The history of modern ophthalmology began with the discovery of the ophthalmoscope by Hermann von Helmholtz in 1851. This device made it possible to examine the fundus with precision, and to observe the retina and its vessels, the optic disc (head of the optic nerve) and the macula. Fundus examination led to the description of a large number of eye diseases. Later, the discovery of fluorescence angiography (to visualize the vessels of the retina and choroid) opened the way to the analysis and treatment of many eye diseases. These advances in retinal exploration techniques have not only led to the description of very common diseases such as age-related macular degeneration (AMD), venous occlusions and diabetic retinopathy, but have also led to the quantification of neuronal loss occurring during various pathological processes, the correlation between retinal structure and function, analysis of the stage of disease progression and its correlation with genetic abnormalities to propose therapeutic targets.
The lecture provides essential information on the operating principles and numerous diagnostic opportunities offered by modern high-resolution imaging techniques such as optical coherence tomography (OCT) and adaptive optics. For example, adaptive optics enables us to visualize cones in the fundus, retinal vessels, vessel walls and blood flow, and the optic nerve. Microhemorrhages or inflammation around the vessels can thus be detected. Multimodal imaging and all retinal exploration techniques make it possible to characterize the morphology and function of the disease. This analysis enables us not only to establish structure/function correlations and phenotype/genotype correlations, but also to determine the rate of disease progression, and make therapeutic decisions for personalized medicine.
We are currently working on the HELMHOLTZ project, which brings together the Institut de la Vision and the Institut Langevin, and is supported by the European Research Council (ERC-Synergy). The aim of this project is to develop non-invasive, ultra-fast ultrasound and optical imaging technologies to study the structure and function of retinal cells and vessels in real time, and to design clinical applications. These new tools will enable a better understanding of retinal function and the discovery of new therapeutic strategies for vision diseases (retinopathies pigmentosa, AMD, diabetic retinopathy, retinal vein occlusions, glaucoma, etc.), which could be extended to other areas of neuroscience.
