This manuscript describes the novel setup and operating procedure of a photoacoustic microscopy and optical coherence tomography dual-modality system for noninvasive, label-free chorioretinal imaging of larger animals, such as rabbits.
Photoacoustic ocular imaging is an emerging ophthalmic imaging technology that can noninvasively visualize ocular tissue by converting light energy into sound waves and is currently under intensive investigation. However, most reported work to date is focused on the imaging of the posterior segment of the eyes of small animals, such as rats and mice, which poses challenges for clinical human translation due to small eyeball sizes. This manuscript describes a novel photoacoustic microscopy (PAM) and optical coherence tomography (OCT) dual-modality system for posterior segment imaging of the eyes of larger animals, such as rabbits. The system configuration, system alignment, animal preparation, and dual-modality experimental protocols for in vivo, noninvasive, label-free chorioretinal imaging in rabbits are detailed. The effectiveness of the method is demonstrated through representative experimental results, including retinal and choroidal vasculature obtained by the PAM and OCT. This manuscript provides a practical guide to reproducing the imaging results in rabbits and advancing photoacoustic ocular imaging in larger animals.
Recent decades have witnessed the explosive development of the field of biomedical photoacoustic imaging1,2,3,4,5,6,7,8. Based on the energy conversion of light into sound, the emerging photoacoustic imaging can visualize biological samples at scales from organelles, cells, tissues, organs to small-animal whole body and can reveal its anatomical, functional, molecular, genetic, and metabolic information1,2,9,10,11,12. Photoacoustic imaging has found unique applications in a range of biomedical fields, such as cell biology13,14, vascular biology15,16, neurology17,18, oncology19,20,21,22, dermatology23, pharmacology24, and hematology25,26. Its application in ophthalmology, that is, photoacoustic ocular imaging, has attracted substantial interests from both scientists and clinicians and is currently under active investigation.
In contrast to routinely used ocular imaging technologies27, such as fluorescein angiography (FA) and indocyanine green angiography (ICGA) (based on fluorescence contrast), optical coherence tomography (OCT) (based on optical scattering contrast), and its derivative OCT angiography (based on motion contrast of red blood cells), photoacoustic ocular imaging uses optical absorption as the contrast mechanism. This is different from conventional ocular imaging technologies and provides a unique tool for studying optical absorption properties of the eye, which are usually associated with the pathophysiological status of ocular tissue28. To date, significant excellent work has been done in photoacoustic ocular imaging29,30,31,32,33,34,35,36,37, but these studies focus on the posterior segment of the eyes of small animals, such as rats and mice. The pioneering studies well demonstrate the feasibility of photoacoustic imaging in ophthalmology but there is still a long way to go towards clinical translation of the technology since eyeball sizes of rats and mice are much smaller (less than one-third) than that of humans. Due to the propagation of ultrasound waves over a significantly longer distances, signal intensity and image quality may greatly suffer when the technique is used for imaging the posterior segment of larger eyes.
Towards this goal, we recently reported the noninvasive, label-free chorioretinal imaging in living rabbits using integrated photoacoustic microscopy (PAM) and spectral-domain OCT (SD-OCT)38. The system has excellent performance and could visualize the retina and choroid of the eyes of larger animals based on endogenous absorption and scattering contrast of ocular tissue. Preliminary results in rabbits show that the PAM could noninvasively distinguish individual retinal and choroidal blood vessels using a laser exposure dose (~80 nJ) significantly below the American National Standards Institute (ANSI) safety limit (160 nJ) at 570 nm39; and the OCT could clearly resolve different retinal layers, the choroid, and the sclera. It is the very first demonstration of posterior segment imaging of larger animals using PAM and might be a major step towards clinical translation of the technology considering that the eyeball size of rabbits (18.1 mm)40 is almost 80% of the axial length of humans (23.9 mm).
In this work, we provide a detailed description of the dual-modality imaging system and experimental protocols used for noninvasive, label-free chorioretinal imaging in living rabbits and demonstrate the system performance through representative retinal and choroidal imaging results.
Rabbits are a United States Department of Agriculture (USDA) covered species. Its use in biomedical research needs to follow strict regulations. All rabbit experiments were performed in accordance with the ARVO (The Association for Research in Vision and Ophthalmology) Statement for the Use of Animals in Ophthalmic and Vision Research, after approval of the laboratory animal protocol by the University Committee on Use and Care of Animals (UCUCA) of the University of Michigan (Protocol PRO00006486, PI Yannis Paulus).
1. System configuration
2. System alignment
3. Rabbit preparation
4. SD-OCT imaging
5. PAM imaging
6. Post imaging
The dual-modality imaging system and experimental protocol have been successfully tested in the authors' laboratory using four New Zealand White rabbits. The following showcases some representative results.
Figure 1 shows the schematic of the PAM and SD-OCT dual-modality imaging system. It is composed of the following modules: photoacoustic light source, variable laser attenuator, beam collimator, energy meter, scan head, photoacoustic detection and acquisition module, OCT unit, and synchronization electronics. Detailed system configurations are itemized in Section 1.1.
