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Karen M Joos, Robert Matthews, Nabil Simaan, Ratna Prasad, Tomas Moreno, Yuankai Tao, Jin H Shen; A method of identifying and semi-quantifying retinal pigment epithelial damage following pre-clinical subretinal injections. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5438.
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© ARVO (1962-2015); The Authors (2016-present)
Retinal pigment epithelial (RPE) disturbance has been noted after subretinal injections, but is not well characterized. A method of better describing and quantifying RPE disruption/depigmentation would be useful to improve and optimize the surgical technique to improve subretinal injection precision. This study tested the hypothesis that optical coherence tomography (OCT) may be used to image and quantify RPE and retinal disturbance immediately after acute subretinal injection with additional benefit of avoiding known processing artifacts present in standard serial-section histological evaluation.
In fresh cadaver pig eyes, a 36-gauge cannula connected with fused silica tubing to a 1 cc syringe delivered 30 µl of physiologic saline solution at a rate of 0.2 ml/min by a micro-injection pump. Visualization of the injections occurred with a heads-up 3D-display surgical microscope system. Corneas and lenses were removed to image the injection sites with a 1325 nm spectral domain OCT system (12 µm axial/ 13 µm lateral resolution). The retinas were removed and the underlying tissues were re-imaged to measure the greatest linear disruption of the apical processes of the RPE in orthogonal B-scans using ImageJ software. The disrupted area was estimated using an ellipse encompassing the B-scan measurements.
Retinal holes, subretinal fluid, and underlying RPE disruptions could be visualized using OCT. Following removal of the retina, the estimated RPE disruption area averaged 0.12 ± 0.07 mm2 in 15 specimens with a range of 0.03 mm2 to 0.24 mm2 with these injection parameters.
Optical coherence tomography imaging is capable of semi-quantifying RPE disruptions following subretinal injections and may be useful in comparing parameters and surgical techniques for optimizing subretinal injection delivery.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
Figure: RPE disruption in the XZ-plane of one specimen.
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