Investigation of the Influence of Pulse Duration and Application Mode on Microsecond Laser Microsurgery of the Retinal Pigment Epithelium

Life · 7 authors, 2 centres

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TL;DR

OCT-based real-time feedback dosimetry correctly detected RPE cell damage with 96% sensitivity and 97% specificity at 8 µs pulse duration in ramp mode.

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RPE cell damage was quantified via fluorescence-based cell viability assay, and OCT-based real-time feedback dosimetry (RFD) was simultaneously recorded. Experiments indicated cumulative RPE damage for pulse bursts of 16 and 20 µs, whereas no cumulative effects were found for 8 and 12 µs pulses applied in ramp mode. OCT-RFD correctly detected RPE cell damage with 96% sensitivity and 97% specificity at 8 µs duration in ramp mode. Visual CFP evaluation detected tissue changes in only 2 of 9 samples for 8 and 12 µs durations, limiting overall threshold determination.

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other

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ophthalmology

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ORIGINAL PAPER

PMC10302843

Investigation of the Influence of Pulse Duration and Application Mode on Microsecond Laser Microsurgery of the Retinal Pigment Epithelium

Life

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ABSTRACT

Abstract Featured Application Real-time feedback-controlled dosimetry of selective retina therapy (SRT) using spectral domain optical coherence tomography. SRT is a minimally invasive cellular-level surgical laser treatment method for various diseases of the fundus, i.e., central serous chorioretinopathy or diabetic macular edema, associated with reduced retinal pigment epithelium function. Abstract Optical microsurgery confined to the retinal pigment epithelium (RPE) requires locally optimized laser parameters and reliable real-time feedback dosimetry (RFD) to prevent unwanted neuroretinal overexposure. This study aimed to compare pulses of different durations and application modes (single, ramp, burst). Moreover, optical coherence tomography (OCT)-based RFD was investigated in an ex vivo experiment, utilizing nine porcine eyes that were exposed to laser pulses of 8, 12, 16 and 20 µs duration (wavelength: 532 nm, exposure area: 90 × 90 µm 2 , radiant exposure: 247 to 1975 mJ/µm 2 ). Simultaneously, time-resolved OCT M-scans were recorded (central wavelength: 870 nm, scan rate: 85 kHz) for RFD. Post irradiation, retinal changes were assessed with color fundus photography (CFP) and cross-sectional OCT B-scans. RPE cell damage was quantified via fluorescence-based cell viability assay and compared to the OCT dosimetry feedback. Our experiments indicate cumulative RPE damage for pulse bursts of 16 µs and 20 µs, whereas no cumulative effects were found for pulse durations of 8 µs and 12 µs applied in ramp mode. According to statistical analysis, OCT-RFD correctly detected RPE cell damage with 96% sensitivity and 97% specificity using pulses of 8 µs duration in ramp mode. Keywords: selective retina therapy, real-time feedback-controlled dosimetry, micropulse laser, RPE rejuvenation, microbubble formation, photodisruptive laser therapy, fringe washout, RELITE

CITATION EXPORT

Christian Burri, Simon Salzmann, Mylène Amstutz et al.. Investigation of the Influence of Pulse Duration and Application Mode on Microsecond Laser Microsurgery of the Retinal Pigment Epithelium. Life. (2023). https://doi.org/10.3390/life13061314

AUTHORS

7 · 2 CENTRES

Christian Burri, Simon Salzmann, Mylène Amstutz, Leonie Hoffmann, Boris Považay, Christoph Meier, Martin Frenz

1Biomedical Photonics Group, University of Bern, Sidlerstrasse 5, 3012 Bern, Switzerland; [email protected]
2Institute for Human Centered Engineering (HuCE)—OptoLab, Bern University of Applied Sciences, Quellgasse 21, 2501 Biel, Switzerland; [email protected] (S.S.); [email protected] (M.A.); [email protected] (L.H.); [email protected] (B.P.); [email protected] (C.M.)