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Biomedical subjects

Mahnaz Shahidi

Publications and source records attributed to Mahnaz Shahidi.

16 recordsLinked to original sources

A method for chorioretinal oxygen tension measurement.

PURPOSE: To report an optical imaging system that was developed to measure oxygen tension (pO2) in the chorioretinal vasculatures. The feasibility of the system for the measurement of changes in pO2 separately in the retinal and choroidal vasculatures was established in rat eyes by varying the fraction of inspired oxygen and inhibiting nitric oxide activity. METHODS: Our optical section phosphorescence imaging system was modified to provide quantitative measurements of pO2 separately in the retinal and choroidal vasculatures. A narrow laser line was projected at an angle on the retina after intravenous injection of an oxygen-sensitive probe (Pd-porphyrin), and phosphorescence emission was imaged. A frequency-domain approach allowed measurements of the phosphorescence lifetime by varying the phase relationship between the modulated excitation laser light and sensitivity of the imaging camera. Chorioretinal pO2 was measured while varying the fraction of inspired oxygen and during intravenous infusion of Nomega-nitro-L-arginine (Nomega-NLA), a nonselective nitric oxide synthase inhibitor. RESULTS: The systemic arterial pO2 varied according to the fraction of inspired oxygen. The pO2 in the retinal and choroidal vasculatures increased as the fraction of inspired oxygen was increased. Compared with baseline, choroidal pO2 decreased during infusion of Nomega-NLA, whereas the pO2 in the retinal vasculatures remained relatively unchanged. The choroidal pO2 decreased markedly with each incremental increase in Nomega-NLA infusion rate, in the range 1-6 mg/min, and there was no additional change in the choroidal pO2 at Nomega-NLA infusion rates above 6 mg/min. CONCLUSIONS: An optical method combining pO2 phosphorescence imaging with chorioretinal optical sectioning was established that can potentially be applied for better understanding of retinal and choroidal oxygen dynamics in physiologic and pathologic states.

Animals↗

Nerve fiber layer thickness in glaucoma patients with asymmetric hemifield visual field loss.

PURPOSE: To investigate the presence of retinal nerve fiber layer (RNFL) thinning and determine the relationship between RNFL thickness and visual field sensitivity loss in glaucoma patients with asymmetric hemifield visual field loss. PATIENTS AND METHODS: Thirty glaucoma patients with asymmetric hemifield visual field loss and 30 normal control subjects were included in the study. RNFL thickness was measured by optical coherence tomography and visual field sensitivity was measured by automated perimetry. Glaucoma patients with advanced visual field loss restricted to 1 hemifield and early or absent glaucomatous field loss in the other hemifield on the basis of the visual field data were included. Visual field sensitivity and mean deviation (MD) were averaged separately in each of the 2 hemifields. The hemifields in each eye were categorized as early (MD>or=-6 dB) and advanced (MD<-6 dB) glaucomatous hemifields. RESULTS: RNFL thickness measurements in corresponding (eg, superior peripapillary quadrant with inferior hemifield) advanced glaucomatous hemifields (59+/-16 microm) were significantly (P<0.001) lower than in corresponding early glaucomatous hemifields (90+/-25 microm). The mean RNFL thickness in corresponding advanced and early glaucomatous hemifields were significantly lower than in normal control subjects (P<0.0001). On the basis of the normative database supplied by optical coherence tomography software, 100% and 43% of eyes had abnormal RNFL thickness in corresponding advanced and early glaucomatous hemifields, respectively. A linear correlation was found between RNFL thickness and MD in the early (r=0.6; P<0.001) and advanced (r=0.5; P=0.007) glaucomatous hemifields. CONCLUSIONS: RNFL thinning was present in corresponding hemifields of glaucomatous eyes with minimal visual field defect and correlated with visual field sensitivity loss. Measurement of RNFL thickness has potential for detection of early nerve fiber loss owing to glaucoma.

Aged↗

Chorioretinal vascular oxygen tension changes in response to light flicker.

