Polarisation-sensitive OCT is useful for evaluating retinal pigment epithelial lesions in patients with neovascular AMD.

BACKGROUND/AIMS: To examine the reproducibility of lesion dimensions of the retinal pigment epithelium (RPE) in neovascular age-related macular degeneration (AMD) with polarisation-sensitive optical coherence tomography (PS-OCT), specifically imaging the RPE. METHODS: Twenty-six patients (28 eyes) with neovascular AMD were included in this study, and examined by a PS-OCT prototype. Each patient was scanned five times at a 1-day visit. The PS-OCT B-scan located closest to the macular centre presenting with RPE atrophy was identified, and the longitudinal diameter of the lesion was quantified manually using AutoCAD 2008. This procedure was followed for the identical B-scan position in all five scans per eye and patient. Reproducibility of qualitative changes in PS-OCT was evaluated. Interobserver variability was assessed. Results were compared with intensity-based spectral-domain OCT (SD-OCT) imaging. RESULTS: Mean variability of all atrophy lesion dimensions was 0.10 mm (SD±=0.06 mm). Coefficient of variation (SD±/mean) was 0.06 on average (SD±=0.03). Interobserver variability assessment showed a mean difference of 0.02 mm across all patients regarding RPE lesion size evaluation (paired t test: p=0.38). Spearman correlation coefficient was r=0.98, p<0.001. Results revealed a good overall reproducibility of ∼90%. PS-OCT specifically detected the RPE in all eyes compared with conventional intensity-based SD-OCT that was not capable to clearly identify RPE atrophy in 25 eyes (89.3%, p<0.01). CONCLUSIONS: PS-OCT offers good reproducibility of RPE atrophy assessment in neovascular AMD, and may be suitable for precise RPE evaluation in clinical practice. PS-OCT unambiguously identifies RPE changes in choroidal neovascularisation compared with intensity-based SD-OCT that does not identify the RPE status reliably.

Spectral degree of polarization uniformity for polarization-sensitive OCT.

Depolarization of light can be measured by polarization-sensitive optical coherence tomography (PS-OCT) and has been used to improve tissue discrimination as well as segmentation of pigmented structures. Most approaches to depolarization assessment for PS-OCT - such as the degree of polarization uniformity (DOPU) - rely on measuring the uniformity of polarization states using spatial evaluation kernels. In this article, we present a different approach which exploits the spectral dimension. We introduce the spectral DOPU for the pixelwise analysis of polarization state variations between sub-bands of the broadband light source spectrum. Alongside a comparison with conventional spatial and temporal DOPU algorithms, we demonstrate imaging in the healthy human retina, and apply the technique for contrasting hard exudates in diabetic retinopathy and investigating the pigment epithelium of the rat iris.

Peripapillary rat sclera investigated in vivo with polarization-sensitive optical coherence tomography.

PURPOSE: To demonstrate polarization-sensitive (PS) optical coherence tomography (OCT) for noninvasive, volumetric, and quantitative imaging of the birefringent properties of the peripapillary rat sclera; to compare the findings from PS-OCT images to state-of-the-art histomorphometric analysis of the same tissues. METHODS: A high-speed PS-OCT prototype operating at 840 nm was modified for imaging the rat eye. Densely sampled PS-OCT raster scans covering an area of ~1.5 × 1.5 mm centered at the papilla were acquired in the eyes of anesthetized male Sprague-Dawley rats. Cross-sectional PS-OCT images were computed, and fundus maps displaying the birefringent properties of the sclera were analyzed. Postmortem histomorphologic analysis was performed. RESULTS: Polarization-sensitive OCT enables visualization of the polarization properties of ocular tissues in vivo. The birefringent characteristics of the rat sclera were quantitatively assessed. Scleral birefringence formed a donut-shaped pattern around the papilla with significantly increased values of 0.703 ± 0.089°/µm (i.e., 1.64 × 10(-3) ± 0.2 × 10(-3); mean ± standard deviation) and 0.721 ± 0.084°/µm (i.e., 1.68 × 10(-3) ± 0.2 × 10(-3)) at an eccentricity of 0.4 mm for the left and right eyes, respectively. Birefringent axis orientation maps revealed a ring-shaped distribution around the optic nerve. Postmortem PS-OCT micrographs provided access to retinal and scleral microstructure and were compared to standard histomorphologic analysis. CONCLUSIONS: Polarization-sensitive OCT enables quantitative imaging of tissue polarization properties in addition to conventional OCT imaging based on reflectivity. In the rat sclera, in vivo PS-OCT provides access to volumetric mapping of birefringence. Scleral birefringence is associated with microstructural tissue organization. Therefore, PS-OCT should prove a valuable tool for the in vivo investigation of peripapillary sclera in glaucoma.

