A field of the invention sensors and sensing, particularly ocular sensors and sensing.
Ocular sensors and sensing are important to monitor patient intraocular pressure (IOP). Ocular tonometry techniques are currently used in standard practice to monitor IOP. These techniques provide only a snapshot of the pressure profile and give an indirect measurement of IOP.
More recently, there have been efforts to develop implantable sensors using MEMS (micro electromechanical systems) technology. Many of these devices use capacitive sensing and require electrical components including batteries. Difficulties with these devices include signal readout, size, sensitivity, power consumption and biocompatibility.
Active implants that include active components such as transducers, modulators, microprocessors and transmitters are disclosed in the following publications.
J. Coosemans, M. Catrysse, and R. Puers, “A readout circuit for an intraocular pressure sensor,” Sens. Actuators A, vol. 110, pp. 432-438, 2004.
R. Puers, “Linking sensors with telemetry: Impact on system design,” in Proc. 8th Int. Conf. Solid-State Sens. Actuators, Eurosens. IX, Stockholm, Sweden, Jun. 25-29, 1995, pp. 169-174.
K. Stangel, S. Kolnsberg, Hammerschmidt, H. K. Trieu, and W. Mokwa, “A programmable Intraocular CMOS pressure sensor system Implant,” IEEE J. Solid State, vol. 36, no. 7, pp. 1094-1100, July 2001.
W. Mokwa and U. Schnakenberg, “Micro-transponder systems for medical applications,” IEEE Trans. Instrument. Measure., vol. 50, no. 6, pp. 1551-1555, December 2001.
There are some prior passive IOP sensors. One system and method for sensing intraocular pressure is based on detecting spectrum shift in reflectance of a nano photonic structure to monitoring IOP. This method requires a specialized spectrometer to send in infrared light and obtain reflecting light which renders it inconvenient for users. Complex fabrication process of multiple layers of nanophotonic structure requires high precision and may lead to issue with reliability.
The following publications discuss passive implants where wireless monitoring of the IOP is achieved through mutual inductance coupling between the inductor on the sensor and the external loop antenna.
C. C. Collins, “Miniature passive pressure transensor for implanting in eye,” IEEE Trans. Bio-Med. Eng., vol. BME-14, no. 2, pp. 74-83, April 1967
Y. Backlund, L. Rosengren, B. Hok, and B. Svedbergh, “Passive silicon transensor intended for biomedical, remote pressure monitoring,” Sens. Actuators, vol. A21-A23, pp. 58-61, 1990.
L. Rosengren, Y. Backlund, T. Sjostrom, B. Hok, and B. Svedbergh, “A system for wireless intraocular pressure measurements using a silicon micromachined sensor,” J. Micromech. Microeng., vol. 2, pp. 202-204, 1992.
L. Rosengren, P. Rangsten, Y. Backlund, B. Hok, B. Svedbergh, and G. Selen, “A system for passive implantable pressure sensors,” Sens. Actuators A, vol. 43, pp. 55-58,1994.
K. Van Schuylenbergh and R. Pures, “Passive telemetry by harmonics detection,” in Proc. 18th Annu. Int. Conf. IEEE Eng. Med. Biol. Soc., Amsterdam, The Netherlands, 1996, vol. 1, pp. 299-300.
R. Puers, G. Vandevoorde, and D. De Bruyker, “Electrodeposited copper inductors for intraocular pressure telemetry,” J. Micromech. Microeng., vol. 10, pp. 124-129,2000.
O. Akar, T. Akin, and K. Najafi, “A wireless batch sealed absolute capacitive pressure sensor,” Sens. Actuator A, vol. 95, pp. 29-38,2001.
I. Araci, B. Su, S Quake, Y. Mandel, “An implantable microfluidic device for self-monitoring of intraocular pressure,” Nature Medicine 20,1074-1078, 2014.
