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Biomedical Optics Express

Biomedical Optics Express

  • Editor: Joseph A. Izatt
  • Vol. 4, Iss. 3 — Mar. 1, 2013
  • pp: 466–480
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Simultaneous real-time imaging of the ocular anterior segment including the ciliary muscle during accommodation

Yilei Shao, Aizhu Tao, Hong Jiang, Meixiao Shen, Jianguang Zhong, Fan Lu, and Jianhua Wang  »View Author Affiliations


Biomedical Optics Express, Vol. 4, Issue 3, pp. 466-480 (2013)
http://dx.doi.org/10.1364/BOE.4.000466


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Abstract

We demonstrated a novel approach of imaging the anterior segment including the ciliary muscle using combined and synchronized two spectral domain optical coherence tomography devices (SD-OCT). In one SD-OCT, a Complementary Metal-Oxide-Semiconductor Transistor (CMOS) camera and an alternating reference arm was used to image the anterior segment from the cornea to the lens. Another SD-OCT for imaging the ciliary muscle was equipped with a light source with a center wavelength of 1,310 nm and a bandwidth of 75 nm. Repeated measurements were performed under relaxed and 4.00 D accommodative stimulus states in six eyes from 6 subjects. We also imaged dynamic changes in the anterior segment in one eye during accommodation. The biometry of the anterior segment and the ciliary muscle was obtained. The combined system appeared to be capable to simultaneously real-time image the biometry of the anterior segment, including the ciliary muscle, in vivo during accommodation.

© 2013 OSA

1. Introduction

As a muscle-induced activity, accommodation in the human eye is a highly fluctuant and dynamic process. According to the classic accommodative theory of Helmholtz, the ciliary muscle contracts when accommodation occurs, causing the release of the zonular fibers, allowing the crystalline lens to increase curvature and thickness, and leading to an increase in the ocular refractive power to change the focus on a close target [1

1. H. von Helmholtz, “Uber die akkommodation des auges,” Arch. Ophthalmol. 1, 1–74 (1855).

]. Initially, the ciliary muscle plays a role, while the crystalline lens serves as an effector in the process of accommodation. The capacity for accommodation declines with age, evidently due to the degeneration in both the elasticity of the crystalline lens and the activity of the ciliary muscle; this leads to presbyopia [2

2. D. A. Atchison, “Accommodation and presbyopia,” Ophthalmic Physiol. Opt. 15(4), 255–272 (1995). [CrossRef] [PubMed]

7

7. S. A. Strenk, L. M. Strenk, and J. F. Koretz, “The mechanism of presbyopia,” Prog. Retin. Eye Res. 24(3), 379–393 (2005). [CrossRef] [PubMed]

]. However, this theory may not fully explain the development of presbyopia. Investigating the crystalline lens response to ciliary muscle contraction may be beneficial to better understanding the aging problem. Nevertheless, the relationship between the crystalline lens response and ciliary muscle contraction has not been fully studied, mainly due to the technical difficulty of simultaneously imaging the anterior segment and the ciliary muscle in real-time.

2. Methods

2.1 Two SD-OCT devices

Another SD-OCT (CM-OCT) was used to image the ciliary muscle for acceptable penetration (Fig. 1). The spectrometer was custom-developed (Bioptigen, Durham, NC), and this device has been described elsewhere for imaging the anterior segment [23

23. T. Ide, J. Wang, A. Tao, T. Leng, G. D. Kymionis, T. P. O’Brien, and S. H. Yoo, “Intraoperative use of three-dimensional spectral-domain optical coherence tomography,” Ophthalmic Surg. Lasers Imaging 41(2), 250–254 (2010). [CrossRef] [PubMed]

,24

24. T. Leng, B. J. Lujan, S. H. Yoo, and J. Wang, “Three-dimensional spectral domain optical coherence tomography of a clear corneal cataract incision,” Ophthalmic Surg. Lasers Imaging 39(4Suppl), S132–S134 (2008). [PubMed]

]. The light source was an SLD centered at a wavelength of 1,310 nm with a full-width at half maximum bandwidths of 75 nm. The output on the eye was set to 2.6 mW which was well below the ANSI safety limit for maximum permissible exposure of 15.4 mW at the wavelength [25

25. American National Standards Institute, “American national standard for safe use of lasers,” in Laser Institute of America (Orlando, FL, 2000), pp. 45–49.

]. In addition, most of the 1310 nm beam did not reach the retina because the iris blocked the light and the beam was directed to the limbal area. The scan depth was 3.8 mm with an axial resolution of ~8.0 μm in air. An indium gallium arsenide (InGaAs) camera (SU1024, Goodrich Sensors Unlimited Inc, Princeton, NJ) was used, and the system could image at 7 frames per second with an acquisition speed of 7,000 A-lines/s, corresponding to a frame of 1,000 A-lines. In real-time imaging, the images were continually acquired, processed and displayed. An electronic shutter (JML Optical, Rochester, NY) was implanted in the reference arm and used to insert a sync signal into OCT image acquisition during real-time imaging. The system ran with a proprietary program for data acquisition.

2.2 Combined sample arms and the synchronized real-time imaging

The sample arms of the two SD-OCT systems were combined and mounted on a slit-lamp microscope (Fig. 2
Fig. 2 Schematic diagram depicting the combination of the probes. LCD: liquid-crystal display.
). The probe of the AS-OCT was mounted on top of the slit-lamp microscope. A pair of X-Y galvanometers served as the scanner to image the anterior segment. Cross-hair scanning at the horizontal and the vertical meridians was used to align the scanning position of the eye by viewing the iris images in both horizontal and vertical images. The probe of the CM-OCT was placed on a translation stage that replaced the lamp holder of the slit-lamp. The platform of the stage had the capacity to rotate and vertically move, allowing a horizontal galvanometer to linearly scan the ciliary muscle at the temporal side through the sclera. The two beams were pre-aligned at the same altitude to cross at the corneal apex. The angle between the two probes was set at 30~50 degrees by moving the slit-lamp arms and rotating the stage platform. Both of the two beams from the two devices were focused on the sample by the objective lenses (f = 100 mm), which gave the lateral resolution of ~20 μm [10

10. M. Shen, L. Cui, M. Li, D. Zhu, M. R. Wang, and J. Wang, “Extended scan depth optical coherence tomography for evaluating ocular surface shape,” J. Biomed. Opt. 16(5), 056007 (2011). [CrossRef] [PubMed]

].

