Subjective measurement of the Stiles-Crawford effect with different field sizes.

The Stiles-Crawford effect of the first kind (SCE) is the phenomenon in which light entering the eye near the center of the pupil appears brighter than light entering near the edge. Previous investigations have found an increase in the directionality (steepness) of the effect as the testing location moves from the center of the visual field to parafoveal positions, but the effect of central field size has not been considered. The influence of field size on the SCE was investigated using a uniaxial Maxwellian system in which stimulus presentation was controlled by an active-matrix liquid crystal display. SCE directionality increased as field size increased from 0.5° to 4.7° diameter, although this was noted in four mild myopes and not in two emmetropes. The change with field size was supported by a geometric optics absorption model.

Subjective measurement of the Stiles-Crawford effect of the first kind with variation in accommodation.

PURPOSE: To measure the Stiles-Crawford effect of the first kind (SCE-I), corresponding to central vision, with innovative technology to evaluate changes in the directionality and photoreceptor alignment with accommodation. METHODS: A uniaxial Maxwellian system (spot size in pupil 0.5 mm diameter) was employed, incorporating a spatial light modulator to flicker at 2 Hz between two 2.3° fields corresponding to test (peripheral pupil) and reference (pupil centre) positions. Participants determined thresholds at 13 positions along the horizontal pupil meridian by indicating if the test field was brighter or dimmer than the reference field. Thresholds were determined by a staircase procedure after four reversals at each pupil location. After pupil dilation, seven emmetropes were tested at 0 D to 6 D accommodation stimulus levels in 2 D intervals. Data were fit by the Gaussian function, both when the fits were unforced or forced to pass through the sensitivity expected for the reference point. Directionality (ρ) and peak location values (xmax) were determined for unforced and forced fits. RESULTS: Regression slopes for ρ as a function of accommodation stimulus were not significant. There was a tendency for xmax to shift temporally with increasing accommodation across the 6 D stimulus range. This was not significant for regression fitting (-0.059 mm/D, R2  = 0.06, p = 0.20), but a paired t-test for 0 and 6 D stimuli showed a weakly significant change of 0.62 mm (p = 0.05). The differences between the two fitting approaches were small and non-significant. CONCLUSIONS: Directionality did not change with accommodation, but the pupil peak location showed a significant temporal shift of approximately 0.62 mm with 6 D accommodation stimulus. It is possible that substantial changes in the directionality and a shift in the direction of peak location might occur at very high levels of accommodation.

Digital holographic microscope for human eye retinal structures recording in vivo.

We introduce the digital holographic microscope for recording in vivo human eye retinal structures. Current eye imaging technologies cannot provide images with resolutions better than 1 µm within depths of a few hundred micrometers. This can be improved with digital holography, in which a hologram of the eye captured with digital camera contains information about structures over the full depth of the eye. This information can be reconstructed either optically or numerically. Our hologram recording scheme utilizes working principles of the off-axis digital holographic microscope, designed for reflective micro-object investigation. The eye cornea and lens form the microscope objective. We can record in vivo digital holograms of the human eye retina with resolution after reconstruction of at least 1.3 micrometer.

Fixation Stability with Bessel Beams.

SIGNIFICANCE: Ophthalmic imaging instruments that require stable fixation can benefit by using Bessel beams in the form of monitor-based Bessel images. PURPOSE: The purpose of this study was to investigate fixation stability using laser Bessel and Gaussian beams and monitor-based images of these targets. METHODS: The right eyes of 16 participants were presented with seven fixation targets: monitor-based images of a bull's eye/cross hair, a Gaussian beam, a Bessel beam with four rings and a Bessel beam with three rings; laser Gaussian beam, laser Bessel beam with four rings, and laser Bessel beam with three rings. Participants fixated target centers for five runs, in which each run presented the seven targets for 20 seconds each. An Eye Tribe tracker sampled eye positions at 30 Hz. Standard deviations along horizontal (σx) and vertical meridians (σy) and areas of bivariate contour ellipses (BCEAs) of fixation positions were calculated, and statistical significances of target differences for these parameters were determined. RESULTS: Average σx, σy, and BCEAs ranged from 0.26 to 0.35°, 0.38 to 0.55°, and 0.78 to 1.31 degrees, respectively. Target differences in σx (χ6 = 13.0, P = .04), (σy) (χ6 = 36.819, P < .001), and BCEA (χ6 = 34.406, P < .001) were statistically significant. There were significant post hoc differences between some of the target pairs for σy and BCEA, but not for σx. Monitor-based Bessel beam targets provided significantly smaller σy and BCEAs than the bull's eye/cross hair combination and the monitor- and laser-based Gaussian beam targets. CONCLUSIONS: Monitor-based images of Bessel beams provided better fixation targets than did a bull's eye/cross hair combination, monitor-based Gaussian images, and laser Gaussian beams, but no claim can be made that laser Bessel beams provide better fixation targets than do laser Gaussian beams. Monitor-based Bessel images should be useful for ophthalmic imaging instruments requiring stable fixation.

