1 00:00:06,473 --> 00:00:10,543 WELCOME TO THE SYMPOSIUM ON OCT 2 00:00:10,610 --> 00:00:11,244 TECHNOLOGY CELEBRATING 3 00:00:11,311 --> 00:00:11,878 TRANSFORMATIVE IMPACT ON EYE 4 00:00:11,945 --> 00:00:13,446 CARE AND BEYOND. 5 00:00:13,513 --> 00:00:14,848 BEFORE WE GET STARTED, I WANTED 6 00:00:14,914 --> 00:00:17,784 TO TAKE A MINUTE TO THANK THE 7 00:00:17,851 --> 00:00:19,686 PEOPLE WHO MADE THIS POSSIBLE, 8 00:00:19,753 --> 00:00:22,088 MADE SURE SEVERAL OF YOU MADE IT 9 00:00:22,155 --> 00:00:23,356 HERE WITHOUT STANDING IN LINES. 10 00:00:23,423 --> 00:00:25,158 IF I CAN HAVE THE NEXT SLIDE. 11 00:00:25,225 --> 00:00:26,593 MAYBE I CAN DO IT. 12 00:00:26,659 --> 00:00:26,960 YES. 13 00:00:27,026 --> 00:00:29,963 THESE ARE THE PEOPLE WHO HELPED 14 00:00:30,029 --> 00:00:31,331 ORGANIZE THIS SYMPOSIUM, ADMIN 15 00:00:31,398 --> 00:00:34,901 STAFF FROM MY OFFICE, I SHOULD 16 00:00:34,968 --> 00:00:36,936 SAY I'M THE SCIENTIFIC DIRECTOR, 17 00:00:37,003 --> 00:00:39,973 NATIONAL EYE INSTITUTE. 18 00:00:40,039 --> 00:00:45,645 PEOPLE FROM MY OFFICE, MIKA, 19 00:00:45,712 --> 00:00:46,279 CHARLES 20 00:00:46,346 --> 00:00:47,614 PRINCESS HAVE HELPED, STILL 21 00:00:47,680 --> 00:00:53,052 OUTSIDE THE FRONT DESK, IF YOU 22 00:00:53,119 --> 00:00:54,921 NEED HELP, NATHAN, CINDY, WITH 23 00:00:54,988 --> 00:00:57,090 MY STAFF HELPING THEM ORGANIZE 24 00:00:57,157 --> 00:00:57,891 THE SYMPOSIUM. 25 00:00:57,957 --> 00:01:00,427 A BIG THANKS TO THE PLANNING 26 00:01:00,493 --> 00:01:01,394 COMMITTEE TO IN A VERY SHORT 27 00:01:01,461 --> 00:01:04,831 TIME FROM THE TIME OF OUR 28 00:01:04,898 --> 00:01:07,600 CONCEPTION SINCE THE LASKER 29 00:01:07,667 --> 00:01:09,469 AWARD TO PUTTING THIS TOGETHER 30 00:01:09,536 --> 00:01:11,638 MAKING THIS HAPPEN, A WONDERFUL 31 00:01:11,704 --> 00:01:13,339 AGENDA, FULL DAY AND A HALF FOR 32 00:01:13,406 --> 00:01:21,981 ALL OF YOU STARTING WITH JOHNNY 33 00:01:22,048 --> 00:01:26,820 TAM, TIERNAN KEENAN, TONY 34 00:01:26,886 --> 00:01:32,992 DRIVER, AND PAEK LEE, AND DAVID 35 00:01:33,059 --> 00:01:33,393 SCHNEEWEIS. 36 00:01:33,460 --> 00:01:35,061 I THANK THEM ALL. 37 00:01:35,128 --> 00:01:37,464 LAST BUT NOT LEAST THE IMPORTANT 38 00:01:37,530 --> 00:01:43,236 PIECES, AMY AND HER CONSULTING 39 00:01:43,303 --> 00:01:44,604 COMPANY, WHO YOU'VE GOTTEN 40 00:01:44,671 --> 00:01:46,439 MULTIPLE E-MAILS FROM AMY. 41 00:01:46,506 --> 00:01:49,142 I THANK THEM ALL FOR MAKING THIS 42 00:01:49,209 --> 00:01:49,943 EVENT POSSIBLE. 43 00:01:50,009 --> 00:01:53,880 WITH THAT, I'LL MOVE TO 44 00:01:53,947 --> 00:01:55,081 INTRODUCING THE NEI DIRECTOR, 45 00:01:55,148 --> 00:01:56,449 DR. MICHAEL CHANG, TO SAY A FEW 46 00:01:56,516 --> 00:02:00,820 WORDS AS OPENING REMARKS FOR THE 47 00:02:00,887 --> 00:02:01,187 SYMPOSIUM. 48 00:02:01,254 --> 00:02:03,456 [APPLAUSE] 49 00:02:08,561 --> 00:02:11,064 >> WELL, GOOD MORNING TO ALL OF 50 00:02:11,131 --> 00:02:11,631 YOU. 51 00:02:11,698 --> 00:02:13,566 WE'RE REALLY EXCITED ABOUT THESE 52 00:02:13,633 --> 00:02:15,435 NEXT COUPLE DAYS HERE. 53 00:02:15,502 --> 00:02:19,072 AND I JUST WANT TO THANK YOU FOR 54 00:02:19,138 --> 00:02:20,373 COMING HERE TO BETHESDA. 55 00:02:20,440 --> 00:02:23,309 WHAT WE DID IS PUT THIS ON IN 56 00:02:23,376 --> 00:02:25,879 FAIRLY SHORT NOTICE. 57 00:02:25,945 --> 00:02:29,682 WHAT REALLY SPURRED THIS WAS THE 58 00:02:29,749 --> 00:02:30,850 LASKER AWARD AND NATIONAL MEDAL 59 00:02:30,917 --> 00:02:31,985 OF TECHNOLOGY. 60 00:02:32,051 --> 00:02:35,488 WE WANTED TO GET THIS DONE AT A 61 00:02:35,555 --> 00:02:37,323 TIME THAT WAS -- WHILE IT WAS 62 00:02:37,390 --> 00:02:38,191 STILL FRESH. 63 00:02:38,258 --> 00:02:40,693 BECAUSE OF THAT, THIS WHOLE 64 00:02:40,760 --> 00:02:41,928 GROUP THAT WAS TALKED ABOUT DID 65 00:02:41,995 --> 00:02:44,130 A LOT OF WORK TO PUT THIS 66 00:02:44,197 --> 00:02:44,998 TOGETHER ON SHORT NOTICE. 67 00:02:45,064 --> 00:02:47,600 JUST ANOTHER WORD OF THANKS TO 68 00:02:47,667 --> 00:02:48,034 THEM. 69 00:02:48,101 --> 00:02:50,370 AND TO ALL OF YOU FOR MAKING IT 70 00:02:50,436 --> 00:02:51,905 HERE TO BETHESDA. 71 00:02:51,971 --> 00:02:58,678 IN ADDITION TO THE FOLKS, I WANT 72 00:02:58,745 --> 00:02:59,779 TO CREDIT KAPIL, WHOSE IDEA IT 73 00:02:59,846 --> 00:03:01,014 WAS TO PUT THIS TOGETHER. 74 00:03:01,080 --> 00:03:04,751 HE WAS THE ONE THAT ASSEMBLED 75 00:03:04,817 --> 00:03:05,251 THIS PLANNING GROUP. 76 00:03:05,318 --> 00:03:07,787 THERE WERE SOME FOLKS FROM NIBIB 77 00:03:07,854 --> 00:03:12,158 WHO HELPED US OUT AS WELL, JUST 78 00:03:12,225 --> 00:03:13,826 ANOTHER WORD OF THANKS TO AMY 79 00:03:13,893 --> 00:03:17,230 FOR REALLY BEING THE ONE IN 80 00:03:17,297 --> 00:03:19,999 CAPITOL CONSULTING GROUP TO DO 81 00:03:20,066 --> 00:03:21,467 THE LOGISTICS. 82 00:03:21,534 --> 00:03:27,273 WHAT WE WANT TO DO IS LOOK BACK 83 00:03:27,340 --> 00:03:28,708 AND CELEBRATE THIS TECHNOLOGY 84 00:03:28,775 --> 00:03:29,676 AND LOOK FORWARD. 85 00:03:29,742 --> 00:03:31,678 WHERE DO WE GO FROM HERE? 86 00:03:31,744 --> 00:03:33,846 AND I JUST WANT TO SAY A FEW 87 00:03:33,913 --> 00:03:37,350 REMARKS TO PUT THIS INTO 88 00:03:37,417 --> 00:03:39,319 PERSPECTIVE BECAUSE I THINK THAT 89 00:03:39,385 --> 00:03:41,087 OCT IMAGING HAS BEEN 90 00:03:41,154 --> 00:03:42,722 TRANSFORMATIVE TO THE WAY WE 91 00:03:42,789 --> 00:03:44,791 TAKE CARE OF PATIENTS AND THE 92 00:03:44,857 --> 00:03:48,661 WAY WE THINK OF RESEARCH IN 93 00:03:48,728 --> 00:03:50,063 VISION SCIENCE. 94 00:03:50,129 --> 00:03:53,333 AND THE WAY THAT I LOOK AT THIS 95 00:03:53,399 --> 00:03:57,904 IS THAT WHEN I WAS A RESIDENT, 96 00:03:57,971 --> 00:04:04,744 SO I FINISHED IN 2001, SEE DAVE 97 00:04:04,811 --> 00:04:06,679 GITEN, ONE OF MY FELLOWSHIP 98 00:04:06,746 --> 00:04:06,980 MEANTORIES. 99 00:04:07,046 --> 00:04:10,850 I HAD TO LEARN TO USE THIS 100 00:04:10,917 --> 00:04:11,117 DEVICE. 101 00:04:11,184 --> 00:04:11,851 CONTACT LENS. 102 00:04:11,918 --> 00:04:15,321 TO EXAMINE ALL THE NUANCE OF THE 103 00:04:15,388 --> 00:04:17,090 OPTIC NERVE HEAD AND MACULA. 104 00:04:17,156 --> 00:04:18,858 I ALWAYS THOUGHT THAT WAS MY 105 00:04:18,925 --> 00:04:21,561 ADDED VALUE AS AN 106 00:04:21,628 --> 00:04:22,328 OPHTHALMOLOGIST. 107 00:04:22,395 --> 00:04:23,563 BUT BECAUSE OF THESE 108 00:04:23,630 --> 00:04:24,430 TECHNOLOGIES, PEOPLE DON'T DO 109 00:04:24,497 --> 00:04:26,532 THIS ANYMORE. 110 00:04:26,599 --> 00:04:27,266 THEY GET IMAGES. 111 00:04:27,333 --> 00:04:31,070 AND, YOU KNOW, IN A WAY THAT'S 112 00:04:31,137 --> 00:04:32,005 BEEN COMPLETELY TRANSFORMATIVE 113 00:04:32,071 --> 00:04:36,109 IN WAYS THAT I THINK NOT 114 00:04:36,175 --> 00:04:39,545 EVERYBODY TOTALLY APPRECIATES. 115 00:04:39,612 --> 00:04:43,349 IT'S BECAUSE OF THAT, DAVID, 116 00:04:43,416 --> 00:04:45,852 JIM, AND ERIC RECEIVED THE 117 00:04:45,918 --> 00:04:46,285 LASKER AWARD. 118 00:04:46,352 --> 00:04:47,787 A FEW WEEKS LATER THEY FOUND 119 00:04:47,854 --> 00:04:50,823 THEMSELVES IN THE WHITE HOUSE 120 00:04:50,890 --> 00:04:52,125 RECEIVING A NATIONAL MEDAL OF 121 00:04:52,191 --> 00:04:53,426 TECHNOLOGY AND INNOVATION FROM 122 00:04:53,493 --> 00:04:55,395 THE PRESIDENT, A REALLY BIG WIN 123 00:04:55,461 --> 00:04:58,231 FOR THE VISION COMMUNITY. 124 00:04:58,297 --> 00:05:00,199 AND JUST REALLY EXCITED THAT 125 00:05:00,266 --> 00:05:03,603 DAVID AND JIM ARE HERE IN 126 00:05:03,670 --> 00:05:03,836 PERSON. 127 00:05:03,903 --> 00:05:05,071 ERIC UNFORTUNATELY COULDN'T MAKE 128 00:05:05,138 --> 00:05:06,406 IT BUT I WANTED TO CONGRATULATE 129 00:05:06,472 --> 00:05:08,241 BOTH OF YOU FOR THAT 130 00:05:08,307 --> 00:05:08,941 ACCOMPLISHMENT. 131 00:05:09,008 --> 00:05:11,244 [APPLAUSE] 132 00:05:18,885 --> 00:05:22,121 SO, JUST TO SAY THE OBVIOUS. 133 00:05:22,188 --> 00:05:25,058 IT'S BEEN -- THESE TECHNOLOGIES, 134 00:05:25,124 --> 00:05:26,392 OCT, OTHER IMAGING TECHNOLOGIES, 135 00:05:26,459 --> 00:05:29,028 THAT HAVE REALLY DRIVEN ALL THIS 136 00:05:29,095 --> 00:05:30,296 ADVANCE IN DATA SCIENCE AND A.I. 137 00:05:30,363 --> 00:05:33,166 THAT WE'VE SEEN IN THE VISION 138 00:05:33,232 --> 00:05:33,399 FIELD. 139 00:05:33,466 --> 00:05:35,535 AND NOW WHAT WE'RE HEARING ABOUT 140 00:05:35,601 --> 00:05:38,071 IS GROWTH IN THE FIELD THAT IS 141 00:05:38,137 --> 00:05:41,040 NOW WELCOMING KNOWN AS 142 00:05:41,107 --> 00:05:42,475 OCULOMICS, WHERE THERE'S BEEN 143 00:05:42,542 --> 00:05:43,342 IMPRESSIVE WORK YOU'VE READ 144 00:05:43,409 --> 00:05:46,079 ABOUT AND YOU'LL HEAR ABOUT OVER 145 00:05:46,145 --> 00:05:48,481 THE NEXT COUPLE DAYS, INVOLVING 146 00:05:48,548 --> 00:05:50,450 A.I. MODELS TRAINED USING THESE 147 00:05:50,516 --> 00:05:54,087 TECHNOLOGIES TO LOOK AT 148 00:05:54,153 --> 00:05:58,091 DIAGNOSIS, PREDICTION OF 149 00:05:58,157 --> 00:06:00,059 SYSTEMIC DISEASE, 150 00:06:00,126 --> 00:06:02,361 NEURODEGENERATIVE DISEASE, 151 00:06:02,428 --> 00:06:02,895 PARKINSON'S, ALZHEIMER'S, 152 00:06:02,962 --> 00:06:04,363 PSYCHIATRIC DISEASE, CARDIAC 153 00:06:04,430 --> 00:06:04,597 DISEASE. 154 00:06:04,664 --> 00:06:09,502 THE QUESTION IS OBVIOUSLY WE'VE 155 00:06:09,569 --> 00:06:10,470 GOT THESE TECHNOLOGIES, HOW ARE 156 00:06:10,536 --> 00:06:14,006 WE GOING TO BUILD ON THEM. 157 00:06:14,073 --> 00:06:15,441 FOUR THINGS WE'RE INTERESTED IN 158 00:06:15,508 --> 00:06:17,510 HOW WE CAN TRY TO PROVIDE 159 00:06:17,577 --> 00:06:19,812 FRAMEWORK TO HELP THE COMMUNITY 160 00:06:19,879 --> 00:06:21,481 IN THESE AREAS. 161 00:06:21,547 --> 00:06:23,883 NUMBER ONE IS THAT I THINK ONE 162 00:06:23,950 --> 00:06:25,184 THING THAT'S OBVIOUS IS THAT 163 00:06:25,251 --> 00:06:27,487 WE'RE GOING TO NEED LARGE 164 00:06:27,553 --> 00:06:30,156 DATASETS OF IMAGES. 165 00:06:30,223 --> 00:06:32,525 A.I.-READY DATASETS THAT AVOID 166 00:06:32,592 --> 00:06:33,526 BIAS. 167 00:06:33,593 --> 00:06:35,161 DIFFERENT IMAGING DEVICE, 168 00:06:35,228 --> 00:06:35,795 DIFFERENT RACES, DIFFERENT 169 00:06:35,862 --> 00:06:36,362 POPULATIONS. 170 00:06:36,429 --> 00:06:38,931 AND AT THE NIH, ONE OF THE 171 00:06:38,998 --> 00:06:40,066 THINGS THAT WE REALLY GOT 172 00:06:40,133 --> 00:06:41,734 INTERESTED IN IS TRYING TO 173 00:06:41,801 --> 00:06:42,068 ADDRESS THIS. 174 00:06:42,135 --> 00:06:44,237 ONE PROJECT I WANT TO MAKE SURE 175 00:06:44,303 --> 00:06:47,206 YOU'RE AWARE OF IS AN NIH COMMON 176 00:06:47,273 --> 00:06:47,540 FUND PROJECT. 177 00:06:47,607 --> 00:06:51,277 SO ANY AREA OF SCIENCE, ANY AREA 178 00:06:51,344 --> 00:06:53,746 OF MEDICINE CALLED BRIDGE TO 179 00:06:53,813 --> 00:06:56,716 A.I., IT WAS A PROJECT THAT 180 00:06:56,783 --> 00:06:57,617 BEGAN IN 2021. 181 00:06:57,683 --> 00:07:01,788 AND SO THE FIRST PHASE OF THAT 182 00:07:01,854 --> 00:07:03,156 PROJECT COMMITS $130 MILLION 183 00:07:03,222 --> 00:07:05,491 OVER FOUR YEARS TO BUILD 184 00:07:05,558 --> 00:07:05,758 DATASETS. 185 00:07:05,825 --> 00:07:08,194 AT NIH, MANY OF YOU KNOW NIH 186 00:07:08,261 --> 00:07:09,362 EXTREMELY WELL. 187 00:07:09,428 --> 00:07:13,399 WE'VE GOT THIS MANTRA, 188 00:07:13,466 --> 00:07:14,033 HYPOTHESIS-DRIVEN RESEARCH. 189 00:07:14,100 --> 00:07:15,768 THIS IS $130 MILLION FOR 190 00:07:15,835 --> 00:07:19,105 BUILDING DATASETS, MORE OF A 191 00:07:19,172 --> 00:07:20,306 HYPOTHESIS-GENERATING FRAMEWORK. 192 00:07:20,373 --> 00:07:22,708 IN ADDITION TO BUILDING 193 00:07:22,775 --> 00:07:26,946 MULTI-MODAL DATASETS, WE'VE 194 00:07:27,013 --> 00:07:27,947 GOTTEN ETHICS COMPONENTS 195 00:07:28,014 --> 00:07:29,382 INTEGRATED UP FRONT TO REDUCE 196 00:07:29,448 --> 00:07:33,553 BIAS AND DEAL WITH PRIVACY. 197 00:07:33,619 --> 00:07:35,354 AND IT'S MANAGED, ALTHOUGH IT'S 198 00:07:35,421 --> 00:07:40,793 TRANS-NIH, IT'S MANAGED BY FIVE 199 00:07:40,860 --> 00:07:41,093 INSTITUTES. 200 00:07:41,160 --> 00:07:42,528 BIOMEDICAL, NIBIB, NATIONAL 201 00:07:42,595 --> 00:07:44,931 LIBRARY OF MEDICINE, 202 00:07:44,997 --> 00:07:45,565 COMPLEMENTARY MEDICINE AND 203 00:07:45,631 --> 00:07:46,999 HEALTH, GENOME AND US. 204 00:07:47,066 --> 00:07:48,634 THERE ARE FOUR DATA GENERATION 205 00:07:48,701 --> 00:07:50,069 PROJECT AND ONE AWARDS FOR 206 00:07:50,136 --> 00:07:51,370 SO-CALLED BRIDGE CENTER TO UNIFY 207 00:07:51,437 --> 00:07:53,439 ALL OF THAT. 208 00:07:53,506 --> 00:07:55,074 AND ONE THING THAT WE WERE 209 00:07:55,141 --> 00:07:56,843 EXCITED ABOUT, ONE OF THOSE FOUR 210 00:07:56,909 --> 00:07:59,345 DATA GENERATION TEAMS IS LED BY 211 00:07:59,412 --> 00:08:02,815 A GROUP OF OPHTHALMOLOGISTS, 212 00:08:02,882 --> 00:08:03,950 CECILIA LEE AND AARON LEE. 213 00:08:04,016 --> 00:08:06,385 AARON LEE IS ONE OF THE SPEAKERS 214 00:08:06,452 --> 00:08:07,220 HERE. 215 00:08:07,286 --> 00:08:08,588 BIG DATA, LARGE DATASETS, 216 00:08:08,654 --> 00:08:10,056 AVOIDING BIAS IS NUMBER ONE. 217 00:08:10,122 --> 00:08:13,559 NUMBER TWO IS DATA SHARING AND 218 00:08:13,626 --> 00:08:13,893 HARMONIZATION. 219 00:08:13,960 --> 00:08:14,994 CLEARLY MODERN RESEARCH RELIES 220 00:08:15,061 --> 00:08:20,366 ON BIG DATA, REGARDLESS OF 221 00:08:20,433 --> 00:08:22,034 IMAGING OR ANY TYPE OF DATA. 222 00:08:22,101 --> 00:08:23,669 WE NEED DATA SHARING, DATA 223 00:08:23,736 --> 00:08:24,503 HARMONIZATION TO TAKE ADVANTAGE 224 00:08:24,570 --> 00:08:26,005 OF THAT. 225 00:08:26,072 --> 00:08:28,207 TO REALLY JUST DIVE INTO THAT 226 00:08:28,274 --> 00:08:30,676 MORE, WE'VE GOT THIS PARADIGM, 227 00:08:30,743 --> 00:08:33,012 THERE ARE OFTEN MULTIPLE SMALL 228 00:08:33,079 --> 00:08:34,046 STUDIES GOING ON AROUND THE 229 00:08:34,113 --> 00:08:35,748 WORLD THAT ARE ESSENTIALLY 230 00:08:35,815 --> 00:08:38,017 TRYING TO ANSWER THE SAME 231 00:08:38,084 --> 00:08:38,651 QUESTION. 232 00:08:38,718 --> 00:08:39,185 YET ARE INDIVIDUALLY 233 00:08:39,252 --> 00:08:41,187 UNDERPOWERED TO BE ABLE TO FULLY 234 00:08:41,254 --> 00:08:44,891 ANSWER THOSE QUESTIONS AND 235 00:08:44,957 --> 00:08:45,558 ADVANCE THE FIELD. 236 00:08:45,625 --> 00:08:47,393 IN MY OPINION ONE OF THE 237 00:08:47,460 --> 00:08:48,861 CHALLENGES OUR ACADEMIC SYSTEM 238 00:08:48,928 --> 00:08:50,496 IS OFTEN NOT SET UP TO PROVIDE 239 00:08:50,563 --> 00:08:52,131 INCENTIVES FOR PEOPLE TO SHARE. 240 00:08:52,198 --> 00:08:55,868 I'D ARGUE SOMETIMES THE SYSTEM 241 00:08:55,935 --> 00:08:57,403 DISINCENTIVIZES PEOPLE TO SHARE. 242 00:08:57,470 --> 00:08:58,471 ANOTHER PROBLEM THOUGH IS EVEN 243 00:08:58,537 --> 00:09:00,740 IF PEOPLE DID WANT TO SHARE, 244 00:09:00,806 --> 00:09:02,875 WHEN YOU REPRESENT AND COLLECT 245 00:09:02,942 --> 00:09:04,944 YOUR DATA INCONSISTENTLY YOU 246 00:09:05,011 --> 00:09:07,213 CANNOT JUST COMBINE DATASETS. 247 00:09:07,280 --> 00:09:10,049 WE NEED METHODS OF STANDARDIZED 248 00:09:10,116 --> 00:09:11,250 DATA REPRESENTATION. 249 00:09:11,317 --> 00:09:13,052 IN TERMS OF SHARING PIECE MANY 250 00:09:13,119 --> 00:09:14,787 OF YOU KNOW AT THE NIH AND WHITE 251 00:09:14,854 --> 00:09:16,088 HOUSE THERE ARE DATA SHARING 252 00:09:16,155 --> 00:09:16,455 POLICIES. 253 00:09:16,522 --> 00:09:18,925 IF YOU DON'T COME UP WITH A PLAN 254 00:09:18,991 --> 00:09:20,026 WE WON'T FUND YOUR RESEARCH. 255 00:09:20,092 --> 00:09:23,362 AND THAT'S WHAT I WOULD CONSIDER 256 00:09:23,429 --> 00:09:24,630 A STICK. 257 00:09:24,697 --> 00:09:26,465 I FEEL STRONGLY THAT IN ADDITION 258 00:09:26,532 --> 00:09:33,539 TO THOSE SO-CALLED STICKS WE 259 00:09:33,606 --> 00:09:34,407 NEED INCENTIVES, CARROTS TO 260 00:09:34,473 --> 00:09:37,076 MOTIVATE IF YOU WANT TO DO THAT. 261 00:09:37,143 --> 00:09:38,778 I MEET WITH EDITORS IN CHIEF OF 262 00:09:38,844 --> 00:09:40,579 SOME OF THE MAJOR VISION 263 00:09:40,646 --> 00:09:43,282 JOURNALS A FEW TIMES A YEAR. 264 00:09:43,349 --> 00:09:44,684 WHAT CAN WE DO TOGETHER TO 265 00:09:44,750 --> 00:09:45,318 ADVANCE THE COMMUNITY? 266 00:09:45,384 --> 00:09:47,086 ONE OF THE THINGS WE CAME UP 267 00:09:47,153 --> 00:09:50,189 WITH WAS TO TRY TO CREATE A NEW 268 00:09:50,256 --> 00:09:51,824 PUBLICATION TYPE, A DATASET OR 269 00:09:51,891 --> 00:09:52,892 SOFTWARE LIBRARY WHERE YOU CAN 270 00:09:52,959 --> 00:09:55,528 WRITE A PAPER JUST ABOUT YOUR 271 00:09:55,594 --> 00:09:55,861 DATASETS. 272 00:09:55,928 --> 00:10:01,434 AND THAT WAY WE'LL COULD GET 273 00:10:01,500 --> 00:10:03,102 ACADEMIC CREDIT, YOU CAN CITE IT 274 00:10:03,169 --> 00:10:04,403 USING PubMed. 275 00:10:04,470 --> 00:10:08,574 A SHOUT OUT TO MARCO ZARBIN, 276 00:10:08,641 --> 00:10:10,209 EDITOR OF CHIEF, PIERCE KEY AND 277 00:10:10,276 --> 00:10:11,911 AARON LEE FOR WRITING A PAPER 278 00:10:11,978 --> 00:10:13,579 THAT DEFINED THAT TYPE OF 279 00:10:13,646 --> 00:10:22,188 PUBLICATION A FEW YEARS AGO. 280 00:10:22,254 --> 00:10:24,757 EMILY CHEW IS HERE, THE SECOND 281 00:10:24,824 --> 00:10:25,758 JOURNAL THAT'S IMPLEMENTED THAT. 282 00:10:25,825 --> 00:10:27,526 I HOPE IT'S THINGS LIKE THAT 283 00:10:27,593 --> 00:10:29,895 THAT SHIFT THE CULTURE TOWARD 284 00:10:29,962 --> 00:10:31,364 INCENTIVIZING DATA SHARING AND 285 00:10:31,430 --> 00:10:31,697 TEAM SCIENCE. 286 00:10:31,764 --> 00:10:33,432 I THINK WE'RE GOING TO NEED THAT 287 00:10:33,499 --> 00:10:34,767 AS A COMMUNITY. 288 00:10:34,834 --> 00:10:37,403 WE'RE GOING TO NEED A COMMON 289 00:10:37,470 --> 00:10:39,038 DATA MODEL FOR OPHTHALMOLOGY, 290 00:10:39,105 --> 00:10:40,106 VISION SCIENCE, AND IMAGING. 291 00:10:40,172 --> 00:10:41,874 AND AT THE NATIONAL EYE 292 00:10:41,941 --> 00:10:42,875 INSTITUTE WE'VE BEEN WORKING 293 00:10:42,942 --> 00:10:44,844 WITH THE AMERICAN ACADEMY OF 294 00:10:44,910 --> 00:10:46,345 OPHTHALMOLOGY TO DEVELOP THAT 295 00:10:46,412 --> 00:10:48,147 COMMON DATA MODEL, AND WHO IS 296 00:10:48,214 --> 00:10:49,515 LEADING THAT. 297 00:10:49,582 --> 00:10:53,919 SALLY BAXTER FROM SAN DIEGO, 298 00:10:53,986 --> 00:10:55,421 KERRY GOETZ FROM THE NATIONAL 299 00:10:55,488 --> 00:11:00,760 EYE INSTITUTE HERE TODAY AND 300 00:11:00,826 --> 00:11:02,428 MICHELLE RIBAR DOING A 301 00:11:02,495 --> 00:11:04,196 SABBATICAL AT NEI TWO YEARS, 302 00:11:04,263 --> 00:11:06,032 BASED IN OREGON, THOSE ARE 303 00:11:06,098 --> 00:11:07,233 IMPORTANT, DATA SHARING, DATA 304 00:11:07,299 --> 00:11:13,939 HARMONIZATION FOR IMAGING IN THE 305 00:11:14,006 --> 00:11:14,173 FUTURE. 306 00:11:14,240 --> 00:11:15,241 NUMBER THREE, OCULAR EMISSION 307 00:11:15,307 --> 00:11:15,708 STANDARDS. 308 00:11:15,775 --> 00:11:17,843 TO DO THE BEST RESEARCH AND TAKE 309 00:11:17,910 --> 00:11:22,048 THE BEST CARE OF PATIENTS THESE 310 00:11:22,114 --> 00:11:23,215 IMAGING DEVICES WILL HAVE TO 311 00:11:23,282 --> 00:11:25,518 TALK EACH OTHER AND TALK TO 312 00:11:25,584 --> 00:11:26,752 EHRS, IMAGE MANAGEMENT SYSTEMS. 313 00:11:26,819 --> 00:11:29,121 ONE OF THE CHALLENGES IN THE 314 00:11:29,188 --> 00:11:31,257 RADIOLOGY WORLD, THEY HAVE DONE 315 00:11:31,323 --> 00:11:34,994 THIS FOR DECADES, BASICALLY 316 00:11:35,061 --> 00:11:36,796 EVERY DEVICE SOLD ADHERES TO 317 00:11:36,862 --> 00:11:38,731 DICOM STANDARDS, PLUG AND PLAY. 318 00:11:38,798 --> 00:11:41,600 IN THE VISION FIELD DICOM 319 00:11:41,667 --> 00:11:42,468 COMPLIANCE, STANDARDS DEFINED 320 00:11:42,535 --> 00:11:44,904 FOR ALMOST EVERY MAJOR IMAGING 321 00:11:44,970 --> 00:11:47,873 DEVICE BUT COMPLIANCE CONTINUES 322 00:11:47,940 --> 00:11:52,878 TO BE OPTIONAL AND FAIRLY LOW. 323 00:11:52,945 --> 00:11:54,113 DEVICES MARKETED AS COMPLIANT 324 00:11:54,180 --> 00:11:55,815 OFTEN DO NOT MEET FULL 325 00:11:55,881 --> 00:11:57,483 FUNCTIONALITY, A BARRIER TO 326 00:11:57,550 --> 00:11:58,250 DEVELOPING LARGE TRAINING SETS 327 00:11:58,317 --> 00:12:00,186 FOR A.I. AND MACHINE LEARNING 328 00:12:00,252 --> 00:12:01,821 AND JUST FOR CLINICAL CARE 329 00:12:01,887 --> 00:12:02,588 OVERALL. 330 00:12:02,655 --> 00:12:04,256 WHAT ARE WE TRYING TO DO ABOUT 331 00:12:04,323 --> 00:12:05,091 THAT? 332 00:12:05,157 --> 00:12:07,426 WHEN I STARTED THIS POSITION, 333 00:12:07,493 --> 00:12:09,395 ABOUT THREE YEARS AGO, I REALLY 334 00:12:09,462 --> 00:12:11,597 FELT LIKE WE HAVE TO SOLVE THIS. 335 00:12:11,664 --> 00:12:14,133 SO, WE STARTED WORKING WITH THE 336 00:12:14,200 --> 00:12:19,205 FDA AND THAT GROUP AT THE FDA 337 00:12:19,271 --> 00:12:25,611 WAS LED BY MALPINA EDELMAN AND 338 00:12:25,678 --> 00:12:32,952 THE OEC GROUP IS LED BY MICKEY 339 00:12:33,018 --> 00:12:34,620 TRIPATHI, REGULATING ELECTRONIC 340 00:12:34,687 --> 00:12:35,721 DATA EXCHANGE. 341 00:12:35,788 --> 00:12:37,957 WHAT CAN WE DO WORKING TOGETHER 342 00:12:38,023 --> 00:12:44,096 TO ADVANCE TOWARD MORE OF AN 343 00:12:44,163 --> 00:12:45,064 INTRAOPERABLE WORLD. 344 00:12:45,131 --> 00:12:47,266 WE SPENT NINE MONTHS PLANNING 345 00:12:47,333 --> 00:12:50,769 THE WORKSHOP IN MAY 2022, OUR 346 00:12:50,836 --> 00:12:55,741 LEAD WAS KERRY GOETZ WITH AMBER 347 00:12:55,808 --> 00:12:58,077 REID, A GREAT WORKSHOP, HUNDREDS 348 00:12:58,144 --> 00:13:01,347 ATTENDED. 349 00:13:01,413 --> 00:13:03,983 SIX MONTHS AFTER THAT, TWO MAJOR 350 00:13:04,049 --> 00:13:05,584 RESEARCH SOCIETIES PUBLISHED A 351 00:13:05,651 --> 00:13:08,988 POSITION PAPER SAYING WE NEED 352 00:13:09,054 --> 00:13:10,589 HAVE INTRAOPERABILITY OF 353 00:13:10,656 --> 00:13:10,823 DEVICES. 354 00:13:10,890 --> 00:13:12,625 AND A FEW MONTHS AGO WE 355 00:13:12,691 --> 00:13:13,459 PUBLISHED POSITION PAPER 356 00:13:13,526 --> 00:13:15,728 TOGETHER WITH THE FDA AND ONC 357 00:13:15,794 --> 00:13:17,496 THAT LAYS OUT WHAT ARE THE 358 00:13:17,563 --> 00:13:19,165 LEVERS WE WANT TO USE AS THESE 359 00:13:19,231 --> 00:13:21,534 AGENCIES TO TRY TO ADVANCE THE 360 00:13:21,600 --> 00:13:21,734 FIELD. 361 00:13:21,800 --> 00:13:25,304 SO THE FDA HAS THEIR SO-CALLED 362 00:13:25,371 --> 00:13:29,675 LEVERS, ONC HAS THEIRS TO LIMIT 363 00:13:29,742 --> 00:13:30,142 INFORMATION BLOCKING. 364 00:13:30,209 --> 00:13:31,977 FROM MY PERSPECTIVE I DON'T WANT 365 00:13:32,044 --> 00:13:33,612 TO BE FUNDING GRANTS IN THE 366 00:13:33,679 --> 00:13:36,115 FUTURE IF THEY USE DEVICES THAT 367 00:13:36,182 --> 00:13:37,683 DON'T CONFORM TO STANDARDS LIKE 368 00:13:37,750 --> 00:13:39,218 DICOM BECAUSE I JUST DON'T THINK 369 00:13:39,285 --> 00:13:41,020 THAT'S HOW WE'RE GOING TO DO THE 370 00:13:41,086 --> 00:13:42,521 BEST RESEARCH, OF THE SORT WE 371 00:13:42,588 --> 00:13:44,223 SHOWED ON THE PREVIOUS SLIDES, 372 00:13:44,290 --> 00:13:50,062 OR FRANKLY TAKE THE BEST CARE OF 373 00:13:50,129 --> 00:13:50,629 PATIENTS. 374 00:13:50,696 --> 00:13:55,267 REALLY IMPORTANT, OCULAR IMAGING 375 00:13:55,334 --> 00:13:55,801 STANDARDS. 376 00:13:55,868 --> 00:13:56,735 LASTLY WE'VE GOTTEN INTERESTED 377 00:13:56,802 --> 00:13:59,638 IN TRYING TO ADVANCE OCULAR 378 00:13:59,705 --> 00:14:00,539 IMAGING FOR OCULOMICS. 379 00:14:00,606 --> 00:14:05,678 AND ABOUT A WEEK AGO, THE 380 00:14:05,744 --> 00:14:06,779 OFFICIAL ROLLOUT, RESEARCH 381 00:14:06,845 --> 00:14:07,680 OPPORTUNITY ANNOUNCEMENT WAS 382 00:14:07,746 --> 00:14:10,950 PUBLISHED FOR A NEW COMMON FUND 383 00:14:11,016 --> 00:14:11,684 VENTURE INITIATIVE CALLED 384 00:14:11,750 --> 00:14:12,117 OCULOMICS. 385 00:14:12,184 --> 00:14:16,155 AND THE GOAL OF THIS IS TO 386 00:14:16,222 --> 00:14:17,623 DEVELOP NOVEL NON-INVASIVE 387 00:14:17,690 --> 00:14:18,857 OCULAR EMISSION TECHNOLOGIES, 388 00:14:18,924 --> 00:14:21,760 MACHINE LEARNING ALGORITHMS AND 389 00:14:21,827 --> 00:14:23,128 OTHER TOOLS TO IDENTIFY 390 00:14:23,195 --> 00:14:24,830 BIOMARKERS FOR SYSTEMIC DISEASE. 391 00:14:24,897 --> 00:14:26,031 THIS IS SOMETHING WE'RE EXCITED 392 00:14:26,098 --> 00:14:26,265 ABOUT. 393 00:14:26,332 --> 00:14:29,668 I JUST WANT TO CALL OUT IT CAME 394 00:14:29,735 --> 00:14:32,738 OUT OF DISCUSSIONS THAT STARTED 395 00:14:32,805 --> 00:14:36,442 WITH OUR PROGRAM OFFICERS AND 396 00:14:36,508 --> 00:14:40,512 NEI WITH NIBIB, BIOMEDICAL 397 00:14:40,579 --> 00:14:43,549 ENGINEERING, BIOENGINEERING, 398 00:14:43,616 --> 00:14:44,149 NINDS, NEUROSCIENCE, TOGETHER 399 00:14:44,216 --> 00:14:50,322 WITH NHLBI, HEART LUNG, AND NIA 400 00:14:50,389 --> 00:14:50,689 AGING. 401 00:14:50,756 --> 00:14:52,625 TONY GOVER IS THE LEAD, TONY IS 402 00:14:52,691 --> 00:14:53,158 HERE. 403 00:14:53,225 --> 00:14:54,260 CAN YOU RAISE YOUR HAND? 404 00:14:54,326 --> 00:14:56,362 UP IN THE FRONT THERE. 405 00:14:56,428 --> 00:14:58,097 IF YOU'RE INTERESTED IN THIS, 406 00:14:58,163 --> 00:15:00,866 TONY IS THE BEST CONTACT PERSON 407 00:15:00,933 --> 00:15:01,500 FOR THIS. 408 00:15:01,567 --> 00:15:03,969 SO SORRY TO DO THAT TO YOU. 409 00:15:04,036 --> 00:15:06,739 THEY HAVE DONE A GREAT JOB IN 410 00:15:06,805 --> 00:15:07,640 PUTTING THIS TOGETHER. 411 00:15:07,706 --> 00:15:09,408 AND SO IT'S ON A FAIRLY 412 00:15:09,475 --> 00:15:10,909 AGGRESSIVE TIME FRAME WHERE THE 413 00:15:10,976 --> 00:15:12,311 LETTERS OF INTENT AND DEADLINES 414 00:15:12,378 --> 00:15:14,546 ARE DUE WITHIN THE NEXT FEW 415 00:15:14,613 --> 00:15:14,780 MONTHS. 416 00:15:14,847 --> 00:15:16,148 BUT WE'RE REALLY EXCITED ABOUT 417 00:15:16,215 --> 00:15:17,349 THIS, CONNECTING THE EYE WITH 418 00:15:17,416 --> 00:15:18,651 THE REST OF THE BODY. 419 00:15:18,717 --> 00:15:21,520 AND JUST WHERE ARE THESE IMAGING 420 00:15:21,587 --> 00:15:23,155 TECHNOLOGIES GOING. 421 00:15:23,222 --> 00:15:25,057 WITH THAT, THIS IS MY LAST 422 00:15:25,124 --> 00:15:25,357 SLIDE. 423 00:15:25,424 --> 00:15:27,726 I WANT TO JUST FINISH BY SAYING 424 00:15:27,793 --> 00:15:29,161 THAT I'M REALLY EXCITED TO HAVE 425 00:15:29,228 --> 00:15:31,797 ALL OF US HERE, I HOPE THERE'S A 426 00:15:31,864 --> 00:15:32,798 LOT OF GOOD CONVERSATION, BOTH 427 00:15:32,865 --> 00:15:35,501 UP HERE AT THE PODIUM, AT THE 428 00:15:35,567 --> 00:15:38,270 MICROPHONES, JUST IN THE 429 00:15:38,337 --> 00:15:38,804 HALLWAYS. 430 00:15:38,871 --> 00:15:39,772 WELCOME TO BETHESDA. 431 00:15:39,838 --> 00:15:41,473 AND KAPIL, I'M GOING TO HAVE YOU 432 00:15:41,540 --> 00:15:44,710 COME UP ON STAGE TO INTRODUCE 433 00:15:44,777 --> 00:15:44,910 JIM. 434 00:15:44,977 --> 00:15:46,712 AND THANK YOU ALL VERY MUCH. 435 00:15:46,779 --> 00:15:49,114 [APPLAUSE] 436 00:16:02,161 --> 00:16:04,697 >> I REALIZED IF I GO TO 437 00:16:04,763 --> 00:16:06,031 ACCOMPLISHMENTS AND AWARDS WE'LL 438 00:16:06,098 --> 00:16:06,999 SPEND A GOOD PART OF THE MORNING 439 00:16:07,066 --> 00:16:08,133 DOING THAT. 440 00:16:08,200 --> 00:16:10,502 I'M GOING TO DO SNIPPETS OF HIS 441 00:16:10,569 --> 00:16:13,339 RESEARCH AND AWARDS AND HOPE 442 00:16:13,405 --> 00:16:14,006 IT'S ACCEPTABLE. 443 00:16:14,073 --> 00:16:16,642 AS WE KNOW, HE'S A PROFESSOR OF 444 00:16:16,709 --> 00:16:17,776 BIOMEDICAL ENGINEERING AND 445 00:16:17,843 --> 00:16:22,548 ELECTRICAL ENGINEERING, M.I.T., 446 00:16:22,614 --> 00:16:25,050 CO-INVENTOR OF OCT, CO-RECIPIENT 447 00:16:25,117 --> 00:16:26,151 OF LASKER AWARD AND NATIONAL 448 00:16:26,218 --> 00:16:31,290 MEDAL OF TECHNOLOGY AND 449 00:16:31,357 --> 00:16:34,059 INNOVATION IN 23 PRESENTED BY 450 00:16:34,126 --> 00:16:34,693 PRESIDENT OBAMA. 451 00:16:34,760 --> 00:16:35,427 PRESIDENT BIDEN. 452 00:16:35,494 --> 00:16:46,004 HE'S A MEMBER OF -- I LEARNED 453 00:16:47,639 --> 00:16:49,541 DETAILS OF HIS LIFE I THOUGHT I 454 00:16:49,608 --> 00:16:51,844 WAS SHARING WITH ALL OF YOU. 455 00:16:51,910 --> 00:16:53,812 AND THERE ARE A FEW KEY WORDS IN 456 00:16:53,879 --> 00:16:55,347 HIS LIFE, IN HIS SPEECH HE USED 457 00:16:55,414 --> 00:16:59,118 AND SOME OF THESE ARE PASSION, 458 00:16:59,184 --> 00:17:01,487 DEDICATION, TENACITY FOR HIS 459 00:17:01,553 --> 00:17:02,054 RESEARCH. 460 00:17:02,121 --> 00:17:04,022 AND PAYING ATTENTION OR DOING 461 00:17:04,089 --> 00:17:05,657 TEAM SCIENCE AND TRANSLATION 462 00:17:05,724 --> 00:17:07,559 RESEARCH, AS YOU HEARD FROM 463 00:17:07,626 --> 00:17:09,862 MIKE'S OPENING REMARKS IS A KEY 464 00:17:09,928 --> 00:17:11,363 ELEMENT FOR US, AND WE'LL SEE 465 00:17:11,430 --> 00:17:13,999 THAT TEAM FOR THE NEXT DAY AND A 466 00:17:14,066 --> 00:17:17,469 HALF THROUGHOUT MANY TALKS AND 467 00:17:17,536 --> 00:17:17,836 MANY WAYS. 468 00:17:17,903 --> 00:17:19,471 AND THE LAST THING I LEARNED 469 00:17:19,538 --> 00:17:22,608 FROM HIS SPEECH WAS HIS 470 00:17:22,674 --> 00:17:24,376 ATTENTION TO LISTENING TO HIS 471 00:17:24,443 --> 00:17:26,078 TEACHERS AND MENTORS AND I HOPE 472 00:17:26,145 --> 00:17:27,780 TRAINEES IN THE AUDIENCE ARE 473 00:17:27,846 --> 00:17:28,747 LISTENING TO THAT AS HE REALLY 474 00:17:28,814 --> 00:17:30,616 HAS AN EAR FOR WHAT HIS TEACHERS 475 00:17:30,682 --> 00:17:31,316 ADVISE HIM. 476 00:17:31,383 --> 00:17:33,452 I'LL TELL YOU WHY THAT'S 477 00:17:33,519 --> 00:17:36,088 IMPORTANT FOR ALL OF US. 478 00:17:36,155 --> 00:17:40,793 HE WAS SO PASSIONATE ABOUT 479 00:17:40,859 --> 00:17:42,194 ELECTRONICS, AS A TEEN USING A 480 00:17:42,261 --> 00:17:43,662 KIT DEVELOPED A TELEVISION BY 481 00:17:43,729 --> 00:17:45,397 HIMSELF, I WAS TELLING MY SON 482 00:17:45,464 --> 00:17:47,065 LAST NIGHT, HE WAS EXCITED TO 483 00:17:47,132 --> 00:17:48,066 HEAR THAT. 484 00:17:48,133 --> 00:17:50,068 HIS SECOND TALENT WAS HE WAS 485 00:17:50,135 --> 00:17:51,403 GOOD AT MUSIC, AND SO GOOD AT 486 00:17:51,470 --> 00:17:53,705 SOME POINT HE THOUGHT HE WANTED 487 00:17:53,772 --> 00:17:57,142 TO BE A PROFESSIONAL MUSICIAN. 488 00:17:57,209 --> 00:18:00,145 SO A GOOD FORTUNE ALL OF US HE 489 00:18:00,212 --> 00:18:01,246 LISTENED TO HIS TEACHERS' ADVICE 490 00:18:01,313 --> 00:18:07,186 AND DIDN'T GO INTO MUSIC AS A 491 00:18:07,252 --> 00:18:07,419 CAREER. 492 00:18:07,486 --> 00:18:09,588 LASTLY, I LEARNED FROM ERIC 493 00:18:09,655 --> 00:18:10,823 SWANSON'S SPEECH TESTAMENT TO 494 00:18:10,889 --> 00:18:13,358 DEDICATION FOR HIS WORK WHEN HE, 495 00:18:13,425 --> 00:18:14,626 DAVID, ERIC, ALL OF THEM, WERE 496 00:18:14,693 --> 00:18:16,728 DISCUSSING WHO WILL BE THE FIRST 497 00:18:16,795 --> 00:18:20,032 VOLUNTEER TO TEST THE OCT, AND 498 00:18:20,098 --> 00:18:21,767 VOLUNTEERED HAVE A LASER BEAM 499 00:18:21,834 --> 00:18:22,701 SWEPT ACROSS THEIR RETINA, YOU 500 00:18:22,768 --> 00:18:24,736 CAN IMAGINE AT THE TIME WAS 501 00:18:24,803 --> 00:18:26,004 POTENTIALLY UNSAFE AND THERE WAS 502 00:18:26,071 --> 00:18:27,673 ANXIETY AROUND IT, HE WAS THE 503 00:18:27,739 --> 00:18:31,844 FIRST TO PUT HIS CLINTON -- 504 00:18:31,910 --> 00:18:36,615 CHIN ON THE STAND. 505 00:18:36,682 --> 00:18:39,485 THAT'S JAMES FUJIMOTO, AND 506 00:18:39,551 --> 00:18:43,088 WITHOUT FURTHER ADO I WOULD LIKE 507 00:18:43,155 --> 00:18:43,689 TO WELCOME HIM. 508 00:18:43,755 --> 00:18:49,795 [APPLAUSE] 509 00:18:56,902 --> 00:18:57,936 >> THANK YOU. 510 00:18:58,003 --> 00:19:01,240 IT'S A PRIVILEGE TO SPEAK TO YOU 511 00:19:01,306 --> 00:19:02,074 SPECIFICALLY BECAUSE IN THE 512 00:19:02,140 --> 00:19:04,243 AUDIENCE ARE MANY OF THE KEY 513 00:19:04,309 --> 00:19:09,548 THOUGHT LEADERS IN CLINICAL 514 00:19:09,615 --> 00:19:11,149 MEDICINE, FUNDAMENTAL RESEARCH 515 00:19:11,216 --> 00:19:13,118 THAT DROVE DEVELOPMENT OF THIS 516 00:19:13,185 --> 00:19:15,854 TECHNOLOGY, BOTH IN FUNDAMENTAL 517 00:19:15,921 --> 00:19:25,297 SCIENCE AS WELL AS CLINICAL 518 00:19:25,364 --> 00:19:26,164 TRANSLATION. 519 00:19:26,231 --> 00:19:29,468 THIS PRESENTATION IS GOING TO 520 00:19:29,535 --> 00:19:30,669 DESCRIBE HISTORY, EVOLUTION, 521 00:19:30,736 --> 00:19:33,505 FUTURE PROSPECTS OF OCT. 522 00:19:33,572 --> 00:19:35,707 AND BEFORE I BEGIN I WANTED TO 523 00:19:35,774 --> 00:19:37,643 ACKNOWLEDGE OUR COLLABORATORS. 524 00:19:37,709 --> 00:19:41,413 WE WERE FORTUNATE TO WORK WITH 525 00:19:41,480 --> 00:19:44,449 OUTSTANDING CLINICAL SHOT 526 00:19:44,516 --> 00:19:45,851 LEADERS. 527 00:19:45,918 --> 00:19:56,361 A LONGTIME COLLABORATION. 528 00:20:00,766 --> 00:20:02,568 IN THE AREA COMPUTATION, AND 529 00:20:02,634 --> 00:20:09,775 INDUSTRY AS WELL. 530 00:20:09,841 --> 00:20:13,745 IT HAS MULTIPLE APPLICATIONS, IN 531 00:20:13,812 --> 00:20:15,347 OPHTHALMOLOGY, ALSO IN 532 00:20:15,414 --> 00:20:17,282 CARDIOLOGY, HAS MANY FUNDAMENTAL 533 00:20:17,349 --> 00:20:19,284 RESEARCH APPLICATIONS, USED IN 534 00:20:19,351 --> 00:20:21,553 DIVERSE APPLICATIONS SUCH AS 535 00:20:21,620 --> 00:20:25,591 ENDOSCOPY AND OTHER TYPES OF 536 00:20:25,657 --> 00:20:26,158 ENDOSCOPIC IMAGING. 537 00:20:26,224 --> 00:20:31,730 SO THE THEMES OF THIS 538 00:20:31,797 --> 00:20:34,032 PRESENTATION ARE -- WE'LL 539 00:20:34,099 --> 00:20:35,701 DISCUSS HISTORY OF OCT, AND TO 540 00:20:35,767 --> 00:20:38,103 USE A PHRASE DEVELOPED BY ERIC 541 00:20:38,170 --> 00:20:40,706 SWANSON THERE'S AN ECOSYSTEM OF 542 00:20:40,772 --> 00:20:42,307 TECHNOLOGY TRANSLATION THAT 543 00:20:42,374 --> 00:20:52,217 REQUIRES BASIC SCIENCE AND 544 00:20:52,284 --> 00:20:53,819 TECHNOLOGY, APPLIED SCIENCE AND 545 00:20:53,885 --> 00:20:54,086 MEDICINE. 546 00:20:54,152 --> 00:20:56,922 WE'LL DESCRIBE ADVANCES THAT 547 00:20:56,989 --> 00:21:02,294 ENABLED ENHANCED FUNCTIONALITY, 548 00:21:02,361 --> 00:21:04,529 SPECTRAL DOMAIN, AND FINALLY 549 00:21:04,596 --> 00:21:06,865 WE'LL LOOK AT SCIENTIFIC 550 00:21:06,932 --> 00:21:09,968 CLINICAL AND ECONOMIC IMPACT. 551 00:21:10,035 --> 00:21:13,205 SO, ONE OF THE THEMES IS CONCEPT 552 00:21:13,271 --> 00:21:15,307 THAT THERE'S AN ECOSYSTEM. 553 00:21:15,374 --> 00:21:17,175 GOVERNMENT FUNDING SUPPORTS 554 00:21:17,242 --> 00:21:19,011 BASIC SCIENCE AND TECHNOLOGY 555 00:21:19,077 --> 00:21:23,949 WHICH CAN THEN BE DEVELOPED INTO 556 00:21:24,016 --> 00:21:26,151 APPLIED SCIENCE AND ENGINEERING. 557 00:21:26,218 --> 00:21:28,153 IN CLINICAL APPLICATIONS, 558 00:21:28,220 --> 00:21:29,655 CLINICAL STUDIES IN MEDICINE BY 559 00:21:29,721 --> 00:21:33,492 THOUGHT LEADERS ARE CRITICAL 560 00:21:33,558 --> 00:21:34,226 COMPONENT, INDUSTRY 561 00:21:34,292 --> 00:21:34,760 PARTICIPATION, INVESTMENT, 562 00:21:34,826 --> 00:21:35,794 DEVELOPMENT, ROLE OF 563 00:21:35,861 --> 00:21:36,862 ENTREPRENEURSHIP ARE ALSO 564 00:21:36,928 --> 00:21:37,229 IMPORTANT. 565 00:21:37,295 --> 00:21:40,499 ALL OF THESE ARE SYNERGISTIC TO 566 00:21:40,565 --> 00:21:45,971 IMPROVE PATIENT CARE AND 567 00:21:46,038 --> 00:21:46,738 OUTCOMES. 568 00:21:46,805 --> 00:21:49,808 WE ALSO HAVE ADVANCES FROM 569 00:21:49,875 --> 00:21:50,676 INNOVATION TRANSFERRED FROM 570 00:21:50,742 --> 00:21:51,877 OTHER OTHERS, AS WELL AS 571 00:21:51,943 --> 00:21:58,884 ECONOMIC COMPONENT TO ALL OF 572 00:21:58,950 --> 00:21:59,384 THIS. 573 00:21:59,451 --> 00:22:01,920 I WAS FORTUNATE TO WORK WITH 574 00:22:01,987 --> 00:22:05,357 ERIC IPPEN, ONE OF THE FOUNDERS, 575 00:22:05,424 --> 00:22:06,825 I DID MY DOCTORAL STUDIES WITH 576 00:22:06,892 --> 00:22:11,897 HIM AND MOUNTAIN -- AT M.I.T. 577 00:22:11,963 --> 00:22:15,567 IN THE 1980s, THIS IS THE 578 00:22:15,634 --> 00:22:17,569 TECHNOLOGY AT THE TIME, 579 00:22:17,636 --> 00:22:19,004 OSCILLATORS AND AMPLIFIERS, 580 00:22:19,071 --> 00:22:22,507 USING THIS WE BECAME INTERESTED 581 00:22:22,574 --> 00:22:26,111 IN THERAPEUTICS, APPROACHED BY 582 00:22:26,178 --> 00:22:28,814 CARMEN AND DID SOME OF THE FIRST 583 00:22:28,880 --> 00:22:29,948 LASER RETINAL INJURY STUDIES 584 00:22:30,015 --> 00:22:32,050 WHICH LED TO STUDIES THAT 585 00:22:32,117 --> 00:22:35,887 EXPANDED THE STANDARD TO SHORT 586 00:22:35,954 --> 00:22:36,121 PULSES. 587 00:22:36,188 --> 00:22:40,425 I'LL MENTION WE WERE FORTUNATE 588 00:22:40,492 --> 00:22:43,095 TO WORK WITH REGINALD, WHO 589 00:22:43,161 --> 00:22:44,396 BECAME DIRECTOR OF A MEDICAL 590 00:22:44,463 --> 00:22:53,004 CENTER IN GERMANY, AND YOU MAY 591 00:22:53,071 --> 00:22:57,008 NOTICE ATUL WHO BECAME A 592 00:22:57,075 --> 00:22:59,711 RESEARCHER, A VERY UNUSUAL GROUP 593 00:22:59,778 --> 00:23:01,213 OF CO-AUTHORS, OUTSTANDING 594 00:23:01,279 --> 00:23:01,513 COLLEAGUES. 595 00:23:01,580 --> 00:23:03,348 WE FIRST BECAME INTERESTED IN 596 00:23:03,415 --> 00:23:06,051 THE CONCEPT OF IMAGING BECAUSE 597 00:23:06,118 --> 00:23:11,223 OF WORK DONE BY MICHELLE AT AT&T 598 00:23:11,289 --> 00:23:12,924 BELL LABORATORIES IN 1971 AND 599 00:23:12,991 --> 00:23:18,296 HAD THE CONCEPT OF AN OPTICAL 600 00:23:18,363 --> 00:23:19,798 SHUTTER, A PICO SECOND, TO 601 00:23:19,865 --> 00:23:21,566 PHOTOGRAPH A PULSE OF LIGHT 602 00:23:21,633 --> 00:23:22,501 TRAVELING THROUGH MILK. 603 00:23:22,567 --> 00:23:24,970 HERE YOU SEE THE PHOTOGRAPH. 604 00:23:25,036 --> 00:23:27,139 THIS IS AN ULTIMATE HIGH SPEED 605 00:23:27,205 --> 00:23:30,041 PHOTOGRAPH ON THE PICO SECOND 606 00:23:30,108 --> 00:23:34,146 TIME SCALE. 607 00:23:34,212 --> 00:23:36,581 IN HIS PUBLICATION, DUGUAAY 608 00:23:36,648 --> 00:23:37,549 DEVELOPED PICTURE RANGING, IF 609 00:23:37,616 --> 00:23:39,951 YOU PLACE AN OBJECT BEHIND A 610 00:23:40,018 --> 00:23:41,386 SCATTERING MATERIAL AND YOU 611 00:23:41,453 --> 00:23:43,889 COULD THEN DO A HIGH SPEED 612 00:23:43,955 --> 00:23:44,689 PHOTOGRAPH, PHOTOGRAPHING ONLY 613 00:23:44,756 --> 00:23:46,992 THE LIGHT THAT COMES FROM THE 614 00:23:47,058 --> 00:23:48,493 OBJECT, ESSENTIALLY YOU COULD 615 00:23:48,560 --> 00:23:53,732 SEE BEHIND THE SCATTERING 616 00:23:53,799 --> 00:23:53,999 MATERIAL. 617 00:23:54,065 --> 00:23:56,067 HE PARTIALLY RECOVERED THE ATT 618 00:23:56,134 --> 00:23:56,601 LOGO. 619 00:23:56,668 --> 00:23:58,770 HE ALSO SAID ONE POSSIBILITY OF 620 00:23:58,837 --> 00:23:59,971 GATED PICTURE RANGING IS 621 00:24:00,038 --> 00:24:06,978 POTENTIAL TO SEE THROUGH HUMAN 622 00:24:07,045 --> 00:24:08,113 SKIN. 623 00:24:08,180 --> 00:24:10,248 CONCEPT OF INTERNAL BODY 624 00:24:10,315 --> 00:24:10,916 IMAGING. 625 00:24:10,982 --> 00:24:12,484 WE APPLIED TECHNOLOGIES FOR 626 00:24:12,551 --> 00:24:14,419 IMAGING AND INTERNAL BODY 627 00:24:14,486 --> 00:24:14,986 APPLICATIONS. 628 00:24:15,053 --> 00:24:17,889 SO, IT WAS POSSIBLE TO USE 629 00:24:17,956 --> 00:24:19,291 TECHNIQUE WHICH ESSENTIALLY 630 00:24:19,357 --> 00:24:21,793 MEASURED REFLECTIONS OR BACK 631 00:24:21,860 --> 00:24:24,596 SCATTER BY COMPARING TO 632 00:24:24,663 --> 00:24:26,565 REFERENCE PULSE, AND WITH THIS 633 00:24:26,631 --> 00:24:31,803 IT WAS -- WE WERE ABLE TO 634 00:24:31,870 --> 00:24:37,242 MEASURE CORNEAL THICKNESS, 635 00:24:37,309 --> 00:24:45,383 CORNEA TO AQUEOUS, AND THIS WAS 636 00:24:45,450 --> 00:24:46,251 POSSIBLE AND REQUIRED SHORT 637 00:24:46,318 --> 00:24:47,786 PULSE LASERS. 638 00:24:47,853 --> 00:24:54,359 IT WAS POSSIBLE TO AN OLD 639 00:24:54,426 --> 00:24:57,762 TECHNIQUE DATING BACK TO SIR 640 00:24:57,829 --> 00:24:59,431 ISAAC NEWTON, TO COMPARE LIGHT 641 00:24:59,497 --> 00:25:06,771 BEAM TO REFERENCE PATH, IF -- 642 00:25:06,838 --> 00:25:12,477 IT WAS POSSIBLE TO MEASURE, AND 643 00:25:12,544 --> 00:25:16,748 MEASURED ANTERIOR CHAMBER, 644 00:25:16,815 --> 00:25:19,117 MEASURING DISTANCE TO IRIS, BY 645 00:25:19,184 --> 00:25:21,586 DAVID HUANG, A MD/PHD STUDENT IN 646 00:25:21,653 --> 00:25:22,220 OUR GROUP. 647 00:25:22,287 --> 00:25:23,889 DAVID RECOGNIZED IT WAS POSSIBLE 648 00:25:23,955 --> 00:25:26,591 TO GO BEYOND THIS AND EXTEND THE 649 00:25:26,658 --> 00:25:28,760 CONCEPT TO IMAGING BY SCANNING 650 00:25:28,827 --> 00:25:31,563 THE BEAM IN THE TRANSVERSE 651 00:25:31,630 --> 00:25:32,030 DIRECTION. 652 00:25:32,097 --> 00:25:35,367 SO THIS REPRESENTS EARLY OCT 653 00:25:35,433 --> 00:25:37,235 IMAGE EX VIVO, THE BEAM IS 654 00:25:37,302 --> 00:25:39,404 INCIDENT, DISPLAYED AS A FALSE 655 00:25:39,471 --> 00:25:41,573 COLOR SCALE, BONDING HISTOLOGY 656 00:25:41,640 --> 00:25:44,109 FROM EX VIVO EYE. 657 00:25:44,175 --> 00:25:45,844 AND I APOLOGIZE FOR SHOWING 658 00:25:45,911 --> 00:25:47,078 THIS, DAVID. 659 00:25:47,145 --> 00:25:48,246 IT'S A GREAT PHOTO. 660 00:25:48,313 --> 00:25:48,680 OKAY. 661 00:25:48,747 --> 00:25:51,983 SO THIS IS A PHOTO OF DR. HUANG 662 00:25:52,050 --> 00:25:54,719 WHEN HE WAS A Ph.D. STUDENT IN 663 00:25:54,786 --> 00:25:58,089 OUR GROUP AT THE INTERNATIONAL 664 00:25:58,156 --> 00:25:59,324 QUANTUM ELECTRONICS CONFERENCE 665 00:25:59,391 --> 00:26:00,191 IN VIENNA, 1992. 666 00:26:00,258 --> 00:26:03,929 AND DAVID LATER WENT ON TO 667 00:26:03,995 --> 00:26:05,664 BECOME PROFESSOR OF 668 00:26:05,730 --> 00:26:06,665 OPHTHALMOLOGY AND BIOENGINEERING 669 00:26:06,731 --> 00:26:08,300 AT OREGON HEALTH AND SCIENCES 670 00:26:08,366 --> 00:26:10,402 UNIVERSITY AND HE'S MADE MANY 671 00:26:10,468 --> 00:26:13,905 POWERFUL CONTRIBUTIONS IN THE 672 00:26:13,972 --> 00:26:15,073 FIELD OF OPHTHALMOLOGY. 673 00:26:15,140 --> 00:26:18,576 I SHOULD ALSO MENTION THE 674 00:26:18,643 --> 00:26:20,078 CONCEPT OF GENERATING IMAGES 675 00:26:20,145 --> 00:26:24,149 FROM REFLECTED LIGHT WAVE WAS 676 00:26:24,215 --> 00:26:27,385 INDEPENDENTLY DESCRIBED BY 677 00:26:27,452 --> 00:26:29,220 PROFESSOR HIROTANO IN JAPAN AT 678 00:26:29,287 --> 00:26:31,723 AROUND THE SAME TIME. 679 00:26:31,790 --> 00:26:33,391 WE WERE FORTUNATE TO WORK WITH 680 00:26:33,458 --> 00:26:34,693 ERIC SWANSON. 681 00:26:34,759 --> 00:26:35,393 UNFORTUNATELY ERIC COULD NOT 682 00:26:35,460 --> 00:26:36,127 ATTEND TODAY. 683 00:26:36,194 --> 00:26:37,896 HE HAD A BOARD MEETING PLANNED 684 00:26:37,963 --> 00:26:42,167 SEVERAL MONTHS IN ADVANCE AND 685 00:26:42,233 --> 00:26:44,936 COULD NOT MOVE. 686 00:26:45,003 --> 00:26:45,870 AT THE TIME WE STARTED 687 00:26:45,937 --> 00:26:49,140 COLLABORATION HE WAS AT M.I.T. 688 00:26:49,207 --> 00:26:52,210 LINCOLN LABORATORIES, THIS SHOWS 689 00:26:52,277 --> 00:26:54,212 EARLY OCT TECHNOLOGY, NOT REALLY 690 00:26:54,279 --> 00:26:58,116 POSSIBLE TO USE FOR CLINICAL 691 00:26:58,183 --> 00:26:59,451 IMAGING. 692 00:26:59,517 --> 00:27:01,286 ERIC REDESIGNED THIS INTO A 693 00:27:01,353 --> 00:27:03,621 COMPACT FORM AND PATIENT 694 00:27:03,688 --> 00:27:05,857 INTERFACE THAT INCREASED IMAGING 695 00:27:05,924 --> 00:27:08,159 SPEED, ALLOWING IMAGES TO BE 696 00:27:08,226 --> 00:27:10,261 FORMED IN SECONDS, PATIENT 697 00:27:10,328 --> 00:27:11,896 INTERFACE SOFTWARE CONTROL. 698 00:27:11,963 --> 00:27:13,932 AND I SHOULD ALSO MENTION THAT 699 00:27:13,999 --> 00:27:16,368 ERIC WENT ON TO BECOME 700 00:27:16,434 --> 00:27:21,806 CO-FOUNDER OF THE FIRST OCT 701 00:27:21,873 --> 00:27:25,910 COMPANIES, AND IT'S INTERESTING 702 00:27:25,977 --> 00:27:29,514 HE CO-FOUNDED COMPANIES SIX MORE 703 00:27:29,581 --> 00:27:31,416 NETWORKS, ACACIA, RECENTLY 704 00:27:31,483 --> 00:27:33,651 ACQUIRED BY CISCO, WENT PUBLIC 705 00:27:33,718 --> 00:27:36,187 WITH A MULTI-BILLION DOLLAR 706 00:27:36,254 --> 00:27:36,521 MARKET CAP. 707 00:27:36,588 --> 00:27:47,065 THIS IS A PHOTOGRAPH OF OUR 708 00:27:48,600 --> 00:27:50,335 EARLY OCT RESEARCH TEAM. 709 00:27:50,402 --> 00:27:52,437 JOE IZATT, A POSTDOC, WENT ON TO 710 00:27:52,504 --> 00:27:55,040 BECOME PROFESSOR AT DUKE 711 00:27:55,106 --> 00:27:57,976 UNIVERSITY, AND MICHAEL HE, 712 00:27:58,043 --> 00:27:59,744 MD/PHD STUDENT IN PRIVATE 713 00:27:59,811 --> 00:28:05,083 PRACTICE, WHEN WITH A US 714 00:28:05,150 --> 00:28:06,551 DEVELOPED SOFTWARE PROTOCOLS AND 715 00:28:06,618 --> 00:28:09,020 EXAMINATION METHODS IN USE FOR 716 00:28:09,087 --> 00:28:10,922 10 OR 20 YEARS. 717 00:28:10,989 --> 00:28:15,493 WE SEE AN EXAMPLE OF THE FIRST 718 00:28:15,560 --> 00:28:18,029 OCT INSTRUMENT, EARLY 1980s, 719 00:28:18,096 --> 00:28:20,265 USING A MAC COMPUTER, THE BEAM 720 00:28:20,331 --> 00:28:22,734 SCANNING ON THE RETINA, 721 00:28:22,801 --> 00:28:27,972 GENERATION OF OCT IMAGES ON 722 00:28:28,039 --> 00:28:28,640 MacINTOSH. 723 00:28:28,706 --> 00:28:30,608 WE WERE FORTUNATE TO WORK 724 00:28:30,675 --> 00:28:33,111 CLOSELY WITH CLINICAL THOUGHT 725 00:28:33,178 --> 00:28:35,747 LEADERS, CARMEN AT THE NEW 726 00:28:35,814 --> 00:28:38,383 ENGLAND EYE CENTER, LED STUDIES 727 00:28:38,450 --> 00:28:40,885 IN 5,000 PATIENTS, IN THE LATE 728 00:28:40,952 --> 00:28:43,721 TO 1990s, THIS IS AN EXAMPLE 729 00:28:43,788 --> 00:28:46,825 OF FIRST OCT IMAGING STUDY OF 730 00:28:46,891 --> 00:28:48,593 MACULAR DISEASE SHOWING MACULAR 731 00:28:48,660 --> 00:28:54,165 HOLES, ALSO STUDIES IN DIABETIC 732 00:28:54,232 --> 00:28:55,633 RETINOPATHY AND MACULAR 733 00:28:55,700 --> 00:28:55,967 DEGENERATION. 734 00:28:56,034 --> 00:28:57,969 I WANTED TO ACKNOWLEDGE WORK OF 735 00:28:58,036 --> 00:28:59,504 JOEL SCHUMAN WHO WILL BE 736 00:28:59,571 --> 00:29:03,108 SPEAKING TODAY, JOEL DID THE 737 00:29:03,174 --> 00:29:05,810 FIRST STUDIES IN OCT IN 738 00:29:05,877 --> 00:29:08,379 OPHTHALMOLOGY, THIS INTRODUCED 739 00:29:08,446 --> 00:29:10,081 THE CONCEPT OF QUANTITATIVE 740 00:29:10,148 --> 00:29:17,388 MEASUREMENT OF THE NERVE FIBER 741 00:29:17,455 --> 00:29:17,922 LAYER, MAPPING, GLAUCOMA 742 00:29:17,989 --> 00:29:18,990 DETECTION, PROGRESSION, RESPONSE 743 00:29:19,057 --> 00:29:19,958 TO THERAPY. 744 00:29:20,024 --> 00:29:21,292 QUANTITATIVE MEASURES OF 745 00:29:21,359 --> 00:29:24,762 SURROGATE MARKERS ARE EXTREMELY 746 00:29:24,829 --> 00:29:28,266 IMPORTANT TODAY. 747 00:29:28,333 --> 00:29:30,768 CARMEN AND JOEL LED DEVELOPMENT 748 00:29:30,835 --> 00:29:33,605 OF FIRST OCT ATLAS, AN IMPORTANT 749 00:29:33,671 --> 00:29:35,507 STEP IN FACILITATING CLINICAL 750 00:29:35,573 --> 00:29:39,511 ADOPTION BECAUSE TECHNOLOGY AND 751 00:29:39,577 --> 00:29:41,045 METHOD WAS RELATIVELY UNKNOWN AT 752 00:29:41,112 --> 00:29:42,280 THE, GUIDING THE INTERPRETATION 753 00:29:42,347 --> 00:29:45,717 OF OCT AS A NEW MODALITY, IN 754 00:29:45,783 --> 00:29:50,054 IT'S FOURTH EDITION NOW LED BY 755 00:29:50,121 --> 00:29:51,256 JOEL SCHUMAN, EXPANDED 500 PAGES 756 00:29:51,322 --> 00:29:54,092 AT THIS POINT. 757 00:29:54,159 --> 00:29:55,326 THERE'S ALSO IMPORTANT 758 00:29:55,393 --> 00:29:56,461 INVESTMENT FROM INDUSTRY. 759 00:29:56,528 --> 00:30:02,033 JOHN MOORE WAS THE PRESIDENT OF 760 00:30:02,100 --> 00:30:03,701 HUMPHREY ZEISS AND MADE A 761 00:30:03,768 --> 00:30:07,405 COURAGEOUS DECISION, THERE WAS 762 00:30:07,472 --> 00:30:08,439 NO PRECEDENT FOR DEVELOPING OCT 763 00:30:08,506 --> 00:30:15,180 AT THAT TIME, A TREMENDOUS 764 00:30:15,246 --> 00:30:17,582 COMMERCIAL RISK. 765 00:30:17,649 --> 00:30:20,218 JAY WEI DEVELOPED THE ZEIZZ 766 00:30:20,285 --> 00:30:24,055 INSTRUMENT, BECAME FOUNDER OF 767 00:30:24,122 --> 00:30:27,358 OPTI VIEW. 768 00:30:27,425 --> 00:30:28,193 THERE ARE MULTIPLE GENERATIONS, 769 00:30:28,259 --> 00:30:30,495 THE STRATUS IS WHERE WE STARTED 770 00:30:30,562 --> 00:30:33,198 TO SEE LARGER SCALE CLINICAL 771 00:30:33,264 --> 00:30:36,568 ACCEPTANCE, INTRODUCED IN 2002. 772 00:30:36,634 --> 00:30:39,070 WE CAN SEE THAT THERE'S 773 00:30:39,137 --> 00:30:43,341 REPRESENTATIVE IMAGES, INITIAL 774 00:30:43,408 --> 00:30:45,176 PROTOTYPE IMAGES, RELATIVELY LOW 775 00:30:45,243 --> 00:30:46,744 PIXEL RESOLUTION, THE STRATUS 776 00:30:46,811 --> 00:30:49,380 HAD HIGHER IMAGING SPEED. 777 00:30:49,447 --> 00:30:50,582 RESOLUTION AND AXIAL DIRECTION 778 00:30:50,648 --> 00:30:52,217 WAS THE SAME. 779 00:30:52,283 --> 00:30:53,751 BUT THE HIGHER SPEED ALLOWED 780 00:30:53,818 --> 00:30:55,486 HIGHER DEFINITION IMAGE. 781 00:30:55,553 --> 00:30:58,890 THAT WAS AN IMPORTANT FACTOR IN 782 00:30:58,957 --> 00:30:59,357 ACCELERATING CLINICAL 783 00:30:59,424 --> 00:30:59,891 ACCEPTANCE. 784 00:30:59,958 --> 00:31:03,294 SO IF YOU LOOK AT THE HISTORY OF 785 00:31:03,361 --> 00:31:05,597 OCT, WELL, THERE'S A RELATIVELY 786 00:31:05,663 --> 00:31:07,332 LONG HISTORY, UNTIL WE STARTED 787 00:31:07,398 --> 00:31:09,934 TO SEE APPRECIABLE CLINICAL 788 00:31:10,001 --> 00:31:10,835 UPTAKE. 789 00:31:10,902 --> 00:31:15,506 I WANTED TO MENTION THAT 790 00:31:15,573 --> 00:31:17,408 1999-2001, THESE ARE EXTREMELY 791 00:31:17,475 --> 00:31:19,777 BAD FAILS COMPARED TO WHAT YOU 792 00:31:19,844 --> 00:31:22,981 WOULD EXPECT IN OTHER AREAS. 793 00:31:23,047 --> 00:31:29,254 AND ONLY WITH THE DEVELOPMENT OF 794 00:31:29,320 --> 00:31:30,989 THERAPY, ANTI-VEGF, PIONEERED BY 795 00:31:31,055 --> 00:31:34,025 PHIL ROSENFELD, DID WE SEE 796 00:31:34,092 --> 00:31:38,096 APPRECIATABLE UPTAKE OF OCT IN 797 00:31:38,162 --> 00:31:39,664 OPHTHALMOLOGY. 798 00:31:39,731 --> 00:31:50,208 I WANTED TO ACKNOWLEDGE PHIL 799 00:31:52,944 --> 00:31:55,513 ROSENFELD, AND ACCELERATED 800 00:31:55,580 --> 00:31:59,984 ACCEPTANCE OF IMAGING TECHNOLOGY 801 00:32:00,051 --> 00:32:01,986 BECAUSE PERSONALIZATION OF THE 802 00:32:02,053 --> 00:32:05,556 TREATMENT WAS NEEDED, AND THIS 803 00:32:05,623 --> 00:32:08,526 DROVE THE ADOPTION BUT ALSO 804 00:32:08,593 --> 00:32:10,061 SAVED HEALTH CARE COST. 805 00:32:10,128 --> 00:32:12,130 SO THE ACADEMY OF OPHTHALMOLOGY 806 00:32:12,196 --> 00:32:14,632 IN 2006, WE STARTED TO SEE WIDER 807 00:32:14,699 --> 00:32:16,401 SPREAD APPLICATION OF OCT, 808 00:32:16,467 --> 00:32:19,137 MULTIPLE COMPANIES THAT WERE 809 00:32:19,203 --> 00:32:20,772 MARKETING OCT TECHNOLOGY. 810 00:32:20,838 --> 00:32:23,841 AND THEN IN PARALLEL WITH THIS 811 00:32:23,908 --> 00:32:27,812 THERE WAS DEVELOPMENT OF 812 00:32:27,879 --> 00:32:30,648 SPECTRAL DOMAIN, THIS DATES BACK 813 00:32:30,715 --> 00:32:30,882 TO 1995. 814 00:32:30,948 --> 00:32:33,618 BUT WITH THE DEVELOPMENT OF 815 00:32:33,685 --> 00:32:36,988 HIGHER SPEED, IT BECAME POSSIBLE 816 00:32:37,055 --> 00:32:37,522 TO INCREASE FUNCTIONALITY. 817 00:32:37,588 --> 00:32:40,625 I WANTED TO MENTION THAT THIS 818 00:32:40,692 --> 00:32:42,060 REALLY WAS AN INTERNATIONAL 819 00:32:42,126 --> 00:32:46,030 EFFORT PIONEERING WORK AT THE 820 00:32:46,097 --> 00:32:52,670 MEDICAL UNIVERSITY OF VIENNA, 821 00:32:52,737 --> 00:32:54,706 PROFESSOR FERCHER, COPERNICUS 822 00:32:54,772 --> 00:32:56,574 UNIVERSITY AND MULTIPLE GROUPS 823 00:32:56,641 --> 00:32:58,576 DEMONSTRATED SPEED AND 824 00:32:58,643 --> 00:32:59,243 ADVANTAGES. 825 00:32:59,310 --> 00:33:01,612 IT BECAME POSSIBLE DO VIDEO RATE 826 00:33:01,679 --> 00:33:04,048 FRAME ACQUISITION, LIKE YOU SEE 827 00:33:04,115 --> 00:33:06,984 HER, OPTIC DISK, FIBER LAYER, 828 00:33:07,051 --> 00:33:11,022 FLOOD FLOW IN RETINAL 829 00:33:11,089 --> 00:33:11,923 VASCULATURE. 830 00:33:11,989 --> 00:33:22,066 THIS ENABLED VOLUMETRIC OCT, 831 00:33:22,133 --> 00:33:24,168 SCANNING SEQUENTIAL FRAMES 832 00:33:24,235 --> 00:33:27,638 ALLOWS PROJECTION, ENABLES 833 00:33:27,705 --> 00:33:29,941 LONGITUDINAL STUDIES, WORK BY 834 00:33:30,007 --> 00:33:32,744 GREGORI AND PHIL ROSENFELD AT 835 00:33:32,810 --> 00:33:35,413 BASKIN PALMER DEMONSTRATING ONE 836 00:33:35,480 --> 00:33:37,415 COULD TAKE VOLUMETRIC IMAGES, 837 00:33:37,482 --> 00:33:39,851 PROCESS TO EXTRACT FEATURES, DO 838 00:33:39,917 --> 00:33:41,719 LONGITUDINAL FOLLOW-UP ON 839 00:33:41,786 --> 00:33:43,988 SEQUENTIAL PATIENT VISITS TO 840 00:33:44,055 --> 00:33:45,890 EXAMINE TREATMENT RESPONSE OR 841 00:33:45,957 --> 00:33:46,424 PROGRESSION. 842 00:33:46,491 --> 00:33:51,229 IT'S POSSIBLE TO EXTEND SPECTRAL 843 00:33:51,295 --> 00:33:55,433 DOMAIN TO HIGH RESOLUTION, HERE 844 00:33:55,500 --> 00:33:56,467 REWEI SEE TRADITIONAL 845 00:33:56,534 --> 00:33:59,070 LOGARITHMIC DISPLAY SCALE, TO 846 00:33:59,137 --> 00:34:01,105 HAVE HIGH RESOLUTION WE NEED TO 847 00:34:01,172 --> 00:34:02,140 USE LINEAR SCALE. 848 00:34:02,206 --> 00:34:06,611 WE CAN SEE DETAILS IN OUTER 849 00:34:06,677 --> 00:34:08,112 RETINA APPROACHING WHAT ONE CAN 850 00:34:08,179 --> 00:34:10,014 SEE IN HISTOLOGY IN TERMS OF 851 00:34:10,081 --> 00:34:11,349 MEASURING THICKNESSES OF 852 00:34:11,416 --> 00:34:13,851 STRUCTURES WHICH COULD BE 853 00:34:13,918 --> 00:34:17,622 POTENTIAL SURROGATE MARKERS. 854 00:34:17,688 --> 00:34:19,791 IT'S POSSIBLE TO TAKE VOLUME 855 00:34:19,857 --> 00:34:22,593 MEASUREMENTS TO PERFORM MOTION 856 00:34:22,660 --> 00:34:23,628 CORRECTION AND VOLUME AVERAGING, 857 00:34:23,694 --> 00:34:28,499 THIS IS A VOLUME AVERAGE IMAGE 858 00:34:28,566 --> 00:34:29,967 THAT'S CUT-AWAY VIEWS, 859 00:34:30,034 --> 00:34:31,436 TREMENDOUS AMOUNT OF INFORMATION 860 00:34:31,502 --> 00:34:37,341 FROM FEATURES IN THE OUTER 861 00:34:37,408 --> 00:34:39,710 RETINA TO DRUSEN, ABILITY TO 862 00:34:39,777 --> 00:34:41,345 IDENTIFY DIFFERENT TYPES AND MAP 863 00:34:41,412 --> 00:34:43,881 OVER WIDE FIELDS OF VIEW, 864 00:34:43,948 --> 00:34:47,485 REQUIRING A.I. METHODS. 865 00:34:47,552 --> 00:34:47,819 OKAY. 866 00:34:47,885 --> 00:34:52,356 NOBODY MAJOR DEVELOPMENT WITH 867 00:34:52,423 --> 00:34:55,059 OCT ANGIOGRAPHY ENABLED BY HIGH 868 00:34:55,126 --> 00:34:57,161 SPEED, ENABLED REPEATED SCANNING 869 00:34:57,228 --> 00:34:59,297 TO DETECT MOTION CONTRAST FROM 870 00:34:59,363 --> 00:35:02,099 BLOOD FLOW. 871 00:35:02,166 --> 00:35:05,670 THIS ENABLED THREE DIMENSIONAL 872 00:35:05,736 --> 00:35:09,373 IMAGING, IMAGES WERE SHARP, NOT 873 00:35:09,440 --> 00:35:15,179 OBSCURED BY DYE LEAKAGE AS YOU 874 00:35:15,246 --> 00:35:17,181 SEE WITH FLUORINE, THIS COULD BE 875 00:35:17,248 --> 00:35:19,317 PERFORMED ON EVERY PATIENT VISIT 876 00:35:19,383 --> 00:35:22,019 ENABLING LONGITUDINAL STUDIES. 877 00:35:22,086 --> 00:35:23,488 THIS HAD SOME CHALLENGES. 878 00:35:23,554 --> 00:35:26,891 THERE WERE LONG ACQUISITION 879 00:35:26,958 --> 00:35:27,558 TIMES, GENERATING LARGE 880 00:35:27,625 --> 00:35:30,828 DATASETS, STILL LIMITATIONS IN 881 00:35:30,895 --> 00:35:32,697 ABILITY TO DIFFERENTIATE FLOW 882 00:35:32,763 --> 00:35:35,199 SPEED, AND ALSO THIS REQUIRES 883 00:35:35,266 --> 00:35:36,100 CAREFUL EXAMINATION, CAREFUL 884 00:35:36,167 --> 00:35:39,270 MANAGEMENT OF DATA, BECAUSE 885 00:35:39,337 --> 00:35:40,805 THERE'S POTENTIAL FOR ARTIFACTS. 886 00:35:40,872 --> 00:35:47,945 OCT ANGIOGRAPHY DATES BACK TO 887 00:35:48,012 --> 00:35:50,448 BEFORE 2006, A GROUP IN JAPAN. 888 00:35:50,515 --> 00:35:54,018 ONE OF THE SEMINAL CONTRIBUTIONS 889 00:35:54,085 --> 00:35:58,055 WAS THE WORK BY OHSU, WHO IS 890 00:35:58,122 --> 00:36:01,659 ALSO ON THIS PROGRAM, SPECTRUM 891 00:36:01,726 --> 00:36:02,793 AMPLITUDE CORRELATION AND 892 00:36:02,860 --> 00:36:05,763 GEOGRAPHY, ACCELERATING ADOPTION 893 00:36:05,830 --> 00:36:10,468 OF ANGIOGRAPHY INTO COMMERCIAL 894 00:36:10,535 --> 00:36:11,002 APPLICATION. 895 00:36:11,068 --> 00:36:12,737 SO, ESSENTIALLY OCT ANGIOGRAPHY 896 00:36:12,803 --> 00:36:15,806 WORKS BY REPEATING SCANS AT SAME 897 00:36:15,873 --> 00:36:23,915 LOCATION MULTIPLE TIMES, 898 00:36:23,981 --> 00:36:25,716 GENERATING DECORRELATION IMAGE, 899 00:36:25,783 --> 00:36:27,018 DATA INTENSIVE BUT GENERATES 900 00:36:27,084 --> 00:36:28,185 VASCULAR CONTRAST, DEPTH 901 00:36:28,252 --> 00:36:28,452 RESOLVED. 902 00:36:28,519 --> 00:36:30,154 YOU CAN SEE EXAMPLE OF THIS 903 00:36:30,221 --> 00:36:33,224 CIRCA 2010 GOING THROUGH THE 904 00:36:33,291 --> 00:36:35,626 RETINAL VASCULATURE, INTO THE 905 00:36:35,693 --> 00:36:37,295 SUBRETINAL SPACE. 906 00:36:37,361 --> 00:36:42,767 YOU CAN ALSO SEE THE CHOROIDAL 907 00:36:42,833 --> 00:36:43,200 VASCULATURE. 908 00:36:43,267 --> 00:36:44,669 THERE'S BEEN TREMENDOUS INTEREST 909 00:36:44,735 --> 00:36:47,471 ACADEMICALLY AND THIS ALSO 910 00:36:47,538 --> 00:36:49,006 STIMULATED COMMERCIAL 911 00:36:49,073 --> 00:36:52,410 DEVELOPMENT, MULTIPLE COMPANIES 912 00:36:52,476 --> 00:36:53,311 INTRODUCED OCT ANGIOGRAPHY, 913 00:36:53,377 --> 00:36:55,313 ACCELERATING OUR UNDERSTAND OF 914 00:36:55,379 --> 00:36:56,113 DISEASE PATHOGENESIS AND 915 00:36:56,180 --> 00:36:58,049 PROVIDES NEW MARKERS FOR 916 00:36:58,115 --> 00:37:00,918 MEASURING PROGRESSION AND 917 00:37:00,985 --> 00:37:02,320 TREATMENT RESPONSE. 918 00:37:02,386 --> 00:37:05,823 THERE'S AN ALTERNATE METHOD OF 919 00:37:05,890 --> 00:37:08,192 IMAGING WHICH IS THE DOMINANT 920 00:37:08,259 --> 00:37:10,361 METHOD THAT'S USED IN ALMOST ALL 921 00:37:10,428 --> 00:37:14,799 OTHER APPLICATIONS FOR INTERNAL 922 00:37:14,865 --> 00:37:17,835 MEDICINE, DATES BACK TO 1992, 923 00:37:17,902 --> 00:37:19,537 THERE WERE MULTIPLE 924 00:37:19,604 --> 00:37:20,638 DEMONSTRATIONS, AND LATER 925 00:37:20,705 --> 00:37:22,873 RECOGNIZED THIS HAD A TREMENDOUS 926 00:37:22,940 --> 00:37:24,809 SPEED ADVANTAGE. 927 00:37:24,875 --> 00:37:26,944 I ESPECIALLY WANTED TO MENTION 928 00:37:27,011 --> 00:37:29,714 THAT THE LASER LIGHT SOURCE IS A 929 00:37:29,780 --> 00:37:31,782 CHALLENGE FOR SWEPT SOURCE. 930 00:37:31,849 --> 00:37:39,657 HERE WE SEE EXAMPLE OF SO-CALLED 931 00:37:39,724 --> 00:37:42,059 VERTICAL CAVITY EMITTING LASER, 932 00:37:42,126 --> 00:37:43,828 ASPIRING INNOVATION FROM OPTICAL 933 00:37:43,894 --> 00:37:46,330 COMMUNICATIONS, THIS IS AN 934 00:37:46,397 --> 00:37:47,865 ENABLING TECHNOLOGY FOR 935 00:37:47,932 --> 00:37:54,772 VIRTUALLY ALL OF WIDE FIELD OCT 936 00:37:54,839 --> 00:37:57,808 AND OCT ANGIOGRAPHY WE SEE 937 00:37:57,875 --> 00:37:58,442 TODAY, SWEEP RATES INTO 938 00:37:58,509 --> 00:38:00,444 MEGAHERTZ, SO HERE WE SEE 939 00:38:00,511 --> 00:38:06,017 EXAMPLE OF WIDE FIELD OF VIEW 940 00:38:06,083 --> 00:38:08,719 FLY-THROUGH, 600 KILOHERTZ SCAN 941 00:38:08,786 --> 00:38:10,388 RATE, 23 MILLIMETER FIELD OF 942 00:38:10,454 --> 00:38:13,090 VIEW, EXACTING A SINGLE B SCAN 943 00:38:13,157 --> 00:38:14,258 WHICH SCANS OPTIC NERVE HEAD, 944 00:38:14,325 --> 00:38:18,629 MACULA, MORE INTO THE PERIPHERY. 945 00:38:18,696 --> 00:38:20,898 WE CAN GENERATE WIDE FIELD 946 00:38:20,965 --> 00:38:23,734 IMAGES THAT SPAN FIELDS OF VIEW 947 00:38:23,801 --> 00:38:25,169 WITH SCANNING LASER 948 00:38:25,236 --> 00:38:25,503 OPHTHALMOLOGY. 949 00:38:25,569 --> 00:38:30,875 WE CAN LOOK AT THE DIFFERENT 950 00:38:30,941 --> 00:38:33,144 RETINAL LAYERS THROUGH 951 00:38:33,210 --> 00:38:34,378 HIGHLIGHTING THE NERVE FIBER 952 00:38:34,445 --> 00:38:39,517 LAYER, SECTION DEEPER INTO 953 00:38:39,583 --> 00:38:45,556 SUBRETINAL SPACE, VORTEX VEIN 954 00:38:45,623 --> 00:38:45,956 SPES. 955 00:38:46,023 --> 00:38:47,391 THIS IS CAPTURED ACROSS FIELD OF 956 00:38:47,458 --> 00:38:49,226 VIEW, POSSIBLE TO ZOOM ON 957 00:38:49,293 --> 00:38:51,996 DIFFERENT REGIONS AND PERFORM 958 00:38:52,063 --> 00:38:53,297 HIGHER RESOLUTION SCAN, IN THE 959 00:38:53,364 --> 00:38:56,233 FULL VIEW REGION OR DIRECTING TO 960 00:38:56,300 --> 00:38:58,035 MORE PERIPHERAL REGION HERE. 961 00:38:58,102 --> 00:39:01,872 WE CAN START TO SEE INDIVIDUAL 962 00:39:01,939 --> 00:39:02,273 CAPILLARIES. 963 00:39:02,339 --> 00:39:05,543 WE CAN USE LONG RANGE PROVIDED 964 00:39:05,609 --> 00:39:11,415 BY SWEPT SOURCE TO ANTERIOR EYE 965 00:39:11,482 --> 00:39:13,884 BIOMETRY, 25 KILOHERTZ, THIS CAN 966 00:39:13,951 --> 00:39:14,785 SPAN THE INTERIOR CHAMBER, TO 967 00:39:14,852 --> 00:39:16,821 THE BACK OF THE LENS. 968 00:39:16,887 --> 00:39:20,491 ONE CAN DO WIDE FIELD OF VIEW, 969 00:39:20,558 --> 00:39:22,893 THIS IS 25-MILLIMETER SQUARE 970 00:39:22,960 --> 00:39:25,062 FIELD OF VIEW, RENDERING THE 971 00:39:25,129 --> 00:39:25,329 EYE. 972 00:39:25,396 --> 00:39:26,130 AND THE EYELIDS. 973 00:39:26,197 --> 00:39:29,400 YOU CAN TAKE THIS TO EXTREMELY 974 00:39:29,467 --> 00:39:30,468 SEVERE DISTANCES. 975 00:39:30,534 --> 00:39:33,471 THIS IS A CUBIC MILLIMETER FIELD 976 00:39:33,537 --> 00:39:37,541 OF VIEW, LIFE SIZE REPLICA OF A 977 00:39:37,608 --> 00:39:39,944 PERSON AND CHESS BOARD. 978 00:39:40,010 --> 00:39:40,144 OKAY. 979 00:39:40,211 --> 00:39:42,046 BUT I THINK MORE INTERESTING IN 980 00:39:42,113 --> 00:39:44,115 RETINA IS ABILITY TO TAKE THIS 981 00:39:44,181 --> 00:39:46,517 TO EXTREMELY SMALL SCALE, HIGH 982 00:39:46,584 --> 00:39:48,052 DEFINITION SCANNING. 983 00:39:48,119 --> 00:39:50,154 WITH HIGH SAMPLE DENSITY HERE WE 984 00:39:50,221 --> 00:39:52,857 CAN START TO RESOLVE THE 985 00:39:52,923 --> 00:39:56,193 CAPILLARIES AND SEE CAPILLARY 986 00:39:56,260 --> 00:39:56,927 CONNECTIVITY, SKELETONIZED, WE 987 00:39:56,994 --> 00:39:59,330 CAN LOOK AT THE THREE 988 00:39:59,396 --> 00:40:00,898 DIMENSIONAL STRUCTURE. 989 00:40:00,965 --> 00:40:02,032 SO REPRESENTING THIS AS A GRAPH, 990 00:40:02,099 --> 00:40:04,802 THIS COULD BE POTENTIALLY QUITE 991 00:40:04,869 --> 00:40:06,771 IMPORTANT FOR DIABETIC 992 00:40:06,837 --> 00:40:08,405 RETINOPATHY, WHERE WE COULD 993 00:40:08,472 --> 00:40:09,974 IDENTIFY NON-PERFUSION AT THE 994 00:40:10,040 --> 00:40:15,546 CAPILLARY LEVEL AND TRACK ITS 995 00:40:15,613 --> 00:40:17,581 PROGRESSION AND RESPONSE. 996 00:40:17,648 --> 00:40:19,850 THERE'S INTEREST IN RESOLVING 997 00:40:19,917 --> 00:40:22,319 BLOOD FLOW SPEED AT CAPILLARY 998 00:40:22,386 --> 00:40:24,288 LEVEL USING SCAN TIME ANALYSIS, 999 00:40:24,355 --> 00:40:27,792 WE CAN ASSESS THE SATURATION OF 1000 00:40:27,858 --> 00:40:30,995 THE OCT-A SIGNAL WITH TIME, 1001 00:40:31,061 --> 00:40:33,364 REPORTED TIME, REPEATED TIME 1002 00:40:33,430 --> 00:40:33,697 MEASUREMENTS. 1003 00:40:33,764 --> 00:40:37,868 AND BY DOING FOUR TO FIVE 1004 00:40:37,935 --> 00:40:40,271 REPEATED B SCANS AND COMPARING 1005 00:40:40,337 --> 00:40:42,006 OCT ANGIOGRAPHY AND DIFFERENT 1006 00:40:42,072 --> 00:40:45,843 TIME INTERVALS CAN EXTRACT 1007 00:40:45,910 --> 00:40:49,046 SURROGATE MARKETER FOR BLOOD 1008 00:40:49,113 --> 00:40:53,217 FLOW SPEED, CAN BE EVALUATED, 1009 00:40:53,284 --> 00:40:56,720 DATA INTENSIVE, CAN CLASSIFY BY 1010 00:40:56,787 --> 00:40:58,889 SURROGATE MARKER FOREBLOOD FLOW 1011 00:40:58,956 --> 00:41:05,696 SPEED, DISPLAYED, SO HERE YOU 1012 00:41:05,763 --> 00:41:12,169 SEE RETINAL NERVE FIBER LAYER, 1013 00:41:12,236 --> 00:41:13,437 SLOWER SPEED, VERSUS DEEP 1014 00:41:13,504 --> 00:41:17,174 CAPILLARY PLEXUS, SLOWER SPEED 1015 00:41:17,241 --> 00:41:18,776 AND DCP. 1016 00:41:18,843 --> 00:41:24,415 WE CAN LOOK AT EXAMPLES IN 1017 00:41:24,481 --> 00:41:25,616 DIABETIC RETINOPATHY VERSUS 1018 00:41:25,683 --> 00:41:27,918 HEALTHY, MILD PDR, VERSE U.S. 1019 00:41:27,985 --> 00:41:30,054 SEVERE NPDR, YOU SEE CAPILLARY 1020 00:41:30,120 --> 00:41:31,989 DROPOUT BUT WE SEE ALTERATIONS 1021 00:41:32,056 --> 00:41:35,993 IN BLOOD FLOW SPEED IN DIFFERENT 1022 00:41:36,060 --> 00:41:37,027 CAPILLARY PLEXUS, BY ASSESSING 1023 00:41:37,094 --> 00:41:38,863 FLOW IMPAIRMENT THE HOPE IS THIS 1024 00:41:38,929 --> 00:41:42,900 MIGHT BE A REVERSIBLE MARKER 1025 00:41:42,967 --> 00:41:44,235 THAT PRECEDES CAPILLARY 1026 00:41:44,301 --> 00:41:44,568 NON-PERFUSION. 1027 00:41:44,635 --> 00:41:47,705 WE CAN LOOK AT THE INDIVIDUAL 1028 00:41:47,771 --> 00:41:52,343 CAPILLARY LEVEL, HERE YOU SEE 1029 00:41:52,409 --> 00:41:53,510 ENLARGEMENT, STANDARD OCT 1030 00:41:53,577 --> 00:41:54,745 ANGIOGRAPHY, VERSUS SCAN TIME 1031 00:41:54,812 --> 00:41:55,479 ANALYSIS. 1032 00:41:55,546 --> 00:41:56,847 WE CAN START TO SEE DIFFERENCES 1033 00:41:56,914 --> 00:42:00,417 IN FLOW WHICH ARE NOT 1034 00:42:00,484 --> 00:42:02,086 NECESSARILY REFLECTED IN THE 1035 00:42:02,152 --> 00:42:02,753 GRAYSCALE IMAGE. 1036 00:42:02,820 --> 00:42:06,056 SO WE THINK THIS IS POTENTIALLY 1037 00:42:06,123 --> 00:42:07,758 QUITE AN EXCITING TECHNIQUE. 1038 00:42:07,825 --> 00:42:13,464 THIS CAN ALSO BE APPLIED TO THE 1039 00:42:13,530 --> 00:42:17,067 CHORIOCAPILLARIS, COMPARING 1040 00:42:17,134 --> 00:42:18,702 HEALTHY NORMAL VERSUS 1041 00:42:18,769 --> 00:42:19,169 DIABETIC-TREATED PDR, 1042 00:42:19,236 --> 00:42:22,873 ALTERATIONS OF COURSE IN THE 1043 00:42:22,940 --> 00:42:23,741 CHORIOCAPILLARIS AREAS OF 1044 00:42:23,807 --> 00:42:26,543 NON-PERFUSION, BUT ALSO AREAS OF 1045 00:42:26,610 --> 00:42:27,645 FLOW IMPAIRMENT. 1046 00:42:27,711 --> 00:42:29,513 AGAIN, THIS MIGHT BE A 1047 00:42:29,580 --> 00:42:32,316 REVERSIBLE MARKER, NOT ONLY IN 1048 00:42:32,383 --> 00:42:38,522 DIABETIC RETINOPATHY BUT IN AMD. 1049 00:42:38,589 --> 00:42:38,889 OKAY. 1050 00:42:38,956 --> 00:42:40,257 LET'S CONSIDER THE SCIENTIFIC 1051 00:42:40,324 --> 00:42:42,860 CLINICAL AND ECONOMIC IMPACT. 1052 00:42:42,927 --> 00:42:46,063 I WANT TO EMPHASIZE THE 1053 00:42:46,130 --> 00:42:48,098 INTERNATIONAL COMMUNITY. 1054 00:42:48,165 --> 00:42:49,366 THERE'S MULTIPLE RESEARCHERS, 1055 00:42:49,433 --> 00:42:50,467 OVER 500 ORGANIZATIONS 1056 00:42:50,534 --> 00:42:51,869 PERFORMING OCT RESEARCH. 1057 00:42:51,936 --> 00:42:56,006 THIS WAS A SURVEY BACK IN 2015, 1058 00:42:56,073 --> 00:42:59,443 YOU SEE THE LINES REPRESENT 1059 00:42:59,510 --> 00:43:00,144 COLLABORATIVE CONNECTIONS 1060 00:43:00,210 --> 00:43:01,111 BETWEEN DIFFERENT RESEARCH 1061 00:43:01,178 --> 00:43:01,712 GROUPS. 1062 00:43:01,779 --> 00:43:04,315 THIS WAS REALLY CRITICAL 1063 00:43:04,381 --> 00:43:06,150 COMPONENT IN ADVANCING THE 1064 00:43:06,216 --> 00:43:09,687 TECHNOLOGY AND IN ADVANCING 1065 00:43:09,753 --> 00:43:10,254 HEALTH CARE. 1066 00:43:10,321 --> 00:43:14,725 THIS IS ALSO AN EXAMINATION OF 1067 00:43:14,792 --> 00:43:18,562 PUBLICATIONS, AND WE CAN NOTICE 1068 00:43:18,629 --> 00:43:21,832 THAT PUBLICATIONS TRACK THE 1069 00:43:21,899 --> 00:43:22,232 COMMERCIALIZATION. 1070 00:43:22,299 --> 00:43:25,602 SO DEVELOPMENT OF OCT AND 1071 00:43:25,669 --> 00:43:27,571 OPHTHALMOLOGY LED TO 1072 00:43:27,638 --> 00:43:28,973 AVAILABILITY OF TECHNOLOGY FOR 1073 00:43:29,039 --> 00:43:31,508 FUNDAMENTAL RESEARCH AS WELL AS 1074 00:43:31,575 --> 00:43:33,777 CLINICAL STUDIES, INTRODUCTION 1075 00:43:33,844 --> 00:43:36,814 OF OCT COMMERCIALLY IN 1076 00:43:36,880 --> 00:43:38,182 CARDIOVASCULAR ALSO ENABLED 1077 00:43:38,248 --> 00:43:40,017 WIDER SPREAD STUDIES, AND 1078 00:43:40,084 --> 00:43:41,018 THERE'S MULTIPLE COMPANIES 1079 00:43:41,085 --> 00:43:45,990 DEVELOPING PRODUCTS IN THIS 1080 00:43:46,056 --> 00:43:47,491 AREA. 1081 00:43:47,558 --> 00:43:48,993 OPHTHALMOLOGY, I'M SO SORRY. 1082 00:43:49,059 --> 00:43:49,793 UH-OH. 1083 00:43:49,860 --> 00:43:57,868 THE COMPUTER HAS FROZEN. 1084 00:43:57,935 --> 00:43:59,403 IT'S NONRESPONSIVE. 1085 00:43:59,470 --> 00:44:01,071 CAN I GET ASSISTANCE? 1086 00:44:01,138 --> 00:44:02,039 >> WE'RE GETTING IT. 1087 00:44:02,106 --> 00:44:07,277 >> OKAY. 1088 00:44:07,344 --> 00:44:11,849 LET ME TRY TO ADVANCE. 1089 00:44:11,915 --> 00:44:12,649 STILL NONRESPONSIVE. 1090 00:44:12,716 --> 00:44:14,051 THE KEYBOARD IS NONRESPONSIVE 1091 00:44:14,118 --> 00:44:14,284 TOO. 1092 00:44:14,351 --> 00:44:14,585 OKAY. 1093 00:44:14,651 --> 00:44:18,055 CAN YOU CLICK FORWARD FOR ME? 1094 00:44:18,122 --> 00:44:22,026 FORTUNATELY WE'RE NEAR THE END. 1095 00:44:22,092 --> 00:44:25,729 OKAY. 1096 00:44:25,796 --> 00:44:30,067 CAN YOU CLICK. 1097 00:44:30,134 --> 00:44:31,068 MAYBE IT'S WORKING. 1098 00:44:31,135 --> 00:44:33,771 SO OPHTHALMOLOGY IS THE LARGEST 1099 00:44:33,837 --> 00:44:34,738 AREA WE SEE PUBLICATION, 1100 00:44:34,805 --> 00:44:39,410 REPRESENTED BY THE GREEN BAR 1101 00:44:39,476 --> 00:44:40,210 HERE. 1102 00:44:40,277 --> 00:44:41,645 IT IS STILL NONRESPONSIVE. 1103 00:44:41,712 --> 00:44:44,748 LET ME GO BACK. 1104 00:44:44,815 --> 00:44:47,017 CARDIOLOGY, THE BLUE BAR, THE 1105 00:44:47,084 --> 00:44:48,585 SECOND AREA. 1106 00:44:48,652 --> 00:44:50,054 AND THERE'S MULTIPLE OTHER AREAS 1107 00:44:50,120 --> 00:45:00,564 THAT ARE BEING DEVELOPED. 1108 00:45:05,636 --> 00:45:06,737 THE SECOND LARGEST CLINICAL 1109 00:45:06,804 --> 00:45:09,306 APPLICATION IS IN CARDIOLOGY. 1110 00:45:09,373 --> 00:45:14,078 I SHOULD MENTION THAT THIS WAS 1111 00:45:14,144 --> 00:45:16,513 LED BY A GROUP AT MASSACHUSETTS 1112 00:45:16,580 --> 00:45:17,848 GENERAL HOSPITAL. 1113 00:45:17,915 --> 00:45:22,019 THEY PERFORMED THE FIRST IN-MAN 1114 00:45:22,086 --> 00:45:22,486 STUDIES USING OCT. 1115 00:45:22,553 --> 00:45:26,423 THIS HAS BEEN A POWERFUL 1116 00:45:26,490 --> 00:45:27,458 TECHNOLOGY FOR UNDERSTANDING 1117 00:45:27,524 --> 00:45:28,859 PATHOGENESIS OF CARDIOVASCULAR 1118 00:45:28,926 --> 00:45:29,793 DISEASE. 1119 00:45:29,860 --> 00:45:31,395 THERE'S MULTIPLE CLINICAL 1120 00:45:31,462 --> 00:45:32,729 STUDIES UNDERWAY. 1121 00:45:32,796 --> 00:45:36,800 STILL RELATIVELY EARLY IN TERMS 1122 00:45:36,867 --> 00:45:37,935 OF STANDARD OF CARE. 1123 00:45:38,001 --> 00:45:42,840 OCT IS BEING DEVELOPED IN MANY 1124 00:45:42,906 --> 00:45:44,041 OTHER CLINICAL SPECIALTIESN 1125 00:45:44,108 --> 00:45:49,980 GASTROENTEROLOGY AND DETERMINE 1126 00:45:50,047 --> 00:45:51,081 NOTHING AND PULMONOLOGY. 1127 00:45:51,148 --> 00:45:53,484 IF WE COME BACK TO OPHTHALMOLOGY 1128 00:45:53,550 --> 00:45:55,119 THIS HAS A VERY, VERY LONG 1129 00:45:55,185 --> 00:45:58,088 HISTORY, REQUIRED A LONG TIME TO 1130 00:45:58,155 --> 00:45:59,590 DEVELOP, SINCE THE INITIAL 1131 00:45:59,656 --> 00:46:00,057 DEMONSTRATION. 1132 00:46:00,124 --> 00:46:01,892 THIS TRACKS THE DEVELOPMENT TO 1133 00:46:01,959 --> 00:46:08,065 THE COMMERCIAL INTRODUCTION OF 1134 00:46:08,132 --> 00:46:11,869 OCT ANGIOGRAPHY BY OPTIVIEW IN 1135 00:46:11,935 --> 00:46:12,970 2014. 1136 00:46:13,036 --> 00:46:15,472 AND IN GENERAL, CLINICAL 1137 00:46:15,539 --> 00:46:23,280 INSTRUMENTATION IS A VERY LONG 1138 00:46:23,347 --> 00:46:24,181 PROCESS. 1139 00:46:24,248 --> 00:46:26,750 MULTIPLE YEARS, LABORATORY 1140 00:46:26,817 --> 00:46:28,418 STUDIES, APPROVAL, MULTI-CENTER 1141 00:46:28,485 --> 00:46:29,052 STUDIES, EFFICACY, REIMBURSEMENT 1142 00:46:29,119 --> 00:46:34,057 TO THE POINT THERE'S RETURN ON 1143 00:46:34,124 --> 00:46:44,301 VERY KNEW, AND THE MARKET IS 1144 00:46:44,368 --> 00:46:45,802 LIMITED COMPARED TO 1145 00:46:45,869 --> 00:46:46,336 PHARMACEUTICAL. 1146 00:46:46,403 --> 00:46:47,204 WE'VE SEEN TREMENDOUS ECONOMIC 1147 00:46:47,271 --> 00:46:49,439 IMPACT, SO WITH THE DEVELOPMENT 1148 00:46:49,506 --> 00:46:52,709 OF ANTI-VEGF AND USE OF OCT TO 1149 00:46:52,776 --> 00:46:55,479 PERSONALIZE ANTI-VEGF, THERE WAS 1150 00:46:55,546 --> 00:46:58,282 A STUDY IN 2018 THAT 1151 00:46:58,348 --> 00:47:02,085 DEMONSTRATED THAT IT WAS 1152 00:47:02,152 --> 00:47:03,987 POSSIBLE TO SAVE OVER $10 1153 00:47:04,054 --> 00:47:07,391 MILLION TO THE GOVERNMENT AND TO 1154 00:47:07,457 --> 00:47:08,592 PATIENTS BY USING OCT. 1155 00:47:08,659 --> 00:47:11,195 THIS OF COURSE IS JUST ONE 1156 00:47:11,261 --> 00:47:11,495 MEASUREMENT. 1157 00:47:11,562 --> 00:47:15,165 I THINK THE MAJOR IMPACT IS ON 1158 00:47:15,232 --> 00:47:17,568 PATIENT CARE. 1159 00:47:17,634 --> 00:47:20,837 EARLY DIAGNOSIS PREVENTING LOSS 1160 00:47:20,904 --> 00:47:22,372 OF VISION, MANAGING TREATMENT, 1161 00:47:22,439 --> 00:47:24,474 THIS IS REALLY THE MAJOR IMPACT 1162 00:47:24,541 --> 00:47:26,677 LED BY CLINICAL THOUGHT LEADERS, 1163 00:47:26,743 --> 00:47:27,978 AND CLINICIANS WHO ARE ON THE 1164 00:47:28,045 --> 00:47:29,646 FRONT LINES OF CLINICAL CARE. 1165 00:47:29,713 --> 00:47:31,615 THIS IS VERY HARD TO MEASURE BUT 1166 00:47:31,682 --> 00:47:33,350 I THINK IT'S THE PRIMARY 1167 00:47:33,417 --> 00:47:35,018 OBJECTIVE FOR WHAT ALL OF US ARE 1168 00:47:35,085 --> 00:47:35,519 DOING. 1169 00:47:35,586 --> 00:47:37,621 THE TAKEHOME MESSAGES ARE THE 1170 00:47:37,688 --> 00:47:39,856 DEVELOPMENT OF OCT IS AN 1171 00:47:39,923 --> 00:47:42,125 EXAMPLE, ONE EXAMPLE OF 1172 00:47:42,192 --> 00:47:43,026 TRANSLATION OF RESEARCH TO 1173 00:47:43,093 --> 00:47:43,727 CLINICAL IMPACT. 1174 00:47:43,794 --> 00:47:46,997 I THINK THERE ARE MANY POTENTIAL 1175 00:47:47,064 --> 00:47:48,865 TECHNOLOGIES, METHODS, THAT CAN 1176 00:47:48,932 --> 00:47:51,201 BE TRANSLATED OF COURSE. 1177 00:47:51,268 --> 00:47:52,836 DOCTORAL TRAINEES AND EARLY 1178 00:47:52,903 --> 00:47:55,973 CAREER PROFESSIONALS MADE MAJOR 1179 00:47:56,039 --> 00:47:57,941 ADVANCES, THIS IS POSSIBLE AT 1180 00:47:58,008 --> 00:47:59,309 EARLY CAREER STAGE. 1181 00:47:59,376 --> 00:48:00,043 INTERNATIONAL COMMUNITY PLAYED A 1182 00:48:00,110 --> 00:48:02,846 CRITICAL ROLE IN THE DEVELOPMENT 1183 00:48:02,913 --> 00:48:04,982 OF OCT. 1184 00:48:05,048 --> 00:48:07,918 ADVANCES IN TECHNOLOGY, OPTICAL 1185 00:48:07,985 --> 00:48:08,652 COMMUNICATIONS, COMPUTATION, 1186 00:48:08,719 --> 00:48:10,754 IMAGING PROCESSING IN PARTICULAR 1187 00:48:10,821 --> 00:48:13,824 COULD BE TRANSLATED TO ENABLE 1188 00:48:13,890 --> 00:48:16,360 ADVANCES IN MEDICINE AND 1189 00:48:16,426 --> 00:48:18,195 WIDESPREAD IMPACT REQUIRES 1190 00:48:18,262 --> 00:48:20,330 ECOSYSTEM OF GOVERNMENT FUNDING, 1191 00:48:20,397 --> 00:48:22,032 FUNDAMENTAL RESEARCH, 1192 00:48:22,099 --> 00:48:24,201 ENGINEERING, CLINICAL STUDIES BY 1193 00:48:24,268 --> 00:48:25,068 CLINICIANS, SCIENTISTS, INDUSTRY 1194 00:48:25,135 --> 00:48:26,870 INVESTMENT AND MANY OTHER 1195 00:48:26,937 --> 00:48:27,170 COMPONENTS. 1196 00:48:27,237 --> 00:48:29,339 AGAIN, I WANTED TO ACKNOWLEDGE 1197 00:48:29,406 --> 00:48:32,743 ALL OF OUR COLLABORATORS, AND 1198 00:48:32,809 --> 00:48:33,610 THEN ESPECIALLY ACKNOWLEDGE THE 1199 00:48:33,677 --> 00:48:35,679 NATIONAL INSTITUTES OF HEALTH. 1200 00:48:35,746 --> 00:48:38,649 WE WERE FORTUNATE TO HAVE 1201 00:48:38,715 --> 00:48:43,587 LONG-RUNNING GRANT FROM NEI, AND 1202 00:48:43,654 --> 00:48:47,491 AIR FORCE OFFICE OF SCIENTIFIC 1203 00:48:47,557 --> 00:48:49,259 RESEARCH INSTRUMENTAL IN FUNDING 1204 00:48:49,326 --> 00:48:50,027 TECHNOLOGY DEVELOPMENT, INDUSTRY 1205 00:48:50,093 --> 00:48:50,927 AND FOUNDATION SUPPORT. 1206 00:48:50,994 --> 00:48:53,530 I HOPE THIS GIVES A SENSE FOR 1207 00:48:53,597 --> 00:48:56,700 THE DEVELOPMENT OF OCT 1208 00:48:56,767 --> 00:49:02,806 TECHNOLOGY, AND THE COMMUNITY 1209 00:49:02,873 --> 00:49:03,674 REALLY THAT DEVELOPED THIS. 1210 00:49:03,740 --> 00:49:05,809 SO THANK YOU VERY MUCH FOR YOUR 1211 00:49:05,876 --> 00:49:06,076 ATTENTION. 1212 00:49:06,143 --> 00:49:08,545 [APPLAUSE] 1213 00:49:18,322 --> 00:49:22,125 >> TIME FOR QUESTIONS? 1214 00:49:33,103 --> 00:49:33,603 >> CONGRATULATIONS FOR 1215 00:49:33,670 --> 00:49:35,539 COMPREHENSIVE REVIEW, 1216 00:49:35,605 --> 00:49:36,473 OUTSTANDING CONTRIBUTION FOR 1217 00:49:36,540 --> 00:49:40,143 GIVING US VISIONS OF THE FUTURE. 1218 00:49:40,210 --> 00:49:44,548 SO, I WAS LOOKING AT THE 1219 00:49:44,614 --> 00:49:46,817 OUTSTANDING DEMONSTRATION OF THE 1220 00:49:46,883 --> 00:49:49,786 PHOTOGRAPHS AT THE HIGH 1221 00:49:49,853 --> 00:49:50,187 RESOLUTION. 1222 00:49:50,253 --> 00:49:59,296 WHAT ULTIMATELY IN TISSUE 1223 00:49:59,363 --> 00:50:05,669 ISCHEMIA PLAYS CRITICAL FROM 1224 00:50:05,736 --> 00:50:14,077 CARDIOVASCULAR DISEASE, ISCHEMIC 1225 00:50:14,144 --> 00:50:14,878 DEATH OF PHOTO, SPECULATION, IS 1226 00:50:14,945 --> 00:50:16,913 THERE A WAY TO COME UP WITH 1227 00:50:16,980 --> 00:50:18,281 PHOTOGRAPHS? 1228 00:50:18,348 --> 00:50:19,616 >> YOU'RE ASKING ABOUT ISCHEMIA 1229 00:50:19,683 --> 00:50:21,084 IN CONTEXT OF RETINA? 1230 00:50:21,151 --> 00:50:21,485 >> YES. 1231 00:50:21,551 --> 00:50:22,986 >> THIS IS A GENERAL ISSUE. 1232 00:50:23,053 --> 00:50:25,389 >> IN THE BLOOD FLOW PARAMETERS. 1233 00:50:25,455 --> 00:50:25,856 >> YEAH. 1234 00:50:25,922 --> 00:50:31,061 SO THAT'S AN IMPORTANT AND 1235 00:50:31,128 --> 00:50:32,295 INTERESTING QUESTION. 1236 00:50:32,362 --> 00:50:33,897 OCT ANGIOGRAPHY CAN MEASURE 1237 00:50:33,964 --> 00:50:34,998 VASCULAR STRUCTURE, NOW WE'RE 1238 00:50:35,065 --> 00:50:37,968 STARTING TO GET TO THE POINT WE 1239 00:50:38,034 --> 00:50:40,137 CAN ASSESS FLOW. 1240 00:50:40,203 --> 00:50:41,872 TO THE EXTENT THAT THAT'S 1241 00:50:41,938 --> 00:50:42,672 RELATED, RIGHT? 1242 00:50:42,739 --> 00:50:46,076 ONE CAN ASSESS IT. 1243 00:50:46,143 --> 00:50:49,446 HOWEVER, IF YOU'RE ASKING ABOUT 1244 00:50:49,513 --> 00:50:51,882 SO-2 OR PO-2 THAT IS VERY HARD. 1245 00:50:51,948 --> 00:50:55,185 IDEALLY ONE WOULD LIKE TO ASSESS 1246 00:50:55,252 --> 00:50:55,419 THIS. 1247 00:50:55,485 --> 00:50:59,456 BUT THAT'S METABOLIC. 1248 00:50:59,523 --> 00:51:04,661 SO THE TRANSS FROM STRUCTURAL TO 1249 00:51:04,728 --> 00:51:09,099 FUNCTIONAL TO METABOLIC IS VERY 1250 00:51:09,166 --> 00:51:09,499 HARD. 1251 00:51:09,566 --> 00:51:12,803 >> THANK YOU FOR THE FASCINATING 1252 00:51:12,869 --> 00:51:14,337 TALK AND CONGRATULATIONS. 1253 00:51:14,404 --> 00:51:17,073 I HAD A QUESTION ABOUT THE GRID, 1254 00:51:17,140 --> 00:51:18,208 WHICH IS THE MOST IMPORTANT 1255 00:51:18,275 --> 00:51:21,211 THING THAT ALL OF US USE, 1256 00:51:21,278 --> 00:51:24,714 CENTRAL FIELD THICKNESS, NINE 1257 00:51:24,781 --> 00:51:25,081 SUBFIELDS. 1258 00:51:25,148 --> 00:51:30,320 AND, YOU KNOW, THIS WAS MACULAR 1259 00:51:30,387 --> 00:51:31,521 GRID, CIRCULAR CONCENTRIC ONE, 1260 00:51:31,588 --> 00:51:32,689 FROM THE '70s. 1261 00:51:32,756 --> 00:51:33,890 WONDERING WHAT'S THE STORY 1262 00:51:33,957 --> 00:51:40,030 BEHIND HOW IT CAME TO OCT, WAS 1263 00:51:40,096 --> 00:51:42,799 THAT YOUR TEAM, HOW DID IT GET 1264 00:51:42,866 --> 00:51:45,101 ADOPTED INTO OCT IMAGING WITH 1265 00:51:45,168 --> 00:51:47,704 THE CIRCULAR GRID ON SQUARE 1266 00:51:47,771 --> 00:51:49,206 IMAGING VIEW? 1267 00:51:49,272 --> 00:51:50,240 >> I'M SORRY, THE SOUND QUALITY 1268 00:51:50,307 --> 00:51:52,509 IS NOT VERY GOOD UP HERE. 1269 00:51:52,576 --> 00:51:56,580 >> THE GRID. 1270 00:51:56,646 --> 00:51:57,614 >> THE ADAPTION TO -- 1271 00:51:57,681 --> 00:51:59,850 >> OCT OF CIRCULAR GRID WITH 1272 00:51:59,916 --> 00:52:01,151 CENTRAL SUBFIELD THICKNESS, ALL 1273 00:52:01,218 --> 00:52:02,719 THE NINE SUBFIELDS THAT ARE 1274 00:52:02,786 --> 00:52:02,919 THERE? 1275 00:52:02,986 --> 00:52:04,754 >> OH, OKAY. 1276 00:52:04,821 --> 00:52:06,089 YOU'RE ASKING ABOUT ETTRS? 1277 00:52:06,156 --> 00:52:08,191 >> YES. 1278 00:52:08,258 --> 00:52:08,458 >> OKAY. 1279 00:52:08,525 --> 00:52:11,361 WITH THE RATIONALE, THE EARLY 1280 00:52:11,428 --> 00:52:12,028 INSTRUMENTS HAD LIMITED 1281 00:52:12,095 --> 00:52:13,663 ACQUISITION SPEED. 1282 00:52:13,730 --> 00:52:15,465 SO THE CONCEPT IN THOSE 1283 00:52:15,532 --> 00:52:21,271 INSTRUMENTS, THIS IS VERY 1284 00:52:21,338 --> 00:52:24,407 SPECIFIC, TO SCAN RADIALLY, TO 1285 00:52:24,474 --> 00:52:28,144 MAP THICKNESS AND SUPERIMPOSE ON 1286 00:52:28,211 --> 00:52:29,613 ETTDRS. 1287 00:52:29,679 --> 00:52:31,181 WITH THE DEVELOPMENT OF HIGH 1288 00:52:31,248 --> 00:52:34,718 SPEED STANDARD IS VOLUMETRIC 1289 00:52:34,784 --> 00:52:35,685 ACQUISITION, THIS GENERATES 1290 00:52:35,752 --> 00:52:38,522 COMPREHENSIVE DATA, THINGS HAVE 1291 00:52:38,588 --> 00:52:41,925 EVOLVED SINCE THE EARLIER 1292 00:52:41,992 --> 00:52:42,325 COMMERCIALIZATION. 1293 00:52:42,392 --> 00:52:44,494 >> THANK YOU. 1294 00:52:46,930 --> 00:52:49,633 >> PROFESSOR, I'D LIKE TO ADD MY 1295 00:52:49,699 --> 00:52:50,066 CONGRATULATIONS. 1296 00:52:50,133 --> 00:52:52,435 YOU ARE CERTAINLY HAVE SHOWN US 1297 00:52:52,502 --> 00:52:53,737 A NEW WORLD CLINICALLY. 