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Eye ManifestationsMIOCTNCT01588041

Intraoperative OCT Guidance of Intraocular Surgery

An observational study of Eye Manifestations, run by Duke University at 2 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to investigate the use of optical coherence tomography imaging integrated with an operating microscope (MIOCT) in ophthalmic surgeries. Read more about this study

Who is it for?
Ages 0 years and olderHealthy volunteers can take part
Conditions the study is for
Eye Manifestations
How many people
269 participants
Where
2 sitesUnited States
Study dates
Sep 2009to 8 Aug 2018
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 0 years and older
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Study population: A total of 722 subjects identified and recruited from the clinics of Duke Eye Center and Cole Eye Institute. Of those, there will be 500 retina subjects and 222 anterior segment subjects. Control subjects may include employees and students of both institutions.

Who may be able to join

  • subjects undergoing surgery for vitreoretinal interface disease
  • subjects undergoing surgery for macular hole
  • subjects undergoing surgery for retinal detachment
  • subjects undergoing surgery for diabetic retinopathy with macular edema and/or traction detachments
  • subjects undergoing surgery for epiretinal membranes
  • subjects undergoing surgery for rare related macular diseases like myopic schisis.
  • subjects undergoing endothelial keratoplasty or anterior lamellar keratoplasty
  • subjects with normal ocular pathology enrolled as controls

Who cannot join

  • 1. Any ocular disease that restricts the ability to perform MIOCT scanning.

Trial locations and contacts

2 sites in 1 country.

United States2 sites
  • Cole Eye Institute at the Cleveland Clinic Lemer College of Medicine

    Cleveland, Ohio, 44195

  • Duke University Eye Center

    Durham, North Carolina, 27705

Other trials in United States

About this study

The purpose of this study is to investigate the use of optical coherence tomography imaging integrated with an operating microscope (MIOCT) in ophthalmic surgeries.

Read the detailed description

Optical Coherence Tomography (OCT) is used to capture reproducible ocular morphology and cross-sectional tissue measurements in-vivo in a rapid, non-invasive, non-contact manner. It has displaced ophthalmoscopy and stereo photography for clinical assessment and documentation of retinal microanatomy including thickness, cystoid structures, subretinal fluid and retinal traction.(1) Spectral Domain Optical Coherence Tomography (SDOCT) has the speed and resolution required for real-time noninvasive three-dimensional imaging of critical pathology.

While modern ophthalmic surgery has benefited from rapid advances in instrumentation and techniques (2-6), the basic principles of the stereo zoom operating microscope have not changed (except for increased automation) since the 1930's. (7-9) The ability to better resolve tissue microanatomy through real-time micro-imaging would have a dramatic impact on ophthalmic surgeon's capabilities, foster the development of new surgical techniques, and potentially improve surgical outcomes.

Complementary to microscope integrated OCT (MIOCT) testing, we use a commercial hand-held SDOCT instrument (Bioptigen, Inc.) during pauses in both anterior segment and retinal surgery to document surgical process.

While both the handheld instrument and Duke's Generation 1 (G1) MIOCT prototype have demonstrated that high-quality OCT imaging is possible during surgery, in both cases control of the OCT scan location and display of the real-time image data are managed on the OCT system console, located up to several feet from the surgeon. Thus, the potential dramatic impact of this technology on ophthalmic surgery is constrained by its limited integration with the surgical environment. The primary technical goal of this project is to address this issue through novel advances in OCT technology, automated tracking of surgical instruments and tools, and fusion of OCT controls, images and measurements into a seamless interface for the surgeon.

This study will facilitate future quality improvement processes based on intraoperative data matched to postoperative outcomes. Intraoperative OCT feedback will revolutionize communication in surgical research, clinical communication, surgeon training and continuing education, and will provide measurable data regarding disease patterns and intraoperative response, novel instrument and adjuvant use.

This study will prospectively examine the surgical utility of MIOCT in retinal and anterior segment surgery. A total of 722 subjects will be enrolled at 2 sites, Duke Eye Center and Cole Eye Institute. Of those, there will be 500 retina subjects and 222 anterior segment subjects. There will be a small number of normal subjects, who are not undergoing eye surgery, enrolled in this portion of this study for non-surgical study of the MIOCT system imaging, particularly for Generation 2 (G2) MIOCT. Rate of recruitment: 460 retina subjects will be enrolled at the rate of approximately 115 per year (~57 per year at both Duke and Cole) for years 1-4 and approximately 40 subjects will be enrolled in year 5 (adding up to a total of 500 subjects).

