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Duan H, Yan W. Visual fatigue a comprehensive review of mechanisms of occurrence, animal model design and nutritional intervention strategies. Crit Rev Food Sci Nutr 2023:1-25. [PMID: 38153314 DOI: 10.1080/10408398.2023.2298789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
When the eyes work intensively, it is easy to have eye discomfort such as blurred vision, soreness, dryness, and tearing, that is, visual fatigue. Visual fatigue not only affects work and study efficiency, but long-term visual fatigue can also easily affect physical and mental health. In recent years, with the popularization of electronic products, although it has brought convenience to the office and study, it has also caused more frequent visual fatigue among people who use electronic devices. Moreover, studies have reported that the number of people with visual fatigue is showing a trend of increasing year by year. The range of people involved is also extensive, especially students, people who have been engaged in computer work and fine instruments (such as microscopes) for a long time, and older adults with aging eye function. More and more studies have proposed that supplementation with the proper nutrients can effectively relieve visual fatigue and promote eye health. This review discusses the physiological mechanisms of visual fatigue and the design ideas of animal experiments from the perspective of modern nutritional science. Functional food ingredients with the ability to alleviate visual fatigue are discussed in detail.
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Affiliation(s)
- Hao Duan
- College of Biochemical Engineering, Beijing Key Laboratory of Bioactive Substances and Functional Food, Beijing Union University, Beijing, China
| | - Wenjie Yan
- College of Biochemical Engineering, Beijing Key Laboratory of Bioactive Substances and Functional Food, Beijing Union University, Beijing, China
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2
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Li JD, Viehland C, Dhalla AH, Trout R, Raynor W, Kuo AN, Toth CA, Vajzovic LM, Izatt JA. Visualization of surgical maneuvers using intraoperative real-time volumetric optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2023; 14:3798-3811. [PMID: 37497507 PMCID: PMC10368043 DOI: 10.1364/boe.488967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/25/2023] [Accepted: 06/12/2023] [Indexed: 07/28/2023]
Abstract
Ophthalmic microsurgery is traditionally performed using stereomicroscopes and requires visualization and manipulation of sub-millimeter tissue structures with limited contrast. Optical coherence tomography (OCT) is a non-invasive imaging modality that can provide high-resolution, depth-resolved cross sections, and has become a valuable tool in clinical practice in ophthalmology. While there has been substantial progress in both research and commercialization efforts to bring OCT imaging into live surgery, its use is still somewhat limited due to factors such as low imaging speed, limited scan configurations, and suboptimal data visualization. In this paper we describe, to the best of our knowledge, the translation of the fastest swept-source intraoperative OCT system with real-time volumetric imaging with stereoscopic data visualization provided via a heads-up display into the operating room. Results from a sampling of human anterior segment and retinal surgeries chosen from 93 human surgeries using the system are shown and the benefits that this mode of intrasurgical OCT imaging provides are discussed.
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Affiliation(s)
- Jianwei D. Li
- Department of Biomedical Engineering, 101 Science Drive, Durham, NC 27708, USA
| | - Christian Viehland
- Department of Biomedical Engineering, 101 Science Drive, Durham, NC 27708, USA
| | - Al-Hafeez Dhalla
- Department of Biomedical Engineering, 101 Science Drive, Durham, NC 27708, USA
| | - Robert Trout
- Department of Biomedical Engineering, 101 Science Drive, Durham, NC 27708, USA
| | - William Raynor
- Department of Ophthalmology, Duke University Medical Center, 2351 Erwin Road, Durham, NC 27710, USA
| | - Anthony N. Kuo
- Department of Biomedical Engineering, 101 Science Drive, Durham, NC 27708, USA
- Department of Ophthalmology, Duke University Medical Center, 2351 Erwin Road, Durham, NC 27710, USA
| | - Cynthia A. Toth
- Department of Biomedical Engineering, 101 Science Drive, Durham, NC 27708, USA
- Department of Ophthalmology, Duke University Medical Center, 2351 Erwin Road, Durham, NC 27710, USA
| | - Lejla M. Vajzovic
- Department of Ophthalmology, Duke University Medical Center, 2351 Erwin Road, Durham, NC 27710, USA
| | - Joseph A. Izatt
- Department of Biomedical Engineering, 101 Science Drive, Durham, NC 27708, USA
- Department of Ophthalmology, Duke University Medical Center, 2351 Erwin Road, Durham, NC 27710, USA
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3
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Trout RM, Viehland C, Li JD, Raynor W, Dhalla AH, Vajzovic L, Kuo AN, Toth CA, Izatt JA. Methods for real-time feature-guided image fusion of intrasurgical volumetric optical coherence tomography with digital microscopy. BIOMEDICAL OPTICS EXPRESS 2023; 14:3308-3326. [PMID: 37497493 PMCID: PMC10368056 DOI: 10.1364/boe.488975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/01/2023] [Accepted: 06/01/2023] [Indexed: 07/28/2023]
Abstract
4D-microscope-integrated optical coherence tomography (4D-MIOCT) is an emergent multimodal imaging technology in which live volumetric OCT (4D-OCT) is implemented in tandem with standard stereo color microscopy. 4D-OCT provides ophthalmic surgeons with many useful visual cues not available in standard microscopy; however it is challenging for the surgeon to effectively integrate cues from simultaneous-but-separate imaging in real-time. In this work, we demonstrate progress towards solving this challenge via the fusion of data from each modality guided by segmented 3D features. In this way, a more readily interpretable visualization that combines and registers important cues from both modalities is presented to the surgeon.
