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Preclinical evaluation and intraoperative human retinal imaging with a high-resolution microscope-integrated spectral domain optical coherence tomography device.

Publication ,  Journal Article
Hahn, P; Migacz, J; O'Donnell, R; Day, S; Lee, A; Lin, P; Vann, R; Kuo, A; Fekrat, S; Mruthyunjaya, P; Postel, EA; Izatt, JA; Toth, CA
Published in: Retina
2013

PURPOSE: The authors have recently developed a high-resolution microscope-integrated spectral domain optical coherence tomography (MIOCT) device designed to enable OCT acquisition simultaneous with surgical maneuvers. The purpose of this report is to describe translation of this device from preclinical testing into human intraoperative imaging. METHODS: Before human imaging, surgical conditions were fully simulated for extensive preclinical MIOCT evaluation in a custom model eye system. Microscope-integrated spectral domain OCT images were then acquired in normal human volunteers and during vitreoretinal surgery in patients who consented to participate in a prospective institutional review board-approved study. Microscope-integrated spectral domain OCT images were obtained before and at pauses in surgical maneuvers and were compared based on predetermined diagnostic criteria to images obtained with a high-resolution spectral domain research handheld OCT system (HHOCT; Bioptigen, Inc) at the same time point. Cohorts of five consecutive patients were imaged. Successful end points were predefined, including ≥80% correlation in identification of pathology between MIOCT and HHOCT in ≥80% of the patients. RESULTS: Microscope-integrated spectral domain OCT was favorably evaluated by study surgeons and scrub nurses, all of whom responded that they would consider participating in human intraoperative imaging trials. The preclinical evaluation identified significant improvements that were made before MIOCT use during human surgery. The MIOCT transition into clinical human research was smooth. Microscope-integrated spectral domain OCT imaging in normal human volunteers demonstrated high resolution comparable to tabletop scanners. In the operating room, after an initial learning curve, surgeons successfully acquired human macular MIOCT images before and after surgical maneuvers. Microscope-integrated spectral domain OCT imaging confirmed preoperative diagnoses, such as full-thickness macular hole and vitreomacular traction, and demonstrated postsurgical changes in retinal morphology. Two cohorts of five patients were imaged. In the second cohort, the predefined end points were exceeded with ≥80% correlation between microscope-mounted OCT and HHOCT imaging in 100% of the patients. CONCLUSION: This report describes high-resolution MIOCT imaging using the prototype device in human eyes during vitreoretinal surgery, with successful achievement of predefined end points for imaging. Further refinements and investigations will be directed toward fully integrating MIOCT with vitreoretinal and other ocular surgery to image surgical maneuvers in real time.

Duke Scholars

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Published In

Retina

DOI

EISSN

1539-2864

Publication Date

2013

Volume

33

Issue

7

Start / End Page

1328 / 1337

Location

United States

Related Subject Headings

  • Tomography, Optical Coherence
  • Surveys and Questionnaires
  • Surgery, Computer-Assisted
  • Retinal Diseases
  • Ophthalmology & Optometry
  • Monitoring, Intraoperative
  • Microscopy
  • Imaging, Three-Dimensional
  • Humans
  • Diagnostic Techniques, Ophthalmological
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Hahn, P., Migacz, J., O’Donnell, R., Day, S., Lee, A., Lin, P., … Toth, C. A. (2013). Preclinical evaluation and intraoperative human retinal imaging with a high-resolution microscope-integrated spectral domain optical coherence tomography device. Retina, 33(7), 1328–1337. https://doi.org/10.1097/IAE.0b013e3182831293
Hahn, Paul, Justin Migacz, Rachelle O’Donnell, Shelley Day, Annie Lee, Phoebe Lin, Robin Vann, et al. “Preclinical evaluation and intraoperative human retinal imaging with a high-resolution microscope-integrated spectral domain optical coherence tomography device.Retina 33, no. 7 (2013): 1328–37. https://doi.org/10.1097/IAE.0b013e3182831293.
Hahn, Paul, et al. “Preclinical evaluation and intraoperative human retinal imaging with a high-resolution microscope-integrated spectral domain optical coherence tomography device.Retina, vol. 33, no. 7, 2013, pp. 1328–37. Pubmed, doi:10.1097/IAE.0b013e3182831293.
Hahn P, Migacz J, O’Donnell R, Day S, Lee A, Lin P, Vann R, Kuo A, Fekrat S, Mruthyunjaya P, Postel EA, Izatt JA, Toth CA. Preclinical evaluation and intraoperative human retinal imaging with a high-resolution microscope-integrated spectral domain optical coherence tomography device. Retina. 2013;33(7):1328–1337.

Published In

Retina

DOI

EISSN

1539-2864

Publication Date

2013

Volume

33

Issue

7

Start / End Page

1328 / 1337

Location

United States

Related Subject Headings

  • Tomography, Optical Coherence
  • Surveys and Questionnaires
  • Surgery, Computer-Assisted
  • Retinal Diseases
  • Ophthalmology & Optometry
  • Monitoring, Intraoperative
  • Microscopy
  • Imaging, Three-Dimensional
  • Humans
  • Diagnostic Techniques, Ophthalmological