Imaging retinal pigment epithelial proliferation secondary to PASCAL photocoagulation in vivo by polarization-sensitive optical coherence tomography.

PURPOSE: To image the retinal pigment epithelium (RPE) after macular laser and to monitor healing responses over time in vivo in patients with diabetic maculopathy using polarization-sensitive optical coherence tomography (OCT). DESIGN: Prospective, nonrandomized clinical trial. METHODS: In this single-center trial (Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria), 13 patients (13 eyes) underwent grid photocoagulation for diabetic maculopathy. Retinal healing processes were continuously followed over the course of 3 months. A polarization-sensitive OCT prototype was used, allowing detection and measurement of the RPE changes based on their specific polarization-scrambling qualities. RESULTS: After 1 day, the intraretinal photocoagulation lesions were sharply demarcated, whereas RPE changes were rather subtle. At 1 week, all lesions exhibited traction of the inner retinal layers toward the RPE and loss of photoreceptor cells. In tissue-sensitive polarization-sensitive OCT imaging, polarization-scrambling columns were found at the level of the RPE. During follow-up, different healing responses were seen in the polarization-scrambling RPE layer, ranging from hyperproliferation to focal atrophy. CONCLUSION: Because of the properties of the polarization state of backscattered light, polarization-sensitive OCT revealed specific morphologic changes in the RPE and outer retinal layers secondary to retinal laser treatment undetectable with intensity-based spectral-domain OCT. The increase in polarization-scrambling tissue over the course of 3 months indicates a more intense healing reaction and proliferation of RPE cells than previously characterized in rodent studies.

Retinal polarization-sensitive optical coherence tomography at 1060 nm with 350 kHz A-scan rate using an Fourier domain mode locked laser.

We present a novel, high-speed, polarization-sensitive, optical coherence tomography set-up for retinal imaging operating at a central wavelength of 1060 nm which was tested for in vivo imaging in healthy human volunteers. We use the system in combination with a Fourier domain mode locked laser with active spectral shaping which enables the use of forward and backward sweep in order to double the imaging speed without a buffering stage. With this approach and with a custom designed data acquisition system, we show polarization-sensitive imaging with an A-scan rate of 350 kHz. The acquired three-dimensional data sets of healthy human volunteers show different polarization characteristics in the eye, such as depolarization in the retinal pigment epithelium and birefringence in retinal nerve fiber layer and sclera. The increased speed allows imaging of large volumes with reduced motion artifacts. Moreover, averaging several two-dimensional frames allows the generation of high-definition B-scans without the use of an eye-tracking system. The increased penetration depth of the system, which is caused by the longer probing beam wavelength, is beneficial for imaging choroidal and scleral structures and allows automated segmentation of these layers based on their polarization characteristics.

Lesion size detection in geographic atrophy by polarization-sensitive optical coherence tomography and correlation to conventional imaging techniques.

