Topographic, haemodynamic and psychophysical investigation of glaucomatous optic neuropathy

Loss of optic nerve head (ONH) axons in primary open angle glaucoma (POAG) has been attributed to both mechanical and vascular factors. Confocal scanning laser ophthalmoscopy (cSLO) provides a promising tool for the topographic follow-up of the ONH in glaucoma, while scanning laser Doppler flowmetry (SLDF) facilitates the rapid non-invasive assessment of retinal capillary blood flow. The purposes of these investigations were to optimise the techniques and explore their potential to classify and monitor disease. Preliminary investigations explored the reproducibility and validity of cSLO and SLDF and showed that: For cSLO: In a model eye, measurements are accurate over a range of axial lengths. For best reproducibility, seven images per visit are required, with a contour line located on Elschnig's scleral ring and transferred automatically between images. For SLDF: Three perfusion images are required for optimum reproducibility. Physiological changes induced by gas perturbation can be measured. Cross-sectional comparison of groups of normal subjects and early POAG patients showed that: cSLO parameters differentiate the early POAG group. Blood volume measured by SLDF showed group differences in superior nasal retina only. Longitudinal investigation of ONH topography, haemodynamic and visual field indices in normal subjects and POAG patients showed that: cSLO detects topographical change over time more frequently in the POAG group. Important parameters include: C:D area ratio, cup and rim area, mean depth in contour, volumes above and below reference and surface. Factor analysis identified "cup" and "rim" factors that can be used to detect change over time in individual patients. Blood flow changes were most apparent in the inferior nasal peripapillary retina of the POAG group. Perimetry is of clinical value for the identification of glaucoma but is less sensitive than cSLO for monitoring glaucomatous change.

Regional variation in peripapillary retinal blood flow in primary open angle glaucoma:a follow-up study

Purpose: To investigate whether regional long-term changes in peripapillary retinal flow, measured by scanning laser Doppler flowmetry (SLDF), occur in patients with primary open angle glaucoma (POAG). Methods: 31 healthy volunteers (mean age: 65 8.3 years) and 33 POAG patients (mean age: 71.2 7.6 years) were followed up every 4 months for 16 months. Using SLDF, three images of the superior and inferior optic nerve head were obtained for each subject. A 1010-pixel frame was used to measure blood flow, volume and velocity in the four quadrants of the peripapillary retina. Central 24-2 visual field testing was carried out at each visit. Repeated measures analysis of covariance was used to assess change over time between the normal and POAG groups for the SLDF parameters. Univariate linear regression analysis for mean deviation and glaucoma change probability (GCP) analysis were used to identify visual field progression. Results: Blood volume, flow and velocity measured in the inferior nasal quadrant of the peripapillary retina decreased significantly over time for the POAG group compared to the normal group (p=0.0073, 0.0097, 0.0095 respectively). Overall, 2 glaucoma patients showed a significantly deteriorating MD slope, while 7 patients showed visual field progression with GPA. All of the patients progressing with GPA, showed change in the superior hemifield and, of those, 14% showed change in the inferior hemifield. Conclusion: Glaucoma patients showed a decrease in blood flow, volume and velocity in the inferior nasal peripapillary retina. A regional variation in microvascular retinal capillary blood flow may provide insight into the pathogenesis of glaucomatous optic neuropathy. Keywords: 331 blood supply • 554 retina • 624 visual fields

Abnormal systemic and ocular vascular response to temperature provocation in primary open-angle glaucoma patients:a case for autonomic failure?

PURPOSE. To assess systemic and ocular vascular reactivity in response to warm and cold provocation in untreated patients with primary open-angle glaucoma and normal control subjects. METHODS. Twenty-four patients with primary open-angle glaucoma and 22 normal control subjects were subjected to a modified cold pressor test involving immersion of the right hand in 40°C warm water followed by 4°C cold water exposure, and finger and ocular blood flow were assessed by means of peripheral laser Doppler flowmetry and retinal flowmetry, respectively. Finger and body temperature as well as intraocular pressure, systemic blood pressure, systemic pulse pressure, heart rate, and ocular perfusion pressure were also monitored. RESULTS. The patients with glaucoma demonstrated an increase in diastolic blood pressure (P = 0.023), heart rate (P = 0.010), and mean ocular perfusion pressure (P = 0.039) during immersion of the tested hand in 40°C water. During cold provocation, the patients demonstrated a significant decrease in finger (P = 0.0003) and ocular blood flow (the parameter velocity measured at the temporal neuroretinal rim area; P = 0.021). Normal subjects did not demonstrate any blood flow or finger temperature changes during immersion of the tested hand in 40°C water (P > 0.05); however, they exhibited increases in systolic blood pressure (P = 0.034) and pulse pressure (P = 0.0009) and a decrease in finger blood flow (P = 0.0001) during cold provocation. In normal subjects, the ocular blood flow was unchanged during high- and low-temperature challenge. CONCLUSIONS. Cold provocation elicits a different blood pressure, and ocular blood flow response in patients with primary open-angle glaucoma compared with control subjects. These findings suggest a systemic autonomic failure and ocular vascular dysregulation in POAG patients.

