Time-Resolved Ultra–High Resolution Optical Coherence Tomography for Real-Time Monitoring of Selective Retina Therapy

Steiner, Patrick; Ebneter, Andreas; Berger, Lieselotte Erika; Zinkernagel, Martin; Povazay, Boris; Meier, Christoph; Kowal, Horst Jens; Framme, Carsten Karl Josef; Brinkmann, Ralf; Wolf, Sebastian; Sznitman, Raphael (2015). Time-Resolved Ultra–High Resolution Optical Coherence Tomography for Real-Time Monitoring of Selective Retina Therapy. Investigative ophthalmology & visual science, 56(11), pp. 6654-6662. Association for Research in Vision and Ophthalmology 10.1167/iovs.15-17151

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Purpose: Selective retina therapy (SRT) is a novel treatment for retinal pathologies, solely targeting the retinal pigment epithelium (RPE). During SRT, the detection of an immediate tissue reaction is challenging as tissue effects remain limited to intracellular RPE photodisruption. Time-resolved ultra-high axial resolution optical coherence tomography (OCT) is thus evaluated for the monitoring of dynamic optical changes at and around the RPE during SRT. Methods: An experimental OCT system with an ultra-high axial resolution of 1.78 µm was combined with an SRT system and time-resolved OCT M-scans of the target area were recorded from four patients undergoing SRT. OCT scans were analyzed and OCT morphology was correlated with findings in fluorescein angiography, fundus photography and cross-sectional OCT. Results: In cases where the irradiation caused RPE damage proven by fluorescein angiography, the lesions were well discernible in time-resolved OCT images but remained invisible in fundus photography and cross-sectional OCT acquired after treatment. If RPE damage was introduced, all applied SRT pulses led to detectable signal changes in the time-resolved OCT images. The extent of optical signal variation seen in the OCT data appeared to scale with the applied SRT pulse energy. Conclusion: The first clinical results proved that successful SRT irradiation induces detectable changes in the OCT M-scan signal while it remains invisible in conventional ophthalmoscopic imaging. Thus, real-time high-resolution OCT is a promising modality to monitor and analyze tissue effects introduced by selective retina therapy and may be used to guide SRT in an automatic feedback mode.

Item Type:

Journal Article (Original Article)

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; Ebneter, Andreas; Berger, Lieselotte Erika; Zinkernagel, Martin; Kowal, Horst Jens; Framme, Carsten Karl Josef; Wolf, Sebastian and Sznitman, Raphael

Subjects:

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

ISSN:

0146-0404

Publisher:

Association for Research in Vision and Ophthalmology

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Patrick Steiner

Date Deposited:

04 Nov 2015 16:13

Last Modified:

06 Nov 2015 18:39

Publisher DOI:

10.1167/iovs.15-17151

BORIS DOI:

10.7892/boris.71509

URI:

https://boris.unibe.ch/id/eprint/71509

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