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Two Research Partnerships To Develop AO For High-Resolution Retinal Imaging

Bethesda, Maryland – March 1, 2003:   Two five-year Bioengineering Research Partnerships (BRPs) funded by the National Institutes of Health will combine adaptive optics with confocal scanning laser ophthalmoscopy and optical coherence tomography to image the human retina at high resolution.
  Both efforts are outgrowths of research to develop instruments for high-resolution retinal imaging funded by the Center for Adaptive Optics at UC Santa Cruz. The goal is to develop and test clinical ophthalmic instruments using MEMS AO devices to revolutionize the diagnosis and treatment of the diseases that cause blindness and to develop techniques for vision correction in the general population.

The first Bioengineering Research Partnership is led by the University of Rochester. It will develop a portable, MEMS-based AO confocal scanning laser ophthalmoscope.

The second Bioengineering Research Partnership, led by the University of California Davis Medical Center, will combine MEMS-based adaptive optics technology with OCT instruments to improve the ability to visualize the retina in three dimensions with cellular-level resolution.
Atlas of Laser Scanning Ophthalmoscopy, Scheuerle
The two Biomedical Research Partnerships will start in 2003 and run for five years. They have the following goals:

"Optics Instrumentation for Advanced Ophthalmic Imaging," David R. Williams, University of Rochester 
This research partnership has two goals. The first is to design and construct a new generation of instruments for noninvasive imaging of the mammalian retina with 3-D resolution superior to existing technology and capable of resolving single cells in vivo.  
The second is to explore the value of this technology through application to human retinal disease and retinal surgery. These instruments will combine adaptive optics, a technology borrowed from astronomy that automatically corrects all the eye's aberrations, with confocal microscopy, a technology for optically sectioning the retina.  
The lead institution will be the University of Rochester, and partners include Lawrence Livermore National Laboratory, the Doheny Eye Institute at the University of Southern California, the University of Houston, the University of California at Berkeley, and the Schepens Eye Research Institute.  
By the end of year 1, a device will be operational at each of four clinical sites: University of Southern California, Rochester, Houston, and Schepens. In years 2-5, these devices will provide high resolution imaging of neovascularization in age related macular degeneration and diabetic retinopathy, photoreceptors in retinal degenerative disease such as retinitis pigmentosa, ganglion cell bodies in glaucoma, individual retinal pigment epithelial cells, and blood flow in the smallest retinal capilliaries. In year 3, a new surgical microscope equipped with adaptive optics will be constructed by LLNL. Retinal surgeons at USC will evaluate this device in years 4-5. Based on its experience with earlier instruments, the BRP will design and build a sixth instrument in year 4 that will be portable, compact, and user friendly. This device will be available to investigators outside the BRP.  
The BRP brings together optical engineers, basic vision scientists, and clinical vision researchers. This will allow engineers to design instrumentation informed by the specific needs of clinical research, allowing them to translate adaptive optics technology directly into clinical application.  
LLNL brings to the partnership expertise in optical engineering and adaptive optics from the fields of astronomy and laser fusion. Rochester and Houston will contribute experience in adaptive optics applied to retinal imaging. Rochester first applied adaptive optics to high resolution retinal imaging and Houston has recently demonstrated a prototype adaptive optics system that is the precursor for the devices proposed here. Schepens brings international leadership in scanning laser ophthalmoscopy. UC Berkeley provides expertise in the study of retinal degenerative diseases. The University of Southern California, with its innovative approaches to retinal disease and retinal surgery, will join Rochester, Houston, and Schepens in providing clinical sites for the evaluation of confocal adaptive optics technology.

"Ophthalmic Imaging Using Adaptive Optics and OCT," John S. Werner, University of California, Davis 
The purpose of this BRP is to develop and evaluate new instrumentation that will permit unprecedented three dimensional imaging of single cells in the human retina, specifically rod and cone photoreceptors and ganglion cells.  
An interdisciplinary team will combine adaptive optics (AO), enabling the best lateral resolution for retinal imaging, with optical coherence tomography (OCT), providing the best axial resolution for retinal imaging. Two instruments will be developed using complementary OCT imaging modalities, flood illumination and enface scanning. These instruments will be used to study cellular morphology associated with normal aging, age related macular degeneration (AMD) and glaucoma. The instruments will be compared quantitatively with each other and with existing retinal imaging devices.  
The project will be led by University of California Davis, where a high-performance AO system has been developed in collaboration with the Lawrence Livermore National Laboratory (LLNL). This collaboration will be expanded to include a team of OCT experts at LLNL and Indiana University. The Indiana University team has previously collaborated with LLNL through the Center for Adaptive Optics and has already developed a working prototype AO-OCT system for retinal imaging.  
In this BRP project, LLNL will construct one AO-OCT instrument at the UC Davis site to be tested clinically in years 3-5, while the second AO-OCT instrument will be developed at Indiana University in collaboration with LLNL and tested in the laboratory in years 4-5. Comparisons of AO-OCT and functional measures will be obtained at UC Davis and Indiana University.  
Both instruments will be made available for use by scientists and clinicians who are not part of the BRP, and will be refined through the course of the project period. UC Davis has expertise in vision science, aging, and evaluation of AMD and glaucoma progression and treatment. LLNL has a long history of research on AO for astronomy and has transferred some of its AO technology to vision science at UC Davis. LLNL also has expertise in OCT, and has pioneered its application to in vivo imaging of oral and vascular structures. The Indiana University team has experience in AO-OCT and vision science with specific expertise in visual optics and retinal electrophysiology.  
This BRP is buttressed by consultants who have developed ophthalmic OCT technology at the University of Texas and Carl Zeiss Meditec. The Zeiss group has already transferred OCT technology to the clinic via commercial development and will facilitate incorporation of user friendly interfaces for our AO-OCT systems.

This BRP thus combines the unique expertise of engineers, vision scientists and clinicians who have experience working together to effect a smooth transition from the laboratory to applications. This synergistic team will develop a new generation of instruments to advance vision science, permit retinal dysfunction to be studied in vivo in a way that will offer new insights into normal aging, the pathogenesis of glaucoma and macular degeneration, and a reliable method to monitor novel treatments for retinal disease.
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