A method to improve visualization with handheld adaptive optics scanning laser ophthalmoscope

Unmet Need

The integration of adaptive optics (AO) technology into ophthalmic imaging systems has allowed for the dynamic compensation of ocular and system aberrations. Using wavefront sensor or sensorless approaches, AO-enhanced retinal imaging systems have achieved near diffraction-limited performance, enabling the in vivo visualization of retinal cellular and sub-cellular features. In particular, the confocal AO scanning laser ophthalmoscope (AOSLO) has enabled reliable rod and cone photoreceptor imaging, presenting the potential use for AOSLO images in investigations of retinal disease biomarkers. However, conventional AOSLO systems span large optical tables, often require subject stabilization mechanisms, and cannot accommodate a variety of subject positions during imaging sessions. To address these limitations and extend AO imaging to non-cooperative patient populations, the inventors previously developed the first confocal handheld AOSLO (HAOSLO) system able to resolve individual cone photoreceptors in neonates and supine adults, while maintaining a compact form factor. However, as shown in multiple recent studies, confocal AOSLO imaging may result in ambiguity in visualization and analysis of retinal photoreceptors. Thus far, current complicate AOSLO system designs and have only been able to be demonstrated in tabletop systems. There is a need for handheld AOSLO imaging with improved visualization.


Duke inventors have developed a method to improve images collected with a handheld AOSLO device. Specifically, this is the first demonstration of a compact and handheld AOSLO capable of simultaneous non-confocal SD and confocal imaging of cone photoreceptors. The inventors adapted the collection channel of the previous confocal HAOSLO probe to enable simultaneous three-channel detection. A working prototype of this technology was used to image the right eye of four healthy adult subjects that were either mildly hyperopic or emmetropic which resulted in joint improvement of confocal and SD images.


  • Enables improved diagnosis and treatment through for previously excluded patient populations through more comprehensive data collection
  • Offers unprecedented miniature size and weight
  • M-HAOSLO prototype is also the first system to perform sensorless wavefront-corrected SD imaging of cone photoreceptors