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Introduction to the Eye and AO in Vision Science
Stacey S. Choi O.D., Ph.D.
Department of Ophthalmology & Vision ScienceUniversity of California, Davis
2008 CfAO Summer School, August 4 - 8
Outline
• Principle of AO in Vision Science
• AO in Retinal Imaging (UC Davis) • Clinical Application of AO (UC Davis)• Ongoing Work/Future Applications
• AO in Vision Testing (UC Davis)
• Basics on the eye
Structure of the Eye• Basic components: Cornea, iris (pupil), lens, retina
Cornea
Pupil
Lens
Iris
Optic Nerve
Retina
Fovea
Refractive indicesCornea = 1.376Humors = 1.336Lens = 1.41-1.38
Radii of CurvatureAnterior cornea = 7.7 mm ⇒ +49DPosterior cornea = 6.8 mm ⇒ -6DAnterior lens = 10.0 mm ⇒ +6DPosterior lens = -6.0 mm ⇒ +11D
Total = 60D
Eye length = 24 mmPupil diameter = 2-8 mmCorneal thickness ~ 0.5-0.7mmLens thickness = 4 mm, φ = 9 mm
Vision• Emmetropia
Light focuses on the retina
Vision• Emmetropia
– Sharp vision– No correction required– Vision: 20/20 or better (2/15)
Refractive Error• Myopia (= nearsightedness)
Light focuses in front of the retina
Refractive Error• Myopia (= nearsightedness)
– Too powerful optics before the retina– Long eyeball– Vision: poorer than 20/20, e.g. 20/30,
20/40 …20/200 etc. (20/200 = seeing details that a normal eye
can see at 200 feet away at 20 feet)– Negative spherical lens to correct
Refractive Error• Hypermetropia (= farsightedness or hyperopia)
Light focuses behind the retina
Refractive Error
• Hypermetropia (= farsightedness)
– Too weak optics before the retina– Short eyeball– Vision: poorer than 20/20, e.g. 20/30,
20/40 …20/200 etc. – Positive spherical lens to correct
Refractive Error• Astigmatism
Light focuses at different planes along vertical and horizontal meridians
– Rugby ball or American football shaped cornea
Refractive Error• Astigmatism
and/or
– Lens position, e.g. tilted (lenticularastig.)
– Cylinder lens to correct– Can occur in conjunction with myopia
and hyperopia
Spherical Cornea = no astigmatism
Presbyopia– Reduction in the focusing power of the eye
with age (i.e. loss of accommodation)– Hardening of lens inside the eye– Requires reading glasses
Layers of the Retina• Light must travel through all of the blood vessels and
neural cells before being absorbed by the rods and cones.
RodsCones
Horizontal Cells
Bipolar CellsAmacrine Cells
Ganglion Cells
Pigment Epithelium
> 200 µm
light
Blood Vessels
Outline
• Principle of AO in Vision Science
• AO in Retinal Imaging (UC Davis) • Clinical Application of AO (UC Davis)• Ongoing Work/Future Applications
• AO in Vision Testing (UC Davis)
• Basics on the eye
Photo Courtesy of R. Wainscoat
Adaptive optics allows telescopes to see through the turbulent atmosphere
Without AO With AO
Weather on Neptune Resolved With AO
Courtesy of Bruce Macintosh, LLNL
Wavefront Error
SPATIAL Cornea ⇒ anterior surface⇒ posterior surface
Crystalline lens
Cornea (Anterior > Posterior) > LensΔn = 0.376 Δn = 0.05
TEMPORAL Accommodation, Tear film qualityEye / Head movements
Perfect Eye
Planar wavefront
Spherical wavefront
Aberrated Eye
Aberrated wavefront
Wavefront Errors of the Eye:
Aberrations in Lens and Cornea Distort Wavefront
Deformable MirrorCorrects Wavefront
Sharp ImageThis correction, which can typically be completed in less than half a second, provides substantial improvements in visual performance and the quality of retinal images.
How Adaptive Optics works:
Adaptive optics can correct the eye’s higher order aberrations
Aberration Map Point of Light Image
6.8 mm pupil
Before adaptive optics:
After adaptive optics: 1 deg
Adaptive Optics for Vision Science
Without AO With AO
Improving qualityof the retinal images
Without AO With AO
Improvinghuman vision
Upcoming presentations…….
• Robert Zawadzki– AO Instrumentation Vision Science
(9am, 8/7, Thurs.)
• Austin Roorda– AO-Psychophysics (9am, 8/8, Fri.)
• Don Miller– AO System Design Vision Science
(2pm, 8/7, Thurs.)