PURPOSE: To investigate oxygen tension (P(O2)) changes in the retinal and choroidal vasculatures in response to visual stimulation by light flicker. METHODS: A previously developed optical section phosphorescence imaging system was used to measure P(O2) separately in the retinal veins, arteries, and capillaries and in the choroid before and during light flicker. Imaging was performed in rats during light flicker at frequencies between 0 and 14 Hz. Light flicker-induced changes in the chorioretinal vasculature P(O2) and arteriovenous P(O2) differences were determined. Retinal arterial and venous P(O2) were measured along blood vessels as a function of the distance from the optic nerve head. RESULTS: Retinal arterial P(O2) and arteriovenous P(O2) differences increased with increasing light flicker at frequencies up to 10 Hz, after which no further increase was observed. Significant increases in retinal arterial P(O2) (P = 0.009; n =10) and in retinal capillary P(O2) (P = 0.04, n = 10) were measured in response to light flicker at 10 Hz. Retinal arteriovenous P(O2) differences during light flicker were significantly greater than differences before light flicker (P = 0.01; n = 10). Retinal arterial P(O2) decreased significantly with increased distance from the optic nerve head (P < or = 0.004), whereas retinal venous P(O2) remained relatively unchanged (P > or= 0.4). CONCLUSIONS: Measurement of changes in the chorioretinal vasculature P(O2) can potentially advance the understanding of oxygen dynamics in challenged physiological states and in animal models of human retinal diseases.

Animals↗

Quantitative thickness measurement of retinal layers imaged by optical coherence tomography.

PURPOSE: To report an image analysis algorithm that was developed to provide quantitative thickness measurement of retinal layers on optical coherence tomography (OCT) images. DESIGN: Prospective cross-sectional study. METHODS: Imaging was performed with an OCT3 commercial instrument in 10 visually normal healthy subjects. A dedicated software algorithm was developed to process the raw OCT images and detect the depth location of peaks from intensity profiles. Quantitative thickness measurements of three retinal layers, in addition to total retinal thickness, were derived. Total retinal thickness measurements obtained by the algorithm were compared with measurements provided by the standard OCT3 software. RESULTS: The total retinal thickness profile demonstrated foveal depression, corresponding to normal anatomy, with a thickness range of 160 to 291 microm. Retinal thickness measured by the algorithm and by the standard OCT3 software were highly correlated (R = 0.98). The inner retinal thickness profile predictably demonstrated a minimum thickness at the fovea, ranging between 58 to 217 microm along the 6-mm scan. The outer retinal thickness profile displayed a maximum thickness at the fovea, ranging between 66 to 107 microm along the 6-mm scan. The photoreceptor outer segment thickness profile was relatively constant along the 6-mm scan through the fovea, ranging between 42 to 50 microm. The intrasubject variabilities of the inner retina, outer retina, and photoreceptor outer segment thickness was 14, 10, and 6 microm, respectively. CONCLUSIONS: Thickness measurements of retinal layers derived from OCT images have potential value for objectively documenting disease-related retinal thickness abnormalities and monitoring progressive changes over time.

Adult↗

Noninvasive assessment of chorioretinal oxygenation changes in experimental carotid occlusion.

PURPOSE: To demonstrate the capability of our optical imaging system to assess oxygenation changes in chorioretinal vasculatures due to experimentally induced carotid occlusion. METHODS: Chorioretinal oxygenation was assessed by projecting a narrow laser line at an angle on the retina after intravenous injection of an oxygen sensitive probe and imaging phosphorescence emission. Optical section phosphorescence imaging was performed in rats, under steady-state conditions and during unilateral occlusion of the common carotid artery. Phosphorescence intensity was measured in the retinal vein, artery, capillaries, and choroid vascular areas. Oxygenation was defined as the inverse of phosphorescence intensity. Oxygenation changes in the four vascular areas were determined relative to initial preocclusion oxygenation values and compared to measured changes under steady-state conditions. RESULTS: Under steady-state conditions, phosphorescence intensity in chorioretinal vasculatures remained constant, displaying a change of < or = 8% over time. At 12 +/- 5 s from initiation of occlusion, oxygenation decreased in the retinal venous, arterial, capillary, and choroidal circulations by -41 +/-19%, -10 +/- 5%, -20 +/- 18%, -10 +/- 5%, respectively (p < or = 0.05; n = 6). At 30 +/- 10 s from initiation of occlusion, oxygenation change in the retinal vein, artery, capillaries, and choroid was -9 +/- 12%, -2 +/- 4%, -11 +/- 21%, -1 +/- 8%, respectively, and not statistically different as compared to steady-state oxygenation changes (p > or = 0.3; n = 6). CONCLUSIONS: Optical section phosphorescence imaging technique can be used to assess intravascular oxygenation changes and may be a valuable tool for studying disease-related oxygen dynamics in the chorioretinal vasculatures.

