This Bioengineering Research Partnership proposal brings together a team of experts in ophthalmic imaging and surgery to advance the state of the art in image-guided surgical interventions. We seek to overcome limitations to the surgeon's current stereo microscopic view of ocular structures by bringing optical coherence tomography (OCT) technology, which is already well accepted in ophthalmic practice, into the operating room. In modern microsurgeries of both the anterior segment and retina, the inability to distinguish delicate, microscopic tissue structures of subtle contrast, or to judge the location of surgical instruments relative to adjacent microstructures, limits achievement of surgical endpoints and patient outcomes. The overall five-year goals of the project are to develop, optimize, apply and document a clinically useful, microscope integrated OCT (MIOCT) technology for ophthalmic surgery that overcomes these limitations. We will also facilitate dissemination of this technology through commercial partnerships. We believe this technology will not only improve outcomes in current surgeries, but will also enable novel ophthalmic and other microsurgeries not possible due to current limitations in visualization. Under previous NIH support (R21EY019411), our leadership team has developed a first-generation OCT- enabled microscope that is specialized for vitreoretinal surgery, and is now undergoing clinical trials at Duke University. This first-generation system delivers unprecedented cross-sectional and three-dimensional views of the retina during surgery. It is now ready for clinical evaluation in a wider range of surgeries, including anterior segment surgery. However, the current prototype lacks real-time feedback for the surgeon, and significant advances are needed in the image acquisition, data visualization and integration, and surgical instrument design, to provide a robust and seamless platform for widespread use by ophthalmic surgeons. Our proposed project is based on multidisciplinary collaborations between biomedical engineers, surgeons and image processing experts devoted to translational advances in imaging for improved outcomes in ophthalmic surgery. The proposed Biomedical Research Partnership comprises academic and clinical faculty from Duke University Biomedical Engineering Department (BME) and Duke Eye Center (DEC), faculty at the Cole Eye Institute (CEI) of the Cleveland Clinic Foundation, and substantial support and collaboration from manufacturers of commercial OCT systems, surgical instruments, and surgical microscopes. Page 1 of 1

Public Health Relevance

This Bioengineering Research Partnership proposal brings together a team of experts in ophthalmic imaging and surgery to advance the state of the art in image-guided ophthalmic surgery. The overall five-year goals of the project are to develop, optimize, apply and document the use of optical coherence tomography imaging integrated with an operating microscope in ophthalmic surgeries. We believe this technology will enable novel ophthalmic and other microsurgeries not possible due to current limitations in surgical visualization. Page 1 of 1

Agency
National Institute of Health (NIH)
Institute
National Eye Institute (NEI)
Type
Research Project (R01)
Project #
5R01EY023039-02
Application #
8596822
Study Section
Biomedical Imaging Technology Study Section (BMIT)
Program Officer
Mckie, George Ann
Project Start
2013-01-01
Project End
2016-12-31
Budget Start
2014-01-01
Budget End
2014-12-31
Support Year
2
Fiscal Year
2014
Total Cost
$886,367
Indirect Cost
$237,835
Name
Duke University
Department
Biomedical Engineering
Type
Schools of Engineering
DUNS #
044387793
City
Durham
State
NC
Country
United States
Zip Code
27705
Grewal, Dilraj S; Bhullar, Paramjit K; Pasricha, Neel D et al. (2016) Intraoperative 4-Dimensional Microscope-Integrated Optical Coherence Tomography-Guided 27-Gauge Transvitreal Choroidal Biopsy for Choroidal Melanoma. Retina :
Viehland, Christian; Keller, Brenton; Carrasco-Zevallos, Oscar M et al. (2016) Enhanced volumetric visualization for real time 4D intraoperative ophthalmic swept-source OCT. Biomed Opt Express 7:1815-29
Carrasco-Zevallos, O M; Keller, B; Viehland, C et al. (2016) Live volumetric (4D) visualization and guidance of in vivo human ophthalmic surgery with intraoperative optical coherence tomography. Sci Rep 6:31689
Veerappan, Malini; El-Hage-Sleiman, Abdul-Karim M; Tai, Vincent et al. (2016) Optical Coherence Tomography Reflective Drusen Substructures Predict Progression to Geographic Atrophy in Age-related Macular Degeneration. Ophthalmology 123:2554-2570
Carrasco-Zevallos, Oscar M; Keller, Brenton; Viehland, Christian et al. (2016) Optical Coherence Tomography for Retinal Surgery: Perioperative Analysis to Real-Time Four-Dimensional Image-Guided Surgery. Invest Ophthalmol Vis Sci 57:OCT37-50
Shen, Liangbo; Carrasco-Zevallos, Oscar; Keller, Brenton et al. (2016) Novel microscope-integrated stereoscopic heads-up display for intrasurgical optical coherence tomography. Biomed Opt Express 7:1711-26
McNabb, Ryan P; Grewal, Dilraj S; Mehta, Rajvi et al. (2016) Wide field of view swept-source optical coherence tomography for peripheral retinal disease. Br J Ophthalmol 100:1377-82
Todorich, Bozho; Shieh, Christine; DeSouza, Philip J et al. (2016) Impact of Microscope-Integrated OCT on Ophthalmology Resident Performance of Anterior Segment Surgical Maneuvers in Model Eyes. Invest Ophthalmol Vis Sci 57:OCT146-53
McNabb, Ryan P; Blanco, Tomas; Bomze, Howard M et al. (2016) Method for single illumination source combined optical coherence tomography and fluorescence imaging of fluorescently labeled ocular structures in transgenic mice. Exp Eye Res 151:68-74
Pasricha, Neel D; Shieh, Christine; Carrasco-Zevallos, Oscar M et al. (2016) Needle Depth and Big-Bubble Success in Deep Anterior Lamellar Keratoplasty: An Ex Vivo Microscope-Integrated OCT Study. Cornea 35:1471-1477

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