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Affiliation(s)
- Robert M. Trout
- Department of Biomedical Engineering, Duke University, 101 Science Drive, Durham, NC 27708, USA
| | - Christian Viehland
- Department of Biomedical Engineering, Duke University, 101 Science Drive, Durham, NC 27708, USA
| | - Jianwei D. Li
- Department of Biomedical Engineering, Duke University, 101 Science Drive, Durham, NC 27708, USA
| | - William Raynor
- Department of Ophthalmology, Duker University Medical Center, 2351 Erwin Road, Durham, NC 27705, USA
| | - Al-Hafeez Dhalla
- Department of Biomedical Engineering, Duke University, 101 Science Drive, Durham, NC 27708, USA
| | - Lejla Vajzovic
- Department of Ophthalmology, Duker University Medical Center, 2351 Erwin Road, Durham, NC 27705, USA
| | - Anthony N. Kuo
- Department of Biomedical Engineering, Duke University, 101 Science Drive, Durham, NC 27708, USA
- Department of Ophthalmology, Duker University Medical Center, 2351 Erwin Road, Durham, NC 27705, USA
| | - Cynthia A. Toth
- Department of Biomedical Engineering, Duke University, 101 Science Drive, Durham, NC 27708, USA
- Department of Ophthalmology, Duker University Medical Center, 2351 Erwin Road, Durham, NC 27705, USA
| | - Joseph A. Izatt
- Department of Biomedical Engineering, Duke University, 101 Science Drive, Durham, NC 27708, USA
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4
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Huang Y, Asaria R, Stoyanov D, Sarunic M, Bano S. PseudoSegRT: efficient pseudo-labelling for intraoperative OCT segmentation. Int J Comput Assist Radiol Surg 2023:10.1007/s11548-023-02928-9. [PMID: 37233893 PMCID: PMC10329588 DOI: 10.1007/s11548-023-02928-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 04/19/2023] [Indexed: 05/27/2023]
Abstract
PURPOSE Robotic ophthalmic microsurgery has significant potential to help improve the success of challenging procedures and overcome the physical limitations of the surgeon. Intraoperative optical coherence tomography (iOCT) has been reported for the visualisation of ophthalmic surgical manoeuvres, where deep learning methods can be used for real-time tissue segmentation and surgical tool tracking. However, many of these methods rely heavily on labelled datasets, where producing annotated segmentation datasets is a time-consuming and tedious task. METHODS To address this challenge, we propose a robust and efficient semi-supervised method for boundary segmentation in retinal OCT to guide a robotic surgical system. The proposed method uses U-Net as the base model and implements a pseudo-labelling strategy which combines the labelled data with unlabelled OCT scans during training. After training, the model is optimised and accelerated with the use of TensorRT. RESULTS Compared with fully supervised learning, the pseudo-labelling method can improve the generalisability of the model and show better performance for unseen data from a different distribution using only 2% of labelled training samples. The accelerated GPU inference takes less than 1 millisecond per frame with FP16 precision. CONCLUSION Our approach demonstrates the potential of using pseudo-labelling strategies in real-time OCT segmentation tasks to guide robotic systems. Furthermore, the accelerated GPU inference of our network is highly promising for segmenting OCT images and guiding the position of a surgical tool (e.g. needle) for sub-retinal injections.
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Affiliation(s)
- Yu Huang
- Department of Computer Science, University College London, London, UK
| | - Riaz Asaria
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, UK
- Ophthalmology, Royal Free Hospital, London, UK
| | - Danail Stoyanov
- Department of Computer Science, University College London, London, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, UK
| | - Marinko Sarunic
- Institute of Ophthalmology, University College London, London, UK
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Sophia Bano
- Department of Computer Science, University College London, London, UK.
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, UK.
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5
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Yusef YN, Petrachkov DV. [Intraoperative optical coherence tomography in vitreoretinal surgery]. Vestn Oftalmol 2023; 139:113-120. [PMID: 37942605 DOI: 10.17116/oftalma2023139051113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
This article reviews literature on the use of intraoperative optical coherence tomography (iOCT) in vitreoretinal surgery, describes the historical aspects of the development of this technology from portable devices to optical coherence tomographs integrated into the surgical microscope, considers the advantages, limitations and disadvantages of this technology, which are now becoming obvious due to the accumulated experience. The review also explores the prospects for the development of iOCT and possible ways to solve its problems. In addition, the review presents and systematizes clinical findings that can be revealed with iOCT in such diseases as rhegmatogenous retinal detachment, complications of proliferative diabetic retinopathy, macular pathology, etc.
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Affiliation(s)
- Yu N Yusef
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - D V Petrachkov
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
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6
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Tang EM, El-Haddad MT, Patel SN, Tao YK. Automated instrument-tracking for 4D video-rate imaging of ophthalmic surgical maneuvers. BIOMEDICAL OPTICS EXPRESS 2022; 13:1471-1484. [PMID: 35414968 PMCID: PMC8973184 DOI: 10.1364/boe.450814] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/07/2022] [Accepted: 02/09/2022] [Indexed: 05/11/2023]
Abstract
Intraoperative image-guidance provides enhanced feedback that facilitates surgical decision-making in a wide variety of medical fields and is especially useful when haptic feedback is limited. In these cases, automated instrument-tracking and localization are essential to guide surgical maneuvers and prevent damage to underlying tissue. However, instrument-tracking is challenging and often confounded by variations in the surgical environment, resulting in a trade-off between accuracy and speed. Ophthalmic microsurgery presents additional challenges due to the nonrigid relationship between instrument motion and instrument deformation inside the eye, image field distortion, image artifacts, and bulk motion due to patient movement and physiological tremor. We present an automated instrument-tracking method by leveraging multimodal imaging and deep-learning to dynamically detect surgical instrument positions and re-center imaging fields for 4D video-rate visualization of ophthalmic surgical maneuvers. We are able to achieve resolution-limited tracking accuracy at varying instrument orientations as well as at extreme instrument speeds and image defocus beyond typical use cases. As proof-of-concept, we perform automated instrument-tracking and 4D imaging of a mock surgical task. Here, we apply our methods for specific applications in ophthalmic microsurgery, but the proposed technologies are broadly applicable for intraoperative image-guidance with high speed and accuracy.
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Affiliation(s)
- Eric M. Tang
- Vanderbilt University, Department of Biomedical Engineering, Nashville, TN 37232, USA
| | - Mohamed T. El-Haddad
- Vanderbilt University, Department of Biomedical Engineering, Nashville, TN 37232, USA
| | - Shriji N. Patel
- Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Yuankai K. Tao
- Vanderbilt University, Department of Biomedical Engineering, Nashville, TN 37232, USA
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7
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Abstract
Optical coherence tomography (OCT) is widely applied in diagnosis and management of retina diseases particularly macular diseases in adult retina practices. However, it has been under-utilized in pediatric retinal diseases especially in neonates and infants. Utilization of OCT in primary macular diseases in this age group is also uncommon and is less reported. Challenges involved in image acquisition and limitations with available devices technique can explain the limited research and accurate data availability in the literature in this field. Purpose of this review article is to summarize the use of OCT and its importance in various infantile retinal pathologies such as vascular diseases, tumors, retinal dystrophies, and optic nerve pathologies with primary focus on neonates and infants, along with infant choroid. In addition, we also discuss about future directions including OCT angiography for infants.
