Effect of multiple light paths on retinal vessel oximetry.

Techniques for noninvasively measuring the oxygen saturation of blood in retinal arteries and veins are reported in the literature, but none have been sufficiently accurate and reliable for clinical use. Addressing the need for increased accuracy, we present a series of oximetric equations that explicitly consider the effects of backscattering by red blood cells and lateral diffusion of light in the ocular fundus. The equations are derived for the specific geometry of a scanning-beam retinal vessel oximeter; however, the results should also be applicable to photographic oximeters. We present in vitro and in vivo data that suggest the validity of these equations.

Retinal venous oxygen saturation correlates with blood volume.

OBJECTIVES: To evaluate the sensitivity of retinal venous O2 saturation (SrvO2) for early blood loss and reinfusion. A secondary objective was to measure the correlation between SrvO2 and mixed venous O2 saturation (SvO2) during blood loss and reinfusion. METHODS: Seven anesthetized swine were bled at 0.8 mL/kg/min to 16 mL/kg. Shed blood was re-infused at the same rate and the swine were allowed to equilibrate. After equilibration, repeat hemorrhages were performed at 1.6 mL/kg/min and 2.4 mL/kg/min. SrvO2 was measured using an eye oximeter (EOX) and SvO2 was measured using a fiber-optic catheter. RESULTS: During blood loss, SrvO2 correlated with blood removed (r = -0.88, -0.97, -0.96) and SvO2 (r = 0.87, 0.98, 0.92). During reinfusion, SrvO2 correlated with blood re-infused (r = 0.63, 0.76, 0.82) and SvO2 (r = 0.80, 0.93, 0.96). SrvO2 decreased 1.22 +/- 0.60%/mL/kg of blood removed. The rate of decrease in SrvO2 per minute (deltaSrvO2) when blood was removed at 2.4 mL/kg/min was significantly greater than deltaSrvO2 when blood was removed at 0.8 mL/kg/min (p < 0.007). The rates of change in blood pressure (BP) and pulse were not significantly different at any rate of blood removal. CONCLUSIONS: In this model, retinal venous O2 saturation correlated with blood volume and central venous O2 saturation. Unlike the rate of change in BP and heart rate, deltaSrvO2 values were significantly different at different rates of blood removal. Use of an EOX to monitor for blood loss, estimate the rate of hemorrhage, and evaluate the response to therapy during resuscitation warrants further study.

Oxygen Saturation Measurements of Blood in Retinal Vessels during Blood Loss.

We describe a noninvasive technique and instrumentation for measuring the oxygen saturation of blood in retinal arteries and veins. The measurements are made by shining low-power lasers into the eye, and scanning the beams across a retinal blood vessel. The light reflected and scattered back out of the eye is collected and measured. The oxygen saturation of blood within the vessel is determined by analyzing the vessel absorption profiles at two wavelengths. A complete saturation measurement can be made in less than 1 s, allowing real-time measurement during physiologic changes. The sensitivity of this measurement technique to changes in retinal saturation has been demonstrated through a series of pilot studies in anesthetized swine. We present data indicating that retinal venous oxygen saturation decreases during ongoing blood loss, demonstrating a potential application of an eye oximeter to noninvasively monitor blood loss. © 1998 Society of Photo-Optical Instrumentation Engineers.

Retinal large vessel oxygen saturations correlate with early blood loss and hypoxia in anesthetized swine.

BACKGROUND: Noninvasive monitoring would likely improve trauma care. Using laser technology, we monitored the oxygen saturation in retinal vessels during exsanguination and hypoxia. METHODS: Seven anesthetized swine were bled at 0.4 mL/kg/min for 40 minutes. During exsanguination, retinal venous saturation (SrvO2) was measured using an eye oximeter, and central venous saturation (SvO2) was measured using a fiber-optic catheter. After the shed blood was reinfused, the FiO2 was progressively decreased from 0.97 to 0.07. Femoral artery oxygen saturation (SaO2) and retinal artery oxygen saturation (SraO2) were measured at each increment. RESULTS: During exsanguination, SrvO2 correlated with blood loss (r = -0.93) and SvO2 (r = 0.94). SraO2 correlated with SaO2 during incremental hypoxia (R2 = 0.93 +/- 0.15). CONCLUSIONS: In this model of exsanguination, retinal venous oxygen saturation correlates with blood volume and with central venous oxygen saturation. The SraO2 correlates with SaO2 during graded hypoxia. Use of an eye oximeter to noninvasively monitor trauma patients appears promising and warrants further study.

Aberrations of a horizontal-vertical depolarizer.

We use ray-trace equations for uniaxial birefringent materials to derive third-order estimates for aberrations that are produced in imaging through uniaxial plates and horizontal-vertical (HV) depolarizers. An HV depolarizer is a spatial pseudodepolarizer; it converts a uniform input polarization state into a continuum of spatially varying polarization states in an output beam. An HV depolarizer consists of two birefringent wedges whose crystal axes are crossed at 90 degrees . The interface between the wedges is inclined, which leads to a spatially varying retardance that provides the spatial pseudodepolarization. In HV depolarizers, spherical aberration, astigmatism, and image doubling are the principal aberrations for on-axis objects. Only spherical aberration occurs in isotropic plates, while the presence of birefringent wedges introduces astigmatism and image doubling. It is shown that image separation is proportional tothe magnitude of the retardance variation. Image separation is independent of the thickness, wedge angle, and refractive indices that are used to achieve this variation. A computer program is used to perform an exact birefringent ray trace and produces spot diagrams that confirm the aberration estimates.

Natural modes for the analysis of optical bistability and laser instability.

A self-consistent description is given for the propagation of a weak optical probe beam through a homogeneously broadened two-level medium in the presence of a strong, collinear, near-resonant pump beam. The propagation of the probe beam is given in terms of bichromatic natural modes, which contain frequency components symmetrically displaced from that of the pump beam. The two frequency components have a definite relative amplitude and phase, which are determined solely by the frequency detunings of the optical fields from the atomic resonance and by the intensity of the pump field. A simple method for calculating these natural modes is derived, and their importance in describing nearly degenerate four-wave mixing, optical bistability, and the stability of homogeneously broadened ring lasers is discussed.