The blood perfusion and NADH/FAD content combined analysis in patients with diabetes foot

Skin blood microcirculation and the metabolism activity of tissue were examined on the patients with type 2 diabetes. Laser Doppler flowmetry (LDF) with 1064 nm laser light source and fluorescence spectroscopy (FS) with excitation light of 365 nm and 450 nm have been used to monitor the blood perfusion and the content of coenzymes NADH and FAD. Concluding, the proposed combined LDF and tissue FS approach allows to identify the significant violations in the blood microcirculation and metabolic activity for type 2 diabetes patients.

The development of attenuation compensation models of fluorescence spectroscopy signals

This study examines the effect of blood absorption on the endogenous fluorescence signal intensity of biological tissues. Experimental studies were conducted to identify these effects. To register the fluorescence intensity, the fluorescence spectroscopy method was employed. The intensity of the blood flow was measured by laser Doppler flowmetry. We proposed one possible implementation of the Monte Carlo method for the theoretical analysis of the effect of blood on the fluorescence signals. The simulation is constructed as a four-layer skin optical model based on the known optical parameters of the skin with different levels of blood supply. With the help of the simulation, we demonstrate how the level of blood supply can affect the appearance of the fluorescence spectra. In addition, to describe the properties of biological tissue, which may affect the fluorescence spectra, we turned to the method of diffuse reflectance spectroscopy (DRS). Using the spectral data provided by the DRS, the tissue attenuation effect can be extracted and used to correct the fluorescence spectra.

Laser doppler imaging in a paediatric burns population

Objective Laser Doppler imaging (LDI) was compared to wound outcomes in children's burns, to determine if the technology could be used to predict these outcomes. Methods Forty-eight patients with a total of 85 burns were included in the study. Patient median age was 4 years 10 months and scans were taken 0–186 h post-burn using the fast, low-resolution setting on the Moor LDI2 laser Doppler imager. Wounds were managed by standard practice, without taking into account the scan results. Time until complete re-epithelialisation and whether or not grafting and scar management were required were recorded for each wound. If wounds were treated with Silvazine™ or Acticoat™ prior to the scan, this was also recorded. Results The predominant colour of the scan was found to be significantly related to the re-epithelialisation, grafting and scar management outcomes and could be used to predict those outcomes. The prior use of Acticoat™ did not affect the scan relationship to outcomes, however, the use of Silvazine™ did complicate the relationship for light blue and green scanned partial thickness wounds. Scans taken within the 24-h window after-burn also appeared to be accurate predictors of wound outcome. Conclusion Laser Doppler imaging is accurate and effective in a paediatric population with a low-resolution fast-scan.

Estimation of vibration amplitude in Fourier domain optical coherence tomography interferometric signals from Doppler spectrum

In presented method combination of Fourier and Time domain detection enables to broaden the effective bandwidth for time dependent Doppler Signal that allows for using higher-order Bessel functions to calculate unambiguously the vibration amplitudes.

Doppler and Pathloss Characterization for Vehicle-to-Vehicle communications at 5.8 GHz

Due to significant increase in vehicular accident and traffic congestions, vehicle to vehicle (V2V) communication based on the intelligent transport system (ITS) was introduced. However, to carry out efficient design and implementation of a reliable vehicular communication systems,a deep knowledge of the propagation channel characteristics in different environments is crucial, in particular the Doppler and pathloss parameters. Therefore, this paper presents an empirical V2V channel characterization and measurement performed under realistic urban, suburban and highway driving conditions in Brisbane, Australia. Based on Lin Cheng statistical Doppler Model (LCDM), values for the RMS Doppler spread and coherence time due to time selective nature of V2V channels were presented. Also, based on Log-distance power law model, values for the mean pathloss exponent and the standard deviation of shadowing were reported for urban, suburban and highway environments. The V2V channel parameters can be useful to system designers for the purpose of evaluating, simulating and developing new protocols and systems.

