Pacientes com compressão quiasmática apresentam perda das fibras nervosas da retina nasal que decussam no quiasma óptico. Por conseguinte, ocorre perda das fibras nervosas, predominantemente, no setor nasal e temporal do disco óptico, que se manifesta por atrofia em banda do nervo óptico ao exame oftalmoscópico e hemianopsia temporal ao exame de campo visual. Trabalhos anteriores mostraram que o tomógrafo de coerência óptica é capaz de diferenciar pacientes com atrofia em banda do nervo óptico associada à hemianopsia temporal completa de indivíduos normais através da análise da camada de fibras nervosas peripapilar. Estudos em glaucoma têm sugerido que a avaliação da espessura macular poderia ser útil na quantificação da perda neural como um método alternativo ou complementar ao estudo da camada de fibras nervosas da retina. No presente estudo, a espessura macular e da camada de fibras nervosas foram avaliadas pelo tomógrafo de coerência óptica em pacientes com atrofia em banda do nervo óptico e graus variados de hemianopsia temporal. O desempenho dos parâmetros maculares para detecção da atrofia em banda do nervo óptico foi avaliado pela área sob a curva ROC (AROC) e sensibilidades para especificidades fixas e os resultados foram comparados aos parâmetros da camada de fibras nervosas peripapilar. Para identificar os parâmetros do Stratus OCT que apresentaram melhor desempenho para diferenciar pacientes com AB do nervo óptico de indivíduos normais, modelos de regressão logística foram utilizados. A correlação estrutura-função foi realizada entre o grau do defeito temporal e os valores de espessura macular e da camada de fibras peripapilar através do coeficiente de correlação de Spearman. A categorização diagnóstica dos parâmetros da camada de fibras nervosas através do banco de dados normativos foi avaliada pelos valores de sensibilidade e especificidade calculados pelo teste exato de Fisher. Quarenta e quatro olhos com atrofia em banda e 47 olhos normais foram avaliados no estudo. Entre os parâmetros maculares, os parâmetros da retina nasal apresentaram melhor desempenho para detectar atrofia em banda do nervo óptico comparados aos parâmetros da retina temporal. Não houve diferença significante (p=0,32) entre as áreas sob a curva ROC do melhor parâmetro macular (AROC=0,97) e do melhor parâmetro da camada de fibras nervosas retiniana (AROC=0,99). Na avaliação da correlação estrutura-função, os parâmetros da retina nasal apresentaram maior correlação com o defeito campimétrico comparados aos parâmetros da camada de fibras nervosas da retinal. Entre os parâmetros maculares, a espessura nasal média apresentou a maior correlação (rs=0,618). Entre os parâmetros da camada de fibras nervosas da retina, a espessura média apresentou a maior correlação (rs=0,479). Os parâmetros espessura média, espessura nasal e espessura temporal da camada de fibras nervosas da retina apresentaram melhor desempenho diagnóstico baseado na categorização diagnóstica do banco de dados normativos. Os resultados obtidos no estudo mostraram que os parâmetros maculares discriminam olhos com atrofia em banda do nervo óptico em pacientes com graus variados de defeito temporal. Além disso, os parâmetros da retina nasal podem colaborar com o exame perimétrico e os parâmetros da camada de fibras nervosas para o seguimento dos pacientes com compressão quiasmática. / Patients with chiasmal compression present damage of crossed fibers of nasal retina. Therefore, retinal nerve fiber layer loss occurs predominantly on the nasal and temporal sides of the optic disc, a pattern that can be identified on ophthalmoscopy as band atrophy of the optic nerve and on visual field as temporal hemianopia. Previous studies have been demonstrated that optical coherence tomography is able to detect retinal nerve fiber layer loss in patients with lesions of the optic chiasm and complete temporal hemianopia. Studies in glaucoma have been suggested that macular thickness measurements could be useful in quantification of optical nerve axonal loss as alternative or complement method to evaluate the retinal nerve fiber layer. The purpose of the present study was to compare macular thickness and retinal nerve fiber thickness measurements in patients with band atrophy of the optic nerve and different severities of visual field defect using optical coherence tomography. Area under the receiver operating characteristic curve (AROC) and sensitivities at fixed specificities were performed for evaluation of diagnostic accuracy of macular and retinal nerve fiber layer parameters. To identify the best optical coherence tomography measurements to differentiate band atrophy of the optic nerve patients from normal individuals, logistic regression models were performed. Association between optical coherence tomography parameters and temporal field defect were examined by Spearman coefficient of correlation. Fisher\'s exact test was performed to evaluate diagnostic ability of retinal nerve fiber parameters by optical coherence tomography in eyes with band atrophy using comparison with its internal normative database. A total of 44 eyes with band atrophy of the optic nerve and 47 normal eyes were studied. Among macular parameters, nasal retina measurements showed diagnostic accuracy better than temporal retina measurements. No statistically significant difference (p=0.32) was found between areas under ROC curve for the best macular parameter (AROC=0.97) and the best retinal nerve fiber layer parameter (AROC=0.99). Nasal retina parameters correlations were higher than retinal nerve fiber parameters. The highest correlation was observed for the mean nasal thickness (rs=0.618) for macular parameters. In retinal nerve fiber parameters, the highest correlation was observed for the average thickness (rs=0.479). In evaluation of diagnostic ability of normative database, the average thickness parameter demonstrated the highest sensitivity for detection of abnormalities in eyes with band atrophy, followed by the parameters related to the nasal and temporal quadrants. These results suggest that macular thickness measurements discriminate eyes with band atrophy of the optic nerve with different severities of temporal field defect. Results also suggest that nasal retina thickness measurements could potentially be used to evaluate retinal ganglion cell loss in patients with chiasmal compression.

