Highspeed, motion-stabilized, handheld OCTA for pediatric imaging

在早产儿中，视网膜和视网膜血管系统的发育在出生时是不完全的， 在婴儿出生后的最初几个月里，许多儿童视网膜疾病，包括视网膜病变， 早产（ROP）具有血管病因学，并且是由视网膜血管系统发育不良引起的。 这段快速增长的时期。有ROP风险的早产儿占新生儿人口的1.4%。光学 相干断层扫描（OCT）是一种非侵入性成像模式 in vivo.这一特点使OCT成为诊断和监测成人疾病的金标准 眼科最近，OCT血管造影术（OCTA）的发展使人们对以下方面有了新的认识： 糖尿病视网膜病变等疾病。然而，这些研究中使用的OCTA系统是大型台式系统， 无法轻易用于新生儿重症监护室（NICU）中婴儿成像的系统。 为了将OCT引入NICU，在过去的十年中，我们的杜克团队已经成为NICU领域的世界领导者。 手持式光学相干断层扫描（HH-OCT）系统的开发和使用。我们率先使用 HH-OCT在新生儿重症监护室我们在HH-OCT系统的使用和设计方面的经验指出了一个明显的问题 儿科眼科的需求。虽然OCT技术在商业桌面系统中发展迅速， 为了包括能够进行OCTA的新的高速OCT技术，商业HH-OCT系统仍然使用较慢的， 十年前的OCT 32 kHz谱域OCT引擎。根据以前的NIH资助（RO 1 EY 025009），我们有 利用我们在手持式眼科成像系统开发方面的专业知识， 基于200 kHz OCT引擎的手持式OCT血管造影（HH-OCTA）探头，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。本研究 项目资助提案旨在汇集一个光学工程师和儿科眼科医生团队， 在HH-OCT系统的设计和翻译方面的专业知识， HH-OCTA硬件的改进，具体目标如下：具体目标1：开发 具有6轴运动稳定功能的高速手持式OCTA系统：对于该提案，我们将开发 运动稳定的HH-OCTA系统，使用800 kHz发动机和惯性测量反馈 该单元可为操作员手部运动提供6轴主动补偿。具体目标2：发展单一 光学相干断层扫描（OCT）视网膜跟踪和眼球运动校正：我们将开发新的扫描协议， 能够实现运动伪影的真实的检测、去除和重新扫描的软件， 扫描激光检眼镜或其它类似的成像模式。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，能够进行宽视场、运动校正成像。 鉴于许多儿童视网膜疾病的血管性质，我们期望这些图像将导致新的见解 在患病和正常状态下视网膜的发育过程中。

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.