Evaluation of the Anterior Chamber Angle Structures in Perinatal Infants Using a Wide-Field Digital Fundus Camera

Objective This study aimed to evaluate the ability of a digital fundus camera to observe the development of the anterior chamber angle(ACA)in premature infants.Methods Forty-eight eyes of preterm infants(n=48)were examined by a digital fundus camera to observe the development of the ACA.ACA grading was performed based on the visualization of the anterior chamber structures according to the Scheie Angle Depth Evaluating System.Results ACA images from all 48 infants were successfully acquired using RetCam3.The corrected gestational age ranged from 30 weeks to 49 weeks,which covered the period from 2 months preterm to>2 months post-term.As the corrected gestational age increased,the corrected gestational age grading was significantly decreased.The mean corrected gestational ages of the infants corresponding to the ACA classification from grade IV to grade 0 were 32.75±1.89,37.20±1.30,39.75±2.38,40.56±2.24,and 44.23±2.14 weeks,respectively,which were all significantly different(P<0.05).The regression analysis showed a linear correlation between the grading of the ACA and the corrected gestational age(R2=0.724,P=0.0001).Conclusion The ACA of a full-term newborn can be fully detected and evaluated by a digital fundus camera.For premature infants,part of the ACA is not visible physiologically;however,it should not be misdiagnosed as angle closure or a narrow angle.

Near-infrared fundus camera based on polarization switch in stray light elimination

This letter shows that the human eye fundus tissue has higher reflectivity at the near-infrared （NIR） wavelength, and that some aberrations exist at the pre-optical system from cornea to vitreous. We design a NIR fundus camera with inner focusing, which can be applied to the -10 D to 10 D range of vision and has the advantage of ensuring the stability of image when is focused. Considered as Liou＇s eye aberration model, we correct the integrated aberration to ensure a 100 lp/mm resolution when we complete the assembly and calibration of the fundus camera. Kohler illumination is also applied to obtain uniform fundus illumination. Moreover, we put forward a novel method for stray light elimination based on polarization switch, which inhibits ghost image formation near the focal plane when the illumination beam is reflected by the eyepiece surface. The result shows that this method is effective in ensuring an illumination uniformity of 80%, with the advantage of simple structure and easy assembly.

A GAN-based deep enhancer for quality enhancement of retinal images photographed by a handheld fundus camera

Objective:Due to limited imaging conditions,the quality of fundus images is often unsatisfactory,especially for images photographed by handheld fundus cameras.Here,we have developed an automated method based on combining two mirror-symmetric generative adversarial networks(GANs)for image enhancement.Methods:A total of 1047 retinal images were included.The raw images were enhanced by a GAN-based deep enhancer and another methods based on luminosity and contrast adjustment.All raw images and enhanced images were anonymously assessed and classified into 6 levels of quality classification by three experienced ophthalmologists.The quality classification and quality change of images were compared.In addition,imagedetailed reading results for the number of dubiously pathological fundi were also compared.Results:After GAN enhancement,42.9% of images increased their quality,37.5%remained stable,and 19.6%decreased.After excluding the images at the highest level(level 0)before enhancement,a large number(75.6%)of images showed an increase in quality classification,and only a minority(9.3%)showed a decrease.The GANenhanced method was superior for quality improvement over a luminosity and contrast adjustment method(P<0.001).In terms of image reading results,the consistency rate fluctuated from 86.6%to 95.6%,and for the specific disease subtypes,both discrepancy number and discrepancy rate were less than 15 and 15%,for two ophthalmologists.Conclusions:Learning the style of high-quality retinal images based on the proposed deep enhancer may be an effective way to improve the quality of retinal images photographed by handheld fundus cameras.