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Affiliation(s)
- Sushma Jayanna
- Consultant Ophthalmologist, Department of Srimathi Kannuri Santhamma Center of Vitreoretinal Eye Disease, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Subhadra Jalali
- Consultant Ophthalmologist, Department of Srimathi Kannuri Santhamma Center of Vitreoretinal Eye Disease, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Tapas R Padhi
- Consultant Ophthalmologist, Department of Retina and Vitreous, Mithu Tulasi Chanrai Campus, Bhubaneswar, LV Prasad Eye Institute, India
| | - Komal Agarwal
- Consultant Ophthalmologist, Department of Srimathi Kannuri Santhamma Center of Vitreoretinal Eye Disease, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Jay Chhablani
- University of Pittsburgh, UPMC Eye Center, Pittsburgh, PA, USA
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8
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Abstract
PURPOSE To report on the indications, outcomes, and complications of endoscopic vitrectomy in a large cohort of pediatric vitreoretinal patients. METHODS This is a retrospective interventional case series consisting of 244 eyes of 211 patients aged 18 years or younger undergoing a total of 326 endoscopic vitrectomies from 2008 to 2017. A 23-gauge vitrectomy was performed with use of a 19-gauge endoscope. RESULTS Two hundred and eleven patients with a mean age of 7.5 years (range: 0-18 years) and median follow-up since last surgery of 28 months (range: 3 months-8.7 years) were included. The most common indication for endoscopic vitrectomy was retinal detachment (234/326; 72%) with proliferative vitreoretinopathy (162/234; 69%). Other diagnoses included trauma (25%), retinopathy of prematurity (15%), and glaucoma (9%). Twenty-five percent of surgeries (80/326) were performed on eyes with significant corneal opacities. Retinal reattachment was achieved in 67% of eyes with retinal detachment (119/178). Visual acuity improved in 26% of retinal detachment eyes versus 53% of nonretinal detachment eyes (P = 0.005). Surgical complications included band keratopathy (15%), hypotony (8%), cataract (7%), and elevated intraocular pressure (3%). CONCLUSION In this large series of pediatric endoscopic vitreoretinal surgeries, anatomic outcomes and complication rates were comparable with previous studies.
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9
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Four-Dimensional Microscope-Integrated Optical Coherence Tomography Guidance in a Model Eye Subretinal Surgery. Retina 2020; 39 Suppl 1:S194-S198. [PMID: 31090685 DOI: 10.1097/iae.0000000000002518] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Pujari A, Agarwal D, Chawla R, Kumar A, Sharma N. Intraoperative Optical Coherence Tomography Guided Ocular Surgeries: Critical Analysis of Clinical Role and Future Perspectives. Clin Ophthalmol 2020; 14:2427-2440. [PMID: 32904675 PMCID: PMC7457570 DOI: 10.2147/opth.s270708] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 08/07/2020] [Indexed: 11/23/2022] Open
Abstract
Intraoperative imaging of ocular tissues for diagnostic and therapeutic applications has gained immense admiration in recent years. The real time cross-sectional imaging, as well as three and four dimensional reconstruction abilities of intraoperative optical coherence tomography (iOCT), has enhanced our knowledge on many fronts in surgical maneuvers. In this review, we discuss the iOCT discovered constructive knowledge in the cornea, cataract, refractive, glaucoma, pediatric ocular, and various retinal conditions. The practical utility with decision modifying aspects along the specified ocular tissues and with respect to specific ocular entities have been narrated. Moreover, limitations and future directions have also been emphasized to make ophthalmic care more comprehensive in the future.
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Affiliation(s)
- Amar Pujari
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Divya Agarwal
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Rohan Chawla
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Atul Kumar
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Namrata Sharma
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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11
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Emil Tampu I, Maintz M, Koller D, Johansson K, Gimm O, Capitanio A, Eklund A, Haj-Hosseini N. Optical coherence tomography for thyroid pathology: 3D analysis of tissue microstructure. BIOMEDICAL OPTICS EXPRESS 2020; 11:4130-4149. [PMID: 32923033 PMCID: PMC7449746 DOI: 10.1364/boe.394296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/20/2020] [Accepted: 06/22/2020] [Indexed: 06/11/2023]
Abstract
To investigate the potential of optical coherence tomography (OCT) to distinguish between normal and pathologic thyroid tissue, 3D OCT images were acquired on ex vivo thyroid samples from adult subjects (n=22) diagnosed with a variety of pathologies. The follicular structure was analyzed in terms of count, size, density and sphericity. Results showed that OCT images highly agreed with the corresponding histopatology and the calculated parameters were representative of the follicular structure variation. The analysis of OCT volumes provides quantitative information that could make automatic classification possible. Thus, OCT can be beneficial for intraoperative surgical guidance or in the pathology assessment routine.
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Affiliation(s)
- Iulian Emil Tampu
- Department of Biomedical Engineering, Linköping University, Linköping 581 85, Sweden
| | - Michaela Maintz
- Department of Biomedical Engineering, Linköping University, Linköping 581 85, Sweden
| | - Daniela Koller
- Department of Biomedical Engineering, Linköping University, Linköping 581 85, Sweden
| | - Kenth Johansson
- Department of Surgery, Västervik Hospital and Örebro University Hospital, Västervik and Örebro, Sweden
| | - Oliver Gimm
- Department of Surgery, and Department of Biomedical and Clinical Sciences, Linköping University Hospital and Linköping University, Linköping 581 85, Sweden
| | - Arrigo Capitanio
- Department of Clinical Pathology, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping 581 85, Sweden
| | - Anders Eklund
- Department of Biomedical Engineering, Linköping University, Linköping 581 85, Sweden
- Division of Statistics & Machine Learning, Department of Computer and Information Science, Linköping University, Linköping 581 83, Sweden
- Center for Medical Image Science and Visualization, Linköping University, Linköping 581 85, Sweden
| | - Neda Haj-Hosseini
- Department of Biomedical Engineering, Linköping University, Linköping 581 85, Sweden
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12
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Janpongsri W, Huang J, Ng R, Wahl DJ, Sarunic MV, Jian Y. Pseudo-real-time retinal layer segmentation for high-resolution adaptive optics optical coherence tomography. JOURNAL OF BIOPHOTONICS 2020; 13:e202000042. [PMID: 32421890 DOI: 10.1002/jbio.202000042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/04/2020] [Accepted: 04/28/2020] [Indexed: 06/11/2023]
Abstract
We present a pseudo-real-time retinal layer segmentation for high-resolution Sensorless Adaptive Optics-Optical Coherence Tomography (SAO-OCT). Our pseudo-real-time segmentation method is based on Dijkstra's algorithm that uses the intensity of pixels and the vertical gradient of the image to find the minimum cost in a geometric graph formulation within a limited search region. It segments six retinal layer boundaries in an iterative process according to their order of prominence. The segmentation time is strongly correlated to the number of retinal layers to be segmented. Our program permits en face images to be extracted during data acquisition to guide the depth specific focus control and depth dependent aberration correction for high-resolution SAO-OCT systems. The average processing times for our entire pipeline for segmenting six layers in a retinal B-scan of 496 × 400 and 240 × 400 pixels are around 25.60 and 13.76 ms, respectively. When reducing the number of layers segmented to only two layers, the time required for a 240 × 400 pixel image is 8.26 ms.
