Intraoperative Optical Coherence Tomography for Ophthalmic Surgery

项目摘要 光学相干断层扫描(OCT)已经彻底改变了眼科疾病的管理 它为非侵入性成像提供了精确的解剖信息。高分辨率横断面组织 细节使OCT成为眼科手术的天然补充。术中OCT(IOCT)有可能 向外科医生提供实时反馈，从而改善手术护理和结果。这项研究活动将 专注于将OCT技术转化为手术室，将由The 克利夫兰临床科尔眼科研究所。埃勒斯博士是一位训练有素的视网膜外科医生，在 IOCT领域。他近期的职业目标包括通过以下途径发展他作为临床医生-科学家的技能 在为OCT在手术中的使用建立临床框架的同时，专注于教育努力 房间。这项研究活动的三个目标反映了这些目标，并包括(1)完成 在眼科手术中应用iOCT的综合前瞻性研究，(2)OCT-OCT的设计和测试 友好的手术器械；(3)iOCT软件平台的开发和实施。这个 First Aim将为iOCT在各种手术(如白内障手术、角膜手术)中的应用提供丰富的数据库 移植、黄斑裂孔手术、视网膜前膜手术)。根据初步可行性研究， 将开展多项针对具体情况的研究，以完善iOCT的使用。第二个目标将解决 当前仪器的问题以及与之相关的光透过率差和OCT能见度有限。 正在对新材料和仪器原型进行光学性能测试，以开发OCT友好型 允许对下面的组织和器械进行可视化的仪器。第三个目标将解决 当前软件包的缺点。为此正在开发新的软件算法 研究活动将提供对眼睛状况的细微变化的自动实时分析 在手术期间(例如，黄斑裂孔几何形状改变)。从长远来看，埃勒斯博士计划开发 综合针对疾病的平台，将iOCT应用于外科眼科护理，以改进 并在多中心临床试验中测试这些适应症。除了研究活动， 埃勒斯博士将报名参加凯斯西储大学的临床研究学者计划，以进一步 磨练他的研究技能，为作为一名独立的临床科学家的成功职业生涯奠定基础。 埃勒斯博士组建了一支杰出的导师团队(彼得·凯泽博士、辛西娅·托斯博士和威廉·J·托斯博士)。 Dupps)。导师在仪器设计、生物医学工程、翻译型OCT研究、 软件开发，而iOCT极大地增强了这一研究提案的实力。埃勒斯博士还 与仪器设计(百富勤外科)、软件领域的合作者建立了牢固的合作伙伴关系 开发(ImageIQ)和OCT技术(Bioptigen)。这些伙伴关系还极大地加强了 提案的基础以及短期和长期成功的可能性。

Project Summary Optical coherence tomography (OCT) has revolutionized the management of ophthalmic diseases with the precise anatomic information it provides with non-invasive imaging. The high-resolution cross-sectional tissue details make OCT a natural complement to ophthalmic surgery. Intraoperative OCT (iOCT) has the potential to provide real-time feedback to surgeons thus improving surgical care and outcomes. This research activity will focus on translating OCT technology into the operating room and will be led by Justis P. Ehlers, MD, of the Cleveland Clinic Cole Eye Institute. Dr. Ehlers is a highly trained retina surgeon with extensive experience in the field of iOCT. His immediate career goals include developing his skills as a clinician-scientist through focused educational endeavors while establishing a clinical framework for the use of OCT in the operating room. The three aims of this research activity reflect these goals and include (1) completion of a comprehensive prospective study utilizing iOCT during ophthalmic surgery, (2) design and testing of OCT- friendly surgical instrumentation, and (3) development and implementation of iOCT software platforms. The first aim will provide a rich database for the utility of iOCT in various procedures (e.g., cataract surgery, corneal transplantation, macular hole surgery, epiretinal membrane surgery). Based on the initial feasibility study, multiple condition-specific studies will be carried out to refine the use of iOCT. The second aim will address the problems with current instrumentation and the associated poor light transmission and limited OCT-visibility. Novel materials and instrument prototypes are being tested for their optical properties to develop OCT-friendly instruments that allow for visualization of the underlying tissue and the instrument. The third aim will address the shortcomings of current software packages. Novel software algorithms are in development for this research activity that will provide automated real-time analysis of subtle changes in the conditions of the eye during surgery (e.g., macular hole geometry alterations). In the long-term, Dr. Ehlers plans to develop comprehensive disease-specific platforms for the application of iOCT to surgical eye care in order to improve patient outcomes and test these indications in a multi-center clinical trial. In addition to the research activity, Dr. Ehlers will enroll in the Clinical Research Scholars Program at Case Western Reserve University to further hone his research skills and develop a foundation for a successful career as an independent clinician-scientist. Dr. Ehlers has assembled an outstanding mentorship team (Drs. Peter Kaiser, Cynthia Toth, and William J. Dupps). The mentors' experience in instrument design, biomedical engineering, translational OCT research, software development, and iOCT greatly enhances the strength of this research proposal. Dr. Ehlers has also developed strong partnerships with collaborators in instrument design (Peregrine Surgical), software development (ImageIQ), and OCT technology (Bioptigen). These partnerships also greatly strengthen the foundation of the proposal and the likelihood of both short-term and long-term success.