PURPOSE: To investigate the reproducibility of automated lesion size detection in patients with geographic atrophy (GA) using polarization-sensitive spectral-domain optical coherence tomography (PS-OCT) and to compare findings with scanning laser ophthalmoscopy (SLO), fundus autofluorescence (FAF), and intensity-based spectral-domain OCT (SD-OCT). METHODS: Twenty-nine eyes of 22 patients with GA were examined by PS-OCT, selectively identifying the retinal pigment epithelium (RPE). A novel segmentation algorithm was applied, automatically detecting and quantifying areas of RPE atrophy. The reproducibility of the algorithm was assessed, and lesion sizes were correlated with manually delineated SLO, FAF, and intensity-based SD-OCT images to validate the clinical applicability of PS-OCT in GA evaluation. RESULTS: Mean GA lesion size of all patients was 5.28 mm(2) (SD: 4.92) in PS-OCT. Mean variability of individual repeatability measurements was 0.83 mm(2) (minimum: 0.05; maximum: 3.65). Mean coefficient of variation was 0.07 (min: 0.01; max: 0.19). Mean GA area in SLO (Spectralis OCT) was 5.15 mm(2) (SD: 4.72) and 2.5% smaller than in PS-OCT (P = 0.9, Pearson correlation coefficient = 0.98, P < 0.01). Mean GA area in intensity-based SD-OCT pseudo-SLO images (Cirrus OCT) was 5.14 mm(2) (SD: 4.67) and 2.7% smaller than in PS-OCT (P = 0.9, Pearson correlation coefficient = 0.98, P < 0.01). Mean GA area of all eyes measured 5.41 mm(2) (SD: 4.75) in FAF, deviating by 2.4% from PS-OCT results (P = 0.89, Pearson correlation coefficient = 0.99, P < 0.01). CONCLUSIONS: PS-OCT demonstrated high reproducibility of GA lesion size determination. Results correlated well with SLO, FAF, and intensity-based SD-OCT fundus imaging. PS-OCT may therefore be a valuable and specific imaging modality for automated GA lesion size determination in scientific studies and clinical practice.

Measuring retinal nerve fiber layer birefringence, retardation, and thickness using wide-field, high-speed polarization sensitive spectral domain OCT.

PURPOSE: We presented a novel polarization sensitive optical coherence tomography (PS-OCT) system for measuring retinal nerve fiber layer (RNFL) birefringence, retardation, and thickness, and report on the repeatability of acquiring these quantities. METHODS: A new PS-OCT system, measuring at 840 nm, was developed that supports scan angles of up to 40° × 40° with an A-scan rate of 70 kHz. To test the performance and reproducibility, we measured 10 eyes of 5 healthy human volunteers five times each. All volunteers were imaged further with scanning laser polarimetry (SLP). The obtained RNFL birefringence, retardation, and thickness maps were averaged, and standard deviation maps were calculated. For quantitative comparison between the new PS-OCT and SLP, a circumpapillary evaluation within 2 annular segments (superior and inferior to the optic disc) was performed. RESULTS: High quality RNFL birefringence, retardation, and thickness maps were obtained. Within the superior and inferior segments, the mean retardation for individual eyes ranged from 20° to 28.9° and 17.2° to 28.2°, respectively. The quadrant precision over the 5 consecutive measurements for each subject, calculated for the average retardation obtained within the superior and inferior quadrants ranged from 0.16° to 0.69°. The mean birefringence ranged from 0.106°/µm to 0.141°/µm superior and 0.101°/µm to 0.135°/µm inferior, with a quadrant precision of 0.001°/µm to 0.007°/µm. The mean RNFL thickness varied from 114 to 150 µm superior, and 111 to 140.9 µm inferior (quadrant precision ranged from 3.6 to 11.9 µm). CONCLUSIONS: The new PS-OCT system showed high image quality and reproducibility, and, therefore, might be a valuable tool for glaucoma diagnosis.

Large-field high-speed polarization sensitive spectral domain OCT and its applications in ophthalmology.

We present a novel spectral domain polarization sensitive OCT system (PS-OCT) that operates at an A-scan rate of 70 kHz and supports scan angles of up to 40° × 40°. The high-speed imaging allows the acquisition of up to 1024 × 250 A-scans per 3D scan, which, together with the large field of view, considerably increases the informative value of the images. To demonstrate the excellent performance of the new PS-OCT system, we imaged several healthy volunteers and patients with various diseases such as glaucoma, AMD, Stargardt's disease, and albinism. The results are compared with clinically established methods such as scanning laser polarimetry and autofluorescence.