Les travaux développés dans ce manuscrit de thèse concernent la proposition et la mise au point d’une nouvelle architecture optique basée sur la modulation de cohérence (MC) d’une source à spectre large dédiée aux calculs arithmétiques et au traitement des signaux. La modulation de cohérence de lumière est une technique particulière de codage optique qui autorise, entre autres, le multiplexage des signaux à travers une seule porteuse. Les signaux à traiter sont codés en MC par le biais de paires modulateur de lumière/lame de phase placées en série et éclairées par un seul faisceau de lumière polarisée. Cette technique est basée sur l’introduction d’un retard optique supérieur à la longueur de cohérence de la source utilisée. La validation expérimentale de l’approche proposée pour la réalisation d’opérations arithmétiques, telles que la somme et la soustraction, a été effectuée par le biais de signaux temporels. Différentes formes et fréquences des signaux ont été testées et ont parfaitement validé l’approche. L’impact du cross-talk des signaux et de la divergence du faisceau gaussien sur la qualité des opérations effectuées a été étudié. Ces effets se traduisent par un bruit de modulation d’intensité affectant le résultat des opérations effectuées. Dans ce travail, nous avons proposé des solutions permettant de minimiser son impact. L’originalité de la technique proposée est qu’elle permet la réalisation d’opérations multiples entre plusieurs signaux. Des tests ont été réalisés sur des images à deux et plusieurs niveaux de gris. Les résultats obtenus ont été évalués par les figures de mérite incluant le rapport signal sur bruit (SNR, signal to noise ratio), le rapport signal/bruit crête à crête (PSNR, peak signal to noise ratio) et l’erreur quadratique moyenne (MSE, mean squared error). Enfin, nous avons appliqué la technique à la cryptographie par contenu. Nous avons démontré la performance et la robustesse de la technique. Comme perspectives de ce travail, nous envisageons exploiter d’avantage la technique dans le domaine de la cryptographie (ie: utilisation d’une phase aléatoire pour le codage des images). De plus, une extension de l’étude à la compression des images sera utile. Une autre perspective de ce travail de recherche est l’étude de l’impact de l’incohérence spatiale sur le codage et le décodage des signaux / In this thesis, we study and developed the use of coherence multiplexing (also called path-difference, by analogy with WDM optical communications) to achieve simultaneous coding and decoding of analogue signals. The coherence modulation of light consists in encoding a signal on a light beam as an optical path-difference larger than its coherence length. This opens the way to the use of broadband sources in systems that thought to be restricted to quasi-monochromatic light. The different signals to be processed are encoded by using an Electro-optic Modulator and a birefringent plate placed between two polarizers. First, we have shown how the coherence multiplexing process can be exploited to achieve parallel real-time all optical signal addition and subtraction. Then, we have studied the impact of the crosstalk, due to the imperfection of the opto-geometrical parameters of the elements in the architecture, in the quality of the obtained results. The second part of the work consists of the validation of the technique to image signals. Thus, we have tested both image with binary and several gray levels. Also, we have confirmed that the method can be used for simple and multiplex encoding module. After that, we have evaluated the performance of the processor as a function of the continuous optical path-difference ratio in terms of Signal to Noise Ratio (SNR), Mean Square Error (MSE) and Peak to peak Signal to Noise Ratio (PSNR). Finally, we have tested the coherence multiplexing method to the encryption method based on merging together multiple-images. Therefore, we have evaluated the performance and the robustness of the method

INTRODUÇÃO: O tratamento padrão estabelecido pelo Early Treatment Diabetic Retinopathy Study (ETDRS) para retinopatia diabética proliferativa (RDP), com ou sem edema macular clinicamente significativo (EMCS), é a panfotocoagulação com laser. Essa forma de tratamento reduz o risco de perda visual, mas não proporciona ganho de visão. O objetivo deste estudo é avaliar os efeitos do acetonido de triancinolona associado à panfotocoagulação na RDP. MÉTODOS: Realizou-se um ensaio clínico randomizado, prospectivo e aberto com portadores de RDP bilateral e simétrica, submetidos à panfotocoagulação com laser em ambos os olhos. Portadores de EMCS foram tratados com fotocoagulação focal na região macular no primeiro episódio da panfotocoagulação. A injeção intravítrea de acetonido de triancinolona (4 mg/0,1 ml) foi administrada aleatoriamente em um dos olhos (grupo estudo), após último episódio da laserterapia, e o contralateral foi adotado para comparação (grupo controle), sendo