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Affiliation(s)
- Worawee Janpongsri
- Biomedical Optics Research Group, School of Engineering Science, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Joey Huang
- Biomedical Optics Research Group, School of Engineering Science, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Ringo Ng
- Biomedical Optics Research Group, School of Engineering Science, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Daniel J Wahl
- Biomedical Optics Research Group, School of Engineering Science, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Marinko V Sarunic
- Biomedical Optics Research Group, School of Engineering Science, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Yifan Jian
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon, USA
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13
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Juncheed K, Kohlstrunk B, Friebe S, Dallacasagrande V, Maurer P, Reichenbach A, Mayr SG, Zink M. Employing Nanostructured Scaffolds to Investigate the Mechanical Properties of Adult Mammalian Retinae Under Tension. Int J Mol Sci 2020; 21:ijms21113889. [PMID: 32485972 PMCID: PMC7313470 DOI: 10.3390/ijms21113889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/25/2020] [Accepted: 05/25/2020] [Indexed: 12/01/2022] Open
Abstract
Numerous eye diseases are linked to biomechanical dysfunction of the retina. However, the underlying forces are almost impossible to quantify experimentally. Here, we show how biomechanical properties of adult neuronal tissues such as porcine retinae can be investigated under tension in a home-built tissue stretcher composed of nanostructured TiO2 scaffolds coupled to a self-designed force sensor. The employed TiO2 nanotube scaffolds allow for organotypic long-term preservation of adult tissues ex vivo and support strong tissue adhesion without the application of glues, a prerequisite for tissue investigations under tension. In combination with finite element calculations we found that the deformation behavior is highly dependent on the displacement rate which results in Young’s moduli of (760–1270) Pa. Image analysis revealed that the elastic regime is characterized by a reversible shear deformation of retinal layers. For larger deformations, tissue destruction and sliding of retinal layers occurred with an equilibration between slip and stick at the interface of ruptured layers, resulting in a constant force during stretching. Since our study demonstrates how porcine eyes collected from slaughterhouses can be employed for ex vivo experiments, our study also offers new perspectives to investigate tissue biomechanics without excessive animal experiments.
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Affiliation(s)
- Kantida Juncheed
- Soft Matter Physics Division and Biotechnology & Biomedical Group, Peter-Debye-Institute for Soft Matter Physics, Leipzig University, Linnéstr. 5, 04103 Leipzig, Germany; (K.J.); (B.K.); (V.D.)
- Paul Flechsig Institute for Brain Research, Leipzig University, Liebigstr. 19, 04103 Leipzig, Germany;
| | - Bernd Kohlstrunk
- Soft Matter Physics Division and Biotechnology & Biomedical Group, Peter-Debye-Institute for Soft Matter Physics, Leipzig University, Linnéstr. 5, 04103 Leipzig, Germany; (K.J.); (B.K.); (V.D.)
| | - Sabrina Friebe
- Division of Surface Physics, Department of Physics and Earth Sciences, Leipzig University and Leibniz Institute of Surface Engineering (IOM), Permoser Str. 15, 04318 Leipzig, Germany; (S.F.); (S.G.M.)
| | - Valentina Dallacasagrande
- Soft Matter Physics Division and Biotechnology & Biomedical Group, Peter-Debye-Institute for Soft Matter Physics, Leipzig University, Linnéstr. 5, 04103 Leipzig, Germany; (K.J.); (B.K.); (V.D.)
- Paul Flechsig Institute for Brain Research, Leipzig University, Liebigstr. 19, 04103 Leipzig, Germany;
| | - Patric Maurer
- Institute of Food Hygiene, Faculty of Veterinary Medicine, Leipzig University, Augustusplatz 10, 04109 Leipzig, Germany;
| | - Andreas Reichenbach
- Paul Flechsig Institute for Brain Research, Leipzig University, Liebigstr. 19, 04103 Leipzig, Germany;
| | - Stefan G. Mayr
- Division of Surface Physics, Department of Physics and Earth Sciences, Leipzig University and Leibniz Institute of Surface Engineering (IOM), Permoser Str. 15, 04318 Leipzig, Germany; (S.F.); (S.G.M.)
| | - Mareike Zink
- Soft Matter Physics Division and Biotechnology & Biomedical Group, Peter-Debye-Institute for Soft Matter Physics, Leipzig University, Linnéstr. 5, 04103 Leipzig, Germany; (K.J.); (B.K.); (V.D.)
- Correspondence: ; Tel.: +49-(341)-9732573; Fax: +49-(341)-9732479
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14
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Soliman SE, VandenHoven C, MacKeen LD, Gallie BL. Secondary Prevention of Retinoblastoma Revisited. Ophthalmology 2020; 127:122-127. [DOI: 10.1016/j.ophtha.2019.08.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 08/08/2019] [Accepted: 08/13/2019] [Indexed: 01/02/2023] Open
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15
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Kim W, Kim S, Huang S, Oghalai JS, Applegate BE. Picometer scale vibrometry in the human middle ear using a surgical microscope based optical coherence tomography and vibrometry system. BIOMEDICAL OPTICS EXPRESS 2019; 10:4395-4410. [PMID: 31565497 PMCID: PMC6757470 DOI: 10.1364/boe.10.004395] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 07/18/2019] [Accepted: 07/19/2019] [Indexed: 05/10/2023]
Abstract
We have developed a highly phase stable optical coherence tomography and vibrometry system that attaches directly to the accessory area of a surgical microscope common to both the otology clinic and operating room. Careful attention to minimizing sources of phase noise has enabled a system capable of measuring vibrations of the middle ear with a sensitivity of < 5 pm in an awake human patient. The system is shown to be capable of collecting a wide range of information on the morphology and function of the ear in live subjects, including frequency tuning curves below the hearing threshold, maps of tympanic membrane vibrational modes and thickness, and measures of distortion products due to the nonlinearities in the cochlear amplifier.
