Development of Intraoperative Optical Coherence Tomography and Imaging Systems
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2024
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Optical coherence tomography (OCT) is a non-invasive optical imaging modality that enables cross-sectional visualization of the tissue structures within the eye with micrometer level resolution. While this technology has become standard in clinical ophthalmology settings for diagnostics and monitoring disease progression, its use in surgical settings remains limited since commercially available systems utilize spectral-domain OCT (SD-OCT) with slow scan speeds and limited imaging depth. While research swept-source OCT (SS-OCT) systems have improved upon those limitations, their use in surgery have highlighted additional challenges including: (1) limited imaging speed and reliance on the presence of an additional operator, (2) lack of quantitative measurements from intraoperative OCT imaging, and (3) the large size of current surgical microscopes. In this dissertation, we aim to address these limitations through the development of new hardware and software. First, we built and deployed a new intraoperative OCT sample arm. This sample arm was used to develop new software to perform real-time spiral scanning, which offered improved scan efficiency compared to traditional raster scan patterns. We again improved the intraoperative system with a customized Leica Enfocus and faster engine. However, this intraoperative system requires the use of an additional operator. We are also developing new hardware and software to enable standalone surgeon control of the system. While the improved field-of-view and imaging depth of the intraoperative OCT system provided valuable images, new advances in therapeutics highlighted the important need for quantitative measurements of such treatments delivered within the eye. We developed measurement procedures that allowed us to build an optical model of the OCT sample path and obtain the voxel pitch throughout an OCT volume. When combined with segmentations of regions of interest, we demonstrated quantitative measurements of intraocular structures. Finally, we aimed to develop a new surgical microscope that is smaller and lighter than a traditional ophthalmic microscope which relies on optical zoom elements and oculars which add significant bulk and weight. We utilized a small multi-camera array with sensor cropping to meet the resolution requirements across the entire zoom range. With a smaller footprint, such a microscope integrated with an OCT system could be mounted on a robotic arm to enable automatic motion tracking during surgery. Overall, these contributions have the potential to advance the use of intraoperative OCT with improved visualization, additional quantitative measurement endpoints, as well as improved ease of use.
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Li, Jianwei David (2024). Development of Intraoperative Optical Coherence Tomography and Imaging Systems. Dissertation, Duke University. Retrieved from https://hdl.handle.net/10161/30798.
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