Keywords
Microscope mounted SDOCT
Medical subject headings
Eye Manifestations

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT01588041
Study groupRoleWhat they receive
Vitreoretinal Interface Disease GroupA minimum of 50 subjects with vitreoretinal interface disease will be imaged with MIOCT prior to surgery, during surgical maneuvers, during a normal pause in surgery, and at 2 post-operative follow-up visits.
Macular Hole GroupA minimum of 50 subjects with macular hole with be imaged with MIOCT prior to surgery, during surgical maneuvers, during a normal pause in surgery, and at 2 post-operative follow-up visits.
Retinal Detachment GroupA minimum of 50 subjects with retinal detachment will be imaged with MIOCT prior to surgery, during surgical maneuvers, during a normal pause in surgery, and at 2 post-operative follow-up visits.
Diabetic Retinopathy GroupA minimum of 50 subjects with diabetic retinopathy will be imaged with MIOCT prior to surgery, during surgical maneuvers, during a normal pause in surgery, and at 2 post-operative follow-up visits.
Rare Related Macular Disease GroupUp to 70 subjects with rare related macular diseases will be imaged with MIOCT prior to surgery, during surgical maneuvers, during a normal pause in surgery, and at 2 post-operative follow-up visits.
Generation 2 MIOCT Transition Group80 of the subjects recruited in years 1 through 5 (40 normal, 40 diseased) will be imaged with both the generation 1 MIOCT and the generation 2 MIOCT systems prior to surgery, during surgical maneuvers, during a normal pause in surgery, and at 2 post-operative follow-up visits.
Endothelial Keratoplasty Group150 subjects undergoing Descemet Stripping Endothelial Keratoplasty (DSEK) will be imaged with MIOCT at the conclusion of the surgical procedure and may be imaged during follow-up visits.
Anterior Lamellar Keratoplasty Group150 subjects undergoing Deep Anterior Lamellar Keratoplasty (DALK) will be imaged with MIOCT at the conclusion of the surgical procedure and may be imaged during follow-up visits.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Test and provide feedback on the intraoperative system both in laboratory and then in the operating room.

    The primary outcome of this project is to integrate optical coherence tomography (OCT) with the surgical environment through novel advances in OCT technology, automated tracking of surgical instruments and tools, and fusion of OCT controls, images and measurements into a seamless interface for the surgeon.

    Measured: 8.5 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted30 Apr 2012 (estimated)
  2. Study startSep 2009
  3. Primary completion8 Aug 2018
  4. Study completion8 Aug 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
269 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01588041
Sponsor's protocol ID
Pro00016827
Other IDs
R01EY023039
Acronym
MIOCT
Status last verified
Apr 2023
First submitted
26 Apr 2012
Last updated
19 Apr 2023
Results posted
No
Data monitoring committee
Yes
Individual data sharing
Yes: All findings resulting from the MIOCT study will be prepared for publication in peer-reviewed journals and posted on PubMed Central once accepted. We are also strong advocates of open-access publishing whenever possible; one of the MPIs (Prof. Izatt) is the founding editor-in-chief of the Optical Society of America's (OSA) newest on-line, open-access journal Biomedical Optics Express (http://www.opticsinfobase.org/boe/home.cfm). We are supportive of efforts by publishers and professional societies to develop technologies for on-line publishing of entire experimental datasets. We have published such datasets using OSA's Interactive Science Publishing technology in the recent past (http://midas.osa.org/midaspub/item/view/1123). We will archive experimental results and findings from the proposed project for at least the duration of the project, and make the underlying datasets available to other researchers upon request.

Publications

  • Mirza RG, Johnson MW, Jampol LM. Optical coherence tomography use in evaluation of the vitreoretinal interface: a review. Surv Ophthalmol. 2007 Jul-Aug;52(4):397-421. doi: 10.1016/j.survophthal.2007.04.007.

    PubMed 17574065
  • Machemer R. The development of pars plana vitrectomy: a personal account. Graefes Arch Clin Exp Ophthalmol. 1995 Aug;233(8):453-68. doi: 10.1007/BF00183425. No abstract available.

    PubMed 8537019
  • Tan DT, Mehta JS. Future directions in lamellar corneal transplantation. Cornea. 2007 Oct;26(9 Suppl 1):S21-8. doi: 10.1097/ICO.0b013e31812f685c.

