Leica Microsystems’s EnFocus Intraoperative Optical Coherence Tomography Development Team Wins Optica’s 2022 Paul F. Forman Team Engineering Excellence Award

Advancing Optics and Photonics Worldwide, is pleased to announce that Leica Microsystems's EnFocus Intraoperative Optical Coherence Tomography Development Team , has received the 2022 Paul F. Forman Team Engineering Excellence Award . The team is recognized, “for developing an optically brilliant, latency-free intrasurgical optical coherence tomography microscope that fully integrates into the ophthalmic surgical workflow, allowing a surgeon to see more and do more to preserve patient sight.” The 2022 award will be presented during Frontiers in Optics + Laser Science ( FiO LS ). A list of the team members is available below. “Optica is proud to honor this diverse team for their impactful work to improve the outcomes of ophthalmic surgeries by providing surgeons with real-time information and a complete picture of subsurface details,” said Optica President, Satoshi Kawata. The Paul F. Forman Team Engineering Excellence Award was established in 1989 and named i...

Feasibility of a portable optical coherence tomography system in children with craniosynostosis

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Craniosynostosis is characterised by the premature fusion of cranial sutures and can be associated with intracranial hypertension (IH), which can damage the brain and vision if left unaddressed [ 1 ]. The gold standard method for measuring intracranial pressure (ICP) is invasive ICP monitoring, requiring hospital admission, general anaesthesia and risks such as bleeding and infection [ 2 ]. Optical coherence tomography (OCT) is a non-invasive imaging technique providing ultra-high resolution cross-sectional images of the optic nerve within seconds. OCT has demonstrated promise as a non-invasive surrogate marker for IH, but standard table-mounted OCT devices are difficult to use in infants and young children [ 3 ]. Here, we assessed the feasibility of a portable OCT device (Fig. 1 ) in children with craniosynostosis. ( Read Full Article )

Intraoperative OCT Guidance of Intraocular Surgery (MIOCT)

Optical Coherence Tomography (OCT) is used to capture reproducible ocular morphology and cross-sectional tissue measurements in-vivo in a rapid, non-invasive, non-contact manner. It has displaced ophthalmoscopy and stereo photography for clinical assessment and documentation of retinal microanatomy including thickness, cystoid structures, subretinal fluid and retinal traction.(1) Spectral Domain Optical Coherence Tomography (SDOCT) has the speed and resolution required for real-time noninvasive three-dimensional imaging of critical pathology. While modern ophthalmic surgery has benefited from rapid advances in instrumentation and techniques (2-6), the basic principles of the stereo zoom operating microscope have not changed (except for increased automation) since the 1930's. (7-9) The ability to better resolve tissue microanatomy through real-time micro-imaging would have a dramatic impact on ophthalmic surgeon's capabilities, foster the development of new surgical techniques, and p...

Optica Names Joseph A. Izatt the 2022 Stephen D. Fantone Distinguished Service Award Recipient

Optica (formerly OSA) is pleased to announce that Joseph A. Izatt, Duke University, USA, has been selected as the 2022 recipient of the Stephen D. Fantone Distinguished Service Award . Izatt is being honored for over 25 years of outstanding service to the optics community and Optica in areas as diverse as publications, conferences, strategic planning, and the Optica Board of Directors. Joseph A. Izatt received his PhD from the Massachusetts Institute of Technology, USA. He is currently the Michael J. Fitzpatrick Professor of Engineering in the Edmund T. Pratt, Jr. School of Engineering. He co-founded Bioptigen and previously held positions at University Hospitals of Cleveland, USA, and Case Western Reserve University, USA. Izatt is a long-time volunteer and leader who has helped shape and strengthen Optica’s conferences, publications, and overall strategy. He has served on many committees and councils, including the Board of Editors, Publications Council, Board of Directors, a...

The outcomes and usefulness of Intraoperative Optical Coherence Tomography in vitreoretinal surgery and its impact on surgical decision making

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Objective. To evaluate the utility of intraoperative OCT and its influence on the surgeon's decision during vitreoretinal surgery. Methods. This was a pilot, prospective case series conducted at a tertiary care ophthalmology department in Lahore, Pakistan. Sixteen patients undergoing vitreoretinal surgeries were included using the Leica Enfocus microscope integrated intraoperative optical coherence tomography (IOCT). We also investigated the changes in surgical decision making based on the findings revealed by IOCT using a questionnaire. Results. 16 patients with a mean age of 40.6 ± 19.0 (range: 11-66) years, were included in the study; one case of acute postoperative endophthalmitis could not be imaged. The surgeon had to modify surgical decisions in four (26.7%) cases. IOCT clearly delineated various tissue planes for efficient and safe surgical dissection in pathologies such as posterior vitreous detachment, vitreomacular traction and epiretinal membranes. Furthermore, it...