To synchronize both sub-systems, a synchronization signal was needed to set the start point. We were not able to modify the proprietary software in the CM-OCT and the CM-OCT run during live view and the recording. If we stopped the recording during the alignment, we were not able to see the live view. Therefore, we implanted a shutter in the reference arm which provided the synchronization signal to the CM-OCT accounting as the start point. The acquisition of the AS-OCT was controlled by a foot switch that signaled the electronic shutter in the reference arm of the CM-OCT as described above (Fig. 1). The shutter, powered with a 5 volt direct current, could quickly block the light beam reflected in the reference arm. When the shutter closed at the onset of scanning, the detector of the CM-OCT did not receive the light from the reference arm, resulting in a blank frame without any information that served as a synchronization signal.

2.3 Accommodative module

A liquid-crystal display (LCD) screen showed a white Snellen letter “E” on a black background as the fixation target and was placed 10 cm from the tested eye. A trial lens combined with the LCD was used to compensate for the refractive error at close proximity and to stimulate the accommodation during image acquisition. The LCD and the trial lens were located on a translation stage with a dual axis for horizontal and vertical adjustments. The LCD was coupled with AS-OCT using a hot mirror (Fig. 2) and was synchronized with the acquisition of the OCT devices by the foot switch (Fig. 1) to alter the boundaries of the target between a blurred or sharp picture.

2.4 Participants and experiments

In the second experiment, the left eye from a 26-year-old subject was imaged in real-time twice. The fixation target was blurred at first to fog the eye, and the picture was sharpened 1 second after the onset of the scanning to stimulate the accommodation. During the experiment, the subject was asked to keep the target as clear and sharp as possible. Sixty-two images, corresponding to thirty-one combined images of the anterior segment at the horizontal meridian, with 1,024 × 4,096 pixels (lateral × axial) per frame, were sequentially acquired using the AS-OCT in 3.72 seconds, with a single frame rate of 8.33 Hz. Meanwhile, the ciliary muscle at the temporal side was imaged using the CM-OCT at a frame-rate of 7 Hz. The starting point of the CM-OCT acquisition was one frame behind that of the AS-OCT because the first frame was uninformed. Thus, a total of 25 frames of the ciliary muscle were obtained over a total duration of 3.71 seconds.

2.5 Image process and analysis

Overlaying multiple images for averaging was used to enhance the images of the ciliary muscle (Fig. 4). Four images were averaged. From the averaged images, the boundaries of the ciliary muscle, which defined as the intraocular boundaries of the sclera, the external edge of the pigmented ciliary epithelium and the internal edge of the iris, were manually segmented using custom developed software. After image correction for the optical distortion, the thickness of the ciliary muscle was evaluated by drawing lines through the points at 1 mm (CMT1) posterior to the scleral spur that were perpendicular to the local curvature of the sclera and extended to pigmented ciliary epithelium or the internal edge of the iris [12

12. L. A. Lossing, L. T. Sinnott, C. Y. Kao, K. Richdale, and M. D. Bailey, “Measuring changes in ciliary muscle thickness with accommodation in young adults,” Optom. Vis. Sci. 89(5), 719–726 (2012). [CrossRef] [PubMed]

,35

35. M. D. Bailey, L. T. Sinnott, and D. O. Mutti, “Ciliary body thickness and refractive error in children,” Invest. Ophthalmol. Vis. Sci. 49(10), 4353–4360 (2008). [CrossRef] [PubMed]

]. The thicknesses of the ciliary muscle at 2 mm (CMT2) and 3 mm (CMT3) posterior to the scleral spur and the maximum thickness of the ciliary muscle (CMTM) were calculated [12

12. L. A. Lossing, L. T. Sinnott, C. Y. Kao, K. Richdale, and M. D. Bailey, “Measuring changes in ciliary muscle thickness with accommodation in young adults,” Optom. Vis. Sci. 89(5), 719–726 (2012). [CrossRef] [PubMed]

,35

35. M. D. Bailey, L. T. Sinnott, and D. O. Mutti, “Ciliary body thickness and refractive error in children,” Invest. Ophthalmol. Vis. Sci. 49(10), 4353–4360 (2008). [CrossRef] [PubMed]

]. It is worth noting that the iris in the CM-OCT images (Figs. 4, 5
Fig. 5 The entire anterior segment (A and B) and the ciliary muscle (C and D) obtained from a 26-year-old subject using the combined devices in relaxed (A and C) and accommodative (B and D) states. The scan width of the anterior segment was set to 12 mm, with an image size of 2,048 × 4,096 pixels (lateral × axial), and to 10.3 mm for the ciliary muscle, with an image size of 1,000 × 1,223 pixels (lateral × axial). Bar = 1 mm. Note the iris (C and D) was flipped as the mirror image due to placement of the delay line inside the eye (bottom of the image).
and 7) was shown as the flipped image. We put the OCT delay-line inside the eye (the bottom of the image) to improve the image quality of the ciliary muscle, resulting in the flipped iris image (as the conjugated artifact). The conjugated artifact is common in SD-OCT, unless phase shift method is used [20

20. C. Dai, C. Zhou, S. Fan, Z. Chen, X. Chai, Q. Ren, and S. Jiao, “Optical coherence tomography for whole eye segment imaging,” Opt. Express 20(6), 6109–6115 (2012). [CrossRef] [PubMed]

,36

36. I. Grulkowski, M. Gora, M. Szkulmowski, I. Gorczynska, D. Szlag, S. Marcos, A. Kowalczyk, and M. Wojtkowski, “Anterior segment imaging with Spectral OCT system using a high-speed CMOS camera,” Opt. Express 17(6), 4842–4858 (2009). [CrossRef] [PubMed]

]. The conjugate artifact is not in time-domain OCT [35

35. M. D. Bailey, L. T. Sinnott, and D. O. Mutti, “Ciliary body thickness and refractive error in children,” Invest. Ophthalmol. Vis. Sci. 49(10), 4353–4360 (2008). [CrossRef] [PubMed]

,37

37. A. L. Sheppard and L. N. Davies, “In vivo analysis of ciliary muscle morphologic changes with accommodation and axial ametropia,” Invest. Ophthalmol. Vis. Sci. 51(12), 6882–6889 (2010). [CrossRef] [PubMed]

] or swept light source OCT [18

18. I. Grulkowski, J. J. Liu, B. Potsaid, V. Jayaraman, C. D. Lu, J. Jiang, A. E. Cable, J. S. Duker, and J. G. Fujimoto, “Retinal, anterior segment and full eye imaging using ultrahigh speed swept source OCT with vertical-cavity surface emitting lasers,” Biomed. Opt. Express 3(11), 2733–2751 (2012). [CrossRef] [PubMed]

]. The details of the conjugated artifact of the iris and its relation to the placement of the delay line have been reported in some published work [20

20. C. Dai, C. Zhou, S. Fan, Z. Chen, X. Chai, Q. Ren, and S. Jiao, “Optical coherence tomography for whole eye segment imaging,” Opt. Express 20(6), 6109–6115 (2012). [CrossRef] [PubMed]

,38

38. M. V. Sarunic, S. Asrani, and J. A. Izatt, “Imaging the ocular anterior segment with real-time, full-range Fourier-domain optical coherence tomography,” Arch. Ophthalmol. 126(4), 537–542 (2008). [CrossRef] [PubMed]

]. The same phenomenon was shown in the attached video clips.