Figure 2 demonstrates typical imaging results of rabbit choroidal vasculature acquired using the dual-modality imaging system. Figure 2(a) is a fundus photograph showing that choroidal vessels spread over most parts of the rabbit fundus while retinal vessels are confined within the medullary ray. Figure 2(b) is a typical PAM image showing the choroidal vasculature within the fundus photograph. The choroidal blood vessels were delineated at high lateral resolution. Figure 2(c) is an OCT B-scan image acquired to look at the fundus anatomy and confirms the presence of the choroidal vessels. The retina, the choroid, and the sclera could be visualized with a high axial resolution with the choroidal vessels below the retinal pigment epithelium (RPE) layer.
Figure 3 demonstrates typical imaging results of rabbit retinal vasculature acquired using the dual-modality imaging system. Figures 3(a) and 3(b) are 2D MIP and 3D volumetric rendering of retinal vessels obtained by PAM, respectively. Figure 3(c) shows orthogonal slices of the 3D image. The results show that the PAM could also visualize individual retinal vessels, which lie above the RPE layer, and confirms that retinal vessels and choroidal vessels are at different depths. Figure 3(d) illustrates a corresponding OCT B-scan image, showing cross sections of individual retinal vessels and the nerve fiber layer (NFL).
Figure 1.Schematic of the integrated photoacoustic microscopy and optical coherence tomography dual-modality imaging system. OPO: Optical parametric oscillator; BS: beam splitter; PD: photodiode; M: Mirror; DM: dichroic mirror; SL: scan lens; OL: ophthalmic lens; SMF: single-mode fiber; DCG: dispersion compensation glass; CCD: charge-coupled device. Please click here to view a larger version of this figure.
Figure 2. PAM and OCT dual-modality imaging of choroidal blood vessels in rabbits. (a) Fundus photograph showing that choroidal vessels (CVs) spread over the entire fundus while retinal vessels (RVs) are confined within the medullary ray since rabbits are merangiotic animals. (b) PAM C-scan image of CVs showing that PAM can delineate CVs at high lateral resolution. (c) OCT B-scan image showing the anatomical structure of rabbit fundus and axial position of choroidal vessels. GCL: Ganglion cell layer; INL: inner nuclear layer; IPL: inner plexiform layer; ONL: outer nuclear layer; OPL: outer plexiform layer; OLM: outer limiting membrane; EZ: ellipsoid zone; MZ: myoid zone; OS: outer segment; BM, Bruch's membrane; IZ: interdigitation zone38. Please click here to view a larger version of this figure.
Figure 3. PAM and OCT dual-modality imaging of retinal blood vessels in rabbits. (a) PAM C-scan image of RVs and CVs. (b) 3D volumetric rendering of the PAM image. (c) 2D orthogonal slices of the PAM image showing that RVs and CVs are at different depths. (d) OCT B-scan image illustrating the RVs, the NFL, and the sclera38. Please click here to view a larger version of this figure.
An intact and regular tear film is essential for high-quality fundus images. An irregular and deteriorated tear films can significantly degrade image quality42. To preserve the integrity of the tear film and prevent corneal superficial punctate keratopathy, it is critical to lubricate the cornea using eyewash very frequently, approximately every two min. If there are any concerns regarding the opacity of the eye, use a slit lamp and fluorescein strips to check the cornea conditions.
Several difficulties may be present for posterior segment imaging of the eyes of larger animals, including photoacoustic signal attenuation with distance particularly for high-frequency components, corneal dehydration, and optical aberrations. Photoacoustic signal amplitude typically experiences significant attenuation before being detected by the needle-shaped ultrasonic transducer. The larger the eyeball size, the greater the attenuation. The eyeball size of rabbits (~18.1mm) is about three times larger than that of rats and six times larger than that of mice, which makes rabbit eye imaging particularly challenging. To achieve reasonable imaging quality, a laser beam with a small diameter (2 mm after the beam collimator in this study) and collimated wavefront (ideally planar wavefront) is preferred because it will be minimally affected by intrinsic optical aberrations of the cornea and can be well focused onto the retina. This point is of critical importance in terms of reducing the laser exposure dose and improving image resolution. In addition, an ultrasonic transducer with a center frequency of 27 MHz rather than a higher center frequency due to experimental results indicating that this is the maximal ultrasound signal at this distance.
While OCT and OCTA are well-established technologies used in the clinic for anatomical and functional imaging of the eye, their molecular imaging capability is limited due to the contrast mechanisms43. PAM is an emerging eye imaging modality based on optical absorption contrast of ocular tissue. It is sensitive to endogenous and exogenous chromophores, like hemoglobin, melanin, and externally-administrated contrast agents. Visualizing vascular structure demonstrated in this work is one of the many applications of PAM. Other important applications include functional and molecular imaging, such as blood flow speed detection, hemoglobin concentration quantification, oxygen saturation mapping, and biomarker visualization, which are important to study the pathophysiology of a myriad of retinal vascular diseases, including diabetic retinopathy, macular degeneration, retinal vein occlusions, retinal artery occlusions, sickle cell retinopathy, and presumed ocular histoplasmosis, to name a few. Moreover, PAM has greater penetration depth than OCT, which makes it suitable for the study of some choroidal diseases, such as polypoidal choroidal vasculopathy, central serous chorioretinopathy, pachychoroid diseases, and choroidal neovascularization. From these perspectives, PAM might be able to provide useful complementary information to OCT and OCTA to give a more comprehensive evaluation of ocular diseases in the future.
