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Ab Externo Imaging of Human Episcleral Vessels Using Fiberoptic Confocal Laser Endomicroscopy

PURPOSE: There is a growing interest in targeting minimally invasive surgery devices to the aqueous outflow system to optimize treatment outcomes. However, methods to visualize functioning, large-caliber aqueous and episcleral veins in-vivo are lacking. This pilot study establishes an ex-vivo system...

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Autores principales: Lin, Ken Y., Mosaed, Sameh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: PUBLISHED BY KNOWLEDGE E 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6815344/
https://www.ncbi.nlm.nih.gov/pubmed/31660106
http://dx.doi.org/10.18502/jovr.v14i3.4783
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author Lin, Ken Y.
Mosaed, Sameh
author_facet Lin, Ken Y.
Mosaed, Sameh
author_sort Lin, Ken Y.
collection PubMed
description PURPOSE: There is a growing interest in targeting minimally invasive surgery devices to the aqueous outflow system to optimize treatment outcomes. However, methods to visualize functioning, large-caliber aqueous and episcleral veins in-vivo are lacking. This pilot study establishes an ex-vivo system to evaluate the use of a confocal laser microendoscope to noninvasively image episcleral vessels and quantify regional flow variation along the limbal circumference. METHODS: A fiber-optic confocal laser endomicroscopy (CLE) system with lateral and axial resolution of 3.5 [Formula: see text] m and 15 [Formula: see text] m, respectively, was used on three porcine and four human eyes. Diluted fluorescein (0.04%) was injected into eyes kept under constant infusion. The microprobe was applied to the sclera 1 mm behind the limbus to acquire real-time video. Image acquisition was performed at 15-degree intervals along the limbal circumference to quantify regional flow variation in human eyes. RESULTS: Vascular structures were visualized in whole human eyes without processing. Schlemm's canal was visualized only after a scleral flap was created. Fluorescent signal intensity and vessel diameter variation were observed along the limbal circumference, with the inferior quadrant having a statistically higher fluorescein signal compared to the other quadrants in human eyes ([Formula: see text] < 0.05). CONCLUSION: This study demonstrates for the first time that the fiber-optic CLE platform can visualize the episcleral vasculature with high resolution ex-vivo with minimal tissue manipulation. Intravascular signal intensities and vessel diameters were acquired in real-time; such information can help select target areas for minimally invasive glaucoma surgery (MIGS) to achieve greater intraocular pressure reduction.
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spelling pubmed-68153442019-10-28 Ab Externo Imaging of Human Episcleral Vessels Using Fiberoptic Confocal Laser Endomicroscopy Lin, Ken Y. Mosaed, Sameh J Ophthalmic Vis Res Original Article PURPOSE: There is a growing interest in targeting minimally invasive surgery devices to the aqueous outflow system to optimize treatment outcomes. However, methods to visualize functioning, large-caliber aqueous and episcleral veins in-vivo are lacking. This pilot study establishes an ex-vivo system to evaluate the use of a confocal laser microendoscope to noninvasively image episcleral vessels and quantify regional flow variation along the limbal circumference. METHODS: A fiber-optic confocal laser endomicroscopy (CLE) system with lateral and axial resolution of 3.5 [Formula: see text] m and 15 [Formula: see text] m, respectively, was used on three porcine and four human eyes. Diluted fluorescein (0.04%) was injected into eyes kept under constant infusion. The microprobe was applied to the sclera 1 mm behind the limbus to acquire real-time video. Image acquisition was performed at 15-degree intervals along the limbal circumference to quantify regional flow variation in human eyes. RESULTS: Vascular structures were visualized in whole human eyes without processing. Schlemm's canal was visualized only after a scleral flap was created. Fluorescent signal intensity and vessel diameter variation were observed along the limbal circumference, with the inferior quadrant having a statistically higher fluorescein signal compared to the other quadrants in human eyes ([Formula: see text] < 0.05). CONCLUSION: This study demonstrates for the first time that the fiber-optic CLE platform can visualize the episcleral vasculature with high resolution ex-vivo with minimal tissue manipulation. Intravascular signal intensities and vessel diameters were acquired in real-time; such information can help select target areas for minimally invasive glaucoma surgery (MIGS) to achieve greater intraocular pressure reduction. PUBLISHED BY KNOWLEDGE E 2019-07-18 /pmc/articles/PMC6815344/ /pubmed/31660106 http://dx.doi.org/10.18502/jovr.v14i3.4783 Text en Copyright © 2019 Lin and Mosaed. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. which permits unrestricted use and redistribution provided that the original author and source are credited.
spellingShingle Original Article
Lin, Ken Y.
Mosaed, Sameh
Ab Externo Imaging of Human Episcleral Vessels Using Fiberoptic Confocal Laser Endomicroscopy
title Ab Externo Imaging of Human Episcleral Vessels Using Fiberoptic Confocal Laser Endomicroscopy
title_full Ab Externo Imaging of Human Episcleral Vessels Using Fiberoptic Confocal Laser Endomicroscopy
title_fullStr Ab Externo Imaging of Human Episcleral Vessels Using Fiberoptic Confocal Laser Endomicroscopy
title_full_unstemmed Ab Externo Imaging of Human Episcleral Vessels Using Fiberoptic Confocal Laser Endomicroscopy
title_short Ab Externo Imaging of Human Episcleral Vessels Using Fiberoptic Confocal Laser Endomicroscopy
title_sort ab externo imaging of human episcleral vessels using fiberoptic confocal laser endomicroscopy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6815344/
https://www.ncbi.nlm.nih.gov/pubmed/31660106
http://dx.doi.org/10.18502/jovr.v14i3.4783
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