3. Results

Figure 5 shows the ciliary muscle and the anterior segment from the same subject before and after accommodation. Compared to the relaxed condition, pachynsis contraction was noted in the anterior portion of the ciliary muscle under accommodative condition. Although the thinning in the posterior part was not apparent in the figure, the averaged results from the study group showed significant thinning at the posterior portion of the ciliary muscle measured as the CMT3 (Fig. 6
Fig. 6 Biometry of the anterior segment at the horizontal (A) and the vertical (B) meridians, as well as the ciliary muscle (C), within two visits during accommodation. PD: pupil diameter; ACD: anterior chamber depth; CAL: curvature radius of the anterior surface of the lens; CPL: curvature radius of the posterior surface of the lens; CLT: central lens thickness; CMT1-3: ciliary muscle thickness; CMTM: maximum thickness of the ciliary muscle. P value: difference of the mean values between the relaxed and the accommodative states. non-ACC: Relax status; ACC: Accommodative status; V1: visit 1; V2: visit 2.
). In addition, changes in the anterior segment, including a thickening of the lens, a steepening in the lens surface, an increased shallowness in the anterior chamber depth, and the onset of miosis, were clearly observed. Figure 6 shows similar results between the two repeated measurements, as well as the biometric changes between the two states.

Figure 7
Fig. 7 Real-time display of the anterior segment (A) and the ciliary muscle (B) from a 26-year-old subject during 4.00D accommodation (Media 1 and Media 2). The frame rates of the movies were 8.33 fps (A) and 7 fps (B), respectively. Bar = 1 mm. Note the iris (B and Media 2) was flipped as the mirror image due to placement of the delay line inside the eye (bottom of the image).
shows the dynamic deformation of the ciliary muscle and the anterior segment in real-time. The biometric parameters of the lens and the ciliary muscle were calculated as the mean values before and after the accommodative stimulus onset, as shown in Table 1

Table 1. The biometry of the ciliary muscle and the anterior segment before and after accommodation in a 26-year-old subject (unit: mm)

table-icon
View This Table
, and the dynamic changes calculated as the function of time are shown in Fig. 8
Fig. 8 Dynamics of the biometry of the ciliary muscle (A and B) and the anterior segment (C-F) during accommodation acquired at two visits (v1 and v2). Accommodative stimulus was set at 1 second after the start point of the scanning. CMT1: ciliary muscle thickness at 1 mm posterior to the sclera spur (A); CMTM: maximum thickness of the ciliary muscle (B); CAL: curvature radius of the anterior surface of the lens (C); CLT: central lens thickness (D); PD: pupil diameter (E); ACD: anterior chamber depth (F). V1: visit 1; V2: visit 2.
. After the accommodative stimulus was given, the CMT1 and CMTM increased gradually, and reached the stable status at approximate 2 second (Figs. 8A and 8B, Table 1). Meanwhile, the CAL, PD and ACD decreased with the increasing in the CLT, and reached the accommodative status at approximate 2.5 second (Figs. 8C-8F, Table 1).

4. Discussion

Imaging the entire anterior segment has presented a substantial challenge. Strenk et al. developed high-resolution magnetic resonance imaging (MRI) for imaging the whole eye during accommodation to investigate the relationship between the ciliary muscle and the crystalline lens [39

39. S. A. Strenk, J. L. Semmlow, L. M. Strenk, P. Munoz, J. Gronlund-Jacob, and J. K. DeMarco, “Age-related changes in human ciliary muscle and lens: a magnetic resonance imaging study,” Invest. Ophthalmol. Vis. Sci. 40(6), 1162–1169 (1999). [PubMed]

]. This technology offers direct visualization of the ciliary muscle and the lens periphery simultaneously without preventing visualization of the iris. This MRI has the disadvantage of a low spatial resolution (approximately 156 μm), which is roughly equivalent to the change in the maximum thickness of the lens and the ciliary muscle (approximate 100 to 200 μm) during accommodation. Time-consuming exams and high costs may limit its application to real-time imaging and to research on dynamic accommodation. Ultrasound biomicroscopy (UBM), which has good resolution (approximate 50 μm) and scan speed (more than 8 Hz), have been used to image the crystalline lens [40

40. A. P. Beers and G. L. van der Heijde, “Age-related changes in the accommodation mechanism,” Optom. Vis. Sci. 73(4), 235–242 (1996). [CrossRef] [PubMed]

,41

41. A. P. Beers and G. L. Van Der Heijde, “In vivo determination of the biomechanical properties of the component elements of the accommodation mechanism,” Vision Res. 34(21), 2897–2905 (1994). [CrossRef] [PubMed]

] and the ciliary muscle [42

42. M. A. Croft, A. Glasser, G. Heatley, J. McDonald, T. Ebbert, D. B. Dahl, N. V. Nadkarni, and P. L. Kaufman, “Accommodative ciliary body and lens function in rhesus monkeys, I: normal lens, zonule and ciliary process configuration in the iridectomized eye,” Invest. Ophthalmol. Vis. Sci. 47(3), 1076–1086 (2006). [CrossRef] [PubMed]

,43

43. S. Jeon, W. K. Lee, K. Lee, and N. J. Moon, “Diminished ciliary muscle movement on accommodation in myopia,” Exp. Eye Res. 105, 9–14 (2012). [CrossRef] [PubMed]

]. With this contact method, the configuration of the ciliary muscle was clearly visualized and the changes in the accommodative response could be documented. Moreover, with iridectomies in animal models, the ciliary process and the crystalline lens equator can be visualized using goniovideography [42

42. M. A. Croft, A. Glasser, G. Heatley, J. McDonald, T. Ebbert, D. B. Dahl, N. V. Nadkarni, and P. L. Kaufman, “Accommodative ciliary body and lens function in rhesus monkeys, I: normal lens, zonule and ciliary process configuration in the iridectomized eye,” Invest. Ophthalmol. Vis. Sci. 47(3), 1076–1086 (2006). [CrossRef] [PubMed]

,44

44. M. A. Croft, P. L. Kaufman, K. S. Crawford, M. W. Neider, A. Glasser, and L. Z. Bito, “Accommodation dynamics in aging rhesus monkeys,” Am. J. Physiol. 275(6 Pt 2), R1885–R1897 (1998). [PubMed]

]. These features cannot be visualized using OCT method if the iridectomy is not performed in human subjects.