1298 00:52:53,803 --> 00:52:56,239 I THINK THE IMPACT IS 1299 00:52:56,306 --> 00:52:59,609 TREMENDOUS, AS A CLINICIAN I CAN 1300 00:52:59,676 --> 00:53:02,045 APPRECIATE THE -- THE TIME I WAS 1301 00:53:02,112 --> 00:53:02,345 IN TRAINING. 1302 00:53:02,412 --> 00:53:04,014 MY QUESTION IS, SO WHERE DO YOU 1303 00:53:04,080 --> 00:53:06,650 THINK WE'RE GOING TO GO FROM 1304 00:53:06,716 --> 00:53:09,920 HERE IN THE NEXT TEN YEARS WITH 1305 00:53:09,986 --> 00:53:10,754 THIS TECHNOLOGY? 1306 00:53:10,820 --> 00:53:14,224 I'M SURE YOU HAVE SOME IDEAS 1307 00:53:14,291 --> 00:53:15,392 THAT YOU'RE HOLDING OUT. 1308 00:53:15,458 --> 00:53:17,460 I KNOW EVERY TIME I ASK YOU 1309 00:53:17,527 --> 00:53:20,230 QUESTIONS LIKE THIS, YOU HAVE A 1310 00:53:20,297 --> 00:53:25,936 FEW THINGS IN YOUR POCKET. 1311 00:53:26,002 --> 00:53:26,303 >> WOW! 1312 00:53:26,369 --> 00:53:26,937 OKAY. 1313 00:53:27,003 --> 00:53:28,672 SO, I THINK IT WOULD BE 1314 00:53:28,738 --> 00:53:30,073 INTERESTING TO SEE THE 1315 00:53:30,140 --> 00:53:31,942 APPLICATIONS IN OTHER AREAS, 1316 00:53:32,008 --> 00:53:32,576 RIGHT? 1317 00:53:32,642 --> 00:53:37,747 SO INTERNAL MEDICINE, SURGICAL 1318 00:53:37,814 --> 00:53:40,717 GUIDANCE, THESE ARE POTENTIALLY 1319 00:53:40,784 --> 00:53:43,253 VERY INTERESTING, POWERFUL 1320 00:53:43,320 --> 00:53:43,453 AREAS. 1321 00:53:43,520 --> 00:53:44,421 EACH OF THESE INDICATIONS 1322 00:53:44,487 --> 00:53:46,056 REQUIRES A SEPARATE DEVELOPMENT. 1323 00:53:46,122 --> 00:53:47,290 THIS IS AMAZINGLY CHALLENGING. 1324 00:53:47,357 --> 00:53:52,395 IT TOOK A LONG TIME TO GET OCT 1325 00:53:52,462 --> 00:53:54,497 ESTABLISHED IN OPHTHALMOLOGY. 1326 00:53:54,564 --> 00:53:56,700 I THINK IN OPHTHALMOLOGY WE'RE 1327 00:53:56,766 --> 00:53:59,936 STARTING TO SEE INTEGRATION OF 1328 00:54:00,003 --> 00:54:01,771 FUNCTIONAL IMAGING, RIGHT? 1329 00:54:01,838 --> 00:54:03,406 WITH STRUCTURAL IMAGING. 1330 00:54:03,473 --> 00:54:06,009 IN THE PROGRAM YOU'LL HEAR MANY 1331 00:54:06,076 --> 00:54:09,179 PRESENTATIONS THAT HAVE -- 1332 00:54:09,245 --> 00:54:12,849 LOOKING AT FUNDAMENTAL RESEARCH, 1333 00:54:12,916 --> 00:54:13,617 CLINICAL APPLICATIONS, VISIBLE 1334 00:54:13,683 --> 00:54:15,952 OCT, ALL OF THESE TECHNIQUES ARE 1335 00:54:16,019 --> 00:54:17,887 STARTING TO EXTEND INTO 1336 00:54:17,954 --> 00:54:20,023 FUNCTIONAL AND POSSIBLY INTO 1337 00:54:20,090 --> 00:54:21,224 METABOLIC, SO I THINK THAT'S 1338 00:54:21,291 --> 00:54:23,259 VERY INTERESTING. 1339 00:54:23,326 --> 00:54:26,696 ALSO OF COURSE LOW COST 1340 00:54:26,763 --> 00:54:28,531 EXTENDING POINT OF CARE TO THE 1341 00:54:28,598 --> 00:54:30,634 PHARMACY, TO THE PRIMARY CARE, 1342 00:54:30,700 --> 00:54:34,104 MAYBE PRIMARY CARE, THAT WOULD 1343 00:54:34,170 --> 00:54:38,074 HAVE TREMENDOUS IMPACT ON VISION 1344 00:54:38,141 --> 00:54:40,810 LOSS, EARLY DETECTION OF OCCULT 1345 00:54:40,877 --> 00:54:41,211 DISEASE. 1346 00:54:41,277 --> 00:54:45,548 >> THANK YOU. 1347 00:54:48,151 --> 00:54:50,787 >> I'D LIKE TO THANK DR. 1348 00:54:50,854 --> 00:54:51,421 FUJIMOTO FOR THE TALK. 1349 00:54:51,488 --> 00:54:54,124 [APPLAUSE] 1350 00:55:09,472 --> 00:55:10,840 >> GOOD MORNING, I'M DEPUTY 1351 00:55:10,907 --> 00:55:11,708 SCIENTIFIC DIRECTOR IN NEI. 1352 00:55:11,775 --> 00:55:17,080 MY JOB IS TO GIVE A FEW 1353 00:55:17,147 --> 00:55:18,481 HOUSEKEEPING ITEMS, ALSO GET 1354 00:55:18,548 --> 00:55:20,150 FIRST SESSION UNDERWAY. 1355 00:55:20,216 --> 00:55:22,085 WHILE I DO HOUSEKEEPING MAYBE 1356 00:55:22,152 --> 00:55:23,186 THE SPEAKERS FOR FIRST SESSION 1357 00:55:23,253 --> 00:55:26,890 CAN COME UP SO WE CAN GET MOVING 1358 00:55:26,956 --> 00:55:27,123 RAPIDLY. 1359 00:55:27,190 --> 00:55:28,358 FIRST OF ALL, I'M SUPPOSED TO 1360 00:55:28,425 --> 00:55:30,193 MAKE EVERYBODY AWARE OF THE FACT 1361 00:55:30,260 --> 00:55:34,064 THAT THIS MEETING IS BEING 1362 00:55:34,130 --> 00:55:37,067 RECORDED AND ALSO LIVECAST. 1363 00:55:37,133 --> 00:55:38,068 THERE'S AN AUDIENCE, WE DON'T 1364 00:55:38,134 --> 00:55:41,137 KNOW HOW LARGE IT IS AT THIS 1365 00:55:41,204 --> 00:55:46,710 POINT BUT ABOUT OVER 100 PEOPLE 1366 00:55:46,776 --> 00:55:47,944 HAVE REGISTERED. 1367 00:55:48,011 --> 00:55:49,279 LOOKING FORWARD TO NEXT AND 1368 00:55:49,345 --> 00:55:54,317 SUBSEQUENT SESSIONS. 1369 00:55:54,384 --> 00:55:56,019 SPEAKERS ARE ASKED TO PLEASE 1370 00:55:56,086 --> 00:55:57,987 PROVIDE PRESENTATIONS TO A.V. 1371 00:55:58,054 --> 00:55:59,189 FOLKS AT THE BACK OF THE ROOM IF 1372 00:55:59,255 --> 00:56:00,690 YOU HAVEN'T ALREADY, AND MEET AT 1373 00:56:00,757 --> 00:56:03,126 THE PODIUM A FEW MINUTES BEFORE 1374 00:56:03,193 --> 00:56:03,793 THE SESSION. 1375 00:56:03,860 --> 00:56:05,495 LOOKING FORWARD TO THE BREAK 1376 00:56:05,562 --> 00:56:06,429 AFTER THIS SESSION. 1377 00:56:06,496 --> 00:56:13,636 IF YOU HAVE A GREEN DOT ON YOUR 1378 00:56:13,703 --> 00:56:15,271 BADGE IT MEANS YOU PAID FOR 1379 00:56:15,338 --> 00:56:16,606 LUNCH WHICH GETS YOU COFFEE 1380 00:56:16,673 --> 00:56:19,209 DURING THE BREAK. 1381 00:56:19,275 --> 00:56:21,511 SO THAT WILL BE OUTSIDE, AROUND 1382 00:56:21,578 --> 00:56:27,617 TO THE RIGHT IN THE FAES 1383 00:56:27,684 --> 00:56:28,218 TERRACE. 1384 00:56:28,284 --> 00:56:34,023 IF YOU DID NOT PAY FOR LUNCH THE 1385 00:56:34,090 --> 00:56:36,426 COFFEE SHOP IS 20 YARDS DOWN THE 1386 00:56:36,493 --> 00:56:39,395 HALLWAY NEAR THE BOOK STORE. 1387 00:56:39,462 --> 00:56:43,099 I THINK YOU HAVE DISCOVERED 1388 00:56:43,166 --> 00:56:44,300 ALREADY YOU'RE NOT ALLOWED TO 1389 00:56:44,367 --> 00:56:46,035 HAVE FOOD OR DRINK IN THE 1390 00:56:46,102 --> 00:56:46,336 AUDITORIUM. 1391 00:56:46,402 --> 00:56:49,973 AND SO YOU NEED TO KEEP THAT 1392 00:56:50,039 --> 00:56:53,309 OUTSIDE, RESTROOMS ARE JUST 1393 00:56:53,376 --> 00:56:58,815 OUTSIDE OF THE AUDITORIUM, 1394 00:56:58,882 --> 00:57:01,284 RESTROOMS ARE OUTSIDE THE 1395 00:57:01,351 --> 00:57:02,852 AUDITORIUM. 1396 00:57:02,919 --> 00:57:08,158 I THINK WE CAN PROBABLY MOVE ON. 1397 00:57:08,224 --> 00:57:14,063 THE FIRST SESSION IS TRADITIONAL 1398 00:57:14,130 --> 00:57:14,664 STRUCTURES/BIOMECHANICAL OCT, 1399 00:57:14,731 --> 00:57:16,766 AND EACH SESSION IS GOING TO 1400 00:57:16,833 --> 00:57:18,935 BE -- GOING TO HAVE SEVERAL 1401 00:57:19,002 --> 00:57:20,270 SPEAKERS AND A MODERATOR, AND WE 1402 00:57:20,336 --> 00:57:22,672 ASK THAT YOU HOLD YOUR QUESTIONS 1403 00:57:22,739 --> 00:57:27,210 TO THE END OF EACH SESSION. 1404 00:57:27,277 --> 00:57:28,945 GETTING THE FIRST SESSION, 1405 00:57:29,012 --> 00:57:33,082 MODERATING THE FIRST IS DR. 1406 00:57:33,149 --> 00:57:35,685 KIRILL LARIN, THE CULLEN COLLEGE 1407 00:57:35,752 --> 00:57:37,554 OF ENGINEERING DISTINGUISHED 1408 00:57:37,620 --> 00:57:40,757 PROFESSOR OF BIOMEDICAL 1409 00:57:40,824 --> 00:57:42,725 ENGINEERING, UNIVERSITY OF 1410 00:57:42,792 --> 00:57:43,526 HOUSTON. 1411 00:57:43,593 --> 00:57:45,328 I INVITE DR. LARIN UP TO LEAD 1412 00:57:45,395 --> 00:57:51,768 THE SESSION. 1413 00:57:51,835 --> 00:57:57,440 >> THANK YOU VERY MUCH. 1414 00:57:57,740 --> 00:58:00,176 >> WELCOME TO THE SESSION. 1415 00:58:00,243 --> 00:58:02,245 TO CELEBRATE OCT MADE PROGRESS 1416 00:58:02,312 --> 00:58:09,586 FOR CLINICAL RESEARCH OVER THE 1417 00:58:09,652 --> 00:58:10,119 YEARS. 1418 00:58:10,186 --> 00:58:17,427 I'M PLEASED REMIND EVERY SPEAKER 1419 00:58:17,493 --> 00:58:19,729 PRESENTING DATA, HOLD THE 1420 00:58:19,796 --> 00:58:20,997 QUESTIONS. 1421 00:58:21,064 --> 00:58:25,101 I'VE BEEN ASKED TO PUT DOWN THIS 1422 00:58:25,168 --> 00:58:25,435 PAGE. 1423 00:58:25,501 --> 00:58:28,938 YOU DON'T NEED TO SIT HERE, YOU 1424 00:58:29,005 --> 00:58:33,476 CAN ENJOY FROM AUDIENCE. 1425 00:58:33,543 --> 00:58:44,053 LET ME INTRODUCE DR. XU, M.D. 1426 00:58:48,524 --> 00:58:56,132 PhD from Columbia University, 1427 00:58:56,199 --> 00:58:56,966 residency, University of 1428 00:58:57,033 --> 00:59:05,608 California San Diego, and 1429 00:59:05,675 --> 00:59:06,242 currently assistant professor 1430 00:59:06,309 --> 00:59:08,077 University of Southern 1431 00:59:08,144 --> 00:59:09,612 California. 1432 00:59:09,679 --> 00:59:19,255 >> THANK YOU FOR THE 1433 00:59:19,322 --> 00:59:21,090 INTRODUCTION. 1434 00:59:21,157 --> 00:59:23,159 I'D LIKE TO THANK THE ORGANIZERS 1435 00:59:23,226 --> 00:59:27,430 FOR INVITATION TO SPEAK TODAY. 1436 00:59:27,497 --> 00:59:31,234 IT'S A GREAT HONOR TO BE HERE 1437 00:59:31,301 --> 00:59:41,811 AND CELEBRATE ACHIEVEMENTS OF 1438 00:59:42,612 --> 00:59:45,081 THE THREE, AND I'M EXCITED TO 1439 00:59:45,148 --> 00:59:49,786 SHARE WORK OCT ENABLED FOR US IN 1440 00:59:49,852 --> 00:59:51,688 OUR LAB. 1441 00:59:51,754 --> 00:59:53,523 I'D LIKE TO ACKNOWLEDGE FUNDING 1442 00:59:53,589 --> 00:59:55,925 SOURCES, I DO RECEIVE RESEARCH 1443 00:59:55,992 --> 00:59:57,327 SUPPORT FROM HEIDELBERG 1444 00:59:57,393 --> 01:00:00,063 ENGINEERING, I'LL BE TALKING 1445 01:00:00,129 --> 01:00:04,133 ABOUT THEIR SYSTEM TODAY. 1446 01:00:04,200 --> 01:00:06,803 PRIME PACG IS A COMMON CAUSE OF 1447 01:00:06,869 --> 01:00:11,774 PERMANENT VISION LOSS WORLDWIDE, 1448 01:00:11,841 --> 01:00:16,612 AFFECTING 24 MILLION PEOPLE, 1449 01:00:16,679 --> 01:00:18,514 THREE-QUARTERS IN ASIAN REGIONS, 1450 01:00:18,581 --> 01:00:21,517 EXPECTED TO RISE DUE TO AGING OF 1451 01:00:21,584 --> 01:00:22,719 WORLD'S POPULATION, CONCERNING 1452 01:00:22,785 --> 01:00:29,459 AS PACG IS MORE VISUALLY 1453 01:00:29,525 --> 01:00:31,294 DAMAGING CONFERRING 2.4 TIMES 1454 01:00:31,361 --> 01:00:35,198 HIGHER ODDS OF BLINDLESS. 1455 01:00:35,264 --> 01:00:39,035 THERE'S CONTACT BETWEEN THE MESH 1456 01:00:39,102 --> 01:00:40,770 WORK AND EYE WORK, IN SEVERE 1457 01:00:40,837 --> 01:00:46,009 CASES CAN LEAD TO ELEVATED 1458 01:00:46,075 --> 01:00:49,579 INTRAOCULAR PRESSURE AND 1459 01:00:49,645 --> 01:00:50,279 NEUROPATHY. 1460 01:00:50,346 --> 01:00:54,050 CURRENT CLINICAL STANDARD TO 1461 01:00:54,117 --> 01:00:59,188 DETECT ANGLE CLOSURE IS 1462 01:00:59,255 --> 01:01:01,090 GONEOSCOPEY, WHEN WE CAN'T SEE 1463 01:01:01,157 --> 01:01:03,126 THIS STRUCTURE WE TELL PATIENTS 1464 01:01:03,192 --> 01:01:06,062 THEY HAVE ANGLE CLOSURE AND MAY 1465 01:01:06,129 --> 01:01:09,699 BE AT RISK FOR PACG. 1466 01:01:09,766 --> 01:01:12,101 ANGLE CLOSURE FORMS THE BASIS OF 1467 01:01:12,168 --> 01:01:14,270 CURRENT DEFINITION OF PRIMARY 1468 01:01:14,337 --> 01:01:17,040 ANGLE CLOSURE DISEASE, MILDEST 1469 01:01:17,106 --> 01:01:27,583 FORM, THERE ARE TWO OR MORE 1470 01:01:29,952 --> 01:01:30,253 QUADRANTS. 1471 01:01:30,319 --> 01:01:32,855 PACG IS DIAGNOSED IN THE 1472 01:01:32,922 --> 01:01:34,424 PRESENCE OF GLAUCOMA OPTIC NERVE 1473 01:01:34,490 --> 01:01:39,195 DAMAGE WITH OR WITHOUT VISUAL 1474 01:01:39,262 --> 01:01:39,662 FIELD DEFECTS. 1475 01:01:39,729 --> 01:01:48,471 IT HAS A NUMBER OF LIMITATIONS, 1476 01:01:48,538 --> 01:01:51,507 SUBJECTIVE, EXPERTISE DEPEND, 1477 01:01:51,574 --> 01:01:52,241 MODERATE REPRODUCIBILITY. 1478 01:01:52,308 --> 01:01:54,210 THE CONTACT METHOD CAN BE 1479 01:01:54,277 --> 01:01:56,813 UNCOMFORTABLE AND TIME CONSUMING 1480 01:01:56,879 --> 01:01:59,282 FOR SOME PATIENTS, THESE 1481 01:01:59,348 --> 01:02:01,584 LIMITATIONS LEAD THIS TO BE 1482 01:02:01,651 --> 01:02:02,452 UNDERPERFORMED BY PHYSICIANS AT 1483 01:02:02,518 --> 01:02:04,187 LEAST IN THE UNITED STATES. 1484 01:02:04,253 --> 01:02:09,025 A STUDY FOUND PATIENTS 1485 01:02:09,092 --> 01:02:10,359 UNDERGOING FIRST-TIME GLAUCOMA 1486 01:02:10,426 --> 01:02:20,670 EVALUATIONS, ONLY 30% ARE 1487 01:02:20,736 --> 01:02:22,171 RECEIVING GONIOSCOPY. 1488 01:02:22,238 --> 01:02:26,209 LIMITATIONS CONTRIBUTE TO MAKE 1489 01:02:26,275 --> 01:02:34,083 ISSUE IN ANGLE CLOSURE, REMAINS 1490 01:02:34,150 --> 01:02:35,184 UNDIAGNOSED AND UNTREATED UNTIL 1491 01:02:35,251 --> 01:02:39,422 AFTER VISION LOSS OCCURS. 1492 01:02:39,489 --> 01:02:43,392 WE CAN SEE HERE THIS PREVALENCE 1493 01:02:43,459 --> 01:02:47,096 OFTEN EXCEEDS 25%, EXCEPTION 1494 01:02:47,163 --> 01:02:49,332 BEING IN COUNTRIES IN SINGAPORE 1495 01:02:49,398 --> 01:02:51,167 AND JAPAN WITH BETTER EYE CARE. 1496 01:02:51,234 --> 01:02:55,571 OUR LAB USED DATA FROM THE IRIS 1497 01:02:55,638 --> 01:02:58,307 REGISTRY, ELECTRONIC HEALTH CARE 1498 01:02:58,374 --> 01:02:59,275 DATABASE ADMINISTERED BY 1499 01:02:59,342 --> 01:03:01,544 AMERICAN ACADEMY OF 1500 01:03:01,611 --> 01:03:01,878 OPHTHALMOLOGY. 1501 01:03:01,944 --> 01:03:02,979 IN THE IRIS REGISTRY WE 1502 01:03:03,045 --> 01:03:06,382 IDENTIFIED 49,000 PATIENTS WITH 1503 01:03:06,449 --> 01:03:13,289 NEWLY DIAGNOSED PACG, FOUND THAT 1504 01:03:13,356 --> 01:03:15,024 12.4%, 1 OUT OF 8 BLIND IN ONE 1505 01:03:15,091 --> 01:03:18,094 EYE AT THE TIME OF DIAGNOSIS, 1506 01:03:18,161 --> 01:03:19,395 HIGHER AMONG BLACK AND HISPANIC 1507 01:03:19,462 --> 01:03:19,762 AMERICANS. 1508 01:03:19,829 --> 01:03:21,430 WE FOUND THAT LATE DETECTION 1509 01:03:21,497 --> 01:03:24,200 WHICH WE DEFINE AS ONSET OF 1510 01:03:24,267 --> 01:03:26,435 GLAUCOMA WITHOUT PRIOR DETECTION 1511 01:03:26,502 --> 01:03:29,038 OF ANGLE CLOSURE CONFERRED A 1512 01:03:29,105 --> 01:03:31,541 HIGHER RISK OF BLINDNESS NEARLY 1513 01:03:31,607 --> 01:03:33,276 DOUBLING THE ODDS. 1514 01:03:33,342 --> 01:03:36,078 THESE DATA CONVEY URGENT NEED IN 1515 01:03:36,145 --> 01:03:39,882 THE FIELD OF ANGLE CLOSURE FOR A 1516 01:03:39,949 --> 01:03:41,617 METHOD TO DETECT PATIENTS AT 1517 01:03:41,684 --> 01:03:42,618 RISK FOR PACG. 1518 01:03:42,685 --> 01:03:48,324 THANKS TO OUR HONORREERS WE LIVE 1519 01:03:48,391 --> 01:03:53,696 IN GENERATION OF OCT PROVIDING 1520 01:03:53,763 --> 01:03:56,265 ALTERNATIVE FOR EVALUATING 1521 01:03:56,332 --> 01:03:56,799 ANTERIOR SEGMENTS. 1522 01:03:56,866 --> 01:04:00,670 THERE'S RAPID EVOLUTION OF 1523 01:04:00,736 --> 01:04:02,405 TECHNOLOGY TO MORE MODERN DOMAIN 1524 01:04:02,471 --> 01:04:07,476 AND SWEPT SOURCE SYSTEMS. 1525 01:04:07,543 --> 01:04:08,878 IT PRODUCES BEAUTIFUL IMAGES OF 1526 01:04:08,945 --> 01:04:11,614 THE ANTERIOR SEGMENT AND 1527 01:04:11,681 --> 01:04:12,081 ANATOMICAL STRUCTURES. 1528 01:04:12,148 --> 01:04:17,520 WE CAN SEE THE CORNEA, IRIS, 1529 01:04:17,587 --> 01:04:18,487 LENS, ANGLE RECESS. 1530 01:04:18,554 --> 01:04:21,724 A FEW YEARS AGO MY LAB ASKED THE 1531 01:04:21,791 --> 01:04:30,800 QUESTION, CAN ANALYSIS OF AS-OCT 1532 01:04:30,866 --> 01:04:31,601 DETECT GONIOSCOPYIC ANGLE 1533 01:04:31,667 --> 01:04:32,501 CLOSURE? 1534 01:04:32,568 --> 01:04:37,340 WE LIVE IN THE ERA OF A.I., WHEN 1535 01:04:37,406 --> 01:04:42,111 COMPUTERS ARE TAUGHT COGNITIVE 1536 01:04:42,178 --> 01:04:43,946 FUNCTION, ANALYZING IMAGES, 1537 01:04:44,013 --> 01:04:45,448 HOLDS POTENTIAL TO REVOLUTIONIZE 1538 01:04:45,514 --> 01:04:47,750 HEALTH CARE BY INCREASING ACCESS 1539 01:04:47,817 --> 01:04:51,921 TO CARE AND DECREASING COSTS. 1540 01:04:51,988 --> 01:04:53,656 IN 2019 WE PUBLISHED THIS PAPER, 1541 01:04:53,723 --> 01:04:58,027 DEVELOPED A.I. ALGORITHM TO 1542 01:04:58,094 --> 01:05:03,933 AUTOMATE DETECTION USING DATA 1543 01:05:04,000 --> 01:05:06,669 FROM CHINESE-AMERICAN EYE STUDY 1544 01:05:06,736 --> 01:05:09,538 FUNDED BY NATIONAL EYE 1545 01:05:09,605 --> 01:05:11,607 INSTITUTE, CONDUCTED IN LOS 1546 01:05:11,674 --> 01:05:14,777 ANGELES BY USC INVESTIGATORS. 1547 01:05:14,844 --> 01:05:19,548 OVER 4500 CHINESE AMERICANS WERE 1548 01:05:19,615 --> 01:05:23,019 RECRUITED, ALL RECEIVED 1549 01:05:23,085 --> 01:05:25,755 GONIOSCOPY AND OCT IMAGING. 1550 01:05:32,395 --> 01:05:39,035 IN ORDER TO DEVELOP OUR 1551 01:05:39,101 --> 01:05:39,935 ALGORITHM WE USED 4,000 IMAGES, 1552 01:05:40,002 --> 01:05:43,339 PAIRED WITH A GRADE PROVIDED BY 1553 01:05:43,406 --> 01:05:43,973 A TRAINED OPHTHALMOLOGIST 1554 01:05:44,040 --> 01:05:45,941 PERFORMING MANUAL GONIOSCOPY ON 1555 01:05:46,008 --> 01:05:47,843 EACH PARTICIPANT. 1556 01:05:47,910 --> 01:05:49,011 THESE ARE RECEIVING OPERATING 1557 01:05:49,078 --> 01:05:51,213 CHARACTERISTICS CURVES THAT SHOW 1558 01:05:51,280 --> 01:05:51,881 PERFORMANCE OF THIS ALGORITHM, 1559 01:05:51,947 --> 01:05:53,849 IN THE RED CURVE WE CAN SEE 1560 01:05:53,916 --> 01:05:57,219 ABILITY OF THE ALGORITHM TO 1561 01:05:57,286 --> 01:05:58,621 DETECT ANGLE CLOSURE BASED ON A 1562 01:05:58,688 --> 01:05:59,855 SINGLE IMAGE. 1563 01:05:59,922 --> 01:06:00,856 HERE THE PERFORMANCE WAS GOOD 1564 01:06:00,923 --> 01:06:09,065 WITH AREA UNDER THE CURVE OF 0. 1565 01:06:09,131 --> 01:06:09,699 93. 1566 01:06:09,765 --> 01:06:13,402 FOR DETECTING ANGLE CLOSURE IN 1567 01:06:13,469 --> 01:06:15,938 MULTIPLE QUADRANTS IT'S EVEN 1568 01:06:16,005 --> 01:06:16,405 BETTER. 1569 01:06:16,472 --> 01:06:19,809 RECENTLY WE'VE PERFORMED WORK TO 1570 01:06:19,875 --> 01:06:22,078 DEMONSTRATE GENERALIZABILITY IN 1571 01:06:22,144 --> 01:06:22,578 COMMUNITY-BASE AND 1572 01:06:22,645 --> 01:06:24,814 HOSPITAL-BASED CLINICS. 1573 01:06:24,880 --> 01:06:29,318 WE RUN INTO ANOTHER ISSUE WHICH 1574 01:06:29,385 --> 01:06:31,821 IS THAT GONIOSCOPY IS WEAKLY 1575 01:06:31,887 --> 01:06:33,556 PREDICTIVE OF WHICH PATIENTS 1576 01:06:33,622 --> 01:06:36,392 WILL DEVELOP PACG, THE TOPIC OF 1577 01:06:36,459 --> 01:06:42,098 A LANDMARK STUDY IN THE FIELD OF 1578 01:06:42,164 --> 01:06:44,834 ANGLE CLOSURE AND GLAUCOMA, THE 1579 01:06:44,900 --> 01:06:47,903 ZAP TRIAL IN "LANCET" IN 2019, 1580 01:06:47,970 --> 01:06:52,842 TO LOOK AT BENEFIT OF LASER 1581 01:06:52,908 --> 01:06:58,881 PERIPHERAL IRIDOTOMY, FOR THE 1582 01:06:58,948 --> 01:07:00,483 PREVENTION OF ANGLE CLOSURE. 1583 01:07:00,549 --> 01:07:02,351 THIS CREATES COMMUNICATION 1584 01:07:02,418 --> 01:07:07,390 BETWEEN THE ANTERIOR AND 1585 01:07:07,456 --> 01:07:10,126 POSTERIOR CHAMBERS, EQUALIZATION 1586 01:07:10,192 --> 01:07:12,094 ALLOWS FOR MORE FACILE AQUEOUS 1587 01:07:12,161 --> 01:07:14,630 FLOW, LEADS TO FLATTENING OF THE 1588 01:07:14,697 --> 01:07:15,831 IRIS CURVATURE, WIDENING OF 1589 01:07:15,898 --> 01:07:18,334 ANGLE WIDTH AND IN SEVERE 1590 01:07:18,401 --> 01:07:24,173 CLOSURE REDUCTION IN INTRAOCULAR 1591 01:07:24,240 --> 01:07:26,041 PRESSURE. 1592 01:07:26,108 --> 01:07:31,881 THE TRIAL RECRUITED 889 1593 01:07:31,947 --> 01:07:32,681 PARTICIPANTS, BETWEEN 50-70, 1594 01:07:32,748 --> 01:07:33,983 MAINLY CHINESE, RANDOMIZED TO 1595 01:07:34,049 --> 01:07:36,552 LPI IN ONE EYE, MONITORING OF 1596 01:07:36,619 --> 01:07:38,254 OTHER EYE, FOLLOWED FOR SIX 1597 01:07:38,320 --> 01:07:38,687 YEARS. 1598 01:07:38,754 --> 01:07:40,389 ENDPOINT WAS PROGRESSION TO 1599 01:07:40,456 --> 01:07:43,325 PRIMARY ANGLE CLOSURE MARKED BY 1600 01:07:43,392 --> 01:07:45,728 FORMATION OF PAS, ELEVATED IOP, 1601 01:07:45,795 --> 01:07:48,030 ACUTE ANGLE CLOSURE ATTACK. 1602 01:07:48,097 --> 01:07:52,268 THE ZAP TRIAL FIELDED TWO 1603 01:07:52,334 --> 01:07:54,170 FINDINGS, LPI WORKS, REDUCING 1604 01:07:54,236 --> 01:07:57,273 RISK OF PROGRESSION BY 50%. 1605 01:07:57,339 --> 01:07:58,741 HOWEVER, THE OTHER FINDING WAS 1606 01:07:58,808 --> 01:08:00,476 THAT EVEN IN UNTREATED EYES RISK 1607 01:08:00,543 --> 01:08:03,946 OF PROGRESSION WAS VERY LOW AT 1608 01:08:04,013 --> 01:08:07,483 ONLY 0.8% PER EYE YEAR. 1609 01:08:07,550 --> 01:08:14,256 THIS LED ZAP TRIAL TO CONCLUDE 1610 01:08:14,323 --> 01:08:16,892 IT'S NOT THE BEST USE OF 1611 01:08:16,959 --> 01:08:17,159 RESOURCES. 1612 01:08:17,226 --> 01:08:21,197 MORE RECENTLY WE USED DATA FROM 1613 01:08:21,263 --> 01:08:23,365 DATABASE, HEALTH CARE CLAIMS 1614 01:08:23,432 --> 01:08:24,633 DATABASE, TO ASSESS LPI 1615 01:08:24,700 --> 01:08:28,704 UTILIZATION IN THE REAL WORLD. 1616 01:08:28,771 --> 01:08:30,072 HERE IN OVER 52,000 PATIENTS 1617 01:08:30,139 --> 01:08:31,674 NEWLY DIAGNOSED WITH ANATOMICAL 1618 01:08:31,740 --> 01:08:34,076 NARROW ANGLES WE FOUND OVER A 1619 01:08:34,143 --> 01:08:37,112 QUARTER OF PATIENTS RECEIVED LPI 1620 01:08:37,179 --> 01:08:38,147 WHICH IS OVERUTILIZATION BASED 1621 01:08:38,214 --> 01:08:40,516 ON FINDINGS BY THE ZAP TRIAL. 1622 01:08:40,583 --> 01:08:43,719 WE ALSO FOUND THAT THE ODDS OF 1623 01:08:43,786 --> 01:08:45,354 TREATMENT WAS HIGHER AMONGST 1624 01:08:45,421 --> 01:08:46,789 ASIANS AND HISPANIC AMERICANS, 1625 01:08:46,856 --> 01:08:48,224 WHICH SUGGESTS PERHAPS DISEASE 1626 01:08:48,290 --> 01:08:52,728 SEVERITY MAY BE HIGHER IN 1627 01:08:52,795 --> 01:08:58,300 CERTAIN RACIAL POPULATIONS A 1628 01:08:58,367 --> 01:09:01,070 SECOND URGENT NEED, TO RISK 1629 01:09:01,136 --> 01:09:07,409 STRATIFY FOR ANGLE CLOSURE 1630 01:09:07,476 --> 01:09:07,877 PROGRESSION. 1631 01:09:07,943 --> 01:09:16,385 FORTUNATELY, AS-OCT IMAGED CAN 1632 01:09:16,452 --> 01:09:19,221 BE ASSESSED QUANTITATIVELY, ABLE 1633 01:09:19,288 --> 01:09:20,723 TO OBTAIN MEASUREMENTS OF 1634 01:09:20,789 --> 01:09:22,491 BIOMETRIC PARAMETERS THAT 1635 01:09:22,558 --> 01:09:23,626 DESCRIBE SIZE, SHAPE, 1636 01:09:23,692 --> 01:09:25,094 CONFIGURATION OF THE ANTERIOR 1637 01:09:25,160 --> 01:09:28,297 SEGMENT AND ITS ANATOMICAL 1638 01:09:28,364 --> 01:09:28,631 STRUCTURES. 1639 01:09:28,697 --> 01:09:30,165 OVER THE PAST FOUR YEARS OR SO 1640 01:09:30,232 --> 01:09:35,004 MY LAB HAS BEEN ASKING THIS 1641 01:09:35,070 --> 01:09:36,205 QUESTION, ARE AS-OCT 1642 01:09:36,272 --> 01:09:38,941 MEASUREMENTS PREDICTIVE OF ANGLE 1643 01:09:39,008 --> 01:09:39,942 CLOSURE OUTCOMES? 1644 01:09:40,009 --> 01:09:40,709 IN 2020 COLLABORATED WITH 1645 01:09:40,776 --> 01:09:44,079 AUTHORS OF THE ZAP TRIAL IN 1646 01:09:44,146 --> 01:09:46,248 ORDER TO CONDUCT STUDY, 1647 01:09:46,315 --> 01:09:49,418 ASSESSING RISK FACTORS FOR 1648 01:09:49,485 --> 01:09:50,786 PROGRESSION. 1649 01:09:50,853 --> 01:09:55,257 IN THIS STUDY WE TOOK DATA FROM 1650 01:09:55,324 --> 01:10:02,298 643 UNTREATED EYES, ALL RECEIVED 1651 01:10:02,364 --> 01:10:04,033 BASELINE GONIOSCOPY USING AN 1652 01:10:04,099 --> 01:10:05,734 OLDER DEVICE, OUTCOME MEASURE 1653 01:10:05,801 --> 01:10:13,309 WAS PROGRESSION FROM PACS TO 1654 01:10:13,375 --> 01:10:14,243 PAC. 1655 01:10:14,310 --> 01:10:16,679 THIS SHOWS MULTI-VARIABLE MODEL, 1656 01:10:16,745 --> 01:10:17,913 ASSESSING PREDICTORS OF 1657 01:10:17,980 --> 01:10:18,314 PROGRESSION. 1658 01:10:18,380 --> 01:10:26,455 OUR MEASURE OF ANGLE WIDTH WAS 1659 01:10:26,522 --> 01:10:28,324 AOD, ANGLE OPENING DISTANCE. 1660 01:10:28,390 --> 01:10:33,228 THIS MODEL IS ADJUSTED FOR IRIS 1661 01:10:33,295 --> 01:10:34,330 CURVATURE, AGE, ANTERIOR CHAMBER 1662 01:10:34,396 --> 01:10:35,164 DEPTH. 1663 01:10:35,230 --> 01:10:41,837 WE CAN SEE SMALLER AOD, EACH 10 1664 01:10:41,904 --> 01:10:46,141 MICRONS SMALLER CONFERS 10% 1665 01:10:46,208 --> 01:10:48,143 HIGHER ODDS TO PROGRESSION. 1666 01:10:48,210 --> 01:10:50,613 WHEN WE REPLACED WITH GONIOSCOPY 1667 01:10:50,679 --> 01:10:53,048 SCORE, THE SUM OF THE GONIOSCOPY 1668 01:10:53,115 --> 01:10:54,650 GRADES BETWEEN FOUR QUADRANTS, 1669 01:10:54,717 --> 01:10:57,286 GONIOSCOPY IS NOT PREDICTIVE OF 1670 01:10:57,353 --> 01:11:01,757 ANGLE CLOSURE PROGRESSION. 1671 01:11:01,824 --> 01:11:04,627 THIS EVIDENCE PROVIDES EVIDENCE 1672 01:11:04,693 --> 01:11:06,128 THAT AS-OCT PROVIDES CLINICAL 1673 01:11:06,195 --> 01:11:08,130 INFORMATION NOT AVAILABLE USING 1674 01:11:08,197 --> 01:11:10,032 CONVENTIONAL ASSESSMENT METHODS. 1675 01:11:10,099 --> 01:11:12,368 MORE RECENTLY WE'VE PUBLISHED 1676 01:11:12,434 --> 01:11:14,370 OTHER PAPERS DEMONSTRATING THE 1677 01:11:14,436 --> 01:11:16,305 UTILITY OF AS-OCT IN TERMS OF 1678 01:11:16,372 --> 01:11:17,806 PREDICTING OUTCOMES IN ANGLE 1679 01:11:17,873 --> 01:11:20,109 CLOSURE EYES, BOTH IN RESPONSE 1680 01:11:20,175 --> 01:11:22,678 TO TREATMENT, AFTER LPI, AS WELL 1681 01:11:22,745 --> 01:11:28,050 AS RISK OF PROGRESSION IN 1682 01:11:28,117 --> 01:11:29,652 LPI-TREATED PACS EYES. 1683 01:11:29,718 --> 01:11:35,858 LOOKING AHEAD IT'S CLEAR AT THIS 1684 01:11:35,924 --> 01:11:40,829 POINT THAT AS-OCT HOLDS 1685 01:11:40,896 --> 01:11:42,498 POTENTIAL WORLDWIDE, HAS NOT 1686 01:11:42,564 --> 01:11:43,932 BEEN WIDELY ADOPTED INTO ROUTINE 1687 01:11:43,999 --> 01:11:44,967 CLINICAL CARE. 1688 01:11:45,034 --> 01:11:47,002 IT'S IMPORTANT TO CONSIDER 1689 01:11:47,069 --> 01:11:48,003 CERTAIN BARRIERS TO CLINICAL 1690 01:11:48,070 --> 01:11:50,939 IMPLEMENTATION THAT MIGHT LIMIT 1691 01:11:51,006 --> 01:11:53,642 ULTIMATE CLINICAL BENEFIT OF 1692 01:11:53,709 --> 01:11:57,513 AS-OCT IMAGING. 1693 01:11:57,579 --> 01:11:58,313 FIRST BARRIER MOST PROVIDERS 1694 01:11:58,380 --> 01:12:03,152 DON'T HAVE TIME OR EXPERTISE TO 1695 01:12:03,218 --> 01:12:06,055 MANUALLY ANALYZE AS-OCT IMAGES. 1696 01:12:06,121 --> 01:12:10,726 THIS LED OUR LAB TO COLLABORATE 1697 01:12:10,793 --> 01:12:12,194 WITH HEIDELBERG ENGINEERING TO 1698 01:12:12,261 --> 01:12:13,495 PROVIDE EXPERT LEVEL DETECTION 1699 01:12:13,562 --> 01:12:19,201 AS WELL AS QUANTITATIVE 1700 01:12:19,268 --> 01:12:21,036 BIOMETRIC ANALYSIS. 1701 01:12:21,103 --> 01:12:24,973 HERE WE DEVELOPED ALGORITHM THAT 1702 01:12:25,040 --> 01:12:27,042 COULD PREDICT COORDINATES OF THE 1703 01:12:27,109 --> 01:12:29,511 SPUR TO TRAIN THIS ALGORITHM WE 1704 01:12:29,578 --> 01:12:32,748 USED JUST OVER 4,000 IMAGES, AND 1705 01:12:32,815 --> 01:12:37,586 IT'S IMPORTANT TO MENTION THE 1706 01:12:37,653 --> 01:12:44,960 SCLERAL PURCHASE IS POSTERIOR TO 1707 01:12:45,027 --> 01:12:47,396 MESHWORK, AND TRABECULAR 1708 01:12:47,463 --> 01:12:52,000 MESHWORK CANNOT BE VISUALIZED, 1709 01:12:52,067 --> 01:12:52,801 CANNOT PROCEED UNTIL THE SCLERAL 1710 01:12:52,868 --> 01:12:55,304 SPUR HAS BEEN MARKED. 1711 01:12:55,370 --> 01:12:59,341 WE TESTED THE ALGORITHM BETWEEN 1712 01:12:59,408 --> 01:13:00,743 TWO HUMAN GRADERS IDENTIFYING 1713 01:13:00,809 --> 01:13:02,644 2600 SCLERAL SPURS, THE ERROR OF 1714 01:13:02,711 --> 01:13:07,015 SECOND HUMAN WAS CALCULATED AS 1715 01:13:07,082 --> 01:13:10,018 REFERENCE MINUS PREDICTED 1716 01:13:10,085 --> 01:13:12,254 COORDINATES, MEDIAN ERROR 60 1717 01:13:12,321 --> 01:13:13,355 MICRONS, THIS SHOWS AGREEMENT 1718 01:13:13,422 --> 01:13:16,225 BETWEEN HUMAN AND MACHINE, WE 1719 01:13:16,291 --> 01:13:19,161 SEE SCATTER PLOT LOOKS SIMILAR, 1720 01:13:19,228 --> 01:13:21,463 MEDIAN ERROR IS 56 MICRONS. 1721 01:13:21,530 --> 01:13:24,266 THIS TABLE THE SHOWS INTEGRATOR 1722 01:13:24,333 --> 01:13:27,269 REPRODUCIBILITY OF MEASUREMENTS 1723 01:13:27,336 --> 01:13:31,073 ASSOCIATED WITH PREDICTED 1724 01:13:31,140 --> 01:13:31,340 LOCATIONS. 1725 01:13:31,406 --> 01:13:35,911 BETWEEN THE TWO WE SEE AGREEMENT 1726 01:13:35,978 --> 01:13:37,746 WAS EXCELLENT WITH INTRACLASS 1727 01:13:37,813 --> 01:13:39,982 CORRELATION EXCEEDING 0.96 FOR 1728 01:13:40,048 --> 01:13:40,916 ALL BIOMETRIC PARAMETERS, 1729 01:13:40,983 --> 01:13:42,818 MATCHED BY THE DEEP LEARNING 1730 01:13:42,885 --> 01:13:45,888 ALGORITHM WHICH PRODUCED 1731 01:13:45,954 --> 01:13:48,590 SIMILARLY HIGH ICC VALUES, WHEN 1732 01:13:48,657 --> 01:13:50,025 COMPARED WITH REFERENCE GRADER. 1733 01:13:50,092 --> 01:13:53,729 A SECOND BARRIER TO THE 1734 01:13:53,796 --> 01:13:56,165 IMPLEMENTATION IS THE FACT THAT 1735 01:13:56,231 --> 01:13:59,868 AS-OCT DEVICES ARE STILL 1736 01:13:59,935 --> 01:14:02,371 RELATIVELY UNCOMMON AND 1737 01:14:02,437 --> 01:14:02,971 EXPENSIVE. 1738 01:14:03,038 --> 01:14:04,339 FORTUNATELY MODERN BIOMETERS 1739 01:14:04,406 --> 01:14:06,642 USED TO PERFORM CALCULATIONS FOR 1740 01:14:06,708 --> 01:14:09,378 CATARACT SURGERY ARE BUILT ON 1741 01:14:09,444 --> 01:14:11,446 SWEPT SOURCE AS-OCT DEVICE WHICH 1742 01:14:11,513 --> 01:14:14,783 PROVIDES TROJAN HORSE FOR 1743 01:14:14,850 --> 01:14:17,786 GETTING TECHNOLOGY INTO CLINICS. 1744 01:14:17,853 --> 01:14:26,361 THESE SYSTEMS INCLUDE 1745 01:14:26,428 --> 01:14:27,229 HEIDELBERG, ALCON AND TOMEY, 1746 01:14:27,296 --> 01:14:29,031 WITH POTENTIAL TO USE THEM FOR 1747 01:14:29,097 --> 01:14:30,666 ANGLE CARE PATIENTS, IMPORTANT 1748 01:14:30,732 --> 01:14:32,167 TO EMPHASIZE THESE DEVICES ARE 1749 01:14:32,234 --> 01:14:34,903 ALL VERY EXPENSIVE AND LOW COST 1750 01:14:34,970 --> 01:14:39,408 OCT TECHNOLOGY IS NEEDED FOR 1751 01:14:39,474 --> 01:14:40,375 MORE RESOURCE-LIMITED SETTINGS. 1752 01:14:40,442 --> 01:14:41,910 A THIRD BARRIER TO 1753 01:14:41,977 --> 01:14:43,212 IMPLEMENTATION IS THE FACT THERE 1754 01:14:43,278 --> 01:14:45,848 IS A LACK OF STANDARDIZATION 1755 01:14:45,914 --> 01:14:49,017 BETWEEN AS-OCT SYSTEM AND 1756 01:14:49,084 --> 01:14:49,751 IMAGES. 1757 01:14:49,818 --> 01:14:52,087 HERE ARE REPRESENTATIVE IMAGES 1758 01:14:52,154 --> 01:14:55,490 FROM VARIOUS DEDICATED AS-OCT 1759 01:14:55,557 --> 01:14:58,327 SYSTEMS OR TRADITIONAL SPECIAL 1760 01:14:58,393 --> 01:14:59,795 DOMAIN AS-OCT SYSTEMS WITH 1761 01:14:59,862 --> 01:15:01,630 CUSTOM LENSES. 1762 01:15:01,697 --> 01:15:04,366 THE IMAGE APPEARANCE DIFFERS 1763 01:15:04,433 --> 01:15:05,767 BETWEEN DIFFERENT DEVICES, 1764 01:15:05,834 --> 01:15:08,003 PARTLY BECAUSE REFRACTION 1765 01:15:08,070 --> 01:15:08,837 CORRECTION ALGORITHMS APPLIED 1766 01:15:08,904 --> 01:15:12,841 DIFFERS FROM COMPANY TO 1767 01:15:12,908 --> 01:15:13,442 COMPANY. 1768 01:15:13,508 --> 01:15:17,412 THEREFORE IT'S IMPORTANT TO 1769 01:15:17,479 --> 01:15:18,513 CONSIDER INTRAOPERABILITY OF 1770 01:15:18,580 --> 01:15:19,781 DEVICES AND MEASUREMENTS. 1771 01:15:19,848 --> 01:15:23,318 IN THIS STUDY WHEN I WAS A 1772 01:15:23,385 --> 01:15:28,790 FELLOW WE COMPARED MEASUREMENTS, 1773 01:15:28,857 --> 01:15:31,226 FOR THE MEASUREMENT OF ANGLE 1774 01:15:31,293 --> 01:15:31,994 OPENING DISTANCE WHILE 1775 01:15:32,060 --> 01:15:33,595 MEASUREMENTS CAN CORRELATED THEY 1776 01:15:33,662 --> 01:15:35,697 ARE NOT INTERCHANGEABLE BETWEEN 1777 01:15:35,764 --> 01:15:37,099 THE TWO DEVICES. 1778 01:15:37,165 --> 01:15:40,602 HOWEVER, MORE RECENTLY WE 1779 01:15:40,669 --> 01:15:45,641 PERFORMED COMPARISON BETWEEN TWO 1780 01:15:45,707 --> 01:15:47,843 SWEPT SOURCE DEVICES, RESULTS 1781 01:15:47,910 --> 01:15:49,278 WERE MORE ENCOURAGING ESPECIALLY 1782 01:15:49,344 --> 01:15:51,380 AFTER COLLECTING FOR PUPILLARY 1783 01:15:51,446 --> 01:15:51,680 DIAMETER. 1784 01:15:51,747 --> 01:15:52,748 HERE THERE'S EXCELLENT 1785 01:15:52,814 --> 01:15:55,417 CORRELATION AND WE CONCLUDED IN 1786 01:15:55,484 --> 01:15:57,486 FACT THESE MEASUREMENTS COULD BE 1787 01:15:57,552 --> 01:15:59,321 USED INTERCHANGEABLY BETWEEN THE 1788 01:15:59,388 --> 01:16:00,088 TWO DEVICES. 1789 01:16:00,155 --> 01:16:02,424 THE FINAL BARRIER THAT I'LL TALK 1790 01:16:02,491 --> 01:16:04,960 ABOUT IS THAT LITTLE IS KNOWN 1791 01:16:05,027 --> 01:16:07,129 ABOUT THE RACIAL DIFFERENCES IN 1792 01:16:07,195 --> 01:16:08,630 PATHOGENESIS, MOST OF THE DATA 1793 01:16:08,697 --> 01:16:11,199 THAT I PRESENTED TODAY WAS 1794 01:16:11,266 --> 01:16:14,036 DERIVED FROM MOSTLY ASIAN 1795 01:16:14,102 --> 01:16:16,204 POPULATIONS, AND AS YOU HEARD 1796 01:16:16,271 --> 01:16:21,443 EARLIER ON, THE DISEASE TENDS TO 1797 01:16:21,510 --> 01:16:22,144 DISPROPORTIONATELY AFFECT RACIAL 1798 01:16:22,210 --> 01:16:23,512 MINORITIES IN THE UNITED STATES. 1799 01:16:23,578 --> 01:16:28,216 I'M EXCITED TO SHARE THE 1800 01:16:28,283 --> 01:16:31,920 OBJECTIVES OF OUR MULTI-RACIAL 1801 01:16:31,987 --> 01:16:34,056 ANGLE CLOSURE STUDY, A STUDY 1802 01:16:34,122 --> 01:16:37,192 WE'LL BE CONDUCTING IN LOS 1803 01:16:37,259 --> 01:16:38,860 ANGELES COUNTY USING OUR ACCESS, 1804 01:16:38,927 --> 01:16:41,463 UNIQUE ACCESS TO A MULTI-RACIAL 1805 01:16:41,530 --> 01:16:42,998 POPULATION, WITH THESE GOALS IN 1806 01:16:43,065 --> 01:16:43,598 MIND. 1807 01:16:43,665 --> 01:16:47,703 FIRST WE WANT TO ANSWER 1808 01:16:47,769 --> 01:16:48,670 FUNDAMENTAL QUESTIONS, WHY ARE 1809 01:16:48,737 --> 01:16:52,207 SOME GROUPS AT HIGH RECOLLECT OF 1810 01:16:52,274 --> 01:17:00,782 PACZ G, THIS PROVIDES A 1811 01:17:00,849 --> 01:17:02,417 POTENTIAL SOLUTION TO THE 1812 01:17:02,484 --> 01:17:03,251 PROBLEM. 1813 01:17:03,318 --> 01:17:05,787 WE WOULD LIKE TO ESTABLISH 1814 01:17:05,854 --> 01:17:08,090 DEFINITIONS OF NARROW ANGLES TO 1815 01:17:08,156 --> 01:17:09,791 ENTRENCH THIS TECHNOLOGY INTO 1816 01:17:09,858 --> 01:17:11,893 CLINICAL USE, AND FINALLY WANT 1817 01:17:11,960 --> 01:17:14,963 TO IDENTIFY NOVEL OCT-BASED RISK 1818 01:17:15,030 --> 01:17:18,667 FACTORS BASED ON DYNAMIC LIGHT 1819 01:17:18,734 --> 01:17:20,602 TO DARK IMAGING, HIGH RESOLUTION 1820 01:17:20,669 --> 01:17:23,405 HIGH DENSITY OCT IMAGEEL. 1821 01:17:23,472 --> 01:17:25,140 PACG IS A DEVASTATING DISEASE 1822 01:17:25,207 --> 01:17:27,743 AFFECTING MILLIONS OF PEOPLE 1823 01:17:27,809 --> 01:17:28,710 WORLDWIDE, ANGLE CLOSURE 1824 01:17:28,777 --> 01:17:34,016 DETECTION CAN BE AUTOMATED USING 1825 01:17:34,082 --> 01:17:37,686 AS-OCT COMBINED WITH A.I., 1826 01:17:37,753 --> 01:17:38,387 PROVIDES UNIQUE CLINICAL 1827 01:17:38,453 --> 01:17:39,421 INFORMATION THAT GONIOSCOPY DOES 1828 01:17:39,488 --> 01:17:40,122 NOT. 1829 01:17:40,188 --> 01:17:44,159 MORE WORK IS NEEDED TO OVERCOME 1830 01:17:44,226 --> 01:17:45,560 IMPLEMENTATION BARRIERS, TO 1831 01:17:45,627 --> 01:17:48,430 HARNESS AS-OCT TECHNOLOGY FOR 1832 01:17:48,497 --> 01:17:49,131 ANGLE CLOSURE CARE. 1833 01:17:49,197 --> 01:17:54,169 I'D LIKE TO THANK YOU FOR YOUR 1834 01:17:54,236 --> 01:17:54,903 ATTENTION TODAY. 1835 01:17:54,970 --> 01:17:57,339 AND CONGRATULATIONS AGAIN TO OUR 1836 01:17:57,406 --> 01:17:59,341 HONOREES. 1837 01:17:59,408 --> 01:18:02,044 >> THANK YOU VERY MUCH. 1838 01:18:02,110 --> 01:18:03,645 [APPLAUSE] 1839 01:18:03,712 --> 01:18:04,813 PLEASE HOLD YOUR QUESTIONS TO 1840 01:18:04,880 --> 01:18:05,647 DISCUSSION LATER ON. 1841 01:18:05,714 --> 01:18:16,191 LET ME INTRODUCE THE SECOND 1842 01:18:18,260 --> 01:18:19,261 SPEAKER, KRISTINA IRSCH, WHILE 1843 01:18:19,327 --> 01:18:22,864 WORKING ON HER Ph.D. SHE WAS 1844 01:18:22,931 --> 01:18:25,333 SPENDING SOME TIME IN WILMER EYE 1845 01:18:25,400 --> 01:18:29,371 INSTITUTE IN BALTIMORE, REMAINED 1846 01:18:29,438 --> 01:18:33,408 AT POSTDOC, RECEIVED FELLOWSHIP. 1847 01:18:33,475 --> 01:18:34,843 SHE REMAINED AT JOHNS HOPKINS 1848 01:18:34,910 --> 01:18:39,314 UNIVERSITY SCHOOL OF MEDICINE 1849 01:18:39,381 --> 01:18:40,515 AND CURRENTLY ASSISTANT 1850 01:18:40,582 --> 01:18:45,654 PROFESSOR. 1851 01:18:45,720 --> 01:18:45,987 WELCOME. 1852 01:18:46,054 --> 01:18:47,823 >> THANK YOU. 1853 01:18:47,889 --> 01:18:49,558 MY INTERESTS HAVE BEEN IN USING 1854 01:18:49,624 --> 01:19:00,168 THE EYE AS A PORTAL TO PERFORM 1855 01:19:01,937 --> 01:19:02,804 IN VIVO HUMAN. 1856 01:19:02,871 --> 01:19:04,539 IT HAS POTENTIAL TO SERVE AS 1857 01:19:04,606 --> 01:19:06,641 WINDOW INTO THE BODY INCLUDING 1858 01:19:06,708 --> 01:19:10,979 THE BRAIN TO STUDY BASIC 1859 01:19:11,046 --> 01:19:12,747 SYSTEMIC PATHOPHYSIOLOGY. 1860 01:19:12,814 --> 01:19:14,816 MUCH OF THIS PROMISE, HOWEVER, 1861 01:19:14,883 --> 01:19:16,485 REMAINED UNFULFILLED BECAUSE WE 1862 01:19:16,551 --> 01:19:20,455 STILL HAVE NOT TAKEN INTO 1863 01:19:20,522 --> 01:19:24,392 ACCOUNT THE HUMAN FACTOR. 1864 01:19:24,459 --> 01:19:24,860 MAXIMUM RESOLUTION 1865 01:19:24,926 --> 01:19:26,328 STATE-OF-THE-ART RETINAL IMAGE 1866 01:19:26,394 --> 01:19:29,798 THAT CAN BE OBTAINED FROM A 1867 01:19:29,865 --> 01:19:33,201 HEALTHY YOUNG VOLUNTEER WITH A 1868 01:19:33,268 --> 01:19:34,336 PERFECTLY TRANSPARENT EYE HAS 1869 01:19:34,402 --> 01:19:37,806 VERY LITTLE TO DO WITH THE REAL 1870 01:19:37,873 --> 01:19:39,341 LIFE PATIENTS. 1871 01:19:39,407 --> 01:19:41,409 WITH EYES THAT MOVE, OR OLDER 1872 01:19:41,476 --> 01:19:45,614 EYES THAT ARE NOT SO TRANSPARENT 1873 01:19:45,680 --> 01:19:46,781 ANYMORE. 1874 01:19:46,848 --> 01:19:48,550 PATIENTS BY DEFINITION HAVE 1875 01:19:48,617 --> 01:19:51,419 PATHOLOGY AND ARE NOT IDEAL 1876 01:19:51,486 --> 01:19:51,820 SUBJECTS. 1877 01:19:51,887 --> 01:19:55,390 SO, OUR RESEARCH IS AIMED AT 1878 01:19:55,457 --> 01:19:57,225 SOLVING FUNDAMENTAL PROBLEMS, 1879 01:19:57,292 --> 01:20:03,765 SUCH AS MOTION ARTIFACTS AND 1880 01:20:03,832 --> 01:20:06,535 OCULAR SCATTERING TO USE THE EYE 1881 01:20:06,601 --> 01:20:08,036 AS IN VIVO MICROSCOPE. 1882 01:20:08,103 --> 01:20:11,439 CURRENT WORK IS MAINLY DIRECTED 1883 01:20:11,506 --> 01:20:14,543 TO TACKLING ISSUES WITH 1884 01:20:14,609 --> 01:20:15,143 IMPERFECT OCULAR MEDIA 1885 01:20:15,210 --> 01:20:18,146 TRANSPARENCY, STARTING WITH THE 1886 01:20:18,213 --> 01:20:19,514 CORNEA, THAT IS OUR WINDOW INTO 1887 01:20:19,581 --> 01:20:22,717 THE EYE AND TO THE RETINA, AND 1888 01:20:22,784 --> 01:20:24,586 IF THIS WINDOW BECOMES CLOUDY, 1889 01:20:24,653 --> 01:20:28,089 SUCH AS WITH AGE OR MANY CORNEAL 1890 01:20:28,156 --> 01:20:29,524 DISEASES, WE NOR THE PATIENT 1891 01:20:29,591 --> 01:20:39,968 WILL BE ABLE TO SEE THROUGH IT. 1892 01:20:40,035 --> 01:20:41,970 CORNEA TRANSPARENCY RELATES TO 1893 01:20:42,037 --> 01:20:42,938 STROMAL STRUCTURE, INTERACTION 1894 01:20:43,004 --> 01:20:46,575 BETWEEN LIGHT AND REGULAR 1895 01:20:46,641 --> 01:20:48,310 ARRANGEMENT OF COLLAGEN FIBRILS 1896 01:20:48,376 --> 01:20:51,713 RESPONSIBLE FOR THE TRANSPARENCY 1897 01:20:51,780 --> 01:20:53,481 OF THE CORNEA. 1898 01:20:53,548 --> 01:20:55,350 CHANGES IN COLLAGEN FIBER 1899 01:20:55,417 --> 01:20:57,953 ARRANGEMENT CAUSED BY AGING, 1900 01:20:58,019 --> 01:21:00,689 INFECTION, INHERIT PATHOLOGY, 1901 01:21:00,755 --> 01:21:01,489 TRAUMA, SURGERY, CAUSES 1902 01:21:01,556 --> 01:21:02,891 INCREASED LIGHT SCATTERING WHICH 1903 01:21:02,958 --> 01:21:08,563 THEN CAUSES A LOSS OF 1904 01:21:08,630 --> 01:21:08,897 TRANSPARENCY. 1905 01:21:08,964 --> 01:21:10,131 DESPITE ITS SIGNIFICANCE, 1906 01:21:10,198 --> 01:21:13,335 CURRENT MEANS TO ASSESS CORNEA 1907 01:21:13,401 --> 01:21:16,938 TRANSPARENCY EXTREMELY LIMITED. 1908 01:21:17,005 --> 01:21:18,440 NORMALLY CONSISTING OF 1909 01:21:18,506 --> 01:21:23,778 UNDETAILED AND GROSS OBSERVATION 1910 01:21:23,845 --> 01:21:26,047 OF VISIBLE OPACITIES, USING 1911 01:21:26,114 --> 01:21:27,782 MICROSCOPE WITH HUMAN OBSERVER. 1912 01:21:27,849 --> 01:21:31,820 DUE TO SUBJECTIVE AND ONLY 1913 01:21:31,886 --> 01:21:33,088 QUALITATIVE NATURE RESULTS 1914 01:21:33,154 --> 01:21:36,057 OBSERVER DEPENDENT, DIFFICULT TO 1915 01:21:36,124 --> 01:21:42,697 STANDARDIZE OR FOLLOW, LACK 1916 01:21:42,764 --> 01:21:44,099 REPRODUCIBILITY, IT'S NEBULOUS 1917 01:21:44,165 --> 01:21:46,368 AND DIFFICULT OF DESCRIBING 1918 01:21:46,434 --> 01:21:47,902 CLOUDS AND CHANGES IN THE 1919 01:21:47,969 --> 01:21:50,405 ATMOSPHERE, SO THERE IS A CLEAR 1920 01:21:50,472 --> 01:21:54,042 NEED FOR AN OBJECTIVE AND 1921 01:21:54,109 --> 01:21:56,077 QUANTITATIVE ABILITY TO ASSESS 1922 01:21:56,144 --> 01:22:00,715 CORNEAL FINDINGS LEADING US TO 1923 01:22:00,782 --> 01:22:01,983 OUR FIRST GOAL. 1924 01:22:02,050 --> 01:22:05,987 NONE OF THE AVAILABLE CLINICAL 1925 01:22:06,054 --> 01:22:07,355 IMAGING MODALITIES PROVIDES HIGH 1926 01:22:07,422 --> 01:22:09,691 RESOLUTION IN ALL THREE 1927 01:22:09,758 --> 01:22:10,959 DIMENSIONS. 1928 01:22:11,026 --> 01:22:12,827 WHAT CLINICAL OCT SYSTEMS ENABLE 1929 01:22:12,894 --> 01:22:14,696 CROSS-SECTIONAL VIEWS OF THE 1930 01:22:14,763 --> 01:22:19,401 CORNEA, AND DETECTION OF STROMAL 1931 01:22:19,467 --> 01:22:22,737 OPACITIES, AT AXIAL RESOLUTION 1932 01:22:22,804 --> 01:22:26,675 SUPERIOR OF COURSE THAN SPLIT 1933 01:22:26,741 --> 01:22:28,843 LENS BIOMICROSCOPY, LATERAL 1934 01:22:28,910 --> 01:22:37,485 RESOLUTION IS LIMITED. 1935 01:22:37,552 --> 01:22:43,658 CONFOCAL MICROSCOPY IS LIMITED 1936 01:22:43,725 --> 01:22:43,892 AXIALLY. 1937 01:22:43,958 --> 01:22:50,065 WITH SO-CALLED FULL-FIT OCT OR 1938 01:22:50,131 --> 01:22:57,372 OCM DEVELOPED IN PARIS, BOTH 1939 01:22:57,439 --> 01:22:58,173 HIGH RESOLUTION CROSS-SECTIONS 1940 01:22:58,239 --> 01:23:04,179 AND EN FACE USE CANNING ACHIEVED 1941 01:23:04,245 --> 01:23:06,581 COMBINING ELEMENTS OF BOTH. 1942 01:23:06,648 --> 01:23:10,518 IT HAD REMAINED LIMITED TO ONLY 1943 01:23:10,585 --> 01:23:14,055 EX VIVO APPLICATIONS, ALSO 1944 01:23:14,122 --> 01:23:18,293 REQUIRING CONTACT ONTO 1945 01:23:18,360 --> 01:23:20,028 STATIONARY TISSUE SAMPLES. 1946 01:23:20,095 --> 01:23:26,067 SPECIFIC AIMS HAVE BEEN TO MAKE 1947 01:23:26,134 --> 01:23:29,671 FULL FIT OCT IN VIVO MICROSCOPE 1948 01:23:29,738 --> 01:23:32,340 TAILORED TO NEEDS OF 1949 01:23:32,407 --> 01:23:34,042 QUANTITATIVE ASSESSMENT. 1950 01:23:34,109 --> 01:23:35,710 LET ME SHOW YOU PRELIMINARY 1951 01:23:35,777 --> 01:23:36,778 RESULTS ON QUANTITATIVE 1952 01:23:36,845 --> 01:23:37,779 ASSESSMENT. 1953 01:23:37,846 --> 01:23:39,748 WE DEVELOPED AN IMAGE 1954 01:23:39,814 --> 01:23:41,316 ANALYSIS-BASED APPROACH BASED ON 1955 01:23:41,383 --> 01:23:45,453 A PHYSICAL MODEL THAT USES 1956 01:23:45,520 --> 01:23:46,621 STROMAL LIGHT SCATTERING AS 1957 01:23:46,688 --> 01:23:47,422 OBJECTIVE INDICATOR. 1958 01:23:47,489 --> 01:23:51,926 ON THE LEFT YOU SEE A TYPICAL 1959 01:23:51,993 --> 01:23:54,062 CROSS-SECTION OF FULL FIT OCT 1960 01:23:54,129 --> 01:23:58,032 IMAGE EX VIVO OF NORMAL CORNEA. 1961 01:23:58,099 --> 01:24:00,101 NOTE IN THE STROMA THE SIGNAL 1962 01:24:00,168 --> 01:24:01,636 DECREASES WITH DEPTH. 1963 01:24:01,703 --> 01:24:05,473 IN FACT IT'S EXPECTED TO FOLLOW 1964 01:24:05,540 --> 01:24:07,642 EXPONENTIAL DECAY BECAUSE LIGHT 1965 01:24:07,709 --> 01:24:12,447 IS EXPECTED TO BE ATTENUATED BY 1966 01:24:12,514 --> 01:24:15,016 SCATTERING PROCESSES IN THE 1967 01:24:15,083 --> 01:24:15,984 STROMA. 1968 01:24:16,050 --> 01:24:19,120 FROM THE RATE OF EXPONENTIAL 1969 01:24:19,187 --> 01:24:25,460 DECAY WE CAN CALCULATE THE 1970 01:24:25,527 --> 01:24:27,829 SCATTERING OF PHOTON PATH OF 1971 01:24:27,896 --> 01:24:30,732 QUANTITATIVE MEASURE OF GRADE OF 1972 01:24:30,799 --> 01:24:31,099 TRANSPARENCY. 1973 01:24:31,166 --> 01:24:33,568 SO IT REPRESENTS THE AVERAGE 1974 01:24:33,635 --> 01:24:36,104 DISTANCE THAT THE LIGHT PHOTONS 1975 01:24:36,171 --> 01:24:37,405 CAN TRAVEL UNIMPEDED WITHOUT 1976 01:24:37,472 --> 01:24:38,440 BEING SCATTERED. 1977 01:24:38,506 --> 01:24:43,378 SO THE HIGHER THE VALUE, THE 1978 01:24:43,445 --> 01:24:46,414 MORE TRANSPARENT THE CORNEA. 1979 01:24:46,481 --> 01:24:48,950 ANY SITUATION CAN'T DEVIATION 1980 01:24:49,017 --> 01:24:56,357 FROM EXPONENTIAL DECAY WHICH WE 1981 01:24:56,424 --> 01:25:01,930 ESTIMATE BY REDUCED CHI-SQUARE 1982 01:25:01,996 --> 01:25:03,698 STATISTICS, LET'S HAVE A LOOK AT 1983 01:25:03,765 --> 01:25:04,098 EXAMPLES. 1984 01:25:04,165 --> 01:25:10,939 ON TOP WE HAVE A NORMAL CORNEA 1985 01:25:11,005 --> 01:25:13,675 WITH INTACT TRANSPARENCY, NORMAL 1986 01:25:13,741 --> 01:25:18,012 EXPONENTIAL DECAY CONFIRMED BY 1987 01:25:18,079 --> 01:25:21,416 RATIO CLOSE TO ONE. 1988 01:25:21,483 --> 01:25:25,553 THIS, NOTE WE'RE NOT RESOLVING 1989 01:25:25,620 --> 01:25:28,857 FINAL ENDOTHELIAL LAYER HERE, 1990 01:25:28,923 --> 01:25:29,924 SHOWS FASTER DECAYING 1991 01:25:29,991 --> 01:25:33,361 EXPONENTIAL PROFILE CON 1992 01:25:33,428 --> 01:25:36,164 CONFIRMED BY LOWER VALUE. 1993 01:25:36,231 --> 01:25:38,333 THIS PATHOLOGICAL CORNEA WITH 1994 01:25:38,399 --> 01:25:41,236 SOME STROMAL SCARRING SHOWS 1995 01:25:41,302 --> 01:25:43,972 NON-EXPONENTIAL PROFILE, AND 1996 01:25:44,038 --> 01:25:46,808 THAT'S CONFIRMED BY RATIO FAR 1997 01:25:46,875 --> 01:25:49,777 GREATER THAN ONE. 1998 01:25:49,844 --> 01:25:53,181 HERE THE FIT BY STANDARD DECLAY 1999 01:25:53,248 --> 01:25:58,720 MODEL WHERE WE HAVE THE DEPTH, 2000 01:25:58,786 --> 01:26:00,822 THE SCATTERING DEPTH DEPENDENT 2001 01:26:00,889 --> 01:26:03,124 CONFIRMS THERE IS SIGNIFICANT 2002 01:26:03,191 --> 01:26:06,928 DEVIATION FROM THE MONO 2003 01:26:06,995 --> 01:26:10,331 EXPONENTIAL FIT BELOW 150 2004 01:26:10,398 --> 01:26:14,035 MICRONS, ASSOCIATED WITH STROMAL 2005 01:26:14,102 --> 01:26:16,738 HETEROGENEITY IN THAT AREA. 2006 01:26:16,804 --> 01:26:19,541 WHILE DEVELOPMENT OF FULL FIT 2007 01:26:19,607 --> 01:26:21,276 OCT HAS BEEN ONGOING FOR USE IN 2008 01:26:21,342 --> 01:26:22,644 VIVO WHICH I'M GOING TO TALK 2009 01:26:22,710 --> 01:26:25,713 ABOUT IN A LITTLE BIT, THE SAME 2010 01:26:25,780 --> 01:26:29,918 METHOD MAY ALREADY BE APPLIED TO 2011 01:26:29,984 --> 01:26:31,486 CURRENT CLINICAL IMAGING 2012 01:26:31,553 --> 01:26:33,788 MODALITIES, INCLUDING STANDARD 2013 01:26:33,855 --> 01:26:36,958 SPECTRAL DOMAIN OCT, AND ENABLE 2014 01:26:37,025 --> 01:26:38,793 OBJECTIVE QUANTITATIVE 2015 01:26:38,860 --> 01:26:39,294 ASSESSMENT OF CORNEA 2016 01:26:39,360 --> 01:26:45,166 TRANSPARENCY IN THE CLINICAL 2017 01:26:45,233 --> 01:26:45,700 SETTING. 2018 01:26:45,767 --> 01:26:47,902 A SPECIFIC EXAMPLE OF 2019 01:26:47,969 --> 01:26:49,637 APPLICATION IN OPHTHALMOLOGY 2020 01:26:49,704 --> 01:26:51,306 PRACTICE, ASIDE FROM 2021 01:26:51,372 --> 01:26:54,075 STANDARDIZED DIAGNOSIS, IT CAN 2022 01:26:54,142 --> 01:26:55,476 BE USED FOR STANDARDIZED 2023 01:26:55,543 --> 01:26:56,411 TREATMENT FOLLOW-UP. 2024 01:26:56,477 --> 01:27:00,815 SO FOR EXAMPLE, IN THIS PILOT 2025 01:27:00,882 --> 01:27:03,685 STUDY INCLUDING 21 PATIENTS WITH 2026 01:27:03,751 --> 01:27:05,520 FUCHS DYSTROPHY WHO RECEIVED 2027 01:27:05,587 --> 01:27:09,223 CORNEA CRAFT WE MONITORED CORNEA 2028 01:27:09,290 --> 01:27:10,425 TRANSPARENCY IN INTERVAL OF AT 2029 01:27:10,491 --> 01:27:12,527 LEAST THREE MONTHS. 2030 01:27:12,594 --> 01:27:15,530 ON THE Y-AXIS HERE WE PLOT THE 2031 01:27:15,597 --> 01:27:18,333 DEGREE OF TRANSPARENCY IN TERMS 2032 01:27:18,399 --> 01:27:20,468 OF FRACTION OF TRANSMITTED 2033 01:27:20,535 --> 01:27:24,472 LIGHT, WHAT WE TERM COHERENT 2034 01:27:24,539 --> 01:27:26,074 TRANSMITTANCE, THAT ALSO 2035 01:27:26,140 --> 01:27:27,976 EXPRESSES THE PHOTON OF 2036 01:27:28,042 --> 01:27:30,011 SCATTERING MEAN-FREE PATH IN 2037 01:27:30,078 --> 01:27:31,813 RELATION TO ACTUAL THICKNESS OF 2038 01:27:31,879 --> 01:27:32,547 THE CORNEA. 2039 01:27:32,614 --> 01:27:38,653 SO WHAT IS SHOWN HERE IS CORNEA 2040 01:27:38,720 --> 01:27:40,221 TRANSPARENCY IMPROVES AND 2041 01:27:40,288 --> 01:27:41,489 STABILIZES AROUND SIX MONTHS 2042 01:27:41,556 --> 01:27:45,360 WHICH IN FACT APPEARS TO 2043 01:27:45,426 --> 01:27:55,970 CORRELATE WITH STABILIZATION OF 2044 01:28:02,010 --> 01:28:02,744 VISUAL ACUITY. 2045 01:28:02,810 --> 01:28:04,879 IN COLLABORATION WORK HAS BEEN 2046 01:28:04,946 --> 01:28:10,018 ONGOING TO MAKE FULL FIT OCT 2047 01:28:10,084 --> 01:28:15,356 SUIT SUITABLE FOR IN VIVO 2048 01:28:15,423 --> 01:28:15,957 EXAMINATION. 2049 01:28:16,024 --> 01:28:18,393 ON THE RESULT ANTERIOR AND 2050 01:28:18,459 --> 01:28:19,961 POSTERIOR LAYERS OF CORNEA, AND 2051 01:28:20,028 --> 01:28:24,399 NOTE BECAUSE OF THE CURVATURE OF 2052 01:28:24,465 --> 01:28:27,735 THE CORNEA SINGLE LAYER MAY CUT 2053 01:28:27,802 --> 01:28:29,270 AND CONTAIN SEVERAL CORNEA 2054 01:28:29,337 --> 01:28:31,873 LAYERS AT A TIME. 2055 01:28:31,939 --> 01:28:33,775 GOING THROUGH INDIVIDUAL LAYERS, 2056 01:28:33,841 --> 01:28:37,145 STARTING WITH THE EPITHELIUM, 2057 01:28:37,211 --> 01:28:39,847 AND ALSO SHOWING THIS ZOOMED 2058 01:28:39,914 --> 01:28:42,617 AREA WITH NON-CONTACT FULL FIT 2059 01:28:42,684 --> 01:28:47,588 OCT SYSTEM, IN COMPARISON WITH 2060 01:28:47,655 --> 01:28:50,825 CLINICAL CONTACT CONFOCAL 2061 01:28:50,892 --> 01:28:51,125 MICROSCOPY. 2062 01:28:51,192 --> 01:28:58,032 SUBBASAL NERVE PLEXUS SHOWING 2063 01:28:58,099 --> 01:28:59,167 INDIVIDUAL NERVES, HERE STROMA, 2064 01:28:59,233 --> 01:29:00,668 MIDDLE STROMA, YOU SEE THICKER 2065 01:29:00,735 --> 01:29:11,212 NERVES THAN IN THE SUBBASAL 2066 01:29:12,180 --> 01:29:14,716 NERVE PLEXUS. 2067 01:29:14,782 --> 01:29:16,050 POSTERIOR. 2068 01:29:16,117 --> 01:29:18,052 TO ACCOUNT FOR CURVATURE WE 2069 01:29:18,119 --> 01:29:20,354 RECENTLY REDESIGNED IN VIVO 2070 01:29:20,421 --> 01:29:22,790 SETUP BY REPLACING THE FLAT 2071 01:29:22,857 --> 01:29:26,227 MIRROR IN THE REFERENCE ARM WITH 2072 01:29:26,294 --> 01:29:28,696 CURVED REFERENCE MIRROR TO MIMIC 2073 01:29:28,763 --> 01:29:35,703 CORNEA CURVATURE IN WHAT WE 2074 01:29:35,770 --> 01:29:37,805 TERMED CURVED FIELD OCT TO 2075 01:29:37,872 --> 01:29:39,540 CAPTURE LARGER FIELDS OF 2076 01:29:39,607 --> 01:29:43,044 INDIVIDUAL LAYERS SUCH AS FINE 2077 01:29:43,111 --> 01:29:45,079 SUBBASAL NERVE PLEXUS, IN 2078 01:29:45,146 --> 01:29:54,188 COMPARISON TO FULL FIELD OCT. 2079 01:29:54,255 --> 01:29:56,124 TO FURTHER ENHANCE FULL FIELD 2080 01:29:56,190 --> 01:29:59,794 OCT TECHNOLOGY WE'RE EXPLORING 2081 01:29:59,861 --> 01:30:01,896 MOTION COMPENSATION TECHNIQUES, 2082 01:30:01,963 --> 01:30:03,464 IN COLLABORATION WITH THE GROUP 2083 01:30:03,531 --> 01:30:06,467 AT JOHNS HOPKINS. 2084 01:30:06,534 --> 01:30:09,771 I ONLY SHOWED YOU SLICES OF THE 2085 01:30:09,837 --> 01:30:11,506 CORNEA WITH OUR IN VIVO FULL 2086 01:30:11,572 --> 01:30:13,441 FIELD OCT SETUP, NO 2087 01:30:13,508 --> 01:30:15,543 CROSS-SECTIONAL VIEWS OF THE 2088 01:30:15,610 --> 01:30:17,245 ENTIRE CORNEA, AND THIS IS 2089 01:30:17,311 --> 01:30:20,715 BECAUSE OUR EYE IS CONSTANTLY IN 2090 01:30:20,782 --> 01:30:22,917 MOTION, EVEN DURING SO-CALLED 2091 01:30:22,984 --> 01:30:25,553 STEADY FIXATION, AND MAJOR 2092 01:30:25,620 --> 01:30:30,024 SOURCE OF INVOLUNTARY MOTION IS 2093 01:30:30,091 --> 01:30:34,662 ACTUALLY FROM VASCULAR PULSATION 2094 01:30:34,729 --> 01:30:35,730 RESPIRATION THAT MANIFESTS IN 2095 01:30:35,797 --> 01:30:36,731 AXIAL DIRECTION. 2096 01:30:36,798 --> 01:30:40,101 SIMPLY THE INTEGRATION OF 2097 01:30:40,168 --> 01:30:42,904 SPECTRAL DOMAIN OCT WITHIN FULL 2098 01:30:42,970 --> 01:30:45,773 FIELD OCT TO LOCATE AND TRACK 2099 01:30:45,840 --> 01:30:49,043 CORNEA SURFACE WHICH HELPS US TO 2100 01:30:49,110 --> 01:30:50,645 GUIDE FULLFIELD OCT IMAGING HAS 2101 01:30:50,711 --> 01:30:54,849 ALREADY ALLOWED US TO IMAGE THE 2102 01:30:54,916 --> 01:30:55,750 TRABECULAR MESHWORK WITH 2103 01:30:55,817 --> 01:31:01,756 IMPLICATIONS AS YOU HEARD FOR 2104 01:31:01,823 --> 01:31:04,792 GLAUCOMA RESEARCH AND DIAGNOSIS. 2105 01:31:04,859 --> 01:31:06,561 RECENT ADVANCES IN PHYSICS OF 2106 01:31:06,627 --> 01:31:09,197 TURBID MEDIA ALLOW US TO GO A 2107 01:31:09,263 --> 01:31:11,632 STEP FURTHER TO CONCEIVE 2108 01:31:11,699 --> 01:31:14,869 DEVELOPMENT OF SYSTEMS THAT 2109 01:31:14,936 --> 01:31:17,271 BEYOND CHARACTERIZE WILL ALSO 2110 01:31:17,338 --> 01:31:23,978 ENABLE COMPENSATION FOR LOSS OF 2111 01:31:24,045 --> 01:31:26,314 TRANSPARENCY. 2112 01:31:26,380 --> 01:31:31,152 LIGHT CAN BE FOCUSED BY SHAPING 2113 01:31:31,219 --> 01:31:34,455 LIGHT WITH THE SPATIAL LIGHT 2114 01:31:34,522 --> 01:31:37,024 MODULATOR, SLM, AND THIS HAS 2115 01:31:37,091 --> 01:31:39,160 OPENED A NEW ROUTE TOWARDS 2116 01:31:39,227 --> 01:31:41,996 MATRIX APPROACH OF LIGHT 2117 01:31:42,063 --> 01:31:44,198 PROPAGATION THROUGH COMPLEX 2118 01:31:44,265 --> 01:31:48,035 MEDIA RELATING THE INPUT MODES 2119 01:31:48,102 --> 01:31:51,739 SUCH AS GENERATED SLM TO OUTPUT 2120 01:31:51,806 --> 01:31:57,111 MODES DETECTED BY CCD CAMERA. 2121 01:31:57,178 --> 01:31:57,912 FOR EXAMPLE, BIOILLUMINATING 2122 01:31:57,979 --> 01:32:02,283 CLOUDY MEDIUM WITH ARRAY OF 2123 01:32:02,350 --> 01:32:07,655 INDIVIDUALLY MODIFIABLE 2124 01:32:07,722 --> 01:32:08,556 ILLILLUMINATORS, DETECTING 2125 01:32:08,623 --> 01:32:11,259 RESPONSES, IT'S POSSIBLE TO 2126 01:32:11,325 --> 01:32:13,527 CONSTRUCT A MATRIX THAT 2127 01:32:13,594 --> 01:32:14,428 CHARACTERIZES THE SCATTERED 2128 01:32:14,495 --> 01:32:16,163 MEDIUM ITSELF. 2129 01:32:16,230 --> 01:32:18,566 AND THEN WITH THIS INFORMATION 2130 01:32:18,633 --> 01:32:22,670 WE CAN THEN MANIPULATE THE ARRAY 2131 01:32:22,737 --> 01:32:26,774 OF ILLILLUMINATORS TO OPTIMIZE 2132 01:32:26,841 --> 01:32:28,442 LIGHT TRANSMISSION AND FOCUS 2133 01:32:28,509 --> 01:32:30,244 IMAGE THROUGH A CLOUDY MEDIUM 2134 01:32:30,311 --> 01:32:39,820 SUCH AS EGG SHELL IN THIS 2135 01:32:39,887 --> 01:32:40,621 EXAMPLE. 2136 01:32:40,688 --> 01:32:42,023 IN COLLABORATION WE'VE BEEN 2137 01:32:42,089 --> 01:32:44,759 INVESTIGATING SUCH A NOVEL ARRAY 2138 01:32:44,825 --> 01:32:46,060 ILLILLUMINATOR OR MATRIX 2139 01:32:46,127 --> 01:32:50,631 APPROACH TO OCT WITH THE AIM OF 2140 01:32:50,698 --> 01:32:52,066 EVENTUALLY PERFORMING RETINAL 2141 01:32:52,133 --> 01:32:54,468 IMAGING THROUGH CLOUDY CORNEA OR 2142 01:32:54,535 --> 01:33:02,710 CRYSTALLINE LENS SUCH AS EYES 2143 01:33:02,777 --> 01:33:05,813 WITH CATARACTS. 2144 01:33:05,880 --> 01:33:06,747 COULD DEMONSTRATE 2145 01:33:06,814 --> 01:33:07,381 PROOF-OF-CONCEPT WITH 2146 01:33:07,448 --> 01:33:11,986 DETERIORATED TRANSPARENCY. 2147 01:33:12,053 --> 01:33:14,388 FOR EXAMPLE, SHOWING RESOLUTION 2148 01:33:14,455 --> 01:33:17,058 TARGET UNDER CLOUDY EX VIVO 2149 01:33:17,124 --> 01:33:18,693 CORNEA IMAGED OUT CORRECTION, 2150 01:33:18,759 --> 01:33:22,196 THIS IS WITH ADAPTIVE OPTICS 2151 01:33:22,263 --> 01:33:23,698 LIGHT CORRECTION OF ABERRATIONS, 2152 01:33:23,764 --> 01:33:27,068 THIS IS WITH MATRIX APPROACH 2153 01:33:27,134 --> 01:33:28,336 CORRECTION OF SCATTERING 2154 01:33:28,402 --> 01:33:30,571 INCLUDING ABERRATIONS. 2155 01:33:30,638 --> 01:33:33,441 SO NOTE THAT UNLIKE MORE 2156 01:33:33,507 --> 01:33:34,208 CONVENTIONAL ADAPTIVE OPTICS, 2157 01:33:34,275 --> 01:33:36,844 THAT ALLOWS TO CORRECT FOR ONE 2158 01:33:36,911 --> 01:33:39,880 PART OF THE IMAGE, MATRIX 2159 01:33:39,947 --> 01:33:42,149 APPROACH YIELDS HIGH QUALITY 2160 01:33:42,216 --> 01:33:44,418 IMAGE OF THE RESOLUTION TARGET 2161 01:33:44,485 --> 01:33:50,958 OVER THE ENTIRE FIELD OF HAVE 2162 01:33:51,025 --> 01:33:51,525 YOU. 2163 01:33:51,592 --> 01:33:57,498 FULL FIELD OCT SHOWS PROMISE FOR 2164 01:33:57,565 --> 01:33:59,600 CORNEA CHARACTERIZATION AND 2165 01:33:59,667 --> 01:34:00,701 QUANTITATIVE ASSESSMENT, 2166 01:34:00,768 --> 01:34:03,237 CELLULAR RESOLUTION BEYOND 2167 01:34:03,304 --> 01:34:05,506 CAPABILITIES OF STANDARD OCT. 2168 01:34:05,573 --> 01:34:08,676 ASSESSMENT OF STROMAL LIGHT BACK 2169 01:34:08,743 --> 01:34:10,778 SCATTERING WITH FULL FIELD OCTS 2170 01:34:10,845 --> 01:34:21,389 SHOWS PROMISE AS OBJECTIVE MEANS 2171 01:34:21,856 --> 01:34:24,859 TO QUANTIFY TRANSPARENCY. 2172 01:34:24,925 --> 01:34:25,760 WE CAN DIFFERENTIATE 2173 01:34:25,826 --> 01:34:29,630 HETEROGENEOUS PATHOLOGIC TISSUES 2174 01:34:29,697 --> 01:34:31,766 FROM HOMOGENOUS ONES, ALLOWING 2175 01:34:31,832 --> 01:34:38,039 US TO QUANTIFY THE DEGREE OF 2176 01:34:38,105 --> 01:34:40,041 TRANSPARENCY IN HOMOGENOUS 2177 01:34:40,107 --> 01:34:40,574 TISSUES. 2178 01:34:40,641 --> 01:34:43,377 MOTION COMPENSATION AND ARRAY 2179 01:34:43,444 --> 01:34:46,680 ILLUMINATION, MATRIX APPROACHES, 2180 01:34:46,747 --> 01:34:49,050 MAY FURTHER ENHANCE OCT 2181 01:34:49,116 --> 01:34:51,685 TECHNOLOGY AND ENABLE DEEPER 2182 01:34:51,752 --> 01:34:58,592 PARENTHESES TRYINGS -- 2183 01:34:58,659 --> 01:34:59,093 PENETRATION. 2184 01:34:59,160 --> 01:35:07,468 I'D LIKE TO THANK MY PRIMARY 2185 01:35:07,535 --> 01:35:08,869 MENTORS, WHO IS SITTING RIGHT IN 2186 01:35:08,936 --> 01:35:11,605 THE FRONT IN THE AUDIENCE, I'VE 2187 01:35:11,672 --> 01:35:14,341 WORKED WITH THEM SENSE GITTING 2188 01:35:14,408 --> 01:35:21,715 MY Ph.D. END JOSEF BILLE WHO 2189 01:35:21,782 --> 01:35:23,451 INTRODUCED ADAPTIVE OPTICS TO 2190 01:35:23,517 --> 01:35:27,421 OPHTHALMOLOGY AND A FRIEND OF 2191 01:35:27,488 --> 01:35:28,556 HIDE ELBERG ENGINEERING, WHO 2192 01:35:28,622 --> 01:35:30,925 PASSED AWAY A FEW MONTHS AGO. 2193 01:35:30,991 --> 01:35:32,760 THIS ENTIRE GROUP SHOWN HERE, 2194 01:35:32,827 --> 01:35:34,962 LISTED, HAS BEEN WORKING 2195 01:35:35,029 --> 01:35:36,397 TOGETHER TO CONTINUE TO ADVANCE 2196 01:35:36,464 --> 01:35:42,903 TOWARDS THE GOAL OF IMPROVING 2197 01:35:42,970 --> 01:35:45,539 OCULAR IMAGING WITH POTENTIAL 2198 01:35:45,606 --> 01:35:46,240 RAMIFICATION FOR IMPROVING 2199 01:35:46,307 --> 01:35:48,442 OVERALL HEALTH. 2200 01:35:48,509 --> 01:35:50,044 THANK YOU. 2201 01:35:50,111 --> 01:35:50,878 [APPLAUSE] 2202 01:36:04,692 --> 01:36:15,136 >> NEXT TALK, CRISTINA 2203 01:36:27,114 --> 01:36:33,921 CANAVESI, SHE'S FOUNDER AND 2204 01:36:33,988 --> 01:36:36,090 PRESIDENT OF LIGHTOP 2205 01:36:36,157 --> 01:36:36,590 CORPORATION. 2206 01:36:36,657 --> 01:36:37,124 >> GOOD MORNING. 2207 01:36:37,191 --> 01:36:38,459 MANY THANKS TO THE ORGANIZERS 2208 01:36:38,526 --> 01:36:40,861 FOR INCLUDING ME IN THIS 2209 01:36:40,928 --> 01:36:43,197 WONDERFUL AND MUCH DESERVED 2210 01:36:43,264 --> 01:36:50,504 CELEBRATION OF THE INVENTORS OF 2211 01:36:50,571 --> 01:36:51,972 OCT. 2212 01:36:52,039 --> 01:36:53,340 BEFORE I START, I WANTED TO 2213 01:36:53,407 --> 01:36:58,913 PROVIDE A SHORT BACKGROUND OF MY 2214 01:36:58,979 --> 01:37:01,515 COMPANY, STARTED IN 2013, A 2215 01:37:01,582 --> 01:37:08,022 WOMEN-OWNED BUSINESS. 2216 01:37:08,088 --> 01:37:13,327 WE'RE GRADUATE OF THE I-CORPS 2217 01:37:13,394 --> 01:37:17,164 PROGRAM AND ILLUMINATE. 2218 01:37:17,231 --> 01:37:17,998 FUNDED BY NATIONAL SCIENCE 2219 01:37:18,065 --> 01:37:19,133 FOUNDATION AND NATIONAL 2220 01:37:19,200 --> 01:37:20,868 INSTITUTES OF HEALTH VIA SBIR 2221 01:37:20,935 --> 01:37:22,236 PROGRAMS AND PROGRAMS IN NEW 2222 01:37:22,303 --> 01:37:27,374 YORK STATE AND ROCHESTER WHERE 2223 01:37:27,441 --> 01:37:28,108 WE'RE BASED. 2224 01:37:28,175 --> 01:37:32,079 OCX IS A NEW TYPE OF INSTRUMENT 2225 01:37:32,146 --> 01:37:33,581 THAT OPERATES AT DIFFERENT 2226 01:37:33,647 --> 01:37:35,216 SCALES STARRING FROM OCT ON THE 2227 01:37:35,282 --> 01:37:38,085 CORNEA IN THIS EXAMPLE WITH WIDE 2228 01:37:38,152 --> 01:37:44,358 FIELD OF VIEW AND THEN MOVING 2229 01:37:44,425 --> 01:37:45,859 SEAMLESSLY TO MICROSCOPIC SCALE 2230 01:37:45,926 --> 01:37:48,495 TO CELLULAR LEVEL WHERE WE CAN 2231 01:37:48,562 --> 01:37:50,397 SEE THE INDIVIDUAL ENDOTHELIAL 2232 01:37:50,464 --> 01:37:51,465 CELLS LINING THE POSTERIOR 2233 01:37:51,532 --> 01:37:53,334 SURFACE OF THE CORNEA. 2234 01:37:53,400 --> 01:37:59,640 THIS IS ONE OF SEVERAL EXAMPLES 2235 01:37:59,707 --> 01:38:01,108 BRINGING BETTER IMAGES FOR 2236 01:38:01,175 --> 01:38:03,177 BETTER RESEARCH. 2237 01:38:03,244 --> 01:38:05,079 WHAT IS OCX AND WHY IS IT 2238 01:38:05,145 --> 01:38:05,346 DIFFERENT? 2239 01:38:05,412 --> 01:38:07,781 IT IS A NOVEL CLASS OF IMAGING 2240 01:38:07,848 --> 01:38:10,017 THAT COMBINES FOR THE FIRST TIME 2241 01:38:10,084 --> 01:38:20,594 IN A SINGLE INSTRUMENT OPTICAL 2242 01:38:24,965 --> 01:38:27,901 CORNEA GDOCM, CALLING THIS OCX. 2243 01:38:27,968 --> 01:38:30,070 I'M SHOWING HOW THE SYSTEM IS 2244 01:38:30,137 --> 01:38:32,606 ABLE TO SURVEY THE REGION OF 2245 01:38:32,673 --> 01:38:33,974 INTEREST WITH OCT FIRST, OVER 2246 01:38:34,041 --> 01:38:36,677 LARGE FIELD OF VIEW AND THEN 2247 01:38:36,744 --> 01:38:39,980 ZERO IN WITH HIGH MAGNIFICATION 2248 01:38:40,047 --> 01:38:43,817 TO CAPTURE TARGETED IMAGE WITH 2249 01:38:43,884 --> 01:38:45,986 OUR PATENTED GDOCM TECHNOLOGY, 2250 01:38:46,053 --> 01:38:48,656 PROVIDING AN IMAGE WITH 16 TIMES 2251 01:38:48,722 --> 01:38:51,158 HIGHER LATERAL RESOLUTION THAN 2252 01:38:51,225 --> 01:38:52,926 TRADITIONAL OCT LEADING TO 2253 01:38:52,993 --> 01:39:00,567 BETTER IMAGES AND BETTER DATA. 2254 01:39:00,634 --> 01:39:02,536 GDOCM THEY ARE INTEGRATED WITH 2255 01:39:02,603 --> 01:39:05,072 EASY TO USE INTERFACE THAT LETS 2256 01:39:05,139 --> 01:39:06,907 RESEARCHERS FOCUS ON THE SCIENCE 2257 01:39:06,974 --> 01:39:11,378 RATHER THAN ON THE INSTRUMENT 2258 01:39:11,445 --> 01:39:13,380 ITSELF. 2259 01:39:13,447 --> 01:39:15,316 THESE CAPABILITIES RESULT IN 2260 01:39:15,382 --> 01:39:17,284 NON-INVASIVE IMAGES OF TISSUE 2261 01:39:17,351 --> 01:39:19,720 WITH CELLULAR RESOLUTION 2262 01:39:19,787 --> 01:39:24,525 COMPARABLE TO HISTOLOGY. 2263 01:39:24,591 --> 01:39:27,628 SINCE THE HIGH RESOLUTION 2264 01:39:27,695 --> 01:39:29,630 DATASETS THAT RESULT IT'S 2265 01:39:29,697 --> 01:39:32,232 DESIRABLE TO COMBINE THEM WITH 2266 01:39:32,299 --> 01:39:34,735 MACHINE LEARNING APPROACHES FOR 2267 01:39:34,802 --> 01:39:41,108 AUTOMATED ASSESSMENT OF CELLULAR 2268 01:39:41,175 --> 01:39:41,375 FEATURES. 2269 01:39:41,442 --> 01:39:43,510 FUNCTIONAL ASSESSMENT CAN BE 2270 01:39:43,577 --> 01:39:46,213 ACHIEVED BY COMBINING OCX WITH 2271 01:39:46,280 --> 01:39:48,849 OTHER MODALITIES, ONE EXAMPLE IS 2272 01:39:48,916 --> 01:39:51,785 ANGIOGRAPHY, A TOPIC OF A LATER 2273 01:39:51,852 --> 01:39:56,056 SESSION, AND IN OUR CASE WE 2274 01:39:56,123 --> 01:39:58,158 ASSESS VASCULATURE WITH NOVEL 2275 01:39:58,225 --> 01:40:01,895 EFFECTOR ANNUAL APPROACH FOR 2276 01:40:01,962 --> 01:40:02,162 OCT-A. 2277 01:40:02,229 --> 01:40:05,733 SO, YOU HAVE SEEN A VERSION OF 2278 01:40:05,799 --> 01:40:09,103 THIS CHART BEFORE, COMPARING OCT 2279 01:40:09,169 --> 01:40:11,472 WITH OTHER NON-INVASIVE 2280 01:40:11,538 --> 01:40:11,772 MODALITIES. 2281 01:40:11,839 --> 01:40:13,674 THIS ONE IS DIFFERENT BECAUSE ON 2282 01:40:13,741 --> 01:40:15,776 THE VERTICAL AXIS WE HAVE 2283 01:40:15,843 --> 01:40:18,412 LATERAL RESOLUTION, WHICH IS THE 2284 01:40:18,479 --> 01:40:21,348 PARAMETER THAT IS KEY IF YOU'RE 2285 01:40:21,415 --> 01:40:28,889 INTERESTED IN CELLULAR LEVEL. 2286 01:40:28,956 --> 01:40:32,526 WE HAVE PENETRATION INTO TISSUE, 2287 01:40:32,593 --> 01:40:33,827 NATURAL TRADEOFF BETWEEN 2288 01:40:33,894 --> 01:40:35,295 PARAMETERS, DIFFERENT METHODS 2289 01:40:35,362 --> 01:40:36,964 FALL ALONG THE DIAGONAL. 2290 01:40:37,030 --> 01:40:40,768 SO THE GOAL FOR VISUALIZING 2291 01:40:40,834 --> 01:40:43,637 PROCESSES AT THE CELLULAR LEVEL 2292 01:40:43,704 --> 01:40:46,507 TO OBTAIN RESOLUTION AND 2293 01:40:46,573 --> 01:40:47,040 MICROMETER SCALE OVER 2294 01:40:47,107 --> 01:40:48,809 PENETRATION DEPTH OF THE 2295 01:40:48,876 --> 01:40:49,877 MILLIMETER SCALE. 2296 01:40:49,943 --> 01:40:53,080 SO IN THE UPPER PART OF THE 2297 01:40:53,147 --> 01:40:57,484 CHART THERE ARE METHODS THAT 2298 01:40:57,551 --> 01:40:59,653 HAVE INADEQUATE RESOLUTION TO 2299 01:40:59,720 --> 01:41:01,755 IMAGE INDIVIDUAL CELLS. 2300 01:41:01,822 --> 01:41:04,057 ULTRASOUND AS AN EXAMPLE HAS 2301 01:41:04,124 --> 01:41:05,259 EXCELLENT PENETRATION INSIDE THE 2302 01:41:05,325 --> 01:41:08,962 BODY BUT RESOLUTION IS GENERALLY 2303 01:41:09,029 --> 01:41:11,465 LIMITED. 2304 01:41:11,532 --> 01:41:15,302 AND THIS IS CROSS-SECTIONAL 2305 01:41:15,369 --> 01:41:16,403 PRESENTATION OF ULTRASOUND. 2306 01:41:16,470 --> 01:41:20,908 OCT WHICH WE ALL KNOW AND LOVE 2307 01:41:20,974 --> 01:41:24,278 HAS THE EXQUISITE CAPABILITY TO 2308 01:41:24,344 --> 01:41:26,013 RESOLVE LAYERS IN THE 2309 01:41:26,079 --> 01:41:27,514 CROSS-SECTIONAL VIEW DOWN TO THE 2310 01:41:27,581 --> 01:41:28,449 MICROMETER SCALE. 2311 01:41:28,515 --> 01:41:32,219 BUT IT DOESN'T HAVE ENOUGH 2312 01:41:32,286 --> 01:41:35,789 RESOLUTION IN THE ORTHOGONAL OR 2313 01:41:35,856 --> 01:41:36,790 LATERAL DIMENSION. 2314 01:41:36,857 --> 01:41:39,159 OPPOSITE SIDE WE HAVE MICROSCOPY 2315 01:41:39,226 --> 01:41:42,229 TECHNIQUES WHICH ARE CAPABLE OF 2316 01:41:42,296 --> 01:41:44,998 RESOLVING DOWN TO THE CELLULAR 2317 01:41:45,065 --> 01:41:46,934 AND SUBCELLULAR LEVEL BUT SUFFER 2318 01:41:47,000 --> 01:41:47,701 FROM LIMITED PENETRATION INSIDE 2319 01:41:47,768 --> 01:41:48,969 OF THE TISSUE. 2320 01:41:49,036 --> 01:41:57,311 SO WE HAVE CONFOCAL MICROSCOPY. 2321 01:41:57,377 --> 01:42:03,784 HERE IS SHOWING ENDOTHELIUM, AND 2322 01:42:03,851 --> 01:42:06,453 THIS VIEW IS PARALLEL TO THE 2323 01:42:06,520 --> 01:42:07,221 SURFACE OF THE TISSUE. 2324 01:42:07,287 --> 01:42:11,024 AND THIS IS A TYPICAL VIEW OF 2325 01:42:11,091 --> 01:42:12,893 MICROSCOPY, AS WAS DISCUSSED IN 2326 01:42:12,960 --> 01:42:15,462 PREVIOUS TALK THIS IS A 2327 01:42:15,529 --> 01:42:17,664 BEAUTIFUL PRESENTATION BUT 2328 01:42:17,731 --> 01:42:19,299 SUFFERS FROM PENETRATION AND 2329 01:42:19,366 --> 01:42:21,168 ALSO GREATLY SUFFERS IN FIELD OF 2330 01:42:21,235 --> 01:42:23,270 VIEW WHICH IS TYPICALLY LESS 2331 01:42:23,337 --> 01:42:27,641 THAN HALF A MILLIMETER. 2332 01:42:27,708 --> 01:42:36,416 SO, THIS WAS INTRODUCED, OPTICAL 2333 01:42:36,483 --> 01:42:39,186 CURRENT MICROSCOPY OCM BY 2334 01:42:39,253 --> 01:42:40,921 INCREASING NUMERICAL APERTURE, 2335 01:42:40,988 --> 01:42:42,589 ACHIEVES EXCELLENT LATERAL 2336 01:42:42,656 --> 01:42:44,057 RESOLUTION AGAIN WITH 2337 01:42:44,124 --> 01:42:45,959 LIMITATIONS AT THE DEPTH OF 2338 01:42:46,026 --> 01:42:47,828 FOCUS BECOME SHALLOW DOWN TO 2339 01:42:47,895 --> 01:42:53,634 TENS OF MICRONS. 2340 01:42:53,700 --> 01:42:55,202 SO, GDOCM WAS INTRODUCED TO 2341 01:42:55,269 --> 01:42:58,772 BRIDGE THE GAP BETWEEN THESE TWO 2342 01:42:58,839 --> 01:43:00,941 SETS OF TECHNIQUES. 2343 01:43:01,008 --> 01:43:03,810 ACHIEVED MICROMETER SCALE 2344 01:43:03,877 --> 01:43:05,145 RESOLUTION OVER CLINICALLY 2345 01:43:05,212 --> 01:43:07,314 RELEVANT DEPTH. 2346 01:43:07,381 --> 01:43:11,718 BY INTEGRATING LIQUID LENS TO 2347 01:43:11,785 --> 01:43:12,653 DYNAMICALLY REFOCUS HIGH 2348 01:43:12,719 --> 01:43:15,856 NUMERICAL APERTURE BEAM OF LIGHT 2349 01:43:15,923 --> 01:43:17,958 IN THE TISSUE, GDOCM MAINTAINS 2350 01:43:18,025 --> 01:43:19,026 HIGH LATERAL RESOLUTION 2351 01:43:19,092 --> 01:43:20,694 THROUGHOUT THE DEPTH OF IMAGING. 2352 01:43:20,761 --> 01:43:25,265 ON THE RIGHT IS AN EXAMPLE OF A 2353 01:43:25,332 --> 01:43:28,635 HUMAN CORNEA IMAGE WITH GDOCM. 2354 01:43:28,702 --> 01:43:32,873 AND SINCE GDOCM IMAGING ACQUIRES 2355 01:43:32,940 --> 01:43:34,875 3D IMAGES, TWO MICRON 2356 01:43:34,942 --> 01:43:37,210 RESOLUTION, WE HAVE VISUALIZE 2357 01:43:37,277 --> 01:43:40,781 THE CROSS-SECTIONAL B SCANS AT 2358 01:43:40,847 --> 01:43:43,650 THE TOP AS WELL AS VIEWS TYPICAL 2359 01:43:43,717 --> 01:43:45,485 OF MICROSCOPY SHOWN AT THE 2360 01:43:45,552 --> 01:43:46,687 BOTTOM. 2361 01:43:46,753 --> 01:43:48,989 AND THIS VIEW HIGHLIGHTS THE 2362 01:43:49,056 --> 01:43:50,123 CELLULAR RESOLUTION CAPABILITY 2363 01:43:50,190 --> 01:43:54,728 IN THE LATERAL PLANE. 2364 01:43:54,795 --> 01:43:57,030 SO, BY COMBINING OCT AND GDOCM 2365 01:43:57,097 --> 01:44:01,902 IN A SINGLE INSTRUMENT, OCX 2366 01:44:01,969 --> 01:44:11,545 ALLOWS WIDE FIELD OF VIEW TO 2367 01:44:11,612 --> 01:44:12,946 CELLULAR LEVEL. 2368 01:44:13,013 --> 01:44:15,549 OUR VISION WITH DUAL MODALITY 2369 01:44:15,616 --> 01:44:19,286 OCX IMAGING IS TO SUPPORT ENTIRE 2370 01:44:19,353 --> 01:44:22,022 OCULOMICS PIPELINE FROM DRUG 2371 01:44:22,089 --> 01:44:23,557 DISCOVERY AND DISEASE 2372 01:44:23,624 --> 01:44:26,159 INVESTIGATIONS IN VITRO AND EX 2373 01:44:26,226 --> 01:44:28,128 VIVO, AND TO TESTING FOR 2374 01:44:28,195 --> 01:44:31,632 MANUFACTURING OF CONTACT LENSES 2375 01:44:31,698 --> 01:44:33,967 AND INTRAOCULAR DEVICES INTO 2376 01:44:34,034 --> 01:44:34,935 PRE-CLINICAL AND CLINICAL 2377 01:44:35,002 --> 01:44:35,669 STUDIES. 2378 01:44:35,736 --> 01:44:39,973 WE BRING DUAL MODALITY IMAGING 2379 01:44:40,040 --> 01:44:41,908 CAPABILITY, AND 3D WITH CELLULAR 2380 01:44:41,975 --> 01:44:46,546 RESOLUTION, ASSOCIATED ANALYSIS 2381 01:44:46,613 --> 01:44:50,050 BASED ON A.I. AND MACHINE 2382 01:44:50,117 --> 01:44:50,317 LEARNING. 2383 01:44:50,384 --> 01:44:51,885 I WILL HIGHLIGHT A FEW 2384 01:44:51,952 --> 01:44:55,956 APPLICATIONS INCLUDING CORNEA 2385 01:44:56,023 --> 01:44:58,492 AND RETINAL IMAGING AND 2386 01:44:58,558 --> 01:44:59,126 REGENERATIVE MEDICINE. 2387 01:44:59,192 --> 01:45:01,928 SO HERE ARE SOME HIGHLIGHTS ON 2388 01:45:01,995 --> 01:45:07,200 OUR WORK ON CORNEAL IMAGING TO 2389 01:45:07,267 --> 01:45:10,303 GET BETTER RESULTS FASTER, WE 2390 01:45:10,370 --> 01:45:11,438 CAN PERFORM TRADITIONAL 2391 01:45:11,505 --> 01:45:13,507 MEASUREMENTS AND TASKS, OCT IS 2392 01:45:13,573 --> 01:45:15,175 CURRENTLY EMPLOYED SUCH AS 2393 01:45:15,242 --> 01:45:15,942 MEASURING THICKNESSES OF THE 2394 01:45:16,009 --> 01:45:17,678 DIFFERENT LAYERS OF THE CORNEA. 2395 01:45:17,744 --> 01:45:20,047 AND WE CAN DO THIS, FOR EXAMPLE, 2396 01:45:20,113 --> 01:45:21,648 AT EYE BANKS. 2397 01:45:21,715 --> 01:45:23,950 HERE IS A PICTURE SHOWING 2398 01:45:24,017 --> 01:45:26,353 IMAGING OF DONOR TISSUE, DONOR 2399 01:45:26,420 --> 01:45:29,923 CORNEAL TISSUE, STORED IN 2400 01:45:29,990 --> 01:45:30,824 VIEWING CHAMBER WITHOUT 2401 01:45:30,891 --> 01:45:32,726 CONTACTING TISSUE OR EXPOSING IT 2402 01:45:32,793 --> 01:45:35,629 TO THE OUTSIDE ENVIRONMENT. 2403 01:45:35,696 --> 01:45:40,033 AND WE CAN ALSO PERFORM DETAILED 2404 01:45:40,100 --> 01:45:42,302 CELLULAR EXAMINATION BY 2405 01:45:42,369 --> 01:45:43,537 AUTOMATICALLY SEGMENTS 2406 01:45:43,603 --> 01:45:45,038 ENDOTHELIUM AND NUMERICALLY 2407 01:45:45,105 --> 01:45:47,040 FLATTENING SO WE CAN PRESENT 2408 01:45:47,107 --> 01:45:49,209 ENDOTHELIAL CELLS IN A SINGLE 2409 01:45:49,276 --> 01:45:50,410 PLANE. 2410 01:45:50,477 --> 01:45:53,413 AND USING MACHINE LEARNING TO 2411 01:45:53,480 --> 01:45:55,549 AUTOMATICALLY COUNT THE CELLS 2412 01:45:55,615 --> 01:45:59,753 AND PROVIDE UNBIASED ESTIMATION 2413 01:45:59,820 --> 01:46:02,656 OF ENDOTHELIAL CELL DENSITY. 2414 01:46:02,723 --> 01:46:05,759 SO HERE'S AN EXAMPLE, I 2415 01:46:05,826 --> 01:46:08,729 APOLOGIZE FOR THE FORMATTING. 2416 01:46:08,795 --> 01:46:11,732 SO, THIS IS AN EXAMPLE OF OCX 2417 01:46:11,798 --> 01:46:13,667 IMAGING IN MICE. 2418 01:46:13,734 --> 01:46:19,106 WE HAVE ON THE LEFT OCT OR WIDE 2419 01:46:19,172 --> 01:46:22,008 FIELD OF VIEW AND GDOCM ON THE 2420 01:46:22,075 --> 01:46:22,309 RIGHT. 2421 01:46:22,375 --> 01:46:27,114 WE'RE ABLE IN VIVO TO VISUALIZE 2422 01:46:27,180 --> 01:46:31,485 EPITHELIAL CELLS, ENDOTHELIAL, 2423 01:46:31,551 --> 01:46:34,020 CORNEAL NERVES. 2424 01:46:34,087 --> 01:46:36,556 WHEN IMAGING EXCISED HUMAN 2425 01:46:36,623 --> 01:46:39,359 RETINA WE CAN START WITH THE OCT 2426 01:46:39,426 --> 01:46:43,563 IMAGING OF THE LARGER FIELD OF 2427 01:46:43,630 --> 01:46:46,933 VIEW AND DETAILED EXAMINATION OF 2428 01:46:47,000 --> 01:46:50,036 RETINA WITH GDOCM AND HIGH 2429 01:46:50,103 --> 01:46:50,737 RESOLUTION. 2430 01:46:50,804 --> 01:46:53,273 SO MOVING TO REGENERATIVE 2431 01:46:53,340 --> 01:46:54,074 MEDICINE, THIS MULTI-SCALE 2432 01:46:54,141 --> 01:46:57,544 APPROACH OF OCX IS SUITED TO 2433 01:46:57,611 --> 01:46:58,545 IMAGE ORGANOIDS, HERE'S AN 2434 01:46:58,612 --> 01:47:01,815 EXAMPLE OF THE SAME RETINAL 2435 01:47:01,882 --> 01:47:08,255 ORGANOIDS IMAGED ON THE LEFT 2436 01:47:08,321 --> 01:47:15,262 WITH LEICA BIOOPTIGEN SYSTEM, 2437 01:47:15,328 --> 01:47:19,533 YOU CAN APPRECIATE THE ADVANTAGE 2438 01:47:19,599 --> 01:47:21,201 BY HIGH LATERAL RESOLUTION. 2439 01:47:21,268 --> 01:47:23,236 LEVEL OF DETAIL IN OCX IMAGE 2440 01:47:23,303 --> 01:47:25,005 SHOWS DIFFERENTIATION IN LAYER 2441 01:47:25,071 --> 01:47:30,277 OF THE ORGANOIDS, INCLUDING 2442 01:47:30,343 --> 01:47:36,049 OUTER LAYER, AND THIS 2443 01:47:36,116 --> 01:47:37,751 COMBINATION OF OCT AND GDOCM IS 2444 01:47:37,818 --> 01:47:40,153 SUITED TO HIGH-THROUGHPUT 2445 01:47:40,220 --> 01:47:42,355 SCREENING OF ORGANIZE AND OTHER 2446 01:47:42,422 --> 01:47:44,958 3D CELL TISSUE CULTURES WITHOUT 2447 01:47:45,025 --> 01:47:49,896 NEED FOR SPECIALIZED 2448 01:47:49,963 --> 01:47:51,097 PREPARATION. 2449 01:47:51,164 --> 01:47:51,865 OCX IS NON-INVASIVE, 2450 01:47:51,932 --> 01:47:53,366 NON-CONTACT, ENABLES 2451 01:47:53,433 --> 01:47:56,169 LONGITUDINAL STUDIES ON THE SAME 2452 01:47:56,236 --> 01:47:59,139 SAMPLE OVER TIME. 2453 01:47:59,206 --> 01:48:00,707 SO, BEFORE I CONCLUDE, I WAS 2454 01:48:00,774 --> 01:48:03,276 ASKED TO INCLUDE A FEW WORDS 2455 01:48:03,343 --> 01:48:04,578 ABOUT STANDARDIZATION OF DATA 2456 01:48:04,644 --> 01:48:05,879 ACROSS PLATFORMS. 2457 01:48:05,946 --> 01:48:07,214 I WANTED TO HIGHLIGHT THE WORK 2458 01:48:07,280 --> 01:48:09,716 WE'VE DONE TO DEVELOP AND 2459 01:48:09,783 --> 01:48:11,685 COMMERCIALIZE TOOLS TO EXTRACT 2460 01:48:11,751 --> 01:48:13,653 RELEVANT BIOMARKERS FROM OCT 2461 01:48:13,720 --> 01:48:13,987 DATA. 2462 01:48:14,054 --> 01:48:18,358 IN THIS CONTEXT, WE HAVE 2463 01:48:18,425 --> 01:48:19,893 DEVELOPED SOOLS THAT WORK FOR 2464 01:48:19,960 --> 01:48:22,762 DATA SETS ON MULTIPLE 2465 01:48:22,829 --> 01:48:25,699 INSTRUMENTS, THE GOAL TO ADVANCE 2466 01:48:25,765 --> 01:48:27,434 THE PACE OF DISCOVERIES WITHOUT 2467 01:48:27,500 --> 01:48:29,402 DUPLICATING WORK SO A BIG PART 2468 01:48:29,469 --> 01:48:31,037 OF OUR EFFORT GOES INTO 2469 01:48:31,104 --> 01:48:34,908 DEVELOPING TOOLS EASY TO USE AND 2470 01:48:34,975 --> 01:48:38,278 PROVIDE NEW CAPABILITIES, SUCH 2471 01:48:38,345 --> 01:48:39,279 AS OCT ANGIOGRAPHY. 2472 01:48:39,346 --> 01:48:44,217 HERE IS THE EXAMPLE OF THE WORK 2473 01:48:44,284 --> 01:48:45,719 FLOW INTEGRATING SOFTWARE TOOLS 2474 01:48:45,785 --> 01:48:47,587 WITH THIRD PARTY INSTRUMENTS, IN 2475 01:48:47,654 --> 01:48:50,891 THIS CASE IMAGE ACQUISITION IS 2476 01:48:50,957 --> 01:48:53,226 PERFORMED WITH LEICA OCT SYSTEM, 2477 01:48:53,293 --> 01:48:55,695 TO EXTRACT THE DYNAMIC COMPONENT 2478 01:48:55,762 --> 01:49:01,234 OF THE FLOWING BLOOD CELLS FOR 2479 01:49:01,301 --> 01:49:02,202 REPEATED ACQUISITION, THESE 2480 01:49:02,269 --> 01:49:06,473 SCANS REPEATED AT EACH LOCATION. 2481 01:49:06,539 --> 01:49:08,541 OVER TIME. 2482 01:49:08,608 --> 01:49:12,145 FIRST SOFTWARE TOOL IS FRAME 2483 01:49:12,212 --> 01:49:14,881 ALIGN, PROPRIETARY ALGORITHM FOR 2484 01:49:14,948 --> 01:49:16,616 VOLUME REGISTRATION THAT 2485 01:49:16,683 --> 01:49:17,918 MINIMIZES DISTORTIONS, THIS IS 2486 01:49:17,984 --> 01:49:23,290 NEEDED TO CORRECT FOR MOTION 2487 01:49:23,356 --> 01:49:29,329 ARTIFACTS FROM IN VIVO IMAGING. 2488 01:49:29,396 --> 01:49:31,298 OCTA SIGNATURES ARE EXTRACTED 2489 01:49:31,364 --> 01:49:35,302 USING NOVEL FACTOR ANALYSIS 2490 01:49:35,368 --> 01:49:35,568 APPROACH. 2491 01:49:35,635 --> 01:49:40,707 OCTA TOOL OUTPUTS TWO FILES, ONE 2492 01:49:40,774 --> 01:49:46,012 CONTAINS STRUCTURAL SIGNAL, THE 2493 01:49:46,079 --> 01:49:48,548 OTHER DYNAMIC VASCULAR 2494 01:49:48,615 --> 01:49:52,152 SIGNATURES, BOTH, FRAME ALIGN 2495 01:49:52,218 --> 01:49:53,420 AND OCTA TOOL WERE DESIGNED SO 2496 01:49:53,486 --> 01:49:56,323 THEY ARE EASY TO USE, DEVELOPED 2497 01:49:56,389 --> 01:49:58,625 SO RESEARCHERS CAN FOCUS ON THE 2498 01:49:58,692 --> 01:50:01,962 IMAGING AND BIOLOGY WITHOUT 2499 01:50:02,028 --> 01:50:03,196 HAVING TO TWEAK PARAMETERS 2500 01:50:03,263 --> 01:50:08,468 ENDLESSLY TO GET A DECENT 2501 01:50:08,535 --> 01:50:08,935 RESULT. 2502 01:50:09,002 --> 01:50:12,138 THE 3D IMAGES ARE DISPLAYED IN 2503 01:50:12,205 --> 01:50:13,640 THE VIEWER WHICH YOU'VE BEEN 2504 01:50:13,707 --> 01:50:16,443 SEEING IN ACTION THROUGHOUT THE 2505 01:50:16,509 --> 01:50:17,077 PRESENTATION. 2506 01:50:17,143 --> 01:50:20,847 SO HERE IS AN EXAMPLE OF THE 2507 01:50:20,914 --> 01:50:25,218 OCTA RESULT FOR MICE RETINA. 2508 01:50:25,285 --> 01:50:27,954 THESE ARE ALL PROJECTION OF 2509 01:50:28,021 --> 01:50:29,923 RETINAL NERVE FIBER LAYER, ALL 2510 01:50:29,990 --> 01:50:32,792 THREE OF THESE IMAGES ORIGINATE 2511 01:50:32,859 --> 01:50:34,394 FROM THE SAME DATASET, PROCESSED 2512 01:50:34,461 --> 01:50:36,029 IN DIFFERENT WAYS. 2513 01:50:36,096 --> 01:50:38,498 THE FIRST TWO IMAGES AT THE LEFT 2514 01:50:38,565 --> 01:50:41,835 AND CENTER ARE THE STRUCTURAL 2515 01:50:41,901 --> 01:50:46,806 OCT DATA, WHILE THE RIGHT MOST 2516 01:50:46,873 --> 01:50:52,846 IMAGE IS FUNCTIONAL OCTA DATA. 2517 01:50:52,912 --> 01:50:58,685 YOU CAN APPRECIATE INTERNAL 2518 01:50:58,752 --> 01:51:01,254 STRICTURES AND FIBERS ARE NO 2519 01:51:01,321 --> 01:51:03,757 LONGER PRESENT, THIS IS THE 2520 01:51:03,823 --> 01:51:05,425 WALLS OF THE VASCULATURE. 2521 01:51:05,492 --> 01:51:09,996 TO CONCLUDE I WANT TO SHARE OUR 2522 01:51:10,063 --> 01:51:11,931 EXCITEMENT TO BE WORKING AT 2523 01:51:11,998 --> 01:51:18,638 BASKIN PALMER EYE INSTITUTE TO 2524 01:51:18,705 --> 01:51:19,939 INVESTIGATE OCX CAPABILITIES ON 2525 01:51:20,006 --> 01:51:23,676 FOUR PATIENT GROUPS IN AN 2526 01:51:23,743 --> 01:51:27,180 IRB-APPROVED STUDY FOR CORNEAL 2527 01:51:27,247 --> 01:51:29,749 INFECTION, DRY EYE, OCULAR 2528 01:51:29,816 --> 01:51:30,383 SURFACE, NEOPLASIA, FUCHS 2529 01:51:30,450 --> 01:51:30,717 DYSTROPHY. 2530 01:51:30,784 --> 01:51:33,119 HERE IS A PICTURE OF THE 2531 01:51:33,186 --> 01:51:34,320 INSTRUMENT SETUP. 2532 01:51:34,387 --> 01:51:37,023 WATCH FOR UPDATES IN THE COMING 2533 01:51:37,090 --> 01:51:40,460 MONTHS. 2534 01:51:40,527 --> 01:51:41,961 MANY TALENTED INDIVIDUALS HAVE 2535 01:51:42,028 --> 01:51:45,598 CONTRIBUTED TO THE DEVELOPMENT 2536 01:51:45,665 --> 01:51:47,200 OF THIS TECHNOLOGY, SHOWN HERE. 2537 01:51:47,267 --> 01:51:52,038 A LOT OF THEM, IN NO PARTICULAR 2538 01:51:52,105 --> 01:51:55,875 ORDER, FROM SCIENTIFIC 2539 01:51:55,942 --> 01:51:57,377 COLLABORATORS, MANUFACTURING, 2540 01:51:57,444 --> 01:51:58,144 PRE-CLINICAL, CLINICAL 2541 01:51:58,211 --> 01:52:01,147 DEVELOPMENTS AND EVERYTHING IN 2542 01:52:01,214 --> 01:52:02,982 BETWEEN. 2543 01:52:03,049 --> 01:52:05,151 AND WITH THAT IF YOU'D LIKE TO 2544 01:52:05,218 --> 01:52:07,153 DISCUSS HOW OCX CAN BENEFIT YOUR 2545 01:52:07,220 --> 01:52:09,756 RESEARCH PLEASE COME FIND ME IN 2546 01:52:09,823 --> 01:52:12,258 PERSON TODAY, TOMORROW, OR REACH 2547 01:52:12,325 --> 01:52:13,493 OUT TO ME VIA E-MAIL, I'D BE 2548 01:52:13,560 --> 01:52:15,061 HAPPY TO TALK MORE. 2549 01:52:15,128 --> 01:52:15,428 THANKS. 2550 01:52:15,495 --> 01:52:18,098 [APPLAUSE] 2551 01:52:22,502 --> 01:52:24,537 >> THE FLOOR IS OPEN FOR 2552 01:52:24,604 --> 01:52:28,508 QUESTIONS FOR ALL THE SPEAKERS. 2553 01:52:35,982 --> 01:52:37,317 >> WONDERFUL PANEL. 2554 01:52:37,383 --> 01:52:38,318 GREAT DISCUSSION. 2555 01:52:38,384 --> 01:52:46,626 GREAT TALKS. 2556 01:52:46,693 --> 01:52:47,494 SO, QUESTIONS, YOU SHOWED HIGH 2557 01:52:47,560 --> 01:52:51,364 RESOLUTION WAYS OF LOOKING AT 2558 01:52:51,431 --> 01:52:52,665 CORNEA. 