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NATO Science for Peace Project 974292
High Resolution Fundus Imager

Dr. Andrey Larichev, IPLIT and Moscow State University, Shartura, Russia Dr. Leonard John Otten, Kestrel Corporation, Albuquerque, USA

Figure 1. Medical technical staff reviewing human subject imagery collected after installation of one of the units in the United States for evaluation. Installation of this device in the United States made possible the importing of these instruments for medical research, a critical step in obtaining permission to use the instruments in a clinical environment. The picture shows three NATO country participants and three of the Partner country participants.

News 07/10/2003 2003 NATO Science Partnership Prize

The overall objectives of the high resolution fundus imager grant was to demonstrate that a combination of advanced optical correction technologies and an optimised image processing technique could be used to increase the resolution in a camera used to examine the human retina, that the information would improve the level of ophthalmologic healthcare, and that the resulting advances would initiate continuing research and product development for commercial purposes. These objectives were all successfully accomplished.

In order to meet these objectives a number of key technical and business advances needed to be accomplished. Technically, before the imager could be designed the theory of retinal image formation was modified to account for a previously ignored condition found in the human eye. The appropriate theory was developed and has been published. To our knowledge this was the first complete modelling of this phenomena, called the anisoplanatic effect, for the human eye. Since its completion, the theoretical model has had uses in advancing the development of a number of related ophthalmic instruments.

Under the SfP Grant, the theory was used to develop a specialized sensor to measure the aberrations within the eye and to then correct these by applying a correction to an imaging sensor in a very short period of time (1/30th of a second). When coupled to a standard fundus camera, such as found in virtually all ophthalmic clinics, this specialized sensor provides very high resolution images of the retina, Figure 1. The quality of these images showed for the first time in a living human eye features that had previously only been observed in dissected organs, Figure 2. The implications of this are only now being understood but, as an example of the eventual application, during some of our laboratory examinations lesions were located on a subject that had not been observed during normal ophthalmic examinations, thus allowing the individual to receive treatment that resulted in the vision in that eye being saved.

Figure 2. High resolution image of the human retina collected by the instrument developed under the NATO SfP Grant. These data show the nerve fiber ending pattern on the retina. Images of this type have never before been seen in vivo.

The impact of this research on the Partner country has produced both immediate and longer term results. Individual participants have published over 10 technical articles on the work and, because of this, are now recognized as a leading international research team in the field of ophthalmic imaging. A US $950,000 grant from the National Eye Institute was awarded in 2002 to continue the research and to construct the first clinical prototypes of the device originally developed under SfP sponsorship.

Development of this second generation device is now being accomplished jointly by the Partner and NATO country participants, taking advantage of the knowledge and capability acquired during the SfP program. Contracts that account for over 17% of the primary participating Partner country institute’s annual budget have been placed for modelling, design, and fabrication of components for the second generation device. Perhaps more importantly, the SfP research has resulted in orders for equipment components developed in conjunction with the grant being received by the Partner country participants from within Russia, European, and United States sources.

To date, these include the innovative light sources that are used to safely illuminate the eye now being part of four clinical instrument development programmes in the United States; versions of the device that measures the aberrations in the eye being used in research programs within Russia and the United Sates; adaptive optics elements being fabricated and distributed for use in the United Sates, Germany, Switzerland, and England; and the modified ophthalmic instrument finding use in research and limited production efforts in the United States and England, Figure 3.

As a side note, the use of these ophthalmic instruments represent the first time such a device has ever been used in the West which is a direct result of the SfP Grant sponsoring the testing of the high resolution instrument in the United States. This in turn allowed the participants to obtain United States approval to import the devices for medical research, a major hurdle that must be overcome in medical instrumentation.

Figure 3. Adaptation of components developed under the SfP Grant are finding their way into related research such as this hyperspectral retinal imager which takes advantage of the light sources, the box on the left side of the picture, and the modified ophthalmic imager, the device in the center of the picture, both originally designed and fabricated under the SfP Grant sponsorship.

Taken in total, the direct follow on support, and its related activities, has created a new hardware development capability within the Partner country institutes that participated in the Grant. An unexpected side benefit from using Partner country hardware developed under the Grant has been exposure of the equipment manufactures to United States customers. Overall, US $2,200,000 worth of commercial and research work has been generated within the first year after completing the Grant with expectations of sustaining this at the US $750,000 per year level over the next four years, Figure 4.

A final benefit to the Partner country was the awarding of several US patents on the device developed during the research and a closely related set of patents based on using a number of the components developed under SfP Grant sponsorship. These patents not only protect the intellectual property but put in place a method where the Partner country institutes can participate in a royalty stream as the technology emerges into the commercial market.

Figure 4. Projected gross revenues directly related to the research originally sponsored under the SfP 974292 Grant. Funds in 2001 and part of the 2002 revenues are the NATO SfP Grant. All other revenues are from non NATO sources as a direct result of the research sponsored in the SfP Programme. The decrease in funds in the 05 and 06 years is related to the clinical testing that is required to obtain government approval of new medical instruments.

When taken in total, SfP Grant 974292 met its technical, business, and political objectives. A new ophthalmic instrument has been introduced into the medical research community. More importantly, a new line of development and manufacturing has been started in the Partner country with business and technical research links that would not have been possible without the SfP Grant. And, lastly, strong technical and business ties have been established between researchers and manufactures in the United Sates and Russia that would not have existed without the NATO SfP sponsorship.

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