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Affiliation(s)
- Wihan Kim
- Department of Otolaryngology–Head and Neck Surgery, University of Southern California, Los Angeles, CA 90033, USA
| | - Sangmin Kim
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA
| | - Shuning Huang
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA
| | - John S. Oghalai
- Department of Otolaryngology–Head and Neck Surgery, University of Southern California, Los Angeles, CA 90033, USA
| | - Brian E. Applegate
- Department of Otolaryngology–Head and Neck Surgery, University of Southern California, Los Angeles, CA 90033, USA
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089, USA
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16
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Abstract
Intraoperative OCT (iOCT) is an emerging modality capable of displaying real-time OCT images to the surgeon during surgery. The use of iOCT during vitreoretinal surgery improves our understanding of the tissue alterations that occur during surgical manipulations, which may impact surgical decision-making. We review the current iOCT modalities and clinical applications of iOCT.
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Affiliation(s)
- Cindy Ung
- a Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology , Harvard Medical School , Boston , MA , USA
| | - John B Miller
- a Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology , Harvard Medical School , Boston , MA , USA
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Lu CD, Waheed NK, Witkin A, Baumal CR, Liu JJ, Potsaid B, Joseph A, Jayaraman V, Cable A, Chan K, Duker JS, Fujimoto JG. Microscope-Integrated Intraoperative Ultrahigh-Speed Swept-Source Optical Coherence Tomography for Widefield Retinal and Anterior Segment Imaging. Ophthalmic Surg Lasers Imaging Retina 2019; 49:94-102. [PMID: 29443358 DOI: 10.3928/23258160-20180129-03] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 12/18/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To demonstrate the feasibility of retinal and anterior segment intraoperative widefield imaging using an ultrahigh-speed, swept-source optical coherence tomography (SS-OCT) surgical microscope attachment. PATIENTS AND METHODS A prototype post-objective SS-OCT using a 1,050-nm wavelength, 400 kHz A-scan rate, vertical cavity surface-emitting laser (VCSEL) light source was integrated to a commercial ophthalmic surgical microscope after the objective. Each widefield OCT data set was acquired in 3 seconds (1,000 × 1,000 A-scans, 12 × 12 mm2 for retina and 10 × 10 mm2 for anterior segment). RESULTS Intraoperative SS-OCT was performed in 20 eyes of 20 patients. In six of seven membrane peels and five of seven rhegmatogenous retinal detachment repair surgeries, widefield retinal imaging enabled evaluation pre- and postoperatively. In all seven cataract cases, anterior imaging evaluated the integrity of the posterior lens capsule. CONCLUSIONS Ultrahigh-speed SS-OCT enables widefield intraoperative viewing in the posterior and anterior eye. Widefield imaging visualizes ocular structures and pathology without requiring OCT realignment. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:94-102.].
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18
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Carrasco-Zevallos OM, Viehland C, Keller B, McNabb RP, Kuo AN, Izatt JA. Constant linear velocity spiral scanning for near video rate 4D OCT ophthalmic and surgical imaging with isotropic transverse sampling. BIOMEDICAL OPTICS EXPRESS 2018; 9:5052-5070. [PMID: 30319921 PMCID: PMC6179405 DOI: 10.1364/boe.9.005052] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 09/12/2018] [Accepted: 09/13/2018] [Indexed: 05/05/2023]
Abstract
Ultrahigh speed optical coherence tomography (OCT) systems with >100 kHz A-scan rates can generate volumes rapidly with minimal motion artifacts and are well suited for 4D imaging (volumes through time) applications such as intra-operative imaging. In such systems, high OCT data acquisition efficiency (defined as the fraction of usable A-scans generated during the total acquisition time) is desired to maximize the volumetric frame rate and sampling pitch. However, current methods for beam scanning using non-resonant and resonant mirror scanners can result in severe scan distortion and transverse oversampling as well as require acquisition dead times, which limit the acquisition efficiency and performance of ultrahigh speed 4D OCT. We introduce constant linear velocity spiral scanning (CLV-SC) as a novel beam scanning method to maximize the data acquisition efficiency of ultrahigh speed 4D OCT systems. We demonstrate that CLV-SC does not require acquisition dead times and achieves more uniform transverse sampling compared to raster scanning. To assess its clinical utility, we implement CLV-SC with a 400 kHz OCT system and image the anterior eye and retina of healthy adults at up to 10 volumes per second with isotropic transverse sampling, allowing B-scans with equal sampling pitch to be extracted from arbitrary locations within a single volume. The feasibility of CLV-SC for intra-operative imaging is also demonstrated using a 800 kHz OCT system to image simulated retinal surgery at 15 volumes per second with isotropic transverse sampling, resulting in high quality volume renders that enable clear visualization of surgical instruments and manipulation of tissue.
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Affiliation(s)
| | - Christian Viehland
- Department of Biomedical Engineering, Duke University, Durham, NC 27708 USA
| | - Brenton Keller
- Department of Biomedical Engineering, Duke University, Durham, NC 27708 USA
| | - Ryan P. McNabb
- Department of Ophthalmology, Duke University Medical Center, NC 27710 USA
| | - Anthony N. Kuo
- Department of Biomedical Engineering, Duke University, Durham, NC 27708 USA
- Department of Ophthalmology, Duke University Medical Center, NC 27710 USA
| | - Joseph A. Izatt
- Department of Biomedical Engineering, Duke University, Durham, NC 27708 USA
- Department of Ophthalmology, Duke University Medical Center, NC 27710 USA
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19
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VISUALIZATION FROM INTRAOPERATIVE SWEPT-SOURCE MICROSCOPE-INTEGRATED OPTICAL COHERENCE TOMOGRAPHY IN VITRECTOMY FOR COMPLICATIONS OF PROLIFERATIVE DIABETIC RETINOPATHY. Retina 2018; 38 Suppl 1:S110-S120. [PMID: 29324591 DOI: 10.1097/iae.0000000000002021] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the use of live volumetric (4D) intraoperative swept-source microscope-integrated optical coherence tomography in vitrectomy for proliferative diabetic retinopathy complications. METHODS In this prospective study, we analyzed a subgroup of patients with proliferative diabetic retinopathy complications who required vitrectomy and who were imaged by the research swept-source microscope-integrated optical coherence tomography system. In near real time, images were displayed in stereo heads-up display facilitating intraoperative surgeon feedback. Postoperative review included scoring image quality, identifying different diabetic retinopathy-associated pathologies and reviewing the intraoperatively documented surgeon feedback. RESULTS Twenty eyes were included. Indications for vitrectomy were tractional retinal detachment (16 eyes), combined tractional-rhegmatogenous retinal detachment (2 eyes), and vitreous hemorrhage (2 eyes). Useful, good-quality 2D (B-scans) and 4D images were obtained in 16/20 eyes (80%). In these eyes, multiple diabetic retinopathy complications could be imaged. Swept-source microscope-integrated optical coherence tomography provided surgical guidance, e.g., in identifying dissection planes under fibrovascular membranes, and in determining residual membranes and traction that would benefit from additional peeling. In 4/20 eyes (20%), acceptable images were captured, but they were not useful due to high tractional retinal detachment elevation which was challenging for imaging. CONCLUSION Swept-source microscope-integrated optical coherence tomography can provide important guidance during surgery for proliferative diabetic retinopathy complications through intraoperative identification of different complications and facilitation of intraoperative decision making.
