Abstract

Measurements of the human ocular fundus that make use of the light returning through the pupil are called reflectometry. Early reflectometry studies were limited by poor light return from the retina and strong reflections from the anterior surface of the eye. Artifacts produced misleading results in diseases like age-related macular degeneration. Novel laser sources, scanning, confocal optics, and digital imaging provide improved sampling of the signal from the tissues of interest: photoreceptors and retinal pigment epithelial cells. A wider range of wavelengths is now compared, including the near infrared. Reflectometry now provides functional mapping, even in severe pathology.

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  1. F. C. Delori and K. P. Pflibsen, "Spectral reflectance of the human ocular fundus," Appl. Opt. 28, 1061-1077 (1989).
    [CrossRef] [PubMed]
  2. A. E. Elsner, S. A. Burns, J. J. Weiter and F. C. Delori, "Infrared imaging of subretinal structures in the human ocular fundus," Vision Res. 36, 191-205 (1996).
    [CrossRef] [PubMed]
  3. S. A. Burns, S. Wu, F. C. Delori and A. E. Elsner, "Direct Measurement of human cone photoreceptor alignment," J. Opt. Soc. Am. A 12, 2329-2338 (1995).
    [CrossRef]
  4. A. E. Elsner, S. A. Burns, G. W. Hughes and R. H. Webb, "Reflectometry with a Scanning Laser Ophthalmoscope," Appl. Opt. 31, 3697-3710 (1992).
    [CrossRef] [PubMed]
  5. S. Marcos, R.-P. Tornow, A. E. Elsner and R. Navarro, "Foveal cone spacing and cone photopigment density difference: objective measurements in the same subjects." Vision Res. 37, 1909-1915 (1997).
    [CrossRef] [PubMed]
  6. A. E. Elsner, S. A. Burns, E. Beausencourt and J. J. Weiter, "Foveal cone photopigment distribution: small alterations associated with macular pigment distribution," Invest. Ophthalmol. Vis. Sci. 39, 2394-2404 (1998).
    [PubMed]
  7. A. E. Elsner, S. A. Burns, F. C. Delori and R. H. Webb, "Quantitative Reflectometry with the SLO," in Laser Scanning Ophthalmoscopy and Tomography, J. E. Nasemann and R.O.W. Burk eds. (Quintessenz-Verlag, Munich, 1990), pp. 109-121.
  8. A. E, Elsner, S. A. Burns, M. R. Kreitz and J. J. Weiter, "New views of the retina/RPE complex: quantifying sub-retinal pathology," in Noninvasive Assessment of the Visual System, Vol, 1 of OSA Proceedings Series (Optical Society of America, Washington, D.C., 1991), pp. 150-153.
  9. A. E. Elsner, D.-U. Bartsch, J. J. Weiter and M. E. Hartnett, "New devices in retinal imaging and functional evaluation," in Practical Atlas of Retinal Disease and Therapy, W. Freeman ed. (Lippincott-Raven, New York, 1998) 2nd edition, pp. 19-55.
  10. L. M. Kelley, J. P. Walker, G. L. Wing, P. A. Raskauskas and A. E. Elsener, "Scanning laser ophthalmoscope imaging of age related macular degeneration and neoplasms," J. Ophthalmic Photography 3, 89-94 (1997).
  11. M E. Hartnett and A. E. Elsner, "Characteristics of exudative age-related macular degeneration determined in vivo with confocal direct and indirect infrared imaging," Ophthalmol. 103, 58-71 (1996).
  12. L. V. Johnson, S. Ozak, M. I. Staples, P. A., Erickson and D. H. Anderson, "Potential role for immune complex pathogenesis in drusen formation," Exp. Eye Res. 70, 441-449 (2000).
    [CrossRef] [PubMed]
  13. The longitudinal study and image of the first patient re-tested are at http://color.eri.harvard.edu/annhom.htm
  14. A. E. Elsner, L. Moraes, C. W. Kunze and M. E. Hartnett, "Foveal cone photopigment distribution in age-related macular degeneration: association with fundus features," in Vision Science and Its Applications, Vol. 1 of OSA Proceedings Series (Optical Society of America, Washington, D.C., 1998) pp.14-17.
  15. A. E. Elsner, A. Remky, E. Beausencourt and S. A. Burns, "A statistical method to quantify drusen in SLO images," in Vision Science and Its Applications, Vol. 1 of OSA Proceedings Series (Optical Society of America, Washington, D.C., 1996), pp. 268-271.
  16. R.-P. Tornow and R. Stilling, "Scanning laser densitometry and color perimetry demonstrate reduced photopigment density and sensitivity in two patients with retinal degeneration" Vision Res. 39, 3630-3641 (1999).
    [CrossRef]
  17. M. A. Sandberg, B. S. Pawlyk E. L. Berson, "Acuity recovery and cone pigment regeneration after a bleach in patients with retinitis pigmentosa and rhodopsin mutations," Invest. Ophthalmol. Vis. Sci. 40, 2457-2461 (1999).
    [PubMed]
  18. S. A. Burns, S. Wu, J. He, J and A. E. Elsner, "Variations in photoreceptor directionality across the central retina," J. Opt. Society Amer A 14, 2033-2040 (1997).
    [CrossRef]
  19. P. J. DeLint, T. T. Berendschot and D. A. van Norren, "A comparison of the optical Stiles-Crawford effect and retinal densitometry in a clinical setting," Invest. Ophthalmol. Vis. Sci. 39, 1519-1523 (1998).
    [PubMed]