seguidos por 6 meses. Os parâmetros adotados para avaliar os efeitos terapêuticos foram: acuidade visual com melhor correção óptica (tabela do ETDRS), medidas de espessura central e de volume macular por meio da tomografia de coerência óptica e taxa de sangramento (hemorragia pré-retiniana ou vítrea). As potenciais complicações da droga foram avaliadas durante o seguimento (pressão intra-ocular, catarata, endoftalmite e pseudo-endoftalmite). RESULTADOS: Foram incluídos 28 (vinte e oito) indivíduos com diabetes melito tipo 2. Quanto ao EMCS, 22 olhos apresentaram no grupo estudo e 23, no grupo controle (p= 0,317). A média de idade foi de 61,36 ± 5,77 anos, com predominância do sexo ferminino (57,1%). A maioria era portadora de hipertensão arterial sistêmica (82,1%) e usuária de insulina (75,0%). Não houve diferença significante nas médias de número de disparos da panfotocoagulação e da fotocoagulação na região macular entre os grupos. Quanto à acuidade visual, o grupo estudo apresentou pior acuidade antes do tratamento em relação ao grupo controle (p= 0,040), não havendo diferença significativa na primeira semana do tratamento. Durante o seguimento, o grupo estudo evoluiu com melhora na acuidade visual no primeiro (p< 0,001), no terceiro (p< 0,001) e no sexto meses (p< 0,001) em relação ao controle. Em relação às medidas de espessura central e de volume macular, os grupos não apresentaram diferença significativa antes do tratamento, no entanto, o grupo estudo apresentou medidas significativamente menores na primeira semana, no primeiro, no terceiro e no sexto meses em relação ao controle. Quanto à taxa de sangramento, 9 olhos (32,1%) do grupo controle evoluíram com sangramento e nenhum do grupo estudo (p< 0,001). Os grupos apresentaram diferença na pressão intra-ocular apenas na primeira semana do tratamento, quando as medidas do grupo estudo foram maiores que as do controle (p< 0,05). Nenhum dos olhos apresentou catarata com indicação cirúrgica, endoftalmite ou pseudo-endoftalmite. CONCLUSÃO: Os resultados deste estudo sugerem que a injeção intravítrea de triancinolona é um procedimento seguro e pode melhorar o prognóstico funcional e estrutural da mácula em olhos com RDP submetidos a panfotocoagulação com laser. / INTRODUCTION: The gold standard treatment for proliferative diabetic retinopahty (PDR) with and without clinically significant macular edema (CSME), as stablished by the Early Treatment Diabetic Retinopathy Study (ETDRS), is panretinal photocoagulation (PRP). This treatment lowers the rate of severe vision loss, but does not increase vision. The aim of this study is to evaluate the efficacy and safety of triamcinolone acetonide associated to PRP for the management of PDR. METHOD: This is a prospective, randomized clinical trial for patients with bilateral and symmetrical PDR who had undergone PRP in both eyes. Patients who had CSME were treated with macular focal photocoagulation on the first episode of the PRP. Intravitreal injection of triamcinolone acetonide (4 mg/0.1 ml) was given to the study eye after the last episode of PRP and the fellow eye was used as control. Follow up was 6 months long. Best-corrected visual acuity (BCVA) using ETDRS charts, central macular thickness and macular volume as measured by the optical coherence tomography software, and the amount of bleeding (both preretinal and vitreous) were the parameters chosen to analyse outcome. Side effects of triamcinolone acetonide such as intraocular pressure, cataracts and severe inflammation, were also followed during the study. RESULTS: Twenty eight diabetes type 2 patients were included. Twenty two study eyes and 23 fellow eyes (controls) presented with CSME (p= 0.317). Mean age was 61.36 ± 5.77 years, with 57.1% females. Many patients had hypertension (82.1%) and used insulin (75.0%). There was no significant difference on the number of spots used for PRP or macular photocoagulation in between the groups. The study eyes had lower BCVA on baseline than the control eyes (p= 0.040). One week after the treatment, there was no difference on BCVA between the study and control eyes. During the follow up, the study group increased their BCVA on the first (p< 0.001), third (p< 0.001) and sixth month (p< 0.001) compared to control. Even thought there was no significant difference on central macular thickness and macular volume between groups on baseline, the study eyes had significant lower measurements on the first week and first, third and sixth months in comparison to controls. Nine control eyes (32.1%) had hemorrhages and none study eyes (p< 0.001). Injected eyes had higher intraocular pressure than controls on the first week of treatment (p< 0.05). None of the eyes developed cataracts that needed surgery, endophthalmits or severe inflammation. CONCLUSION: This study suggests intravitreal injection of triamcinolone is a safe procedure that increases funcional and anatomical prognosis of the macula in PDR eyes that underwent PRP.