Choo, Hyuck, David Sretavan, and Myung-Ki Kim. System and Method for Sensing Intraocular Pressure. Patent W02013090886 A1. 20 Jun. 2013.
Chen, Po-Jui, Damien Rodger, Mark Humayun, Yu-Chong Tai. “Unpowered spiral-tube parylene pressure sensor for intraocular pressure sensing.” Sensors and Actuators A: Physical, vol. 127, pp. 276-282, 2006.
Ghannad-Reizaie, M. “A powerless optical microsensor for monitoring intraocular pressure with keratoprostheses.” Solid-State Sensors, Conference. IEEE, 2013.
An implantable microfluidic device for self-monitoring of intraocular pressure has been implemented based on measuring the displacement of a gas-fluid interface as a function of pressure. This is described in Araci, et al., supra [0019]. This design suffers from difficulty with detecting the gas-fluid interface due to low contrast. One end of the channel is open to aqueous humor in the anterior chamber which makes it susceptible to clogging due to protein deposition. There is also the potential of gas leaking through the sensor walls over time compromising the device's integrity and reading accuracy.
A powerless optical microsensor for monitoring intraocular pressure with a keratoprostheses has been developed by Ghannad-Reizaie, M, supra [0022]. It is based on comparing relative reflectance intensities from two different layers of quantum dots in order to measure IOP. This complicated design poses difficulties during the manufacturing process along with high cost. It requires a specialized light source and detection unit to take measurement. Sensitivity is relatively low at 2 mmHg.
An unpowered spiral tube parylene pressure sensor for IOP sensing is based on detecting rotational displacement of the pointing tip of an Archimedean coil. The coil is open to the aqueous humor, which makes it susceptible to environmental changes. This could affect the device's sensitivity and reliability.
A contact lens with a microstraingauge embedded has been disclosed to measure changes in IOP by sensing the deformation of the corneal curvature by M. Leonardi, P. Leuenberger, D. Bertrand, A. Bertsch, and P. Renaud, “First steps toward noninvasive intraocular pressure monitoring with a sensing contact lens,” Investigative Ophthalmol. Vis. Sci., vol. 45, no. 9, Sep. 2004.
A technology that is state of the art in actual use and viewed favorably in the art is known as the Goldmann Applanation Tonometer. See, Kakaday, T, Hewitt AW, Voelcker NH, et al. “Advances in telemetric continuous intraocular pressure assessment.” British Journal of Ophthalmology., vol. 98, pp. 992-996, 2009. This technique and system measure IOP by applying a force that flattens the cornea. A plastic biprism contacts the cornea to provide an optical reference and optical viewing. The clinician adjusts pressure until optical reference semicircles come together as an indication of the IOP. This technique is conducted by doctors or clinicians, requiring close supervision. Some patients have trouble with this test, shying from the contact induced during the procedure. Some patients also tense, which can increase IOP during testing.
An embodiment of the invention is an optical pressure sensor sized to be implanted at an intraocular location and formed from biocompatible materials. The sensor includes a rigid structure that supports a deformable structure arranged such that deformation of the deformable structure can be monitored optically when implanted in the intraocular location.
A preferred intraocular sensor includes a deformation structure arranged with respect to a rigid structure. Both are formed from or packaged within biocompatible materials and the sensor is sized to be installed at an intraocular location. The deformation structure deforms in response to intraocular pressures. The deformation structure is arranged to be imaged by an optical sensor when installed in the intraocular location such that deformation can be detected and measured. The deformation structure is preferably an elastomer materials. Example forms include columns and layers, periodic and irregular surfaces. Another preferred deformation structures include membranes and diaphragms. In a preferred embodiment, a membrane compresses one or more columns. In another embodiment, a diaphragm is suspended over a central cavity.