Other (19)

F. C. Delori and K. P. Pflibsen, "Spectral reflectance of the human ocular fundus," Appl. Opt. 28, 1061-1077 (1989).
[CrossRef] [PubMed]

A. E. Elsner, S. A. Burns, J. J. Weiter and F. C. Delori, "Infrared imaging of subretinal structures in the human ocular fundus," Vision Res. 36, 191-205 (1996).
[CrossRef] [PubMed]

S. A. Burns, S. Wu, F. C. Delori and A. E. Elsner, "Direct Measurement of human cone photoreceptor alignment," J. Opt. Soc. Am. A 12, 2329-2338 (1995).
[CrossRef]

A. E. Elsner, S. A. Burns, G. W. Hughes and R. H. Webb, "Reflectometry with a Scanning Laser Ophthalmoscope," Appl. Opt. 31, 3697-3710 (1992).
[CrossRef] [PubMed]

S. Marcos, R.-P. Tornow, A. E. Elsner and R. Navarro, "Foveal cone spacing and cone photopigment density difference: objective measurements in the same subjects." Vision Res. 37, 1909-1915 (1997).
[CrossRef] [PubMed]

A. E. Elsner, S. A. Burns, E. Beausencourt and J. J. Weiter, "Foveal cone photopigment distribution: small alterations associated with macular pigment distribution," Invest. Ophthalmol. Vis. Sci. 39, 2394-2404 (1998).
[PubMed]

A. E. Elsner, S. A. Burns, F. C. Delori and R. H. Webb, "Quantitative Reflectometry with the SLO," in Laser Scanning Ophthalmoscopy and Tomography, J. E. Nasemann and R.O.W. Burk eds. (Quintessenz-Verlag, Munich, 1990), pp. 109-121.

A. E, Elsner, S. A. Burns, M. R. Kreitz and J. J. Weiter, "New views of the retina/RPE complex: quantifying sub-retinal pathology," in Noninvasive Assessment of the Visual System, Vol, 1 of OSA Proceedings Series (Optical Society of America, Washington, D.C., 1991), pp. 150-153.

A. E. Elsner, D.-U. Bartsch, J. J. Weiter and M. E. Hartnett, "New devices in retinal imaging and functional evaluation," in Practical Atlas of Retinal Disease and Therapy, W. Freeman ed. (Lippincott-Raven, New York, 1998) 2nd edition, pp. 19-55.

