Selective retina therapy (SRT) in patients with geographic atrophy due to age-related macular degeneration

For geographic atrophy (GA) due to age-related macular degeneration (AMD) there is so far no approved treatment option. Usually, increased autofluorescence (AF) levels of different patterns adjacent to the atrophic area indicate lipofuscin-laden retinal pigment epithelium (RPE) cells at a high risk for apoptosis. Herein, SRT was used to selectively treat these cells to stimulate RPE proliferation, in order to reduce or ideally stop further growth of the atrophic area

Three-Dimensional Topographic Angiography in Chorioretinal Vascular Disease

PURPOSE. To evaluate a new angiographic technique that offers three-dimensional imaging of chorioretinal vascular diseases. METHODS. Fluorescein (FA) and indocyanine green angiography (ICGA) were performed using a confocal scanning laser ophthalmoscope. Tomographic series with 32 images per set were taken over a depth of 4 mm at an image frequency of 20 Hz. An axial analysis was performed for each x/y position to determine the fluorescence distribution along the z-axis. The location of the onset of fluorescence at a defined threshold intensity was identified and a depth profile was generated. The overall results of fluorescence topography were displayed in a gray scale-coded image and three-dimensional relief. RESULTS. Topographic angiography delineated the choriocapillary surface covering the posterior pole with exposed larger retinal vessels. Superficial masking of fluorescence by hemorrhage or absorbing fluid did not preclude detection of underlying diseases. Choroidal neovascularization (CNV) appeared as a vascular formation with distinct configuration and prominence. Chorioretinal infiltrates exhibited perfusion defects with dye pooling. Retinal pigment epithelium detachments (PEDs) demonstrated dynamic filling mechanisms. Intraretinal extravasation in retinal vascular disease was detected within a well-demarcated area with prominent retinal thickening. CONCLUSIONS. Confocal topographic angiography allows highresolution three-dimensional imaging of chorioretinal vascular and exudative diseases. Structural vascular changes (e.g., proliferation) are detected in respect to location and size. Dynamic processes (e.g., perfusion defects, extravasation, and barrier dysfunction) are clearly identified and may be quantified. Topographic angiography is a promising technique in the diagnosis, therapeutic evaluation, and pathophysiological evaluation of macular disease. (Invest Ophthalmol Vis Sci. 2001;42: 2386 -2394 C horioretinal vascular disease of the macular area (e.g., diabetic maculopathy [DMP] and age-related macular degeneration [ARMD]) are the main reasons for progressive and severe visual loss by occlusive, proliferative, and/or exudative mechanisms. 1,2 Fluorescein angiography (FA) is the classic diagnostic tool but is often compromised by masking phenomena as a consequence of the short wavelength used. Diffuse leakage of the small fluorescein molecule causes further difficulties in identifying the origin and quantifying the dynamics of leakage. Despite stereoscopic viewing systems, many lesions remain occult, and prominence and extent of exudation are evaluated only subjectively. 2,3 Indocyanine green angiography (ICGA) is effective in the near-infrared spectrum which allows improved transmission, and, mostly bound to albumin, it is thought to extravasate minimally. 5-7 Scanning laser ophthalmoscopy (SLO), with point-source illumination and optimized excitation, has further enhanced diagnostic efficacy. 9,10 The option to scan through different retinal layers is nevertheless limited to a depth resolution of approximately 300 m. It may be used, however, to obtain topographic profiles of strongly reflecting intraocular structures, such as the optic disc and the macular region. 11 Morphometric imaging of vascular structures of retina and choroid would significantly improve the diagnosis of macular disease. A novel angiographic technology, confocal topographic angiography, has been developed that allows threedimensional (3-D) documentation of vascular structures and characterization of dynamic phenomena such as perfusion and leakage. The technique of topographic image processing was applied in the FA and ICGA analyses of representative types of chorioretinal vascular disease, to document structural and dynamic changes and to evaluate the diagnostic potential of the new method. MATERIALS AND METHODS The basic topographic principle is to use a series of lateral confocal optical sections of the chorioretinal fluorescence distribution and, by introducing a smart algorithm, to extract the 3-D profile of the surface of vascular structures and related leakage. Data acquisition was achieved with a conventional confocal scanning laser angiograph. Data processing and topographic analysis were performed on a standard desktop computer, using newly developed software. The method of confocal laser scanning topography based on ICGA has been published. 12,13 Data Acquisition FA and ICGA were performed using a confocal SLO (Heidelberg Retina Angiograph; Heidelberg Engineering, Dossenheim, Germany). Infrared images were taken for optical alignment with the fovea in the center of a 30°field corresponding to a retinal area of 9 ϫ 9 mm. For FA, 5 ml of 10% fluorescein solution (Alcon Pharma GmbH, Freiburg, Germany), an argon laser emitting at 488 nm for excitation, and filters blocking transmission of wavelengths below 510 nm were used for detection. For ICGA a 50-mg solution of ICG (ICG Pulsion, München, Germany) was administered intravenously, and excitation and detection were performed, using a diode laser emitting at 795 nm and blocking filters for wavelengths below 835 nm. The diameter of the excitation beam was 10 m at the retina. The Rayleigh range of the focal beam's waist determining depth resolution was 300 m. During the early transit phase, the scanning laser was focused onto the retinal vessels and the excitation intensity was adjusted to obtain adequate illumination. An additive ϩ3-diopter (D) refractive correction was added by using the internal focus adjustment to create a preretinal initial focus for complete sectioning of elevated lesions. An early FA/ICGA series of 32 tomographic sections was taken over a depth of 4 mm, each separated From th

