用OCT实时追踪眼球运动，提升机器人眼内注射精度
Towards Motion Compensation in Autonomous Robotic Subretinal Injections
- 用快速OCT扫描捕捉视网膜上下移动，动态补偿呼吸心跳
- 100微米运动幅度下偏差达200微米，25微米时超80微米
- 适合做眼科手术机器人研发或微创治疗系统设计者
渗出性（湿性）年龄相关性黄斑变性是老年人失明的主要原因，通常通过玻璃体注射治疗。新兴疗法如干细胞、基因治疗、小分子药物及RPE细胞的视网膜下注射，需精确递送以避免损伤脆弱视网膜结构。机器人系统有望提供所需精度。本文提出一种新型机器人视网膜下注射运动补偿方法，利用实时光学相干断层扫描（OCT）实现。该方法采用B⁵-扫描技术，快速获取小体积OCT数据，动态追踪视网膜沿Z轴的运动，补偿呼吸、心跳等生理运动。在离体猪眼验证中发现，维持工具-视网膜距离存在挑战：100μm振幅运动下偏差达200μm，25μm振幅运动下超过80μm。视网膜下注射还面临相位偏移问题，导致针头偏离靶点，误入玻璃体腔。结果凸显了改进运动预测与水平稳定性对提升机器人视网膜下操作精度与安全性的必要性。
原文摘要 · Abstract (English)
Exudative (wet) age-related macular degeneration (AMD) is a leading cause of vision loss in older adults, typically treated with intravitreal injections. Emerging therapies, such as subretinal injections of stem cells, gene therapy, small molecules and RPE cells require precise delivery to avoid damaging delicate retinal structures. Robotic systems can potentially offer the necessary precision for these procedures. This paper presents a novel approach for motion compensation in robotic subretinal injections, utilizing real time Optical Coherence Tomography (OCT). The proposed method leverages B$^5$-scans, a rapid acquisition of small-volume OCT data, for dynamic tracking of retinal motion along the Z-axis, compensating for physiological movements such as breathing and heartbeat. Validation experiments on ex vivo porcine eyes revealed challenges in maintaining a consistent tool-to-retina distance, with deviations of up to 200 $μm$ for 100 $μm$ amplitude motions and over 80 $μm$ for 25 $μm$ amplitude motions over one minute. Subretinal injections faced additional difficulties, with phase shifts causing the needle to move off-target and inject into the vitreous. These results highlight the need for improved motion prediction and horizontal stability to enhance the accuracy and safety of robotic subretinal procedures.
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