Augmented Reality in Ophthalmology: Applications and Challenges.
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ABSTRACT:
SUBMITTER: Li T
PROVIDER: S-EPMC8703032 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:PurposeMost published systematic reviews have focused on the use of virtual reality (VR)/augmented reality (AR) technology in ophthalmology as it relates to surgical training. To date, this is the first review that investigates the current state of VR/AR technology applied more broadly to the entire field of ophthalmology.MethodsPubMed, Embase, and CINAHL databases were searched systematically from January 2014 through December 1, 2020. Studies that discussed VR and/or AR as it relates to the field of ophthalmology and provided information on the technology used were considered. Abstracts, non-peer-reviewed literature, review articles, studies that reported only qualitative data, and studies without English translations were excluded.ResultsA total of 77 studies were included in this review. Of these, 28 evaluated the use of VR/AR in ophthalmic surgical training/assessment and guidance, 7 in clinical training, 23 in diagnosis/screening, and 19 in treatment/therapy. 15 studies used AR, 61 used VR, and 1 used both. Most studies focused on the validity and usability of novel technologies.ConclusionsOphthalmology is a field of medicine that is well suited for the use of VR/AR. However, further longitudinal studies examining the practical feasibility, efficacy, and safety of such novel technologies, the cost-effectiveness, and medical/legal considerations are still needed. We believe that time will indeed foster further technological advances and lead to widespread use of VR/AR in routine ophthalmic practice.
| S-EPMC9167643 | biostudies-literature
Project description:BackgroundVirtual reality, augmented reality, and mixed reality make use of a variety of different software and hardware, but they share three main characteristics: immersion, presence, and interaction. The umbrella term for technologies with these characteristics is extended reality. The ability of extended reality to create environments that are otherwise impossible in the real world has practical implications in the medical discipline. In ophthalmology, virtual reality simulators have become increasingly popular as tools for surgical education. Recent developments have also explored diagnostic and therapeutic uses in ophthalmology.ObjectiveThis systematic review aims to identify and investigate the utility of extended reality in ophthalmic education, diagnostics, and therapeutics.MethodsA literature search was conducted using PubMed, Embase, and Cochrane Register of Controlled Trials. Publications from January 1, 1956 to April 15, 2020 were included. Inclusion criteria were studies evaluating the use of extended reality in ophthalmic education, diagnostics, and therapeutics. Eligible studies were evaluated using the Oxford Centre for Evidence-Based Medicine levels of evidence. Relevant studies were also evaluated using a validity framework. Findings and relevant data from the studies were extracted, evaluated, and compared to determine the utility of extended reality in ophthalmology.ResultsWe identified 12,490 unique records in our literature search; 87 met final eligibility criteria, comprising studies that evaluated the use of extended reality in education (n=54), diagnostics (n=5), and therapeutics (n=28). Of these, 79 studies (91%) achieved evidence levels in the range 2b to 4, indicating poor quality. Only 2 (9%) out of 22 relevant studies addressed all 5 sources of validity evidence. In education, we found that ophthalmic surgical simulators demonstrated efficacy and validity in improving surgical performance and reducing complication rates. Ophthalmoscopy simulators demonstrated efficacy and validity evidence in improving ophthalmoscopy skills in the clinical setting. In diagnostics, studies demonstrated proof-of-concept in presenting ocular imaging data on extended reality platforms and validity in assessing the function of patients with ophthalmic diseases. In therapeutics, heads-up surgical systems had similar complication rates, procedural success rates, and outcomes in comparison with conventional ophthalmic surgery.ConclusionsExtended reality has promising areas of application in ophthalmology, but additional high-quality comparative studies are needed to assess their roles among incumbent methods of ophthalmic education, diagnostics, and therapeutics.
| S-EPMC8414293 | biostudies-literature
Project description:3D visualization technologies such as virtual reality (VR), augmented reality (AR), and mixed reality (MR) have gained popularity in the recent decade. Digital extended reality (XR) technologies have been adopted in various domains ranging from entertainment to education because of their accessibility and affordability. XR modalities create an immersive experience, enabling 3D visualization of the content without a conventional 2D display constraint. Here, we provide a perspective on XR in current biomedical applications and demonstrate case studies using cell biology concepts, multiplexed proteomics images, surgical data for heart operations, and cardiac 3D models. Emerging challenges associated with XR technologies in the context of adverse health effects and a cost comparison of distinct platforms are discussed. The presented XR platforms will be useful for biomedical education, medical training, surgical guidance, and molecular data visualization to enhance trainees' and students' learning, medical operation accuracy, and the comprehensibility of complex biological systems.
