Large Field of View Corneal Epithelium and Bowman's Layer Thickness Maps in Keratoconic and Healthy Eyes.

PURPOSE: To assess differences between epithelium thickness (ET) and Bowman's layer thickness (BLT) maps in keratoconic eyes and healthy eyes. DESIGN: Cross-sectional study. METHODS: Setting: institutional. STUDY POPULATION: 47 patients (1 eye) with keratoconus (KC) and 20 healthy subjects (1 eye). OBSERVATION PROCEDURE: epithelium and Bowman's layer measurements were performed by using custom-designed polarization-sensitive optical coherence tomography (PS-OCT) with a conical scanning optics design. En face corneal ET and BLT maps with a diameter of 11 mm were computed. Main outcome measurements were mean ET and BLT of 25 sectors; the thinnest (minET, minBLT) and thickest sectors (maxET, maxBLT) were assessed. Ratios between thinnest/thickest sectors (R1) and between mean ET and BLT of the inferior temporal quadrant/superior nasal quadrant (R2) were calculated (R1ET, R1BLT; R2ET, R2BLT). Receiver operator characteristic (ROC) curve analysis was used to assess the diagnostic power of statistically different parameters. RESULTS: In healthy eyes, smooth ET maps were observed. KC eyes showed a "doughnut pattern." The BLT maps of healthy eyes had a smooth appearance, but highly irregular "moth"-like damage pattern could be observed in keratoconic eyes. Highest area under the curve values were found for the thinnest sector of the BLT map, the R1ET, and the thinnest sector of the ET map. CONCLUSIONS: PS-OCT imaging enables the visualization of significant differences of the corneal epithelium and the Bowman's layer in en face maps covering almost the entire cornea. ET and BLT profiles could clearly show their diagnostic importance for the distinguishing of keratoconic eyes and healthy eyes.

Investigating spontaneous retinal venous pulsation using Doppler optical coherence tomography.

We demonstrate the advantages of optical coherence tomography (OCT) imaging for investigation of spontaneous retinal venous pulsation (SRVP). The pulsatile changes in venous vessel caliber are analyzed qualitatively and quantitatively using conventional intensity-based OCT as well as the functional extension Doppler OCT (DOCT). Single-channel and double-channel line scanning protocols of our multi-channel OCT prototype are employed to investigate venous pulsatile caliber oscillations as well as venous flow pulsatility in the eyes of healthy volunteers. A comparison to recordings of scanning laser ophthalmoscopy (SLO) - a standard en-face imaging modality for evaluation of SRVP - is provided, emphasizing the advantages of tomographic image acquisition. To the best of our knowledge, this is the first quantitative time-resolved investigation of SRVP and associated retinal perfusion characteristics using OCT.

Ultrahigh Resolution Polarization Sensitive Optical Coherence Tomography of the Human Cornea with Conical Scanning Pattern and Variable Dispersion Compensation.

Noninvasive corneal imaging is essential for the diagnosis and treatment control of various diseases affecting the anterior segment of the eye. This study presents an ultrahigh resolution polarization sensitive optical coherence tomography instrument operating in the 840 nm wavelength band that incorporates a conical scanning design for large field of view imaging of the cornea. As the conical scanning introduces a dispersion mismatch depending on the scanning angle, this study implemented variable, location dependent, numerical dispersion compensation in order to achieve high axial resolution throughout the imaged volume. The corneal images were recorded in vivo in healthy volunteers showing various details of corneal structures.

Mapping of Corneal Layer Thicknesses With Polarization-Sensitive Optical Coherence Tomography Using a Conical Scan Pattern.

