Ophthalmic optical coherence tomography (OCT) imaging devices have revolutionized how we investigate the human visual system and its disorders via cross-sectional retinal layer visualization. Adaptive optics (AO) in tum has pushed that examination to the cellular level. Clinical OCT instruments still must contend with eye motion at the volume rates at which they operate. Recent advances and commercialization of ultrahigh-speed imaging sources. in particular swept source Fourier domain mode-locked (FOML) laser technology, have enabled OCT imaging line rates in the MHz domain, offering a potentially mature and reliable avenue for video rate volumetric acquisition speeds. We developed a multimodal adaptive optics system that includes an FDML-based OCT channel that operates at 3.4 MHz line rates and 13.4 volumes/s. The system achieves exquisite resolution and sensitivity for pan-macular and transretinal visualization of retinal cells and structures, While providing functional assessment of the same cells. The ultra-high speed also enables wide field scans for clinical operation and angiography for vascular visualization. These technological advances. deployed with efficient designs, can help mitigate long- standing issues like eye motion in current clinical ophthalmic imaging instrumentation. Ultimately. however, demand for AO clinical translation will increase only When AO technology is shown to be essential to the diagnosis and treatment of patients in the practice of ophthalmology. Toward that end, novel cellular biomarker development has the potential to provide ear1ier and more targeted measures of disease initiation. progression. and therapeutic effectiveness. We are exploring several AO-based structural and functional biomarkers of ophthalmic and neurological diseases, Including retinal ganglion cell morphological changes in inner retinal disease like glaucoma and multiple sclerosis, and photoreceptor function and retinal pigment epithelium organelle motility in outer retinal diseases. Assessment of innovative device methodology and biomarker development are two aspects of the FDA’s regulatory science mission as specifically applied in the field of ophthalmology
About the speaker
Staff Fellow, Division of Biomedical Physics (DBP), Center for Devices and Radiological Health (CDRH), U. S. Food and Drug Administration (FDA)
