| Author |
Sznitman, Raphael Berger, Lieselotte Erika Kowal, Jens H. Framme, Carsten Brinkmann, Ralf Steiner, Patrick Zinkernagel, Martin Povazay, Boris Meier, Christoph Ebneter, Andreas Wolf, Sebastian |
| Description |
Country affiliation: Switzerland Author Affiliation: Steiner P ( ARTORG Center, University of Bern, Bern, Switzerland 2HuCE OptoLab, Berne University of Applied Sciences, Biel, Switzerland.); Ebneter A ( Department of Ophthalmology, Inselspital, Bern, Switzerland.); Berger LE ( Department of Ophthalmology, Inselspital, Bern, Switzerland.); Zinkernagel M ( Department of Ophthalmology, Inselspital, Bern, Switzerland.); Povazay B ( HuCE OptoLab, Berne University of Applied Sciences, Biel, Switzerland.); Meier C ( HuCE OptoLab, Berne University of Applied Sciences, Biel, Switzerland.); Kowal JH ( ARTORG Center, University of Bern, Bern, Switzerland.); Framme C ( Department for Ophthalmology, Medizinische Hochschule Hannover, Hannover, Germany.); Brinkmann R ( Institute of Biomedical Optics, University of Lübeck, Lübeck, Germany 6Medical Laser Center Lübeck GmbH, Lübeck, Germany.); Wolf S ( Department of Ophthalmology, Inselspital, Bern, Switzerland.); Sznitman R ( ARTORG Center, University of Bern, Bern, Switzerland 3Department of Ophthalmology, Inselspital, Bern, Switzerland.) |
| Abstract |
PURPOSE: Selective retina therapy (SRT) is a novel treatment for retinal pathologies, solely targeting the 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. Optical coherence tomography scans were analyzed and OCT morphology was correlated with findings in fluorescein angiography, fundus photography, and cross-sectional OCT. RESULTS: In cases in which 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. CONCLUSIONS: 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 (www.swissmedic.ch number, 2011-MD-0006). |
