This dissertation documents the development of a new illumination technique for use in the studies of retinal oximetry and fundus spectroscopy. Intravitreal illumination is a technique where the back of the eye is illuminated trans-sclerally using a scanning monochromator coupled into a fiber optic illuminator. Retinal oximetry is the processof measuring the oxygen saturation of blood contained in retinal vessels by quantitative measurement of the characteristic color shift seen as blood oxygen saturation changes from oxygenated blood (reddish) to deoxygenated blood (bluish). Retinal oximetry was first attempted in 1963 but due to a variety of problems with accuracy and difficulty of measurement, has not matured to the point of clinical acceptabilityor commercial viability.Accurate retinal oximetry relies in part on an adequate understanding of the spectral reflectance characteristics of the fundus. The use of intravitreal illumination allows new investigations into the spectral reflectance properties of the fundus. The results of much research in fundus reflectance and retinal oximetry is detailed in thisdocument, providing new insight into both of these related fields of study.Intravitreal illumination has been used to study retinal vessel oximetry and fundus reflectometry resulting in several important findings that are presented in this document. Studies on enucleated swine eyes have provided new insight into the bidirectional reflectance distribution function of the fundus. Research on live swine hasshown accurate measurement of retinal vessel oxygen saturation and provided the first in vivo spectral transmittance measurement of the sensory retina. A secondary discovery during this research suggests that vitrectomy alters the retinal vasculature,a finding that should spawn new research in its own right.

The ability to measure the oxygen saturation, oximetry, of retinal blood both non-invasively and in-vivo has been a goal of eye research for years. Retinal oximetry can in principle be achieved from the measurement of the reflectance spectrum of the ocular fundus. Oximetry calculations are however complicated by the scattering of red blood cells, the different pathways of light through blood and the ocular tissues that light interacts with before exiting the eye. The goal of this thesis was to investigate the influence of red blood cell scattering for different light paths relevant to retinal oximetry. Results of in-vitro whole blood experiments found calculated oxygen saturation differences between blood samples measured under different retinal light paths, and these differences did not depend on the absorbance path length. We also showed that the calculated oxygen saturation value determined by a multiple linear regression Beer-Lambert absorbance model depended on the wavelength range chosen for analysis. The wavelength dependency on the calculated oxygen saturation value is due in part to the correlation that exists between the oxyhaemoglobin and deoxyhaemoglobin extinction coefficient spectra and to errors in the assumptions built into the Beer-Lambert absorbance model. A wavelength region with low correlation between the oxyhaemoglobin and deoxyhaemoglobin extinction coefficients was found that is hypothesized to be a good range to calculate oxygen saturation using a multiple linear regression approach.

The ability to measure the oxygen saturation, oximetry, of retinal blood both non-invasively and in-vivo has been a goal of eye research for years. Retinal oximetry can in principle be achieved from the measurement of the reflectance spectrum of the ocular fundus. Oximetry calculations are however complicated by the scattering of red blood cells, the different pathways of light through blood and the ocular tissues that light interacts with before exiting the eye. The goal of this thesis was to investigate the influence of red blood cell scattering for different light paths relevant to retinal oximetry. Results of in-vitro whole blood experiments found calculated oxygen saturation differences between blood samples measured under different retinal light paths, and these differences did not depend on the absorbance path length. We also showed that the calculated oxygen saturation value determined by a multiple linear regression Beer-Lambert absorbance model depended on the wavelength range chosen for analysis. The wavelength dependency on the calculated oxygen saturation value is due in part to the correlation that exists between the oxyhaemoglobin and deoxyhaemoglobin extinction coefficient spectra and to errors in the assumptions built into the Beer-Lambert absorbance model. A wavelength region with low correlation between the oxyhaemoglobin and deoxyhaemoglobin extinction coefficients was found that is hypothesized to be a good range to calculate oxygen saturation using a multiple linear regression approach.

The ability to measure the oxygen saturation, oximetry, of retinal blood both non-invasively and in-vivo has been a goal of eye research for years. Retinal oximetry can in principle be achieved from the measurement of the reflectance spectrum of the ocular fundus. Oximetry calculations are however complicated by the scattering of red blood cells, the different pathways of light through blood and the ocular tissues that light interacts with before exiting the eye. The goal of this thesis was to investigate the influence of red blood cell scattering for different light paths relevant to retinal oximetry. Results of in-vitro whole blood experiments found calculated oxygen saturation differences between blood samples measured under different retinal light paths, and these differences did not depend on the absorbance path length. We also showed that the calculated oxygen saturation value determined by a multiple linear regression Beer-Lambert absorbance model depended on the wavelength range chosen for analysis. The wavelength dependency on the calculated oxygen saturation value is due in part to the correlation that exists between the oxyhaemoglobin and deoxyhaemoglobin extinction coefficient spectra and to errors in the assumptions built into the Beer-Lambert absorbance model. A wavelength region with low correlation between the oxyhaemoglobin and deoxyhaemoglobin extinction coefficients was found that is hypothesized to be a good range to calculate oxygen saturation using a multiple linear regression approach.