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20
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Hitzenberger CK. Optical coherence tomography in Optics Express [Invited]. OPTICS EXPRESS 2018; 26:24240-24259. [PMID: 30184910 DOI: 10.1364/oe.26.024240] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 08/15/2018] [Indexed: 06/08/2023]
Abstract
Optical coherence tomography (OCT) is one of the most successful technologies in the history of biomedical optics. Optics Express played an important role in communicating groundbreaking technological achievements in the field of OCT, and, conversely, OCT papers are among the most frequently cited papers published in Optics Express. On the occasion of the 20th anniversary of the journal, this review analyzes the reasons for the success of OCT papers in Optics Express and discusses possible motivations for researchers to submit some of their best OCT papers to the journal.
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21
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Real-Time Volumetric Imaging of Vitreoretinal Surgery with a Prototype Microscope-Integrated Swept-Source OCT Device. ACTA ACUST UNITED AC 2018; 2:401-410. [DOI: 10.1016/j.oret.2017.08.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Revised: 08/24/2017] [Accepted: 08/28/2017] [Indexed: 11/21/2022]
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22
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Hsu ST, Gabr H, Viehland C, Sleiman K, Ngo HT, Carrasco-Zevallos OM, Vajzovic L, McNabb RP, Stinnett SS, Izatt JA, Kuo AN, Toth CA. Volumetric Measurement of Subretinal Blebs Using Microscope-Integrated Optical Coherence Tomography. Transl Vis Sci Technol 2018; 7:19. [PMID: 29651361 PMCID: PMC5894912 DOI: 10.1167/tvst.7.2.19] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 02/02/2018] [Indexed: 02/06/2023] Open
Abstract
PURPOSE We advance studies of subretinal treatments by developing a microscope-integrated optical coherence tomography (MIOCT) image-based method for measuring the volume of therapeutics delivered into the subretinal space. METHODS A MIOCT image-based volume measurement method was developed and assessed for accuracy and reproducibility by imaging an object of known size in model eyes. This method then was applied to subretinal blebs created by injection of diluted triamcinolone. Bleb volumes obtained from MIOCT were compared to the intended injection volume and the surgeon's estimation of leakage. RESULTS Validation of the image-based volume measurement method showed accuracy to ±1.0 μL (6.0% of measured volume) with no statistically significant variation under different imaging settings. When this method was applied to subretinal blebs, four of 11 blebs without surgeon-observed leakage yielded a mean volume of 32 ± 12.5 μL, in contrast to the intended 50 μL volume injected from the delivery device. This constituted a mean difference of -18 μL (mean percent error, 36 ± 25%). For all 11 blebs, the surgeon's estimations of leakage were significantly different from and showed no correlation with the volume loss based on image-based volume measurements (P < 0.001, paired t-test; intraclass correlation = 0). CONCLUSIONS We validated an accurate and reproducible method for measuring subretinal volumes using MIOCT. Use of this method revealed that the intended volume might not be delivered into the subretinal space. MIOCT can allow for accurate assessment of subretinal dose delivered, which may have therapeutic implications in evaluating the efficacy and toxicity of subretinal therapies. TRANSLATIONAL RELEVANCE Use of MIOCT can provide feedback on the accuracy of subretinal injection volumes delivered.
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Affiliation(s)
- S. Tammy Hsu
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Hesham Gabr
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
- Department of Ophthalmology, Ain-Shams University, Cairo, Egypt
| | | | - Karim Sleiman
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Hoan T. Ngo
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | | | - Lejla Vajzovic
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Ryan P. McNabb
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Sandra S. Stinnett
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Joseph A. Izatt
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Anthony N. Kuo
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Cynthia A. Toth
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
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23
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Uchida A, Srivastava SK, Ehlers JP. Update on the Intraoperative OCT: Where Do We Stand? CURRENT OPHTHALMOLOGY REPORTS 2018. [DOI: 10.1007/s40135-018-0160-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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24
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Bhullar PK, Carrasco-Zevallos OM, Dandridge A, Pasricha ND, Keller B, Shen L, Izatt JA, Toth CA, Kuo AN. Intraocular Pressure and Big Bubble Diameter in Deep Anterior Lamellar Keratoplasty: An Ex-Vivo Microscope-Integrated OCT With Heads-Up Display Study. Asia Pac J Ophthalmol (Phila) 2017; 6:412-417. [PMID: 28930381 PMCID: PMC5658009 DOI: 10.22608/apo.2017265] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 09/06/2017] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To investigate the relationship between intraocular pressure (IOP) and big bubble (BB) formation in a model of deep anterior lamellar keratoplasty (DALK). DESIGN Ex-vivo. METHODS Corneoscleral buttons from human donors were loaded onto an artificial anterior chamber connected to a column of balanced salt solution. A surgeon-in-training learned to perform DALK via the BB technique using swept-source microscope-integrated optical coherence tomography (SS-MIOCT) with heads-up display (HUD). DALK procedures were performed at 6 different IOPs (5, 10, 15, 20, 30, or 40 mm Hg; n = 6 per group) in a randomized fashion, with the surgeon-in-training masked to the pressure and guided by SS-MIOCT with HUD. For a subset of corneas within each pressure group, DALK was performed on matching donor tissue at a control IOP. BB diameter was recorded, and a diameter exceeding the trephine diameter was considered optimal. RESULTS Wilcoxon rank sum test showed a difference in BB diameter among the different pressure groups (mean ± SD of 7.75 ± 1.60, 8.33 ± 1.99, 10.9 ± 0.92, 9.08 ± 1.07, 6.67 ± 3.33, and 3.42 ± 3.77 mm in the 5, 10, 15, 20, 30, and 40 mm Hg groups, respectively; P = 0.0014). Per Tukey test, this difference was attributable to comparisons between the 40 mm Hg group and the 5, 10, 15, or 20 mm Hg groups (P = 0.04, 0.02, 0.0001, 0.004, respectively). CONCLUSIONS In this ex-vivo model of DALK, the BB technique guided by SS-MIOCT with HUD yielded bubbles of optimal diameters only at physiologic pressures (10‒20 mm Hg). Extremely high IOP (40 mm Hg) resulted in BBs of significantly smaller diameter than BBs obtained at physiologic and low (5 mm Hg) IOPs.
