# Assistive Robotically Aligning Optical Coherence Tomography and Laser Photocoagulation Therapy of the Retinal Periphery

> **NIH NIH R21** · DUKE UNIVERSITY · 2024 · $201,250

## Abstract

PROJECT SUMMARY/ABSTRACT
 Retinal detachments can cause significant vision loss and frequently begin as small breaks in the
peripheral retina (from ocular globe equator to the ora serrata). These breaks allow fluid to enter the sub-retinal
space, detaching the retina and leading to retinal ischemia and dysfunction. Laser photocoagulation (LP)
therapy can be utilized in the clinic reducing the risk of subsequent detachment tenfold (50% to 5%) but only if
breaks are detected early and before excess fluid has accumulated under the retina. The long-term goal is to
develop a system that provides 360° visualization of the peripheral retina replacing the current standard of care
for evaluation of the retinal periphery for breaks: indirect ophthalmoscopy with scleral depression, a procedure
requiring the examiner to mechanically indent the eye at multiple locations and use an indirect ophthalmoscope
and condensing lens to attempt to visualize the retina peripherally and over 360°. The rationale for this project
is that in addition to being extremely uncomfortable for the patient, this technique requires considerable skill
with specialized training. Furthermore, the exam does not create a direct record of the findings – the examiner
must illustrate a guide map from memory for subsequent LP therapy utilizing this same manual technique.
These objectives will be achieved by pursuing two specific aims: 1) Adapt a custom conical mirror contact lens
and robotically aligning platform to optically access the peripheral retina with OCT and laser photocoagulation
therapy; and 2) Validate peripheral retina robotically aligning OCT against scleral depressed exam in eyes with
and without peripheral retinal breaks requiring treatment. Under the first aim the conical mirror contact lens and
robotically aligning platform will be redesigned to deliver both OCT and LP therapy light to the peripheral retina.
The system will be validated for field-of-view and resolution and evaluated for the ability to deliver LP therapy
in ex vivo porcine eyes to created breaks throughout the peripheral retinal with real-time OCT image guidance.
Under the second aim, the robotically aligning OCT imaging system will be used in vivo. First a pilot study will
be performed on healthy subjects optimizing for robot-operator interactions. Upon completion, a powered study
will test the null hypothesis that there is no difference between paired differences in the number of breaks per
eye as observed by peripheral retina RAOCT versus clinical exam in eyes with and without peripheral retinal
breaks requiring treatment. The proposed research is technically innovative, in the applicant’s opinion,
because it directly addresses optical issues for accessing and aligning to the retinal periphery by using a
custom conical mirror contact designed for use with OCT and LP therapy coupled with 3D tracking and
compensation. The proposed research is further clinically innovative, in the applicant’s opinion, becaus...

## Key facts

- **NIH application ID:** 10770475
- **Project number:** 5R21EY033959-02
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** RYAN P MCNABB
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $201,250
- **Award type:** 5
- **Project period:** 2023-02-01 → 2026-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10770475

## Citation

> US National Institutes of Health, RePORTER application 10770475, Assistive Robotically Aligning Optical Coherence Tomography and Laser Photocoagulation Therapy of the Retinal Periphery (5R21EY033959-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10770475. Licensed CC0.

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