2559 01:52:52,732 --> 01:52:53,533 CRISTY SHOWED IN 2560 01:52:53,600 --> 01:52:54,501 POST-TRANSPLANTER PATIENTS 2561 01:52:54,567 --> 01:52:56,069 LOOKING AT CLARITY BUT 2562 01:52:56,136 --> 01:52:57,537 TECHNIQUES MIGHT BE USEFUL FOR 2563 01:52:57,604 --> 01:53:02,175 LOOKING AT -- AS A BIOMARKER FOR 2564 01:53:02,242 --> 01:53:03,510 ENDOTHELIAL CELL FUNCTION, EVEN 2565 01:53:03,576 --> 01:53:05,912 EARLY STAGES OF CORNEAL 2566 01:53:05,979 --> 01:53:06,279 DECOMPENSATION. 2567 01:53:06,346 --> 01:53:10,116 HAVE YOU THOUGHT ABOUT USING IT 2568 01:53:10,183 --> 01:53:10,850 IN THOSE SETTINGS? 2569 01:53:10,917 --> 01:53:12,952 >> DO YOU WANT ME TO ANSWER? 2570 01:53:13,019 --> 01:53:17,223 YOUR CLINICAL STUDY IS STILL 2571 01:53:17,290 --> 01:53:17,490 UNDERWAY. 2572 01:53:17,557 --> 01:53:19,492 YEAH, NO, GOOD QUESTION. 2573 01:53:19,559 --> 01:53:24,030 SO THE RESULTS ARE SHOWN ON THE 2574 01:53:24,097 --> 01:53:24,564 CORNEA TRANSPARENCY, 2575 01:53:24,631 --> 01:53:29,169 STANDARDIZED TREATMENT FOLLOW-UP 2576 01:53:29,235 --> 01:53:36,309 WHICH USES STANDARD OCT, OPTOVUE 2577 01:53:36,376 --> 01:53:37,510 DEVICE. 2578 01:53:37,577 --> 01:53:39,045 I FEAR MOTION COMPENSATION 2579 01:53:39,112 --> 01:53:42,348 STRATEGIES TO COMPENSATE FOR THE 2580 01:53:42,415 --> 01:53:46,186 ACTION MOTION REALLY IS NEEDED 2581 01:53:46,252 --> 01:53:48,154 BECAUSE IT'S NOT SO EASY TO USE 2582 01:53:48,221 --> 01:53:48,922 ON PATIENTS. 2583 01:53:48,988 --> 01:53:52,025 MOST OF THE IMAGES I SHOWED WAS 2584 01:53:52,091 --> 01:53:53,059 MY EYE. 2585 01:53:53,126 --> 01:53:57,697 I'M VERY TRAINED FROM DAVID 2586 01:53:57,764 --> 01:53:59,566 GITEN'S LAB TO FIXATE ON A 2587 01:53:59,632 --> 01:53:59,799 TARGET. 2588 01:53:59,866 --> 01:54:00,934 I'M VERY STILL. 2589 01:54:01,000 --> 01:54:03,870 THESE ARE ALL GOOD COMMENTS, AND 2590 01:54:03,937 --> 01:54:05,738 TO LOOK AT. 2591 01:54:05,805 --> 01:54:08,841 IT'S STILL A TIME DOMAIN 2592 01:54:08,908 --> 01:54:16,516 TECHNIQUE, FULLFIELD OCT 2593 01:54:16,583 --> 01:54:16,916 SYSTEMS. 2594 01:54:16,983 --> 01:54:21,487 TO GET THE VOLUME WHICH WE 2595 01:54:21,554 --> 01:54:26,993 HAVEN'T SUCCEEDED GETTING IN 2596 01:54:27,060 --> 01:54:37,604 VIVO IMAGES, YOU DO TIME DOMAIN 2597 01:54:41,040 --> 01:54:42,141 SCANNING. 2598 01:54:42,208 --> 01:54:44,811 >> IN OUR CASE, WE GET ENTIRE 2599 01:54:44,877 --> 01:54:45,745 DEPTH PROFILE, DEFINITELY WILL 2600 01:54:45,812 --> 01:54:48,147 BE INTERESTING TO INVESTIGATE 2601 01:54:48,214 --> 01:54:50,416 THAT. 2602 01:54:50,483 --> 01:54:50,950 THANKS. 2603 01:54:51,017 --> 01:54:54,354 >> MY QUESTION IS TO KRISTINA 2604 01:54:54,420 --> 01:54:55,655 WITH A K. 2605 01:54:55,722 --> 01:54:59,993 AS YOU'RE PLOTTING INTENSITY OF 2606 01:55:00,059 --> 01:55:03,930 LIGHT FROM CORNEA, WHAT YOU 2607 01:55:03,997 --> 01:55:05,465 PLOTTED IS PROBABLY A 2608 01:55:05,531 --> 01:55:07,767 (INDISCERNIBLE), JUST FROM THE 2609 01:55:07,834 --> 01:55:13,773 NATURE OF THE PLOTTING, SO YOU 2610 01:55:13,840 --> 01:55:14,974 COULD PROBABLY SUBTRACT LOWER 2611 01:55:15,041 --> 01:55:17,010 LEVEL TO GET THE MAJOR 2612 01:55:17,076 --> 01:55:18,845 COMPONENT, WHICH MIGHT ACCOUNT 2613 01:55:18,911 --> 01:55:21,214 FOR MAYBE 10 TO 15% OF THE 2614 01:55:21,281 --> 01:55:24,817 INTENSITY SO THAT MIGHT GIVE YOU 2615 01:55:24,884 --> 01:55:30,123 A NUMBER PROBABLY YOU'RE LOOKING 2616 01:55:30,189 --> 01:55:30,390 FOR. 2617 01:55:30,456 --> 01:55:33,259 >> THE ECHO IS SO BAD, I ONLY 2618 01:55:33,326 --> 01:55:34,861 GOT BITS AND PIECES. 2619 01:55:34,927 --> 01:55:36,663 YOU'RE SAYING OUR ANALYSIS, HOW 2620 01:55:36,729 --> 01:55:42,035 IT'S AFFECTED BY THE SURFACE OR 2621 01:55:42,101 --> 01:55:42,368 SOMETHING? 2622 01:55:42,435 --> 01:55:44,103 >> YES, YES. 2623 01:55:44,170 --> 01:55:53,012 SPECTROSCOPY, WE USED TO DO 2624 01:55:53,079 --> 01:55:53,746 STRIPPING, IT APPEARS 2625 01:55:53,813 --> 01:55:55,815 BIEXPONENTIAL, YOU MIGHT HAVE A 2626 01:55:55,882 --> 01:55:58,584 MINOR COMPONENT AT LOWER LEVEL, 2627 01:55:58,651 --> 01:56:01,821 BY SUBTRACTING ONE YOU GET THE 2628 01:56:01,888 --> 01:56:04,490 MAJOR COMPONENT WITH PROBABLY 2629 01:56:04,557 --> 01:56:06,426 HIGHER LEVEL OF ACCURACY. 2630 01:56:06,492 --> 01:56:08,261 >> I APOLOGIZE, IT'S A LOT OF 2631 01:56:08,328 --> 01:56:10,096 ECHO FOR US HERE, NOT AT THE 2632 01:56:10,163 --> 01:56:10,463 PODIUM. 2633 01:56:10,530 --> 01:56:11,731 MAYBE WE CAN DISCUSS MORE IN THE 2634 01:56:11,798 --> 01:56:12,098 BREAK. 2635 01:56:12,165 --> 01:56:15,134 I WANT TO POINT OUT ONE THING, I 2636 01:56:15,201 --> 01:56:18,171 DIDN'T GET ALL THE POINTS, 2637 01:56:18,237 --> 01:56:18,738 SORRY. 2638 01:56:18,805 --> 01:56:21,240 FOR THAT ANALYSIS, I'M SO HAPPY 2639 01:56:21,307 --> 01:56:26,512 ABOUT THE STANDARD, THE MEASURES 2640 01:56:26,579 --> 01:56:31,851 FOR PUTTING STANDARDIZATION IN 2641 01:56:31,918 --> 01:56:32,719 IMAGING. 2642 01:56:32,785 --> 01:56:35,054 WE WORK WITH A BLACK BOX 2643 01:56:35,121 --> 01:56:37,657 CLINICAL SYSTEM, WE DID ANALYSIS 2644 01:56:37,724 --> 01:56:40,059 IN J PEG IMAGES BECAUSE WE 2645 01:56:40,126 --> 01:56:42,562 DIDN'T HAVE ACCESS TO RAW DATA. 2646 01:56:42,628 --> 01:56:45,098 WE DO STANDARDIZATION OF IMAGES, 2647 01:56:45,164 --> 01:56:46,199 SO WITH THE EPITHELIAL SURFACE, 2648 01:56:46,265 --> 01:56:49,035 AND I DIDN'T HAVE TIME TO GET 2649 01:56:49,102 --> 01:56:50,002 INTO THIS. 2650 01:56:50,069 --> 01:56:53,740 THERE'S A LOT OF ARTIFACT, 2651 01:56:53,806 --> 01:56:55,408 REFLECTION, THAT WE COMPENSATE 2652 01:56:55,475 --> 01:57:02,148 FOR AND POSTERIOR STROMAL 2653 01:57:02,215 --> 01:57:03,383 ARTIFACT, PCA ANALYSIS TO 2654 01:57:03,449 --> 01:57:08,588 STANDARDIZE ALL THE IMAGES SO 2655 01:57:08,654 --> 01:57:11,557 WE'RE STARTING FROM THE SAME 2656 01:57:11,624 --> 01:57:12,291 BASELINE. 2657 01:57:12,358 --> 01:57:13,025 >> CONGRATULATIONS. 2658 01:57:13,092 --> 01:57:14,727 >> WE CAN DISCUSS MORE LATER. 2659 01:57:14,794 --> 01:57:15,995 VERY INTERESTING. 2660 01:57:16,062 --> 01:57:18,030 THANK YOU. 2661 01:57:18,097 --> 01:57:19,832 >> EXCELLENT WORK. 2662 01:57:19,899 --> 01:57:25,705 THANK YOU. 2663 01:57:25,772 --> 01:57:26,305 >> DAVID? 2664 01:57:26,372 --> 01:57:26,672 >> THANK YOU. 2665 01:57:26,739 --> 01:57:28,541 I HAVE A COMMENT FOR BEN. 2666 01:57:28,608 --> 01:57:33,613 I'M VERY HAPPY TO HEAR THAT 2667 01:57:33,679 --> 01:57:35,548 ANTERIOR SEGMENT OCT IMAGES OF 2668 01:57:35,615 --> 01:57:41,387 THE ANGLE, ANGLE PARAMETER, AOD, 2669 01:57:41,454 --> 01:57:47,994 ET CETERA, CONTAIN INFORMATION 2670 01:57:48,060 --> 01:57:49,128 THAT'S AVAILABLE IN GONIOSCOPY, 2671 01:57:49,195 --> 01:57:51,798 LONGITUDINAL TRIAL, WE WERE 2672 01:57:51,864 --> 01:57:56,803 INVOLVED IN DEVELOPMENT OF THOSE 2673 01:57:56,869 --> 01:57:59,806 METRICS, WITH OCT, AND IT WAS 2674 01:57:59,872 --> 01:58:01,007 QUESTIONABLE BACK THEN WHETHER 2675 01:58:01,073 --> 01:58:04,210 THEY WERE OF ADDITIONAL VALUE. 2676 01:58:04,277 --> 01:58:09,015 OFTEN IT'S HARD TO PUBLISH THESE 2677 01:58:09,081 --> 01:58:09,849 OCT METRICS OR MEASUREMENTS 2678 01:58:09,916 --> 01:58:13,453 BECAUSE A LOT OF REVIEWERS HAVE 2679 01:58:13,519 --> 01:58:15,221 QUESTIONS, YOU'RE NOT SHOWING 2680 01:58:15,288 --> 01:58:16,322 ANYTHING DIFFERENT. 2681 01:58:16,389 --> 01:58:18,825 THERE ARE NO ADDITIONAL VALUE. 2682 01:58:18,891 --> 01:58:21,360 IT OFTEN TAKES DECADES FOR IT TO 2683 01:58:21,427 --> 01:58:24,730 SHOW UP WITH LONGITUDINAL DATA, 2684 01:58:24,797 --> 01:58:26,732 SO ANYWAY, WHEN YOU REVIEW A 2685 01:58:26,799 --> 01:58:28,267 PAPER, WITH SOME NEW METRIC, 2686 01:58:28,334 --> 01:58:31,170 JUST KEEP THAT IN MIND. 2687 01:58:31,237 --> 01:58:34,040 DON'T REQUIRE THAT THE AUTHOR 2688 01:58:34,106 --> 01:58:36,309 HAVE TO SHOW THEY ACTUALLY HAVE 2689 01:58:36,375 --> 01:58:38,778 CLINICAL SIGNIFICANCE IN THE 2690 01:58:38,845 --> 01:58:39,612 FIRST PUBLICATION. 2691 01:58:39,679 --> 01:58:46,486 THAT'S ONE OF MY PET PEEVES. 2692 01:58:46,552 --> 01:58:50,890 AND I HAVE QUESTION FOR CHRISTY 2693 01:58:50,957 --> 01:58:54,827 AND CHRISTINA, I'M INTERESTED IN 2694 01:58:54,894 --> 01:58:55,828 OPTICAL COHERENCE MICROSCOPY OF 2695 01:58:55,895 --> 01:58:56,662 THE CORNEA. 2696 01:58:56,729 --> 01:59:00,066 I NOTICE IN OUR OWN WORK, ALSO 2697 01:59:00,132 --> 01:59:03,336 IN PUBLICATIONS THAT THE 2698 01:59:03,402 --> 01:59:07,073 CONTRAST FOR ESPECIALLY FOR 2699 01:59:07,139 --> 01:59:10,176 NERVE AND COLLAGEN FIBERS ARE 2700 01:59:10,243 --> 01:59:11,477 DIFFERENT AT DIFFERENT 2701 01:59:11,544 --> 01:59:11,978 WAVELENGTHS. 2702 01:59:12,044 --> 01:59:16,015 I DON'T THINK THERE HAS BEEN 2703 01:59:16,082 --> 01:59:16,482 SYSTEMATIC COMPARISON. 2704 01:59:16,549 --> 01:59:20,386 BUT I LIKE TO KNOW IN YOUR WORK 2705 01:59:20,453 --> 01:59:23,589 HAVE YOU NOTICED DIFFERENT 2706 01:59:23,656 --> 01:59:28,861 APPEARANCES AT DIFFERENT 2707 01:59:28,928 --> 01:59:29,729 WAVELENGTHS? 2708 01:59:29,795 --> 01:59:30,296 >> WE OPERATE AROUND 850 2709 01:59:30,363 --> 01:59:32,899 NANOMETERS, WE HAVEN'T LOOKED AT 2710 01:59:32,965 --> 01:59:33,466 OTHER WAVELENGTHS. 2711 01:59:33,533 --> 01:59:36,536 >> IT'S A GOOD POINT. 2712 01:59:36,602 --> 01:59:38,271 WE'VE ALSO LOOKED WITH 850, SO, 2713 01:59:38,337 --> 01:59:41,574 YEAH, NOT MUCH EXPERIENCE THERE. 2714 01:59:41,641 --> 01:59:43,943 GOOD POINT TO EXPLORE. 2715 01:59:44,010 --> 01:59:44,310 >> THANK YOU. 2716 01:59:44,377 --> 01:59:46,612 >> I JUST WANTED TO COMMENT ON 2717 01:59:46,679 --> 01:59:47,380 DAVID'S POINT. 2718 01:59:47,446 --> 01:59:48,881 FIRST, THANK YOU FOR SHARING THE 2719 01:59:48,948 --> 01:59:52,318 STORY OF WHERE THESE BIOMETRIC 2720 01:59:52,385 --> 01:59:53,319 PARAMETERS CAME FROM. 2721 01:59:53,386 --> 01:59:56,689 IT WAS VERY CRUCIAL TO HAVE 2722 01:59:56,756 --> 01:59:57,857 HANDCRAFTED FEATURES EARLY ON SO 2723 01:59:57,924 --> 01:59:59,525 WE COULD UNDERSTAND EXACTLY HOW 2724 01:59:59,592 --> 02:00:02,028 THE DISEASE PROCESS WORKED. 2725 02:00:02,094 --> 02:00:03,129 NOWADAYS, THE MOST LIKELY 2726 02:00:03,195 --> 02:00:05,898 APPROACH IS JUST TO USE A.I. BY 2727 02:00:05,965 --> 02:00:07,700 STICKING IMAGES IN DIRECTLY, 2728 02:00:07,767 --> 02:00:10,636 OBVIOUSLY THERE'S LACKS OF 2729 02:00:10,703 --> 02:00:11,037 EXPLAINABILITY AND 2730 02:00:11,103 --> 02:00:16,042 INTERPRETABILITY, TO TAKE THE 2731 02:00:16,108 --> 02:00:19,345 TIME TO CRAFT FEATURES HELPED 2732 02:00:19,412 --> 02:00:21,581 ESTABLISH THE FIELD AND THE WORK 2733 02:00:21,647 --> 02:00:21,781 I DO. 2734 02:00:21,847 --> 02:00:23,649 >> THANK YOU. 2735 02:00:23,716 --> 02:00:24,750 >> A FEW QUICK QUESTIONS AND FEW 2736 02:00:24,817 --> 02:00:26,118 QUICK ANSWER IN THE INTEREST OF 2737 02:00:26,185 --> 02:00:27,453 TIME. 2738 02:00:27,520 --> 02:00:29,488 >> THANKS FOR THE EXCELLENT 2739 02:00:29,555 --> 02:00:32,291 TALKS, I HAVE A QUESTION FOR 2740 02:00:32,358 --> 02:00:32,658 BEN. 2741 02:00:32,725 --> 02:00:37,263 LOOKING AT THOSE ANTERIOR IMAGES 2742 02:00:37,330 --> 02:00:38,164 FROM DIFFERENT DEVICES, IT WAS 2743 02:00:38,230 --> 02:00:40,633 JUST A LITTLE BIT, YOU KNOW, ODD 2744 02:00:40,700 --> 02:00:42,435 TO SEE SO MUCH VARIATION IN THE 2745 02:00:42,501 --> 02:00:44,837 WAY THAT THE FEATURES ARE 2746 02:00:44,904 --> 02:00:45,671 PRESENTED. 2747 02:00:45,738 --> 02:00:49,408 SO, I WAS WONDERING WHEN WE GO 2748 02:00:49,475 --> 02:00:51,644 TOWARDS MORE OBJECTIVE MEASURES, 2749 02:00:51,711 --> 02:00:52,345 ANTERIOR SEGMENT QUANTITATIVE 2750 02:00:52,411 --> 02:00:54,680 PARAMETERS, SO WHAT ARE YOUR 2751 02:00:54,747 --> 02:00:56,849 SUGGESTIONS LIKE TRYING TO 2752 02:00:56,916 --> 02:00:57,950 COMPARE DIFFERENT CLINICAL 2753 02:00:58,017 --> 02:00:59,585 NUMBERS THAT YOU'RE GETTING FROM 2754 02:00:59,652 --> 02:01:05,458 DIFFERENT SYSTEMS TO GET 2755 02:01:05,524 --> 02:01:06,759 OBJECTIVE SENSE OF PARAMETERS OF 2756 02:01:06,826 --> 02:01:08,728 INTEREST. 2757 02:01:08,794 --> 02:01:10,162 WE HAVE DIFFERENT DEVICES 2758 02:01:10,229 --> 02:01:10,896 DIVERSITYING DIFFERENT IMAGES, 2759 02:01:10,963 --> 02:01:14,700 MAYBE THE PARAMETERS ARE NOT 2760 02:01:14,767 --> 02:01:16,135 CONSISTENT BETWEEN DEVICES. 2761 02:01:16,202 --> 02:01:26,712 >> THAT'S A VERY IMPORTANT 2762 02:01:27,546 --> 02:01:27,613 POINT. 2763 02:01:27,680 --> 02:01:28,381 WE'RE INVESTING TIME, RESOURCE, 2764 02:01:28,447 --> 02:01:31,083 HARD WORK TO ESTABLISH CUTOFFS 2765 02:01:31,150 --> 02:01:32,418 TO REDEFINE NARROW ANGLES BUT 2766 02:01:32,485 --> 02:01:33,886 LOCKED INTO A SINGLE SYSTEM, 2767 02:01:33,953 --> 02:01:37,390 THAT WE USE TO COLLECT THE DATA. 2768 02:01:37,456 --> 02:01:40,026 AND SO WITHOUT THE ABILITY TO 2769 02:01:40,092 --> 02:01:45,965 TRANSLATE THESE FINDINGS BETWEEN 2770 02:01:46,032 --> 02:01:49,268 DIFFERENT DEVICES HAVE TRUE 2771 02:01:49,335 --> 02:01:50,603 INTEROPERABILITY IT LIMITS TO A 2772 02:01:50,670 --> 02:01:52,004 SINGLE SYSTEM, THIS IS AN 2773 02:01:52,071 --> 02:01:53,339 IMPORTANT CONVERSATION WE NEED 2774 02:01:53,406 --> 02:01:58,477 TO CONTINUE TO HAVE, DEVELOP 2775 02:01:58,544 --> 02:02:00,212 TECHNIQUES FOR INTEROPERABILITY 2776 02:02:00,279 --> 02:02:02,548 AND ABILITY TO TRANSLATE 2777 02:02:02,615 --> 02:02:04,016 FINDINGS BETWEEN DIFFERENT 2778 02:02:04,083 --> 02:02:04,917 DEVICES. 2779 02:02:04,984 --> 02:02:06,285 THANK YOU VERY MUCH. 2780 02:02:06,352 --> 02:02:06,919 >> ONE MORE QUESTION. 2781 02:02:06,986 --> 02:02:08,754 >> IN THE INTEREST OF TIME I'M 2782 02:02:08,821 --> 02:02:09,889 GOING TO SAVE MY COMMENT FOR 2783 02:02:09,955 --> 02:02:11,057 LATER AND JUST THANK THE 2784 02:02:11,123 --> 02:02:17,196 PANELIST S FOR THREE AWESOME 2785 02:02:17,263 --> 02:02:18,030 TALKS. 2786 02:02:18,097 --> 02:02:19,865 [APPLAUSE] 2787 02:02:23,202 --> 02:02:25,871 >> WE'RE MOVING TO A BREAK. 2788 02:02:25,938 --> 02:02:27,406 WE HAVE HOUSEKEEPING. 2789 02:02:27,473 --> 02:02:29,141 >> YEAH, THAT CONCLUDES THE 2790 02:02:29,208 --> 02:02:29,608 SESSION. 2791 02:02:29,675 --> 02:02:35,014 LET'S TAKE A 15-MINUTE BREAK 2792 02:02:35,081 --> 02:02:35,481 NOW. 2793 02:02:35,548 --> 02:02:38,417 RETURN AT -- LET'S SAY 11:05 TO 2794 02:02:38,484 --> 02:02:39,185 KEEP IT EASY. 2795 02:02:39,251 --> 02:02:42,722 TRY TO BE HERE ON TIME SO WE CAN 2796 02:02:42,788 --> 02:02:50,463 GET AN ON-TIME START. 2797 02:02:50,529 --> 02:02:52,465 >> WE THOUGHT IT WOULD BE 2798 02:02:52,531 --> 02:02:54,867 IMPORTANT TO IMPROVE THE VISUAL 2799 02:02:54,934 --> 02:02:56,869 EXPERIENCE OF EVERYBODY, SO 2800 02:02:56,936 --> 02:02:58,370 WE'RE HAVING THE SPEAKERS SIT IN 2801 02:02:58,437 --> 02:03:00,506 THE FRONT ROW SO THEY CAN SEE 2802 02:03:00,573 --> 02:03:01,474 THE SCREEN. 2803 02:03:01,540 --> 02:03:04,176 AND WE'RE HOPING THAT THE BOTTOM 2804 02:03:04,243 --> 02:03:05,811 20% OF THE SCREEN WILL NOW BE 2805 02:03:05,878 --> 02:03:08,647 VISIBLE TO EVERYBODY ELSE IN THE 2806 02:03:08,714 --> 02:03:09,915 AUDIENCE. 2807 02:03:09,982 --> 02:03:12,384 SO, WITH THAT, I WILL INTRODUCE 2808 02:03:12,451 --> 02:03:18,991 THE NEXT SESSION, WHICH IS HIGH 2809 02:03:19,058 --> 02:03:24,497 RESOLUTION AND AO-OCT, MODERATED 2810 02:03:24,563 --> 02:03:27,199 BY AUSTIN RORDA FROM UNIVERSITY 2811 02:03:27,266 --> 02:03:28,100 OF -- WELL, BERKELEY, UNIVERSITY 2812 02:03:28,167 --> 02:03:30,803 OF CALIFORNIA AT BERKELEY. 2813 02:03:30,870 --> 02:03:35,274 I THINK, DR. RORDA, YOU'RE GOING 2814 02:03:35,341 --> 02:03:36,642 TO SPEAK FROM DOWN THERE, OR 2815 02:03:36,709 --> 02:03:39,345 MOVE OVER AND TURN AROUND? 2816 02:03:39,411 --> 02:03:40,045 >> YES. 2817 02:03:40,112 --> 02:03:40,379 >> GREAT. 2818 02:03:40,446 --> 02:03:42,915 >> WELCOME TO THE NEXT SESSION, 2819 02:03:42,982 --> 02:03:44,884 HIGH RESOLUTION AND AO OCT. 2820 02:03:44,950 --> 02:03:46,252 I'LL KEEP THE INTRO SHORT IN THE 2821 02:03:46,318 --> 02:03:47,586 INTEREST OF TIME. 2822 02:03:47,653 --> 02:03:49,922 THE FIRST SPEAKER IN THE SESSION 2823 02:03:49,989 --> 02:03:53,359 IS DON MILLER, PROFESSOR AT THE 2824 02:03:53,425 --> 02:03:55,494 SCHOOL OF OPTOMETRY, INDIANA 2825 02:03:55,561 --> 02:03:59,098 UNIVERSITY, THE TITLE IS RECENT 2826 02:03:59,165 --> 02:04:09,708 ADVANCES IN ADAPTIVE OPTICS OCT 2827 02:04:10,376 --> 02:04:16,015 TECHNOLOGY AND USE. 2828 02:04:32,865 --> 02:04:37,670 >> I WANT TO THANK THE 2829 02:04:37,736 --> 02:04:38,771 ORGANIZERS FOR THE INVITE, TO 2830 02:04:38,838 --> 02:04:40,606 COMMENT IN A COUPLE AREAS, 2831 02:04:40,673 --> 02:04:47,146 RECENT ADVANCES IN MY LAB, 2832 02:04:47,213 --> 02:04:48,113 INDIANA UNIVERSITY. 2833 02:04:48,180 --> 02:04:51,851 I HOPE YOU'LL LEARN OUR 2834 02:04:51,917 --> 02:04:54,954 MOTIVATION FOR IMAGING RETINA 2835 02:04:55,020 --> 02:04:58,190 WITH THIS COMBINATION OF AO AND 2836 02:04:58,257 --> 02:05:00,292 OCT, DEVELOPING HIGH SPEED AO 2837 02:05:00,359 --> 02:05:02,795 SYSTEM AND BENEFIT THAT MAY 2838 02:05:02,862 --> 02:05:03,863 ACCRUE, AND A SPECIFIC 2839 02:05:03,929 --> 02:05:05,764 APPLICATION OF USING THIS TECH 2840 02:05:05,831 --> 02:05:09,268 NOTHING TO LOOK AT PHOTORECEPTOR 2841 02:05:09,335 --> 02:05:09,835 CELLS. 2842 02:05:09,902 --> 02:05:13,572 TECHNOLOGY TO LOOK AT 2843 02:05:13,639 --> 02:05:14,840 PHOTORECEPTOR CELLS. 2844 02:05:14,907 --> 02:05:17,042 THIS USES A SENSOR TO MEASURE 2845 02:05:17,109 --> 02:05:18,777 ABERRATIONS OF THE EYE AND 2846 02:05:18,844 --> 02:05:21,480 INFORMATION IS FED VIA COMPUTER 2847 02:05:21,547 --> 02:05:24,149 TO TAKE THOSE ABERRATIONS OUT. 2848 02:05:24,216 --> 02:05:28,153 DOING THAT GETS US DOWN TO ABOUT 2849 02:05:28,220 --> 02:05:30,456 A 2-MICRON LATERAL RESOLUTION IN 2850 02:05:30,522 --> 02:05:30,689 RETINA. 2851 02:05:30,756 --> 02:05:36,896 TAKE AN AO, PUT IT INTO THE 2852 02:05:36,962 --> 02:05:40,833 SAMPLE ARM, YOU END UP WITH 3D 2853 02:05:40,900 --> 02:05:44,203 RESOLUTION DOWN TO THE IMPORTANT 2854 02:05:44,270 --> 02:05:45,671 SPATIAL SCALE, RESPONDING TO 2855 02:05:45,738 --> 02:05:48,040 DIMENSIONS OF SINGLE CELLS. 2856 02:05:48,107 --> 02:05:49,341 HERE'S AN EXAMPLE THAT 2857 02:05:49,408 --> 02:05:50,342 ILLUSTRATES THE CELLULAR DETAILS 2858 02:05:50,409 --> 02:05:53,979 WE CAN SEE IN THE RETINA WITH 2859 02:05:54,046 --> 02:05:58,183 THIS COMBINATION, IN ADDITION TO 2860 02:05:58,250 --> 02:05:58,984 POST-PROCESSING, A COMPOSITE 2861 02:05:59,051 --> 02:06:01,086 IMAGE WHERE WE COLLECT IMAGES, 2862 02:06:01,153 --> 02:06:03,188 IN THIS CASE THE SAME PATCH, A 2863 02:06:03,255 --> 02:06:06,792 LITTLE OFF FROM THE FOVEA. 2864 02:06:06,859 --> 02:06:10,362 THIS IS A FLY-THROUGH OF THE 2865 02:06:10,429 --> 02:06:10,696 VOLUME. 2866 02:06:10,763 --> 02:06:13,499 NERVE FIBER LAYERS ON TOP. 2867 02:06:13,565 --> 02:06:14,500 YELLOW LINE CORRESPONDS TO 2868 02:06:14,566 --> 02:06:16,001 CROSS-SECTION OVER HERE ON THE 2869 02:06:16,068 --> 02:06:16,368 RIGHT. 2870 02:06:16,435 --> 02:06:19,672 SO WE'RE JUST GETTING INTO THE 2871 02:06:19,738 --> 02:06:21,907 GANGLION CELL LAYER, YOU CAN SEE 2872 02:06:21,974 --> 02:06:26,245 THE STACKS ON TOP OF THE OTHER, 2873 02:06:26,312 --> 02:06:33,018 THE SOMA, FIRST PLEXUS, 2874 02:06:33,085 --> 02:06:33,652 INTERPLEXIFORMILAYER, INNER 2875 02:06:33,719 --> 02:06:35,554 NUCLEAR LAYER, BRIGHT SOMAS HERE 2876 02:06:35,621 --> 02:06:37,623 WE BELIEVE ARE THE DISPLACED 2877 02:06:37,690 --> 02:06:39,925 RETINAL GANGLIA CELLS BUT THAT 2878 02:06:39,992 --> 02:06:43,562 REMAINS IN DEBATE ABOUT THAT. 2879 02:06:43,629 --> 02:06:47,499 INTO THE OUTER PLEXIFORM LAYER, 2880 02:06:47,566 --> 02:06:50,669 ANOTHER PLEXUS, INTO THE DARK 2881 02:06:50,736 --> 02:06:53,806 OUTER NUCLEAR LAYER, YOU SEE 2882 02:06:53,872 --> 02:06:55,975 STRIATIONS WHICH MAY BE 2883 02:06:56,041 --> 02:06:59,278 INDIVIDUAL AXONS, AND THE OUTER 2884 02:06:59,345 --> 02:07:04,083 LAYERS, CONE CELL, FINALLY RPE 2885 02:07:04,149 --> 02:07:04,450 MOSAIC. 2886 02:07:04,516 --> 02:07:06,051 EACH BLEMISH IS INDIVIDUAL RPE 2887 02:07:06,118 --> 02:07:06,652 CELL. 2888 02:07:06,719 --> 02:07:09,621 THAT'S THE TYPE OF IMAGE WE CAN 2889 02:07:09,688 --> 02:07:10,055 GET. 2890 02:07:10,122 --> 02:07:13,392 AND WITH A BIT OF WORK, SO THIS 2891 02:07:13,459 --> 02:07:15,928 TYPE OF VOLUME CONTAINS 2892 02:07:15,995 --> 02:07:17,763 THOUSANDS OF CELLS, DIFFERENT 2893 02:07:17,830 --> 02:07:20,299 TYPES, THAT WE CAN NOW STUDY 2894 02:07:20,366 --> 02:07:21,734 USING THIS TECHNOLOGY. 2895 02:07:21,800 --> 02:07:23,002 IT DIDN'T HAPPEN OVERNIGHT. 2896 02:07:23,068 --> 02:07:25,170 IF YOU LOOK AT THE HISTORY OF 2897 02:07:25,237 --> 02:07:28,173 IT, IT GOES WAY BACK 25 YEARS, 2898 02:07:28,240 --> 02:07:32,878 AND I THINK KIND OF A NICE 2899 02:07:32,945 --> 02:07:34,079 REFLECTION OF THE DEVELOPMENTS 2900 02:07:34,146 --> 02:07:36,582 OVER TIME HAS BEEN INCREASE IN 2901 02:07:36,648 --> 02:07:40,686 SPEED OF THESE SYSTEMS, 2902 02:07:40,753 --> 02:07:42,454 ILLUSTRATED IN TERMS HERE. 2903 02:07:42,521 --> 02:07:44,223 THERE'S IMPROVEMENT OF 500 TIMES 2904 02:07:44,289 --> 02:07:48,027 IN SPEED, BIG JUMP FROM TIME 2905 02:07:48,093 --> 02:07:49,795 DOMAIN WITH UP TO SPECTER 2906 02:07:49,862 --> 02:07:51,930 DOMAIN, TIME DOMAIN WAS HARD TO 2907 02:07:51,997 --> 02:07:53,866 DO WITH AO. 2908 02:07:53,932 --> 02:07:56,235 THE LAST DECADE ANOTHER 40 TIMES 2909 02:07:56,301 --> 02:08:04,143 INCREASE, THAT GOT US UP INTO 2910 02:08:04,209 --> 02:08:05,811 THE MEGAHERTZ RANGE, POINT 2911 02:08:05,878 --> 02:08:08,747 SCANNING, LINE SCANNING, FULL 2912 02:08:08,814 --> 02:08:19,291 FIELD, BROKEN INTO SPECTER 2913 02:08:25,064 --> 02:08:25,898 DOMAIN, SWEPT SOURCE. 2914 02:08:25,964 --> 02:08:32,237 MANY IF NOT MOST USE MEGAHERTZ 2915 02:08:32,304 --> 02:08:32,805 SPEEDS. 2916 02:08:32,871 --> 02:08:34,073 AS GREAT AS TECHNOLOGIES ARE 2917 02:08:34,139 --> 02:08:36,809 OVER HERE, I DON'T THINK ANY OF 2918 02:08:36,875 --> 02:08:39,578 THESE MEGAHERTZ SYSTEMS ARE 2919 02:08:39,645 --> 02:08:43,382 COMMERCIALLY VIABLE, BASED ON 2920 02:08:43,449 --> 02:08:45,918 OPTICAL TECHNOLOGIES OVERLY 2921 02:08:45,984 --> 02:08:56,495 BULKY, COMPLEX, EXPENSIVE, AND 2922 02:08:57,896 --> 02:08:58,097 NON-SCALABLE. 2923 02:08:58,163 --> 02:09:01,200 WORK INTO DEVELOPING HIGH SPEED 2924 02:09:01,266 --> 02:09:11,777 AO SYSTEM, BY A POSTDOC IN MY 2925 02:09:12,044 --> 02:09:12,811 LAB. 2926 02:09:12,878 --> 02:09:14,813 WE NEEDS TO GO TO HIGH ENOUGH 2927 02:09:14,880 --> 02:09:21,753 LOOP RATE TO KEEP RESIDUAL 2928 02:09:21,820 --> 02:09:23,188 ABERRATIONS LOW, MOST CORRECT UP 2929 02:09:23,255 --> 02:09:24,389 TO A COUPLE HERTZ. 2930 02:09:24,456 --> 02:09:30,762 THIS IS BASED ON MEASUREMENTS 2931 02:09:30,829 --> 02:09:40,038 ACQUIRED IN HEALTHY SUBJECTS, 2932 02:09:40,105 --> 02:09:41,440 IDEAL CONDITIONS. 2933 02:09:41,507 --> 02:09:43,342 THERE MAY BE ADDITIONAL MORE 2934 02:09:43,408 --> 02:09:44,243 ELEVATED ABERRATIONS. 2935 02:09:44,309 --> 02:09:54,686 OUR GOAL WAS TO SEE HOW FAST WE 2936 02:09:54,753 --> 02:09:59,925 COULD GO, WE GOT UP TO 33 HERTZ, 2937 02:09:59,992 --> 02:10:02,161 40 HERTZ CUTOFF FREQUENCY, ABOUT 2938 02:10:02,227 --> 02:10:05,831 20 TO 40 TIMES HIGHER THAN THE 2939 02:10:05,898 --> 02:10:08,634 CUTOFF OF CURRENT SYSTEMS. 2940 02:10:08,700 --> 02:10:11,370 OBVIOUSLY THE QUESTION IS, IS 2941 02:10:11,436 --> 02:10:16,175 THERE ANY BENEFIT IN GOING 2942 02:10:16,241 --> 02:10:16,575 FASTER. 2943 02:10:16,642 --> 02:10:18,110 SO, WE LOOKED AT A NUMBER OF 2944 02:10:18,177 --> 02:10:21,580 CLINICAL CONDITIONS WHERE WE 2945 02:10:21,647 --> 02:10:22,548 THOUGHT INCREASED TEMPORAL 2946 02:10:22,614 --> 02:10:23,782 ABERRATIONS MAY OCCUR. 2947 02:10:23,849 --> 02:10:27,386 AND THERE'S A LIST OF SOME OF 2948 02:10:27,452 --> 02:10:28,554 THESE OUGHT OFFICIAL TEARS, 2949 02:10:28,620 --> 02:10:31,823 PEOPLE USE THOSE A LOT, THEY 2950 02:10:31,890 --> 02:10:35,527 CREATE IRREGULAR TEAR FIRM, 2951 02:10:35,594 --> 02:10:36,628 EXCESSIVE BLINKING, AN ISSUE 2952 02:10:36,695 --> 02:10:37,629 WITH AO. 2953 02:10:37,696 --> 02:10:41,900 WE LOOK AT INCREASE THE 2954 02:10:41,967 --> 02:10:44,770 NYSTAGMUS, INCREASED EYE MOTION, 2955 02:10:44,836 --> 02:10:47,472 NON-CYCLED PLEGED EYES, IF YOU 2956 02:10:47,539 --> 02:10:53,812 HAVE A LARGE ENOUGH PUPIL MORE 2957 02:10:53,879 --> 02:10:54,947 CLINICALLY PEEPEL WITH NARROW 2958 02:10:55,013 --> 02:10:56,715 ANSWER ALSO, AND PEOPLE WITH 2959 02:10:56,782 --> 02:11:01,920 CONTACT LENSES MOVE ON THE 2960 02:11:01,987 --> 02:11:03,889 RETINA, HIGH -- SOMEONE WITH 2961 02:11:03,956 --> 02:11:06,658 HIGH MYOPIA WHO GOES OUTSIDE 2962 02:11:06,725 --> 02:11:13,765 DYNAMIC RANGE OR CLINICALLY WITH 2963 02:11:13,832 --> 02:11:17,502 KERATACONUS, MANY EXACERBATED IN 2964 02:11:17,569 --> 02:11:25,010 OLDER PATIENTS, AND PATIENTS 2965 02:11:25,077 --> 02:11:25,344 WITH DISEASE. 2966 02:11:25,410 --> 02:11:29,047 THIS IS LOOKING AT ABERRATIONS, 2967 02:11:29,114 --> 02:11:31,883 TYPICALLY CHARACTERIZED IN TERMS 2968 02:11:31,950 --> 02:11:33,819 OF POWER SPECTRA, WHICH IS IN 2969 02:11:33,885 --> 02:11:38,190 THIS CASE DECREASE AS EXPECTED 2970 02:11:38,257 --> 02:11:39,558 MYOTONICALLY WITH TEMPORAL 2971 02:11:39,625 --> 02:11:39,925 FREQUENCY. 2972 02:11:39,992 --> 02:11:44,062 IMPORTANT IS THIS LINE, THIS IS 2973 02:11:44,129 --> 02:11:45,297 THE DIFFRACTION LIMIT LINE, 2974 02:11:45,364 --> 02:11:48,834 ANYTHING BELOW THAT MEANS THE AO 2975 02:11:48,900 --> 02:11:49,901 IS PROVIDING DIFFRACTION-LIMITED 2976 02:11:49,968 --> 02:11:50,102 IMAGE. 2977 02:11:50,168 --> 02:11:51,236 THAT'S THE NORMAL SUBJECT. 2978 02:11:51,303 --> 02:11:53,272 IF WE LOOK AT CASES I HAD A LIST 2979 02:11:53,338 --> 02:11:56,241 OF ON THE PREVIOUS SLIDE, 2980 02:11:56,308 --> 02:12:00,545 CLINICAL ONES, WE GET WAY UP 2981 02:12:00,612 --> 02:12:02,247 HERE. 2982 02:12:02,314 --> 02:12:05,651 THIS IS TYPICALLY 1 TO -- IT 2983 02:12:05,717 --> 02:12:07,819 FROZE UP. 2984 02:12:07,886 --> 02:12:08,954 HERE WE GO. 2985 02:12:09,021 --> 02:12:10,589 OH, TOO FAR. 2986 02:12:10,656 --> 02:12:14,293 GOES UP 1 TO 2 ORDERS OF 2987 02:12:14,359 --> 02:12:16,728 MAGNITUDE. 2988 02:12:16,795 --> 02:12:19,865 HIGHER. 2989 02:12:19,931 --> 02:12:21,733 AND SO THESE AREN'T GOING TO BE 2990 02:12:21,800 --> 02:12:23,035 CORRECTED WITH CONVENTIONAL 2991 02:12:23,101 --> 02:12:23,835 SYSTEM. 2992 02:12:23,902 --> 02:12:26,004 THIS FOR REFERENCE IS OUR LINE, 2993 02:12:26,071 --> 02:12:27,639 AT OUR HIGH SPEED SYSTEM. 2994 02:12:27,706 --> 02:12:31,143 AND SO THEY DO FALL BELOW THAT. 2995 02:12:31,209 --> 02:12:34,780 AND SO, A LITTLE BIT OF TROUBLE 2996 02:12:34,846 --> 02:12:36,181 WITH THE -- HERE WE GO. 2997 02:12:36,248 --> 02:12:37,849 AND SO THE ANSWER THEN TO THAT 2998 02:12:37,916 --> 02:12:39,584 QUESTION ON THE PREVIOUS SLIDE 2999 02:12:39,651 --> 02:12:43,188 IS, YEAH, THE FASTER AO IS 3000 02:12:43,255 --> 02:12:44,656 REQUIRED TO REACH DIFFRACTION 3001 02:12:44,723 --> 02:12:46,191 LIMITED PERFORMANCE, FOR OTHER 3002 02:12:46,258 --> 02:12:47,893 CASES THAT -- OR ALL THESE OTHER 3003 02:12:47,959 --> 02:12:52,264 CASES THAT WE HAD LOOKED AT. 3004 02:12:59,571 --> 02:13:00,605 TWO EXAMPLES GOING HIGH SPEED, 3005 02:13:00,672 --> 02:13:02,507 YOU GET A FEEL FOR WHAT WE SEE, 3006 02:13:02,574 --> 02:13:05,644 THIS IS THE CASE WITH SOMEONE 3007 02:13:05,711 --> 02:13:06,812 WITH HIGH VISCOUS ARTIFICIAL 3008 02:13:06,878 --> 02:13:07,112 TEARS. 3009 02:13:07,179 --> 02:13:08,413 THIS IS RIGHT AFTER THEY OPEN 3010 02:13:08,480 --> 02:13:13,752 THEIR EYE AFTER A BLINK, WITHOUT 3011 02:13:13,819 --> 02:13:16,355 AO, MATCHES UP HERE, NO CHANGE. 3012 02:13:16,421 --> 02:13:21,159 THIS IS WHAT IT EVOLVES DOWN TO, 3013 02:13:21,226 --> 02:13:24,096 TAKES A SECOND TO CONVERGE TO 3014 02:13:24,162 --> 02:13:26,431 DIFFRACTION LIMIT, AN AVERAGE 3015 02:13:26,498 --> 02:13:28,867 EVER 12 TRACES, ULTRA FAST, DOWN 3016 02:13:28,934 --> 02:13:30,235 TO 63 SECONDS. 3017 02:13:30,302 --> 02:13:35,540 AND THIS DIFFERENCE YOU CAN SEE 3018 02:13:35,607 --> 02:13:44,883 IN OUR AS-OCT, THE CONE MOSAIC, 3019 02:13:44,950 --> 02:13:47,452 CONSECUTIVE FRAMES AFTER THE 3020 02:13:47,519 --> 02:13:50,222 BLINK, 60 MILLISECONDS, SHARP 3021 02:13:50,288 --> 02:13:52,090 IMAGES OF CONE MOSAIC, 3022 02:13:52,157 --> 02:13:53,925 CORRECTION IS STABLE. 3023 02:13:53,992 --> 02:13:55,060 CONVENTIONAL TAKES LONGER TO 3024 02:13:55,127 --> 02:13:56,228 CONVERGE, THERE'S OSCILLATIONS 3025 02:13:56,294 --> 02:13:57,662 AS WELL. 3026 02:13:57,729 --> 02:13:59,698 HERE IS ANOTHER EXAMPLE, THIS IS 3027 02:13:59,765 --> 02:14:08,273 A SUBJECT WITH NYSTAGMUS, A 3028 02:14:08,340 --> 02:14:15,547 FRACTION OF A MILLIMETER. 3029 02:14:15,614 --> 02:14:16,748 THIS IS CONVENTIONAL, ULTRA FAST 3030 02:14:16,815 --> 02:14:19,317 DOES A BIT BETTER. 3031 02:14:19,384 --> 02:14:21,987 IN TERMS OF AVERAGE RATIO WITH 3032 02:14:22,053 --> 02:14:26,224 ULTRA FAST DOWN TO ALMOST GET TO 3033 02:14:26,291 --> 02:14:27,559 DIFFRACTION LIMIT OF .8, 3034 02:14:27,626 --> 02:14:30,028 CONVENTIONAL IS A BIT LOWER. 3035 02:14:30,095 --> 02:14:33,331 AND HERE'S SOME EXAMPLES OF 3036 02:14:33,398 --> 02:14:36,535 IMAGING IN THAT NYSTAGMUS EYE, 3037 02:14:36,601 --> 02:14:37,936 WITH CONVENTIONAL FRAMES DON'T 3038 02:14:38,003 --> 02:14:40,405 EACH GOOD ENOUGH IMAGE QUALITY 3039 02:14:40,472 --> 02:14:42,908 TO SEE THE CONES, LIKE DOWN IN 3040 02:14:42,974 --> 02:14:44,509 HERE, THIS LOCATION. 3041 02:14:44,576 --> 02:14:47,679 IN CONTRAST WITH HIGH SPEED AO, 3042 02:14:47,746 --> 02:14:49,714 WE'RE ABLE TO GET CONSISTENTLY 3043 02:14:49,781 --> 02:14:52,317 GOOD IMAGE QUALITY ACROSS IT. 3044 02:14:52,384 --> 02:14:57,856 IN BOTH CASES, THE MOTION OF THE 3045 02:14:57,923 --> 02:14:59,324 RETINA WE'RE NOT ABLE TO CORRECT 3046 02:14:59,391 --> 02:15:09,167 WITH AO, IT'S GOING TO BE IN THE 3047 02:15:09,234 --> 02:15:09,734 DATA. 3048 02:15:09,801 --> 02:15:12,170 TEMPORAL ABERRATIONS NOTABLY 3049 02:15:12,237 --> 02:15:14,206 ELEVATED IN THE NUMEROUS 3050 02:15:14,272 --> 02:15:15,207 CLINICALLY MORE RELEVANT 3051 02:15:15,273 --> 02:15:17,843 SCENARIOS, BUT IT'S ALL KIND OF 3052 02:15:17,909 --> 02:15:20,779 A GRAY CONTINUUM THERE. 3053 02:15:20,846 --> 02:15:23,081 IN THESE SCENARIOS ULTRA FAST 3054 02:15:23,148 --> 02:15:25,283 AO, ALPHA FORMS, CONVENTIONAL 3055 02:15:25,350 --> 02:15:28,019 AO, WE HAVEN'T FOUND ANY 3056 02:15:28,086 --> 02:15:28,820 PERFORMANCE PENALTY IN 3057 02:15:28,887 --> 02:15:30,989 INCREASING THE AO SPEED. 3058 02:15:31,056 --> 02:15:33,458 SO THAT GETS US TO THE LAST 3059 02:15:33,525 --> 02:15:37,829 PROJECT WHICH IS A SPECIFIC USE 3060 02:15:37,896 --> 02:15:40,131 OF AS-OCT, AND THIS ONE IS 3061 02:15:40,198 --> 02:15:43,768 GETTING DOWN TO THE CONE OUTER 3062 02:15:43,835 --> 02:15:47,038 SEGMENT LENGTH, LED BY A Ph.D. 3063 02:15:47,105 --> 02:15:50,108 STUDENT IN MY GROUP, GIVING A 3064 02:15:50,175 --> 02:15:52,177 DETAILED PRESENTATION AT ARVO, 3065 02:15:52,244 --> 02:15:53,311 FOR THOSE INTERESTED. 3066 02:15:53,378 --> 02:15:57,249 SO LET'S START WITH THIS. 3067 02:15:57,315 --> 02:16:00,852 IN MANY AS-OCT STUDIES WE USE 3068 02:16:00,919 --> 02:16:03,255 THE SAME CONE REFLECTIONS, AS 3069 02:16:03,321 --> 02:16:09,861 YOU FIND IN CLINICAL IMAGES, 3070 02:16:09,928 --> 02:16:12,931 CONE OUTER SEGMENT TIP BAND, WE 3071 02:16:12,998 --> 02:16:16,635 CAN ZOOM IN, THEY GET BLURRY BUT 3072 02:16:16,701 --> 02:16:18,803 STRADDLE THE OUTER SEGMENT. 3073 02:16:18,870 --> 02:16:21,239 AND IF WE MEASURE DISTANCE 3074 02:16:21,306 --> 02:16:23,308 BETWEEN THE TWO BANDS, 3075 02:16:23,375 --> 02:16:25,043 CORRESPONDS TO CONE OUTER 3076 02:16:25,110 --> 02:16:27,145 SEGMENT LENGTH. 3077 02:16:27,212 --> 02:16:28,780 WITH AS-OCT THAT AFFORDS HIGHER 3078 02:16:28,847 --> 02:16:33,051 RESOLUTION, BANDS TURN INTO ROWS 3079 02:16:33,118 --> 02:16:36,187 MUCH PUNCTATED REFLECTIONS, EACH 3080 02:16:36,254 --> 02:16:39,391 IS LIGHT REFLECTING FROM 3081 02:16:39,457 --> 02:16:41,593 INDIVIDUAL CELLS, IN AGGREGATE 3082 02:16:41,660 --> 02:16:44,129 THE LENGTH SHOULD BE SIMILAR TO 3083 02:16:44,195 --> 02:16:47,265 OVER HERE WITH CLINICAL OCT. 3084 02:16:47,332 --> 02:16:51,636 NOW LET'S GO TO A DISEASED EYE, 3085 02:16:51,703 --> 02:16:52,971 RETINITIS PIGMENTOSA, A DISEASE 3086 02:16:53,038 --> 02:16:56,875 WE'VE BEEN STUDYING IN MY LAB. 3087 02:16:56,942 --> 02:16:59,144 CHARACTERIZED BY HEALTHY CENTRAL 3088 02:16:59,210 --> 02:17:01,212 ISLAND SEPARATED FROM THE 3089 02:17:01,279 --> 02:17:04,082 ATROPIC ZONE BY THIS TRANSITION 3090 02:17:04,149 --> 02:17:05,450 ZONE IN BETWEEN. 3091 02:17:05,517 --> 02:17:07,619 AND THAT TRANSITION ZONE IS 3092 02:17:07,686 --> 02:17:09,354 OFTEN OPERATIONALLY DEFINED BY 3093 02:17:09,421 --> 02:17:11,556 WHERE THE COST BAND HERE ENDS. 3094 02:17:11,623 --> 02:17:14,726 AND THEN WHERE THE ISO S BAND 3095 02:17:14,793 --> 02:17:16,428 ENDS OVER HERE. 3096 02:17:16,494 --> 02:17:17,462 THIS NATURALLY BRINGS UP THIS 3097 02:17:17,529 --> 02:17:19,464 QUESTION, WHAT IS THE OUTER 3098 02:17:19,531 --> 02:17:21,299 SEGMENT OF LENGTH OF CONES IN 3099 02:17:21,366 --> 02:17:22,667 THIS TRANSITION ZONE GIVEN THERE 3100 02:17:22,734 --> 02:17:25,904 IS NO COST BAND IN HERE FROM 3101 02:17:25,971 --> 02:17:28,573 CLINICAL OCT. 3102 02:17:28,640 --> 02:17:30,609 AND SO WE THOUGHT MAYBE AS-OCT 3103 02:17:30,675 --> 02:17:32,110 WOULD PROVIDE CLUES TO WHAT'S 3104 02:17:32,177 --> 02:17:32,677 GOING ON. 3105 02:17:32,744 --> 02:17:36,915 HERE IS AN EXAMPLE OF ANOTHER RP 3106 02:17:36,982 --> 02:17:38,950 PATIENT, IMAGED AT THESE THREE 3107 02:17:39,017 --> 02:17:40,785 LOCATIONS, CRITICAL IS JUST 3108 02:17:40,852 --> 02:17:42,887 REALLY THAT THE 6-DEGREE 3109 02:17:42,954 --> 02:17:43,989 LOCATION IN THE TRANSITION ZONE, 3110 02:17:44,055 --> 02:17:48,226 IF THIS WAS A NORMAL HEALTHY 3111 02:17:48,293 --> 02:17:50,528 RETINA AT 6 DEGREES WE WOULD SEE 3112 02:17:50,595 --> 02:17:52,831 THESE TWO ROWS OF PUNCTATED 3113 02:17:52,897 --> 02:17:56,468 REFLECTIONS, AND GIVEN THIS IS 3114 02:17:56,534 --> 02:17:58,770 AN RP PATIENT, CLINICAL OCT, 3115 02:17:58,837 --> 02:18:01,640 REASONABLE GUESS WOULD BE WE 3116 02:18:01,706 --> 02:18:05,143 JUST DON'T SEE THIS BRIGHT BAND 3117 02:18:05,210 --> 02:18:05,810 OF REFLECTIONS. 3118 02:18:05,877 --> 02:18:08,380 WHEN WE LOOK INTO IT, THIS IS 3119 02:18:08,446 --> 02:18:09,180 WHAT WE GET. 3120 02:18:09,247 --> 02:18:11,116 WE DON'T GET LESS REFLECTIONS, 3121 02:18:11,182 --> 02:18:12,951 WE GET A WHOLE BUNCH MORE, ALL 3122 02:18:13,018 --> 02:18:15,186 OVER THE PLACE. 3123 02:18:15,253 --> 02:18:16,721 SO THERE'S REALLY NO OBVIOUS 3124 02:18:16,788 --> 02:18:17,922 VISUAL CORRELATION BETWEEN THIS 3125 02:18:17,989 --> 02:18:21,026 TYPE OF IMAGE AND WHAT YOU GET 3126 02:18:21,092 --> 02:18:22,861 CLINICALLY OVER HERE. 3127 02:18:22,927 --> 02:18:24,796 SO OUR GOAL WAS -- OR REALLY 3128 02:18:24,863 --> 02:18:26,364 QUESTION, CAN WE DEVELOP A 3129 02:18:26,431 --> 02:18:30,502 METHOD THAT WILL ALLOW US TO 3130 02:18:30,568 --> 02:18:32,904 DECIPHER THIS MESS, WHICH BOILS 3131 02:18:32,971 --> 02:18:34,973 DOWN TO WHICH OVER HERE, WHICH 3132 02:18:35,040 --> 02:18:37,909 REFLECTIONS OVER HERE ARE THAT 3133 02:18:37,976 --> 02:18:41,780 THE COST REFLECTION OF EACH 3134 02:18:41,846 --> 02:18:45,383 CELL, AND SO GEORGE JI CAME UP 3135 02:18:45,450 --> 02:18:51,289 WITH THIS METHOD, BASED ON THE 3136 02:18:51,356 --> 02:18:51,990 OPTORETINOGRAM, A WHOLE SESSION 3137 02:18:52,057 --> 02:18:53,358 THIS AFTERNOON. 3138 02:18:53,425 --> 02:18:55,226 I'LL GIVE TWO SENTENCES. 3139 02:18:55,293 --> 02:18:59,497 FIRST IS JUST DEFINITION, AS I 3140 02:18:59,564 --> 02:19:01,266 THINK OF IT, OPTICAL MEASUREMENT 3141 02:19:01,332 --> 02:19:04,235 OF CHANGE IN CONE CELL IN 3142 02:19:04,302 --> 02:19:05,403 RESPONSE TO LIGHT STIMULATION, 3143 02:19:05,470 --> 02:19:08,173 AND THAT'S ALMOST ALWAYS USED IN 3144 02:19:08,239 --> 02:19:10,575 TERMS OF THE CONES LOOKING AT 3145 02:19:10,642 --> 02:19:13,545 THE DIFFERENCE IN PHASE BETWEEN 3146 02:19:13,611 --> 02:19:15,947 THE IS/OS AND COST REFLECTION OF 3147 02:19:16,014 --> 02:19:16,614 THE SAME CELL. 3148 02:19:16,681 --> 02:19:19,884 GEORGE WENT IN AND LOOKED AT ALL 3149 02:19:19,951 --> 02:19:22,287 THE REFLECTIONS BEHIND HERE, AND 3150 02:19:22,353 --> 02:19:23,788 LOOKED AT ORG SIGNAL. 3151 02:19:23,855 --> 02:19:26,091 SO BASED ON THAT HE WAS ABLE TO 3152 02:19:26,157 --> 02:19:28,259 INFER IF A REFLECTION OCCURRED 3153 02:19:28,326 --> 02:19:29,894 INSIDE OF THE OUTER SEGMENT AT 3154 02:19:29,961 --> 02:19:34,332 THE TIP OF THE OUTER SEGMENT, OR 3155 02:19:34,399 --> 02:19:36,067 DOWN BENEATH. 3156 02:19:36,134 --> 02:19:38,236 AND HE HAD A COMPLICATED METHOD, 3157 02:19:38,303 --> 02:19:43,174 I WON'T GO THROUGH IT HERE. 3158 02:19:43,241 --> 02:19:45,043 BUT HAPPY TO ANSWER YOUR 3159 02:19:45,110 --> 02:19:46,644 QUESTIONS AT ARVO ABOUT IT. 3160 02:19:46,711 --> 02:19:48,146 I'M JUST GOING TO JUMP TO 3161 02:19:48,213 --> 02:19:50,348 RESULTS WITH THIS IS METHOD. 3162 02:19:50,415 --> 02:19:59,758 AND SO WE CAN READILY FIND THE 3163 02:19:59,824 --> 02:20:01,726 IS/OS REFLECTION, NORMAL OR 3164 02:20:01,793 --> 02:20:03,595 DISEASE, BY YELLOW STARS. 3165 02:20:03,661 --> 02:20:05,196 USING GEORGE'S METHOD, THE RED 3166 02:20:05,263 --> 02:20:06,598 SPOTS CORRESPOND TO WHERE COST 3167 02:20:06,664 --> 02:20:07,031 IS. 3168 02:20:07,098 --> 02:20:13,505 SO NOW WE'RE IN A POSITION TO 3169 02:20:13,571 --> 02:20:14,472 MEASURE OUTER SEGMENT LENGTH 3170 02:20:14,539 --> 02:20:16,875 EVEN IN THE DISEASED PATCH AND 3171 02:20:16,941 --> 02:20:24,616 FIGURE OUT WHICH CONES HAVE 3172 02:20:24,682 --> 02:20:25,083 ADDITIONAL REFLECTION. 3173 02:20:25,150 --> 02:20:25,917 LAST SLIDE, THE CONTROL SUBJECT, 3174 02:20:25,984 --> 02:20:28,753 WE HAVE A NUMBER OF THEM BUT 3175 02:20:28,820 --> 02:20:29,754 IMAGING AT TWO, FOUR, SIX 3176 02:20:29,821 --> 02:20:32,323 DEGREES, THIS IS THE 3177 02:20:32,390 --> 02:20:34,359 DISTRIBUTION OF CONE OUTER 3178 02:20:34,425 --> 02:20:35,627 SEGMENT LENGTH, FAIRLY 3179 02:20:35,693 --> 02:20:37,128 HOMOGENOUS IN OUTER SEGMENT 3180 02:20:37,195 --> 02:20:37,962 LENGTH HERE. 3181 02:20:38,029 --> 02:20:39,864 WE CAN GO IN NOW AND MEASURE 3182 02:20:39,931 --> 02:20:41,032 WHICH ONES HAVE EXTRA 3183 02:20:41,099 --> 02:20:42,200 REFLECTIONS HERE, AND THIS IS 3184 02:20:42,267 --> 02:20:44,335 THE PERCENTAGE OF THEM. 3185 02:20:44,402 --> 02:20:46,871 THEY VARY BETWEEN 6 TO 10%. 3186 02:20:46,938 --> 02:20:49,140 SO VERY SMALL PERCENTAGE OF THEM 3187 02:20:49,207 --> 02:20:50,809 HAVE THESE EXTRA REFLECTIONS. 3188 02:20:50,875 --> 02:20:54,245 WE NOW GO INTO A DISEASE PATCH, 3189 02:20:54,312 --> 02:20:59,851 TWO EXAMPLES HERE, TWO SUBJECTS. 3190 02:20:59,918 --> 02:21:04,923 TWO, FOUR, SIX, CENTRAL HEALTHY 3191 02:21:04,989 --> 02:21:07,992 ISLAND 2 AND 4 GET CONES OF SAME 3192 02:21:08,059 --> 02:21:09,327 LENGTH BUT EXTRA REFLECTIONS, 3193 02:21:09,394 --> 02:21:11,196 MORE IN THIS PARTICULAR ONE, 3194 02:21:11,262 --> 02:21:14,599 LIKE 33%. 3195 02:21:14,666 --> 02:21:16,234 THEN THE TRANSITION ZONE, 3196 02:21:16,301 --> 02:21:17,902 BECOMES BIMODAL, A LOT OF SHORT 3197 02:21:17,969 --> 02:21:18,736 LENGTH CONES. 3198 02:21:18,803 --> 02:21:20,605 FOR THE LONGER LENGTH CONES 3199 02:21:20,672 --> 02:21:22,240 STILL NORMAL IN LENGTH, HALF OF 3200 02:21:22,307 --> 02:21:24,309 THEM HAVE THESE EXTRA 3201 02:21:24,375 --> 02:21:24,843 REFLECTIONS. 3202 02:21:24,909 --> 02:21:28,079 WE HAVE A SIMILAR STORY FOR THE 3203 02:21:28,146 --> 02:21:29,113 SECOND RP. 3204 02:21:29,180 --> 02:21:30,982 KIND OF KEY FINDINGS AT THIS 3205 02:21:31,049 --> 02:21:32,917 POINT IN OUR PROJECT IS THAT IN 3206 02:21:32,984 --> 02:21:36,554 THE TRANSITION ZONE WE TEND TO 3207 02:21:36,621 --> 02:21:38,990 GET THIS BIMODAL DISUSING, A LOT 3208 02:21:39,057 --> 02:21:40,825 OF DIFFERENT LENGTHS, AND THAT 3209 02:21:40,892 --> 02:21:42,727 THESE NORMAL LENGTH CONES HERE 3210 02:21:42,794 --> 02:21:48,266 ON THIS MODE AND THIS MODE DOWN 3211 02:21:48,333 --> 02:21:52,070 HERE WHICH IS SMALLER LIKELY TO 3212 02:21:52,136 --> 02:21:53,304 HAVE EXTRA REFLECTIONS, FIVE TO 3213 02:21:53,371 --> 02:21:55,740 SEVEN TIMES MORE. 3214 02:21:55,807 --> 02:21:59,110 MAYBE NORMAL LENGTH CONES MAY 3215 02:21:59,177 --> 02:22:04,449 ALREADY BE COMPROMISED. 3216 02:22:04,515 --> 02:22:05,984 WE TESTED BY LONGITUDINALLY 3217 02:22:06,050 --> 02:22:08,386 TRACKING THESE CONES OVER TIME. 3218 02:22:08,453 --> 02:22:11,022 SO IN CONCLUSION I GAVE A LITTLE 3219 02:22:11,089 --> 02:22:12,924 BIT OF INTRODUCTION TO AS-OCT 3220 02:22:12,991 --> 02:22:16,828 AND MOTIVATION FOR IT, USED ON 3221 02:22:16,895 --> 02:22:17,829 DEVELOPING HIGH SPEED, BENEFIT 3222 02:22:17,896 --> 02:22:20,531 THAT SEEMS TO ACCRUE FROM GOING 3223 02:22:20,598 --> 02:22:23,234 FASTER, AND INTO SPECIFIC 3224 02:22:23,301 --> 02:22:25,937 APPLICATION LOOKING AT CONE 3225 02:22:26,004 --> 02:22:27,305 PHOTORECEPTOR CELLS, OUTER 3226 02:22:27,372 --> 02:22:29,173 SEGMENT LENGTHS AND ADDITIONAL 3227 02:22:29,240 --> 02:22:29,474 REFLECTIONS. 3228 02:22:29,540 --> 02:22:29,774 THANK YOU. 3229 02:22:29,841 --> 02:22:32,110 [APPLAUSE] 3230 02:22:37,849 --> 02:22:41,653 THANKS 3231 02:22:41,719 --> 02:22:43,655 >> THANKS FOR THE GREAT START, 3232 02:22:43,721 --> 02:22:45,924 DON. 3233 02:22:45,990 --> 02:22:50,228 NEXT SPEAKER IS FROM NEI, ANDREW 3234 02:22:50,295 --> 02:22:51,896 BOWER, FROM NEI, SURFACING 3235 02:22:51,963 --> 02:22:55,433 RESOLUTION LIMIT OF ADAPTIVE 3236 02:22:55,500 --> 02:23:05,476 OPTICS OCT IMAGING. 3237 02:23:05,543 --> 02:23:06,544 >> THANKS FOR THE INTRODUCTION, 3238 02:23:06,611 --> 02:23:06,778 AUSTIN. 3239 02:23:06,844 --> 02:23:09,914 WE HEARD A GREAT TALK FROM DON 3240 02:23:09,981 --> 02:23:11,716 GIVING BACKGROUND IN AS-OCT, AND 3241 02:23:11,783 --> 02:23:13,685 EXCITING NEW DEVELOPMENTS IN THE 3242 02:23:13,751 --> 02:23:14,886 FIELD. 3243 02:23:14,953 --> 02:23:16,421 MY BACKGROUND IS MICROSCOPY, 3244 02:23:16,487 --> 02:23:17,622 RESOLUTION IS CENTRAL TO 3245 02:23:17,689 --> 02:23:20,258 EVERYTHING THAT WE THINK ABOUT. 3246 02:23:20,325 --> 02:23:24,896 AND REALLY DEFINES THE WAY WE 3247 02:23:24,963 --> 02:23:30,301 THINK ABOUT THE FIELD. 3248 02:23:30,368 --> 02:23:31,202 SUPER RESOLUTION TECHNIQUES 3249 02:23:31,269 --> 02:23:33,204 CHANGED THE WAY WE DO SCIENCE, 3250 02:23:33,271 --> 02:23:35,440 ALLOWING US TO ASK AND ANSWER 3251 02:23:35,506 --> 02:23:36,808 QUESTIONS WE NEVER IMAGINED IN 3252 02:23:36,874 --> 02:23:38,343 THE PAST. 3253 02:23:38,409 --> 02:23:39,410 RETINAL IMAGING FIELD, I'VE 3254 02:23:39,477 --> 02:23:41,379 FOUND THAT WE ARE AT THE 3255 02:23:41,446 --> 02:23:45,116 PRECIPICE OF A SIMILAR KIND OF 3256 02:23:45,183 --> 02:23:47,752 REVOLUTION, TODAY I'D LIKE TO 3257 02:23:47,819 --> 02:23:49,687 SHARE PART OF THAT JOURNEY HOW 3258 02:23:49,754 --> 02:23:50,822 WE'VE BEEN PUSHING RESOLUTION 3259 02:23:50,888 --> 02:23:53,925 LIMITS BEYOND WHAT WE MAY BE 3260 02:23:53,992 --> 02:23:57,595 ABLE TO ACHIEVE WITH ADAPTIVE 3261 02:23:57,662 --> 02:23:59,030 OPTICS ALONE SPECIFICALLY FOR 3262 02:23:59,097 --> 02:24:00,465 AS-OCT IMAGE. 3263 02:24:00,531 --> 02:24:01,733 AN EXAMPLE WHERE I'M COMING FROM 3264 02:24:01,799 --> 02:24:06,270 HERE LET ME START WITH A 3265 02:24:06,337 --> 02:24:08,439 CLINICAL INFRARED REFLECTANCE 3266 02:24:08,506 --> 02:24:11,209 IMAGING A HEALTHY SUBJECT WE 3267 02:24:11,275 --> 02:24:12,276 IMAGED UPSTAIRS IN THE EYE 3268 02:24:12,343 --> 02:24:12,744 CLINIC. 3269 02:24:12,810 --> 02:24:14,612 YOU CAN SEE THE DISC HERE, 3270 02:24:14,679 --> 02:24:16,881 CENTERED AT THE FOVEA HERE. 3271 02:24:16,948 --> 02:24:22,720 IF WE ZOOM IN ON A REGION OF 3272 02:24:22,787 --> 02:24:26,691 RETINA 2 OR 3 MILLIMETERS FROM 3273 02:24:26,758 --> 02:24:29,293 THE FOVEA WE CAN GET A NICE 3274 02:24:29,360 --> 02:24:30,928 IMAGE OF PHOTORECEPTORS LIKE DON 3275 02:24:30,995 --> 02:24:31,696 SHOWED EARLIER. 3276 02:24:31,763 --> 02:24:33,431 BECAUSE THIS IS THREE 3277 02:24:33,498 --> 02:24:35,833 DIMENSIONAL, WE GET NOT ONLY A 3278 02:24:35,900 --> 02:24:38,069 VIEW OF THE PHOTORECEPTOR LAYER 3279 02:24:38,136 --> 02:24:40,304 SHOWING US BRIGHT SPOTS AND 3280 02:24:40,371 --> 02:24:42,473 DISKS CORRESPONDING TO 3281 02:24:42,540 --> 02:24:45,777 PHOTORECEPTOR OUTER SEGMENTS, 3282 02:24:45,843 --> 02:24:48,379 THREE DIMENSIONAL VIEW, YOU CAN 3283 02:24:48,446 --> 02:24:51,082 SEE PHOTORECEPTOR REFLECTIONS 3284 02:24:51,149 --> 02:24:53,918 HERE AND THE RPE CELLS 3285 02:24:53,985 --> 02:24:54,452 UNDERNEATH. 3286 02:24:54,519 --> 02:24:57,622 HOWEVER, IF WE MOVE A FEW 3287 02:24:57,688 --> 02:25:02,727 MILLIMETERS CLOSER TO THE FOVEA, 3288 02:25:02,794 --> 02:25:05,229 CAPTURE THE EDGE, YOU SEE THE 3289 02:25:05,296 --> 02:25:07,765 DARK IMAGE AND DOME SHAPE, 3290 02:25:07,832 --> 02:25:09,634 IMAGES LOOK DIFFERENT IN OUR 3291 02:25:09,700 --> 02:25:10,134 SYSTEM. 3292 02:25:10,201 --> 02:25:13,771 YOU CAN SEE THESE CONES ARE MUCH 3293 02:25:13,838 --> 02:25:15,706 SMALLER, MUCH CLOSER SPACED 3294 02:25:15,773 --> 02:25:17,208 TOGETHER AS WE EXPECT, PUSHING 3295 02:25:17,275 --> 02:25:20,111 THE LIMITS OF WHAT WE ACHIEVE 3296 02:25:20,178 --> 02:25:21,112 DUE TO RESOLUTION CAPABILITIES 3297 02:25:21,179 --> 02:25:23,848 OF OUR INSTRUMENT. 3298 02:25:23,915 --> 02:25:32,690 AT THE TOP LEFT YOU CAN 3299 02:25:32,757 --> 02:25:33,891 DISTINGUISH PHOTORECEPTORS. 3300 02:25:33,958 --> 02:25:35,793 CLOSER YOU SEE IMAGES BLURRY, 3301 02:25:35,860 --> 02:25:37,695 HAZY, A SPECKLED APPEARANCE. 3302 02:25:37,762 --> 02:25:39,931 IT BECOMES DIFFICULT TO 3303 02:25:39,997 --> 02:25:41,032 DISTINGUISH PHOTORECEPTORS AND 3304 02:25:41,099 --> 02:25:45,136 UNDERSTAND WHAT WE'RE REALLY 3305 02:25:45,203 --> 02:25:45,470 SEEING. 3306 02:25:45,536 --> 02:25:46,170 THIS IS UNFORTUNATE BECAUSE THIS 3307 02:25:46,237 --> 02:25:48,172 IS A VERY IMPORTANT AND CRITICAL 3308 02:25:48,239 --> 02:25:49,740 PART OF OUR VISUAL SYSTEM. 3309 02:25:49,807 --> 02:25:52,643 IT'S UNIQUE TO THE HUMAN VISUAL 3310 02:25:52,710 --> 02:25:53,744 SYSTEM, A MISSED OPPORTUNITY TO 3311 02:25:53,811 --> 02:25:56,347 SHOW YOU CELLS IN MORE DETAIL. 3312 02:25:56,414 --> 02:25:59,283 SO FOR US IT LED TO THE QUESTION 3313 02:25:59,350 --> 02:26:03,488 THAT SPAWNED THIS, HOW CAN WE 3314 02:26:03,554 --> 02:26:10,394 IMPROVE LATERAL RESOLUTION 3315 02:26:10,461 --> 02:26:11,362 BEYOND DIFFRACTION LIMIT THAT 3316 02:26:11,429 --> 02:26:12,130 AS-OCT ALLOWS. 3317 02:26:12,196 --> 02:26:14,799 WE TOOK A STEP BACK, LOOKING AT 3318 02:26:14,866 --> 02:26:18,002 WHAT WE LEARNED FROM THE 3319 02:26:18,069 --> 02:26:25,676 SCANNING FIELD, 2D ANALOG TO 3D 3320 02:26:25,743 --> 02:26:26,444 IMAGES. 3321 02:26:26,511 --> 02:26:30,581 THIS IS A 790-NANOMETER, LOWER 3322 02:26:30,648 --> 02:26:33,684 WAVELENGTH, HIGHER RESOLUTION, 3323 02:26:33,751 --> 02:26:35,086 FOVEA OF HEALTHY SUBJECT, AND 3324 02:26:35,153 --> 02:26:39,490 YOU CAN SEE THESE ARE GOOD 3325 02:26:39,557 --> 02:26:39,724 IMAGES. 3326 02:26:39,790 --> 02:26:40,458 WE CAN DELINEATE PHOTORECEPTORS 3327 02:26:40,525 --> 02:26:41,559 QUITE WELL. 3328 02:26:41,626 --> 02:26:44,395 IF WE ZOOM IN ON A REGION VERY 3329 02:26:44,462 --> 02:26:49,000 CLOSE TO THE FOVEA CENTER 3330 02:26:49,066 --> 02:26:49,967 THERE'S BLURRINESS, HAZINESS, 3331 02:26:50,034 --> 02:26:53,504 AND WE CAN GET BEYOND THIS NICE 3332 02:26:53,571 --> 02:26:54,906 IMAGE AND PUSH FURTHER. 3333 02:26:54,972 --> 02:26:58,576 FIRST THING WE CAN DO IS BRING 3334 02:26:58,643 --> 02:27:01,746 IN SUBAREA DETECTION SIGNAL, A 3335 02:27:01,812 --> 02:27:04,415 SMALL PIN HOLE ALLOWING US TO 3336 02:27:04,482 --> 02:27:08,286 REFLECT SLIGHT COMING BACK TO A 3337 02:27:08,352 --> 02:27:11,155 SMALL PATCH, ELIMINATING BLURRY, 3338 02:27:11,222 --> 02:27:12,957 HAZY LIGHT. 3339 02:27:13,024 --> 02:27:14,692 WE CAN MODIFY ILLUMINATION, WHAT 3340 02:27:14,759 --> 02:27:16,827 WE SENDING TO THE RETINA. 3341 02:27:16,894 --> 02:27:20,331 INSTEAD OF ILLUMINATING WITH 3342 02:27:20,398 --> 02:27:23,534 CIRCULAR BEAN WITH ILLUMINATE 3343 02:27:23,601 --> 02:27:25,436 WITH A RING-SHAPED BEAM. 3344 02:27:25,503 --> 02:27:27,205 COMBINING THE TWO APPROACHES, 3345 02:27:27,271 --> 02:27:29,307 RING ILLUMINATION, AND SUBAREA 3346 02:27:29,373 --> 02:27:38,983 DETECTION, WE GET BY FAR BEST 3347 02:27:39,050 --> 02:27:40,251 RESULTS WITH OUR AO-SLO. 3348 02:27:40,318 --> 02:27:42,653 WE GO FROM SOMETHING THAT IS 3349 02:27:42,720 --> 02:27:44,889 VERY GOOD WITH AO ALONE AND PUSH 3350 02:27:44,956 --> 02:27:46,991 BEYOND THAT RESOLUTION LIMIT TO 3351 02:27:47,058 --> 02:27:49,727 GET SOMETHING THAT'S EVEN 3352 02:27:49,794 --> 02:27:51,596 BETTER. 3353 02:27:51,662 --> 02:27:53,864 SO, THE IDEA KIND OF CAN WE 3354 02:27:53,931 --> 02:27:57,702 THROW IT IN AND USE IT IN OUR 3355 02:27:57,768 --> 02:27:58,035 AS-OCT SYSTEM? 3356 02:27:58,102 --> 02:27:59,904 THE ANSWER IS NOT EXACTLY, NOT 3357 02:27:59,971 --> 02:28:01,272 RIGHT AWAY. 3358 02:28:01,339 --> 02:28:03,541 THE CHALLENGE HERE IS THAT IN 3359 02:28:03,608 --> 02:28:05,710 OUR AS-OCT SYSTEM AND IN SEVERAL 3360 02:28:05,776 --> 02:28:07,278 WE HAVE THIS ARCHITECTURE THAT 3361 02:28:07,345 --> 02:28:11,816 HAS A SHARED ILLUMINATION AND 3362 02:28:11,882 --> 02:28:15,119 DETECTION PATH. 3363 02:28:15,186 --> 02:28:16,854 BASIC SETUP, 3 MEGAHERTZ, LIGHT 3364 02:28:16,921 --> 02:28:18,823 SOURCE, SEND IT THROUGH 3365 02:28:18,889 --> 02:28:20,358 SCANNERS, SCANS THE PATTERN ON 3366 02:28:20,424 --> 02:28:22,326 THE RETINA, THAT LIGHT THAT 3367 02:28:22,393 --> 02:28:26,063 RETURNS TAKES THE SAME PATH BACK 3368 02:28:26,130 --> 02:28:27,732 AND SENT TO DETECTION CHANNELS. 3369 02:28:27,798 --> 02:28:29,700 YOU CAN IMAGINE IF WE WANTED TO 3370 02:28:29,767 --> 02:28:35,006 PUT A RING ILLUMINATION, LIGHT 3371 02:28:35,072 --> 02:28:37,608 COMING BACK WOULD ALSO HIT THAT 3372 02:28:37,675 --> 02:28:38,776 RING PATTERN AND WOULD AFFECT 3373 02:28:38,843 --> 02:28:40,077 OUR DETECTION SIDE. 3374 02:28:40,144 --> 02:28:42,613 SAME WITH THE SUBAREA DETECTION 3375 02:28:42,680 --> 02:28:42,847 SIGNALS. 3376 02:28:42,913 --> 02:28:45,149 THEY ARE AFFECTING EACH OTHER, 3377 02:28:45,216 --> 02:28:45,983 NOT INDEPENDENTLY CONTROLLING 3378 02:28:46,050 --> 02:28:48,252 WHERE WE NEED TO BE. 3379 02:28:48,319 --> 02:28:49,186 AO IS HAPPENING IN THE 3380 02:28:49,253 --> 02:28:51,022 BACKGROUND THE WHOLE TIME SO 3381 02:28:51,088 --> 02:28:55,092 WE'RE USING AO TO KEEP 3382 02:28:55,159 --> 02:28:56,594 OURSELVES AT DIVERSITY FRACTION 3383 02:28:56,661 --> 02:28:57,028 LIMIT. 3384 02:28:57,094 --> 02:28:59,730 WE TAKE A DIFFERENT APPROACH, 3385 02:28:59,797 --> 02:29:03,401 SEPARATE THESE TWO, NOW WE HAVE 3386 02:29:03,467 --> 02:29:08,039 TWO INDEPENDENT PATHS. 3387 02:29:08,105 --> 02:29:09,840 RING ILLUMINATION MASK, SEND 3388 02:29:09,907 --> 02:29:10,708 BEAM TO SCANNERS, SCAN ACROSS 3389 02:29:10,775 --> 02:29:16,547 THE RHETT -- RETINA. 3390 02:29:16,614 --> 02:29:18,883 LIGHT GOES TO SEPARATE DETECTION 3391 02:29:18,949 --> 02:29:23,421 PATH, PUT THE SUBAREA DETECTION 3392 02:29:23,487 --> 02:29:23,754 IN. 3393 02:29:23,821 --> 02:29:25,456 DETECT IN TYPICAL OCT SETUP. 3394 02:29:25,523 --> 02:29:30,761 WE HAVE INDEPENDENT CONTROL OF 3395 02:29:30,828 --> 02:29:31,629 ILLUMINATION AND DETECTION. 3396 02:29:31,696 --> 02:29:33,931 WE CAN SEE HOW WELL THIS WORKS. 3397 02:29:33,998 --> 02:29:35,666 TO START WE DID THIS OUTSIDE THE 3398 02:29:35,733 --> 02:29:37,635 EYE, JUST TO VALIDATE THE 3399 02:29:37,702 --> 02:29:40,805 RESOLUTION IMPROVEMENT WE EXPECT 3400 02:29:40,871 --> 02:29:48,879 TO SEE BASED ON AO-SLO. 3401 02:29:48,946 --> 02:29:50,448 BAR TARGET, AS SIZES GET SMALLER 3402 02:29:50,514 --> 02:29:51,949 WE WANT TO DISTINGUISH THREE 3403 02:29:52,016 --> 02:29:53,918 BARS FOR EACH PATTERN. 3404 02:29:53,984 --> 02:29:56,654 IF WE SHOW IMPROVEMENT BETWEEN 3405 02:29:56,721 --> 02:29:57,755 CONVENTIONAL TYPICAL CASE AND 3406 02:29:57,822 --> 02:29:59,857 OUR RING ILLUMINATION AND 3407 02:29:59,924 --> 02:30:01,459 SUBAREA DETECTION CASE, WE'LL BE 3408 02:30:01,525 --> 02:30:04,028 MORE CONVINCED THIS IS WORKING. 3409 02:30:04,095 --> 02:30:08,366 ZOOM IN ON A SMALL PATCH AND USE 3410 02:30:08,432 --> 02:30:09,400 CONVENTIONAL CASE, THE ACCEPTUP 3411 02:30:09,467 --> 02:30:12,303 WE CAN TELL MAYBE THERE'S A FEW 3412 02:30:12,370 --> 02:30:14,338 AREAS WHERE WE CAN DISTINGUISH 3413 02:30:14,405 --> 02:30:17,341 THIS BAR, BAR PATTERNS, BUT IT'S 3414 02:30:17,408 --> 02:30:18,709 VERY BLURRY AND RIGHT AT THE 3415 02:30:18,776 --> 02:30:23,414 LIMITS OF WHAT OUR SYSTEM CAN 3416 02:30:23,481 --> 02:30:24,548 RESOLVE. 3417 02:30:24,615 --> 02:30:26,050 BRINGING IN SUBAREA DETECTION 3418 02:30:26,117 --> 02:30:28,853 PIN HOLE WE SEE IMPROVEMENT. 3419 02:30:28,919 --> 02:30:30,421 ESPECIALLY TOWARDS THE TOP LEFT 3420 02:30:30,488 --> 02:30:32,056 PORTIONS, COMPARING THEM YOU CAN 3421 02:30:32,123 --> 02:30:33,624 SEE A SMALL IMPROVEMENT IN 3422 02:30:33,691 --> 02:30:34,692 ABILITY TO RESOLVE FINER 3423 02:30:34,759 --> 02:30:37,294 FEATURES BUT BY FAR THE BEST 3424 02:30:37,361 --> 02:30:39,930 RESULTS ARE COMBINING THESE AS 3425 02:30:39,997 --> 02:30:41,399 WE EXPECT FROM OUR AO-SLO 3426 02:30:41,465 --> 02:30:42,900 RESULTS, MAKING OUT MORE 3427 02:30:42,967 --> 02:30:44,869 PATTERNS, DOWN TO FINE PATTERNS 3428 02:30:44,935 --> 02:30:49,373 THAT ARE BASICALLY NOT ABLE TO 3429 02:30:49,440 --> 02:30:51,308 BE RESOLVED IN CONVENTIONAL 3430 02:30:51,375 --> 02:30:51,776 APPROACH. 3431 02:30:51,842 --> 02:30:54,645 DRAWING A LINE, WE CAN SEE FOR 3432 02:30:54,712 --> 02:30:55,880 THIS BAR PATTERN CONVENTIONAL 3433 02:30:55,946 --> 02:30:58,749 CASE WE DON'T SEE CLEAR CONTRAST 3434 02:30:58,816 --> 02:31:01,786 BETWEEN BARS, BRINGING IN 3435 02:31:01,852 --> 02:31:02,620 SUBAREA DETECTION SCHEME WE SEE 3436 02:31:02,686 --> 02:31:06,891 A LITTLE BIT OF CONTRAST THERE 3437 02:31:06,957 --> 02:31:10,461 BUT, AGAIN, AGREEING WITH WHAT 3438 02:31:10,528 --> 02:31:14,131 WE SEE BEST IS COMBINING IN 3439 02:31:14,198 --> 02:31:15,299 ADDITION TO ADAPTIVE OPTICS. 3440 02:31:15,366 --> 02:31:16,467 THIS LOOKS LIKE IT'S WORKING 3441 02:31:16,534 --> 02:31:18,769 OUTSIDE THE EYE BUT THE REAL 3442 02:31:18,836 --> 02:31:20,404 IMPORTANCE HERE IS HOW WELL IT 3443 02:31:20,471 --> 02:31:21,839 WORKS INSIDE THE HIGH. 3444 02:31:21,906 --> 02:31:28,813 WE STARTED FIRST BY LOOKING AT 3445 02:31:28,879 --> 02:31:33,484 FOVEAL SCANS, CONVENTIONAL 3446 02:31:33,551 --> 02:31:34,185 FIRST. 3447 02:31:34,251 --> 02:31:36,220 ASTERISK AGAIN, THE SMALL 3448 02:31:36,287 --> 02:31:36,854 PHOTORECEPTORS, TIGHTLY SPACED 3449 02:31:36,921 --> 02:31:37,955 IN THE HUMAN EYE. 3450 02:31:38,022 --> 02:31:41,425 YOU CAN SEE A BIT OF CHALLENGES 3451 02:31:41,492 --> 02:31:43,260 WE'RE FACING RIGHT AWAY AT THE 3452 02:31:43,327 --> 02:31:45,162 FIRST REFLECTIVE LAYER. 3453 02:31:45,229 --> 02:31:49,800 YOU START TO SEE SMEARING ALONG 3454 02:31:49,867 --> 02:31:50,301 THIS PHOTORECEPTOR BAND, 3455 02:31:50,367 --> 02:31:52,136 INDICATING WE'RE AGAIN AT THE 3456 02:31:52,203 --> 02:31:53,471 LIMIT OF RESOLUTION, WHAT WE CAN 3457 02:31:53,537 --> 02:31:54,538 SEE IN THE CONES. 3458 02:31:54,605 --> 02:31:56,574 REALLY EXCITING WHEN WE BRING IN 3459 02:31:56,640 --> 02:31:57,741 THE SUBAREA DETECTION CASE WE 3460 02:31:57,808 --> 02:32:01,145 CAN START TO SEE WHAT DON WAS 3461 02:32:01,212 --> 02:32:06,484 DESCRIBING EARLIER, PUNCTATE IN 3462 02:32:06,550 --> 02:32:11,055 THE RECEPTOR RECEPTOR BANS NOW 3463 02:32:11,121 --> 02:32:14,859 SEEN IN INDIVIDUAL CONES. 3464 02:32:14,925 --> 02:32:18,329 WE CAN SEE PUNCTATE GETTING 3465 02:32:18,395 --> 02:32:21,565 CLOSER TO FOVEAL CENTER, A BIG 3466 02:32:21,632 --> 02:32:22,600 IMPROVEMENT, EXCITING TO SEE. 3467 02:32:22,666 --> 02:32:25,069 THE BEST WAY IS ZOOMING IN, YOU 3468 02:32:25,135 --> 02:32:26,437 CAN SEE INDIVIDUAL REFLECTIONS 3469 02:32:26,504 --> 02:32:33,511 BECOMING MUCH MORE CLEAR AS THEY 3470 02:32:33,577 --> 02:32:34,345 ADD RESOLUTION-ENHANCING 3471 02:32:34,411 --> 02:32:34,645 CONDITIONS. 3472 02:32:34,712 --> 02:32:38,682 THIS IS A 2D IMAGES, SPEED 3473 02:32:38,749 --> 02:32:40,251 INCREASES OVER THE COURSE IS 3474 02:32:40,317 --> 02:32:44,054 BEING ABLE TO DO TRUE VOLUMETRIC 3475 02:32:44,121 --> 02:32:45,856 IMAGING WITH DENSE SAMPLING. 3476 02:32:45,923 --> 02:32:48,726 WE WERE EXCITED TO GO AFTER THAT 3477 02:32:48,792 --> 02:32:50,761 NEXT, LOOKING AT THE FIRST 3478 02:32:50,828 --> 02:32:52,730 PHOTORECEPTOR AT THE FOVEAL 3479 02:32:52,796 --> 02:32:53,697 SECTION, A DIFFERENT SUBJECT, 3480 02:32:53,764 --> 02:32:57,201 LOOKING CENTERED AT THE FOVEAL 3481 02:32:57,268 --> 02:32:57,568 CENTER. 3482 02:32:57,635 --> 02:33:00,838 WE TAKE A SLAB THROUGH THAT 3483 02:33:00,905 --> 02:33:02,439 PHOTORECEPTOR REFLECTION, TURN 3484 02:33:02,506 --> 02:33:04,642 IT ON ITS SIDE AT THE LOOK AT 3485 02:33:04,708 --> 02:33:08,245 THE PROJECTION. 3486 02:33:08,312 --> 02:33:09,480 CONVENTIONAL IMAGE LOOKS LIKE 3487 02:33:09,547 --> 02:33:11,715 THIS, DUE TO THE DOME SHAPE OF 3488 02:33:11,782 --> 02:33:13,317 THE PHOTORECEPTORS AS WE MIGHT 3489 02:33:13,384 --> 02:33:13,751 EXPECT. 3490 02:33:13,817 --> 02:33:18,122 TOWARDS THE EDGES MAYBE YOU CAN 3491 02:33:18,188 --> 02:33:21,492 RESOLVE A FEW BUT VERY HAZY 3492 02:33:21,559 --> 02:33:23,494 SPECKLED IMAGE DIFFICULT TO 3493 02:33:23,561 --> 02:33:24,795 DETERMINE CELLULAR STRUCTURE OF. 3494 02:33:24,862 --> 02:33:27,264 WHEN WE BRING IN THE SUBAREA 3495 02:33:27,331 --> 02:33:28,866 DETECTION CASE WE IMMEDIATELY 3496 02:33:28,933 --> 02:33:30,067 SEE IMPROVEMENT, ESPECIALLY ON 3497 02:33:30,134 --> 02:33:32,469 EDGES OF IMAGES WHERE THE CONES 3498 02:33:32,536 --> 02:33:34,405 AT THE EDGES ARE NOW EASY TO 3499 02:33:34,471 --> 02:33:35,739 DISTINGUISH. 3500 02:33:35,806 --> 02:33:40,077 WE SEE A BIT OF A HAZY PATTERN 3501 02:33:40,144 --> 02:33:43,914 AS WE GET CLOSER TO THE CENTER 3502 02:33:43,981 --> 02:33:45,516 OF THE FOVEA. 3503 02:33:45,583 --> 02:33:48,719 A BIG IMPROVEMENT. 3504 02:33:48,786 --> 02:33:49,887 WHEN WE BRING IN COMBINED 3505 02:33:49,954 --> 02:33:52,156 APPROACH WITH RING ILLUMINATION 3506 02:33:52,222 --> 02:33:54,858 AND SUBAREA DETECTION ALL EDGES 3507 02:33:54,925 --> 02:33:56,527 ARE VISIBLE, SPECKLED APPEARANCE 3508 02:33:56,594 --> 02:33:58,362 STARTS TO DIMINISH, WE START TO 3509 02:33:58,429 --> 02:34:00,397 GET CLOSE TO THE FOVEAL CENTER 3510 02:34:00,464 --> 02:34:04,835 IN ABILITY TO REDUCE THESE 3511 02:34:04,902 --> 02:34:05,035 CELLS. 3512 02:34:05,102 --> 02:34:06,503 I'M GOING TO LET THIS PLAY SO 3513 02:34:06,570 --> 02:34:11,275 YOU CAN SEE THE IMPROVEMENT SIDE 3514 02:34:11,342 --> 02:34:13,777 LIE SIDE. 3515 02:34:22,453 --> 02:34:24,989 IT LOOKS LIKE A BIG IMPROVEMENT, 3516 02:34:25,055 --> 02:34:26,123 VERY EXCITING, BUT PUTTING 3517 02:34:26,190 --> 02:34:28,626 EVERYTHING SIDE BY SIDE WE WANT 3518 02:34:28,692 --> 02:34:31,695 TO KNOW HOW MUCH WE CAN EXPECT 3519 02:34:31,762 --> 02:34:34,732 TO ACHIEVE IN DOING THIS, 3520 02:34:34,798 --> 02:34:39,870 BRINGING THESE MODULES IN. 3521 02:34:39,937 --> 02:34:41,605 A SMALL REGION, VISUALLY WE 3522 02:34:41,672 --> 02:34:43,507 CAN'T RESOLVE MUCH TO SOMETHING 3523 02:34:43,574 --> 02:34:45,609 THAT'S A LITTLE BETTER WITH 3524 02:34:45,676 --> 02:34:47,444 SUBAREA DETECTION TO SOME IMAGES 3525 02:34:47,511 --> 02:34:50,147 WHERE WE CAN SEE EVERY CONE 3526 02:34:50,214 --> 02:34:53,450 PHOTORECEPTOR WITH COMBINED RING 3527 02:34:53,517 --> 02:34:54,852 AND SUBAREA MODULES. 3528 02:34:54,918 --> 02:34:56,387 TO QUANTIFY THIS, ONE OF THE 3529 02:34:56,453 --> 02:34:59,923 TOOLS WE USE IS POWER SPECTRUM 3530 02:34:59,990 --> 02:35:01,525 DENSITY, SIMILAR TO WHAT DON WAS 3531 02:35:01,592 --> 02:35:03,661 DOING IN A MORE SPATIAL SENSE. 3532 02:35:03,727 --> 02:35:06,563 WE WANT TO LOOK AT SOME KIND OF 3533 02:35:06,630 --> 02:35:09,333 RESOLUTION OR CONTRAST METRIC 3534 02:35:09,400 --> 02:35:10,934 THAT RANGES ACROSS FEATURE SIZE 3535 02:35:11,001 --> 02:35:13,037 SO ON THE Y-AXIS YOU'RE LOOKING 3536 02:35:13,103 --> 02:35:15,339 AT CONTRAST RESOLUTION TYPE 3537 02:35:15,406 --> 02:35:16,440 METRIC, X-AXIS WE'RE LOOKING AT 3538 02:35:16,507 --> 02:35:18,275 SPATIAL FEATURE SIZE AND 3539 02:35:18,342 --> 02:35:19,209 SPACING, SO TOWARDS THE LEFT 3540 02:35:19,276 --> 02:35:22,246 LARGE FEATURES THAT ARE SPACED 3541 02:35:22,312 --> 02:35:23,814 FAR APART, TOWARDS THE RIGHT 3542 02:35:23,881 --> 02:35:25,416 SMALLER OBJECTS MORE CLOSELY 3543 02:35:25,482 --> 02:35:27,551 SPACED TOGETHER. 3544 02:35:27,618 --> 02:35:29,420 YOU CAN IMAGINE FOVEAL CONE 3545 02:35:29,486 --> 02:35:31,989 SPACING LIES IN THE MIDDLE HERE, 3546 02:35:32,056 --> 02:35:33,791 AND WHAT WE'D EXPECT TO SEE WITH 3547 02:35:33,857 --> 02:35:36,193 IMPROVEMENT IN RESOLUTION IS A 3548 02:35:36,260 --> 02:35:37,761 PEAK TO OCCUR ABOVE BASELINE 3549 02:35:37,828 --> 02:35:41,598 PROVIDED TO THE CONVENTIONAL 3550 02:35:41,665 --> 02:35:41,799 CASE. 3551 02:35:41,865 --> 02:35:44,001 EVERYTHING IS IN REFERENCE TO 3552 02:35:44,068 --> 02:35:45,769 CONVENTIONAL CASE. 3553 02:35:45,836 --> 02:35:47,271 SUBAREA, WE DO THE PEAK 3554 02:35:47,337 --> 02:35:48,472 CORRESPONDING TO THE SPACING 3555 02:35:48,539 --> 02:35:52,142 WE'D EXPECT TO SEE FOVEA 3556 02:35:52,209 --> 02:35:53,644 PHOTORECEPTORS AT. 3557 02:35:53,711 --> 02:35:56,580 AND BRINGING IN THE RING AREA WE 3558 02:35:56,647 --> 02:35:59,616 SEE DRAMATIC INCREASE THAT WE 3559 02:35:59,683 --> 02:36:01,819 SEE VISUALLY SHOWING 20X 3560 02:36:01,885 --> 02:36:04,655 IMPROVEMENT IN THIS PSC METRIC 3561 02:36:04,722 --> 02:36:07,124 RELATIVE TO CONVENTIONAL CASE, 3562 02:36:07,191 --> 02:36:13,897 DRAMATIC IMPROVEMENT IN 3563 02:36:13,964 --> 02:36:15,332 RESOLUTION FOR AO-OCT SYSTEM. 3564 02:36:15,399 --> 02:36:19,136 COMING BACK TO THE WHOLE 3565 02:36:19,203 --> 02:36:21,572 APPROACH, WE STARTED WITH OUR 3566 02:36:21,638 --> 02:36:24,208 AO-SLO, WE START WITH NICE 3567 02:36:24,274 --> 02:36:25,676 IMAGES WITH CONVENTIONAL 3568 02:36:25,743 --> 02:36:26,710 ADAPTIVE OPTICS. 3569 02:36:26,777 --> 02:36:29,546 WE FOUND WITH ENHANCING USING 3570 02:36:29,613 --> 02:36:30,414 RESOLUTION-ENHANCING MODULES CAN 3571 02:36:30,481 --> 02:36:32,249 TAKE A NICE IMAGE AND PUSH 3572 02:36:32,316 --> 02:36:35,552 BOUNDARIES FURTHER TO GET IMAGES 3573 02:36:35,619 --> 02:36:36,887 EVEN SHARPER, EVEN CLEARER. 3574 02:36:36,954 --> 02:36:38,055 WE'VE TAKEN THESE IDEAS AND 3575 02:36:38,122 --> 02:36:44,061 TRIED TO MOVE TO THREE 3576 02:36:44,128 --> 02:36:44,862 DIMENSIONAL AO-OCT, LOWER 3577 02:36:44,928 --> 02:36:46,730 RESOLUTION BECAUSE OF LOWER 3578 02:36:46,797 --> 02:36:48,198 WAIVE LENGTH BUT STILL QUITE 3579 02:36:48,265 --> 02:36:52,069 NICE, TO WHERE WE CAN NOW REVEAL 3580 02:36:52,136 --> 02:36:55,606 UNDERLYING CELLULAR STRUCTURE WE 3581 02:36:55,672 --> 02:36:56,840 WEREN'T ABLE TO DELINEATE, AN 3582 02:36:56,907 --> 02:36:57,875 EXCITING OPPORTUNITY HERE. 3583 02:36:57,941 --> 02:37:00,811 I'M EXCITED TO SEE THIS AS WE 3584 02:37:00,878 --> 02:37:02,045 PUSH THIS CLOSER TOWARDS 3585 02:37:02,112 --> 02:37:03,380 CLINICAL SETTINGS AND TRY TO 3586 02:37:03,447 --> 02:37:09,119 UNDERSTAND A LOT OF THE 3587 02:37:09,186 --> 02:37:10,354 PROPERTIES FOVEAL CONE MOSAIC, 3588 02:37:10,420 --> 02:37:14,525 AND THIS IS ONLY THE BEGINNING. 3589 02:37:14,591 --> 02:37:15,559 OUR SYSTEM, THERE'S SOME THINGS 3590 02:37:15,626 --> 02:37:17,928 WE CAN DO TO IMPROVE RESOLUTION 3591 02:37:17,995 --> 02:37:21,665 FUNDAMENTALLY BY GOING TO LOWER 3592 02:37:21,732 --> 02:37:23,167 WAVELENGTHS, THERE'S A LOT OF 3593 02:37:23,233 --> 02:37:24,501 ROOM FOR IMPROVEMENT, WE'RE 3594 02:37:24,568 --> 02:37:25,702 EXCITED TO PUSH BOUNDARIES 3595 02:37:25,769 --> 02:37:29,273 FURTHER AND GET CLOSER TO 3596 02:37:29,339 --> 02:37:33,577 SOMETHING, FINDINGS RESOLUTION 3597 02:37:33,644 --> 02:37:35,279 COMMUNITIES OR MICROSCOPY 3598 02:37:35,345 --> 02:37:36,480 COMMUNITIES FOUND IN THE PAST 3599 02:37:36,547 --> 02:37:37,915 AND PUSHED BOUNDARIES OF WHAT 3600 02:37:37,981 --> 02:37:38,982 WE'RE ABLE TO DO. 3601 02:37:39,049 --> 02:37:40,384 WITH THAT I'D LIKE TO 3602 02:37:40,450 --> 02:37:42,519 ACKNOWLEDGE THE MEMBERS OF MIGHT 3603 02:37:42,586 --> 02:37:45,589 HAVE LAB INCLUDING P.I., DR. 3604 02:37:45,656 --> 02:37:47,457 JOHNNY TAM, COLLABORATORS WITH 3605 02:37:47,524 --> 02:37:53,931 NIH AND AS WELL AS STANFORD 3606 02:37:53,997 --> 02:37:57,935 UNIVERSITY AND THE FDA. 3607 02:37:58,001 --> 02:37:59,203 THANK YOU. 3608 02:37:59,269 --> 02:37:59,736 [APPLAUSE] 3609 02:37:59,803 --> 02:38:00,704 THANKS, ANDREW. 3610 02:38:00,771 --> 02:38:05,776 THE THIRD SPEAKER TODAY IS 3611 02:38:05,843 --> 02:38:07,077 ZHOULIN LIU, STAFF FELLOW, 3612 02:38:07,144 --> 02:38:09,680 OFFICE OF SCIENCE AND 3613 02:38:09,746 --> 02:38:10,547 ENGINEERING LABS, U.S. FOOD AND 3614 02:38:10,614 --> 02:38:13,450 DRUG ADMINISTRATION, THE TITLE 3615 02:38:13,517 --> 02:38:17,187 IS IMAGING HUMAN 3616 02:38:17,254 --> 02:38:18,956 CHORIOCAPILLARIS WITH ADAPTIVE 3617 02:38:19,022 --> 02:38:19,356 OPTICS-OCT. 3618 02:38:19,423 --> 02:38:21,992 >> THANK YOU VERY MUCH, FOR THE 3619 02:38:22,059 --> 02:38:22,326 INTRODUCTION. 3620 02:38:22,392 --> 02:38:29,666 IT IS AN HONOR TO BE HERE TO 3621 02:38:29,733 --> 02:38:32,236 SHARE HOUR RESEARCH AT THE FDA. 3622 02:38:32,302 --> 02:38:37,975 PREVIOUS SPEAKERS TALKED ABOUT 3623 02:38:38,041 --> 02:38:38,442 CLINICAL APPLICATIONS. 3624 02:38:38,508 --> 02:38:44,448 I'D LIKE TO START WITH THE 3625 02:38:44,514 --> 02:38:45,916 AO-OCT DEVICE. 3626 02:38:45,983 --> 02:38:49,786 THE COMPANIES WHO HAVE ACHIEVED 3627 02:38:49,853 --> 02:38:51,855 AO COMMERCIALIZATION HAVE AO 3628 02:38:51,922 --> 02:39:00,264 DEVICES IMPLEMENTED WITH 3629 02:39:00,330 --> 02:39:02,366 DIFFERENT IMAGE MODALITIES. 3630 02:39:02,432 --> 02:39:04,201 AND THOSE COMPANIES RECEIVED 3631 02:39:04,268 --> 02:39:06,637 COMMERCIALIZATION OUTSIDE OF THE 3632 02:39:06,703 --> 02:39:07,204 U.S. 3633 02:39:07,271 --> 02:39:10,007 WHY HAS AO-OCT NOT ACHIEVED FULL 3634 02:39:10,073 --> 02:39:11,341 CLINICAL TRANSLATION? 3635 02:39:11,408 --> 02:39:15,078 IN TERMS OF REGULATORY BURDEN 3636 02:39:15,145 --> 02:39:16,713 THERE'S PERFORMANCE ASSESSMENT 3637 02:39:16,780 --> 02:39:18,448 FOR STANDARDIZATION AND 3638 02:39:18,515 --> 02:39:24,454 REGULATORY EVALUATION, IN TERMS 3639 02:39:24,521 --> 02:39:29,293 OF DEVICE LIMITATIONS, SMALL 3640 02:39:29,359 --> 02:39:32,963 IMAGING TRANSLATING INTO 3641 02:39:33,030 --> 02:39:35,332 INCOMPLETE PICTURE. 3642 02:39:35,399 --> 02:39:38,602 NEW TECHNOLOGIES AUTOMATED 3643 02:39:38,669 --> 02:39:40,370 ALGORITHMS, AI AND BEST 3644 02:39:40,437 --> 02:39:42,139 PRACTICES HAVE NOT FULLY 3645 02:39:42,205 --> 02:39:49,146 IMPLEMENTED IN THAT SPACE. 3646 02:39:49,212 --> 02:39:56,153 THEY LACK VALIDATED BIOMARKERS, 3647 02:39:56,219 --> 02:39:58,422 WITH USE AO-OCT. 3648 02:39:58,488 --> 02:40:04,227 OF AO PROGRAM AT FDA ATTEMPTED 3649 02:40:04,294 --> 02:40:10,233 TO ADDRESS SOME HURDLES, AS WELL 3650 02:40:10,300 --> 02:40:11,201 AS BIOMARKER DEVELOPMENTS WHICH 3651 02:40:11,268 --> 02:40:13,937 I'M GOING TO TALK MORE IN THE 3652 02:40:14,004 --> 02:40:17,174 NEXT TWO SLIDES. 3653 02:40:17,240 --> 02:40:19,609 I LIKE TO THINK AS A PERSONAL 3654 02:40:19,676 --> 02:40:23,246 DEVICE THAT CREATES CHALLENGES 3655 02:40:23,313 --> 02:40:25,916 FOR THE DEVELOPERS AND REVIEWERS 3656 02:40:25,983 --> 02:40:32,022 IN TERMS OF STANDARDIZATION IN 3657 02:40:32,089 --> 02:40:32,656 ASSESSMENT. 3658 02:40:32,723 --> 02:40:37,527 NOTICE THERE ARE METRICS YOU CAN 3659 02:40:37,594 --> 02:40:39,396 TARGET. 3660 02:40:39,463 --> 02:40:49,940 WE DEVELOPED AO PHANTOM FOR 3661 02:40:53,710 --> 02:40:55,979 RESOLUTION ASSESSMENT. 3662 02:40:56,046 --> 02:41:00,050 WE CREATE THAT HOLLOW CONE AS 3663 02:41:00,117 --> 02:41:00,517 PHOTORECEPTOR PHANTOM. 3664 02:41:00,584 --> 02:41:05,055 YOU MAY SHOW ON THE RIGHT 3665 02:41:05,122 --> 02:41:08,258 HERE -- SORRY ABOUT THAT. 3666 02:41:08,325 --> 02:41:12,996 IMAGE ON THE RIGHT IS TAKEN WITH 3667 02:41:13,063 --> 02:41:14,965 OUR AO INSTRUMENT. 3668 02:41:15,032 --> 02:41:18,602 AO PHOTORECEPTOR PHANTOM IS USED 3669 02:41:18,668 --> 02:41:20,904 IN MULTI-SITE CLINICAL STUDY, 3670 02:41:20,971 --> 02:41:30,480 WILL BE SUBMITTED TO THE PHANTOM 3671 02:41:30,547 --> 02:41:31,214 LIBRARY. 3672 02:41:31,281 --> 02:41:33,350 WE DEVELOPED BIOMARKERS THAT 3673 02:41:33,417 --> 02:41:41,658 TARGET DIFFERENT DISEASES. 3674 02:41:41,725 --> 02:41:44,494 WE STUDY MORPHOLOGY. 3675 02:41:44,561 --> 02:41:49,132 ALSO WE DEVELOPED RETINAL 3676 02:41:49,199 --> 02:41:51,134 GANGLIA CELL BIOMARKERS. 3677 02:41:51,201 --> 02:41:56,373 THE DENSITY REDUCTION WITH CELL 3678 02:41:56,440 --> 02:41:57,340 BODY ENLARGEMENT IN GLAUCOMA 3679 02:41:57,407 --> 02:42:01,578 COMPARED WITH CONTROL SUBJECTS 3680 02:42:01,645 --> 02:42:05,882 TAKEN AT THE SAME. 3681 02:42:05,949 --> 02:42:09,486 BEYOND OPHTHALMOLOGY TO STUDY 3682 02:42:09,553 --> 02:42:11,054 NEUROLOGICAL DISEASE WHICH 3683 02:42:11,121 --> 02:42:13,623 CALLED MULTIPLE SCLEROSIS. 3684 02:42:13,690 --> 02:42:16,693 FOR OTHER DISEASE WE TARGET 3685 02:42:16,760 --> 02:42:19,663 RECEPTOR, PIGMENT EPITHELIUM 3686 02:42:19,729 --> 02:42:20,530 CELLS, BEGIN ESTABLISHING 3687 02:42:20,597 --> 02:42:24,067 NORMATIVE DATA FOR RPE AND 3688 02:42:24,134 --> 02:42:25,735 PHOTORECEPTOR MORPHOLOGY. 3689 02:42:25,802 --> 02:42:29,473 WE'RE REALLY DEVELOPING A 3690 02:42:29,539 --> 02:42:30,674 GROWING LIST OF AOCT 3691 02:42:30,740 --> 02:42:32,642 CAPABILITIES WE HOPE TO IMPACT 3692 02:42:32,709 --> 02:42:37,581 FOR CLINICAL TRANSLATION AS WELL 3693 02:42:37,647 --> 02:42:39,583 AS WELL AS REGULATORY SCIENCE. 3694 02:42:39,649 --> 02:42:43,253 THE TALK ALIGNS WITH PREVIOUS 3695 02:42:43,320 --> 02:42:46,022 EFFORT IN TERMS OF CELLULAR 3696 02:42:46,089 --> 02:42:47,858 BIOMARKER DEVELOPMENT, STEPPED 3697 02:42:47,924 --> 02:42:53,497 OUR CAPABILITY TO IMAGE HUMAN 3698 02:42:53,563 --> 02:42:53,897 CHORIOCAPILLARIS. 3699 02:42:53,964 --> 02:42:56,700 WE KNOW THE HUMAN 3700 02:42:56,766 --> 02:42:58,568 CHORIOCAPILLARIS APPLIES 3701 02:42:58,635 --> 02:43:03,373 METABOLIC NEEDS FOR 3702 02:43:03,440 --> 02:43:05,442 PHOTORECEPTOR RPE COMPLEX, AND 3703 02:43:05,509 --> 02:43:09,913 WE ALSO KNOW THAT THE CC PLAYS 3704 02:43:09,980 --> 02:43:18,522 ESSENTIAL RETINAL HEALTH. 3705 02:43:18,588 --> 02:43:19,122 VISUALIZING INDIVIDUAL 3706 02:43:19,189 --> 02:43:21,758 CHORIOCAPILLARIS SEGMENTS WITH 3707 02:43:21,825 --> 02:43:24,394 CURRENT AVAILABLE IMAGING 3708 02:43:24,461 --> 02:43:25,595 MODALITIES, IMPOSING OR LIMITS 3709 02:43:25,662 --> 02:43:27,063 UNDERSTANDING ON DISEASE 3710 02:43:27,130 --> 02:43:30,433 MECHANISM AND ABILITY TO MONITOR 3711 02:43:30,500 --> 02:43:33,036 DISEASE PROGRESSION. 3712 02:43:33,103 --> 02:43:34,070 PREVIOUS ATTEMPTS ON RESOLVING 3713 02:43:34,137 --> 02:43:35,539 CHORIOCAPILLARIS WITH AO-OCT HAS 3714 02:43:35,605 --> 02:43:39,276 LIMIT IMAGING FIELD OF VIEW, AND 3715 02:43:39,342 --> 02:43:40,243 REQUIRED EXTREMELY LONG 3716 02:43:40,310 --> 02:43:42,179 ACQUISITION TIME. 3717 02:43:42,245 --> 02:43:52,189 SO, OBJECTIVE HERE TODAY IS 3718 02:43:52,255 --> 02:43:57,227 REALLY TO DEVELOP AO-OCT TO MAP 3719 02:43:57,294 --> 02:43:58,428 HUMAN MORPHOLOGY. 3720 02:43:58,495 --> 02:44:01,531 WE USE OCT SYSTEM, HERE IS A 3721 02:44:01,598 --> 02:44:03,800 SCHEMATIC DIAGRAM OF THE LAYOUT. 3722 02:44:03,867 --> 02:44:05,936 I WON'T GO INTO DETAIL BUT 3723 02:44:06,002 --> 02:44:08,438 HIGHLIGHT A FEW KEY FEATURES, 3724 02:44:08,505 --> 02:44:14,644 THAT IS VERY IMPORTANT FOR THIS 3725 02:44:14,711 --> 02:44:15,378 STUDY. 3726 02:44:15,445 --> 02:44:18,715 THAT IS THE ACQUISITION SPEED 3727 02:44:18,782 --> 02:44:25,355 ALONG WITH RELATIVELY LARGE 3728 02:44:25,422 --> 02:44:28,792 IMAGE FIELD OF VIEW. 3729 02:44:28,858 --> 02:44:31,494 AND THEN WE DESIGN INTO TWO 3730 02:44:31,561 --> 02:44:32,395 PARTS. 3731 02:44:32,462 --> 02:44:36,099 FIRST PROTOCOL AIMED TO OPTIMIZE 3732 02:44:36,166 --> 02:44:37,400 EYE POSITION, WE STUDY HOW 3733 02:44:37,467 --> 02:44:40,270 REPEATED B SCAN AND NUMBER OF 3734 02:44:40,337 --> 02:44:44,107 VOLUME AVERAGING COULD AFFECT CC 3735 02:44:44,174 --> 02:44:44,674 IMAGING. 3736 02:44:44,741 --> 02:44:48,979 PROTOCOL 2, TO ESTABLISH 3737 02:44:49,045 --> 02:44:51,982 NORMATIVE DATA, HUMAN 3738 02:44:52,048 --> 02:44:53,917 CHORIOCAPILLARIS MORPHOLOGY. 3739 02:44:53,984 --> 02:44:57,954 CO-ALIGNING INFORMATION ARE 3740 02:44:58,021 --> 02:45:01,925 OBTAINED FROM THE SAME AO-OCT 3741 02:45:01,992 --> 02:45:06,196 VOLUME FOR VISUALIZATION. 3742 02:45:06,263 --> 02:45:09,532 AFTER SEGMENTATION WE CAN HAVE 3743 02:45:09,599 --> 02:45:11,601 MORPHOLOGICAL PARAMETERS TO SOME 3744 02:45:11,668 --> 02:45:12,936 RESULTS PRESENTED LATER. 3745 02:45:13,003 --> 02:45:19,042 SO, LET'S LOOK AT RESULTS. 3746 02:45:19,109 --> 02:45:21,111 HOW NUMBERS AFFECT SHOWING FROM 3747 02:45:21,177 --> 02:45:24,814 LEFT THROUGH RIGHT HERE IS THE 3748 02:45:24,881 --> 02:45:28,652 CHORIOCAPILLARIS VIEW FROM 3749 02:45:28,718 --> 02:45:29,986 SINGLE VOLUME ACQUISITION, 3750 02:45:30,053 --> 02:45:31,755 DIFFERENT B SCAN SETTINGS. 3751 02:45:31,821 --> 02:45:34,591 WE CAN SEE THE VESSEL CONTRAST 3752 02:45:34,658 --> 02:45:36,526 IMPROVED WITH INCREASING NUMBER 3753 02:45:36,593 --> 02:45:39,062 OF REPEAT B SCANS BUT LARGE 3754 02:45:39,129 --> 02:45:43,033 REPEAT B SCANS WILL RESULT IN 3755 02:45:43,099 --> 02:45:44,534 LONG VOLUME ACQUISITION TIMES 3756 02:45:44,601 --> 02:45:46,736 AND BECOME A PROBLEM. 3757 02:45:46,803 --> 02:45:49,406 REGARDLESS, IF WE LOOK AT ZOOMED 3758 02:45:49,472 --> 02:45:52,842 IN IMAGES FROM THE SAME LOCATION 3759 02:45:52,909 --> 02:45:55,412 WE CAN APPRECIATE THE BENEFIT 3760 02:45:55,478 --> 02:45:58,615 FROM INCREASING REPEAT NUMBER OF 3761 02:45:58,682 --> 02:46:04,354 B SCANS, QUANTIFIED BY TAKING 3762 02:46:04,421 --> 02:46:07,524 SEGMENTATION RESULTS, COMPARE 3763 02:46:07,590 --> 02:46:10,026 THE SIGNAL FROM THE VESSEL AREA 3764 02:46:10,093 --> 02:46:13,897 VERSUS SIGNAL AREA FROM THE 3765 02:46:13,963 --> 02:46:14,331 VOID. 3766 02:46:14,397 --> 02:46:16,266 THIS SHOWS INCREASE IN SIGNAL TO 3767 02:46:16,333 --> 02:46:18,201 NOISE WITH INCREASING NUMBER OF 3768 02:46:18,268 --> 02:46:24,374 REPEAT SCANS FROM FOUR TO 3769 02:46:24,441 --> 02:46:25,008 TWELVE. 3770 02:46:25,075 --> 02:46:27,644 WE WANT TO KNOW HOW SIGNAL NOISE 3771 02:46:27,711 --> 02:46:29,846 IS BENEFIT FROM VOLUME AVERAGE, 3772 02:46:29,913 --> 02:46:33,717 DEFINE TOTAL ACQUISITION TIME 3773 02:46:33,783 --> 02:46:35,251 TWO SECONDS, WHICH IS BEFORE OUR 3774 02:46:35,318 --> 02:46:36,252 PATIENTS HOLD THEIR EYE OPEN, 3775 02:46:36,319 --> 02:46:38,588 THAT WOULD BE THE TIME WHEN YOU 3776 02:46:38,655 --> 02:46:43,827 ASK THE SUBJECT TO OPEN YOUR 3777 02:46:43,893 --> 02:46:46,863 EYES, ONE TWO, TWO SECONDS LATER 3778 02:46:46,930 --> 02:46:48,965 YOU GET IMAGE, SIGNAL TO NOISE 3779 02:46:49,032 --> 02:46:51,101 IMPROVING WITH INCREASING VOLUME 3780 02:46:51,167 --> 02:46:53,370 AVERAGING THAT AGREES WITH OUR 3781 02:46:53,436 --> 02:46:54,371 VISUAL INSPECTION. 3782 02:46:54,437 --> 02:47:00,243 WE CAN DO THE SAME WITH OTHER 3783 02:47:00,310 --> 02:47:01,911 REPEATED SCAN SIGHTINGS. 3784 02:47:01,978 --> 02:47:06,182 HERE IS THE RESULTS WITH MAXIMUM 3785 02:47:06,249 --> 02:47:09,352 PERMISSIBLE VOLUME AVERAGE, AND 3786 02:47:09,419 --> 02:47:12,722 THIS IS FOR REPEAT, SCAN OF 3787 02:47:12,789 --> 02:47:17,360 FOUR, NUMBER SIX, UP TO 12. 3788 02:47:17,427 --> 02:47:19,229 WE CONCLUDE THE MOST BENEFIT ON 3789 02:47:19,295 --> 02:47:23,266 SIGNAL TO NOISE IS COMING FROM 3790 02:47:23,333 --> 02:47:29,305 NUMBER OF B SCANS, REPEAT B SCAN 3791 02:47:29,372 --> 02:47:30,840 USE, VOLUME AVERAGING. 3792 02:47:30,907 --> 02:47:35,678 WE THINK IMAGES WITH SIGNAL TO 3793 02:47:35,745 --> 02:47:38,148 NOISE ABOVE 20 DB ALLOWS 3794 02:47:38,214 --> 02:47:39,282 VISUALIZATION, AND THERE IS A 3795 02:47:39,349 --> 02:47:41,418 SWEET SPOT WHERE YOU GET A GOOD 3796 02:47:41,484 --> 02:47:42,786 BALANCE IN BETWEEN SIGNAL TO 3797 02:47:42,852 --> 02:47:46,122 NOISE AND EYE MOTION. 3798 02:47:46,189 --> 02:47:48,925 WE FINALIZE REPEAT SCANS AS 3799 02:47:48,992 --> 02:47:50,427 OPTIMAL SCAN PARAMETER FOR 3800 02:47:50,493 --> 02:47:52,929 SUFFICIENT SIGNAL TO NOISE, NO 3801 02:47:52,996 --> 02:47:55,598 NEED FOR VOLUME AVERAGING. 3802 02:47:55,665 --> 02:47:59,436 SO, WITH THAT SCAN PROTOCOL, WE 3803 02:47:59,502 --> 02:48:01,070 CAN MAP OUT PHOTORECEPTOR 3804 02:48:01,137 --> 02:48:03,039 COMPLEX. 3805 02:48:03,106 --> 02:48:08,011 HERE IS EXAMPLE FROM 38-YEAR-OLD 3806 02:48:08,077 --> 02:48:11,281 SUBJECT, HEALTHY VOLUNTEER, THIS 3807 02:48:11,347 --> 02:48:13,416 IS MONTAGE, GENERATED FROM 3808 02:48:13,483 --> 02:48:19,622 SINGLE VOLUMES, HERE SHOWS 3809 02:48:19,689 --> 02:48:19,989 CORRESPONDENTING 3810 02:48:20,056 --> 02:48:22,692 CHORIOCAPILLARIS REGION. 3811 02:48:22,759 --> 02:48:24,093 FOR GENERATING DATA TOOK PLACE 3812 02:48:24,160 --> 02:48:26,362 UNDER TWO MINUTES. 3813 02:48:26,429 --> 02:48:28,531 HOWEVER, THE TOTAL IMAGING TIME 3814 02:48:28,598 --> 02:48:30,366 LASTS ABOUT ONE HOUR. 3815 02:48:30,433 --> 02:48:36,606 BELIEVE IT OR NOT, WE FOUND THE 3816 02:48:36,673 --> 02:48:38,675 STREAMING THE DATA, FROM OUR 3817 02:48:38,741 --> 02:48:40,143 DIGITIZER TO THE COMPUTER TAKES 3818 02:48:40,210 --> 02:48:42,412 MOST OF THE TIME. 3819 02:48:42,479 --> 02:48:44,380 MORE THAN 90% OF THE TIME 3820 02:48:44,447 --> 02:48:46,883 SUBJECTS WERE WAITING, KEEP 3821 02:48:46,950 --> 02:48:47,884 THEIR EYE CLOSED. 3822 02:48:47,951 --> 02:48:52,055 JOHNNY TAM AND TEAM AT NEI HAVE 3823 02:48:52,121 --> 02:48:55,658 DEMONSTRATED SIMILAR DATA 3824 02:48:55,725 --> 02:48:58,695 STREAMING WITH DATA PIKING AND 3825 02:48:58,761 --> 02:49:00,563 ABERRANT STRATEGY, WE ESTIMATED 3826 02:49:00,630 --> 02:49:02,198 IMAGING, TOTAL TIME DURATION CAN 3827 02:49:02,265 --> 02:49:04,701 BE SHORTENED DOWN TO FIVE TO TEN 3828 02:49:04,767 --> 02:49:08,104 MINUTES TO GENERATE THE DATA 3829 02:49:08,171 --> 02:49:10,507 THAT CREATED SUCH A PICTURE. 