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Theses

Clinical application of laser Doppler holography in ophthalmology

Abstract : This PhD aimed at introducing laser Doppler holography (LDH) into the field of ophthalmology in order to image blood flow in the eye posterior pole. Perfusion abnormalities play a central role in the development of ocular pathologies, which calls for the development of suitable instruments to elucidate it. LDH had previously demonstrated its ability to perform non-invasive and quantitative blood flow imaging with a high temporal resolution, but only in rodents. In this thesis, it is demonstrated that with a fast camera and a short-time Fourier transform analysis of the Doppler broadening, LDH can image blood flow changes in the human retina during cardiac cycles with a resolution of a few milliseconds. LDH is able to measure distinct systolodiastolic variations in retinal arteries and veins, and can be used for a full field mapping of the local resistivity index that allows unambiguous identification of retinal arteries and veins. LDH can also be used to reveal the choroid with a contrast quality similar to that of state of art instruments based on indocyanin-green angiography and optical coherence tomography, but unlike these methods LDH additionally provides a quantitative blood flow contrast. This ability was used to bring to light large differences of blood flow between choroidal arteries and veins, which is a feature that can be exploited to perform another arteriovenous differentiation appropriate for choroidal vessels. The higher Doppler frequency shifts of light scattered in choroidal arteries allows LDH to be especially efficient to reveal them, in some cases from their formation at short posterior ciliary arteries all the way to the arterioles branching. Overall, the unmatched temporal resolution with which LDH is able to measure blood flow and the new insight it provides into the choroid are especially full of promise for further clinical applications.
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  • HAL Id : tel-02881930, version 1

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Léo Puyo. Clinical application of laser Doppler holography in ophthalmology. Physics [physics]. Université Paris sciences et lettres, 2019. English. ⟨NNT : 2019PSLET022⟩. ⟨tel-02881930⟩

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