A Clinical Planning Module for Adaptive Optics SLO Imaging

Purpose. To develop a clinical planning module (CPM) to improve the efficiency of imaging subjects with a steerable wide-field adaptive optics scanning laser ophthalmoscope (AOSLO) and to evaluate the performance of this module by imaging the retina in healthy and diseased eyes. Methods. We developed a software-based CPM with two submodules: a navigation module and a montage acquisition module. The navigation module guides the AOSLO to image identified retinal regions from a clinical imaging platform using a matrix-based mapping between the two. The montage acquisition module systematically moves the AOSLO steering mirrors across the retina in predefined patterns. The CPM was calibrated using a model eye and tested on five normal subjects and one patient with a retinal nerve fiber layer defect. Results. Within the central ±7° from the fixation target, the CPM can direct the AOSLO beam to the desired regions with localization errors of <0.3°. The navigation error increases with eccentricity, and larger errors (up to 0.8°) were evident for regions beyond 7°. The repeatability of CPM navigation was tested on the same locations from two subjects. The localization errors between trials on different days did not differ significantly (p > 0.05). The region with a size of approximately 13° × 10° can be imaged in about 30 min. An approximately 12° × 4.5° montage of the diseased region from a patient was imaged in 18 min. Conclusions. We have implemented a clinical planning module to accurately guide the AOSLO imaging beam to desired locations and to quickly acquire high-resolution AOSLO montages. The approach is not only friendly for patients and clinicians but also convenient to relate the imaging data between different imaging platforms.