Anterior segment OCT has been used to analyze the biometric changes of the ciliary muscle during accommodation [12

12. L. A. Lossing, L. T. Sinnott, C. Y. Kao, K. Richdale, and M. D. Bailey, “Measuring changes in ciliary muscle thickness with accommodation in young adults,” Optom. Vis. Sci. 89(5), 719–726 (2012). [CrossRef] [PubMed]

14

14. K. Richdale, M. D. Bailey, L. T. Sinnott, C. Y. Kao, K. Zadnik, and M. A. Bullimore, “The effect of phenylephrine on the ciliary muscle and accommodation,” Optom. Vis. Sci. 89(10), e1507–e1511 (2012). [CrossRef] [PubMed]

,35

35. M. D. Bailey, L. T. Sinnott, and D. O. Mutti, “Ciliary body thickness and refractive error in children,” Invest. Ophthalmol. Vis. Sci. 49(10), 4353–4360 (2008). [CrossRef] [PubMed]

,37

37. A. L. Sheppard and L. N. Davies, “In vivo analysis of ciliary muscle morphologic changes with accommodation and axial ametropia,” Invest. Ophthalmol. Vis. Sci. 51(12), 6882–6889 (2010). [CrossRef] [PubMed]

,51

51. H. A. Lewis, C. Y. Kao, L. T. Sinnott, and M. D. Bailey, “Changes in ciliary muscle thickness during accommodation in children,” Optom. Vis. Sci. 89(5), 727–737 (2012). [CrossRef] [PubMed]

]. Sheppard and Davies observed that the ciliary muscle showed a contractile shortening and a thickening in the anterior portion under the accommodative state [37

37. A. L. Sheppard and L. N. Davies, “In vivo analysis of ciliary muscle morphologic changes with accommodation and axial ametropia,” Invest. Ophthalmol. Vis. Sci. 51(12), 6882–6889 (2010). [CrossRef] [PubMed]

]. Lossing combined an AS-OCT and an auto-refractor to investigate the relationship between the contraction of the ciliary muscle and the accommodative response [12

12. L. A. Lossing, L. T. Sinnott, C. Y. Kao, K. Richdale, and M. D. Bailey, “Measuring changes in ciliary muscle thickness with accommodation in young adults,” Optom. Vis. Sci. 89(5), 719–726 (2012). [CrossRef] [PubMed]

]. In those studies, the measurements were taken at separate states, but not dynamically, mainly due to their slow scan speeds (approximately 2,000 A-lines/s) using time domain OCTs (TD-OCT) [12

12. L. A. Lossing, L. T. Sinnott, C. Y. Kao, K. Richdale, and M. D. Bailey, “Measuring changes in ciliary muscle thickness with accommodation in young adults,” Optom. Vis. Sci. 89(5), 719–726 (2012). [CrossRef] [PubMed]

,13

13. A. L. Sheppard and L. N. Davies, “The effect of ageing on in vivo human ciliary muscle morphology and contractility,” Invest. Ophthalmol. Vis. Sci. 52(3), 1809–1816 (2011). [CrossRef] [PubMed]

,37

37. A. L. Sheppard and L. N. Davies, “In vivo analysis of ciliary muscle morphologic changes with accommodation and axial ametropia,” Invest. Ophthalmol. Vis. Sci. 51(12), 6882–6889 (2010). [CrossRef] [PubMed]

,51

51. H. A. Lewis, C. Y. Kao, L. T. Sinnott, and M. D. Bailey, “Changes in ciliary muscle thickness during accommodation in children,” Optom. Vis. Sci. 89(5), 727–737 (2012). [CrossRef] [PubMed]

].

The custom-developed SD-OCT used in the present study improved the scanning speed for real-time imaging. In this static experiment, image enhancement was accomplished by averaging multiple images. The entire configuration of the ciliary muscle in non-human primate eyes has been previously documented using UBM [42

42. M. A. Croft, A. Glasser, G. Heatley, J. McDonald, T. Ebbert, D. B. Dahl, N. V. Nadkarni, and P. L. Kaufman, “Accommodative ciliary body and lens function in rhesus monkeys, I: normal lens, zonule and ciliary process configuration in the iridectomized eye,” Invest. Ophthalmol. Vis. Sci. 47(3), 1076–1086 (2006). [CrossRef] [PubMed]

,44

44. M. A. Croft, P. L. Kaufman, K. S. Crawford, M. W. Neider, A. Glasser, and L. Z. Bito, “Accommodation dynamics in aging rhesus monkeys,” Am. J. Physiol. 275(6 Pt 2), R1885–R1897 (1998). [PubMed]

], which could be used for imaging dynamic changes of the ciliary muscle. To the best of our knowledge, this is the first time that the dynamics of the ciliary muscle biometry on the human eye have been visualized by SD-OCT during accommodation. The combination of the two SD-OCT devices enabled the simultaneous imaging of the entire anterior segment. Due to the inaccessibility of the OCT software in the custom CM-OCT, the use of the synchronization marker in image recording may be an easy way to synchronize both systems. Further advances may involve data acquisition from two spectrometers with one computer, similar to the system used in the two-channel OCT system [19

19. C. Zhou, J. Wang, and S. Jiao, “Dual channel dual focus optical coherence tomography for imaging accommodation of the eye,” Opt. Express 17(11), 8947–8955 (2009). [CrossRef] [PubMed]

].

In summary, we combined two custom-built spectral domain optical coherence tomography devices (SD-OCT) to simultaneously image the anterior segment and the ciliary muscle during accommodation. We also imaged dynamic changes of the anterior segment in one eye during accommodation. The combined systems provided the capacity for simultaneous, real-time imaging of the biometry of the anterior segment, including the ciliary muscle, in vivo during accommodation.

Acknowledgments

This study was supported by research grants from the NIH 1R21EY021336, NIH Center Grant P30 EY014801 and Research to Prevent Blindness (RPB).

References and links

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2.

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8.

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L. A. Lossing, L. T. Sinnott, C. Y. Kao, K. Richdale, and M. D. Bailey, “Measuring changes in ciliary muscle thickness with accommodation in young adults,” Optom. Vis. Sci. 89(5), 719–726 (2012). [CrossRef] [PubMed]

13.

A. L. Sheppard and L. N. Davies, “The effect of ageing on in vivo human ciliary muscle morphology and contractility,” Invest. Ophthalmol. Vis. Sci. 52(3), 1809–1816 (2011). [CrossRef] [PubMed]

14.

