Intraoperative Optical Coherence Tomography for Ophthalmic Surgery

眼科手术术中光学相干断层扫描

• 批准号: 8708879
• 负责人: Justis Ehlers
• 金额: $ 20.31万
• 依托单位: CLEVELAND CLINIC LERNER COM-CWRU
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8708879
• 关键词: Address; Affect; Algorithm Design; Algorithmic Software; Anatomy; Anterior; Architecture; Area; Biomedical Engineering; Caring; Cataract Extraction; Cicatrix; Clinic; Clinical; Clinical Research; Clinical Trials; Complement; Computer software; Data; Databases; Development; Disease; Edema; Effectiveness; Enrollment; Epiretinal Membrane; Eye; Feasibility Studies; Feedback; Foundations; Future; Geometry; Goals; Image; Imagery; Imaging Techniques; Institutes; Intervention; Keratoplasty; Knowledge; Macular Hole; Membrane; Mentors; Mentorship; Multi-Institutional Clinical Trial; NCI Scholars Program; Operating Rooms; Operative Surgical Procedures; Optical Coherence Tomography; Optics; Outcome; Patient Care; Patients; Procedures; Process; Property; Prospective Studies; Research; Research Activity; Research Proposals; Resolution; Retina; Retinal; Scientist; Shadowing (Histology); Surgeon; Surgical Instruments; System; Technology; Testing; Thick; Time; Tissues; Training; Translating; Translations; Universities; base; career; clinical application; design; experience; improved; instrument; instrumentation; knowledge base; light scattering; light transmission; non-invasive imaging; novel; prospective; prototype; public health relevance; research and development; skills; software development; success

DESCRIPTION (provided by applicant): 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 carrid 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, r. 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.

描述（由申请人提供）：光学相干断层扫描（OCT）通过非侵入性成像提供精确的解剖信息，彻底改变了眼科疾病的管理。高分辨率的横截面组织细节使OCT成为眼科手术的自然补充。术中OCT（iOCT）有可能为外科医生提供实时反馈，从而改善手术护理和结局。这项研究活动将侧重于将OCT技术转化为手术室，并将由克利夫兰诊所科尔眼科研究所的Justis P. Ehlers博士领导。埃勒斯博士是一位训练有素的 在iOCT领域拥有丰富经验的视网膜外科医生。他的近期职业目标包括通过集中的教育努力发展他作为临床科学家的技能，同时建立在手术室中使用OCT的临床框架。本研究活动的三个目标反映了这些目标，包括（1）完成在眼科手术中使用iOCT的全面前瞻性研究，（2）设计和测试OCT友好型手术器械，以及（3）开发和实施iOCT软件平台。第一个目标是为iOCT在各种手术中的应用提供丰富的数据库 (e.g.,白内障手术、角膜移植、黄斑裂孔手术、视网膜前膜手术）。根据初步可行性研究，将开展多项特定条件研究，以完善iOCT的使用。第二个目标将解决当前仪器的问题以及相关的光传输差和OCT可见度有限。正在测试新型材料和仪器原型的光学特性，以开发OCT友好型仪器，从而实现底层组织和仪器的可视化。第三个目标是解决目前软件包的缺点。正在为这项研究活动开发新的软件算法，该算法将提供手术期间眼睛状况细微变化的自动实时分析（例如，黄斑裂孔几何形状改变）。从长远来看，Ehlers博士计划开发全面的疾病特异性平台，将iOCT应用于外科眼科护理，以改善患者的预后，并在多中心临床试验中测试这些适应症。除了研究活动，R。埃勒斯将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，并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·凯撒博士、辛西娅·托特博士和威廉·J·杜普斯博士）。导师们在仪器设计、生物医学工程、平移OCT研究、软件开发和iOCT方面的经验大大增强了这项研究提案的实力。Ehlers博士还与仪器设计（Peregrine Surgical）、软件开发（ImageIQ）和OCT技术（Bioptigen）方面的合作者建立了牢固的合作伙伴关系。这些伙伴关系还大大加强了提案的基础，以及短期和长期成功的可能性。