Cette thèse traite de l’étude et du développement d’un système d’optique adaptative pour la tomographie par cohérence optique plein champ (AO-FFOCT en anglais) appliquée à l’imagerie haute résolution de la rétine. L’analyse de l’effet des aberrations géométriques sur les performances en FFOCT a montré que pour une illumination spatialement incohérente, la résolution transverse est insensible aux aberrations et ne fait que diminuer le niveau du signal. Comme ce sont des aberrations de bas ordres comme la myopie et l’astigmatisme qui prédominent pour l’œil humain, une méthode d’optique adaptative avec une configuration sans conjugaison qui utilise une correction de front d’onde en transmission est suggérée, puis appliquée à la correction de ces ordres afin de simplifier le système d’AO-FFOCT. Des corrections de front d’onde sont effectuées sans analyseur de surface d’onde, en utilisant le niveau du signal de FFOCT comme métrique. Des expériences avec des échantillons diffusants et un œil artificiel sont menées pour démontrer la faisabilité d’un système d’AO-FFOCT conçu pour la correction d’aberration. Afin de résoudre les problèmes posés par les mouvements oculaires et de compenser en temps réel la différence de chemin optique entre les deux bras de l’interféromètre, l’instrument de FFOCT est couplé à un système d’OCT spectral. Avec cette combinaison de systèmes, l’imagerie FFOCT in vivo cellulaire de la rétine à haute résolution a été réalisée pour la première fois sur l’œil humain. / This thesis follows the study and development of an adaptive optics full-field optical coherence tomography (AO-FFOCT) system, aiming for high resolution en face human retinal imaging. During the quantification of the effects of geometrical aberrations on the FFOCT system performance, it is shown that, with spatially incoherent illumination, the lateral resolution of FFOCT is insensitive to aberrations, which only cause the FFOCT signal reduction. Since low order aberrations like myopia and astigmatism dominate in human eye, a non-conjugate AO configuration by using transmissive wavefront corrector is suggested and applied for low order aberrations correction to simplify the AO-FFOCT system. Wavefront corrections are done with a wavefront sensorless method by using FFOCT signal level as the metric. Experiments with scattering samples and artificial eye model are conducted to demonstrate the feasibility of the customized AO-FFOCT system for aberration correction. In order to resolve the eye motion effects and employ real-time matching of the optical path lengths of the two interferometric arms in FFOCT, a system combination of traditional spectral-domain OCT (SDOCT) with FFOCT is adopted. With this combined system, high resolution FFOCT cellular retinal imaging is achieved in human eye in vivo for the first time.

La tomographie de cohérence optique plein champ est une technique de microscopie permettant d’imager un plan d’intérêt en profondeur dans un milieu diffusant. Cette technique a été utilisée pour l’examen de pièces opératoires dans un but de diagnostic en cancérologie. L’utilisation de cette technique permettrait en effet de fournir un outil de diagnostic peropératoire rapide et fiable, évitant ainsi de nombreuses procédures de réopération. Ces réopérations peuvent survenir lorsque – lors du diagnostic final par analyse de coupes histologiques – le pathologiste décèle la présence de tissus cancéreux restant, non retirés au cours de l’opération.L’OCT plein champ a montré de bons résultats pour cette application. Néanmoins, cette technique ne fournit qu’un contraste morphologique des tissus, ne permettant pas d’utiliser des critères de qualification des pièces opératoires basées – par exemple – sur la morphologie ou la densité cellulaire.Nous avons développé une nouvelle modalité d’imagerie basée sur l’OCT plein champ permettant de révéler un contraste métabolique dans le tissu à une échelle subcellulaire. Ce contraste permet de révéler les cellules précédemment non distinguées en OCT plein champ. Nous avons également utilisé la mesure quantitative de cette modalité pour réaliser des outils d’aide au diagnostic utilisant des approches d’apprentissage par ordinateur. / Full filed optical coherence tomography is a microscopy imaging technique allowing to image a specific slice in a scattering medium, in depth. This technique has been used for the diagnosis of biopsy in cancerology. This technique could be an efficient and fast way to diagnose excised tissues during surgery. This would avoid numerous reoperations procedures. These reoperations are necessary when a pathologist suspects cancerous tissue to still be present in the patient, based on histological slide examination.FFOCT has shown promising results for that purpose. Nevertheless, this technique only gives a morphological contrast of tissues, which is not enough for applying some diagnostic criteria such as cell morphology or cell density.We developed a new imaging modality based on FFOCT allowing to reveal metabolic contrast in tissues at the subcellular scale. This contrast reveals cells previously indistinguishable with FFOCT. We also used this quantitative metric to propose tools to facilitate diagnosis, using machine learning approaches.