| S-EPMC8324499 | biostudies-literature
Project description:Liquid crystal displays (LCDs) and photonic devices play a pivotal role to augmented reality (AR) and virtual reality (VR). The recently emerging high-dynamic-range (HDR) mini-LED backlit LCDs significantly boost the image quality and brightness and reduce the power consumption for VR displays. Such a light engine is particularly attractive for compensating the optical loss of pancake structure to achieve compact and lightweight VR headsets. On the other hand, high-resolution-density, and high-brightness liquid-crystal-on-silicon (LCoS) is a promising image source for the see-through AR displays, especially under high ambient lighting conditions. Meanwhile, the high-speed LCoS spatial light modulators open a new door for holographic displays and focal surface displays. Finally, the ultrathin planar diffractive LC optical elements, such as geometric phase LC grating and lens, have found useful applications in AR and VR for enhancing resolution, widening field-of-view, suppressing chromatic aberrations, creating multiplanes to overcome the vergence-accommodation conflict, and dynamic pupil steering to achieve gaze-matched Maxwellian displays, just to name a few. The operation principles, potential applications, and future challenges of these advanced LC devices will be discussed.
| S-EPMC9151772 | biostudies-literature
Project description:BackgroundAugmented reality (AR) is increasingly being explored in neurosurgical practice. By visualizing patient-specific, three-dimensional (3D) models in real time, surgeons can improve their spatial understanding of complex anatomy and pathology, thereby optimizing intra-operative navigation, localization, and resection. Here, we aimed to capture applications of AR in glioma surgery, their current status and future potential.MethodsA systematic review of the literature was conducted. This adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. PubMed, Embase, and Scopus electronic databases were queried from inception to October 10, 2022. Leveraging the Population, Intervention, Comparison, Outcomes, and Study design (PICOS) framework, study eligibility was evaluated in the qualitative synthesis. Data regarding AR workflow, surgical application, and associated outcomes were then extracted. The quality of evidence was additionally examined, using hierarchical classes of evidence in neurosurgery.ResultsThe search returned 77 articles. Forty were subject to title and abstract screening, while 25 proceeded to full text screening. Of these, 22 articles met eligibility criteria and were included in the final review. During abstraction, studies were classified as "development" or "intervention" based on primary aims. Overall, AR was qualitatively advantageous, due to enhanced visualization of gliomas and critical structures, frequently aiding in maximal safe resection. Non-rigid applications were also useful in disclosing and compensating for intra-operative brain shift. Irrespective, there was high variance in registration methods and measurements, which considerably impacted projection accuracy. Most studies were of low-level evidence, yielding heterogeneous results.ConclusionsAR has increasing potential for glioma surgery, with capacity to positively influence the onco-functional balance. However, technical and design limitations are readily apparent. The field must consider the importance of consistency and replicability, as well as the level of evidence, to effectively converge on standard approaches that maximize patient benefit.
| S-EPMC10476869 | biostudies-literature
Project description:Lymphaticovenular anastomosis (LVA) is a widely performed surgical procedure for the treatment of lymphedema. For good LVA outcomes, identifying lymphatic vessels and venules is crucial. Photoacoustic lymphangiography (PAL) is a new technology for visualizing lymphatic vessels. It can depict lymphatic vessels at high resolution; therefore, this study focused on how to apply PAL for lymphatic surgery. To visualize lymphatic vessels, indocyanine green was injected as a color agent. PAI-05 was used as the photoacoustic imaging device. Lymphatic vessels and veins were visualized at 797- and 835-nm wavelengths. First, it was confirmed whether the branching of the vasculature as depicted by the PAL was consistent with the actual branching of the vasculature as confirmed intraoperatively. Second, to use PAL images for surgical planning, preoperative photoacoustic images were superimposed onto the patient limb through augmented reality (AR) glasses (MOVERIO Smart Glass BT-30E). Lymphatics and venule markings drawn using AR glasses were consistent with the actual intraoperative images obtained during LVA. To anastomose multiple lymphatic vessels, a site with abundant venous branching was selected as the incision site; and selecting the incision site became easier. The anatomical morphology obtained by PAL matched the surgical field. AR-based marking could be very useful in future LVA.
