Significance: Selective retina therapy (SRT) selectively targets the retinal pigment epithelium (RPE) and reduces negative side effects by avoiding thermal damages of the adjacent photoreceptors, the neural retina, and the choroid. However, the selection of proper laser energy for the SRT is challenging because of ophthalmoscopically invisible lesions in the RPE and different melanin concentrations among patients or even regions within an eye.
Aim: We propose and demonstrate SRT monitoring based on speckle variance optical coherence tomography (svOCT) for dosimetry control.
Approach: M-scans, time-resolved sequence of A-scans, of ex vivo bovine retina irradiated by 1.7-μs duration laser pulses were obtained by a swept-source OCT. SvOCT images were calculated as interframe intensity variance of the sequence. Spatial and temporal temperature distributions in the retina were numerically calculated in a 2-D retinal model using COMSOL Multiphysics. Microscopic images of treated spots were obtained before and after removing the upper neural retinal layer to assess the damage in both RPE and neural layers.
Results: SvOCT images show abrupt speckle variance changes when the retina is irradiated by laser pulses. The svOCT intensities averaged in RPE and photoreceptor layers along the axial direction show sharp peaks corresponding to each laser pulse, and the peak values were proportional to the laser pulse energy. The calculated temperatures in the neural retina layer and RPE were linearly fitted to the svOCT peak values, and the temperature of each lesion was estimated based on the fitting. The estimated temperatures matched well with previously reported results.
Conclusion: We found a reliable correlation between the svOCT peak values and the degree of retinal lesion formation, which can be used for selecting proper laser energy during SRT.
A commercial ophthalmic laser system (R;GEN, Lutronic Corp) was integrated with a swept-source optical coherence tomography (OCT) imaging system for real-time tissue temperature monitoring. M-scan OCT images were acquired during laser-pulse radiation, and speckle variance OCT (svOCT) images were analyzed to deduce temporal signal variations related to tissue temperature change from laser-pulse radiation. A phantom study shows that svOCT magnitude increases abruptly after laser pulse radiation and recovered exponentially, and the peak intensity of svOCT image was linearly dependent on pulse laser energy until it saturates. A study using bovine iris also showed signal variation dependence on the laser pulse radiation, and the variation was more distinctive with higher energy level.