Selective retina therapy: toward an optically controlled automatic dosing

Eric Seifert; Jan Tode; Amelie Pielen; Dirk Theisen-Kunde; Carsten Framme; Johann Roider; Yoko Miura; Reginald Birngruber M.D.; Ralf Brinkmann

doi:10.1117/1.JBO.23.11.115002

3 November 2018 Selective retina therapy: toward an optically controlled automatic dosing

Eric Seifert, Jan Tode, Amelie Pielen, Dirk Theisen-Kunde, Carsten Framme, Johann Roider, Yoko Miura, Reginald Birngruber M.D., Ralf Brinkmann

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Journal of Biomedical Optics, Vol. 23, Issue 11, 115002 (November 2018). https://doi.org/10.1117/1.JBO.23.11.115002

Abstract

Selective retina therapy (SRT) targets the retinal pigment epithelium (RPE) with pulsed laser irradiation by inducing microbubble formation (MBF) at the intracellular melanin granula, which leads to selective cell disruption. The following wound healing process rejuvenates the chorio-retinal junction. Pulse energy thresholds for selective RPE effects vary intra- and interindividually. We present the evaluation of an algorithm that processes backscattered treatment light to detect MBF as an indicator of RPE cell damage since these RPE lesions are invisible during treatment. Eleven patients with central serous chorioretinopathy and four with diabetic macula edema were treated with a SRT system, which uses a wavelength of 527 nm, a repetition rate of 100 Hz, and a pulse duration of 1.7 μs. Fifteen laser pulses with stepwise increasing pulse energy were applied per treatment spot. Overall, 4626 pulses were used for algorithm parameter optimization and testing. Sensitivity and specificity were the metrics maximized through an automatic optimization process. Data were verified by fluorescein angiography. A sensitivity of 1 and a specificity of 0.93 were achieved. The method introduced in this paper can be used for guidance or automatization of microbubble-related treatments like SRT or selective laser trabeculoplasty.

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Eric Seifert, Jan Tode, Amelie Pielen, Dirk Theisen-Kunde, Carsten Framme, Johann Roider, Yoko Miura, Reginald Birngruber M.D., and Ralf Brinkmann "Selective retina therapy: toward an optically controlled automatic dosing," Journal of Biomedical Optics 23(11), 115002 (3 November 2018). https://doi.org/10.1117/1.JBO.23.11.115002

Received: 7 May 2018; Accepted: 4 October 2018; Published: 3 November 2018

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