High-speed polarization sensitive optical coherence tomography scan engine based on Fourier domain mode locked laser.

We report on a new swept source polarization sensitive optical coherence tomography scan engine that is based on polarization maintaining (PM) fiber technology. The light source is a Fourier domain mode locked laser with a PM cavity that operates in the 1300 nm wavelength regime. It is equipped with a PM buffer stage that doubles the fundamental sweep frequency of 54.5 kHz. The fiberization allows coupling of the scan engine to different delivery probes. In a first demonstration, we use the system for imaging human skin at an A-scan rate of 109 kHz. The system illuminates the sample with circularly polarized light and measures reflectivity, retardation, optic axis orientation, and Stokes vectors simultaneously. Furthermore, depolarization can be quantified by calculating the degree of polarization uniformity (DOPU). The high scanning speed of the system enables dense sampling in both, the x- and y-direction, which provides the opportunity to use 3D evaluation windows for DOPU calculation. This improves the spatial resolution of DOPU images considerably.

Polarization sensitive optical coherence tomography of melanin provides intrinsic contrast based on depolarization.

Polarization sensitive optical coherence tomography (PS-OCT) is a functional extension of OCT. In addition to imaging based on tissue reflectivity, PS-OCT also enables depth-resolved mapping of sample polarization properties such as phase-retardation, birefringent axis orientation, Stokes vectors, and degree of polarization uniformity (DOPU). In this study, PS-OCT was used to investigate the polarization properties of melanin. In-vitro measurements in samples with varying melanin concentrations revealed polarization scrambling, i.e. depolarization of backscattered light. Polarization scrambling in the PS-OCT images was more pronounced for higher melanin concentrations and correlated with the concentration of the melanin granules in the phantoms. Moreover, in-vivo PS-OCT was performed in the retinas of normal subjects and individuals with albinism. Unlike in the normal eye, polarization scrambling in the retinal pigment epithelium (RPE) was less pronounced or even not observable in PS-OCT images of albinos. These results indicate that the depolarizing appearance of pigmented structures like, for instance, the RPE is likely to be caused by the melanin granules contained in these cells.

High-speed retinal imaging with polarization-sensitive OCT at 1040 nm.

PURPOSE: To demonstrate the ability of a new high-speed polarization-sensitive optical coherence tomography (PS-OCT) system for retinal imaging at 1040 nm. METHODS: A new polarization-sensitive swept source OCT system in the 1 µm wavelength range is used to image the retina of healthy volunteers. The instrument is operated at an A-scan rate of 100 kHz which is about three times faster than previously reported PS-OCT instruments in this wavelength region. The increased imaging speed can be used to record densely sampled volumes of the retina. Moreover, it enables averaging of several B-scans recorded at the same location to obtain high-definition B-scans without the use of an eye tracker. RESULTS: Polarization-sensitive images of healthy volunteers clearly show the retinal pigment epithelium as a depolarizing layer. In addition, the good tissue penetration of the system allows the visualization of the sclera, which is highly birefringent and therefore shows increased image contrast with PS-OCT. CONCLUSIONS: PS-OCT in the 1 µm wavelength region shows similar polarization effects as in the 840 nm wavelength range. The high speed enables averaging of several B-scans to obtain high-definition polarization-sensitive images. The new system provides excellent penetration depth into the choroid and sclera.

Automated measurement of choroidal thickness in the human eye by polarization sensitive optical coherence tomography.

We present a new method to automatically segment the thickness of the choroid in the human eye by polarization sensitive optical coherence tomography (PS-OCT). A swept source PS-OCT instrument operating at a center wavelength of 1040 nm is used. The segmentation method is based entirely on intrinsic, tissue specific polarization contrast mechanisms. In a first step, the anterior boundary of the choroid, the retinal pigment epithelium, is segmented based on depolarization. In a second step, the choroid-sclera interface is found by using the birefringence of the sclera. The method is demonstrated in five healthy eyes. The mean repeatability (standard deviation) of thickness measurement was found to be 18.3 µm.