K. Richdale, M. D. Bailey, L. T. Sinnott, C. Y. Kao, K. Zadnik, and M. A. Bullimore, “The effect of phenylephrine on the ciliary muscle and accommodation,” Optom. Vis. Sci. 89(10), e1507–e1511 (2012). [CrossRef] [PubMed]

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H. Furukawa, H. Hiro-Oka, N. Satoh, R. Yoshimura, D. Choi, M. Nakanishi, A. Igarashi, H. Ishikawa, K. Ohbayashi, and K. Shimizu, “Full-range imaging of eye accommodation by high-speed long-depth range optical frequency domain imaging,” Biomed. Opt. Express 1(5), 1491–1501 (2010). [CrossRef] [PubMed]

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B. Potsaid, B. Baumann, D. Huang, S. Barry, A. E. Cable, J. S. Schuman, J. S. Duker, and J. G. Fujimoto, “Ultrahigh speed 1050nm swept source/Fourier domain OCT retinal and anterior segment imaging at 100,000 to 400,000 axial scans per second,” Opt. Express 18(19), 20029–20048 (2010). [CrossRef] [PubMed]

18.

I. Grulkowski, J. J. Liu, B. Potsaid, V. Jayaraman, C. D. Lu, J. Jiang, A. E. Cable, J. S. Duker, and J. G. Fujimoto, “Retinal, anterior segment and full eye imaging using ultrahigh speed swept source OCT with vertical-cavity surface emitting lasers,” Biomed. Opt. Express 3(11), 2733–2751 (2012). [CrossRef] [PubMed]

19.

C. Zhou, J. Wang, and S. Jiao, “Dual channel dual focus optical coherence tomography for imaging accommodation of the eye,” Opt. Express 17(11), 8947–8955 (2009). [CrossRef] [PubMed]

20.

C. Dai, C. Zhou, S. Fan, Z. Chen, X. Chai, Q. Ren, and S. Jiao, “Optical coherence tomography for whole eye segment imaging,” Opt. Express 20(6), 6109–6115 (2012). [CrossRef] [PubMed]

21.

C. Du, D. Zhu, M. Shen, M. Li, M. R. Wang, and J. Wang, “Novel optical coherence tomography for imaging the entire anterior segment of the eye,” Invest. Ophthalmol. Vis. Sci. 52, ARVO E-Abstract 3023 (2011). [PubMed]

22.

M. Ruggeri, S. R. Uhlhorn, C. De Freitas, A. Ho, F. Manns, and J. M. Parel, “Imaging and full-length biometry of the eye during accommodation using spectral domain OCT with an optical switch,” Biomed. Opt. Express 3(7), 1506–1520 (2012). [CrossRef] [PubMed]

23.

T. Ide, J. Wang, A. Tao, T. Leng, G. D. Kymionis, T. P. O’Brien, and S. H. Yoo, “Intraoperative use of three-dimensional spectral-domain optical coherence tomography,” Ophthalmic Surg. Lasers Imaging 41(2), 250–254 (2010). [CrossRef] [PubMed]

24.

T. Leng, B. J. Lujan, S. H. Yoo, and J. Wang, “Three-dimensional spectral domain optical coherence tomography of a clear corneal cataract incision,” Ophthalmic Surg. Lasers Imaging 39(4Suppl), S132–S134 (2008). [PubMed]

25.

American National Standards Institute, “American national standard for safe use of lasers,” in Laser Institute of America (Orlando, FL, 2000), pp. 45–49.

26.

S. Ortiz, P. Pérez-Merino, E. Gambra, A. de Castro, and S. Marcos, “In vivo human crystalline lens topography,” Biomed. Opt. Express 3(10), 2471–2488 (2012). [CrossRef] [PubMed]

27.

S. Ortiz, P. Pérez-Merino, N. Alejandre, E. Gambra, I. Jimenez-Alfaro, and S. Marcos, “Quantitative OCT-based corneal topography in keratoconus with intracorneal ring segments,” Biomed. Opt. Express 3(5), 814–824 (2012). [CrossRef] [PubMed]

28.

D. Siedlecki, A. de Castro, E. Gambra, S. Ortiz, D. Borja, S. Uhlhorn, F. Manns, S. Marcos, and J. M. Parel, “Distortion correction of OCT images of the crystalline lens: gradient index approach,” Optom. Vis. Sci. 89(5), E709–E718 (2012). [CrossRef] [PubMed]

29.

S. Ortiz, D. Siedlecki, I. Grulkowski, L. Remon, D. Pascual, M. Wojtkowski, and S. Marcos, “Optical distortion correction in optical coherence tomography for quantitative ocular anterior segment by three-dimensional imaging,” Opt. Express 18(3), 2782–2796 (2010). [CrossRef] [PubMed]

30.

S. Ortiz, D. Siedlecki, L. Remon, and S. Marcos, “Optical coherence tomography for quantitative surface topography,” Appl. Opt. 48(35), 6708–6715 (2009). [CrossRef] [PubMed]

31.

C. Du, J. Wang, L. Cui, M. Shen, and Y. Yuan, “Vertical and horizontal corneal epithelial thickness profiles determined by ultrahigh resolution optical coherence tomography,” Cornea 31(9), 1036–1043 (2012). [CrossRef] [PubMed]

32.

S. R. Uhlhorn, F. Manns, H. Tahi, P. O. Rol, and J.-M. A. Parel, “Corneal group refractive index measurement using low-coherence interferometry,” Proc. SPIE 3246, 14–21 (1998). [CrossRef]

33.

D. A. Atchison and G. Smith, “Chromatic dispersion of the ocular media of human eyes,” J. Opt. Soc. Am. A 22(1), 29–37 (2005). [CrossRef]

34.

S. R. Uhlhorn, D. Borja, F. Manns, and J. M. Parel, “Refractive index measurement of the isolated crystalline lens using optical coherence tomography,” Vision Res. 48(27), 2732–2738 (2008). [CrossRef] [PubMed]

35.

M. D. Bailey, L. T. Sinnott, and D. O. Mutti, “Ciliary body thickness and refractive error in children,” Invest. Ophthalmol. Vis. Sci. 49(10), 4353–4360 (2008). [CrossRef] [PubMed]

36.

I. Grulkowski, M. Gora, M. Szkulmowski, I. Gorczynska, D. Szlag, S. Marcos, A. Kowalczyk, and M. Wojtkowski, “Anterior segment imaging with Spectral OCT system using a high-speed CMOS camera,” Opt. Express 17(6), 4842–4858 (2009). [CrossRef] [PubMed]

37.

A. L. Sheppard and L. N. Davies, “In vivo analysis of ciliary muscle morphologic changes with accommodation and axial ametropia,” Invest. Ophthalmol. Vis. Sci. 51(12), 6882–6889 (2010). [CrossRef] [PubMed]

38.

M. V. Sarunic, S. Asrani, and J. A. Izatt, “Imaging the ocular anterior segment with real-time, full-range Fourier-domain optical coherence tomography,” Arch. Ophthalmol. 126(4), 537–542 (2008). [CrossRef] [PubMed]

39.

S. A. Strenk, J. L. Semmlow, L. M. Strenk, P. Munoz, J. Gronlund-Jacob, and J. K. DeMarco, “Age-related changes in human ciliary muscle and lens: a magnetic resonance imaging study,” Invest. Ophthalmol. Vis. Sci. 40(6), 1162–1169 (1999). [PubMed]

40.

