Highspeed, motion-stabilized, handheld OCTA for pediatric imaging

早产儿的视网膜和视网膜血管系统在出生时发育不全并逐渐发展。 在婴儿出生后的头几个月里。许多儿科视网膜疾病，包括视网膜病变 早产儿(ROP)，有血管病因学，由视网膜血管发育不良引起 这段快速增长的时期。有ROP风险的早产儿占新生儿总数的1.4%。光学 相干层析成像(OCT)是一种非侵入性的成像方式，可以提供微米级的组织成像 在活体内。这一特点使OCT成为成人疾病诊断和监测的金标准 眼科。最近，OCT血管造影术(OCTA)的发展带来了对 糖尿病视网膜病变等疾病。然而，这些研究中使用的OCTA系统都是大型桌面 新生儿重症监护病房(NICU)中不能轻易用于对婴儿进行成像的系统。 为了将OCT引入NICU，在过去的十年里，我们的杜克团队已经成为世界领先的 手持式光学相干层析成像(HH-OCT)系统的开发和使用。我们率先使用了 NICU的HH-OCT。我们在使用和设计HH-OCT系统方面的经验表明， 儿科眼科的需要。虽然商用桌面系统中的OCT技术发展迅速 为了包括能够进行OCTA的新的高速OCT技术，商用HH-OCT系统仍然使用较慢的， 十年OCT 32千赫频域OCT引擎。根据之前的NIH资金(RO1 EY025009)，我们有 利用我们在手持眼科成像系统开发方面的专业知识来开发原型 手持式OCT血管造影术(HH-OCTA)探头，基于200 kHz OCT发动机，已提供初始OCTA NICU中清醒的早产儿视网膜血管发育和病理的图像。这项研究 项目赠款提案旨在将光学工程师和儿科眼科医生团队聚集在一起， 在HH-OCT系统的设计和翻译方面的专业知识，以开发重要的 以下具体目标描述了对HH-OCTA硬件的改进：具体目标1：发展 一种具有6轴运动稳定的高速手持OCTA系统：我们将为这一提议开发 一种运动稳定的HH-OCTA系统，使用800 kHz发动机和惯性测量反馈 该装置可提供操作员手部运动的6轴主动补偿。具体目标2：开发Single 模式(OCT)视网膜跟踪和眼动矫正：我们将开发新的扫描方案和 该软件将实现运动伪像的实时检测、移除和重新扫描，而无需 扫描激光检眼镜或其他类似成像方式。这项提议的预期结果是 设计了一种高速、运动稳定的HH-OCTA系统，能够进行大视场、运动校正成像。 考虑到许多儿科视网膜疾病的血管性质，我们希望这些图像将带来新的见解 在疾病和正常状态下的视网膜的发育。

In pre-term infants the development of the retina and retinal vasculature is incomplete at birth and progresses rapidly during the infant’s first few months of life. Many pediatric retinal diseases, including retinopathy of prematurity (ROP), have a vascular etiology and are caused by mal-development of retinal vasculature during this period of rapid growth. Preterm infants at risk for ROP make up 1.4% of the newborn population. Optical coherence tomography (OCT) is a non-invasive imaging modality that can provide micron scale imaging of tissue in vivo. This characteristic has made OCT the gold standard for diagnosis and monitoring of diseases in adult ophthalmology. More recently the development of OCT angiography (OCTA) has led to new insights into diseases such as diabetic retinopathy. However, the OCTA systems used in these studies are large tabletop systems that cannot be readily used to image infants in the neonatal intensive care unit (NICU). In order to bring OCT into the NICU, over the last decade our Duke team has become world leaders in the development and use of handheld optical coherence tomography (HH-OCT) systems. We pioneered the use of HH-OCT in the NICU. Our experience with the use and design of HH-OCT systems have pointed out a glaring need in pediatric ophthalmology. While OCT technology in commercial tabletop systems has progressed rapidly to include new highspeed OCT technologies capable of OCTA, commercial HH-OCT systems still use slower, decade old OCT 32 kHz spectral domain OCT engines. Under previous NIH funding (RO1 EY025009) we have leveraged our expertise in the development of handheld ophthalmic imaging systems to develop a prototype handheld OCT angiography (HH-OCTA) probe based on a 200 kHz OCT engine that has provided initial OCTA images of retinal vascular development and pathology in awake, pre-term infants in the NICU. This Research Project Grant proposal aims to bring together a team of optical engineers and pediatric ophthalmologists with expertise in the design and translation of HH-OCT systems for the purpose of developing significant improvements to the HH-OCTA hardware descried by the following specific aims: Specific aim 1: Development of a high speed, handheld OCTA system with 6-axis motion stabilization: For this proposal we will develop a motion stabilized HH-OCTA system that uses and 800 kHz engine and feedback from an inertial measurement unit to provide 6 axis active compensation of operator hand motion. Specific aim 2: Development of single modality (OCT) retinal tracking and eye motion correction: We will develop new scanning protocols and software that will enable real time detection, removal, and re-scanning of motion artifacts in without the need for scanning laser ophthalmoscope or other similar imaging modality. The expected outcome of this proposal is the design of a highspeed, motion stabilized HH-OCTA system capable of wide field, motion corrected imaging. Given the vascular nature of many pediatric retinal diseases we expect that these images will lead to new insights into the development of the retina in both diseased and normal states.