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Affiliation(s)
- Paramjit K Bhullar
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC
| | | | | | - Neel D Pasricha
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC
| | - Brenton Keller
- Department of Biomedical Engineering, Duke University, Durham, NC
| | - Liangbo Shen
- Department of Biomedical Engineering, Duke University, Durham, NC
| | - Joseph A Izatt
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC
- Department of Biomedical Engineering, Duke University, Durham, NC
| | - Cynthia A Toth
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC
- Department of Biomedical Engineering, Duke University, Durham, NC
| | - Anthony N Kuo
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC
- Department of Biomedical Engineering, Duke University, Durham, NC
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25
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Chen X, Viehland C, Carrasco-Zevallos OM, Keller B, Vajzovic L, Izatt JA, Toth CA. Microscope-Integrated Optical Coherence Tomography Angiography in the Operating Room in Young Children With Retinal Vascular Disease. JAMA Ophthalmol 2017; 135:483-486. [PMID: 28384676 DOI: 10.1001/jamaophthalmol.2017.0422] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Importance Intraoperative optical coherence tomography (OCT) has gained traction as an important adjunct for clinical decision making during vitreoretinal surgery, and OCT angiography (OCTA) has provided novel insights in clinical evaluation of retinal diseases. To date, these two technologies have not been applied in combination to evaluate retinal vascular disease in the operating suite. Objective To conduct microscope-integrated, swept-source OCTA (MIOCTA) in children with retinal vascular disease. Design, Setting, and Participants In this case report analysis, OCT imaging in pediatric patients, MIOCTA images were obtained during examination under anesthesia from a young boy with a history of idiopathic vitreous hemorrhage and a female infant with familial exudative vitreoretinopathy. Main Outcomes and Measures Side-by-side comparison of research MIOCT angiograms and clinically indicated fluorescein angiograms. Results In 2 young children with retinal vascular disease, the MIOCTA images showed more detailed vascular patterns than were visible on the fluorescein angiograms although within a more posterior field of view. The MIOCTA system allowed visualization of small pathological retinal vessels in the retinal periphery that were obscured in the fluorescein angiograms by fluorescein staining from underlying, preexisting laser scars. Conclusions and Relevance This is the first report to date of the use of MIOCTA in the operating room for young children with retinal vascular disease. Further optimization of this system may allow noninvasive detailed evaluation of retinal vasculature during surgical procedures and in patients who could not cooperate with in-office examinations.
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Affiliation(s)
- Xi Chen
- Department of Ophthalmology, Duke University, Durham, North Carolina
| | - Christian Viehland
- Department of Biomedical Engineering, Duke University, Durham, North Carolina
| | | | - Brenton Keller
- Department of Biomedical Engineering, Duke University, Durham, North Carolina
| | - Lejla Vajzovic
- Department of Ophthalmology, Duke University, Durham, North Carolina
| | - Joseph A Izatt
- Department of Biomedical Engineering, Duke University, Durham, North Carolina
| | - Cynthia A Toth
- Department of Ophthalmology, Duke University, Durham, North Carolina2Department of Biomedical Engineering, Duke University, Durham, North Carolina
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26
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Chen X, Viehland C, Carrasco-Zevallos OM, Keller B, Vajzovic L, Izatt JA, Toth CA. Microscope-Integrated Optical Coherence Tomography Angiography in the Operating Room in Young Children With Retinal Vascular Disease. JAMA Ophthalmol 2017. [PMID: 28384676 PMCID: PMC5847110 DOI: 10.1001/jamaophthalmol.2017.0422&utm_campaign=articlepdf%26utm_medium=articlepdflink%26utm_source=articlepdf%26utm_content=jamaophthalmol.2017.0422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Importance Intraoperative optical coherence tomography (OCT) has gained traction as an important adjunct for clinical decision making during vitreoretinal surgery, and OCT angiography (OCTA) has provided novel insights in clinical evaluation of retinal diseases. To date, these two technologies have not been applied in combination to evaluate retinal vascular disease in the operating suite. Objective To conduct microscope-integrated, swept-source OCTA (MIOCTA) in children with retinal vascular disease. Design, Setting, and Participants In this case report analysis, OCT imaging in pediatric patients, MIOCTA images were obtained during examination under anesthesia from a young boy with a history of idiopathic vitreous hemorrhage and a female infant with familial exudative vitreoretinopathy. Main Outcomes and Measures Side-by-side comparison of research MIOCT angiograms and clinically indicated fluorescein angiograms. Results In 2 young children with retinal vascular disease, the MIOCTA images showed more detailed vascular patterns than were visible on the fluorescein angiograms although within a more posterior field of view. The MIOCTA system allowed visualization of small pathological retinal vessels in the retinal periphery that were obscured in the fluorescein angiograms by fluorescein staining from underlying, preexisting laser scars. Conclusions and Relevance This is the first report to date of the use of MIOCTA in the operating room for young children with retinal vascular disease. Further optimization of this system may allow noninvasive detailed evaluation of retinal vasculature during surgical procedures and in patients who could not cooperate with in-office examinations.
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Affiliation(s)
- Xi Chen
- Department of Ophthalmology, Duke University, Durham, North Carolina
| | - Christian Viehland
- Department of Biomedical Engineering, Duke University, Durham, North Carolina
| | | | - Brenton Keller
- Department of Biomedical Engineering, Duke University, Durham, North Carolina
| | - Lejla Vajzovic
- Department of Ophthalmology, Duke University, Durham, North Carolina
| | - Joseph A. Izatt
- Department of Biomedical Engineering, Duke University, Durham, North Carolina
| | - Cynthia A. Toth
- Department of Ophthalmology, Duke University, Durham, North Carolina,Department of Biomedical Engineering, Duke University, Durham, North Carolina
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27
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Carrasco-Zevallos OM, Viehland C, Keller B, Draelos M, Kuo AN, Toth CA, Izatt JA. Review of intraoperative optical coherence tomography: technology and applications [Invited]. BIOMEDICAL OPTICS EXPRESS 2017; 8:1607-1637. [PMID: 28663853 PMCID: PMC5480568 DOI: 10.1364/boe.8.001607] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 02/09/2017] [Accepted: 02/09/2017] [Indexed: 05/19/2023]
Abstract
During microsurgery, en face imaging of the surgical field through the operating microscope limits the surgeon's depth perception and visualization of instruments and sub-surface anatomy. Surgical procedures outside microsurgery, such as breast tumor resections, may also benefit from visualization of the sub-surface tissue structures. The widespread clinical adoption of optical coherence tomography (OCT) in ophthalmology and its growing prominence in other fields, such as cancer imaging, has motivated the development of intraoperative OCT for real-time tomographic visualization of surgical interventions. This article reviews key technological developments in intraoperative OCT and their applications in human surgery. We focus on handheld OCT probes, microscope-integrated OCT systems, and OCT-guided laser treatment platforms designed for intraoperative use. Moreover, we discuss intraoperative OCT adjuncts and processing techniques currently under development to optimize the surgical feedback derivable from OCT data. Lastly, we survey salient clinical studies of intraoperative OCT for human surgery.
