# Enabling technology for image-guided robot-assisted sub-retinal injections

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2021 · $468,446

## Abstract

Project Summary
 The goal of this proposal is to design, develop and evaluate a novel clinically compatible surgical platform
for enhancing the retina surgeon's ability to provide therapy to the subretinal domain. Efficient, safe, reproducible
delivery methods would enable safe and precise delivery of stem cell, nanoparticle and gene therapies for
prevalent ocular diseases including but not limited to Age-related Macular Degeneration (AMD). The proposed
cooperative surgical robot utilizes force-sensing instruments that are guided by 4D intraoperative Optical
Coherence Tomography (4D-iOCT) imaging for intuitive surgeon-robot-patient interfaces.
 It is recognized that precise surgical access to the subretinal and intraretinal spaces would provide novel
treatment options for a number of prevalent ocular diseases; the fact that AMD remains the leading cause of
blindness in the elderly as well as its extraordinary cost of care makes it a strategic prototype condition for
advances in therapy. During the last decade, stem cells and gene therapy have been extensively explored as
treatments for AMD. Preliminary results indicate a promising safety profile, and suggest potential efficacy for
both. However, translation of these methods into a clinical standard of care has in part, been limited by lack of a
method to easily, safely, reproducibly and effectively deliver fully viable agents to the subretinal space.
 By advancing robotic technology, we seek to safely and reliably enhance access to the subretinal space to
allow for the targeted delivery of novel therapeutic agents in the setting of prevalent retinal diseases, such as
AMD. Our aims are: (1) Develop and evaluate a clinically compatible cooperative-controlled robotic assistant to
enable precise tool manipulation. The enhanced functionality will allow for precise targeted delivery, proper
orientation of cells and genetic cargo in the subretinal space, and enhanced survival of therapeutic biological
agents; (2) Develop and integrate a novel path planning function to the workstation that will facilitate robot-
assisted subretinal injections: utilizing real-time intraoperative 3D OCT images we will detect and track previously
invisible subretinal microstructure, optimize approach trajectories to achieve safe, controlled and precise
subretinal injections into the target space. Virtual fixtures will be incorporated into the design to avoid dangerous
motions; (3) System integration and preclinical evaluation: we will develop assistive control schemes and
workflow that fuse the tool-tissue interactions captured by the force-sensing instruments and the visual
information provided by the OCT system. In addition, comparison of the new technology against current surgical
techniques, in vivo, will be conducted to demonstrate the feasibility of our approach.
 This highly innovative system will enable surgeons to perform complex maneuvers in a tremor free
environment with a higher level of precision than previousl...

## Key facts

- **NIH application ID:** 10248434
- **Project number:** 5R01EB025883-03
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** IULIAN IOAN IORDACHITA
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $468,446
- **Award type:** 5
- **Project period:** 2019-09-20 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10248434

## Citation

> US National Institutes of Health, RePORTER application 10248434, Enabling technology for image-guided robot-assisted sub-retinal injections (5R01EB025883-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10248434. Licensed CC0.

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