Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA.
Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA; Department of Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA; Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, WI, USA.
Prog Retin Eye Res. 2021 Jul;83:100920. doi: 10.1016/j.preteyeres.2020.100920. Epub 2020 Nov 6.
Adaptive optics scanning light ophthalmoscopy (AOSLO) allows visualization of the living human retina with exquisite single-cell resolution. This technology has improved our understanding of normal retinal structure and revealed pathophysiological details of a number of retinal diseases. Despite the remarkable capabilities of AOSLO, it has not seen the widespread commercial adoption and mainstream clinical success of other modalities developed in a similar time frame. Nevertheless, continued advancements in AOSLO hardware and software have expanded use to a broader range of patients. Current devices enable imaging of a number of different retinal cell types, with recent improvements in stimulus and detection schemes enabling monitoring of retinal function, microscopic structural changes, and even subcellular activity. This has positioned AOSLO for use in clinical trials, primarily as exploratory outcome measures or biomarkers that can be used to monitor disease progression or therapeutic response. AOSLO metrics could facilitate patient selection for such trials, to refine inclusion criteria or to guide the choice of therapy, depending on the presence, absence, or functional viability of specific cell types. Here we explore the potential of AOSLO retinal imaging by reviewing clinical applications as well as some of the pitfalls and barriers to more widespread clinical adoption.
自适应光学扫描激光检眼镜（AOSLO）允许以精细的单细胞分辨率可视化活的人视网膜。这项技术提高了我们对正常视网膜结构的理解，并揭示了许多视网膜疾病的病理生理细节。尽管 AOSLO 具有出色的功能，但它并没有像在类似时间框架内开发的其他模式那样得到广泛的商业采用和主流的临床成功。尽管如此，AOSLO 硬件和软件的持续进步已经将其应用扩展到更广泛的患者群体。目前的设备能够对多种不同的视网膜细胞类型进行成像，最近在刺激和检测方案方面的改进使得可以监测视网膜功能、微观结构变化，甚至亚细胞活动。这使得 AOSLO 可以用于临床试验，主要作为探索性的结局指标或生物标志物，用于监测疾病进展或治疗反应。AOSLO 指标可以帮助患者选择此类试验，根据特定细胞类型的存在、缺失或功能活力来细化纳入标准或指导治疗选择。在这里，我们通过回顾临床应用以及更广泛的临床应用所面临的一些陷阱和障碍，探讨了 AOSLO 视网膜成像的潜力。