Improvements to Phakometry Using Bessel Beams.

SIGNIFICANCE: The main problem with phakometry is the low visibility of the third Purkinje image. We built a phakometer using Bessel beams, which have properties of being resistant to diffraction and the potential for self-reconstruction. This instrument had lenticular images three times brighter than those of a conventional phakometer. PURPOSE: To investigate Purkinje image brightness, accuracy, and repeatability of a "Bessel" phakometer compared with those of a conventional phakometer. METHODS: Phakometers were developed with a telecentric imaging system focused at the pupil plane of the eye to capture anterior cornea, anterior lens (PIII), and posterior lens (PIV) Purkinje images. A Bessel beam was generated by a diode laser beam passing through a high-powered doublet with a central obstruction. Software was used to determine image sizes and estimate lens anterior and posterior surface radii of curvature (Ra, Rp), equivalent refractive index (RI), and equivalent power (F). The Bessel phakometer's accuracy was assessed using a model eye. Repeatability (interobserver and intraobserver) and Purkinje images brightnesses of Bessel and conventional phakometers were assessed with six participants. RESULTS: The lens parameters of the model eye determined by the Bessel phakometer were similar to those provided by the model eye's manufacturer with differences (manufacturer - Bessel) in Ra and Rp, RI, and F of +1.18 mm, 0.18 mm, +0.0053, and -0.55 D, respectively. The intraobserver repeatabilities for the Bessel and conventional phakometers were similar. The interobserver repeatabilities of Ra, Rp, and RI for the Bessel phakometer were almost half those (i.e., two times better) for the conventional phakometer. Brightnesses of PIII and PIV were approximately three times higher with the Bessel phakometer than with the conventional phakometer. CONCLUSIONS: The Bessel beam phakometer provided accurate estimates of lens parameters of a model eye and produced brighter Purkinje images and better interobserver repeatability than that of a conventional phakometer.

Intelligent estimation of noise and blur variances using ANN for the restoration of ultrasound images.

Ultrasound (US) imaging is a widely used clinical diagnostic tool in medical imaging techniques. It is a comparatively safe, economical, painless, portable, and noninvasive real-time tool compared to the other imaging modalities. However, the image quality of US imaging is severely affected by the presence of speckle noise and blur during the acquisition process. In order to ensure a high-quality clinical diagnosis, US images must be restored by reducing their speckle noise and blur. In general, speckle noise is modeled as a multiplicative noise following a Rayleigh distribution and blur as a Gaussian function. Hereto, we propose an intelligent estimator based on artificial neural networks (ANNs) to estimate the variances of noise and blur, which, in turn, are used to obtain an image without discernible distortions. A set of statistical features computed from the image and its complex wavelet sub-bands are used as input to the ANN. In the proposed method, we solve the inverse Rayleigh function numerically for speckle reduction and use the Richardson-Lucy algorithm for de-blurring. The performance of this method is compared with that of the traditional methods by applying them to a synthetic, physical phantom and clinical data, which confirms better restoration results by the proposed method.

Peripheral detection and resolution with mid-/long-wavelength and short-wavelength sensitive cone systems.