Dynamic microscopic optical coherence tomography to visualize the morphological and functional micro-anatomy of the airways

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In the imaging of airway tissue, optical coherence tomography (OCT) provides cross-sectional images of tissue structures, shows cilia movement and mucus secretion, but does not provide sufficient contrast to differentiate individual cells. By using fast sequences of microscopic resolution OCT (mOCT) images, OCT can use small signal fluctuations to overcome lack in contrast and speckle noise. In this way, OCT visualizes airway morphology on a cellular level and allows the tracking of the dynamic behavior of immune cells, as well as mucus transport and secretion. Here, we demonstrate that mOCT, by using temporal tissue fluctuation as contrast (dynamic mOCT), provides the possibility to study physiological and pathological tissue processes in vivo . ( Read Full Article )

3D Microstructure of the Healthy Non-Human Primate Lamina Cribrosa by Optical Coherence Tomography Imaging

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Purpose: The lamina cribrosa (LC) has an important role in the pathophysiology of ocular diseases. The purpose of this study is to characterize in vivo, noninvasively, and in 3D the structure of the LC in healthy non-human primates (NHPs). Methods: Spectral-domain optical coherence tomography (OCT; Leica, Chicago, IL) scans of the optic nerve head (ONH) were obtained from healthy adult rhesus macaques monkeys. Using a previously reported semi-automated segmentation algorithm, microstructure measurements were assessed in central and peripheral regions of an equal area, in quadrants and depth-wise. Linear mixed-effects models were used to compare parameters among regions, adjusting for visibility, age, analyzable depth, graded scan quality, disc area, and the correlation between eyes. Spearmen's rank correlation coefficients were calculated for assessing the association between the lamina's parameters. Results: Sixteen eyes of 10 animals (7 males and 3 females; 9 OD, 7 OS) were analyz...

Application of Intraoperative Optical Coherence Tomography Technology in Anterior Segment Surgery

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The use of optical coherence tomography (OCT) technology in anterior segment diseases allows for precise assessment of the changes following anterior segment surgery. Advances in microscope-integrated OCT systems have allowed the utilization of intraoperative OCT (iOCT) in anterior segment surgeries, i.e., cornea, cataract, and refractive surgery. iOCT has enabled real-time precise visualization of anterior segment tissues as well as interactions between surgical instruments and ocular tissue; thus, the device can facilitate surgical procedures and provide valuable information for decision-making during anterior segment surgeries. In this review, the authors will introduce studies regarding the development of iOCT technology and its application in various anterior segment surgeries. Multiple studies have shown the efficacy of the iOCT for intraoperative assistance and guidance, suggesting the potential of the device for optimizing the surgical outcomes after cornea, cataract, and re...

Comparison of Autonomous AS-OCT Deep Learning Algorithm and Clinical Dry Eye Tests in Diagnosis of Dry Eye Disease

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Objective: To evaluate a deep learning-based method to autonomously detect dry eye disease (DED) in anterior segment optical coherence tomography (AS-OCT) images compared to common clinical dry eye tests. Methods: In this study, 27,180 AS-OCT images were prospectively collected from 151 eyes of 91 patients. Images were used to train and test the deep learning model. Masked cornea specialist ophthalmologist diagnoses were used as the gold standard. Clinical dry eye tests were performed on patients in the DED group to compare the results of the model. The dry eye tests performed were tear break-up time (TBUT), Schirmer’s test, corneal staining, conjunctival staining, and Ocular Surface Disease Index (OSDI). Results: Our deep learning model achieved an accuracy of 84.62%, sensitivity of 86.36%, and specificity of 82.35% in the diagnosis of DED. The positive likelihood ratio was 4.89, and the negative likelihood ratio was 0.17. The mean DED probability score was 0.81 ± 0.23...

Statistical modeling of retinal optical coherence tomography using the Weibull mixture model

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In this paper, a novel statistical model is proposed for retinal optical coherence tomography (OCT) images. According to the layered structure of the retina, a mixture of six Weibull distributions is proposed to describe the main statistical features of OCT images. We apply Weibull distribution to establish a more comprehensive model but with fewer parameters that has better goodness of fit (GoF) than previous models. Our new model also takes care of features such as asymmetry and heavy-tailed nature of the intensity distribution of retinal OCT data. In order to test the effectiveness of this new model, we apply it to improve the low quality of the OCT images. For this purpose, the spatially constrained Gaussian mixture model (SCGMM) is implemented. Since SCGMM is designed for data with Gaussian distribution, we convert our Weibull mixture model to a Gaussian mixture model using histogram matching before applying SCGMM. The denoising results illustrate the remarkable performance in ...

