THE POSSIBILITIES OF USING ADAPTIVE OPTICS IN MODERN OPHTHALMOLOGY

Anna A. Pavlova, Stella S. Nastenko, Aziza A. Bolatkhanova, Valeriya Yu. Marchenko, Darya V. Lukyanova, Maria D. Burnasheva, Zagid Z. Zarbaliev, Ilya A. Bespalov, Pavel N. Kalyuzhnyi, Diana R. Kanina, Andrey E. Shlychkov, Sonya G. Tarasova
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Abstract

Until recently, the assessment of individual retinal cells was possible only with the help of histological examination, since such retinal imaging methods as scanning laser ophthalmoscopy and optical coherence tomography had low resolution to obtain images of structures at the cellular level, which was mainly due to aberrations caused by the optics of the eye. Adaptive Optics (AO) technology has improved the performance of optical systems by correcting optical wavefront aberrations. AO allows noninvasively visualizing the retina at the microscopic level in vivo, providing the opportunity to analyze individual structures such as photoreceptors, blood vessels, nerve fibers, ganglion cells and a lattice plate. AO imaging in patients with diabetic retinopathy (DR) makes it possible to accurately determine the spatial distribution of cones, a decrease in which is associated with the presence of diabetic retinopathy and an increase in the severity of the disease. The detection of differences in cone distribution density between the control group and patients with diabetes mellitus without clinical signs of DR may contribute to its early diagnosis, as well as a deeper understanding of the consequences of changes in the photoreceptor apparatus. AO imaging methods are able to identify disorders of photoreceptor cells and assess the degree of progression of age-related macular degeneration (AMD), which definitely expands diagnostic capabilities at the early stages of its detection. Assessment of the condition of nerve fiber bundles through the use of AO helps to identify changes associated with glaucoma, and also provides the ability to visualize details that cannot be evaluated using optical coherence tomography (OCT). AO imaging allows you to directly measure the wall of retinal vessels and the diameter of their lumen. The ratio of wall thickness to vessel lumen and the cross-sectional area of the vessel wall directly reflect the remodeling process and can be used for the purpose of early diagnosis and monitoring of hypertension.
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在现代眼科中使用自适应光学技术的可能性
直到最近,由于扫描激光眼底镜和光学相干断层扫描等视网膜成像方法的分辨率较低,无法获得细胞层面的结构图像,因此只能借助组织学检查对单个视网膜细胞进行评估。自适应光学(AO)技术通过校正光学波前像差提高了光学系统的性能。自适应光学技术可在显微镜下对视网膜进行非侵入性的活体观察,为分析光感受器、血管、神经纤维、神经节细胞和晶格板等单个结构提供了机会。对糖尿病视网膜病变(DR)患者进行 AO 成像可以准确确定视锥的空间分布,视锥的减少与糖尿病视网膜病变的存在和病情严重程度的增加有关。检测对照组与无糖尿病视网膜病变临床表现的糖尿病患者之间视锥分布密度的差异,有助于早期诊断糖尿病视网膜病变,并加深对感光器变化后果的理解。AO 成像方法能够识别感光细胞的病变,并评估老年性黄斑变性(AMD)的进展程度,这无疑扩大了早期发现阶段的诊断能力。使用 AO 评估神经纤维束的状况有助于识别与青光眼有关的变化,还能观察到光学相干断层扫描 (OCT) 无法评估的细节。AO 成像可以直接测量视网膜血管壁及其管腔直径。血管壁厚度与血管腔的比率以及血管壁的横截面积直接反映了血管的重塑过程,可用于早期诊断和监测高血压。
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