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Chrishan Duminda Gunasekera, Jignesh Patel, Peter Thomas, Philip Alexander; Intracoronary optical coherence tomography catheter for fiber-optic endoscopic trans-vitreal optical coherence tomography of the retina to diagnose peripheral retinal tears. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3127.
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© ARVO (1962-2015); The Authors (2016-present)
Intraoperative Optical Coherence Tomography (OCT) is currently limited to use in the posterior pole of the retina.Imaging the peripheral retina may aid retinal surgeons identifying retinal tears during vitrectomy or retinal detachment surgery. In a proportion of patients, a retinal tear is not identifiable. This may be due to the limited resolving power of the surgeon. OCT can provide high-resolution images.Endoscopic fiber-optic intracoronary OCT is an evolving technology in Cardiology. An OCT catheter is passed into the coronary arteries to obtain high-resolution in vivo images of coronary arteries and deployed stents.We present pilot images from an ex vivo feasibility study using an intracoronary OCT catheter for ocular use in order to visualize peripheral retina, retinal tears and detachments.
A swept source handheld 2.7 french (20 gauge) frequency domain Dragonfly™ OPTIS™ OCT catheter from St. Jude Medical was used on enucleated porcine eyes. Images were obtained with the ILUMIEN™ OPTIS™ PCI Optimization™ System.Retinal tears and detachment were created using a 30 gauge needle in enucleated porcine eyes and scanned under direct observation. The OCT catheter was placed 2-4mm away from retina to obtain real-time images.
Enucleated porcine peripheral retina was successfully imaged with real time endoscopic trans-vitreal OCT. Peripheral retina, retinal tears (Figure 1) and detachments (Figure 2) were successfully imaged. Scleral indentation aided in identifying retinal tears. The axial resolution was between 15-20 µm scanning 20-40mm sections at 180 frames per second. 560 lines per frame were generated with 2.0 mm of tissue penetration.
We determined that it is possible to use existing intracoronary OCT technology for ocular use in enucleated porcine eyes to identify retinal tears and detachments.Given that real time imaging may take place, dynamic examination with scleral indentation is also possible to identify further tears. Imaging the peripheral retina with OCT may aid retinal surgeons identifying retinal tears.Further studies would be required to determine if the catheter could be used intra-operatively to identify undiagnosed peripheral retinal tears in humans.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
Figure 1: Retinal tear (arrow) with subretinal fluid.
Figure 2: Retinal detachment with subretinal fluid (arrow).
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