Retinal Disease
Conditions
Keywords
Optical Coherence Tomography (OCT)
Brief summary
Optical coherence tomography (OCT) is a 3D imaging technology that has seen wide adoption within ophthalmology. However, optical access to the retinal periphery remains a challenge for conventional OCT systems. The study team plans to innovate peripheral retinal OCT imaging technology by first developing the first robotic OCT system capable of autonomously assisting the operator during imaging of the human peripheral retina using 3D active tracking and compensation and then by developing of the first OCT system designed for treatment of the retinal periphery.
Detailed description
Purpose and Objectives: The long-term goal is to develop a system that provides 360° visualization of the peripheral retina replacing the current standard of care for evaluation of the retinal periphery for breaks: indirect ophthalmoscopy with scleral depression, a procedure requiring the examiner to mechanically indent the eye at multiple locations and use an indirect ophthalmoscope and condensing lens to attempt to visualize the retina peripherally and over360°. The rationale for this project is that in addition to being extremely uncomfortable for the patient, this technique requires considerable skill with specialized training. Furthermore, the exam does not create a direct record of the findings - the examiner must illustrate a guide map from memory for subsequent laser photocoagulation (LP) therapy utilizing this same manual technique. These objectives will be achieved by pursuing two specific aims: 1) Adapt a custom conical mirror contact lens and robotically aligning platform to optically access the peripheral retina with OCT and laser photocoagulation therapy; and 2) Validate peripheral retina robotically aligning OCT against scleral depressed exam in eyes with and without peripheral retinal breaks requiring treatment. To validate our imaging technique, the investigators will conduct a powered study in eyes with and without known peripheral retina breaks comparing total number of detected peripheral retinal breaks per eye by Peripheral Retina Robotically Aligned OCT (PR-RAOCT) versus clinical exam. As a secondary outcome, the investigators will evaluate subject comfort level following each method. The investigators will recruit patients presenting at the Duke Eye Center with complaints of "flashers and floaters" and have undergone indirect ophthalmoscopy with scleral depression as part of their standard of care.
Interventions
DEVICEPeripheral retina robotically aligned optical coherence tomography (OCT) system
To visualize the full 360° of the retinal periphery (from equator to the more anterior ora serrata), investigators developed and redesigned a conical mirror contact lens and our non-contact robotically aligning platform to deliver OCT to the peripheral retina. The peripheral retina robotically aligned OCT (PR-RAOCT) system is built around a 6-axis cooperative robot (UR5e, Universal Robots), using our previously developed RAOCT control software.
OTHERLikert Scales
Survey evaluating relative comfort with each type of peripheral exam (scleral depression vs. PR-RAOCT). Participants will rate 3 items on a 1 (non) to 5 (maximum) Likert scale: overall discomfort, physical pain, and photophobia for each exam.
Sponsors
Duke University
National Institutes of Health (NIH)
National Eye Institute (NEI)
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Intervention model description
Participants will be assigned to a group based on ocular history/diagnosis. Each participant will receive the same intervention.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Subject is able and willing to consent to study participation * Subject is more than 18 years of age * Healthy adult volunteers without known ocular issues other than refractive error
Exclusion criteria
* Subject is unwilling or unable to provide consent * Subject is less than 18 years of age * Students or employees under direct supervision of the investigators * Subjects with eye trauma, infection of the anterior ocular tissues or corneal conditions like keratoconus, Peter's anomaly, corneal edema, dense cataracts obscuring the retina and dense capsule opacities in pseudophakes The investigators will not exclude subjects based on eyes being phakic, pseudo-phakic, or aphakic.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Presence of peripheral retinal break/s - Optical Coherence Tomography (OCT) | Single imaging session (day 1) | Presence of peripheral retinal break as measured by OCT reading |
| Presence of peripheral retinal break/s - clinical exam | Single imaging session (day 1) | Presence of peripheral retinal break as measured by clinical exam |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Location of peripheral break | Single imaging session (day 1) | Peripheral break quadrant location (superior, inferior, temporal, nasal) for each exam as seen on OCT. |
| Comfort evaluation | Single session (day 1) | Participants will complete a survey evaluating relative comfort with each type of peripheral exam. Participants will rate three items on a 1(none) to 5(maximum) Likert scale. Lower Likert scores equate to a negative response (less comfortable) and a higher Likert score equates to a more positive response (more comfortable). |
Contacts
PRINCIPAL_INVESTIGATORCynthia A Toth, MD
Duke University Eye Center
Outcome results
None listed