3830 02:49:10,573 --> 02:49:12,308 NOW I'D LIKE TO GO BACK TO 3831 02:49:12,375 --> 02:49:15,578 IMAGES FOR A LITTLE BIT MORE 3832 02:49:15,645 --> 02:49:17,213 DETAILS, IN THE MONTAGE SHOWS 3833 02:49:17,280 --> 02:49:21,918 NOT ONLY WE CAN VISUALIZE 3834 02:49:21,985 --> 02:49:26,189 INDIVIDUAL CHORIOCAPILLARIS BUT 3835 02:49:26,256 --> 02:49:27,924 LOBULAR STRUCTURE AND 3836 02:49:27,991 --> 02:49:30,593 DISTRIBUTION, CONSIDERED AS A 3837 02:49:30,660 --> 02:49:34,597 VERY IMPORTANT ROLE IN TERMS OF 3838 02:49:34,664 --> 02:49:39,569 REGULAR FLOW OF CIRCULATION. 3839 02:49:39,636 --> 02:49:42,272 AND SHOWS SIMILARITY, COMPARED 3840 02:49:42,338 --> 02:49:43,339 WITH HUMAN CHORIOCAPILLARIS, 3841 02:49:43,406 --> 02:49:47,777 WHEN WE PUT SIDE BY SIDE AT THE 3842 02:49:47,844 --> 02:49:51,347 SAME SKILL PERSPECTIVE. 3843 02:49:51,414 --> 02:49:54,751 FURTHERMORE IF WE COMPARE AO-OCT 3844 02:49:54,817 --> 02:49:57,387 DATA WITH CONVENTIONAL IMAGE 3845 02:49:57,453 --> 02:50:01,925 FROM THE SAME SUBJECT, WE CAN 3846 02:50:01,991 --> 02:50:03,960 APPRECIATE LEVEL OF DETAILS AND 3847 02:50:04,027 --> 02:50:06,930 RESOLUTION FROM USING AO, 3848 02:50:06,996 --> 02:50:09,766 ALTHOUGH SOME COARSE FEATURES 3849 02:50:09,832 --> 02:50:12,702 CAN BE VISUALIZED IN BOTH IMAGES 3850 02:50:12,769 --> 02:50:14,804 INDICATED HERE. 3851 02:50:14,871 --> 02:50:17,040 WE ESTABLISH NORMATIVE DATA FOR 3852 02:50:17,106 --> 02:50:17,740 CHORIOCAPILLARIS QUANTIFICATION 3853 02:50:17,807 --> 02:50:20,243 FROM 21 HEALTHY SUBJECTS OR 3854 02:50:20,310 --> 02:50:21,044 VOLUNTEERS. 3855 02:50:21,110 --> 02:50:24,180 AND OUR RESULTS INDICATE THAT 3856 02:50:24,247 --> 02:50:26,015 HUMAN CHORIOCAPILLARIS SHOWS 3857 02:50:26,082 --> 02:50:28,051 DIFFERENCES IN VASODENSITY, 3858 02:50:28,117 --> 02:50:31,988 DIAMETER, AS WELL AS VOID 3859 02:50:32,055 --> 02:50:32,255 DIAMETER. 3860 02:50:32,322 --> 02:50:38,628 WITH THIS NORMATIVE DATA WE CAN 3861 02:50:38,695 --> 02:50:40,196 QUANTIFY HOW CHORIOCAPILLARIS 3862 02:50:40,263 --> 02:50:42,565 MORPHOLOGY DIFFER IN DISEASED 3863 02:50:42,632 --> 02:50:43,700 CONDITION. 3864 02:50:43,766 --> 02:50:46,336 HERE IS EXAMPLE OF 58 YEARS OLD 3865 02:50:46,402 --> 02:50:50,139 VOLUNTEER WHO HAD NO DIAGNOSIS 3866 02:50:50,206 --> 02:50:52,875 OF CURATIVE DISEASE, IMAGED 3867 02:50:52,942 --> 02:50:54,644 MACULAR ACROSS HORIZONTAL AND 3868 02:50:54,711 --> 02:50:56,946 VERTICAL MAIN LINE, IN AO-OCT 3869 02:50:57,013 --> 02:51:02,752 VOLUMES WE SEE MOST OF THE CONES 3870 02:51:02,819 --> 02:51:04,053 ARE GUIDING REGARDLESS OF 3871 02:51:04,120 --> 02:51:09,459 PRESENCE OF DRUSEN AT CENTRAL 3872 02:51:09,525 --> 02:51:10,226 MACULA. 3873 02:51:10,293 --> 02:51:14,764 AS AN RPE LAYER REVIEWS MORE 3874 02:51:14,831 --> 02:51:17,667 DRUSEN ACROSS IMAGING FIELD, 3875 02:51:17,734 --> 02:51:18,434 CORRESPONDING CHORIOCAPILLARY 3876 02:51:18,501 --> 02:51:20,770 MONTAGE AT SAME LOCATION. 3877 02:51:20,837 --> 02:51:23,606 THERE IS A CORRESPONDENCE 3878 02:51:23,673 --> 02:51:25,375 BETWEEN PRESENCE OF DRUSEN AND 3879 02:51:25,441 --> 02:51:30,279 FLOW SIGNAL, CONFIRMED WHEN WE 3880 02:51:30,346 --> 02:51:33,516 SEPARATE DRUSEN REGIONS. 3881 02:51:33,583 --> 02:51:36,619 WE OBSERVE A 13% DENSITY 3882 02:51:36,686 --> 02:51:38,454 REDUCTION IN DRUSEN REGION 3883 02:51:38,521 --> 02:51:41,924 COMPARED WITH NEIGHBORING 3884 02:51:41,991 --> 02:51:42,992 NON-DRUSEN REGIONS. 3885 02:51:43,059 --> 02:51:45,094 HERE IS ANOTHER EXAMPLE, A 3886 02:51:45,161 --> 02:51:47,597 SUBJECT WITH A CONE-ROD ATROPHY, 3887 02:51:47,664 --> 02:51:49,766 AO-OCT SCANS SHOW CENTRAL 3888 02:51:49,832 --> 02:51:53,002 MACULAR BEAM MOSTLY AFFECTED BY 3889 02:51:53,069 --> 02:51:57,874 DISEASE, ALONG WITH PRESENCE OF 3890 02:51:57,940 --> 02:51:58,274 DRUSEN. 3891 02:51:58,341 --> 02:52:02,478 HOWEVER CHORIOCAPILLARY AND 3892 02:52:02,545 --> 02:52:06,616 VESSELS ARE INTACT AS WE CAN SEE 3893 02:52:06,683 --> 02:52:07,850 HERE. 3894 02:52:07,917 --> 02:52:12,555 WE DID OBSERVE AROUND THE CENTER 3895 02:52:12,622 --> 02:52:14,991 FOVEA AND VESSELS ARE VISIBLE, 3896 02:52:15,058 --> 02:52:18,995 CLEARLY RESOLVED UNDER THE 3897 02:52:19,062 --> 02:52:24,133 DRUSEN REGION IF WE COMPARE. 3898 02:52:24,200 --> 02:52:25,568 THE ORGANIZATION IS DISRUPTED AT 3899 02:52:25,635 --> 02:52:26,869 THE CENTER MACULA INDICATING 3900 02:52:26,936 --> 02:52:29,072 THIS KIND OF REGIMEN AND 3901 02:52:29,138 --> 02:52:37,914 DISTRIBUTION CAN BE USED AS 3902 02:52:37,980 --> 02:52:42,118 POTENTIAL BIOMARKER FOR 3903 02:52:42,185 --> 02:52:42,685 CHORIOCAPILLARY NORMITY. 3904 02:52:42,752 --> 02:52:43,653 I'D LIKE TO GO BACK TO THE 3905 02:52:43,720 --> 02:52:52,028 PICTURE I SHOWED AT THE 3906 02:52:52,095 --> 02:52:54,230 BEGINNING, DEVICES OFFER 3907 02:52:54,297 --> 02:52:58,735 RESOLUTION AND SENSITIVITY FOR 3908 02:52:58,801 --> 02:53:02,405 LIVING HUMAN EYE, WITH 3909 02:53:02,472 --> 02:53:04,073 GEOGRAPHY, APPROACH PROVIDES 3910 02:53:04,140 --> 02:53:09,245 COMPLETE VIEW OF THE OUTER 3911 02:53:09,312 --> 02:53:10,413 RETINA. 3912 02:53:10,480 --> 02:53:13,382 WHICH OPENS TREMENDOUS 3913 02:53:13,449 --> 02:53:14,283 OPPORTUNITY TO STUDY 3914 02:53:14,350 --> 02:53:16,619 CHORIORETINAL DISEASE SUCH AS 3915 02:53:16,686 --> 02:53:21,624 MACULAR DEGENERATION AND HELP 3916 02:53:21,691 --> 02:53:23,392 IMPROVE OUR DISEASE MECHANISM, 3917 02:53:23,459 --> 02:53:26,362 TRACKING DISEASE PROGRESSION. 3918 02:53:26,429 --> 02:53:31,467 AND IMAGING WITH LARGE VIEW 3919 02:53:31,534 --> 02:53:33,236 MAKES THIS METHOD EXTREMELY 3920 02:53:33,302 --> 02:53:37,373 VALUABLE AND HELPFUL FOR EARLY 3921 02:53:37,440 --> 02:53:42,745 DISEASES, DISEASE PROGRESSION, 3922 02:53:42,812 --> 02:53:47,116 ASSESS TREATMENT OUTCOME. 3923 02:53:47,183 --> 02:53:50,453 THIS WORK COULD NOT BE 3924 02:53:50,520 --> 02:53:53,489 ACCOMPLISHED WITH SUPPORT. 3925 02:53:53,556 --> 02:54:03,566 THE LEAD OF THE OPHTHALMOLOGY 3926 02:54:03,633 --> 02:54:04,133 PROGRAM, AND OTHERS. 3927 02:54:04,200 --> 02:54:13,676 I'D LIKE TO ACKNOWLEDGE MY 3928 02:54:13,743 --> 02:54:14,043 COLLABORATORS. 3929 02:54:14,110 --> 02:54:15,178 THANKS FOR THE SUPPORTING, 3930 02:54:15,244 --> 02:54:16,813 FUNDING SUPPORT, AND THANK YOU 3931 02:54:16,879 --> 02:54:17,246 FOR YOUR ATTENTION. 3932 02:54:17,313 --> 02:54:19,715 [APPLAUSE] 3933 02:54:25,388 --> 02:54:25,688 >> THANKS. 3934 02:54:25,755 --> 02:54:27,957 NOW WE'LL TRANSITION, WE HEARD 3935 02:54:28,024 --> 02:54:32,228 THREE PRESENTATIONS THAT USED 3936 02:54:32,295 --> 02:54:33,896 ADAPTIVE OPTICS, THE SECOND, 3937 02:54:33,963 --> 02:54:36,632 LAST TWO TALKS, ABOUT BE 3938 02:54:36,699 --> 02:54:38,534 SWITCHING FROM INFRARED 3939 02:54:38,601 --> 02:54:39,902 WAVELENGTHS TO VISIBLE 3940 02:54:39,969 --> 02:54:41,103 WAVELENGTHS TO IMPROVE 3941 02:54:41,170 --> 02:54:43,272 RESOLUTION OF OCT. 3942 02:54:43,339 --> 02:54:53,883 FIRST IN THE SECOND HALF IS HAO 3943 02:55:00,489 --> 02:55:02,458 ZHANG. 3944 02:55:02,525 --> 02:55:07,463 >> I'LL FOCUS ON THE TECHNOLOGY 3945 02:55:07,530 --> 02:55:09,532 HISTORY, MY COLLABORATORS WILL 3946 02:55:09,599 --> 02:55:11,067 SHARE ON APPLICATIONS. 3947 02:55:11,133 --> 02:55:17,773 I ACKNOWLEDGE I RECEIVED 3948 02:55:17,840 --> 02:55:20,476 TREMENDOUS HELP FROM 3949 02:55:20,543 --> 02:55:20,943 HARD-WORKING TEAM AND 3950 02:55:21,010 --> 02:55:22,778 COLLABORATORS WHO PROVIDE ALL 3951 02:55:22,845 --> 02:55:24,680 SORTS OF SUPPORT AT DIFFERENT 3952 02:55:24,747 --> 02:55:25,948 STAINS OF TECHNOLOGY 3953 02:55:26,015 --> 02:55:28,284 DEVELOPMENT, ESPECIALLY FOR 3954 02:55:28,351 --> 02:55:32,622 HUMAN STUDY PROFESSOR SCHUMAN, 3955 02:55:32,688 --> 02:55:34,390 JUST STEPPED OUT, PROVIDING 3956 02:55:34,457 --> 02:55:42,765 SUPPORT IN INITIAL ADAPTATION , 3957 02:55:42,832 --> 02:55:44,267 AND JEFF GOLDBERG, PUT THE 3958 02:55:44,333 --> 02:55:49,872 DEVICE IN A STRESS TEST THAT 3959 02:55:49,939 --> 02:55:51,474 DISCLOSED DESIGN IMPERFECTION 3960 02:55:51,540 --> 02:55:54,343 AND DEFECTS, LOTS OF WORK IS 3961 02:55:54,410 --> 02:55:57,280 CO-DEVELOPED WITH MY START-UP 3962 02:55:57,346 --> 02:56:06,489 COMPANY SO I HAVE TO DISCLOSE 3963 02:56:06,555 --> 02:56:16,666 HERE. 3964 02:56:17,833 --> 02:56:19,936 THESE ARE OUTLINES. 3965 02:56:20,002 --> 02:56:20,536 MICHAEL MENTIONED 3966 02:56:20,603 --> 02:56:21,170 STANDARDIZATION. 3967 02:56:21,237 --> 02:56:25,408 THIS IS OUR EFFORT TRYING TO DO 3968 02:56:25,474 --> 02:56:26,976 THAT. 3969 02:56:27,043 --> 02:56:28,144 FUTURE TECHNOLOGY DEVELOPMENT. 3970 02:56:28,210 --> 02:56:30,746 IN 2013, OUR LAB PUBLISHED THE 3971 02:56:30,813 --> 02:56:35,017 FIRST IN VIVO IMAGING FOR 3972 02:56:35,084 --> 02:56:37,920 VISUALIZED OCT TO ACHIEVE HIGHER 3973 02:56:37,987 --> 02:56:43,492 RESOLUTION, HIGHER CONTRAST. 3974 02:56:43,559 --> 02:56:47,196 WE MOVED TO 1330, TO 510 TO 610, 3975 02:56:47,263 --> 02:56:53,903 GREENISH TO YELLOW LIGHT. 3976 02:56:53,970 --> 02:56:56,939 THE BENEFIT, 1.3-MICRON, IF WE 3977 02:56:57,006 --> 02:56:59,775 NORMALIZE, WE HAVE TO BE VERY 3978 02:56:59,842 --> 02:57:02,845 CAUTIOUS OF THE POWER ON CORNEA 3979 02:57:02,912 --> 02:57:07,283 SO WE CONTROL LIGHT INTENSITY TO 3980 02:57:07,350 --> 02:57:12,254 BE WITHIN QUARTER OF A 3981 02:57:12,321 --> 02:57:13,522 MICROWATT, TYPICALLY 3982 02:57:13,589 --> 02:57:17,593 ILLUMINATION IS 1 TO 2 3983 02:57:17,660 --> 02:57:19,328 MILIWATTS. 3984 02:57:19,395 --> 02:57:24,266 WE DESIGN BECAUSE OF THE NATURAL 3985 02:57:24,333 --> 02:57:25,801 BANDWIDTH LIMIT 3986 02:57:25,868 --> 02:57:32,908 WE'RE TRYING TO MAXIMIZE ROLLOFF 3987 02:57:32,975 --> 02:57:37,046 TO OR MINIMIZE ROLLOFF IN OUR 3988 02:57:37,113 --> 02:57:37,813 DESIGN. 3989 02:57:37,880 --> 02:57:40,383 THE WHOLE WORLD HAS SEEN 3990 02:57:40,449 --> 02:57:42,351 TREMENDOUS GROWTH IN RESEARCH, 3991 02:57:42,418 --> 02:57:45,354 NOT ONLY FOR TECHNOLOGY 3992 02:57:45,421 --> 02:57:48,691 DEVELOPMENT BUT ALSO FOR 3993 02:57:48,758 --> 02:57:49,658 APPLICATIONS. 3994 02:57:49,725 --> 02:57:58,034 IN 2002 THE NAME CAME OUT FIRST, 3995 02:57:58,100 --> 02:58:02,905 PROFESSOR WOLFGANG PUT OUT 3996 02:58:02,972 --> 02:58:07,843 ABSTRACT AT A TIME UTILIZED, 3997 02:58:07,910 --> 02:58:09,678 GOING THROUGH A DOUBLE PRISM 3998 02:58:09,745 --> 02:58:13,883 ASSEMBLY TO SELECT DESIRED WAIVE 3999 02:58:13,949 --> 02:58:16,285 LENGTH AND QUANTIFY THE 4000 02:58:16,352 --> 02:58:20,089 RESOLUTION UP TO .7 MICRONS. 4001 02:58:20,156 --> 02:58:28,898 IN 2012 THE TEAM LED BY 4002 02:58:28,964 --> 02:58:35,171 PROFESSOR (INDISCERNIBLE) USED A 4003 02:58:35,237 --> 02:58:37,139 130 FEMTOSECOND LASER, THERE 4004 02:58:37,206 --> 02:58:39,642 COULD BE A NON-DOUBLED BEAM FOR 4005 02:58:39,708 --> 02:58:47,349 INFRARED, DOUBLE FOR VISIBLE 4006 02:58:47,416 --> 02:58:48,517 LIGHT. 4007 02:58:48,584 --> 02:58:50,519 GOES THROUGH THE TWO 4008 02:58:50,586 --> 02:58:51,821 SPECTROMETERS TO HAVE 4009 02:58:51,887 --> 02:59:01,330 NEAR-INFRARED AND VISIBLE LIGHT 4010 02:59:01,397 --> 02:59:01,497 OCT. 4011 02:59:01,564 --> 02:59:04,767 A TEAM FROM TAIWAN VERY MANY 4012 02:59:04,834 --> 02:59:06,902 STRAIGHT A CONCEPT, RECEIVED 4013 02:59:06,969 --> 02:59:10,439 NOBEL PRIZE FOR PHYSICS. 4014 02:59:10,506 --> 02:59:16,445 BLUE LIGHT TO PUMP, USING STRONG 4015 02:59:16,512 --> 02:59:21,217 BLUE LIGHT TO FOCUS AT THE 4016 02:59:21,283 --> 02:59:28,524 POWDER OF THE PHOSPHOR, AND 4017 02:59:28,591 --> 02:59:33,629 COLLECTING THE LIGHT, THEY WERE 4018 02:59:33,696 --> 02:59:42,271 ABLE TO DEMONSTRATE LED 4019 02:59:42,338 --> 02:59:45,908 PHOSPHOR, MORE PEOPLE CAN 4020 02:59:45,975 --> 02:59:49,211 ACHIEVE VISIBILITY, A DANISH 4021 02:59:49,278 --> 02:59:51,547 COMPANY START TO COMMERCIALIZE 4022 02:59:51,614 --> 02:59:54,984 THE LASER, THEY HAVE A DIFFERENT 4023 02:59:55,050 --> 02:59:57,319 RANGE OF LASER, PROVIDE 4024 02:59:57,386 --> 02:59:59,421 400-NANOMETER TO 20 TO 4025 02:59:59,488 --> 03:00:01,624 40-NANOMETER ILLUMINATION RANGE. 4026 03:00:01,690 --> 03:00:04,894 WE USE LASER FROM THE VERY 4027 03:00:04,960 --> 03:00:08,797 BEGINNING SO THIS TALK FOCUS ON 4028 03:00:08,864 --> 03:00:10,099 DATA ACQUIRED FROM NKT, THANKS 4029 03:00:10,166 --> 03:00:13,702 FOR THE SUPPORT FROM NIH WE'RE 4030 03:00:13,769 --> 03:00:15,704 WORKING ON THE NEXT GENERATION 4031 03:00:15,771 --> 03:00:15,938 SOURCE. 4032 03:00:16,005 --> 03:00:21,911 SO AT THE TIME WE WERE USING 4033 03:00:21,977 --> 03:00:22,478 85-NANOMETER BANDWIDTH. 4034 03:00:22,545 --> 03:00:24,847 WE CANNOT FIND FIBEROPTIC 4035 03:00:24,914 --> 03:00:27,783 COMPONENT FOR VISIBLE LIGHT. 4036 03:00:27,850 --> 03:00:32,288 IT WAS BUILT IN FREE SPACE. 4037 03:00:32,354 --> 03:00:34,456 A SIMPLE SEGMENTATION VISUALIZED 4038 03:00:34,523 --> 03:00:36,959 CAPILLARY, ANOTHER SEGMENTATION 4039 03:00:37,026 --> 03:00:39,795 OF THE PROJECTION VISUALIZED THE 4040 03:00:39,862 --> 03:00:42,464 FIBER BUNDLES AT THE TIME. 4041 03:00:42,531 --> 03:00:45,568 AS WE KEEP DEVELOPING TECHNOLOGY 4042 03:00:45,634 --> 03:00:47,336 WITH BETTER SPECTROMETRY DESIGN, 4043 03:00:47,403 --> 03:00:49,371 BETTER NOISE SUPPRESSION, WE 4044 03:00:49,438 --> 03:00:52,041 WERE ABLE TO ACQUIRE REALLY HIGH 4045 03:00:52,107 --> 03:00:54,276 QUALITY IMAGE FROM SMALL 4046 03:00:54,343 --> 03:00:57,680 ANIMALS, I WILL SHOW A FEW CASES 4047 03:00:57,746 --> 03:01:00,916 OF THE ANATOMIC IMAGE, 4048 03:01:00,983 --> 03:01:02,418 FUNCTIONAL IMAGING FOR ANIMAL 4049 03:01:02,484 --> 03:01:03,185 RESEARCH. 4050 03:01:03,252 --> 03:01:06,789 WE ALSO SPENT QUITE A FEW EFFORT 4051 03:01:06,855 --> 03:01:09,658 TRYING TO MAP OUT PATHWAY OF 4052 03:01:09,725 --> 03:01:12,161 CANAL AND VASCULAR HOPING IN THE 4053 03:01:12,228 --> 03:01:16,432 FUTURE WE CAN GUIDE MINIMAL 4054 03:01:16,498 --> 03:01:18,834 INVASIVE GLAUCOMA SURGERY. 4055 03:01:18,901 --> 03:01:23,639 I'LL USE OCT FIBRO GRAM AS 4056 03:01:23,706 --> 03:01:24,440 EXAMPLE. 4057 03:01:24,506 --> 03:01:25,841 FIRST STEP TO ACQUIRE VOLUME OF 4058 03:01:25,908 --> 03:01:29,678 OCT, THE VOLUME OF OCT USING 4059 03:01:29,745 --> 03:01:31,880 TEMPORAL AVERAGING, THIS IS 4060 03:01:31,947 --> 03:01:34,617 COMBINED FIBER BUNDLES WITH 4061 03:01:34,683 --> 03:01:34,883 CAPILLARY. 4062 03:01:34,950 --> 03:01:39,154 AT THE SAME TIME SCAN -- USING 4063 03:01:39,221 --> 03:01:42,224 SAME VOLUME, APPLIED THE 4064 03:01:42,291 --> 03:01:45,361 ANGIOGRAM ALGORITHM, FIBERS ARE 4065 03:01:45,427 --> 03:01:47,463 GONE, NO MOTION CONTRAST FROM 4066 03:01:47,529 --> 03:01:48,897 FIBERS, CAP LOWER CAPPED, TAKE 4067 03:01:48,964 --> 03:01:52,001 THE DIFFERENCE WE'LL BE ABLE TO 4068 03:01:52,067 --> 03:01:55,804 VISUALIZE ALL THE FIBERS AND ALL 4069 03:01:55,871 --> 03:01:59,775 THE CAPILLARIES. 4070 03:01:59,842 --> 03:02:02,544 IF WE MONTAGE, THERE WILL BE 4071 03:02:02,611 --> 03:02:03,779 FIBERS AND CAPILLARY. 4072 03:02:03,846 --> 03:02:06,248 HOW ARE WE GOING TO USE THAT? 4073 03:02:06,315 --> 03:02:09,418 ONE OF THE ANALYTICAL SHOW 4074 03:02:09,485 --> 03:02:10,986 ANALYSIS, CONSIDER A PHANTOM, 4075 03:02:11,053 --> 03:02:13,122 HERE IS THE OPTICAL DISC, WITH 4076 03:02:13,188 --> 03:02:23,198 ALL THE FIBERS STORMING A STAR 4077 03:02:23,265 --> 03:02:25,501 SHAPE WITH DIFFERENT FIBERS, 4078 03:02:25,567 --> 03:02:28,470 COUNT HOW MANY INTERSECTIONS, 4079 03:02:28,537 --> 03:02:30,439 AND PLOT RADIUS, EXPECTED A 4080 03:02:30,506 --> 03:02:36,345 NUMBER OF INTERSECTIONS, CALL 4081 03:02:36,412 --> 03:02:37,846 THAT A DECAY, INTERESTINGLY 4082 03:02:37,913 --> 03:02:41,817 CORRESPONDING TO DENSITY OF THE 4083 03:02:41,884 --> 03:02:42,051 FIBERS. 4084 03:02:42,117 --> 03:02:45,187 THIS ANALYSIS CAN ALSO PERFORM 4085 03:02:45,254 --> 03:02:47,089 BY FOUR QUADRANTS, WHICH MORE 4086 03:02:47,156 --> 03:02:55,230 ALIGN WITH CLINICAL STUDIES. 4087 03:02:55,297 --> 03:02:57,566 I MENTIONED TAKING ADVANTAGE OF 4088 03:02:57,633 --> 03:03:03,672 THE HIGH RESOLUTION, WE'RE 4089 03:03:03,739 --> 03:03:04,473 WORKING WITH COLLABORATORS, SCAN 4090 03:03:04,540 --> 03:03:05,941 ACROSS ANTERIOR SIGNAL OF THE 4091 03:03:06,008 --> 03:03:06,475 EYE. 4092 03:03:06,542 --> 03:03:08,110 WHAT'S THE BENEFIT? 4093 03:03:08,177 --> 03:03:10,579 WE'LL BE ABLE TO ACQUIRE 4094 03:03:10,646 --> 03:03:12,648 SO-CALLED DIGITAL TWIN, THIS HAS 4095 03:03:12,715 --> 03:03:14,550 BEEN WIDELY USED FOR ANY BRAIN 4096 03:03:14,616 --> 03:03:15,951 SURGERY THAT THERE'S A 3D 4097 03:03:16,018 --> 03:03:17,119 RECONSTRUCTION OF THE WHOLE 4098 03:03:17,186 --> 03:03:19,555 BRAIN AND HOW TO DO THE SURGICAL 4099 03:03:19,621 --> 03:03:21,523 PLANNING IS ALL RELYING ON THAT. 4100 03:03:21,590 --> 03:03:23,492 WE TRY TO DUPLICATE FOR 4101 03:03:23,559 --> 03:03:24,593 OPHTHALMOLOGY. 4102 03:03:24,660 --> 03:03:27,529 THIS IS THE WHOLE EYE DIGITAL 4103 03:03:27,596 --> 03:03:36,939 TWIN FROM THERE WE SEGMENT THE 4104 03:03:37,005 --> 03:03:43,746 CANAL, ANTERIOR AND POSTERIOR 4105 03:03:43,812 --> 03:03:44,213 CHAMBER. 4106 03:03:44,279 --> 03:03:46,582 IT PROVIDES CONTRAST TO 4107 03:03:46,648 --> 03:03:50,319 POTENTIALLY CONTRIBUTE TO 4108 03:03:50,386 --> 03:03:53,021 HEMODYNAMIC ANALYSIS. 4109 03:03:53,088 --> 03:03:57,860 THIS IS MD/PHD STUDENT 4110 03:03:57,926 --> 03:03:59,695 CONTRIBUTE ON THE STUDY. 4111 03:03:59,762 --> 03:04:03,565 TAKE A B SCAN, FROM THE B SCAN 4112 03:04:03,632 --> 03:04:09,271 IMAGE TAKE A VESSEL SCAN. 4113 03:04:09,338 --> 03:04:12,241 ACROSS THE WHOLE BANDWIDTH OF 4114 03:04:12,307 --> 03:04:16,078 THE NANOMETERS TAKE A SHORTER 4115 03:04:16,145 --> 03:04:20,015 BAND AND PERFORM TRANSFORM OF 4116 03:04:20,082 --> 03:04:23,919 SHORTER BANDWIDTH, THE DOWN SIDE 4117 03:04:23,986 --> 03:04:29,925 FOR THE SHORTER BANDWIDTH, THE 4118 03:04:29,992 --> 03:04:33,462 UPSIDE IS WE HAVE SPECTROSCOPY 4119 03:04:33,529 --> 03:04:34,029 INFORMATION. 4120 03:04:34,096 --> 03:04:36,732 BY ANALYZING WITH KNOWN SPECTRAL 4121 03:04:36,799 --> 03:04:38,267 INFORMATION OF HEMOGLOBIN WE'LL 4122 03:04:38,333 --> 03:04:44,306 BE ABLE TO MAP CAPILLARY -- 4123 03:04:44,373 --> 03:04:46,708 OXYGEN CONCENTRATION IN BLOOD 4124 03:04:46,775 --> 03:04:48,210 INDIVIDUAL VESSELS. 4125 03:04:48,277 --> 03:04:49,778 SO, ONE OF THE KEY DEMONSTRATION 4126 03:04:49,845 --> 03:04:52,714 IS HOW WE VALIDATE THAT. 4127 03:04:52,781 --> 03:04:55,284 WE CAN SAY RANDOM NUMBER FOR 4128 03:04:55,350 --> 03:04:58,954 CAPILLARY, WHETHER TRUE OR NOT. 4129 03:04:59,021 --> 03:05:06,428 WE STUDY -- THIS STUDY HAS BEEN 4130 03:05:06,495 --> 03:05:07,629 PAINFULLY DRAGED FOR A NUMBER OF 4131 03:05:07,696 --> 03:05:10,132 YEARS BEFORE WE FOUND IT'S TRUE. 4132 03:05:10,199 --> 03:05:13,836 BOTTOM RIGHT FIGURE, HORIZONTAL 4133 03:05:13,902 --> 03:05:15,971 AXIS IS THE OXYGEN PRESSURE WE 4134 03:05:16,038 --> 03:05:18,040 CONTROL OF SMALL ANIMAL. 4135 03:05:18,106 --> 03:05:19,241 WE CONTROL THE INHALATION 4136 03:05:19,308 --> 03:05:22,311 CONCENTRATION OF OXYGEN TO THE 4137 03:05:22,377 --> 03:05:23,378 ANIMAL. 4138 03:05:23,445 --> 03:05:27,449 PRESSURE DROP. 4139 03:05:27,516 --> 03:05:33,355 WE PROVIDE LESS FROM LEFT TO 4140 03:05:33,422 --> 03:05:33,555 RIGHT. 4141 03:05:33,622 --> 03:05:38,026 IF WE READ THE CURVE CAREFULLY 4142 03:05:38,093 --> 03:05:40,195 WE PROVIDE LESS OXYGEN THE ICON 4143 03:05:40,262 --> 03:05:41,196 SUPERVISORS MORE. 4144 03:05:41,263 --> 03:05:43,332 IN THE VERY BEGINNING WE SAID 4145 03:05:43,398 --> 03:05:45,033 SOMETHING MUST BE WRONG. 4146 03:05:45,100 --> 03:05:52,941 WE PROVIDE LESS OXYGEN HOW COME 4147 03:05:53,008 --> 03:05:55,811 THE EYE CONSUMES MORE. 4148 03:05:55,878 --> 03:05:57,312 THROUGHOUT THE 30 YEARS OF A 4149 03:05:57,379 --> 03:06:00,516 CAREER HE MASTERED TECHNOLOGY 4150 03:06:00,582 --> 03:06:01,717 USING ELECTRODES TO MAP OUT 4151 03:06:01,783 --> 03:06:03,452 PARTIAL PRESSURE OF OXYGEN AT 4152 03:06:03,519 --> 03:06:07,956 DIFFERENT LAYERS OF THE RETINA. 4153 03:06:08,023 --> 03:06:13,562 USE FORM AN ANALYTICAL MODEL, 4154 03:06:13,629 --> 03:06:14,863 USING CHOROIDAL CONCENTRATION, 4155 03:06:14,930 --> 03:06:16,798 CHANGE BOUNDARY CONDITION, USING 4156 03:06:16,865 --> 03:06:21,637 THE MODEL, TO ESTIMATE WHETHER 4157 03:06:21,703 --> 03:06:24,706 THE OCT MEASURES OXYGEN 4158 03:06:24,773 --> 03:06:26,375 CONSUMPTION MAP WITH BIAS, 4159 03:06:26,441 --> 03:06:28,110 CALIBRATABLE BUT THE TREND SHOWS 4160 03:06:28,176 --> 03:06:28,477 THE SAME THING. 4161 03:06:28,544 --> 03:06:32,447 AT THE END IT WAS VERY EASY 4162 03:06:32,514 --> 03:06:38,720 EXPLAINABLE IS MEASURED IN 4163 03:06:38,787 --> 03:06:39,988 RETINAL CIRCULATION, SUPPORTED, 4164 03:06:40,055 --> 03:06:44,126 MAJORITY OF THE OXYGEN SUPPLY 4165 03:06:44,192 --> 03:06:47,095 COMES FROM CIRCULATION WITHOUT 4166 03:06:47,162 --> 03:06:48,230 ACTIVE VASOCONSTRICTION OR 4167 03:06:48,297 --> 03:06:50,532 VASODILATION FEEDBACK. 4168 03:06:50,599 --> 03:06:53,135 WHEN WE SUPPLY LESS OXYGEN, THE 4169 03:06:53,201 --> 03:06:55,737 SYSTEMIC SUPPLY BECAME LESS. 4170 03:06:55,804 --> 03:06:57,372 NOW, INNER RETINAL CIRCULATION 4171 03:06:57,439 --> 03:06:59,141 HAS TO COMPENSATE FOR THE OXYGEN 4172 03:06:59,207 --> 03:07:05,347 SUPPLY IN ORDER TO MAINTAIN 4173 03:07:05,414 --> 03:07:06,949 DEMAND. 4174 03:07:07,015 --> 03:07:10,819 ANOTHER STUDY WE CONDUCTED TOO 4175 03:07:10,886 --> 03:07:13,922 USE TYPE 1 DIABETIC MOUSE WITH 4176 03:07:13,989 --> 03:07:14,823 GENE KNOCKOUT. 4177 03:07:14,890 --> 03:07:17,726 BY WEEK 25 THIS GROUP OF MOUSE 4178 03:07:17,793 --> 03:07:20,662 WILL SHOW CAPILLARY DROPOUT 4179 03:07:20,729 --> 03:07:23,332 WHICH MEANS HAS A PHENOTYPICAL 4180 03:07:23,398 --> 03:07:26,401 ALTERATION CAUSED BY DIABETES. 4181 03:07:26,468 --> 03:07:32,307 WE IMAGED THEM AT 7, 9, 11, 13 4182 03:07:32,374 --> 03:07:34,910 WEEK, WE SHOW THE TWO GROUPS OF 4183 03:07:34,977 --> 03:07:37,679 ANIMALS GROW AS EXPECTED, 4184 03:07:37,746 --> 03:07:39,081 DIABETIC ANIMAL HAS HIGH GLUCOSE 4185 03:07:39,147 --> 03:07:40,382 CON TRYINGS, NO CAPILLARY CHANGE 4186 03:07:40,449 --> 03:07:41,750 AT ANY TIME. 4187 03:07:41,817 --> 03:07:43,919 THE CELL COUNTS ARE THE SAME 4188 03:07:43,986 --> 03:07:46,755 BETWEEN THE TWO GROUPS. 4189 03:07:46,822 --> 03:07:49,925 BUT THE METABOLIC DEMAND BECAME 4190 03:07:49,992 --> 03:07:51,793 SPECIFICALLY SIGNIFICANT BY WEEK 4191 03:07:51,860 --> 03:07:52,194 11. 4192 03:07:52,260 --> 03:07:55,931 SO WHICH MEANS IF WE TAKE THE 4193 03:07:55,998 --> 03:07:58,900 OCT ANGIOGRAM, OCT IMAGE OF THE 4194 03:07:58,967 --> 03:08:02,237 TWO GROUPS OF ANIMALS, THOSE ARE 4195 03:08:02,304 --> 03:08:04,139 BOTH HEALTHY. 4196 03:08:04,206 --> 03:08:06,775 USING METABOLIC IMAGING, WE SHOW 4197 03:08:06,842 --> 03:08:09,411 THAT THE INNER RETINAL 4198 03:08:09,478 --> 03:08:10,912 CIRCULATION IS ALREADY PROVIDING 4199 03:08:10,979 --> 03:08:17,953 MORE OXYGEN SUPPLY TO THE EYE, 4200 03:08:18,020 --> 03:08:21,123 MAY BENEFIT HYPOTHESIS TEST AS 4201 03:08:21,189 --> 03:08:22,524 THE ISCHEMIC DRIVEN PROCESS 4202 03:08:22,591 --> 03:08:26,061 START WAY EARLY THAN ANY 4203 03:08:26,128 --> 03:08:27,529 CAPILLARY DROPOUT. 4204 03:08:27,596 --> 03:08:29,064 SO, NOW, EVENTUALLY WE WANT TO 4205 03:08:29,131 --> 03:08:30,565 PUSH TO THE HUMAN STUDY. 4206 03:08:30,632 --> 03:08:36,304 WE HAVE TO MAKE SURE IT'S SAFE. 4207 03:08:36,371 --> 03:08:38,674 VELOCITY USED AROUND TEN, 100 TO 4208 03:08:38,740 --> 03:08:40,876 A QUARTER OF MILIWATTS, 4209 03:08:40,942 --> 03:08:43,345 MICROWATTS, MEASURED CLINICAL 4210 03:08:43,412 --> 03:08:45,781 DEVICE THAT ACCESSIBLE, IN THE 4211 03:08:45,847 --> 03:08:47,015 HOSPITAL, COMPARABLES. 4212 03:08:47,082 --> 03:08:50,385 WE'RE WELL WITHIN THE SAFETY 4213 03:08:50,452 --> 03:08:51,820 RANGE. 4214 03:08:51,887 --> 03:08:52,854 AND FDA PROVIDES NON-SIGNIFICANT 4215 03:08:52,921 --> 03:08:58,393 RISK WHEN WE PROVIDE ALL. 4216 03:08:58,460 --> 03:09:01,663 WE APPRECIATE THE HELP FROM NIH 4217 03:09:01,730 --> 03:09:03,365 THAT SUPPORTED TECHNICAL 4218 03:09:03,432 --> 03:09:07,602 ITERATION YEAR AFTER YEAR AFTER 4219 03:09:07,669 --> 03:09:08,303 YEAR. 4220 03:09:08,370 --> 03:09:09,071 LIKE PROFESSOR FUJIMOTO 4221 03:09:09,137 --> 03:09:12,474 MENTIONED, THIS IS A SLOW 4222 03:09:12,541 --> 03:09:13,241 PROCESS, TRANSLATING ANYBODY TO 4223 03:09:13,308 --> 03:09:14,342 THE LAB REQUIRES MULTIPLE YEARS 4224 03:09:14,409 --> 03:09:16,645 OF EFFORT AND CAN BE EXPENSIVE. 4225 03:09:16,712 --> 03:09:18,647 IN 2015 WE VIEWED THE FIRST 4226 03:09:18,714 --> 03:09:19,848 PROTOTYPE, ONLY LAB MEMBERS WERE 4227 03:09:19,915 --> 03:09:24,286 BRAVE ENOUGH TO BE SCANNED. 4228 03:09:24,352 --> 03:09:25,821 2016 MACHINES WERE BEING 4229 03:09:25,887 --> 03:09:29,791 PACKAGED TO A BIG CABINET SO CAN 4230 03:09:29,858 --> 03:09:36,998 BE MOVED TO HOSPITAL FOR PATIENT 4231 03:09:37,065 --> 03:09:37,265 SCANNING. 4232 03:09:37,332 --> 03:09:44,873 2017 MY START-UP COMPANY VIEWED 4233 03:09:44,940 --> 03:09:49,177 FIRST PROTOTYPE, 2018 THE SECOND 4234 03:09:49,244 --> 03:09:51,880 GENERATION WAS INSTALLED AT 4235 03:09:51,947 --> 03:09:54,382 PROFESSOR SCHUMAN'S LAB AT NEW 4236 03:09:54,449 --> 03:09:54,883 YORK. 4237 03:09:54,950 --> 03:09:59,287 AND YEAR AFTER YEAR WE KEEP 4238 03:09:59,354 --> 03:09:59,554 ITERATING. 4239 03:09:59,621 --> 03:10:05,427 WE ONLY HAVE SEVEN PEOPLE, 4240 03:10:05,494 --> 03:10:06,628 REINVENTING THE WHEEL THAT 4241 03:10:06,695 --> 03:10:07,729 OTHERS ARE DOING, I DON'T KNOW 4242 03:10:07,796 --> 03:10:10,265 HOW BIG THE TEAMS ARE. 4243 03:10:10,332 --> 03:10:11,700 SO G.E. CONTRIBUTED TREMENDOUSLY 4244 03:10:11,767 --> 03:10:22,277 TO THE SO JI CONTRIBUTED, NOW 4245 03:10:22,644 --> 03:10:29,684 AT HOPKINS, AND WE ALSO COMPARED 4246 03:10:29,751 --> 03:10:31,419 THE IMAGE UNDER THE SAME NUMBER 4247 03:10:31,486 --> 03:10:33,255 OF B SCAN AVERAGES. 4248 03:10:33,321 --> 03:10:36,625 THE DOWN SIDE CLEARLY IS WE 4249 03:10:36,691 --> 03:10:39,194 CANNOT GO BEYOND RPE BECAUSE 4250 03:10:39,261 --> 03:10:41,463 PIGMENTATION BLOCKS VISIBLE 4251 03:10:41,530 --> 03:10:49,371 LIGHT, ALMOST A HARD LIMIT FOR 4252 03:10:49,437 --> 03:10:49,971 VELOCITY. 4253 03:10:50,038 --> 03:10:56,678 THESE ARE FINE LAYERS NOT EASILY 4254 03:10:56,745 --> 03:11:04,352 DIFFERENTIATABLE BY INFRARED 4255 03:11:04,419 --> 03:11:04,886 LIED. 4256 03:11:04,953 --> 03:11:06,221 THIRD ONE, THE PROFESSOR ACQUIRE 4257 03:11:06,288 --> 03:11:08,523 THE SAME SUBJECT, WITHIN SAME 4258 03:11:08,590 --> 03:11:11,560 HOUR BY VELOCITY, AND FOR 4259 03:11:11,626 --> 03:11:13,929 LEADING CLINICAL DEVICES. 4260 03:11:13,995 --> 03:11:14,763 THE 4261 03:11:14,830 --> 03:11:18,033 AT THE TIME IT WAS NOT THE MOST 4262 03:11:18,099 --> 03:11:19,134 ADVANCED SIGNAL PROCESSING, 4263 03:11:19,201 --> 03:11:23,605 OPTICAL DESIGN FOR DEVELOPS ON 4264 03:11:23,672 --> 03:11:25,173 VELOCITY BUT BENEFIT FOR HIGH 4265 03:11:25,240 --> 03:11:27,142 CONTRAST AND RESOLUTION IS 4266 03:11:27,209 --> 03:11:29,077 OBVIOUS IN MY OPINION. 4267 03:11:29,144 --> 03:11:32,047 NOW HERE'S THE MAJOR TECHNICAL 4268 03:11:32,113 --> 03:11:34,115 BARRIER THAT WE FACE AT THE 4269 03:11:34,182 --> 03:11:38,086 TIME, WAS IF WE HAVE A SLOW 4270 03:11:38,153 --> 03:11:40,055 RATE, 20 KILOHERTZ, EVERYTHING 4271 03:11:40,121 --> 03:11:40,255 FINE. 4272 03:11:40,322 --> 03:11:43,558 THIS JUST TWO SLOW FOR ANY HUMAN 4273 03:11:43,625 --> 03:11:44,125 IMAGES. 4274 03:11:44,192 --> 03:11:47,829 PUSH TO HIGHER SPEED, SO 125 IS 4275 03:11:47,896 --> 03:11:54,069 COMMONLY USED FOR VELOCITY. 4276 03:11:54,135 --> 03:11:58,540 WHY THAT'S THE CASE, INTRINSIC 4277 03:11:58,607 --> 03:12:02,911 NOISE ASSOCIATED WITH NON-LINEAR 4278 03:12:02,978 --> 03:12:08,049 GENERATION OF BROADENING CAUSED 4279 03:12:08,116 --> 03:12:15,423 BY FEMTO SECOND, PICO SECOND 4280 03:12:15,490 --> 03:12:16,091 LASER, SIGNALING INTENSITY, WE 4281 03:12:16,157 --> 03:12:17,592 CANNOT PUMP MORE ENERGY WITH THE 4282 03:12:17,659 --> 03:12:19,227 HOPE OF SUPPRESSING THE NOISE. 4283 03:12:19,294 --> 03:12:22,430 THE MORE ENERGY WE APPLY, THE 4284 03:12:22,497 --> 03:12:26,434 MORE NOISE WE END UP WITH. 4285 03:12:26,501 --> 03:12:29,104 SO ONE TEAM MEMBER GENIUSLY 4286 03:12:29,170 --> 03:12:30,805 DESIGNED A BALANCE DETECTION OF 4287 03:12:30,872 --> 03:12:31,139 ARCHITECTURE. 4288 03:12:31,206 --> 03:12:38,513 IN OTHER WORDS, A TYPICAL IS 4289 03:12:38,580 --> 03:12:39,114 INTEGRATED. 4290 03:12:39,180 --> 03:12:43,184 IN OTHER WORDS, THE DELAY LINE 4291 03:12:43,251 --> 03:12:46,521 IS USED BY A TRANSMISSION, AND 4292 03:12:46,588 --> 03:12:51,159 RETURN LIGHT AND DELAY LINE GOES 4293 03:12:51,226 --> 03:12:55,130 THROUGH 50-50 INFLAMMATORY SO 4294 03:12:55,196 --> 03:12:55,764 SPECTROMETERS ACQUIRE OPPOSITE 4295 03:12:55,830 --> 03:12:57,299 PHASE INTERFERENCE WHICH HAS TO 4296 03:12:57,365 --> 03:13:00,435 BE THE CASE BECAUSE ENERGY 4297 03:13:00,502 --> 03:13:02,904 CALIBRATION, IF WE CALIBRATE TWO 4298 03:13:02,971 --> 03:13:03,805 CAREFULLY THE OPPOSITE PHASE 4299 03:13:03,872 --> 03:13:04,906 CANCEL THE NOISE. 4300 03:13:04,973 --> 03:13:09,945 I'LL SHOW HOW IT'S GOING TO 4301 03:13:10,011 --> 03:13:10,145 WORK. 4302 03:13:10,211 --> 03:13:12,247 THE BRIGHT BACKGROUND IS CAUSED 4303 03:13:12,314 --> 03:13:14,316 BY THE GREEN NOISE. 4304 03:13:14,382 --> 03:13:20,889 GREEN NOISE IS DOMINANTLY CLOSER 4305 03:13:20,956 --> 03:13:22,524 TO ZERO LINE POSITION. 4306 03:13:22,590 --> 03:13:27,362 SO IN OTHER WORDS, THE PERFECTLY 4307 03:13:27,429 --> 03:13:32,133 CALIBRATED SPECTROMETER AT THE 4308 03:13:32,200 --> 03:13:33,635 SUBPICO METER ACCURACY WILL 4309 03:13:33,702 --> 03:13:35,937 PROVIDE ALMOST PERFECT NOISE 4310 03:13:36,004 --> 03:13:38,573 CANCELLATION TO REACH A NOISE 4311 03:13:38,640 --> 03:13:41,943 LIMIT. 4312 03:13:42,010 --> 03:13:43,912 HERE IS ANOTHER CASE, WITH AND 4313 03:13:43,979 --> 03:13:44,846 WITHOUT DETECTION. 4314 03:13:44,913 --> 03:13:46,648 WHAT WE'VE DONE IS BY REDUCING 4315 03:13:46,715 --> 03:13:48,950 THE NOISE WE CAN AFFORD TO GO 4316 03:13:49,017 --> 03:13:49,918 HIGHER SPEED. 4317 03:13:49,985 --> 03:13:52,120 BY PUSHING THE SPEED TO A HIGHER 4318 03:13:52,187 --> 03:13:54,189 LEVEL, WE CAN AFFORD TO HAVE A 4319 03:13:54,255 --> 03:13:56,725 LARGER FIELD OF VIEW, MORE 4320 03:13:56,791 --> 03:14:00,695 SELECTABLE IN DESIGNING SCANNING 4321 03:14:00,762 --> 03:14:01,029 PROTOCOLS. 4322 03:14:01,096 --> 03:14:06,801 AND THIS IS A SCANNING-EM IMAGE 4323 03:14:06,868 --> 03:14:09,938 FROM A STANFORD TEAM OF A 4324 03:14:10,005 --> 03:14:11,239 MONKEY, IT SHOWS THE FIBER 4325 03:14:11,306 --> 03:14:18,079 BUNDLE MAP OF THE FUNDUS. 4326 03:14:18,146 --> 03:14:20,348 WE SHOW ALMOST IDENTICAL BUNDLES 4327 03:14:20,415 --> 03:14:22,984 IN HUMANS, IT PROVIDES 4328 03:14:23,051 --> 03:14:24,886 TREMENDOUS OPPORTUNITY TO 4329 03:14:24,953 --> 03:14:27,989 ANALYZE FIBER DENSITY, FIBER 4330 03:14:28,056 --> 03:14:29,824 ORIENTATION, POTENTIALLY 4331 03:14:29,891 --> 03:14:32,927 CORRELATE WITH VISUAL FIELD. 4332 03:14:32,994 --> 03:14:36,431 IN ORDER TO FACILITATE 4333 03:14:36,498 --> 03:14:38,400 COLLABORATION ACROSS THE 4334 03:14:38,466 --> 03:14:41,136 COUNTRY, OUR TEAM WITH SUPPORT 4335 03:14:41,202 --> 03:14:44,939 FROM NIH PUT TOGETHER SOFTWARE, 4336 03:14:45,006 --> 03:14:46,074 INTEGRATE ALL THE LATEST 4337 03:14:46,141 --> 03:14:47,142 TECHNOLOGY DEVELOPMENT WE HAVE 4338 03:14:47,208 --> 03:14:57,585 DONE IN THE LAB, IT TO 4339 03:15:00,188 --> 03:15:03,258 PYTHON-BASED FREEWARE. 4340 03:15:03,324 --> 03:15:06,294 THE RED DOT REPRESENT THE LABS 4341 03:15:06,361 --> 03:15:12,700 IN HOSPITALS ACQUIRED A FROM US, 4342 03:15:12,767 --> 03:15:14,669 MY START-UP COMPANY. 4343 03:15:14,736 --> 03:15:19,908 BLUE DOTS REPRESENT LABS AND 4344 03:15:19,974 --> 03:15:20,642 HOSPITALS DOING TECHNOLOGY 4345 03:15:20,708 --> 03:15:21,142 DEVELOPMENT. 4346 03:15:21,209 --> 03:15:24,746 THIS IS ONLY THE U.S. 4347 03:15:24,813 --> 03:15:26,815 I'M NOT INCLUDING ASIA AND 4348 03:15:26,881 --> 03:15:27,248 EUROPEAN COUNTRIES. 4349 03:15:27,315 --> 03:15:29,551 IT'S GROWING. 4350 03:15:29,617 --> 03:15:31,719 TRYING TO PROVIDE MORE 4351 03:15:31,786 --> 03:15:32,420 STANDARDIZED DATA PROCESSING 4352 03:15:32,487 --> 03:15:34,189 WILL HELP TECHNOLOGY TO BE 4353 03:15:34,255 --> 03:15:36,558 BETTER ADAPTED. 4354 03:15:36,624 --> 03:15:39,094 SO WHAT'S THE FUTURE TECHNOLOGY, 4355 03:15:39,160 --> 03:15:39,928 TECHNICAL AND CLINICAL 4356 03:15:39,994 --> 03:15:40,562 DEVELOPMENT? 4357 03:15:40,628 --> 03:15:43,465 WE HAVE TO WORK WITH -- WE AS 4358 03:15:43,531 --> 03:15:46,401 ENGINEERS HAVE TO WORK WITH 4359 03:15:46,468 --> 03:15:50,905 BIOLOGISTS AND CLINICIANS TO 4360 03:15:50,972 --> 03:15:53,208 IDENTIFY FUNCTIONAL BIOMARKERS 4361 03:15:53,274 --> 03:15:56,277 AGAINST ACTUAL DISEASE 4362 03:15:56,344 --> 03:15:58,146 MANAGEMENT. 4363 03:15:58,213 --> 03:16:00,348 WE WANT STANDARDIZED PROTOCOL SO 4364 03:16:00,415 --> 03:16:09,557 STABILITY WON'T BE AN ISSUE. 4365 03:16:09,624 --> 03:16:12,427 WE'LL TRY TO PROVIDE MORE ROBUST 4366 03:16:12,494 --> 03:16:15,763 USER-FRIENDLY DEVICES, AND WE 4367 03:16:15,830 --> 03:16:19,267 TRY TO -- WORKING WITH WHOEVER 4368 03:16:19,334 --> 03:16:21,069 WILL BE INTERESTED TO BROADEN 4369 03:16:21,136 --> 03:16:22,003 THE TECHNICAL IMPACT. 4370 03:16:22,070 --> 03:16:24,205 AGAIN, THIS IS THE BEGINNING. 4371 03:16:24,272 --> 03:16:26,975 WE TRY OUR BEST TO PUSH 4372 03:16:27,041 --> 03:16:29,144 TECHNOLOGY FORWARD WITH ALL THE 4373 03:16:29,210 --> 03:16:31,346 HELP FROM NIH AND MY 4374 03:16:31,412 --> 03:16:33,081 COLLABORATORS. 4375 03:16:33,148 --> 03:16:35,116 THANK YOU VERY MUCH. 4376 03:16:35,183 --> 03:16:41,890 [APPLAUSE] 4377 03:16:41,956 --> 03:16:52,500 >> LAST TALK IN THE SESSION IS 4378 03:16:58,173 --> 03:16:59,674 XIAORONG LIU, ASSOCIATE 4379 03:16:59,741 --> 03:17:00,408 PROFESSOR OF BIOLOGY AND 4380 03:17:00,475 --> 03:17:01,543 PSYCHOLOGY AT UNIVERSITY OF 4381 03:17:01,609 --> 03:17:01,809 VIRGINIA. 4382 03:17:01,876 --> 03:17:09,784 >> MY TALK IS A CONTINUATION. 4383 03:17:09,851 --> 03:17:13,321 WE'RE INTERESTED TO DEVELOP A 4384 03:17:13,388 --> 03:17:14,189 NOVEL BIOMARKER FOR RETINAL 4385 03:17:14,255 --> 03:17:16,124 GANGLION CELL DAMAGE. 4386 03:17:16,191 --> 03:17:20,161 YOU ALL KNOW RETINAL NEUROFIBER 4387 03:17:20,228 --> 03:17:24,332 LAYER CONTAINS THINGS IN 4388 03:17:24,399 --> 03:17:26,234 ADDITION TO AXON BUNDLES, 4389 03:17:26,301 --> 03:17:27,835 CELLULAR STRUCTURES, STARTING 4390 03:17:27,902 --> 03:17:30,905 IDEA WAS SIMPLE. 4391 03:17:30,972 --> 03:17:32,540 IF WE CAN VISUALIZE INDIVIDUAL 4392 03:17:32,607 --> 03:17:36,945 AXON BUNDLES MAYBE WE'LL HAVE A 4393 03:17:37,011 --> 03:17:39,347 BETTER IDEA WHAT'S GOING WITH 4394 03:17:39,414 --> 03:17:39,847 RGC. 4395 03:17:39,914 --> 03:17:41,849 WE STARTED IN MICE. 4396 03:17:41,916 --> 03:17:46,888 AS YOU KNOW, IN MICE IT'S MOST 4397 03:17:46,955 --> 03:17:49,390 WIDELY USED RESEARCH ANIMAL 4398 03:17:49,457 --> 03:17:55,430 MODELS, BECAUSE OF THE 4399 03:17:55,496 --> 03:17:56,331 AVAILABILITY OF GENETIC DISCERN 4400 03:17:56,397 --> 03:17:59,167 AND EYE DISEASE MODELS. 4401 03:17:59,234 --> 03:18:05,607 WE TAKE RETINA OUT, FLATTEN, CUT 4402 03:18:05,673 --> 03:18:07,909 TO FOUR LEAVES, STAIN TO EXAMINE 4403 03:18:07,976 --> 03:18:10,111 HOW GANGLION CELLS SURVIVE OR 4404 03:18:10,178 --> 03:18:12,180 DIE IN DIFFERENT CONDITIONS. 4405 03:18:12,247 --> 03:18:16,217 THEY ARE STAINED IN THIS CASE, 4406 03:18:16,284 --> 03:18:19,287 TRANSCRIPTION FACTOR, EACH DOT 4407 03:18:19,354 --> 03:18:20,588 REPRESENTS ONE SINGLE RETINAL 4408 03:18:20,655 --> 03:18:20,922 GANGLION CELL. 4409 03:18:20,989 --> 03:18:25,827 IF WE CHANGE THE FOCUS SLIGHTLY 4410 03:18:25,893 --> 03:18:29,230 TO THE MORE SUPERFICIAL LAYER, 4411 03:18:29,297 --> 03:18:30,798 THE RETINAL GANGLION CELL ON THE 4412 03:18:30,865 --> 03:18:36,271 TOP FACING UP, IF WE CHANGE THE 4413 03:18:36,337 --> 03:18:39,207 FOCUS A LITTLE BIT WE CAN SEE 4414 03:18:39,274 --> 03:18:44,345 NERVE FIBER LAYER IN MICE. 4415 03:18:44,412 --> 03:18:47,282 BLOOD VESSELS ARE STAINED IN 4416 03:18:47,348 --> 03:18:47,448 RED. 4417 03:18:47,515 --> 03:18:50,218 IN BETWEEN BLOOD VESSELS YOU CAN 4418 03:18:50,285 --> 03:18:53,921 SEE FIBER BUNDLES. 4419 03:18:53,988 --> 03:18:55,857 THESE ARE STAINED BY SMI-32, 4420 03:18:55,923 --> 03:19:01,195 MARKER FOR SMALL GROUP OF 4421 03:19:01,262 --> 03:19:02,297 RETINAL GANGLION CELLS. 4422 03:19:02,363 --> 03:19:05,033 WE CAN SEE THESE WELL IN EX VIVO 4423 03:19:05,099 --> 03:19:05,933 CONFOCAL IMAGES. 4424 03:19:06,000 --> 03:19:12,240 NOW CAN WE SEE IT IN VIVO? 4425 03:19:12,307 --> 03:19:17,378 WE USE A SYSTEM BUILT BY HAO 4426 03:19:17,445 --> 03:19:19,747 ZHANG'S COMPANY, RODENTS, MICE 4427 03:19:19,814 --> 03:19:30,358 NEED TO BE ANESTHETIZED, TAKE A 4428 03:19:30,558 --> 03:19:32,360 PICTURE, USE THE BLOOD VESSELS 4429 03:19:32,427 --> 03:19:40,234 AS LANDMARKS. 4430 03:19:40,301 --> 03:19:42,437 WE CAN ALIGN THEM, MUCH BIGGER 4431 03:19:42,503 --> 03:19:45,406 FIELD OF VIEW. 4432 03:19:45,473 --> 03:19:48,343 AS WE SCAN THROUGH THE EYE WE 4433 03:19:48,409 --> 03:19:55,450 COLLECTED B SCANS, FOCUS ON TOP 4434 03:19:55,516 --> 03:19:56,584 SUPERFICIAL THICKNESS LAYER. 4435 03:19:56,651 --> 03:19:59,620 YOU CAN SEE BLOOD VESSELS. 4436 03:19:59,687 --> 03:20:01,089 OPTIC NERVE HAT, AT THE CENTER 4437 03:20:01,155 --> 03:20:02,824 IN BETWEEN THE VESSELS YOU SEE 4438 03:20:02,890 --> 03:20:05,226 THE FIBERS. 4439 03:20:05,293 --> 03:20:09,764 SAME EYE, NOW WE PROCESS FOR 4440 03:20:09,831 --> 03:20:10,164 NERVE FIBERS. 4441 03:20:10,231 --> 03:20:14,802 THEN WE CAN USE AGAIN THE BLOOD 4442 03:20:14,869 --> 03:20:16,838 VESSELS, THIS IS ONE OF THE 4443 03:20:16,904 --> 03:20:19,607 FIRST GROUP OF IMAGES WE 4444 03:20:19,674 --> 03:20:22,443 COLLECTED FROM MICE IN 2019, AND 4445 03:20:22,510 --> 03:20:24,746 THIS GIVE US THE CONFIDENCE FOR 4446 03:20:24,812 --> 03:20:26,814 THE FIRST TIME, WE PROBABLY CAN 4447 03:20:26,881 --> 03:20:29,217 SEE THE INDIVIDUAL AXON BUNDLES 4448 03:20:29,283 --> 03:20:30,251 IN VIVO. 4449 03:20:30,318 --> 03:20:35,690 SO THIS IS JUST PUT IN A 3D 4450 03:20:35,757 --> 03:20:40,495 RENDERING, A MOUSE RETINA, AND 4451 03:20:40,561 --> 03:20:42,530 OPTIC NERVE HAT, AND STARTING 4452 03:20:42,597 --> 03:20:45,933 FROM THE BOTTOM THESE ARE THE 4453 03:20:46,000 --> 03:20:48,302 CHOROID RPE, MICE ARE NOCTURNAL, 4454 03:20:48,369 --> 03:20:51,239 THEY HAVE A LOT OF 4455 03:20:51,305 --> 03:20:53,441 PHOTORECEPTORS, THEY DON'T HAVE 4456 03:20:53,508 --> 03:21:03,785 MANY CONES, AND ROUGH LAYER OF 4457 03:21:03,851 --> 03:21:05,253 30 LAYERS, THEN GO UP. 4458 03:21:05,319 --> 03:21:07,488 I WANTED TO POINT OUT FOR MOUSE 4459 03:21:07,555 --> 03:21:09,357 RETINA THEY DON'T HAVE MANY 4460 03:21:09,424 --> 03:21:10,925 RETINAL GANGLION CELLS. 4461 03:21:10,992 --> 03:21:14,061 YOU BARELY SEE A REAL BAND OF 4462 03:21:14,128 --> 03:21:15,696 GCL. 4463 03:21:15,763 --> 03:21:23,571 BECAUSE THEY DON'T HAVE MANY, 4464 03:21:23,638 --> 03:21:24,806 DEPENDING ON SPECIES, SOME 4465 03:21:24,872 --> 03:21:27,442 VARIATIONS, COMPARED TO HUMAN 4466 03:21:27,508 --> 03:21:30,711 EYES WE HAVE A MILLION CELLS. 4467 03:21:30,778 --> 03:21:32,680 WHAT YOU SEE HERE IS THAT'S 4468 03:21:32,747 --> 03:21:36,451 PROBABLY JUST ONE SINGLE LAYER 4469 03:21:36,517 --> 03:21:38,486 OF SOMA, TIGHTLY SQUEEZED IN 4470 03:21:38,553 --> 03:21:39,921 FIBERS AND AXON BUNDLES. 4471 03:21:39,987 --> 03:21:43,624 BLOOD VESSELS AS YOU NOTICED 4472 03:21:43,691 --> 03:21:45,159 CAST DARK SHADOWS, IN BETWEEN 4473 03:21:45,226 --> 03:21:47,728 BLOOD VESSELS YOU CAN SEE 4474 03:21:47,795 --> 03:21:52,733 INDIVIDUAL AXON BUNDLES OVER 4475 03:21:52,800 --> 03:21:53,034 THERE. 4476 03:21:53,100 --> 03:22:00,374 AND SO WE DID A SCAN, WE CALL 4477 03:22:00,441 --> 03:22:02,777 THIS B SCAN, OPTIC NERVE HAT, AT 4478 03:22:02,844 --> 03:22:04,545 THE CENTER DO ADJUSTMENT TO MAKE 4479 03:22:04,612 --> 03:22:06,948 SURE WE SCAN ALL THE AXON 4480 03:22:07,014 --> 03:22:11,519 BUNDLES AT THE SAME ANGLE. 4481 03:22:11,586 --> 03:22:17,792 SO THIS IS MOUSE EYE, RADIUS 4482 03:22:17,859 --> 03:22:21,662 AROUND 350 MICRO METER. 4483 03:22:21,729 --> 03:22:25,233 YOU CAN SEE INDIVIDUAL AXON 4484 03:22:25,299 --> 03:22:29,937 BUNDLES RATHER THAN PIXELATED 4485 03:22:30,004 --> 03:22:30,204 LAYER. 4486 03:22:30,271 --> 03:22:33,241 THIS GIVE US THE -- MAKES US 4487 03:22:33,307 --> 03:22:35,843 FEEL WE CAN QUANTIFY ALL 4488 03:22:35,910 --> 03:22:37,845 DIFFERENT CHANGES. 4489 03:22:37,912 --> 03:22:43,618 THIS SHOWS EXAMPLE, DISTRIBUTION 4490 03:22:43,684 --> 03:22:46,053 OF THE AXON BUNDLE HEIGHT RATHER 4491 03:22:46,120 --> 03:22:51,526 THAN SPECIFICALLY IN C57 BLACK. 4492 03:22:51,592 --> 03:22:54,929 THEY ARE LOOSELY PACKED IN THE 4493 03:22:54,996 --> 03:23:00,701 RNFL, A SINGLE LAYER, ROUND 4494 03:23:00,768 --> 03:23:06,374 SHAPE, AND SO WE TRACKED THE 4495 03:23:06,440 --> 03:23:08,109 CHANGES OF INDIVIDUAL BUNDLES, 4496 03:23:08,175 --> 03:23:11,312 ALSO IN CHRONIC MODELS OF OCULAR 4497 03:23:11,379 --> 03:23:11,879 HYPERTENSION. 4498 03:23:11,946 --> 03:23:15,049 THE IDEA WE CAN QUANTIFY THE 4499 03:23:15,116 --> 03:23:19,220 NUMBERS, PATTERNING, THE SIZE OF 4500 03:23:19,287 --> 03:23:21,155 AXON BUNDLES, CORRELATED WITH 4501 03:23:21,222 --> 03:23:23,291 GANGLION CELL DENSITY, WHICH I'M 4502 03:23:23,357 --> 03:23:25,693 NOT GOING INTO DETAILS TODAY. 4503 03:23:25,760 --> 03:23:27,862 SO FAR, ALL THE IMAGES ARE IN 4504 03:23:27,929 --> 03:23:30,264 VIVO, AS YOU CAN IMAGINE PEOPLE 4505 03:23:30,331 --> 03:23:36,270 WILL ASK US FOR VALIDATION. 4506 03:23:36,337 --> 03:23:38,272 ESPECIALLY FOR FIBRO GRAMS, 4507 03:23:38,339 --> 03:23:40,007 HEAVILY PROCESSED IMAGES. 4508 03:23:40,074 --> 03:23:42,877 WHAT WE DID IS TAKE IN VIVO 4509 03:23:42,944 --> 03:23:45,479 IMAGE BY VISIBLE LIGHT, 4510 03:23:45,546 --> 03:23:49,083 SACRIFICE THE ANIMAL, TAKE THE 4511 03:23:49,150 --> 03:23:52,887 RETINA OUT, FLAT MOUNT, STAIN 4512 03:23:52,954 --> 03:23:55,656 FOR MARKER FOR AXONS. 4513 03:23:55,723 --> 03:23:58,926 AND IF WE ZOOM IN, WE CAN MATCH 4514 03:23:58,993 --> 03:24:03,864 EVERY SINGLE FIBER FROM IN VIVO 4515 03:24:03,931 --> 03:24:04,966 PICTURE TO CONFOCAL PICTURE, ONE 4516 03:24:05,032 --> 03:24:10,104 TO FOUR ARE AXON BUNDLES, FIVE 4517 03:24:10,171 --> 03:24:14,475 THROUGH SEVEN ARE BLOOD VESSELS. 4518 03:24:14,542 --> 03:24:17,545 ON THE RIGHT BLOOD VESSELS ARE 4519 03:24:17,612 --> 03:24:22,650 DARK BANDS IN BETWEEN. 4520 03:24:22,717 --> 03:24:24,652 YELLOW-- ORANGE ARROWS POINT TO 4521 03:24:24,719 --> 03:24:25,686 FIBERS. 4522 03:24:25,753 --> 03:24:27,488 FOR EXAMPLE, THE NUMBER 1 AT THE 4523 03:24:27,555 --> 03:24:30,124 BOTTOM WE CAN MATCH FIBER TO 4524 03:24:30,191 --> 03:24:32,293 FIBER, DIAMETER FOR THAT FIBER 4525 03:24:32,360 --> 03:24:35,997 IS ABOUT 8 MICROMETERS. 4526 03:24:36,063 --> 03:24:40,134 WE ALSO SHOW THIN LINE, NUMBER 4527 03:24:40,201 --> 03:24:41,502 3, 2.5 MICROMETER DIAMETER. 4528 03:24:41,569 --> 03:24:46,907 SO, SO FAR WE FEEL LIKE YES WE 4529 03:24:46,974 --> 03:24:49,910 ESTABLISHED ESPECIALLY TO IMAGE 4530 03:24:49,977 --> 03:24:52,580 THE FIBERS IN THE RNFL LAYER. 4531 03:24:52,647 --> 03:24:57,151 MOUSE EYES ARE SIMPLE. 4532 03:24:57,218 --> 03:24:59,320 THEY DON'T HAVE STRUCTURED OPTIC 4533 03:24:59,387 --> 03:25:05,159 NERVE HAT, AND THE AXON BUNDLES 4534 03:25:05,226 --> 03:25:08,896 ALSO PASS INNED RNFL, MANY 4535 03:25:08,963 --> 03:25:10,097 FEATURES WE'D LIKE TO STUDY MICE 4536 03:25:10,164 --> 03:25:11,599 DO NOT HAVE. 4537 03:25:11,666 --> 03:25:13,334 WE'RE LOOKING FOR ANIMAL MODEL 4538 03:25:13,401 --> 03:25:14,802 TO BRIDGE MOUSE RESEARCH WITH 4539 03:25:14,869 --> 03:25:21,709 CLINICAL RESEARCH. 4540 03:25:21,776 --> 03:25:28,683 SO, WE STARTED TO IMAGE THIS 4541 03:25:28,749 --> 03:25:29,917 MODEL, THREE SHREW. 4542 03:25:29,984 --> 03:25:32,186 SMALL NUMBER OF PAPERS PUBLISHED 4543 03:25:32,253 --> 03:25:36,490 TO STUDY NOT ONLY EYE 4544 03:25:36,557 --> 03:25:37,792 DEVELOPMENT, ALSO DISEASE, ALSO 4545 03:25:37,858 --> 03:25:40,528 VISUAL PATHWAYS FROM EYE TO 4546 03:25:40,594 --> 03:25:45,199 BRAIN, COMPARE MOUSE EYES, TREE 4547 03:25:45,266 --> 03:25:50,404 SHREW EYES ARE MUCH BIGGER, 4548 03:25:50,471 --> 03:25:53,207 8-MILLIMETER VERSUS 3. 4549 03:25:53,274 --> 03:25:55,910 IF WE FLAT MOUNT, SAME SCALE, 4550 03:25:55,976 --> 03:25:58,679 MOUSE EYES ARE REALLY SMALL. 4551 03:25:58,746 --> 03:26:02,717 AND BOTH ARE STAINED FOR 2G-1. 4552 03:26:02,783 --> 03:26:06,353 ON THE LEFT YOU CAN SEE FIBERS 4553 03:26:06,420 --> 03:26:07,655 ARE VERY LOOSE, CONVERGE TO THE 4554 03:26:07,722 --> 03:26:10,357 CENTER OF OPTIC NERVE HAT. 4555 03:26:10,424 --> 03:26:12,560 FOR TREE SHREW EYES MUCH BIGGER. 4556 03:26:12,626 --> 03:26:14,729 YOU CAN SEE FIBERS TIGHTLY 4557 03:26:14,795 --> 03:26:19,567 PACKED NEXT TO EACH OTHER. 4558 03:26:19,633 --> 03:26:23,804 LEFT SIDE IS OCT FIBROGRAM, SAME 4559 03:26:23,871 --> 03:26:26,741 EYE WE USED BLOOD VESSELS AS 4560 03:26:26,807 --> 03:26:30,344 MARKERS SO WE CAN ALIGN THEM IN 4561 03:26:30,411 --> 03:26:33,247 VIVO VERSUS EX VIVO. 4562 03:26:33,314 --> 03:26:39,386 AND THERE ARE MUCH MORE FIBER 4563 03:26:39,453 --> 03:26:40,287 BUNDLES. 4564 03:26:40,354 --> 03:26:44,058 AXON COUNTING WAS DONE. 4565 03:26:44,125 --> 03:26:45,292 TREE SHREW EYES HAVE 300,000 4566 03:26:45,359 --> 03:26:47,728 GANGLION CELLS, WE MUCH MORE 4567 03:26:47,795 --> 03:26:48,462 THAN MOUSE EYES. 4568 03:26:48,529 --> 03:26:52,299 WAY MUCH MORE THAN MOUSE EYES. 4569 03:26:52,366 --> 03:26:56,403 WE COMPARE B SCANS SIDE BY SIDE, 4570 03:26:56,470 --> 03:26:57,204 TREE SHREW EYES, MOUSE EYES ON 4571 03:26:57,271 --> 03:26:58,372 THE RIGHT. 4572 03:26:58,439 --> 03:27:02,443 YOU CAN SEE CLOSER TO OPTIC 4573 03:27:02,510 --> 03:27:09,683 NERVE HAT, AXON BUNDLES GOT 4574 03:27:09,750 --> 03:27:10,251 ELONGATED VERTICALLY, MUCH 4575 03:27:10,317 --> 03:27:14,889 THICKER COMPARED TO MOUSE EYES, 4576 03:27:14,955 --> 03:27:17,391 SIMPLE SHAPE AXON BUNDLES. 4577 03:27:17,458 --> 03:27:19,527 EVEN THOUGH THEY LOOK LIKE THERE 4578 03:27:19,593 --> 03:27:21,929 MIGHT BE LAYERS, I THINK IT'S 4579 03:27:21,996 --> 03:27:23,697 STILL ONE SINGLE LAYERED AXON 4580 03:27:23,764 --> 03:27:25,566 BUNDLES BECAUSE THIS IS A 4581 03:27:25,633 --> 03:27:27,735 DEVELOPMENTAL ISSUE AS THE AXONS 4582 03:27:27,802 --> 03:27:29,737 STARTED TO GROW. 4583 03:27:29,804 --> 03:27:31,872 THEY NEEDED TO FIND A PATH WHERE 4584 03:27:31,939 --> 03:27:35,743 TO GO INSTEAD OF CIRCLING AROUND 4585 03:27:35,810 --> 03:27:36,911 IN RETINA EARLIER BEFORE THEY 4586 03:27:36,977 --> 03:27:39,380 REACH TO OPTIC NERVE HAT. 4587 03:27:39,446 --> 03:27:43,784 THEY NEED TO CRAWL A INNER 4588 03:27:43,851 --> 03:27:45,920 SURFACE, AS MORE CELLS JOIN IN 4589 03:27:45,986 --> 03:27:48,422 TOWARDS THE CENTRAL AREAS, THEY 4590 03:27:48,489 --> 03:27:53,928 KEEP HOLDING NEW AXON ON TOP OF 4591 03:27:53,994 --> 03:28:00,601 EACH OTHER. 4592 03:28:00,668 --> 03:28:02,002 PERIPHERAL, YOU SEE BUNDLES ARE 4593 03:28:02,069 --> 03:28:03,671 GETTING MORE ROUND SHAPE, TAKING 4594 03:28:03,737 --> 03:28:05,840 UP MORE SPACE. 4595 03:28:05,906 --> 03:28:08,642 WE ALSO DID VALIDATION CONFOCAL 4596 03:28:08,709 --> 03:28:09,910 IMAGING, NOT EXACTLY THE SAME 4597 03:28:09,977 --> 03:28:12,213 LOCATION, THEY ARE THE SAME 4598 03:28:12,279 --> 03:28:15,482 EYES, ONE THING WE CANNOT DO 4599 03:28:15,549 --> 03:28:17,551 CIRCULAR SECTION FOR CONFOCAL 4600 03:28:17,618 --> 03:28:19,119 IMAGING. 4601 03:28:19,186 --> 03:28:21,255 ALSO FOR TREE SHREW EYES, THEY 4602 03:28:21,322 --> 03:28:23,157 ARE TOO BIG, HARD TO MATCH 4603 03:28:23,224 --> 03:28:26,894 IDENTICAL LOCATION FROM IN VIVO 4604 03:28:26,961 --> 03:28:31,265 TO EX VIVO. 4605 03:28:31,332 --> 03:28:34,935 GRAY SIGNAL FROM 2J-1, 4606 03:28:35,002 --> 03:28:39,607 VERTICALLY ELONGATED BUNDLES. 4607 03:28:39,673 --> 03:28:41,141 BLUE SIGNALS, NUCLEAR EYE. 4608 03:28:41,208 --> 03:28:44,345 FOR MOUSE A THICK LAYER, FOR 4609 03:28:44,411 --> 03:28:52,119 TREE SHREWS THEY ARE DIURNAL, 4610 03:28:52,186 --> 03:28:56,123 AND NOT AS THICK AS MOUSE EYES. 4611 03:28:56,190 --> 03:29:00,160 WE FOCUS ON INNER RETINA. 4612 03:29:00,227 --> 03:29:06,000 LEFT SIDE IN VIVO IMAGE, RIGHT 4613 03:29:06,066 --> 03:29:06,834 SIDE IS CONFOCAL. 4614 03:29:06,901 --> 03:29:11,138 ON THE LEFT SIDE YOU CAN SEE 4615 03:29:11,205 --> 03:29:12,139 INDIVIDUAL AXON BUNDLES 4616 03:29:12,206 --> 03:29:13,641 VERTICALLY ELONGATED. 4617 03:29:13,707 --> 03:29:17,011 NOW WE HAVE A GANGLION CELL 4618 03:29:17,077 --> 03:29:27,554 LAYER, DARK BANDS, THREE TO FIVE 4619 03:29:27,621 --> 03:29:32,660 SOMA LAYERS, TWO MARKERS. 4620 03:29:32,726 --> 03:29:37,898 AND NOW WE CAN SEE SUBLAYERS. 4621 03:29:37,965 --> 03:29:42,970 THIS COULD BE INTERESTING FOR 4622 03:29:43,037 --> 03:29:43,804 GLAUCOMA, EARLY INDICATOR FOR 4623 03:29:43,871 --> 03:29:46,573 GANGLION CELLS DEATH. 4624 03:29:46,640 --> 03:29:49,510 WHEN CELLS START TO DEGENERATE, 4625 03:29:49,576 --> 03:29:52,913 TREES WILL RESHAPE, START TO 4626 03:29:52,980 --> 03:29:55,215 MODEL, MAY CHANGE THE 4627 03:29:55,282 --> 03:29:56,050 SUBSTRUCTURE. 4628 03:29:56,116 --> 03:30:01,088 SO TISSUE WILL GIVE US POTENTIAL 4629 03:30:01,155 --> 03:30:02,756 TO MONITOR ALL THE SUBTLE 4630 03:30:02,823 --> 03:30:03,557 CHANGES, ESPECIALLY AT EARLIER 4631 03:30:03,624 --> 03:30:05,492 STAGE OF DISEASE. 4632 03:30:05,559 --> 03:30:09,496 WE WILL START TO DEVELOP TREE 4633 03:30:09,563 --> 03:30:11,198 SHREW OCULAR HYPERTENSION MODEL, 4634 03:30:11,265 --> 03:30:15,703 AND THEN WE CAN MONITOR ALL THE 4635 03:30:15,769 --> 03:30:19,640 DIFFERENT STRUCTURES IN THE RNFL 4636 03:30:19,707 --> 03:30:21,709 GANGLION LAYER AND IPL TO 4637 03:30:21,775 --> 03:30:24,979 QUANTIFY AND TRACK ALL THE 4638 03:30:25,045 --> 03:30:26,513 CHANGES WITH DISEASE 4639 03:30:26,580 --> 03:30:27,281 DEVELOPMENT. 4640 03:30:27,348 --> 03:30:29,917 WE SUBMITTED THIS MANUSCRIPT 4641 03:30:29,984 --> 03:30:36,690 LAST YEAR, I STATED TREE SHREW 4642 03:30:36,757 --> 03:30:38,759 REPRESENT MODEL BETTER TO HUMAN 4643 03:30:38,826 --> 03:30:39,193 EYES. 4644 03:30:39,259 --> 03:30:43,731 REVIEWERS ASK, YOU'VE GOT TO 4645 03:30:43,797 --> 03:30:47,067 SHOW THE HUMAN DATA. 4646 03:30:47,134 --> 03:30:56,710 WE STARTED IN COLLABORATION WITH 4647 03:30:56,777 --> 03:31:05,919 PETER NETLAND AT UVA. 4648 03:31:05,986 --> 03:31:08,322 THIS STARTED RIGHT AFTER COVID, 4649 03:31:08,389 --> 03:31:10,224 THAT'S OCT TRADITION FROM JAMES 4650 03:31:10,290 --> 03:31:14,194 FUJIMOTO, WHOEVER BUILD A SYSTEM 4651 03:31:14,261 --> 03:31:15,729 WILL BE TESTED FIRST. 4652 03:31:15,796 --> 03:31:17,264 OUR EYES ARE NOT GOOD. 4653 03:31:17,331 --> 03:31:21,869 OLD EYES WITH ALL KINDS OF 4654 03:31:21,935 --> 03:31:23,937 THINGS, MYOPIA, NOT EASY TO FIND 4655 03:31:24,004 --> 03:31:25,039 A FLATTENED AREA. 4656 03:31:25,105 --> 03:31:33,447 WE MOVED DOWN FROM THE P.I.s, 4657 03:31:33,514 --> 03:31:35,783 POSTDOCS, GRADUATE, JUST 4658 03:31:35,849 --> 03:31:37,718 GRADUATED FROM COLLEGE, GOT THIS 4659 03:31:37,785 --> 03:31:40,721 BUILT, THE DARK CENTER IS THE 4660 03:31:40,788 --> 03:31:41,989 FOVEA. 4661 03:31:42,056 --> 03:31:44,658 YOU CAN SEE FIBERS CURVE AROUND 4662 03:31:44,725 --> 03:31:47,261 THE FOVEA. 4663 03:31:47,327 --> 03:31:49,430 YOU PROBABLY HAVE SEEN THIS 4664 03:31:49,496 --> 03:31:51,432 PICTURE, FREE HAND DRAWING OF 4665 03:31:51,498 --> 03:31:53,934 THE HUMAN FOVEA FIBERS. 4666 03:31:54,001 --> 03:31:54,701 YOU MIGHT KNOW THIS. 4667 03:31:54,768 --> 03:31:56,503 AT THAT TIME I WAS RESEARCHING 4668 03:31:56,570 --> 03:31:59,239 TO FIGURE OUT WHO DID THIS 4669 03:31:59,306 --> 03:32:01,608 BEAUTIFUL PICTURE, AND I FOUND 4670 03:32:01,675 --> 03:32:04,778 ALL KIND OF REVIEWS, DIFFERENT 4671 03:32:04,845 --> 03:32:06,647 VARIATIONS, NOT SURE WHERE IT'S 4672 03:32:06,713 --> 03:32:11,018 FROM UNTIL I TALKED TO MY 4673 03:32:11,085 --> 03:32:12,119 POSTDOC, DAVE, UCSF. 4674 03:32:12,186 --> 03:32:14,521 HE GIVE ME THIS BOOK, HISTOLOGY 4675 03:32:14,588 --> 03:32:15,322 OF THE HUMAN EYE. 4676 03:32:15,389 --> 03:32:20,127 IN THE BOOK WE FOUND THIS 4677 03:32:20,194 --> 03:32:20,661 PICTURE. 4678 03:32:20,727 --> 03:32:25,666 DR. WILLIAM HOYT, WHO WE SEE HIS 4679 03:32:25,732 --> 03:32:29,736 COLLEAGUES, 1960 IT'S AND '70s 4680 03:32:29,803 --> 03:32:35,876 BASEED ON SUPER STAINING OF 4681 03:32:35,943 --> 03:32:44,351 POSTMORTEM HUMAN EYE DID THIS 4682 03:32:44,418 --> 03:32:45,352 FREE HAND DRAWING. 4683 03:32:45,419 --> 03:32:47,488 AND DAVE WAS GENEROUS ENOUGH TO 4684 03:32:47,554 --> 03:32:50,324 GIVE ME THE BOOK, BUT THAT BOOK 4685 03:32:50,390 --> 03:32:56,029 CONTAINS THIS INTERESTING NOTE. 4686 03:32:56,096 --> 03:32:58,732 HE TOOK IT, AND MATT RETIRED, IF 4687 03:32:58,799 --> 03:33:00,701 YOU SEE THIS, SORRY MATT, BUT 4688 03:33:00,767 --> 03:33:04,738 THANK YOU DAVE, THIS WORK IS 4689 03:33:04,805 --> 03:33:06,840 MINE NOW. 4690 03:33:06,907 --> 03:33:09,843 I WILL SUMMARIZE AND CONCLUDE. 4691 03:33:09,910 --> 03:33:12,679 WE STARTED OUT WORK FROM MICE. 4692 03:33:12,746 --> 03:33:15,382 IT'S BEEN WONDERFUL 4693 03:33:15,449 --> 03:33:17,784 COLLABORATION WITH HAO ZHANG AND 4694 03:33:17,851 --> 03:33:19,786 GROUP, WORK IN COLLABORATION 4695 03:33:19,853 --> 03:33:22,589 BETWEEN MY POSTDOC FELLOW MARTA 4696 03:33:22,656 --> 03:33:26,527 WHO DID ALL THE IMAGING, 4697 03:33:26,593 --> 03:33:29,429 INCLUDING MOUSE TISSUE AND 4698 03:33:29,496 --> 03:33:34,635 HUMAN, AND DAVE MILLER WHO 4699 03:33:34,701 --> 03:33:36,537 GRADUATED FROM ZHANG'S LAB, WHO 4700 03:33:36,603 --> 03:33:42,609 DID THE COATING, COLLABORATING 4701 03:33:42,676 --> 03:33:49,149 NOW WITH MY STUDENT, AND THE 4702 03:33:49,216 --> 03:33:53,220 BEAUTIFUL CONFOCAL IMAGES, AND 4703 03:33:53,287 --> 03:34:00,394 THE TREE SHREW COLONIES AT UVA, 4704 03:34:00,460 --> 03:34:03,864 THAT'S GRACE. 4705 03:34:03,931 --> 03:34:09,336 AND FINALLY TWO CLINICIANS, DR. 4706 03:34:09,403 --> 03:34:15,142 NETLAND AND DR. COSTE UVA 4707 03:34:15,209 --> 03:34:17,477 OPHTHALMOLOGY. 4708 03:34:17,544 --> 03:34:20,847 AND FINALLY THE FUNDING. 4709 03:34:20,914 --> 03:34:21,448 THANK YOU ALL. 4710 03:34:21,515 --> 03:34:21,748 [APPLAUSE] 4711 03:34:21,815 --> 03:34:24,218 THANKS TO ALL THE SPEAKERS. 4712 03:34:24,284 --> 03:34:25,519 YOU'RE ALL ON TIME. 4713 03:34:25,586 --> 03:34:27,187 NOW YOU HAVE A CHANCE TO SIT IN 4714 03:34:27,254 --> 03:34:34,895 FRONT OF THE ROOM AND STAKE 4715 03:34:34,962 --> 03:34:45,439 QUESTIONS FROM THE AUDIENCE. 4716 03:35:08,629 --> 03:35:10,731 I'M GOING TO BE A QUESTIONER SO 4717 03:35:10,797 --> 03:35:20,140 I'M GOING TO BE ON THIS SIDE. 4718 03:35:28,782 --> 03:35:30,617 ANY QUESTIONS FROM THE AUDIENCE? 4719 03:35:30,684 --> 03:35:32,219 IF NOT, THINK ABOUT SOME. 4720 03:35:32,286 --> 03:35:39,693 THERE'S A HARD STOP AT 1:00. 4721 03:35:39,760 --> 03:35:43,063 AND IF -- YOU CAN GO AHEAD. 4722 03:35:43,130 --> 03:35:44,598 >> WONDERFUL TALKS, REALLY 4723 03:35:44,665 --> 03:35:45,832 AMAZING TECHNOLOGY. 4724 03:35:45,899 --> 03:35:48,702 I'M BLOWN AWAY EVERY TIME. 4725 03:35:48,769 --> 03:35:52,739 I HAVE A QUESTION. 4726 03:35:52,806 --> 03:35:56,109 WHEN SHOWING TRANSITION ZONE, IN 4727 03:35:56,176 --> 03:35:58,679 YOUR RP PATIENTS, WHAT -- IS 4728 03:35:58,745 --> 03:36:01,415 THERE ANY CHANCE THOSE ARE 4729 03:36:01,481 --> 03:36:04,117 MIGRATING RP CELLS, ROD OUTER 4730 03:36:04,184 --> 03:36:08,855 SEGMENT, HOW DO YOU KNOW? 4731 03:36:08,922 --> 03:36:13,493 CAN YOU TELL US MORE ABOUT THAT? 4732 03:36:13,560 --> 03:36:15,062 >> YES, ABOUT THE TRANSITIONS, 4733 03:36:15,128 --> 03:36:19,132 CERTAINLY WITH THE RPE CELLS, WE 4734 03:36:19,199 --> 03:36:21,968 CAN FIND IF YOU -- IF YOU FIND 4735 03:36:22,035 --> 03:36:24,004 THOSE, IF YOU GO OUT FARTHER 4736 03:36:24,071 --> 03:36:25,272 BEYOND TRANSITION ZONE YOU START 4737 03:36:25,339 --> 03:36:31,611 TO SEE THEM LIFT OFF CLUMPS OF 4738 03:36:31,678 --> 03:36:33,680 RPE CELLS, COME INTO THE INNER 4739 03:36:33,747 --> 03:36:33,914 RETINA. 4740 03:36:33,980 --> 03:36:35,415 THOSE HAPPEN LATER IN THE 4741 03:36:35,482 --> 03:36:36,216 PROCESS, NOT WITHIN THE 4742 03:36:36,283 --> 03:36:42,789 TRANSITION ZONE THAT WE FIND. 4743 03:36:42,856 --> 03:36:46,860 WE DO SEE RODS IN THE -- 4744 03:36:46,927 --> 03:36:57,237 >> (INAUDIBLE). 4745 03:37:02,109 --> 03:37:06,413 >> WE DO SEE RODS IN THERE. 4746 03:37:06,480 --> 03:37:08,215 WE DISCOUNT THEM, THE OUTER TIP 4747 03:37:08,281 --> 03:37:09,282 OF RODS, THEY GO ALL THE WAY 4748 03:37:09,349 --> 03:37:11,651 DOWN TO THE TOP OF THE RPE, 4749 03:37:11,718 --> 03:37:14,821 FURTHER DOWN THAN THE CONE OUTER 4750 03:37:14,888 --> 03:37:17,657 TIP, WE CAN SEPARATE THOSE OUT. 4751 03:37:17,724 --> 03:37:19,793 IF THEY MESS IN THERE, IT'S A 4752 03:37:19,860 --> 03:37:22,662 REAL MESS, YOU LIKE WORKING WITH 4753 03:37:22,729 --> 03:37:25,165 NORMAL RETINA, YOU GET TO THE 4754 03:37:25,232 --> 03:37:26,666 DISEASE AND YOUR HEART SINKS BUT 4755 03:37:26,733 --> 03:37:27,634 WE'RE WORKING THROUGH THAT. 4756 03:37:27,701 --> 03:37:33,039 THAT WAS A PROJECT THERE. 4757 03:37:33,106 --> 03:37:36,243 >> WE HAD SIMILAR OBSERVATION, 4758 03:37:36,309 --> 03:37:37,544 RELATIVELY HEALTHY, YOU CAN 4759 03:37:37,611 --> 03:37:39,679 SEGMENT OUT LAYERS FROM CONES 4760 03:37:39,746 --> 03:37:42,048 AND RPE AND DEEPER LAYERS AS 4761 03:37:42,115 --> 03:37:43,884 WELL BUT IN DISEASED CONDITIONS 4762 03:37:43,950 --> 03:37:47,087 SUPER HARD, YOU CAN SEE RPE 4763 03:37:47,154 --> 03:37:47,788 CELLS. 4764 03:37:47,854 --> 03:37:49,256 LAYERS STILL THERE. 4765 03:37:49,322 --> 03:37:50,824 OVER THE TIME, ESPECIALLY IN THE 4766 03:37:50,891 --> 03:37:54,327 LATE STAGE OF THE DISEASE 4767 03:37:54,394 --> 03:37:57,931 DEVELOPMENT, YOU CANNOT SEE RP 4768 03:37:57,998 --> 03:37:59,533 CELLS MIGRATE AND FORM A LAYER 4769 03:37:59,599 --> 03:38:01,501 WHETHER YOU CAN IDENTIFY THE 4770 03:38:01,568 --> 03:38:03,703 CELLS ABOVE THE NORMAL RPE 4771 03:38:03,770 --> 03:38:04,004 LAYER. 4772 03:38:04,070 --> 03:38:06,773 YOU CAN COUNT THEM AND MAP OUT 4773 03:38:06,840 --> 03:38:09,910 THEIR MORPHOLOGY. 4774 03:38:09,976 --> 03:38:13,713 WE BELIEVE THOSE ARE RPE ELSE 4775 03:38:13,780 --> 03:38:16,450 BUT BECAUSE THE RETINA IS SO 4776 03:38:16,516 --> 03:38:18,819 MESSED UP IT'S HARD. 4777 03:38:18,885 --> 03:38:21,087 >> YOU SHOULD MAKE COMMENT WE 4778 03:38:21,154 --> 03:38:23,657 USE ORG SIGNAL TO SEPARATE OUT 4779 03:38:23,723 --> 03:38:25,592 RODS FROM CONES, SO THE RODS 4780 03:38:25,659 --> 03:38:27,494 HAVE A SEPARATE DISTINCT ORG 4781 03:38:27,561 --> 03:38:27,828 SIGNAL. 4782 03:38:27,894 --> 03:38:36,470 THAT HELPS US, IF THERE'S A 4783 03:38:36,536 --> 03:38:37,604 SHORT ROD, -- 4784 03:38:37,671 --> 03:38:42,242 >> IT IS DIFFICULT TO HEAR 4785 03:38:42,309 --> 03:38:43,276 QUESTIONS FROM THE MICROPHONE 4786 03:38:43,343 --> 03:38:44,678 BECAUSE OF THE ECHO. 4787 03:38:44,744 --> 03:38:48,482 IF THEY ASK YOU TO REPEAT, 4788 03:38:48,548 --> 03:38:51,084 REPEAT SLOWLY OR MAKE THE FIRST 4789 03:38:51,151 --> 03:38:51,651 QUESTION SLOW. 4790 03:38:51,718 --> 03:38:55,689 >> MY QUESTION FOLLOWS CLOSELY 4791 03:38:55,755 --> 03:38:55,956 ON AMIR'S. 4792 03:38:56,022 --> 03:38:59,793 CAN YOU HEAR ME OKAY? 4793 03:38:59,860 --> 03:39:05,131 I AM FOLLOWING UP ON AMIR'S 4794 03:39:05,198 --> 03:39:05,565 QUESTION. 4795 03:39:05,632 --> 03:39:08,935 I GUESS SINCE WE FIRST STARTED 4796 03:39:09,002 --> 03:39:13,907 OBSERVING THESE THINGS, IN YOUR 4797 03:39:13,974 --> 03:39:17,344 GROUP, DON, IT'S BEEN ISO COST, 4798 03:39:17,410 --> 03:39:23,283 YOU'RE SHOWING IMAGES EVEN IF 4799 03:39:23,350 --> 03:39:24,584 THE REFLECTIONS OVERLAP NO 4800 03:39:24,651 --> 03:39:29,289 GUARANTEE IT'S ISO OR COST. 4801 03:39:29,356 --> 03:39:31,291 CLINICIANS ARE GOOD AT LOOKING 4802 03:39:31,358 --> 03:39:34,995 AT IMAGE, THIS LOOKS SICK TO ME, 4803 03:39:35,061 --> 03:39:36,830 BUT FROM MY PERSPECTIVE, I HAVE 4804 03:39:36,897 --> 03:39:40,133 NO IDEA UNTIL WE PUT NUMBERS, 4805 03:39:40,200 --> 03:39:41,701 IT'S HARD TO SAY MUCH. 4806 03:39:41,768 --> 03:39:45,906 DO YOU THINK -- ARE THERE 4807 03:39:45,972 --> 03:39:48,575 PROSPECTS FOR QUANTIFICATION OF 4808 03:39:48,642 --> 03:39:53,046 ORG OR MORPHOLOGICAL 4809 03:39:53,113 --> 03:39:55,015 QUANTIFICATION AGNOSTIC TO THE 4810 03:39:55,081 --> 03:39:57,083 CHANGES OR, YOU KNOW, YEAH 4811 03:39:57,150 --> 03:39:58,285 MORPHOLOGICAL CHANGES SEEN IN 4812 03:39:58,351 --> 03:39:58,852 DISEASE? 4813 03:39:58,919 --> 03:40:05,625 DO YOU THINK IT'S A AN AVENUE, 4814 03:40:05,692 --> 03:40:05,992 YOU KNOW -- 4815 03:40:06,059 --> 03:40:09,496 >> YEAH, A LONG QUESTION, RAVI. 4816 03:40:09,563 --> 03:40:11,531 THE ONE THING WE WERE MAYBE 4817 03:40:11,598 --> 03:40:13,700 RELATED TO THAT WAS THOSE CONES 4818 03:40:13,767 --> 03:40:16,503 THAT HAD EXTRA REFLECTIONS IN 4819 03:40:16,570 --> 03:40:18,438 THEM THAT HAD KIND OF NORMAL 4820 03:40:18,505 --> 03:40:21,174 LENGTH IN RP WE THOUGHT IF WE 4821 03:40:21,241 --> 03:40:23,176 MEASURE THEIR ORG THAT THEY 4822 03:40:23,243 --> 03:40:26,212 WOULD BE REDUCED RELATIVE TO 4823 03:40:26,279 --> 03:40:28,114 THOSE CONES OF SIMILAR LENGTH 4824 03:40:28,181 --> 03:40:29,716 THAT DIDN'T HAVE EXTRA 4825 03:40:29,783 --> 03:40:30,016 REFLECTIONS. 4826 03:40:30,083 --> 03:40:32,018 WHAT GEORGE FOUND THERE WASN'T 4827 03:40:32,085 --> 03:40:33,887 ANY STATISTICAL DIFFERENCE 4828 03:40:33,954 --> 03:40:39,326 BETWEEN THE TWO. 4829 03:40:39,392 --> 03:40:41,695 SO THAT'S THE EXTRA COMPLICATION 4830 03:40:41,761 --> 03:40:43,196 HOW WE RELATE THE FUNCTIONAL 4831 03:40:43,263 --> 03:40:48,969 PART TO ANATOMICALLY WITH EXTRA 4832 03:40:49,035 --> 03:40:50,203 REFLECTIONS. 4833 03:40:50,270 --> 03:40:51,838 WHAT GEORGE FINDS WITH ORG IF 4834 03:40:51,905 --> 03:40:55,875 IT'S INSIDE OF WHAT WE THINK OF, 4835 03:40:55,942 --> 03:40:57,911 INTERPRETED CORRECTLY, THE OUTER 4836 03:40:57,978 --> 03:40:58,945 SEGMENT, THEN THE DEEPER THAT 4837 03:40:59,012 --> 03:41:03,850 REFLECTION IS IN THE OUTER 4838 03:41:03,917 --> 03:41:05,986 SEGMENT, THE STRONGER THE ORG 4839 03:41:06,052 --> 03:41:07,687 SIGNAL IS. 4840 03:41:07,754 --> 03:41:11,625 IF IT'S A SHORTER LENGTH, IT 4841 03:41:11,691 --> 03:41:12,692 WILL BE CORRESPONDLY REDUCED ORG 4842 03:41:12,759 --> 03:41:17,497 WITH THE UNIQUE SIGNATURE TO 4843 03:41:17,564 --> 03:41:21,001 IDENTIFY AS S,M, OR L CONE. 4844 03:41:21,067 --> 03:41:22,035 >> JOEL? 4845 03:41:22,102 --> 03:41:22,435 >> JOEL SCHUMAN. 4846 03:41:22,502 --> 03:41:24,704 FIRST OF ALL, GREAT TALKS. 4847 03:41:24,771 --> 03:41:29,175 AND I'D LIKE TO TAKE YOU TO THE 4848 03:41:29,242 --> 03:41:30,543 INNER RETINA. 4849 03:41:30,610 --> 03:41:31,978 SO, YOU'VE PRESENTED REALLY 4850 03:41:32,045 --> 03:41:39,085 BEAUTIFUL IMAGES OF THE RETINAL 4851 03:41:39,152 --> 03:41:41,054 GANGLION CELLS, AND YOU 4852 03:41:41,121 --> 03:41:43,089 PRESENTED REALLY NICE IMAGES IN 4853 03:41:43,156 --> 03:41:45,859 HUMAN EYES, LOOKING AT THE 4854 03:41:45,925 --> 03:41:48,061 RETINAL GANGLION CELL AXONS. 4855 03:41:48,128 --> 03:41:54,868 AND HAO, I'M SORRY I MISSED 4856 03:41:54,934 --> 03:41:55,201 YOUR TALK. 4857 03:41:55,268 --> 03:41:57,904 I WANT TO FIND OUT WHAT YOU 4858 03:41:57,971 --> 03:41:59,839 LEARNED IN TERMS OF GLAUCOMA 4859 03:41:59,906 --> 03:42:02,175 LOOKING AT RETINAL GANGLION 4860 03:42:02,242 --> 03:42:03,143 CELLS, LOOKING AT CELLS DAMAGED 4861 03:42:03,209 --> 03:42:04,277 IN THE DISEASE. 4862 03:42:04,344 --> 03:42:06,413 YOU SHOWED YOU COULD VISUALIZE 4863 03:42:06,479 --> 03:42:07,547 THESE CELLS, OVER TIME WHAT 4864 03:42:07,614 --> 03:42:08,848 HAPPENS TO THESE CELLS? 4865 03:42:08,915 --> 03:42:11,117 AND WHAT HAPPENS TO THE NERVE 4866 03:42:11,184 --> 03:42:16,122 FIBER BUNDLES WHEN YOU LOOK AT 4867 03:42:16,189 --> 03:42:21,561 IT WITH VISIBLE LIGHT OCT? 4868 03:42:21,628 --> 03:42:22,295 >> HELLO? 4869 03:42:22,362 --> 03:42:22,696 OKAY. 4870 03:42:22,762 --> 03:42:26,199 SO, WE DID SHOW A LOT OF BASIC 4871 03:42:26,266 --> 03:42:28,601 RESEARCH DONE IN ANIMAL MODELS, 4872 03:42:28,668 --> 03:42:31,237 ESPECIALLY IN MICE, GLAUCOMA 4873 03:42:31,304 --> 03:42:31,771 MODELS. 4874 03:42:31,838 --> 03:42:35,675 PEOPLE NOW REALIZE AGAIN IN 4875 03:42:35,742 --> 03:42:37,877 CELLS, THERE'S A SUBTYPE 4876 03:42:37,944 --> 03:42:39,579 DEPENDENT MANNER, LOCATION 4877 03:42:39,646 --> 03:42:41,481 DEPENDENT DIFFERENCES, AND ALSO 4878 03:42:41,548 --> 03:42:44,050 WHEN THEY DIE THEY DON'T JUST 4879 03:42:44,117 --> 03:42:46,553 DIE RIGHT OVER THERE. 4880 03:42:46,619 --> 03:42:49,656 DENDRITIC STRUCTURE CHANGES IN 4881 03:42:49,723 --> 03:42:53,893 IPL, SO MUCH CHANGES, AXON 4882 03:42:53,960 --> 03:42:57,330 RETRACTION, THEY COULD BE LIKE 4883 03:42:57,397 --> 03:43:00,433 DEPARTMENTALIZED DAMAGE TO ONE 4884 03:43:00,500 --> 03:43:01,868 INDIVIDUAL CELL, AND THERE'S 4885 03:43:01,935 --> 03:43:04,471 STILL A LOT WE NEED TO LEARN HOW 4886 03:43:04,537 --> 03:43:06,372 BUNDLES BREAK DOWN AND THERE'S 4887 03:43:06,439 --> 03:43:09,409 ONE INTERESTING DETAIL WE 4888 03:43:09,476 --> 03:43:10,443 NOTICED, THE LARGE BUNDLES TEND 4889 03:43:10,510 --> 03:43:12,846 TO BREAK DOWN TO SMALLER ONES AT 4890 03:43:12,912 --> 03:43:14,214 EARLIER STAGE OF GLAUCOMA. 4891 03:43:14,280 --> 03:43:15,982 BUT WE DON'T KNOW WHY AND HOW 4892 03:43:16,049 --> 03:43:16,883 THIS HAPPENS. 4893 03:43:16,950 --> 03:43:23,690 AND EVEN FOR AXON BUNDLES WE 4894 03:43:23,757 --> 03:43:25,125 KNOW -- WE DON'T KNOW WHY THEY 4895 03:43:25,191 --> 03:43:27,927 JOIN THIS BUNDLE, NOT THE OTHER 4896 03:43:27,994 --> 03:43:28,428 BUNDLE. 4897 03:43:28,495 --> 03:43:30,463 IT'S NOT TYPE SPECIFIC. 4898 03:43:30,530 --> 03:43:32,098 MAYBE LOCATION DEPENDENT, MAYBE 4899 03:43:32,165 --> 03:43:33,233 THIS IS DEVELOPMENTAL ISSUE. 4900 03:43:33,299 --> 03:43:37,003 STILL A LOT OF QUESTIONS WE NEED 4901 03:43:37,070 --> 03:43:37,904 TO LOOK INTO. 4902 03:43:37,971 --> 03:43:40,039 >> HOW THAT GOES INTO THE CELL 4903 03:43:40,106 --> 03:43:40,640 BODIES? 4904 03:43:40,707 --> 03:43:42,108 >> I CANNOT HEAR YOU. 4905 03:43:42,175 --> 03:43:45,912 >> HOW IS THAT GOING TO THE CELL 4906 03:43:45,979 --> 03:43:46,146 BODIES? 4907 03:43:46,212 --> 03:43:48,581 >> RDC SOMAS? 4908 03:43:48,648 --> 03:43:54,087 >> RIGHT, TO YOUR RIGHT. 4909 03:43:54,154 --> 03:44:04,531 >> DON OR ZHOULIN? 4910 03:44:05,131 --> 03:44:11,171 >> SO, THAT WAS A SMALL STUDY, 4911 03:44:11,237 --> 03:44:15,175 WE RECRUIT GLAUCOMA SUBJECTS, 4912 03:44:15,241 --> 03:44:17,811 PATIENTS, WE COMPARED RDC 4913 03:44:17,877 --> 03:44:21,347 MORPHOLOGY, ALSO DEMONSTRATED 4914 03:44:21,414 --> 03:44:23,283 DEMONSTRATED AND SHOWN? 4915 03:44:23,349 --> 03:44:26,052 SLIDES WE FOUND DENSITY DECREASE 4916 03:44:26,119 --> 03:44:31,224 WERE REDUCTION AND SOMA IN LARGE 4917 03:44:31,291 --> 03:44:33,226 IS CORRELATED WITH HEMIFIELD 4918 03:44:33,293 --> 03:44:33,459 DEFECT. 4919 03:44:33,526 --> 03:44:35,762 THAT MEANS THE DISEASE WHERE 4920 03:44:35,829 --> 03:44:37,197 CELL BODY REFLECTS DIFFERENT 4921 03:44:37,263 --> 03:44:39,532 STAGE OF THE DISEASE DEVELOPMENT 4922 03:44:39,599 --> 03:44:42,702 BECAUSE WE LOOK AT THE PATIENTS 4923 03:44:42,769 --> 03:44:45,638 WITH DIFFERENT STAGE OF THEIR -- 4924 03:44:45,705 --> 03:44:48,675 ON THEIR DISEASE DEVELOPMENT. 4925 03:44:48,741 --> 03:44:51,244 YOU MEASURE THE NERVE FIBER 4926 03:44:51,311 --> 03:44:52,545 BUNDLES AS WELL. 4927 03:44:52,612 --> 03:44:58,885 ON THAT SLIDE WE DIDN'T 4928 03:44:58,952 --> 03:44:59,652 EMPHASIZE. 4929 03:44:59,719 --> 03:45:01,721 FIVE YEARS OUT, WE FOLLOWED SOME 4930 03:45:01,788 --> 03:45:03,790 OF THE SUBJECTS OVER TIME, OVER 4931 03:45:03,857 --> 03:45:06,793 THE FIVE YEARS PERIOD OF TIME. 4932 03:45:06,860 --> 03:45:10,129 BUT BECAUSE THE DATASET IS SO 4933 03:45:10,196 --> 03:45:12,332 HUGE, JUST COUNTING THE CELLS IS 4934 03:45:12,398 --> 03:45:15,702 REALLY TAKING A LOT OF TIME. 4935 03:45:15,768 --> 03:45:17,537 IN ONE SINGLE AO-OCT VOLUME YOU 4936 03:45:17,604 --> 03:45:20,340 MAY HAVE THOUSANDS OF CELLS, 4937 03:45:20,406 --> 03:45:22,175 JUST SMALL REGION, REALLY HAVE 4938 03:45:22,242 --> 03:45:24,043 TO DO KILLER JOB COUNTING THOSE 4939 03:45:24,110 --> 03:45:24,677 CELLS. 4940 03:45:24,744 --> 03:45:28,114 BUT OVER THE YEARS WE 4941 03:45:28,181 --> 03:45:29,415 COLLABORATED WITH OUR 4942 03:45:29,482 --> 03:45:30,483 COLLABORATORS LIKE DUKE 4943 03:45:30,550 --> 03:45:34,187 UNIVERSITY, TRY TO DEVELOP 4944 03:45:34,254 --> 03:45:35,154 MACHINE LEARNING-BASED AUTOMATED 4945 03:45:35,221 --> 03:45:36,723 MACHINE LEARNING ALGORITHM TO 4946 03:45:36,789 --> 03:45:37,523 AID FOR CELL COUNTING. 4947 03:45:37,590 --> 03:45:39,225 SO WE'RE GOING TO FIND OUT. 4948 03:45:39,292 --> 03:45:40,793 WE COLLECT THOSE DATA BUT HAVE 4949 03:45:40,860 --> 03:45:43,296 NOT YET HAD THE TIME TO 4950 03:45:43,363 --> 03:45:44,530 FINALIZE, ANALYZE THOSE DATA 4951 03:45:44,597 --> 03:45:44,697 YET. 4952 03:45:44,764 --> 03:45:47,500 >> THANK YOU. 4953 03:45:47,567 --> 03:45:48,601 >> I'LL LET YOU KNOW. 4954 03:45:48,668 --> 03:45:50,637 >> MAY I ADD ONE MORE. 4955 03:45:50,703 --> 03:45:52,872 WE'RE DOING A LONGITUDINAL STUDY 4956 03:45:52,939 --> 03:45:56,209 LOOKING AT GLAUCOMA, AND WE HAVE 4957 03:45:56,276 --> 03:45:57,343 SOMEBODY PRESENTING AT ARCO, 4958 03:45:57,410 --> 03:45:59,646 MACK KELLER. 4959 03:45:59,712 --> 03:46:01,080 WE'RE TRACKING THE SAME CELLS, 4960 03:46:01,147 --> 03:46:03,483 THEY DROP OUT AT A MUCH HIGHER 4961 03:46:03,549 --> 03:46:05,685 RATE THAN WHAT WE'RE FINDING IN 4962 03:46:05,752 --> 03:46:08,488 JUST NORMAL AGING, IN OUR CASES 4963 03:46:08,554 --> 03:46:10,189 WE PICKED LOCATIONS IN THESE 4964 03:46:10,256 --> 03:46:11,024 DEFECTS GOING INTO THEM. 4965 03:46:11,090 --> 03:46:15,161 WHEE 4966 03:46:15,228 --> 03:46:17,130 WE HAD TO BE EXTRA WHERE WE 4967 03:46:17,196 --> 03:46:17,330 PICK. 4968 03:46:17,397 --> 03:46:20,300 IN THOSE CASES WE'RE PICKING WE 4969 03:46:20,366 --> 03:46:23,469 DO SEE NOTABLY HIGHER RATE OF 4970 03:46:23,536 --> 03:46:25,171 SOMA LOSS, SUBCLINICAL, AND 4971 03:46:25,238 --> 03:46:28,107 MAKES OUR CLINICAL COLLABORATOR 4972 03:46:28,174 --> 03:46:28,675 NERVOUS, WORKING WITH THESE 4973 03:46:28,741 --> 03:46:31,711 PATIENTS. 4974 03:46:36,649 --> 03:46:36,950 >> CHRISTINE? 4975 03:46:37,016 --> 03:46:38,184 >> CONGRATULATIONS TO EVERYONE. 4976 03:46:38,251 --> 03:46:39,185 REALLY WONDERFUL TALKS. 4977 03:46:39,252 --> 03:46:42,956 I'D OF I HAVE QUESTIONS ABOUT 4978 03:46:43,022 --> 03:46:43,690 OUTER RETINA. 4979 03:46:43,756 --> 03:46:44,757 ONE IS A COMMENT. 4980 03:46:44,824 --> 03:46:46,592 THE OTHER IS A QUESTION. 4981 03:46:46,659 --> 03:46:50,763 THE COMMENT IS THAT THERE WAS A 4982 03:46:50,830 --> 03:46:52,632 PAPER IN EXPERIMENTAL EYE 4983 03:46:52,699 --> 03:46:53,733 RESEARCH ON AGING MONKEYS, AND 4984 03:46:53,800 --> 03:46:56,803 THEY HAD WHAT THEY CALLED WHITE 4985 03:46:56,869 --> 03:46:59,806 DOTS, IN THAT PLACE BETWEEN WHAT 4986 03:46:59,872 --> 03:47:02,508 I CALL EZ AND IZ. 4987 03:47:02,575 --> 03:47:03,376 I'M WONDERING IF THEY ARE THE 4988 03:47:03,443 --> 03:47:06,312 SAME THINGS YOU'RE SEEING IN 4989 03:47:06,379 --> 03:47:07,814 YOUR RPE PATIENTS BECAUSE THEY 4990 03:47:07,880 --> 03:47:09,849 MIGHT BE THE SAME PHENOMENON, 4991 03:47:09,916 --> 03:47:12,251 GOOD IF THAT COULD BE FOUND 4992 03:47:12,318 --> 03:47:13,453 BECAUSE IT'S AN AGING 4993 03:47:13,519 --> 03:47:13,953 PHENOMENON. 4994 03:47:14,020 --> 03:47:17,824 THAT'S THE FIRST COMMENT. 4995 03:47:17,890 --> 03:47:21,728 THE QUESTION WAS, ARE YOU ABLE 4996 03:47:21,794 --> 03:47:23,963 TO DETERMINE IF SOME OF THESE 4997 03:47:24,030 --> 03:47:25,932 PHENOMENA YOU'RE SEEING IN RPE 4998 03:47:25,999 --> 03:47:28,768 PATIENTS I HEARD TWO OF YOU SAY 4999 03:47:28,835 --> 03:47:30,670 THE RPE IS LEAVING A LAYER. 5000 03:47:30,737 --> 03:47:32,739 I'VE BEEN TO MEETINGS WHERE 5001 03:47:32,805 --> 03:47:36,009 PEOPLE WILL INSIST THOSE ARE 5002 03:47:36,075 --> 03:47:37,210 MACROPHAGES OR MICROGLIA WHO 5003 03:47:37,276 --> 03:47:45,318 CAME AND ATE RPE. 5004 03:47:45,385 --> 03:47:48,354 SO MY E.M., MAYBE THAT COUNTS, 5005 03:47:48,421 --> 03:47:54,293 MAYBE IT DOESN'T BUT HOW DO YOU 5006 03:47:54,360 --> 03:47:57,697 DISTINGUISH BETWEEN RPE AND RPE 5007 03:47:57,764 --> 03:47:58,898 MASQUERADING AND HOW SOON CAN 5008 03:47:58,965 --> 03:48:03,403 YOU DO THAT IF YOU CAN DO IT? 5009 03:48:03,469 --> 03:48:03,803 >> THAT'S TOUGH. 5010 03:48:03,870 --> 03:48:12,078 >> [OFF MICROPHONE]. 5011 03:48:12,145 --> 03:48:13,446 >> YEAH, THAT'S BETTER, YEAH. 5012 03:48:13,513 --> 03:48:16,983 YEAH, WE GO TO ARVO. 5013 03:48:17,050 --> 03:48:18,084 I SEE PRESENTATIONS WHERE 5014 03:48:18,151 --> 03:48:20,353 MICROGLIA GO TO THE 5015 03:48:20,420 --> 03:48:21,454 PHOTORECEPTOR LAYER IN RPE 5016 03:48:21,521 --> 03:48:21,721 PATIENTS. 5017 03:48:21,788 --> 03:48:25,892 WE WERE ANXIOUS TO SEE IF WE 5018 03:48:25,958 --> 03:48:27,727 COULD DO AO-OCT ANGIOGRAPHY TO 5019 03:48:27,794 --> 03:48:30,897 SEE THE MOTION OF MICROGLIAL 5020 03:48:30,963 --> 03:48:33,533 CELLS EATING PHOTORECEPTORS 5021 03:48:33,599 --> 03:48:35,234 BECAUSE ADJACENT PHOTORECEPTORS 5022 03:48:35,301 --> 03:48:39,305 SHOULDN'T BE MOVING AROUND LIKE 5023 03:48:39,372 --> 03:48:40,239 MYOGLIA, SHOULD BE ACTIVE. 5024 03:48:40,306 --> 03:48:41,441 WE HAVEN'T SEEN THAT. 5025 03:48:41,507 --> 03:48:43,076 WHATEVER WE'RE DOING, WE'RE 5026 03:48:43,142 --> 03:48:43,876 MISSING THE MICROGLIAL DOWN 5027 03:48:43,943 --> 03:48:44,110 THERE. 5028 03:48:44,177 --> 03:48:45,845 THEY NEED TO BE DOWN THERE BUT 5029 03:48:45,912 --> 03:48:50,650 WE JUST HAVEN'T BEEN ABLE TO 5030 03:48:50,716 --> 03:48:52,418 DETECT SOMETHING. 5031 03:48:52,485 --> 03:48:58,324 SO, YEAH, WE CAN'T DO IT. 5032 03:48:58,391 --> 03:49:01,794 MAYBE ZHOULIN CAN. 5033 03:49:01,861 --> 03:49:04,030 >> CAN YOU TRACK THE DIFFERENT 5034 03:49:04,097 --> 03:49:07,567 PHENOMENA FROM MICROGLIA COMING 5035 03:49:07,633 --> 03:49:07,767 DOWN? 5036 03:49:07,834 --> 03:49:09,602 >> YEAH, WE CAN TRACK THAT. 5037 03:49:09,669 --> 03:49:12,105 >> MY ARGUMENT IS ALWAYS YOU 5038 03:49:12,171 --> 03:49:14,240 HAVE TO RECREATE THE BEHAVIOR 5039 03:49:14,307 --> 03:49:16,075 WHICH MEANS SOME OTHER CELL TYPE 5040 03:49:16,142 --> 03:49:18,911 HAS TO GET INTO THE LAYER, 5041 03:49:18,978 --> 03:49:20,947 PRETEND TO BE RPE AND HEAD UP. 5042 03:49:21,013 --> 03:49:23,149 CAN YOU SHOW THAT ONE WAY OR THE 5043 03:49:23,216 --> 03:49:23,349 OTHER? 5044 03:49:23,416 --> 03:49:25,384 I'M HAPPY TO BE WRONG. 5045 03:49:25,451 --> 03:49:28,354 >> WE CAN CERTAINLY SHOW THE RPE 5046 03:49:28,421 --> 03:49:28,955 MIGRATING UP. 5047 03:49:29,021 --> 03:49:33,793 I DON'T KNOW IF WE WOULD BE ABLE 5048 03:49:33,860 --> 03:49:35,962 TO PUBLISH IT THOUGH. 5049 03:49:36,028 --> 03:49:36,596 >> RICHARD? 5050 03:49:36,662 --> 03:49:40,166 >> YEAH, TWO QUICK QUESTIONS. 5051 03:49:40,233 --> 03:49:42,568 ONE FOR ZHOULIN AND ONE FOR DON. 5052 03:49:42,635 --> 03:49:45,738 FIRST OF ALL, ALL THESE 5053 03:49:45,805 --> 03:49:48,875 PRESENTATIONS WERE FANTASTIC. 5054 03:49:48,941 --> 03:49:49,742 LOOKING AT THE CHORIOCAPILLARIS 5055 03:49:49,809 --> 03:49:54,247 ARE YOU ABLE TO SEE ANY DYNAMICS 5056 03:49:54,313 --> 03:49:56,482 OF THE CAPILLARIES CONTRACTING 5057 03:49:56,549 --> 03:49:58,417 OR EXPANDING IN YOUR IMAGING, 5058 03:49:58,484 --> 03:50:00,653 AND CAN YOU WITHOUT -- IT'S 5059 03:50:00,720 --> 03:50:02,688 DIFFICULT WHEN YOU HAVE TO DO 5060 03:50:02,755 --> 03:50:03,656 ALL THAT AVERAGING BUT -- 5061 03:50:03,723 --> 03:50:05,525 >> THANK YOU FOR THE QUESTION. 5062 03:50:05,591 --> 03:50:09,128 THIS IS A REALLY LIKE THE 5063 03:50:09,195 --> 03:50:10,496 PRELIMINARY OUTLIER COLLECTED, 5064 03:50:10,563 --> 03:50:11,898 DATA WE COLLECTED RECENTLY. 5065 03:50:11,964 --> 03:50:13,733 I THINK THE TECHNOLOGY WILL 5066 03:50:13,799 --> 03:50:18,437 ALLOW YOU TO TRACK LIKE THE 5067 03:50:18,504 --> 03:50:20,540 SHRINKAGE OF THE VESSEL, IF YOU 5068 03:50:20,606 --> 03:50:23,176 MONITOR THEM OVER TIME. 5069 03:50:23,242 --> 03:50:29,382 WE HAVEN'T DONE THAT TYPE OF 5070 03:50:29,448 --> 03:50:29,849 STUDY. 5071 03:50:29,916 --> 03:50:34,854 >> I DON'T HAVE ANYTHING TO ADD. 5072 03:50:34,921 --> 03:50:38,157 WE'RE WORKING, IT DOESN'T 5073 03:50:38,224 --> 03:50:46,132 PENETRATE WELL BEHIND THE 5074 03:50:46,199 --> 03:50:46,999 CHORIOCAPILLARIS. 5075 03:50:47,066 --> 03:50:49,168 WITH THE 750, THAT'S A NICE 5076 03:50:49,235 --> 03:50:49,402 SYSTEM. 5077 03:50:49,468 --> 03:50:50,102 >> WE PUBLISHED. 5078 03:50:50,169 --> 03:50:52,171 >> BUT WE DIDN'T PUBLISH THAT 5079 03:50:52,238 --> 03:50:54,707 ABOUT THICKNESS CHANGES. 5080 03:50:54,774 --> 03:50:55,107 YEAH. 5081 03:50:55,174 --> 03:50:57,543 >> AND JUST BRIEFLY HOW, I MEAN, 5082 03:50:57,610 --> 03:51:00,479 I THINK OBVIOUSLY WE'RE ALL 5083 03:51:00,546 --> 03:51:02,582 EXCITED WITH VISIBLE OCT FOR ITS 5084 03:51:02,648 --> 03:51:05,618 CAPABILITY OF LOOKING AT 5085 03:51:05,685 --> 03:51:06,919 METABOLIC CHANGE BUT IT'S VERY 5086 03:51:06,986 --> 03:51:07,119 BRIGHT 5087 03:51:07,186 --> 03:51:09,755 WHAT ARE YOUR STRATEGIES MOVING 5088 03:51:09,822 --> 03:51:13,092 FORWARD TO INCREASE THE 5089 03:51:13,159 --> 03:51:16,262 USABILITY FOR HUMAN SUBJECTS? 5090 03:51:17,763 --> 03:51:21,500 >> YEAH, THANKS FOR THE 5091 03:51:21,567 --> 03:51:22,168 QUESTION. 5092 03:51:22,235 --> 03:51:23,202 FOR THE BRIGHTNESS CAUSE 5093 03:51:23,269 --> 03:51:25,504 POTENTIALLY TWO ISSUES. 5094 03:51:25,571 --> 03:51:28,774 A, PATIENT EYE GOT TIRED AFTER 5095 03:51:28,841 --> 03:51:29,041 ALIGNMENT. 5096 03:51:29,108 --> 03:51:30,910 B, FOR ALIGNMENT TAKING TOO 5097 03:51:30,977 --> 03:51:33,246 LONG, THEY MIGHT TRIGGER 5098 03:51:33,312 --> 03:51:34,180 NEUROVASCULAR CAPILLARY CAUSING 5099 03:51:34,247 --> 03:51:37,550 METABOLIC FEATURES TO BE 5100 03:51:37,617 --> 03:51:38,517 CHANGED. 5101 03:51:38,584 --> 03:51:41,821 SO, THE TWO POTENTIAL SOLUTIONS, 5102 03:51:41,887 --> 03:51:43,356 ONE IS MAKING FASTER, SO LOTS OF 5103 03:51:43,422 --> 03:51:46,559 EFFORT TRYING TO PUSH FROM 20 5104 03:51:46,626 --> 03:51:49,028 KILOHERTZ TO 200 KILOHERTZ, 5105 03:51:49,095 --> 03:51:52,898 WE'RE AT 100 KILOHERTZ AT THE 5106 03:51:52,965 --> 03:51:56,369 MOMENT, 200 KILOHERTZ NOT THERE 5107 03:51:56,435 --> 03:51:56,736 YET. 5108 03:51:56,802 --> 03:51:57,970 MIGHT REACH 200 KILOHERTZ OR 5109 03:51:58,037 --> 03:52:03,542 HIGHER, WE'RE NOT THERE YET. 5110 03:52:03,609 --> 03:52:07,880 ANOTHER COMPROMISE IS DON'T USE 5111 03:52:07,947 --> 03:52:10,583 VISIBILITY UNTIL IT'S ABSOLUTELY 5112 03:52:10,650 --> 03:52:10,850 NECESSARY. 