The authors have nothing to disclose.
This work was supported by the generous support of the National Eye Institute 4K12EY022299 (YMP), Fight for Sight-International Retinal Research Foundation FFS GIA16002 (YMP), unrestricted departmental support from Research to Prevent Blindness, and the University of Michigan Department of Ophthalmology and Visual Sciences. This work utilized the Core Center for Vision Research funded by P30 EY007003 from the National Eye Institute.
Dual-modality imaging system | |||
OPO laser | Ekspla (Vilnius, Lithuania) | NT-242 | |
Beam attenuator | Thorlabs, Inc. (Newton, NJ, USA) | AHWP10M-600 | |
Motorized rotation stage | Thorlabs, Inc. (Newton, NJ, USA) | PRM1/MZ8 | |
Motorized rotation stage controller | Thorlabs, Inc. (Newton, NJ, USA) | TDC001 | |
Focusing lens | Thorlabs, Inc. (Newton, NJ, USA) | AC254-250-B | |
Pinhole | Thorlabs, Inc. (Newton, NJ, USA) | P50S | |
Collimating lens | Thorlabs, Inc. (Newton, NJ, USA) | AC127-030-B | |
Photodiode | Thorlabs, Inc. (Newton, NJ, USA) | PDA36A | |
Laser shutter | Vincent Associates Inc. (Toronto, Canada) | LS6S2T0 | |
Laser shutter driver | Vincent Associates Inc. (Toronto, Canada) | VCM-D1 | |
Dichroic mirror | Semrock, Inc. (Rochester, NY, USA) | Di03-R785-t3-25×36 | |
Scan lens | Thorlabs, Inc. (Newton, NJ, USA) | OCT-LK3-BB | |
Ophthalmic lens | Thorlabs, Inc. (Newton, NJ, USA) | AC080-010-B-ML | |
Ultrasonic transducer | Optosonic Inc. (Arcadia, CA, USA) | Custom | |
Amplifier | L3 Narda-MITEQ (Hauppauge, NY, USA) | AU-1647 | |
Band-pass filter | Mini-Circuits (Brooklyn, NY, USA) | BLP-30+ | |
Digitizer | DynamicSignals LLC (Lockport, IL, USA) | PX1500-4 | |
Synchronization electronics | National Instruments Corporation (Austin, TX, USA) | USB-6353 | |
OCT module | Thorlabs, Inc. (Newton, NJ, USA) | Ganymede-II-HR | |
Dispersion compensation glass | Thorlabs, Inc. (Newton, NJ, USA) | LSM03DC | |
Illumination LED light | Thorlabs, Inc. (Newton, NJ, USA) | MCWHF2 | |
Power meter | Thorlabs, Inc. (Newton, NJ, USA) | S121C | |
Power meter interface | Thorlabs, Inc. (Newton, NJ, USA) | PM100USB | |
Height measurement tool | Thorlabs, Inc. (Newton, NJ, USA) | BHM1 | |
Fundus camera | Topcon Corporation (Tokyo, Japan) | TRC 50EX | |
Matlab | MathWorks (Natick, MA, USA) | 2017a | |
Oscilloscope | Teledyne LeCroy (Chestnut Ridge, NY, USA) | WaveJet 354T | |
Animal experiment | |||
Water-circulating blanket | Stryker Corporation (Kalamazoo, MI, USA) | TP-700 | |
Ketamine hydrochloride injection | Par pharmaceutical, Inc. (Woodcliff Lake, NJ, USA) | NDC code 42023-115-10 | |
Xylazine hydrochloride | VetOne (Boise, ID, USA) | NDC code 13985-704-10 | |
Tropicamide ophthalmic | Akorn Pharmaceuticals Inc. (Lake Forest, IL, USA) | NDC code 17478-102-12 | |
Phenylephrine hydrochloride ophthalmic | Paragon BioTeck, Inc. (Portland, OR, USA) | NDC code 42702-102-15 | |
Eye lubricant | Hub Pharmaceuticals LLC (Rancho Cucamonga, CA, USA) | NDC code 17238-610-15 | |
Eyewash | Altaire Pharmaceuticals, Inc. (Aquebogue, NY, USA) | NDC code 59390-175-18 | |
Tetracaine hydrochloride ophthalmic solution | Bausch & Lomb, Inc. (Rochester, NY, USA) | NDC code 24208-920-64 | |
Flurbiprofen sodium ophthalmic solution | Bausch & Lomb, Inc. (Rochester, NY, USA) | NDC code 24208-314-25 | |
Neomycin and Polymyxin B Sulfates and Dexamethasone Ophthalmic Ointment | Bausch & Lomb, Inc. (Rochester, NY, USA) | NDC code 24208-795-35 | |
Meloxicam injection | Henry Schein Inc. (Queens, NY, USA) | NDC code 11695-6925-1 |