Recent advances in retinal imaging have made it possible to take measurements of retinal oxygen saturation noninvasively in humans. This allows studying the supply of oxygen in healthy and diseased retinae, thereby advancing our understanding of both the normal functioning of the retina and of retinal pathologies. However, retinal oximetry is still a research tool only and requires further improvement before being used in a clinical setting. Here, a single-wavelength flickering light was used to increase retinal blood flow in healthy subjects. This increase is revealed by both vasodilation and an increase in retinal oxygen saturation. A flickering light stimulus provides the means to assess the sensitivity of any retinal oximetry system, as such systems should be able to pick up this increase in retinal blood flow. In addition, the flickering light allows for com- parison to be made within rather than between subjects and can be used to examine the activation of the eye. This reduces the influence of potential confounding factors between subjects including differences in fundus pigmentation and illumination. The most commonly used method to measure retinal oxygenation is the optical density ra- tio (ODR) approach. The standard approach is to compute the average ODR for each vessel segment by combining the hundreds of individual ODR readings and then to use the mean of these segment averages as a measure of oxygen saturation. Alternatively, it has been suggested that the peak location of Gaussian functions fitted to histograms of individual ODR readings can be used as an measure of retinal oxygenation. In response to a 10Hz flickering light, the venular diameter increased by 3.44% (SEM: ±0.53%) (n=16, p<0.05) and the arteriolar diameter by 1.87% (±0.72 %) (p<0.05). The optical density ratio, measured with the Gaussian fit, decreased in the venules from 0.713 (±0.015) to 0.694 (±0.015) (p<0.05). No changes in arteriolar optical density ratios were measured. The post-flicker measurement was computed as the average of up to four post-flicker datasets obtained at 10s, 20s, 30s and 40s after onset of flickering. These results suggest that the flickering light increased retinal blood flow. The mean absolute percentage error was lower in venules for the Gaussian fit method than for the gold standard method for datasets taken at 30s and 40s after onset of flickering. Thus, the Gaussian fit method was more robust. All measurements were taken with a custom-made retinal oximeter. The pixel intensity of the blood vessel and the intensity on either side of the vessel had to be extracted to compute the individual optical density ratios. This required the automatic extraction of the retinal vasculature. Two such algorithms were developed and applied to two databases of retinal fundus images: the DRIVE and the novel DR HAGIS database. One algorithm was purely based on the pixel intensities, while the other made use of oriented Gabor filters. These two algorithms segmented the images to a similar accuracy (DRIVE: 94.56% and 94.54%, DR HAGIS: 95.83% and 95.71% for the intensity and Gabor filter based algorithm, respectively) and performed as well as a human expert (DRIVE: 94.73%). These algorithms were of sufficient quality to extract individual segments for the oximetry study and to align fundus images.

The ability to measure the oxygen saturation, oximetry, of retinal blood both non-invasively and in-vivo has been a goal of eye research for years. Retinal oximetry can in principle be achieved from the measurement of the reflectance spectrum of the ocular fundus. Oximetry calculations are however complicated by the scattering of red blood cells, the different pathways of light through blood and the ocular tissues that light interacts with before exiting the eye. The goal of this thesis was to investigate the influence of red blood cell scattering for different light paths relevant to retinal oximetry. Results of in-vitro whole blood experiments found calculated oxygen saturation differences between blood samples measured under different retinal light paths, and these differences did not depend on the absorbance path length. We also showed that the calculated oxygen saturation value determined by a multiple linear regression Beer-Lambert absorbance model depended on the wavelength range chosen for analysis. The wavelength dependency on the calculated oxygen saturation value is due in part to the correlation that exists between the oxyhaemoglobin and deoxyhaemoglobin extinction coefficient spectra and to errors in the assumptions built into the Beer-Lambert absorbance model. A wavelength region with low correlation between the oxyhaemoglobin and deoxyhaemoglobin extinction coefficients was found that is hypothesized to be a good range to calculate oxygen saturation using a multiple linear regression approach.