Stereoscopic visualiation of real-time intraoperative 4D-miOCT in opthalmology

Abstract

Four dimensional microscope-integrated optical coherence tomography (4D-miOCT) has been proposed as an alternative to conventional white light microscopy in ophthalmic surgery. However, the specific method suitable for intraoperative visualization of this large amount of data is still a subject of ongoing research. This thesis investigates the use of an autostereoscopic tablet, while comparing it to already available means of visualization. Using a custom multiVNC based viewer on the client-side, we stream the 4D-miOCT renderings to an autostereoscopic tablet trying to achieve low latency. To compare the quality of visualization of the tablet and TV with that of a state-of-the-art surgical light microscope, we utilized the fastest 4D-miOCT engine and a modern digital ophthalmic surgical microscope. We conducted a user study with 35 participants (14 physicians and 21 laypersons). The user survey included subjective feedback and a quantitative performance assessment, as well as several quantitative measures, such as time to task completion. We were able to stream 4D-miOCT video live to an autostereoscopic light-field tablet, measuring a latency of 151 ms from server to client and a volume rate of 10 volumes-per-second, displaying the 4D-miOCT rendering on a TV. The light microscope and the TV performed best in terms of both performance rating and feedback on the visualizations. The tablet showed shortcomings in terms of resolution, 3D effect and latency, compared to the other visualizations. Subjective feedback suggests that the tablet has great potential to replace the TV. However, for this application to become clinically feasible, issues such as latency, resolution, and the quality of the 3D effect need to be addressed. The feedback collected in the user study, will further enable the optimization of 4D-miOCT streaming and visualization for surgeons during ophthalmic procedures, progressing towards a better integration into the surgical workflow.