AO systems at UC Davis
AO-Flood Illuminated Fundus Camera AO-OCT
Outline
• Principle of AO in Vision Science
• AO in Retinal Imaging (UC Davis) • Clinical Application of AO (UC Davis)• Ongoing Work/Future Applications
• AO in Vision Testing (UC Davis)
• Basics on the eye
Spatial frequency [c/deg]
Correcting higher order aberrations as well asdefocus and astigmatism increases contrast
sensitivity about 2 fold in white light
1 10 100
GYY
Con
trast
sen
sitiv
ity
1
10
100
Higher order aberrations also corrected with AO
Defocus and astigmatism onlycorrected
YY
1 10 100
x 2.4 x 1.8
6 mm pupil57 td
Courtesy of GY Yoon
Aging effect on CSF
Elliot, Choi, Doble, Hardy, Evans, Werner (2008)
Average CSF
Young Subjects
Old Subjects
Without AO
With AO
With AO
Without AO
Without AO With AO
Reducing Higher Order AberrationsReduces Haloes and Sharpens Edges
Next Generation PhoropterCurrent Phoropter
Requires lengthy subjective procedure
Computes refraction automaticallyfrom wave aberration
Simulation of Visual Benefit
Bausch & Lomb AO Zywave
M. Venkiteshwar et al. – Accepted for ARVO 2008
Clinical Application of Correcting Higher Order Aberrations
• Customized Laser Refractive Surgery
– Wavefront-guided LASIK (Laser-Assisted In-Situ Keratomileusis)
– LASEK (Laser epithelial keratomileusis)
• Customized Contact Lenses
• Customized Intraocular Lenses
• Microkeratome to cut a thin flap of cornea
• Apply the excimer laser to remove tissue from within the cornea
• Became the most popular and trusted technique for correcting vision, exceeding one million cases per year
LASIK Procedure:
LASEK: similar to LASIK with much thinner flap
• The excimer laser uses wavefront information to change the shape of the cornea by ablating tissue.
• “CustomCornea” (Alcon LADARVision laser), “CustomVue” (Visx S4 laser), and “Zyoptix” (Bausch & Lomb Technolas 217z laser) have the ability to create an ablation customized from an individual patient's wavefront evaluation.
Wavefront LASIK / LASEK
Customized Contact Lenses
Phase Plate
Yoon’s laboratory, Center for Visual Science, U of Rochester
Cataracts
Normal Cataract
Intraocular Lens (IOL)
Outline
• Principle of AO in Vision Science
• AO in Retinal Imaging (UC Davis) • Clinical Application of AO (UC Davis)• Ongoing Work/Future Applications
• AO in Vision Testing (UC Davis)
• Basics on the eye
Current Camera for Taking Images of the Retina
Conventional Adaptive Optics Fundus Camera
Fourier-domain OCT
AO-OCT
∆x ~ 2.5 µm; 7 mm pupil
∆x ~ 15 µm, ∆z ~ 3.5 - 6 µm; 36 fps, 6.7 mm pupil
∆x ~ 3 µm, ∆z ~ 6 µm; 36 fps, 6.7 mm pupil
Imaging Modalities
DM
WFSSC
EYESLD
UC Davis AO Flood Illuminated Fundus Camera
AO - OCT system
AO images of cones in normal retina
200 μm
AO-OCT
AO-FundusCamera
Outline
• Principle of AO in Vision Science
• AO in Retinal Imaging (UC Davis) • Clinical Application of AO (UC Davis)• Ongoing Work/Future Applications
• AO in Vision Testing (UC Davis)
• Basics on the eye
Retinal Dystrophy
• 33 year-old female
• VA 20/25
• Color Vision: within
normal limits
Rod-Cone Dystrophy
0 2 4 6 8 10 12 14nV/deg^2
Field View
45°
0 2 4 6 8 10 12 14nV/deg^2
Field View
45°
49%
57% 61% 74%
96%
AO en face Images
200μm
100μm8° NR4° NR 2° TR
100μm 100μm 100μm
1000 A-scans; Δ x = 6 mm; δx ~ 15 μm; δz ~ 3 μm; τ = 100 μs; T = 0.1 s
1000 A-scans; Δ x =1 mm; δx ~ 3.5 μm; δz ~ 6 μm; τ = 50 μs; T = 0.05 s; 18 frames/s
Contrast Sensitivity Function (CSF)
Choi et al., “In vivo Imaging of the Photoreceptor Mosaic in Retinal Dystrophies and correlations with Visual Function”, IOVS, 2006, 47, No. 5, 2080-2092.
AMD
0 2 4 6 8 10 12 14nV/deg^2
Field View
45°
0 2 4 6 8 10 12 14nV/deg^2
Field View
45°
• 80 year-old male
• VA 20/20
• Color Vision: within normal limits
• Humphrey Visual Field: within
normal limits
Non-Exudative AMD
1000 A-scans; Δ x = 6 mm; δx ~ 15 μm; δz ~ 4.5 μm; τ = 100 μs; T = 0.1 s
100μm
200 μm
100μm
FD-OCT Image
1000 A-scans; 1x1 mm; 3D Volume / 100 B-scans, τ = 50 μs; 18 Frames/s; 5.6 s / Volume
Optic Neuropathy
NAION• 57 year old male
• Diagnosis: Bilateral non-arteritic anterior ischemic optic neuropathy (NAION)
• Year of Diagnosis: OS 1994 OD 1996
• VA: OD 20/60+2OS 20/20-2
• Color vision: OD abnormalOS borderline
Right eye – AO en face Images
Right eye - AO-OCT
(a)
12
(b)
2
RPE
31
Choi et al., “Changes in Cellular Structures revealed by Ultra-high Resolution Retinal Imaging in Optic Neuropathies ”, IOVS, 2008, 49, 2103-2119.
Outline
• Principle of AO in Vision Science
• AO in Retinal Imaging (UC Davis) • Clinical Application of AO (UC Davis)• Ongoing Work/Future Applications
• AO in Vision Testing (UC Davis)
• Basics on the eye
Ongoing Work / Future Applications:• Improvement of current systems (e.g. better DMs)
• Track photoreceptor loss in retinal degenerative diseases
• Try to image more cell types in the retina
• Monitor the health of retinal vasculature without fluorescein angiography (i.e. leakages)
• Perform retinal surgeries with AO precision e.g. more localized and precise laser surgery for retinal vascular diseases