Purpose: We demonstrate segmentation and mapping of corneal layers (epithelium, Bowman's layer, and stroma) across the entire cornea (limbus to limbus), using additional contrast provided by polarization-sensitive optical coherence tomography (PS-OCT) and analyze the reproducibility of the procedure. Methods: A custom built PS-OCT system operating at 1045 nm central wavelength with conical scanning was used for image acquisition. Conical scanning allows for almost perpendicular beam incidence on the corneal surface and provides good signal quality over the entire field of view. Epithelium, Bowman's layer, and stroma were segmented using the additional contrast provided by PS-OCT. Thickness maps were computed and analyzed in sectors. Both eyes of 20 healthy volunteers were imaged at least three times to test this method and to quantify reproducibility. Results: Thickness maps of the epithelium show significant (P < 0.001) superior thinning and an inferior thickening. Bowman's layer appears homogeneous within the central 7 to 8 mm diameter of the cornea and gets thinner toward the periphery until this layer disappears between 4 and 5.5 mm eccentricity from the center. Intersubject variations of the measured thicknesses of epithelium (coefficient of variation [CV] ∼8%), Bowman's layer (CV∼25%), and stroma (CV∼10%) were observed. Very good reproducibility of thickness measurements of epithelium (CV < 3%), Bowman's layer (CV < 5%), and stroma (CV < 2%) was found. Furthermore, a significant correlation (P < 0.001) between layer thicknesses of the right and left eyes of the same subject was found. Conclusions: PS-OCT with conical scanning is a feasible approach for determining thickness maps of corneal layers on a large field of view with high reproducibility.

Adaptable switching schemes for time-encoded multichannel optical coherence tomography.

We introduce the approach of variable time encoding for multichannel optical coherence tomography (OCT). High-speed fiber optical switches are applied for sequential sample arm switching to enable quasisimultaneous image acquisition from three different orientation angles. In comparison with previous multichannel OCT (using simultaneous sample illumination), time-encoded multichannel OCT has no need for division of illumination power among the respective channels to satisfy laser safety requirements. Especially for ophthalmic applications-in particular retinal imaging, which the presented prototype was developed for-this advantage strongly influences image quality through an enhanced sensitivity. Nevertheless, time encoding comes at the cost of a decrease in imaging speed due to sequential channel illumination. For the typical multichannel OCT modality Doppler OCT, this results in a reduction of the maximum unambiguously determinable Doppler velocity. However, we demonstrate that this drawback can be overcome by adaptation of the illumination channel switching scheme. Thus, a re-extension of the maximum unambiguously determinable Doppler frequency to the full A-scan rate of the tunable light source is presented. The performance of the technique is demonstrated by flow phantom experiments and measurements of retinal blood flow in the eyes of healthy human volunteers.

Conical scan pattern for enhanced visualization of the human cornea using polarization-sensitive OCT.

Conventional imaging of the human cornea with optical coherence tomography (OCT) relies on telecentric scanning optics with sampling beams that are parallel to the optical axis of the eye. Because of the shape of the cornea, the beams have in some areas considerable inclination to the corneal surface which is accompanied by low signal intensities in these areas and thus an inhomogeneous appearance of corneal structures. In addition, alterations in the polarization state of the probing light depend on the angle between the imaging beam and the birefringent axis of the sample. Therefore, changes in the polarization state observed with polarization-sensitive (PS-) OCT originate mainly from the shape of the cornea. In order to minimize the effects of the corneal shape on intensity and polarization-sensitive based data, we developed a conical scanning optics design. This design provides imaging beams that are essentially orthogonal to the corneal surface. Thus, high signal intensity throughout the entire imaged volume is obtained and the influence of the corneal shape on polarization-sensitive data is greatly reduced. We demonstrate the benefit of the concept by comparing PS-OCT imaging results of the human cornea in healthy volunteers using both scanning schemes.

Multi-directional optical coherence tomography for retinal imaging.

We introduce multi-directional optical coherence tomography (OCT), a technique for investigation of the scattering properties of directionally reflective tissue samples. By combining the concepts of multi-channel and directional OCT, this approach enables simultaneous acquisition of multiple reflectivity depth-scans probing a mutual sample location from differing angular orientations. The application of multi-directional OCT in retinal imaging allows for in-depth investigations on the directional reflectivity of the retinal nerve fiber layer, Henle's fiber layer and the photoreceptor layer. Major ophthalmic diseases (such as glaucoma or age-related macular degeneration) have been reported to alter the directional reflectivity properties of these retinal layers. Hence, the concept of multi-directional OCT might help to gain improved understanding of pathology development and progression. As a first step, we demonstrate the capabilities of multi-directional OCT in the eyes of healthy human volunteers.