RetiVue EntireEyeScope: A high resolution, top-down view, stereo, endoscopic viewing system for vitreoretinal surgery

Project Summary There are 300,000 vitreo-retinal procedures performed in the US each year, with the goal of restoring vision lost from a myriad of retinal diseases including retinal detachment, vitreous hemorrhage, endophthalmitis, pro- liferative diabetic retinopathy, and ocular trauma. The traditional surgical approach uses a top-down widefield viewing system thru the cornea and lens to be able to visualize the retina sufficiently to perform necessary fine tissue manipulation. Difficulty arises when this view is compromised due to corneal and lenticular opacifica- tion, which may precede any surgical intervention or arise during the attempted surgical repair itself. Up to 30% of surgeries encounter a compromised surgical view and this directly corresponds to the complexity of the reti- nal pathology and depth of visual loss from retinal disease. For the last 30 years ophthalmic endoscopy has been available to bypass an obscured anterior segment view, but despite this it remains poorly utilized. Key reasons for low adoption rates of this technology all stem from the non-intuitive view the endoscope probe provides: skewed perspective, flat 2-D image, reduced field of view, difficulty maintaining probe orientation in the eye, and lack of correspondence between surgeon instru- ment hand movement and what is seen on screen. The image is also provided on a separate screen to the side of the surgical field, and the constant need to hold the probe removes the capability of bi-manual surgery. To overcome these hurdles RetiVue L.L.C. proposes to develop the EntireEyeScope, the first 3-D stereo endo- scopic viewing system to provide a traditional heads-up, top-down view of the retina as if one is looking thru a clear cornea and lens. This will be accomplished by insertion of two miniature camera modules through 20G sclerotomies, enabling 4X the resolution of current fiber optic based ophthalmic endoscopes. Advanced image processing will transform the video stream from both cameras real-time into a standard 3-D, always in focus top-down view for the surgeon as if they were visualizing the retina thru a clear cornea and lens. This view will be compatible with a VR headset or feed into the surgical microscope directly. An endoscopic approach that closely recapitulates the traditional surgeon view should facilitate a greater rate of adoption of this technology, and allows for precision manipulation of retinal tissue not available in commer- cially available devices to date. Ultimately, this device will help improve surgical outcomes for patients, leading to greater recovery of vision.