Measurement of ocular fundus pulsation in healthy subjects using a novel Fourier-domain optical coherence tomography.

PURPOSE Anomalies in the pulsatility of the eye have been associated with many types of ocular pathology. Estimation of ocular pulsatility is usually obtained by measuring the variation in the intraocular pressure using tonometry-based instruments. In this work, the authors present and demonstrate the applicability of a novel and noninvasive Fourier-domain optical coherence tomography (FD-OCT) system to measure pulsatile ocular tissue movements. METHODS The authors simultaneously measured the longitudinal movement of the cornea and the retina driven by the cardiac cycle in 21 healthy volunteers using their custom-made FD-OCT. They calculated the corresponding fundus pulse amplitude (FPA), which is the variation in the distance between the cornea and the retina. RESULTS It was found that in young, healthy subjects, the cornea and the retina move axially during the cardiac cycle, with almost equal amplitude but with a phase difference ranging between 1° and 20°. The measured FPA was found to be mostly due to the relative phase difference between corneal and retinal movements, and frequency analysis revealed the presence of the harmonics of heartbeat. The root-mean-square values for cornea, retina, and FPA movements were found to be 28 ± 9 μm, 29 ± 9 μm, and 4 ± 2 μm, respectively. The dominant frequency component in corneal and retinal movement was found to be the second harmonic of the heartbeat. CONCLUSIONS The technique described here is useful for a precise description of FPA and the movement of ocular tissues. Further investigations and technical improvements will be beneficial for understanding the role of choroidal pulsation in the pathophysiology of ocular diseases.

[1]  M. Langham,et al.  A clinical procedure for the measurements of the ocular pulse-pressure relationship and the ophthalmic arterial pressure. , 1978, Experimental eye research.

[2]  J. Zuckerman,et al.  Noncontact detection of ocular pulse--correlation with carotid stenosis. , 1977, Investigative ophthalmology & visual science.

[3]  M. O'Rourke,et al.  Input Impedance of the Systemic Circulation , 1967, Circulation research.

[4]  D. R. Iskander,et al.  Spectral characteristics of longitudinal corneal apex velocities and their relation to the cardiopulmonary system , 2007, Eye.

[5]  G. Ravalico,et al.  Pulsatile ocular blood flow variations with axial length and refractive error. , 1997, Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde.

[6]  Mei Chen,et al.  Correcting Motion Artifacts in Retinal Spectral Domain Optical Coherence Tomography via Image Registration , 2009, MICCAI.

[7]  T Ozaki,et al.  Spectral-domain phase microscopy with improved sensitivity using two-dimensional detector arrays. , 2011, The Review of scientific instruments.

[8]  A. Fercher,et al.  Eye elongation during accommodation in humans: differences between emmetropes and myopes. , 1998, Investigative ophthalmology & visual science.

[9]  L. Schmetterer,et al.  Topical fundus pulsation measurement in patients with active central serous chorioretinopathy. , 2003, Archives of ophthalmology.

[10]  C. O'brien,et al.  Pulsatile ocular blood flow investigation in asymmetric normal tension glaucoma and normal subjects , 1998, The British journal of ophthalmology.

[11]  B. Peterson,et al.  Mechanisms controlling human head stabilization. I. Head-neck dynamics during random rotations in the horizontal plane. , 1995, Journal of neurophysiology.

[12]  C. Andersen,et al.  Ocular pneumoplethysmography: detection of carotid occlusive disease. , 1979, Annals of surgery.

[13]  Malgorzata A. Kowalska,et al.  Comparison of high‐speed videokeratoscopy and ultrasound distance sensing for measuring the longitudinal corneal apex movements , 2009, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[14]  C. Kniestedt,et al.  Dynamische Konturtonometrie , 2006, Der Ophthalmologe.

[15]  P Schilder,et al.  Estimation of pulsatile ocular blood flow from intraocular pressure , 1989, Acta ophthalmologica. Supplement.

[16]  S M Finkelstein,et al.  Arterial Vascular Compliance Response to Vasodilators by Fourier and Pulse Contour Analysis , 1988, Hypertension.

[17]  R. Sergott,et al.  Ocular pneumoplethysmography can help in the diagnosis of giant-cell arteritis. , 1989, Archives of ophthalmology.

[18]  Leopold Schmetterer,et al.  Depth-resolved measurement of ocular fundus pulsations by low-coherence tissue interferometry. , 2009, Journal of biomedical optics.