Animals↗

Higher-order wavefront aberrations in retinitis pigmentosa.

PURPOSE: The purpose of this study was to characterize higher-order wavefront aberrations associated with posterior subcapsular (PSC) cataracts in patients with retinitis pigmentosa (RP). METHODS: Wavefront aberrations were measured by Shack-Hartmann (SH) aberrometry in eight patients with RP who had PSC cataracts, 10 patients with RP who had minimal or no PSC cataracts, and 16 age-equivalent visually normal control subjects. Higher-order wavefront aberrations for 3-mm and 6-mm pupil diameters were defined as the root mean square (RMS) of the wavefront aberration functions. RESULTS: For a 6-mm pupil diameter, the mean RMS for total higher-order wavefront aberrations was significantly larger for the patients with RP than for the control subjects, both for patients with PSC cataract (F = 17.30, p < 0.001) and for those with minimal or no PSC cataract (F = 4.80, p < 0.05). The mean RMS for third-order aberrations was not significantly different for patients with RP than for the control subjects. However, the mean RMS for fourth-order aberrations was significantly larger for the patients with RP than for the control subjects, both for patients with PSC cataract (F = 8.85, p < 0.01) and those with minimal or no PSC cataract (F = 5.07, p < 0.05). There were no significant differences in higher-order aberrations between the patients with RP and the control subjects for a 3-mm pupil diameter. CONCLUSIONS: Increased higher-order wavefront aberrations were present in patients with RP with and without clinically observable PSC cataracts. The measurement of wavefront aberrations in patients with RP provides an objective and quantitative method for detecting and monitoring disease-related changes in the optics of the eye.

Adult↗

A method for differentiating ocular higher-order aberrations from light scatter applied to retinitis pigmentosa.

PURPOSE: The purpose of this study is to report a method for differentiating ocular higher-order aberrations and intraocular light scatter based on a deconvolution technique. METHODS: An optical system was used to image a laser slit on the retina and also to perform Shack-Hartmann wavefront sensing. From the laser slit image, the line spread function, incorporating both ocular higher-order aberrations and light scatter, was derived. The laser slit image was deconvolved with a point spread function obtained from the Shack-Hartmann image. The area under the line spread function that was derived from the laser slit image after deconvolution provided a measurement of intraocular light scatter. The deconvolution technique was applied to images obtained in a group of 13 patients (mean age +/- 1 standard deviation: 42 +/- 12 years) with retinitis pigmentosa (RP), a retinal disease in which, by clinical examination, changes in the lens of the eye can be manifested. Measurements were compared with those obtained from 20 visually normal control subjects (mean age +/- 1 standard deviation: 43 +/- 17 years). RESULTS: Combined higher-order aberrations and light scatter, measured as the area under the line spread function derived from the laser slit image, were increased significantly in the patients with RP as compared with the control subjects (p = 0.004). Ocular higher-order aberrations obtained from the Shack-Hartmann images were higher in the patients with RP than in the control subjects (p = 0.05). Intraocular light scatter derived from the deconvolved laser slit image was significantly higher in the patients with RP than in the control subjects (p = 0.009). Minimizing the contribution of ocular higher-order aberrations by deconvolution reduced the area under the line spread function in the control subjects and patients with RP, denoting an improvement in retinal image quality. CONCLUSIONS: A method for differentiating ocular higher-order aberrations and intraocular light scatter based on deconvolution was developed that may be useful for determining the level of improvement in retinal image quality that can be anticipated by the application of adaptive optics to aging and diseased human eyes.

