The overall five-year goals of the project are to develop novel technology to provide actionable new information through provision of live volumetric imaging during surgery, improving surgical practice and outcomes. The investigators believe this technology will enable novel ophthalmic and other microsurgeries not possible due to current limitations in surgical visualization.
Healthy controls: Healthy eyes without known disease: refractive error including myopia and non-significant cataract is allowed. For selected testing pseudophakia is allowed.
Surgeons as research subjects: Adult (≥18 years old)
Surgical patients (vitreoretinal surgery): Patients undergoing examination under anesthesia or surgery for vitreoretinal diseases
Surgical patients (anterior segment surgery-glaucoma, ocular surface or strabismus requiring extraocular muscle surgery): Include both adults and children. Patient undergoing primary, elective minimally invasive glaucoma surgery, ocular surface surgery, or strabismus surgery.
Healthy controls: Any ocular disease that restricts the ability to perform OCT scanning. Conflict of interest with investigators/study personnel, e.g. a student in the lab of an investigator.
Surgeons as research subjects: no specific exclusion criteria.
Surgical patients (vitreoretinal surgery): Neonates (< 4 weeks of age) and patients with any ocular disease that restricts the ability to perform OCT scanning.
Surgical patients (anterior segment surgery-corneal and cataract diseases): Pediatric patients: The cornea and cataract surgery studies will be restricted to adults (≥ 18 years). Children do not have cataract surgery typically by residents and therefore would not fit our study design. Similarly pediatric corneal transplants are very rare.
262 subjects enrolled in 3 groups as follows: 1. Healthy Controls: 50 subjects 2. Surgeons as research subjects performing randomized testing in wet lab: 22 subjects 3. Surgical patients as research subjects for application to ocular vitreoretinal and anterior segment surgery: 190 subjects
Cohort
Prospective
Microscope integrated optical coherence tomography
DeviceThis is translational study in which subjects will either be imaged with a microscope integrated optical coherence tomography (MIOCT) system or they will use MIOCT during surgical procedures. OCT systems are optical imaging technology that allow non-contact imaging of the microanatomy of the retina, cornea, optic nerve head and retinal blood vessels. The MIOCT has been integrated into the surgical microscope used in retinal and anterior segment surgeries so it does not touch the eye. Unlike visible light from many examination devices, the infrared OCT beam is barely visible to the human eye as it sweeps across the retina. Thus the patient is not disturbed by the light.
Retinal and/or corneal microscope integrated optical coherence tomography image capture
Ability to capture images
Quality of retinal and/or corneal microscope integrated optical coherence tomography image capture
Quality of MIOCT images scored based on standard microanatomy and ability to detect presence or absence of ocular pathologies based on review by a masked grader.
Retinal vascular flow on optical coherence tomography angiography (OCTA) versus fluorescein angiography
Cross correlation of ability to capture vessels and vessel pathology between OCTA and fluorescein angiographic images.
Assessment of change in pattern of ocular vascular flow before and after standard clinical surgical steps.
Presence or absence of change in ocular morphology in pattern of vascular flow compared to prior to surgical steps
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Duke University
Lead sponsor
National Eye Institute (NEI)
Collaborator