5113 03:52:10,916 --> 03:52:16,889 WE THINK WITHIN THE LAST TWO 5114 03:52:16,956 --> 03:52:18,057 LATEST ITERATIONS, PREVIOUS 5115 03:52:18,124 --> 03:52:21,327 VELOCITY, EVERYTHING IS DONE BY 5116 03:52:21,394 --> 03:52:24,030 NEAR-INFRARED CELL, SWITCH TO 5117 03:52:24,096 --> 03:52:25,531 OCT. 5118 03:52:25,598 --> 03:52:29,935 DOWN SIDE WAS THE TWO MODALITIES 5119 03:52:30,002 --> 03:52:32,071 ARE PERFORMED INCONSEQUENTIAL. 5120 03:52:32,138 --> 03:52:34,240 THERE'S A TIME DELAY, THE EYE 5121 03:52:34,307 --> 03:52:35,441 MAY MOVE. 5122 03:52:35,508 --> 03:52:37,343 BY CONSULTING WITH COLLABORATORS 5123 03:52:37,410 --> 03:52:39,512 AROUND THE COUNTRY, THE BETTER 5124 03:52:39,578 --> 03:52:43,582 SOLUTION FROM THE COLLABORATORS 5125 03:52:43,649 --> 03:52:48,988 ARE HAVING ALWAYS ON, INFRARED 5126 03:52:49,055 --> 03:52:51,123 FUNDUS, DON'T TURN ON VISIBILITY 5127 03:52:51,190 --> 03:52:53,426 UNTIL ABSOLUTELY NECESSARY. 5128 03:52:53,492 --> 03:52:55,961 FINISH ALIGNMENT, SHUT AND SCAN. 5129 03:52:56,028 --> 03:52:56,495 THAT'S IT. 5130 03:52:56,562 --> 03:52:58,130 TRYING TO MINIMIZE EXPOSURE, 5131 03:52:58,197 --> 03:52:59,498 THAT'S THE CURRENT SOLUTION, 5132 03:52:59,565 --> 03:52:59,932 TECHNICAL SOLUTION. 5133 03:52:59,999 --> 03:53:01,267 >> WE HAVE TIME FOR ONE LAST 5134 03:53:01,334 --> 03:53:03,869 QUICK QUESTION. 5135 03:53:06,172 --> 03:53:10,242 >> SIPS WE HAVE THE -- SINCE WE 5136 03:53:10,309 --> 03:53:12,812 HAVE TIME TO USE A.I. ANALYSIS 5137 03:53:12,878 --> 03:53:14,647 WE'VE LEARNED SO MUCH. 5138 03:53:14,714 --> 03:53:19,085 ONE IS THE EASY LAYER SEEMS TO 5139 03:53:19,151 --> 03:53:21,687 THIN OUT INTO JUNCTION ACTIVE 5140 03:53:21,754 --> 03:53:23,155 ZONE OF A LESION GROWTH. 5141 03:53:23,222 --> 03:53:33,766 THIS IS WHAT WE SEEM TO TO SEE 5142 03:53:34,767 --> 03:53:44,844 IN OCT. 5143 03:54:00,226 --> 03:54:01,360 >> I'M HAVING A LITTLE HARD TIME 5144 03:54:01,427 --> 03:54:04,330 HEARING. 5145 03:54:04,397 --> 03:54:07,400 WE HAVE NOT FOLLOWED THE EASY 5146 03:54:07,466 --> 03:54:09,602 THICKNESS SO THAT'S NOT KIND OF 5147 03:54:09,668 --> 03:54:10,703 A BIOMARKER WE'VE BEEN LOOKING 5148 03:54:10,770 --> 03:54:15,174 AT FOR THES. 5149 03:54:15,241 --> 03:54:19,545 SO I CAN'T PROVIDE ANYTHING BUT 5150 03:54:19,612 --> 03:54:22,047 I THINK JOLI NHAS A LOT OF 5151 03:54:22,114 --> 03:54:23,149 INSIDE, SHE'LL BE ABLE TO 5152 03:54:23,215 --> 03:54:23,416 PROVIDE -- 5153 03:54:23,482 --> 03:54:24,583 >> WE HAVE TO WRAP IT UP BECAUSE 5154 03:54:24,650 --> 03:54:25,985 WE'RE GOING TO HAVE SOME LUNCH. 5155 03:54:26,051 --> 03:54:28,621 I THINK WE CAN JUST TAKE THESE 5156 03:54:28,687 --> 03:54:29,855 CONVERSATIONS OFFLINE. 5157 03:54:29,922 --> 03:54:33,426 >> IS IT THE LAST PHRASE? 5158 03:54:33,492 --> 03:54:34,794 >> YOU CAN INTERRUPT DAVID IF 5159 03:54:34,860 --> 03:54:36,495 YOU WANT, BUT YOU CAN'T 5160 03:54:36,562 --> 03:54:39,698 INTERRUPT ME. 5161 03:54:39,765 --> 03:54:42,501 >> I THINK WE HAVE TO GET TO 5162 03:54:42,568 --> 03:54:44,370 LUNCH RIGHT NOW, SO THANKS TO 5163 03:54:44,437 --> 03:54:46,338 EVERYBODY IN THIS SESSION. 5164 03:54:46,405 --> 03:54:48,407 IN TERMS OF LUNCH OPTIONS, THOSE 5165 03:54:48,474 --> 03:54:51,577 OF YOU WHO DID NOT PURCHASE A 5166 03:54:51,644 --> 03:54:52,678 BOX LUNCH MIGHT WANT TO MAKE 5167 03:54:52,745 --> 03:54:55,414 YOUR WAY DOWN TO THE CAFETERIA 5168 03:54:55,481 --> 03:54:57,583 THAT'S ONE FLOOR DOWN ON THE 5169 03:54:57,650 --> 03:54:57,917 B1 LEVEL. 5170 03:54:57,983 --> 03:54:59,318 THERE'S ALSO THE COFFEE SHOP 5171 03:54:59,385 --> 03:55:00,986 RIGHT OUTSIDE IN THE -- NEAR THE 5172 03:55:01,053 --> 03:55:01,754 BOOK STORE. 5173 03:55:01,821 --> 03:55:04,390 THERE'S ALSO ANOTHER KIND OF A 5174 03:55:04,457 --> 03:55:06,692 FAKE STARBUCKS THAT'S IN THE 5175 03:55:06,759 --> 03:55:08,761 ATRIUM OF THE MEDICAL CENTER 5176 03:55:08,828 --> 03:55:10,729 THAT'S JUST ABOUT A THREE-MINUTE 5177 03:55:10,796 --> 03:55:13,866 WALK AWAY. 5178 03:55:13,933 --> 03:55:15,201 AND LET ME ALSO MENTION THAT WE 5179 03:55:15,267 --> 03:55:17,736 PUT A MAP OF THE CAMPUS INTO THE 5180 03:55:17,803 --> 03:55:19,038 AGENDA, SO IF YOU WANT TO GO 5181 03:55:19,104 --> 03:55:21,874 BACK TO THE WEBSITE FOR THE 5182 03:55:21,941 --> 03:55:22,975 MEETING, AND ARE INTERESTED IN 5183 03:55:23,042 --> 03:55:25,044 THAT, YOU CAN GRAB THAT. 5184 03:55:25,110 --> 03:55:27,146 AND WE WILL RECONVENE AT 5185 03:55:27,213 --> 03:55:28,547 2:00 P.M. 5186 03:55:28,614 --> 03:55:29,849 SO 10 MINUTES LATER THAN 5187 03:55:29,915 --> 03:55:31,717 INDICATED IN THE PROGRAM, SINCE 5188 03:55:31,784 --> 03:55:33,919 WE'RE ENDING A LITTLE BIT LATE, 5189 03:55:33,986 --> 03:55:35,221 SO 2:00 P.M., LET'S BE READY TO 5190 03:55:35,287 --> 03:55:35,988 GO IN HERE. 5191 03:55:36,055 --> 03:55:36,889 THANKS, EVERYBODY. 5192 03:55:36,956 --> 03:55:39,692 [APPLAUSE] 5193 03:55:39,758 --> 03:55:50,035 [SPEAKER NOT ON MIC] 5194 03:56:20,099 --> 03:56:30,376 [SPEAKER NOT ON MIC] 5195 03:56:55,200 --> 03:57:05,477 [SPEAKER NOT ON MIC] 5196 03:59:43,102 --> 03:59:53,445 [WAITING FOR AUDIO FEED] 5197 04:01:52,231 --> 04:02:02,341 [NO AUDIO] 5198 04:06:38,016 --> 04:06:39,384 KIND OF LIKE DIABETES. 5199 04:06:39,451 --> 04:06:41,486 SO WE WONDERED WHETHER WE CAN 5200 04:06:41,553 --> 04:06:44,222 USE OCTA TO TRY TO ASSESS 5201 04:06:44,289 --> 04:06:46,825 CHANGES THAT MIGHT PREDISPOSE TO 5202 04:06:46,892 --> 04:06:48,026 VASCULAR DEMENTIA, BECAUSE 5203 04:06:48,093 --> 04:06:49,995 DIABETES IS ACTUALLY ALSO A RISK 5204 04:06:50,061 --> 04:06:51,663 FACTOR FOR VASCULAR DEMENTIA. 5205 04:06:51,730 --> 04:06:53,398 AND THE REASON WE WANTED TO DO 5206 04:06:53,465 --> 04:06:54,599 THIS WAS BECAUSE SEVERAL 5207 04:06:54,666 --> 04:06:56,902 STUDIES, AND ONE I'M SHOWING 5208 04:06:56,968 --> 04:06:58,737 HERE, ON AN EPIDEMIOLOGIC LEVEL 5209 04:06:58,803 --> 04:07:00,071 HAD SHOWN THAT RETINOPATHY, 5210 04:07:00,138 --> 04:07:02,040 WHICH IS THE END STAGE OF 5211 04:07:02,107 --> 04:07:04,342 CAPILLARY DAMAGE, ACTUALLY 5212 04:07:04,409 --> 04:07:06,945 PREDICTS COGNITIVE IMPAIRMENT IN 5213 04:07:07,012 --> 04:07:08,046 A 10-YEAR STUDY. 5214 04:07:08,113 --> 04:07:09,681 SO IF YOU HAVE BASELINE LEVELS 5215 04:07:09,748 --> 04:07:10,782 OF RETINOPATHY, YOU'RE MORE 5216 04:07:10,849 --> 04:07:12,083 LIKELY TO HAVE SOME LEVEL OF 5217 04:07:12,150 --> 04:07:14,152 COGNITIVE IMPAIRMENT IN THE 5218 04:07:14,219 --> 04:07:15,153 SUBSEQUENT 10 YEARS AS MEASURED 5219 04:07:15,220 --> 04:07:17,122 BY YOUR ABILITY TO RECALL 5220 04:07:17,189 --> 04:07:18,790 CERTAIN WORDS OR TO MEMORIZE A 5221 04:07:18,857 --> 04:07:21,493 CERTAIN PATTERN. 5222 04:07:21,560 --> 04:07:24,029 AND SO THIS ALONG WITH THE IDEA 5223 04:07:24,095 --> 04:07:25,897 THAT WE CAN DETECT SUBCLINICAL 5224 04:07:25,964 --> 04:07:28,266 CHANGES IN THE RETINA, IN THE 5225 04:07:28,333 --> 04:07:29,935 RETINAL CAPILLARIES, MADE US 5226 04:07:30,001 --> 04:07:30,902 THINK THAT WE COULD ACTUALLY 5227 04:07:30,969 --> 04:07:32,671 GAIN SOME INSIGHT INTO VASCULAR 5228 04:07:32,737 --> 04:07:34,072 COGNITIVE IMPAIRMENT. 5229 04:07:34,139 --> 04:07:37,042 SO ONE OF MY POSTDOCS STARTED TO 5230 04:07:37,108 --> 04:07:38,476 LOOK AT A SMALL COHORT OF 5231 04:07:38,543 --> 04:07:40,512 PATIENTS WHO HAD BEEN WELL 5232 04:07:40,579 --> 04:07:42,614 CHARACTERIZED BY NEUROLOGISTS 5233 04:07:42,681 --> 04:07:44,683 AND NEUROPSYCHOLOGISTS FOR THEIR 5234 04:07:44,749 --> 04:07:45,917 COGNITIVE ABILITY, AND WE FOUND 5235 04:07:45,984 --> 04:07:48,119 THAT ACTUALLY WHEN WE LOOK HE AT 5236 04:07:48,186 --> 04:07:49,988 THESE COHORTS AND CDR SOME OF 5237 04:07:50,055 --> 04:07:52,357 THE BOXES HERE, THE ORANGE BOX 5238 04:07:52,424 --> 04:07:54,793 IS A MEASURE OF PEOPLE WHO 5239 04:07:54,859 --> 04:07:55,760 HAVE -- INDICATES PEOPLE WHO 5240 04:07:55,827 --> 04:07:57,529 HAVE SOME LEVEL OF COGNITIVE OR 5241 04:07:57,596 --> 04:07:59,064 BEHAVIORAL IMPAIRMENT. 5242 04:07:59,130 --> 04:08:00,799 AND BLUE REPRESENTS NORMAL. 5243 04:08:00,865 --> 04:08:02,667 AND WHAT YOU SEE IS THAT PEOPLE 5244 04:08:02,734 --> 04:08:04,236 WHO ARE ON THE LEFT SIDE OF THE 5245 04:08:04,302 --> 04:08:05,737 VESSEL SKELETON DENSITY SCUFER 5246 04:08:05,804 --> 04:08:07,072 THERE OR PLOT ARE THE ONES WHO 5247 04:08:07,138 --> 04:08:07,572 ARE ORANGE. 5248 04:08:07,639 --> 04:08:09,007 THE OTHER ONES WHO HAVE SOME 5249 04:08:09,074 --> 04:08:10,208 LEVEL OF COGNITIVE IMPAIRMENT. 5250 04:08:10,275 --> 04:08:13,812 AND IN FACT, THERE WAS A FOUR 5251 04:08:13,878 --> 04:08:15,046 FOLD INCREASED RISK OF HAVING 5252 04:08:15,113 --> 04:08:16,648 SOME LEVEL OF BEHAVIORAL OR 5253 04:08:16,715 --> 04:08:17,983 COGNITIVE IMPAIRMENT, THIS IS 5254 04:08:18,049 --> 04:08:19,517 SUBCLINICAL NOW, THESE ARE NOT 5255 04:08:19,584 --> 04:08:21,953 PEOPLE WHO ARE BEHAVIORALLY -- 5256 04:08:22,020 --> 04:08:23,989 WHO ARE DIAGNOSED WITH A 5257 04:08:24,055 --> 04:08:24,990 CONDITION, BUT THEY'RE 5258 04:08:25,056 --> 04:08:29,027 COGNITIVELY IMPAIRED IN SUBTLE 5259 04:08:29,094 --> 04:08:30,895 WAYS, THOSE PEOPLE HAVE MUCH 5260 04:08:30,962 --> 04:08:31,963 LOWER VESSEL DENSITY. 5261 04:08:32,030 --> 04:08:34,699 THEY'RE IN THE LOWER TERTILE OF 5262 04:08:34,766 --> 04:08:44,876 THE CAPILLARY DENSITY. 5263 04:08:44,943 --> 04:08:46,077 THE DENSITY ACTUALLY CORRELATES 5264 04:08:46,144 --> 04:08:46,745 WITH COGNITION. 5265 04:08:46,811 --> 04:08:48,480 IT TOOK ME A LONG TIME TO WRAP 5266 04:08:48,546 --> 04:08:49,180 MY HEAD AROUND THAT. 5267 04:08:49,247 --> 04:08:50,782 BUT WE LOOKED IN LATIN 5268 04:08:50,849 --> 04:08:52,984 AMERICANS, WE'VE LOOKED IN BLACK 5269 04:08:53,051 --> 04:08:54,853 AMERICANS, WE HAVE A COHORT OF 5270 04:08:54,919 --> 04:08:56,588 CAUCASIAN AMERICANS NOW, AND 5271 04:08:56,655 --> 04:08:57,689 USING SEVERAL DIFFERENT MEASURES 5272 04:08:57,756 --> 04:09:00,959 OF COGNITION, INCLUDING NIH 5273 04:09:01,026 --> 04:09:02,527 TOOLBOX AND COGNITIVE 5274 04:09:02,594 --> 04:09:03,795 ASSESSMENT, WE'VE REPEATEDLY 5275 04:09:03,862 --> 04:09:05,330 DEMONSTRATED THAT THERE'S A 5276 04:09:05,397 --> 04:09:06,298 CORRELATION, SIGNIFICANT 5277 04:09:06,364 --> 04:09:08,166 CORRELATION BETWEEN CAPILLARY 5278 04:09:08,233 --> 04:09:09,701 DENSITY IN THE RETINA AND 5279 04:09:09,768 --> 04:09:10,802 COGNITIVE ABILITY. 5280 04:09:10,869 --> 04:09:13,204 IT'S NOT NECESSARILY DEMENTIA, 5281 04:09:13,271 --> 04:09:14,639 OR SEVERE COGNITIVE IMPAIRMENT, 5282 04:09:14,706 --> 04:09:16,808 BUT JUST COGNITIVE ABILITY. 5283 04:09:16,875 --> 04:09:19,210 AND SO THE IDEA THEN THAT WE ARE 5284 04:09:19,277 --> 04:09:21,079 ABLE TO DETECT PRE-CLINICAL 5285 04:09:21,146 --> 04:09:22,947 CHANGES IN TERMS OF WHAT'S 5286 04:09:23,014 --> 04:09:24,482 HAPPENING IN THE EYE AND WHAT'S 5287 04:09:24,549 --> 04:09:26,217 HAPPENING IN THE BRAIN SEEMS TO 5288 04:09:26,284 --> 04:09:27,786 REALLY HAVE TAKEN HOLD AT LEAST 5289 04:09:27,852 --> 04:09:29,387 IN MY MIND, AND SO I'M NOT GOING 5290 04:09:29,454 --> 04:09:30,488 TO TALK A LOT ABOUT THE 5291 04:09:30,555 --> 04:09:31,823 COGNITIVE WORK, BUT I'M GOING TO 5292 04:09:31,890 --> 04:09:33,992 TURN AND SAY -- SO WHAT IS THE 5293 04:09:34,059 --> 04:09:36,194 BIOLOGICAL SUBSTRATE BETWEEN 5294 04:09:36,261 --> 04:09:37,495 THINGS THAT ARE HAPPENING IN 5295 04:09:37,562 --> 04:09:38,730 RETINAL BLOOD VESSELS AND THINGS 5296 04:09:38,797 --> 04:09:41,766 THAT ARE HAPPENING IN THE BRAIN. 5297 04:09:41,833 --> 04:09:44,069 AND SO WHAT WE DID WAS 5298 04:09:44,135 --> 04:09:46,237 COLLABORATE WITH AN 5299 04:09:46,304 --> 04:09:47,572 EPIDEMIOLOGIST WHO'S WORKED A 5300 04:09:47,639 --> 04:09:50,408 LOT WITH LOS ANGELES LATINO EYE 5301 04:09:50,475 --> 04:09:51,943 STUDY AND AFRICAN AMERICAN EYE 5302 04:09:52,010 --> 04:09:54,179 DISEASE STUDY AND A POSTDOC TO 5303 04:09:54,245 --> 04:09:55,313 CORRELATE THE MEASURES OF 5304 04:09:55,380 --> 04:09:58,149 RETINAL CAPILLARY DENSITY WITH 5305 04:09:58,216 --> 04:09:59,918 INTRACRANIAL MEASURES OF 5306 04:09:59,984 --> 04:10:00,885 PERFUSION IN THE WHITE MATTER. 5307 04:10:00,952 --> 04:10:02,887 THESE ARE TWO SUCH MEASURES 5308 04:10:02,954 --> 04:10:03,955 PLOTTED HERE. 5309 04:10:04,022 --> 04:10:05,323 MEAN-FREE WATER IS A MEASURE 5310 04:10:05,390 --> 04:10:07,125 DERIVED FROM MRI SCANS AND 5311 04:10:07,192 --> 04:10:08,560 REFLECTS INTEGRITY OF WHITE 5312 04:10:08,626 --> 04:10:11,629 MATTER TRACKS, AND PEAK 5313 04:10:11,696 --> 04:10:12,497 SKELETONIZING DIFFUSIVITY IS 5314 04:10:12,564 --> 04:10:13,932 ANOTHER MEASURE OF WHITE MATTER 5315 04:10:13,998 --> 04:10:14,499 INTEGRITY. 5316 04:10:14,566 --> 04:10:17,402 AND THESE ARE USED KIND OF IN 5317 04:10:17,469 --> 04:10:18,403 THE NEUROLOGICAL WORLD TO ASSESS 5318 04:10:18,470 --> 04:10:20,038 WHITE MATTER DISEASE. 5319 04:10:20,105 --> 04:10:22,874 AND IN BOTH CASES, THOSE 5320 04:10:22,941 --> 04:10:25,076 MEASURES CORRELATED WITH BOTH 5321 04:10:25,143 --> 04:10:27,579 VESSEL SKELETON DENSITY IN THE 5322 04:10:27,645 --> 04:10:29,013 RETINA AS WELL AS VESSEL AREA 5323 04:10:29,080 --> 04:10:30,749 FLUX, OR THE FLUX MEASURES WHICH 5324 04:10:30,815 --> 04:10:32,150 I DESCRIBED TO YOU EARLIER, AND 5325 04:10:32,217 --> 04:10:34,386 THE REASON WHY I'M SHOWING YOU 5326 04:10:34,452 --> 04:10:35,453 THE FLUX MEASURES HERE IS 5327 04:10:35,520 --> 04:10:36,321 BECAUSE THEY WERE MORE 5328 04:10:36,388 --> 04:10:37,856 SIGNIFICANT AND MORE ROBUST THAN 5329 04:10:37,922 --> 04:10:39,624 THE SKELETON DENSITY MEASURES. 5330 04:10:39,691 --> 04:10:41,826 AND SO THE IDEA HERE I THAT THE 5331 04:10:41,893 --> 04:10:42,894 CHANGES THAT ARE OCCURRING IN 5332 04:10:42,961 --> 04:10:46,297 THE RETINAL KEAB LE CAPILLARIESE 5333 04:10:46,364 --> 04:10:47,165 OCCURRING IN THE BRAIN ACTUALLY 5334 04:10:47,232 --> 04:10:50,001 HAS A BIOLOGICAL SUBSTRATE IN 5335 04:10:50,068 --> 04:10:51,202 MEASURES OF WHITE MATTER 5336 04:10:51,269 --> 04:10:52,737 INTENSITY. 5337 04:10:52,804 --> 04:10:53,838 THE NEXT THING WE ACTUALLY 5338 04:10:53,905 --> 04:10:56,241 STARTED TO LOOK AT WAS TO SAY 5339 04:10:56,307 --> 04:10:58,977 WELL, WHAT ARE THE BIOLOGICAL 5340 04:10:59,043 --> 04:11:00,078 SUBSTRATES BEHIND THESE KINDS OF 5341 04:11:00,145 --> 04:11:01,746 CHANGES IN CAPILLARES, BOTH IN 5342 04:11:01,813 --> 04:11:03,348 THE BRAIN AND IN THE EYE, AND 5343 04:11:03,415 --> 04:11:04,983 THERE'S OBVIOUSLY MANY POTENTIAL 5344 04:11:05,049 --> 04:11:06,151 WAYS THAT THAT COULD WORK, BUT 5345 04:11:06,217 --> 04:11:08,286 ONE OF THE LEADING CONTENDERS TO 5346 04:11:08,353 --> 04:11:14,659 DRIVE SUCH CHANGES WOULD BE APOE 5347 04:11:14,726 --> 04:11:16,628 LIPOPROTEIN 4 WHICH IS A MAJOR 5348 04:11:16,694 --> 04:11:18,296 RISK FACTOR FOR VASCULAR 5349 04:11:18,363 --> 04:11:19,898 DEMENTIA, COGNITIVE IMPAIRMENT, 5350 04:11:19,964 --> 04:11:21,332 AS WELL AS FOR ALZHEIMER'S. 5351 04:11:21,399 --> 04:11:23,535 SO THE HYPOTHESIS IS THAT 5352 04:11:23,601 --> 04:11:26,704 PERHAPS PATIENTS WHO HAVE APOE 5353 04:11:26,771 --> 04:11:28,006 E4 ALLELES HAVE POSSIBILITY FOR 5354 04:11:28,072 --> 04:11:30,842 HAVING DECREASED OR ACCELERATED 5355 04:11:30,909 --> 04:11:33,845 CAPILLARY DENSITY LOSS OVER TI 5356 04:11:33,912 --> 04:11:36,014 TIME. 5357 04:11:36,080 --> 04:11:38,216 SO WE TEAMED UP WITH A NEWER 5358 04:11:38,283 --> 04:11:39,717 TOLL GIST AT UNIVERSITY OF 5359 04:11:39,784 --> 04:11:40,285 CALIFORNIA SAN FRANCISCO IN 5360 04:11:40,351 --> 04:11:41,820 THEIR MEMORY AND AGING CENTER 5361 04:11:41,886 --> 04:11:43,988 THERE AND RECRUITED ABOUT 100 5362 04:11:44,055 --> 04:11:45,557 SUBJECTS WHO WERE PARTICIPATING 5363 04:11:45,623 --> 04:11:47,425 IN A MEMORY AND AGING STUDY. 5364 04:11:47,492 --> 04:11:49,761 THESE ARE HEALTHY CAUCASIAN 5365 04:11:49,828 --> 04:11:50,895 ADULTS WHO HAVE JUST BEEN IN 5366 04:11:50,962 --> 04:11:52,297 THIS LONGITUDAL STUDY. 5367 04:11:52,363 --> 04:11:54,065 THEY GET MRI SCANS, THEY GET PET 5368 04:11:54,132 --> 04:11:56,134 SCANS, THEY HAVE COGNITIVE 5369 04:11:56,201 --> 04:11:57,268 EVALUATIONS, AND WHAT WE WANTED 5370 04:11:57,335 --> 04:11:59,437 TO DO WAS TO SEE IF THOSE 5371 04:11:59,504 --> 04:12:01,706 PATIENTS PERHAPS HAD DECREASED 5372 04:12:01,773 --> 04:12:03,908 CAPILLARY DENSITY BASED ON THEIR 5373 04:12:03,975 --> 04:12:05,109 APOE PHENOTYPE. 5374 04:12:05,176 --> 04:12:06,978 AND IT LOOKS LIKE AFTER 5375 04:12:07,045 --> 04:12:08,179 ADJUSTING FOR ALL THE THINGS 5376 04:12:08,246 --> 04:12:09,481 THAT ONE WOULD WANT TO ADJUST 5377 04:12:09,547 --> 04:12:11,783 FOR, WHICH IS, YOU KNOW, GENDER 5378 04:12:11,850 --> 04:12:13,318 AND HYPERTENSIVE STATUS AND 5379 04:12:13,384 --> 04:12:14,519 DIABETIC STATUS AND ALL THE 5380 04:12:14,586 --> 04:12:17,155 OTHER RISK FACTORS, PATIENTS WHO 5381 04:12:17,222 --> 04:12:23,361 HAD APOE4 -- AT LEAST ONE APOE R 5382 04:12:23,428 --> 04:12:24,996 CAPILLARY DENSITY THAN PATIENTS 5383 04:12:25,063 --> 04:12:26,431 WHO HAD NO ALLELES. 5384 04:12:26,498 --> 04:12:27,732 THESE ARE PATIENTS WHO ARE 5385 04:12:27,799 --> 04:12:29,934 HEALTHY, THEY HAVE NO COGNITIVE, 5386 04:12:30,001 --> 04:12:31,035 NO VISUAL COMPLAINTS, AND THEY 5387 04:12:31,102 --> 04:12:33,238 HAVE SOME COMORBIDITIES WHICH 5388 04:12:33,304 --> 04:12:33,972 WE'VE ADJUSTED FOR. 5389 04:12:34,038 --> 04:12:35,840 SO THAT IDEA WAS VERY 5390 04:12:35,907 --> 04:12:36,708 INTERESTING AND ACTUALLY 5391 04:12:36,774 --> 04:12:37,675 SURPRISED ME BECAUSE I DIDN'T 5392 04:12:37,742 --> 04:12:38,877 THINK WE WOULD ACTUALLY SEE SUCH 5393 04:12:38,943 --> 04:12:39,344 AN ASSOCIATION. 5394 04:12:39,410 --> 04:12:41,513 AND WE DID CONTROL FOR ALL KINDS 5395 04:12:41,579 --> 04:12:44,148 OF AMYLOID ON THE PET SCAN AND 5396 04:12:44,215 --> 04:12:45,884 FOR INTERCEREBRAL VOLUME, 5397 04:12:45,950 --> 04:12:46,985 DIFFERENT PARTS OF THE BRAIN 5398 04:12:47,051 --> 04:12:48,620 VOLUME AND WHOLE BRAIN VOLUME, 5399 04:12:48,686 --> 04:12:50,154 AND NONE OF THOSE THINGS MADE A 5400 04:12:50,221 --> 04:12:51,890 DIFFERENCE. 5401 04:12:51,956 --> 04:12:52,790 AND WHAT WAS MORE INTERESTING IS 5402 04:12:52,857 --> 04:12:54,325 WHEN WE LOOKED AT ACTUALLY THIS 5403 04:12:54,392 --> 04:12:55,827 POPULATION OF PATIENTS AND WE 5404 04:12:55,894 --> 04:12:56,661 LOOKED AT THE ASSOCIATION 5405 04:12:56,728 --> 04:12:59,030 BETWEEN RETINAL CAPILLARY 5406 04:12:59,097 --> 04:13:02,300 DENSITY AND AGE, THERE WAS A 5407 04:13:02,367 --> 04:13:02,967 SIGNIFICANT ASSOCIATION ONLY IN 5408 04:13:03,034 --> 04:13:05,136 PATIENTS WHO HAD AN APOE4 5409 04:13:05,203 --> 04:13:07,438 ALLELE, SUGGESTING THAT APOE4 IS 5410 04:13:07,505 --> 04:13:09,073 ACTUALLY DRIVING A DECREASE IN 5411 04:13:09,140 --> 04:13:10,708 CAPILLARY DENSITY IN AN 5412 04:13:10,775 --> 04:13:11,809 AGE-DEPENDENT MANNER, AND IF 5413 04:13:11,876 --> 04:13:13,344 YOU'LL REMEMBER IN OUR AFRICAN 5414 04:13:13,411 --> 04:13:14,879 AMERICAN EYE DISEASE STUDY, AGE 5415 04:13:14,946 --> 04:13:16,948 WAS INDEPENDENTLY A PREDICTOR OF 5416 04:13:17,015 --> 04:13:18,583 VESSEL SKELETON DENSITY THAN 5417 04:13:18,650 --> 04:13:20,018 DIABETES AND HYPERTENSION. 5418 04:13:20,084 --> 04:13:21,553 AND SO THIS ACTUALLY WAS A 5419 04:13:21,619 --> 04:13:23,187 REALLY EXCITING FINDING THAT 5420 04:13:23,254 --> 04:13:24,722 PERHAPS PROVIDED BIOLOGICAL 5421 04:13:24,789 --> 04:13:26,591 SUBSTRATE TO THE WAY IN WHICH 5422 04:13:26,658 --> 04:13:28,860 CAPILLARY DENSITY IS DECREASING 5423 04:13:28,927 --> 04:13:30,728 IN THE EYE AND REFLECTING 5424 04:13:30,795 --> 04:13:33,231 CHANGES IN THE BRAIN. 5425 04:13:33,298 --> 04:13:35,099 SO TAKE-HOME POINTS ARE THAT 5426 04:13:35,166 --> 04:13:37,068 OCTA IS ABLE TO DETECT 5427 04:13:37,135 --> 04:13:38,169 SUBCLINICAL CHANGES IN 5428 04:13:38,236 --> 04:13:39,704 CAPILLARY -- RETINAL CAPILLARY 5429 04:13:39,771 --> 04:13:41,105 DENSITY ACROSS A SPECTRUM OF NOT 5430 04:13:41,172 --> 04:13:43,107 ONLY RETINAL DISEASES BUT 5431 04:13:43,174 --> 04:13:44,075 SYSTEMIC DISEASES AND YOU'LL 5432 04:13:44,142 --> 04:13:45,810 HEAR A LOT MORE ABOUT RETINAL 5433 04:13:45,877 --> 04:13:46,611 DISEASES. 5434 04:13:46,678 --> 04:13:48,780 OCTA MEASURES CORRELATE WITH 5435 04:13:48,846 --> 04:13:49,547 COGNITIVE ABILITY. 5436 04:13:49,614 --> 04:13:51,249 EVEN IN PATIENTS WHO ARE 5437 04:13:51,316 --> 04:13:53,151 NEUROLOGICALLY INTACT AND HAVE 5438 04:13:53,217 --> 04:14:01,459 NO OPT K OPT KNOW LOGIC SYMPTOMR 5439 04:14:01,526 --> 04:14:03,995 COMPLAINTS. 5440 04:14:04,062 --> 04:14:05,196 IT SEEMS THAT THIS KIND OF 5441 04:14:05,263 --> 04:14:06,497 CHANGE IS ACTUALLY DRIVEN AT 5442 04:14:06,564 --> 04:14:09,667 LEAST IN PART BY APOE4 MEDIATING 5443 04:14:09,734 --> 04:14:12,303 CHANGES IN CAPILLARY INTEGRITY. 5444 04:14:12,370 --> 04:14:13,905 SO I'D LIKE TO THANK AGAIN ALL 5445 04:14:13,972 --> 04:14:14,706 MY COLLABORATORS. 5446 04:14:14,772 --> 04:14:15,807 I'VE TRIED TO MENTION THE PEOPLE 5447 04:14:15,873 --> 04:14:16,574 ALONG THE WAY THAT CONTRIBUTED 5448 04:14:16,641 --> 04:14:19,611 TO THE WORK THAT I SHOWED HERE, 5449 04:14:19,677 --> 04:14:21,045 AND ALWAYS SAY THAT WE'RE 5450 04:14:21,112 --> 04:14:22,380 INTERESTED IN POSTDOCTORAL 5451 04:14:22,447 --> 04:14:23,681 FELLOWS AND STUDENTS WHO ARE 5452 04:14:23,748 --> 04:14:24,749 INTERESTED IN PARTICIPATING IN 5453 04:14:24,816 --> 04:14:25,216 OUR WORK. 5454 04:14:25,283 --> 04:14:26,384 THANK YOU VERY MUCH, THANK YOU 5455 04:14:26,451 --> 04:14:28,586 TO THE NIH FOR YOUR FUNDING, AND 5456 04:14:28,653 --> 04:14:30,888 THANKS TO THE LASKER AWARD 5457 04:14:30,955 --> 04:14:32,790 WINNERS FOR ALL THEIR 5458 04:14:32,857 --> 04:14:34,626 CONTRIBUTIONS TO OUR WORK. 5459 04:14:34,692 --> 04:14:44,869 [APPLAUSE] 5460 04:14:49,874 --> 04:14:51,242 >> HI. 5461 04:14:51,309 --> 04:14:52,210 I'M RICHARD ROSEN. 5462 04:14:52,276 --> 04:14:54,946 TODAY I HAVE THE PLEASURE OF 5463 04:14:55,013 --> 04:15:03,388 INTRODUCING YALI JIA, JENNIE 5464 04:15:03,454 --> 04:15:05,790 WEEKS PROFESSOR OF OPHTHALMOLOGY 5465 04:15:05,857 --> 04:15:07,859 AT THE OREGON HEALTH AND SCIENCE 5466 04:15:07,925 --> 04:15:10,928 UNIVERSITY. 5467 04:15:10,995 --> 04:15:12,697 DR. JIA IS RENOWNED FOR HER 5468 04:15:12,764 --> 04:15:14,766 CONTRIBUTIONS TO THIS FIELD, 5469 04:15:14,832 --> 04:15:18,770 HAVING DEVELOPED THE SADA 5470 04:15:18,836 --> 04:15:19,370 ALGORITHM, PROBABLY ONE OF THE 5471 04:15:19,437 --> 04:15:21,873 MOST WIDELY USED OCTA ALGORITHM, 5472 04:15:21,939 --> 04:15:25,143 AND HAS ADDED TREMENDOUSLY TO 5473 04:15:25,209 --> 04:15:26,010 THIS FIELD. 5474 04:15:26,077 --> 04:15:32,050 SO YALI? 5475 04:15:32,116 --> 04:15:34,752 >> THANK YOU, DR. ROSENFELD, FOR 5476 04:15:34,819 --> 04:15:36,621 THE INTRODUCTION, AND ALSO IT'S 5477 04:15:36,688 --> 04:15:38,823 MY GREAT HONOR TO BE IN THIS 5478 04:15:38,890 --> 04:15:43,428 ROOM WITH SUCH A HIGH LEVEL OCT 5479 04:15:43,494 --> 04:15:43,728 CROWD. 5480 04:15:43,795 --> 04:15:46,030 TODAY I'M GOING TO TALK ABOUT 5481 04:15:46,097 --> 04:15:49,300 OUR RECENT WORK IN OUR LAB 5482 04:15:49,367 --> 04:15:53,905 FOCUSED ON TWO OF THE ADVANCES 5483 04:15:53,971 --> 04:15:57,408 ON OCT RESEARCH WE TRIED TO PUSH 5484 04:15:57,475 --> 04:15:59,911 FORWARD OCT INTO THE CLINIC. 5485 04:15:59,977 --> 04:16:03,381 TODAY'S TALK IS A FOCUS ON THE 5486 04:16:03,448 --> 04:16:06,484 DIABETIC RETINOPATHY. 5487 04:16:06,551 --> 04:16:11,756 WE ALREADY KNOW OCT IS A TYPE 5488 04:16:11,823 --> 04:16:14,358 OF -- ALGORITHM, IT HAS BEEN 5489 04:16:14,425 --> 04:16:16,894 PROVED VERY SUCCESSFUL. 5490 04:16:16,961 --> 04:16:18,730 IT'S A VERY SUCCESSFUL EXTENSION 5491 04:16:18,796 --> 04:16:19,931 OF OCT. 5492 04:16:19,997 --> 04:16:22,567 AND WE ALREADY SEE THIS KIND OF 5493 04:16:22,633 --> 04:16:30,108 A COMPARISON, OCTA COMPARES 5494 04:16:30,174 --> 04:16:32,510 FLUORESCING -- DUE TO THOSE 5495 04:16:32,577 --> 04:16:36,114 THREE-DIMENSIONAL NATURE, IT CAN 5496 04:16:36,180 --> 04:16:38,116 DEFINITIVELY DEFINE THOSE 5497 04:16:38,182 --> 04:16:41,052 RETINAL NEOVASCULARRIZATION AND 5498 04:16:41,119 --> 04:16:42,920 THE CAPILLARY DROPOUT. 5499 04:16:42,987 --> 04:16:43,988 SO THE QUESTION IS HOW ARE WE 5500 04:16:44,055 --> 04:16:49,160 GOING TO QUANTIFY THOSE TINY 5501 04:16:49,227 --> 04:16:49,694 NEOVASCULARRIZATION IN THE 5502 04:16:49,761 --> 04:16:51,662 DIFFERENT LOCATIONS. 5503 04:16:51,729 --> 04:16:58,002 ACTUALLY OCTA IS MO MORE 5504 04:16:58,069 --> 04:16:59,437 SUSCEPTIBLE TO -- THAN THE 5505 04:16:59,504 --> 04:17:05,510 CONVENTIONAL OCT, FOR EXAMPLE 5506 04:17:05,576 --> 04:17:07,178 THE MOTION ARTIFACTS IS VERY 5507 04:17:07,245 --> 04:17:08,479 PRONOUNCED, SIGNAL ATTENUATION 5508 04:17:08,546 --> 04:17:09,781 ARTIFACTS DUE TO THE SHADOW OR 5509 04:17:09,847 --> 04:17:13,618 DUE TO THE -- AND THE PROJECTION 5510 04:17:13,684 --> 04:17:16,888 ARTIFACTS DUE TO THE MULTIPLE 5511 04:17:16,954 --> 04:17:18,589 SCATTERING PHENOMENA. 5512 04:17:18,656 --> 04:17:20,625 SO ALL OF THOSE ARTIFACTS SHOULD 5513 04:17:20,691 --> 04:17:23,995 BE RESOLVED FOR FURTHER 5514 04:17:24,061 --> 04:17:25,530 MEASUREMENTS AND WE SHOULD TAKE 5515 04:17:25,596 --> 04:17:31,335 ADVANTAGE THE ADVANCE TRYING TO 5516 04:17:31,402 --> 04:17:33,971 USE THOSE CONCEPTUAL INFORMATION 5517 04:17:34,038 --> 04:17:35,606 AND MINIMIZE THE INTERFERENCE 5518 04:17:35,673 --> 04:17:37,008 FROM THE ARTIFACTS. 5519 04:17:37,074 --> 04:17:38,776 I'M GOING TO SHOW YOU A COUPLE 5520 04:17:38,843 --> 04:17:43,581 OF EXAMPLES TO SEE HOW A.I. CAN 5521 04:17:43,648 --> 04:17:44,782 HELP OCTA RESEARCH. 5522 04:17:44,849 --> 04:17:47,752 FIRST I START WITH 5523 04:17:47,819 --> 04:17:51,022 VISUALIZATION. 5524 04:17:51,088 --> 04:17:54,091 SO A.I. CAN HELP IMPROVE THE 5525 04:17:54,158 --> 04:17:56,260 OCTA IMAGE GENERATION, 5526 04:17:56,327 --> 04:18:00,064 CONSTRUCTION, AND ALSO IMPROVE 5527 04:18:00,131 --> 04:18:00,665 RESOLUTION. 5528 04:18:00,731 --> 04:18:04,135 FIRST OF ALL, THIS STEP IS QUITE 5529 04:18:04,202 --> 04:18:05,670 ESSENTIAL, BECAUSE FOR THE 5530 04:18:05,736 --> 04:18:10,241 LAMINAR STRUCTURE OF THOSE 5531 04:18:10,308 --> 04:18:11,475 CAPILLARY PLEXUS, WE SHOULD 5532 04:18:11,542 --> 04:18:13,878 PROJECT IT ON TO 2D FIRST, 5533 04:18:13,945 --> 04:18:15,413 RIGHT, BEFORE WE MOVE TO THE 5534 04:18:15,479 --> 04:18:19,350 BIOMARKER MEASUREMENT. 5535 04:18:19,417 --> 04:18:21,752 SO SLAB SEDIMENTATION IS VERY 5536 04:18:21,819 --> 04:18:22,186 SIGNIFICANT STEP. 5537 04:18:22,253 --> 04:18:24,889 WE HAVE TO MAKE SURE THIS STEP 5538 04:18:24,956 --> 04:18:28,893 IS VERY ACCURATE SO WE USE DEEP 5539 04:18:28,960 --> 04:18:34,332 LEARNING TO MAKE SURE THE FIRST 5540 04:18:34,398 --> 04:18:39,804 STEP CROSS SEDIMENTATION USE 5541 04:18:39,871 --> 04:18:41,439 THOSE SEMANTIC SEGMENTATION BY 5542 04:18:41,505 --> 04:18:42,807 THE FIRST STEP BY DEEP LEARNING, 5543 04:18:42,874 --> 04:18:45,376 THEN WE ADD THE GRAPH SEARCH TO 5544 04:18:45,443 --> 04:18:46,677 REFINE THE RESULTS. 5545 04:18:46,744 --> 04:18:49,881 THIS HAS BEEN DEMONSTRATED ON 5546 04:18:49,947 --> 04:18:53,050 THE VERY CHALLENGING 5547 04:18:53,117 --> 04:18:53,818 PARAPAPILLARY SCANS. 5548 04:18:53,885 --> 04:18:58,389 THEN AFTER WE PROJECT THE OCT 5549 04:18:58,456 --> 04:19:01,559 SIGNAL ON TO THE 2D MAP, FOR 5550 04:19:01,626 --> 04:19:02,660 SOME SCANS ACTUALLY WE DON'T 5551 04:19:02,727 --> 04:19:06,430 HAVE ENOUGH RESOLUTION BECAUSE 5552 04:19:06,497 --> 04:19:11,269 WE HAVE TO -- MAKE SURE WE CAN 5553 04:19:11,335 --> 04:19:16,173 CATCH THE SCAN'S REASONABLE 5554 04:19:16,240 --> 04:19:16,941 AREA. 5555 04:19:17,008 --> 04:19:18,910 SO LOW DEFINITION IMAGE, IN OUR 5556 04:19:18,976 --> 04:19:24,115 LAB WE TRIED TO USE THOSE SMALL 5557 04:19:24,181 --> 04:19:27,618 AREA SCAN WITH HIGH DEFINITION, 5558 04:19:27,685 --> 04:19:30,321 HIGH-DENSITY SCANS USED AS -- TO 5559 04:19:30,388 --> 04:19:34,191 TRY TO BORROW THE 5560 04:19:34,258 --> 04:19:36,594 SUPERRESOLUTION CONSTRUCTION 5561 04:19:36,661 --> 04:19:38,796 FROM THE MICROSCOPY AREA, AND WE 5562 04:19:38,863 --> 04:19:41,065 TRIED TO LEARN THOSE DEEPER 5563 04:19:41,132 --> 04:19:43,467 FEATURES FROM THE CAPILLARY 5564 04:19:43,534 --> 04:19:46,103 DETAILS AND RECONSTRUCT THE 5565 04:19:46,170 --> 04:19:47,405 CAPILLARY DETAILS FROM THE LOW 5566 04:19:47,471 --> 04:19:48,172 RESOLUTION IMAGE. 5567 04:19:48,239 --> 04:19:53,210 IN THIS WAY, WE CAN IMPROVE 5568 04:19:53,277 --> 04:19:54,412 THOSE VISUAL -- AND THE 5569 04:19:54,478 --> 04:19:58,015 APPEARANCE FOR THOSE PATHOLOGIES 5570 04:19:58,082 --> 04:19:59,784 ON THE ANGIOGRAMS CAN HELP US TO 5571 04:19:59,850 --> 04:20:02,086 DO THE DIAGNOSIS AND THE 5572 04:20:02,153 --> 04:20:02,520 STAGING. 5573 04:20:02,586 --> 04:20:04,689 I HOPE YOU CAN PERCEIVE THE 5574 04:20:04,755 --> 04:20:05,690 DIFFERENCE BEFORE AND AFTER THIS 5575 04:20:05,756 --> 04:20:10,261 STEP. 5576 04:20:10,328 --> 04:20:13,898 ALSO THAT'S ALSO HELP FOR OTHER 5577 04:20:13,965 --> 04:20:14,432 BIOMARKER DETECTION. 5578 04:20:14,498 --> 04:20:17,401 YOU KNOW, WE COULD FIRST IMPROVE 5579 04:20:17,468 --> 04:20:20,671 THE CAPILLARY RESOLUTION AND 5580 04:20:20,738 --> 04:20:24,175 THEY MOVE TO ANOTHER NEURAL 5581 04:20:24,241 --> 04:20:28,012 NETWORK AND WE'RE ABLE TO 5582 04:20:28,079 --> 04:20:33,451 CLASSIFY ARTERIES AND VEINS TWO 5583 04:20:33,517 --> 04:20:34,986 TYPE OF VESSELS FROM THE SINGLE 5584 04:20:35,052 --> 04:20:36,187 MAP. 5585 04:20:36,253 --> 04:20:38,923 ACTUALLY DEEP LEARNING DID A 5586 04:20:38,990 --> 04:20:42,526 VERY GOOD JOB EVEN OVER AUTO 5587 04:20:42,593 --> 04:20:45,062 PERFORM THE HUMAN -- SO THE 5588 04:20:45,129 --> 04:20:47,999 DETAIL -- SO THEY CAN SEPARATE 5589 04:20:48,065 --> 04:20:51,502 THOSE TWO TYPE OF VESSELS AND 5590 04:20:51,569 --> 04:20:54,472 THEN LATER WE CAN GO TO THE 5591 04:20:54,538 --> 04:20:56,874 CAPILLARY MAP GENERATOR, 5592 04:20:56,941 --> 04:20:59,443 CAPILLARY MAP AND ALSO CAN 5593 04:20:59,510 --> 04:21:05,783 QUANTIFY THE TORE TEU TORTUOSITR 5594 04:21:05,850 --> 04:21:08,019 FURTHER ANALYSIS. 5595 04:21:08,085 --> 04:21:09,787 AFTER WE DO THE RECONSTRUCTION, 5596 04:21:09,854 --> 04:21:14,925 WE CAN IMPROVE THOSE OCT 5597 04:21:14,992 --> 04:21:18,629 SIGNALS, AFTER WE OVERLAY OCT 5598 04:21:18,696 --> 04:21:21,265 ONTO THE MAP, WE'RE ABLE TO 5599 04:21:21,332 --> 04:21:25,302 DIFFERENTIATE THE PERFUSION 5600 04:21:25,369 --> 04:21:34,278 CENTERS OF THE -- WE MICRO ANEU, 5601 04:21:34,345 --> 04:21:35,279 SO THOSE DIFFERENT TYPES 5602 04:21:35,346 --> 04:21:38,749 CORRELATED WITH THE LOCATION TO 5603 04:21:38,816 --> 04:21:40,618 THE RETINAL FLUID. 5604 04:21:40,684 --> 04:21:45,656 IN OUR STUDY, WE FIND THOSE 5605 04:21:45,723 --> 04:21:48,726 PERFUSED THE MICRO ANEURYSMS 5606 04:21:48,793 --> 04:21:52,863 MORE COLOCATED WITH RETINAL 5607 04:21:52,930 --> 04:21:54,398 FLUID, PROBABLY EARLIER 5608 04:21:54,465 --> 04:21:55,933 BIOMARKER THAN WHEN WE -- BEFORE 5609 04:21:56,000 --> 04:22:00,071 WE DETECT THE RETINAL FLUID IN 5610 04:22:00,137 --> 04:22:00,604 CLINIC. 5611 04:22:00,671 --> 04:22:05,443 NEXT WE'LL MOVE TO SEE HOW A.I. 5612 04:22:05,509 --> 04:22:06,744 IMPROVES THE BIOMARKER 5613 04:22:06,811 --> 04:22:07,845 MEASUREMENT. 5614 04:22:07,912 --> 04:22:10,381 AND AS I ALREADY INDICATED, YOU 5615 04:22:10,448 --> 04:22:14,819 KNOW, OCT MERELY PROVIDED TWO 5616 04:22:14,885 --> 04:22:17,488 TYPE OF BIOMARKER FOR THE 5617 04:22:17,555 --> 04:22:18,789 CURRENT D.R. RESEARCH. 5618 04:22:18,856 --> 04:22:21,859 FIRST OF ALL IT'S THE CAPILLARY 5619 04:22:21,926 --> 04:22:22,426 NON-PERFUSION AREA. 5620 04:22:22,493 --> 04:22:24,528 HERE WE MEASURE THE AVASCULAR 5621 04:22:24,595 --> 04:22:27,198 AREA INSTEAD OF THE VESSEL 5622 04:22:27,264 --> 04:22:27,665 DENSITY. 5623 04:22:27,731 --> 04:22:32,369 SO IN OUR EARLIER WORK, WE 5624 04:22:32,436 --> 04:22:34,972 ALREADY -- OCT AND 5625 04:22:35,039 --> 04:22:36,507 FLUORESCING -- THE RESULT IS NOT 5626 04:22:36,574 --> 04:22:38,876 EQUIVALENT BUT THEY ALREADY SHOW 5627 04:22:38,943 --> 04:22:39,810 MAJORITY AGREEMENT. 5628 04:22:39,877 --> 04:22:44,949 AND THEN ALSO WHEN WE SPLIT INTO 5629 04:22:45,015 --> 04:22:47,651 THE THREE SLAB SUPERFICIAL 5630 04:22:47,718 --> 04:22:51,055 INTERMEDIATE -- THE DEEP FLEX 5631 04:22:51,122 --> 04:22:52,590 US, NON-PERFUSION AREA CAN BE 5632 04:22:52,656 --> 04:22:53,324 BETTER VISUALIZED. 5633 04:22:53,390 --> 04:22:57,628 AND YOU CAN APPRECIATE THOSE 5634 04:22:57,695 --> 04:23:04,368 ENLARGE THE CAPILLARY SPACE NEAR 5635 04:23:04,435 --> 04:23:05,803 THE -- THE DIABETES GROUP 5636 04:23:05,870 --> 04:23:06,804 WITHOUT D.R. EVEN. 5637 04:23:06,871 --> 04:23:09,106 SO THAT'S KIND OF AN EARLIER 5638 04:23:09,173 --> 04:23:10,908 BIOMARKER WE CAN CONSIDER FOR 5639 04:23:10,975 --> 04:23:15,579 THE FUTURE RESEARCH. 5640 04:23:15,646 --> 04:23:18,516 MOTIVATED BY THE NON-PERFUSION 5641 04:23:18,582 --> 04:23:20,017 AREA'S FUNCTION, SO IN OUR 5642 04:23:20,084 --> 04:23:26,390 GROUP, WE INTELLIGENTLY PUT -- 5643 04:23:26,457 --> 04:23:28,893 CT AND OCT MAP TOGETHER ALSO 5644 04:23:28,959 --> 04:23:34,598 COMBINED WITH THE INNER RETINAL 5645 04:23:34,665 --> 04:23:35,466 SIGNALINGS AND TOGETHER WE ARE 5646 04:23:35,533 --> 04:23:39,503 ABLE TO DIFFERENTIATE THE TWO 5647 04:23:39,570 --> 04:23:47,978 AVASCTRUEAVASCULAR AREA, WE CANR 5648 04:23:48,045 --> 04:23:48,612 FROM SIGNAL LOSS. 5649 04:23:48,679 --> 04:23:50,147 WE ALSO KNOW THE IPT IMMEDIATE 5650 04:23:50,214 --> 04:23:54,952 AND DEEP LAYERS MORE FREQUENTLY 5651 04:23:55,019 --> 04:23:59,790 CONFOUNDED BY MOTION AND SOME 5652 04:23:59,857 --> 04:24:03,060 RESIDUAL PROJECTION ARTIFACTS 5653 04:24:03,127 --> 04:24:04,929 SO -- WORK ON THOSE AI MODEL TO 5654 04:24:04,995 --> 04:24:06,330 IMPROVE THE NON-PERFUSION AREA 5655 04:24:06,397 --> 04:24:07,765 ON THREE LAYERS. 5656 04:24:07,831 --> 04:24:09,533 AND A GOOD DEEP LEARNING 5657 04:24:09,600 --> 04:24:11,835 ALGORITHM ALSO SHOULD BE APPLIED 5658 04:24:11,902 --> 04:24:13,571 ON THE DIFFERENT, YOU KNOW, 5659 04:24:13,637 --> 04:24:17,541 VARIOUS REGIONS OF THE OCTA. 5660 04:24:17,608 --> 04:24:20,277 THIS SHOWS AN EXAMPLE FOR OUR 5661 04:24:20,344 --> 04:24:22,046 RESEARCH. 5662 04:24:22,112 --> 04:24:24,348 IN OUR OHSU COHORT, WE ALSO USED 5663 04:24:24,415 --> 04:24:29,787 THIS DEEP LEARNING, W WHICH SHOS 5664 04:24:29,853 --> 04:24:33,190 IN THE SUPERFICIAL VASCULAR -- 5665 04:24:33,257 --> 04:24:34,425 AVASCULAR AREA ACTUALLY IT'S 5666 04:24:34,491 --> 04:24:36,460 ASSOCIATED WITH DISEASE 5667 04:24:36,527 --> 04:24:40,864 PROGRESSION IN ONE YEAR, AND THE 5668 04:24:40,931 --> 04:24:44,268 DCP AVASCULAR AREA AT BASELINE 5669 04:24:44,335 --> 04:24:45,769 CAN PREDICT THE TREATMENT 5670 04:24:45,836 --> 04:24:47,104 REQUIREMENT IN ONE YEAR. 5671 04:24:47,171 --> 04:24:51,675 AND THE RESULT CORRESPONDS TO 5672 04:24:51,742 --> 04:24:55,079 THE PREVIOUS STUDY VERY SMALLER 5673 04:24:55,145 --> 04:25:00,651 COHORT FROM OTHER GROUP. 5674 04:25:00,718 --> 04:25:02,620 WE ARE ABLE TO USE THE OCT 5675 04:25:02,686 --> 04:25:04,922 SIGNAL FROM THE OCT VOLUME WE 5676 04:25:04,989 --> 04:25:10,594 DON'T WANT TO GET READ OF THOSE 5677 04:25:10,661 --> 04:25:12,029 HIGH-DENSITY, HIGH DEFINITION -- 5678 04:25:12,096 --> 04:25:15,099 VOLUME THAT ALSO PROVIDE VERY 5679 04:25:15,165 --> 04:25:19,670 RICH INFORMATION, AND THAT'S 5680 04:25:19,737 --> 04:25:21,538 INTRINSIC HIGH ASSEMBLING 5681 04:25:21,605 --> 04:25:23,741 VOLUME, AND IN OUR STUDY WE 5682 04:25:23,807 --> 04:25:27,778 TESTED A UNIT LIKE A CONVOLUTION 5683 04:25:27,845 --> 04:25:32,249 NEURAL NETWORK AND THE 5684 04:25:32,316 --> 04:25:33,784 INTERRETINAL -- FLUID AND 5685 04:25:33,851 --> 04:25:35,753 SUBRETINAL FLUID CAN BE 5686 04:25:35,819 --> 04:25:39,923 EXTRACTED AND BY ADDING THOSE 5687 04:25:39,990 --> 04:25:43,961 OCTA SIGNAL -- SO CAN FURTHER 5688 04:25:44,028 --> 04:25:46,797 ENHANCE THE ROBUSTNESS OF THE 5689 04:25:46,864 --> 04:25:47,131 NETWORK. 5690 04:25:47,197 --> 04:25:50,200 THAT SHOWS HOW THOSE CAN BE 5691 04:25:50,267 --> 04:25:53,737 SIMULTANEOUSLY -- TOGETHER SO ON 5692 04:25:53,804 --> 04:25:56,106 ONE HAND WE COULD FIGURE OUT THE 5693 04:25:56,173 --> 04:25:57,875 RETINAL FLUID ON THE OTHER HAND, 5694 04:25:57,941 --> 04:26:00,711 WE COULD FIGURE OUT THE ISCHEMIA 5695 04:26:00,778 --> 04:26:03,013 STATUS. 5696 04:26:03,080 --> 04:26:04,515 THIS SHOWS YOU AN EXAMPLE BEFORE 5697 04:26:04,581 --> 04:26:06,617 AND AFTER THE TREATMENT, SO WE 5698 04:26:06,684 --> 04:26:11,088 COULD CHECK THOSE NEW FLUID AND 5699 04:26:11,155 --> 04:26:12,723 CHANGE -- THE FLUID AND ALSO WE 5700 04:26:12,790 --> 04:26:16,126 CAN COMPARE TO THE OCTA CHANGE 5701 04:26:16,193 --> 04:26:20,497 WITHIN THOSE TWO TIME POINTS. 5702 04:26:20,564 --> 04:26:24,868 IN OUR STUDY, WE ALSO CHOSE A 5703 04:26:24,935 --> 04:26:27,171 DEEP LEARNING BASE THAT FLUID 5704 04:26:27,237 --> 04:26:30,107 VOLUME IS MORE ACCURATE THAN THE 5705 04:26:30,174 --> 04:26:34,511 CONVENTIONAL SUBFIELD SIGNALS IN 5706 04:26:34,578 --> 04:26:35,579 MACULAR EDEMA STUDY. 5707 04:26:35,646 --> 04:26:41,285 THIS SHOWS THAT'S NOT RED FLAG 5708 04:26:41,352 --> 04:26:43,587 TO -- THE CONVENTIONAL -- OCT 5709 04:26:43,654 --> 04:26:46,190 BUT ALREADY SHOWS VERY DRAMATIC 5710 04:26:46,256 --> 04:26:48,492 FLUID INSIDE OF THE VOLUME. 5711 04:26:48,559 --> 04:26:52,529 AND WE ALSO DID ANOTHER STUDY IN 5712 04:26:52,596 --> 04:26:55,399 DME, WE FOUND THAT FLUID 5713 04:26:55,466 --> 04:26:59,436 ACTUALLY -- THAT'S RESOLVED IF 5714 04:26:59,503 --> 04:27:04,475 WE -- THE FLUID IN THE INNER 5715 04:27:04,541 --> 04:27:06,643 NUCLEAR LAYER, IT'S A VERY 5716 04:27:06,710 --> 04:27:07,745 SUPERFICIAL INNER FLUID THAT'S 5717 04:27:07,811 --> 04:27:10,481 HIGHLY CORRELATED WITH VISUAL 5718 04:27:10,547 --> 04:27:10,881 ACUITY. 5719 04:27:10,948 --> 04:27:14,752 EVEN WHEN WE DO THE MULTIVARIATE 5720 04:27:14,818 --> 04:27:16,820 ANALYSIS, INCLUDE OTHER 5721 04:27:16,887 --> 04:27:18,355 OCT-BASED BIOMARKER OR OTHER 5722 04:27:18,422 --> 04:27:23,594 STRUCTURE SIGNALING MEASUREMENT. 5723 04:27:23,660 --> 04:27:24,962 THIS IS STILL THE STRONGEST 5724 04:27:25,028 --> 04:27:26,864 FACTOR FOR THE VISUAL ACUITY. 5725 04:27:26,930 --> 04:27:29,400 NOW I WANT TO SWITCH THE GEAR TO 5726 04:27:29,466 --> 04:27:32,035 THE DIRECT DIAGNOSIS. 5727 04:27:32,102 --> 04:27:33,771 THINK ABOUT THINGS WE PUT A LOT 5728 04:27:33,837 --> 04:27:36,407 OF EFFORT FOR EXTRACTING THE 5729 04:27:36,473 --> 04:27:36,673 BIOMARKER. 5730 04:27:36,740 --> 04:27:39,476 HOW ABOUT WE JUST INPUT TO THE 5731 04:27:39,543 --> 04:27:42,613 OCT AND OCTA PICTURES OR 5732 04:27:42,679 --> 04:27:44,281 VOLUMES, RIGHT, LET THE MACHINE 5733 04:27:44,348 --> 04:27:45,916 TO DO ALL THE WORK. 5734 04:27:45,983 --> 04:27:47,785 WE JUST WANT TO KNOW IF THIS 5735 04:27:47,851 --> 04:27:49,420 CASE ARE REFERABLE OR 5736 04:27:49,486 --> 04:27:49,853 NON-REFERABLE. 5737 04:27:49,920 --> 04:27:51,588 IT REALLY BASED ON THE CLINICAL 5738 04:27:51,655 --> 04:27:54,358 NEEDS, AND SOMETIMES WE WANT TO 5739 04:27:54,425 --> 04:27:58,162 DO THOSE TWO CLASS SEPARATION, 5740 04:27:58,228 --> 04:28:00,130 FIGURE OUT THE NON-PRODUCTIVE 5741 04:28:00,197 --> 04:28:01,565 AND PRODUCTIVE AND ALSO WE WANT 5742 04:28:01,632 --> 04:28:03,634 TO HAVE A NARROWER 5743 04:28:03,700 --> 04:28:05,269 CLASSIFICATION. 5744 04:28:05,335 --> 04:28:14,044 SO WE TEST IT USING EPBRS, AND 5745 04:28:14,111 --> 04:28:17,080 WE FOUND OUR RESULT IS NOT 5746 04:28:17,147 --> 04:28:23,120 PERFECT FOR THE -- BECAUSE IT'S 5747 04:28:23,187 --> 04:28:24,755 VERY -- SHOWS VERY CLOSE SCORE 5748 04:28:24,822 --> 04:28:27,991 TO THE MODERATE NBPR BUT FOR THE 5749 04:28:28,058 --> 04:28:29,560 2-CLASS, WE ARE ABLE TO PROVIDE 5750 04:28:29,626 --> 04:28:35,032 THE EQUIVALENT SENSITIVITY OR 5751 04:28:35,098 --> 04:28:37,434 DIAGNOSIS POWER FOR 5752 04:28:37,501 --> 04:28:38,869 DIFFERENTIATING THE REFERABLE 5753 04:28:38,936 --> 04:28:40,404 D.R., WHICH CAN REDUCE THE 5754 04:28:40,471 --> 04:28:49,913 BURDEN FOR THE REFERRAL. 5755 04:28:49,980 --> 04:28:53,517 THIS DIRECT DIAGNOSIS CAN BE 5756 04:28:53,584 --> 04:28:57,354 DONE ON THE 6 -- IMAGE WHICH 5757 04:28:57,421 --> 04:28:58,222 REQUIRES SEGMENTATION OR WE 5758 04:28:58,288 --> 04:29:00,724 COULD BE DONE ON THE 2 VOLUME 5759 04:29:00,791 --> 04:29:03,260 DIRECTLY, THE BENEFIT IS VERY 5760 04:29:03,327 --> 04:29:04,661 APPARENT AND NO SEGMENTATION 5761 04:29:04,728 --> 04:29:06,930 REQUIRED. 5762 04:29:06,997 --> 04:29:09,366 AFTER THE DIAGNOSIS STEP, WE 5763 04:29:09,433 --> 04:29:14,404 FREQUENTLY HEAR ABOUT THIS TERM, 5764 04:29:14,471 --> 04:29:17,040 HEAT MAP, AND THEN GENERATED 5765 04:29:17,107 --> 04:29:22,279 THIS COLORFUL MAP. 5766 04:29:22,346 --> 04:29:24,581 IT BARELY GIVES US USEFUL 5767 04:29:24,648 --> 04:29:26,984 INFORMATION, WE DON'T KNOW WHICH 5768 04:29:27,050 --> 04:29:28,285 AREA IN DECISION-MAKING. 5769 04:29:28,352 --> 04:29:31,455 SO IN OUR GROUP, WE WORK ON TO 5770 04:29:31,522 --> 04:29:34,658 GENERATE ACTIVATION MAP TO TRY 5771 04:29:34,725 --> 04:29:36,493 TO IMPROVE THE RESOLUTION, TRY 5772 04:29:36,560 --> 04:29:40,531 TO GIVE YOU BIOMARKER ACTIVATION 5773 04:29:40,597 --> 04:29:44,167 MAP TO SHOW WHERE OR WHICH 5774 04:29:44,234 --> 04:29:46,236 PATHOLOGIES REALLY CONTRIBUTE TO 5775 04:29:46,303 --> 04:29:46,904 THE DISEASE. 5776 04:29:46,970 --> 04:29:49,940 THIS INCLUDED TWO STEP OF DEEP 5777 04:29:50,007 --> 04:29:50,507 LEARNING. 5778 04:29:50,574 --> 04:29:54,745 FIRST OF ALL, WE NEED TO HAVE A 5779 04:29:54,811 --> 04:29:56,847 DEEP LEARNING D.R. CLASSIFIER. 5780 04:29:56,914 --> 04:30:01,218 IN THIS CASE, WE SHOULD CLASSIFY 5781 04:30:01,285 --> 04:30:02,953 NON-REFERABLE FROM REFERABLE, 5782 04:30:03,020 --> 04:30:06,924 AND IN THOSE CLASSIFIER MOVE TO 5783 04:30:06,990 --> 04:30:10,060 THE BIOMARKER ACTIVATION MAP 5784 04:30:10,127 --> 04:30:14,231 GENERATION FRAMEWORK HERE, WE 5785 04:30:14,298 --> 04:30:15,499 USE THE -- NETWORK. 5786 04:30:15,566 --> 04:30:17,501 I SHOW YOU HOW. 5787 04:30:17,568 --> 04:30:22,539 AND BASICALLY NOT TO JUST TELL 5788 04:30:22,606 --> 04:30:23,974 US YES OR NO DECISION AND ALSO 5789 04:30:24,041 --> 04:30:30,747 PROVIDE US A MAP TO TELL US 5790 04:30:30,814 --> 04:30:33,150 WHERE THE NETWORK MAKES THIS 5791 04:30:33,216 --> 04:30:39,923 DECISION FROM THE OCT AND THE -- 5792 04:30:39,990 --> 04:30:40,390 OCT. 5793 04:30:40,457 --> 04:30:44,861 SO BASICALLY THIS AGAIN IS 5794 04:30:44,928 --> 04:30:45,963 GENERATIVE LEARNING NETWORK, 5795 04:30:46,029 --> 04:30:50,434 THEY TRY TO KEEP CHANGING USING 5796 04:30:50,500 --> 04:30:51,969 THE -- STEP, KEEP CHANGING THE 5797 04:30:52,035 --> 04:30:55,906 PIXEL BRIGHTENINGS, THEY MAKE 5798 04:30:55,973 --> 04:30:58,208 SURE THOSE POSITIVE GROUP HERE 5799 04:30:58,275 --> 04:30:59,943 IS REFERABLE GROUP. 5800 04:31:00,010 --> 04:31:03,780 THEY TRY TO CREATE THE FORGED, 5801 04:31:03,847 --> 04:31:05,415 THE IMAGE, AND TRY TO FOOL THE 5802 04:31:05,482 --> 04:31:07,150 NETWORK TO BE CONSIDERED AS A 5803 04:31:07,217 --> 04:31:08,819 HEALTHY CONTROL. 5804 04:31:08,885 --> 04:31:13,724 SO ONCE THEY PASS THIS TEST, AND 5805 04:31:13,790 --> 04:31:15,158 THE DIFFERENCE BETWEEN THOSE 5806 04:31:15,225 --> 04:31:19,062 PIXELS AND THE ORIGINAL PICTURES 5807 04:31:19,129 --> 04:31:21,932 CAN BE FIGURED OUT IS THAT THE 5808 04:31:21,999 --> 04:31:27,070 PIXELS WE CONSIDER FOR THE BAM. 5809 04:31:27,137 --> 04:31:29,339 AND FOR THE BAM PIXEL GROUP, WE 5810 04:31:29,406 --> 04:31:33,510 COMPARE TO THOSE BIOMARKER BASED 5811 04:31:33,577 --> 04:31:34,945 SEGMENTATION NON-PERFUSION AREAS 5812 04:31:35,012 --> 04:31:37,781 AND THE FLUID -- THEY EXACTLY 5813 04:31:37,848 --> 04:31:39,116 MATCH EACH OTHER. 5814 04:31:39,182 --> 04:31:42,586 SO THAT'S KIND OF INDIRECTLY CAN 5815 04:31:42,653 --> 04:31:44,021 VALIDATE BAM, GIVE US THE 5816 04:31:44,087 --> 04:31:45,656 REASONABLE INFORMATION. 5817 04:31:45,722 --> 04:31:48,725 SO USING THIS BIOMARKER 5818 04:31:48,792 --> 04:31:51,895 ACTIVATION MAP, WE DON'T HAVE TO 5819 04:31:51,962 --> 04:31:56,066 DO THE DEEP LEARNING BIOMARKER 5820 04:31:56,133 --> 04:32:02,739 EXTRACTION, YOU KNOW, -- TO PULL 5821 04:32:02,806 --> 04:32:07,210 OUT OF THOSE PIXEL GROUPS 5822 04:32:07,277 --> 04:32:08,979 WHERE -- PATHOLOGIES THEY MAY BE 5823 04:32:09,046 --> 04:32:10,180 NON-PERFUSION, THEY MAY BE FLUID 5824 04:32:10,247 --> 04:32:17,954 OR THEY MAY BE MICRO ANEURYSM. 5825 04:32:18,021 --> 04:32:19,690 SO THE SUMMARY FOR THIS SECTION 5826 04:32:19,756 --> 04:32:22,526 IS DEEP LEARNING DO PROVE VERY 5827 04:32:22,592 --> 04:32:25,395 POWERFUL FOR STUDYING OCT IN 5828 04:32:25,462 --> 04:32:27,464 D.R., AND WE HAVE THE REVIEW 5829 04:32:27,531 --> 04:32:28,932 PAPER PUBLISHED A FEW YEARS AGO 5830 04:32:28,999 --> 04:32:30,734 IF YOU HAVE INTEREST, YOU CAN 5831 04:32:30,801 --> 04:32:32,836 CHECK OUT THE DETAILS, ALSO 5832 04:32:32,903 --> 04:32:35,005 INCLUDE A LOT OF WORK FROM OTHER 5833 04:32:35,072 --> 04:32:36,073 GROUPS. 5834 04:32:36,139 --> 04:32:38,375 I WANT TO SWITCH TO ANOTHER 5835 04:32:38,442 --> 04:32:41,144 ADVANCE WHICH ALSO HELPS FOR THE 5836 04:32:41,211 --> 04:32:43,547 DIAGNOSIS OF D.R. 5837 04:32:43,613 --> 04:32:48,885 WE HAVE BEEN PUT TO OUR 5838 04:32:48,952 --> 04:32:53,356 STUDENT -- TOGETHER -- HIGH 5839 04:32:53,423 --> 04:32:54,458 RESOLUTION PROTOTYPE, BUILD UP 5840 04:32:54,524 --> 04:32:56,660 THIS HIGH PERFORMANCE IMAGING 5841 04:32:56,727 --> 04:32:58,195 PLATFORM, ACTUALLY IT'S JUST 5842 04:32:58,261 --> 04:32:59,930 LIKE BUILD A FANCY CAMERA. 5843 04:32:59,996 --> 04:33:04,201 WE HAVE TO FIGURE OUT THOSE SIX 5844 04:33:04,267 --> 04:33:08,338 COMPONENTS, LENS, LASER, HOW TO 5845 04:33:08,405 --> 04:33:10,907 STABILIZE, HOW TO MAKE THE 5846 04:33:10,974 --> 04:33:12,075 ALGORITHM EFFICIENT. 5847 04:33:12,142 --> 04:33:16,146 SO WE VERY DILIGENTLY STARTED 5848 04:33:16,213 --> 04:33:19,516 ABOUT 10 YEARS AGO FROM OUR 5849 04:33:19,583 --> 04:33:24,755 FIRST GENERATION AND -- EVERY 5850 04:33:24,821 --> 04:33:28,058 PAPER WE MAKE A SINGLE STEP, 5851 04:33:28,125 --> 04:33:32,629 TRIED TO CONQUER A SINGLE 5852 04:33:32,696 --> 04:33:33,964 PROBLEM AND FINALLY WE ARE ABLE 5853 04:33:34,030 --> 04:33:36,900 TO GENERATE THOSE SINGLE SHOT 5854 04:33:36,967 --> 04:33:42,172 AND THEN -- SCANS, THIS SHOWS 5855 04:33:42,239 --> 04:33:45,776 NON-PRO LIVE TIP DRIs, WE'RE 5856 04:33:45,842 --> 04:33:48,945 ABLE TO VISUALIZE THIS -- IN A 5857 04:33:49,012 --> 04:33:50,347 SINGLE SYSTEM, AND ALSO WE ARE 5858 04:33:50,413 --> 04:33:53,850 ABLE TO SEE THOSE VERY EARLY 5859 04:33:53,917 --> 04:33:55,385 SPROUTS OF THE 5860 04:33:55,452 --> 04:33:56,153 NEOVASCULARRIZATION. 5861 04:33:56,219 --> 04:33:58,121 I THINK YOU HAVE TO BE VERY 5862 04:33:58,188 --> 04:34:00,323 CLOSELY MAYBE I SHOULD MAGNIFY 5863 04:34:00,390 --> 04:34:04,194 THOSE AREAS. 5864 04:34:04,261 --> 04:34:07,397 ALL THOSE ADVANCED -- OTHER 5865 04:34:07,464 --> 04:34:12,102 GROUP OF FOLKS WIDE FIELD OCT 5866 04:34:12,169 --> 04:34:16,173 AND IT'S GREAT NEWS THAT HAS 5867 04:34:16,239 --> 04:34:18,241 BEEN -- INHERITED BY SOME 5868 04:34:18,308 --> 04:34:19,543 COMMERCIAL OCT COMPANY. 5869 04:34:19,609 --> 04:34:21,611 THEY ALREADY MAKE IT 5870 04:34:21,678 --> 04:34:26,650 COMMERCIALIZED, 18 BY 18, AND 5871 04:34:26,716 --> 04:34:28,652 EVEN LARGER SCANS FROM THE 5872 04:34:28,718 --> 04:34:34,124 SINGLE EYE. 5873 04:34:34,191 --> 04:34:36,960 ACTUALLY THE SOURCE IS NOT 5874 04:34:37,027 --> 04:34:40,564 THE -- LASER, THAT'S JUST THE 5875 04:34:40,630 --> 04:34:42,532 200-KILOHERTZ 16-NANOMETER. 5876 04:34:42,599 --> 04:34:45,702 AND IN THE MILD D.R., WE CAN SEE 5877 04:34:45,769 --> 04:34:48,004 THE -- AND WE ALSO COULD SEE 5878 04:34:48,071 --> 04:34:52,175 CORRESPONDED TO THE 5879 04:34:52,242 --> 04:34:53,043 CROSS-SECTIONALS TO WIDE FIELD 5880 04:34:53,109 --> 04:34:55,779 OF VIEW AND THE MODERATOR MPBR, 5881 04:34:55,846 --> 04:34:57,414 WE PROBABLY WANT TO LOOK AT 5882 04:34:57,480 --> 04:35:01,885 WHERE IS THE MPA AND THE 5883 04:35:01,952 --> 04:35:02,352 NEOVASCULARIZATION IS. 5884 04:35:02,419 --> 04:35:05,522 I'M NOT SURE IF YOU CAN SEARCH, 5885 04:35:05,589 --> 04:35:08,892 YOU CAN FIND OUT THIS KNEW OWE 5886 04:35:08,959 --> 04:35:10,627 VASCULARIZATION SPROUT FROM THIS 5887 04:35:10,694 --> 04:35:11,194 ENTIRE IMAGE. 5888 04:35:11,261 --> 04:35:13,263 IF I CHANGE THE COLOR YOU'RE 5889 04:35:13,330 --> 04:35:14,564 PROBABLY ABLE TO SEE IN THE 5890 04:35:14,631 --> 04:35:16,433 BOTTOM, THOSE TWO DOTS, YELLOW 5891 04:35:16,500 --> 04:35:18,835 DOTS, THAT'S NEW VESSELS. 5892 04:35:18,902 --> 04:35:25,842 SO IT'S JUST A SUBCLINICAL 5893 04:35:25,909 --> 04:35:27,477 INFORMATION CAUGHT BY THAT 5894 04:35:27,544 --> 04:35:27,911 SINGLE SHOT. 5895 04:35:27,978 --> 04:35:36,219 I DO HAVE A DISCLOSURE HERE, 5896 04:35:36,286 --> 04:35:38,088 INTALIGHT PROVIDED THE 5897 04:35:38,154 --> 04:35:39,055 SOFTWARE -- I SHOW YOU A CASE 5898 04:35:39,122 --> 04:35:41,691 FOR THE PROLIFERATIVE D.R. AND 5899 04:35:41,758 --> 04:35:43,894 USING THIS SINGLE 12 BY 12, YOU 5900 04:35:43,960 --> 04:35:47,797 CAN RESOLVE THIS TYPE OF LARGE 5901 04:35:47,864 --> 04:35:50,734 VESSELS, AND WHEN WE EXTE EXTEND 5902 04:35:50,800 --> 04:35:52,769 THE FIELD OF VIEW, YOU CAN SEE 5903 04:35:52,836 --> 04:35:54,938 MORE, AND THIS CAN BE EASY TO 5904 04:35:55,005 --> 04:35:56,139 IGNORE FROM A CLINICAL. 5905 04:35:56,206 --> 04:36:03,046 AND ALL THOSE SPROWDZ ARE 5906 04:36:03,113 --> 04:36:05,015 CORRESPONDING TO THE 5907 04:36:05,081 --> 04:36:12,322 CROSS-SHEX-SECTIONAL SCANS, WE N 5908 04:36:12,389 --> 04:36:15,959 VALIDATE NEOVASCULARIZATION. 5909 04:36:16,026 --> 04:36:17,827 SO THE INNER RETINAL SLAB, ALSO 5910 04:36:17,894 --> 04:36:22,299 WE COULD OVERLAID -- BETTER 5911 04:36:22,365 --> 04:36:22,632 IDEA. 5912 04:36:22,699 --> 04:36:26,002 AND COMPARED TO THE 5913 04:36:26,069 --> 04:36:27,871 FLUORESCING -- YOU PROBABLY CAN 5914 04:36:27,938 --> 04:36:32,909 SEE EVEN SOME AREAS ALREADY SHOW 5915 04:36:32,976 --> 04:36:36,947 BY THIS VERY DEFINITIVE OCTA 5916 04:36:37,013 --> 04:36:40,150 SCANS. 5917 04:36:40,216 --> 04:36:44,287 AND THE -- VOLUME -- AND DEEP 5918 04:36:44,354 --> 04:36:47,223 LEARNING RESOLVED FROM THIS 5919 04:36:47,290 --> 04:36:50,727 MODERATE NPBR SCANS VERY TINY 5920 04:36:50,794 --> 04:36:53,263 AREAS, AND THAT'S ACTUALLY -- WE 5921 04:36:53,330 --> 04:36:56,099 JUST APPLIED OUR PREVIOUS DEEP 5922 04:36:56,166 --> 04:36:58,168 LEARNING ALGORITHM ON THOSE WILD 5923 04:36:58,234 --> 04:36:59,369 FIELD SCANS. 5924 04:36:59,436 --> 04:37:01,671 WE DL NOT DO ANY CHANGE JUST 5925 04:37:01,738 --> 04:37:04,741 BECAUSE THOSE WIDE FIELD SCANS 5926 04:37:04,808 --> 04:37:06,376 PROVIDED SUFFICIENT RESOLUTION, 5927 04:37:06,443 --> 04:37:09,346 AND THE RETINAL SIGNALING GAVE 5928 04:37:09,412 --> 04:37:12,949 US A BETTER IDEA ON THE SIGNALS 5929 04:37:13,016 --> 04:37:14,351 CHANGE ON THE WIDE ANGLE 5930 04:37:14,417 --> 04:37:15,452 COMPARED TO THE CONVENTIONAL 5931 04:37:15,518 --> 04:37:16,686 AREAS WE CAN SEE FROM THE 5932 04:37:16,753 --> 04:37:21,691 CLINIC. 5933 04:37:21,758 --> 04:37:24,094 FOR THE -- DEFECT WE ALSO CAN 5934 04:37:24,160 --> 04:37:26,529 REVIEW THOSE -- WE ALSO CAN 5935 04:37:26,596 --> 04:37:29,566 REVIEW THOSE PHOTORECEPTOR LOSS 5936 04:37:29,632 --> 04:37:33,403 FROM THE -- AREAS AND WE ALSO 5937 04:37:33,470 --> 04:37:37,107 BENEFIT FROM THOSE 5938 04:37:37,173 --> 04:37:38,108 CROSS-SECTIONAL, YOU'RE ABLE TO 5939 04:37:38,174 --> 04:37:41,611 SEE PHOTORECEPTOR LOSS. 5940 04:37:41,678 --> 04:37:42,912 CHOROIDAL VASCULATURE ALSO CAN 5941 04:37:42,979 --> 04:37:45,749 BE VISUALIZED DUE TO THE DEEPER 5942 04:37:45,815 --> 04:37:53,289 HIGH PEN TAITION O PENETRATION. 5943 04:37:53,356 --> 04:37:54,891 I WANT TO USE SOME SPECULATION 5944 04:37:54,958 --> 04:37:58,762 ON THE FUTURE TO CONCLUDE MY 5945 04:37:58,828 --> 04:37:59,863 TALK. 5946 04:37:59,929 --> 04:38:01,297 WE ALREADY KNOW THERE IS TWO 5947 04:38:01,364 --> 04:38:02,932 TYPE OF SOFTWARE, VERY 5948 04:38:02,999 --> 04:38:06,002 SUCCESSFUL FOR D.R. SEGMENTATION 5949 04:38:06,069 --> 04:38:07,203 BASED ON THE PHOTO. 5950 04:38:07,270 --> 04:38:10,874 WE REALLY HOPE THOSE WHO ADVANCE 5951 04:38:10,940 --> 04:38:13,443 TO OCT AND OCT CAN DO SOMETHING 5952 04:38:13,510 --> 04:38:16,379 TO HELP, COMBINE WITH AI TO 5953 04:38:16,446 --> 04:38:21,618 HELP, ALSO FOR OTHER TYPE OF -- 5954 04:38:21,684 --> 04:38:24,921 DISEASE, AND THE WIDE FIELD OF 5955 04:38:24,988 --> 04:38:27,957 VIEW MAY GIVE US BETTER 5956 04:38:28,024 --> 04:38:31,694 INFORMATION AND FURTHER COMBINE 5957 04:38:31,761 --> 04:38:33,763 AND INTEGRATE I. 5958 04:38:33,830 --> 04:38:35,965 I WANT TO ACKNOWLEDGE, WE HAVE A 5959 04:38:36,032 --> 04:38:40,537 WONDERFUL COLLABORATOR TEAM FROM 5960 04:38:40,603 --> 04:38:42,405 RETINAL SERVICE AND MENTORS, 5961 04:38:42,472 --> 04:38:45,475 ALSO THE NIH FUNDING SUPPORT AND 5962 04:38:45,542 --> 04:38:47,777 THE BRIGHT FOCUS FOUNDATION 5963 04:38:47,844 --> 04:38:49,312 SUPPORT, AND THE MATERIAL 5964 04:38:49,379 --> 04:38:53,016 SUPPORT, AND THERE IS A 5965 04:38:53,083 --> 04:38:58,154 WONDERFUL SUPPORT FROM OUR TEAM, 5966 04:38:58,221 --> 04:38:58,788 THE LAB. 5967 04:38:58,855 --> 04:39:00,223 I WANT TO STOP OVER HERE. 5968 04:39:00,290 --> 04:39:01,024 THANK YOU SO MUCH. 5969 04:39:01,091 --> 04:39:08,798 [APPLAUSE] 5970 04:39:08,865 --> 04:39:12,068 >> KNE THANK YOU, YALI, FOR THAT 5971 04:39:12,135 --> 04:39:13,136 TOUR DEFORCE. 5972 04:39:13,203 --> 04:39:16,206 IT IS NOW MY PLEASURE TO 5973 04:39:16,272 --> 04:39:26,382 INTRODUCE DR. TOCO CHUI. 5974 04:39:26,449 --> 04:39:28,251 SHE ALSO CODIRECTS THE ADVANCED 5975 04:39:28,318 --> 04:39:30,987 RETINAL IMAGING LABORATORY WITH 5976 04:39:31,054 --> 04:39:32,956 PROFESSOR RICH ROSEN, SO TWO 5977 04:39:33,022 --> 04:39:35,125 GIANTS IN ONE SPACE. 5978 04:39:35,191 --> 04:39:35,592 TOCO? 5979 04:39:35,658 --> 04:39:45,902 COME ON OVER. 5980 04:39:53,243 --> 04:39:54,511 >> HELLO, EVERYONE. 5981 04:39:54,577 --> 04:39:54,944 HOW ARE YOU? 5982 04:39:55,011 --> 04:39:57,013 IT IS A GREAT HONOR AND A 5983 04:39:57,080 --> 04:39:58,882 PRIVILEGE TO PARTICIPATE IN 5984 04:39:58,948 --> 04:40:00,183 TODAY'S SYMPOSIUM. 5985 04:40:00,250 --> 04:40:03,786 I WOULD LIKE TO CONGRATULATE 5986 04:40:03,853 --> 04:40:06,322 JIM, DAVID AND ERIC FOR THEIR 5987 04:40:06,389 --> 04:40:07,524 VERY WELL-DESERVED SUCCESS OF 5988 04:40:07,590 --> 04:40:09,259 THE INVENTION OF OCT. 5989 04:40:09,325 --> 04:40:11,794 IT IS TRULY REVOLUTIONARY IN THE 5990 04:40:11,861 --> 04:40:13,763 FIELD OF OCULAR HEALTHCARE AND 5991 04:40:13,830 --> 04:40:14,964 CLINICAL RESEARCH. 5992 04:40:15,031 --> 04:40:17,467 AND TODAY, I WILL BE SHOWING YOU 5993 04:40:17,534 --> 04:40:24,807 HOW OUR LAB USES O.C.T. ANG 5994 04:40:24,874 --> 04:40:28,211 YOGRAPHY TO EVALUATE 5995 04:40:28,278 --> 04:40:29,279 VASO-OCCLUSION DYNAMICS IN 5996 04:40:29,345 --> 04:40:30,580 PATIENTS WITH SICKLE CELL 5997 04:40:30,647 --> 04:40:30,813 DISEASE. 5998 04:40:30,880 --> 04:40:32,348 I WOULD LIKE TO ACKNOWLEDGE THE 5999 04:40:32,415 --> 04:40:34,751 MANY MEMBERS OF MY TEAM AND 6000 04:40:34,817 --> 04:40:35,952 COLLABORATORS WHO MADE THIS 6001 04:40:36,019 --> 04:40:39,455 PRESENTATION POSSIBLE. 6002 04:40:39,522 --> 04:40:41,858 I WOULD ALSO LIKE TO THANK THE 6003 04:40:41,925 --> 04:40:43,293 VERY GENEROUS SUPPORT FROM THESE 6004 04:40:43,359 --> 04:40:47,030 FUNDING SOURCES, ESPECIALLY THE 6005 04:40:47,096 --> 04:40:48,431 NATIONAL EYE INSTITUTE AND THE 6006 04:40:48,498 --> 04:40:50,934 NATIONAL HEART, LUNG AND BLOOD 6007 04:40:51,000 --> 04:40:52,902 INSTITUTE FOR THE MAJOR SUPPORT 6008 04:40:52,969 --> 04:40:53,903 OF OUR SICKLE CELL DISEASE 6009 04:40:53,970 --> 04:40:56,406 RESEARCH. 6010 04:40:56,472 --> 04:40:57,707 OKAY. 6011 04:40:57,774 --> 04:41:00,009 SO A VERY SHORT INTRODUCTION 6012 04:41:00,076 --> 04:41:02,212 ABOUT SICKLE CELL DISEASE, SCD. 6013 04:41:02,278 --> 04:41:06,149 IT IS THE MOST COMMON INHERITED 6014 04:41:06,216 --> 04:41:08,451 BLOOD DISORDER. 6015 04:41:08,518 --> 04:41:13,690 ABNORMAL HEMOGLOBIN IN SICKLE 6016 04:41:13,756 --> 04:41:17,060 CELLS BECOME VERY HARD AND LOOK 6017 04:41:17,126 --> 04:41:17,727 LIKE A SICKLE. 6018 04:41:17,794 --> 04:41:20,997 TODAY I WILL SHOW YOU HOW WE 6019 04:41:21,064 --> 04:41:24,067 VALIDATE CROSS-SECTIONALLY -- IN 6020 04:41:24,133 --> 04:41:25,935 SICKLE CELL DISEASE PATIENTS AND 6021 04:41:26,002 --> 04:41:29,439 TO MONITOR THE TREATMENT EFFECT 6022 04:41:29,505 --> 04:41:32,609 OF HYDROXYUREA AND CRISPR BASED 6023 04:41:32,675 --> 04:41:33,910 GENE EDITING USING CLINICAL 6024 04:41:33,977 --> 04:41:36,779 OCTA. 6025 04:41:36,846 --> 04:41:40,383 SO SICKLE HEMOGLOBIN FIBER 6026 04:41:40,450 --> 04:41:41,684 FORMATION WITHIN RED BLOOD CELLS 6027 04:41:41,751 --> 04:41:44,854 LEADS TO AN INCREASE IN CELL 6028 04:41:44,921 --> 04:41:46,823 STIFFNESS AND BLOOD VISCOSITY. 6029 04:41:46,889 --> 04:41:51,861 AND THE FORMATION OF THESE 6030 04:41:51,928 --> 04:41:55,698 FIBERS STIFFEN AND CAN CHANGE 6031 04:41:55,765 --> 04:41:57,767 THE CELL'S MORPHOLOGY TO SICKLE 6032 04:41:57,834 --> 04:42:00,737 SHAPE. 6033 04:42:00,803 --> 04:42:03,573 THE FORMED CELLS CAN INJURE 6034 04:42:03,640 --> 04:42:05,642 BLOOD VESSELS IN THE EYE. 6035 04:42:05,708 --> 04:42:08,478 AS SEEN IN THIS ANIMATION ON THE 6036 04:42:08,544 --> 04:42:10,880 LEFT, BLOOD VESSELS CAN GET 6037 04:42:10,947 --> 04:42:14,183 BLUNTED BY SICKLE CELLS, CAUSING 6038 04:42:14,250 --> 04:42:14,951 INTERMITTENT PERFUSION OR 6039 04:42:15,018 --> 04:42:17,020 PERMANENT OCCLUSION. 6040 04:42:17,086 --> 04:42:19,956 AND WE HYPOTHESIZE THAT PRIOR TO 6041 04:42:20,023 --> 04:42:21,724 PERMANENT OCCLUSION, MONITORING 6042 04:42:21,791 --> 04:42:24,894 THE FREQUENCY OF INTERMITTENT 6043 04:42:24,961 --> 04:42:27,730 PERFUSION MAY HAVE PROGNOSTIC 6044 04:42:27,797 --> 04:42:29,365 VALUE FOR ASSESSING SICKLE CELL 6045 04:42:29,432 --> 04:42:30,466 DISEASE ACTIVITY. 6046 04:42:30,533 --> 04:42:32,435 AND I WOULD LIKE TO DRAWL YOUR 6047 04:42:32,502 --> 04:42:34,304 ATTENTION TO THE BACKGROUND 6048 04:42:34,370 --> 04:42:37,707 IMAGE HERE, WHICH IS A WILD 6049 04:42:37,774 --> 04:42:40,610 FIELD OCTA IMAGE THAT WE 6050 04:42:40,677 --> 04:42:42,345 OBTAINED RECENTLY ON A PATIENT 6051 04:42:42,412 --> 04:42:44,881 WITH SICKLE CELL RETINOPATHY AND 6052 04:42:44,947 --> 04:42:45,415 NEOVASCULARIZATION IN THE 6053 04:42:45,481 --> 04:42:48,384 PERIPHERY. 6054 04:42:48,451 --> 04:42:51,220 SO BY NOW, WE ALL -- WE SHOULD 6055 04:42:51,287 --> 04:42:55,024 ALL KNOW THAT O.C.T. IS A 6056 04:42:55,091 --> 04:42:59,095 NONINVASIVE AND DYE-FREE IMAGING 6057 04:42:59,162 --> 04:42:59,395 TECHNIQUE. 6058 04:42:59,462 --> 04:43:02,932 ON THE RIGHT IT'S A FULL 6059 04:43:02,999 --> 04:43:08,504 VASCULAR OCT ANG YOGRAPHY. AND 6060 04:43:08,571 --> 04:43:12,108 IN HERE IT'S A COLOR-CODED OCTA, 6061 04:43:12,175 --> 04:43:15,144 WHICH SHOWS THE FLEE DIFFERENT 6062 04:43:15,211 --> 04:43:16,679 RETINAL CAPILLARY LAYERS. 6063 04:43:16,746 --> 04:43:20,983 AND THIS IS A 3D RENDER OF MICRO 6064 04:43:21,050 --> 04:43:22,719 VASCULATURE OF THE SAME CONTROL 6065 04:43:22,785 --> 04:43:26,322 SUBJECT, AND THE CENTER SHOWS 6066 04:43:26,389 --> 04:43:27,857 THE -- WITH SURROUNDING VASCULAR 6067 04:43:27,924 --> 04:43:30,159 NETWORK GOING FROM THE 6068 04:43:30,226 --> 04:43:31,361 SUPERFICIAL LAYER TO THE DEEP 6069 04:43:31,427 --> 04:43:34,630 LAYER. 6070 04:43:34,697 --> 04:43:37,600 I HOPE YOU CAN TELL THAT THESE 6071 04:43:37,667 --> 04:43:41,137 ARE NOT O.C.T. IMAGES. 6072 04:43:41,204 --> 04:43:45,942 THIS IS A SCREENSHOT FROM THE 6073 04:43:46,008 --> 04:43:47,710 LASKER DEBAKEY AWARD YOUTUBE 6074 04:43:47,777 --> 04:43:49,579 VIDEO WHICH I EDITED TO MAKE TWO 6075 04:43:49,645 --> 04:43:50,546 SLIGHTLY DIFFERENT IMAGES. 6076 04:43:50,613 --> 04:43:52,949 BY THE WAY, PLEASE GO WATCH THIS 6077 04:43:53,015 --> 04:43:53,816 YOUTUBE VIDEO WHEN YOU HAVE 6078 04:43:53,883 --> 04:43:54,717 TIME. 6079 04:43:54,784 --> 04:43:56,486 THE PRODUCTION IS EXCELLENT. 6080 04:43:56,552 --> 04:43:58,221 BUT DON'T WATCH IT RIGHT NOW. 6081 04:43:58,287 --> 04:43:59,455 JUST STAY WITH US. 6082 04:43:59,522 --> 04:44:01,190 OKAY? 6083 04:44:01,257 --> 04:44:02,625 [LAUGHTER ?CHT TRUST ME, THE 6084 04:44:02,692 --> 04:44:06,863 VIDEO IS GREAT. 6085 04:44:06,929 --> 04:44:08,531 SO INTERMITTENT PERFUSION 6086 04:44:08,598 --> 04:44:09,632 IMAGING AND QUANTIFICATION 6087 04:44:09,699 --> 04:44:10,933 APPROACH THAT I'M GOING TO TALK 6088 04:44:11,000 --> 04:44:13,436 ABOUT WILL ACTUALLY -- WERE 6089 04:44:13,503 --> 04:44:17,273 ACTUALLY INSPIRED BY MY FAVORITE 6090 04:44:17,340 --> 04:44:18,374 CHILDHOOD GAME, SPOT THE 6091 04:44:18,441 --> 04:44:18,708 DIFFERENCE. 6092 04:44:18,775 --> 04:44:20,209 TO YOU GUYS KNOW ABOUT THIS 6093 04:44:20,276 --> 04:44:20,777 GAME? 6094 04:44:20,843 --> 04:44:21,110 YES? 6095 04:44:21,177 --> 04:44:21,377 EXCELLENT. 6096 04:44:21,444 --> 04:44:25,681 IN ORDER TO SPOT THE DIFFERENCES 6097 04:44:25,748 --> 04:44:27,550 WE NEED TO GO BACK AND FORTH 6098 04:44:27,617 --> 04:44:28,885 BETWEEN THESE TWO IMAGES, RIGHT? 6099 04:44:28,951 --> 04:44:31,187 CAN YOU TELL ME THE THREE 6100 04:44:31,254 --> 04:44:36,526 DIFFERENCES ON DAVID, JIM AND 6101 04:44:36,592 --> 04:44:38,060 ERIC CARTOON CHARACTERS? 6102 04:44:38,127 --> 04:44:39,162 YOU CAN JUST SHOUT OUT THE 6103 04:44:39,228 --> 04:44:39,829 ANSWER. 6104 04:44:39,896 --> 04:44:41,798 YES, EXCELLENT! 6105 04:44:41,864 --> 04:44:42,165 CONGRATULATIONS. 6106 04:44:42,231 --> 04:44:47,637 LEVEL UP. 6107 04:44:47,703 --> 04:44:52,508 SO I'M -- REVIEW THE DIFFERENCES 6108 04:44:52,575 --> 04:44:56,279 LIKE THIS. 6109 04:44:56,345 --> 04:44:57,580 TO FURTHER CHARACTERIZE THE 6110 04:44:57,647 --> 04:45:00,450 DIFFERENCES OF FEATURES THAT 6111 04:45:00,516 --> 04:45:03,286 ONLY APPEARED IN IMAGE ONE ARE 6112 04:45:03,352 --> 04:45:04,587 COLORED IN RED AND FEATURES 6113 04:45:04,654 --> 04:45:07,123 APPEAR ONLY IN IMAGE TWO ARE 6114 04:45:07,190 --> 04:45:09,959 COLORED IN CYAN. 6115 04:45:10,026 --> 04:45:13,362 SO HERE ARE TWO AVERAGE OCTA 6116 04:45:13,429 --> 04:45:15,832 SCANS OBTAINED AT BASELINE IN 6117 04:45:15,898 --> 04:45:17,967 ONE HOUR FOLLOW-UP IN A SICKLE 6118 04:45:18,034 --> 04:45:22,772 CELL PATIENT WITH HBSS GENOTYPE. 6119 04:45:22,839 --> 04:45:23,739 NOW, LET'S SPOT THE DIFFERENCES 6120 04:45:23,806 --> 04:45:26,175 IN THESE TWO AVERAGE OCTAs. 6121 04:45:26,242 --> 04:45:26,843 NEAR-INFRARED ONE WOULD LIKE TO 6122 04:45:26,909 --> 04:45:28,244 GIVE IT A TRY? 6123 04:45:28,311 --> 04:45:31,414 I CAN SEE SOME OF YOU ARE 6124 04:45:31,481 --> 04:45:33,516 ACTUALLY SHAKING YOUR HEADS. 6125 04:45:33,583 --> 04:45:34,617 YES, I DON'T BLAME YOU. 6126 04:45:34,684 --> 04:45:36,352 IT'S NOT EASY, RIGHT? 6127 04:45:36,419 --> 04:45:39,755 OKAY. 6128 04:45:39,822 --> 04:45:42,091 SO TO OBJECTIVELY IDENTIFY 6129 04:45:42,158 --> 04:45:45,027 PERFUSION DIFFERENCES OVER ONE 6130 04:45:45,094 --> 04:45:46,762 HOUR, WE FIRST COMPUTED THE 6131 04:45:46,829 --> 04:45:53,669 NORMAL VAIR YAI VARIATION IN PIL 6132 04:45:53,736 --> 04:45:55,004 INTENSITY DIFFERENCE -- 6133 04:45:55,071 --> 04:45:55,872 UNAFFECTED CONTROLS. 6134 04:45:55,938 --> 04:45:59,175 AND THEN DETERMINE THE -- FOR 6135 04:45:59,242 --> 04:46:00,610 NON-PERFUSION AND REPERFUSION 6136 04:46:00,676 --> 04:46:02,712 OVER ONE HOUR. 6137 04:46:02,778 --> 04:46:05,982 AND WE THEN USED THE CUTOFFS TO 6138 04:46:06,048 --> 04:46:08,951 IDENTIFY CAPILLARY -- AT NORMAL 6139 04:46:09,018 --> 04:46:10,052 PERFUSION IN SICKLE CELL DISEASE 6140 04:46:10,119 --> 04:46:12,455 PATIENTS. 6141 04:46:12,522 --> 04:46:13,789 CAPILLARY SEDIMENTS APPEARED 6142 04:46:13,856 --> 04:46:15,958 ONLY AT THE BASELINE WERE 6143 04:46:16,025 --> 04:46:19,028 IDENTIFIED AS NON-PERFUSION AND 6144 04:46:19,095 --> 04:46:20,329 CAPILLARY SEDIMENTS APPEARED 6145 04:46:20,396 --> 04:46:23,065 ONLY AT THE FOLLOW-UP VISIT OR 6146 04:46:23,132 --> 04:46:26,369 FOLLOW UP SECTION, WERE DEFINED 6147 04:46:26,435 --> 04:46:27,236 AS REPERFUSION. 6148 04:46:27,303 --> 04:46:30,439 SO ON THE RIGHT NOW, IT'S AN 6149 04:46:30,506 --> 04:46:32,608 INTERMITTENT PERFUSION MAP WHICH 6150 04:46:32,675 --> 04:46:34,243 SHOWS CAPILLARY NON-PERFUSION IN 6151 04:46:34,310 --> 04:46:37,113 RED, AND REPERFUSION IN CYA FL 6152 04:46:37,179 --> 04:46:38,748 COLOR. 6153 04:46:38,814 --> 04:46:39,749 OKAY. 6154 04:46:39,815 --> 04:46:42,585 SO HERE IT ANOTHER EXAMPLE WE 6155 04:46:42,652 --> 04:46:46,956 SHOWED -- WHICH SHOWS BOTH THE 6156 04:46:47,023 --> 04:46:50,059 MACULA AND THE -- RETINA. 6157 04:46:50,126 --> 04:46:52,328 SO ACTUALLY TOGGLING BACK AND 6158 04:46:52,395 --> 04:46:56,699 FORTH WITH AN INTERMITTENT -- AT 6159 04:46:56,766 --> 04:46:59,669 THE END OF THE VIDEO, AGAIN, THE 6160 04:46:59,735 --> 04:47:03,506 INTERMITTENT PERFUSION MAP SHOWS 6161 04:47:03,573 --> 04:47:06,576 REPERFUSION IN CYAN. 6162 04:47:06,642 --> 04:47:09,779 THIS MAP PROVIDES INSTANT 6163 04:47:09,845 --> 04:47:10,646 QUALITATIVE INTERPRETATION OF 6164 04:47:10,713 --> 04:47:13,583 THE PERFUSION STATUS OVER ONE 6165 04:47:13,649 --> 04:47:17,186 HOUR. 6166 04:47:17,253 --> 04:47:19,722 HERE WE CAN SEE THE INCREASING 6167 04:47:19,789 --> 04:47:22,258 INTERMITTENT PERFUSION WITH 6168 04:47:22,325 --> 04:47:23,125 INCREASING DISEASE ACTIVITY WITH 6169 04:47:23,192 --> 04:47:25,628 THE HIGHEST LEVEL OF 6170 04:47:25,695 --> 04:47:27,730 INTERMITTENT PERFUSION FOUND IN 6171 04:47:27,797 --> 04:47:29,699 HBSS GENOTYPE. 6172 04:47:29,765 --> 04:47:31,000 OKAY. 6173 04:47:31,067 --> 04:47:33,970 SO TO QUANTIFY THE INTERMITTENT 6174 04:47:34,036 --> 04:47:35,838 PERFUSION CHANGES, WE CALCULATED 6175 04:47:35,905 --> 04:47:40,543 THE PERCENT OF PIXELS WITH 6176 04:47:40,610 --> 04:47:42,845 NON-PERFUSION AND WREE PERFUSION 6177 04:47:42,912 --> 04:47:45,915 OVER ONE HOUR. 6178 04:47:45,982 --> 04:47:47,984 INTERMITTENT PERFUSION INDEX WAS 6179 04:47:48,050 --> 04:47:50,086 DEFINED AS THE TOTAL PERCENTAGE 6180 04:47:50,152 --> 04:47:53,155 OF NON-PERFUSION AND REPERFUSION 6181 04:47:53,222 --> 04:47:55,124 AREAS IDENTIFIED USING OUR 6182 04:47:55,191 --> 04:47:56,659 NORMATIVE BASE IMAGE PROCESSING 6183 04:47:56,726 --> 04:47:58,628 APPROACH. 6184 04:47:58,694 --> 04:48:01,163 SIGNIFICANT DIFFERENCES WERE 6185 04:48:01,230 --> 04:48:03,232 OBSERVED BETWEEN CONTROLS AND 6186 04:48:03,299 --> 04:48:06,068 PATIENT WITH HBSC AND HBSS 6187 04:48:06,135 --> 04:48:08,938 GENOTYPES. 6188 04:48:09,005 --> 04:48:11,774 WE ALSO FOLLOWED THREE SICKLE 6189 04:48:11,841 --> 04:48:14,076 CELL PATIENTS BEFORE AND AFTER 6190 04:48:14,143 --> 04:48:14,610 TREATMENT. 6191 04:48:14,677 --> 04:48:17,146 AS YOU CAN SEE ON THE RIGHT SIDE 6192 04:48:17,213 --> 04:48:19,548 OF THIS BOX PLOT, INTERMITTENT 6193 04:48:19,615 --> 04:48:21,317 PERFUSION INDEX WAS OBVIOUSLY 6194 04:48:21,384 --> 04:48:24,754 LOWER AFTER TREATMENT. 6195 04:48:24,820 --> 04:48:29,125 AND HERE IS A TREATMENT-NAIVE 6196 04:48:29,191 --> 04:48:30,626 HBSS PATIENTS IMAGE PRIOR TO THE 6197 04:48:30,693 --> 04:48:33,295 INITIATION OF HYDROXYUREA. 6198 04:48:33,362 --> 04:48:36,132 AGAIN THE TWO MACULAR OCTA 6199 04:48:36,198 --> 04:48:38,868 TOGGLING BACK AND FORTH WITH THE 6200 04:48:38,934 --> 04:48:39,769 INTERMITTENT PERFUSION MAP 6201 04:48:39,835 --> 04:48:43,272 SHOWING AT THE END OF THE VIDEO, 6202 04:48:43,339 --> 04:48:45,007 AND INTER MITT ENT PERFUSION 6203 04:48:45,074 --> 04:48:47,877 INDEX WAS ABOUT 3% BEFORE 6204 04:48:47,943 --> 04:48:48,310 TREATMENT. 6205 04:48:48,377 --> 04:48:52,748 ON THE RIGHT NOW YOU CAN SEE THE 6206 04:48:52,815 --> 04:48:56,419 EFFECT OF HYDROXYUREA TWO MONTHS 6207 04:48:56,485 --> 04:48:57,086 AFTER TREATMENT. 6208 04:48:57,153 --> 04:49:01,057 IT WORKS BY MAKING THE RETINAL 6209 04:49:01,123 --> 04:49:02,591 CELL MORE FLEXIBLE, THEREFORE 6210 04:49:02,658 --> 04:49:03,225 IMPROVING BLOOD FLOW. 6211 04:49:03,292 --> 04:49:07,063 THERE'S A SIX-TIME REDUCTION IN 6212 04:49:07,129 --> 04:49:08,297 INTERMITTENT PERFUSION EVENT 6213 04:49:08,364 --> 04:49:10,232 SINCE WITH THIS NORMATIVE BASE 6214 04:49:10,299 --> 04:49:14,203 IMAGE PROCESSING APPROACH. 6215 04:49:14,270 --> 04:49:20,543 AND NALD IN ADDITION TO OCTA IG 6216 04:49:20,609 --> 04:49:25,715 WE ALSO IMPLEDGE OF ALLEGIANCED 6217 04:49:25,781 --> 04:49:29,285 THIS -- ONE THING WE'RE NOT ABLE 6218 04:49:29,351 --> 04:49:32,154 TO SEE IN OCTA IS THE ACTUAL 6219 04:49:32,221 --> 04:49:34,356 BLOOD CELL MOTION. 6220 04:49:34,423 --> 04:49:40,796 AND ADAPTIVE OPTICS -- OF BLOOD 6221 04:49:40,863 --> 04:49:43,432 CELLS AND REVIEW BLOOD FREL 6222 04:49:43,499 --> 04:49:45,501 DYNAMICS, UNAVAILABLE FROM OCTA. 6223 04:49:45,568 --> 04:49:48,471 AND IN PARTICULAR, ADAPTIVE 6224 04:49:48,537 --> 04:49:51,674 OPTICS IMAGING CAN PROVIDE 6225 04:49:51,741 --> 04:49:53,309 VISUALIZATION OF RETINAL CELLS 6226 04:49:53,375 --> 04:49:55,044 IN PERFUSED AND NON-PERFUSED 6227 04:49:55,111 --> 04:49:55,845 BLOOD VESSEL. 6228 04:49:55,911 --> 04:50:02,051 SO BASELINE ADAPTIVE OPTICS IS 6229 04:50:02,118 --> 04:50:06,222 SHOWN TWOP MONTHS AFTER 6230 04:50:06,288 --> 04:50:10,059 HYDROXYUREA IT ON THE RIGHT. 6231 04:50:10,126 --> 04:50:13,662 -- REVIEWED TWO OCCLUDED 6232 04:50:13,729 --> 04:50:17,166 CAPILLARIES WITH -- AND 6233 04:50:17,233 --> 04:50:17,833 SLUDGING. 6234 04:50:17,900 --> 04:50:19,902 AND THESE WERE REPERFUSED TWO 6235 04:50:19,969 --> 04:50:22,104 MONTHS AFTER HYDROXYUREA 6236 04:50:22,171 --> 04:50:30,579 TREATMENT. 6237 04:50:30,646 --> 04:50:31,714 INTERESTINGLY -- WAS OBSERVED AT 6238 04:50:31,781 --> 04:50:36,719 A PREVIOUSLY OBSERVED VO 6239 04:50:36,786 --> 04:50:44,493 CAPILLARY -- ADAPTIVE -- 6240 04:50:44,560 --> 04:50:45,394 IMPROVED BLOOD FLOW AFTER 6241 04:50:45,461 --> 04:50:45,828 TREATMENT. 6242 04:50:45,895 --> 04:50:47,363 THIS IS A SICKLE CELL PATIENT 6243 04:50:47,429 --> 04:50:52,201 IMAGE BEFORE CRISPR. 6244 04:50:52,268 --> 04:50:54,036 -- INDEX WAS ABOUT 3%. 6245 04:50:54,103 --> 04:50:57,573 IN SIX MONTHS AFTER CRISPR, OCTA 6246 04:50:57,640 --> 04:51:00,209 SHOWS FOUR TIMES REDUCTION IN 6247 04:51:00,276 --> 04:51:02,044 INTERMITTENT PERFUSION INDEX. 6248 04:51:02,111 --> 04:51:04,713 AND THIS CASE SUGGESTS THAT 6249 04:51:04,780 --> 04:51:06,182 CRISPR BASE GENE EDITING IN 6250 04:51:06,248 --> 04:51:09,518 SICKLE CELL DISEASE WHILE 6251 04:51:09,585 --> 04:51:11,487 SUBSTANTIALLY EFFECTIVE MAY NOT 6252 04:51:11,554 --> 04:51:13,889 COMPLETELY ELIMINATE 6253 04:51:13,956 --> 04:51:16,091 VASO-OCCLUSIVE ACTIVITY. 6254 04:51:16,158 --> 04:51:19,495 OKAY. 6255 04:51:19,562 --> 04:51:22,865 SO TO VALIDATE INTERMITTENT 6256 04:51:22,932 --> 04:51:24,733 PERFUSION INDEX AS OBJECTIVE 6257 04:51:24,800 --> 04:51:25,534 INDICATOR OF DISEASE ACTIVITY 6258 04:51:25,601 --> 04:51:28,137 AND TREATMENT SUCCESS, WE WILL 6259 04:51:28,204 --> 04:51:32,508 MONITOR OUR PATIENTS FOR FIVE 6260 04:51:32,575 --> 04:51:33,742 YEARS USING OCTA. 6261 04:51:33,809 --> 04:51:35,477 WE JUST FINISHED OUR FIRST YEAR 6262 04:51:35,544 --> 04:51:36,812 TIME POINT AND HERE IT'S AN 6263 04:51:36,879 --> 04:51:38,781 EXAMPLE OF INTERMITTENT 6264 04:51:38,848 --> 04:51:40,749 PERFUSION OVER ONE YEAR IN A 6265 04:51:40,816 --> 04:51:46,555 PATIENT WITH HBSS GENOTYPE. 6266 04:51:46,622 --> 04:51:48,958 OUR HYPOTHESIS IS THAT 6267 04:51:49,024 --> 04:51:50,192 INTERMITTENT PERFUSION INDEX 6268 04:51:50,259 --> 04:51:51,594 WILL CORRELATE MORE STRONGLY 6269 04:51:51,660 --> 04:51:52,895 WITH SICKLE CELL DISEASE 6270 04:51:52,962 --> 04:51:53,562 SEVERITY. 6271 04:51:53,629 --> 04:51:55,865 THEN ANY OTHER CURRENTLY 6272 04:51:55,931 --> 04:51:57,299 AVAILABLE BIOMARKER. 6273 04:51:57,366 --> 04:52:00,236 THESO HOPEFULLY I WILL HAVE MORE 6274 04:52:00,302 --> 04:52:01,470 PRELIMINARY DATA TO SHOW YOU 6275 04:52:01,537 --> 04:52:08,043 NEXT YEAR. 6276 04:52:08,110 --> 04:52:09,879 THIS IS A 3D RETINAL PERFUSION 6277 04:52:09,945 --> 04:52:10,646 OVER ONE YEAR OF THE SAME 6278 04:52:10,713 --> 04:52:10,880 PATIENT. 6279 04:52:10,946 --> 04:52:12,748 HERE YOU CAN SEE MORE CLEARLY 6280 04:52:12,815 --> 04:52:15,584 THE PRESENCE OF INTERMITTENT 6281 04:52:15,651 --> 04:52:16,919 PERFUSION AT DIFFERENT CAPILLARY 6282 04:52:16,986 --> 04:52:19,521 LAYERS. 6283 04:52:19,588 --> 04:52:22,725 ARE YOU ABLE TO SEE IT OKAY? 6284 04:52:22,791 --> 04:52:23,525 OKAY. 6285 04:52:23,592 --> 04:52:26,228 SO THIS IS A MOVIE OF SHOWING 6286 04:52:26,295 --> 04:52:28,530 RETINAL INTERMITTENT PERFUSION 6287 04:52:28,597 --> 04:52:30,399 ONE YEAR -- OVER ONE YEAR IN A 6288 04:52:30,466 --> 04:52:33,035 PATIENT WITH HBSC GENOTYPE. 6289 04:52:33,102 --> 04:52:37,973 WE CAN SEE MULTIPLE CAPILLARY 6290 04:52:38,040 --> 04:52:39,275 SEDIMENT WITH INTERMITTENT 6291 04:52:39,341 --> 04:52:40,142 PERFUSION. 6292 04:52:40,209 --> 04:52:44,413 ON THE RIGHT, IT THE 6293 04:52:44,480 --> 04:52:45,047 CORRESPONDING CHORIOCAPILLARIS 6294 04:52:45,114 --> 04:52:45,247 LAYER. 6295 04:52:45,314 --> 04:52:46,282 I'M A LITTLE EMBARRASSED TO SHOW 6296 04:52:46,348 --> 04:52:51,220 YOU RIGHT NOW AFTER SEEING 6297 04:52:51,287 --> 04:52:53,622 JOLIN'S AOCT CHORIOCAPILLARIS 6298 04:52:53,689 --> 04:52:55,925 IMAGE, BUT THAT'S WHY I WANT TO 6299 04:52:55,991 --> 04:52:58,360 EMPHASIZE THAT THIS IS DONE 6300 04:52:58,427 --> 04:53:02,097 USING CLINICAL OCTA, SO IT'S 6301 04:53:02,164 --> 04:53:05,467 NOT -- IT'S NOT ADAPTABLE -- 6302 04:53:05,534 --> 04:53:11,040 IT'S CLINICAL OCTA. 6303 04:53:11,106 --> 04:53:13,108 OKAY. 6304 04:53:13,175 --> 04:53:15,878 SO ON THE RIGHT, IT'S A 6305 04:53:15,945 --> 04:53:17,279 CORRESPONDING CHORIOCAPILLARIS 6306 04:53:17,346 --> 04:53:18,847 LAYER, SO OVERALL, THE PERFUSION 6307 04:53:18,914 --> 04:53:21,116 STATUS WAS QUITE CONSISTENT OVER 6308 04:53:21,183 --> 04:53:23,986 ONE YEAR. 6309 04:53:24,053 --> 04:53:24,887 EXCEPT WITH SEVERAL LOCATIONS 6310 04:53:24,954 --> 04:53:26,956 YOU CAN SEE SOME MINOR 6311 04:53:27,022 --> 04:53:28,157 INTERMITTENT PERFUSION AS 6312 04:53:28,223 --> 04:53:30,059 INDICATED BY THE YELLOW ARROWS 6313 04:53:30,125 --> 04:53:33,329 HERE. 6314 04:53:33,395 --> 04:53:36,699 AND THIS IS A MORE CONVINCING 6315 04:53:36,765 --> 04:53:39,034 EXAMPLE OF CHORIOCAPILLARIS 6316 04:53:39,101 --> 04:53:40,202 INTERMITTENT PERFUSION OVER ONE 6317 04:53:40,269 --> 04:53:40,469 YEAR. 6318 04:53:40,536 --> 04:53:45,074 DO YOU SEE THOSE DARK REGIONS 6319 04:53:45,140 --> 04:53:46,909 FLICKERING. 6320 04:53:46,976 --> 04:53:49,812 THOSE ARE -- AT THE 6321 04:53:49,878 --> 04:53:50,446 CHORIOCAPILLARIS LAYER. 6322 04:53:50,512 --> 04:53:52,848 SO TO MAKE SURE THAT THESE 6323 04:53:52,915 --> 04:53:53,983 CHORIOCAPILLARIS INTERMITTENT 6324 04:53:54,049 --> 04:53:55,451 PERFUSION AREAS ARE REAL, NOT 6325 04:53:55,517 --> 04:54:00,089 DUE TO SOME OCT'S SEDIMENTATION 6326 04:54:00,155 --> 04:54:04,460 ERROR, WE ALSO REVIEWED THE 6327 04:54:04,526 --> 04:54:07,763 STRUCTURE O.C.T. LOCATED RIGHT 6328 04:54:07,830 --> 04:54:10,165 BELOW THE -- BRAIN SHOWN ON THE 6329 04:54:10,232 --> 04:54:11,033 LEFT PANEL HERE. 6330 04:54:11,100 --> 04:54:19,808 SO AS YOU CAN SEE, OVER ONE 6331 04:54:19,875 --> 04:54:21,477 YEAR, SUGGESTING THE 6332 04:54:21,543 --> 04:54:22,778 INTERMITTENT PERFUSION 6333 04:54:22,845 --> 04:54:24,747 VISUALIZED ON THE OCTA VIEW NOT 6334 04:54:24,813 --> 04:54:30,019 DUE TO SOME SEGMENTATION ERROR. 6335 04:54:30,085 --> 04:54:31,453 DOES IT MAKE SENSE? 6336 04:54:31,520 --> 04:54:31,887 OKAY. 6337 04:54:31,954 --> 04:54:33,956 HERE IT'S ANOTHER EXAMPLE WITH 6338 04:54:34,023 --> 04:54:44,500 EVEN MORE SEVERE INTER -- QK 6339 04:54:45,934 --> 04:54:47,236 DROPOUTS, I LOVE THIS VIDEO SO I 6340 04:54:47,302 --> 04:54:48,904 WILL JUST KEEP STALLING. 6341 04:54:48,971 --> 04:54:51,440 ARE YOU ABLE TO SEE INTERMITTENT 6342 04:54:51,507 --> 04:54:52,307 PERFUSION? 6343 04:54:52,374 --> 04:54:55,244 THIS IS ONE YEAR. 6344 04:54:55,310 --> 04:54:57,980 LGBT. 6345 04:54:58,047 --> 04:55:02,384 IN ADDITION TO THE INTERMITTENT 6346 04:55:02,451 --> 04:55:06,889 PERFUSION INDEX, WE ALSO 6347 04:55:06,955 --> 04:55:10,726 MEASURED PERIVASCULAR DENSITY. 6348 04:55:10,793 --> 04:55:13,128 COLORED IN RED AND CYAN 6349 04:55:13,195 --> 04:55:13,896 RESPECTIVELY. 6350 04:55:13,962 --> 04:55:15,297 SO ONE CONTROVERSY IN SICKLE 6351 04:55:15,364 --> 04:55:17,099 CELL DISEASE HAS BEEN THE ACTUAL 6352 04:55:17,166 --> 04:55:19,168 SITE OF OCCLUSION. 6353 04:55:19,234 --> 04:55:24,540 IN SOME ANIMAL STUDIES -- VENUES 6354 04:55:24,606 --> 04:55:26,875 MAY BE THE PREFERENTIAL SITE OF 6355 04:55:26,942 --> 04:55:31,880 OCCLUSION DUE TO THE ADHESION OF 6356 04:55:31,947 --> 04:55:35,284 SITES IN SICKLE CELLS. 6357 04:55:35,350 --> 04:55:37,453 OUR PRELIMINARY O.C.T. FINDINGS, 6358 04:55:37,519 --> 04:55:38,720 HOWEVER, WOULD SUGGEST THE SITE 6359 04:55:38,787 --> 04:55:41,690 WITH HIGH RISK OF VASO-OCCLUSION 6360 04:55:41,757 --> 04:55:46,995 IS ACTUALLY LOCATED IN THE 6361 04:55:47,062 --> 04:55:51,834 CAPILLARY -- RATIO IN PATIENTS 6362 04:55:51,900 --> 04:55:58,207 WITH SICKLE CELL DISEASE. 6363 04:55:58,273 --> 04:56:01,376 HERE WE ARE LOOKING AT 22 OCTA 6364 04:56:01,443 --> 04:56:02,744 MONTAGES COLLECTED OVER ONE 6365 04:56:02,811 --> 04:56:03,178 HOUR. 6366 04:56:03,245 --> 04:56:04,980 SO THIS IS ONE OUR, NOT ONE 6367 04:56:05,047 --> 04:56:07,015 YEAR. 6368 04:56:07,082 --> 04:56:12,087 SO 11 IMAGES AT THE BASELINE 6369 04:56:12,154 --> 04:56:14,823 SECTION AND 11 IMAGES AT THE ONE 6370 04:56:14,890 --> 04:56:16,358 HOUR FOLLOW-UP. 6371 04:56:16,425 --> 04:56:18,994 SO AT BASELINE, WE CAN SEE 6372 04:56:19,061 --> 04:56:22,698 MULTIPLE REGIONS WITH OWE 6373 04:56:22,764 --> 04:56:25,367 CLEUPTION NEAR -- AND THE 6374 04:56:25,434 --> 04:56:26,235 TEMPORO RETINA. 6375 04:56:26,301 --> 04:56:28,537 THESE REGIONS ARE SLOWLY 6376 04:56:28,604 --> 04:56:31,306 REPERFUSED OVER TIME AND WOULD 6377 04:56:31,373 --> 04:56:32,274 COMPLETELY REPERFUSE AFTER ONE 6378 04:56:32,341 --> 04:56:35,544 HOUR. 6379 04:56:35,611 --> 04:56:39,281 AND HERE I TINTED THE ARTERIOLES 6380 04:56:39,348 --> 04:56:40,749 IN RED AND THE VENULES IN 6381 04:56:40,816 --> 04:56:40,983 PURPLE. 