Adult↗

Optical section retinal imaging and wavefront sensing in diabetes.

PURPOSE: To investigate differences in higher-order ocular aberrations and in optical section retinal image resolution between healthy normal and diabetic subjects. METHODS: An optical imaging system was established for combined retinal optical section imaging and wavefront sensing. A laser beam was expanded and focused to a point on the retina by the optics of the eye. For optical section retinal imaging, a cylindrical lens was placed in the path of the incident laser beam to form a focused line on the retina. Because of the angle between the incident laser and imaging path, an optical section image of the retina was captured. For wavefront sensing, a Shack-Hartmann aberrometer was incorporated in the imaging system. Twenty-two subjects with diabetes (average age, 52 +/- 12 years) and 13 normal subjects (average age, 47 +/- 9 years) were imaged. Retinal depth resolution was determined from the width of the laser line on the retina. Higher-order ocular aberrations were determined from the root mean square of the third to seventh Zernike terms, characterizing the wavefront aberration function. The data were analyzed statistically using Student's t-test and linear regression. RESULTS: Higher-order ocular aberrations in diabetic subjects were significantly higher than in normal subjects (p=0.03). The retinal image depth resolution in diabetic subjects was significantly lower than in normal subjects (p <0.001). The retinal image depth resolution was inversely correlated with higher-order aberrations (r=-0.5; p=0.007; N=35). CONCLUSIONS: The results demonstrate disease-related increases in higher-order ocular aberrations that influence retinal image resolution in diabetic eyes. This information is useful for designing high-resolution retinal imaging systems applicable for eyes with retinal disease.

Adult↗

Is "whole eye" wavefront analysis helpful to corneal refractive therapy?

PURPOSE: To examine how corneal refractive therapy (CRT) affects the balance between corneal surface and whole eye spherical aberration (Z4) and to identify whether corneal aberrations alone can accurately predict optical outcomes of CRT. METHODS: Whole eye and corneal spherical aberrations were measured at baseline and 1 month after CRT in 12 dilated eyes (baseline myopia range, -2.25 to -6.00 diopters [D]; mean, -3.23 +/- 1.06D). Whole eye aberrations were measured under cycloplegia using a Shack-Hartmann aberrometer, and corneal aberrations were measured using Keratron corneal topography elevation maps converted to wavefront Zernike polynomials using VOL-CT. Whole eye and corneal surface aberrations were scaled for 6-mm pupil diameters. RESULTS: No statistically significant correlation existed between corneal and whole eye spherical aberration at baseline. Corneal and whole eye spherical aberration increased in all eyes after CRT. A statistically significant and moderately positive correlation was found between corneal and whole eye spherical aberration after CRT (R = 0.632, P = 0.004). The linear regression slope was positive (m = +1.449) and indicated that whole eye spherical aberration exceeds corneal spherical aberration after CRT. CONCLUSIONS: Whole eye wavefront analysis is essential to methods designed to optimize visual performance with CRT; results indicate that CRT affects the entire optical system and not just the anterior corneal surface. Moreover, because CRT-induced whole eye spherical aberration cannot be explained by corneal aberrations alone, commonly accepted beliefs that the mechanism of action is limited to corneal tissue redistribution may need to be revisited.

Adult↗

Measurements of ocular aberrations and light scatter in healthy subjects.

PURPOSE: To report and validate an optical imaging system that provides measurements of higher order ocular aberrations and light scatter in human eyes. METHODS: An optical imaging system has been established that provides for combined measurements of ocular aberrations and light scatter. A laser beam was expanded and focused to a point on the retina by the optics of the eye. Wavefront sensing was performed with a Shack-Hartmann aberrometer to determine the wavefront aberration function and calculate the point spread function, giving information on ocular aberrations. A cylindrical lens was placed in the path of the incident laser beam path, and the line spread function was derived from the laser slit, giving information on combined ocular aberrations and light scatter. A relative index for ocular light scatter was determined by subtracting the area under the two line spread functions. Measurements were performed in one eye of 20 normal healthy subjects. The subjects' ages ranged between 21 and 78 years, and the average for all the eyes was 43 +/- 17 years (mean +/- SD). RESULTS: Higher order ocular aberrations were correlated with subjects' ages (r = 0.6; p = 0.01; N = 20). Combined higher order ocular aberrations and light scatter were correlated with age (r = 0.7; p = 0.0002; N = 20). Light scatter was correlated with age (r = 0.6; p = 0.002; N = 20). CONCLUSIONS: A method was established to measure age-related changes in ocular higher order aberrations and light scatter. Differentiating the contribution of ocular aberrations and light scatter to the retinal image quality has potential value for anticipating the outcome of procedures that attempt to compensate for ocular aberrations and for providing information on factors that degrade the optical performance of the eye in health and disease.

