June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
A method of identifying and semi-quantifying retinal pigment epithelial damage following pre-clinical subretinal injections
Author Affiliations & Notes
  • Karen M Joos
    Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, Tennessee, United States
    Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, United States
  • Robert Matthews
    Molecular Physiology and BioPhysics, Vanderbilt University, Nashville, Tennessee, United States
  • Nabil Simaan
    Mechanical Engineering, Vanderbilt University, Nashville, Tennessee, United States
  • Ratna Prasad
    Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Tomas Moreno
    Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Yuankai Tao
    Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, United States
  • Jin H Shen
    Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Footnotes
    Commercial Relationships   Karen Joos, Vanderbilt University (P); Robert Matthews, None; Nabil Simaan, Auris Surgical (P), Intuitive Surgical (P), Titan Medical (P), Vanderbilt University (P); Ratna Prasad, None; Tomas Moreno, None; Yuankai Tao, Leica (P), Leica (R); Jin Shen, Vanderbilt University (P)
  • Footnotes
    Support  Physician in Residence VISE Program, NSFCMMI-1537659, Joseph Ellis Family Research Fund, William Black Research Fund, NIH P30EY008126 to Vanderbilt Vision Research Center, and an Unrestricted Departmental Grant from Research to Prevent Blindness, Inc., N.Y. to the Vanderbilt Eye Institute
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 5438. doi:
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    • Get Citation

      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)

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Abstract

Purpose : 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.

Methods : 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.

Results : 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.

Conclusions : 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.

Figure: RPE disruption in the XZ-plane of one specimen.

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