Real-time ultra-high optical coherence tomography monitoring of optical tissue effects caused by selective retina therapy

Steiner, Patrick; Meier, Christoph; Berger, Lieselotte Erika; Ebneter, Andreas; Zinkernagel, Martin; Wolf, Sebastian; Sznitman, Raphael (4 May 2015). Real-time ultra-high optical coherence tomography monitoring of optical tissue effects caused by selective retina therapy. In: ARVO Annual Meeting. ARVO

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Purpose: Selective retina therapy (SRT) has shown great promise compared to conventional retinal laser photocoagulation as it avoids collateral damage and selectively targets the retinal pigment epithelium (RPE). Its use, however, is challenging in terms of therapy monitoring and dosage because an immediate tissue reaction is not biomicroscopically discernibel. To overcome these limitations, real-time optical coherence tomography (OCT) might be useful to monitor retinal tissue during laser application. We have thus evaluated a proprietary OCT system for its capability of mapping optical changes introduced by SRT in retinal tissue. Methods: Freshly enucleated porcine eyes, covered in DMEM upon collection were utilized and a total of 175 scans from ex-vivo porcine eyes were analyzed. The porcine eyes were used as an ex-vivo model and results compared to two time-resolved OCT scans, recorded from a patient undergoing SRT treatment (SRT Vario, Medical Laser Center Lübeck). In addition to OCT, fluorescin angiography and fundus photography were performed on the patient and OCT scans were subsequently investigated for optical tissue changes linked to laser application. Results: Biomicroscopically invisible SRT lesions were detectable in OCT by changes in the RPE / Bruch's complex both in vivo and the porcine ex-vivo model. Laser application produced clearly visible optical effects such as hyperreflectivity and tissue distortion in the treated retina. Tissue effects were even discernible in time-resolved OCT imaging when no hyper-reflectivity persisted after treatment. Data from ex-vivo porcine eyes showed similar to identical optical changes while effects visible in OCT appeared to correlate with applied pulse energy, leading to an additional reflective layer when lesions became visible in indirect ophthalmoscopy. Conclusions: Our results support the hypothesis that real-time high-resolution OCT may be a promising modality to obtain additional information about the extent of tissue damage caused by SRT treatment. Data shows that our exvivo porcine model adequately reproduces the effects occurring in-vivo, and thus can be used to further investigate this promising imaging technique.

Item Type:

Conference or Workshop Item (Poster)

Division/Institute:

10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Image Guided Therapy > ARTORG Center - Ophthalmic Technology Lab
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ophthalmology

Graduate School:

Graduate School for Cellular and Biomedical Sciences (GCB)

UniBE Contributor:

Steiner, Patrick; Berger, Lieselotte Erika; Ebneter, Andreas; Zinkernagel, Martin; Wolf, Sebastian and Sznitman, Raphael

Subjects:

600 Technology > 610 Medicine & health
600 Technology > 620 Engineering

Publisher:

ARVO

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Patrick Steiner

Date Deposited:

26 May 2015 14:08

Last Modified:

26 May 2015 14:08

BORIS DOI:

10.7892/boris.68893

URI:

https://boris.unibe.ch/id/eprint/68893

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