Design of illumination system using characterized illuminances for smartphone-based fundus camera.

Recently, smartphone-based fundus camera (SBFC) research has been actively conducted in response to the need to expand medical infrastructure in underdeveloped countries and the increased telemedicine since the COVID-19 pandemic. Compared to the conventional table-top system, SBFCs have technical challenges that make it difficult to guarantee uniform illumination and avoid back-reflection because of the design constraints of minimizing the form factor and cost. This paper proposes a novel illumination design methodology using characterized illuminance to obtain high-quality fundus images for SBFCs. Key performance indicators (KPIs), such as retinal uniformity, back-reflection suppression, and optical efficiency, were defined to evaluate the performance of the illumination system. Each KPI was calculated using optical simulation software based on Monte-Carlo ray tracing and mapped into a normalized three-dimensional coordinate, the retinal illumination performance space (RIPS). In RIPS, the KPIs are combined into a single parameter ΔRIPS, which is the quantitative difference evaluated as the Euclidean distance between the ideal and actual design point. A compact SBFC illumination system with five design variables was presented to verify the proposed methodology. The final design values at the minimum ΔRIPS were determined using the Taguchi method and response surface methodology. Finally, a working prototype was built, and fundus images were acquired by clinical testing under institutional review board approval. The fundus image had sufficient brightness and resolution to diagnose the lesion with a viewing angle of approximately 50° in one shot.

Inside-the-body light delivery system using endovascular therapy-based light illumination technology.

BACKGROUND: Light-based therapies are promising for treating diseases including cancer, hereditary conditions, and protein-related disorders. However, systems, methods, and devices that deliver light deep inside the body are limited. This study aimed to develop an endovascular therapy-based light illumination technology (ET-BLIT), capable of providing deep light irradiation within the body. METHODS: The ET-BLIT system consists of a catheter with a single lumen as a guidewire and diffuser, with a transparent section at the distal end for thermocouple head attachment. The optical light diffuser alters the emission direction laterally, according to the optical fibre's nose-shape angle. If necessary, after delivering the catheter to the target position in the vessel, the diffuser is inserted into the catheter and placed in the transparent section in the direction of the target lesion. FINDINGS: ET-BLIT was tested in an animal model. The 690-nm near-infrared (NIR) light penetrated the walls of blood vessels to reach the liver and kidneys without causing temperature increase, vessel damage, or blood component alterations. NIR light transmittance from the diffuser to the detector within the organ or vessel was approximately 30% and 65% for the renal and hepatic arteries, respectively. INTERPRETATION: ET-BLIT can be potentially used in clinical photo-based medicine, as a far-out technology. ET-BLIT uses a familiar method that can access the whole body, as the basic procedure is comparable to that of endovascular therapy in terms of sequence and technique. Therefore, the use of the ET-BLIT system is promising for many light-based therapies that are currently in the research phase. FUNDING: Supported by Programme for Developing Next-generation Researchers (Japan Science and Technology Agency); JSPS KAKENHI (18K15923, 21K07217); JST-CREST (JPMJCR19H2); JST-FOREST-Souhatsu (JPMJFR2017); The Uehara Memorial Foundation; Yasuda Memorial Medical Foundation; Mochida Memorial Foundation for Medical and Pharmaceutical Research; Takeda Science Foundation; The Japan Health Foundation; Takahashi Industrial and Economic Research Foundation; AICHI Health Promotion Foundation; and Princess Takamatsu Cancer Research Fund.

Simulation and Experimental Research on a Beam Homogenization System of a Semiconductor Laser.

Aiming at the application of laser active imaging detection technology, this paper studied the beam homogenization system of a semiconductor laser based on a homogenizing pipe. Firstly, the principle of the homogenizing pipe was introduced. Secondly, the homogenization effect, which was influenced by several geometric parameters (aperture size, length, and taper) of the homogenizing pipe using the optical design software, was simulated for the fiber-coupled semiconductor laser. Finally, according to the simulated results, a laser illumination system composed of a fiber-coupled semiconductor laser, a homogenizing pipe, and an aspheric lens was designed, which can obtain a rectangular uniform light spot in a long distance. The effectiveness of the illumination system was verified by simulation and experiment, respectively. Simulation results suggested that the uniformity of the spot at a distance of 20 m was 85.6%, while divergence angle was 10 mrad. The uniformity of the spot at a distance of 120 m was 91.5%, while divergence angle was 10 mrad. Experimental results showed that the uniformity of the spot at a distance of 20 m was 87.7%, while divergence angle was 13 mrad. The uniformity of the spot at a distance of 120 m was 93.3%, while divergence angle was 15 mrad. The laser illumination system designed in this paper was simple and easy to assemble, and has strong practicability. The results in this paper have certain reference value and guiding significance for the homogenization design of semiconductor lasers.

