title: Time-Resolved Ultra-High Resolution Optical Coherence Tomography for Real-Time Monitoring of Selective Retina Therapy.
abstract: OBJECTIVE
  Selective retina therapy (SRT) is a novel treatment for retinal pathologies, solely targeting the RPE. During SRT, the detection of an immediate tissue reaction is challenging, as tissue effects remain limited to intracellular RPE photodisruption. Time-resolved ultra-high axial resolution optical coherence tomography (OCT) is thus evaluated for the monitoring of dynamic optical changes at and around the RPE during SRT.
  
  
  METHODS
  An experimental OCT system with an ultra-high axial resolution of 1.78 μm was combined with an SRT system and time-resolved OCT M-scans of the target area were recorded from four patients undergoing SRT. Optical coherence tomography scans were analyzed and OCT morphology was correlated with findings in fluorescein angiography, fundus photography, and cross-sectional OCT.
  
  
  RESULTS
  In cases in which the irradiation caused RPE damage proven by fluorescein angiography, the lesions were well discernible in time-resolved OCT images but remained invisible in fundus photography and cross-sectional OCT acquired after treatment. If RPE damage was introduced, all applied SRT pulses led to detectable signal changes in the time-resolved OCT images. The extent of optical signal variation seen in the OCT data appeared to scale with the applied SRT pulse energy.
  
  
  CONCLUSIONS
  The first clinical results proved that successful SRT irradiation induces detectable changes in the OCT M-scan signal while it remains invisible in conventional ophthalmoscopic imaging. Thus, real-time high-resolution OCT is a promising modality to monitor and analyze tissue effects introduced by selective retina therapy and may be used to guide SRT in an automatic feedback mode (www.swissmedic.ch number, 2011-MD-0006).
authors.affiliation: ARTORG Center, University of Bern, Bern, Switzerland 2HuCE OptoLab, Berne University of Applied Sciences, Biel, Switzerland.
authors.forename: Patrick
authors.initials: P
authors.lastname: Steiner
authors.affiliation: Department of Ophthalmology, Inselspital, Bern, Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Ebneter
authors.affiliation: Department of Ophthalmology, Inselspital, Bern, Switzerland.
authors.forename: Lieselotte Erika
authors.initials: LE
authors.lastname: Berger
authors.affiliation: Department of Ophthalmology, Inselspital, Bern, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Zinkernagel
authors.affiliation: HuCE OptoLab, Berne University of Applied Sciences, Biel, Switzerland.
authors.forename: Boris
authors.initials: B
authors.lastname: Považay
authors.affiliation: HuCE OptoLab, Berne University of Applied Sciences, Biel, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Meier
authors.affiliation: ARTORG Center, University of Bern, Bern, Switzerland.
authors.forename: Jens H
authors.initials: JH
authors.lastname: Kowal
authors.affiliation: Department for Ophthalmology, Medizinische Hochschule Hannover, Hannover, Germany.
authors.forename: Carsten
authors.initials: C
authors.lastname: Framme
authors.affiliation: Institute of Biomedical Optics, University of Lübeck, Lübeck, Germany 6Medical Laser Center Lübeck GmbH, Lübeck, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Brinkmann
authors.affiliation: Department of Ophthalmology, Inselspital, Bern, Switzerland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Wolf
authors.affiliation: ARTORG Center, University of Bern, Bern, Switzerland 3Department of Ophthalmology, Inselspital, Bern, Switzerland.
authors.forename: Raphael
authors.initials: R
authors.lastname: Sznitman
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods; D008297:Male; D012164:Retinal Diseases / Q000175:diagnosis* / Q000601:surgery*; D055213:Retinal Pigment Epithelium / Q000528:radiation effects*; D041623:Tomography, Optical Coherence / Q000379:methods*