6382 04:56:41,049 --> 04:56:45,420 DID YOU NOTICE ANYTHING IN 6383 04:56:45,487 --> 04:56:46,622 COMMON FOR THESE OCCLUDED 6384 04:56:46,688 --> 04:56:51,994 RENALES? 6385 04:56:52,060 --> 04:56:54,663 THEY ARE ALL ASSOCIATED WITH 6386 04:56:54,730 --> 04:56:56,298 ARTERIOLES RATHER THAN VENULES. 6387 04:56:56,365 --> 04:56:59,368 SUGGESTING THAT ARTERIOLE 6388 04:56:59,434 --> 04:57:00,335 CAPILLARY JUNCTION AS THE 6389 04:57:00,402 --> 04:57:01,904 PREFERENTIAL SITE OF 6390 04:57:01,970 --> 04:57:05,607 VASO-OCCLUSIONS. 6391 04:57:05,674 --> 04:57:12,181 SO IN CONCLUSION, OCTA 6392 04:57:12,247 --> 04:57:13,382 ANGIOGRAPHY PRESENTS A PROMISING 6393 04:57:13,448 --> 04:57:14,850 AVENUE IN THE MANAGEMENT OF 6394 04:57:14,917 --> 04:57:15,717 SICKLE CELL DISEASE THROUGH THE 6395 04:57:15,784 --> 04:57:17,452 DEVELOPMENT OF NONINVASIVE 6396 04:57:17,519 --> 04:57:20,255 BIOMARKERS TO PROGNOSTICATE 6397 04:57:20,322 --> 04:57:21,790 PROGRESSION AND MEASURE THE 6398 04:57:21,857 --> 04:57:23,292 RESPONSE TO TREATMENT. 6399 04:57:23,358 --> 04:57:24,693 THANK YOU FOR YOUR ATTENTION. 6400 04:57:24,760 --> 04:57:34,937 [APPLAUSE] 6401 04:57:44,813 --> 04:57:46,515 >> OKAY. 6402 04:57:46,582 --> 04:57:49,151 SO -- AND NOW FOR THE FINAL 6403 04:57:49,218 --> 04:57:50,352 PRESENTATION FROM THIS SESSION, 6404 04:57:50,419 --> 04:57:54,223 I HAVE MYCO-MODERATOR, NADIA 6405 04:57:54,289 --> 04:57:55,857 WAHID, PROFESSOR OF 6406 04:57:55,924 --> 04:57:57,626 OPHTHALMOLOGY AT TUFTS 6407 04:57:57,693 --> 04:57:58,160 UNIVERSITY. 6408 04:57:58,227 --> 04:58:02,664 SHE ALSO IS THE DIRECTOR OF THE 6409 04:58:02,731 --> 04:58:07,069 O.C.T. READING CENTER AND SHE'S 6410 04:58:07,135 --> 04:58:09,137 GOING TO SHARE WITH US OCTA, 6411 04:58:09,204 --> 04:58:10,138 UNDERSTANDING PATHOGENESIS AND 6412 04:58:10,205 --> 04:58:12,241 PROGRESSION OF RETINAL DISEASE, 6413 04:58:12,307 --> 04:58:22,618 FOCUSING ON A.M.D. 6414 04:58:23,885 --> 04:58:25,220 THANK YOU RICH, THANK YOU, MIKE 6415 04:58:25,287 --> 04:58:26,521 AND TO THE NIH FOR ORGANIZING 6416 04:58:26,588 --> 04:58:36,698 THIS. 6417 04:58:41,637 --> 04:58:42,371 I'M STUCK. 6418 04:58:42,437 --> 04:58:43,205 SLIDES NOT FORWARDING. 6419 04:58:43,272 --> 04:58:43,672 THEY ARE NOW. 6420 04:58:43,739 --> 04:58:45,307 HERE ARE MY DISCLOSURES. 6421 04:58:45,374 --> 04:58:47,576 OF NOTE, MY INSTITUTION RECEIVES 6422 04:58:47,643 --> 04:58:49,144 RESEARCH SUPPORT FROM PRETTY 6423 04:58:49,211 --> 04:58:52,314 MUCH, YOU KNOW, AND DEVICES FROM 6424 04:58:52,381 --> 04:58:53,982 PRETTY MUCH ALL OF THE O.C.T. 6425 04:58:54,049 --> 04:58:54,950 DEVICE COMPANIES. 6426 04:58:55,017 --> 04:58:57,185 WE HELP GIVE THEM FEEDBACK THAT 6427 04:58:57,252 --> 04:58:59,588 AIDS IN THE DEVELOPMENT OF THESE 6428 04:58:59,655 --> 04:59:05,494 DEVICES. 6429 04:59:05,560 --> 04:59:06,128 OKAY. 6430 04:59:06,194 --> 04:59:07,596 SO I'D JUST LIKE TO START WITH 6431 04:59:07,663 --> 04:59:08,664 MY ACKNOWLEDGMENTS. 6432 04:59:08,730 --> 04:59:11,300 IT HAS REALLY BEEN A GREAT 6433 04:59:11,366 --> 04:59:13,201 PRIVILEGE TO WORK OVER THE PAST 6434 04:59:13,268 --> 04:59:14,970 DECADE AND A HALF IN 6435 04:59:15,037 --> 04:59:19,975 COLLABORATION WITH PROFESSOR JIM 6436 04:59:20,042 --> 04:59:23,178 FUJ IMOTO'S LAB AT MIT, IT'S 6437 04:59:23,245 --> 04:59:24,179 VERY RARE TO FIND A COLLEAGUE 6438 04:59:24,246 --> 04:59:28,750 LIKE THIS WHO IS BOTH INCREDIBLY 6439 04:59:28,817 --> 04:59:30,419 BRILLIANT, VERY, VERY CAREFUL 6440 04:59:30,485 --> 04:59:31,953 AND INTELLECTUALLY HONEST AND, 6441 04:59:32,020 --> 04:59:34,723 AT THE SAME TIME, AS COLLEGIAL 6442 04:59:34,790 --> 04:59:36,692 AND AS WONDERFUL A PERSON TO 6443 04:59:36,758 --> 04:59:39,027 WORK WITH AS JIM, SO IT REALLY 6444 04:59:39,094 --> 04:59:40,062 HAS BEEN BOTH A PLEASURE AS WELL 6445 04:59:40,128 --> 04:59:41,163 AS A GREAT LEARNING EXPERIENCE 6446 04:59:41,229 --> 04:59:42,164 FOR ME. 6447 04:59:42,230 --> 04:59:45,267 I ALSO WANT TO ACKNOWLEDGE JAY 6448 04:59:45,334 --> 04:59:45,701 DUKER. 6449 04:59:45,767 --> 04:59:47,569 HE HAD STARTED OR WAS INITIALLY 6450 04:59:47,636 --> 04:59:48,804 INVOLVED IN THE COLLABORATION 6451 04:59:48,870 --> 04:59:51,006 WITH JIM AND VERY LIKELY WHEN HE 6452 04:59:51,073 --> 04:59:53,508 BECAME CHAIRPERSON, PASSED THE 6453 04:59:53,575 --> 04:59:56,511 LAB OVER TO ME, PROFESSOR 6454 04:59:56,578 --> 05:00:02,217 ROSENFELD, WHO WE'VE HAD A 6455 05:00:02,284 --> 05:00:04,186 PROFESSIONAL -- ALL OF THESE 6456 05:00:04,252 --> 05:00:05,053 STUDIES I'M GOING TO PRESENT 6457 05:00:05,120 --> 05:00:06,355 TODAY AS WELL AS THE CLINICAL 6458 05:00:06,421 --> 05:00:07,389 GROUP AT THE NEW ENGLAND EYE 6459 05:00:07,456 --> 05:00:08,590 CENTER, AND VERY IMPORTANTLY, I 6460 05:00:08,657 --> 05:00:16,365 WANT TO ACKNOWLEDGE THE NIH NEI 6461 05:00:16,431 --> 05:00:17,799 SUPPORT WITHOUT THIS WHICH IT 6462 05:00:17,866 --> 05:00:19,901 WOULDN'T HAVE BEEN POSSIBLE THAT 6463 05:00:19,968 --> 05:00:21,203 HAS ENABLED US TO CONTINUE THIS 6464 05:00:21,269 --> 05:00:22,971 JOURNEY OVER THE PAST LIKE I 6465 05:00:23,038 --> 05:00:24,639 MENTIONED DECADE AND A HALF TO 6466 05:00:24,706 --> 05:00:25,974 BETTER UNDERSTAND DISEASE 6467 05:00:26,041 --> 05:00:27,175 PATHOGENESIS, AND VERY 6468 05:00:27,242 --> 05:00:28,810 IMPORTANTLY HAS LED TO THE NEXT 6469 05:00:28,877 --> 05:00:30,579 GENERATION OF THERAPEUTICS AND 6470 05:00:30,645 --> 05:00:33,115 IS LEADING TO THE DEVELOPMENT OF 6471 05:00:33,181 --> 05:00:35,317 THE FIRST GENERATION OF 6472 05:00:35,384 --> 05:00:36,518 THERAPEUTICS FOR DRY M.D. THAT 6473 05:00:36,585 --> 05:00:37,986 YOU ARE STARTING TO SEE, TWO IN 6474 05:00:38,053 --> 05:00:39,721 CLINIC AT THIS POINT, SO JUST 6475 05:00:39,788 --> 05:00:41,723 REALLY WANT TO CALL THAT OUT, 6476 05:00:41,790 --> 05:00:43,925 THIS HAS BEEN ONE OF THE FASTEST 6477 05:00:43,992 --> 05:00:45,594 TRANSLATIONS FROM BASIC SCIENCE 6478 05:00:45,660 --> 05:00:48,964 INTO THE CLINIC THAT I THINK HAS 6479 05:00:49,030 --> 05:00:50,966 COME OUT IN MEDICINE AND REALLY 6480 05:00:51,032 --> 05:00:52,067 WANT TO ACKNOWLEDGE THE SUPPORT 6481 05:00:52,134 --> 05:00:54,903 THAT WE AND OTHER GROUPS HAVE 6482 05:00:54,970 --> 05:00:59,674 RECEIVED FROM THE NIH, NEI. 6483 05:00:59,741 --> 05:01:01,743 SO TALKING A LITTLE BIT ABOUT 6484 05:01:01,810 --> 05:01:03,845 A.M.D., I'M PRIMARILY GOING 6485 05:01:03,912 --> 05:01:05,647 FOCUS ON OCTA TODAY BECAUSE I 6486 05:01:05,714 --> 05:01:06,615 KNOW YOU'VE HAD TALKS AND ARE 6487 05:01:06,681 --> 05:01:08,150 GOING TO HAVE TALKS ON O.C.T., 6488 05:01:08,216 --> 05:01:11,119 BUT WHEN WE TALK ABOUT GRADING 6489 05:01:11,186 --> 05:01:12,921 OF A.M.D. THERE'S SYSTEMS TO 6490 05:01:12,988 --> 05:01:15,991 GRADE SEVERITY, EARLY, 6491 05:01:16,057 --> 05:01:17,626 INTERMEDIATE, LATE, THERE'S THE 6492 05:01:17,692 --> 05:01:19,428 AREDS CLASSIFICATION AND THE CAM 6493 05:01:19,494 --> 05:01:20,862 GROUP THAT'S PRIMARILY 6494 05:01:20,929 --> 05:01:22,597 O.C.T.-BASED. 6495 05:01:22,664 --> 05:01:26,301 THERE ARE ALSO ONES THAT ASSESS 6496 05:01:26,368 --> 05:01:29,638 PROGRESSION RISK, ON -- SO ONE 6497 05:01:29,704 --> 05:01:31,273 OF THE BIG FOCUSES IN OUR LAB 6498 05:01:31,339 --> 05:01:33,141 WHEN WE'RE TALKING ABOUT OCTA 6499 05:01:33,208 --> 05:01:36,812 HAS BEEN LOOKING TO SEE -- ADD 6500 05:01:36,878 --> 05:01:38,680 OCTA AS PART OF THESE GRADING 6501 05:01:38,747 --> 05:01:40,949 SYSTEMS AND ESPECIALLY TO ASSESS 6502 05:01:41,016 --> 05:01:43,518 THE PROGRESSION OF DISEASE. 6503 05:01:43,585 --> 05:01:44,920 ONE CAME OUT EARLY ON IN THE 6504 05:01:44,986 --> 05:01:46,588 DAYS OF O.C.T. AS WE AND OTHER 6505 05:01:46,655 --> 05:01:50,959 GROUPS WERE LOOKING AT? 6506 05:01:51,026 --> 05:01:52,861 -- AND IN THING CHANGES IN THE 6507 05:01:52,928 --> 05:01:53,528 CHORIOCAPILLARIS AND HERE ARE 6508 05:01:53,595 --> 05:01:54,729 SOME OF THE MAJOR GROUPS THAT 6509 05:01:54,796 --> 05:01:57,232 HAVE BEEN WORKING SPECIFICALLY 6510 05:01:57,299 --> 05:02:01,436 ON THE CHORIOCAPILLARIS IN 6511 05:02:01,503 --> 05:02:02,204 AGE-RELATED MACULAR 6512 05:02:02,270 --> 05:02:02,537 DEGENERATION. 6513 05:02:02,604 --> 05:02:06,575 WE'VE KNOWN FOR A WHILE, 6514 05:02:06,641 --> 05:02:07,342 ALTERATIONS IN THE 6515 05:02:07,409 --> 05:02:09,244 CHORIOCAPILLARIS ARE ASSOCIATED 6516 05:02:09,311 --> 05:02:11,213 WITH AGE-RELATED MACULAR 6517 05:02:11,279 --> 05:02:11,746 DEGENERATION. 6518 05:02:11,813 --> 05:02:13,415 SCOTT MA CLOUD SHOWED THAT WAY 6519 05:02:13,482 --> 05:02:13,949 BACK. 6520 05:02:14,015 --> 05:02:16,618 ROB MULLINS HAS DONE A LOT OF 6521 05:02:16,685 --> 05:02:18,153 WORK ON THIS AS WELL, AND WE 6522 05:02:18,220 --> 05:02:20,989 KNOW THAT THESE CHORIOCAPILLARIS 6523 05:02:21,056 --> 05:02:22,224 CHANGES, SPECIFICALLY LOSS OF 6524 05:02:22,290 --> 05:02:23,425 THE CHORIOCAPILLARIS STARTS VERY 6525 05:02:23,492 --> 05:02:26,962 EARLY IN THESE PISHTS. 6526 05:02:27,028 --> 05:02:32,434 VPATIENTS, VERYEARLY ON, IN FACT 6527 05:02:32,501 --> 05:02:33,835 WITH THE NORMAL AGING PROCESS 6528 05:02:33,902 --> 05:02:35,470 AND THERE IS SOME DEBATE ABOUT 6529 05:02:35,537 --> 05:02:37,772 WHETHER THE CHORIOCAPILLARIS 6530 05:02:37,839 --> 05:02:40,542 LOSS PERCEIVES -- BUT I THINK 6531 05:02:40,609 --> 05:02:41,376 IT'S RECOGNIZED THAT 6532 05:02:41,443 --> 05:02:42,711 CHORIOCAPILLARIS AND RPE START 6533 05:02:42,777 --> 05:02:45,881 VERY, VERY EARLY ON IN DISEASE. 6534 05:02:45,947 --> 05:02:50,085 NOW ONE OF THE NICE PARTS ABOUT 6535 05:02:50,151 --> 05:02:51,953 OCD IN GEOGRAPHY IS YOU CAN 6536 05:02:52,020 --> 05:02:54,456 FOLLOW PATIENTS LONGITUDALLY, 6537 05:02:54,523 --> 05:02:56,458 UNLIKE IN PATHOLOGY, YOU CAN 6538 05:02:56,525 --> 05:02:57,993 ACTUALLY LOOK AT A PATIENT AND 6539 05:02:58,059 --> 05:02:59,361 FOLLOW THEM UP A YEAR LATER AND 6540 05:02:59,427 --> 05:03:01,096 FOUR YEARS AND FIVE YEARS LATER, 6541 05:03:01,162 --> 05:03:02,864 AND SEE HOW THEY HAVE BEEN 6542 05:03:02,931 --> 05:03:04,065 PROGRESSING. 6543 05:03:04,132 --> 05:03:06,701 SO THE QUESTIONS FOR US THAT OUR 6544 05:03:06,768 --> 05:03:08,069 LAB HAS BEEN TRYING TO ASSESS 6545 05:03:08,136 --> 05:03:10,238 OVER THE PAST 15 YEARS, 10, 15 6546 05:03:10,305 --> 05:03:14,543 YEARS IS, DOES CHORIOCAPILLARIS 6547 05:03:14,609 --> 05:03:15,944 LOSS HAPPEN? 6548 05:03:16,011 --> 05:03:17,078 IN EARLY AND 6549 05:03:17,145 --> 05:03:17,846 INTERMEDIATE A.M.D.? 6550 05:03:17,913 --> 05:03:19,581 IS IT WORSE AS A.M.D. 6551 05:03:19,648 --> 05:03:20,115 PROGRESSES? 6552 05:03:20,181 --> 05:03:22,784 WHAT ARE THE CONFOUNDERS, IS 6553 05:03:22,851 --> 05:03:23,785 IT -- THINGS THAT ARE ASSOCIATED 6554 05:03:23,852 --> 05:03:25,153 WITH BOTH THE STAGE OF A.M.D. AS 6555 05:03:25,220 --> 05:03:25,887 WELL AS ASSOCIATED WITH 6556 05:03:25,954 --> 05:03:27,188 PROGRESSION AND THEREFORE CAN 6557 05:03:27,255 --> 05:03:28,456 CONFOUND OUR RESULTS, AND THEN 6558 05:03:28,523 --> 05:03:31,393 WHAT KIND OF LONGITUDAL STUDIES 6559 05:03:31,459 --> 05:03:33,361 CAN WE DO TO BETTER ASSESS THESE 6560 05:03:33,428 --> 05:03:35,697 RELATIONSHIPS. 6561 05:03:35,764 --> 05:03:37,766 SO MOST OF THE WORK THAT I'M 6562 05:03:37,832 --> 05:03:41,303 PRESENTING NOW HAS BEEN DONE ON 6563 05:03:41,369 --> 05:03:46,675 USING JIM FUJIMOTO'S PROTOTYPE, 6564 05:03:46,741 --> 05:03:49,210 THESE PATIENTS ARE ALSO LOOKED 6565 05:03:49,277 --> 05:03:51,713 AT STRUCTURAL O.C.T. USING THE 6566 05:03:51,780 --> 05:03:53,081 ULTRA-HIGH RESOLUTION PROTOTYPE 6567 05:03:53,148 --> 05:03:54,382 DEVICE DEVELOPED BY PROFESSOR 6568 05:03:54,449 --> 05:03:59,220 FEW JFUJIMOTO'S GROUP AGAIN. 6569 05:03:59,287 --> 05:04:01,890 WE USE BOTH OF THESE DEVICES TO 6570 05:04:01,957 --> 05:04:04,392 KIND OF STUDY AND UNDERSTAND 6571 05:04:04,459 --> 05:04:06,828 DISEASE PATHOGENESIS AS WELL AS 6572 05:04:06,895 --> 05:04:08,330 PROGRESSION. 6573 05:04:08,396 --> 05:04:10,465 IN THIS STUDY WE PROSPECTIVELY 6574 05:04:10,532 --> 05:04:11,700 ENROLLED NORMAL VOLUNTEERS IN 6575 05:04:11,766 --> 05:04:13,401 PATIENTS WITH VARYING STAGES OF 6576 05:04:13,468 --> 05:04:13,969 DRY A.M.D. 6577 05:04:14,035 --> 05:04:14,769 ONE OF THE THINGS THAT WE'VE 6578 05:04:14,836 --> 05:04:16,204 ALSO STARTED DOING IN 6579 05:04:16,271 --> 05:04:17,772 COLLABORATION WITH PROFESSOR 6580 05:04:17,839 --> 05:04:21,509 FUJI KNOW TOE'S LAB IS ALSO 6581 05:04:21,576 --> 05:04:23,545 STARTING TO ENROLL THESE 6582 05:04:23,612 --> 05:04:24,879 PATIENTS ON TO COMMERCIAL 6583 05:04:24,946 --> 05:04:26,748 DEVICES TO TRY AND SEE IF WE CAN 6584 05:04:26,815 --> 05:04:27,549 TRANSLATES THE RUTLE WE'RE 6585 05:04:27,616 --> 05:04:29,618 SEEING IN THIS VERY HIGH-TECH 6586 05:04:29,684 --> 05:04:31,386 PROTOTYPE DEVICE INTO THE 6587 05:04:31,453 --> 05:04:32,587 COMMERCIAL DEVICES AS THESE GET 6588 05:04:32,654 --> 05:04:33,822 ROLLED INTO CLINICS. 6589 05:04:33,888 --> 05:04:39,728 AND THE REASON WE LIKE USING 6590 05:04:39,794 --> 05:04:41,363 SWEAT SOURCE, THE LONGER 6591 05:04:41,429 --> 05:04:43,932 WAVELENGTHS HAVE BETTERTER 6592 05:04:43,999 --> 05:04:45,033 PENETRANCE INTO THE 6593 05:04:45,100 --> 05:04:50,372 CHORIOCAPILLARIS AN AND AS WELLS 6594 05:04:50,438 --> 05:04:52,941 THE OUTER CHANGES SUCH AS DRUSEN 6595 05:04:53,008 --> 05:04:55,043 THAT HAPPEN IN PATIENTS WITH 6596 05:04:55,110 --> 05:04:56,778 MACULAR DEGENERATION THAT MAKE 6597 05:04:56,845 --> 05:04:59,414 EVALUATION OF THE COROLLARY 6598 05:04:59,481 --> 05:05:01,650 CAPILLARIS IF YOU'RE USING A 6599 05:05:01,716 --> 05:05:04,819 STANDARD SPECTRAL DOMAIN SYSTEM. 6600 05:05:04,886 --> 05:05:06,688 SO SOME OF THE FIRST THINGS THAT 6601 05:05:06,755 --> 05:05:08,223 WE STARTED OUT WITH, WHEN WE 6602 05:05:08,289 --> 05:05:10,358 STARTED STUDYING THE 6603 05:05:10,425 --> 05:05:11,026 CHORIOCAPILLARIS IN THE MACULAR 6604 05:05:11,092 --> 05:05:12,327 REGION OF NORMAL SUBJECTS, WE 6605 05:05:12,394 --> 05:05:13,328 NOTICED THAT THIS WAS GENERALLY 6606 05:05:13,395 --> 05:05:16,598 DENSE AND H HOMOGENEOUS, THAT 6607 05:05:16,665 --> 05:05:17,165 THERE WAS LOSS OF 6608 05:05:17,232 --> 05:05:17,899 CHORIOCAPILLARIS WITH AGE, AND 6609 05:05:17,966 --> 05:05:19,801 THIS WAS MORE PRONOUNCED IN THE 6610 05:05:19,868 --> 05:05:22,504 CENTRAL FOVEAL REGION, AND THESE 6611 05:05:22,570 --> 05:05:24,572 RESULTS AGAIN HAVE BEEN 6612 05:05:24,639 --> 05:05:25,974 VALIDATED ACROSS MULTIPLE 6613 05:05:26,041 --> 05:05:28,276 DIFFERENT GROUPS THAT HAVE 6614 05:05:28,343 --> 05:05:34,983 LOOKED AT -- IN NORMAL AGING. 6615 05:05:35,050 --> 05:05:36,418 SO WHAT DO WE START SEEING IN 6616 05:05:36,484 --> 05:05:37,185 PATIENTS WITH A.M.D.? 6617 05:05:37,252 --> 05:05:40,188 AS I MENTIONED WE KNOW FROM 6618 05:05:40,255 --> 05:05:43,458 HISTOPATHOLOGIC STUDIES HAVE A 6619 05:05:43,525 --> 05:05:45,827 PRETTY ENLARGED -- WE STARTED 6620 05:05:45,894 --> 05:05:47,462 ENROLLING THESE PATIENTS IN 6621 05:05:47,529 --> 05:05:48,363 CROSS-SECTIONAL STUDIES USING 6622 05:05:48,430 --> 05:05:49,831 THE DEVICES THAT I SPOKE ABOUT, 6623 05:05:49,898 --> 05:05:54,836 AND YOU KNOW, WE KNOW BASED ON 6624 05:05:54,903 --> 05:05:58,473 DATA FROM ROBYN GUYMER'S GROUP 6625 05:05:58,540 --> 05:05:59,941 AND VARIOUS INVESTIGATORS THAT 6626 05:06:00,008 --> 05:06:01,042 STRUCTURAL CHANGES CAN BE SEEN 6627 05:06:01,109 --> 05:06:02,577 VERY EARLY AND PRECEDE THE 6628 05:06:02,644 --> 05:06:06,481 DEVELOPMENT OF COMPLETE 6629 05:06:06,548 --> 05:06:08,850 GEOGRAPHIC -- AND WHETHER THESE 6630 05:06:08,917 --> 05:06:10,051 PATIENTS -- WE STARTED ENROLLING 6631 05:06:10,118 --> 05:06:11,519 PATIENTS WHO ARE AT A HIGH RISK 6632 05:06:11,586 --> 05:06:14,389 OF DEVELOPING ATROPHY PATIENTS 6633 05:06:14,456 --> 05:06:17,525 WITH SAY NASCENT ATROPHY OR LOSS 6634 05:06:17,592 --> 05:06:21,563 OF THE OUTER RETINA, ALONG WITH 6635 05:06:21,629 --> 05:06:23,965 INTERMEDIATE A.M.D. PRIOR TO 6636 05:06:24,032 --> 05:06:25,066 DEVELOPMENT AND WE STARTED 6637 05:06:25,133 --> 05:06:26,067 LOOKING AT THE CHORIOCAPILLARIS 6638 05:06:26,134 --> 05:06:26,801 IN THESE PATIENTS. 6639 05:06:26,868 --> 05:06:29,070 AND WHAT WE FOUND WAS THAT THEY 6640 05:06:29,137 --> 05:06:29,938 WERE CHORIOCAPILLARIS 6641 05:06:30,004 --> 05:06:32,207 ALTERATIONS IN EYES WITH NASCENT 6642 05:06:32,273 --> 05:06:35,410 ATROPHY AND DRUSEN -- WHICH WERE 6643 05:06:35,477 --> 05:06:37,312 THE TERMS THAT WERE PREVIOUSLY 6644 05:06:37,378 --> 05:06:40,381 USED FOR WHAT'S NOW CLASSIFIED 6645 05:06:40,448 --> 05:06:44,319 AS IRORA FOR THE -- 6646 05:06:44,385 --> 05:06:45,019 PREDICTICALLY UNDER THESE AREAS 6647 05:06:45,086 --> 05:06:46,354 WE STARTED FINDING THERE WERE 6648 05:06:46,421 --> 05:06:48,089 AREAS OF CHORIOCAPILLARIS LOSS. 6649 05:06:48,156 --> 05:06:49,090 SO IF YOU WALK THAT BACK A 6650 05:06:49,157 --> 05:06:53,394 LITTLE BIT AND START LOOKING AT 6651 05:06:53,461 --> 05:06:56,131 PATIENTS WITH DR USEN TO SEE 6652 05:06:56,197 --> 05:06:57,132 WHERE THESE CHANGES START 6653 05:06:57,198 --> 05:06:58,399 HAPPENING UNDERNEATH THESE AREAS 6654 05:06:58,466 --> 05:07:02,537 OF DRUSEN, WE NOTICED THERE WAS 6655 05:07:02,604 --> 05:07:05,173 LOSS OF CHORIOCAPILLARIS AND 6656 05:07:05,240 --> 05:07:08,309 EVEN UNDER AREAS OF DRUSEN THAT 6657 05:07:08,376 --> 05:07:11,045 DON'T YET HAVE ANY ATROPHY 6658 05:07:11,112 --> 05:07:13,448 ASSOCIATED WITH THEM. 6659 05:07:13,515 --> 05:07:14,649 ON THE OTHER HAND, THERE WERE 6660 05:07:14,716 --> 05:07:16,651 ALSO DRUSEN THAT DID NOT SHOW 6661 05:07:16,718 --> 05:07:17,886 CHORIOCAPILLARIS LOSS, AND THIS 6662 05:07:17,952 --> 05:07:21,122 WAS REPLICATED BY AGAIN AS I 6663 05:07:21,189 --> 05:07:22,690 MENTIONED ACROSS VARIOUS 6664 05:07:22,757 --> 05:07:24,926 MULTIPLE GROUPS SINCE WE 6665 05:07:24,993 --> 05:07:26,561 INITIALLY PUBLISHED THOSE 6666 05:07:26,628 --> 05:07:26,995 RESULTS. 6667 05:07:27,061 --> 05:07:29,297 HOWEVER, DOING A DRUSEN BY 6668 05:07:29,364 --> 05:07:30,231 DRUSEN EVALUATION IS CHALLENGING 6669 05:07:30,298 --> 05:07:32,300 IN A CLINICAL TRIAL SETTING, 6670 05:07:32,367 --> 05:07:34,068 IT'S QUALITATIVE, IT VERY 6671 05:07:34,135 --> 05:07:35,737 TIME-CONSUMING, SO CAN WE NOW DO 6672 05:07:35,804 --> 05:07:36,938 THIS AT A LARGER LEVEL AND LOOK 6673 05:07:37,005 --> 05:07:39,040 AT IT IN A MORE QUANTITATIVE 6674 05:07:39,107 --> 05:07:40,475 SCWAIL? 6675 05:07:40,542 --> 05:07:40,942 SCALE? 6676 05:07:41,009 --> 05:07:42,377 SO QAWPT TAITIVE SCALES ARE ONE 6677 05:07:42,443 --> 05:07:43,778 OF THE THINGS WE TRIED TO 6678 05:07:43,845 --> 05:07:44,312 ESTABLISH BECAUSE THEY'RE 6679 05:07:44,379 --> 05:07:45,580 SOMETHING YOU CAN MOVE FORWARD 6680 05:07:45,647 --> 05:07:47,215 INTO CLINIC AND SOMETHING YOU 6681 05:07:47,282 --> 05:07:48,750 CAN MOVE FORWARD INTO CLINICAL 6682 05:07:48,817 --> 05:07:50,618 TRIALS THAT LOOK AT DRUG 6683 05:07:50,685 --> 05:07:51,486 DEVELOPMENT. 6684 05:07:51,553 --> 05:07:55,690 WELL LOOKED AT THIS METRIC FOR 6685 05:07:55,757 --> 05:07:57,559 QUANTIFYING CHORIOCAPILLARIS 6686 05:07:57,625 --> 05:08:00,161 FLOW VOIDS AND WE USED A 6687 05:08:00,228 --> 05:08:03,965 MULTI-SCALE FLOW VOID MAPPING, 6688 05:08:04,032 --> 05:08:05,166 VARIOUS FORMS HAVE BEEN USED 6689 05:08:05,233 --> 05:08:07,135 SINCE THAT, AND ALL OF THESE 6690 05:08:07,202 --> 05:08:14,576 ESSENTIALLY LOOK FOR -- IN THE 6691 05:08:14,642 --> 05:08:18,780 CHORIOCACAPILLARIS IN VARYING 6692 05:08:18,847 --> 05:08:19,547 LEVELS OF A.M.D. 6693 05:08:19,614 --> 05:08:21,950 NOT ONLY WAS THE AREA OF 6694 05:08:22,016 --> 05:08:22,584 CHORIOCAPILLARIS LOSS IMPORTANT 6695 05:08:22,650 --> 05:08:24,853 BUT THE CLUSTERING OF THESE 6696 05:08:24,919 --> 05:08:27,822 AREAS TOGETHER ALSO PREDICATED 6697 05:08:27,889 --> 05:08:28,690 MORE ADVANCED DEVELOPMENT OF 6698 05:08:28,756 --> 05:08:29,023 DISEASE. 6699 05:08:29,090 --> 05:08:30,525 SO WHEN WE STRATIFIED PATIENTS 6700 05:08:30,592 --> 05:08:31,793 BY SEVERITY OF A.M.D., WE FOUND 6701 05:08:31,860 --> 05:08:33,761 THAT NOT ONLY WAS THERE 6702 05:08:33,828 --> 05:08:34,629 INCREASED CHORIOCAPILLARIS 6703 05:08:34,696 --> 05:08:37,532 ALTERATION BY AGE, BUT THERE WAS 6704 05:08:37,599 --> 05:08:38,333 ALSO INCREASING CHORIOCAPILLARIS 6705 05:08:38,399 --> 05:08:39,868 ALTERATION WITH MORE ADVANCED 6706 05:08:39,934 --> 05:08:40,201 DISEASE STATE. 6707 05:08:40,268 --> 05:08:42,170 SO WHEN YOU LOOK 6708 05:08:42,237 --> 05:08:43,304 CROSS-SECTIONALLY AS YOU GET 6709 05:08:43,371 --> 05:08:44,405 MORE ADVANCED DISEASE STATE, YOU 6710 05:08:44,472 --> 05:08:46,708 GET WORSE AND WORSE AND WORSE 6711 05:08:46,774 --> 05:08:47,108 CHORIOCAPILLARIS. 6712 05:08:47,175 --> 05:08:48,610 SO ALL OF THIS IS WELL AND GOOD 6713 05:08:48,676 --> 05:08:50,044 IF YOU'RE DOING IT IN A 6714 05:08:50,111 --> 05:08:51,246 PROTOTYPE SYSTEM, THERE'S ONLY 6715 05:08:51,312 --> 05:08:53,114 ONE OF THAT PROAT SIDE SYSTEM OR 6716 05:08:53,181 --> 05:08:54,382 IT MAY BE TWO IN THE WORLD, 6717 05:08:54,449 --> 05:08:56,718 THEY'RE ALL DEPLOYED IN OUR LAB 6718 05:08:56,784 --> 05:08:57,986 AT THE NEW ENGLAND EYE CENTER, 6719 05:08:58,052 --> 05:08:59,888 HOW DO YOU THEN TAKE WHAT JIM IS 6720 05:08:59,954 --> 05:09:01,122 DEVELOPING IN HIS MACHINES AND 6721 05:09:01,189 --> 05:09:05,493 APPLY IT ON A MORE BROAD SCALE 6722 05:09:05,560 --> 05:09:06,761 ACROSS CLINICAL TRIALS AND IN 6723 05:09:06,828 --> 05:09:10,632 PATIENTS. 6724 05:09:10,698 --> 05:09:13,568 SO PHIL BRAUN, POST-DOCTORAL 6725 05:09:13,635 --> 05:09:14,636 FELLOW WITH US, THEN TOOK THIS 6726 05:09:14,702 --> 05:09:24,979 ON TO THE SLAB SOURCE O.C.T. AN- 6727 05:09:25,046 --> 05:09:26,681 HE LOOKED AT THESE FLOW VOIDS. 6728 05:09:26,748 --> 05:09:28,349 OF COURSE ONE OF THE ISSUES WITH 6729 05:09:28,416 --> 05:09:29,884 COMMERCIAL MACHINES IS THAT YOU 6730 05:09:29,951 --> 05:09:31,619 GET THE DATA IS MUCH LESS 6731 05:09:31,686 --> 05:09:32,787 FLEXIBLE, IT'S A LITTLE BIT OF A 6732 05:09:32,854 --> 05:09:34,522 BLACK BOX, YOU GET THE DATA THAT 6733 05:09:34,589 --> 05:09:37,058 YOU GET, AND YOU ARE NOT ABLE TO 6734 05:09:37,125 --> 05:09:39,961 RUN VERY MANY VARIATIONS ON THE 6735 05:09:40,028 --> 05:09:41,696 O.C.T. IN GEOGRAPHY RAW DATA. 6736 05:09:41,763 --> 05:09:45,533 SO WE USE THIS TECHNOLOGY 6737 05:09:45,600 --> 05:09:49,437 DEVELOPED BY ZHANG IN THE LAB 6738 05:09:49,504 --> 05:09:54,842 OVER IN RICKEY WANG'S LAB IN 6739 05:09:54,909 --> 05:09:58,179 WASHINGTON, AS WELL AS THE 6740 05:09:58,246 --> 05:09:59,647 O.C.T. -- AND ADJUST FOR AREAS 6741 05:09:59,714 --> 05:10:00,982 OF SHADOWING TO MAKE SURE WE 6742 05:10:01,049 --> 05:10:02,617 WERE NOT PICKING UP AREAS JUST 6743 05:10:02,684 --> 05:10:04,752 OF SHADOWING, AND TO DEVELOP 6744 05:10:04,819 --> 05:10:06,387 THESE OCTA AND GEOGRAPHY MAPS, 6745 05:10:06,454 --> 05:10:08,022 AND THEN WE LOOKED AT THE 6746 05:10:08,089 --> 05:10:09,857 CENTRAL 1-MILLIMETER, 6747 05:10:09,924 --> 05:10:11,626 3-MILLIMETER AND 5-MILLIMETER 6748 05:10:11,693 --> 05:10:12,994 CIRCLES AND WHAT WE FOUND WAS 6749 05:10:13,061 --> 05:10:14,896 THAT AS YOU LOOKED AT THESE 6750 05:10:14,963 --> 05:10:17,265 SERVICES, THAT THE CENTRAL AREAS 6751 05:10:17,332 --> 05:10:18,700 BECAME VERY QUICKLY AFFECTED BY 6752 05:10:18,766 --> 05:10:19,033 AGING. 6753 05:10:19,100 --> 05:10:22,303 SO THE CENTRAL 1 AND 6754 05:10:22,370 --> 05:10:24,339 3-MILLIMETER CIRCLES WERE VERY 6755 05:10:24,405 --> 05:10:25,773 EASILY AFFECTED THEREFORE WERE 6756 05:10:25,840 --> 05:10:27,275 NOT VERY SENSITIVE TO STAGE OF 6757 05:10:27,342 --> 05:10:30,778 DISEASE BECAUSE ALMOST EVERYONE 6758 05:10:30,845 --> 05:10:33,348 WAS AGED TEND TO HAVE MORE FLOW 6759 05:10:33,414 --> 05:10:34,449 VOIDS, HOWEVER WHEN YOU MOVED 6760 05:10:34,515 --> 05:10:38,019 OUT OF THOSE CENTRAL CIRCLES AND 6761 05:10:38,086 --> 05:10:39,220 LOOKED AT LIKE THE 5-MILLIMETER 6762 05:10:39,287 --> 05:10:41,956 AREA OR LOOKED AT THE ENTIRE 6763 05:10:42,023 --> 05:10:43,558 SLAB, YOU GOT A VERY HIGH 6764 05:10:43,624 --> 05:10:49,797 SENSITIVITY FOR STAGE OF DISE 6765 05:10:49,864 --> 05:10:51,632 DISEASE, AND THAT WAS INITIALLY 6766 05:10:51,699 --> 05:10:53,735 DONE AT THE NEW ENGLAND EYE 6767 05:10:53,801 --> 05:10:55,203 CENTER, WE THEN COLLABORATED 6768 05:10:55,269 --> 05:10:56,404 ACROSS A LARGE DATASET THAT SHE 6769 05:10:56,471 --> 05:10:58,940 HAD COLLECTED AS PART OF HER 6770 05:10:59,007 --> 05:11:05,213 RESEARCH, SUGGESTING LOCALIZED 6771 05:11:05,279 --> 05:11:06,547 IMPAIRMENT AND REDUCED BLOOD 6772 05:11:06,614 --> 05:11:08,082 FLOW PRECEDING THE DEVELOPMENT 6773 05:11:08,149 --> 05:11:09,717 OF ATROPHIC A.M.D. LESIONS IN 6774 05:11:09,784 --> 05:11:14,822 HER COHORT OF PATIENTS AS WELL. 6775 05:11:14,889 --> 05:11:17,025 SO NOW WHAT ABOUT GEOGRAPHIC 6776 05:11:17,091 --> 05:11:17,258 ATROPHY? 6777 05:11:17,325 --> 05:11:19,193 WE ACTUALLY STARTED WITH G.A. 6778 05:11:19,260 --> 05:11:20,061 BECAUSE THIS WAS ONE OF THE 6779 05:11:20,128 --> 05:11:20,695 EASIEST THINGS TO SEE. 6780 05:11:20,762 --> 05:11:22,463 SO THIS IS ONE OF OUR VERY FIRST 6781 05:11:22,530 --> 05:11:25,633 PUBLICATIONS THAT WE DID LOOKING 6782 05:11:25,700 --> 05:11:26,901 AT CHORIOCAPILLARIS BLOOD FLOW 6783 05:11:26,968 --> 05:11:29,637 UNDER GEOGRAPHIC ATROPHY. 6784 05:11:29,704 --> 05:11:31,939 WE FOUND NOT ONLY WAS THERE LOSS 6785 05:11:32,006 --> 05:11:32,607 OF CHORIOCAPILLARIS BLOOD FLOW 6786 05:11:32,673 --> 05:11:37,712 UNDER THE AREA OF GEOGRAPHIC 6787 05:11:37,779 --> 05:11:38,880 ATROPHY BUT YOU SEE THERE ALSO 6788 05:11:38,946 --> 05:11:41,949 APPEARS TO BE LOSS OF 6789 05:11:42,016 --> 05:11:42,784 CHORIOCAPILLARIS OUTSIDE OF THE 6790 05:11:42,850 --> 05:11:46,187 IMMEDIATE AREAS OF GEOGRAPHIC 6791 05:11:46,254 --> 05:11:50,324 ATROPHY. 6792 05:11:50,391 --> 05:11:51,726 I'M GOING TO TALK ABOUT VISTA 6793 05:11:51,793 --> 05:11:54,062 THAT WAS DEVELOPED AGAIN BY 6794 05:11:54,128 --> 05:11:57,632 JIM'S GROUP AT THE MIT LAB, AND 6795 05:11:57,698 --> 05:11:58,933 THIS UTILIZES VARIATIONS IN THE 6796 05:11:59,000 --> 05:12:02,203 TIME INTERVALS BETWEEN 6797 05:12:02,270 --> 05:12:03,905 CONSECUTIVE OCTA SCANS TO ASSESS 6798 05:12:03,971 --> 05:12:08,176 NOT JUST THE BINARY PRESENT FLOW 6799 05:12:08,242 --> 05:12:09,343 OR ABSENT BUT ALSO SPEED OF FLOW 6800 05:12:09,410 --> 05:12:10,478 IN THE RETINA. 6801 05:12:10,545 --> 05:12:12,080 THESE ARE NOW GETTING ROLLED TO 6802 05:12:12,146 --> 05:12:13,815 COMMERCIAL DEVICES FINALLY AFTER 6803 05:12:13,881 --> 05:12:15,450 ALMOST EIGHT OR NINE YEARS OF 6804 05:12:15,516 --> 05:12:16,684 THE INITIAL PUBLICATIONS AND 6805 05:12:16,751 --> 05:12:17,919 WE'RE REALLY EXCITED ABOUT THE 6806 05:12:17,985 --> 05:12:19,020 CAPABILITIES THAT THIS WILL 6807 05:12:19,087 --> 05:12:20,455 BRING TO THOSE COMMERCIAL 6808 05:12:20,521 --> 05:12:20,755 DEVICES. 6809 05:12:20,822 --> 05:12:22,890 SO WE LOOKED AT THE VISTA IN 6810 05:12:22,957 --> 05:12:24,225 THESE PATIENTS WITH GEOGRAPHIC 6811 05:12:24,292 --> 05:12:27,361 ATROPHY AND WHAT WE SAW WAS THAT 6812 05:12:27,428 --> 05:12:29,764 THERE WAS AN ALMOST TOTAL LOSS 6813 05:12:29,831 --> 05:12:30,431 OF CHORIOCAPILLARIS UNDER LYING 6814 05:12:30,498 --> 05:12:32,266 THE AREAS BUT WHEN YOU LOOKED IT 6815 05:12:32,333 --> 05:12:33,701 THE AREA AROUND THE GEOGRAPHIC 6816 05:12:33,768 --> 05:12:35,203 ATROPHY, THERE WAS SOME LOSS OF 6817 05:12:35,269 --> 05:12:35,837 CHORIOCAPILLARIS BUT THERE WAS 6818 05:12:35,903 --> 05:12:37,138 ALSO A LOT OF SLOWING DOWN OF 6819 05:12:37,205 --> 05:12:38,473 THE BLOOD FLOW. 6820 05:12:38,539 --> 05:12:40,074 NOTE VERY NICELY OVER HERE THAT 6821 05:12:40,141 --> 05:12:41,709 THERE IS SLOW BUT PRESERVED 6822 05:12:41,776 --> 05:12:45,546 BLOOD FLOW IN THAT SMALL AREA 6823 05:12:45,613 --> 05:12:48,149 THAT HAS MACULAR SPARING, THE 6824 05:12:48,216 --> 05:12:50,418 FOVEAL SPARING IN THIS PATIENT. 6825 05:12:50,485 --> 05:12:52,587 SO REALLY TO HAVE VIABLE RETINA, 6826 05:12:52,653 --> 05:12:54,255 EVEN IF YOU HAD SLOW BLOOD FLOW, 6827 05:12:54,322 --> 05:12:56,958 YOU NEEDED TO HAVE BLOOD FLOW 6828 05:12:57,024 --> 05:12:57,492 DOWN THERE. 6829 05:12:57,558 --> 05:13:00,328 SO ONE OF THE QUESTIONS WAS, IS 6830 05:13:00,394 --> 05:13:01,095 GLOBAL CHORIOCAPILLARIS 6831 05:13:01,162 --> 05:13:02,263 IMPAIRMENT CORRELATED WITH G.A. 6832 05:13:02,330 --> 05:13:02,697 GROWTH RATE. 6833 05:13:02,763 --> 05:13:03,998 SO NOW THIS IS TAKING ALL THE 6834 05:13:04,065 --> 05:13:05,933 DATA THAT WE ACQUIRED 6835 05:13:06,000 --> 05:13:06,601 CROSS-SECTIONALLY AND TRYING TO 6836 05:13:06,667 --> 05:13:08,336 SEE HOW WE CAN TRANSLATE THIS 6837 05:13:08,402 --> 05:13:09,537 INTO A RISK ASSESSMENT FOR 6838 05:13:09,604 --> 05:13:10,404 PATIENTS. 6839 05:13:10,471 --> 05:13:12,006 SO GLOBAL CHORIOCAPILLARIS 6840 05:13:12,073 --> 05:13:14,208 IMPAIRMENT IS CORRELATED WITH 6841 05:13:14,275 --> 05:13:20,882 G.A. GROWTH RATE, THEY DID THIS 6842 05:13:20,948 --> 05:13:22,383 REALLY NICE SMALL LONGITUDAL 6843 05:13:22,450 --> 05:13:24,118 STUDY WHERE WE LOOKED AT SOME 6844 05:13:24,185 --> 05:13:24,986 PATIENTS AT THE NEW ENGLAND EYE 6845 05:13:25,052 --> 05:13:26,854 CENTER AND FOLLOWED THEM UP OVER 6846 05:13:26,921 --> 05:13:28,890 TIME, AND WE INDEED DID FIND, IF 6847 05:13:28,956 --> 05:13:33,494 YOU SEPARATE OUT THE UNIFOCAL 6848 05:13:33,561 --> 05:13:34,462 PATIENTS THAT GLOBAL 6849 05:13:34,529 --> 05:13:35,496 CHORIOCAPILLARIS IMPAIRMENT WAS 6850 05:13:35,563 --> 05:13:36,497 CORRELATED WITH G.A. GROWTH 6851 05:13:36,564 --> 05:13:37,064 RATE. 6852 05:13:37,131 --> 05:13:39,133 OUR NEXT QUESTION WAS IS 6853 05:13:39,200 --> 05:13:43,171 CHORIOCAPILLARIS IMPAIRMENT 6854 05:13:43,237 --> 05:13:45,206 ADJACENT MORE CORRELATED WITH 6855 05:13:45,273 --> 05:13:46,974 G.A. GROWTH RATE FURTHER FROM 6856 05:13:47,041 --> 05:13:48,409 THE G.A. MARGINS AND WHEN WE 6857 05:13:48,476 --> 05:13:49,944 LOOKED AT THAT, IT DIDN'T REALLY 6858 05:13:50,011 --> 05:13:51,445 LOOK LIKE IT, AT LEAST NOT IN 6859 05:13:51,512 --> 05:13:56,017 OUR COHORT OF PATIENTS. 6860 05:13:56,083 --> 05:13:58,419 SO THERE IS SOME VARIABLE DATA 6861 05:13:58,486 --> 05:13:59,820 ON THIS DEPENDING ON WHICH YOU 6862 05:13:59,887 --> 05:14:01,122 LOOK AT BUT OUR DAY IT DID NOT 6863 05:14:01,189 --> 05:14:02,557 SUPPORT THE HYPOTHESIS THAT 6864 05:14:02,623 --> 05:14:03,758 IMPAIRMENT IN REGIONS CLOSER TO 6865 05:14:03,824 --> 05:14:05,259 THE MARGIN WAS MORE STRONGLY 6866 05:14:05,326 --> 05:14:06,994 CORRELATED WITH LESION GROWTH 6867 05:14:07,061 --> 05:14:08,329 RATE THAN IN REGIONS FURTHER 6868 05:14:08,396 --> 05:14:09,897 AWAY FROM THE MARGIN, THAT'S 6869 05:14:09,964 --> 05:14:11,032 ACTUALLY GOOD NEWS BECAUSE YOU 6870 05:14:11,098 --> 05:14:13,501 CAN DO A MORE SIMPLER GLOBAL 6871 05:14:13,568 --> 05:14:16,704 ANALYSIS TO ACTUALLY ASSESS RI 6872 05:14:16,771 --> 05:14:18,172 RISK. 6873 05:14:18,239 --> 05:14:20,174 THEN THE FINAL QUESTION WAS DO 6874 05:14:20,241 --> 05:14:21,809 G.A. LESIONS PREEF RENGSLY GROW 6875 05:14:21,876 --> 05:14:23,110 INTO REGIONS OF CHORIOCAPILLARIS 6876 05:14:23,177 --> 05:14:23,511 IMPAIRMENT? 6877 05:14:23,578 --> 05:14:24,912 I WON'T GO INTO THIS DETAILED 6878 05:14:24,979 --> 05:14:26,047 ANALYSIS BUT AS YOU CAN SEE WE 6879 05:14:26,113 --> 05:14:27,448 DID VERY LOCAL ANALYSES OF 6880 05:14:27,515 --> 05:14:28,516 CHORIOCAPILLARIS IMPAIRMENT AT 6881 05:14:28,583 --> 05:14:30,384 EACH SPOT ALONG THE G.A. MARGIN 6882 05:14:30,451 --> 05:14:31,786 AND THEN MAPPED OUT THE GROWTH 6883 05:14:31,852 --> 05:14:35,256 RATE OF EACH SIDE OF THE G.A. 6884 05:14:35,323 --> 05:14:36,591 LESION AND WHAT WE DID FIND WAS 6885 05:14:36,657 --> 05:14:39,727 THAT ACTUALLY PROBABLY NOT, THEY 6886 05:14:39,794 --> 05:14:41,829 PROBABLY DON'T GROW IN REGIONS 6887 05:14:41,896 --> 05:14:42,897 OF CHORIOCAPILLARIS IMPAIRMENT 6888 05:14:42,964 --> 05:14:48,135 BUT IT'S OVERALL THESE SCHEMA 6889 05:14:48,202 --> 05:14:49,670 THAT'S DRIVING GROWTH AND NOT 6890 05:14:49,737 --> 05:14:50,871 NECESSARILY DRIVING DIRECTIONAL 6891 05:14:50,938 --> 05:14:52,240 GROWTH. 6892 05:14:52,306 --> 05:14:54,542 SO IS CHORIOCAPILLARIS LOSS IN 6893 05:14:54,609 --> 05:14:56,277 INIMMEDIATE A.M.D. A MARKER FOR 6894 05:14:56,344 --> 05:14:56,711 PROGRESSION? 6895 05:14:56,777 --> 05:15:00,514 IT HAPPENS EARLY, IT'S WORSE AS 6896 05:15:00,581 --> 05:15:01,983 DISEASE ADVANCES. 6897 05:15:02,049 --> 05:15:06,454 AGE IS A DOMINANT CONFOUNDER, 6898 05:15:06,520 --> 05:15:08,189 AND THE EFFECT IS SEEN IN THE 6899 05:15:08,256 --> 05:15:09,357 OUTER RINGS BUT ALSO IN THE 6900 05:15:09,423 --> 05:15:11,759 WHOLE SLAB ANALYSIS. 6901 05:15:11,826 --> 05:15:14,195 AND ARE THERE LONGITUDAL 6902 05:15:14,262 --> 05:15:14,495 ANALYSES? 6903 05:15:14,562 --> 05:15:16,998 AT THAT POINT WE STARTED A 6904 05:15:17,064 --> 05:15:18,966 COUPLE OF LARGE LONGITUDINAL 6905 05:15:19,033 --> 05:15:20,935 STUDIES WHICH ARE THE IMPACT AND 6906 05:15:21,002 --> 05:15:21,569 SWAGGER STUDDIES. 6907 05:15:21,636 --> 05:15:22,970 WE HAVE MOSH TWO YEARS OF 6908 05:15:23,037 --> 05:15:26,607 FOLLOW-UP IN THESE PATIENTS NOW, 6909 05:15:26,674 --> 05:15:27,575 AND THE ANALYSIS ARE CURRENTLY 6910 05:15:27,642 --> 05:15:31,712 OP GOINGONGOING SO YOU SHOULD SE 6911 05:15:31,779 --> 05:15:33,447 RESULTS COMING OUT SOON. 6912 05:15:33,514 --> 05:15:35,049 IT MAY BE A USEFUL MARKER FOR 6913 05:15:35,116 --> 05:15:37,018 THE STAGE OF A.M.D. AND MAY HELP 6914 05:15:37,084 --> 05:15:38,219 US DETERMINE WHAT PATIENTS ARE 6915 05:15:38,286 --> 05:15:39,987 LIKELY TO BE FAST PROGRESSERS 6916 05:15:40,054 --> 05:15:40,921 VERSUS WHAT PATIENTS ARE LIKELY 6917 05:15:40,988 --> 05:15:42,590 TO BE SLOW PROGRESSERS IN 6918 05:15:42,657 --> 05:15:44,892 COLLABORATION WITH THE OTHER 6919 05:15:44,959 --> 05:15:45,760 STRUCTURAL BIOMARKERS THAT WE 6920 05:15:45,826 --> 05:15:46,327 KNOW NOW. 6921 05:15:46,394 --> 05:15:49,030 THE CAVEAT OVER HERE IS, THERE 6922 05:15:49,096 --> 05:15:50,531 WAS THIS REALLY NICE ANALYSIS 6923 05:15:50,598 --> 05:15:51,599 THAT SHOWED THAT THE TECHNIQUES 6924 05:15:51,666 --> 05:15:54,235 THAT HE USED TO BINARRIZE AND 6925 05:15:54,302 --> 05:15:55,436 THRESHOLD CAN INTRODUCE AS OR 6926 05:15:55,503 --> 05:15:56,537 AND THEREFORE YOU HAVE TO BE 6927 05:15:56,604 --> 05:15:58,339 VERY CAREFUL ABOUT BINARIZATION 6928 05:15:58,406 --> 05:15:59,774 AND THRESHOLD IN THE 6929 05:15:59,840 --> 05:16:00,441 CHORIOCAPILLARIS, AND THERE DOES 6930 05:16:00,508 --> 05:16:02,176 HAVE TO BE CONSENSUS AROUND THE 6931 05:16:02,243 --> 05:16:04,245 BEST WAY OF ANALYZING COMMERCIAL 6932 05:16:04,312 --> 05:16:07,381 IMAGES ESPECIALLY FOR THE BLACK 6933 05:16:07,448 --> 05:16:08,916 BOX THAT IS COMMERCIAL IMAGES, 6934 05:16:08,983 --> 05:16:10,484 AS WELL AS TRANSPARENCY FROM THE 6935 05:16:10,551 --> 05:16:11,719 DEVICE MANUFACTURERS ON THE WAY 6936 05:16:11,786 --> 05:16:14,455 THESE IMAGES ARE ENHANCED AND 6937 05:16:14,522 --> 05:16:15,690 THE WAYS IN WHICH THEY'RE 6938 05:16:15,756 --> 05:16:16,891 ANALYZED IN THESE COMMERCIAL 6939 05:16:16,957 --> 05:16:17,625 DEVICES. 6940 05:16:17,692 --> 05:16:21,562 SO WHAT ARE THE IMPLICATIONS? 6941 05:16:21,629 --> 05:16:22,997 A LOT OF DEATH AND DESTRUCTION 6942 05:16:23,064 --> 05:16:23,664 GOING ON IN THE 6943 05:16:23,731 --> 05:16:24,065 CHORIOCAPILLARIS. 6944 05:16:24,131 --> 05:16:26,701 AS WE AGE, WE ALL LOSE 6945 05:16:26,767 --> 05:16:27,568 CHORIOCAPILLARIS BUT METRICS CAN 6946 05:16:27,635 --> 05:16:29,170 ALSO BE A MARKER FOR THE 6947 05:16:29,236 --> 05:16:30,938 SEVERITY OF A.M.D. AND MAY BE 6948 05:16:31,005 --> 05:16:34,542 USEFUL IN STRATIFYING PATIENTS 6949 05:16:34,608 --> 05:16:36,410 FOR CLINICAL TRIALS OF EARLY AND 6950 05:16:36,477 --> 05:16:37,578 INTERMEDIATE A.M.D. AND THEY DO 6951 05:16:37,645 --> 05:16:39,547 CORRELATE ARE THE RATE OF 6952 05:16:39,613 --> 05:16:41,415 PROGRESSION IN G.A. BUT 6953 05:16:41,482 --> 05:16:41,982 ASSESSING CHORIOCAPILLARIS 6954 05:16:42,049 --> 05:16:43,117 METRICS IS DIFFICULT AND 6955 05:16:43,184 --> 05:16:44,118 REQUIRES VERY COMPLEX ANALYSES 6956 05:16:44,185 --> 05:16:45,553 AND RIGOROUS QUALITY CONTROL AND 6957 05:16:45,619 --> 05:16:48,589 THERE DOES NEED TO BE RIS RUSS 6958 05:16:48,656 --> 05:16:49,890 STANDARDIZATION OF THESE 6959 05:16:49,957 --> 05:16:50,124 METRICS. 6960 05:16:50,191 --> 05:16:53,294 I WANT TO END OVER HERE, THANK 6961 05:16:53,361 --> 05:16:54,161 EVERYONE INVOLVED IN THIS 6962 05:16:54,228 --> 05:16:55,329 RESEARCH AND THANK YOU FOR YOUR 6963 05:16:55,396 --> 05:16:55,796 ATTENTION TODAY. 6964 05:16:55,863 --> 05:17:03,571 [APPLAUSE] 6965 05:17:03,637 --> 05:17:05,106 >> SO ACTUALLY I THINK TIME FOR 6966 05:17:05,172 --> 05:17:06,140 THE PANEL DISCUSSION, SO RICH, 6967 05:17:06,207 --> 05:17:07,241 IF YOU WANT TO COME UP AND IF 6968 05:17:07,308 --> 05:17:08,442 ALL THE PRESENTERS WILL PLEASE 6969 05:17:08,509 --> 05:17:12,046 MAKE THEIR WAY UP ON STAGE. 6970 05:17:12,113 --> 05:17:13,314 IF THERE ARE ANY QUESTIONS, 6971 05:17:13,381 --> 05:17:14,515 PLEASE FEEL FREE TO COME TO THE 6972 05:17:14,582 --> 05:17:18,352 MICS AND GO AHEAD AND START WITH 6973 05:17:18,419 --> 05:17:23,691 ASKING. 6974 05:17:23,758 --> 05:17:25,893 >> SO I HAVE A QUESTION FOR YOU, 6975 05:17:25,960 --> 05:17:26,327 NADIA. 6976 05:17:26,394 --> 05:17:27,661 BEAUTIFUL WORK, VERY NICE 6977 05:17:27,728 --> 05:17:30,064 PRESENTATION. 6978 05:17:30,131 --> 05:17:31,198 SO DID YOU LOOK AT ANY PATIENTS 6979 05:17:31,265 --> 05:17:35,035 WHO HAD EARLY INTERMEDIATE 6980 05:17:35,102 --> 05:17:36,437 A.M.D., AND WHAT WAS THE 6981 05:17:36,504 --> 05:17:38,506 INCIDENCE OF CHORIOCAPILLARIS 6982 05:17:38,572 --> 05:17:39,907 DROPOUT IN THOSE PATIENTS THAT 6983 05:17:39,974 --> 05:17:42,777 HAVE NO EVIDENCE OF ATROPHY? 6984 05:17:42,843 --> 05:17:48,349 >> SO WE DID FIND THAT IT'S 6985 05:17:48,416 --> 05:17:50,184 REALLY INTERESTING BECAUSE YOU 6986 05:17:50,251 --> 05:17:53,421 CAN'T DEFINE A BINARY OF 6987 05:17:53,487 --> 05:17:55,189 CHORIOCAPILLARIS DROPOUT YES 6988 05:17:55,256 --> 05:17:57,625 VERSUS NO ABOVE AND BEYOND AGESG 6989 05:17:57,691 --> 05:17:59,460 SO WE'RE LOOKING AT AVERAGES. 6990 05:17:59,527 --> 05:18:00,561 BUT WHEN YOU LOOK AT THE 6991 05:18:00,628 --> 05:18:01,896 AVERAGES, THE VAST MAJORITY OF 6992 05:18:01,962 --> 05:18:03,264 PATIENTS WHO HAVE EARLY A.M.D. 6993 05:18:03,330 --> 05:18:05,699 AT LEAST IN OUR STUDIES, I THINK 6994 05:18:05,766 --> 05:18:09,069 IT'S BEEN REPLICATED ACROSS MANY 6995 05:18:09,136 --> 05:18:10,905 DIFFERENT GROUPS, DO SEEM TO ON 6996 05:18:10,971 --> 05:18:12,440 AVERAGE HAVE MUCH MORE 6997 05:18:12,506 --> 05:18:15,376 CHORIOCAPILLARIS DROPOUT 6998 05:18:15,443 --> 05:18:19,313 COMPARED TO NORMAL AGING. 6999 05:18:19,380 --> 05:18:20,648 AND I THINK IT'S ESPECIALLY 7000 05:18:20,714 --> 05:18:21,816 VISIBLE WHEN YOU MOVE OUTSIDE OF 7001 05:18:21,882 --> 05:18:23,384 THE IMMEDIATE CENTRAL REGION AND 7002 05:18:23,451 --> 05:18:26,620 INTO THE VERY CENTRAL REGION. 7003 05:18:26,687 --> 05:18:30,124 BUT OF COURSE PATIENTS WHO TEND 7004 05:18:30,191 --> 05:18:31,826 TO PROGRESS TEND TO HAVE MORE 7005 05:18:31,892 --> 05:18:34,795 THAN PATIENTS OR AT LEAST WHAT 7006 05:18:34,862 --> 05:18:36,197 WE'VE SEEN THAN PATIENTS WHO 7007 05:18:36,263 --> 05:18:37,364 DON'T TEND TO PROGRESS AS FAST. 7008 05:18:37,431 --> 05:18:41,268 >> IT'S VERY EXCITING THAT HE YU 7009 05:18:41,335 --> 05:18:42,636 SHOWED IT WASN'T LOCALIZED WHICH 7010 05:18:42,703 --> 05:18:44,405 REALLY BACKS UP THE WORK THAT 7011 05:18:44,472 --> 05:18:45,940 PEOPLE HAVE FAILED TO SHOW FOR A 7012 05:18:46,006 --> 05:18:48,008 LONG TIME. 7013 05:18:48,075 --> 05:18:49,743 I KNOW VLAS WAS WORKING ON THIS 7014 05:18:49,810 --> 05:18:51,612 FOR A LONG TIME AND IT NEVER 7015 05:18:51,679 --> 05:18:52,279 SEEMED TO PAN OUT. 7016 05:18:52,346 --> 05:18:54,215 >> I THINK IT'S A MORE 7017 05:18:54,281 --> 05:18:55,850 GENERALIZED ISCHEMIC PHENOMENON 7018 05:18:55,916 --> 05:18:57,451 THAN IT IS A LOCAL PHENOMENON. 7019 05:18:57,518 --> 05:18:58,519 SO IF WE HAVE SOME PEOPLE HERE 7020 05:18:58,586 --> 05:19:00,521 TO ASK QUESTIONS? 7021 05:19:00,588 --> 05:19:02,389 >> HI, NADIA. 7022 05:19:02,456 --> 05:19:05,526 PAT DEMORI FROM MOUNT ZION. 7023 05:19:05,593 --> 05:19:07,261 THIS MAY BE A PREMATURE QUESTION 7024 05:19:07,328 --> 05:19:09,663 BUT, IS IT POSSIBLE NOW OR EVER 7025 05:19:09,730 --> 05:19:11,799 TO CORRELATE THE DEGREE OF 7026 05:19:11,866 --> 05:19:15,636 CHORIOCAPILLARIS DROPOUT WITH 7027 05:19:15,703 --> 05:19:18,272 THE SIZE OF THE DRUSEN, EITHER 7028 05:19:18,339 --> 05:19:20,140 TOTAL SIZE OR HEIGHT? 7029 05:19:20,207 --> 05:19:22,176 I'VE ALWAYS THOUGHT HEIGHT OF 7030 05:19:22,243 --> 05:19:24,578 DRUSEN WAS GOING TO BE REALLY 7031 05:19:24,645 --> 05:19:26,580 LIKE A -- IT'S ISCHEMIA, BUT IN 7032 05:19:26,647 --> 05:19:29,917 MY OPINION, IT'S ALSO A BARRIER 7033 05:19:29,984 --> 05:19:33,854 FOR THE VEGF COMING FROM RPE 7034 05:19:33,921 --> 05:19:34,622 THAT THE CHORIOCAPILLARIS NEEDS 7035 05:19:34,688 --> 05:19:36,156 TO SURVIVE. 7036 05:19:36,223 --> 05:19:38,359 SO THAT'S A BARRIER NOT ONLY OF 7037 05:19:38,425 --> 05:19:40,160 OXYGEN BUT OF OTHER DIFFUSION. 7038 05:19:40,227 --> 05:19:48,769 AND TET, BROO BROOKS IS THICKENR 7039 05:19:48,836 --> 05:19:51,071 AT LEAST BECOMING MORE 7040 05:19:51,138 --> 05:19:51,338 PERMEABLE. 7041 05:19:51,405 --> 05:19:53,140 >> I THINK THAT WOULD ALSO 7042 05:19:53,207 --> 05:19:54,575 EXPLAIN WHY YOU HAVE 7043 05:19:54,642 --> 05:19:55,643 CHORIOCAPILLARIS DROPOUT JUST 7044 05:19:55,709 --> 05:19:56,076 WITH AGING. 7045 05:19:56,143 --> 05:19:57,945 I THINK GROUPS HAVE CORRELATED 7046 05:19:58,012 --> 05:19:59,246 CHORIOCAPILLARIS DROPOUT 7047 05:19:59,313 --> 05:20:03,250 WITHDRDROPOUT WITHDRUSEN VOLUME. 7048 05:20:03,317 --> 05:20:04,785 I DON'T KNOW IF NEAR-INFRARED 7049 05:20:04,852 --> 05:20:05,786 ONE HAS LOOKED SPECIFICALLY AT 7050 05:20:05,853 --> 05:20:06,754 HEIGHT BUT THAT'S AN INTERESTING 7051 05:20:06,820 --> 05:20:07,888 QUESTION AND THE DATA IS 7052 05:20:07,955 --> 05:20:09,456 DEFINITELY THERE, SO WE SHOULD 7053 05:20:09,523 --> 05:20:10,658 BE ABLE TO GO BACK AND HAVE A 7054 05:20:10,724 --> 05:20:11,759 LOOK AT THAT SO LET'S CHAT. 7055 05:20:11,825 --> 05:20:17,765 >> OKAY, GREAT. 7056 05:20:17,831 --> 05:20:17,965 DAVID. 7057 05:20:18,032 --> 05:20:19,266 >> HI, I HAVE A QUESTION FOR 7058 05:20:19,333 --> 05:20:29,009 TOCO. 7059 05:20:29,076 --> 05:20:32,079 YOU HAVE EXPLORED INTERMITTENT 7060 05:20:32,146 --> 05:20:37,985 FLOW AND SERVE -- SO MY QUESTION 7061 05:20:38,052 --> 05:20:41,021 IS ABOUT THAT, WHETHER IT USEFUL 7062 05:20:41,088 --> 05:20:47,761 TO LOOK AT TIME WITHIN A CARDIAC 7063 05:20:47,828 --> 05:20:48,996 CYCLE AND BEYOND A CARDIAC 7064 05:20:49,063 --> 05:20:50,731 CYCLE, THERE ARE MINUTES, HOURS 7065 05:20:50,798 --> 05:20:56,203 AND DAYS. 7066 05:20:56,270 --> 05:21:02,576 I WOULD ASSUME THERE -- DO YOU N 7067 05:21:02,643 --> 05:21:03,844 IDEA WHICH ONE IS CLINICALLY 7068 05:21:03,911 --> 05:21:06,080 USEFUL IN THE DISEASE SETTING? 7069 05:21:06,146 --> 05:21:09,283 >> I DON'T HAVE A VERY CLEAR 7070 05:21:09,350 --> 05:21:13,120 IDEA ABOUT THAT RIGHT NOW. 7071 05:21:13,187 --> 05:21:16,156 BUT BASED ON OUR PRELIMINARY 7072 05:21:16,223 --> 05:21:18,759 DATA, THE INTERMITTENT 7073 05:21:18,826 --> 05:21:19,960 PROFICIENT INDEX THAT WE MEASURE 7074 05:21:20,027 --> 05:21:21,061 IN SICKLE CELL DISEASE, IT WORKS 7075 05:21:21,128 --> 05:21:22,596 BECAUSE IT HAS A VERY CLEAR 7076 05:21:22,663 --> 05:21:23,964 SEPARATION BETWEEN THE TWO 7077 05:21:24,031 --> 05:21:26,266 SECTIONS. 7078 05:21:26,333 --> 05:21:28,469 HAVING SAID THAT, WE ALSO NOTICE 7079 05:21:28,535 --> 05:21:30,337 IPT MITT ENT PERFUSION WITHIN 7080 05:21:30,404 --> 05:21:31,872 ONE SECTION. 7081 05:21:31,939 --> 05:21:35,476 BUT WE WERE NOT ABLE TO QUANTIFY 7082 05:21:35,542 --> 05:21:37,111 THAT INTERMITTENT PERFUSION 7083 05:21:37,177 --> 05:21:39,713 WITHIN SECTION BECAUSE WE ARE 7084 05:21:39,780 --> 05:21:40,914 LIMITED BY THE LOWER 7085 05:21:40,981 --> 05:21:45,386 SIGNAL-TO-NOISE RATIO. 7086 05:21:45,452 --> 05:21:47,988 BUT I DO SEE IF WE HAVE A FASTER 7087 05:21:48,055 --> 05:21:53,160 SCANNER, BETTER IMAGE QUALITY, 7088 05:21:53,227 --> 05:21:57,097 WE SHOULD BE ABLE TO MEASURE 7089 05:21:57,164 --> 05:21:58,866 INTERMITTENT PERFUSION -- 7090 05:21:58,932 --> 05:22:00,200 QUANTIFY INTERMITTENT PERFUSION 7091 05:22:00,267 --> 05:22:01,268 JUST WITHIN THE FIRST SECTION 7092 05:22:01,335 --> 05:22:04,271 WHICH IS LESS THAN 10 MINUTES. 7093 05:22:04,338 --> 05:22:06,674 OR IF WE EVEN HAVE A FASTER 7094 05:22:06,740 --> 05:22:10,611 SCANNER OR THE VISTA MACHINE, WE 7095 05:22:10,678 --> 05:22:12,479 SHOULD BE ABLE TO DO IT WITHIN 7096 05:22:12,546 --> 05:22:16,216 ONE SCAN. 7097 05:22:16,283 --> 05:22:17,785 >> SO IT DOESN'T HAVE TO TAKE A 7098 05:22:17,851 --> 05:22:18,919 LOT OF TIME IN CLINIC? 7099 05:22:18,986 --> 05:22:20,254 >> IT DOESN'T NEED TO TAKE A LOT 7100 05:22:20,320 --> 05:22:23,824 OF TIME. 7101 05:22:23,891 --> 05:22:25,225 TAKE MY STUDY AS PROOF OF 7102 05:22:25,292 --> 05:22:25,659 CONCEPT STUDY. 7103 05:22:25,726 --> 05:22:27,194 I JUST WANT TO SHOW PEOPLE THAT, 7104 05:22:27,261 --> 05:22:29,563 YES, WE'RE ABLE TO SEE THIS 7105 05:22:29,630 --> 05:22:30,664 INTERMITTENT PERFUSION. 7106 05:22:30,731 --> 05:22:33,634 BUT I'M VERY HOPEFUL THAT WE 7107 05:22:33,701 --> 05:22:36,670 COULD SHORTEN THE ENTIRE IMAGING 7108 05:22:36,737 --> 05:22:39,173 TIME INTO MAYBE LESS THAN A 7109 05:22:39,239 --> 05:22:41,809 MINUTE OR EVEN WITHIN SECONDS. 7110 05:22:41,875 --> 05:22:44,178 >> BY THE WAY, I NEVER WEAR A 7111 05:22:44,244 --> 05:22:45,746 WATCH AND ERIC SWANSON NEVER 7112 05:22:45,813 --> 05:22:50,851 WEARS A MUSTACHE, SO -- THOSE 7113 05:22:50,918 --> 05:22:52,252 CARTOON VIDEOS ARE TAKING A LOT 7114 05:22:52,319 --> 05:22:54,421 OF LIBERTY WITH OUR APPEARANCE, 7115 05:22:54,488 --> 05:22:56,090 BUT IT ALL IN THE SPIRIT OF FUN. 7116 05:22:56,156 --> 05:22:58,258 >> I HOPE YOU RECOGNIZE YOURSELF 7117 05:22:58,325 --> 05:23:01,495 IN THAT CARTOON CHARACTER. 7118 05:23:01,562 --> 05:23:05,666 YOU DON'T? 7119 05:23:05,733 --> 05:23:05,933 [LAUGHTER] 7120 05:23:05,999 --> 05:23:08,268 >> QUESTION TO THE SICKLE CELL 7121 05:23:08,335 --> 05:23:11,038 EXPERT. 7122 05:23:11,105 --> 05:23:14,808 SO AS THE SICKLE CELLS ARE 7123 05:23:14,875 --> 05:23:16,577 CLUSTERING AND ULTIMATELY THE 7124 05:23:16,643 --> 05:23:19,513 VESSEL LETS THEM GO, IS THERE A 7125 05:23:19,580 --> 05:23:21,014 CHANGE IN THE ARTERIAL 7126 05:23:21,081 --> 05:23:21,682 PLASTICITY IN THE SICKLE CELL 7127 05:23:21,749 --> 05:23:24,084 DISEASE? 7128 05:23:24,151 --> 05:23:26,386 >> SORRY, I'M NOT ABLE TO HEAR 7129 05:23:26,453 --> 05:23:27,588 VERY WELL FROM HERE. 7130 05:23:27,654 --> 05:23:28,956 YOU WERE ASKING -- 7131 05:23:29,022 --> 05:23:31,859 >> THERE IS TEMPORARY BLOCKAGE, 7132 05:23:31,925 --> 05:23:34,795 BUT THEN THE CELLS -- SICKLE 7133 05:23:34,862 --> 05:23:38,098 CELLS WERE ABLE TO GO THROUGH. 7134 05:23:38,165 --> 05:23:39,600 SO IS THERE A CHANGE IN THE 7135 05:23:39,666 --> 05:23:42,136 ARTERIAL PLASTICITY IN SICKLE 7136 05:23:42,202 --> 05:23:43,971 CELL DISEASE? 7137 05:23:44,037 --> 05:23:46,206 OBVIOUSLY ALL OF THE -- CENTRAL 7138 05:23:46,273 --> 05:23:46,607 IN THE ARTERY. 7139 05:23:46,673 --> 05:23:50,310 >> I SEE. 7140 05:23:50,377 --> 05:23:54,348 SO THERE ARE MULTIPLE FACTORS, 7141 05:23:54,414 --> 05:23:56,750 SO THE INTERMITTENT PERFUSION 7142 05:23:56,817 --> 05:23:59,520 EVENT OR THE INDEX IS AFFECTED 7143 05:23:59,586 --> 05:24:02,089 BY THE NUMBERS OF SICKLE CELLS 7144 05:24:02,156 --> 05:24:04,391 THAT ARE FLOWING INSIDE THE 7145 05:24:04,458 --> 05:24:08,195 BLOODSTREAM, AND ALSO THE 7146 05:24:08,262 --> 05:24:10,164 ELASTICITY OF THE VASCULATURE, 7147 05:24:10,230 --> 05:24:12,666 OF THE BLOOD VESSEL WALL, YES, 7148 05:24:12,733 --> 05:24:15,302 SO THAT'S MORE THAN -- IT'S NOT 7149 05:24:15,369 --> 05:24:16,937 JUST THE BLOOD CELL ISSUE, IT'S 7150 05:24:17,004 --> 05:24:19,006 ALSO THE VASCULAR WALL ISSUE. 7151 05:24:19,072 --> 05:24:22,075 >> SO IT WOULD BE MORE 7152 05:24:22,142 --> 05:24:24,912 INTERESTING TO SEE ULTRASOUND 7153 05:24:24,978 --> 05:24:26,313 TECHNIQUE -- IN THE PERIPHERAL 7154 05:24:26,380 --> 05:24:28,715 ARTERY, WHERE IT MIGHT BE EASIER 7155 05:24:28,782 --> 05:24:31,218 TO MEASURE THE ARTERIAL 7156 05:24:31,285 --> 05:24:33,787 PLASTICITY. 7157 05:24:33,854 --> 05:24:36,156 >> I'M NOT -- DR. ROSEN, ARE YOU 7158 05:24:36,223 --> 05:24:37,524 ABLE TO GET THAT QUESTION? 7159 05:24:37,591 --> 05:24:41,228 >> I DIDN'T HEAR. 7160 05:24:41,295 --> 05:24:43,030 >> IT APPEARS YOU'RE THE 7161 05:24:43,096 --> 05:24:44,031 MODERATOR HERE SO YOU CAN HELP 7162 05:24:44,097 --> 05:24:44,565 ME WITH THIS. 7163 05:24:44,631 --> 05:24:46,033 I WORK WITH DR. ROSEN, SO HE 7164 05:24:46,099 --> 05:24:47,601 MIGHT BE ABLE TO -- 7165 05:24:47,668 --> 05:24:52,539 >> SO ONE MORE QUESTION TO 7166 05:24:52,606 --> 05:24:52,973 DR. KASANI. 7167 05:24:53,040 --> 05:24:54,174 EXCELLENT WORK AND EXCELLENT 7168 05:24:54,241 --> 05:24:55,275 PRESENTATION. 7169 05:24:55,342 --> 05:24:57,911 SOLACE YOU ARE FOLLOWING UP THE 7170 05:24:57,978 --> 05:25:03,917 VASCULAR DENSITY, SO INSTEAD OF 7171 05:25:03,984 --> 05:25:05,953 MAPPING A FEW AREAS, YOU MUST DO 7172 05:25:06,019 --> 05:25:07,154 THE COMPLETE MAPPING, SO THAT 7173 05:25:07,221 --> 05:25:10,791 WAY YOU GET AN INTEGRAL VIEW. 7174 05:25:10,858 --> 05:25:11,925 AND THEN YOU COULD FOLLOW UP HOW 7175 05:25:11,992 --> 05:25:13,727 IT IS CHANGING WITH AGE, WITH 7176 05:25:13,794 --> 05:25:14,695 DEGENERATION, WITH TREATMENT AND 7177 05:25:14,761 --> 05:25:19,933 EVERYTHING ELSE. 7178 05:25:20,000 --> 05:25:21,768 SO WHAT ARE YOU MEASURING IN 7179 05:25:21,835 --> 05:25:23,637 CAPILLARY DENSITY? 7180 05:25:23,704 --> 05:25:28,775 IS IT THE NUMBER OF CAPILLARIES 7181 05:25:28,842 --> 05:25:31,478 FOR A UNIT AREA, THEIR DIVERSITY 7182 05:25:31,545 --> 05:25:35,616 BECAUSE CA THEY HAVE DIFFERENT 7183 05:25:35,682 --> 05:25:36,416 SIZES AND FUNCTION. 7184 05:25:36,483 --> 05:25:37,684 SO IS THERE SOMETHING YOU COULD 7185 05:25:37,751 --> 05:25:38,785 ULTIMATELY RELATE TO THE BLOOD 7186 05:25:38,852 --> 05:25:39,453 FLOW? 7187 05:25:39,519 --> 05:25:41,521 >> SO THAT'S A GOOD QUESTION. 7188 05:25:41,588 --> 05:25:42,923 SO THERE'S MANY DIFFERENT WAYS 7189 05:25:42,990 --> 05:25:45,993 OF QUANTIFYING THOSE OCTA MAPS. 7190 05:25:46,059 --> 05:25:50,130 AND THE METRIC THAT WE USE MOST 7191 05:25:50,197 --> 05:25:51,431 FREQUENTLY IS CALLED VESSEL 7192 05:25:51,498 --> 05:25:52,566 SKELETON DENSITY, SO BASICALLY 7193 05:25:52,633 --> 05:25:55,135 WHAT YOU DO IS YOU TAKE THE OCTA 7194 05:25:55,202 --> 05:25:56,970 IMAGE THAT IS GENERATED BY THE 7195 05:25:57,037 --> 05:25:59,706 DEVICE AND THEN YOU ACTUALLY 7196 05:25:59,773 --> 05:26:01,141 JUST LOOK AT EITHER THE AREA OF 7197 05:26:01,208 --> 05:26:04,177 THE IMAGE THAT'S COVERED BY 7198 05:26:04,244 --> 05:26:06,246 BINARIZED PIXELS, VESSEL AREA 7199 05:26:06,313 --> 05:26:08,081 DENSITY, OR YOU SKELETONIZE 7200 05:26:08,148 --> 05:26:10,951 THOSE CAPILLARES PROFILES AND 7201 05:26:11,018 --> 05:26:12,452 YOU LOOK AT THE ABSOLUTE LENGTH 7202 05:26:12,519 --> 05:26:16,957 OF CAPILLARES. 7203 05:26:17,024 --> 05:26:21,528 CAPILLARIES, SO IT'S EITHER 7204 05:26:21,595 --> 05:26:23,964 LENGTH OR UNITS IN AN IMAGE. 7205 05:26:24,031 --> 05:26:24,831 THERE'S MULTIPLE OTHER METRICS 7206 05:26:24,898 --> 05:26:26,266 THAT YOU CAN USE, BUT IN THAT 7207 05:26:26,333 --> 05:26:27,801 AREA, IT IS A GLOBAL MAP AND YOU 7208 05:26:27,868 --> 05:26:28,969 CAN LOOK AT DIFFERENT LAYERS, 7209 05:26:29,036 --> 05:26:30,604 RIGHT, YOU CAN LOOK AT THE 7210 05:26:30,671 --> 05:26:31,705 SUPERFICIAL LAYER OR THE 7211 05:26:31,772 --> 05:26:32,606 INTERMEDIATE LAYER OR THE DEEP 7212 05:26:32,673 --> 05:26:34,541 LAYER OR THE FULL THICKNESS. 7213 05:26:34,608 --> 05:26:37,945 AND WE'VE DONE IT EVERY WHICH 7214 05:26:38,011 --> 05:26:39,579 WAY, AND THE FINDINGS ARE 7215 05:26:39,646 --> 05:26:46,119 USUALLY MUST ROB MORE ROBUST FOE 7216 05:26:46,186 --> 05:26:49,957 SUPERFICIAL LAYER AND DEEP -- 7217 05:26:50,023 --> 05:26:51,558 PROJECTION ARTIFACT ALGORITHMS 7218 05:26:51,625 --> 05:26:52,960 ARE PRETTY GOODENOW TOO, BUT 7219 05:26:53,026 --> 05:26:53,860 LARGER FIELDS OF VIEW, WHEN WE 7220 05:26:53,927 --> 05:26:55,262 WERE DOING A LOT OF THOSE 7221 05:26:55,329 --> 05:26:56,596 STUDIES, LARGER FIELDS OF VEUL 7222 05:26:56,663 --> 05:26:58,131 WERE DEFINITELY NOT COMMERCIALLY 7223 05:26:58,198 --> 05:27:01,001 AVAILABLE OR AVAILABLE AT ALL. 7224 05:27:01,068 --> 05:27:02,536 AND IT WOULD BE GREAT TO DO 7225 05:27:02,602 --> 05:27:04,838 LARGER FIELDS OF VEUL BUT 7226 05:27:04,905 --> 05:27:07,007 RESOLUTION FALLS OFF AND SOME OF 7227 05:27:07,074 --> 05:27:09,409 THE GREAT TALKS YOU HEARD ABOUT 7228 05:27:09,476 --> 05:27:11,712 TODAY LIKE YALI'S TALK ARE 7229 05:27:11,778 --> 05:27:13,013 DESIGNED TO GET WIDER FIELDS OF 7230 05:27:13,080 --> 05:27:15,182 VIEW AND MAINTAIN THE SAME 7231 05:27:15,248 --> 05:27:17,050 RESOLUTION AS YOU GET IN A THREE 7232 05:27:17,117 --> 05:27:18,385 BY THREE OR A SIX BY SIX. 7233 05:27:18,452 --> 05:27:19,886 SO THAT'S CHALLENGING, BUT 7234 05:27:19,953 --> 05:27:21,088 THERE'S PEOPLE WORKING ON IT AND 7235 05:27:21,154 --> 05:27:23,724 I'M SURE IT WILL BE AROUND SOON. 7236 05:27:23,790 --> 05:27:26,093 >> KEEP DOING THE MEASUREMENTS. 7237 05:27:26,159 --> 05:27:27,427 THAT'S WHERE THE GOOD SCIENCE IS 7238 05:27:27,494 --> 05:27:28,662 ALL ABOUT. 7239 05:27:28,729 --> 05:27:29,296 >> THANK YOU. 7240 05:27:29,363 --> 05:27:33,133 THANKS A LOT. 7241 05:27:33,200 --> 05:27:34,968 I HAVE A QUESTION ACTUALLY FOR 7242 05:27:35,035 --> 05:27:37,037 TOCO IF I CAN. 7243 05:27:37,104 --> 05:27:38,672 AND YALI. 7244 05:27:38,739 --> 05:27:43,043 WHEN YOU SAY 3%, YOU WENT FROM 7245 05:27:43,110 --> 05:27:44,578 3% REPERFUSION INDEX OR 7246 05:27:44,644 --> 05:27:46,546 PERFUSION INDEX TO LIKE 0.5, 7247 05:27:46,613 --> 05:27:48,849 DOES THAT MEAN THAT IT'S 3% OF 7248 05:27:48,915 --> 05:27:51,151 THE PIXELS OR 3% OF THE 7249 05:27:51,218 --> 05:27:52,919 CAPILLARY SEGMENTS? 7250 05:27:52,986 --> 05:27:55,188 >> 3% OF THE PIXELS. 7251 05:27:55,255 --> 05:27:56,590 >> 3% OF THE PIXELS. 7252 05:27:56,656 --> 05:27:57,391 YOU A. SO GREAT. 7253 05:27:57,457 --> 05:27:58,892 >> AND I THINK LAST QUESTION 7254 05:27:58,959 --> 05:28:01,561 FROM DAVID. 7255 05:28:01,628 --> 05:28:04,131 >> I HAVE SO THE COMMENT AND 7256 05:28:04,197 --> 05:28:09,836 QUESTION FOR AMIR. 7257 05:28:09,903 --> 05:28:13,874 I FIND YOUR PRESENTATION OF THE 7258 05:28:13,940 --> 05:28:17,911 FLUX DENSITY INTERESTING BUT 7259 05:28:17,978 --> 05:28:18,578 SOMEWHAT PROBLEMATIC. 7260 05:28:18,645 --> 05:28:20,414 YOU KNOW, WE ALSO LOOKED AT 7261 05:28:20,480 --> 05:28:22,949 SOMETHING SIMILAR CALLED FLOW 7262 05:28:23,016 --> 05:28:28,755 INDEX AND I AGREE THAT IT IS A 7263 05:28:28,822 --> 05:28:30,424 MORE ROBUST REFLECTION OF 7264 05:28:30,490 --> 05:28:34,294 DISEASE IN SOME WAY BECAUSE IT 7265 05:28:34,361 --> 05:28:35,962 REFLECTS BOTH THE SKELETAL 7266 05:28:36,029 --> 05:28:39,533 DENSITY AND VELOCITY AND VESSEL 7267 05:28:39,599 --> 05:28:42,736 CALIBER. 7268 05:28:42,803 --> 05:28:44,204 BUT I'VE ALWAYS BEEN BOTHERED BY 7269 05:28:44,271 --> 05:28:46,807 YOUR USE OF THE INTERLIPID 7270 05:28:46,873 --> 05:28:48,442 EXPERIMENT TO MOTIVATE IT 7271 05:28:48,508 --> 05:28:49,743 BECAUSE I DON'T THINK THAT SCALE 7272 05:28:49,810 --> 05:28:51,278 IS TO A CLINICAL SITUATION. 7273 05:28:51,344 --> 05:28:52,412 THE EXPERIMENTS ARE DONE AT 7274 05:28:52,479 --> 05:28:55,649 CONCENTRATION OF 1, 2, 3, 4%, 7275 05:28:55,715 --> 05:28:57,651 LOW PERCENTAGE, BUT IT DOESN'T 7276 05:28:57,717 --> 05:29:00,487 REALLY SCALE TO HIGHER 7277 05:29:00,554 --> 05:29:03,256 PERCENTAGES BECAUSE IF YOU THINK 7278 05:29:03,323 --> 05:29:04,791 OF 100% LIPID, THERE WOULD BE NO 7279 05:29:04,858 --> 05:29:05,792 FLOW SIGNAL. 7280 05:29:05,859 --> 05:29:07,727 100% WATER, NO FLOW SIGNAL. 7281 05:29:07,794 --> 05:29:11,832 IT MAXIMIZES AT 50%. 7282 05:29:11,898 --> 05:29:14,101 AND THAT'S WHERE RED BLOOD CELL 7283 05:29:14,167 --> 05:29:15,202 DENSITY SITS. 7284 05:29:15,268 --> 05:29:18,371 SO IT DOESN'T REALLY REFLECT RED 7285 05:29:18,438 --> 05:29:22,876 BLOOD CELL DENSITY THAT MUCH. 7286 05:29:22,943 --> 05:29:24,411 THAT LAST JUST DOESN'T FOLLOW. 7287 05:29:24,478 --> 05:29:25,612 THAT'S MY OPINION. 7288 05:29:25,679 --> 05:29:29,549 BUT MY QUESTION IS, WE FOUND 7289 05:29:29,616 --> 05:29:35,021 FLOW INDEX FLUX DENSITY MAY 7290 05:29:35,088 --> 05:29:36,556 PROBLEMATIC IN THAT IT WOULD BE 7291 05:29:36,623 --> 05:29:43,330 HIGH LEER SUSCEPTIBLE TO SIGNAL 7292 05:29:43,396 --> 05:29:43,964 STRENGTH VARIATION. 7293 05:29:44,030 --> 05:29:45,165 DO YOU FIND THAT AS WELL IN YOUR 7294 05:29:45,232 --> 05:29:45,599 FLUX WORK? 7295 05:29:45,665 --> 05:29:46,933 >> GREAT POINT INITIALLY. 7296 05:29:47,000 --> 05:29:51,671 SO WE DON'T HAVE IN VITRO FLUID 7297 05:29:51,738 --> 05:29:53,740 IK MODEL USING RBCs AND 7298 05:29:53,807 --> 05:29:57,844 CERTAINLY IN VIVO, IT IS VERY 7299 05:29:57,911 --> 05:29:58,612 DIFFERENT, THERE'S LOTS OF 7300 05:29:58,678 --> 05:29:59,579 DIFFERENT THINGS GOING ON. 7301 05:29:59,646 --> 05:30:00,914 HOWEVER, THE CORRELATIONS EXIST, 7302 05:30:00,981 --> 05:30:01,214 RIGHT? 7303 05:30:01,281 --> 05:30:02,716 AND SO THAT'S WHY WE DID THE 7304 05:30:02,782 --> 05:30:07,154 EXPERIMENTS THAT I SHOWED YOU IN 7305 05:30:07,220 --> 05:30:07,687 HUMAN SUBJECTS. 7306 05:30:07,754 --> 05:30:09,556 WE ACTUALLY LOOKED AT HUMAN 7307 05:30:09,623 --> 05:30:11,858 SUBJECTS ACROSS A NORMAL 7308 05:30:11,925 --> 05:30:13,393 HEMATOCRIT SO THE CORRELATIONS 7309 05:30:13,460 --> 05:30:14,594 EXIST AND THEY'RE VERY 7310 05:30:14,661 --> 05:30:15,795 SIGNIFICANT AND THEY'RE 7311 05:30:15,862 --> 05:30:16,997 REPRODUCIBLE AND WE'RE ACTUALLY 7312 05:30:17,063 --> 05:30:18,298 DOING IT ON A VERY LARGE SCALE. 7313 05:30:18,365 --> 05:30:20,167 SO I AGREE IT PROBABLY DOESN'T 7314 05:30:20,233 --> 05:30:23,436 TRANSLATE 100% BETWEEN MICRO 7315 05:30:23,503 --> 05:30:24,971 SPHERES OR LIPID SPHERES OR 7316 05:30:25,038 --> 05:30:26,373 WHATEVER YOU USE IN VITRO, BUT 7317 05:30:26,439 --> 05:30:27,607 IT DOES TRANSLATE ENOUGH FOR US 7318 05:30:27,674 --> 05:30:30,544 TO GET A SIGNAL THAT IS 7319 05:30:30,610 --> 05:30:34,281 SOMETHING MORE THAN JUST 7320 05:30:34,347 --> 05:30:35,815 THRESHOLDING AN IMAGE AND 7321 05:30:35,882 --> 05:30:36,449 BINARIZING IT. 7322 05:30:36,516 --> 05:30:38,852 SO WHAT EXACTLY THAT IS WILL 7323 05:30:38,919 --> 05:30:40,720 PROBABLY TAKE A LOT MORE IN 7324 05:30:40,787 --> 05:30:42,923 VITRO WORK. 7325 05:30:42,989 --> 05:30:44,758 WHICH I'D LOVE TO DO WITH 7326 05:30:44,824 --> 05:30:45,959 SOMEBODY. 7327 05:30:46,026 --> 05:30:47,861 THE SECOND PART OF YOUR QUESTION 7328 05:30:47,928 --> 05:30:48,495 WAS? 7329 05:30:48,562 --> 05:30:50,897 SORRY, I FOR FORGOT THE SECOND. 7330 05:30:50,964 --> 05:30:52,532 WHAT WAS THE SECOND? 7331 05:30:52,599 --> 05:30:53,333 OH, SIGNAL STRENGTH. 7332 05:30:53,400 --> 05:30:56,403 IT IS HIGHLY SENSITIVE TO SIGNAL 7333 05:30:56,469 --> 05:30:58,905 STRENGTH. 7334 05:30:58,972 --> 05:30:59,773 EXTRAORDINARILY SENSITIVE TO 7335 05:30:59,839 --> 05:31:00,907 SIGNAL STRENGTH. 7336 05:31:00,974 --> 05:31:04,811 SO THAT'S ONE OF THE REASONS WHY 7337 05:31:04,878 --> 05:31:06,680 WE STILL LOOK AT VESSEL SKELETON 7338 05:31:06,746 --> 05:31:08,315 DENSITY IN ALMOST EVERY MEASURE. 7339 05:31:08,381 --> 05:31:10,917 SO YOU CAN ONLY TAKE THE BEST OF 7340 05:31:10,984 --> 05:31:13,019 THE BEST OCTA IMAGES AND USE 7341 05:31:13,086 --> 05:31:13,453 FLUX. 7342 05:31:13,520 --> 05:31:15,522 AND IN FACT WE ONLY DO IT WITH 7343 05:31:15,589 --> 05:31:16,856 THE SWEAT SOURCE DEVICE WHICH IS 7344 05:31:16,923 --> 05:31:18,491 WHY I DON'T PRESENT IT ON EVERY 7345 05:31:18,558 --> 05:31:19,025 SINGLE DATASET. 7346 05:31:19,092 --> 05:31:21,127 SO IT TAKES, AS NADIA SAID, A 7347 05:31:21,194 --> 05:31:23,964 LOT OF QC, A LOT OF EFFORT TO 7348 05:31:24,030 --> 05:31:25,498 ACQUIRE THOSE IMAGES AND SO YOU 7349 05:31:25,565 --> 05:31:26,800 JUST CAN'T THROW SOMEBODY BEHIND 7350 05:31:26,866 --> 05:31:28,568 A SCANNER AND GET FLUX MEASURES. 7351 05:31:28,635 --> 05:31:29,936 BUT THAT IS ONE OF THE DRAWBACKS 7352 05:31:30,003 --> 05:31:32,405 FOR SURE. 7353 05:31:32,472 --> 05:31:34,241 >> I HAVE A QUESTION FOR YALI. 7354 05:31:34,307 --> 05:31:36,977 SO I REALLY LIKED THE 7355 05:31:37,043 --> 05:31:41,248 COMBINATION OF STRUCTURAL AND 7356 05:31:41,314 --> 05:31:45,018 OCTA, IT'S SO MUCH MORE POWERFUL 7357 05:31:45,085 --> 05:31:46,286 IN TERMS OF SHOWING WHAT'S 7358 05:31:46,353 --> 05:31:47,287 REALLY GOING ON. 7359 05:31:47,354 --> 05:31:49,456 SO IN TERMS OF A.I., IS IT 7360 05:31:49,522 --> 05:31:50,657 CONCEIVABLE THAT TOOLS WOULD BE 7361 05:31:50,724 --> 05:31:51,858 DEVELOPED THAT WOULD 7362 05:31:51,925 --> 05:31:53,059 SPECIFICALLY -- FOR MOST 7363 05:31:53,126 --> 05:31:54,060 CLINICIANS, THEY DON'T HAVE TIME 7364 05:31:54,127 --> 05:31:58,098 TO GO THROUGH ALL THESE GREAT 7365 05:31:58,164 --> 05:32:00,066 IMAGES, BECAUSE WE HAVE ONLY 7366 05:32:00,133 --> 05:32:03,803 MICRO SECONDS TO SEE PATIENTS. 7367 05:32:03,870 --> 05:32:06,740 AND SO THE QUESTION IS, CAN 7368 05:32:06,806 --> 05:32:09,042 THE -- DO YOU THINK THAT THE 7369 05:32:09,109 --> 05:32:11,211 SOFTWARE IN THE CONCEIVABLE 7370 05:32:11,278 --> 05:32:13,113 FUTURE WILL BE AVAILABLE THAT 7371 05:32:13,179 --> 05:32:16,916 BASICALLY WOULD BE ABLE TO PICK 7372 05:32:16,983 --> 05:32:18,785 UP, SAY, NEOVASCULAR VESSELS 7373 05:32:18,852 --> 05:32:21,621 RIGHT ON THE SURFACE AND GIVE A 7374 05:32:21,688 --> 05:32:24,257 READING BASED ON YOUR A.I. 7375 05:32:24,324 --> 05:32:25,892 SEGMENTATION? 7376 05:32:25,959 --> 05:32:32,332 YOU KNOW, SOME OF THESE FEATU 7377 05:32:32,399 --> 05:32:33,099 FEATURES -- AUTOMATED IN A WAY 7378 05:32:33,166 --> 05:32:34,000 THAT WOULD BE USEFUL. 7379 05:32:34,067 --> 05:32:35,135 >> THANKS FOR THE QUESTION, BY 7380 05:32:35,201 --> 05:32:35,635 THE WAY. 7381 05:32:35,702 --> 05:32:42,075 I REALLY HOPE TH SOMEONE IN THE 7382 05:32:42,142 --> 05:32:43,009 O.C.T. INDUSTRY IN THE AUDIENCE, 7383 05:32:43,076 --> 05:32:44,477 I REALLY WANT TO LET THEM KNOW, 7384 05:32:44,544 --> 05:32:48,548 WE DO NEED A.I. BASED 7385 05:32:48,615 --> 05:32:50,617 AUTOMATION, YOU KNOW, WHATEVER 7386 05:32:50,684 --> 05:32:53,353 YOU CAN MAKE FOR USE A.I. POWER 7387 05:32:53,420 --> 05:32:55,689 TO IMPROVE THE VISUALIZATION, 7388 05:32:55,755 --> 05:33:00,460 YOU KNOW, YOU CAN GATHER NOISE, 7389 05:33:00,527 --> 05:33:02,529 BACKGROUND NOISE AND A LOT OF 7390 05:33:02,595 --> 05:33:03,963 ARTIFACT. 7391 05:33:04,030 --> 05:33:08,768 SO HELP OUR DOCTORS TO -- TO SEE 7392 05:33:08,835 --> 05:33:11,738 THE IMAGE, THAT'S NUMBER ONE, 7393 05:33:11,805 --> 05:33:12,372 RIGHT? 7394 05:33:12,439 --> 05:33:13,907 AND BIOMARKER MEASUREMENT, THEN 7395 05:33:13,973 --> 05:33:17,410 A.I. CAN PROVIDE THE VALUE, 7396 05:33:17,477 --> 05:33:19,913 RELIABLE VALUE, THEN OUR 7397 05:33:19,979 --> 05:33:23,316 CLINICIANS CAN EASILY TO SEE THE 7398 05:33:23,383 --> 05:33:25,819 FOLLOW-UP COMPARED TO THE 7399 05:33:25,885 --> 05:33:28,355 BASELINE, THEN, YOU KNOW, THAT'S 7400 05:33:28,421 --> 05:33:29,322 GOING TO SAVE YOU TIME. 7401 05:33:29,389 --> 05:33:33,727 SO THE IDEA OF THE A.I., JUST 7402 05:33:33,793 --> 05:33:35,128 TRY TO SAVE USER'S TIME, THAT 7403 05:33:35,195 --> 05:33:37,163 SHOULD BE IMPLEMENTED IN THE 7404 05:33:37,230 --> 05:33:38,631 DEVICE. 7405 05:33:38,698 --> 05:33:40,066 HOPEFULLY IN NEAR FUTURE. 7406 05:33:40,133 --> 05:33:44,571 BUT I THINK THE VISUALIZATION 7407 05:33:44,637 --> 05:33:49,042 PART, THIS HAS BEEN SUCCESSFULLY 7408 05:33:49,109 --> 05:33:52,011 BEEN IMPLEMENTED BY SOME OF THE 7409 05:33:52,078 --> 05:33:53,747 OCTA DEVICE ALREADY. 7410 05:33:53,813 --> 05:33:56,049 I THINK THAT'S A FIRST STEP. 7411 05:33:56,116 --> 05:33:57,617 I'M NOT SURE WHY THEY ARE KIND 7412 05:33:57,684 --> 05:34:00,653 OF HESITANT TO USE THE 7413 05:34:00,720 --> 05:34:02,956 A.I.-BASED MEASUREMENT. 7414 05:34:03,022 --> 05:34:07,227 MAYBE THE -- THIS IS A HUGE STEP 7415 05:34:07,293 --> 05:34:09,396 FOR THEM TO MOVE FORWARD, OR 7416 05:34:09,462 --> 05:34:11,698 MAYBE THEY'RE WAITING ON SOME 7417 05:34:11,765 --> 05:34:14,234 LARGE DATASET, YOU KNOW, THAT'S 7418 05:34:14,300 --> 05:34:16,202 THE WHOLE COMMUNITY SHOULD GET A 7419 05:34:16,269 --> 05:34:18,505 LOT OF DATASETS TO VALIDATE. 7420 05:34:18,571 --> 05:34:22,308 >> I THINK THE VALIDATION SORT 7421 05:34:22,375 --> 05:34:24,277 OF HOLDS BEFORE PEOPLE READILY 7422 05:34:24,344 --> 05:34:25,612 EMBRACE IT. 7423 05:34:25,678 --> 05:34:25,879 BEAUTIFUL. 7424 05:34:25,945 --> 05:34:26,813 THANK YOU. 7425 05:34:26,880 --> 05:34:28,148 >> THANKS FOR THE QUESTION. 7426 05:34:28,214 --> 05:34:28,782 >> OKAY. 7427 05:34:28,848 --> 05:34:30,950 I THINK WE'RE DONE IF THERE ARE 7428 05:34:31,017 --> 05:34:33,753 NO OTHER QUESTIONS. 7429 05:34:33,820 --> 05:34:35,588 WANT TO GIVE US THE NEW TIME 7430 05:34:35,655 --> 05:34:36,022 SCHEDULE? 7431 05:34:36,089 --> 05:34:38,124 I THINK WE'RE ON SOME DIFFERENT 7432 05:34:38,191 --> 05:34:38,324 TIMES. 7433 05:34:38,391 --> 05:34:40,193 >> I'D LIKE TO THANK THE 7434 05:34:40,260 --> 05:34:40,660 SPEAKERS AGAIN. 7435 05:34:40,727 --> 05:34:46,766 [APPLAUSE] 7436 05:34:46,833 --> 05:34:49,169 AND LET'S RECONVENE AT 4:00 FOR 7437 05:34:49,235 --> 05:34:52,472 THE FINAL SESSION OF THE DAY. 7438 05:34:52,539 --> 05:34:53,740 I'D LIKE TO GET GOING WITH THE 7439 05:34:53,807 --> 05:34:57,911 FINAL SESSION OF THE AFTERNOON. 7440 05:34:57,977 --> 05:35:00,880 I'M PLEASED TO INTRODUCE JESSICA 7441 05:35:00,947 --> 05:35:02,615 MORGAN FROM THE UNIVERSITY OF 7442 05:35:02,682 --> 05:35:03,917 PENNSYLVANIA, AND JESSICA WILL 7443 05:35:03,983 --> 05:35:06,519 BE MODERATING THE SESSION ON 7444 05:35:06,586 --> 05:35:09,389 OPTORET NOGRAPHY. 7445 05:35:11,925 --> 05:35:16,963 ON OPTORETINOGRAPHY. 7446 05:35:17,030 --> 05:35:18,231 >> THANK YOU ALL SO MUCH. 7447 05:35:18,298 --> 05:35:19,766 IT TRULY IS AN HONOR TO BE PART 7448 05:35:19,833 --> 05:35:22,869 OF THIS REALLY SPECTACULAR 7449 05:35:22,936 --> 05:35:23,970 PROGRAM. 7450 05:35:24,037 --> 05:35:25,371 I'VE REALLY ENJOYED ALL OF THE 7451 05:35:25,438 --> 05:35:27,106 SESSIONS SO FAR TODAY, AND IT IS 7452 05:35:27,173 --> 05:35:28,875 MY HONOR TO MODERATE THIS FINAL 7453 05:35:28,942 --> 05:35:32,479 SESSION OF THE AFTERNOON ON OP 7454 05:35:32,545 --> 05:35:34,881 KNOW RETINOGRAPHY. 7455 05:35:34,948 --> 05:35:40,787 OUR FIRST SPEAKER IS RAM SABE 7456 05:35:40,854 --> 05:35:42,322 SABESAN, HE'S GOING TO BE 7457 05:35:42,388 --> 05:35:43,756 SPEAKING ON THE MECHANISMS AND M 7458 05:35:43,823 --> 05:35:46,693 ACATIONS OF OPTORETINOGRAPHY. 7459 05:35:46,759 --> 05:35:57,103 RAM, IT'S ALL YOURS. 7460 05:36:02,375 --> 05:36:05,178 >> ALL RIGHT. 7461 05:36:05,245 --> 05:36:07,514 THANK YOU TO THE ORGANIZERS FOR 7462 05:36:07,580 --> 05:36:07,814 INVITING ME. 7463 05:36:07,881 --> 05:36:09,782 IT IS MY PRIVILEGE AND HONOR TO 7464 05:36:09,849 --> 05:36:10,216 BE HERE. 7465 05:36:10,283 --> 05:36:14,487 AS FAR AS THE HI HISTORY OF O.C. 7466 05:36:14,554 --> 05:36:19,425 GOES, I'M A TOTAL NWEBIE OR AS 7467 05:36:19,492 --> 05:36:21,594 THE KIDS CALL IT NEWB, ONLY 7468 05:36:21,661 --> 05:36:22,929 DOING IT IN THE LAST SEVEN OR 7469 05:36:22,996 --> 05:36:24,130 EIGHT YEARS, SO I HAVE BEEN A 7470 05:36:24,197 --> 05:36:24,964 DIRECT BENEFICIARY OF ALL THE 7471 05:36:25,031 --> 05:36:28,201 WORK THAT THE LASKER AWARDEES 7472 05:36:28,268 --> 05:36:29,936 HAVE DONE OVER THE PAST VERY 7473 05:36:30,003 --> 05:36:32,472 MANY YEARS TO PROMOTE THE FIELD 7474 05:36:32,539 --> 05:36:34,107 OF O.C.T. 7475 05:36:34,173 --> 05:36:35,975 SO I WILL BE TELLING YOU ABOUT A 7476 05:36:36,042 --> 05:36:38,845 NEW AND EMERGING APPLICATION OF 7477 05:36:38,912 --> 05:36:41,114 O.C.T. THAT WE LIKE TO CALL 7478 05:36:41,180 --> 05:36:41,748 OPTORETINOGRAPHY AND I'LL TAKE 7479 05:36:41,814 --> 05:36:43,850 YOU INTO A LITTLE JOURNEY ON 7480 05:36:43,917 --> 05:36:47,320 STUDYING ITS MECHANISMS AND ITS 7481 05:36:47,387 --> 05:36:48,354 APPLICATIONS. 7482 05:36:48,421 --> 05:36:50,323 SO JUST AS A 30,000-FOOT VIEW, 7483 05:36:50,390 --> 05:36:52,325 WE CAN THINK ABOUT THE VARIOUS 7484 05:36:52,392 --> 05:36:54,060 METHODS THAT ARE USED TO ASSESS 7485 05:36:54,127 --> 05:36:55,161 THE HUMAN RETINA IN HEALTH AND 7486 05:36:55,228 --> 05:36:57,897 DISEASE IN THIS 2 BY 2 GRID, 7487 05:36:57,964 --> 05:36:59,632 WHERE STRUCTURE AND FUNCTION IN 7488 05:36:59,699 --> 05:37:02,602 THE COLUMBUS AND SUBJECTIVE AND 7489 05:37:02,669 --> 05:37:08,074 ON JEKTIVE ASSAYS ARE ON THE 7490 05:37:08,141 --> 05:37:10,376 ROWS. 7491 05:37:10,443 --> 05:37:12,879 RETINAL CAMERAS PROVIDING US 7492 05:37:12,946 --> 05:37:15,281 OBJECTIVE AND SUBJECTIVE 7493 05:37:15,348 --> 05:37:18,051 STRUCTURE. 7494 05:37:18,117 --> 05:37:19,452 PROVIDING SUBJECTIVE ASSAYS OF 7495 05:37:19,519 --> 05:37:20,653 FUNCTION AND AS FAR AS OBJECTIVE 7496 05:37:20,720 --> 05:37:23,723 ASSAYS OF FUNCTION GO, THERE ARE 7497 05:37:23,790 --> 05:37:24,724 NOT VERY MANY AVAILABLE OUT 7498 05:37:24,791 --> 05:37:26,926 THERE, AND ELECTRORETINOGRAPHY 7499 05:37:26,993 --> 05:37:29,228 IS PERHAPS THE MOST COMMON 7500 05:37:29,295 --> 05:37:31,297 PREVALENT ONE, AND THIS IS 7501 05:37:31,364 --> 05:37:32,298 PERHAPS AS THRILLED AS I CAN 7502 05:37:32,365 --> 05:37:33,499 APPEAR GETTING ONE OF THESE DONE 7503 05:37:33,566 --> 05:37:36,002 WITH TAPE ON MY FOREHEAD AND 7504 05:37:36,069 --> 05:37:37,470 LITTLE ELECTRODES RUNNING DOWN 7505 05:37:37,537 --> 05:37:38,771 MY LOWER EYELID, AND OF COURSE 7506 05:37:38,838 --> 05:37:40,840 THERE ARE VARIETY OF DIFFERENT 7507 05:37:40,907 --> 05:37:43,810 DISADVANTAGES OF USING ERG, 7508 05:37:43,876 --> 05:37:46,646 PRIMARILY THAT ITS RESOLUTION IS 7509 05:37:46,713 --> 05:37:48,948 TOO COARSE TO BE ABLE TO MEASURE 7510 05:37:49,015 --> 05:37:50,717 SCALE LAR CELL ACTIVITY IN THE 7511 05:37:50,783 --> 05:37:51,050 RETINA. 7512 05:37:51,117 --> 05:37:53,119 SO THE TERMINOLOGY OF THE OR 7513 05:37:53,186 --> 05:37:55,755 GWAS REALLY PROPOSED BY DON MA 7514 05:37:55,822 --> 05:37:57,624 CLOUD, DAVID WILLIAMS, HIS PH.D. 7515 05:37:57,690 --> 05:37:58,958 SUPERVISOR IN THE EARLY 80s. 7516 05:37:59,025 --> 05:38:01,561 AT THE TIME THEY DID NOT MEASURE 7517 05:38:01,628 --> 05:38:05,498 ANY VISUALLY EVOKED CHANGES. 7518 05:38:05,565 --> 05:38:09,769 AND I WAS NOT AWARE OF IT UNTIL 7519 05:38:09,836 --> 05:38:15,241 WE ATTENDED THE FESH -- WHEN ONE 7520 05:38:15,308 --> 05:38:16,809 OF HIS STUDENTS TOLD US AS EARLY 7521 05:38:16,876 --> 05:38:18,778 AS 1980, DON HAD COINED THIS 7522 05:38:18,845 --> 05:38:22,181 TERM TO DESCRIBE A CHANGE IN THE 7523 05:38:22,248 --> 05:38:24,384 NEAR INFRARED FOLLOWING VISUAL 7524 05:38:24,450 --> 05:38:26,653 STIMULATION AND WHEN THEY WERE 7525 05:38:26,719 --> 05:38:30,156 STUDYING THESE PAPERS ON TOAD 7526 05:38:30,223 --> 05:38:30,757 RETINA. 7527 05:38:30,823 --> 05:38:32,492 THIS RESONATED WITH US AND WE 7528 05:38:32,558 --> 05:38:34,727 BEGAN TO USE IT IN ABOUT THE 7529 05:38:34,794 --> 05:38:35,328 2019 TIME FRAME. 7530 05:38:35,395 --> 05:38:36,763 THESE ARE ALL THE PAPERS AROUND 7531 05:38:36,829 --> 05:38:39,065 THAT TIME WHO HAVE USED THE SAME 7532 05:38:39,132 --> 05:38:40,700 TERMINOLOGY, IT'S NOT TO SAY 7533 05:38:40,767 --> 05:38:42,268 THAT WE'RE THE PIONEERS OF THIS 7534 05:38:42,335 --> 05:38:43,670 FIELD NECESSARILY. 7535 05:38:43,736 --> 05:38:46,472 JUST THAT WE BEGAN TO USE IT 7536 05:38:46,539 --> 05:38:49,142 FIRST. 7537 05:38:49,208 --> 05:38:51,110 BUT THESE GUYS HAVE BEEN DOING 7538 05:38:51,177 --> 05:38:55,381 THESE KINDS OF MEASUREMENTS OF 7539 05:38:55,448 --> 05:38:56,149 NEAR-INFRARED CHANGES FOLLOWING 7540 05:38:56,215 --> 05:38:57,784 A VISUAL STIMULUS FOR ABOUT THE 7541 05:38:57,850 --> 05:38:59,052 LAST 20 YEARS OR 15 TO 20 YEARS 7542 05:38:59,118 --> 05:39:03,823 OR SO. 7543 05:39:03,890 --> 05:39:05,458 SO I DON'T HAVE TIME TO REALLY 7544 05:39:05,525 --> 05:39:07,960 GET INTO THE HISTORY OF 7545 05:39:08,027 --> 05:39:08,961 OPTORETINOGRAPHY BUT I'LL POINT 7546 05:39:09,028 --> 05:39:09,862 YOU TO THIS LITTLE WEBINAR I DID 7547 05:39:09,929 --> 05:39:10,630 A FEW YEARS AGO. 7548 05:39:10,697 --> 05:39:11,831 SO THE GENERAL PARADIGM IS THE 7549 05:39:11,898 --> 05:39:12,298 FOLLOWING. 7550 05:39:12,365 --> 05:39:16,135 THINK OF THIS AS THE 7551 05:39:16,202 --> 05:39:17,003 CROSS-SECTION SIGNAL OF THE 7552 05:39:17,070 --> 05:39:18,638 RETINA AND WE CAN STATION AN 7553 05:39:18,705 --> 05:39:21,708 IMAGING BEAM SO, AND WHAT WE 7554 05:39:21,774 --> 05:39:25,545 REALLY WACHT WAN WANT TO DO IS W 7555 05:39:25,611 --> 05:39:27,013 THE ACTIVITY IN DIFFERENT RAYS 7556 05:39:27,080 --> 05:39:29,182 OF THE RETINA FOLLOWING A VISUAL 7557 05:39:29,248 --> 05:39:31,250 STIMULUS STARTING FROM THE PHOTO 7558 05:39:31,317 --> 05:39:32,919 RECEPTORS DOWN TO THE GANGLION 7559 05:39:32,985 --> 05:39:33,119 CELLS. 7560 05:39:33,186 --> 05:39:34,887 SO THIS IS REALLY THE DREAM AND 7561 05:39:34,954 --> 05:39:36,889 A THE DREAM IS TO CREATE AN 7562 05:39:36,956 --> 05:39:37,957 ALL-OPTICAL ANALOG OF THE 7563 05:39:38,024 --> 05:39:41,027 ELECTRODE TO BE ABLE TO USE IT 7564 05:39:41,094 --> 05:39:44,097 IN A NONINVASIVE WAY IN A LIVING 7565 05:39:44,163 --> 05:39:47,200 EYE. 7566 05:39:47,266 --> 05:39:53,506 BUT THE STUDY OF THE DEFORMATION 7567 05:39:53,573 --> 05:39:54,373 CHANGES ARE NOT NEW. 7568 05:39:54,440 --> 05:39:56,275 THIS PAPER IS FROM THE 1970s, 7569 05:39:56,342 --> 05:39:57,477 ABOUT 10 OR 12 YEARS AFTER 7570 05:39:57,543 --> 05:39:59,545 INVENTION OF THE LASER WHERE 7571 05:39:59,612 --> 05:40:00,947 THEY USE A LASER TO MEASURE 7572 05:40:01,013 --> 05:40:02,982 CHANGES IN THE SHAPE OF A 7573 05:40:03,049 --> 05:40:04,951 CRAYFISH AXON WHERE THEY HOLD IT 7574 05:40:05,017 --> 05:40:07,453 UNDER THESE ELECTRODES AND 7575 05:40:07,520 --> 05:40:11,724 MONITOR THE OPTICAL CHANGE IN 7576 05:40:11,791 --> 05:40:12,725 THE -- AMOUNT OF THE OPTICAL 7577 05:40:12,792 --> 05:40:13,926 CHANGE IN THE AXON ALONG WITH 7578 05:40:13,993 --> 05:40:15,128 ITS ELECTRICAL ACTIVITY. 7579 05:40:15,194 --> 05:40:17,130 THE KEY POINT HERE IS THAT THEY 7580 05:40:17,196 --> 05:40:19,198 MEASURE CHANGES ON THE ORDER OF 7581 05:40:19,265 --> 05:40:21,601 ABOUT 10 ANGST TROMS IN ABOUT 7582 05:40:21,667 --> 05:40:26,572 1 MILLISECOND IN THIS AXON WHICH 7583 05:40:26,639 --> 05:40:27,206 ACCOMPANIES THE ACTION 7584 05:40:27,273 --> 05:40:27,673 POTENTIAL. 7585 05:40:27,740 --> 05:40:30,610 SO FAST FORWARD ABOUT 35 YEARS 7586 05:40:30,676 --> 05:40:33,146 LATER, OPTICAL -- WAS USED IN 7587 05:40:33,212 --> 05:40:34,480 PHASE RESULT CONFIGURATION BY 7588 05:40:34,547 --> 05:40:36,549 THESE GUYS OVER HERE MEASURING 7589 05:40:36,616 --> 05:40:39,519 THE SQUID GIANT AXON WHERE THEY 7590 05:40:39,585 --> 05:40:41,387 MEASURED SIMILAR KINDS OF 7591 05:40:41,454 --> 05:40:44,457 CHANGES ON THE SCALE OF ABOUT 1T 7592 05:40:44,524 --> 05:40:45,892 1 MILLISECOND. 7593 05:40:45,958 --> 05:40:47,226 NOW LET'S FAST FORWARD ABOUT 15 7594 05:40:47,293 --> 05:40:48,628 YEARS SINCE THEN, OUR 7595 05:40:48,694 --> 05:40:50,897 COLLABORATORS AT STANFORD AN NTU 7596 05:40:50,963 --> 05:40:52,698 HAVE USED QUANTITATIVE PHASED 7597 05:40:52,765 --> 05:40:53,800 IMAGING TECHNIQUE TO MEASURE 7598 05:40:53,866 --> 05:40:55,968 CHANGES IN THE SHAPE OF A 7599 05:40:56,035 --> 05:41:00,807 CORTICAL NEURON WHERE THE 7600 05:41:00,873 --> 05:41:02,475 MEMBRANE TENSION DURING DEEP 7601 05:41:02,542 --> 05:41:03,776 POLARIZATION OF A NEURON CAUSES 7602 05:41:03,843 --> 05:41:04,877 A REDISTRIBUTION OF CHARGES ON 7603 05:41:04,944 --> 05:41:06,646 THE SURFACE OF THE NEURON, WHICH 7604 05:41:06,712 --> 05:41:09,282 CAUSES TO BECOME MORE SPHE SPHE, 7605 05:41:09,348 --> 05:41:11,818 AND THEY DESCRIBE A VOLTAGE 7606 05:41:11,884 --> 05:41:12,919 DEPENDENT MEMBRANE CHANGE MODEL 7607 05:41:12,985 --> 05:41:14,020 SO LET'S MAKE A MENTAL NOTE OF 7608 05:41:14,086 --> 05:41:15,988 THAT AND A WE'LL COME BACK TO 7609 05:41:16,055 --> 05:41:18,524 THAT IN A SECOND AS TO HOW IT 7610 05:41:18,591 --> 05:41:20,159 RELATES TO CHANGES IN 7611 05:41:20,226 --> 05:41:21,360 PHOTORECEPTORS. 7612 05:41:21,427 --> 05:41:21,994 PHOTORECEPTORS SEEM TO HAVE A 7613 05:41:22,061 --> 05:41:23,496 BIT OF A BONANZA, IF YOU WILL, 7614 05:41:23,563 --> 05:41:25,565 WHEN IT COMES TO MEASURING THEIR 7615 05:41:25,631 --> 05:41:28,668 NEURAL ACTIVITY BUT BEFORE WE GO 7616 05:41:28,734 --> 05:41:30,403 THERE I'LL GIVE YOU A PRIMER ON 7617 05:41:30,469 --> 05:41:32,071 OSMOSIS OR OSMOTIC PRESSURE. 7618 05:41:32,138 --> 05:41:33,706 HI TO TURN TO HIGH SCHOOL 7619 05:41:33,773 --> 05:41:35,141 PHYSICS AND CHEMISTRY TO 7620 05:41:35,208 --> 05:41:36,375 REMEMBER WHAT THIS WAS. 7621 05:41:36,442 --> 05:41:37,176 OSMOSIS IS REALLY THE MOVEMENT 7622 05:41:37,243 --> 05:41:39,445 OF SOLVENT FROM HIGH KOL VENT 7623 05:41:39,512 --> 05:41:42,915 CONCENTRATION SUCH AS OVER HERE 7624 05:41:42,982 --> 05:41:46,252 TO LOW CONCENTRATION ACROSS A 7625 05:41:46,319 --> 05:41:46,786 PERMEABLE MEMBRANE. 7626 05:41:46,853 --> 05:41:50,423 SO THEY SUSPENDED ISOLATED -- 7627 05:41:50,489 --> 05:41:52,458 SEGMENTS -- WHAT THEY FOUND WAS 7628 05:41:52,525 --> 05:41:53,826 THE ROD OUTER SEGMENTS CHANGE IN 7629 05:41:53,893 --> 05:41:55,695 THEIR WIDTH, LENGTH AND VOLUME, 7630 05:41:55,761 --> 05:41:58,764 THE ENTIRE SHAPE OF THE ROD 7631 05:41:58,831 --> 05:42:00,066 OUTER SEGMENT CHANGES WHEN 7632 05:42:00,132 --> 05:42:01,434 THEY'RE IN A DISH OF DIFFERENT 7633 05:42:01,500 --> 05:42:02,001 CONCENTRATION. 7634 05:42:02,068 --> 05:42:03,369 THEY ALSO CHANGE WHEN THEY ARE 7635 05:42:03,436 --> 05:42:04,370 HIT WITH SOME LIGHT. 7636 05:42:04,437 --> 05:42:06,772 AND SO THE ARGUMENT THERE IS 7637 05:42:06,839 --> 05:42:08,307 THAT PHOTO TRANSDUCTION PRODUCTS 7638 05:42:08,374 --> 05:42:09,642 ALTER THE OUTER SEGMENT VOLUME 7639 05:42:09,709 --> 05:42:11,377 DUE TO OSMOSIS. 