Cette thèse porte sur l’étude de l’anatomie de la cornée après 3 techniques de greffe soient, la greffe totale traditionnelle (GTT) et des techniques de greffe lamellaire postérieur (GLP) telles que la greffe lamellaire endothéliale profonde (DLEK) et la greffe endothélium/membrane de Descemet (EDMG) pour le traitement des maladies de l’endothélium, telles que la dystrophie de Fuchs et de la kératopathie de l’aphaque et du pseudophaque. Dans ce contexte, cette thèse contribue également à démontrer l’utilité de la tomographie de cohérence optique (OCT) pour l’étude de l’anatomie des plaies chirurgicales la cornée post transplantation. Au cours de ce travail nous avons étudié l'anatomie de la DLEK, avant et 1, 6, 12 et 24 mois après la chirurgie. Nous avons utilisé le Stratus OCT (Version 3, Carl Zeiss, Meditec Inc.) pour documenter l’anatomie de la plaie. L'acquisition et la manipulation des images du Stratus OCT, instrument qui à été conçu originalement pour l’étude de la rétine et du nerf optique, ont été adaptées pour l'analyse du segment antérieur de l’oeil. Des images cornéennes centrales verticales et horizontales, ainsi que 4 mesures radiaires perpendiculaires à la plaie à 12, 3, 6 et 9 heures ont été obtenues. Les paramètres suivants ont été étudiés: (1) Les espaces (gap) entre les rebords du disque donneur et ceux du receveur, (2) les dénivelés de surface postérieure (step) entre le les rebords du disque donneur et ceux du receveur, (3) la compression tissulaire, (4) le décollement du greffon, 6) les élévations de la surface antérieure de la cornée et 7) la pachymétrie centrale de la cornée. Les mesures d’épaisseur totale de la cornée ont été comparées et corrélées avec celles obtenues avec un pachymètre à ultra-sons. Des mesures d’acuité visuelle, de réfraction manifeste et de topographie ont aussi été acquises afin d’évaluer les résultats fonctionnels. Enfin, nous avons comparé les données de DLEK à celles obtenues de l’EDMG et de la GTT, afin de caractériser les plaies et de cerner les avantages et inconvénients relatifs à chaque technique chirurgicale. Nos résultats anatomiques ont montré des différences importantes entre les trois techniques chirurgicales. Certains des paramètres étudiés, comme le sep et le gap, ont été plus prononcés dans la GTT que dans la DLEK et complètement absents dans l’EDMG. D’autres, comme la compression tissulaire et le décollement du greffon n’ont été observés que dans la DLEK. Ceci laisse entrevoir que la distorsion de la plaie varie proportionnellement à la profondeur de la découpe stromale du receveur, à partir de la face postérieure de la cornée. Moins la découpe s’avance vers la face antérieure (comme dans l’EDMG), moins elle affecte l’intégrité anatomique de la cornée, le pire cas étant la découpe totale comme dans la GTT. Cependant, tous les paramètres d’apposition postérieure sous-optimale et d’élévation de la surface antérieure (ce dernier observé uniquement dans la GTT) finissent par diminuer avec le temps, évoluant à des degrés variables vers un profil topographique plus semblable à celui d’une cornée normale. Ce processus paraît plus long et plus incomplet dans les cas de GTT à cause du type de plaie, de la présence de sutures et de la durée de la cicatrisation. Les valeurs moyennes d’épaisseur centrale se sont normalisées après la chirurgie. De plus, ces valeurs moyennes obtenues par OCT étaient fortement corrélées à celles obtenues par la pachymétrie à ultra-sons et nous n’avons remarqué aucune différence significative entre les valeurs moyennes des deux techniques de mesure. L’OCT s’est avéré un outil utile pour l’étude de l’anatomie microscopique des plaies chirurgicales. Les résultats d’acuité visuelle, de réfraction et de topographie des techniques de GLP ont montré qu’il existe une récupération visuelle rapide et sans changements significatifs de l’astigmatisme, contrairement à la GTT avec et sans suture. La GLP a permis une meilleure conservation de la morphologie de la cornée, et par conséquence des meilleurs résultats fonctionnels que la greffe de pleine épaisseur. Ceci