By the time diseases of the retina are detected, serious damage has often already been done. An advanced optical imaging instrument called the adaptive optics scanning laser ophthalmoscopy (AOSLO) can be used to directly visualize the cellular structure of the retina in the living human eye. Adaptive optics is a technology for measuring and correcting the optical imperfections in the human eye. When adaptive optics is combined with an imaging platform, highly detailed images of the human retina can be acquired. Our research utilizes this technology to image cells in patients eyes through the newly-established Adaptive Optics Clinic within the NIH Clinical Center. Processing of adaptive optics is highly time-consuming and labor intensive. Currently, there are very few publicly-available tools for handling of adaptive optics data. We have been actively developing novel computational tools for the computer aided analysis of adaptive optics imaging data which will greatly enhance and accelerate our progress towards assembling a normal database of adaptive optics imaging data. Examples of such tools include the automated identification, segmentation, and tracking of photoreceptor neurons on split detection adaptive optics images. Such tools are becoming increasingly important for unraveling the clinical meaning of our images, which contain unprecedented levels of detail that can be difficult to interpret otherwise. Our long-term goal is to make the tools that we develop publicly-available to facilitate large-scale data science as well as data reproducibility. We remain very interested in exploring new technologies for improving our state-of-the-art, custom-built adaptive optics instrument in the NEI eye clinic with the overarching goal of augmenting the translational research capabilities at the NIH Clinical Center. We have recently invented a new method based on adaptive optics enhanced indocyanine green (AO-ICG) imaging to simultaneously image the retinal pigment epithelial cells alongside the photoreceptors directly inside the living human eye. Characterizing how these images look in healthy and diseased eyes may lead to new insights about the pathophysiology of retinal diseases. We are also collaborating with Dr. Yang of the University of Rochester and Drs. Pursley and Pohida, CIT, to implement state-of-the-art, real-time eye tracking capabilities for adaptive optics retinal imaging, as well as with Dr. Hammer of the FDA to explore complementary advanced imaging modalities compatible with adaptive optics. Progress towards these projects are facilitated by ongoing collaborations with Howard Metger and Robert Clary, and with the NIH Library for custom machining or 3D printing of components related to various modules within the custom-built adaptive optics instrument. Finally, through collaboration with Drs. Cukras, Huryn, Zein, Brooks, Wong, Chew, Wiley, Hufnagel, and other NEI clinicians, we are beginning to explore the manifestation of sight-threatening diseases at the cellular level. Translation of our technology and tools into these patients will lead to the ability to monitor the progression of disease in actual patients at the cell-to-cell level.