This study compared neural resolution and detection limits of the human mid-/long-wavelength and short-wavelength cone systems with anatomical estimates of photoreceptor and retinal ganglion cell spacings and sizes. Detection and resolution limits were measured from central fixation out to 35° eccentricity across the horizontal visual field using a modified Lotmar interferometer. The mid-/long-wavelength cone system was studied using a green (550 nm) test stimulus to which S-cones have low sensitivity. To bias resolution and detection to the short-wavelength cone system, a blue (450 nm) test stimulus was presented against a bright yellow background that desensitized the M- and L-cones. Participants were three trichromatic males with normal visual functions. With green stimuli, resolution showed a steep central-peripheral gradient that was similar between participants, whereas the detection gradient was shallower and patterns were different between participants. Detection and resolution with blue stimuli were poorer than for green stimuli. The detection of blue stimuli was superior to resolution across the horizontal visual field and the patterns were different between participants. The mid-/long-wavelength cone system's resolution is limited by midget ganglion cell spacing and its detection is limited by the size of the M- and L-cone photoreceptors, consistent with previous observations. We found that no such simple relationships occur for the short-wavelength cone system between resolution and the bistratified ganglion cell spacing, nor between detection and the S-cone photoreceptor sizes.

Speckle-reduction algorithm for ultrasound images in complex wavelet domain using genetic algorithm-based mixture model.

Compared with other medical-imaging modalities, ultrasound (US) imaging is a valuable way to examine the body's internal organs, and two-dimensional (2D) imaging is currently the most common technique used in clinical diagnoses. Conventional 2D US imaging systems are highly flexible cost-effective imaging tools that permit operators to observe and record images of a large variety of thin anatomical sections in real time. Recently, 3D US imaging has also been gaining popularity due to its considerable advantages over 2D US imaging. It reduces dependency on the operator and provides better qualitative and quantitative information for an effective diagnosis. Furthermore, it provides a 3D view, which allows the observation of volume information. The major shortcoming of any type of US imaging is the presence of speckle noise. Hence, speckle reduction is vital in providing a better clinical diagnosis. The key objective of any speckle-reduction algorithm is to attain a speckle-free image while preserving the important anatomical features. In this paper we introduce a nonlinear multi-scale complex wavelet-diffusion based algorithm for speckle reduction and sharp-edge preservation of 2D and 3D US images. In the proposed method we use a Rayleigh and Maxwell-mixture model for 2D and 3D US images, respectively, where a genetic algorithm is used in combination with an expectation maximization method to estimate mixture parameters. Experimental results using both 2D and 3D synthetic, physical phantom, and clinical data demonstrate that our proposed algorithm significantly reduces speckle noise while preserving sharp edges without discernible distortions. The proposed approach performs better than the state-of-the-art approaches in both qualitative and quantitative measures.

Sibanye Methods for Prevention Packages Program Project Protocol: Pilot Study of HIV Prevention Interventions for Men Who Have Sex With Men in South Africa.

BACKGROUND: Human immunodeficiency virus (HIV) prevention intervention programs and related research for men who have sex with men (MSM) in the southern African region remain limited, despite the emergence of a severe epidemic among this group. With a lack of understanding of their social and sexual lives and HIV risks, and with MSM being a hidden and stigmatized group in the region, optimized HIV prevention packages for southern African MSM are an urgent public health and research priority. OBJECTIVE: The objective of the Sibanye Health Project is to develop and evaluate a combination package of biomedical, behavioral, and community-level HIV prevention interventions and services for MSM in South Africa. METHODS: The project consists of three phases: (1) a comprehensive literature review and summary of current HIV prevention interventions (Phase I), (2) agent-based mathematical modeling of HIV transmission in southern African MSM (Phase II), and (3) formative and stigma-related qualitative research, community engagement, training on providing health care to MSM, and the pilot study (Phase III). The pilot study is a prospective one-year study of 200 men in Cape Town and Port Elizabeth, South Africa. The study will assess a package of HIV prevention services, including condom and condom-compatible lubricant choices, risk-reduction counseling, couples HIV testing and counseling, pre-exposure prophylaxis (PrEP) for eligible men, and non-occupational post-exposure prophylaxis for men with a high risk exposure. The pilot study will begin in October 2014. RESULTS: Preliminary results from all components but the pilot study are available. We developed a literature review database with meta-data extracted from 3800 documents from 67 countries. Modeling results indicate that regular HIV testing and promotion of condom use can significantly impact new HIV infections among South African MSM, even in the context of high coverage of early treatment of HIV-positive men and high coverage of PrEP for at-risk HIV-negative men. Formative qualitative research consisted of 79 in-depth interviews, and six focus group discussions in Cape Town and Port Elizabeth. Analysis of these data has informed pilot study protocol development and has been documented in peer-reviewed manuscripts. Qualitative work regarding stigma faced by South African MSM resulted in finalized scales for use in the pilot study questionnaire. A total of 37 health care providers completed training designed to facilitate clinically and culturally competent care for MSM in the Eastern Cape. CONCLUSIONS: The design of a future, larger study of the HIV prevention package will be conducted at the end of the pilot study, powered to detect efficacy of the prevention package. Data from the updated mathematical model, results of the pilot study, acceptability data, and advancements in HIV prevention sciences will be considered in developing the final proposed package and study design. TRIAL REGISTRATION: ClinicalTrials.gov NCT02043015; http://clinicaltrials.gov/show/NCT02043015 (Archived by WebCite at http://www.webcitation.org/6THvp7rAj).