nous permet d’avancer que la GLP pourrait être la technique chirurgicale à adopter comme traitement pour les maladies de l’endothélium cornéen. / This thesis aims to study the anatomy of the corneal wound following 3 techniques of corneal graft: traditional penetrating keratoplasy (PK) and two techniques of posterior lamellar keratoplasy (PLK) which are deep lamellar endothelial keratoplasy (DLEK) and Endothelial-Descemet’s Membrane Graft (EDMG) for the treatment of the endothelial corneal diseases, such as Fuch’s dystrophy and aphakic and pseudopakic bullous keratopathy. In this context, this thesis also contributes to show the utility of the time domain optical coherence tomography (TD-OCT) for studying the anatomy of surgical wounds after corneal transplantation. In this work we studied the anatomy of DLEK, before and 1,6,12 and 24 months after surgery. We used the Stratus OCT. (Version 3, Carl Zeiss, Meditec Inc.) to document the anatomy of the wound. The acquisition and the handling of the images of the Stratus OCT, an instrument originally designed for the study of the retina and the optic nerve, were adapted to analyse the anterior segment of the eye. Vertical and horizontal central images of the cornea, in addition to 4 radial measurements perpendicular to the wound at 12, 3, 6 and 9 hours were obtained. The following parameters were studied: (1) the gap between the edges of the donor disc and those of the recipient, (2) posterior surface mismatch (step) between the edges of the disc donor and those of the recipient, (3) tissue compression, (4) graft detachment, 6) elevations of the anterior corneal surface and 7) the central pachymetry of the cornea. Measurements of the total thickness were compared and correlated with those obtained with an ultrasound pachymeter. Measurements of visual acuity, manifest refraction and topography were also acquired in order to evaluate the functional results. Lastly, we compared the data of DLEK with those obtained from the EDMG and the PK, in order to characterize the wounds and to highlight the advantages and disadvantages relative to each surgical technique.Our anatomical results showed important differences between the three surgical techniques. Some of the studied parameters, like the step and the gap, were more pronounced in PK than in DLEK and completely absent in the EDMG group. Others, like tissue compression and graft detachment were observed only in the DLEK group. This let us predict that the distortion of the wound varies proportionally with the depth of recipient posterior stromal dissection. The less dissection towards the anterior surface (as in EDMG), the less it affects the anatomical integrity of the cornea, the worst case being full thickness trephination as in PK. However, all the parameters of sub-optimal posterior surface apposition and anterior surface elevation (this last only observed in PK) ended up decreasing with time, evolving with variable degrees to a topographic profile more similar to that of a normal cornea. This process appears longer and more incomplete in the cases of PK because of the type of wound, the presence of sutures and the longer healing period. The mean values of central thickness were normal after surgery. Moreover, these mean values obtained by OCT. were strongly correlated with those obtained by ultrasound pachymetry and we did not notice any significant difference between the mean values of the two measurement techniques. OCT proved to be a useful tool for the study of the microscopic anatomy of the corneal surgical wounds. The results of vision, refraction and topography of the techniques of posterior lamellar grafts showed that there was a fast visual recovery and without significant changes in astigmatism, contrary to PK with and without sutures. Posterior lamellar grafts allowed a better conservation of the morphology of the cornea, and consequently better functional results than PK. This enabled us to conclude that posterior lamellar corneal grafts could be the surgical technique of choice for the treatment of corneal endothelial diseases.