The Stability of the Red Reflex Produced by Different Surgical Ophthalmic Microscopes.

The red reflex is produced when coaxial light from the retina is reflected from patient to observer, and acts as an important tool in ophthalmic surgery owing to its application in screening various ocular abnormalities associated with the cornea and iris. Visualization of these intraocular structures could improve surgeons' ability to perform ophthalmic procedures safely. The aim of this podcast, featuring Dr. Laurence Woodard (Medical Director of Omni Eye Services, Atlanta), is to highlight the clinical utility of red reflex stability and intensity provided by nearly collimated and focused beam microscope illumination systems used in ophthalmic surgery. Quantifying red reflex intensity can be challenging due to its subjective nature. Other factors such as phacoemulsification and individual characteristics of the eye, such as pupil size or iris pigment, may affect red reflex intensity. Red reflex stability and intensity may also be altered during the procedure because of excessive eye movement, lack of centering, or if the eye is not perpendicular to the light beam. In addition, differences in nearly collimated and focused illumination systems may affect surgeon fatigue and surgery success. The intensity of the red reflex dictates surgeons' ability to maintain adequate visualization during surgery as well as identify ocular abnormalities. In conclusion, the more intense the red reflex, the more likely a surgeon will be able to maintain adequate visualization during surgery as well as identify corneal and anterior segment abnormalities. The podcast and transcript can be viewed below the abstract of the online version of the manuscript. Alternatively, the podcast can be downloaded here: https://doi.org/10.6084/m9.figshare.14779212 . The Stability of the Red Reflex Produced by Different Surgical Ophthalmic Microscopes (MP4 24363 kb).

Development of a 2-dof uterine manipulator with LED illumination system as a new transvaginal uterus amputation device for gynecological surgeries.

BACKGROUND: Hysterectomy, the most common major gynecological operation worldwide, consists of removal of the uterus and can be performed abdominally, vaginally, or laparoscopically. A uterine manipulator is a key device used for uterine manipulation and cannulation in hysterectomies. The challenges of conventional manipulators are to move the uterus in two distinct planes and to identify cervical landmarks during circular cut and coagulation. MATERIAL AND METHODS: In this study, a structural synthesis of the two degrees of freedom parallel manipulator was performed considering the constraints noted by surgeons. Computer-aided design and assembly of the manipulator, the cervicovaginal cap with LEDs, and the external parts were performed before rapid prototyping. The final design of the uterine manipulator was then manufactured from stainless steel and tested on an artificial uterus model using a test chamber. RESULTS: This article presents the design, production and testing processes of an innovative manipulator with a motion capability up to 80° workspace both in the sagittal and coronal planes and an illumination system, easily detectable by the laparoscope, was successfully implemented on the manipulator's cervical cap in order to overcome the drawbacks of conventional uterine manipulators. CONCLUSIONS: Despite all the current studies and uterine manipulators on the market, no research has incorporated all the features mentioned above.

Gyroscope pivot bearing dimension and surface defect detection.

Because of the perceived lack of systematic analysis in illumination system design processes and a lack of criteria for design methods in vision detection a method for the design of a task-oriented illumination system is proposed. After detecting the micro-defects of a gyroscope pivot bearing with a high curvature glabrous surface and analyzing the characteristics of the surface detection and reflection model, a complex illumination system with coaxial and ring lights is proposed. The illumination system is then optimized based on the analysis of illuminance uniformity of target regions by simulation and grey scale uniformity and articulation that are calculated from grey imagery. Currently, in order to apply the Pulse Coupled Neural Network (PCNN) method, structural parameters must be tested and adjusted repeatedly. Therefore, this paper proposes the use of a particle swarm optimization (PSO) algorithm, in which the maximum between cluster variance rules is used as fitness function with a linearily reduced inertia factor. This algorithm is used to adaptively set PCNN connection coefficients and dynamic threshold, which avoids algorithmic precocity and local oscillations. The proposed method is used for pivot bearing defect image processing. The segmentation results of the maximum entropy and minimum error method and the one described in this paper are compared using buffer region matching, and the experimental results show that the method of this paper is effective.

Management of posteriorly dislocated capsular tension ring with vitrectomy using a "chandelier" illumination system.

Subluxation of the capsular tension ring (CTR) into the vitreous is a rare complication. The explantation of these rings from the vitreous by conventional vitrectomy is often a difficult procedure requiring great surgical skill. We report two cases of posteriorly subluxated endocapsular rings, which were explanted with pars plana vitrectomy using the chandelier illumination system. This illumination system has an external light source which is incorporated via a fibreoptic into the infusion cannula, thereby freeing both hands of the surgeon. This allows surgeon to easily perform bimanual intraocular maneuvers such as external scleral indentation, manipulation of CTR in the vitreous cavity and removal of these rings with the handshake technique.