7640 05:42:11,444 --> 05:42:16,549 THIS WAS REFURBISHED BY 7641 05:42:16,616 --> 05:42:19,819 PROFESSOR ED PU AT UC DAVIS WHO 7642 05:42:19,886 --> 05:42:21,587 PROPOSED WHEN LIGHT HITS A ROD 7643 05:42:21,654 --> 05:42:26,092 OUTER SEGMENT, THEY GET SUSPEND 7644 05:42:26,158 --> 05:42:27,526 SUSPENDED INTO THE CYTOSOL 7645 05:42:27,593 --> 05:42:29,161 CREATING A SITUATION LIKE SO AND 7646 05:42:29,228 --> 05:42:31,030 WATER ENTERS FROM THE CHOROID 7647 05:42:31,097 --> 05:42:32,932 SIDE TO BALANCE THE OSMOTIC 7648 05:42:32,999 --> 05:42:33,199 PRESSURE. 7649 05:42:33,266 --> 05:42:34,133 THEY SHOWED A DIRECT CORRELATION 7650 05:42:34,200 --> 05:42:36,102 OF THIS CHANGE WITH PHOTO 7651 05:42:36,168 --> 05:42:37,069 TRANSDUCTION, SHOWING THAT MICE 7652 05:42:37,136 --> 05:42:43,242 THAT LACKED -- DO NOT SHOW SUCH 7653 05:42:43,309 --> 05:42:45,211 A CHANGE WHEREAS WILD TYPE MICE 7654 05:42:45,278 --> 05:42:45,778 DO. 7655 05:42:45,845 --> 05:42:49,348 AND THEY WERE ABLE TO ESTABLISH 7656 05:42:49,415 --> 05:42:52,084 AN OSMOELASTIC MODEL WHEREBY THE 7657 05:42:52,151 --> 05:42:54,287 BYPRODUCTS OF PHOTO TRANSDUCTION 7658 05:42:54,353 --> 05:42:55,421 GENERATE SUFFICIENT OSMOTIC 7659 05:42:55,488 --> 05:42:57,056 PRESSURE LEADING TO WHATTER IT 7660 05:42:57,123 --> 05:42:58,457 ENTRY INTO THE OUTER SEGMENT AND 7661 05:42:58,524 --> 05:43:04,230 CHANGE ITS SHAPE. 7662 05:43:04,297 --> 05:43:05,231 SO WITH THAT BACKGROUND I WANTED 7663 05:43:05,298 --> 05:43:07,633 TO GIVE YOU A LITTLE OVERVIEW OF 7664 05:43:07,700 --> 05:43:10,536 WHERE WE COME IN INTO 7665 05:43:10,603 --> 05:43:10,937 OPTORETINOGRAPHY. 7666 05:43:11,003 --> 05:43:12,371 WE ARE INVOLVED IN DEVELOPING 7667 05:43:12,438 --> 05:43:15,007 TECHNOLOGY TO STUDY THE ORG. 7668 05:43:15,074 --> 05:43:17,009 WE ARE USING TO STUDY THE 7669 05:43:17,076 --> 05:43:18,945 VARIOUS MECHANISMS OF ULTRA 7670 05:43:19,011 --> 05:43:21,047 RETINAL FUNCTION AND TO USE IT 7671 05:43:21,113 --> 05:43:22,448 FOR RETINAL DISEASE. 7672 05:43:22,515 --> 05:43:24,750 SO I'LL TELL BUT OUR TOOLS, TELL 7673 05:43:24,817 --> 05:43:27,653 YOU ABOUT THE MECHANISMS, 7674 05:43:27,720 --> 05:43:29,055 LEACHING PHOTO TRANSDUCTION OF 7675 05:43:29,121 --> 05:43:30,523 THE VISUAL CYCLE AND HOW WE'RE 7676 05:43:30,589 --> 05:43:33,693 ESTABLISHING A NORMATIVE DATASET 7677 05:43:33,759 --> 05:43:35,428 FOR THE CONE ORG SPECIFICALLY 7678 05:43:35,494 --> 05:43:37,463 AND HOW WE'RE USING IT FOR 7679 05:43:37,530 --> 05:43:38,097 DISEASES. 7680 05:43:38,164 --> 05:43:39,865 SO WHEN THE TIME CAME FOR US TO 7681 05:43:39,932 --> 05:43:41,400 ENTER THIS FIELD, REALLY WE WERE 7682 05:43:41,467 --> 05:43:43,269 LEFT WITH THE CHOICE OF WHICH 7683 05:43:43,336 --> 05:43:45,871 PARADIGM TO GO AND WE ENDED UP 7684 05:43:45,938 --> 05:43:48,507 CHOOSING A -- PARADIGM IN ORDER 7685 05:43:48,574 --> 05:43:52,378 TO OBTAIN THE TRADEOFF BETWEEN 7686 05:43:52,445 --> 05:43:53,779 RESOLUTION, FIELD OF VIEW AND 7687 05:43:53,846 --> 05:43:54,547 SPEED. 7688 05:43:54,613 --> 05:43:58,551 SO SCANNING FULL FIELD SYSTEM, 7689 05:43:58,617 --> 05:44:00,920 STARTS WITH CREATING A LINE 7690 05:44:00,987 --> 05:44:02,121 ELIMINATION IN THE RETINA 7691 05:44:02,188 --> 05:44:04,123 TYPICALLY MADE WITH A 7692 05:44:04,190 --> 05:44:05,157 CYLINDRICAL LENS, BACK SCATTERED 7693 05:44:05,224 --> 05:44:10,363 FROM THE RETINA, DEFRACTURED VIA 7694 05:44:10,429 --> 05:44:11,397 A DIFFRACTION RATING AND 7695 05:44:11,464 --> 05:44:13,232 CAPTURED IN A 2D TYPICALLY HIGH 7696 05:44:13,299 --> 05:44:15,434 SPEED CAMERA AND WITH A SIMPLE 7697 05:44:15,501 --> 05:44:18,637 TRANSFORM GIVES THE B SCAN -- A 7698 05:44:18,704 --> 05:44:20,206 B SCAN CROSS-SECTIONAL IMAGE. 7699 05:44:20,272 --> 05:44:21,607 THEN YOU CAN TAKE A SCANNER AND 7700 05:44:21,674 --> 05:44:23,609 SCAN THAT LINEAR ILLUMINATION 7701 05:44:23,676 --> 05:44:24,910 ACROSS THE RETINA AND IN A 7702 05:44:24,977 --> 05:44:26,679 SINGLE SNAPSHOT, YOU CAN OBTAIN 7703 05:44:26,746 --> 05:44:28,781 THAT B SCAN AND BY SCANNING THE 7704 05:44:28,848 --> 05:44:30,316 SCANNER IN ONE DIMENSION, CREATE 7705 05:44:30,383 --> 05:44:33,085 THESE VOLUMES AT EXTREMELY HIGH 7706 05:44:33,152 --> 05:44:33,519 SPEED. 7707 05:44:33,586 --> 05:44:35,287 SO WE CAN THEN TAKE -- BRING THE 7708 05:44:35,354 --> 05:44:37,556 FOCUS UP TO THE INNER RETINA, 7709 05:44:37,623 --> 05:44:39,658 AND SEE THE VARIOUS CELLS AND 7710 05:44:39,725 --> 05:44:40,426 STRUCTURES INSIDE THE INNER 7711 05:44:40,493 --> 05:44:41,994 RETINA STARTING FROM THE 7712 05:44:42,061 --> 05:44:44,497 MACROPHAGES, THE GANGLION CELLS, 7713 05:44:44,563 --> 05:44:47,366 THE -- VESSELS AND SO ON. 7714 05:44:47,433 --> 05:44:50,536 THE OUTER RETINA, WE CAN SEE 7715 05:44:50,603 --> 05:44:51,871 CONES, INNER SEGMENT, OUTER 7716 05:44:51,937 --> 05:44:54,607 SEGMENT JUNCTION, AND THE RPE. 7717 05:44:54,673 --> 05:44:56,475 BUT REALLY THIS IS ENCOURAGING 7718 05:44:56,542 --> 05:44:58,110 FROM OUR STANDPOINT BECAUSE IF 7719 05:44:58,177 --> 05:44:59,678 YOU CAN VISUALIZE THE CELLS AND 7720 05:44:59,745 --> 05:45:01,280 THE STRUCTURE OF THE CELLS, THEN 7721 05:45:01,347 --> 05:45:03,382 IF YOU DEVELOP TECHNIQUES TO 7722 05:45:03,449 --> 05:45:04,717 IMAGE THEIR ACTIVITY WE CAN 7723 05:45:04,784 --> 05:45:06,485 CORRELATE THE TWO TOGETHER. 7724 05:45:06,552 --> 05:45:07,920 THE REASON THAT WE UNDERTOOK 7725 05:45:07,987 --> 05:45:09,755 THIS PROJECT WAS REALLY TO BE 7726 05:45:09,822 --> 05:45:11,457 ABLE TO PERFORM FUNCTIONAL 7727 05:45:11,524 --> 05:45:12,758 MEASUREMENTS SO HERE WHAT WE DO 7728 05:45:12,825 --> 05:45:15,494 IS WE TAKE THE OUTER RETINA 7729 05:45:15,561 --> 05:45:18,264 SPECIFICALLY AND SECTION OUT 7730 05:45:18,330 --> 05:45:21,634 THE -- AND THE COST, SHINE A 7731 05:45:21,700 --> 05:45:22,501 30-NANOMETER LIGHT AND LET'S SAY 7732 05:45:22,568 --> 05:45:24,837 THIS PATTERN LIKE SO INTEGRATING 7733 05:45:24,904 --> 05:45:25,938 LIKE PATTERN AND IF YOU WERE 7734 05:45:26,005 --> 05:45:28,574 DOING OUR JOB CORRECTLY, THEN WE 7735 05:45:28,641 --> 05:45:30,109 WOULD BE SEEING A CONE 7736 05:45:30,176 --> 05:45:31,877 FUNCTIONAL MAP OF THE SAME KIND 7737 05:45:31,944 --> 05:45:35,815 THROWSHOWING THE THREE-BAR PATTN 7738 05:45:35,881 --> 05:45:37,850 THE SAME WAY THIS EYE 7739 05:45:37,917 --> 05:45:39,251 ILLUMINATION IS SHINING ON THE 7740 05:45:39,318 --> 05:45:39,718 RETINA. 7741 05:45:39,785 --> 05:45:42,221 SO REALLY WE'RE MORE INTERESTED 7742 05:45:42,288 --> 05:45:44,123 IN THE -- HOW DOES THE ORG 7743 05:45:44,190 --> 05:45:48,194 CHANGE WITH THOSE FACTORS, SO WE 7744 05:45:48,260 --> 05:45:50,863 SEE THE OPTICAL -- FIRST 7745 05:45:50,930 --> 05:45:53,432 UNDERGOES A SHARP DECLINE OR 7746 05:45:53,499 --> 05:45:55,634 SHARP SHRINKAGE AND THEN RISES 7747 05:45:55,701 --> 05:45:57,436 AND FINALLY SATURATES, AND IT 7748 05:45:57,503 --> 05:46:00,940 HAS A BLEACHED DEPENDENCE -- THE 7749 05:46:01,006 --> 05:46:03,375 KINETICS AND AMPLITUDE OF THE 7750 05:46:03,442 --> 05:46:04,810 RESPONSE STEADILY INCREASES AS 7751 05:46:04,877 --> 05:46:06,579 YOU INCREASE THE BLEACH. 7752 05:46:06,645 --> 05:46:09,081 SO WE HAVE IMPLEMENTED THIS OR 7753 05:46:09,148 --> 05:46:16,355 DORGPARADIGM, REALIZING IT HAS A 7754 05:46:16,422 --> 05:46:18,591 BLEACH DEPENDENCE, WE CAN PICK A 7755 05:46:18,657 --> 05:46:21,961 WAVE LENGTH WHICH HAS A 7756 05:46:22,027 --> 05:46:23,596 DIFFERENTIAL -- WHEN WE DO THIS, 7757 05:46:23,662 --> 05:46:26,832 WHAT WE CAN FIND, WHAT WE FIND 7758 05:46:26,899 --> 05:46:29,034 IS THAT EACH CONE CHARACTERISTIC 7759 05:46:29,101 --> 05:46:32,471 OF ITS SPECTROTYPE IS SEGREGATED 7760 05:46:32,538 --> 05:46:33,405 IN THE SHORT WAVE OF THE CONE 7761 05:46:33,472 --> 05:46:36,175 WHICH IS PROPORTIONAL AND IT 7762 05:46:36,242 --> 05:46:38,811 SHOWS THE PROPORTIONAL OPTICAL 7763 05:46:38,878 --> 05:46:41,981 PATH LENGTH, WHICH LETS US 7764 05:46:42,047 --> 05:46:42,948 DESIGNATE ITS TYPE. 7765 05:46:43,015 --> 05:46:45,417 WE CAN SACRIFICE FIELD OF VIEW 7766 05:46:45,484 --> 05:46:45,985 OR SACRIFICE RESOLUTION FOR 7767 05:46:46,051 --> 05:46:51,924 FIELD OF VEUL WHEREIN VIEW WHERE 7768 05:46:51,991 --> 05:46:53,325 CAN INCREASE THE FIELD AND IN 7769 05:46:53,392 --> 05:46:54,894 THIS SCENARIO, WE SEE GREATER 7770 05:46:54,960 --> 05:46:56,662 CHANGE STARTING FROM THE FOVEA 7771 05:46:56,729 --> 05:46:57,863 WHERE THE OPTICAL PATH LENGTH IS 7772 05:46:57,930 --> 05:47:01,133 THE HIGHEST, DECREASING AS WE GO 7773 05:47:01,200 --> 05:47:02,701 FURTHER OUT IN ECCENTRICITY IT. 7774 05:47:02,768 --> 05:47:04,370 SO WHAT I'VE SHOWN YOU SO FAR 7775 05:47:04,436 --> 05:47:07,640 ARE CONE SO CALLED CONE 7776 05:47:07,706 --> 05:47:09,875 PHOTORECEPTOR ORGs, THERE ARE 7777 05:47:09,942 --> 05:47:10,776 OTHER PHOTORECEPTOR TYPES IN THE 7778 05:47:10,843 --> 05:47:11,076 RETINA. 7779 05:47:11,143 --> 05:47:12,745 THIS IS JUST TO SHOW THAT IN THE 7780 05:47:12,811 --> 05:47:14,079 SAME PARADIGM WE CAN ALSO 7781 05:47:14,146 --> 05:47:15,748 MEASURE CONE AND ROD FOR 7782 05:47:15,814 --> 05:47:17,583 RECEPTOR ORGs IN THE CORE 7783 05:47:17,650 --> 05:47:19,285 SCALE PARADIGM AND THE ROD PHOTO 7784 05:47:19,351 --> 05:47:23,889 RECEPTORS HAVE A LOWER 7785 05:47:23,956 --> 05:47:26,392 SENSITIVITY AND AMPLITUDE 7786 05:47:26,458 --> 05:47:28,727 COMPARED TO THE CONE WHEREAS IN 7787 05:47:28,794 --> 05:47:30,496 THE AO O.C.T. MODE, WE CAN ZOOM 7788 05:47:30,563 --> 05:47:33,132 IN AND LOCALIZE INDIVIDUAL CELLS 7789 05:47:33,199 --> 05:47:37,770 AND ASSIGN THE OR TB.s TO 7790 05:47:37,836 --> 05:47:38,404 INDIVIDUALS, OR TO INDIVIDUAL 7791 05:47:38,470 --> 05:47:40,839 RODS. 7792 05:47:40,906 --> 05:47:44,009 SO REALLY OUR GOAL HERE IS TO 7793 05:47:44,076 --> 05:47:46,979 STUDY THE MECHANISMS OF THE 7794 05:47:47,046 --> 05:47:47,179 ORGs. 7795 05:47:47,246 --> 05:47:49,315 IN OUR HANDS WE'VE NOTICED THE 7796 05:47:49,381 --> 05:47:50,749 EARLY SHRINKAGE AND THE TWO 7797 05:47:50,816 --> 05:47:52,851 RISING COMPONENTS, THE ONE THAT 7798 05:47:52,918 --> 05:47:53,852 FLATTENS OUT AND THEN ONE THAT 7799 05:47:53,919 --> 05:47:57,790 HAS A SLOWER RISE LIKE SO. 7800 05:47:57,856 --> 05:48:00,226 COMP 1 AND COMP 2. 7801 05:48:00,292 --> 05:48:01,427 FIRST LOOKING AT THIS EARLY 7802 05:48:01,493 --> 05:48:02,661 SHRINKAGE COMPONENT, AS WE 7803 05:48:02,728 --> 05:48:05,564 INCREASE THE BLEACH LEVEL THE 7804 05:48:05,631 --> 05:48:06,565 OPTICAL PATH LENGTH INCREASES 7805 05:48:06,632 --> 05:48:08,500 AND THEN FINALLY SATURATES, AND 7806 05:48:08,567 --> 05:48:13,072 THIS RANGES ABOUT BETWEEN 5 TO 7807 05:48:13,138 --> 05:48:23,182 ABOUT 15-NANOMETERS OR SO. 7808 05:48:23,249 --> 05:48:25,584 TURNS OUT THAT THIS LOW LATENCY 7809 05:48:25,651 --> 05:48:27,219 FAST KINETICS RESPONSE THAT IS 7810 05:48:27,286 --> 05:48:30,389 SEEN IN THE CONE OUTER SEGMENT 7811 05:48:30,456 --> 05:48:38,297 IS LINKED TO PHOTOISOMERIZ AI 7812 05:48:38,364 --> 05:48:40,532 TION DENOTED AS THE EARLY 7813 05:48:40,599 --> 05:48:41,300 RECEPTOR POTENTIAL AND IS 7814 05:48:41,367 --> 05:48:43,269 DIFFERENT FOR THE AMPLIFICATION 7815 05:48:43,335 --> 05:48:48,641 CASCADE THAT WE KNOW OFF IN 7816 05:48:48,707 --> 05:48:48,941 CONES. 7817 05:48:49,008 --> 05:48:51,076 HERE THE GOAL IS TO CHARACTERIZE 7818 05:48:51,143 --> 05:48:52,144 THE SENSITIVITY OF THE LIED 7819 05:48:52,211 --> 05:48:53,612 DPENT DENSE OF THE RESPONSES, 7820 05:48:53,679 --> 05:48:55,581 AND TO CHARACTERIZE THEIR 7821 05:48:55,648 --> 05:48:58,017 KINETICS AND THEN USE THE SAME 7822 05:48:58,083 --> 05:49:01,520 MODEL OF TRANSDUCTION, THAT 7823 05:49:01,587 --> 05:49:03,489 PROFESSOR ED PEW HAD USED TO 7824 05:49:03,555 --> 05:49:05,391 PREDICT THE SENSITIVITY OF 7825 05:49:05,457 --> 05:49:06,058 KINETICS. 7826 05:49:06,125 --> 05:49:07,793 HE'S A CLOSE COLLABORATOR OF 7827 05:49:07,860 --> 05:49:08,460 OURS ON THIS PROJECT. 7828 05:49:08,527 --> 05:49:09,695 THE WAY WE GO ABOUT DOING THIS 7829 05:49:09,762 --> 05:49:11,897 IS TO TAKE THE SATURATED 7830 05:49:11,964 --> 05:49:15,401 RESPONSE AND DIVIDE THEM UP INTO 7831 05:49:15,467 --> 05:49:17,102 EXPONENTIALS AND THEN SEE ITS 7832 05:49:17,169 --> 05:49:24,310 ENERGY DEEP DEPENDENCE. 7833 05:49:24,376 --> 05:49:27,846 SO WHEN WE MEASURE ITS 7834 05:49:27,913 --> 05:49:29,315 SENSITIVITY WE FIND COMPONENT 7835 05:49:29,381 --> 05:49:33,118 ONE IS MUCH FASTER KINETICS AND 7836 05:49:33,185 --> 05:49:34,420 MUCH GREATER SENSITIVITY THAN 7837 05:49:34,486 --> 05:49:36,121 COMP 2, WHICH LEADS US TO 7838 05:49:36,188 --> 05:49:38,957 HYPOTHESIZE THAT COMP 1 ARISES 7839 05:49:39,024 --> 05:49:40,859 FROM AN AMPLIFIED BYPRODUCT OF 7840 05:49:40,926 --> 05:49:43,829 PHOTO TRANSDUCTION, WHEREAS 7841 05:49:43,896 --> 05:49:45,464 COMPONENT 2 ARISES DUE TO A 7842 05:49:45,531 --> 05:49:48,934 MECHANISM LINKED TO BLEACHING. 7843 05:49:49,001 --> 05:49:50,369 SO I WILL NOW GIVE YOU TWO 7844 05:49:50,436 --> 05:49:52,438 EXAMPLES OF SCENARIOS WHICH HAVE 7845 05:49:52,504 --> 05:49:55,341 LED TO PREDICTIONS WHICH HAS LED 7846 05:49:55,407 --> 05:49:58,610 TO TEST THE PREDICTIONS OF 7847 05:49:58,677 --> 05:49:59,712 HYPOTHESES FOR THE DIFFERENT 7848 05:49:59,778 --> 05:50:00,913 COMPONENTS. 7849 05:50:00,979 --> 05:50:04,783 THE FIRST ONE IS A PATIENT WITH 7850 05:50:04,850 --> 05:50:05,651 MICROSCOTOMA, WE CAN FIND 7851 05:50:05,718 --> 05:50:06,785 REGIONS OF THE RETINA WHERE THEY 7852 05:50:06,852 --> 05:50:08,554 DID NOT SEE A VISUAL STIMULUS 7853 05:50:08,620 --> 05:50:09,321 WHEREAS OTHERS RIGHT IN THE 7854 05:50:09,388 --> 05:50:10,622 CENTER OF THE FOVEA HERE WHERE 7855 05:50:10,689 --> 05:50:12,658 THEY DO SEE A VISUAL STIMULUS. 7856 05:50:12,725 --> 05:50:15,260 AND WE CAN THEN GO ON AND 7857 05:50:15,327 --> 05:50:15,928 MEASURE ORGs IN THESE 7858 05:50:15,994 --> 05:50:16,595 DIFFERENT REGIONS. 7859 05:50:16,662 --> 05:50:17,963 SO IN THE AREA WHERE THE PERSON 7860 05:50:18,030 --> 05:50:22,201 HAD NORMAL MICRO PRIM TRI, 7861 05:50:22,267 --> 05:50:24,837 NORMAL VISION, THE ORGs LOOK 7862 05:50:24,903 --> 05:50:26,505 FAIRLY OKAY BUT IF WE LOOK AT 7863 05:50:26,572 --> 05:50:27,406 REGIONS WHERE THEY DID NOT SEE 7864 05:50:27,473 --> 05:50:28,807 THE STIMULUS, WE SEE THAT 7865 05:50:28,874 --> 05:50:30,075 INITIAL SHRINKAGE WHICH IS 7866 05:50:30,142 --> 05:50:33,112 CORRESPONDING TO THE 7867 05:50:33,178 --> 05:50:33,746 PHOTOISOMERIZATION RESPONSE BUT 7868 05:50:33,812 --> 05:50:35,614 WE DON'T SEE THE LATER SLOW RISE 7869 05:50:35,681 --> 05:50:37,116 OF THE RESPONSE WHICH WAS LINKED 7870 05:50:37,182 --> 05:50:38,450 TO PHOTO TRANSDUCTION, LEADING 7871 05:50:38,517 --> 05:50:42,921 US TO CONCLUDE THAT THE LOCAL -- 7872 05:50:42,988 --> 05:50:44,556 WAS REALLY LOCALIZED TO THE 7873 05:50:44,623 --> 05:50:45,824 PHOTO RECEPTORS AND WAS NOT 7874 05:50:45,891 --> 05:50:48,627 CAUSED DUE TO CHANGES DOWNSTREAM 7875 05:50:48,694 --> 05:50:51,296 OF THE PHOTO RECEPTORS. 7876 05:50:51,363 --> 05:50:52,865 THE SECOND EXPERIMENT TO TEST 7877 05:50:52,931 --> 05:50:55,501 THE HYPOTHESIS WAS DONE IN 7878 05:50:55,567 --> 05:50:59,138 PATIENTS WITH A MUTATION CAUSED 7879 05:50:59,204 --> 05:51:01,340 IN THE GENE CODING FOR RGS9. 7880 05:51:01,407 --> 05:51:03,909 THIS IS AN ENZYME THAT IS 7881 05:51:03,976 --> 05:51:05,377 ESSENTIAL FOR THE DEACTIVATION 7882 05:51:05,444 --> 05:51:07,613 OF THE PHOTO TRANSDUCTION 7883 05:51:07,679 --> 05:51:10,115 CASCADE, AND CATALYZES THE 7884 05:51:10,182 --> 05:51:11,650 HYDROLYSIS OF QUANTITY SEEN 7885 05:51:11,717 --> 05:51:12,184 TRIPHOSPHATE. 7886 05:51:12,251 --> 05:51:18,123 THERE'S A SUBJECT GROUP IN 7887 05:51:18,190 --> 05:51:22,161 BRADYO PSI A IN THE EARLY 7888 05:51:22,227 --> 05:51:24,496 2000s THAT -- IF YOU DID 7889 05:51:24,563 --> 05:51:27,032 ORGs IN THESE PATIENTS, THE 7890 05:51:27,099 --> 05:51:28,667 HYPOTHESIS IS WE WOULD NOTICE 7891 05:51:28,734 --> 05:51:33,372 SLOWER RECOVERY OF THE CONE ORG 7892 05:51:33,439 --> 05:51:35,574 IN BRADYOPSIA. 7893 05:51:35,641 --> 05:51:37,910 OF COURSE THE NEXT STEP HERE IS 7894 05:51:37,976 --> 05:51:39,244 TO LINK THE FINDINGS THAT WE 7895 05:51:39,311 --> 05:51:42,114 HAVE HERE IN ORG TO ACTUAL 7896 05:51:42,181 --> 05:51:43,315 BIOPHYSICAL AND BIOCHEMICAL 7897 05:51:43,382 --> 05:51:46,285 MODELS OF PHOTO TRANSDUCTION AND 7898 05:51:46,351 --> 05:51:49,121 SEE -- AND TEST FURTHER HOW OUR 7899 05:51:49,188 --> 05:51:51,457 MODELS CAN BE REFINED TO FURTHER 7900 05:51:51,523 --> 05:51:53,091 GENERATE NEW HYPOTHESIS THAT CAN 7901 05:51:53,158 --> 05:51:54,326 BE TESTED IN THE FUTURE. 7902 05:51:54,393 --> 05:51:55,661 SO CHANGING GEARS NOW, THIS IS 7903 05:51:55,727 --> 05:52:02,234 THE LAST CHAPTER OF THE STORY, 7904 05:52:02,301 --> 05:52:05,871 IS TO APPLY ROENTGENOGRAMS TO 7905 05:52:05,938 --> 05:52:09,608 THOSE WITH DISEASE BUT -- WHAT 7906 05:52:09,675 --> 05:52:12,010 FACTORS AFFECT THE NORMATIVE 7907 05:52:12,077 --> 05:52:13,111 VARIATION IN THE CONE ORG. 7908 05:52:13,178 --> 05:52:16,982 AND SECOND WE WANT TO UNDERSTAND 7909 05:52:17,049 --> 05:52:20,052 HOW THE ORG IS DISRUPTED IN 7910 05:52:20,118 --> 05:52:21,153 RETINITIS PIGMENTOSA AS WE HEARD 7911 05:52:21,220 --> 05:52:24,389 FROM DON THIS MORNING, IT 7912 05:52:24,456 --> 05:52:26,558 CONSISTS OF A HEALTHY ZONE, A 7913 05:52:26,625 --> 05:52:31,129 ZONE OF ACTIVE DEGRADATION, AND 7914 05:52:31,196 --> 05:52:32,698 DISEASE ZONE WHEN BOTH THE 7915 05:52:32,764 --> 05:52:33,599 REFLECTIONS HAVE DISAPPEARED AND 7916 05:52:33,665 --> 05:52:35,667 THIS IS THE HALLMARK SIGN OF RP 7917 05:52:35,734 --> 05:52:37,035 SHOWING THIS KIND OF BULL'S-EYE 7918 05:52:37,102 --> 05:52:39,571 PATTERN WHERE THE RETINA IS, 7919 05:52:39,638 --> 05:52:41,206 QUOTE-UNQUOTE, HEALTHY OR NORMAL 7920 05:52:41,273 --> 05:52:42,307 IN THE CENTER. 7921 05:52:42,374 --> 05:52:44,643 AND OF COURSE WE WANT TO 7922 05:52:44,710 --> 05:52:51,316 UNDERSTAND HERE -- NORMAL 7923 05:52:51,383 --> 05:52:53,719 RETINAL STRUCTURE, NORMAL 7924 05:52:53,785 --> 05:52:55,621 FUNCTION WHEREAS IN THE CASE OF 7925 05:52:55,687 --> 05:52:56,855 BRADY OPS YA, WE'RE INTERESTED 7926 05:52:56,922 --> 05:52:58,323 IN STUDYING THE CORRELATION 7927 05:52:58,390 --> 05:53:03,996 BETWEEN BOTH. 7928 05:53:04,062 --> 05:53:06,265 WE CAN THINK OF TWO DIFFERENT 7929 05:53:06,331 --> 05:53:07,566 FACTORS, ONE IS PRERECEPTOR, 7930 05:53:07,633 --> 05:53:09,635 WHICH IS DICTATED BY THE 7931 05:53:09,701 --> 05:53:11,236 STIMULUS TREND, I TOLD YOU AS WE 7932 05:53:11,303 --> 05:53:12,538 INCREASE THE BLEACH LEVEL IN THE 7933 05:53:12,604 --> 05:53:14,406 RETINA, THE ORG AMPLITUDE AND 7934 05:53:14,473 --> 05:53:15,874 KINETICS INCREASES AND OF COURSE 7935 05:53:15,941 --> 05:53:18,277 ALSO FACTORS PERTINENT TO THE 7936 05:53:18,343 --> 05:53:19,912 ANTERIOR EYE, THINGS SUCH AS 7937 05:53:19,978 --> 05:53:22,180 CATARACT, AGE, LENS MEDIA, AND 7938 05:53:22,247 --> 05:53:23,048 OTHER OPACITIES. 7939 05:53:23,115 --> 05:53:28,086 AND THE RECEPTOR-CONE, SPECIFIC 7940 05:53:28,153 --> 05:53:30,756 PROPERTY SUCH AS THE INNER 7941 05:53:30,822 --> 05:53:33,926 SEGMENT DIAMETER, OUTER SEGMENT 7942 05:53:33,992 --> 05:53:35,260 LENGTH, ET CETERA, WHICH ALSO 7943 05:53:35,327 --> 05:53:38,030 GOVERN THE NORMATIVE VARIATION 7944 05:53:38,096 --> 05:53:39,331 IN THE CONE ORG. 7945 05:53:39,398 --> 05:53:41,733 SO IN ORDER TO CHARACTERIZE THE 7946 05:53:41,800 --> 05:53:46,004 CONE ORG, WE HAVE ESTABLISHED 7947 05:53:46,071 --> 05:53:49,942 THE CORE I TOLD YOU ABOUT A 7948 05:53:50,008 --> 05:53:52,511 LITTLE BIT AGO. 7949 05:53:52,578 --> 05:53:53,645 THIS MEASUREMENT TAKES ABOUT 10 7950 05:53:53,712 --> 05:53:56,248 MINUTES TO COMPLETE AND CAN BE 7951 05:53:56,315 --> 05:53:59,451 DONE ACROSS A LARGE AGE RANGE, A 7952 05:53:59,518 --> 05:53:59,918 LARGE SUBJECT GROUP. 7953 05:53:59,985 --> 05:54:02,087 IT'S MORE EXTENDED FIELD, 7954 05:54:02,154 --> 05:54:04,556 5 DEGREES AS OPPOSED TO 1 DEGREE 7955 05:54:04,623 --> 05:54:06,525 WE WERE DOING WITH ADAPTIVE 7956 05:54:06,592 --> 05:54:07,292 OPTICS, AND THIS IS THE GENERAL 7957 05:54:07,359 --> 05:54:09,261 TREND OF RESPONSES THAT WE SEE 7958 05:54:09,328 --> 05:54:10,963 THAT CLOSE TO THE FOVEA, THE 7959 05:54:11,029 --> 05:54:13,565 RESPONSES ARE THE LARGEST, AND 7960 05:54:13,632 --> 05:54:14,833 THEY DECREASE AS WE GO FURTHER 7961 05:54:14,900 --> 05:54:15,734 AWAY FROM THE FOVEA. 7962 05:54:15,801 --> 05:54:19,237 SO WHEN WE THEN BRING THESE 7963 05:54:19,304 --> 05:54:20,205 OPTICAL PATH LENGTH MEASUREMENTS 7964 05:54:20,272 --> 05:54:21,573 TOGETHER WITH THE OUTER SEGMENT 7965 05:54:21,640 --> 05:54:24,176 LENGTH, WE SEE THE PATH LENGTHS 7966 05:54:24,242 --> 05:54:25,711 OBEY THIS REALLY NICE 7967 05:54:25,777 --> 05:54:26,945 RELATIONSHIP BETWEEN THE OPTICAL 7968 05:54:27,012 --> 05:54:28,647 PATH LENGTH AND OUTER SEGMENT 7969 05:54:28,714 --> 05:54:30,716 LENGTH, AND THEN IF YOU DO THIS 7970 05:54:30,782 --> 05:54:31,817 FOR DIFFERENT BLEACHING 7971 05:54:31,883 --> 05:54:34,052 CONDITIONS OR BLEACHING LEVELS, 7972 05:54:34,119 --> 05:54:37,122 WE SEE THAT THE SLOPE OF THIS 7973 05:54:37,189 --> 05:54:38,557 CURVE UNDERGOES THE STEEPENING. 7974 05:54:38,624 --> 05:54:40,726 SO THE GOAL HERE IS GENERALLY TO 7975 05:54:40,792 --> 05:54:43,095 GENERATE A NORMAL GRAM LET'S SAY 7976 05:54:43,161 --> 05:54:45,397 WHERE WE CAN TAKE A SUBJECT AND 7977 05:54:45,464 --> 05:54:47,799 ACCORDING TO THE OUTER SEGMENT 7978 05:54:47,866 --> 05:54:49,167 LENGTH, ACCORDING TO THE BLEACH 7979 05:54:49,234 --> 05:54:50,202 SCALE, ACCORDING TO DIFFERENT 7980 05:54:50,268 --> 05:54:51,370 PROGRAM TE THE SUBJECT BE ABLE 7981 05:54:51,436 --> 05:54:52,671 TO PREDICT WITHIN A 7982 05:54:52,738 --> 05:54:54,806 CERTAIN DEGREE OF CERTAINTY WHAT 7983 05:54:54,873 --> 05:54:56,475 THEIR CONE ORGANIZE IN A NORMAL 7984 05:54:56,541 --> 05:54:58,410 CIRCUMSTANCE MAY BE, AND TRY TO 7985 05:54:58,477 --> 05:54:59,378 DOCUMENT THE DIFFERENT FACTORS 7986 05:54:59,444 --> 05:55:00,979 THAT AFFECT THE VARIATION OF THE 7987 05:55:01,046 --> 05:55:03,281 CONE ORG. 7988 05:55:03,348 --> 05:55:05,050 OKAY. 7989 05:55:05,117 --> 05:55:06,451 OF COURSE NOW WE'VE ESTABLISHED 7990 05:55:06,518 --> 05:55:08,053 THAT, WE WANT TO STUDY HOW THIS 7991 05:55:08,120 --> 05:55:10,022 IS AFFECTED IN RETINITIS 7992 05:55:10,088 --> 05:55:10,355 PIGMENTOSA. 7993 05:55:10,422 --> 05:55:11,790 AGAIN THIS IS OUR KIND OF 7994 05:55:11,857 --> 05:55:14,793 BULL'S-EYE PATTERN IN RP. 7995 05:55:14,860 --> 05:55:16,428 SO THIS OVERLAYING NOW THE 7996 05:55:16,495 --> 05:55:18,830 FUNCTIONAL MAP OF THE ORG ACROSS 7997 05:55:18,897 --> 05:55:20,132 THE STRUCTURAL MAP WE SEE HOW 7998 05:55:20,198 --> 05:55:22,300 THE ORG RESPONDS, AMPLITUDE IS 7999 05:55:22,367 --> 05:55:23,435 HIGHER IN THE FOVEA AND DEGRADES 8000 05:55:23,502 --> 05:55:24,603 AS YOU GO FURTHER OUT. 8001 05:55:24,670 --> 05:55:30,542 BUT IN THE CASE OF RP, I THINK 8002 05:55:30,609 --> 05:55:40,952 IT'S FROZEN, SORRY. 8003 05:55:45,023 --> 05:55:46,091 I GUESS THE POINT IS VERY CLEAR 8004 05:55:46,158 --> 05:55:47,359 HERE THAT IN THE CASE OF RP, 8005 05:55:47,426 --> 05:55:49,895 EVEN IN THE SO-CALLED HEALTHY 8006 05:55:49,961 --> 05:55:52,164 ZONE OR HEALTHY ZONE TRANSITION 8007 05:55:52,230 --> 05:55:55,067 ZONE, THE OPTICAL PATH LENGTH IS 8008 05:55:55,133 --> 05:55:56,368 FAR REDUCED COMPARED TO THE 8009 05:55:56,435 --> 05:55:58,036 NORMAL SCENARIO, AND ON THE LEFT 8010 05:55:58,103 --> 05:55:59,938 HERE IS SHOWN THE SUMMARY OF ALL 8011 05:56:00,005 --> 05:56:01,139 THIS DATA PUT TOGETHER ACROSS 8012 05:56:01,206 --> 05:56:03,341 PATIENTS WITH VERY DIFFERENT 8013 05:56:03,408 --> 05:56:05,944 GENOTYPES. 8014 05:56:06,011 --> 05:56:09,414 THE IDEA HERE IS -- I SHOULD 8015 05:56:09,481 --> 05:56:10,282 POINT YOUR ATTENTION TO THIS 8016 05:56:10,348 --> 05:56:13,351 PARTICULAR PATIENT WITH AN 8017 05:56:13,418 --> 05:56:14,219 IMPDH1 MUTATION WHERE EVEN 8018 05:56:14,286 --> 05:56:16,521 THOUGH THIS PATIENT'S TRANSITION 8019 05:56:16,588 --> 05:56:17,689 ZONE STARTS OUT HERE AT ABOUT 8020 05:56:17,756 --> 05:56:20,325 3 1/2 DEGREES, EVEN AT THOSE 8021 05:56:20,392 --> 05:56:21,626 SCALES, THEIR OPTICAL PATH 8022 05:56:21,693 --> 05:56:23,995 LENGTH IS FAR REDUCED COMPARED 8023 05:56:24,062 --> 05:56:25,530 TO WHAT YOU WOULD -- COMPARED TO 8024 05:56:25,597 --> 05:56:26,998 NORMAL, SO THIS IS CLEARLY A 8025 05:56:27,065 --> 05:56:27,632 SUBCLINICAL CHANGE THAT WOULD 8026 05:56:27,699 --> 05:56:29,634 NOT HAVE BEEN PICKED UP WITH 8027 05:56:29,701 --> 05:56:38,176 O.C.T. 8028 05:56:38,243 --> 05:56:38,610 OKAY. 8029 05:56:38,677 --> 05:56:42,781 AND REALLY IT'S NOT SO THAT THE 8030 05:56:42,848 --> 05:56:44,015 CORE SCALE ANALOG OF OUR ORG 8031 05:56:44,082 --> 05:56:45,117 REALLY ANSWERS ALL OUR 8032 05:56:45,183 --> 05:56:47,085 QUESTIONS, OF COURSE WE ARE 8033 05:56:47,152 --> 05:56:49,221 INTERESTED IN CELLULAR SCALE 8034 05:56:49,287 --> 05:56:50,088 PHENOTYPIC FEATURES IN PATIENTS 8035 05:56:50,155 --> 05:56:51,189 WITH DIFFERENT MUTATIONS, AND 8036 05:56:51,256 --> 05:56:53,692 HERE JUST SHOWING DIFFERENT 8037 05:56:53,759 --> 05:56:58,997 MUTATIONS FROM SNRNP, RHO, WE 8038 05:56:59,064 --> 05:57:00,432 CAN SEE HOW EVEN THE CONE MOSAIC 8039 05:57:00,499 --> 05:57:03,468 OF THESE PATIENTS OR THE 8040 05:57:03,535 --> 05:57:05,137 DIFFERENT ORG PHENOTYPES, FOR 8041 05:57:05,203 --> 05:57:06,338 EXAMPLE, SHOWING THREE CLUSTERS 8042 05:57:06,404 --> 05:57:08,907 HERE ARE VERY DIFFERENT BETWEEN 8043 05:57:08,974 --> 05:57:09,641 THE DIFFERENT GENES AND WE'RE 8044 05:57:09,708 --> 05:57:11,943 COLLECTING MORE DATA HERE TO 8045 05:57:12,010 --> 05:57:14,579 REALLY ESTABLISH A MORE GENOTYPE 8046 05:57:14,646 --> 05:57:16,348 PHENOTYPE CORRELATION DATABASE 8047 05:57:16,414 --> 05:57:17,415 WITH WHICH TO DRAW MORE 8048 05:57:17,482 --> 05:57:18,083 CONCLUSIONS. 8049 05:57:18,150 --> 05:57:20,385 SO WITH THAT, I'D LEAVE WITH YOU 8050 05:57:20,452 --> 05:57:22,454 A SUMMARY WHICH IS BASICALLY 8051 05:57:22,521 --> 05:57:23,555 THAT ORG IS REALLY A POWERFUL 8052 05:57:23,622 --> 05:57:25,423 TOOL TO REVEAL EARLY STEPS OF 8053 05:57:25,490 --> 05:57:26,625 TRANSDUCTION IN HUMAN RODS AND 8054 05:57:26,691 --> 05:57:27,826 CONES, A STORY THAT I DIDN'T 8055 05:57:27,893 --> 05:57:29,895 TELL YOU TODAY IS TO -- THAT IT 8056 05:57:29,961 --> 05:57:31,763 REVEALS THE TOPOGRAPHY OF THE 8057 05:57:31,830 --> 05:57:33,799 CONE MOSAIC IN THE HUMAN RETINA, 8058 05:57:33,865 --> 05:57:36,635 AND IT PROVIDES AN INSIGHT INTO 8059 05:57:36,701 --> 05:57:40,071 EARLY DYSFUNCTION IN PHENOTYPIC 8060 05:57:40,138 --> 05:57:40,639 VARIATION, RETINAL DISEASE. 8061 05:57:40,705 --> 05:57:41,740 I WOULD TAKE THIS OPPORTUNITY TO 8062 05:57:41,807 --> 05:57:43,041 THANK ALL MY COLLABORATORS, ALL 8063 05:57:43,108 --> 05:57:44,042 MY FUNDING SOURCES, AND THE 8064 05:57:44,109 --> 05:57:45,043 FOLKS IN THE LAB THAT DO ALL THE 8065 05:57:45,110 --> 05:57:45,243 WORK. 8066 05:57:45,310 --> 05:57:45,777 THANK YOU SO MUCH. 8067 05:57:45,844 --> 05:57:53,318 [APPLAUSE] 8068 05:57:53,385 --> 05:57:55,153 >> ALL RIGHT. 8069 05:57:55,220 --> 05:57:57,489 OUR SECOND SPEAKER FOR THIS 8070 05:57:57,556 --> 05:58:06,798 SESSION IS ROBERT ZAWADZKI. 8071 05:58:06,865 --> 05:58:09,668 HIS TALK IS TITLED OPTICAL 8072 05:58:09,734 --> 05:58:12,871 COHERENCE TECHNOLOGY BEHIND ORG. 8073 05:58:12,938 --> 05:58:18,210 ROBERT? 8074 05:58:18,276 --> 05:58:20,045 >> THANK YOU VERY MUCH THE 8075 05:58:20,111 --> 05:58:21,046 ORGANIZERS FOR INVITING ME AND 8076 05:58:21,112 --> 05:58:22,447 FOR GIVING ME THIS OPPORTUNITY 8077 05:58:22,514 --> 05:58:24,516 TO SPEAK TODAY. 8078 05:58:24,583 --> 05:58:27,953 I ALSO WANT TO CONGRATULATE JIM, 8079 05:58:28,019 --> 05:58:31,456 DAVID, AND ERIC FOR THIS GREAT 8080 05:58:31,523 --> 05:58:31,690 AWARD. 8081 05:58:31,756 --> 05:58:32,891 WHEN I WAS ASKED TO GIVE THIS 8082 05:58:32,958 --> 05:58:36,361 TALK, I FIND OUT I'M GOING TO BE 8083 05:58:36,428 --> 05:58:37,562 SANDWICHED BETWEEN RAVI AND RAM 8084 05:58:37,629 --> 05:58:38,997 SO I DECIDED TO KIND OF DO 8085 05:58:39,064 --> 05:58:41,032 SOMETHING DIFFERENT. 8086 05:58:41,099 --> 05:58:41,800 SO I'LL GIVE YOU A LITTLE BIT 8087 05:58:41,867 --> 05:58:43,668 MORE PERSPECTIVE ON ORG WITH 8088 05:58:43,735 --> 05:58:46,805 RESPECT TO O.C.T. 8089 05:58:46,872 --> 05:58:48,974 AND BEFORE I START, I WANT TO 8090 05:58:49,040 --> 05:58:50,709 ACKNOWLEDGE ALL OF THE 8091 05:58:50,775 --> 05:58:54,212 CONTRIBUTIONS FROM OUR 8092 05:58:54,279 --> 05:58:57,482 COLLABORATORS FROM THE LAB THAT 8093 05:58:57,549 --> 05:59:04,122 DID THE ANIMAL WORK. 8094 05:59:04,189 --> 05:59:07,726 FROM ED PU TB. H AND THEN RAVI 8095 05:59:07,792 --> 05:59:09,060 JONNAL FOR THE CLINICAL WORK AND 8096 05:59:09,127 --> 05:59:10,428 ALSO ALL THE COLLABORATORS THAT 8097 05:59:10,495 --> 05:59:11,630 WORKED WITH US THROUGHOUT THE 8098 05:59:11,696 --> 05:59:13,565 YEARS AND ALSO ALL OF THE 8099 05:59:13,632 --> 05:59:17,469 FUNDING SOURCES. 8100 05:59:17,535 --> 05:59:18,670 SO WHAT I WAS GOING TO START 8101 05:59:18,737 --> 05:59:21,640 WITH FIRST IS TALKING ABOUT THE 8102 05:59:21,706 --> 05:59:24,542 TECHNOLOGY IN GENERAL, AND THEN 8103 05:59:24,609 --> 05:59:26,311 I WANT TO USE THIS OPPORTUNITY 8104 05:59:26,378 --> 05:59:31,883 TO ALSO BRING KIND OF MEMORY OF 8105 05:59:31,950 --> 05:59:33,852 MY LATE ADVISER AND HIS 8106 05:59:33,919 --> 05:59:36,955 CONTRIBUTION TO THE FIELD AND 8107 05:59:37,022 --> 05:59:38,590 HOW -- KIND OF WORK HE DID THAT 8108 05:59:38,657 --> 05:59:43,194 REALLY RELATES TO THAT. 8109 05:59:43,261 --> 05:59:44,462 SO FIRST YOU CAN SEE HERE HE WAS 8110 05:59:44,529 --> 05:59:52,804 ONE OF THE PIONEERS OF USING 8111 05:59:52,871 --> 05:59:58,043 INTERFEROMETRY FOR MEASURING THE 8112 05:59:58,109 --> 06:00:05,583 EYE. 8113 06:00:05,650 --> 06:00:07,085 THIS IS VERY SIMILAR TO THE WORK 8114 06:00:07,152 --> 06:00:17,662 DONE BY RAVI JANNAL, USING THE 8115 06:00:17,729 --> 06:00:18,863 SIGNAL FROM THE -- AND RETINA 8116 06:00:18,930 --> 06:00:21,266 AND THIS IS USED TO LOOK AT 8117 06:00:21,333 --> 06:00:22,667 THE -- OF THE EYE AND LATER ON 8118 06:00:22,734 --> 06:00:27,038 IN MODERN ORGs, WITHOUT -- THE 8119 06:00:27,105 --> 06:00:28,540 SAME METHOD IS USED TO LOOK AT 8120 06:00:28,606 --> 06:00:31,076 THE SCINTILLATIONS OF THE PHOTO 8121 06:00:31,142 --> 06:00:33,211 RECEPTORS -- SEGMENT LENGTH 8122 06:00:33,278 --> 06:00:33,645 CHANGE. 8123 06:00:33,712 --> 06:00:36,815 SO LATER ON, THIS WAS ALSO THAT 8124 06:00:36,881 --> 06:00:40,218 KIND OF INITIAL WORK OF MEASURE 8125 06:00:40,285 --> 06:00:42,687 USING -- TO MEASURE THE EYE 8126 06:00:42,754 --> 06:00:44,089 LENGTH, OR MEASURE THE RETINAL 8127 06:00:44,155 --> 06:00:45,090 PROFILE WHICH IS EXACTLY WHAT 8128 06:00:45,156 --> 06:00:49,527 WE'RE DOING IN ORG,, WE'RE USING 8129 06:00:49,594 --> 06:00:51,062 O.C.T. AS A TOOL TO MEASURE 8130 06:00:51,129 --> 06:00:52,063 PRECISELY CHANGING LENGTH WITHIN 8131 06:00:52,130 --> 06:00:56,034 THE RETINA. 8132 06:00:56,101 --> 06:00:58,103 SO WE ARE HERE BECAUSE OF THE 8133 06:00:58,169 --> 06:01:00,171 INVENTION OF O.C.T. WITH THIS 8134 06:01:00,238 --> 06:01:03,842 GREAT, GREAT PAPER BY DAVID WANG 8135 06:01:03,908 --> 06:01:05,410 SHOWN HERE, THIS IS 1991, THAT 8136 06:01:05,477 --> 06:01:10,115 THE GROUP, COLLABORATION OF -- 8137 06:01:10,181 --> 06:01:12,250 TWO YEARS LATER ARE ABLE TO SHOW 8138 06:01:12,317 --> 06:01:14,452 THE FIRST IN VIVO IMAGE OF THE 8139 06:01:14,519 --> 06:01:16,421 RETINA FROM AMERICAN JOURNAL OF 8140 06:01:16,488 --> 06:01:18,623 OPHTHALMOLOGY, AND THEN KIND OF 8141 06:01:18,690 --> 06:01:22,060 LATER ON, PROFESSOR FERCHER PUT 8142 06:01:22,127 --> 06:01:23,361 ON THIS GREAT WORK KIND OF 8143 06:01:23,428 --> 06:01:25,663 LINKING SCATTERING THERAPY AND 8144 06:01:25,730 --> 06:01:27,065 THE INFORMATION IN O.C.T. AND 8145 06:01:27,132 --> 06:01:31,136 YOU CAN SEE HERE THERE'S -- HOW 8146 06:01:31,202 --> 06:01:33,104 THE FIELD IS GENERATED BY THE 8147 06:01:33,171 --> 06:01:33,905 OBJECT. 8148 06:01:33,972 --> 06:01:41,980 HE THEN PUT IN THIS -- LIGHT -- 8149 06:01:42,047 --> 06:01:44,983 POTENTIAL AND THEN LINKED THIS 8150 06:01:45,050 --> 06:01:46,518 WITH GENERATION OF THE REFERENCE 8151 06:01:46,584 --> 06:01:48,787 ARM SIGNAL AND THEN THE SAMPLE 8152 06:01:48,853 --> 06:01:50,522 ARM SIGNAL, SORRY, AND THEN 8153 06:01:50,588 --> 06:01:56,761 LATER ON WITH -- SEE THIS KIND 8154 06:01:56,828 --> 06:01:59,564 OF COMMON DESCRIPTION OF THE 8155 06:01:59,631 --> 06:02:00,765 INTERFERONS BEING -- OF THE 8156 06:02:00,832 --> 06:02:02,300 SAMPLE REFERENCE ARM AND THEN 8157 06:02:02,367 --> 06:02:07,872 INTERFERONS USING THIS FIRST -- 8158 06:02:07,939 --> 06:02:10,141 FUNCTION DESCRIBED LATER IN 8159 06:02:10,208 --> 06:02:12,444 DETAIL, BUT THIS ALREADY, HERE 8160 06:02:12,510 --> 06:02:14,846 YOU HAVE HERE YOUR ENVELOPE OF 8161 06:02:14,913 --> 06:02:17,115 THE O.C.T. SIGNAL AND FRINGE 8162 06:02:17,182 --> 06:02:17,482 PATTERN. 8163 06:02:17,549 --> 06:02:21,186 FOR ALL THESE KR CONTRIBUTIONS 8164 06:02:21,252 --> 06:02:22,487 TOGETHER WITH JIM, DAVID AND 8165 06:02:22,554 --> 06:02:27,892 ERIC, HE WAS AWARDED THIS PRIZE 8166 06:02:27,959 --> 06:02:29,994 IN 2017, RIGHT BEFORE HE PASSED 8167 06:02:30,061 --> 06:02:32,197 AWAY. 8168 06:02:32,263 --> 06:02:34,699 SO NOW LET'S KIND OF MOVE ON AND 8169 06:02:34,766 --> 06:02:37,001 TALK MORE IN DETAIL ABOUT THE -- 8170 06:02:37,068 --> 06:02:40,505 BEHIND THESE HIGH PREVISION 8171 06:02:40,572 --> 06:02:42,440 MEASUREMENTS NEEDED FOR ORG. 8172 06:02:42,507 --> 06:02:44,309 SO FIRST WE KNOW THAT O.C.T. IS 8173 06:02:44,375 --> 06:02:46,478 MEASURING THE EXACT POSITION OF 8174 06:02:46,544 --> 06:02:50,615 THE SCATTERING -- SCATTERED TO 8175 06:02:50,682 --> 06:02:52,350 GENERATE O.C.T., WE'RE BUILDING 8176 06:02:52,417 --> 06:02:53,985 UP THIS IMAGE FROM THE A SCANS 8177 06:02:54,052 --> 06:02:54,986 FOR THE FRONT OR BACK OF THE 8178 06:02:55,053 --> 06:02:57,122 EYE. 8179 06:02:57,188 --> 06:02:59,657 AND THEN THE FIRST MEASUREMENTS 8180 06:02:59,724 --> 06:03:02,727 PERFORMED WERE DONE USING TIME 8181 06:03:02,794 --> 06:03:07,065 DOMAIN O.C.T., SO IN TIME DOMAIN 8182 06:03:07,132 --> 06:03:13,204 O.C.T., YOU SEE THE REFERENCE 8183 06:03:13,271 --> 06:03:17,142 ARM MOVING -- I GUESS IT'S NOT 8184 06:03:17,208 --> 06:03:19,010 MOVING HERE, MOVING BACK AND 8185 06:03:19,077 --> 06:03:20,812 FORTH CREATING THIS WELL-KNOWN 8186 06:03:20,879 --> 06:03:23,982 SIGNAL THAT CREATE -- SO THIS 8187 06:03:24,048 --> 06:03:26,251 WAS KIND OF OLD DAYS WHERE WE 8188 06:03:26,317 --> 06:03:31,055 NEEDED TO HAVE TO SPEND SECONDS 8189 06:03:31,122 --> 06:03:36,995 OR MAYBE HUNDREDS OF HERTZ -- 8190 06:03:37,061 --> 06:03:40,498 BUT THEN DEVELOPED INTO THE -- 8191 06:03:40,565 --> 06:03:41,699 DOMAIN, HERE'S THIS COMBINATION 8192 06:03:41,766 --> 06:03:44,836 OF THE SPECTRAL O.C.T. AND -- 8193 06:03:44,903 --> 06:03:48,339 O.C.T. SHOWING YOU THE GREAT 8194 06:03:48,406 --> 06:03:50,608 ADVANTAGE OF THE ABILITY TO 8195 06:03:50,675 --> 06:03:52,310 MEASURE THE SIMULTANEOUS A SCANS 8196 06:03:52,377 --> 06:03:54,579 WITHOUT THE NEED FOR SCANNING. 8197 06:03:54,646 --> 06:03:57,515 AND THIS CAN BE DONE BY 8198 06:03:57,582 --> 06:03:59,684 COMBINATION OF THIS FACT THAT IF 8199 06:03:59,751 --> 06:04:02,954 YOU'RE MEASURING THE SPECTRAL 8200 06:04:03,021 --> 06:04:05,056 INTERFERON -- DOMAIN, YOU CAN 8201 06:04:05,123 --> 06:04:07,992 THEN FULLY TRANSFORM DATA TO GET 8202 06:04:08,059 --> 06:04:09,827 YOUR INTENSITY AND TIME DOMAIN 8203 06:04:09,894 --> 06:04:11,396 SIGNAL SO YOU CAN GET ALL THE -- 8204 06:04:11,462 --> 06:04:12,363 AT ONCE. 8205 06:04:12,430 --> 06:04:17,569 SO THIS WAS KIND OF REALLY PROOF 8206 06:04:17,635 --> 06:04:23,908 IN EARLY 2000s BY -- AND THE 8207 06:04:23,975 --> 06:04:29,380 MAIN ADVANTAGE HERE IS -- OR 8208 06:04:29,447 --> 06:04:31,349 SPECTRAL DOMAIN O.C.T. IS 8209 06:04:31,416 --> 06:04:33,184 ROUGHLY AMPLIFIED BY THE HANOVER 8210 06:04:33,251 --> 06:04:34,719 TOOL COMPARED TO TIME DOMAIN. 8211 06:04:34,786 --> 06:04:37,455 SO WITHOUT THIS, THERE WILL BE 8212 06:04:37,522 --> 06:04:40,358 REALLY KNOW REVOLUTION IN O.C.T. 8213 06:04:40,425 --> 06:04:41,893 IN THE EARLY 2000s, YOU CAN 8214 06:04:41,960 --> 06:04:46,831 SEE HERE FROM THE PAPER INCREASE 8215 06:04:46,898 --> 06:04:48,967 IN ACQUISITION -- OR THE -- RATE 8216 06:04:49,033 --> 06:04:50,835 OF THE -- YOU CAN SEE TIME 8217 06:04:50,902 --> 06:04:54,239 DOMAINS GOT STUCK AT ABOUT 8218 06:04:54,305 --> 06:04:57,575 THOUSANDS OF -- PER SECOND 8219 06:04:57,642 --> 06:05:02,280 VERSUS -- AND THE SPECTRAL 8220 06:05:02,347 --> 06:05:05,250 O.C.T. BACK IN 2002 AND UP TO 8221 06:05:05,316 --> 06:05:08,286 THE THREE HUNDREDS OF THOUSANDS 8222 06:05:08,353 --> 06:05:10,121 OF HERT AND -- MEGAHERTZ. 8223 06:05:10,188 --> 06:05:12,423 BUT WHAT IS REALLY KIND OF 8224 06:05:12,490 --> 06:05:15,293 NEEDED TO USE O.C.T. FOR SIGNAL 8225 06:05:15,360 --> 06:05:21,065 DETECTION IS THIS COHERENCE 8226 06:05:21,132 --> 06:05:23,001 FUNCTION THAT DESCRIBES THE 8227 06:05:23,067 --> 06:05:24,235 ENVELOPE, THE RED SIGNAL HERE 8228 06:05:24,302 --> 06:05:25,737 AND THE YELLOW IS THE FRINGE 8229 06:05:25,803 --> 06:05:27,705 PATTERN UNDERNEATH. 8230 06:05:27,772 --> 06:05:30,441 THE SHAPE OF THE FRINGE PATTERN 8231 06:05:30,508 --> 06:05:31,943 IS REDEFINED BY THE SPECTRAL 8232 06:05:32,010 --> 06:05:33,845 SHAPE OF THE LIGHT SOURCE. 8233 06:05:33,911 --> 06:05:37,415 AND THIS IS WHAT DEFINES OUR 8234 06:05:37,482 --> 06:05:38,616 COHERENCE LENGTH OR YOUR -- 8235 06:05:38,683 --> 06:05:39,484 RESOLUTION IN THIS CASE. 8236 06:05:39,550 --> 06:05:41,519 SO IN THIS EQUATION, THIS IS 8237 06:05:41,586 --> 06:05:42,854 THIS ENVELOPE AND THEN THIS IS 8238 06:05:42,920 --> 06:05:45,623 OUR UNDERLYING FRINGE PATTERN, 8239 06:05:45,690 --> 06:05:48,693 SO THROUGH THIS THEORY, WE CAN 8240 06:05:48,760 --> 06:05:52,096 NOW LINK THE SPECTRUM, SPECTRAL 8241 06:05:52,163 --> 06:05:53,531 SHAPE OF THE LIGHT SOURCE WITH 8242 06:05:53,598 --> 06:05:55,700 THE COHERENCE LENGTH OF THE 8243 06:05:55,767 --> 06:05:57,535 O.C.T., AND HERE YOU CAN SEE 8244 06:05:57,602 --> 06:06:00,371 THAT FOR THE RED SHAPE OF THE 8245 06:06:00,438 --> 06:06:04,642 SPECTRUM, WHEN WE -- WE GET THIS 8246 06:06:04,709 --> 06:06:06,411 OUT CORRELATION FUNCTION OR 8247 06:06:06,477 --> 06:06:07,679 COHERENCE FUNCTION. 8248 06:06:07,745 --> 06:06:10,315 THE RED SIGNAL, THE RED ENVELOPE 8249 06:06:10,381 --> 06:06:11,616 IS DESCRIBED BY THE SPECTRAL 8250 06:06:11,683 --> 06:06:15,386 SHAPE OF THE SOURCE AND FRINGE 8251 06:06:15,453 --> 06:06:17,622 PATTERN, THE YELLOW PATTERN IS 8252 06:06:17,689 --> 06:06:20,058 DEFINED BY THE KIND OF POSITION 8253 06:06:20,124 --> 06:06:21,993 OF THE CENTRAL WAVELENGTHS OR 8254 06:06:22,060 --> 06:06:23,094 CENTRAL FREQUENCY OF THE 8255 06:06:23,161 --> 06:06:23,361 SPECTRUM. 8256 06:06:23,428 --> 06:06:25,797 SO IN RESPECT TO THE ORG 8257 06:06:25,863 --> 06:06:28,299 TECHNOLOGY WHAT'S REALLY NEEDED 8258 06:06:28,366 --> 06:06:30,535 IS TO -- THE ABILITY TO MEASURE 8259 06:06:30,601 --> 06:06:33,538 THE POSITION OF THE SCATTER -- 8260 06:06:33,604 --> 06:06:34,739 THE OBJECTS THAT WE'RE 8261 06:06:34,806 --> 06:06:36,140 MEASURING, SO TO DO IT WE CAN DO 8262 06:06:36,207 --> 06:06:37,442 IT EITHER USING THE KIND OF 8263 06:06:37,508 --> 06:06:39,077 POSITION OF THE ENVELOPE, THE 8264 06:06:39,143 --> 06:06:42,146 RED FUNCTION OR WE CAN USE IT BY 8265 06:06:42,213 --> 06:06:44,182 EXTRACTING PHASE FROM THE 8266 06:06:44,248 --> 06:06:45,183 UNDERLYING FRINGE PATTERN. 8267 06:06:45,249 --> 06:06:47,251 SO IN CASE OF THE -- OF GETTING 8268 06:06:47,318 --> 06:06:50,755 THE POSITION OF THE ENVELOPE 8269 06:06:50,822 --> 06:06:54,225 HERE, WE WOULD SIMPLY USE THE 8270 06:06:54,292 --> 06:06:56,060 KIND OF -- TRY TO ESTIMATE WHAT 8271 06:06:56,127 --> 06:06:57,395 THE PRECISION OF GETTING THE 8272 06:06:57,462 --> 06:06:58,629 POSITION AND HERE WHAT'S 8273 06:06:58,696 --> 06:06:59,764 INTERESTING IS THAT THIS IS 8274 06:06:59,831 --> 06:07:03,501 REALLY FOLLOWING UP THE -- LIMIT 8275 06:07:03,568 --> 06:07:08,673 COMING FROM THE SUPERRESOLUTION 8276 06:07:08,740 --> 06:07:10,007 MICROSCOPY FROM -- OR STORM SO 8277 06:07:10,074 --> 06:07:11,175 BASICALLY THE PRECISION OF 8278 06:07:11,242 --> 06:07:12,877 ESTIMATION POSITION OF THE PEAK 8279 06:07:12,944 --> 06:07:14,946 USING ENVELOPE IS JUST GIVEN BY 8280 06:07:15,012 --> 06:07:17,782 THE COHERENCE LENGTH IN THIS 8281 06:07:17,849 --> 06:07:20,518 CASE THE BANDWIDTH OF THIS 8282 06:07:20,585 --> 06:07:25,757 PROFILE DEFINED BY -- INDEX AND 8283 06:07:25,823 --> 06:07:28,192 IN CASE OF THE PHASE INFORMATION 8284 06:07:28,259 --> 06:07:31,329 YOU CAN SEE THAT THIS IS ALSO 8285 06:07:31,396 --> 06:07:33,164 DEPENDING ON THE -- RATIO, 8286 06:07:33,231 --> 06:07:37,068 HOWEVER, NOW WE HAVE VALUES THAT 8287 06:07:37,135 --> 06:07:41,172 ARE LINKED WITH THE -- DEFINED 8288 06:07:41,239 --> 06:07:44,242 BY THE SCENARIO IN A WAY -- OF 8289 06:07:44,308 --> 06:07:44,909 THE WAVELENGTHS. 8290 06:07:44,976 --> 06:07:46,377 SO THIS IS THE ABSOLUTE POSITION 8291 06:07:46,444 --> 06:07:48,079 IN CASE OF ORG WE'RE ALWAYS 8292 06:07:48,146 --> 06:07:51,349 MEASURING THE CHANGES IN LENGTH 8293 06:07:51,416 --> 06:07:56,154 BETWEEN TWO STRUCTURES COULD B 8294 06:07:56,220 --> 06:08:00,625 BE -- SO FOR THAT, IF WE GET -- 8295 06:08:00,691 --> 06:08:01,926 NOW THIS DIFFERENCE, THIS 8296 06:08:01,993 --> 06:08:02,693 RELATIVE DIFFERENCE, WE WOULD 8297 06:08:02,760 --> 06:08:05,997 USE THE FOLLOWING EQUATION, AND 8298 06:08:06,063 --> 06:08:09,901 HERE I CALCULATED THE VALUES OF 8299 06:08:09,967 --> 06:08:12,437 THE -- OF EXTRACTING PRECISION 8300 06:08:12,503 --> 06:08:15,239 OF THESE LENGTH MEASUREMENTS FOR 8301 06:08:15,306 --> 06:08:17,141 THREE DIFFERENT VALUES OF SNR 8302 06:08:17,208 --> 06:08:22,747 BEING 10, 100 AND A THOUSAND. 8303 06:08:22,814 --> 06:08:27,618 AND THE SOURCE WAS 850, ABOUT 8304 06:08:27,685 --> 06:08:30,021 6.4 MICRO METERS -- RESOLUTION 8305 06:08:30,087 --> 06:08:33,758 AND THEN USING THIS COHERENCE 8306 06:08:33,825 --> 06:08:34,792 FUNCTION PHASE, WE GET THE 8307 06:08:34,859 --> 06:08:39,130 VALUES THAT ARE ABOUT FACTOR OF 8308 06:08:39,197 --> 06:08:41,499 TWO SO 100 TIMES BETTER SO WE 8309 06:08:41,566 --> 06:08:45,603 HAVE THE SAME PARAMETERS -- SO 8310 06:08:45,670 --> 06:08:47,805 GENERALLY THE PHASE IS MUCH MORE 8311 06:08:47,872 --> 06:08:49,340 STABLE OR MUCH MORE SENSITIVE 8312 06:08:49,407 --> 06:08:50,942 THAN THE INTENSITY BASE 8313 06:08:51,008 --> 06:08:52,276 MEASUREMENTS, HOWEVER, THERE'S 8314 06:08:52,343 --> 06:08:55,079 ADVANTAGE IN USING INTENSIVE 8315 06:08:55,146 --> 06:08:56,013 BASED MEASUREMENTS BECAUSE THEY 8316 06:08:56,080 --> 06:08:57,582 CAN BE EASILY AVERAGED AND IT'S 8317 06:08:57,648 --> 06:08:59,217 ACTUALLY VERY EASY TO GET SNRs 8318 06:08:59,283 --> 06:09:01,519 IN THE RAKE OF THOUSANDS IF 8319 06:09:01,586 --> 06:09:03,588 NEEDED BY SPATIAL AND TEMPORAL 8320 06:09:03,654 --> 06:09:04,355 AVERAGING. 8321 06:09:04,422 --> 06:09:07,959 AS AN EXAMPLE I SHOW YOU HERE, 8322 06:09:08,025 --> 06:09:11,362 THIS IS AN EXAMPLE OF THE SINGLE 8323 06:09:11,429 --> 06:09:17,735 ON TOP AND -- BY AVERAGING 50 OR 8324 06:09:17,802 --> 06:09:22,240 ONE 50 VOLUMES WE GET HUGE 8325 06:09:22,306 --> 06:09:23,207 IMPROVEMENT IN SNR. 8326 06:09:23,274 --> 06:09:24,775 THIS IS JUST AGAIN SOME GRAPHS 8327 06:09:24,842 --> 06:09:28,513 HERE SHOWING YOU THAT INDEED WE 8328 06:09:28,579 --> 06:09:31,749 ARE -- THAT GOES WITH THE SQUARE 8329 06:09:31,816 --> 06:09:33,851 ROOT OF NUMBER OF AVERAGE 8330 06:09:33,918 --> 06:09:36,687 MEASUREMENTS, SO TO INCREASE BY 8331 06:09:36,754 --> 06:09:37,955 FACTOR OF 10 WE NEED TO 8332 06:09:38,022 --> 06:09:39,857 BASICALLY AVERAGE ABOUT 100, 100 8333 06:09:39,924 --> 06:09:40,191 MEASUREMENTS. 8334 06:09:40,258 --> 06:09:41,726 SO THIS CAN BE DONE IN THIS CASE 8335 06:09:41,792 --> 06:09:43,327 OVER TIME. 8336 06:09:43,394 --> 06:09:48,499 OR WE CAN DO IT ALSO HERE AS A 8337 06:09:48,566 --> 06:09:50,334 FUNCTION OF SPACE, SO OFTEN THIS 8338 06:09:50,401 --> 06:09:53,371 IS THE VIDEO SHOWING YOU THE 8339 06:09:53,437 --> 06:09:55,540 EVOLUTION OF THE PHASE IN A 8340 06:09:55,606 --> 06:09:57,975 MOUSE LIFE ON THE STAGE, WE 8341 06:09:58,042 --> 06:09:59,277 BASICALLY ARE LOOKING AT THE 8342 06:09:59,343 --> 06:10:00,244 PHASE DIFFERENCE BETWEEN THE 8343 06:10:00,311 --> 06:10:02,547 INITIAL POSITION AND THEN 8344 06:10:02,613 --> 06:10:03,748 CONSECUTIVE B SCANS SO THIS YOU 8345 06:10:03,814 --> 06:10:08,753 CAN SE SEE THE HEARTBEATING OF E 8346 06:10:08,819 --> 06:10:09,954 MOUSE AND EVENTUALLY IF YOU NOW 8347 06:10:10,021 --> 06:10:14,859 PROCESS THIS, WE CAN PERFORM NOW 8348 06:10:14,926 --> 06:10:16,394 THE SPATIAL AVERAGING AND YOU 8349 06:10:16,460 --> 06:10:18,696 CAN SEE HERE ON THE GRAPH 8350 06:10:18,763 --> 06:10:21,532 ACTUALLY E COMPARISON OF THE 8351 06:10:21,599 --> 06:10:22,500 INTENSITY BASE AND THE PHASE 8352 06:10:22,567 --> 06:10:27,305 BASE PRECISION OF THE INNER 8353 06:10:27,371 --> 06:10:29,173 SEGMENT, OUTER SEGMENT, YOU CAN 8354 06:10:29,240 --> 06:10:31,776 SEE THOSE ARE VERY SIMILAR SO 8355 06:10:31,842 --> 06:10:33,210 THE PHASE IS NOT MUCH HIGHER IN 8356 06:10:33,277 --> 06:10:33,744 THIS CASE. 8357 06:10:33,811 --> 06:10:42,587 SO NOW LET ME GO AND SWITCH 8358 06:10:42,653 --> 06:10:42,820 GEARS. 8359 06:10:42,887 --> 06:10:44,455 AS RAM SAID, THERE'S A LONG 8360 06:10:44,522 --> 06:10:50,695 HISTORY OF USING -- OR MEASURING 8361 06:10:50,761 --> 06:10:51,262 THIS -- IN THE RETINA. 8362 06:10:51,329 --> 06:10:53,097 YOU CAN SEE EXAMPLES OF THE 8363 06:10:53,164 --> 06:10:56,500 CHANGES IN THE SCATTERING AFTER 8364 06:10:56,567 --> 06:10:59,303 LIGHT STIMULATION IN THE RETINA. 8365 06:10:59,370 --> 06:11:01,472 AT THE BOTTOM, WE SEE CHANGES IN 8366 06:11:01,539 --> 06:11:07,511 THE SWELLING OF THE OUTER 8367 06:11:07,578 --> 06:11:08,079 SEGMENT PHOTO RECEPTORS. 8368 06:11:08,145 --> 06:11:09,513 YOU CAN SEE HERE THE DATES AND 8369 06:11:09,580 --> 06:11:16,587 THE NAMES OF THE -- SO THIS 8370 06:11:16,654 --> 06:11:19,090 PAPER IN 2007 IS REALLY THE EE 8371 06:11:19,156 --> 06:11:20,524 EQUIVALENT OF WHAT I WAS SHOWING 8372 06:11:20,591 --> 06:11:22,593 YOU EARLIER ON, WHICH IS THIS 8373 06:11:22,660 --> 06:11:24,762 COMMON PATH INTERFERON -- THAT 8374 06:11:24,829 --> 06:11:27,932 USES THE INTERFERENCE WITHIN THE 8375 06:11:27,999 --> 06:11:28,699 PHOTORECEPTORS OUTER SEGMENT AND 8376 06:11:28,766 --> 06:11:32,403 WHAT YOU SEE SCINTILLATIONS ARE 8377 06:11:32,470 --> 06:11:35,806 JUST A FACT OF THE -- OF THE 8378 06:11:35,873 --> 06:11:36,173 PHOTO RECEPTORS. 8379 06:11:36,240 --> 06:11:41,245 SO THIS WAS KIND OF EARLY WORK. 8380 06:11:41,312 --> 06:11:43,547 AND THEN THERE ARE MANY MORE 8381 06:11:43,614 --> 06:11:45,950 FOLLOW-UP STUDIES OVER YEARS, 8382 06:11:46,017 --> 06:11:47,818 USING DIFFERENT ASPECT OF 8383 06:11:47,885 --> 06:11:50,755 THIS -- SIGNALS BUT THE WORK WAS 8384 06:11:50,821 --> 06:11:55,559 SOMEHOW KIND OF NOT REALLY WELL 8385 06:11:55,626 --> 06:11:56,861 DESCRIBED NR THAT KIND OF 8386 06:11:56,927 --> 06:11:57,495 COHESIVE MANNER. 8387 06:11:57,561 --> 06:11:58,596 WHAT'S REALLY CHANGED IS THAT 8388 06:11:58,663 --> 06:12:00,665 WHEN PEOPLE START LOOKING JUST 8389 06:12:00,731 --> 06:12:02,433 AT PHOTO RECEPTORS, AND JUST AT 8390 06:12:02,500 --> 06:12:05,036 THE CHANGES LOCALLY WITHIN THE 8391 06:12:05,102 --> 06:12:08,673 OUTER SEGMENT AND THEN CAME THIS 8392 06:12:08,739 --> 06:12:11,709 IDEA OF REALLY USING THE PRECISE 8393 06:12:11,776 --> 06:12:13,110 PHASE MEASUREMENT WITHIN THE 8394 06:12:13,177 --> 06:12:19,550 OUTHEOUTER SEGMENT. 8395 06:12:19,617 --> 06:12:20,751 AND THEN SO THIS IS THE WORK YOU 8396 06:12:20,818 --> 06:12:21,752 CAN SEE HERE. 8397 06:12:21,819 --> 06:12:25,022 THERE WAS ALSO WORK ON USING 8398 06:12:25,089 --> 06:12:29,927 O.C.T. INTENSITY AS A WAY TO 8399 06:12:29,994 --> 06:12:33,097 MEASURE -- IN ANIMALS AND ALSO 8400 06:12:33,164 --> 06:12:34,298 CHANGES IN O.C.T. SCATTERING AS 8401 06:12:34,365 --> 06:12:39,637 WELL AS SOME WORK FROM JESSICA 8402 06:12:39,704 --> 06:12:42,707 MORGAN ON SOME KIND OF LINKING 8403 06:12:42,773 --> 06:12:47,845 OF THIS WORK OF FERCHER, BUT IN 8404 06:12:47,912 --> 06:12:50,581 THIS CASE THIS IS THE 8405 06:12:50,648 --> 06:12:53,517 INTERFERENCE FROM THE OUTER 8406 06:12:53,584 --> 06:12:54,385 SEGMENT ITSELF. 8407 06:12:54,452 --> 06:12:56,220 SO WITH THIS KIND OF -- IN MIND 8408 06:12:56,287 --> 06:12:59,390 IN THE LAB WE'VE BEEN WORKING ON 8409 06:12:59,457 --> 06:13:00,725 THE CLINICAL AND BASIC SCIENCE 8410 06:13:00,791 --> 06:13:01,826 WORK. 8411 06:13:01,892 --> 06:13:03,227 SO HERE ARE EXAMPLES OF THE 8412 06:13:03,294 --> 06:13:05,529 CLINICAL SYSTEMS DEVELOPED OVER 8413 06:13:05,596 --> 06:13:06,497 THE YEARS. 8414 06:13:06,564 --> 06:13:11,969 IN CHOIR LAB, RAVI JANNEL WILL 8415 06:13:12,036 --> 06:13:14,472 FOLLOW ME, INCLUDING THE TYPE OF 8416 06:13:14,538 --> 06:13:15,406 SIGNALS EXTRACTED FROM EACH OF 8417 06:13:15,473 --> 06:13:18,642 THE SYSTEMS USING EITHER 8418 06:13:18,709 --> 06:13:22,546 SCANNING AO-O.C.T., FULL FIELD 8419 06:13:22,613 --> 06:13:24,849 AO-O.C.T. OR SOME OTHER PROTO 8420 06:13:24,915 --> 06:13:26,383 CLINICAL SYSTEMS, HOWEVER I WANT 8421 06:13:26,450 --> 06:13:27,518 TO MOVE ON AND SHOW YOU SOME OF 8422 06:13:27,585 --> 06:13:30,187 THE WORK THAT WAS DONE WITH ED 8423 06:13:30,254 --> 06:13:33,023 PUGH IN RESPECT TO THE MOUSE. 8424 06:13:33,090 --> 06:13:34,859 IMAGES MICE AND SOME LATEST 8425 06:13:34,925 --> 06:13:37,595 RESULTS LINKING THE ORGs WITH 8426 06:13:37,661 --> 06:13:42,533 THE WATER FLUXES IN THE RETINA. 8427 06:13:42,600 --> 06:13:45,369 SO IN MICE WE WOULD -- THE 8428 06:13:45,436 --> 06:13:50,508 ANIMAL FOR ABOUT TWO HOURS, THE 8429 06:13:50,574 --> 06:13:54,211 MICE WERE POSITIONED -- INCLUDES 8430 06:13:54,278 --> 06:13:58,582 THE FIVE MINUTE FULL -- IMAGING 8431 06:13:58,649 --> 06:14:00,551 OF DARK ADAPTATION AND THEN 8432 06:14:00,618 --> 06:14:02,086 THERE'S A 10% BLEACH HAPPENING 8433 06:14:02,153 --> 06:14:03,587 ROUGHLY AT THE BEGINNING OF THE 8434 06:14:03,654 --> 06:14:08,959 SEDAN SO THSCAN, AND WE ALSO OBE 8435 06:14:09,026 --> 06:14:10,327 RETINA AFTER THAT FOR ABOUT FIVE 8436 06:14:10,394 --> 06:14:10,961 MINUTES. 8437 06:14:11,028 --> 06:14:16,300 AND SO HERE YOU CAN SEE THE 8438 06:14:16,367 --> 06:14:17,835 IMAGE OF THE RETINA AND THE AREA 8439 06:14:17,902 --> 06:14:19,036 THAT WAS BLEACHED AND THE AREA 8440 06:14:19,103 --> 06:14:21,872 OF THE B SCANS WE ARE ACTUALLY 8441 06:14:21,939 --> 06:14:22,640 EXTRACTING FROM THE MOUSE. 8442 06:14:22,706 --> 06:14:26,577 SO WE ONLY ARE ACQUIRING THE W B 8443 06:14:26,644 --> 06:14:28,012 SCANS BACK THEN ABOUT 1 HERTZ 8444 06:14:28,078 --> 06:14:30,948 RATE SO OUR DATA ARE FAIRLY SLOW 8445 06:14:31,015 --> 06:14:32,449 AND WE CAN FOLLOW ANIMALS FOR 8446 06:14:32,516 --> 06:14:33,450 SUCH A LONG TIME. 8447 06:14:33,517 --> 06:14:35,953 SO WHAT'S HAPPENING AGAIN, THE 8448 06:14:36,020 --> 06:14:37,054 IMAGE OF THE MOUSE RETINA HERE, 8449 06:14:37,121 --> 06:14:40,257 YOU SEE IT RESPONDING 8450 06:14:40,324 --> 06:14:41,859 PHOTORECEPTOR -- IN MOUSE YOU 8451 06:14:41,926 --> 06:14:44,395 CAN SEE THE SYNAPTIC BODY, 8452 06:14:44,461 --> 06:14:46,130 NUCLEI, AND AFTER SEGMENT AND 8453 06:14:46,197 --> 06:14:47,998 OUTER SEGMENT, THE PART OF 8454 06:14:48,065 --> 06:14:50,301 PHOTORECEPTOR THAT WE THINK IS 8455 06:14:50,367 --> 06:14:51,268 LINKED WITH THE SWELLING, SO IF 8456 06:14:51,335 --> 06:14:54,238 YOU LOOK AT THIS LENGTH OF 8457 06:14:54,305 --> 06:14:55,806 RESPONSE OF MOUSE RETINA, YOU 8458 06:14:55,873 --> 06:14:58,676 CAN SEE HERE THAT ON THIS 8459 06:14:58,742 --> 06:14:59,877 PROFILE WE'RE STARTING WITH THE 8460 06:14:59,944 --> 06:15:01,979 BLACK PROFILE BEING PROFILE 8461 06:15:02,046 --> 06:15:04,048 WITHOUT LIGHT STIMULATION, THEN 8462 06:15:04,114 --> 06:15:05,816 THE RED IS DURING LIGHT 8463 06:15:05,883 --> 06:15:07,318 STIMULATION. 8464 06:15:07,384 --> 06:15:09,620 SO HERE WE CAN ALSO TRY TO -- 8465 06:15:09,687 --> 06:15:10,821 INSTEAD OF SHOWING THIS VIDEO WE 8466 06:15:10,888 --> 06:15:16,727 CAN HAVE IT COLOR-CODED -- THE 8467 06:15:16,794 --> 06:15:18,062 COLOR CODES THE TIME AFTER 8468 06:15:18,128 --> 06:15:19,129 STIMULATION, GOING FROM BEFORE 8469 06:15:19,196 --> 06:15:19,964 STIMULATION IS THE BLUE AND ALL 8470 06:15:20,030 --> 06:15:21,398 THE WAY TO THE POST STIMULATION 8471 06:15:21,465 --> 06:15:24,602 ON THE RIGHT. 8472 06:15:24,668 --> 06:15:26,136 YOU CAN HOPEFULLY SEE IN THE 8473 06:15:26,203 --> 06:15:29,106 CASE OF HIGH SOS, THE DIPS, YOU 8474 06:15:29,173 --> 06:15:33,143 HAVE THE STRONGEST EFFECTS IN 8475 06:15:33,210 --> 06:15:34,011 CHANGES OF SCATTERING AND 8476 06:15:34,078 --> 06:15:35,012 CHANGES IN THE POSITION OF THE 8477 06:15:35,079 --> 06:15:35,212 BENDS. 8478 06:15:35,279 --> 06:15:41,452 SO THIS WAS DESCRIBED FROM -- IN 8479 06:15:41,518 --> 06:15:48,993 2017 BY SANG ZHANG, INCREASED 8480 06:15:49,059 --> 06:15:52,162 THICKNESS OF THE BANDS. 8481 06:15:52,229 --> 06:15:55,099 SO THEN WE CREATED -- ED CAME UP 8482 06:15:55,165 --> 06:15:57,167 WITH THE STORY DESCRIBING THIS 8483 06:15:57,234 --> 06:16:00,738 AS A OSMOTIC MOVEMENTS. 8484 06:16:00,804 --> 06:16:06,510 SO WHAT WE DID LATER TO TRY TO 8485 06:16:06,577 --> 06:16:09,546 COLONIZE IT, WE NOW KIND OF SET 8486 06:16:09,613 --> 06:16:11,949 UP THE MODEL IN WHICH INSTEAD OF 8487 06:16:12,016 --> 06:16:13,150 USING THE LIGHT AS A STIMULATION 8488 06:16:13,217 --> 06:16:14,685 FOR RETINAL SWELLING, WE'RE NOW 8489 06:16:14,752 --> 06:16:16,620 USING RETINAL EDEMA, SO IN THIS 8490 06:16:16,687 --> 06:16:19,356 CASE WE'RE INJECTING MICE WITH A 8491 06:16:19,423 --> 06:16:21,125 SMALL AMOUNT OF WATER INTO THEIR 8492 06:16:21,191 --> 06:16:24,495 BODIES AND THIS CHANGES THE 8493 06:16:24,561 --> 06:16:26,030 OSMOLARITY OF THE BLOOD PLASMA 8494 06:16:26,096 --> 06:16:30,501 WHICH IS CAUSING THE SWELLING OF 8495 06:16:30,567 --> 06:16:31,068 OVERALL NEURAL TISSUE IN THE 8496 06:16:31,135 --> 06:16:31,602 BRAIN AND IN THE EYE. 8497 06:16:31,669 --> 06:16:33,237 SO WHAT WE'RE DOING NOW, WE HAVE 8498 06:16:33,304 --> 06:16:40,377 THE SAME KIND OF -- FOR -- BEING 8499 06:16:40,444 --> 06:16:41,578 THE WATER INJECTION VERSUS THE 8500 06:16:41,645 --> 06:16:42,813 FLASH OF LIGHT. 8501 06:16:42,880 --> 06:16:44,114 THE ONLY DIFFERENCE BETWEEN 8502 06:16:44,181 --> 06:16:45,516 THESE TWO EXPERIMENTS IS ORG AND 8503 06:16:45,582 --> 06:16:47,518 THE WATER INJECTION IS THAT THE 8504 06:16:47,584 --> 06:16:49,253 WATER INJECTION CHANGE IS 8505 06:16:49,320 --> 06:16:50,354 HAPPENING AT ABOUT FOUR TIMES 8506 06:16:50,421 --> 06:16:53,057 SLOWER RATE, SO THAT'S WHY WE 8507 06:16:53,123 --> 06:16:54,725 HAVE TO PERFORM THESE 8508 06:16:54,792 --> 06:16:57,761 MEASUREMENTS OVER 20 MINUTES, 8509 06:16:57,828 --> 06:17:00,597 AND THOSE WERE FIVE DIFFERENT 8510 06:17:00,664 --> 06:17:03,901 MEASUREMENTS THAT WE HAVE A 8511 06:17:03,968 --> 06:17:05,736 CONTROL, WITHOUT INJECTION, 8512 06:17:05,803 --> 06:17:06,837 WATER INJECTION, AND THEN A 8513 06:17:06,904 --> 06:17:10,507 FLASH WITH LIGHT, WITHOUT WATER 8514 06:17:10,574 --> 06:17:11,108 INJECTION. 8515 06:17:11,175 --> 06:17:12,443 THE DATA IS NOW ANALYZED IN A 8516 06:17:12,509 --> 06:17:13,744 WAY THAT FOR EACH OF THESE 8517 06:17:13,811 --> 06:17:17,114 BANDS, FOR EACH OF THIS PEAK 8518 06:17:17,181 --> 06:17:23,821 PROFILE, WE ARE MAPPING -- TH 8519 06:17:23,887 --> 06:17:26,090 THE -- WE CAN GET THE INTENSITY, 8520 06:17:26,156 --> 06:17:27,291 THE WIDTH OF THE PEAK AND ALSO 8521 06:17:27,358 --> 06:17:29,827 THE CHYMO GRAPH ON THE IMAGE C 8522 06:17:29,893 --> 06:17:33,197 THAT SHOWS YOU HOW THE RETINA 8523 06:17:33,263 --> 06:17:35,299 SWELLING OVER TIME AFTER WATER 8524 06:17:35,366 --> 06:17:38,135 INJECTION, SORE W SO WITH THIS,N 8525 06:17:38,202 --> 06:17:41,505 NOW KIND OF LOOK AND ANALYZE THE 8526 06:17:41,572 --> 06:17:48,045 SWELLING AND THE CHIMOGRAPHS FOR 8527 06:17:48,112 --> 06:17:49,346 THE LIGHT STIMULATION AND 8528 06:17:49,413 --> 06:17:50,948 THEN -- SO THIS IS SHOWING YOU 8529 06:17:51,015 --> 06:17:58,489 THREE DIFFERENT CASES. 8530 06:17:58,555 --> 06:18:00,357 THE ORG AFTER WATER INJECTION 8531 06:18:00,424 --> 06:18:06,296 AND ORG IN DEHIGH D DEHYDRATIOND 8532 06:18:06,363 --> 06:18:11,068 THE SAME FOR WATER INJECTION. 8533 06:18:11,135 --> 06:18:12,803 THERE'S NOT ENOUGH TIME TO GO 8534 06:18:12,870 --> 06:18:17,408 OVER DETAILS BUT IT LOOKS LIKE 8535 06:18:17,474 --> 06:18:20,277 THE OBSERVATION THAT WE HAVE IS 8536 06:18:20,344 --> 06:18:23,213 THAT THE SAME KIND OF SWELLING, 8537 06:18:23,280 --> 06:18:24,948 CHANGES IN SCATTERING THAT WERE 8538 06:18:25,015 --> 06:18:26,517 OBSERVED WITH THE LIGHT EVOKED 8539 06:18:26,583 --> 06:18:27,484 SIGNALS CAN BE OBSERVED WITH 8540 06:18:27,551 --> 06:18:29,453 THIS █WATER INJECTION, WHICH 8541 06:18:29,520 --> 06:18:30,220 FURTHER VALIDATES THE POINT THAT 8542 06:18:30,287 --> 06:18:31,855 THIS IS DUE TO THE WATER 8543 06:18:31,922 --> 06:18:34,625 INJECTION INITIALLY. 8544 06:18:34,691 --> 06:18:37,628 SO I WANT TO JUST LEAVE YOU NOW 8545 06:18:37,694 --> 06:18:38,362 WITH SOME CONCLUSIONS AND THANK 8546 06:18:38,429 --> 06:18:39,196 YOU VERY MUCH FOR YOUR 8547 06:18:39,263 --> 06:18:39,863 INTENTION. 8548 06:18:39,930 --> 06:18:48,305 [APPLAUSE] 8549 06:18:48,372 --> 06:18:49,473 >> ALL RIGHT. 8550 06:18:49,540 --> 06:18:52,376 OUR THIRD SPEAKER OF THE SESSION 8551 06:18:52,443 --> 06:18:56,080 IS RAVI JONNAL, ASSOCIATE 8552 06:18:56,146 --> 06:18:58,115 PROFESSOR OF OPHTHALMOLOGY AT 8553 06:18:58,182 --> 06:18:59,116 UNIVERSITY OF CALIFORNIA DAVIS 8554 06:18:59,183 --> 06:19:01,218 AND HE'LL BE TALKING TO US ABOUT 8555 06:19:01,285 --> 06:19:02,186 OPTORETINOGRAPHY, BASIC AND 8556 06:19:02,252 --> 06:19:04,054 TRANSLATIONAL APPLICATIONS. 8557 06:19:04,121 --> 06:19:06,356 RAVI. 8558 06:19:06,423 --> 06:19:08,092 >> HI, EVERYONE. 8559 06:19:08,158 --> 06:19:12,696 I WANT TO FIRST CONGRATULATE JIM 8560 06:19:12,763 --> 06:19:15,299 AND DAVID AND ERIC ALSO ON THEIR 8561 06:19:15,365 --> 06:19:18,168 PRESTIGIOUS AWARDS AND JUST SAY 8562 06:19:18,235 --> 06:19:19,670 HOW GRATEFUL I AM TO BE HERE AND 8563 06:19:19,736 --> 06:19:21,338 HAVE AN OPPORTUNITY TO PRESENT 8564 06:19:21,405 --> 06:19:25,042 TO SUCH AN ESTEEMED GROUP OF 8565 06:19:25,109 --> 06:19:27,444 PEOPLE. 8566 06:19:27,511 --> 06:19:31,949 SO I'M GOING TO TALK MORE ABOUT 8567 06:19:32,015 --> 06:19:33,450 OPTORETINOGRAPHY AFTER THE 8568 06:19:33,517 --> 06:19:34,051 EXCELLENT TALKS I DON'T HAVE 8569 06:19:34,118 --> 06:19:35,319 THAT MUCH MORE TO SAY, BUT I'LL 8570 06:19:35,385 --> 06:19:37,287 TRY TO ADD SOMETHING TO THE 8571 06:19:37,354 --> 06:19:38,922 DISCUSSION HERE. 8572 06:19:38,989 --> 06:19:41,225 I'D LIKE TO JUST QUICKLY SHARE 8573 06:19:41,291 --> 06:19:43,193 PHOTOGRAPHS OF PEOPLE PAST AND 8574 06:19:43,260 --> 06:19:44,728 PRESENT WHO HAVE CONTRIBUTED TO 8575 06:19:44,795 --> 06:19:46,864 THESE PROJECTS, EVERYTHING I'M 8576 06:19:46,930 --> 06:19:48,632 GOING TO SHOW DEPENDED 8577 06:19:48,699 --> 06:19:52,603 CRITICALLY ON PEOPLE HERE IN 8578 06:19:52,669 --> 06:19:53,504 THESE PICTURES. 8579 06:19:53,570 --> 06:19:57,407 SO JUST TO ORIENT US, I MEAN, I 8580 06:19:57,474 --> 06:19:59,943 THINK EVERYONE HERE IS QUITE 8581 06:20:00,010 --> 06:20:01,712 FAMILIAR WITH THIS STRUCTURE OF 8582 06:20:01,778 --> 06:20:05,182 THE RETINA, BUT IT BEARS 8583 06:20:05,249 --> 06:20:05,782 MENTIONING NEAR-INFRARED WAY. 8584 06:20:05,849 --> 06:20:08,685 SO I'M GOING TO BE TALKING ABOUT 8585 06:20:08,752 --> 06:20:11,088 WHAT HAPPENS TO THE OUTER 8586 06:20:11,155 --> 06:20:13,924 SEGMENT OF THE PHOTO RECEPTORS 8587 06:20:13,991 --> 06:20:15,592 WHEN YOU STIMULATE THEM WITH 8588 06:20:15,659 --> 06:20:16,994 LIGHT, AND AGAIN, RAM HAS GIVEN 8589 06:20:17,060 --> 06:20:18,962 A LOT OF THE BACKGROUND HERE. 8590 06:20:19,029 --> 06:20:21,698 I'LL TRY TO -- I THINK WHAT I'LL 8591 06:20:21,765 --> 06:20:23,467 SAY, I'LL SAY A LITTLE MORE 8592 06:20:23,534 --> 06:20:24,868 ABOUT HOW THESE EFFECTS ARE 8593 06:20:24,935 --> 06:20:28,038 CAPTURED IN O.C.T., AND THAT 8594 06:20:28,105 --> 06:20:29,806 WILL LEAD ME INTO SOME 8595 06:20:29,873 --> 06:20:32,409 CONCLUDING REMARKS I HAVE ABOUT 8596 06:20:32,476 --> 06:20:34,811 FUTURE DIRECTIONS. 8597 06:20:34,878 --> 06:20:36,446 BUT YEAH, WE'RE GOING TO BE 8598 06:20:36,513 --> 06:20:37,581 LOOKING AT HOW LIGHT CHANGES 8599 06:20:37,648 --> 06:20:38,715 THESE OUTER SEGMENTS OF THE 8600 06:20:38,782 --> 06:20:42,152 PHOTO RECEPTORS. 8601 06:20:42,219 --> 06:20:44,188 THERE ARE TWO KIND OF CRITICAL 8602 06:20:44,254 --> 06:20:44,788 PROCESSES HERE. 8603 06:20:44,855 --> 06:20:46,757 WE'RE TALKING -- WE USE THE TERM 8604 06:20:46,823 --> 06:20:48,692 FUNCTIONAL IMAGING, AND I THINK 8605 06:20:48,759 --> 06:20:50,127 A LOT OF PEOPLE USE IT WITHOUT 8606 06:20:50,194 --> 06:20:53,263 REALLY WONDERING OR SAYING WHAT 8607 06:20:53,330 --> 06:20:53,630 FUNCTION IS. 8608 06:20:53,697 --> 06:20:54,631 OBVIOUSLY THE FUNCTION OF THE 8609 06:20:54,698 --> 06:20:55,832 PHOTO RECEPTORS IS TO TRANSDUCE 8610 06:20:55,899 --> 06:20:57,801 AN ELECTRICAL SIGNAL AFTER 8611 06:20:57,868 --> 06:20:59,770 ABSORBING PHOTONS, BUT THERE'S 8612 06:20:59,836 --> 06:21:02,639 KIND OF A RICH SET OF PROCESSES 8613 06:21:02,706 --> 06:21:05,008 THAT WE'RE POTENTIALLY ABLE TO 8614 06:21:05,075 --> 06:21:05,442 PROBE. 8615 06:21:05,509 --> 06:21:07,211 TWO OF THEM BEING CLOSEST TO THE 8616 06:21:07,277 --> 06:21:08,545 PHOTORECEPTOR ARE, OF COURSE, 8617 06:21:08,612 --> 06:21:10,380 PHOTO TRANSDUCTION, THE VISUAL 8618 06:21:10,447 --> 06:21:12,783 CYCLE, AND THE REASON I NAMED 8619 06:21:12,849 --> 06:21:13,750 THESE TWO PROCESSES IN 8620 06:21:13,817 --> 06:21:17,487 PARTICULAR IS BECAUSE THERE ARE 8621 06:21:17,554 --> 06:21:19,923 A NUMBER OF PROTEINS OR GENES 8622 06:21:19,990 --> 06:21:21,124 INVOLVED IN THESE TWO PROCESSES 8623 06:21:21,191 --> 06:21:22,626 WHICH ARE SUSCEPTIBLE TO 8624 06:21:22,693 --> 06:21:24,394 MUTATION AND THE CAUSE OF MANY 8625 06:21:24,461 --> 06:21:27,130 OF OUR WELL-KNOWN INHERITED 8626 06:21:27,197 --> 06:21:31,702 RETINAL DEGENERATIONS. 8627 06:21:31,768 --> 06:21:35,872 IF YOU -- IF ALL YOU HAVE IS AN 8628 06:21:35,939 --> 06:21:36,473 OPTOROENTGENOGRAM, EVERYTHING 8629 06:21:36,540 --> 06:21:38,375 LOOKS LIKE A PHOTORECEPTOR 8630 06:21:38,442 --> 06:21:40,077 DISEASE, SO THERE ARE TWO REALLY 8631 06:21:40,143 --> 06:21:43,880 TWO CLASSES OF DISEASE THAT 8632 06:21:43,947 --> 06:21:45,215 WE'RE ABLE TO POTENTIALLY STUDY 8633 06:21:45,282 --> 06:21:47,317 AT THIS STAGE, AND THEY ARE 8634 06:21:47,384 --> 06:21:48,385 AGE-RELATED MACULAR 8635 06:21:48,452 --> 06:21:51,555 DEGENERATION, WHICH MAY NOT BE 8636 06:21:51,622 --> 06:21:52,556 THOUGHT TO BE PRIMARILY A 8637 06:21:52,623 --> 06:21:54,424 DISEASE OF PHOTO RECEPTORS BUT 8638 06:21:54,491 --> 06:21:55,492 CERTAINLY IT AFFECTS THEM EARLY 8639 06:21:55,559 --> 06:21:57,794 AND THEN INHERITED RETINAL 8640 06:21:57,861 --> 06:21:58,462 DEGENERATIONS WHICH ARE DISEASES 8641 06:21:58,528 --> 06:22:00,664 OF THE PHOTO RECEPTORS OR OF THE 8642 06:22:00,731 --> 06:22:02,599 RPE CELLS WHICH ARE CRITICAL FOR 8643 06:22:02,666 --> 06:22:05,369 THE HOMEOSTASIS AND THE PHOTO 8644 06:22:05,435 --> 06:22:11,842 RECEPTORS. 8645 06:22:11,908 --> 06:22:14,011 HERE WE SEE A PREFERRED PRACTICE 8646 06:22:14,077 --> 06:22:16,079 PATTERN FOR STAGING AND 8647 06:22:16,146 --> 06:22:16,980 DIAGNOSIS OF A.M.D. 8648 06:22:17,047 --> 06:22:17,981 THERE ARE SOME STRUCTURAL AND 8649 06:22:18,048 --> 06:22:18,749 FUNCTIONAL COMPONENTS. 8650 06:22:18,815 --> 06:22:24,888 ON THE FUNCTIONAL SIDE, THE 8651 06:22:24,955 --> 06:22:28,825 AMSLER GRID IS THE ONLY, 8652 06:22:28,892 --> 06:22:30,560 MICROPERIMETRY IS MENTIONED IN 8653 06:22:30,627 --> 06:22:31,695 PASSING BUT IT'S NOT LIKE A 8654 06:22:31,762 --> 06:22:36,466 CRITICAL ASPECT OF DIAGNOSIS. 8655 06:22:36,533 --> 06:22:37,701 ADAPTIVE OPTICS IS ALSO 8656 06:22:37,768 --> 06:22:38,902 MENTIONED ON THE STRUCTURAL SIDE 8657 06:22:38,969 --> 06:22:40,671 BUT IT'S NOT A MAINSTAY. 8658 06:22:40,737 --> 06:22:42,406 FOR IRDs, WE SEE A LITTLE BIT 8659 06:22:42,472 --> 06:22:44,508 RICHER SET OF TESTS ON THE 8660 06:22:44,574 --> 06:22:46,576 STRUCTURAL SIDE AND FUNCTIONAL 8661 06:22:46,643 --> 06:22:51,181 SIDE, BCVA, VISUAL FIELDS AND 8662 06:22:51,248 --> 06:22:53,050 MICRO PRIM TRI IS CALLED FOR, 8663 06:22:53,116 --> 06:22:54,451 ELECTRORETINOGRAPHY IS CALLED 8664 06:22:54,518 --> 06:22:56,987 FOR BUT I DO KNOW THAT ERGs 8665 06:22:57,054 --> 06:23:00,324 ARE RARELY ORDERED OR NOT RARELY 8666 06:23:00,390 --> 06:23:02,025 BUT OFTEN ARE NOT ORDERED FOR 8667 06:23:02,092 --> 06:23:02,359 IRD PATIENTS. 8668 06:23:02,426 --> 06:23:04,027 OF COURSE GENETIC TESTING IS 8669 06:23:04,094 --> 06:23:05,095 GROWING, IT'S GROWING IN 8670 06:23:05,162 --> 06:23:06,963 SIGNIFICANCE AS THE COST OF 8671 06:23:07,030 --> 06:23:09,166 GENETIC TESTING BECOME MORE 8672 06:23:09,232 --> 06:23:11,368 TRACTABLE, IT'S BECOMING A MORE 8673 06:23:11,435 --> 06:23:13,437 COMMON PART OF THE DIAGNOSIS OF 8674 06:23:13,503 --> 06:23:17,708 INHERITED RETINAL DEGENERATIONS. 8675 06:23:17,774 --> 06:23:19,242 SO EXISTING STRUCTURAL ASSAYS 8676 06:23:19,309 --> 06:23:21,011 REVEAL SOME OF THE WEAKNESSES OF 8677 06:23:21,078 --> 06:23:21,878 EXISTING ASSAYS. 8678 06:23:21,945 --> 06:23:23,847 EXISTING STRUCTURAL ASSAYS 8679 06:23:23,914 --> 06:23:26,817 REVEAL CHANGES ONLY AFTER 8680 06:23:26,883 --> 06:23:28,018 PHOTORECEPTORS ARE LOST AND THEY 8681 06:23:28,085 --> 06:23:30,420 LACK FUNCTIONAL INFORMATION. 8682 06:23:30,487 --> 06:23:33,023 EXISTING FUNCTIONAL ASSAYS, 8683 06:23:33,090 --> 06:23:34,324 THEY'RE OFTENTIMES SUBJECTIVE 8684 06:23:34,391 --> 06:23:35,992 AND SUFFER FROM ASSOCIATED 8685 06:23:36,059 --> 06:23:37,961 SOURCES OF NOISE LIKE LEARNING 8686 06:23:38,028 --> 06:23:40,497 EFFECTS AND FATIGUE, AND THEY 8687 06:23:40,564 --> 06:23:42,366 PROVIDE LIMITED SPATIAL 8688 06:23:42,432 --> 06:23:43,467 LOCALIZATION AND NEURAL 8689 06:23:43,533 --> 06:23:45,969 SPECIFICITY. 8690 06:23:46,036 --> 06:23:49,039 SO OPTORETINOGRAPHY I SEE AS A 8691 06:23:49,106 --> 06:23:50,474 NICE COMPLEMENT TO THESE, ALONG 8692 06:23:50,540 --> 06:23:54,311 WITH AN IMAGE, IT HAS TO HAVE AN 8693 06:23:54,378 --> 06:23:58,348 IMAGE ATTACHED TO IT. 8694 06:23:58,415 --> 06:23:59,883 LIKE RAM MENTIONED, WE'VE BEEN 8695 06:23:59,950 --> 06:24:01,017 DOING THIS FOR QUITE A WHILE, 8696 06:24:01,084 --> 06:24:03,787 AND I PUT THIS SLIDE UP NOT TO 8697 06:24:03,854 --> 06:24:08,091 TOOTHTOOT MY OWN HORN AS MUCH AS 8698 06:24:08,158 --> 06:24:09,226 DON'S, I'M PROBABLY GOING TO 8699 06:24:09,292 --> 06:24:11,294 SKIP SOME SLIDE HERE, WHEN -- SO 8700 06:24:11,361 --> 06:24:12,496 DON AND I WERE UNDER SOME 8701 06:24:12,562 --> 06:24:14,264 PRESSURE TO PRODUCE SOME RESULTS 8702 06:24:14,331 --> 06:24:16,433 BACK THEN, AND WE WERE -- THIS 8703 06:24:16,500 --> 06:24:17,868 WAS A KIND OF LIKE A TANGENT 8704 06:24:17,934 --> 06:24:20,804 FROM THE MAIN O.C.T. PROJECT, 8705 06:24:20,871 --> 06:24:24,975 AND WE STARTED SEEING IN THESE 8706 06:24:25,041 --> 06:24:27,511 SCINTILLATIONS OF CONES AND WE 8707 06:24:27,577 --> 06:24:28,912 WERE -- I WAS TASKED WITH 8708 06:24:28,979 --> 06:24:31,214 PRODUCING A NICE IMAGE OF THE 8709 06:24:31,281 --> 06:24:32,983 PHOTORECEPTOR MOSAIC AND DONE 8710 06:24:33,049 --> 06:24:38,789 DON ANDI WERE SITTING THERE LOOT 8711 06:24:38,855 --> 06:24:40,157 THESE TOGETHER AND I WAS LIKE I 8712 06:24:40,223 --> 06:24:41,358 CAN AVERAGE THESE OUT AND DON 8713 06:24:41,425 --> 06:24:42,559 WAS LIKE SLOW DOWN, THERE'S 8714 06:24:42,626 --> 06:24:44,394 PROBABLY SOMETHING THERE, AND IT 8715 06:24:44,461 --> 06:24:45,295 WAS WITHIN MINUTES WHERE HE'S 8716 06:24:45,362 --> 06:24:48,498 LIKE WELL, THINK THIS MIGHT BE 8717 06:24:48,565 --> 06:24:49,699 AN INTERFERENCE EFFECT AND THAT 8718 06:24:49,766 --> 06:24:51,134 LED TO THIS WHOLE FIELD REALLY, 8719 06:24:51,201 --> 06:24:52,469 AND ALSO IS WHAT KIND OF 8720 06:24:52,536 --> 06:24:54,805 CONVINCED ME TO DO A PH.D. IN 8721 06:24:54,871 --> 06:24:56,206 THE PROJECT. 8722 06:24:56,273 --> 06:25:00,043 SO IT'S NICE TO SEE IT IN THAT 8723 06:25:00,110 --> 06:25:02,946 AERIAL IMAGING MODALITY LIKE 8724 06:25:03,013 --> 06:25:04,147 THAT. 8725 06:25:04,214 --> 06:25:05,582 THAT AREA IS CONTINUING TO BE 8726 06:25:05,649 --> 06:25:06,316 INVESTIGATED. 8727 06:25:06,383 --> 06:25:08,752 WE'RE SORT OF WORKING ON IT BUT 8728 06:25:08,819 --> 06:25:10,086 JESSICA MORGAN IS ESPECIALLY 8729 06:25:10,153 --> 06:25:13,924 WORKING ON IT, HER FORMER 8730 06:25:13,990 --> 06:25:15,192 STUDENT ROB COOPER WORKING ON IT 8731 06:25:15,258 --> 06:25:16,226 AND I'LL SAY MORE ABOUT THAT 8732 06:25:16,293 --> 06:25:17,194 AGAIN AND WHY I THINK IT'S 8733 06:25:17,260 --> 06:25:18,628 IMPORTANT TO MAINTAIN THIS SORT 8734 06:25:18,695 --> 06:25:19,963 OF DIVERSITY OF APPROACHES. 8735 06:25:20,030 --> 06:25:21,064 BUT OF COURSE IT WOULD BE NICE 8736 06:25:21,131 --> 06:25:24,334 DO THIS WITH AOCT AND SO WE'VE 8737 06:25:24,401 --> 06:25:26,002 SEEN AN INTRODUCTION TO 8738 06:25:26,069 --> 06:25:26,336 AO-O.C.T. 8739 06:25:26,403 --> 06:25:28,305 IT'S A THREE-DIMENSIONAL 8740 06:25:28,371 --> 06:25:30,574 CELLULAR RESOLUTION IMAGE OF THE 8741 06:25:30,640 --> 06:25:32,809 PHOTORECEPTOR MOSAIC AND -- OR 8742 06:25:32,876 --> 06:25:33,910 THE WHOLE RETINA. 8743 06:25:33,977 --> 06:25:35,745 SO HERE WE'RE SEEING THE TOP OF 8744 06:25:35,812 --> 06:25:38,815 THE PHOTORECEPTORS, THE ISOS AND 8745 06:25:38,882 --> 06:25:40,016 HERE WE'RE SEEING THE BACK OF 8746 06:25:40,083 --> 06:25:41,451 THE PHOTORECEPTORS, THE COST, 8747 06:25:41,518 --> 06:25:43,153 HERE WE SEE CROSS-SECTIONAL 8748 06:25:43,220 --> 06:25:44,221 IMAGES THROUGH THE MOSAIC. 8749 06:25:44,287 --> 06:25:45,856 AND THIS KIND OF -- ONCE WE 8750 06:25:45,922 --> 06:25:49,025 STARTED GETTING IMAGES LIKE THIS 8751 06:25:49,092 --> 06:25:50,227 HAVE SORT OF OPENED UP THE WORLD 8752 06:25:50,293 --> 06:25:52,162 OR IT OPENED A NEW WORLD OF 8753 06:25:52,229 --> 06:25:57,434 AVENUES OF INVESTIGATION. 8754 06:25:57,501 --> 06:25:59,402 I WAS INSPIRED IN THINKING ABOUT 8755 06:25:59,469 --> 06:26:01,171 THE PHASE SENSITIVE O.C.T. PAPER 8756 06:26:01,238 --> 06:26:05,675 VERY MUCH BY THIS PAPER BY MIKE 8757 06:26:05,742 --> 06:26:07,644 CHOMA AND MIKE ISAT'S GROUP. 8758 06:26:07,711 --> 06:26:10,046 HE WAS ABLE TO SHOW THAT YOU CAN 8759 06:26:10,113 --> 06:26:12,015 USE THE PHASE OFS O.C.T. SIGNAL, 8760 06:26:12,082 --> 06:26:13,450 SO IF YOU EXPRESS THE O.C.T. 8761 06:26:13,517 --> 06:26:16,186 SIGNAL THE FRINGE THIS WAY, 8762 06:26:16,253 --> 06:26:18,021 AFTER 4A TRANSFORM YOU GET THE 8763 06:26:18,088 --> 06:26:20,123 PHASE OUT HERE IN THIS 8764 06:26:20,190 --> 06:26:20,757 COMPONENT. 8765 06:26:20,824 --> 06:26:22,526 AS ROBERT MENTIONED IN HIS TALK 8766 06:26:22,592 --> 06:26:24,461 YOU CAN COMPUTE THE SENSITIVITY 8767 06:26:24,528 --> 06:26:26,229 OF THE -- THE PHASE SENSITIVITY 8768 06:26:26,296 --> 06:26:28,298 ON THIS, IT DEPENDS ON THE SNR 8769 06:26:28,365 --> 06:26:30,300 OF THE O.C.T. BUT FOR 8770 06:26:30,367 --> 06:26:31,968 PHOTORECEPTORS WHICH ARE 8771 06:26:32,035 --> 06:26:36,339 EXTREMELY BRIGHT, WE CAN GET 8772 06:26:36,406 --> 06:26:38,508 DOWN TO A FEW NANOMETERS OF 8773 06:26:38,575 --> 06:26:39,509 PHASE SENSITIVITY. 8774 06:26:39,576 --> 06:26:44,347 WHAT MIKE DID WAS APPLY THIS TO 8775 06:26:44,414 --> 06:26:46,316 CHICKEN CARDIOMYOCYTES IN VITRO, 8776 06:26:46,383 --> 06:26:48,151 AND WAS ABLE TO SHOW THEM 8777 06:26:48,218 --> 06:26:49,719 BEATING THE WAY THAT THEY OUGHT 8778 06:26:49,786 --> 06:26:52,222 TO, AND WHAT I THOUGHT WAS, 8779 06:26:52,289 --> 06:26:53,757 WELL, THE PROBLEM WITH THE HUMAN 8780 06:26:53,823 --> 06:26:55,325 EYE IS THAT IT'S MOVING AROUND A 8781 06:26:55,392 --> 06:26:56,726 LOT, SO THE ABSOLUTE PHASE OF 8782 06:26:56,793 --> 06:26:58,161 THE O.C.T. SIGNAL AT ANY GIVEN 8783 06:26:58,228 --> 06:27:00,230 TIME IS KIND OF MEANINGLESS, YOU 8784 06:27:00,297 --> 06:27:02,232 ABOUT WHAT I PROPOSED WAS THAT 8785 06:27:02,299 --> 06:27:04,935 IF YOU LOOK AT PHASE DIFFERENCES 8786 06:27:05,001 --> 06:27:06,570 INSIDE THE TISSUE, THEN YOU CAN 8787 06:27:06,636 --> 06:27:07,971 EXTRACT -- YOU KIND OF REFERENCE 8788 06:27:08,038 --> 06:27:08,838 THE OBJECT OF INTEREST AS 8789 06:27:08,905 --> 06:27:11,374 SOMETHING ELSE IN THE TISSUE. 8790 06:27:11,441 --> 06:27:13,343 OR IN THE EYE. 8791 06:27:13,410 --> 06:27:15,111 AND THEN IN SO DOING, YOU CAN 8792 06:27:15,178 --> 06:27:16,279 GET SOME VERY NICE CORRELATION 8793 06:27:16,346 --> 06:27:17,614 OF THE PHASE WITHIN 8794 06:27:17,681 --> 06:27:18,648 PHOTORECEPTORS -- SORRY, THIS IS 8795 06:27:18,715 --> 06:27:20,383 A PHASE CORRELATION WITHIN PHOTO 8796 06:27:20,450 --> 06:27:21,051 RECEPTORS. 8797 06:27:21,117 --> 06:27:24,788 AND THAT LED TO THIS KIND OF 8798 06:27:24,854 --> 06:27:26,656 MAIN OBSERVATION. 8799 06:27:26,723 --> 06:27:27,424 THE FIRST TO OBSERVE IT -- I 8800 06:27:27,490 --> 06:27:28,758 MEAN, THE PROBLEM BACK THEN WHEN 8801 06:27:28,825 --> 06:27:30,594 I PUBLISHED THAT PAPER WAS THAT 8802 06:27:30,660 --> 06:27:31,928 THE O.C.T. SYSTEMS WERE NOT FAST 8803 06:27:31,995 --> 06:27:33,463 ENOUGH TO MEASURE THESE CHANGES. 8804 06:27:33,530 --> 06:27:38,501 AND IT WASN'T UNTIL GARY AND 8805 06:27:38,568 --> 06:27:40,503 HOODMAN BUILT THIS PHENOMENALLY 8806 06:27:40,570 --> 06:27:43,340 FAST SYSTEM IN GERMANY IN 2016, 8807 06:27:43,406 --> 06:27:44,441 I'M SORRY I DON'T HAVE A 8808 06:27:44,507 --> 06:27:46,009 CITATION BUT I THINK ROBERT 8809 06:27:46,076 --> 06:27:47,110 SHOWED IT, THAT THEY WERE ABLE 8810 06:27:47,177 --> 06:27:48,979 TO MEASURE THESE IN REALTIME IN 8811 06:27:49,045 --> 06:27:49,713 A REAL HUMAN. 8812 06:27:49,779 --> 06:27:50,847 BUT THE IDEA IS THAT WE'RE 8813 06:27:50,914 --> 06:27:51,748 GETTING LIGHT BACK FROM THE 8814 06:27:51,815 --> 06:27:53,817 FRONT AND BACK OF THE OUTER 8815 06:27:53,883 --> 06:27:55,218 SEGMENT, AND WE'RE MONITORING 8816 06:27:55,285 --> 06:27:56,987 THE PHASE DIFFERENCE BETWEEN 8817 06:27:57,053 --> 06:27:59,055 THOSE TWO IN ORDER TO MONITOR 8818 06:27:59,122 --> 06:28:01,691 CHANGES IN THE OPTICAL PATH 8819 06:28:01,758 --> 06:28:04,761 LENGTH OF THE CELL, OR OF THE 8820 06:28:04,828 --> 06:28:06,663 OUTER SEGMENT. 8821 06:28:06,730 --> 06:28:08,698 SO IN OUR GROUP, WE HAVE FOUR 8822 06:28:08,765 --> 06:28:10,133 DIFFERENT APPROACHES TO STUDY 8823 06:28:10,200 --> 06:28:12,435 THIS PHENOMENON. 8824 06:28:12,502 --> 06:28:17,273 THE FIRST WAS THE SCANNING 8825 06:28:17,340 --> 06:28:17,707 AO-O.C.T. 8826 06:28:17,774 --> 06:28:18,808 I'LL SHOW SOME RESULTS FROM 8827 06:28:18,875 --> 06:28:20,210 THESE ALTHOUGH THEY OVERLAP A 8828 06:28:20,276 --> 06:28:22,345 LOT WITH WHAT RAM HAS SHOWN. 8829 06:28:22,412 --> 06:28:25,281 BUT THE FIRST WAS THE SCANNING 8830 06:28:25,348 --> 06:28:26,149 AO-O.C.T. AND MORE RECENTLY 8831 06:28:26,216 --> 06:28:29,252 WE'VE BEEN TAKING H MEASUREMENTS 8832 06:28:29,319 --> 06:28:30,887 WITH THE FULL FIELD AO-O.C.T. 8833 06:28:30,954 --> 06:28:31,855 I'LL KIND OF GROUP THESE 8834 06:28:31,921 --> 06:28:32,188 TOGETHER. 8835 06:28:32,255 --> 06:28:34,724 THEY HAVE THEIR OWN VIRTUES. 8836 06:28:34,791 --> 06:28:37,560 THEY'RE EXTREMELY COMPLICATED 8837 06:28:37,627 --> 06:28:39,095 SYSTEMS AND DIFFICULT TO 8838 06:28:39,162 --> 06:28:40,597 MAINTAIN AND OPERATE, BUT 8839 06:28:40,664 --> 06:28:43,199 BECAUSE THEY HAVE -- BASICALLY 8840 06:28:43,266 --> 06:28:43,933 THE DIFFERENCE BETWEEN THE TWO 8841 06:28:44,000 --> 06:28:46,036 IS THIS ONE HAS BETTER 8842 06:28:46,102 --> 06:28:48,538 SENSITIVITY AND BETTER 8843 06:28:48,605 --> 06:28:49,339 RESOLUTION. 8844 06:28:49,406 --> 06:28:52,275 AND WE'RE ABLE TO MEASURE ROD 8845 06:28:52,342 --> 06:28:53,476 RESPONSES, FOR INSTANCE, AND 8846 06:28:53,543 --> 06:28:55,245 FOVEAL CONE RESPONSES. 8847 06:28:55,311 --> 06:28:57,547 THE FULL FIELD AO-O.C.T. IS 8848 06:28:57,614 --> 06:28:58,782 FASTER SO WE'RE ABLE TO MEASURE 8849 06:28:58,848 --> 06:29:00,950 MORE OF THE DYNAMICS AND THE 8850 06:29:01,017 --> 06:29:01,951 RESPONSE OF THE ORG. 8851 06:29:02,018 --> 06:29:03,019 AND THEN I'LL MOVE ON TO TALK 8852 06:29:03,086 --> 06:29:05,555 ABOUT THE PROTO CLINICAL O.C.T. 8853 06:29:05,622 --> 06:29:05,989 LATER. 8854 06:29:06,056 --> 06:29:07,190 AND THEN I JUST WANT TO MENTION 8855 06:29:07,257 --> 06:29:08,525 THAT WE'RE STILL INTERESTED IN 8856 06:29:08,591 --> 06:29:12,462 THIS COHERENT AO-SLO APPROACH 8857 06:29:12,529 --> 06:29:13,563 BECAUSE COMPARED TO ALL OF THE 8858 06:29:13,630 --> 06:29:15,965 OTHERS -- WELL, PERHAPS NOT THE 8859 06:29:16,032 --> 06:29:18,068 CLINICAL O.C.T. BUT DEFINITELY 8860 06:29:18,134 --> 06:29:19,235 COMPARED TO THESE TWO, IT'S A 8861 06:29:19,302 --> 06:29:21,037 KIND OF LIGHT WAIT METHOD. 8862 06:29:21,104 --> 06:29:22,439 THE DATA VOLUMES ARE THREE 8863 06:29:22,505 --> 06:29:23,873 ORDERS OF MAGNITUDE SMALLER AND 8864 06:29:23,940 --> 06:29:24,941 THE COMPUTATIONAL BURDEN IS WAY, 8865 06:29:25,008 --> 06:29:26,443 WAY LESS, SO IF YOU START 8866 06:29:26,509 --> 06:29:27,310 THINKING ABOUT THE POSSIBILITY 8867 06:29:27,377 --> 06:29:28,511 OF TRANSLATING THESE THINGS INTO 8868 06:29:28,578 --> 06:29:30,513 THE CLINIC, IT DEFINITELY HAS 8869 06:29:30,580 --> 06:29:32,382 MORE PROMISE THAN EITHER OF 8870 06:29:32,449 --> 06:29:34,217 THESE TWO. 8871 06:29:34,284 --> 06:29:40,590 MAYBE TIED WITH THIS ONE. 8872 06:29:40,657 --> 06:29:43,259 SO HERE'S A SCHEMATIC OF OUR 8873 06:29:43,326 --> 06:29:44,861 SCANNING AO-O.C.T. SYSTEM, IT 8874 06:29:44,928 --> 06:29:46,329 HAS AN SLO CHANNEL AS WELL. 8875 06:29:46,396 --> 06:29:47,230 I MENTIONED FOUR DIFFERENT 8876 06:29:47,297 --> 06:29:48,498 APPROACHES TO MEASURING THE ORK, 8877 06:29:48,565 --> 06:29:53,603 TWOORG,TWO ARE REALLY IN THE SAE 8878 06:29:53,670 --> 06:29:55,004 SYSTEM, THIS ONE WITH ADAPTIVE 8879 06:29:55,071 --> 06:29:55,505 OPTICS. 8880 06:29:55,572 --> 06:29:57,874 HERE WE SEE THE SLO IMAGE AND 8881 06:29:57,941 --> 06:29:59,109 THE O.C.T. IMAGE FROM THE SYSTEM 8882 06:29:59,175 --> 06:30:00,844 A COUPLE OF DEGREES FROM THE 8883 06:30:00,910 --> 06:30:03,947 FOVEA. 