CAPES; CNPq; Fundação Araucária / Esta tese de doutorado apresenta um sistema de monitoração heterogêneo para a caracterização do processo de secagem e cura de filmes poliméricos e resina odontológica. Essa caracterização é de suma importância para aperfeiçoar o processo de fabricação e a escolha das matérias-primas dos mesmos, uma vez que parâmetros como a variação da espessura e a deformação mecânica no material estão diretamente ligadas à sua qualidade e durabilidade. O sensor heterogêneo emprega técnicas complementares para a quantificação de múltiplos parâmetros físicos, visando a compreensão das etapas que acontecem durante o processo de secagem e cura. Os ensaios se deram em períodos de 24 horas analisando amostras de tinta e verniz acrílicos e resina dentária. Foram quantificadas deformações longitudinais, variação de massa, espessura e índice de refração médio. Nas amostras de tinta e verniz acrílicos, obteve-se redução entre 60% e 70% no valor inicial da espessura, enquanto o comportamento do índice de refração do verniz foi associado às diferentes etapas do processo de secagem. As amostras de resina odontológica apresentaram redução da espessura menor que 5% em todos os ensaios realizados, percentual semelhante à variação do índice de refração. Todavia, as redes de Bragg identificaram um aumento de temperatura da resina odontológica de aproximadamente 20°C durante a fotoativação. A flexibilidade do sistema sensor heterogêneo demonstrado permite a análise do processo de secagem ou cura de uma ampla gama de filmes poliméricos e resinas, sem a necessidade de adaptações significativas no arranjo experimental. Com uma caracterização correta das etapas envolvidas na secagem ou cura, todo o processo que vai desde a formulação do produto à aplicação final pode ser otimizado, levando à melhoria da relação custo-benefício para cada aplicação pretendida. / This thesis presents a heterogeneous system to characterize the drying and curing process of polymer films and dental resin. This characterization is important to improve the manufacturing process and the choice of the raw materials, since parameters such as thickness variation and the mechanical deformation in the material are directly related to their quality and durability. The sensor employs heterogeneous complementary techniques for the quantification of multiple physical parameters, aimed to understand the steps that occur during drying and curing. The tests took place in periods of 24 hours analyzing samples of both acrylic paint and varnish, as well as dental resin. Longitudinal deformation, mass variation, thickness and mean refractive index were quantified. In samples of acrylic paint and varnish, a reduction between 60% and 70% in the initial value of the thickness was obtained, while the behavior of the refractive index of the varnish was associated with the different stages of the drying process. Samples of dental resin presented thickness decreasing less than 5% in all tests, percentage similar to the variation of the refractive index. However, fiber Bragg gratings have identified a temperature increase of the dental resin about 20 ° C during the polymerization. The flexibility of the heterogeneous sensor system demonstrated allows the analysis of drying or cure processes of a great variety of polymer films and resins, without the need for important changes in the experimental setup. With the correct characterization of the stages involved in the drying or cure, the whole process from the product formulation to the final application may result in an optimized and cost effective product for any intended application.

SWIFTS (Stationary Wave Integrated Fourier Transform Spectrometer) est une nouvelle technologie innovante de spectrométrie qui permet une réduction radicale de la taille des spectromètres à Transformée de Fourier, tout en conservant, et même en améliorant leurs performances. Grâce aux avancées de l'optique intégrée et des nanotechnologies, SWIFTS repose sur une méthode de détection optique originale, sans aucune partie mobile, où des nanoplots métalliques échantillonnent directement le champ évanescent d'une onde stationnaire dans un guide d'onde.Dans cette thèse, nous proposons de présenter le cheminement complet qui a mené, en partant du concept original, au développement puis à la mise en pratique de la technologie SWIFTS. Le document illustre notamment les caractérisations optiques, les choix technologiques et les optimisations entrepris pour la réalisation de spectromètres fonctionnels dans le domaine visible et proche-infrarouge. Des procédures de calibrages novatrices et complémentaires, basées sur du multiplexage fréquentiel et sur de l'interférométrie à faible cohérence temporelle, ont été développées pour déterminer avec précision les différentes irrégularités de fabrication et de comportement de l'appareil complètement intégré. Les spectromètres calibrés permettent à présent d'aborder des applications diverses en industrie et en recherche, de la caractérisation hautes performances de lasers, à l'interrogation de capteurs fibrés à réseaux de Bragg, aux techniques de spectrométries Raman et LIBS, et de tomographie optique OCT, jusqu'aux sciences de l'Univers (géophysique, astrophysique).SWIFTS est une innovation de rupture qui, de part sa miniaturisation obtenue sans compromis avec de hautes performances d'analyse spectrale, a la capacité de faire passer la spectrométrie du stade de la mesure complexe en laboratoire à celle d'un simple composant intégré pour des applications exigeantes. / SWIFTS (Stationary Wave Integrated Fourier Transform Spectrometer) is a new innovative technology of spectrometry that allows a drastic reduction of the size of Fourier transform spectrometers, while maintaining, and even improving their performance. With advances in integrated optics and nanotechnology, SWIFTS is based on an original method of optical detection, without any moving part, where metallic nanodots directly sample the evanescent field of a standing wave in a waveguide.In this thesis, we propose to present the complete process that led, starting from the original concept, to the development and the applications of the technology. The document illustrates the optical characterizations, the technological choices and the optimizations made for the realization of functional spectrometers in the visible and near-infrared range. Innovative and complementary procedures of calibrations, based on frequency multiplexing and low coherence interferometry, have been developed to accurately determine the various irregularities of the manufacturing and of the behavior of the integrated device. The calibrated spectrometers allow to address various applications in industry and research, such as high performance characterization of lasers, interrogation of fiber Bragg gratings sensors, Raman and LIBS spectrometry, optical coherence tomography OCT, and sciences of the Universe (geophysics, astrophysics).SWIFTS is a breakthrough innovation in spectrometry, without trade-off between miniaturization and high performance, that opens the way for product development based on the most demanding applications currently performed in research laboratories.

