Transscleral visible/near-infrared spectroscopy for quantitative assessment of melanin in a uveal melanoma phantom of ex vivo porcine eyes

Bioinspired Three-Component System to Prepare Full-Color Functional Biomimetic Pigments

Nature provides a great source of inspiration for the development of sustainable materials with excellent properties, among which melanin with optical, electronic, and radiation protection properties are considered to be promising coloring materials. However, compared to chemical pigments, the single color, complex oxidation process, and poor solubility of natural melanin strongly limit their further applications. Here, we introduce a series of melanin-like polymeric pigments with amino acid-encoded physicochemical properties by a simple three-component reaction system. Our protocol enables artificial control of the chromophore structures through the rational design of the substrates and dopants, thereby combining the safety and functionality of biopigments with the color richness of chemical dyes. Similar to the photoprotective effect of natural melanin, the polymeric pigments showed excellent antioxidant activity in reducing free radicals and have the advantages of iridescent color, strong tinting strength, stability, and affordability. Furthermore, due to their ability to dye substrates, these biomimetic are expected to become new low-cost bioactive chromophores and find various biochemical applications such as in clothing and hair dyeing, food addition, and anticounterfeiting detection.

High speed, long range, deep penetration swept source OCT for structural and angiographic imaging of the anterior eye

This study reports the development of prototype swept-source optical coherence tomography (SS-OCT) technology for imaging the anterior eye. Advances in vertical-cavity surface-emitting laser (VCSEL) light sources, signal processing, optics and mechanical designs, enable a unique combination of high speed, long range, and deep penetration that addresses the challenges of anterior eye imaging. We demonstrate SS-OCT with a 325 kHz A-scan rate, 12.2 µm axial resolution (in air), and 15.5 mm depth range (in air) at 1310 nm wavelength. The ultrahigh 325 kHz A-scan rate not only facilitates biometry measurements by minimizing acquisition time and thus reducing motion, but also enables volumetric OCT for comprehensive structural analysis and OCT angiography (OCTA) for visualizing vasculature. The 15.5 mm (~ 11.6 mm in tissue) depth range spans all optical surfaces from the anterior cornea to the posterior lens capsule. The 1310 nm wavelength range enables structural OCT and OCTA deep in the sclera and through the iris. Achieving high speed and long range requires linearizing the VCSEL wavenumber sweep to efficiently utilize analog-to-digital conversion bandwidth. Dual channel recording of the OCT and calibration interferometer fringe signals, as well as sweep to sweep wavenumber compensation, is used to achieve invariant 12.2 µm (~ 9.1 µm in tissue) axial resolution and optimum point spread function throughout the depth range. Dynamic focusing using a tunable liquid lens extends the effective depth of field while preserving the lateral resolution. Improved optical and mechanical design, including parallax “split view” iris cameras and stable, ergonomic patient interface, facilitates accurate instrument positioning, reduces patient motion, and leads to improved imaging data yield and measurement accuracy. We present structural and angiographic OCT images of the anterior eye, demonstrating the unique imaging capabilities using representative scanning protocols which may be relevant to future research and clinical applications.

Cherenkov Luminescence Imaging for Assessment of Radioactive Plaque Position in Brachytherapy of Uveal Melanoma: An In Vivo Feasibility Study

Purpose

To study the feasibility of using Cherenkov luminescence imaging (CLI) to evaluate and document ruthenium-106 plaque position during brachytherapy of uveal melanoma.

Methods

Ruthenium-106 decays by emitting high-energy beta particles. When the electrons pass through the eye, Cherenkov radiation generates a faint light that can be captured by highly sensitive cameras. Patients undergoing ruthenium-106 plaque brachytherapy for posteriorly located choroidal melanoma were examined by CLI, which was performed in complete darkness with an electron multiplying charged-coupled device camera mounted on a fundus camera modified for long exposures.

Results

Ten patients with tumors ranging from 5.8 to 13.0 mm in largest basal diameter and 2.0 to 4.6 mm in height were included. The plaques had an activity between 0.035 and 0.089 MBq/mm² at the time of examination (1–4 days after implantation). CLI revealed the actual plaque position by displaying a circular area of light in the fundus corresponding with the plaque area. The Cherenkov light surrounded the tumor as a halo, which showed some asymmetry when the plaque was slightly displaced. The light intensity correlated positively with plaque activity and negatively with tumor pigmentation. Exposure times between 30 and 60 seconds were required to display the plaque position and delineate the tumor area. The long exposures made it difficult to maintain stable eye fixation and optimal image quality.

Conclusions

CLI is a novel method to assess and document ruthenium-106 plaque position in brachytherapy for uveal melanoma.

Translational Relevance

Ocular CLI may provide relevant radiation data during and after implantation of radioactive plaques, thus improving the accuracy of episcleral brachytherapy.

A Modified Dummy Plaque for the Accurate Placement of Ruthenium-106 Plaques in Brachytherapy of Intraocular Tumours

PURPOSE

To present a new technique to ensure the correct positioning of ruthenium plaques in episcleral brachytherapy.

