Unifying Structure and Function Towards a Comprehensive Macular Evaluation in Eye Disorders: A Multi-Modal Approach Using Microperimetry and Optical Coherence Tomography.

Abstract

We present a new automatic and comprehensive framework to evaluate retinal sub-layer thickness and visual sensitivity at precise retinal locations through multi-modal registration of confocal scanning laser ophthalmoscope (cSLO) images obtained separately from an optical coherence tomography (OCT) device and a microperimeter. We map consecutive B-scans onto the cSLO images after accounting for eye motion. Next, we coarsely register the SLO-microperimetry and cSLO-OCT images using SIFT, followed by precise elastic image registration. Subsequently, we ensure the quality of the co-registered images through single-particle and object tracking of the warped microperimetry test locations. Finally, the retinal thickness is queried from the segmented retinal layers in the co-registered space. A manual mode involving projective transformation accounting for perspective distortions in the images arising from the two modalities is also included. Validation using retinal images of 8 adults with albinism, 16 adults with amblyopia, 3 adults with macular diseases, and 15 visually healthy adults showed results with excellent reliability. The proposed framework enables the evaluation of retinal thickness by utilizing precise structural and functional relationships of the eye through a self-assessing multi-tiered approach. Our framework lays the foundation towards a comprehensive structure-function assessment of the macular region in various eye disorders.