Williams & Fujimoto, Huang, Puliafito, Schuman, Swanson

The 2012 António Champalimaud Vision Award recognised the development of two novel approaches to visualising the living human retina in health and disease. These techniques have provided remarkable opportunities for studying fundamental questions of retinal structure, for unravelling the mechanisms of human ocular disease, and for better monitoring clinical outcomes.

Optical coherence tomography, or OCT, was developed by merging the low coherence interferometry methodologies of James Fujimoto, David Huang and Eric Swanson with insights for their clinical ocular application by Carmen Puliafito and Joel Schuman. By revealing the human retina at remarkable resolution, OCT has already led to improved diagnostics and clinical management.

Adaptive optics technologies, or AO, were originally developed by astronomers to see through atmospheric aberrations. David Williams’ application of AO to the eye brings retinal cells into sharp focus by correcting for natural optical imperfections of the cornea and lens, making it possible to view and count individual cone photoreceptors in the living human retina. This has dramatically advanced the ability to probe the dimensions of the cone spacing matrix, a limiting factor in visual resolution. Imaging individual cones non-invasively over weeks, months and years is proving novel insights about retinal changes caused by aging and disease.

These two techniques for visualising the living retina have already provided fundamentally important details about the structure of the eyes of living patients, in tissue cross-section at macro-scale by OCT, and cell organisation en fas at micro-scale by AO. Previously unknown details of the malleability of the human retina have emerged through application of OCT and AO in health and disease. These methods are dramatically changing ophthalmic practice and our understanding and management of ocular aging and disease. The imaging properties of these two techniques, alone, and potentially together, hold enormous promise for three dimensional in vivo cell scale imaging that will further advance research discovery and clinical care.