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D. Gray, B. Wall, C. Robertson, D. Cairns; A Clinical Adaptive Optics System. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1061.
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A compact widefield adaptive optics (AO) retinal imaging system has been developed to be easy to use and suitable for routine clinical applications. Several imaging modalities are supported providing a broad range of applications.
The imaging system consists of a flexible scan system coupled to a wide field-of-view optical relay, an eye aberration measurement and correction module, and a patient alignment system (PAS) incorporating three-dimensional pupil localization and a fixation target, and a laser and detector module supporting several imaging modalities. The flexible scan system supports an imaging protocol to enable the operator to navigate to pre-selected regions of interest and capture high-resolution retinal images as well as wide-field montages. The PAS system continuously monitors eye location and fixation stability, reporting optimal retinal imaging conditions. All sub-systems including PAS, AO, scanning, and image acquisition are in continuous communication. This permits automation of many functions to relieve the burden on the operator.
10 degree (wide field) and 2.5 degrees (narrow field) retinal images have been acquired on a range of eyes of varying age, refractive error, and pathology. Post-registration and removal of warped frames of sequential, AO corrected, narrow field images have increased signal to noise, revealing a complete cone mosaic. Narrow field images have been registered to wide field images. In turn, these have been registered to ultra-widefield images acquired with Optos standard P200MA imaging systems.
It is clear that practical clinical systems require excellent human factors. This work demonstrates any easy to use AO retinal imaging system designed for that challenge. It combines AO with a flexible scan system, PAS, modular control architecture, and integration with widefield imaging systems. Further work is required for full validation of performance in different clinical settings.
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