from systemic haemodynamics, laser interferometry of ocular fundus pulsations, systolic time intervals from mechanocardiography, a/b ratio from oxymetric fingerplethysmography and Doppler sonography of the radial artery were used to describe the haemodynamic effects of cumulative, stepwise increasing intravenous doses of phenylephrine, isoprenaline, sodium nitroprusside and of placebo. 3. Laser interferometry detected the isoprenaline-effects at the lowest dose level of 0.1 micrograms min-1 with a high signal-to-noise ratio. The reproducibility of measurements under baseline was high, no changes were observed after systemically effective doses of phenylephrine or sodium nitroprusside. Systolic time intervals were sensitive and specific for isoprenaline-induced effects, PEP and QS2c-measurements had high reproducibility. Fingerplethysmography proved a sensitive measurement for the detection of the vasodilating effects of sodium nitroprusside, but was not specific, and showed low reproducibility. Measurements from Doppler sonography had lower reproducibility and sensitivity compared with the other applied methods. 4. There was a significant sex difference for several of the haemodynamic parameters under baseline conditions; however, the responsiveness to the drugs under study was not different, when drug effects were expressed as %-change from the baseline. 5. Laser interferometry is a valuable non-invasive, highly sensitive and specific approach for the detection of pulse pressure changes. A battery of non-invasive tests appears useful for the characterization of cardiovascular drugs. Gender differences may not pose a relevant problem for the study of acute haemodynamic effects of cardiovascular drugs.

Interferometric measurement of corneal thickness with micrometer precision

The recently developed partial coherence laser Doppler interferometry technique was improved to measure central and peripheral corneal thickness with high precision. Corneal thickness profiles were measured on 18 eyes of health, volunteer subjects. All of these eyes were measurable at angles (between visual axis and measuring direction) ranging from 20 degrees nasal to 25 degrees temporal. At larger angles (up to 35 degrees) only part of the eyes was measurable. The thickness profiles of the 18 corneas have a nearly perfectly parabolic shape within the measured region. The precision (standard deviation) was 1.6 microns for central measurements and decreased somewhat to about 3.5 microns at measuring angles in the range of 25 to 30 degrees. No significant interobserver variability was found on 14 eyes measured by three different observers. This study indicates that the new technique is likely to be superior to currently used ultrasound and conventional optical pachymetry techniques, especially for refractive procedures.

Measurement of the axial length of cataract eyes by laser Doppler interferometry

PURPOSE

To examine the applicability of the recently developed laser Doppler interferometry technique for measuring the axial length of cataract eyes in a realistic clinical situation. To determine the performance of the instrument as a function of cataract grade. To compare the results to those of ultrasound methods.

METHODS

A total of 196 cataract eyes of 100 patients were examined. The axial eye length was determined by laser Doppler interferometry and by two different ultrasound techniques, the applanation technique and the immersion technique. The cataract grade was determined by a commercial instrument that measures backscattered light.

RESULTS

Laser Doppler interferometry worked very well except in the cases of the highest cataract grades (4% of the eyes of this study were not measurable because of a too-high lens density). Only 3.5% of the other eyes were not measurable because of fixation problems of the patients. The precision of laser Doppler interferometry is not influenced by the cataract grade (except the highest grade). The standard deviation of the geometric eye length is approximately 20 microns. Linear regression analysis revealed a very good correlation of laser Doppler interferometry and ultrasonic measurements, but a systematic difference was found. The eye lengths measured by laser Doppler interferometry were about 0.18 mm longer than those measured by the immersion technique and about 0.47 mm longer than those measured by the applanation technique.

CONCLUSION

These differences are attributed to the laser Doppler interferometry results including the retinal thickness and indentation of the cornea by the applanation technique. The main advantages of the laser Doppler interferometry technique are high precision, high accuracy, and more comfort for the patient because it is a noncontact method, anesthesia is unnecessary, and the risk of corneal infection is avoided.

Slit lamp laser Doppler interferometer

A slit lamp laser interferometer is described for clinical in vivo eye length measurements. The basic components are a laser Doppler interferometer, a slit lamp attachment, and a commercial slit lamp. First measurements of the axial length of the eye yielded a standard deviation of 0.04 mm and less.

Measurement of corneal thickness by laser Doppler interferometry

The laser Doppler interferometry (LDI) technique, which was recently developed for axial eye length measurement, has been modified to measure the corneal thickness of the human eye in vivo. High accuracy is achieved. The standard deviation of the technique is about 7 microns, and improvement by a factor of 5 is possible. First comparisons with a usual slit lamp pachometer show a general agreement but a systematic difference of about 20 microns. Possible reasons for this discrepancy are discussed. Finally, the new method is compared to standard optical and ultrasound pachometry from a theoretical point of view, and advantages and drawbacks of the various techniques are discussed.

Eye-length measurement by interferometry with partially coherent light

With a multimode semiconductor laser we have been able to measure the optical length of the eye within a precision of 0.03 mm. A first series of in vivo measurements acoustically determined eye length.

Eye-length measurement by interferometry with partially coherent light

With a multimode semiconductor laser we have been able to measure the optical length of the eye within a precision of 0.03 mm. A first series of in vivo measurements acoustically determined eye length.

Retinal blood-flow visualization by means of laser speckle photography

We present the preliminary findings of an investigation into the visualization of retinal blood-flow distribution by means of single-exposure laser-speckle photography. The technique relies on the speckle effect produced when laser light is scattered at a diffusing surface and on the fact that the speckle will be averaged out to some extent when the surface concerned is moving. Spatial filtering techniques are used enhance the resulting variations in speckle contrast. The method is noncontacting and noninvasive, properties shared with the laser Doppler anemometry technique. Although it is less quantitative than the Doppler technique, it does have the advantage of giving an overall map of blood velocities instead of point measurements only, and we offer it as a complementary technique.

Image formation by inversion of scattered field data: experiments and computational simulation

The 3-D scattering potential of microscopic objects is reconstructed as well as the 2-D equivalent object from amplitude and phase data of the scattered field. The experimental setup and results are presented and discussed alongside corresponding computer simulations. In the computational simulation, several small coated spheres were assumed, and the scatter field data were determined by the Mie diffraction theory. In the experiment, a small sphere of 40-microm diam was used, and the scattered field was measured by interferometric methods. Two alternative methods were used to record the scattered field data; their sensitivity to phase quantization is discussed. Since in the experimental situation the scattered field data can only be determined in a very restricted range, a distinct smear of the PSF of this imaging process results. We describe the consequences of this drawback in terms of this PSF. On the other hand, we show that this allows a reduction of computation time in the digital inversion of the scattered field data.