BACKGROUND: With the increasing global incidence of diabetes mellitus (DM), diabetic retinopathy (DR) has become one of the leading causes of blindness in developed countries. DR leads to changes in retinal neurons and microcirculation. Rtx1TM (Imagine Eyes, Orsay, France) is a retinal camera that allows histological visualisations of cones and retinal microcirculation throughout the DM duration.
OBJECTIVE: This study aimed to analyse the cones and retinal microvascular changes in 50 diabetic individuals and 18 healthy volunteers. The patients participated in the initial visit and two follow-up appointments, one and two years after the study, beginning with Rtx1TM image acquisition, visual acuity assessment, macular OCT scans and blood measurements.
RESULTS: The study revealed significant differences in the cone density, mosaic arrangement and vascular morphology between healthy and diabetic patients. The final measurements showed decreased photoreceptor and microvascular parameters in the DR group compared with the control group. Furthermore, in the 2-year follow-up, both groups\' Rtx1TM-acquired morphological changes were statistically significant.
CONCLUSIONS: Rtx1TM technology was successfully used as a non-invasive method of photoreceptors and retinal vasculature assessment over time in patients with diabetic retinopathy. The study revealed a trend toward more vascular morphological changes occurring over time in diabetic patients.

Inherited retinal dystrophies (IRDs) are genetic disorders that lead to the bilateral degeneration of the retina, causing irreversible vision loss. These conditions often manifest during the first and second decades of life, and their primary symptoms can be non-specific. Diagnostic processes encompass assessments of best-corrected visual acuity, fundoscopy, optical coherence tomography, fundus autofluorescence, fluorescein angiography, electrophysiological tests, and genetic testing. This study focuses on the application of adaptive optics (AO), a non-invasive retinal examination, for the assessment of patients with IRDs. AO facilitates the high-quality, detailed observation of retinal photoreceptor structures (cones and rods) and enables the quantitative analysis of parameters such as cone density (DM), cone spacing (SM), cone regularity (REG), and Voronoi analysis (N%6). AO examinations were conducted on eyes diagnosed with Stargardt disease (STGD, N=36), cone dystrophy (CD, N=9), and cone-rod dystrophy (CRD, N=8), and on healthy eyes (N=14). There were significant differences in the DM, SM, REG, and N%6 parameters between the healthy and IRD-affected eyes (p<0.001 for DM, SM, and REG; p=0.008 for N%6). The mean DM in the CD, CRD, and STGD groups was 8900.39/mm2, 9296.32/mm2, and 16,209.66/mm2, respectively, with a significant inter-group difference (p=0.006). The mean SM in the CD, CRD, and STGD groups was 12.37 μm, 14.82 μm, and 9.65 μm, respectively, with a significant difference observed between groups (p=0.002). However, no significant difference was found in REG and N%6 among the CD, CRD, and STGD groups. Significant differences were found in SM and DM between CD and STGD (p=0.014 for SM; p=0.003 for DM) and between CRD and STGD (p=0.027 for SM; p=0.003 for DM). Our findings suggest that AO holds significant potential as an impactful diagnostic tool for IRDs.

BACKGROUND: The study aims to investigate the relationship between the volume-accumulated reflectivity (termed \"integral\") on spectral domain optical coherence tomography (SD-OCT) and cone density on adaptive optics (AO) imaging.
METHODS: In this cross-sectional study, both eyes of 32 healthy subjects and 5 patients with inherited retinal diseases (IRD) were studied. The parameter, integral, was defined as the volume-accumulated reflectivity values in a selected region on OCT images; integrals of the ellipsoid zone (EZ) and interdigitation zone (IZ) were measured at 2°, 3°, 4°, 5°and 6° eccentricity along the four meridians on fovea-centered OCT B-scans. Cone density in the same region was measured using a flood illumination adaptive optics camera RTX1.
RESULTS: Integrals of EZ, IZ and cone density shared similar distribution patterns. Integral of the IZ was better correlated with cone density in both healthy people (r = 0.968, p < 0.001) and those with IRD (r = 0.823, p < 0.001) than direct measurements of reflectivity on OCT images. A strong correlation was found between best corrected visual acuity (BCVA) and cone density at 2° eccentricity (r = -0.857, p = 0.002). BCVA was also correlated with the integral of the IZ at the foveola (r = -0.746, p = 0.013) and fovea (r = -0.822, p = 0.004).
CONCLUSIONS: The new parameter \"integral\" of the photoreceptor outer segment measured from SD-OCT was noted to correlate with cone density and visual function in this pilot study.

A realistic wave optics simulation method has been developed to study how wavefront distortions originating from heat load deformations can be corrected using adaptive X-ray optics. Several planned soft X-ray and tender X-ray insertion-device beamlines in the Advanced Light Source upgrade rely on a common design principle. A flat, first mirror intercepts the white beam; vertical focusing is provided by a variable-line-space monochromator; and horizontal focusing comes from a single, pre-figured, adaptive mirror. A variety of scenarios to cope with thermal distortion in the first mirror are studied by finite-element analysis. The degradation of the intensity distribution at the focal plane is analyzed and the adaptive optics that correct it is modeled. The range of correctable wavefront errors across the operating range of the beamlines is reported in terms of mirror curvature and spatial frequencies. The software developed is a one-dimensional wavefront propagation package made available in the OASYS suite, an adaptable, customizable and efficient beamline modeling platform.

