Adaptive Optics Retinal Imaging

National Eye Institute

Investigators

Linked publications, trials & patents

Abstract

By the time diseases of the retina are detected, serious damage has often already been done. An advanced optical imaging instrument utilizing adaptive optics can be used to directly visualize the cellular structure of the retina in the living human eye. Adaptive optics is a technology for measuring and correcting the optical imperfections in the human eye. When adaptive optics is combined with an imaging platform, highly detailed images of the human retina can be acquired. Our research utilizes this technology to image cells in patients eyes through the Adaptive Optics Clinic within the NIH Clinical Center. Processing of adaptive optics is highly time-consuming and labor intensive. We are starting to pilot the use of cloud based computing for the analysis of adaptive optics imaging data, including deep learning based training for novel algorithms. Leveraging more efficient computational strategies for handling and interpreting adaptive optics imaging data is an important step towards realizing clinical applications. We have also started to leverage previously-developed algorithms for the automated identification of both cone photoreceptors and retinal pigment epithelial cells in healthy and diseased eyes with the aim of revealing how these cells are affected in specific diseases of interest. In particular, through collaboration with NIH clinicians, we characterized how cone photoreceptors and retinal pigment epithelial cells are affected in patients with vitelliform macular dystrophy. It is known that this disease can arise from different genetic mutations, but whether the different genetic mutations manifest with differences in how cell types are disrupted was previously unknown. Using artificial intelligence algorithms, we discovered that cones are more affected than retinal pigment epithelial cells in vitelliform macular dystrophy arises from certain genes, whereas for other genes, retinal pigment epithelial cells are more affected. This finding has important implications for monitoring vitelliform macular dystrophy as well as developing novel treatments that may need to be catered to patients individual genetic mutations. These and other advances represent progress toward our overall goal to develop more sensitive methods to monitor the status and progression of disease at the cellular level in patients. Activities to improve imaging technology are also ongoing, through the design and implementation of upgrades to our state-of-the-art, custom-built adaptive optics instrument in the NEI eye clinic with the overarching goal of augmenting the translational research capabilities at the NIH Clinical Center. A notable strategy developed in the past year is to combine adaptive optics retinal imaging with adaptive optics microscopy, so that retinal tissue can be imaged with three times the resolution, while preserving the same underlying imaging modalities. Traditionally, the imaging modalities used in adaptive optics retinal imaging were not available on commercially-available microscopes. Developing an adaptive optics microscope allows us to better compare in vivo images of cells from patients with ex vivo histology, and provides a direct way to validate in vivo findings.