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Proceedings Paper

Toward automated selective retina treatment (SRT): an optical microbubble detection technique
Author(s): Eric Seifert; Young-Gun Park; Dirk Theisen-Kunde; Young-Jung Roh; Ralf Brinkmann
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Paper 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.

Paper Details

Date Published: 8 March 2018
PDF: 10 pages
Proc. SPIE 10474, Ophthalmic Technologies XXVIII, 104740P (8 March 2018); doi: 10.1117/12.2289409
Show Author Affiliations
Eric Seifert, Medizinisches Laserzentrum Lübeck GmbH (Germany)
Young-Gun Park, Catholic Univ. of Korea (Korea, Republic of)
Dirk Theisen-Kunde, Medizinisches Laserzentrum Lübeck GmbH (Germany)
Young-Jung Roh, Catholic Univ. of Korea (Korea, Republic of)
Ralf Brinkmann, Medizinisches Laserzentrum Lübeck GmbH (Germany)

Published in SPIE Proceedings Vol. 10474:
Ophthalmic Technologies XXVIII
Fabrice Manns; Per G. Söderberg; Arthur Ho, Editor(s)

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