Retinal diseases are a major cause of blindness worldwide. Although widely studied, disease mechanisms are not completely understood, and diagnostic tests may not detect disease early enough for timely intervention. The goal of this research is to contribute to research for more sensitive diagnostic tests that might use the interaction of polarized light with retinal tissue to detect subtle changes in the microstructure. This dissertation describes the GDx-MM, a scanning laser polarimeter which measures a complete 16-element Mueller matrix image of the retina. This full polarization signature may provide new comparative information on the structure of healthy and diseased retinal tissue by highlighting depolarizing structures as well as structures with varying magnitudes and orientations of retardance and diattenuation.The three major components of this dissertation are: 1. Development of methods for polarimeter optimization and error analysis; 2. Design, optimization, assembly, calibration, and validation of the GDx-MM polarimeter; and 3. Analysis of data for several human subjects. Development involved modifications to a Laser Diagnostics GDx, a commercially available scanning laser ophthalmoscope with incomplete polarization capability. Modifications included installation of polarization components, development of a data acquisition system, and implementation of algorithms to convert raw data into polarization parameter images. Optimization involved visualization of polarimeter state trajectories on the Poincaré sphere and a condition number analysis of the instrument matrix. Retinal images are collected non-invasively at 20 ?m resolution over a 15° visual field in four seconds. Validation of the polarimeter demonstrates a polarimetric measurement accuracy of approximately ± 5%.Retinal polarization data was collected on normal human subjects at the University of Arizona and at Indiana University School of Optometry. Calculated polarization parameter images reveal properties of the tissue microstructure. For example, retardance images indicate nerve fiber layer thickness and orientation, and depolarization images (uniform for these normal subjects), are predicted to indicate regions of disease-related tissue disruption. This research demonstrates a method for obtaining a full polarization signature of the retina in one measurement using a polarimetrically optimized instrument, and provides a step toward the use of complete retinal imaging polarimetry in the diagnosis and monitoring of retinal disease.

京都大学 / 新制・課程博士 / 博士(医学) / 甲第24087号 / 医博第4863号 / 新制||医||1059(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 近藤 尚己, 教授 山本 洋介, 教授 辻川 明孝 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

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