The 2012 António Champalimaud Vision Award, given by the Champalimaud Foundation (Lisbon, Portugal), recognized the development of two novel approaches—optical coherence tomography and adaptive optics—for visualizing the living human retina. Both techniques have provided remarkable opportunities for studying fundamental questions of retinal structure, for unraveling the mechanisms of human ocular disease, and for better monitoring clinical outcomes.
Optical coherence tomography (OCT) merges the low coherence interferometry methodologies of James Fujimoto and Eric Swanson of MIT (Cambridge, MA) and David Huang of Oregon Health & Science University (Portland, OR), with insights for their clinical ocular application by Carmen Puliafito of the University of Southern California (Los Angeles, CA) and Joel Schuman of the University of Pittsburgh in Pennsylvania. By revealing the human retina at remarkable resolution, OCT has already led to improved diagnostics and clinical management.
Adaptive optics technologies were originally developed by astronomers to see through atmospheric aberrations. David Williams’ application of adaptive optics to the eye brings retinal cells into sharp focus by correcting for natural optical imperfections of the cornea and lens, making it possible to view and count individual cone photoreceptors in the living human retina. This has dramatically advanced the ability to probe the dimensions of the cone spacing matrix, a limiting factor in visual resolution. Imaging individual cones noninvasively over weeks, months, and years is providing novel insights into retinal changes caused by aging and disease.
Both techniques for visualizing the living retina have already provided fundamentally important details about the structure of the eyes of living patients, in tissue cross-section at macro-scale by OCT, and cell organization en fas at micro-scale by adaptive optics. Previously unknown details of the malleability of the human retina have emerged through application of OCT and adaptive optics in health and disease. These methods are dramatically changing ophthalmic practice and our understanding and management of ocular aging and disease. The imaging properties of these two techniques, alone, and, potentially, together, hold enormous promise for three-dimensional, in-vivo, cell-scale imaging that will further advance research discovery and clinical care.
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