Adult↗

Relationship of retinal structural and clinical vision parameters to driving performance of diabetic retinopathy patients.

This study identifies clinical vision measures or retinal structural measures associated with the driving performance of diabetic retinopathy patients. Twenty-five licensed drivers with diabetic retinopathy (median age, 53 years; range, 34-72 years) completed clinical tests (visual acuity, letter contrast sensitivity, and Humphrey 30-2 visual fields) and structural examinations (retinal thickness analysis and fundus photograph grading of retinopathy and laser scarring). Driving performance was assessed with an interactive driving simulator and a driving history questionnaire. Increased retinal thickness was significantly correlated with a higher frequency of simulator accidents and near accidents. Laser scar grades significantly correlated with steeper brake-response slopes, increased brake-pressure standard deviation (SD), and longer response times. Subjects with focal laser scars had significantly higher average brake-pedal pressure and brake-pressure SD than subjects without focal laser scars. Retinal thickness and laser scarring correlated with driving simulator performance in subjects with diabetic retinopathy.

Accidents, Traffic↗

Higher-order wavefront aberrations in corneal refractive therapy.

PURPOSE: To assess the changes in higher-order (third through sixth) ocular wavefront aberrations produced by Corneal Refractive Therapy (CRT; Paragon Vision Sciences, Mesa, AZ). METHODS: Eighteen eyes of nine myopic subjects were fit with CRT contact lenses. Baseline subjective spherical refraction ranged from -2.25 to -6.00 D (mean +/- SD, -3.33 +/- 1.26 D), and baseline logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity was -0.13 +/- 0.06 (20/15 Snellen equivalent). Whole-eye ocular wavefront aberrations were measured using a previously validated Shack-Hartmann aberrometer. Measurements were taken at baseline and 1 month after treatment initiation. Nine measurements per dilated subject were taken and averaged. Zernike coefficients were used to calculate the third-, fourth-, fifth-, and sixth-order root-mean-square values for each eye for both 3- and 6-mm pupil sizes, and aberrations were averaged and compared with prior baseline readings. RESULTS: The mean (+/-SD) myopia reduction was 3.08 +/- 0.93 D, resulting in a subjective refraction of -0.22 +/- 0.38 D after 1 month of lens wear. Both logMAR uncorrected visual acuity (-0.07 +/- 0.18; 20/15- Snellen equivalent) and best-corrected visual acuity (-0.14 +/- 0.09) after CRT wear were not significantly different from baseline logMAR best-corrected visual acuity (paired two-tailed t-test; p = 0.41 and 0.65, respectively). Whole-eye aberrations showed a statistically significant increase in higher-order aberrations for both 3-mm (factor of 2.66; p = 0.01) and 6-mm pupils (factor of 2.50; p = 0.005). Each individual higher-order aberration also increased, ranging from a factor of 2.01 to 3.20 for 3-mm pupil sizes and 2.52 to 2.98 for 6-mm pupil sizes. Spherical-like aberrations (S4 and S6) increased by a factor of 1.79 for 3-mm pupil sizes and 2.42 for 6-mm pupil sizes. The Zernike coefficient most affected by CRT was spherical aberration (Z40), which increased from 0.084 +/- 0.16 to 0.39 +/- 0.16 microm (p = 0.0002) for 6-mm pupils. CONCLUSIONS: Use of current CRT lenses for the reduction of myopia increased higher-order wavefront aberrations and spherical aberration (Z40) in particular.