    PubMed 17881911
  • Singh MS, MacLaren RE. Stem cells as a therapeutic tool for the blind: biology and future prospects. Proc Biol Sci. 2011 Oct 22;278(1721):3009-16. doi: 10.1098/rspb.2011.1028. Epub 2011 Aug 3.

    PubMed 21813553
  • Weiland JD, Cho AK, Humayun MS. Retinal prostheses: current clinical results and future needs. Ophthalmology. 2011 Nov;118(11):2227-37. doi: 10.1016/j.ophtha.2011.08.042.

    PubMed 22047893
  • Shin JY, Yu HG. Visual prognosis and spectral-domain optical coherence tomography findings of myopic foveoschisis surgery using 25-gauge transconjunctival sutureless vitrectomy. Retina. 2012 Mar;32(3):486-92. doi: 10.1097/IAE.0b013e31822058d1.

    PubMed 21955988
  • Machemer R, Parel JM. An improved microsurgical ceiling-mounted unit and automated television. Am J Ophthalmol. 1978 Feb;85(2):205-9. doi: 10.1016/s0002-9394(14)75949-5.

    PubMed 623191
  • Parel JM, Machemer R, Aumayr W. A new concept for vitreous surgery. 5. An automated operating microscope. Am J Ophthalmol. 1974 Feb;77(2):161-8. doi: 10.1016/0002-9394(74)90668-0. No abstract available.

    PubMed 4812085
  • Hahn P, Carrasco-Zevallos O, Cunefare D, Migacz J, Farsiu S, Izatt JA, Toth CA. Intrasurgical Human Retinal Imaging With Manual Instrument Tracking Using a Microscope-Integrated Spectral-Domain Optical Coherence Tomography Device. Transl Vis Sci Technol. 2015 Jul 1;4(4):1. doi: 10.1167/tvst.4.4.1. eCollection 2015 Jul.

    PubMed 26175961
  • Nam DH, Desouza PJ, Hahn P, Tai V, Sevilla MB, Tran-Viet D, Cunefare D, Farsiu S, Izatt JA, Toth CA. INTRAOPERATIVE SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY IMAGING AFTER INTERNAL LIMITING MEMBRANE PEELING IN IDIOPATHIC EPIRETINAL MEMBRANE WITH CONNECTING STRANDS. Retina. 2015 Aug;35(8):1622-30. doi: 10.1097/IAE.0000000000000534.

    PubMed 25829349
  • Kuo AN, Carrasco-Zevallos O, Toth CA, Izatt JA. Caveats to obtaining retinal topography with optical coherence tomography. Invest Ophthalmol Vis Sci. 2014 Sep 11;55(9):5730-1. doi: 10.1167/iovs.14-15212. No abstract available.

    PubMed 25213121
  • Folgar FA, Yuan EL, Farsiu S, Toth CA. Lateral and axial measurement differences between spectral-domain optical coherence tomography systems. J Biomed Opt. 2014 Jan;19(1):16014. doi: 10.1117/1.JBO.19.1.016014.

    PubMed 24441877
  • Kuo AN, McNabb RP, Chiu SJ, El-Dairi MA, Farsiu S, Toth CA, Izatt JA. Correction of ocular shape in retinal optical coherence tomography and effect on current clinical measures. Am J Ophthalmol. 2013 Aug;156(2):304-11. doi: 10.1016/j.ajo.2013.03.012. Epub 2013 May 6.

    PubMed 23659972
  • Hahn P, Migacz J, O'Donnell R, Day S, Lee A, Lin P, Vann R, Kuo A, Fekrat S, Mruthyunjaya P, Postel EA, Izatt JA, Toth CA. Preclinical evaluation and intraoperative human retinal imaging with a high-resolution microscope-integrated spectral domain optical coherence tomography device. Retina. 2013 Jul-Aug;33(7):1328-37. doi: 10.1097/IAE.0b013e3182831293.

    PubMed 23538579
  • Ehlers JP, Tao YK, Farsiu S, Maldonado R, Izatt JA, Toth CA. Visualization of real-time intraoperative maneuvers with a microscope-mounted spectral domain optical coherence tomography system. Retina. 2013 Jan;33(1):232-6. doi: 10.1097/IAE.0b013e31826e86f5. No abstract available.

    PubMed 23190928

Questions about this trial

What is this clinical trial studying?

An observational study of Eye Manifestations, run by Duke University at 2 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 19 Apr 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Test and provide feedback on the intraoperative system both in laboratory and then in the operating room. (time frame: 8.5 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01588041, which also lists 39 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Apr 2023.

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