High resolution imaging and quantification of the nailfold microvasculature using optical coherence tomography angiography (OCTA) and capillaroscopy: a preliminary study in healthy subjects.

Background: A wide range of diseases, such as systemic sclerosis, can be diagnosed by imaging the nailfold microcirculation, which is conventionally performed using capillaroscopy. This study applied optical coherence tomography angiography (OCTA) as a novel high resolution imaging method for the qualitative and quantitative assessment of the nailfold microvasculature, and compared OCTA imaging with capillaroscopy. Methods: For qualitative assessment, high resolution OCTA imaging was used to achieve images that contained a wide field of view of the nailfold microvasculature through mosaic scanning. OCTA imaging was also used to observe the characteristic changes in the microvasculature under external compression of the upper arm. For quantitative evaluation, the capillary density and the capillary diameter of the nailfold microvasculature were assessed with both OCTA and capillaroscopy by repeated measurements over 2 days in 13 normal subjects. The results were analyzed using the intraclass correlation coefficient (ICC). Results: OCTA imaging showed the typical nailfold microvasculature pattern, part of which was not directly seen with the capillaroscopy. OCTA imaging revealed significant changes in the nailfold microvasculature when a large external pressure was applied via arm compression, but no significant changes were observed using capillaroscopy. The capillary density measured by OCTA and capillaroscopy was 6.8±1.5 and 7.0±1.2 loops/mm, respectively, which was not significantly different (P=0.51). However, the capillary diameter measured by OCTA was significantly larger than that measured using capillaroscopy (19.1±2.5 vs. 13.3±2.3 µm, P<0.001). The capillary diameter measurements using OCTA and capillaroscopy were highly reproducible (ICC =0.926 and 0.973, respectively). While the capillary diameter measured with OCTA was significantly larger, it was rather consistent with the diameter measured using capillaroscopy (ICC =0.705). Conclusions: This study demonstrated that OCTA is a potentially viable and reproducible tool for the imaging and quantification of the capillaries in the nailfold microvasculature. The results of this study provide a solid basis for future applications of OCTA in qualitative and quantitative assessment of nailfold microcirculation in vivo.

Development of a clinical prototype of a miniature hand-held optical coherence tomography probe for prematurity and pediatric ophthalmic imaging.

We report a novel design and operation of a highly integrated miniature handheld OCT probe, with high-speed angiography function that can be used in clinical settings for young children and infants, providing rapid, non-invasive structural and angiographic imaging of the retina and choroid. The imaging system is operated at 200 kHz, with 3D OCT and OCTA scan time of 0.8 and 3.2 seconds, respectively, and the scanning angle on the pupil is ± 36°, covering the full perifoveal region. Operator assisting features of the direct-view iris camera and on-probe display are integrated into the hand-held probe, and the fixation target can display animations to attract the attention of young subjects. Compared to conventional OCT systems, the high-speed hand-held OCT system significantly improves the operator's experience and scanning efficiency, which is important for imaging infants. Imaging results indicate a significant reduction in total time consumption in pediatric ophthalmic imaging sessions, as well as the image quality of OCT angiography.

Ultrafast laser-scanning time-stretch imaging at visible wavelengths.

Optical time-stretch imaging enables the continuous capture of non-repetitive events in real time at a line-scan rate of tens of MHz-a distinct advantage for the ultrafast dynamics monitoring and high-throughput screening that are widely needed in biological microscopy. However, its potential is limited by the technical challenge of achieving significant pulse stretching (that is, high temporal dispersion) and low optical loss, which are the critical factors influencing imaging quality, in the visible spectrum demanded in many of these applications. We present a new pulse-stretching technique, termed free-space angular-chirp-enhanced delay (FACED), with three distinguishing features absent in the prevailing dispersive-fiber-based implementations: (1) it generates substantial, reconfigurable temporal dispersion in free space (>1 ns nm-1) with low intrinsic loss (<6 dB) at visible wavelengths; (2) its wavelength-invariant pulse-stretching operation introduces a new paradigm in time-stretch imaging, which can now be implemented both with and without spectral encoding; and (3) pulse stretching in FACED inherently provides an ultrafast all-optical laser-beam scanning mechanism at a line-scan rate of tens of MHz. Using FACED, we demonstrate not only ultrafast laser-scanning time-stretch imaging with superior bright-field image quality compared with previous work but also, for the first time, MHz fluorescence and colorized time-stretch microscopy. Our results show that this technique could enable a wider scope of applications in high-speed and high-throughput biological microscopy that were once out of reach.