Influence of exposure time and pupil size on a Shack-Hartmann metric of forward scatter

To determine the influence of exposure time and pupil size on a Shack-Hartmann (S/H) derived metric of forward scatter (MAX_SD) using a physical model of nuclear cataract.

A physical model eye was developed and mounted to a S/H wavefront sensor. The eye model consisted of a lens, variable pupil, simulated cataract, and retina. Located behind the pupil, a cuvette contained one of five polystyrene microsphere solutions simulating five levels of nuclear cataract severity. Cataract severity was described using a S/H derived metric of forward scatter (MAX SD), which measures aspects of forward scatter contained in the S/H lenslet point spread functions (PSF). To determine the impact of exposure time and pupil size, measurements of MAX_SD were regressed against cataract severity for three different exposure times and three different pupil sizes.

MAX_SD was well correlated to cataract severity. Exposure time had the largest influence, and pupil size had the smallest influence on the forward scatter metric. When pupil size and exposure time were allowed to vary and image saturation was allowed to occur, MAX SD explained 83% of the variance in cataract severity. Excluding images where saturation occurred, holding optimal exposure time constant, and varying pupil size, MAX_SD explained 97% of the variance in cataract severity.

The ability of the forward scatter metric derived from S/H measurements to predict cataract severity for a longitudinal study is optimized by selecting a patient-specific exposure at the initial cataract assessment to avoid saturation and maximize the dynamic range of the system. This patient-specific exposure should be used in all future visits.