Optical test-benches for multiple source wavefront propagation and spatiotemporal point-spread function emulation.

Precise measurement of aberrations within an optical system is essential to mitigate combined effects of user-generated aberrations for the study of anisoplanatic imaging using optical test benches. The optical system point spread function (PSF) is first defined, and methods to minimize the effects of the optical system are discussed. User-derived aberrations, in the form of low-order Zernike ensembles, are introduced using a liquid crystal spatial light modulator (LC-SLM), and dynamic phase maps are used to study the spatiotemporal PSF. A versatile optical test bench is described, where the Shack Hartmann and curvature wavefront sensors are used to emulate the effects of wavefront propagation over time from two independent sources.

3D CT to 2D low dose single-plane fluoroscopy registration algorithm for in-vivo knee motion analysis.

A limitation to accurate automatic tracking of knee motion is the noise and blurring present in low dose X-ray fluoroscopy images. For more accurate tracking, this noise should be reduced while preserving anatomical structures such as bone. Noise in low dose X-ray images is generated from different sources, however quantum noise is by far the most dominant. In this paper we present an accurate multi-modal image registration algorithm which successfully registers 3D CT to 2D single plane low dose noisy and blurred fluoroscopy images that are captured for healthy knees. The proposed algorithm uses a new registration framework including a filtering method to reduce the noise and blurring effect in fluoroscopy images. Our experimental results show that the extra pre-filtering step included in the proposed approach maintains higher accuracy and repeatability for in vivo knee joint motion analysis.

Improved fixation quality provided by a Bessel beacon in an adaptive optics system.

PURPOSE: We investigate whether a structured probe beam that creates the beacon for use in a retinal imaging adaptive optics system can provide useful side effects. In particular we investigate whether a Bessel beam that is seen by the subject as a set of concentric rings has a dampening effect on fixation variations of the subject under observation. This calming effect would allow longer periods of observation, particularly for patients with abnormal fixation. METHOD: An experimental adaptive optics system developed for retinal imaging is used to monitor the fluctuations in aberrations for artificial and human subjects. The probe beam is alternated between a traditional beacon and one provided by a Bessel beam created by SLM. RESULTS: Time-frequency analysis is used to indicate the differences in power and time variation during fixation depending on whether the Bessel beam or the traditional beacon is employed. Comparison is made with the response for an artificial eye to discount systemic variations. CONCLUSION: Significant evidence is accrued to indicate the reduced fluctuations in fixation when the Bessel beam is employed to create the beacon.

Precision analysis of a multi-slice ultrasound sensor for non-invasive 3D kinematic analysis of knee joints.

Currently the standard clinical practice for measuring the motion of bones in a knee joint with sufficient precision involves implanting tantalum beads into the bones to act as fiducial markers prior to imaging using X-ray equipment. This procedure is invasive in nature and exposure to ionizing radiation imposes a cancer risk and the patient's movements are confined to a narrow field of view. In this paper, an ultrasound based system for non-invasive kinematic evaluation of knee joints is proposed. The results of an initial analysis show that this system can provide the precision required for non-invasive motion analysis while the patient performs normal physical activities.