8884 06:30:04,013 --> 06:30:10,386 AND HERE ARE SOME EXAMPLES OF 8885 06:30:10,453 --> 06:30:12,655 AGES OF THE ROD AND CONE MOSAIC. 8886 06:30:12,722 --> 06:30:13,723 WE'RE USING THE SYSTEM TO 8887 06:30:13,790 --> 06:30:14,624 MEASURE RESPONSES IN RODS AND 8888 06:30:14,691 --> 06:30:15,225 CONES. 8889 06:30:15,291 --> 06:30:19,095 AND THIS IS WHAT WE SAW. 8890 06:30:19,162 --> 06:30:21,631 THIS IS BACK IN 2019 WHERE THE 8891 06:30:21,698 --> 06:30:23,800 CONE MEASUREMENTS IN 2020, THE 8892 06:30:23,867 --> 06:30:24,567 ROD MEASUREMENTS. 8893 06:30:24,634 --> 06:30:29,105 SO I'M SURPRISE DO SURPRISED BYG 8894 06:30:29,172 --> 06:30:30,073 THAT RAM SHOWED. 8895 06:30:30,140 --> 06:30:31,407 WE HAVE QUITE DIFFERENT 8896 06:30:31,474 --> 06:30:32,408 OBSERVATIONS, SO THERE MAY BE 8897 06:30:32,475 --> 06:30:34,144 SOME CAUSE FOR DISCUSSION LATER. 8898 06:30:34,210 --> 06:30:36,679 BUT WE SHOW BASICALLY -- I'LL 8899 06:30:36,746 --> 06:30:37,981 DIRECT YOUR ATTENTION TO THIS 8900 06:30:38,047 --> 06:30:39,983 PANEL HERE, F, WHICH SHOWS KIND 8901 06:30:40,049 --> 06:30:42,051 OF MOST CLEAR LEGAL -- WELL, 8902 06:30:42,118 --> 06:30:44,354 THIS F AND G, WHICH SHOW MOST 8903 06:30:44,420 --> 06:30:46,990 CLEARLY THE DIFFERENCES BETWEEN 8904 06:30:47,056 --> 06:30:50,760 THE RESPONSE OF RODS AND CONES. 8905 06:30:50,827 --> 06:30:53,396 TO US IT LOOKS LIKE THE CONES 8906 06:30:53,463 --> 06:30:54,497 RESPOND FAST AND WITH A LITTLE 8907 06:30:54,564 --> 06:30:56,166 BIT LESS SENSITIVITY, SO THE 8908 06:30:56,232 --> 06:30:56,933 SENSITIVITY DIFFERENCE IS 8909 06:30:57,000 --> 06:30:57,400 VISIBLE HERE. 8910 06:30:57,467 --> 06:30:58,501 YOU CAN SEE THE RODS ARE 8911 06:30:58,568 --> 06:30:59,936 BLEACHED LESS THAN THE CONES IN 8912 06:31:00,003 --> 06:31:01,638 THIS CASE, AND YET RESPOND WITH 8913 06:31:01,704 --> 06:31:05,208 A LONGER ELONGATION OR GREATER 8914 06:31:05,275 --> 06:31:06,509 ELONGATION. 8915 06:31:06,576 --> 06:31:07,710 SO I DON'T KNOW, IT'S FOOD FOR 8916 06:31:07,777 --> 06:31:08,144 THOUGHT. 8917 06:31:08,211 --> 06:31:10,580 IT'S CERTAINLY AN INTERESTING 8918 06:31:10,647 --> 06:31:12,348 DIFFERENCE TO SAY THE RODS ARE 8919 06:31:12,415 --> 06:31:14,083 MORE SENSITIVE AND SLOWER THAN 8920 06:31:14,150 --> 06:31:17,053 THE CONES KIND OF BEARS SOME 8921 06:31:17,120 --> 06:31:19,589 SIMILARITY TO WHAT WE THINK 8922 06:31:19,656 --> 06:31:21,124 ABOUT BEHAVIOR IN, YOU KNOW -- 8923 06:31:21,191 --> 06:31:24,727 IN THE VISUAL SYSTEM. 8924 06:31:24,794 --> 06:31:26,863 I WANT TO SHOW YOU THE RESPONSES 8925 06:31:26,930 --> 06:31:28,932 TO RODS HERE, ONLY TO INDICATE, 8926 06:31:28,998 --> 06:31:30,567 WELL, THERE'S THIS 8927 06:31:30,633 --> 06:31:31,634 DOSE-DEPENDENCE WHICH KIND OF 8928 06:31:31,701 --> 06:31:32,435 CONVINCED US THAT WE WERE 8929 06:31:32,502 --> 06:31:33,870 SEEING, YOU KNOW, A REAL 8930 06:31:33,937 --> 06:31:36,172 FUNCTIONAL RESPONSE IN THE RODS. 8931 06:31:36,239 --> 06:31:39,375 BUT ALSO TO THE -- WE HAVE SK 8932 06:31:39,442 --> 06:31:41,010 SOMETHING LIKE -- WHAT IS THIS, 8933 06:31:41,077 --> 06:31:43,546 LET'S CALL IT FOUR ORDERS OF 8934 06:31:43,613 --> 06:31:49,319 MAGNITUDE -- SOMEWHERE BETWEEN K 8935 06:31:49,385 --> 06:31:50,253 THAT FOR WHEN WE COME TO SOME OF 8936 06:31:50,320 --> 06:31:54,324 THE LATER STUFF. 8937 06:31:54,390 --> 06:31:55,525 SO THE SYSTEM WAS NOT FAST 8938 06:31:55,592 --> 06:31:59,696 ENOUGH TO MEASURE, SO AFTER WE 8939 06:31:59,762 --> 06:32:05,168 REPORTED THOSE OWE LON GAITION N 8940 06:32:05,235 --> 06:32:06,836 RESULTS, WE WANTED TO BE ABLE TO 8941 06:32:06,903 --> 06:32:07,837 MEASURE THAT AS WELL IN ORDER TO 8942 06:32:07,904 --> 06:32:08,771 HAVE A COMPLETE PICTURE OF THE 8943 06:32:08,838 --> 06:32:10,506 ORG AND SO WE BUILT A FULL FEEL, 8944 06:32:10,573 --> 06:32:12,976 I SAY WE, REALLY MY POSTDOC 8945 06:32:13,042 --> 06:32:15,144 EXTREMELY TALENTED POSTDOC 8946 06:32:15,211 --> 06:32:19,082 DENISE BUILT A FULL FIELD A 8947 06:32:19,148 --> 06:32:19,949 AO-O.C.T. SYSTEM IN WHICH WE 8948 06:32:20,016 --> 06:32:21,517 COULD GET IMAGES OF THE CONE 8949 06:32:21,584 --> 06:32:23,820 MOSAIC AND VOW EU METRIC RATES 8950 06:32:23,887 --> 06:32:27,223 AT UP TO 1-KILOHERTZ, SO JUST ME 8951 06:32:27,290 --> 06:32:27,790 NOMINAL, PHENOMENAL RATES. 8952 06:32:27,857 --> 06:32:29,893 WE SHOW THIS DOSE DEPENDENCE 8953 06:32:29,959 --> 06:32:31,060 RESPONSES VERY MUCH LIKE WHAT 8954 06:32:31,127 --> 06:32:35,265 RAF SHOW WHAT 8955 06:32:35,331 --> 06:32:36,699 RAV SHOWED, THE INITIAL 8956 06:32:36,766 --> 06:32:37,467 CONTRACTION OF THE OUTER 8957 06:32:37,533 --> 06:32:39,869 SEGMENT. 8958 06:32:39,936 --> 06:32:43,306 SO AFTER WE SHOWED ALL THAT, I 8959 06:32:43,373 --> 06:32:44,807 STARTED TO WONDER, HOW ARE WE 8960 06:32:44,874 --> 06:32:49,746 GOING TO DO THIS CLINICALLY? 8961 06:32:49,812 --> 06:32:50,980 AND WHAT HAPPENS IF WE REALLY 8962 06:32:51,047 --> 06:32:52,682 SLOW THINGS DOWN? 8963 06:32:52,749 --> 06:32:55,485 SO IN 20 -- STARTING AROUND 2019 8964 06:32:55,551 --> 06:32:59,555 OR 2020, I WITH ANOTHER POSTDOC 8965 06:32:59,622 --> 06:33:02,191 BUILT A SYSTEM THAT WAS 8966 06:33:02,258 --> 06:33:08,097 INTENTIONALLY OLD-FASHIONED, A 8967 06:33:08,164 --> 06:33:10,199 RELATIVELY SLOW LIGHT SOURCE, 8968 06:33:10,266 --> 06:33:13,069 NOTHING ESOTERIC OR FANCY IN THE 8969 06:33:13,136 --> 06:33:14,704 SCANNERS, VERY BOILERPLATE 8970 06:33:14,771 --> 06:33:16,372 BALANCE DETECTION, SO JUST -- I 8971 06:33:16,439 --> 06:33:18,474 MEAN, THE THOUGHT WAS LIKE -- I 8972 06:33:18,541 --> 06:33:19,342 MEAN, THIS IS SOMETHING THAT 8973 06:33:19,409 --> 06:33:20,977 COULD BE COMMERCIALIZED TODAY, 8974 06:33:21,044 --> 06:33:22,845 IN FACT, IT PROBABLY COULDN'T BE 8975 06:33:22,912 --> 06:33:24,280 BECAUSE IT'S TOO OLD-FASHIONED 8976 06:33:24,347 --> 06:33:25,048 FOR COMPANIES ALREADY. 8977 06:33:25,114 --> 06:33:26,249 NOW, HOW DO WE EXTRACT THE 8978 06:33:26,316 --> 06:33:27,383 SIGNAL FROM HERE? 8979 06:33:27,450 --> 06:33:28,584 I'LL TAKE A MOMENT WITH THIS 8980 06:33:28,651 --> 06:33:31,754 SLIDE AND I'LL TRY TO -- THERE 8981 06:33:31,821 --> 06:33:33,723 ARE BLOCK DIAGRAMS IF THAT HELPS 8982 06:33:33,790 --> 06:33:38,261 YOU TO UNDERSTAND IT, FEEL FREE 8983 06:33:38,328 --> 06:33:41,197 TO -- IF YOU CAN'T TRACK -- SO 8984 06:33:41,264 --> 06:33:42,799 IF YOUR O.C.T. IS THIS SLOW, YOU 8985 06:33:42,865 --> 06:33:44,834 CAN'T HOPE TO DO VOLUMETRIC ORG. 8986 06:33:44,901 --> 06:33:47,470 SO WE DO SERIAL LINE SCANNING. 8987 06:33:47,537 --> 06:33:48,705 SO WE'RE JUST SCANNING THE 8988 06:33:48,771 --> 06:33:49,806 RETINA IN ONE PLACE. 8989 06:33:49,872 --> 06:33:51,207 BUT OF COURSE THE RETINA IS 8990 06:33:51,274 --> 06:33:51,774 MOVING, RIGHT? 8991 06:33:51,841 --> 06:33:52,542 SO THAT'S A PROBLEM. 8992 06:33:52,608 --> 06:33:56,412 HOW DO YOU EXTRACT AN 8993 06:33:56,479 --> 06:33:57,180 OPTORETINOGRAPHIC SIGNAL IF THE 8994 06:33:57,246 --> 06:33:59,816 RETINA IS MOVING AND YOU'RE 8995 06:33:59,882 --> 06:34:01,584 SCANNING IN ONE PLACE OR 8996 06:34:01,651 --> 06:34:02,552 EQUIVALENTLY SCANNING DIFFERENT 8997 06:34:02,618 --> 06:34:03,219 PARTS OF THE RETINA. 8998 06:34:03,286 --> 06:34:06,622 SO WHAT WE -- THE METHOD IS -- 8999 06:34:06,689 --> 06:34:08,424 IT'S KIND OF LIKE WHAT I WAS 9000 06:34:08,491 --> 06:34:09,726 CONCOCTING IT, I WAS INSPIRED 9001 06:34:09,792 --> 06:34:12,328 REALLY BY A LOT OF WHAT WAS 9002 06:34:12,395 --> 06:34:14,664 HAPPENING IN OCTA. 9003 06:34:14,731 --> 06:34:16,532 THE IDEA IS THAT OVER THE COURSE 9004 06:34:16,599 --> 06:34:17,667 OF THE ONE SECOND YOU NEED TO 9005 06:34:17,734 --> 06:34:19,268 TAKE A COMPLETE MEASUREMENT, THE 9006 06:34:19,335 --> 06:34:21,037 RETINA DOES MOVE, BUT THERE ARE 9007 06:34:21,104 --> 06:34:22,238 MAYBE 10 MILLISECOND WINDOWS IN 9008 06:34:22,305 --> 06:34:23,473 THERE IN WHICH THE RETINA 9009 06:34:23,539 --> 06:34:25,041 DOESN'T MOVE, AND BY DOESN'T 9010 06:34:25,108 --> 06:34:26,242 MOVE, I MEAN IT DOESN'T MOVE 9011 06:34:26,309 --> 06:34:28,644 RELATIVE TO THE 15-MICRON SPOT 9012 06:34:28,711 --> 06:34:29,512 SIZE ON THE RETINA. 9013 06:34:29,579 --> 06:34:30,613 YOU'RE ESSENTIALLY LOOKING AT 9014 06:34:30,680 --> 06:34:31,414 THE SAME TISSUE. 9015 06:34:31,481 --> 06:34:33,383 SO WE TAKE THE SERIES OF B SCANS 9016 06:34:33,449 --> 06:34:35,418 AND WE DIVIDE IT UP INTO THESE 9017 06:34:35,485 --> 06:34:36,753 OVERLAPPING BLOCKS AND IN THOSE 9018 06:34:36,819 --> 06:34:38,621 OVERLAPPING BLOCKS INSTEAD OF 9019 06:34:38,688 --> 06:34:40,256 LOOKING AT THE POSITION OF THE 9020 06:34:40,323 --> 06:34:42,158 LAYERS, WE COMPUTE THE PHASE 9021 06:34:42,225 --> 06:34:43,526 VELOCITIES OF THE LAYERS, SO YOU 9022 06:34:43,593 --> 06:34:44,894 GO TO THE LAYERS OF INTEREST, 9023 06:34:44,961 --> 06:34:46,996 YOU COMPUTE THE PHASE VELOCITIES 9024 06:34:47,063 --> 06:34:48,164 AND THEN YOU TRACK THAT VELOCITY 9025 06:34:48,231 --> 06:34:48,898 OVER TIME. 9026 06:34:48,965 --> 06:34:51,934 AND WE GOT SOME VERY NICE 9027 06:34:52,001 --> 06:34:54,771 RESULTS. 9028 06:34:54,837 --> 06:34:56,272 IN NOW FAR MORE SUBJECTS. 9029 06:34:56,339 --> 06:34:57,774 THESE WERE PUBLISHED IN 2022, 9030 06:34:57,840 --> 06:34:59,242 BUT IN MANY MORE SUBJECTS THAN 9031 06:34:59,308 --> 06:35:02,311 THIS, WE'VE HAD THIS HIGHLY 9032 06:35:02,378 --> 06:35:03,846 REPRODUCIBLE PATTERN OF 9033 06:35:03,913 --> 06:35:05,248 CONTRACTION AND ELONGATION THAT 9034 06:35:05,314 --> 06:35:06,349 BEARS SIMILARITY TO WHAT WE'VE 9035 06:35:06,416 --> 06:35:09,252 SHOWED WITH THE POSITION BASED 9036 06:35:09,318 --> 06:35:09,786 ORG. 9037 06:35:09,852 --> 06:35:11,554 THE RESPONSES ARE DOSE DEPENDENT 9038 06:35:11,621 --> 06:35:14,424 ALTHOUGH WITH A HIGHLY -- A MUCH 9039 06:35:14,490 --> 06:35:15,958 SMALLER DYNAMIC RANGE, 9040 06:35:16,025 --> 06:35:17,160 PROBABLY -- 10 TO 20DB. 9041 06:35:17,226 --> 06:35:19,562 SO THAT'S IMPORTANT TO NOTE, AB 9042 06:35:19,629 --> 06:35:20,496 IMPORTANT POTENTIAL WEAKNESS OF 9043 06:35:20,563 --> 06:35:21,064 THIS APPROACH. 9044 06:35:21,130 --> 06:35:23,232 AND WE SEE EE CENTRICITY 9045 06:35:23,299 --> 06:35:24,100 DEPENDENCE THAT WE'VE ALL 9046 06:35:24,167 --> 06:35:26,035 OBSERVED WITH THE POSITION-BASED 9047 06:35:26,102 --> 06:35:27,537 ORGs AS WELL. 9048 06:35:27,603 --> 06:35:30,039 AND THEN JUST -- I JUST WANT TO 9049 06:35:30,106 --> 06:35:31,908 TOUCH ON THE APPLICATION TO 9050 06:35:31,974 --> 06:35:34,777 DISEASE HERE, WE'RE SEEING -- 9051 06:35:34,844 --> 06:35:36,045 WE'VE MEASURED -- WELL, OKAY, 9052 06:35:36,112 --> 06:35:37,346 JUST TO BE COMPLETELY HONEST, 9053 06:35:37,413 --> 06:35:42,752 WE'VE MEASURED PROBABLY 30 9054 06:35:42,819 --> 06:35:44,287 PATIENTS, AND IN THE MAJORITY OF 9055 06:35:44,353 --> 06:35:45,721 THESE PATIENTS, THE RETINAL 9056 06:35:45,788 --> 06:35:47,256 LAYERS ARE NOT GOOD ENOUGH FOR 9057 06:35:47,323 --> 06:35:51,894 US TO GET AN ORGAN ORG OUT THERO 9058 06:35:51,961 --> 06:35:53,596 DEGENERATED, TOO MESSED UP, SO 9059 06:35:53,663 --> 06:35:54,797 ARE THERE BLUNTER WAYS IN WHICH 9060 06:35:54,864 --> 06:35:56,632 WE CAN ASSESS THE DISEASE. 9061 06:35:56,699 --> 06:35:59,969 BUT STILL, WE HAVE SOME PATIENTS 9062 06:36:00,036 --> 06:36:02,171 WITH SOME INTERESTING CHANGES 9063 06:36:02,238 --> 06:36:05,541 AND IF WE THROW SOME AD HOC KIND 9064 06:36:05,608 --> 06:36:08,945 OF METHODS OF QUANTIFYING THESE 9065 06:36:09,011 --> 06:36:10,646 CHANGES, WE CAN SEE REAL 9066 06:36:10,713 --> 06:36:12,815 DIFFERENCES BETWEEN THE NORMAL 9067 06:36:12,882 --> 06:36:14,117 AND THE DISEASE AFFECTED RETINA. 9068 06:36:14,183 --> 06:36:15,885 SO THESE ARE NORMALIZED BY THE 9069 06:36:15,952 --> 06:36:19,322 NORMAL RESPONSE, AND WE CAN SEE 9070 06:36:19,388 --> 06:36:22,058 THAT THE VMIN, THAT'S THE 9071 06:36:22,125 --> 06:36:24,360 MAXIMUM CONTRACTION AND V20 TO 9072 06:36:24,427 --> 06:36:26,596 40, VMIN LOOKS LIKE IT'S NORMAL 9073 06:36:26,662 --> 06:36:28,097 IN MANY OF THE LOCATIONS WE 9074 06:36:28,164 --> 06:36:30,633 IMAGED WHEREAS THE ELONGATION 9075 06:36:30,700 --> 06:36:32,535 COMPONENT SEEMS COMPROMISED. 9076 06:36:32,602 --> 06:36:34,303 NOW, I'LL TRY AND GET THROUGH, I 9077 06:36:34,370 --> 06:36:35,605 HAVE A SLIDE AFTER THE 9078 06:36:35,671 --> 06:36:37,039 CONCLUSION SO I'LL TRY TO -- 9079 06:36:37,106 --> 06:36:37,840 I'LL GO THROUGH THIS VERY 9080 06:36:37,907 --> 06:36:38,274 QUICKLY. 9081 06:36:38,341 --> 06:36:39,709 WELL, I DON'T NEED TO READ THESE 9082 06:36:39,775 --> 06:36:40,443 CONCLUSIONS TO YOU. 9083 06:36:40,510 --> 06:36:43,813 I JUST WANT TO GET TO THE LAST 9084 06:36:43,880 --> 06:36:47,316 CONCLUSION AND SAY THAT I WAS -- 9085 06:36:47,383 --> 06:36:48,718 I ADDED THIS NEXT SLIDE JUST 9086 06:36:48,784 --> 06:36:52,155 TODAY BECAUSE I WAS KIND OF 9087 06:36:52,221 --> 06:36:53,256 INSPIRED BY COMMENTS THAT MIKE 9088 06:36:53,322 --> 06:36:54,557 MADE AND JIM IN THEIR MORNING 9089 06:36:54,624 --> 06:36:56,325 TALKS TODAY ABOUT HARMONIZATION 9090 06:36:56,392 --> 06:36:58,995 AND THE IMPORTANCE OF DEPLOYING 9091 06:36:59,061 --> 06:37:00,296 THINGS CLINICALLY OR AT LEAST 9092 06:37:00,363 --> 06:37:01,497 BROADLY FOR THE SAKE OF THE 9093 06:37:01,564 --> 06:37:02,365 SCIENCE, NOT JUST FOR THE SAKE 9094 06:37:02,431 --> 06:37:03,499 OF DISEASE APPLICATIONS BUT FOR 9095 06:37:03,566 --> 06:37:05,067 THE SAKE OF THE SCIENCE. 9096 06:37:05,134 --> 06:37:06,802 IT'S THIS KIND OF ITERATIVE 9097 06:37:06,869 --> 06:37:08,471 CYCLE OF LEARNING MORE ABOUT 9098 06:37:08,538 --> 06:37:09,805 WHAT YOU'RE MEASURING AND THEN 9099 06:37:09,872 --> 06:37:10,606 REFINING YOUR INSTRUMENTATION 9100 06:37:10,673 --> 06:37:13,943 AND GOING BACK AND FORTH AND SO 9101 06:37:14,010 --> 06:37:16,946 I REALLY WANT TO SAY A FEW WORDS 9102 06:37:17,013 --> 06:37:18,581 ABOUT STANDARDS AND 9103 06:37:18,648 --> 06:37:19,348 HARMONIZATION. 9104 06:37:19,415 --> 06:37:20,783 SO THIS IS A PEEK AT WHAT WE'RE 9105 06:37:20,850 --> 06:37:21,784 WORKING ON NOW. 9106 06:37:21,851 --> 06:37:24,654 SO THIS IS A RESPONSE FROM OUR 9107 06:37:24,720 --> 06:37:30,660 FULL FIELD AOCT SYSTEM AND -- 9108 06:37:30,726 --> 06:37:34,530 JUST 15 MORE SECONDS. 9109 06:37:34,597 --> 06:37:35,965 THIS IS A RESPONSE FROM SOME 9110 06:37:36,032 --> 06:37:37,066 CONES IN THE FULL FIELD SYSTEM 9111 06:37:37,133 --> 06:37:38,601 AND NOW WHAT WE'RE TRYING TO DO 9112 06:37:38,668 --> 06:37:41,370 IS TO MODEL THE RESPONSE IN A 9113 06:37:41,437 --> 06:37:43,239 WAY THAT WE CAN EXTRACT SOME 9114 06:37:43,306 --> 06:37:45,107 PARAMETERS OF INTEREST, AND SO 9115 06:37:45,174 --> 06:37:46,442 THIS MODEL THAT WE'RE USING 9116 06:37:46,509 --> 06:37:48,444 RIGHT NOW, IT'S A WORKING MODEL, 9117 06:37:48,511 --> 06:37:49,312 IT'S NOT NECESSARILY THE BEST 9118 06:37:49,378 --> 06:37:50,613 MODEL OF THE RESPONSE, BUT IT 9119 06:37:50,680 --> 06:37:53,182 WORKS PRETTY WELL. 9120 06:37:53,249 --> 06:37:54,817 AND IT HAS THESE DISTINCT 9121 06:37:54,884 --> 06:37:56,018 PARAMETERS HERE WHICH CAN BE 9122 06:37:56,085 --> 06:37:57,286 EXTRACTED FOR ASSESSMENT. 9123 06:37:57,353 --> 06:37:58,487 SO THOSE INDIVIDUAL PARAMETERS 9124 06:37:58,554 --> 06:38:00,256 CAN BE LOOKED AT AS FUNCTIONS OF 9125 06:38:00,323 --> 06:38:01,757 DISEASE OR EE CENTRICITY OR 9126 06:38:01,824 --> 06:38:02,792 WHATEVER AND WE DO SEE SOME 9127 06:38:02,858 --> 06:38:03,693 INTERESTING RELATIONSHIPS 9128 06:38:03,759 --> 06:38:04,026 INTEREST. 9129 06:38:04,093 --> 06:38:05,928 FROM A MODEL LIKE THIS, WE CAN 9130 06:38:05,995 --> 06:38:07,997 DERIVE FIGURES OF MERIT LIKE 9131 06:38:08,064 --> 06:38:09,765 SIMPLER FIGURES OF MERIT SUCH AS 9132 06:38:09,832 --> 06:38:11,601 T MAX LIKE WHEN DOES THIS REACH 9133 06:38:11,667 --> 06:38:12,969 ITS MAXIMUM ELONGATION. 9134 06:38:13,035 --> 06:38:15,371 AND THEN WE CAN ALSO TAKE STEPS 9135 06:38:15,438 --> 06:38:18,007 TOWARDS HARMONIZATION, LIKE FOR 9136 06:38:18,074 --> 06:38:19,208 INSTANCE, GIVEN AN EXPRESSION 9137 06:38:19,275 --> 06:38:20,343 LIKE THIS, WE CAN 9138 06:38:20,409 --> 06:38:23,179 STRAIGHTFORWARDLY COMPUTE THE 9139 06:38:23,246 --> 06:38:24,947 VELOCITY, SO NOW WE HAVE A 9140 06:38:25,014 --> 06:38:26,082 SIMILAR -- ABOUT A MODEL THAT WE 9141 06:38:26,148 --> 06:38:31,354 CAN USE TO MODEL THE PHASED 9142 06:38:31,420 --> 06:38:33,489 VELOCITY APPROACH AS WELL AND WE 9143 06:38:33,556 --> 06:38:35,157 CAN EXTRACT WHAT YOU WOULD SEE 9144 06:38:35,224 --> 06:38:36,525 IN THE -- APPROACHES. 9145 06:38:36,592 --> 06:38:37,727 IT'S LIKE DEVELOPING A KIND OF 9146 06:38:37,793 --> 06:38:39,195 GRAMMAR FOR THE ORG THAT WOULD 9147 06:38:39,262 --> 06:38:40,730 ALLOWL THE DIFFERENT SYSTEMS AND 9148 06:38:40,796 --> 06:38:43,566 DIFFERENT PRACTITIONERS TO TALK 9149 06:38:43,633 --> 06:38:45,334 TO ONE ANOTHER AND PRESERVE SOME 9150 06:38:45,401 --> 06:38:45,935 HOPE. 9151 06:38:46,002 --> 06:38:47,336 BEFORE IT GETS -- I MEAN, IF IT 9152 06:38:47,403 --> 06:38:48,871 GETS COMMERCIALIZED, BUT BEFORE 9153 06:38:48,938 --> 06:38:50,973 IT GETS COMMERCIALIZED, HAVE 9154 06:38:51,040 --> 06:38:52,441 SOMETHING IN PLACE WHERE WE CAN 9155 06:38:52,508 --> 06:38:54,310 KIND OF, YOU KNOW, EXCHANGE 9156 06:38:54,377 --> 06:38:56,345 IDEAS, EXCHANGE DATA, AND IT 9157 06:38:56,412 --> 06:38:57,913 BE -- AND HAVE IT BE MEANINGFUL 9158 06:38:57,980 --> 06:39:00,116 FOR ONE ANOTHER. 9159 06:39:00,182 --> 06:39:04,520 THAT'S NOT IMPORTANT. 9160 06:39:04,587 --> 06:39:05,187 THANKS. 9161 06:39:05,254 --> 06:39:14,263 [APPLAUSE] 9162 06:39:14,330 --> 06:39:15,164 >> ALL RIGHT. 9163 06:39:15,231 --> 06:39:16,465 OUR FINAL SPEAKER OF THIS 9164 06:39:16,532 --> 06:39:25,107 AFTERNOON'S SESSION IS CHAO ZH 9165 06:39:25,174 --> 06:39:27,443 ZHOU, PROFESSOR OF BIOMEDICAL 9166 06:39:27,510 --> 06:39:29,178 ENGINEERING SPEAKING ON 9167 06:39:29,245 --> 06:39:30,813 SPACE-DIVISION MULTIPLEXING 9168 06:39:30,880 --> 06:39:32,581 OPTICAL COHERENCE TOMOGRAPHY AND 9169 06:39:32,648 --> 06:39:38,421 FOE TONPHOTONIC INTEGRATION. 9170 06:39:38,487 --> 06:39:39,188 >> GOOD AFTERNOON. 9171 06:39:39,255 --> 06:39:40,456 I KNOW I'M THE LAST PERSON FOR 9172 06:39:40,523 --> 06:39:44,393 THE TALK. 9173 06:39:44,460 --> 06:39:45,461 I'M BETWEEN YOU AND THE REST OF 9174 06:39:45,528 --> 06:39:47,363 YOUR DAY. 9175 06:39:47,430 --> 06:39:51,334 I HOPE -- ALSO FULL DISCLOSURE, 9176 06:39:51,400 --> 06:39:54,403 MY TALK IS NOT ON ORG BUT I HOPE 9177 06:39:54,470 --> 06:39:55,304 YOU'LL FIND IT EQUALLY 9178 06:39:55,371 --> 06:39:55,604 INTERESTING. 9179 06:39:55,671 --> 06:39:59,275 I WANT TO ADD MY CONGRATULATIONS 9180 06:39:59,342 --> 06:40:02,745 TO PROFESSOR JIM IF YOU GEEMOTO, 9181 06:40:02,812 --> 06:40:04,180 ERIC AND DAVID SWON SON FOR 9182 06:40:04,246 --> 06:40:06,649 THEIR PIONEERING WORK STARTING 9183 06:40:06,716 --> 06:40:07,516 THIS FIELD. 9184 06:40:07,583 --> 06:40:08,718 ALSO THAT'S THE REASON WE ARE 9185 06:40:08,784 --> 06:40:13,556 HERE IN THIS ROOM, ALSO THAT'S 9186 06:40:13,622 --> 06:40:15,257 THE REASON WE HAVE A HUGE AND 9187 06:40:15,324 --> 06:40:17,460 GROWING COMMUNITY IN THE O.C.T. 9188 06:40:17,526 --> 06:40:27,636 FIELD. 9189 06:40:28,871 --> 06:40:29,805 SO TODAY I'M GOING TO SHARE SOME 9190 06:40:29,872 --> 06:40:33,242 OF THE WORK WE DO WITH SPACE 9191 06:40:33,309 --> 06:40:35,978 DIVISION MULTIPLEXING, AND THIS 9192 06:40:36,045 --> 06:40:37,513 IS -- YOU HAVE SEEN THE SLIDES 9193 06:40:37,580 --> 06:40:40,116 FROM DR. FUJIMOTO'S TALK. 9194 06:40:40,182 --> 06:40:42,551 WHAT I WANT TO EMPHASIZE HERE IN 9195 06:40:42,618 --> 06:40:43,919 ADDITION TO THE HUGE IMPACT 9196 06:40:43,986 --> 06:40:47,623 O.C.T. MADE IN OPHTHALMOLOGY, I 9197 06:40:47,690 --> 06:40:51,260 WANT TO POINT OUT THAT THESE RED 9198 06:40:51,327 --> 06:40:53,362 BARS, AND THOSE FOR TECHNOLOGY 9199 06:40:53,429 --> 06:40:53,796 DEVELOPMENT. 9200 06:40:53,863 --> 06:40:55,631 IT'S FOR ONE FIELD EVEN AFTER 9201 06:40:55,698 --> 06:40:58,834 THREE DECADES, THERE'S STILL 9202 06:40:58,901 --> 06:41:00,269 VERY ACTIVE DEVELOPMENT IN 9203 06:41:00,336 --> 06:41:01,804 TECHNOLOGIES, AND YOU HAVE HEARD 9204 06:41:01,871 --> 06:41:03,939 THAT MANY GROUPS ARE WORKING ON 9205 06:41:04,006 --> 06:41:05,241 IMPROVING THE RESOLUTION, 9206 06:41:05,307 --> 06:41:07,877 IMPROVE THE IMAGING SPEED, 9207 06:41:07,943 --> 06:41:09,178 IMPROVING THE FUNCTIONALITY OF 9208 06:41:09,245 --> 06:41:09,879 THIS TECHNOLOGY. 9209 06:41:09,945 --> 06:41:12,081 SO THIS IS A VERY EXCITING FIELD 9210 06:41:12,148 --> 06:41:13,816 AND THERE ARE STILL A LOT MORE 9211 06:41:13,883 --> 06:41:19,155 WE CAN DO TO ADVANCE THIS FIELD. 9212 06:41:19,221 --> 06:41:22,224 SO ONE THING WE'RE LOOKING INTO 9213 06:41:22,291 --> 06:41:24,093 THIS, THERE'S STILL A LOT OF 9214 06:41:24,160 --> 06:41:26,529 TECHNICAL CHALLENGE -- CLINICAL 9215 06:41:26,595 --> 06:41:27,396 CHALLENGES, UNMET CLINICAL 9216 06:41:27,463 --> 06:41:29,265 NEEDS, AND TRADITIONAL O.C.T. 9217 06:41:29,331 --> 06:41:33,369 IMAGING RELIES ON RASTER SCANS. 9218 06:41:33,436 --> 06:41:35,237 WE BASICALLY HAVE A SINGLE 9219 06:41:35,304 --> 06:41:36,405 IMAGING BEAM SCAN BACK AND FORTH 9220 06:41:36,472 --> 06:41:40,943 ON THE SAMPLE IN ORDER TO GET A 9221 06:41:41,010 --> 06:41:42,244 HIGH DEFINITION 3D VOLUMETRIC 9222 06:41:42,311 --> 06:41:44,346 SET FROM THE IMAGES YOU HAVE TO 9223 06:41:44,413 --> 06:41:49,118 COVER ENTIRE FIELD AND ALONG THE 9224 06:41:49,185 --> 06:41:50,186 HORIZONTAL -- WE CAN GET REALLY 9225 06:41:50,252 --> 06:41:51,754 HIGH QUALITY LIKE HIGH 9226 06:41:51,821 --> 06:41:53,155 RESOLUTION CROSS-SECTIONAL VIEW 9227 06:41:53,222 --> 06:41:55,357 OF THE RETINA. 9228 06:41:55,424 --> 06:41:58,360 BUT ALONG THE -- SCANNING AXIS 9229 06:41:58,427 --> 06:41:59,895 WE CAN SEE A LOT OF MOTION 9230 06:41:59,962 --> 06:42:00,162 ARTIFACT. 9231 06:42:00,229 --> 06:42:01,430 SO FURTHER IMPROVING THE SPEED 9232 06:42:01,497 --> 06:42:03,165 WILL HELP US TO MINIMIZE THE 9233 06:42:03,232 --> 06:42:05,768 MOTION ARTIFACT, AND ALSO THAT 9234 06:42:05,835 --> 06:42:07,603 WILL HELP TO IMPROVE THE 9235 06:42:07,670 --> 06:42:10,272 DIAGNOSIS AND TO TRACK DISEASE 9236 06:42:10,339 --> 06:42:12,374 PROGRESSION OVER TIME MORE 9237 06:42:12,441 --> 06:42:12,708 ACCURATELY. 9238 06:42:12,775 --> 06:42:14,143 THE OTHER ASPECT IS IF IT CAN 9239 06:42:14,210 --> 06:42:16,812 IMPROVE THE IMAGING FIELD, AND 9240 06:42:16,879 --> 06:42:18,147 WE'LL BE ABLE TO SIGNIFICANTLY 9241 06:42:18,214 --> 06:42:19,014 IMPROVE THE FIELD OF VIEW THAT 9242 06:42:19,081 --> 06:42:20,316 CAN BE COVERED WITHIN THE SAME 9243 06:42:20,382 --> 06:42:22,151 AMOUNT OF TIME. 9244 06:42:22,218 --> 06:42:25,855 AND THIS WILL BE VERY BENEFI 9245 06:42:25,921 --> 06:42:28,157 BENEFICIAL, TODAY YOU HAVE HEARD 9246 06:42:28,224 --> 06:42:30,793 ABOUT USING WILD FIELD O.C.T. 9247 06:42:30,860 --> 06:42:32,261 AND O.C.T. ANGIOGRAPHY AND THAT 9248 06:42:32,328 --> 06:42:37,967 REALLY ALLOWS US TO SEE LIKE NOT 9249 06:42:38,033 --> 06:42:39,802 JUST CENTRAL VISION BUT 9250 06:42:39,869 --> 06:42:41,036 PERIPHERAL WHERE OFTEN SOME 9251 06:42:41,103 --> 06:42:42,171 DISEASE HAPPENS WITHOUT BEING 9252 06:42:42,238 --> 06:42:44,139 NOTICED BY THE PATIENT. 9253 06:42:44,206 --> 06:42:45,441 SO THIS MOTIVATED US TO FURTHER 9254 06:42:45,508 --> 06:42:48,344 IMPROVE THE IMAGING SPEED. 9255 06:42:48,410 --> 06:42:51,514 THE OTHER UNMET TECHNICAL NEED 9256 06:42:51,580 --> 06:42:53,249 AND CLINICAL NEED IS THAT THE 9257 06:42:53,315 --> 06:42:55,284 CURRENT SYSTEM, THEY ARE GREAT, 9258 06:42:55,351 --> 06:42:56,719 THEY PERFORM VERY, VERY WELL BUT 9259 06:42:56,785 --> 06:42:58,153 THEY ARE BULKY AT THE SAME TIME 9260 06:42:58,220 --> 06:43:00,990 THEY ARE VERY EXPENSIVE. 9261 06:43:01,056 --> 06:43:02,591 NOT EVERYONE CAN AFFORD IT, SO 9262 06:43:02,658 --> 06:43:04,894 IF WE CAN FURTHER IMPROVE THE 9263 06:43:04,960 --> 06:43:06,629 TECHNOLOGY TO MAKE IT MORE 9264 06:43:06,695 --> 06:43:08,898 COMPACT, MORE PORTABLE, AT THE 9265 06:43:08,964 --> 06:43:11,267 SAME TIME IMPROVE THE 9266 06:43:11,333 --> 06:43:12,801 PERFORMANCE, FOR EXAMPLE, IF YOU 9267 06:43:12,868 --> 06:43:14,003 CAN IMPROVE THE SPEED BY A 9268 06:43:14,069 --> 06:43:16,372 FACTOR OF 10 OR EVEN MORE, AND 9269 06:43:16,438 --> 06:43:18,207 THAT WILL BE VERY BENEFICIAL. 9270 06:43:18,274 --> 06:43:24,046 SO WITH THAT, WE WERE THINKING 9271 06:43:24,113 --> 06:43:26,482 TRADITIONAL O.C.T. RELIES ON 9272 06:43:26,549 --> 06:43:29,318 CIRRUS SCANNING, AND THEN IF IT 9273 06:43:29,385 --> 06:43:32,121 CAN FIND THE WAYS TO IMPROVE THE 9274 06:43:32,187 --> 06:43:37,026 IMAGING -- THAT THROUGH PARALLG 9275 06:43:37,092 --> 06:43:39,395 THAT WILL IMPROVE THE SPEED. 9276 06:43:39,461 --> 06:43:40,596 TRADITIONALLY THIS IS VERY 9277 06:43:40,663 --> 06:43:41,564 STRAIGHTFORWARD, STILL NOT 9278 06:43:41,630 --> 06:43:44,400 FINISHED YET, SO CONCEPTUALLY IT 9279 06:43:44,466 --> 06:43:46,435 VERY STRAIGHTFORWARD, AND WE ALL 9280 06:43:46,502 --> 06:43:51,040 KNOW THAT FROM OUR -- LIKE 9281 06:43:51,106 --> 06:43:52,875 EVERYDAY -- EVERY COMPUTER WE 9282 06:43:52,942 --> 06:43:56,245 HAVE, WE HAVE MULTIPLE CORES. 9283 06:43:56,312 --> 06:43:58,447 SO PARALLEL PROCESSING IS A KEY 9284 06:43:58,514 --> 06:44:00,583 TO IMPROVE THE PERFORMANCE AND 9285 06:44:00,649 --> 06:44:01,150 THROUGHPUT. 9286 06:44:01,216 --> 06:44:03,018 BUT FOR O.C.T., IT'S NOT THAT 9287 06:44:03,085 --> 06:44:03,319 TRIVIAL. 9288 06:44:03,385 --> 06:44:07,056 IF YOU THINK ABOUT WHERE'S THE 9289 06:44:07,122 --> 06:44:07,790 STANDARD O.C.T. SYSTEM IF YOU 9290 06:44:07,856 --> 06:44:09,725 WANT TO HAVE PARALLEL IMAGE, YOU 9291 06:44:09,792 --> 06:44:14,830 CAN PUT THE 60 O.C.T. SETUP 9292 06:44:14,897 --> 06:44:16,231 THERE, ONE THE COST WILL 9293 06:44:16,298 --> 06:44:17,232 DRAMATICALLY INCREASE AND NOBODY 9294 06:44:17,299 --> 06:44:18,968 CAN AFFORD IT, AND TWO, THE 9295 06:44:19,034 --> 06:44:20,903 COMPLEXITY OF THE SYSTEM WILL BE 9296 06:44:20,970 --> 06:44:21,804 DRAMATICALLY INCREASED. 9297 06:44:21,870 --> 06:44:24,073 NOW YOU HAVE TO HAVE TO WORRY 9298 06:44:24,139 --> 06:44:25,374 ABOUT HOW TO SYNCHRONIZE 9299 06:44:25,441 --> 06:44:26,542 DIFFERENT CHANNELS, AND THERE'S 9300 06:44:26,609 --> 06:44:27,810 ALSO A HUGE AMOUNT OF DATA YOU 9301 06:44:27,876 --> 06:44:29,511 HAVE TO FIGURE OUT HOW TO DO IT 9302 06:44:29,578 --> 06:44:30,980 EFFICIENTLY. 9303 06:44:31,046 --> 06:44:32,414 SO WE CAME UP WITH APPROACH WE 9304 06:44:32,481 --> 06:44:35,150 CALL THE SPACE DIVISION 9305 06:44:35,217 --> 06:44:36,118 MULTIPLEXING O.C.T. 9306 06:44:36,185 --> 06:44:40,889 SO THIS IS BASED ON -- SOURCE 9307 06:44:40,956 --> 06:44:41,090 O.C.T. 9308 06:44:41,156 --> 06:44:43,092 EARLIER TODAY YOU HEARD LIKE 9309 06:44:43,158 --> 06:44:45,494 PROFESSOR FUJIMOTO TALK ABOUT 9310 06:44:45,561 --> 06:44:49,164 THAT, NOW WE CAN EVEN HAVE LIKE 9311 06:44:49,231 --> 06:44:51,567 WITH THE CURRENT -- TECHNOLOGIES 9312 06:44:51,634 --> 06:44:55,170 THE COHERENCE CAN BE VERY LONG. 9313 06:44:55,237 --> 06:44:57,773 -- IS POSSIBLE IS BECAUSE FOR 9314 06:44:57,840 --> 06:45:00,042 THOSE WEB SOURCE LASERS AT EACH 9315 06:45:00,109 --> 06:45:02,244 MOMENT THE INSTANTANEOUS 9316 06:45:02,311 --> 06:45:04,513 LANGUAGE IS VERY, VERY NARROW. 9317 06:45:04,580 --> 06:45:05,948 THAT GAVE US A VERY LONG-RANGING 9318 06:45:06,015 --> 06:45:08,984 USING THE TECHNIQUE. 9319 06:45:09,051 --> 06:45:09,652 BUT ON THE OTHER HAND, IF YOU 9320 06:45:09,718 --> 06:45:12,588 LOOK AT OUR O.C.T. IMAGING AND 9321 06:45:12,655 --> 06:45:16,859 WOULD HE AREWE ARE ONLY USING AD 9322 06:45:16,925 --> 06:45:18,127 MICRONS OF IMAGING DEPTH, OF 9323 06:45:18,193 --> 06:45:20,262 COURSE WE CAN USE A RANGE OF 9324 06:45:20,329 --> 06:45:22,731 THAT TO ACCOMMODATE MOTION BUT 9325 06:45:22,798 --> 06:45:23,932 THE ACTUAL IMAGES WE GOT IS ONLY 9326 06:45:23,999 --> 06:45:25,034 A FEW HUNDRED MICRONS. 9327 06:45:25,100 --> 06:45:29,238 HOW CAN WE UTILIZE THE STEPS 9328 06:45:29,304 --> 06:45:29,905 THAT'S AVAILABLE? 9329 06:45:29,972 --> 06:45:34,076 AND HAVING LIKE MULTIPLE IMAGES 9330 06:45:34,143 --> 06:45:36,045 STACKED INTO THE ENTIRE IMAGING 9331 06:45:36,111 --> 06:45:37,079 ACQUISITION RANGE. 9332 06:45:37,146 --> 06:45:40,783 SO WE INTRODUCED THIS DIVISION 9333 06:45:40,849 --> 06:45:42,051 MULTIPLEXING APPROACH FOR OUR 9334 06:45:42,117 --> 06:45:43,686 FIRST GENERATION IS VERY 9335 06:45:43,752 --> 06:45:45,387 STRAIGHTFORWARD, IT'S BASICALLY 9336 06:45:45,454 --> 06:45:48,290 ON THE -- WE JUST HAVE A LIGHT 9337 06:45:48,357 --> 06:45:48,957 SPLITTER. 9338 06:45:49,024 --> 06:45:51,260 IT'S A PASSIVE LIGHT SPLITTER. 9339 06:45:51,326 --> 06:45:52,728 WE CAN SPLIT ONE BEAM INTO 9340 06:45:52,795 --> 06:45:53,929 MULTIPLE BEAMS AND BETWEEN EACH 9341 06:45:53,996 --> 06:45:55,698 BEAM, WE CAN INTRODUCE A FEW 9342 06:45:55,764 --> 06:45:59,902 MILLIMETERS OF OPTICAL DELAYS, 9343 06:45:59,968 --> 06:46:01,003 BASICALLY -- THE FIBERS. 9344 06:46:01,070 --> 06:46:03,972 WITH THAT, EACH BEAM WILL BE 9345 06:46:04,039 --> 06:46:05,107 PROJECTED AT DIFFERENT LOCATIONS 9346 06:46:05,174 --> 06:46:05,641 ON THE SAMPLE. 9347 06:46:05,708 --> 06:46:09,044 WITH THAT, WHEN WE COLLECT THE 9348 06:46:09,111 --> 06:46:09,912 INTERFERENCE SIGNAL BACK FROM 9349 06:46:09,978 --> 06:46:14,616 THE TISSUE, THEY ARE ALL IN -- 9350 06:46:14,683 --> 06:46:16,351 WITH THE SAME REFERENCE MIRROR 9351 06:46:16,418 --> 06:46:17,319 BECAUSE EACH CHANNEL HAS A 9352 06:46:17,386 --> 06:46:20,389 DIFFERENT DELAY AND THEN THE 9353 06:46:20,456 --> 06:46:21,690 INTERFERENCE FREQUENCY WILL SHOW 9354 06:46:21,757 --> 06:46:23,425 UP IN DIFFERENT FREQUENCY GAPS. 9355 06:46:23,492 --> 06:46:25,928 SO IN A SENSE, WHAT WE ARE -- I 9356 06:46:25,994 --> 06:46:28,530 ALWAYS USE THIS ANALOGY IS THAT 9357 06:46:28,597 --> 06:46:30,699 WE ALL LIKE LISTEN TO RADIO, AND 9358 06:46:30,766 --> 06:46:32,434 DIFFERENT STATIONS ARE IN THE 9359 06:46:32,501 --> 06:46:33,802 AIR, THEY ARE PLAYED IN THE AIR 9360 06:46:33,869 --> 06:46:34,937 AT THE SAME TIME. 9361 06:46:35,003 --> 06:46:36,371 RIGHT? 9362 06:46:36,438 --> 06:46:38,073 THE REASON THEY ARE ALL IN THE 9363 06:46:38,140 --> 06:46:39,174 AIR AT THE SAME TIME AND NOT GET 9364 06:46:39,241 --> 06:46:42,010 MIXED UP IS BECAUSE THEY ARE 9365 06:46:42,077 --> 06:46:43,846 CARRIED BY -- THEY ARE -- LIKE 9366 06:46:43,912 --> 06:46:45,781 THEY HAVE A DIFFERENT CARRIER 9367 06:46:45,848 --> 06:46:46,081 FREQUENCIES. 9368 06:46:46,148 --> 06:46:48,650 SO IF WE WANT TO LISTEN TO 9369 06:46:48,717 --> 06:46:50,219 CERTAIN CHANNEL WHICH IS TUNED 9370 06:46:50,285 --> 06:46:53,822 TO THE CARRIER FREQUENCY, THEN 9371 06:46:53,889 --> 06:46:54,923 WE WILL HEAR THE PROGRAM FROM 9372 06:46:54,990 --> 06:46:55,591 THAT SPECIFIC STATION. 9373 06:46:55,657 --> 06:46:57,726 SO IN THIS CASE, WE ARE USING 9374 06:46:57,793 --> 06:47:00,262 THESE OPTICAL DELAY AS TO 9375 06:47:00,329 --> 06:47:02,965 INTRODUCE THIS OPTICAL 9376 06:47:03,031 --> 06:47:04,099 MODULATION OF THE INTERFERENCE 9377 06:47:04,166 --> 06:47:05,667 SIGNAL AND THEN IF WE WANT TO 9378 06:47:05,734 --> 06:47:08,837 LOOK AT THE IMAGE AS DIFFERENT 9379 06:47:08,904 --> 06:47:10,172 CHANNELS, WE JUST -- OF COURSE 9380 06:47:10,239 --> 06:47:12,141 WE ACQUIRE ALL TH THE DATA AT TE 9381 06:47:12,207 --> 06:47:15,377 SAME TIME, TH THAT'S HOW WE CANT 9382 06:47:15,444 --> 06:47:16,345 A CONCURRENT MEASUREMENT FROM 9383 06:47:16,411 --> 06:47:17,946 ALL DIFFERENT CHANNELS AND THEN 9384 06:47:18,013 --> 06:47:19,281 IF WE WANT TO SHOW THE IMAGE OF 9385 06:47:19,348 --> 06:47:20,482 INDIVIDUAL CHANNEL, WE JUST 9386 06:47:20,549 --> 06:47:23,318 FOCUS ON THAT FREQUENCY BAND. 9387 06:47:23,385 --> 06:47:26,755 SO WE DEMONSTRATE THE FIRST 9388 06:47:26,822 --> 06:47:28,090 PROTOTYPE OF THE SYSTEM A COUPLE 9389 06:47:28,157 --> 06:47:31,160 YEARS AGO, SO THIS IS USING A 9390 06:47:31,226 --> 06:47:32,427 1 BY 8 ARRAY AND I WILL PLAY 9391 06:47:32,494 --> 06:47:34,963 THIS AGAIN SO YOU CAN SEE, WE 9392 06:47:35,030 --> 06:47:36,265 CAN SCAN EIGHT BEAMS ON THE 9393 06:47:36,331 --> 06:47:39,568 SAMPLE AT ONCE. 9394 06:47:39,635 --> 06:47:41,236 THEN WITHIN ONE ACQUISITION, WE 9395 06:47:41,303 --> 06:47:44,206 GET IMAGES FROM EIGHT DIFFERENT 9396 06:47:44,273 --> 06:47:46,942 LOCATIONS SIMULTANEOUSLY. 9397 06:47:47,009 --> 06:47:48,844 SO THE TOTAL DEPTH RANGE IS LIKE 9398 06:47:48,911 --> 06:47:50,078 TENS OF MILLIMETER. 9399 06:47:50,145 --> 06:47:53,248 THAT'S ENABLED BY THE LASER, 9400 06:47:53,315 --> 06:47:58,020 EVERYONE CAN GET NOW. 9401 06:47:58,086 --> 06:47:59,087 SO ONE ACQUISITION, YOU GET 9402 06:47:59,154 --> 06:48:00,556 EIGHT IMAGES. 9403 06:48:00,622 --> 06:48:02,391 AND THEN IF WE STITCH THOSE 9404 06:48:02,457 --> 06:48:07,629 EIGHT IMAGES TOGETHER, AND EACH 9405 06:48:07,696 --> 06:48:09,164 IMAGE FOCUSES AT A DIFFERENT 9406 06:48:09,231 --> 06:48:10,799 SAMPLE LOCATION THEN YOU CAN GET 9407 06:48:10,866 --> 06:48:13,068 AN ENTIRE 3D SCAN OF THE SAMPLE 9408 06:48:13,135 --> 06:48:13,836 WITHIN A VERY SHORT TIME. 9409 06:48:13,902 --> 06:48:15,137 SO BASICALLY USING THIS 9410 06:48:15,204 --> 06:48:17,306 APPROACH, WE CAN JUST INTRODUCE 9411 06:48:17,372 --> 06:48:20,442 A PASSIVE COMPONENT, WE CAN 9412 06:48:20,509 --> 06:48:22,077 BOOST IMAGING SPEED BY A FACTOR 9413 06:48:22,144 --> 06:48:22,344 OF 8. 9414 06:48:22,411 --> 06:48:25,013 SO FOR THOSE OF YOU WHO KNOW MY 9415 06:48:25,080 --> 06:48:26,515 LAB, WE DO A LOT OF FRUIT FLY 9416 06:48:26,582 --> 06:48:28,183 STUDIES, SO FRUIT FLY IS KIND OF 9417 06:48:28,250 --> 06:48:33,255 THE FAVORITE SUBJECT IN OUR LAB, 9418 06:48:33,322 --> 06:48:34,590 AND WITH THE FRUIT FLY, ACTUALLY 9419 06:48:34,656 --> 06:48:38,627 WE CAN LOOK AT THE DIFFERENT 9420 06:48:38,694 --> 06:48:39,428 DEVELOPMENTAL STAGES AND THIS IS 9421 06:48:39,494 --> 06:48:41,663 FOR THE STUDY WE'RE USING EIGHT 9422 06:48:41,730 --> 06:48:43,632 BEAM SCAN ON THE FLIES, AT THE 9423 06:48:43,699 --> 06:48:46,034 SAME TIME ONE THING TO NOTICE IS 9424 06:48:46,101 --> 06:48:48,737 EACH CHANNEL, THE SCANNING IS 9425 06:48:48,804 --> 06:48:50,806 EXACTLY COMPLETELY SYNCHRONIZED. 9426 06:48:50,873 --> 06:48:53,108 BECAUSE WE'RE USING THE SAME 9427 06:48:53,175 --> 06:48:54,309 SCANNER, ALL THE BEAMS ARE MOVED 9428 06:48:54,376 --> 06:48:57,579 IN THE SAME WAY. 9429 06:48:57,646 --> 06:48:58,881 SO THREE BEAMS SCAN ON THE 9430 06:48:58,947 --> 06:49:01,483 SAMPLE IN THE A5, A6, 9431 06:49:01,550 --> 06:49:03,886 A7 DIFFERENT SEGMENT OF THE FLY 9432 06:49:03,952 --> 06:49:04,119 BODY. 9433 06:49:04,186 --> 06:49:06,755 AND YOU CAN SEE THE HEARTBEATING 9434 06:49:06,822 --> 06:49:09,424 FROM THE FLY. 9435 06:49:09,491 --> 06:49:10,092 THE ONE THING IF YOU NOTICE IS 9436 06:49:10,158 --> 06:49:13,362 THAT FOR DIFFERENT SEGMENT, YOU 9437 06:49:13,428 --> 06:49:14,796 CAN SEE DIFFERENT PHASES OF THE 9438 06:49:14,863 --> 06:49:16,632 CONTRACTION, OKAY? 9439 06:49:16,698 --> 06:49:20,235 SO IF YOU PLOT THE DIAMETER OF 9440 06:49:20,302 --> 06:49:21,436 THE FLY HEART TOO, YOU WILL BE 9441 06:49:21,503 --> 06:49:23,839 ABLE TO SEE A DIFFERENT FLY 9442 06:49:23,906 --> 06:49:26,842 SEGMENT, THERE'S A TIME DELAY OF 9443 06:49:26,909 --> 06:49:29,711 THE CONTRACTION OF DIFFERENT FLY 9444 06:49:29,778 --> 06:49:32,247 HEART -- THAT SHOWS HOW THE -- 9445 06:49:32,314 --> 06:49:33,882 FROM THE BACK OF THE BODY TO THE 9446 06:49:33,949 --> 06:49:34,716 FRONT PART. 9447 06:49:34,783 --> 06:49:38,186 YOU CAN SEE THE SYSTOLIC LIKE 9448 06:49:38,253 --> 06:49:40,489 PULSATION OF THE ANIMAL. 9449 06:49:40,555 --> 06:49:42,357 SO ARE HERE I EMPHASIZE YOU CAN 9450 06:49:42,424 --> 06:49:44,526 USE THIS APPROACH TO SYNCHRONIZE 9451 06:49:44,593 --> 06:49:45,494 THE IMAGING BUT AT THE SAME 9452 06:49:45,560 --> 06:49:48,664 TIME, THIS TECHNOLOGY HAS SOME 9453 06:49:48,730 --> 06:49:51,667 ADDITIONAL BENEFIT THAT CAN BE 9454 06:49:51,733 --> 06:49:52,000 VERY HELPFUL. 9455 06:49:52,067 --> 06:49:54,736 FOR EXAMPLE, LIKE NOW WITH -- IN 9456 06:49:54,803 --> 06:49:57,639 ORDER TO DO O.C.T. ANGIOGRAPHY, 9457 06:49:57,706 --> 06:50:00,275 WE HAVE TO REALLY SCAN -- WE 9458 06:50:00,342 --> 06:50:03,679 HAVE TO DO REPEATED SCAN, ONE TO 9459 06:50:03,745 --> 06:50:05,480 SLOW DOWN THE IMAGING SPEED AND 9460 06:50:05,547 --> 06:50:07,115 IF WE'RE USING HIGH SPEED LASER, 9461 06:50:07,182 --> 06:50:09,418 WE HAVE TO DRIVE THE GAVEL 9462 06:50:09,484 --> 06:50:11,119 REALLY AGGRESSIVELY TO MAKE THE 9463 06:50:11,186 --> 06:50:13,622 GAVEL MOVE VERY FAST, BUT IF WE 9464 06:50:13,689 --> 06:50:15,057 CAN USE THIS APPROACH, ALL THE 9465 06:50:15,123 --> 06:50:17,326 BEAMS WILL BE SCANNED AT THE 9466 06:50:17,392 --> 06:50:17,726 SAME TIME. 9467 06:50:17,793 --> 06:50:20,362 TO IMPROVE THE IMAGING SPEED IS 9468 06:50:20,429 --> 06:50:22,130 THROUGH THE PARALLEL IMAGING 9469 06:50:22,197 --> 06:50:23,799 RATHER THAN DRIVING THE GAVEL 9470 06:50:23,865 --> 06:50:24,366 LIKE CRAZY. 9471 06:50:24,433 --> 06:50:25,267 THERE ARE OTHER ADVANTAGES AS 9472 06:50:25,334 --> 06:50:27,636 WELL. 9473 06:50:27,703 --> 06:50:29,071 SO AFTER OUR FIRST DEMONSTRATION 9474 06:50:29,137 --> 06:50:30,872 AND WE ACTUALLY WERE FACING ONE 9475 06:50:30,939 --> 06:50:34,977 OF THE CHALLENGES IS THAT OUR 9476 06:50:35,043 --> 06:50:37,012 FIRST PROTOTYPE WAS BUILT ON 9477 06:50:37,079 --> 06:50:37,879 THIS FIBEROPTICS. 9478 06:50:37,946 --> 06:50:39,381 IT'S VERY -- IT'S GOOD THAT WE 9479 06:50:39,448 --> 06:50:40,816 SHOW THE PROOF OF PRINCIPLE. 9480 06:50:40,882 --> 06:50:43,118 THIS APPROACH WORKS. 9481 06:50:43,185 --> 06:50:45,320 BUT ON THE OTHER HAND, IT'S VERY 9482 06:50:45,387 --> 06:50:46,788 TEDIOUS AND VERY HARD TO MAKE 9483 06:50:46,855 --> 06:50:49,658 THIS FIBER ARRAY BECAUSE IF YOU 9484 06:50:49,725 --> 06:50:51,626 ACCIDENTALLY BREAK ONE FIBER, 9485 06:50:51,693 --> 06:50:52,661 THE ENTIRE ASSEMBLY IS DONE. 9486 06:50:52,728 --> 06:50:53,929 YOU HAVE TO REDO IT. 9487 06:50:53,996 --> 06:50:57,399 AND ALSO YOU HAVE TO PRECISELY 9488 06:50:57,466 --> 06:50:59,167 CONTROL THE DELAY OF DIFFERENT 9489 06:50:59,234 --> 06:51:01,870 CHANNELS AND THAT'S VERY HARD TO 9490 06:51:01,937 --> 06:51:02,537 DO, REPEATEDLY. 9491 06:51:02,604 --> 06:51:05,707 SO WITH THAT IN MIND, WE 9492 06:51:05,774 --> 06:51:07,743 DEVELOPED OUR FIRST GENERATION 9493 06:51:07,809 --> 06:51:08,744 PHOTONIC CHIP. 9494 06:51:08,810 --> 06:51:12,247 THIS IS PURELY A PASSIVE CHIP. 9495 06:51:12,314 --> 06:51:14,516 THIS IS A SILICON INSULATOR WITH 9496 06:51:14,583 --> 06:51:18,320 THE WORKING WAVELENGTHS AT 9497 06:51:18,387 --> 06:51:19,755 1.3-MICRON. 9498 06:51:19,821 --> 06:51:23,658 IT'S VERY SIM BELL PEL SIMPLE, E 9499 06:51:23,725 --> 06:51:26,261 LIGHT INPUT AND IT SPLIT INTO 9500 06:51:26,328 --> 06:51:27,362 MULTIPLE -- LIKE EIGHT DIFFERENT 9501 06:51:27,429 --> 06:51:27,629 CHANNELS. 9502 06:51:27,696 --> 06:51:29,564 EACH CHANNEL, WE CAN INTRODUCE 9503 06:51:29,631 --> 06:51:30,399 OPTIC DELAY THAT I MENTIONED 9504 06:51:30,465 --> 06:51:30,632 EARLIER. 9505 06:51:30,699 --> 06:51:36,204 SO IN THIS CASE, WE CAN PROJECT 9506 06:51:36,271 --> 06:51:37,572 EIGHT BEAMS ON THE SAMPLE, WE 9507 06:51:37,639 --> 06:51:40,542 CAN GO BACK TO THE SAME CHIP AND 9508 06:51:40,609 --> 06:51:41,643 GET -- WITH THE REST OF THIS 9509 06:51:41,710 --> 06:51:43,445 LIKE A REFERENCE ARM AND YOU CAN 9510 06:51:43,512 --> 06:51:44,012 DETECT IT. 9511 06:51:44,079 --> 06:51:47,082 SO WITH THIS CHIP BASED SYSTEM, 9512 06:51:47,149 --> 06:51:49,684 THE ADVANTAGE IS THAT ONCE YOU 9513 06:51:49,751 --> 06:51:51,520 HAVE THE DESIGN, YOU CAN MAKE AS 9514 06:51:51,586 --> 06:51:53,688 MANY AS YOU WANT. 9515 06:51:53,755 --> 06:51:55,023 THEY ALL HAVE THE SAME 9516 06:51:55,090 --> 06:51:56,124 PERFORMANCE, THEY ALL HAVE THE 9517 06:51:56,191 --> 06:51:58,393 SAME DELAYS IN THE SPACING AND 9518 06:51:58,460 --> 06:52:00,228 POTENTIALLY THIS APPROACH CAN BE 9519 06:52:00,295 --> 06:52:00,495 SCALABLE. 9520 06:52:00,562 --> 06:52:02,164 THE PER-UNIT COST CAN BE VERY, 9521 06:52:02,230 --> 06:52:03,799 VERY LOW ONCE YOU HAVE YOUR 9522 06:52:03,865 --> 06:52:06,001 DESIGN. 9523 06:52:06,068 --> 06:52:08,170 AND WITH THIS CHIP AND LIKE THIS 9524 06:52:08,236 --> 06:52:11,773 ONE BECAUSE IT'S ON SILICON, 9525 06:52:11,840 --> 06:52:14,076 SILICON INSULATOR, IT'S WORKING 9526 06:52:14,142 --> 06:52:15,477 AT 1.3-MICRON AP THEN -- BUT WE 9527 06:52:15,544 --> 06:52:18,080 WERE ABLE TO SHOW THAT WITH THIS 9528 06:52:18,146 --> 06:52:19,414 8-CHANNEL SYSTEM, WE WERE ABLE 9529 06:52:19,481 --> 06:52:23,118 TO SCAN THE ANTERIOR SEGMENT OF 9530 06:52:23,185 --> 06:52:25,487 A -- AND THIS IS EX VIVO. 9531 06:52:25,554 --> 06:52:27,122 THE ENTIRE 3D SCAN CAN BE 9532 06:52:27,189 --> 06:52:28,056 FINISHED IN LESS THAN ONE 9533 06:52:28,123 --> 06:52:33,028 SECOND. 9534 06:52:33,095 --> 06:52:34,763 AND ALSO IF WE SCAN THE FINGER, 9535 06:52:34,830 --> 06:52:37,399 WE CAN REVIEW THE DETAILS OF THE 9536 06:52:37,466 --> 06:52:40,235 FINGERPRINT AND ENTIRE 3D SCAN 9537 06:52:40,302 --> 06:52:41,203 COVERING 18 BY 14-MILLIMETER 9538 06:52:41,269 --> 06:52:44,673 RANGE CAN BE FINISHED IN ONE 9539 06:52:44,739 --> 06:52:46,441 SECOND. 9540 06:52:46,508 --> 06:52:48,410 AND OF COURSE THE MOST IMPACT 9541 06:52:48,477 --> 06:52:53,215 FOR OPHTHALMOLOGY IS IN -- MOST 9542 06:52:53,281 --> 06:52:54,316 IMPACT OF O.C.T. IS IN 9543 06:52:54,382 --> 06:52:58,253 OPHTHALMOLOGY AND WE BUILD THE 9544 06:52:58,320 --> 06:53:04,326 FIRST PROTOTYPE USING 1060 -- 9545 06:53:04,392 --> 06:53:06,528 LASER BUT FOR THIS FIRST 9546 06:53:06,595 --> 06:53:08,263 GENERATION WE WERE STILL RELYING 9547 06:53:08,330 --> 06:53:09,598 ON FIBEROPTICS AND BECAUSE THE 9548 06:53:09,664 --> 06:53:12,501 CHIPS WERE NOT READY FOR THIS 9549 06:53:12,567 --> 06:53:12,734 YET. 9550 06:53:12,801 --> 06:53:16,671 SO WE HAVE FOUR FIBERS COMBINED 9551 06:53:16,738 --> 06:53:18,940 TOGETHER WITH -- DELAY AND WE'RE 9552 06:53:19,007 --> 06:53:21,143 ABLE TO SCAN ENTIRE BACK OF THE 9553 06:53:21,209 --> 06:53:23,879 RETINA IN LESS THAN ONE SECOND. 9554 06:53:23,945 --> 06:53:27,782 AND HAVE A VERY DECENT PICTURE. 9555 06:53:27,849 --> 06:53:34,656 AND THIS IS COLLABORATION WITH 9556 06:53:34,723 --> 06:53:35,557 DR. BRUCKER AT UNIVERSITY OF 9557 06:53:35,624 --> 06:53:36,057 PENNSYLVANIA. 9558 06:53:36,124 --> 06:53:38,894 WE CAN COVER A WIDER FIELD OF 9559 06:53:38,960 --> 06:53:43,498 VIEW, AND WE HAVE MORE SLICES 9560 06:53:43,565 --> 06:53:45,867 FOR THE CUBE SCAN AND WE 9561 06:53:45,934 --> 06:53:47,302 DEMONSTRATED THE TECHNOLOGY IN A 9562 06:53:47,369 --> 06:53:49,905 FEW CLINICAL CASES OF DIABETIC 9563 06:53:49,971 --> 06:53:52,207 RETINOPATHY AND RETINAL 9564 06:53:52,274 --> 06:53:53,175 CHALLENGES. 9565 06:53:53,241 --> 06:53:55,677 WE ALSO SHOW THAT O.C.T. ANG GA 9566 06:53:55,744 --> 06:53:57,412 FEE IS FEASIBLE USING THIS 9567 06:53:57,479 --> 06:53:59,948 APPROACH, AND WE CAN GET LIKE A 9568 06:54:00,015 --> 06:54:01,883 DEPTH RESULT IMAGES OF THE 9569 06:54:01,950 --> 06:54:04,186 FINGERNAIL AND A LOOK AT THE 9570 06:54:04,252 --> 06:54:05,720 CAPILLARIES AT DIFFERENT DEPTHS. 9571 06:54:05,787 --> 06:54:09,524 SO OF COURSE WE ARE NOT THE ONLY 9572 06:54:09,591 --> 06:54:11,259 ONES WHO ARE WORKING ON 9573 06:54:11,326 --> 06:54:12,360 EXPLORING PARALLEL O.C.T. 9574 06:54:12,427 --> 06:54:13,228 IMAGING SYSTEM AND THIS IS ONE 9575 06:54:13,295 --> 06:54:16,932 OF THE EARLIER WORK FROM 9576 06:54:16,998 --> 06:54:20,769 PROFESSOR AUDREY ELLERBE'S LAB 9577 06:54:20,835 --> 06:54:23,505 AT THAT TIME SHE WAS AT 9578 06:54:23,572 --> 06:54:26,308 STANFORD, THE INTERLEAVED O.C.T. 9579 06:54:26,374 --> 06:54:28,376 SYSTEM WHERE THEY USE -- ARRAY 9580 06:54:28,443 --> 06:54:29,578 TO PROJECT THE LIGHT FROM ONE 9581 06:54:29,644 --> 06:54:33,181 BEAM TO MULTIPLE BEAM LOCATIONS 9582 06:54:33,248 --> 06:54:36,017 AND ALSO THE GROUP AT MGH ALSO 9583 06:54:36,084 --> 06:54:37,452 TOOK THE APPROACH OF USING 9584 06:54:37,519 --> 06:54:40,388 MULTIPLE FIBERS, FIBER ARRAYS TO 9585 06:54:40,455 --> 06:54:42,591 PROJECT THE BEAM ON THE SAMPLE 9586 06:54:42,657 --> 06:54:44,326 TO ACHIEVE THE PARALLEL IMAGING 9587 06:54:44,392 --> 06:54:45,093 SYSTEM. 9588 06:54:45,160 --> 06:54:47,495 SO THIS IS LIKE A PARALLEL 9589 06:54:47,562 --> 06:54:48,563 IMAGING SYSTEM IN ORDER TO 9590 06:54:48,630 --> 06:54:51,967 FURTHER SCALE THIS, AND THESE 9591 06:54:52,033 --> 06:54:54,469 APPROACHS ARE NOT VERY EASY TO 9592 06:54:54,536 --> 06:54:56,104 FURTHER SCALE THE TECHNOLOGY TO 9593 06:54:56,171 --> 06:54:58,306 EVEN MORE CHANNELS TO MAKE IT 9594 06:54:58,373 --> 06:55:02,310 SIMPLER, AND SO WE ARE WORKING 9595 06:55:02,377 --> 06:55:04,412 TOWARDS DEVELOPING THE NEXT 9596 06:55:04,479 --> 06:55:10,185 SCANNING GENERATION FOR DEVICES. 9597 06:55:10,252 --> 06:55:11,353 DR. FUJIMOTO'S GROUP DID A 9598 06:55:11,419 --> 06:55:12,454 WONDERFUL STUDY A COUPLE YEARS 9599 06:55:12,520 --> 06:55:18,126 AGO COMBINING USING INTEGRATIVE 9600 06:55:18,193 --> 06:55:23,265 PHOTONIC CHIP TO -- LIKE PS 9601 06:55:23,331 --> 06:55:25,900 O.C.T. RECEIVERS AND THAT CAN BE 9602 06:55:25,967 --> 06:55:28,637 USED FOR -- SENSITIVE O.C.T. 9603 06:55:28,703 --> 06:55:32,007 MEASUREMENT, AND PROFESSOR 9604 06:55:32,073 --> 06:55:33,875 DREXLER'S GROUP OVER IN VIENNA 9605 06:55:33,942 --> 06:55:37,045 ARE WORKING ON INTEGRATING LIKE 9606 06:55:37,112 --> 06:55:38,013 SPECTROMETERS ON THE CHIP AND SO 9607 06:55:38,079 --> 06:55:45,420 THAT YOU CAN GET LIKE A LOW COST 9608 06:55:45,487 --> 06:55:46,655 SPECTROMETER, SPECTRAL DOMAIN 9609 06:55:46,721 --> 06:55:47,856 O.C.T.-BASED SYSTEM. 9610 06:55:47,922 --> 06:55:53,862 LIKE DR. DREXLER AS WELL AS -- 9611 06:55:53,928 --> 06:55:55,063 DEMONSTRATING ANOTHER FOUR 9612 06:55:55,130 --> 06:55:56,598 CHANNEL O.C.T. SYSTEM BASED ON 9613 06:55:56,665 --> 06:56:00,001 THE PHOTONIC CHIP AND THEN LIKE 9614 06:56:00,068 --> 06:56:02,203 PART OF THE SYSTEM WERE 9615 06:56:02,270 --> 06:56:05,006 INTEGRATED ON THIS CHIP DEVICE. 9616 06:56:05,073 --> 06:56:06,775 SO IT'S A VERY EXCITING FIELD, 9617 06:56:06,841 --> 06:56:09,911 AND WE'RE VERY FORTUNATE OF 9618 06:56:09,978 --> 06:56:12,881 RECEIVING LIKE THIS GRANT 9619 06:56:12,947 --> 06:56:14,949 THROUGH THE OPEN PA MECHANISM SO 9620 06:56:15,016 --> 06:56:17,352 OUR GOAL IS IN THE NEXT FEW 9621 06:56:17,419 --> 06:56:18,987 YEARS, WE WANT TO FURTHER 9622 06:56:19,054 --> 06:56:21,923 DEVELOP THE PHOTONIC CHIP BASED 9623 06:56:21,990 --> 06:56:23,792 SYSTEM INTEGRATING MANY 9624 06:56:23,858 --> 06:56:25,093 COMPONENTS OF SWEPT SOURCE 9625 06:56:25,160 --> 06:56:26,428 O.C.T. SYSTEM INSIDE THE CHIP. 9626 06:56:26,494 --> 06:56:29,698 SO OUR FIRST APPROACH IS TO 9627 06:56:29,764 --> 06:56:32,200 INCLUDE -- INTEGRATE ALL THE 9628 06:56:32,267 --> 06:56:33,201 PASSIVE COMPONENTS ON TO THE 9629 06:56:33,268 --> 06:56:35,804 CHIP, AND POTENTIALLY HAVE EIGHT 9630 06:56:35,870 --> 06:56:38,840 CHANNELS, 16 CHANNELS, 32 9631 06:56:38,907 --> 06:56:41,376 CHANNELS SCALE THE IMAGING 9632 06:56:41,443 --> 06:56:42,811 SPEED, AND LATER ON, WE WANT TO 9633 06:56:42,877 --> 06:56:45,080 BE ABLE TO INCLUDE THE ACTIVE 9634 06:56:45,146 --> 06:56:46,915 COMPONENTS, INCLUDING PHOTO 9635 06:56:46,981 --> 06:56:50,652 DETECTORS, AND INCLUDING LIKE 9636 06:56:50,719 --> 06:56:54,789 PHASE MODULATORS, INCLUDING 9637 06:56:54,856 --> 06:56:56,191 THE SWEPT SOURCE LASER IF 9638 06:56:56,257 --> 06:56:57,625 GETTING TO THAT POINT, MAKE THE 9639 06:56:57,692 --> 06:56:58,727 WHOLE SYSTEM COMPLETELY 9640 06:56:58,793 --> 06:56:59,060 INTEGRATABLE. 9641 06:56:59,127 --> 06:57:02,230 AND OF COURSE WE WANT TO ALSO 9642 06:57:02,297 --> 06:57:04,632 INCLUDING OTHER DETECTED 9643 06:57:04,699 --> 06:57:05,233 CUSTOMIZED ELECTRONIC CIRCUIT 9644 06:57:05,300 --> 06:57:08,636 THAT CAN HELP TO IN REALTIME 9645 06:57:08,703 --> 06:57:10,205 PROCESS THE DATA, PRECONDITION 9646 06:57:10,271 --> 06:57:13,141 THE DATA SO THAT WE WERE ABLE TO 9647 06:57:13,208 --> 06:57:16,745 INCLUDE EVERYTHING IN THIS THESE 9648 06:57:16,811 --> 06:57:17,412 PORTABLE DEVICES. 9649 06:57:17,479 --> 06:57:22,984 SO THE CHALLENGES NOW, MOST OF 9650 06:57:23,051 --> 06:57:25,954 THE WORK WILL FOCUS ON O BAND OR 9651 06:57:26,020 --> 06:57:28,556 LIKE A C BAND OR IN THE TELECOM 9652 06:57:28,623 --> 06:57:30,258 WAVELENGTH RANGE, AND FOR THE 9653 06:57:30,325 --> 06:57:32,794 WAVELENGTHS WE WANT TO USE FOR 9654 06:57:32,861 --> 06:57:34,662 OPHTHALMOLOGY, 1060 OR 9655 06:57:34,729 --> 06:57:35,730 800-NANOMETER, THERE'S ALMOST 9656 06:57:35,797 --> 06:57:37,065 NOTHING OUT THERE. 9657 06:57:37,132 --> 06:57:39,667 SO WHAT WE'RE DOING RIGHT NOW IS 9658 06:57:39,734 --> 06:57:41,536 BASICALLY WE WANT TO DEVELOP 9659 06:57:41,603 --> 06:57:44,839 ENABLING TECHNOLOGIES AND WE 9660 06:57:44,906 --> 06:57:46,875 DEVELOPED THE PROCEDURE LIKE 9661 06:57:46,941 --> 06:57:47,776 VALIDATED THE STRUCTURE SO THAT 9662 06:57:47,842 --> 06:57:48,743 MORE AND MORE PEOPLE WILL BE 9663 06:57:48,810 --> 06:57:51,146 ABLE TO BENEFIT FROM THIS 9664 06:57:51,212 --> 06:57:52,914 POTENTIAL PHOTONIC INTEGRATION. 9665 06:57:52,981 --> 06:57:56,351 AND JUST TO BRIEFLY DESCRIBE ONE 9666 06:57:56,418 --> 06:57:58,153 THING IS THAT WE HAVE TO USE A 9667 06:57:58,219 --> 06:58:00,155 DIFFERENT MATERIAL PLATFORM. 9668 06:58:00,221 --> 06:58:01,856 SO SILICON INSULATOR IS NO 9669 06:58:01,923 --> 06:58:03,691 LONGER LIKE FEASIBLE BECAUSE AT 9670 06:58:03,758 --> 06:58:05,593 THE SHORTER WAVELENGTHS, THE 9671 06:58:05,660 --> 06:58:06,761 LOSS IS VERY HIGH. 9672 06:58:06,828 --> 06:58:10,398 AND SO WE'LL FOCUS ON DEVELOPING 9673 06:58:10,465 --> 06:58:11,833 SILICON NITRIDE BASED DEVICES 9674 06:58:11,900 --> 06:58:14,969 THAT HAVE VERY LOW LOSS AND 9675 06:58:15,036 --> 06:58:17,071 VERY -- LIKE KIND OF A TIGHT 9676 06:58:17,138 --> 06:58:18,807 BENDING RADIUS, AND THE 9677 06:58:18,873 --> 06:58:21,209 PERFORMANCE IS PRETTY GOOD, CAN 9678 06:58:21,276 --> 06:58:22,644 BE VERY GOOD. 9679 06:58:22,710 --> 06:58:23,845 AND THEN THERE ARE LIKE 9680 06:58:23,912 --> 06:58:27,449 INDIVIDUAL PIECES, FOR EXAMPLE, 9681 06:58:27,515 --> 06:58:31,386 THE 2 BY 2, 1 BY 2 INFRAFUROM 9682 06:58:31,453 --> 06:58:34,222 ESHES TERS, AND THE CROSSINGS OF 9683 06:58:34,289 --> 06:58:35,523 LIKE A CIRCUIT THAT HAS TO BE 9684 06:58:35,590 --> 06:58:36,925 DEVELOPED AND OPTIMIZED. 9685 06:58:36,991 --> 06:58:38,893 JUST ONE CHALLENGE I MENTION 9686 06:58:38,960 --> 06:58:41,529 LIKE I'LL USE AN EXAMPLE FOR 9687 06:58:41,596 --> 06:58:42,831 THESE WAVE GUIDE, IT'S ONLY 9688 06:58:42,897 --> 06:58:46,100 ABOUT A 200-NANOMETERS THICK AND 9689 06:58:46,167 --> 06:58:47,769 ONLY ABOUT LESS THAN ONE MICRON 9690 06:58:47,836 --> 06:58:48,937 IN THE WIDTH. 9691 06:58:49,003 --> 06:58:50,371 BUT COMPARED TO THE OPTICAL 9692 06:58:50,438 --> 06:58:53,541 FIBER WE'RE USING THE 9693 06:58:53,608 --> 06:58:55,710 MULTI-FIELD DIAMETER CAN BE 7 OR 9694 06:58:55,777 --> 06:58:55,977 8-MICRON. 9695 06:58:56,044 --> 06:58:57,145 SO THE LOSS COULD POTENTIALLY BE 9696 06:58:57,212 --> 06:58:59,347 VERY, VERY HIGH. 9697 06:58:59,414 --> 06:59:01,282 BUT CURRENTLY WE'RE EXPLORING 9698 06:59:01,349 --> 06:59:03,485 WAYS TO MINIMIZE OUR LOSS TO 9699 06:59:03,551 --> 06:59:06,855 LESS THAN LIKE 2DB PER FACET, 9700 06:59:06,921 --> 06:59:07,188 OKAY? 9701 06:59:07,255 --> 06:59:10,124 SO WITH THAT, I WANT TO THANK 9702 06:59:10,191 --> 06:59:11,993 PROFESSOR FUJIMOTO FOR THE 9703 06:59:12,060 --> 06:59:13,194 TRAINING HE PROVIDED ME, AND 9704 06:59:13,261 --> 06:59:17,332 ALSO FOR THE WONDERFUL LIKE 9705 06:59:17,398 --> 06:59:19,300 COMMUNITY WE'RE BUILDING, LIKE 9706 06:59:19,367 --> 06:59:21,703 AROUND THE O.C.T. TECHNOLOGY. 9707 06:59:21,769 --> 06:59:25,874 I WANT TO THANK DR. BRUCKER FOR 9708 06:59:25,940 --> 06:59:27,175 THE COLLABORATION THAT REALLY 9709 06:59:27,242 --> 06:59:29,544 ALLOWED US TO BUILD THE FIRST 9710 06:59:29,611 --> 06:59:31,312 PROTOTYPE AND TEST IT IN HUMAN 9711 06:59:31,379 --> 06:59:34,415 SUBJECTS, AND AS WELL AS MY 9712 06:59:34,482 --> 06:59:35,683 FORMER STUDENTS WHO ARE ACTIVELY 9713 06:59:35,750 --> 06:59:37,318 WORKING ON INTEGRATING THE 9714 06:59:37,385 --> 06:59:40,788 DEVICES ON THE CHIP AND FUNDING 9715 06:59:40,855 --> 06:59:45,960 FROM NIH, NEI AND NIBIB, NSF, 9716 06:59:46,027 --> 06:59:50,198 AND RPB, AS WELL AS OUR RECENT 9717 06:59:50,265 --> 06:59:52,166 FUNDING FROM -- WORKING WITH 9718 06:59:52,233 --> 06:59:55,436 FANTASTIC TEAM OF RESEARCHERS 9719 06:59:55,503 --> 06:59:58,039 WITH BOTH EXPERTISE IN BOTH 9720 06:59:58,106 --> 07:00:00,909 ELECTRONIC ENGINEERING, ELECTRIC 9721 07:00:00,975 --> 07:00:04,913 ENGINEERING PHOTONIC DEVICES AS 9722 07:00:04,979 --> 07:00:05,947 WELL AS THE CLINICAL ASPECT WITH 9723 07:00:06,014 --> 07:00:09,217 LIKE -- AND I THANK YOU VERY 9724 07:00:09,284 --> 07:00:09,984 MUCH FOR YOUR ATTENTION. 9725 07:00:10,051 --> 07:00:20,228 [APPLAUSE] 9726 07:00:21,729 --> 07:00:23,998 >> THANK YOU FOR JUST A 9727 07:00:24,065 --> 07:00:24,766 FASCINATING SESSION. 9728 07:00:24,832 --> 07:00:27,502 IF I COULD HAVE THE SPEAKERS 9729 07:00:27,569 --> 07:00:31,973 COME JOIN UP FRONT AND WE WILL 9730 07:00:32,040 --> 07:00:35,410 OPEN THIS UP FOR DISCUSSION IF 9731 07:00:35,476 --> 07:00:35,810 THERE'S QUESTIONS. 9732 07:00:35,877 --> 07:00:37,679 GO AHEAD. 9733 07:00:37,745 --> 07:00:42,083 >> TH A MORE TECHNICAL QUESTION. 9734 07:00:42,150 --> 07:00:45,653 WHEN YOU HAVE SINGLE MODE 9735 07:00:45,720 --> 07:00:47,188 COUPLING ALLOWED, HOW YOU CAN 9736 07:00:47,255 --> 07:00:49,591 MANAGE THE SPACE IF IT'S 1 TO 8? 9737 07:00:49,657 --> 07:00:53,061 AND THEN DO YOU FIBERIZE IT OR 9738 07:00:53,127 --> 07:00:57,432 YOU HAVE AN ENL COUPLING FOR THE 9739 07:00:57,498 --> 07:00:58,499 PERFORMANCE AFTERWARDS? 9740 07:00:58,566 --> 07:01:00,535 >> SO YOU WERE SAYING LIKE FOR 9741 07:01:00,602 --> 07:01:02,170 SINGLE MODE, COUPLING IN AND 9742 07:01:02,236 --> 07:01:04,372 OUT, HOW DO YOU GET AFTER 9743 07:01:04,439 --> 07:01:04,639 SPLITTING. 9744 07:01:04,706 --> 07:01:06,441 SO THAT PART, WHEN WE HAVE 9745 07:01:06,507 --> 07:01:10,812 8 CHAJS, WE8 CHANNELS, WE HAVE E 9746 07:01:10,878 --> 07:01:12,447 SO IT WILL BE RELAYED BY THE 9747 07:01:12,513 --> 07:01:14,182 LENS AND PROJECTED ON THE 9748 07:01:14,248 --> 07:01:14,415 SAMPLE. 9749 07:01:14,482 --> 07:01:15,717 SO IF WE WERE USING THAT ON THE 9750 07:01:15,783 --> 07:01:17,885 DETECTION SIDE, WE CAN USE A 9751 07:01:17,952 --> 07:01:19,621 FIBER ARRAY TO COUPLE INTO 9752 07:01:19,687 --> 07:01:19,821 THE -- 9753 07:01:19,887 --> 07:01:21,923 >> SO FROM THE FIBER ARRAY, YOU 9754 07:01:21,990 --> 07:01:24,826 USE A SINGLE -- FOR -- COUPLING? 9755 07:01:24,892 --> 07:01:26,728 >> FROM THE CHIP TO THE -- YEAH, 9756 07:01:26,794 --> 07:01:28,429 THAT'S A FREE SPACE COUPLING. 9757 07:01:28,496 --> 07:01:29,030 >> I SEE. 9758 07:01:29,097 --> 07:01:31,399 AND FOR THE DISPERSION 9759 07:01:31,466 --> 07:01:31,933 COMPENSATION OF THE DELAY 9760 07:01:32,000 --> 07:01:34,802 LIERNTION YOU JUST CONSIDER THEY 9761 07:01:34,869 --> 07:01:37,238 ARE COMPENSATED BY THE SAME 9762 07:01:37,305 --> 07:01:39,507 DELAY LINE FOR THE -- 9763 07:01:39,574 --> 07:01:40,074 [INAUDIBLE] 9764 07:01:40,141 --> 07:01:42,977 >> SO CURRENTLY THE SIMPLEST IS 9765 07:01:43,044 --> 07:01:46,614 TO USE THE SAME -- DISPERSION 9766 07:01:46,681 --> 07:01:47,148 COMPENSATION, YEAH. 9767 07:01:47,215 --> 07:01:49,751 BUT LATER WE COULD EXPLORE 9768 07:01:49,817 --> 07:01:52,153 ACTIVE COMPENSATION TO MODULATE 9769 07:01:52,220 --> 07:01:53,488 THE SIGNAL FOR DIFFERENT 9770 07:01:53,554 --> 07:02:00,395 CHANNELS. 9771 07:02:00,461 --> 07:02:01,596 >> DON, GO AHEAD. 9772 07:02:01,663 --> 07:02:02,997 >> A QUICK FOLLOW-UP QUESTION. 9773 07:02:03,064 --> 07:02:05,066 WHEN YOU GO TO A 1 TO 8 COUPLER, 9774 07:02:05,133 --> 07:02:07,168 WHAT IS THE EFFICIENCY LIKE? 9775 07:02:07,235 --> 07:02:08,336 I THINK YOU MENTIONED IT BUT I 9776 07:02:08,403 --> 07:02:09,003 DIDN'T PICK IT UP. 9777 07:02:09,070 --> 07:02:11,305 WHAT IS THE EFFICIENCY LOSS IN 9778 07:02:11,372 --> 07:02:11,472 DB? 9779 07:02:11,539 --> 07:02:14,776 >> SO IF IT'S A 1 TO 8, I THINK 9780 07:02:14,842 --> 07:02:16,210 IN THE FORWARD DIRECTION IT'S 9781 07:02:16,277 --> 07:02:18,046 JUST EVENLY SPLIT, BUT ON THE 9782 07:02:18,112 --> 07:02:24,052 WAY BACK, AND 1 BY 8 YOU HAVE A 9783 07:02:24,118 --> 07:02:25,920 9DB LIKE INSERTION LOSS, BUT WE 9784 07:02:25,987 --> 07:02:28,456 ARE TRYING TO -- WE HAVE A WAY 9785 07:02:28,523 --> 07:02:31,793 IN THE PHOTONIC SYSTEM, NEXT 9786 07:02:31,859 --> 07:02:34,595 GENERATION DEVICES, ROUTED THE 9787 07:02:34,662 --> 07:02:37,398 SIGNAL TO AVOID -- TO ONLY HAVE 9788 07:02:37,465 --> 07:02:39,233 3D LOSS AND AVOID ALL THE OTHER 9789 07:02:39,300 --> 07:02:44,405 LOSSES. 9790 07:02:44,472 --> 07:02:46,908 >> AUSTIN. 9791 07:02:46,974 --> 07:02:49,911 >> YEAH, QUESTION FOR THE ORG 9792 07:02:49,977 --> 07:02:50,945 FOLKS. 9793 07:02:51,012 --> 07:02:53,014 SO I THINK, RAM, I THINK YOU 9794 07:02:53,081 --> 07:02:56,851 SHOWED THAT THE MAGNITUDE OF THE 9795 07:02:56,918 --> 07:02:58,386 ORG LENGTH CHANGE WAS 9796 07:02:58,453 --> 07:02:59,087 PROPORTIONAL TO THE LENGTH OF 9797 07:02:59,153 --> 07:03:01,222 THE OUTER SEGMENT. 9798 07:03:01,289 --> 07:03:03,725 BUT ALSO, IN DISEASES LIKE RP, 9799 07:03:03,791 --> 07:03:05,493 THE OUTER SEGMENTS ARE A LITTLE 9800 07:03:05,560 --> 07:03:07,562 SHORTER. 9801 07:03:07,628 --> 07:03:09,630 SO ARE YOUR RP CHANGES JUST DUE 9802 07:03:09,697 --> 07:03:10,832 TO DIFFERENCES IN LENGTH OF THE 9803 07:03:10,898 --> 07:03:12,266 OUTER SEGMENT OF THESE DISEASES? 9804 07:03:12,333 --> 07:03:15,303 AND IF SO, THEN WHY NOT JUST DO 9805 07:03:15,369 --> 07:03:17,505 A STRUCTURAL MEASUREMENT AND NOT 9806 07:03:17,572 --> 07:03:19,240 A FUNCTIONAL MEASUREMENT? 9807 07:03:19,307 --> 07:03:20,341 SOUNDS LIKE A VERY NEGATIVE 9808 07:03:20,408 --> 07:03:21,209 QUESTION, BUT HOPEFULLY YOU HAVE 9809 07:03:21,275 --> 07:03:31,586 A POSITIVE ANSWER. 9810 07:03:35,022 --> 07:03:40,461 >> SO I THINK THE SIMPLE ANSWER 9811 07:03:40,528 --> 07:03:42,530 IS THAT THE ORG AMPLITUDE DOES 9812 07:03:42,597 --> 07:03:43,965 NOT SCALE WITH OUTER SEGMENT 9813 07:03:44,031 --> 07:03:45,166 LENGTH, AND THAT THERE ARE 9814 07:03:45,233 --> 07:03:46,667 FACTORS BESIDES THE OUTER 9815 07:03:46,734 --> 07:03:49,737 SEGMENT LENGTH SUCH AS WAVE 9816 07:03:49,804 --> 07:03:51,939 GUIDE COUPLING AND WAVE GUIDE 9817 07:03:52,006 --> 07:03:53,574 EFFICIENCY AND BLEACHING THAT IS 9818 07:03:53,641 --> 07:03:55,309 VARIED IN RP THAT DOESN'T FULLY 9819 07:03:55,376 --> 07:03:57,178 EXPLAIN THE CHANGES THAT WE 9820 07:03:57,245 --> 07:03:58,179 CAPTURE, SO NO, IT WON'T BE 9821 07:03:58,246 --> 07:03:59,714 SUFFICIENT TO ONLY MEASURE THE 9822 07:03:59,781 --> 07:04:01,682 OUTER SEGMENT BANDS. 9823 07:04:01,749 --> 07:04:02,884 >> I THINK ALSO -- 9824 07:04:02,950 --> 07:04:05,820 >> JUST AS A FOLLOW-UP, OUR 9825 07:04:05,887 --> 07:04:07,688 MEASUREMENTS ON RP, THEY ARE 9826 07:04:07,755 --> 07:04:09,223 PROPORTIONAL TO OUTER SEGMENT 9827 07:04:09,290 --> 07:04:09,457 LENGTH. 9828 07:04:09,524 --> 07:04:11,626 SO AS YOU SHORTEN IT, THE ORG 9829 07:04:11,692 --> 07:04:13,261 SIGNAL CLEARLY GETS LESS. 9830 07:04:13,327 --> 07:04:14,896 WHEN YOU GET MULTIPLE 9831 07:04:14,962 --> 07:04:17,198 REFLECTIONS IN AN INDIVIDUAL 9832 07:04:17,265 --> 07:04:20,535 CONE, AIM NOT UP THERE -- 9833 07:04:20,601 --> 07:04:23,104 >> SO TO CLARIFY THAT, IN EARLY 9834 07:04:23,171 --> 07:04:29,110 STAGE RP, YES, BUT I THINK AS 9835 07:04:29,177 --> 07:04:32,814 THINGS GET MORE AND MORE -- 9836 07:04:32,880 --> 07:04:34,715 >> ACTIVELY UNDERGOING ATROPHY, 9837 07:04:34,782 --> 07:04:37,251 SO THAT'S NOT EARLY. 9838 07:04:37,318 --> 07:04:41,889 SORRY. 9839 07:04:41,956 --> 07:04:44,592 >> MAYBE I COULD ASK RAVI AND 9840 07:04:44,659 --> 07:04:46,127 RAM, HAVING SEEN EACH OTHER'S 9841 07:04:46,194 --> 07:04:49,864 PRESENTATIONS NOW, WHAT DO WE 9842 07:04:49,931 --> 07:04:51,065 THINK ABOUT THE RODS? 9843 07:04:51,132 --> 07:04:56,537 WITH THOSE ORG MEASUREMENTS? 9844 07:04:56,604 --> 07:04:58,139 ARE YOU -- MAYBE MORE DIRECT 9845 07:04:58,206 --> 07:04:59,774 QUESTION, ARE YOU BOTH OPERATING 9846 07:04:59,841 --> 07:05:03,277 IN A DARK ADAPTED STATE? 9847 07:05:03,344 --> 07:05:05,813 LIKE FULLY DARK ADAPTED AND YOUR 9848 07:05:05,880 --> 07:05:11,085 BLEACHES ARE IN ROD BLEACHING 9849 07:05:11,152 --> 07:05:12,687 NOT CONE BLEACHING? 9850 07:05:12,753 --> 07:05:15,857 >> SO OURS ARE 30 MINUTES OF 9851 07:05:15,923 --> 07:05:16,858 DARK ADAPTATION, WE'RE DOING 9852 07:05:16,924 --> 07:05:19,160 CONE AND ROD MEASUREMENTS AT THE 9853 07:05:19,227 --> 07:05:22,864 SAME TIME. 9854 07:05:22,930 --> 07:05:25,366 THE -- SO IT'S A SINGLE -- IT'S 9855 07:05:25,433 --> 07:05:27,235 ONE -- WE ONLY HAVE ONE STIMULUS 9856 07:05:27,301 --> 07:05:29,770 SOURCE AROUND 550 NANOMETERS AND 9857 07:05:29,837 --> 07:05:32,473 THE L & M CONES ARE -- SHOULD BE 9858 07:05:32,540 --> 07:05:34,008 MORE SENSITIVE THAN THE RODS 9859 07:05:34,075 --> 07:05:34,475 THERE. 9860 07:05:34,542 --> 07:05:36,777 I THINK I -- I THINK THAT'S 9861 07:05:36,844 --> 07:05:37,311 RIGHT. 9862 07:05:37,378 --> 07:05:38,846 SO WE HAVE THE EFFECTIVE -- WE 9863 07:05:38,913 --> 07:05:40,481 REPORTED THE EFFECTIVE BLEACHING 9864 07:05:40,548 --> 07:05:42,683 THAT SHOWED THAT EVEN IF THE 9865 07:05:42,750 --> 07:05:47,922 RODS HAVE LOWER PHOTO PIGMENT 9866 07:05:47,989 --> 07:05:49,023 ISOMERIZATIONS, THEY ELONGATE 9867 07:05:49,090 --> 07:05:49,357 MORE. 9868 07:05:49,423 --> 07:05:51,092 NOW THERE ARE SOME ODDITIES WITH 9869 07:05:51,158 --> 07:05:52,393 THIS WHICH IS THAT IN THE CONES, 9870 07:05:52,460 --> 07:05:54,929 YOU HAVE LIKE CLEAR REFERENCE OF 9871 07:05:54,996 --> 07:05:58,532 THE ISO -- KODZ, IN THE RODS, WE 9872 07:05:58,599 --> 07:06:00,468 HAVE A CLEAR REFERENCE POINT, 9873 07:06:00,534 --> 07:06:03,337 IT'S BOTH AXIALLY AND LATERALLY 9874 07:06:03,404 --> 07:06:04,105 SEGREGATED FROM THE CONES BUT 9875 07:06:04,171 --> 07:06:06,307 WHEN YOU GET TO THE ISOS LAYER, 9876 07:06:06,374 --> 07:06:07,375 THERE'S NO -- WE HAVEN'T SEEN 9877 07:06:07,441 --> 07:06:12,980 LIKE A CLEAR ISOS -- MOSAIC AND 9878 07:06:13,047 --> 07:06:14,849 WE HAVE SOME SORT OF 9879 07:06:14,916 --> 07:06:15,616 CIRCUMSTANTIAL EVIDENCE THAT 9880 07:06:15,683 --> 07:06:17,818 THAT ISOS OF RODS MIGHT BE 9881 07:06:17,885 --> 07:06:21,188 AXIALLY DISPLACED COMPARED TO 9882 07:06:21,255 --> 07:06:22,189 ITS CONE COUNTERPARTS. 9883 07:06:22,256 --> 07:06:24,358 THERE ARE SOME QUESTIONS FOR 9884 07:06:24,425 --> 07:06:27,728 SURE, BUT WE -- YOU KNOW, WE'VE 9885 07:06:27,795 --> 07:06:28,996 MEASURED IT IN SEVERAL SUBJECTS 9886 07:06:29,063 --> 07:06:31,565 AND I MEAN, UNLESS THERE'S A -- 9887 07:06:31,632 --> 07:06:33,768 I DON'T THINK IT'S AN ARTIFACT. 9888 07:06:33,834 --> 07:06:36,070 I SHOULD ALSO SAY THAT RAM'S 9889 07:06:36,137 --> 07:06:37,338 RESPONSE LOOKS A BIT MORE LIKE 9890 07:06:37,405 --> 07:06:46,013 WHAT WAS REPORTED BY -- IT'S AN 9891 07:06:46,080 --> 07:06:47,682 SPIE PROCEEDINGS, SHOWING -- NO, 9892 07:06:47,748 --> 07:06:49,650 OR IS IT A -- DO YOU KNOW? 9893 07:06:49,717 --> 07:06:51,285 NEAR-INFRARED WAY, HER LAST NAME 9894 07:06:51,352 --> 07:06:54,221 IS PFAFFLE, AND SHE HAS A ROD 9895 07:06:54,288 --> 07:06:56,090 RESPONSE THAT LOOKS KIND OF LIKE 9896 07:06:56,157 --> 07:06:59,593 WHAT YOU SHOWED, SORT OF SLOW 9897 07:06:59,660 --> 07:07:00,461 AND VERY ATTENUATED. 9898 07:07:00,528 --> 07:07:02,229 SO QUITE DIFFERENT FROM WHAT WE 9899 07:07:02,296 --> 07:07:02,396 SEE. 9900 07:07:02,463 --> 07:07:04,498 >> YEAH, SO I THINK IN OUR 9901 07:07:04,565 --> 07:07:06,600 HANDS, RODS ARE MORE SENSITIVE 9902 07:07:06,667 --> 07:07:09,203 BUT SLOWER, AND I THINK THE 9903 07:07:09,270 --> 07:07:11,172 SLOWER -- THE SLOWNESS IS 9904 07:07:11,238 --> 07:07:14,375 BECAUSE OF THE FACT THAT THEIR 9905 07:07:14,442 --> 07:07:16,010 MEMBRANES ARE NOT FULLY EXPOSED 9906 07:07:16,077 --> 07:07:18,846 TO THE CYTOSOL IN THE SENSE THAT 9907 07:07:18,913 --> 07:07:20,614 THEY'RE PINCHED TO THE WAY -- 9908 07:07:20,681 --> 07:07:22,450 UNLIKE THE CONE DISKS ARE, WHICH 9909 07:07:22,516 --> 07:07:24,118 ARE COMPLETELY EXPOSED, SO THEY 9910 07:07:24,185 --> 07:07:26,721 HAVE LESS EFFECTIVE PERM YANT SO 9911 07:07:26,787 --> 07:07:28,489 WE'D EXPECT THEM TO SATURATE A 9912 07:07:28,556 --> 07:07:33,294 LOT SLOWER COMPARED TO CONES. 9913 07:07:33,361 --> 07:07:36,931 THE ROD AND CONE ORG TRACES THAT 9914 07:07:36,998 --> 07:07:38,899 I SHOWED I THINK IN THE CORE 9915 07:07:38,966 --> 07:07:41,302 SCALE SITUATION ARE NOT TAKEN 9916 07:07:41,369 --> 07:07:42,069 SIMULTANEOUSLY, THOSE ARE 9917 07:07:42,136 --> 07:07:44,805 EXAMPLES IN THE SENSE THAT THE 9918 07:07:44,872 --> 07:07:46,440 ROD BLEACHES ARE ABOUT FIVE 9919 07:07:46,507 --> 07:07:47,541 TIMES SMALLER THAN THE CONE 9920 07:07:47,608 --> 07:07:52,246 BLEACHES. 9921 07:07:52,313 --> 07:07:54,982 BUT IN THE SINGLE CONE SCENARIO 9922 07:07:55,049 --> 07:07:57,752 WHERE THERE WAS A 669 -- BLEACH 9923 07:07:57,818 --> 07:08:01,022 IS SUFFICIENT TO SEPARATE OUT 9924 07:08:01,088 --> 07:08:06,560 LMS CONES AS WELL AS RODS AT 66L 9925 07:08:06,627 --> 07:08:07,528 AMOUNT OF BLEACH FOR THE RODS, 9926 07:08:07,595 --> 07:08:10,364 WE CAN CALCULATE WHAT THAT IS 9927 07:08:10,431 --> 07:08:10,998 BUT IT -- 9928 07:08:11,065 --> 07:08:13,434 >> THE WHOLE QUESTION MIGHT BE A 9929 07:08:13,501 --> 07:08:13,834 MISUNDERSTANDING. 9930 07:08:13,901 --> 07:08:17,405 I THOUGHT THAT -- 9931 07:08:17,471 --> 07:08:18,839 >> I THINK I MISSPOKE. 9932 07:08:18,906 --> 07:08:20,107 >> OKAY, NEVER MIND. 9933 07:08:20,174 --> 07:08:22,510 >> MAYBE WE CAN COME DOWN HERE. 9934 07:08:22,576 --> 07:08:24,078 >> THANK YOU. 9935 07:08:24,145 --> 07:08:25,379 THESE ARE GREAT TALKS, AND I 9936 07:08:25,446 --> 07:08:27,114 JUST WANTED TO -- SEVERAL OF 9937 07:08:27,181 --> 07:08:28,315 YOU, I REALLY LEARNED A LOT 9938 07:08:28,382 --> 07:08:30,951 ABOUT WHAT YOU DO THROUGH THE 9939 07:08:31,018 --> 07:08:32,153 NEI'S AUDACIOUS GOALS 9940 07:08:32,219 --> 07:08:33,154 INITIATIVE, AND I THINK IT'S 9941 07:08:33,220 --> 07:08:37,425 BEAUTIFUL WORK, AND I JUST -- IT 9942 07:08:37,491 --> 07:08:38,559 SPAWNED A FAIR AMOUNT OF 9943 07:08:38,626 --> 07:08:40,795 DISCUSSION HERE IN BETHESDA 9944 07:08:40,861 --> 07:08:42,763 ABOUT, YOU KNOW, HOW COULD THE 9945 07:08:42,830 --> 07:08:44,865 AVERAGE OPHTHALMOLOGIST ADOPT 9946 07:08:44,932 --> 07:08:46,734 THESE AND, YOU KNOW, WHAT WOULD 9947 07:08:46,801 --> 07:08:48,502 MAKE THEM WANT TO ADOPT THESE IN 9948 07:08:48,569 --> 07:08:48,936 CLINICAL PRACTICE. 9949 07:08:49,003 --> 07:08:50,805 SO I WANTED TO USE THAT TO 9950 07:08:50,871 --> 07:08:52,206 REALLY INTRODUCE A QUESTION NOT 9951 07:08:52,273 --> 07:08:54,942 ONLY TO THE PANEL BUT ALSO TO 9952 07:08:55,009 --> 07:08:58,879 JIM AND TO DAVID, BECAUSE IF I 9953 07:08:58,946 --> 07:09:00,548 THINK BACK, O.C.T. REALLY FROM 9954 07:09:00,614 --> 07:09:02,416 WHEN YOU PUBLISHED THESE PAPERS 9955 07:09:02,483 --> 07:09:03,951 TO WHEN IT BECAME USED 9956 07:09:04,018 --> 07:09:06,687 MAINSTREAM WAS LET'S SAY MAYBE 9957 07:09:06,754 --> 07:09:07,588 20 YEARS PLUS OR MINUS, AND I'D 9958 07:09:07,655 --> 07:09:09,223 LOVE TO HEAR WHAT LESSONS YOU 9959 07:09:09,290 --> 07:09:12,393 FEEL LIKE WE HAVE LEARNED ABOUT 9960 07:09:12,460 --> 07:09:15,329 HOW TO TRANSLATE TECHNOLOGIES 9961 07:09:15,396 --> 07:09:17,965 INTO REAL WORLD CLINICAL USE OF 9962 07:09:18,032 --> 07:09:19,266 THIS SORT, AND ARE THERE THINGS 9963 07:09:19,333 --> 07:09:21,268 THAT YOU'VE LEARNED THAT WE CAN 9964 07:09:21,335 --> 07:09:23,337 TAKE ADVANTAGE OF AS A COMMUNITY 9965 07:09:23,404 --> 07:09:25,206 ABOUT HOW TO INCREASE THE CYCLE 9966 07:09:25,272 --> 07:09:28,008 TIME OF DOING THAT, OR HOW TO 9967 07:09:28,075 --> 07:09:29,944 RECOGNIZE WHEN SOMETHING IS 9968 07:09:30,010 --> 07:09:30,478 TRANSLATABLE AND IS THERE 9969 07:09:30,544 --> 07:09:32,313 ANYTHING WE SHOULD BE DOING AT 9970 07:09:32,379 --> 07:09:40,020 NIH TO HELP SUPPORT THAT? 9971 07:09:40,087 --> 07:09:45,259 >> WHO WANTS TO TACKLE THAT? 9972 07:09:45,326 --> 07:09:55,703 I MEAN, WILL WE BE -- 9973 07:10:05,880 --> 07:10:08,349 >> PART OF THE QUESTION IS 9974 07:10:08,415 --> 07:10:10,484 DIRECTED TO OPTORETINOGRAPHY SO 9975 07:10:10,551 --> 07:10:12,620 I CAN'T RESPOND IN THAT CONTEXT. 9976 07:10:12,686 --> 07:10:18,425 I THINK THE -- THE COMPLICATED 9977 07:10:18,492 --> 07:10:20,194 PROCESS, AND IN O.C.T., WE SAW 9978 07:10:20,261 --> 07:10:23,230 THAT JUST HAVING A DIAGNOSTIC 9979 07:10:23,297 --> 07:10:27,301 WAS NOT ENOUGH LINKING SOMETHING 9980 07:10:27,368 --> 07:10:30,037 TO THERAPY, WHICH WAS REALLY THE 9981 07:10:30,104 --> 07:10:31,805 CLINICAL ADVANCE BY THE CLINICAL 9982 07:10:31,872 --> 07:10:32,673 COMMUNITY, THAT WAS A CRITICAL 9983 07:10:32,740 --> 07:10:34,074 STEP. 9984 07:10:34,141 --> 07:10:37,945 I THINK THE BUSINESS MODEL FOR 9985 07:10:38,012 --> 07:10:39,813 INSTRUMENTATION IS VERY HARD. 9986 07:10:39,880 --> 07:10:42,216 THE MARKET IS VERY SMALL, YOU 9987 07:10:42,283 --> 07:10:45,052 KNOW, COMPARED TO OTHER MARKETS, 9988 07:10:45,119 --> 07:10:47,354 THE REGULATORY PATH IS LONG. 9989 07:10:47,421 --> 07:10:50,157 AND SO THE PATH IF YOU SAY TO GO 9990 07:10:50,224 --> 07:10:52,193 TO FUNDAMENTAL RESEARCH IF 9991 07:10:52,259 --> 07:10:54,161 YOU'RE SELLING TO THE 9992 07:10:54,228 --> 07:10:55,596 CLINICAL -- I'M SORRY -- THE 9993 07:10:55,663 --> 07:10:57,765 BASIC RESEARCH COMMUNITY THAT'S 9994 07:10:57,831 --> 07:10:59,733 MUCH EASIER BUT THAT'S ALSO 9995 07:10:59,800 --> 07:11:04,138 SMALL RELATIVE TO SOFTWARE IN 9996 07:11:04,205 --> 07:11:05,005 GENERAL. 9997 07:11:05,072 --> 07:11:07,408 SO I THINK IT'S A VERY 9998 07:11:07,474 --> 07:11:08,609 CHALLENGING ISSUE AND IT'S NOT 9999 07:11:08,676 --> 07:11:10,711 CLEAR WHAT THE ANSWER IS. 10000 07:11:10,778 --> 07:11:11,345 MAYBE DAVID HAS A DIFFERENT 10001 07:11:11,412 --> 07:11:19,920 OPINION ON THIS THOUGH. 10002 07:11:19,987 --> 07:11:21,422 >> I'M GOING TO TALK ABOUT THAT 10003 07:11:21,488 --> 07:11:23,290 A LITTLE BIT TOMORROW MORNING, 10004 07:11:23,357 --> 07:11:25,826 BUT BASICALLY I THINK IN ORDER 10005 07:11:25,893 --> 07:11:28,429 FOR A TECHNOLOGY TO BE WIDELY 10006 07:11:28,495 --> 07:11:32,032 USED BY CLINICIANS, WE NEED 10007 07:11:32,099 --> 07:11:33,601 PEOPLE IN THE INDUSTRY, IN THE 10008 07:11:33,667 --> 07:11:35,135 BUSINESS COMMUNITY TO RECOGNIZE 10009 07:11:35,202 --> 07:11:39,940 THE CLINICAL POTENTIAL, AND THAT 10010 07:11:40,007 --> 07:11:44,778 TAKES VISION, AND SO THAT IS 10011 07:11:44,845 --> 07:11:46,180 PROBABLY ONE OF THE IMPEDIMENTS, 10012 07:11:46,247 --> 07:11:47,948 IS TO HAVE PEOPLE IN THE 10013 07:11:48,015 --> 07:11:51,151 INDUSTRY WHO HAS THE VISION AND 10014 07:11:51,218 --> 07:11:53,287 WE NEED -- WE OFTEN WANT OUR 10015 07:11:53,354 --> 07:11:55,556 STUDENTS TO COME BACK TO THE 10016 07:11:55,623 --> 07:11:56,657 ACADEMIA, YOU KNOW, YOU WANT TO 10017 07:11:56,724 --> 07:11:58,492 KNOW HOW MANY OF YOUR STUDENTS 10018 07:11:58,559 --> 07:12:01,362 AND POSTDOCS BECOME PROFESSORS, 10019 07:12:01,428 --> 07:12:04,965 BUT ACTUALLY I THINK IT MAY MAKE 10020 07:12:05,032 --> 07:12:06,600 BIGGER IMPACT IF YOU STUDENTS GO 10021 07:12:06,667 --> 07:12:08,269 OUT IN THE INDUSTRY AND BECOME 10022 07:12:08,335 --> 07:12:11,105 LEADERS IN THE INDUSTRY THAT 10023 07:12:11,171 --> 07:12:12,873 CREATES PRODUCTS. 10024 07:12:12,940 --> 07:12:16,777 AND I THINK NIH HAS FACILITATED 10025 07:12:16,844 --> 07:12:24,151 THESE WITH SBIR/STTR GRANTS, BUT 10026 07:12:24,218 --> 07:12:26,687 PROBABLY WHAT MAKES BIGGER 10027 07:12:26,754 --> 07:12:30,291 IMPACT IS REIMBURSEMENT FOR 10028 07:12:30,357 --> 07:12:33,694 THESE, AND OF COURSE LINKING TO 10029 07:12:33,761 --> 07:12:34,461 THERAPEUTICS IS VERY IMPORTANT 10030 07:12:34,528 --> 07:12:35,996 FOR THAT. 10031 07:12:36,063 --> 07:12:38,098 AND ALSO REIMBURSEMENT FOR THE 10032 07:12:38,165 --> 07:12:42,036 DIAGNOSTIC PROCEDURES, AND THOSE 10033 07:12:42,102 --> 07:12:43,704 HAVE BEEN -- THE FACT THAT THEY 10034 07:12:43,771 --> 07:12:45,873 ARE AVAILABLE HAS BEEN VERY 10035 07:12:45,939 --> 07:12:48,509 HELPFUL, THE LENGTHY DELAYS WERE 10036 07:12:48,575 --> 07:12:49,710 NOT HELPFUL, SO THERE WERE A LOT 10037 07:12:49,777 --> 07:12:52,246 OF PLUSES AND MINUSES AND IT'S 10038 07:12:52,313 --> 07:12:54,114 COMPLICATED, BUT I THINK THAT'S 10039 07:12:54,181 --> 07:12:56,183 PROBABLY ONE OF THE BIGGEST 10040 07:12:56,250 --> 07:12:57,584 FACTORS. 10041 07:12:57,651 --> 07:13:01,255 SO THAT'S WHAT I'VE LEARNED, AND 10042 07:13:01,322 --> 07:13:03,324 I THINK CLINICIANS ON THE GROUND 10043 07:13:03,390 --> 07:13:06,060 ACTUALLY PROBABLY HAVE THE MOST 10044 07:13:06,126 --> 07:13:09,330 ACCURATE PICTURE, PEOPLE IN 10045 07:13:09,396 --> 07:13:15,169 ACADEMICS SOMETIMES ARE ACTUALLY 10046 07:13:15,235 --> 07:13:16,136 RESISTANT TO CHANGE IN WHAT THEY 10047 07:13:16,203 --> 07:13:17,471 ARE TEACHING AND CAN ACTUALLY 10048 07:13:17,538 --> 07:13:20,674 HOLD THINGS BACK, BUT ONCE 10049 07:13:20,741 --> 07:13:23,277 SOMETHING HAS DEMONSTRATED 10050 07:13:23,344 --> 07:13:27,214 CLINICAL POTENTIAL, THE 10051 07:13:27,281 --> 07:13:28,315 CLINICIANS WILL TALK ABOUT IT 10052 07:13:28,382 --> 07:13:29,950 AND IT TAKES OFF REALLY QUICKLY, 10053 07:13:30,017 --> 07:13:30,718 IT JUST GOES VIRAL. 10054 07:13:30,784 --> 07:13:33,120 SO I HOPE ORG WILL GO VIRAL 10055 07:13:33,187 --> 07:13:37,491 THROUGH SOME SORT OF PHARMA 10056 07:13:37,558 --> 07:13:38,926 TRAIL WHERE YOU HAD A KILLER APP 10057 07:13:38,992 --> 07:13:43,430 JUST LIKE ORIGINAL O.C.T. WITH 10058 07:13:43,497 --> 07:13:44,598 VEGF SO I HOPE THAT'S POSSIBLE 10059 07:13:44,665 --> 07:13:46,333 AND I HOPE THAT WILL HAPPEN. 10060 07:13:46,400 --> 07:13:47,701 >> THE FIRST TIME I SHOWED THE 10061 07:13:47,768 --> 07:13:49,570 RESULTS TO LARRY MORSE, WHO MANY 10062 07:13:49,636 --> 07:13:53,307 OF YOU KNOW, HE WAS LIKE WOW, 10063 07:13:53,374 --> 07:13:54,541 THAT'S AMAIDSING, I CAN'T 10064 07:13:54,608 --> 07:13:56,377 BELIEVE WHAT YOU'RE SEEING, AND 10065 07:13:56,443 --> 07:13:58,412 I SAID LARRY, WOULD YOU USE THIS 10066 07:13:58,479 --> 07:13:58,812 IN YOUR CLINIC? 10067 07:13:58,879 --> 07:14:00,647 HE SAID NO, NO WAY! 10068 07:14:00,714 --> 07:14:02,216 WHAT WOULD I USE THIS FOR IN MY 10069 07:14:02,282 --> 07:14:05,185 CLINIC? 10070 07:14:05,252 --> 07:14:06,053 THEN ONE OTHER THING, ANOTHER 10071 07:14:06,120 --> 07:14:07,788 LITTLE ANECDOTE, I WAS TALKING 10072 07:14:07,855 --> 07:14:09,022 TO -- YOU KNOW, WHEN WE FIRST 10073 07:14:09,089 --> 07:14:12,092 STARTED PRESENTING THE PROTO 10074 07:14:12,159 --> 07:14:14,828 CLINICAL ORG, THERE WAS SOME 10075 07:14:14,895 --> 07:14:16,897 COMMERCIAL INTEREST AND PEOPLE 10076 07:14:16,964 --> 07:14:18,098 WERE TALKING TO ME AND ROBERT 10077 07:14:18,165 --> 07:14:19,767 ABOUT IT AND ONE PERSON WHO'S 10078 07:14:19,833 --> 07:14:21,635 KIND OF MORE ON THE VC SIDE WAS 10079 07:14:21,702 --> 07:14:23,370 ASKING A LOT OF QUESTIONS AND 10080 07:14:23,437 --> 07:14:24,705 LIKE HOW LONG DOES THE TEST TAKE 10081 07:14:24,772 --> 07:14:25,806 AND I SAID WELL I THINK WE CAN 10082 07:14:25,873 --> 07:14:27,574 DO IT IN FIVE MINUTES, HE'S LIKE 10083 07:14:27,641 --> 07:14:38,118 FORGET IT, THAT'S WAY TOO LONG. 10084 07:14:38,185 --> 07:14:41,922 >> I AGREE -- UNLESS YOU GET THE 10085 07:14:41,989 --> 07:14:43,123 INDUSTRY IN, IT'S GOING TO 10086 07:14:43,190 --> 07:14:47,027 REMAIN IN THE LAB ON A BENCH AND 10087 07:14:47,094 --> 07:14:47,861 WE'RE GOING TO TALK ABOUT IT 10088 07:14:47,928 --> 07:14:53,967 BETWEEN US, BUT JOHN MOREVICH, 10089 07:14:54,034 --> 07:14:55,636 WHEN HE GOT STARTED HE GOT FIRED 10090 07:14:55,702 --> 07:14:57,171 BECAUSE HE WASN'T GENERATING 10091 07:14:57,237 --> 07:15:00,574 ENOUGH -- WHEN I STARTED WITH 10092 07:15:00,641 --> 07:15:02,009 O.C.T. PEOPLE THOUGHT I NEED TO 10093 07:15:02,075 --> 07:15:03,444 EXAMINE MY BRAIN, NOBODY COULD 10094 07:15:03,510 --> 07:15:04,645 FIRE ME BECAUSE IT WAS MY MONEY 10095 07:15:04,711 --> 07:15:06,713 BUT I WAS ON THE VERGE OF 10096 07:15:06,780 --> 07:15:08,482 BANKRUPTCY BECAUSE IT WAS TOO 10097 07:15:08,549 --> 07:15:09,716 EARLY AND CLINICIANS DID NOT 10098 07:15:09,783 --> 07:15:11,452 KNOW WHAT TO DO WITH IT, AND 10099 07:15:11,518 --> 07:15:13,220 THEN SUDDENLY THEY DISCOVERED 10100 07:15:13,287 --> 07:15:13,821 THAT THEY CAN USE IT. 10101 07:15:13,887 --> 07:15:14,488 SO IT'S THE SAME PROBLEM. 10102 07:15:14,555 --> 07:15:17,658 WE NEED TO ENCOURAGE THE 10103 07:15:17,724 --> 07:15:19,393 INDUSTRY TO PUT THEIR HAND IN 10104 07:15:19,460 --> 07:15:20,861 THEIR POCKET AND TAKE THE RISK 10105 07:15:20,928 --> 07:15:21,895 AND PROGRESS FORWARD, OTHERWISE 10106 07:15:21,962 --> 07:15:23,931 IT WILL REMAIN IN THE LAB. 10107 07:15:23,997 --> 07:15:25,399 GREAT INNOVATIONS FOR MANY OF 10108 07:15:25,466 --> 07:15:28,101 THE LAB FOR MANY, MANY, MANY 10109 07:15:28,168 --> 07:15:28,435 YEARS. 10110 07:15:28,502 --> 07:15:29,436 BECAUSE PEOPLE ARE AFRAID TO 10111 07:15:29,503 --> 07:15:33,640 TAKE THE RISK. 10112 07:15:33,707 --> 07:15:35,576 >> ALL RIGHT. 10113 07:15:35,642 --> 07:15:38,979 WELL, WE'VE HAD JUST A FANTASTIC 10114 07:15:39,046 --> 07:15:40,514 DAY TODAY. 10115 07:15:40,581 --> 07:15:42,616 I MYSELF IS LEARNED SO MUCH, I 10116 07:15:42,683 --> 07:15:45,118 DEFINITELY WANT AN ADAPTIVE 10117 07:15:45,185 --> 07:15:46,553 OPTIC O.C.T. WITH 10118 07:15:46,620 --> 07:15:47,988 SUPERRESOLUTION IN VISIBLE 10119 07:15:48,055 --> 07:15:49,523 WAVELENGTHS WITH EIGHT CHANNELS. 10120 07:15:49,590 --> 07:15:51,191 SO IF ANYBODY WANTS TO DEVELOP 10121 07:15:51,258 --> 07:15:53,494 THAT WITH ME, LET'S CHAT. 10122 07:15:53,560 --> 07:15:54,695 I GUESS AT DINNER. 10123 07:15:54,761 --> 07:15:56,597 THANK YOU ALL FOR THIS FABULOUS 10124 07:15:56,663 --> 07:15:57,464 LAST SESSION. 10125 07:15:57,531 --> 07:15:58,565 THANKS TO OUR SPEAKERS AGAIN. 10126 07:15:58,632 --> 07:16:05,472 [APPLAUSE] 10127 07:16:05,539 --> 07:16:06,874 >> WELL, THANK YOU, EVERYONE, 10128 07:16:06,940 --> 07:16:09,176 FOR A STIMULATING DAY OF 10129 07:16:09,243 --> 07:16:11,578 PRESENTATIONS AND QUESTIONS AND 10130 07:16:11,645 DISCUSSION.