Development of a Fiber-Optic Optical Coherence Tomography Probe for Intraocular Use

Abstract

PURPOSE. To evaluate the performance of a newly developed 23-G optical coherence tomography (OCT) probe in animal and human eyes. METHODS.The probe is a side-imaging OCT device with a scanning beam set 438 to the optical axis and a working distance of 1.5 to 2.0 mm. The performance of the OCT probe was tested during vitrectomy in porcine cadaver eyes and rabbit eyes in situ. Optical coherence tomography images of a normal retina, retinal break, optic disc, pars plicata of the ciliary body, and intraoperative surgical manipulations were recorded. The probe was also tested in a pilot study of clinical cases; intraoperative real-time OCT imaging was performed in three patients, including a 56-year-old woman with an epiretinal membrane.RESULTS. The OCT probe was able to delineate intraocular tissues, including the posterior retina, and even the most peripheral pars plicata in animal eyes. The OCT probe also successfully delineated intraoperative surgical maneuvers such as membrane peeling and the minute structures of the vortex veins, ora serrata, and vitreous incarceration in the scleral incision from the trocar with sufficient resolution in the patients. There were no complications resulting from its use.CONCLUSIONS. The ability of this new 23-G OCT probe to obtain images of intraoperative manipulations from the most peripheral tissues in animal and patient eyes suggests that it could enable surgeons to make better decisions during the course of intraocular surgery.

Subretinal surgery: functional and histological consequences of entry into the subretinal space

“…Recently, progress has been made toward motorized, robot‐assisted instruments and the integration of OCT in the intraocular equipment, allowing precise control (Asami et al. ; Willekens et al. ).…”

Correlation of spectral domain optical coherence tomography with histology and electron microscopy in the porcine retina

“…The pig model is being increasingly used to study retinal physiology and pathophysiology related to human diseases (Hein et al, 2012; Hein et al, 2015; Hein et al, 2016; Lim et al, 2018), and several investigators have used the porcine eye to study the application of intraoperative OCT for human vitreoretinal surgery (Asami et al, 2016; Ehlers et al, 2014; Hahn et al, 2013; Li et al, 2014). Recently, investigators have employed advanced clinical imaging techniques, including swept source and spectral domain OCT, and tissue-based biomarkers in the porcine eye in an attempt to reduce the utilization of nonhuman primates for toxicology studies (Atzpodien et al, 2016); however, the correlation between OCT images and the corresponding lamellar architecture and cellular constituents of the retina was not addressed or documented even though the anatomical attribution of OCT signals in the human retina have been studied extensively (Cuenca et al, 2018; Spaide and Curcio, 2011; Staurenghi et al, 2014).…”

Review of intraoperative optical coherence tomography: technology and applications [Invited]

“…The functionality of this probe was evaluated in cadaver porcine eyes. Moreover, a side-imaging 23-gauge OCT probe was demonstrated by Asami et al in 2016 and tested in cadaver porcine eyes and three human retinal surgeries [106]. Using this probe, the researchers successfully imaged various intraoperative maneuvers and subtle surgical structures of interest.…”