UNASSIGNED: To investigate longitudinal changes in the retinal nerve fiber bundle in eyes with primary open angle glaucoma using adaptive optics scanning laser ophthalmoscopy.
UNASSIGNED: A prospective observational case series. Fourteen eyes from 12 patients with primary open angle glaucoma that exhibited retinal nerve fiber layer defects on fundus photography were imaged with adaptive optics scanning laser ophthalmoscopy over time.
UNASSIGNED: The expansion of retinal nerve fiber bundle narrowing was observed on adaptive optics scanning laser ophthalmoscopy in 8 eyes (57.1%) over a period of 1.44 ± 0.42 years. Retinal nerve fiber bundle narrowing expanded horizontally in 2 eyes and vertically in 6 eyes. In 3 eyes, changes in the retinal nerve fiber layer were only detectable on adaptive optics scanning laser ophthalmoscopy images.
UNASSIGNED: The expansion of retinal nerve fiber bundle narrowing was observed using adaptive optics scanning laser ophthalmoscopy. Accordingly, this tool may be a useful tool for detecting glaucoma-related changes in retinal nerve fibers in a short time.

Purpose: To monitor perivascular sheathing during the course of retinal vasculitis by flood illumination adaptive optics ophthalmoscopy (AOO). Methods: Perivenous sheathing and venous diameters were quantitatively analyzed by semi-automatic segmentation of AOO images in 12 eyes of treatment-naive patients with retinal vasculitis. Results: The width of venous sheathing ranged from 45 to 225 µm (mean 101.0 µm ± 54.3). In 10 cases, the underlying vein showed focal narrowing (mean ± SD 14% ± 10). Focal narrowing of arteries was also present in one eye. At presentation, width of sheathing and vessel diameters were not correlated with fluorescein leakage. During follow-up, 5 eyes showed an increase in vein diameter or resolution of narrowing and in 10 eyes a thinning of vascular sheathing was observed (p= .003). Conclusions: Perivenous sheathing may be quantitatively analyzed and monitored by AOO. AOO may therefore contribute to monitor vascular sheathing during posterior uveitis.

UNASSIGNED: To study photoreceptor changes after a successful macular hole surgery using adaptive optics.
UNASSIGNED: Three patients who underwent a successful macular hole surgery were studied. Cone density, spacing, and number of nearest neighbors were analyzed at 2° and 4° of eccentricity in all four quadrants using adaptive optics.
UNASSIGNED: All three patients gained a visual acuity better than logMAR 0.477 (Snellen equivalent 6/18) at 6 months following successful macular hole surgery. Following successful closure of the macular hole, photoreceptors were appreciated at 2° and 4° of eccentricity from the center. However, as compared with the fellow normal eye, cell density was reduced significantly in the inferior (12,929.33 ± 2047.50 versus 23,839.67 ± 3711.16 cells/mm2 at 2°) and temporal quadrant (13,890 ± 3424.26 versus 22,578.67 ± 5651.34 cells/mm2 at 2°), and intercell spacing was increased significantly in inferior (9.6 ± 0.92 versus 7.14 ± 0.545 µm) and nasal quadrant (8.83 ± 0.39 versus 7.49 ± 0.42 µm). Number of nearest neighbors was unaffected after the hole closure.
UNASSIGNED: Postoperative recovery of vision after successful closure of the hole occurs because of the migration or shifting of cells from parafoveal retina toward the center. Cells nearest to the hole margin (at 2° eccentricity) appear to shift more as compared with cells which are further away.

Essential hypertension is associated with structural alterations in the microvessels; in particular, an increase in the media thickness to internal lumen ratio of small resistance arteries (MLR) and a reduction in capillary density have been observed. The evaluation of the morphological characteristics of small resistance arteries in humans is challenging. The gold-standard method is generally considered to be the measurement by wire or pressure micromyography of MLR of subcutaneous small vessels obtained by local biopsies. However, noninvasive techniques for the evaluation of retinal arterioles were recently proposed; in particular, 2 approaches, scanning laser Doppler flowmetry (SLDF) and adaptive optics (AO), seem to provide useful information. Both of them provide an estimation of the wall to lumen ratio (WLR) of retinal arterioles. Moreover, a noninvasive measurement of basal and total capillary density may be obtained by videomicroscopy/capillaroscopy. It has been recently demonstrated that AO has a substantial advantage over SLDF in terms of evaluation of microvascular morphology, since WLR measured with AO is more closely correlated with the M/L of subcutaneous small arteries. The possibility to noninvasively assess in a reliable way, microvascular morphology in a clinical setting may represent a major advancement, since micromyography has substantial limitations in its application due to the local invasiveness of the procedure.

Many of the next generation of adaptive optics systems on large and extremely large telescopes require tomographic techniques in order to correct for atmospheric turbulence over a large field of view. Multi-object adaptive optics is one such technique. In this paper, different implementations of a tomographic reconstructor based on a machine learning architecture named \"CARMEN\" are presented. Basic concepts of adaptive optics are introduced first, with a short explanation of three different control systems used on real telescopes and the sensors utilised. The operation of the reconstructor, along with the three neural network frameworks used, and the developed CUDA code are detailed. Changes to the size of the reconstructor influence the training and execution time of the neural network. The native CUDA code turns out to be the best choice for all the systems, although some of the other frameworks offer good performance under certain circumstances.