The ability to measure retinal blood flow (RBF) accurately and reproducibly is crucial for diagnosing and monitoring ocular diseases such as glaucoma and hypertensive retinopathy. Impaired autoregulation of blood flow plays a key role in both the development and progression of glaucoma. Multimodal adaptive optics (mAO) using scanning laser ophthalmoscopy and optical coherence tomography offer superior spatial and temporal resolution and the ability to measure blood flow in retinal microvasculature. Here we evaluate RBF measurement reproducibility and repeatability using a mAO technique.
Although elevated intraocular pressure (IOP) is considered to be a major precursor for glaucoma, up to 45% of the patients with early glaucoma show signs of disease progression despite IOP reduction therapy. Studies have shown strong clinical evidence for abnormal ocular vessel function and impaired autoregulation of blood flow in early glaucoma subjects and its role in disease development and progression. Here we present direct measure of vascular dysfunction and autoregulation in three healthy human subjects using the erythrocyte mediate angiography and adaptive optics scanning laser ophthalmoscopy line-scan techniques. These novel quantitative blood flow metrics can potentially serve as a sensitive biomarker for early diagnosis and monitoring of ocular disease.
The photoreceptor (PR) – retinal pigment epithelium (RPE) – choriocapillaris (CC) complex is an extremely important group of layers in the outer retina. We demonstrate resolution of the CC vascular network across the macula, as well as the methodology to extract and quantify structural metrics from all three layers from averaged AO-OCT volumes. In diseased eyes, small changes in CC structure may portend the initiation of disease and therefore the investigation of CC structural changes may aid early disease diagnosis for many diseases, both prevalent and rare, that begin in the outer retina.
Recent clinical studies have shown that abnormal retinal blood is associated with many ocular diseases such as age-related macular degeneration, glaucoma, and diabetic retinopathy. Several ocular imaging techniques have been developed to measure retinal blood flow both invasively and non-invasively, including optical coherence tomography angiography (OCTA), erythrocyte mediated angiography (EMA), laser speckle imaging (LSI) and adaptive optics - scanning laser ophthalmoscopy (AO-SLO). Here we present a simple, compact, well-controlled clinical flow phantom model which allows flow evaluation across several techniques to aid in the clinical diagnosis of ocular diseases with abnormal blood flow.
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