Morphologic characteristics of idiopathic juxtafoveal telangiectasia using spectral-domain and polarization-sensitive optical coherence tomography.

PURPOSE: Idiopathic juxtafoveal telangiectasia (IJT) is characteristically associated with pigmentary changes. Polarization-sensitive spectral-domain optical coherence tomography (PS-SD-OCT) enables imaging of the retinal pigment epithelium (RPE) and similar melanin-containing structures based on specific polarization properties. This study examined IJT with the latest-generation SD-OCT and PS-SD-OCT, identifying pathophysiologically relevant characteristics of the retinal layers and RPE. METHODS: Twenty-two eyes of 12 patients with IJT were examined by PS-SD-OCT, with special focus on RPE detection and segmentation. Furthermore, SD-OCT technology (Cirrus, Spectralis, and 3D-OCT-1000) was applied. Characteristics of the retinal layers and RPE were evaluated. A classification system based on OCT characteristics of IJT was suggested. RESULTS: Polarization-sensitive spectral-domain optical coherence tomography together with SD-OCT identified characteristic patterns of IJT, used to classify eyes into three distinct groups. Group 1 (5 eyes) revealed discrete alterations in the inner retinal layers; group 2 (12 eyes) showed irregularities of the junction between the inner and outer photoreceptor segments with outer retinal atrophy but an intact RPE. Group 3 (5 eyes) revealed RPE irregularities and loss in addition to intraretinal alterations and photoreceptor abnormalities. CONCLUSION: This study described characteristic morphologic changes in IJT based on PS-SD-OCT and SD-OCT. Morphologic changes were classified, possibly leading to an OCT-based grading scheme. The intensity images of SD-OCT verified intraretinal and photoreceptor irregularities in great detail, whereas PS-SD-OCT additionally showed RPE alterations.

Speckle noise reduction in high speed polarization sensitive spectral domain optical coherence tomography.

We present a high speed polarization sensitive spectral domain optical coherence tomography system based on polarization maintaining fibers and two high speed CMOS line scan cameras capable of retinal imaging with up to 128 k A-lines/s. This high imaging speed strongly reduces motion artifacts and therefore averaging of several B-scans is possible, which strongly reduces speckle noise and improves image quality. We present several methods for averaging retardation and optic axis orientation, the best one providing a 5 fold noise reduction. Furthermore, a novel scheme of calculating images of degree of polarization uniformity is presented. We quantitatively compare the noise reduction depending on the number of averaged frames and discuss the limits of frame numbers that can usefully be averaged.

Performance of automated drusen detection by polarization-sensitive optical coherence tomography.

PURPOSE: To estimate the potential of polarization-sensitive optical coherence tomography (PS-OCT) for quantitative assessment of drusen in patients with early age-related macular degeneration (AMD). METHODS: Fifteen eyes from 13 patients presenting drusen consistent with Age-Related Eye Disease Study classifications (grades 2 and 3) were examined ophthalmoscopically, followed by fundus photography, autofluorescence imaging, and three-dimensional scanning using a PS-OCT. For the automated evaluation of drusen location, area, and volume, a novel segmentation algorithm was developed based on the polarization scrambling characteristics of the retinal pigment epithelium (RPE) and applied to each complete data set. Subsequently, the drusen in each individual B-scan were identified by two independent expert graders. Concordance between manual and automated segmentation results was analyzed. Errors in the automated segmentation performance were classified as nonsignificant, moderate, or severe. RESULTS. In all, 2355 individual drusen, with a mean of 157 drusen per eye, were analyzed. Of drusen seen in the individual B-scans, 91.4% were detected manually by both expert graders. The automated segmentation algorithm identified 96.5% of all drusen without significant error. The mean difference in manual and automated drusen area (mean, 4.65 mm(2)) was 0.150. The number of detected drusen was significantly higher with automated than that with manual segmentation. PS-OCT segmentation was generally superior to fundus photography (P < 0.001). Particularly in nondetected drusen, a large variability in drusen morphology was noted. CONCLUSIONS: Automated drusen detection based on PS-OCT technology allows a fast and accurate determination of drusen location, number, and total area.