MATERIALS AND METHODS

An acrylic dummy plaque is made opaque by sanding both sides with sandpaper, and its edge is covered by a black marking tape. This modified plaque is temporarily sutured to the sclera overlying the choroidal tumour site. The tip of an endoillumination probe is placed at the anterior edge of the plaque, yielding a strong light scattering within the opaque acrylic material. Due to the light-absorbing tape around the plaque border, the scattered light is confined within the plaque, and its perimeter can be observed by indirect ophthalmoscopy as a circle of transilluminated light surrounding the tumour. When the correct position has been found, the dummy plaque is replaced by a ruthenium-106 plaque.

RESULTS

The technique was successfully applied in 5 patients with posterior choroidal melanoma. Compared to standard focal transillumination, its main advantage is that the position of the entire plaque and tumour can be observed simultaneously in one field without any movement or manipulation of the light probe or plaque.

CONCLUSION

The described transillumination technique and modified dummy plaque facilitate the correct positioning of ruthenium plaques in brachytherapy of choroidal melanoma.

Near-infrared transillumination photography of intraocular tumours

PURPOSE

To present a technique for near-infrared transillumination imaging of intraocular tumours based on the modifications of a conventional digital slit lamp camera system.

METHODS

The Haag-Streit Photo-Slit Lamp BX 900 (Haag-Streit AG) was used for transillumination photography by gently pressing the tip of the background illumination cable against the surface of the patient's eye. Thus the light from the flash unit was transmitted into the eye, leading to improved illumination and image resolution. The modification for near-infrared photography was done by replacing the original camera with a Canon EOS 30D (Canon Inc) converted by Advanced Camera Services Ltd. In this camera, the infrared blocking filter was exchanged for a 720 nm long-pass filter, so that the near-infrared part of the spectrum was recorded by the sensor.

RESULTS

The technique was applied in eight patients: three with anterior choroidal melanoma, three with ciliary body melanoma and two with ocular pigment alterations. The good diagnostic quality of the photographs made it possible to evaluate the exact location and extent of the lesions in relation to pigmented intraocular landmarks such as the ora serrata and ciliary body. The photographic procedure did not lead to any complications.

CONCLUSIONS

We recommend near-infrared transillumination photography as a supplementary diagnostic tool for the evaluation and documentation of anteriorly located intraocular tumours.

Transscleral visible/near-infrared spectroscopy for quantitative assessment of haemoglobin in experimental choroidal tumours

PURPOSE

To study the feasibility of using transscleral visible/near-infrared spectroscopy (Vis/NIRS) to estimate the content of haemoglobin in choroidal tumour phantoms of ex vivo porcine eyes.

METHODS

Thirty enucleated porcine eyes were prepared with a tumour phantom made by injecting a suspension of gelatine, titanium dioxide and human blood into the suprachoroidal space. The blood concentrations used were 2.5%, 25% and 50%, with 10 eyes in each group. Alternating Vis/NIRS measurements were taken over the phantom inclusion and on the opposite (normal) side of each eye. For statistical analysis, a genetic algorithm was utilized to suppress insignificant wavelengths in the spectra. The processed spectra were then used to build a regression model based on partial least squares regression and evaluated by twofold cross-validation.

RESULTS

Ultrasonography revealed that all phantoms were localized within the suprachoroidal space with no penetration through the retina. The largest mean diameters of the phantoms with 2.5%, 25% and 50% blood were 15.5, 15.2 and 15.7 mm, respectively (p > 0.05). The largest mean thicknesses were 4.5, 4.5 and 4.8 mm, respectively (p > 0.05). Statistical analysis of the spectral data showed that it was possible to correctly discriminate between the normal side and the tumour phantom side of the eyes in 99.88% of cases. The phantoms could be correctly classified according to their blood concentrations in 99.42% of cases.

CONCLUSIONS

This study demonstrates that transscleral Vis/NIRS is a feasible and accurate method for the detection of choroidal tumours and to assess the haemoglobin content in such lesions.

Effects of probe geometry on transscleral diffuse optical spectroscopy

The purpose of this study was to investigate how the geometry of a fiber optic probe affects the transmission and reflection of light through the scleral eye wall. Two geometrical parameters of the fiber probe were investigated: the source-detector distance and the fiber protrusion, i.e. the length of the fiber extending from the flat surface of the fiber probe. For optimization of the fiber optic probe geometry, fluorescence stained choroidal tumor phantoms in ex vivo porcine eyes were measured with both diffuse reflectance- and laser-induced fluorescence spectroscopy. The strength of the fluorescence signal compared to the excitation signal was used as a measure for optimization. Intraocular pressure (IOP) and temperature were monitored to assess the impact of the probe on the eye. For visualizing any possible damage caused by the probe, the scleral surface was imaged with scanning electron microscopy after completion of the spectroscopic measurements. A source-detector distance of 5 mm with zero fiber protrusion was considered optimal in terms of spectroscopic contrast, however, a slight fiber protrusion of 0.5 mm is argued to be advantageous for clinical measurements. The study further indicates that transscleral spectroscopy can be safely performed in human eyes under in vivo conditions, without leading to an unacceptable IOP elevation, a significant rise in tissue temperature, or any visible damage to the scleral surface.