An optical intraocular sensor system includes an intraocular sensor of the invention. The system further includes a camera for sensing a characteristic of the deformation structure and a processor for correlating the characteristic to intraocular pressure by image analysis. In a preferred embodiment, the deformation structure is arranged to deform against the rigid structure and the processor correlates a contact area of the deformation structure against the rigid structure to intraocular pressure. In another preferred embodiment, the deformation structure is arranged to deform with respect to the rigid structure and the processor correlates a light intensity pattern to intraocular pressure. In another preferred embodiment, the deformation structure is arranged to deform with respect to the rigid structure and the processor correlates a light reflection pattern to intraocular pressure.
A preferred method of the invention senses intraocular pressure. The method includes implanting a sensor at an intraocular location. The sensor includes a rigid structure that supports a deformable structure. The sensor is subjected the sensor to light stimulation, imaging the deformable structure, and correlating an optical property affected by the state of deformation of the deformable structure to an intraocular pressure.
An embodiment of the invention is an intraocular sensor that offers the users the ability to monitor directly the IOP on a frequent basis using a wireless, passive, optically based pressure sensor. The sensor includes an elastomer that deforms in response to elevated intraocular pressures. A pressure amount and/or an IOP profile is calculated based on deformation of the elastomer, which includes deformable structures in preferred embodiments, e.g., columns, periodic or aperiodic structures, and membranes. An optical sensor device captures optical changes caused by the deformation, e.g. a change in the appearance and/or the light reflecting properties of the sensor due to pressure variation. Data are then analyzed to compute a pressure and/or pressure profile. A camera is an example optical sensor device.
In contrast to prior passive devices and sensing methods discussed in the background, a sensor device and method of the invention does not require specialized equipment such as a spectrometer, applanation tonometer, or detection unit. Data can be acquired and processed, for example, with a cell phone at the convenience of the user allowing a more accurate profile of IOP at arbitrary times. A pressure profile can be constructed based on changes in the appearance and/or the light reflecting properties of the sensor. The testing can be conducted under normal conditions without creating added tension to the subject being tested. Accordingly, some limitations of clinical Goldmann applanation tonomotery are avoided.
The present invention provides sensors that are biocompatible, passive, and sensitive. Preferred sensors of the invention are amenable to mass production at low cost using MEMS fabrication techniques.
A preferred embodiment sensor is an optically-based, passive, wireless intraocular pressure (IOP) sensor that detects small changes in pressure. An IOP profile calculation is based on deformation of an elastomer (e.g. columns, periodic structures, membranes, textured surfaces) in optical indication, e.g., appearance and/or light reflecting properties in response to the pressure changes. Preferred embodiment devices can be (1) integrated with an intraocular lens, (2) integrated with a glaucoma drainage device, (3) independently implanted at the surface of the iris, or (4) independently implanted to be free standing in the anterior chamber or capsule bag. Some of these options limit the surgical procedures necessary to install the sensor.
Preferred embodiment devices provide data acquisition and processing using a cell phone, tablet or other handheld computer device, or another computer device linked via wireless connection at the convenience of a user allowing accurate and frequent monitoring of IOP. In such embodiments, there is no need to use a specialized monitor, such as a spectrometer or detection unit. Sensors of the invention are biocompatible, and are passive. Sensors of the invention are readily fabricated using MEMS technology, and have a non-complex design and material structure. This permits low-cost manufacture. IOP data is readily obtained, transmitted and processed, locally or remotely.
Preferred devices have many ocular health monitoring applications. Patients that are at risk for glaucoma can be monitored and data can be used in a app on the cell phone or transmitted to a data center that performs analysis to identify conditions that trigger an alarm and raise flags that are transmitted to a care professional. In another application, IOP is monitored to establish target IOP for individual patient, and IOP data can be used to adjust intervention to achieve therapeutic goals.
Another important application is post-surgery monitoring. Ocular surgery patients such as cataract surgery patients are monitored after surgery to ensure that IOP remains in a healthy range.
Another application is as a research tool to aid and improve glaucoma studies or drug development in animal models. Other applications are those that require continuous tracking of changes in intraocular pressure such as during clinical trial.