| S-EPMC8745664 | biostudies-literature
Project description:BackgroundCOVID-19 pandemic has significantly impacted the field of medical training, necessitating innovative approaches to education and practice. During this period, the use of novel technologies like virtual reality (VR), augmented reality (AR), and mixed reality (MR) has become increasingly vital. These technologies offer the advantage of transcending the limitations of time and space, thus enabling medical professionals to access various personalized programs for both education and service delivery. This shift is particularly relevant in the realm of pediatric medicine, where traditional training and clinical methods face unique challenges.PurposeThe primary aim of this study is to explore the application of VR, AR, and MR technologies in pediatric medical settings, with a focus on both clinical applications and the training of pediatric medical professionals. We aim to comprehensively search and review studies that have utilized these technologies in the treatment of pediatric patients and the education of healthcare providers in this field.MethodsPeer-reviewed articles published in PubMed, the Cochrane Library, ScienceDirect, Google Scholar, and Scopus from January 1, 2018, to March 1, 2023, were comprehensively searched. The review was conducted according to the PRISMA (Preferred Reporting Items for Systematic review and Meta-Analyses) guidelines. Among the 89 studies, 63 investigated the clinical applications of VR (n=60) or AR (n=3) in pediatric patients, and 25 investigated the applications of VR (n=19), AR (n=5), or MR (n=1) for training medical professionals.ResultsA total of 36 randomized controlled trials (RCTs) for clinical application (n=31) and medical training (n=5) were retrieved. Among the RCTs, 21 reported significant improvements in clinical applications (n=17) and medical training (n=4).ConclusionDespite a few limitations in conducting research on innovative technology, such research has rapidly expanded, indicating that an increasing number of researchers are involved in pediatric research using these technologies.
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Project description:The Rhode Island IDeA Network of Biomedical Research Excellence Molecular Informatics Core at the University of Rhode Island Information Technology Services Innovative Learning Technologies developed virtual and augmented reality applications to teach concepts in biomedical science, including pharmacology, medicinal chemistry, cell culture and nanotechnology. The apps were developed as full virtual reality/augmented reality and 3D gaming versions, which do not require virtual reality headsets. Development challenges included creating intuitive user interfaces, text-to-voice functionality, visualization of molecules and implementing complex science concepts. In-app quizzes are used to assess the user's understanding of topics, and user feedback was collected for several apps to improve the experience. The apps were positively reviewed by users and are being implemented into the curriculum at the University of Rhode Island.
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Project description:There have been decades of research on the usability and educational value of augmented reality. However, less is known about how augmented reality affects social interactions. The current paper presents three studies that test the social psychological effects of augmented reality. Study 1 examined participants' task performance in the presence of embodied agents and replicated the typical pattern of social facilitation and inhibition. Participants performed a simple task better, but a hard task worse, in the presence of an agent compared to when participants complete the tasks alone. Study 2 examined nonverbal behavior. Participants met an agent sitting in one of two chairs and were asked to choose one of the chairs to sit on. Participants wearing the headset never sat directly on the agent when given the choice of two seats, and while approaching, most of the participants chose the rotation direction to avoid turning their heads away from the agent. A separate group of participants chose a seat after removing the augmented reality headset, and the majority still avoided the seat previously occupied by the agent. Study 3 examined the social costs of using an augmented reality headset with others who are not using a headset. Participants talked in dyads, and augmented reality users reported less social connection to their partner compared to those not using augmented reality. Overall, these studies provide evidence suggesting that task performance, nonverbal behavior, and social connectedness are significantly affected by the presence or absence of virtual content.
| S-EPMC6516797 | biostudies-literature
Project description:Recently, metasurfaces composed of artificially fabricated subwavelength structures have shown remarkable potential for the manipulation of light with unprecedented functionality. Here, we first demonstrate a metasurface application to realize a compact near-eye display system for augmented reality with a wide field of view. A key component is a see-through metalens with an anisotropic response, a high numerical aperture with a large aperture, and broadband characteristics. By virtue of these high-performance features, the metalens can overcome the existing bottleneck imposed by the narrow field of view and bulkiness of current systems, which hinders their usability and further development. Experimental demonstrations with a nanoimprinted large-area see-through metalens are reported, showing full-color imaging with a wide field of view and feasibility of mass production. This work on novel metasurface applications shows great potential for the development of optical display systems for future consumer electronics and computer vision applications.
| S-EPMC6212528 | biostudies-literature