A. P. Beers and G. L. van der Heijde, “Age-related changes in the accommodation mechanism,” Optom. Vis. Sci. 73(4), 235–242 (1996). [CrossRef] [PubMed]

41.

A. P. Beers and G. L. Van Der Heijde, “In vivo determination of the biomechanical properties of the component elements of the accommodation mechanism,” Vision Res. 34(21), 2897–2905 (1994). [CrossRef] [PubMed]

42.

M. A. Croft, A. Glasser, G. Heatley, J. McDonald, T. Ebbert, D. B. Dahl, N. V. Nadkarni, and P. L. Kaufman, “Accommodative ciliary body and lens function in rhesus monkeys, I: normal lens, zonule and ciliary process configuration in the iridectomized eye,” Invest. Ophthalmol. Vis. Sci. 47(3), 1076–1086 (2006). [CrossRef] [PubMed]

43.

S. Jeon, W. K. Lee, K. Lee, and N. J. Moon, “Diminished ciliary muscle movement on accommodation in myopia,” Exp. Eye Res. 105, 9–14 (2012). [CrossRef] [PubMed]

44.

M. A. Croft, P. L. Kaufman, K. S. Crawford, M. W. Neider, A. Glasser, and L. Z. Bito, “Accommodation dynamics in aging rhesus monkeys,” Am. J. Physiol. 275(6 Pt 2), R1885–R1897 (1998). [PubMed]

45.

M. Wojtkowski, A. Kowalczyk, R. Leitgeb, and A. F. Fercher, “Full range complex spectral optical coherence tomography technique in eye imaging,” Opt. Lett. 27(16), 1415–1417 (2002). [CrossRef] [PubMed]

46.

M. Wojtkowski, R. Leitgeb, A. Kowalczyk, T. Bajraszewski, and A. F. Fercher, “In vivo human retinal imaging by Fourier domain optical coherence tomography,” J. Biomed. Opt. 7(3), 457–463 (2002). [CrossRef] [PubMed]

47.

D. Zhu, M. Shen, H. Jiang, M. Li, M. R. Wang, Y. Wang, L. Ge, J. Qu, and J. Wang, “Broadband superluminescent diode-based ultrahigh resolution optical coherence tomography for ophthalmic imaging,” J. Biomed. Opt. 16(12), 126006 (2011). [CrossRef] [PubMed]

48.

J. Jungwirth, B. Baumann, M. Pircher, E. Götzinger, and C. K. Hitzenberger, “Extended in vivo anterior eye-segment imaging with full-range complex spectral domain optical coherence tomography,” J. Biomed. Opt. 14(5), 050501 (2009). [CrossRef] [PubMed]

49.

C. Kerbage, H. Lim, W. Sun, M. Mujat, and J. F. de Boer, “Large depth-high resolution full 3D imaging of the anterior segments of the eye using high speed optical frequency domain imaging,” Opt. Express 15(12), 7117–7125 (2007). [CrossRef] [PubMed]

50.

H. Wang, Y. Pan, and A. M. Rollins, “Extending the effective imaging range of Fourier-domain optical coherence tomography using a fiber optic switch,” Opt. Lett. 33(22), 2632–2634 (2008). [CrossRef] [PubMed]

51.

H. A. Lewis, C. Y. Kao, L. T. Sinnott, and M. D. Bailey, “Changes in ciliary muscle thickness during accommodation in children,” Optom. Vis. Sci. 89(5), 727–737 (2012). [CrossRef] [PubMed]

52.

J. F. Koretz, C. A. Cook, and P. L. Kaufman, “Accommodation and presbyopia in the human eye. Changes in the anterior segment and crystalline lens with focus,” Invest. Ophthalmol. Vis. Sci. 38(3), 569–578 (1997). [PubMed]

53.

A. Glasser and P. L. Kaufman, “The mechanism of accommodation in primates,” Ophthalmology 106(5), 863–872 (1999). [CrossRef] [PubMed]

54.

T. E. Lockhart and W. Shi, “Effects of age on dynamic accommodation,” Ergonomics 53(7), 892–903 (2010). [CrossRef] [PubMed]

55.

J. A. Mordi and K. J. Ciuffreda, “Dynamic aspects of accommodation: age and presbyopia,” Vision Res. 44(6), 591–601 (2004). [CrossRef] [PubMed]

56.

H. W. Jeong, S. W. Lee, and B. M. Kim, “Spectral-domain OCT with dual illumination and interlaced detection for simultaneous anterior segment and retina imaging,” Opt. Express 20(17), 19148–19159 (2012). [CrossRef] [PubMed]

OCIS Codes
(170.3880) Medical optics and biotechnology : Medical and biological imaging
(170.4500) Medical optics and biotechnology : Optical coherence tomography
(170.4580) Medical optics and biotechnology : Optical diagnostics for medicine
(330.4460) Vision, color, and visual optics : Ophthalmic optics and devices
(330.7322) Vision, color, and visual optics : Visual optics, accommodation

ToC Category:
Ophthalmology Applications

History
Original Manuscript: December 10, 2012
Revised Manuscript: February 14, 2013
Manuscript Accepted: February 18, 2013
Published: February 21, 2013

Citation
Yilei Shao, Aizhu Tao, Hong Jiang, Meixiao Shen, Jianguang Zhong, Fan Lu, and Jianhua Wang, "Simultaneous real-time imaging of the ocular anterior segment including the ciliary muscle during accommodation," Biomed. Opt. Express 4, 466-480 (2013)
http://www.opticsinfobase.org/boe/abstract.cfm?URI=boe-4-3-466