Robotic Scanner Automates Diagnostic Imaging in the Eye

Engineers and ophthalmologists at Duke University have developed a robotic imaging tool that can automatically detect and scan a patient’s eyes for markers of different eye diseases. The new tool, which combines an imaging scanner with a robotic arm, can automatically track and image a patient’s eyes in less than a minute, and produce images that are as clear as the traditional scanners in specialized eye clinics. Their paper appeared July 12 in Nature Biomedical Engineering. Physicians and researchers use optical coherence tomography, or OCT, to diagnose various diseases in the eye, including glaucoma, diabetic retinopathy and age-related macular degeneration. During the imaging process, a probe sends a beam of light into the eye and measures how long various reflections take to bounce back to decipher the structures within the tissue. In the clinic, OCT systems are traditionally large tabletop systems, which a highly trained technician uses to capture several images of...

Intraoperative OCT – Real-World User Evaluation in Routine Surgery

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Background In recent years, great progress has been made in intraoperative imaging using optical coherence tomography (iOCT). There are now several commercially available iOCT systems that allow high-resolution imaging of all structures of the eye without interrupting surgery. This real-time visualisation can provide additional information to conventional surgical microscopy, but is relatively expensive. The aim of our study was to find out how often OCT integrated into the surgical microscope is used by trained surgeons, or to what extent they consider that iOCT is relevant for intraoperative procedures. Patients and Methods A prospective monocentric analysis was conducted of the field of application and user-friendliness of the EnFocus Ultra-Deep OCT (Leica Microsystems), a mobile device combination of surgical microscope and OCT. The use and benefit were investigated of iOCT, which was not mandatory. Standardised documentation and evaluation using a questionnaire was performed by...

Quantitative Analysis of Gap Between the Intraocular Lens and Posterior Capsule Using Microscope-Integrated Optical Coherence Tomography in Eyes Undergoing Phacoemulsification

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Purpose: To quantitatively analyze the dimensions of the gap between the intraocular lens (IOL) and the posterior capsule using microscope-integrated optical coherence tomography (MIOCT). Setting: Institutional. Design: Prospective, interventional. Methods: A total of 105 eyes of 105 consecutive patients planned for phacoemulsification with IOL implantation were enrolled. At the end of surgery, the gap between the IOL and the posterior capsule (IOL-PC gap) was measured using MIOCT (RESCAN). The same gap was reassessed at 1 week follow-up visit using the Visante-OCT system. The cases were sub-grouped based on the grade of cataract, IOL material, size and design and were analyzed to look for any difference in the IOL-PC gap both intraoperatively and postoperatively. Results: The IOL-PC gap could be successfully measured intra-operatively in all cases, using the RESCAN. The mean gap at the end of phacoemulsification was 385.08± 264.58 μm, and at one week follow up this was 12...

Medical College of Wisconsin Receives NIH Grant for Ophthalmic Microscope with Intraoperative Optical Coherence Tomography.

Medical College of Wisconsin Receives a 2021 NIH Grant for $390,398 for Ophthalmic Microscope with Intraoperative Optical Coherence Tomography. The principal investigator is Iris Kassem. Below is a summary of the proposed work. The Medical College of Wisconsin prioritizes research as one of its missions and includes in its strategic plan “accelerating discovery with cutting-edge, evidence-based research.” With this support we request funds for the shared instrumentation of a Leica Microsystems Proveo 8 ophthalmic surgical microscope with intrasurgical EnFocus optical coherence tomography. The equipment would be used by eleven faculty from four departments from two institutions. We describe four major thematic programs and four additional minor projects that will be supported by eleven users, including five major and six minor users. Uses for the equipment includes ophthalmic, vascular, and oncologic, along with teaching applications. This instrument is requested to repla...

Volumetric tumor delineation and assessment of its early response to radiotherapy with optical coherence tomography

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Texture analyses of optical coherence tomography (OCT) images have shown initial promise for differentiation of normal and tumor tissues. This work develops a fully automatic volumetric tumor delineation technique employing quantitative OCT image speckle analysis based on Gamma distribution fits. We test its performance in-vivo using immunodeficient mice with dorsal skin window chambers and subcutaneously grown tumor models. Tumor boundaries detection is confirmed using epi-fluorescence microscopy, combined photoacoustic-ultrasound imaging, and histology. Pilot animal study of tumor response to radiotherapy demonstrates high accuracy, objective nature, novelty of the proposed method in the volumetric separation of tumor and normal tissues, and the sensitivity of the fitting parameters to radiation-induced tissue changes. Overall, the developed methodology enables hitherto impossible longitudinal studies for detecting subtle tissue alterations stemming from therapeutic insult. ( ...


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