将iOCT图像转为声音反馈,帮医生实时感知眼球内针头位置和组织变形。
Physics-Based iOCT Sonification for Real-time Interaction Awareness in Subretinal Injection

- 用物理模型将iOCT图像中的视网膜层分割结果转为可听声音。
- 在34人测试中事件识别准确率达83.4%,显著优于基线方法。
- 适合眼科手术导航,尤其利于减少术者认知负荷。
视网膜下注射是一种精细的玻璃体视网膜手术,需精确控制针头在视网膜色素上皮(RPE)下方的亚视网膜间隙内推进,避免穿破该层——其再生能力极弱。为提升进针时的深度感知,术中光学相干断层扫描(iOCT)可提供高分辨率横断面图像以观察针-组织交互;但解读这些图像需持续视觉关注,同时结合平面显微镜视野,增加认知负担并影响术者本体觉控制。本文提出一种结构化、实时的声学反馈框架,将iOCT提取的解剖特征映射为听觉信号。该方法基于物理启发的声音模型,利用iOCT B-scan序列中分割出的视网膜层信息,以针头运动和注射引起的视网膜层位移作为激励输入,实现对器械位置与视网膜形变的感知。在34名受试者的对照实验中,该声学系统达到83.4%的视网膜层识别准确率,并显著优于现有最佳基线(60.6%,p<0.001),主要优势体现在注射诱发视网膜形变事件的检测能力提升。四名专家评估确认该方法具有临床相关性与术中应用潜力。结果表明,结构化iOCT声学反馈是视网膜下注射中可行的实时手术引导补充模态。
原文摘要 · Abstract (English)
Subretinal injection is a delicate vitreoretinal procedure requiring precise needle placement within the subretinal space while avoiding perforation of the retinal pigment epithelium (RPE), a layer directly beneath the target with extremely limited regenerative capacity. To enhance depth perception during cannula advancement, intraoperative optical coherence tomography (iOCT) offers high-resolution cross-sectional visualization of needle-tissue interaction; however, interpreting these images requires sustained visual attention alongside the en face microscope view, thereby increasing cognitive load during critical phases and placing additional demands on the surgeon's proprioceptive control. In this paper, we propose a structured, real-time sonification framework designed for extensible mapping of iOCT-derived anatomical features into perceptual auditory feedback. The method employs a physics-inspired acoustic model driven by segmented retinal layers from a stream of iOCT B-scans, with needle motion and injection-induced retinal layer displacements serving as excitation inputs to the sound model, enabling perception of tool position and retinal deformation. In a controlled user study (n=34), the proposed sonification achieved high retinal layer identification accuracy and robust detection of retinal deformation-related events, significantly outperforming a state-of-the-art baseline in overall event identification (83.4% vs. 60.6%, p < 0.001), with gains driven primarily by enhanced detection of injection-induced retinal deformation. Evaluation by experts (n=4) confirmed the clinical relevance and potential intraoperative applicability of the method. These results establish structured iOCT sonification as a viable complementary modality for real-time surgical guidance in subretinal injection.
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