Visualization of microvasculature by dual-beam phase-resolved Doppler optical coherence tomography.

We present a dual-beam Doppler optical coherence tomography system for visualizing the microvasculature within the retina. The sample arm beams from two identical spectral domain optical coherence tomography (SD-OCT) systems are combined such that there is a small horizontal offset between them at the retina. Thereby we record two tomograms which are slightly separated in time. Phase-resolved Doppler analysis is performed between these two data sets. This system allows blood capillary imaging with high flow sensitivity and variable velocity range. To demonstrate the performance of our system we present images of the microvascular network around the fovea and around the optic nerve head of the human eye.

Sample motion-insensitive, full-range, complex, spectral-domain optical-coherence tomography.

We present a full-range, complex, spectral-domain optical-coherence-tomography (SD-OCT) system that is based on a double-beam scanning approach. The sample beams of two identical SD-OCT setups are combined collinearly by a bulk optic beam splitter before illuminating the object. The required phase shift for the complex signal reconstruction comes from the phase difference between both interferometers. Because of the double-beam scanning approach, our system is completely insensitive to sample motion. To demonstrate the performance of our setup, we present images of the human optic nerve head in vivo and of a human tooth.

Dynamic optical studies in materials testing with spectral-domain polarization-sensitive optical coherence tomography.

By combining dynamic mechanical testing with spectral-domain polarization-sensitive optical coherence tomography (SD-PS-OCT) performed at 1550 nm we are able to directly investigate for the first time changes within scattering technical materials during tensile and fracture tests. Spatially and temporally varying polarization patterns, due to defects and material inhomogeneities, were observed within bulk polymer samples and used to finally obtain--with the help of advanced image processing algorithms--quantitative maps of the evolving internal stress distribution. Furthermore, locally increased stress within fiber-reinforced composite materials was identified in situ with SD-PS-OCT to cause depolarizing sites of fiber-matrix debonding prior the onset of complete structural failure.

Polarimetric analysis of the human cornea measured by polarization-sensitive optical coherence tomography.

Corneal polarimetry measurement has been the object of several papers. The results of techniques like polarization-sensitive optical coherence tomography (PS-OCT), scanning laser polarimetry, or polarization microscopy are contradictory. Some studies propose a biaxial-like birefringence pattern, while others postulate that birefringence grows at corneal periphery. Several theoretical approaches were proposed for the interpretation of these measurements, but they usually lack accuracy and an adequate consideration of the nonnormal incidence on the tissue. We analyze corneal polarization effects measured by PS-OCT. In vivo and in vitro PS-OCT images of the human cornea are acquired. PS-OCT measurements are apparently not in agreement with the biaxial-like birefringence pattern. We present a polarimetric model of the human cornea based on the extended Jones matrix formalism applied to multilayered systems. We also apply the Poincaré equivalence theorem to extract optic axis orientation and birefringence. The results show that for a fibrils orientation pattern composed by alternating circular and radial fibrils, the birefringence is biaxial-like at the corneal center, and there is an almost circularly symmetric high-birefringence area at corneal periphery. The model could be useful for diagnosis of corneal diseases or corneal compensation in retinal polarimetric imaging.

In vivo investigation of human cone photoreceptors with SLO/OCT in combination with 3D motion correction on a cellular level.

We present a further improvement of our SLO/OCT imaging system which enables to practically eliminate all eye motion artifacts with a correction accuracy approaching sub-cellular dimensions. Axial eye tracking is achieved by using a hardware based, high speed tracking system that consists of a rapid scanning optical delay line in the reference arm of the interferometer. A software based algorithm is employed to correct for transverse eye motion in a post-processing step. The instrument operates at a frame rate of 40 en-face fps with a field of view of approximately 1 degrees x 1 degrees. Dynamic focusing enables the recording of 3D volumes of the human retina with cellular resolution throughout the entire imaging depth. Several volumes are stitched together to increase the total field of view. Different features of the three dimensional structure of cone photoreceptors are investigated in detail and at different eccentricities from the fovea.