Adult↗

Relation between retinal thickening and clinically visible fundus pathologies in mild nonproliferative diabetic retinopathy.

BACKGROUND AND OBJECTIVE: To determine the association of retinal thickening (RT) with clinically observable retinal pathologies in eyes with mild nonproliferative diabetic retinopathy. PATIENTS AND METHODS: Using an objective quantitative imaging method (Retinal Thickness Analyzer), the ratio relative to normal RT (RTI) was measured in 23 eyes with and 35 eyes without clinically observable diabetic fundus pathology. RTI was analyzed in relation to presence of mild diabetic retinal lesions in the +/-0.5 mm vicinity. RESULTS: The percent of eyes with RTI significantly above normal values did not differ significantly between eyes with and without retinopathy (30% vs 34%). Mean RTI was not associated with local presence of microaneurysms (P=0.92), soft exudates (P=0.55), or retinal hemorrhages (P=0.31). Areas without hard exudates had significantly greater mean RTI (1.10) than areas with exudates (0.97, P=0.009). CONCLUSION: In diabetic patients with mild retinopathy, areas with and without clinically observable retinal pathologies had similar retinal thickness. We conclude that clinical strategies for detection of retinal thickening should not be limited to areas with visible fundus pathologies.

Adult↗

Chorioretinal topography and histopathology in laser-induced choroidal neovascularization.

OBJECTIVE: To investigate the correspondence between topographic mapping of the vitreoretinal and chorioretinal surfaces in vivo and histopathology findings. MATERIALS AND METHODS: Choroidal neovascularization was induced in the retina of a primate by an argon laser. Serial optical section images of the retina were obtained using an optical imaging system based on the Retinal Thickness Analyzer. Topography of the vitreoretinal and chorioretinal surfaces was mapped. The animal was killed and the eyes enucleated for histopathologic examination. RESULTS: In the normal retina, the topography of the vitreoretinal surface showed a depression at the center of the fovea while the chorioretinal surface was relatively flat, corresponding to normal anatomy. In the retina with choroidal neovascularization, the topography of the vitreoretinal surface indicated a smooth elevation while there were irregular elevations in the topography of the chorioretinal surface. Histological sections displayed focal serous retinal detachment, metaplasia of retinal pigment epithelium, and choroidal neovascularization. CONCLUSION: Topographic mapping of the vitreoretinal and chorioretinal surfaces in vivo corresponds with histological findings and shows promise for quantitative evaluation of pathologic alterations caused by chorioretinal diseases.

Animals↗

Feasibility of noninvasive imaging of chorioretinal oxygenation.

BACKGROUND AND OBJECTIVE: The feasibility of an optical system for noninvasive imaging of chorioretinal oxygenation was evaluated. Due to its depth discrimination, this optical section imaging technique has potential for differential imaging of oxygen tension in the chorioretinal vasculatures. MATERIALS AND METHODS: The method consisted of projecting a narrow laser line obliquely on the retina after intravenous injection of an oxygen-sensitive probe and imaging the phosphorescence emission. Due to the angle between the incident laser and imaging path, a phosphorescence optical section image of the retina was captured. The phosphorescence intensity was measured in the chorioretinal vasculatures. The method was tested in three rats while breathing 10% oxygen, 50% oxygen, and room air. RESULTS: On the phosphorescence optical section image, vasculatures appeared laterally displaced according to their depth location, displaying probe phosphorescence separately in the chorioretinal vasculatures. Oxygenation increased in all vasculatures with increased inhaled percent oxygen. Oxygenation in the retinal artery was 2.3, 1.9, and 1.6 times oxygenation in the retinal vein, capillary, and choroid, respectively. During hypoxia, oxygenation decreased by 28%, 18%, 22%, and 14% in the retinal vein, artery, capillary, and choroid, respectively. During hyperoxia, oxygenation increased by 30%, 45%, 36%, and 28% in the retinal vein, artery, capillary, and choroid, respectively. CONCLUSION: The results demonstrate the feasibility of this technique for noninvasive and separate imaging of chorioretinal oxygenation and its potential for three-dimensional oxygen tension imaging.

Animals↗