# US 9,872,798 B2 · System and method for determining dosimetry in ophthalmic photomedicine

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- Number: US 9,872,798 B2
- Document ID: US9872798B2
- Status: Granted
- Kind: B2
- Application number: 15/182,532
- Filed: 2016-06-14
- Published: 2016-10-06
- Granted: 2018-01-23
- Earliest claimed: 2006-11-10
- Assignees: Topcon Medical Laser Systems, Inc.
- Applicants: Topcon Medical Laser Systems, Inc.
- Inventors: Daniel V. Palanker; Dan Andersen
- Web page: https://patentgrep.com/patent/US9872798B2

## CPC

- A61F 9/00821: {for coagulation}
- A61B 18/20: using laser
- A61F 9/008: using laser
- A61N 5/0622: {Optical stimulation for exciting neural tissue}
- A61B 3/102: {for optical coherence tomography [OCT]}
- A61B 90/361: {Image-producing devices, e.g. surgical cameras}
- A61B 2018/20351: {Scanning mechanisms}
- A61B 2018/20361: {with redirecting based on sensed condition, e.g. tissue analysis or tissue movement}
- A61B 2018/2266: {with a lens, e.g. ball tipped}
- A61F 2009/00851: {Optical coherence topography [OCT]}
- A61F 2009/00855: {Calibration of the laser system}
- A61F 2009/00863: {Retina}
- A61F 2009/00868: {Ciliary muscles or trabecular meshwork}
- A61F 2009/00885: {for treating a particular disease}
- A61F 2009/00897: {Scanning mechanisms or algorithms}
- A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C)
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B)

## Abstract

A system and method for treating ophthalmic target tissue, including a light source for generating a beam of light, a beam delivery system that includes a scanner for generating patterns, and a controller for controlling the light source and delivery system to create a dosimetry pattern of the light beam on the ophthalmic target tissue. One or more dosage parameters of the light beam vary within the dosimetry pattern, to create varying exposures on the target tissue. A visualization device observes lesions formed on the ophthalmic target tissue by the dosimetry pattern. The controller selects dosage parameters for the treatment beam based upon the lesions resulting from the dosimetry pattern, either automatically or in response to user input, so that a desired clinical effect is achieved by selecting the character of the lesions as determined by the dosimetry pattern lesions.

## Claims

### Claim 1

A method for treating an eye, comprising:
generating a beam of light using a light source;
delivering the beam of light onto a first target area of the eye and a second target area of the eye using a beam delivery unit having a scanner unit for deflecting the beam of light from the first target area to the second target area;
creating a dosimetry pattern of the beam of light on the first target area and the second target area, the dosimetry pattern having a first dosage of light at the first target area and a second dosage of light at the second target area, the first dosage not equal to the second dosage;
capturing an image of the first target area and the second target area;
receiving information related to the image via a user interface that is connected to a controller that controls at least one of the generating a beam of light and delivering the beam of light; and
delivering the beam of light to a treatment area of the eye, the beam of light to the treatment area having a treatment dosage, the treatment dosage selected based on the received information.

### Claim 2 (depends on 1)

The method of claim 1, wherein the captured image shows a visible lesion created on the eye by the dosimetry pattern of the beam of light.

### Claim 3 (depends on 1)

The method of claim 1, wherein the treatment dosage is selected based on determining a number of visible lesions present at the first target area and second target area of the eye.

### Claim 4 (depends on 1)

The method of claim 1, wherein the delivering of the beam of light having the treatment dosage further comprises:
creating a treatment pattern of the beam of light on the treatment area of the eye.

### Claim 5 (depends on 4)

The method of claim 4, wherein the creating of the treatment pattern of the beam of light on the treatment area of the eye further comprises:
generating an invisible lesion on the treatment area; and
generating a visible lesion on the treatment area that serves as visual locator for the invisible lesion.

### Claim 6 (depends on 1)

The method of claim 1, further comprising:
displaying a visual indicator on the user interface that visually indicates a desired clinical result of a lesion to be generated by the beam of light at the treatment area.

### Claim 7 (depends on 6)

The method of claim 6, further comprising:
receiving a user input at the user interface; and
in accordance with the user input, causing the visual indicator to move from a first position to a second position, wherein the second position of the visual indicator represents a second desired clinical result of a lesion to be generated by the beam of light at the treatment area.

### Claim 8 (depends on 7)

The method of claim 7, wherein the user input includes a sliding input on a sliding bar displayed on the user interface.

### Claim 9 (depends on 8)

The method of claim 8, wherein the sliding bar is associated with values that represent laser power density, spot size, pulse duration, or a threshold of lesion visibility established by the dosimetry pattern scan.

