Depth-Based, Motion-Stabilized Colorization of Microscope-Integrated Optical Coherence Tomography Volumes for Microscope-Independent Microsurgery.

Published online

Journal Article

Purpose: We develop and assess the impact of depth-based, motion-stabilized colorization (color) of microscope-integrated optical coherence tomography (MIOCT) volumes on microsurgical performance and ability to interpret surgical volumes. Methods: Color was applied in real-time as gradients indicating axial position and stabilized based on calculated center of mass. In a test comparing colorization versus grayscale visualizations of prerecorded intraoperative volumes from human surgery, ophthalmologists (N = 7) were asked to identify retinal membranes, the presence of an instrument, its contact with tissue, and associated deformation of the retina. In a separate controlled trial, trainees (N = 15) performed microsurgical skills without conventional optical visualization and compared colorized versus grayscale MIOCT visualization on a stereoptic screen. Skills included thickness identification, instrument placement, and object manipulation, and were assessed based on time, performance metrics, and confidence. Results: In intraoperative volume testing, colorization improved ability to differentiate membrane from retina (P < 0.01), correctly identify instrument contact with membrane (P = 0.03), and retinal deformation (P = 0.01). In model microsurgical skills testing, trainees working with colorized volumes were faster (P < 0.01) and more correct (P < 0.01) in assessments of thickness for recessed and elevated objects, were less likely to inadvertently contact a surface when approaching with an instrument (P < 0.01), and uniformly more confident (P < 0.01 for each) in conducting each skill. Conclusions: Depth-based colorization enables effective identification of retinal membranes and tissue deformation. In microsurgical skill testing, it improves user efficiency, and confidence in microscope-independent, OCT-guided model surgical maneuvers. Translational Relevance: Novel depth-based colorization and stabilization technology improves the use of intraoperative MIOCT.

Full Text

Duke Authors

Cited Authors

  • Bleicher, ID; Jackson-Atogi, M; Viehland, C; Gabr, H; Izatt, JA; Toth, CA

Published Date

  • November 2018

Published In

Volume / Issue

  • 7 / 6

Start / End Page

  • 1 -

PubMed ID

  • 30405965

Pubmed Central ID

  • 30405965

International Standard Serial Number (ISSN)

  • 2164-2591

Digital Object Identifier (DOI)

  • 10.1167/tvst.7.6.1

Language

  • eng

Conference Location

  • United States