ALPAO is proud to have University of Pittsburgh among its references. In October 2023, Ethan Rossi gave us an interview. He answered some questions about Adaptive Optics technology for ophthalmology and his feedback on ALPAO’s products.
Can you introduce your organization?
I am an Assistant professor at the University of Pittsburgh, a public university in the United States in the city of Pittsburgh. I’m in the Department of ophthalmology at the School of Medicine here and we, in my lab, are really focused around advanced optical and ophthalmic imaging of the eye. My lab is really interested right now in studying aging and age-related macular degeneration and also inherited retinal degenerations. Vision restoration is one of the major areas for us because of the opportunities now that exist around restoring vision and also through the leadership of our department chairman, Dr. José Sahel.
In what context do you use adaptive optics and deformable mirrors?
My laboratory uses adaptive optics scanning laser ophthalmoscopy. And we’ve been really focused around trying to see new classes of cells and new structures in the eye. One of the areas that we’ve been focused on lately is using non confocal imaging approaches, where we can achieve a qualitative phase contrast image of the retina. And that has helped us to see things that we couldn’t see before.
One of the more exciting things for us right now is the ability that we’ve had most recently in the past couple of years here to begin imaging the inflammatory response in the eye. There are numerous conditions and diseases that involve an inflammatory component. All the major blinding diseases like age related macular degeneration, glaucoma, diabetic retinopathy, all of them include some inflammatory aspect to them. And we’re now able to image these immune cells that are part of the inflammatory process, which is really exciting.
We’ve been now looking at a number of different conditions and trying to understand the role of these cells and mediating the disease process and also its progression. We use the ALPAO deformable mirror in our system and we’ve been really happy with its performance and have been just cranking out lots of data, imaging lots of patients with our system. And presently, we’re really poised, I think, to make a lot of advances now that we’ve been able to achieve this new imaging approach to see these immune cells.
How long have you been working with our products, with our ALPAO products?
It’s been many years now! So back in Austin Roorda’s lab, when we first started, I believe we were still using the Xynetics mirrors. So that goes way back to David Williams’ first work in this area. And I think the first time, that we were starting to use the ALPAO mirrors was when I went to the University of Rochester for my postdoc with David.
Well, I started at Rochester in 2010, so that was 13 years ago, and I started grad school in Austin’s lab in 2004, almost 20 years ago. So it’s been a long time I’ve been working with adaptive optics.
Pretty much from the moment you guys were delivering the mirrors for vision science, I was working with them.
What advantages do you see in our deformable mirrors, in our technology?
Well, I think there’s several advantages. I mean, I like the size, and the stroke, and the speed, the optical quality. They’ve been really, super stable as well. That’s been great. The reliability has been a really important thing for us to be able to rely on them to just continue to work year after year and just be able to perform in this high-performance imaging environment. So, I think, really, from my perspective, it is the best mirror that exists for the work that we do. And all those aspects that I mentioned, I think, are important for the work that we do. We’re not taking advantage, I think, right now of the speed, but that’s something that we’re working on improving so that we can maybe do our Wavefront Sensing and AO control at a higher rate, because our collaborators have demonstrated the value of that in some of their previous publications.
Would you recommend ALPAO to your scientific community?
Absolutely! We’ve worked with ALPAO for many years now and I’ve worked for many years on trying to develop various systems for clinical use, which is one of the major challenges with adaptive optics ophthalmoscopy is that it’s been challenging to get it into the clinic. There has been some moderate level of success with these commercial devices that have been deployed, but more so in Europe than here in the States. But everyone that I’ve ever worked with that has been trying to build prototypes for clinical use, which includes both large companies that you may have heard of and also smaller ones that you may have also heard of as well. I’ve always told them that your technology is the one that they should use. And that, based on my experience, I’ve used mirrors from others companies, I’ve used SLM as well and I always come back to ALPAO Mirrors because they are the best.
What perspectives do you see for AO in ophthalmology?
I am really exciting about the possibility for the future for ophthalmic AO imaging. There are more smaller companies that are getting involved now that I think have a lot of potential. I think it is really a question of how we can get these tools in the hand of clinicians because we’re going to see they are useful for many clinical applications once they get into the hands of skilled clinicians. Where I think they are going to be most important is around the evaluation of the new cell and gene based therapies that are coming into the market for various conditions, with many now also in clinical trials. We’re going to see more and more need for having this exciting tool in the clinics to evaluate the efficacy of these new therapies.
Dr. Rossi is an Assistant Professor of Ophthalmology at the University of Pittsburgh, where he holds a secondary appointment in Bioengineering. Dr. Rossi received his bachelor’s degree in Brain & Cognitive Sciences from the University of Rochester and completed his PhD training in Vision Science at the University of California, Berkeley in the laboratory of Austin Roorda. Following his PhD training, Dr. Rossi completed a postdoctoral fellowship in the laboratory of David Williams and then joined the Advanced Retinal Imaging Alliance at Rochester as a research associate. Dr. Rossi’s PhD research was focused on the optical, retinal, and cortical factors that govern spatial resolution in humans where he used adaptive optics to study the limits of human vision. In his postdoctoral training, Dr. Rossi improved adaptive optics autofluorescence techniques and applied them to the study of patients with age-related macular degeneration (AMD). As a research associate, Dr. Rossi worked to improve the clinical utility of adaptive optics scanning light ophthalmoscopy (AOSLO) and developed a new detection scheme for AOSLO that allowed retinal ganglion cells to be imaged in the living eye of humans. In his laboratory at Pittsburgh, Dr. Rossi has continued to develop and deploy advanced imaging technologies for the study of human disease. Highlights of recent work include a new image registration approach to minimize distortions for longitudinal tracking of cellular changes and robust eye movement measurement from scanned imaging systems, evaluation of near-infrared autofluorescence in AMD, study of fixational eye movements following concussion, and improved optical detection configurations for nonconfocal AOSLO. These new detection methods for AOSLO recently permitted fine-scale tracking of microglia in normal eyes and inflammation to be studied at the level of single cells in patients with uveitis. Dr. Rossi’s current research interests include adaptive optics ophthalmoscopy, aging, age-related macular degeneration, inherited retinal dystrophies, glaucoma, uveitis, eye movements and concussion. Dr. Rossi has obtained funding for his work from several sources, including the National Eye Institute, the National Institute of Neurological Disorders and Stroke, Foundation Fighting Blindness, BrightFocus Foundation, and the Eye & Ear Foundation of Pittsburgh.