Preferred devices provide data acquisition and processing using a cell phone at the convenience of the user allowing accurate and frequent monitoring of IOP. There is no need for specialized equipment such as a spectrometer or detection unit. Preferred embodiment devices provide IOP data to analyzed locally in a cell phone app or to be transmitted and processed, and incorporated into in-time-patient care remotely and wirelessly.
In a preferred embodiment, a present day smart phone camera is used to capture a optical indication of the deformation of an elastomer due to changes in pressure. The high resolution camera on many modern handheld devices can be used to capture deformation. Magnification lenses attached to the hand held device camera can aid detection. Magnifying lenses for cell phone and tablet cameras are commercially available. Of course, more standard optometric and clinical equipment can alternately be used to capture the deformation. An elastomer column is between two layers or an encasing structure, which receive intraocular forces. As pressure increases, the elastomer begins to deform between the encasing structure. In one embodiment, this deformation results in a change in the contact area, which is then used to calculate a pressure or pressure profile. In other embodiments, a change in the angle of reflected light or another optical indication of the deformation is used to calculate a pressure amount or pressure profile. In some embodiments, the encasing structure is preferably rigid, meaning that the encasing structure does not deform in response to intraocular pressures and will compress the elastomer column. In other embodiments, a membrane deflects to cause an optical change that can be measured.
Preferred embodiments of the invention will now be discussed with respect to the drawings. The drawings may include schematic representations, which will be understood by artisans in view of the general knowledge in the art and the description that follows. Features may be exaggerated in the drawings for emphasis, and features may not be to scale.
The processing to correlate IOP to a reaction of the sensor 10 conducted by the processor 22 can be based upon various optical properties that change due to the compression of the elastomer structure 12, or the deflection of membranes and other elastomer features in additional embodiments. The response to pressure can change a focal point measured by the camera 20. It can also change the light intensity, reflected light wavelength, contact area, etc. These changed properties can be correlated to IOP, and determine a level of IOP.
For any of the
Another preferred embodiment sensor 40 consistent with the above illustrated embodiments is shown in
The sensor 40 includes a rigid plate 42 and a column 44 placed between the rigid plate 42 and a membrane 46. A wall 48 seals the sensor. In
Experiments were conducted to test prototypes. The example sensors were fabricated consistently with
The experimental set-up was created to control the applied pressure, capture the contact area and plot the pressure profile. A schematic of the set-up is shown below in
Miniaturized prototypes have also been made and used to explore the process of fabrication. These prototypes were consistent with
Finite element models were also built to simulate responses of the prototype under applied pressures.
Effect of Pressure Loading
Effect of Membrane Thickness
Effect of Column Height
Effect of Column Width
Summary of Simulation Experiments
The results and simulations showed that various embodiments can provide a linear and measureable contact area change in response to pressure. Measurement sensitivity of 1 mmHG was demonstrated over a range of 0 to 50 mm HG.
Preferred Fabrication Process
The simulated sensor of
Experiments using the
Material Effects
The thickness of the materials affects flexibility as discussed above. The particular materials selected, as well as the ratios of components of the materials can also affect the flexibility. Tests were conducted with example PDMS material of the column have mixing ratios of cross-linker to base polymer of 1:05, 1:10, 1:15 and the response to pressure is shown in
Additional Prototypes and Testing
While specific embodiments of the present invention have been shown and described, it should be understood that other modifications, substitutions and alternatives are to one of ordinary skill in the art. Such modifications, substitutions and alternatives can be made without departing from the spirit and scope of the invention.
Various features of the invention are set forth in the appended claims.
The application claims priority under 35 U.S.C. §119 and all applicable statutes and treaties from prior provisional application Ser. No. 62/065,982, which was filed Oct. 20, 2014.
Filing Document | Filing Date | Country | Kind |
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PCT/US15/56449 | 10/20/2015 | WO | 00 |
Number | Date | Country | |
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62065982 | Oct 2014 | US |