### Claim 10 (depends on 8)

The method of claim 8, wherein the sliding bar represents a range of nonlinear values of a dosage parameter.

### Claim 11 (depends on 6)

The method of claim 6, further comprising:
receiving a second user input representing a request to change a spot size, laser power density, or pulse duration of the beam of light to be delivered to the treatment area; and
in response to receiving the second user input, causing the visual indicator to move from a first position to a third position.

### Claim 12 (depends on 6)

The method of claim 6, wherein the desired clinical result is an intensity or a size of a lesion to be generated by the beam of light at the treatment area.

### Claim 13 (depends on 6)

The method of claim 6, further comprising:
displaying an additional visual indicator on the user interface that visually indicates an actual clinical result of a lesion generated by delivering the beam of light to the treatment area.

### Claim 14 (depends on 13)

The method of claim 13, further comprising:
receiving a user input at the user interface; and
in accordance with the user input, causing the additional visual indicator to move from a first position to a second position, wherein the second position of the additional visual indicator represents the actual clinical result of the lesion generated by delivering the beam of light to the treatment area.

### Claim 15 (depends on 14)

The method of claim 14, further comprising:
delivering the beam of light to a second treatment area of the eye, the beam of light to the second treatment area having a second treatment dosage, the second treatment dosage selected based on the second position of the additional visual indicator.

### Claim 16

A method for treating an eye, comprising:
generating a beam of light using a light source;
delivering a beam of light to a target area of the eye;
generating a dosimetry pattern on the target area of the eye with the delivered beam of light, the dosimetry pattern having a first dosage at a first time and a second dosage at a second time;
capturing an image of the target area with a visualization device, the captured image including a first dosage result and a second dosage result;
determining an expected lesion dosage based on the first dosage result and the second dosage result;
displaying a visual indicator at a first position on a user interface of a visualization device, wherein the first position of the visual indicator represents the expected lesion dosage;
receiving a user input corresponding to a second position on the user interface;
in response to receiving the user input, displaying the visual indicator at the second position on the user interface, wherein the second position of the visual indicator represents a desired clinical result from eye treatment; and
generating a treatment pattern on a treatment area of the eye, the treatment pattern having a treatment dosage based on the second position of the visual indicator.

### Claim 17 (depends on 16)

The method of claim 16, further comprising:
displaying an additional visual indicator on the user interface that visually indicates an actual clinical result of a lesion generated by delivering the beam of light to the treatment area;
receiving a second user input at the user interface; and
in accordance with the second user input, causing the additional visual indicator to move from a first position to a second position, wherein the second position of the additional visual indicator represents the actual clinical result of the lesion generated by the treatment pattern on the treatment area of the eye.

### Claim 18

A method for treating an eye, comprising:
generating a beam of light using a light generation unit;
delivering the beam of light onto the eye using a light delivery unit having a scanner unit for deflecting the beam of light;
controlling the light delivery unit while delivering the beam of light to create a dosimetry pattern with the beam of light, the dosimetry pattern having a first dosage at a first portion of the eye and a second dosage at a second portion of the eye, the first dosage different than the second dosage;
detecting a lesion formed on the eye, the lesion caused by the delivering of the beam of light to create a dosimetry pattern;
receiving information related to an image via a user interface that is connected to a controller that controls at least one of the generating a beam of light and delivering the beam of light;
based on the received information, associating the lesion formed on the eye with the first dosage or the second dosage;
determining a treatment dosage for the beam of light based on the first dosage or the second dosage associated with the lesion; and
delivering the beam of light having the treatment dosage to a treatment area of the eye.

### Claim 19 (depends on 18)

The method of claim 18, further comprising:
displaying a visual indicator on the user interface that visually indicates a desired clinical result of a lesion to be generated by the beam of light at the treatment area;
receiving a user input at the user interface; and
in accordance with the user input, causing the visual indicator to move from a first position to a second position, wherein the second position of the visual indicator represents a second desired clinical result of a lesion to be generated by the beam of light at the treatment area.

### Claim 20 (depends on 18)

The method of claim 18, further comprising:
displaying a visual indicator on the user interface that visually indicates a desired clinical result of a lesion to be generated by the beam of light at the treatment area;
displaying an additional visual indicator on the user interface that visually indicates an actual clinical result of a lesion generated by delivering the beam of light to the treatment area;
receiving a user input at the user interface; and
in accordance with the user input, causing the additional visual indicator to move from a first position to a second position, wherein the second position of the additional visual indicator represents the actual clinical result of the lesion generated by delivering the beam of light to the treatment area.