Abstract
Selective retina therapy (SRT) is an ophthalmological laser technique, targeting the retinal pigment epithelium (RPE) with repetitive microsecond laser pulses, while causing no thermal damage to the neural retina, the photoreceptors as well as the choroid. The RPE cells get damaged mechanically by microbubbles originating, at the intracellular melanosomes. Beneficial effects of SRT on Central Serous Retinopathy (CSR) and Diabetic Macula Edema (DME) have already been shown. Variations in the transmission of the anterior eye media and pigmentation variation of RPE yield in intra- and inter- individual thresholds of the pulse energy required for selective RPE damage. Those selective RPE lesions are not visible. Thus, dosimetry-systems, designed to detect microbubbles as an indicator for RPE cell damage, are demanded elements to facilitate SRT application. Therefore, a technique based on the evaluation of backscattered treatment light has been developed. Data of 127 spots, acquired during 10 clinical treatments of CSR patients, were assigned to a RPE cell damage class, validated by fluorescence angiography (FLA). An algorithm has been designed to match the FLA based information. A sensitivity of 0.9 with a specificity close to 1 is achieved. The data can be processed within microseconds. Thus, the process can be implemented in existing SRT lasers with an automatic pulse wise increasing energy and an automatic irradiation ceasing ability to enable automated treatment close above threshold to prevent adverse effects caused by too high pulse energy. Alternatively, a guidance procedure, informing the treating clinician about the adequacy of the actual settings, is possible.
Original language | English |
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Title of host publication | Ophthalmic Technologies XXVIII |
Editors | Fabrice Manns, Per G. Söderberg, Arthur Ho |
Number of pages | 10 |
Volume | 10474 |
Publisher | SPIE |
Publication date | 08.03.2018 |
Article number | 104740P |
ISBN (Print) | 978-151061433-8 |
DOIs | |
Publication status | Published - 08.03.2018 |
Event | 28th Conference on Ophthalmic Technologies - Moscone Center, San Francisco, United States Duration: 27.01.2018 → 28.01.2018 Conference number: 135614 |
Research Areas and Centers
- Academic Focus: Biomedical Engineering