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References

  1. H. von Helmholtz, “Uber die akkommodation des auges,” Arch. Ophthalmol.1, 1–74 (1855).
  2. D. A. Atchison, “Accommodation and presbyopia,” Ophthalmic Physiol. Opt.15(4), 255–272 (1995). [CrossRef] [PubMed]
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  5. H. J. Wyatt, “Application of a simple mechanical model of accommodation to the aging eye,” Vision Res.33(5-6), 731–738 (1993). [CrossRef] [PubMed]
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  7. S. A. Strenk, L. M. Strenk, and J. F. Koretz, “The mechanism of presbyopia,” Prog. Retin. Eye Res.24(3), 379–393 (2005). [CrossRef] [PubMed]
  8. C. Du, M. Shen, M. Li, D. Zhu, M. R. Wang, and J. Wang, “Anterior segment biometry during accommodation imaged with ultralong scan depth optical coherence tomography,” Ophthalmology119(12), 2479–2485 (2012). [CrossRef] [PubMed]
  9. P. S. Yan, H. T. Lin, Q. L. Wang, and Z. P. Zhang, “Anterior segment variations with age and accommodation demonstrated by slit-lamp-adapted optical coherence tomography,” Ophthalmology117(12), 2301–2307 (2010). [CrossRef] [PubMed]
  10. M. Shen, L. Cui, M. Li, D. Zhu, M. R. Wang, and J. Wang, “Extended scan depth optical coherence tomography for evaluating ocular surface shape,” J. Biomed. Opt.16(5), 056007 (2011). [CrossRef] [PubMed]
  11. Y. Yuan, F. Chen, M. Shen, F. Lu, and J. Wang, “Repeated measurements of the anterior segment during accommodation using long scan depth optical coherence tomography,” Eye Contact Lens38(2), 102–108 (2012). [CrossRef] [PubMed]
  12. L. A. Lossing, L. T. Sinnott, C. Y. Kao, K. Richdale, and M. D. Bailey, “Measuring changes in ciliary muscle thickness with accommodation in young adults,” Optom. Vis. Sci.89(5), 719–726 (2012). [CrossRef] [PubMed]
  13. A. L. Sheppard and L. N. Davies, “The effect of ageing on in vivo human ciliary muscle morphology and contractility,” Invest. Ophthalmol. Vis. Sci.52(3), 1809–1816 (2011). [CrossRef] [PubMed]
  14. K. Richdale, M. D. Bailey, L. T. Sinnott, C. Y. Kao, K. Zadnik, and M. A. Bullimore, “The effect of phenylephrine on the ciliary muscle and accommodation,” Optom. Vis. Sci.89(10), e1507–e1511 (2012). [CrossRef] [PubMed]
  15. H. Furukawa, H. Hiro-Oka, N. Satoh, R. Yoshimura, D. Choi, M. Nakanishi, A. Igarashi, H. Ishikawa, K. Ohbayashi, and K. Shimizu, “Full-range imaging of eye accommodation by high-speed long-depth range optical frequency domain imaging,” Biomed. Opt. Express1(5), 1491–1501 (2010). [CrossRef] [PubMed]
  16. M. Gora, K. Karnowski, M. Szkulmowski, B. J. Kaluzny, R. Huber, A. Kowalczyk, and M. Wojtkowski, “Ultra high-speed swept source OCT imaging of the anterior segment of human eye at 200 kHz with adjustable imaging range,” Opt. Express17(17), 14880–14894 (2009). [CrossRef] [PubMed]
  17. B. Potsaid, B. Baumann, D. Huang, S. Barry, A. E. Cable, J. S. Schuman, J. S. Duker, and J. G. Fujimoto, “Ultrahigh speed 1050nm swept source/Fourier domain OCT retinal and anterior segment imaging at 100,000 to 400,000 axial scans per second,” Opt. Express18(19), 20029–20048 (2010). [CrossRef] [PubMed]
  18. I. Grulkowski, J. J. Liu, B. Potsaid, V. Jayaraman, C. D. Lu, J. Jiang, A. E. Cable, J. S. Duker, and J. G. Fujimoto, “Retinal, anterior segment and full eye imaging using ultrahigh speed swept source OCT with vertical-cavity surface emitting lasers,” Biomed. Opt. Express3(11), 2733–2751 (2012). [CrossRef] [PubMed]
  19. C. Zhou, J. Wang, and S. Jiao, “Dual channel dual focus optical coherence tomography for imaging accommodation of the eye,” Opt. Express17(11), 8947–8955 (2009). [CrossRef] [PubMed]
  20. C. Dai, C. Zhou, S. Fan, Z. Chen, X. Chai, Q. Ren, and S. Jiao, “Optical coherence tomography for whole eye segment imaging,” Opt. Express20(6), 6109–6115 (2012). [CrossRef] [PubMed]
  21. C. Du, D. Zhu, M. Shen, M. Li, M. R. Wang, and J. Wang, “Novel optical coherence tomography for imaging the entire anterior segment of the eye,” Invest. Ophthalmol. Vis. Sci.52, ARVO E-Abstract 3023 (2011). [PubMed]
  22. M. Ruggeri, S. R. Uhlhorn, C. De Freitas, A. Ho, F. Manns, and J. M. Parel, “Imaging and full-length biometry of the eye during accommodation using spectral domain OCT with an optical switch,” Biomed. Opt. Express3(7), 1506–1520 (2012). [CrossRef] [PubMed]
  23. T. Ide, J. Wang, A. Tao, T. Leng, G. D. Kymionis, T. P. O’Brien, and S. H. Yoo, “Intraoperative use of three-dimensional spectral-domain optical coherence tomography,” Ophthalmic Surg. Lasers Imaging41(2), 250–254 (2010). [CrossRef] [PubMed]
  24. T. Leng, B. J. Lujan, S. H. Yoo, and J. Wang, “Three-dimensional spectral domain optical coherence tomography of a clear corneal cataract incision,” Ophthalmic Surg. Lasers Imaging39(4Suppl), S132–S134 (2008). [PubMed]
  25. American National Standards Institute, “American national standard for safe use of lasers,” in Laser Institute of America (Orlando, FL, 2000), pp. 45–49.
  26. S. Ortiz, P. Pérez-Merino, E. Gambra, A. de Castro, and S. Marcos, “In vivo human crystalline lens topography,” Biomed. Opt. Express3(10), 2471–2488 (2012). [CrossRef] [PubMed]
  27. S. Ortiz, P. Pérez-Merino, N. Alejandre, E. Gambra, I. Jimenez-Alfaro, and S. Marcos, “Quantitative OCT-based corneal topography in keratoconus with intracorneal ring segments,” Biomed. Opt. Express3(5), 814–824 (2012). [CrossRef] [PubMed]
  28. D. Siedlecki, A. de Castro, E. Gambra, S. Ortiz, D. Borja, S. Uhlhorn, F. Manns, S. Marcos, and J. M. Parel, “Distortion correction of OCT images of the crystalline lens: gradient index approach,” Optom. Vis. Sci.89(5), E709–E718 (2012). [CrossRef] [PubMed]
  29. S. Ortiz, D. Siedlecki, I. Grulkowski, L. Remon, D. Pascual, M. Wojtkowski, and S. Marcos, “Optical distortion correction in optical coherence tomography for quantitative ocular anterior segment by three-dimensional imaging,” Opt. Express18(3), 2782–2796 (2010). [CrossRef] [PubMed]