Abstract This thesis reports on studies of plasmonic nanoparticles and particularly gold nanostars as signal enhancers and contrast agents for biophotonic applications including visualisation, treatment of living cells and chemical sensing. In this thesis, the optical properties of nanoparticles of different size and morphology and their silica composites were compared. Because they are the most suitable plasmonic nanostructures, gold nanostars were utilised for optical imaging modalities such as confocal microscopy and Doppler optical coherence tomography. The ability of gold nanoparticles to enhance the signal in surface-enhanced vibrational spectroscopy, including Raman and Fourier transform infrared spectroscopy was additionally studied. Finally, various gold nanoparticles were applied for cell optoporation to increase the penetration ability of exogeneous substances. In summary, significant advantages of nanostars such as their low-toxicity, high scattering and contrast abilities, in addition to a broad, tunable, plasmon resonance wavelength range, as well as the capability to enhance the signal of analyte molecules in vibrational spectroscopy were demonstrated in this thesis. The results of this study on the effectiveness of nanostars have a broad scope of utility and open a wide perspective for their utilisation in nanobiophotonics and biomedicine. / Tiivistelmä Tämä opinnäytetyö kertoo tutkimuksista, joissa plasmoninanopartikkeleita ja erityisesti kultananotähtiä on käytetty signaalinvahvistimina biofotoniikan sovelluksissa, kuten visualisointi, elävien solujen käsittely ja kemiallinen tunnistus. Tässä työssä verrattiin eri kokoisten ja muotoisten nanopartikkeleiden ja niiden piioksidikomposiittien optisia ominaisuuksia. Sopivimpina plasmoninanorakenteina kultananotähtiä käytettiin optisiin kuvantamismenetelmiin, kuten konfokaalimikroskopiaan ja Doppler-optiseen koherenssitomografiaan. Lisäksi kuvattiin myös kultananopartikkelien kykyä parantaa pinta-aktivoidun värähtelevän spektroskopian signaalia, mukaan lukien Raman- ja Fourier-muunnos-infrapuna-spektroskopia. Lopuksi, eri kultananopartikkeleita käytettiin soluoptoporaatioon eksogeenisten aineiden läpäisevyyden lisäämiseksi. Yhteenvetona, työssä osoitettiin nanotähtien merkittävät edut, kuten matala-myrkyllisyys, suuret sironta- ja kontrastiominaisuudet, laaja plasmoniresonanssin aallonpituusalue ja sen viritettävyys, sekä kyky parantaa analyyttimolekyylien signaalia värähtelyspektroskopiassa. Niinpä tutkimustulokset nanotähtien tehokkuudesta ovat laajasti käyttökelpoisia ja ne avaavat laajan näkökulman niiden hyödyntämiseen nanobiofotoniikassa ja biolääketieteessä.

L'imagerie par tomographie en cohérence optique (OCT) est prometteuse comme support de la prise de décision au cours des procédures d'interventions coronariennes percutanées (PCI), pou évaluer les lésions athéromateuses, juger de la bonne implantation du stent, et dépister les lésions vasculaires dues au stent. L'OCT représente donc bien une aide potentielle pour le cardiologue interventionnel tout au long de la procédure de stenting, avec un impact certain sur la stratégie interventionnelle initialement programmée. De plus, l'OCT se révèle comme un nouvel outil pour prédire la dissection des bords de stent chez les patient avec ACS sans élévation du segment ST, rendant possible une stratification des patients quant à ce risque. Des essais cliniques randomisés sont maintenant nécessaires pour savoir si l'assistance par l'OCT pendant la procédure améliore le pronostic à long terme des patients après PCI / Optical Coherence Tomography (OCT) imaging is promising in decision making during Percutaneus Coronary Interventions {PCI) procedures, including evaluating controversial plaque lesions, assessing stent implantation, and surveying stent-related vascular injury. Thus, OCT has potential to guide interventional cardiologists throughout the stent implantation procedure, impacting on planned interventional strategy. In addition, OCT is the most novel image technology to predict stent edge dissection for patients with non-ST-segment elevation ACS, enabling risk stratification of patients who are at a higher risk of this complication. Large-scale randomized trials are now warranted to assess whether OCT results and guidance during de procedure improve long-term clinical outcomes of PCis.