Practical Algorithms For Mean Velocity Estimation In Pulse Doppler Weather Radars Using A Small Number Of Samples

Doppler weather radars with fast scanning rates must estimate spectral moments based on a small number of echo samples. This paper concerns the estimation of mean Doppler velocity in a coherent radar using a short complex time series. Specific results are presented based on 16 samples. A wide range of signal-to-noise ratios are considered, and attention is given to ease of implementation. It is shown that FFT estimators fare poorly in low SNR and/or high spectrum-width situations. Several variants of a vector pulse-pair processor are postulated and an algorithm is developed for the resolution of phase angle ambiguity. This processor is found to be better than conventional processors at very low SNR values. A feasible approximation to the maximum entropy estimator is derived as well as a technique utilizing the maximization of the periodogram. It is found that a vector pulse-pair processor operating with four lags for clear air observation and a single lag (pulse-pair mode) for storm observation may be a good way to estimate Doppler velocities over the entire gamut of weather phenomena.

Two Methods of Ambiguity Resolution in Pulse Doppler Weather Radars

A comparison is made of the performance of a weather Doppler radar with a staggered pulse repetition time and a radar with a random (but known) phase. As a standard for this comparison, the specifications of the forthcoming next generation weather radar (NEXRAD) are used. A statistical analysis of the spectral momentestimates for the staggered scheme is developed, and a theoretical expression for the signal-to-noise ratio due to recohering-filteringrecohering for the random phase radar is obtained. Algorithms for assignment of correct ranges to pertinent spectral moments for both techniques are presented.

Influence of validation schemes in a laser Doppler anemometer period timing device for frequency measurement

The short duration of the Doppler signal and noise content in it necessitate a validation scheme to be incorporated in the electronic processor used for frequency measurement, There are several different validation schemes that can be employed in period timing devices. A detailed study of the influence of these validation schemes on the measured frequency has been reported here. These studies were carried out by using a combination of a fast A/D converter and computer. Doppler bursts obtained from an air flow were digitised and stored on magnetic discs. Suitable computer programs were then used to simulate the performance of period timing devices with different validation schemes and the frequency of the stored bursts were evaluated. It is found that best results are obtained when the validation scheme enables frequency measurement to be made over a large number of cycles within the burst.

Simple period timing device for laser Doppler signals

A period timing device suitable for processing laser Doppler anemometer signals has been described here. The important features of this instrument are: it is inexpensive, simple to operate, and easy to fabricate. When the concentration of scattering particles is low the Doppler signal is in the form of a burst and the Doppler frequency is measured by timing the zero crossings of the signal. But the presence of noise calls for the use of validation criterion, and a 5–8 cycles comparison has been used in this instrument. Validation criterion requires the differential count between the 5 and 8 cycles to be multiplied by predetermined numbers that prescribe the accuracy of measurement. By choosing these numbers to be binary numbers, much simplification in circuit design has been accomplished since this permits the use of shift registers for multiplication. Validation accuracies of 1.6%, 3.2%, 6.3%, and 12.5% are possible with this device. The design presented here is for a 16-bit processor and uses TTL components. By substituting Schottky barrier TTLs the clock frequency can be increased from about 10 to 30 MHz resulting in an extension in the range of the instrument. Review of Scientific Instruments is copyrighted by The American Institute of Physics.

Simple period timing device for laser Doppler signals

A period timing device suitable for processing laser Doppler anemometer signals has been described here. The important features of this instrument are: it is inexpensive, simple to operate, and easy to fabricate. When the concentration of scattering particles is low the Doppler signal is in the form of a burst and the Doppler frequency is measured by timing the zero crossings of the signal. But the presence of noise calls for the use of validation criterion, and a 5–8 cycles comparison has been used in this instrument. Validation criterion requires the differential count between the 5 and 8 cycles to be multiplied by predetermined numbers that prescribe the accuracy of measurement. By choosing these numbers to be binary numbers, much simplification in circuit design has been accomplished since this permits the use of shift registers for multiplication. Validation accuracies of 1.6%, 3.2%, 6.3%, and 12.5% are possible with this device. The design presented here is for a 16-bit processor and uses TTL components. By substituting Schottky barrier TTLs the clock frequency can be increased from about 10 to 30 MHz resulting in an extension in the range of the instrument. Review of Scientific Instruments is copyrighted by The American Institute of Physics.