L. M. Kelley, J. P. Walker, G. L. Wing, P. A. Raskauskas and A. E. Elsener, "Scanning laser ophthalmoscope imaging of age related macular degeneration and neoplasms," J. Ophthalmic Photography 3, 89-94 (1997).

M E. Hartnett and A. E. Elsner, "Characteristics of exudative age-related macular degeneration determined in vivo with confocal direct and indirect infrared imaging," Ophthalmol. 103, 58-71 (1996).

L. V. Johnson, S. Ozak, M. I. Staples, P. A., Erickson and D. H. Anderson, "Potential role for immune complex pathogenesis in drusen formation," Exp. Eye Res. 70, 441-449 (2000).
[CrossRef] [PubMed]

The longitudinal study and image of the first patient re-tested are at http://color.eri.harvard.edu/annhom.htm

A. E. Elsner, L. Moraes, C. W. Kunze and M. E. Hartnett, "Foveal cone photopigment distribution in age-related macular degeneration: association with fundus features," in Vision Science and Its Applications, Vol. 1 of OSA Proceedings Series (Optical Society of America, Washington, D.C., 1998) pp.14-17.

A. E. Elsner, A. Remky, E. Beausencourt and S. A. Burns, "A statistical method to quantify drusen in SLO images," in Vision Science and Its Applications, Vol. 1 of OSA Proceedings Series (Optical Society of America, Washington, D.C., 1996), pp. 268-271.

R.-P. Tornow and R. Stilling, "Scanning laser densitometry and color perimetry demonstrate reduced photopigment density and sensitivity in two patients with retinal degeneration" Vision Res. 39, 3630-3641 (1999).
[CrossRef]

M. A. Sandberg, B. S. Pawlyk E. L. Berson, "Acuity recovery and cone pigment regeneration after a bleach in patients with retinitis pigmentosa and rhodopsin mutations," Invest. Ophthalmol. Vis. Sci. 40, 2457-2461 (1999).
[PubMed]

S. A. Burns, S. Wu, J. He, J and A. E. Elsner, "Variations in photoreceptor directionality across the central retina," J. Opt. Society Amer A 14, 2033-2040 (1997).
[CrossRef]

P. J. DeLint, T. T. Berendschot and D. A. van Norren, "A comparison of the optical Stiles-Crawford effect and retinal densitometry in a clinical setting," Invest. Ophthalmol. Vis. Sci. 39, 1519-1523 (1998).
[PubMed]

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Figures (5)

Fig. 1.
Fig. 1.

Left- Cone photopigment distribution in the central macula of a normal 45 yr old male subject. Right- Cone photopigment distribution of a normal 35 year old female, showing a defect in a smooth distribution.

Fig 2.
Fig 2.

Top left- Image of female subject in Fig 1, with a 594 nm, 40 deg field. The bright detect that corresponds to the missing photopigment. Note that this wavelength localizes retinal vasculature, but not macular pigment. Top right- color fundus photograph. Bottom left- 514 nm, 40 deg field, showing little the defect, but little absorption of macular pigment at this wavelength. Bottom right- 488 nm, 40 deg field. The dark central region indicates the location of macular pigment.

Fig. 3.
Fig. 3.

Left- Macular-centered image of a small retinal defect of macular pigment, computed from the images in Fig. 2 and magnified 5X. The contrast is adjusted to enhance the print visualization of the macular pigment. Right- 860 nm, 40 deg image. No large drusen or clumped hyperpigmentation were seen in any normal subject that co-localized with the measured alterations in photopigment or macular pigment distribution.

Fig. 4.
Fig. 4.

Left- Infrared image of the macula of a patient with age-related macular degeneration. The large, bright structures are drusen. Right- Red image of the same patient. The dark structures are hyperpigmentation.

Fig. 5.
Fig. 5.

Pseudo color from images in Fig 4, to show image fusion. Top left- confocal image. Top right- multiply scattered light image. Bottom- fusion image.

Equations (2)

Equations on this page are rendered with MathJax. Learn more.

DD = log ( bleached image ) log ( dark adapted image ) .
MDD = log ( image at 514 nm ) log ( image at 488 nm * c )

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