  30. S. Ortiz, D. Siedlecki, L. Remon, and S. Marcos, “Optical coherence tomography for quantitative surface topography,” Appl. Opt.48(35), 6708–6715 (2009). [CrossRef] [PubMed]
  31. C. Du, J. Wang, L. Cui, M. Shen, and Y. Yuan, “Vertical and horizontal corneal epithelial thickness profiles determined by ultrahigh resolution optical coherence tomography,” Cornea31(9), 1036–1043 (2012). [CrossRef] [PubMed]
  32. S. R. Uhlhorn, F. Manns, H. Tahi, P. O. Rol, and J.-M. A. Parel, “Corneal group refractive index measurement using low-coherence interferometry,” Proc. SPIE3246, 14–21 (1998). [CrossRef]
  33. D. A. Atchison and G. Smith, “Chromatic dispersion of the ocular media of human eyes,” J. Opt. Soc. Am. A22(1), 29–37 (2005). [CrossRef]
  34. S. R. Uhlhorn, D. Borja, F. Manns, and J. M. Parel, “Refractive index measurement of the isolated crystalline lens using optical coherence tomography,” Vision Res.48(27), 2732–2738 (2008). [CrossRef] [PubMed]
  35. M. D. Bailey, L. T. Sinnott, and D. O. Mutti, “Ciliary body thickness and refractive error in children,” Invest. Ophthalmol. Vis. Sci.49(10), 4353–4360 (2008). [CrossRef] [PubMed]
  36. I. Grulkowski, M. Gora, M. Szkulmowski, I. Gorczynska, D. Szlag, S. Marcos, A. Kowalczyk, and M. Wojtkowski, “Anterior segment imaging with Spectral OCT system using a high-speed CMOS camera,” Opt. Express17(6), 4842–4858 (2009). [CrossRef] [PubMed]
  37. A. L. Sheppard and L. N. Davies, “In vivo analysis of ciliary muscle morphologic changes with accommodation and axial ametropia,” Invest. Ophthalmol. Vis. Sci.51(12), 6882–6889 (2010). [CrossRef] [PubMed]
  38. M. V. Sarunic, S. Asrani, and J. A. Izatt, “Imaging the ocular anterior segment with real-time, full-range Fourier-domain optical coherence tomography,” Arch. Ophthalmol.126(4), 537–542 (2008). [CrossRef] [PubMed]
  39. S. A. Strenk, J. L. Semmlow, L. M. Strenk, P. Munoz, J. Gronlund-Jacob, and J. K. DeMarco, “Age-related changes in human ciliary muscle and lens: a magnetic resonance imaging study,” Invest. Ophthalmol. Vis. Sci.40(6), 1162–1169 (1999). [PubMed]
  40. A. P. Beers and G. L. van der Heijde, “Age-related changes in the accommodation mechanism,” Optom. Vis. Sci.73(4), 235–242 (1996). [CrossRef] [PubMed]
  41. A. P. Beers and G. L. Van Der Heijde, “In vivo determination of the biomechanical properties of the component elements of the accommodation mechanism,” Vision Res.34(21), 2897–2905 (1994). [CrossRef] [PubMed]
  42. M. A. Croft, A. Glasser, G. Heatley, J. McDonald, T. Ebbert, D. B. Dahl, N. V. Nadkarni, and P. L. Kaufman, “Accommodative ciliary body and lens function in rhesus monkeys, I: normal lens, zonule and ciliary process configuration in the iridectomized eye,” Invest. Ophthalmol. Vis. Sci.47(3), 1076–1086 (2006). [CrossRef] [PubMed]
  43. S. Jeon, W. K. Lee, K. Lee, and N. J. Moon, “Diminished ciliary muscle movement on accommodation in myopia,” Exp. Eye Res.105, 9–14 (2012). [CrossRef] [PubMed]
  44. M. A. Croft, P. L. Kaufman, K. S. Crawford, M. W. Neider, A. Glasser, and L. Z. Bito, “Accommodation dynamics in aging rhesus monkeys,” Am. J. Physiol.275(6 Pt 2), R1885–R1897 (1998). [PubMed]
  45. M. Wojtkowski, A. Kowalczyk, R. Leitgeb, and A. F. Fercher, “Full range complex spectral optical coherence tomography technique in eye imaging,” Opt. Lett.27(16), 1415–1417 (2002). [CrossRef] [PubMed]
  46. M. Wojtkowski, R. Leitgeb, A. Kowalczyk, T. Bajraszewski, and A. F. Fercher, “In vivo human retinal imaging by Fourier domain optical coherence tomography,” J. Biomed. Opt.7(3), 457–463 (2002). [CrossRef] [PubMed]
  47. D. Zhu, M. Shen, H. Jiang, M. Li, M. R. Wang, Y. Wang, L. Ge, J. Qu, and J. Wang, “Broadband superluminescent diode-based ultrahigh resolution optical coherence tomography for ophthalmic imaging,” J. Biomed. Opt.16(12), 126006 (2011). [CrossRef] [PubMed]
  48. J. Jungwirth, B. Baumann, M. Pircher, E. Götzinger, and C. K. Hitzenberger, “Extended in vivo anterior eye-segment imaging with full-range complex spectral domain optical coherence tomography,” J. Biomed. Opt.14(5), 050501 (2009). [CrossRef] [PubMed]
  49. C. Kerbage, H. Lim, W. Sun, M. Mujat, and J. F. de Boer, “Large depth-high resolution full 3D imaging of the anterior segments of the eye using high speed optical frequency domain imaging,” Opt. Express15(12), 7117–7125 (2007). [CrossRef] [PubMed]
  50. H. Wang, Y. Pan, and A. M. Rollins, “Extending the effective imaging range of Fourier-domain optical coherence tomography using a fiber optic switch,” Opt. Lett.33(22), 2632–2634 (2008). [CrossRef] [PubMed]
  51. H. A. Lewis, C. Y. Kao, L. T. Sinnott, and M. D. Bailey, “Changes in ciliary muscle thickness during accommodation in children,” Optom. Vis. Sci.89(5), 727–737 (2012). [CrossRef] [PubMed]
  52. J. F. Koretz, C. A. Cook, and P. L. Kaufman, “Accommodation and presbyopia in the human eye. Changes in the anterior segment and crystalline lens with focus,” Invest. Ophthalmol. Vis. Sci.38(3), 569–578 (1997). [PubMed]
  53. A. Glasser and P. L. Kaufman, “The mechanism of accommodation in primates,” Ophthalmology106(5), 863–872 (1999). [CrossRef] [PubMed]
  54. T. E. Lockhart and W. Shi, “Effects of age on dynamic accommodation,” Ergonomics53(7), 892–903 (2010). [CrossRef] [PubMed]
  55. J. A. Mordi and K. J. Ciuffreda, “Dynamic aspects of accommodation: age and presbyopia,” Vision Res.44(6), 591–601 (2004). [CrossRef] [PubMed]
  56. H. W. Jeong, S. W. Lee, and B. M. Kim, “Spectral-domain OCT with dual illumination and interlaced detection for simultaneous anterior segment and retina imaging,” Opt. Express20(17), 19148–19159 (2012). [CrossRef] [PubMed]

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