[19]  Leopold Schmetterer,et al.  Estimation of ocular rigidity based on measurement of pulse amplitude using pneumotonometry and fundus pulse using laser interferometry in glaucoma. , 2008, Investigative ophthalmology & visual science.

[20]  Jorge R. Torga,et al.  Wide band interferometry for thickness measurement. , 2003, Optics express.

[21]  Stephen E. Smith,et al.  Factors influencing the ocular pulse — axial length , 2004, Graefe's Archive for Clinical and Experimental Ophthalmology.

[22]  Audrey K. Ellerbee,et al.  Spectral-domain phase microscopy. , 2004, Optics Letters.

[23]  Oliver Findl,et al.  Topical fundus pulsation measurements in age-related macular degeneration , 1998, Graefe's Archive for Clinical and Experimental Ophthalmology.

[24]  E. Perkins,et al.  The ocular pulse and intraocular pressure as a screening test for carotid artery stenosis. , 1985, The British journal of ophthalmology.

[25]  Christopher J. Taylor,et al.  Medical Image Computing and Computer-Assisted Intervention – MICCAI 2009 , 2009, Lecture Notes in Computer Science.

[26]  W E Walker,et al.  Input Impedance of the Systemic Circulation in Man , 1977, Circulation research.

[27]  T. Hikichi,et al.  Pulsatile ocular blood flow study: decreases in exudative age related macular degeneration , 2001, The British journal of ophthalmology.

[28]  D. R. Iskander,et al.  Ultrasonic measurement of binocular longitudinal corneal apex movements and their correlation to cardiopulmonary system [Article in English] , 2008 .

[29]  J. Fujimoto,et al.  Ultrahigh-resolution ophthalmic optical coherence tomography , 2001, Nature Medicine.

[30]  R. Sergott,et al.  Amplitude of the Ocular Pneumoplethysmography Waveform Is Correlated With Cardiac Output , 1993, Stroke.

[31]  Leopold Schmetterer,et al.  Ocular blood flow and systemic blood pressure in patients with primary open-angle glaucoma and ocular hypertension. , 2004, Investigative ophthalmology & visual science.

[32]  H. Hammes,et al.  Ocular pulse amplitude in diabetes mellitus , 2000, British Journal of Ophthalmology.

[33]  Jonas S. Friedenwald,et al.  Contribution to the Theory and Practice of Tonometry , 1937 .

[34]  A. Harris,et al.  The role of optic nerve blood flow in the pathogenesis of glaucoma. , 2005, Ophthalmology clinics of North America.

[35]  J. Duker,et al.  Ultrahigh-resolution, high-speed, Fourier domain optical coherence tomography and methods for dispersion compensation. , 2004, Optics express.

[36]  Leopold Schmetterer,et al.  A comparison between laser interferometric measurement of fundus pulsation and pneumotonometric measurement of pulsatile ocular blood flow 1. Baseline considerations , 2000, Eye.

[37]  Shan C. Lin,et al.  Dynamic contour tonometry: principle and use , 2006, Clinical & experimental ophthalmology.

[38]  O. Schwenn,et al.  Ocular pulse amplitude in patients with open angle glaucoma, normal tension glaucoma, and ocular hypertension , 2002, The British journal of ophthalmology.

[39]  S. Costantino,et al.  Development of a novel instrument to measure the pulsatile movement of ocular tissues. , 2010, Experimental eye research.

[40]  Jun Zhang,et al.  High-dynamic-range quantitative phase imaging with spectral domain phase microscopy. , 2009, Optics letters.

[41]  Josef Flammer,et al.  What is the link between vascular dysregulation and glaucoma? , 2007, Survey of ophthalmology.

[42]  Sarah L. Hosking,et al.  Spectral content of the intraocular pressure pulse wave: glaucoma patients versus normal subjects , 2002, Graefe's Archive for Clinical and Experimental Ophthalmology.

[43]  R. Farrell,et al.  Validity of pulsatile ocular blood flow measurements. , 1994, Survey of ophthalmology.

[44]  Henryk T. Kasprzak,et al.  High Accuracy Measurement of Spectral Characteristics of Movements of the Eye Elements , 2007 .

[45]  C. Bolger,et al.  Dominant frequency content of ocular microtremor from normal subjects , 1999, Vision Research.

[46]  G A Cioffi,et al.  Assessment of human ocular hemodynamics. , 1998, Survey of ophthalmology.