Merging of ultrahigh-resolution optical coherence tomography (UHR OCT) and adaptive optics (AO), resulting in high axial ($3 \mathit{\mu }\mathrm{m}$) and improved transverse resolution ($5–10 \mathit{\mu }\mathrm{m}$) is demonstrated for the first time to our knowledge in in vivo retinal imaging. A compact ($300 \mathrm{mm}\times 300 \mathrm{mm}$) closed-loop AO system, based on a real-time Hartmann–Shack wave-front sensor operating at 30 Hz and a 37-actuator membrane deformable mirror, is interfaced to an UHR OCT system, based on a commercial OCT instrument, employing a compact Ti:sapphire laser with 130-nm bandwidth. Closed-loop correction of both ocular and system aberrations results in a residual uncorrected wave-front rms of $0.1 \mathit{\mu }\mathrm{m}$ for a 3.68-mm pupil diameter. When this level of correction is achieved, OCT images are obtained under a static mirror configuration. By use of AO, an improvement of the transverse resolution of two to three times, compared with UHR OCT systems used so far, is obtained. A significant signal-to-noise ratio improvement of up to 9 dB in corrected compared with uncorrected OCT tomograms is also achieved.

A fundamental problem facing sensory systems is to recover useful information about the external world from signals that are corrupted by the sensory process itself. Retinal images in the human eye are affected by optical aberrations that cannot be corrected with ordinary spectacles or contact lenses, and the specific pattern of these aberrations is different in every eye. Though these aberrations always blur the retinal image, our subjective impression is that the visual world is sharp and clear, suggesting that the brain might compensate for their subjective influence. The recent introduction of adaptive optics to control the eye’s aberrations now makes it possible to directly test this idea. If the brain compensates for the eye’s aberrations, vision should be clearest with the eye’s own aberrations rather than with unfamiliar ones. We asked subjects to view a stimulus through an adaptive optics system that either recreated their own aberrations or a rotated version of them. For all five subjects tested, the stimulus seen with the subject’s own aberrations was always sharper than when seen through the rotated version. This supports the hypothesis that the neural visual system is adapted to the eye’s aberrations, thereby removing somehow the effects of blur generated by the sensory apparatus from visual experience. This result could have important implications for methods to correct higher order aberrations with customized refractive surgery because some benefits of optimizing the correction optically might be undone by the nervous system’s compensation for the old aberrations.

We have developed a prototype apparatus for real-time closed-loop measurement and correction of aberrations in the human eye. The apparatus uses infrared light to measure the wave-front aberration at 25 Hz with a Hartmann–Shack sensor. Defocus is removed by a motorized optometer, and higher-order aberrations are corrected by a membrane deformable mirror. The device was first tested with an artificial eye. Correction of static aberrations takes approximately five iterations, making the system capable of following aberration changes at 5 Hz. This capability allows one to track most of the aberration dynamics in the eye. Results in living eyes showed effective closed-loop correction of aberrations, with a residual uncorrected wave front of $0.1 \mu \mathrm{m}$ for a 4.3-mm pupil diameter. Retinal images of a point source in different subjects with and without adaptive correction of aberrations were estimated in real time. The results demonstrate real-time closed-loop correction of aberration in the living eye. An application of this device is as electro-optic “spectacles” to improve vision.

The performance of a membrane deformable mirror with 37 electrodes (OKO Technologies) is studied in order to characterize its utility as an adaptive optics element. The control procedure is based on knowledge of the membrane’s response under the action of each isolate electrode, i.e., the influence functions. The analysis of the mathematical techniques to obtain the control matrix gives useful information about the surfaces that are within the device’s range of production, thus predicting the best performance of the mirror. We used a straightforward iterative algorithm to control the deformable membrane that permits the induction of surfaces in approximately four iterations, with an acceptable level of stability. The mirror and the control procedure are tested by means of generating Zernike polynomials and other surfaces. The mirror was incorporated in an adaptive optics prototype to compensate the eye’s aberration in real time and in a closed loop. Double-pass retinal images with and without aberration correction were directly recorded in a real eye in order to evaluate the actual performance of the adaptive optics prototype.

Cellular in vivo visualization of the three dimensional architecture of individual human foveal cone photoreceptors is demonstrated by combining ultrahigh resolution optical coherence tomography and a novel adaptive optics modality. Isotropic resolution in the order of 2–3μm, estimated from comparison with histology, is accomplished by employing an ultrabroad bandwidth Titanium:sapphire laser with 140nm bandwidth and previous correction of chromatic and monochromatic ocular aberrations. The latter, referred to as pancorrection, is enabled by the simultaneous use of a specially designed lens and an electromagnetically driven deformable mirror with unprecedented stroke for correcting chromatic and monochromatic aberrations, respectively. The increase in imaging resolution allows for resolving structural details of distal elements of individual foveal cones: inner segment zones - myoids and ellipsoids - are differentiated from outer segments protruding into pigment epithelial processes in the retina. The presented technique has the potential to unveil photoreceptor development and pathogenesis as well as improved therapy monitoring of numerous retinal diseases.

A novel deformable mirror using 52 independent magnetic actuators (MIRAO 52, Imagine Eyes) is presented and characterized for ophthalmic applications. The capabilities of the device to reproduce different surfaces, in particular Zernike polynomials up to the fifth order, are investigated in detail. The study of the influence functions of the deformable mirror reveals a significant linear response with the applied voltage. The correcting device also presents a high fidelity in the generation of surfaces. The ranges of production of Zernike polynomials fully cover those typically found in the human eye, even for the cases of highly aberrated eyes. Data from keratoconic eyes are confronted with the obtained ranges, showing that the deformable mirror is able to compensate for these strong aberrations. Ocular aberration correction with polychromatic light, using a near Gaussian spectrum of 130 nm full width at half maximum centered at 800 nm, in five subjects is accomplished by simultaneously using the deformable mirror and an achromatizing lens, in order to compensate for the monochromatic and chromatic aberrations, respectively. Results from living eyes, including one exhibiting 4.66 D of myopia and a near pathologic cornea with notable high order aberrations, show a practically perfect aberration correction. Benefits and applications of simultaneous monochromatic and chromatic aberration correction are finally discussed in the context of retinal imaging and vision.