Biomedical optics centers: forty years of multidisciplinary clinical translation for improving human health

Despite widespread government and public interest, there are significant barriers to translating basic science discoveries into clinical practice. Biophotonics and biomedical optics technologies can be used to overcome many of these hurdles, due, in part, to offering new portable, bedside, and accessible devices. The current JBO special issue highlights promising activities and examples of translational biophotonics from leading laboratories around the world. We identify common essential features of successful clinical translation by examining the origins and activities of three major international academic affiliated centers with beginnings traceable to the mid-late 1970s: The Wellman Center for Photomedicine (Mass General Hospital, USA), the Beckman Laser Institute and Medical Clinic (University of California, Irvine, USA), and the Medical Laser Center Lübeck at the University of Lübeck, Germany. Major factors driving the success of these programs include visionary founders and leadership, multidisciplinary research and training activities in light-based therapies and diagnostics, diverse funding portfolios, and a thriving entrepreneurial culture that tolerates risk. We provide a brief review of how these three programs emerged and highlight critical phases and lessons learned. Based on these observations, we identify pathways for encouraging the growth and formation of similar programs in order to more rapidly and effectively expand the impact of biophotonics and biomedical optics on human health

Optics and Quantum Electronics

Contains table of contents for Section 2 and reports on eighteen research projects.National Science Foundation (Grant EET 87-00474)Joint Services Electronics Program (Contract DAAL03-86-K-0002)Joint Services Electronics Program (Contract DAALO3-89-C-0001)Charles Stark Draper Laboratory (Grant DL-H-285408)Charles Stark Draper Laboratory (Grant DL-H-2854018)National Science Foundation (Grant EET 87-03404)National Science Foundation (Grant ECS 84-06290)U.S. Air Force - Office of Scientific Research (Contract F49620-88-C-0089)AT&T Bell FoundationNational Science Foundation (Grant ECS 85-52701)National Institutes of Health (Grant 5-RO1-GM35459)Massachusetts General Hospital (Office of Naval Research Contract N00014-86-K-0117)Lawrence Livermore National Laboratory (Subcontract B048704

Optics and Quantum Electronics

Contains reports on eleven research projects.National Science Foundation (Grant EET 87-00474)Joint Services Electronics Program (Contract DAALO03-86-K-O002)Charles Stark Draper Laboratory, Inc. (Grant DL-H-2854018)National Science Foundation (Grant DMR 84-18718)National Science Foundation (Grant EET 87-03404)National Science Foundation (ECS 85-52701)US Air Force - Office of Scientific Research (Contract AFOSR-85-0213)National Institutes of Health (Contract 5-RO1-GM35459)US Navy - Office of Naval Research (Contract N00014-86-K-0117

Optics and Quantum Electronics

Contains table of contents for Section 3 and reports on eighteen research projects.Defense Advanced Research Projects Agency/MIT Lincoln Laboratory Contract MDA972-92-J-1038Joint Services Electronics Program Grant DAAH04-95-1-0038National Science Foundation Grant ECS 94-23737U.S. Air Force - Office of Scientific Research Contract F49620-95-1-0221U.S. Navy - Office of Naval Research Grant N00014-95-1-0715MIT Center for Material Science and EngineeringNational Center for Integrated Photonics Technology Contract DMR 94-00334National Center for Integrated Photonics TechnologyU.S. Navy - Office of Naval Research (MFEL) Contract N00014-94-1-0717National Institutes of Health Grant 9-R01-EY11289MIT Lincoln Laboratory Contract BX-5098Electric Power Research Institute Contract RP3170-25ENEC

Optics and Quantum Electronics

Contains table of contents for Section 3 and reports on twenty research projects.Charles S. Draper Laboratories Contract DL-H-467138Joint Services Electronics Program Contract DAAL03-92-C-0001Joint Services Electronics Program Grant DAAH04-95-1-0038U.S. Air Force - Office of Scientific Research Contract F49620-91-C-0091MIT Lincoln LaboratoryNational Science Foundation Grant ECS 90-12787Fujitsu LaboratoriesNational Center for Integrated PhotonicsHoneywell Technology CenterU.S. Navy - Office of Naval Research (MFEL) Contract N00014-94-1-0717U.S. Navy - Office of Naval Research (MFEL) Grant N00014-91-J-1956National Institutes of Health Grant NIH-5-R01-GM35459-09U.S. Air Force - Office of Scientific Research Grant F49620-93-1-0301MIT Lincoln Laboratory Contract BX-5098Electric Power Research Institute Contract RP3170-25ENEC

Effects on choroidal neovascularization after anti-VEGF Upload using intravitreal ranibizumab, as determined by spectral domain-optical coherence tomography

It is unclear whether anti-VEGF monotherapy in age-related macular degeneration (AMD) achieves morphologic CNV regression or only stops further CNV growth. In this study, spectral domain-optical coherence tomography (SD-OCT) was used to image CNV structure before and after anti-VEGF treatment