This paper describes a compact video-ophthalmoscope (VO) designed for capturing retinal video sequences of the optic nerve head (ONH) under flicker light stimulation. The device uses an OLED display and a fiber optic-coupled LED light source, enabling high-frame-rate video at low illumination intensity (12 μW/cm2). Retinal responses were recorded in 10 healthy subjects during flicker light exposure with a pupil irradiance of 2 μW/cm2. Following 20 s of stimulation, all subjects displayed changes in retinal reflectance and pulsation attenuation, linked to blood flow and volume variations. These findings suggest that increased blood volume leads to decreased retinal reflectance. Temporal analysis confirmed the ability to capture flicker-induced retinal reflectance changes, indicating its potential for spatial and temporal analysis. Overall, this device offers a portable approach for investigating dynamic retinal responses to light stimuli, which can aid the diagnosis of retinal diseases like diabetic retinopathy, glaucoma, or neurodegenerative diseases affecting retinal blood circulation.

• Keywords
• blood volume, fundus reflectance, light flickering, neurovascular coupling, optic nerve head, video‐ophthalmoscopy,
• MeSH
• Video Recording * instrumentation   MeSH
• Adult MeSH
• Humans MeSH
• Young Adult MeSH
• Ophthalmoscopes * MeSH
• Retina * radiation effects   physiology   MeSH
• Photic Stimulation * MeSH
• Light * MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

The paper presents a comparative study of the pulsatile attenuation amplitude (PAA) within the optic nerve head (ONH) at four different areas calculated from retinal video sequences and its relevance to the retinal nerve fiber layer thickness (RNFL) changes in normal subjects and patients with different stages of glaucoma. The proposed methodology utilizes processing of retinal video sequences acquired by a novel video ophthalmoscope. The PAA parameter measures the amplitude of heartbeat-modulated light attenuation in retinal tissue. Correlation analysis between PAA and RNFL is performed in vessel-free locations of the peripapillary region with the proposed evaluating patterns: 360° circular area, temporal semi-circle, nasal semi-circle. For comparison, the full ONH area is also included. Various positions and sizes of evaluating patterns in peripapillary region were tested which resulted in different outputs of correlation analysis. The results show significant correlation between PAA and RNFL thickness calculated in proposed areas. The highest correlation coefficient Rtemp = 0.557 (p<0.001) reflects the highest PAA-RNFL correspondence in the temporal semi-circular area, compared to the lowest value in the nasal semi-circular area (Rnasal = 0.332, p<0.001). Furthermore, the results indicate the most relevant approach to calculate PAA from the acquired video sequences is using a thin annulus near the ONH center. Finally, the paper shows the proposed photoplethysmographic principle based on innovative video ophthalmoscope can be used to analyze changes in retinal perfusion in peripapillary area and can be potentially used to assess progression of the RNFL deterioration.

• MeSH
• Optic Disk * MeSH
• Glaucoma * diagnosis   MeSH
• Humans MeSH
• Nerve Fibers MeSH
• Tomography, Optical Coherence methods   MeSH
• Retinal Ganglion Cells MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Based on our previously developed mono-color video-ophthalmoscope a multi-color video-ophthalmoscope was developed. Using narrow band transmission filters, this instrument allows to measure the pulsatile cardiac cycle induced blood volume changes in the human retina for any wavelength in the sensitivity range of the used CMOS-camera. In this key experiment, video sequences (8 s, 25 fps, 200 frames) of the optic nerve head (ONH) were acquire for seven wavelengths between 475 nm and 677 nm one after the other. After image registration of all frames of each video sequence (to compensate for eye movements) and trend correction (to compensate for slow intensity changes), the amplitude of the cardiac cycle induced light intensity changes (pulsatile absorption amplitude PAA) can be calculated for all seven wavelengths. The results confirmed that the spectral distribution of PAA (λ) follows the distribution of the light absorption of blood. The measured values correspond to the absorption of a thin blood layer of about 0.5 μm thickness.

• Keywords
• blood light absorption, multi-color imaging, photoplethysmography, retina, retinal imaging, video ophthalmoscopy,
• Publication type
• Journal Article MeSH

Theoretical models of retinal hemodynamics showed the modulation of retinal pulsatile patterns (RPPs) by heart rate (HR), yet in-vivo validation and scientific merit of this biological process is lacking. Such evidence is critical for result interpretation, study design, and (patho-)physiological modeling of human biology spanning applications in various medical specialties. In retinal hemodynamic video-recordings, we characterize the morphology of RPPs and assess the impact of modulation by HR or other variables. Principal component analysis isolated two RPPs, i.e., spontaneous venous pulsation (SVP) and optic cup pulsation (OCP). Heart rate modulated SVP and OCP morphology (pFDR < 0.05); age modulated SVP morphology (pFDR < 0.05). In addition, age and HR demonstrated the effect on between-group differences. This knowledge greatly affects future study designs, analyses of between-group differences in RPPs, and biophysical models investigating relationships between RPPs, intracranial, intraocular pressures, and cardiovascular physiology.

• MeSH
• Optic Disk * MeSH
• Humans MeSH
• Intraocular Pressure MeSH
• Pulsatile Flow physiology   MeSH
• Heart Rate MeSH
• Retinal Vein * physiology   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Assessment of retinal blood flow inside the optic nerve head (ONH) and the peripapillary area is an important task in retinal imaging. For this purpose, an experimental binocular video ophthalmoscope that acquires precisely synchronized video sequences of the optic nerve head and peripapillary area from both eyes has been previously developed. It enables to compare specific characteristics of both eyes and efficiently detect the eye asymmetry. In this paper, we describe a novel methodology for the analysis of acquired video data using a photoplethysmographic approach. We describe and calculate the pulsatile attenuation amplitude (PAA) spatial map, which quantifies the maximum relative change of blood volume during a cardiac cycle using a frequency domain approach. We also describe in detail the origin of PAA maps from the fundamental (the first) and the second harmonic component of the pulsatile signal, and we compare the results obtained by time-based and frequency-based approaches. In several cases, we show the advantages and possibilities of this device and the appropriate image analysis approach - fast measurement and comparison of blood flow characteristics of both eyes at a glance, the robustness of this approach, and the possibility of easy detection of asymmetry.

• Publication type
• Journal Article MeSH