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Affiliation(s)
| | - Christian Viehland
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Brenton Keller
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Mark Draelos
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Anthony N. Kuo
- Department of Ophthalmology, Duke University Medical Center, NC 27710, USA
| | - Cynthia A. Toth
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
- Department of Ophthalmology, Duke University Medical Center, NC 27710, USA
| | - Joseph A. Izatt
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
- Department of Ophthalmology, Duke University Medical Center, NC 27710, USA
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28
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Malone JD, El-Haddad MT, Bozic I, Tye LA, Majeau L, Godbout N, Rollins AM, Boudoux C, Joos KM, Patel SN, Tao YK. Simultaneous multimodal ophthalmic imaging using swept-source spectrally encoded scanning laser ophthalmoscopy and optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2017; 8:193-206. [PMID: 28101411 PMCID: PMC5231292 DOI: 10.1364/boe.8.000193] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 12/06/2016] [Accepted: 12/07/2016] [Indexed: 05/18/2023]
Abstract
Scanning laser ophthalmoscopy (SLO) benefits diagnostic imaging and therapeutic guidance by allowing for high-speed en face imaging of retinal structures. When combined with optical coherence tomography (OCT), SLO enables real-time aiming and retinal tracking and provides complementary information for post-acquisition volumetric co-registration, bulk motion compensation, and averaging. However, multimodality SLO-OCT systems generally require dedicated light sources, scanners, relay optics, detectors, and additional digitization and synchronization electronics, which increase system complexity. Here, we present a multimodal ophthalmic imaging system using swept-source spectrally encoded scanning laser ophthalmoscopy and optical coherence tomography (SS-SESLO-OCT) for in vivo human retinal imaging. SESLO reduces the complexity of en face imaging systems by multiplexing spatial positions as a function of wavelength. SESLO image quality benefited from single-mode illumination and multimode collection through a prototype double-clad fiber coupler, which optimized scattered light throughput and reduce speckle contrast while maintaining lateral resolution. Using a shared 1060 nm swept-source, shared scanner and imaging optics, and a shared dual-channel high-speed digitizer, we acquired inherently co-registered en face retinal images and OCT cross-sections simultaneously at 200 frames-per-second.
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Affiliation(s)
- Joseph D. Malone
- Current Affiliation: Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA
- Previous Affiliation: Ophthalmic Imaging Center, Cole Eye Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Mohamed T. El-Haddad
- Current Affiliation: Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA
- Previous Affiliation: Ophthalmic Imaging Center, Cole Eye Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Ivan Bozic
- Current Affiliation: Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA
- Previous Affiliation: Ophthalmic Imaging Center, Cole Eye Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Logan A. Tye
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
| | | | - Nicolas Godbout
- Castor Optics, Montreal, QC H3T 2B1, Canada
- Centre d’Optique Photonique et Lasers, Polytechnique Montreal, Department of Engineering Physics, Montreal, QC H3C 3A7, Canada
| | - Andrew M. Rollins
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Caroline Boudoux
- Castor Optics, Montreal, QC H3T 2B1, Canada
- Centre d’Optique Photonique et Lasers, Polytechnique Montreal, Department of Engineering Physics, Montreal, QC H3C 3A7, Canada
| | - Karen M. Joos
- Current Affiliation: Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA
- Department of Ophthalmology and Visual Sciences, Vanderbilt University, Nashville, TN 37235, USA
| | - Shriji N. Patel
- Department of Ophthalmology and Visual Sciences, Vanderbilt University, Nashville, TN 37235, USA
| | - Yuankai K. Tao
- Current Affiliation: Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA
- Previous Affiliation: Ophthalmic Imaging Center, Cole Eye Institute, Cleveland Clinic, Cleveland, OH 44195, USA
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29
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Carrasco-Zevallos OM, Nankivil D, Viehland C, Keller B, Izatt JA. Pupil Tracking for Real-Time Motion Corrected Anterior Segment Optical Coherence Tomography. PLoS One 2016; 11:e0162015. [PMID: 27574800 PMCID: PMC5004917 DOI: 10.1371/journal.pone.0162015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 08/16/2016] [Indexed: 12/04/2022] Open
Abstract
Volumetric acquisition with anterior segment optical coherence tomography (ASOCT) is necessary to obtain accurate representations of the tissue structure and to account for asymmetries of the anterior eye anatomy. Additionally, recent interest in imaging of anterior segment vasculature and aqueous humor flow resulted in application of OCT angiography techniques to generate en face and 3D micro-vasculature maps of the anterior segment. Unfortunately, ASOCT structural and vasculature imaging systems do not capture volumes instantaneously and are subject to motion artifacts due to involuntary eye motion that may hinder their accuracy and repeatability. Several groups have demonstrated real-time tracking for motion-compensated in vivo OCT retinal imaging, but these techniques are not applicable in the anterior segment. In this work, we demonstrate a simple and low-cost pupil tracking system integrated into a custom swept-source OCT system for real-time motion-compensated anterior segment volumetric imaging. Pupil oculography hardware coaxial with the swept-source OCT system enabled fast detection and tracking of the pupil centroid. The pupil tracking ASOCT system with a field of view of 15 x 15 mm achieved diffraction-limited imaging over a lateral tracking range of +/- 2.5 mm and was able to correct eye motion at up to 22 Hz. Pupil tracking ASOCT offers a novel real-time motion compensation approach that may facilitate accurate and reproducible anterior segment imaging.
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Affiliation(s)
| | - Derek Nankivil
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, United States of America
| | - Christian Viehland
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, United States of America
| | - Brenton Keller
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, United States of America
| | - Joseph A. Izatt
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, United States of America
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina, United States of America
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