WO2021009570A1 - Dispositif de génération de motifs de durcissement lumineux personnalisables pour applications ophtalmiques - Google Patents
Dispositif de génération de motifs de durcissement lumineux personnalisables pour applications ophtalmiques Download PDFInfo
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- WO2021009570A1 WO2021009570A1 PCT/IB2020/050596 IB2020050596W WO2021009570A1 WO 2021009570 A1 WO2021009570 A1 WO 2021009570A1 IB 2020050596 W IB2020050596 W IB 2020050596W WO 2021009570 A1 WO2021009570 A1 WO 2021009570A1
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- Prior art keywords
- light
- corneal
- patient
- cornea
- beam splitter
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/06—Radiation therapy using light
- A61N5/0613—Apparatus adapted for a specific treatment
- A61N5/0624—Apparatus adapted for a specific treatment for eliminating microbes, germs, bacteria on or in the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- 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
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/007—Methods or devices for eye surgery
- A61F9/0079—Methods or devices for eye surgery using non-laser electromagnetic radiation, e.g. non-coherent light or microwaves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- 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
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/007—Methods or devices for eye surgery
- A61F9/008—Methods or devices for eye surgery using laser
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/06—Radiation therapy using light
- A61N5/0613—Apparatus adapted for a specific treatment
- A61N5/062—Photodynamic therapy, i.e. excitation of an agent
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- 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
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/007—Methods or devices for eye surgery
- A61F9/008—Methods or devices for eye surgery using laser
- A61F2009/00844—Feedback systems
- A61F2009/00846—Eyetracking
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- 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
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/007—Methods or devices for eye surgery
- A61F9/008—Methods or devices for eye surgery using laser
- A61F2009/00861—Methods or devices for eye surgery using laser adapted for treatment at a particular location
- A61F2009/00872—Cornea
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/06—Radiation therapy using light
- A61N2005/0635—Radiation therapy using light characterised by the body area to be irradiated
- A61N2005/0643—Applicators, probes irradiating specific body areas in close proximity
- A61N2005/0645—Applicators worn by the patient
- A61N2005/0647—Applicators worn by the patient the applicator adapted to be worn on the head
- A61N2005/0648—Applicators worn by the patient the applicator adapted to be worn on the head the light being directed to the eyes
Definitions
- the present invention relates to a device to generate customizable light patterns to cure adhesives for ophthalmic applications. More particularly, the invention relates to a device with three different functional options that produce customized comeal crosslinking using a light source of any wavelength.
- the cornea is a transparent anterior part of the eye that covers the iris, pupil and the anterior chamber.
- the cornea has unmyelinated nerve endings that are sensitive to stimulus, temperature and chemicals.
- the cornea does not have blood vessels, instead, oxygen dissolved in the tears diffuses throughout the cornea to keep it healthy.
- nutrients are transported via diffusion from the tear fluid through the outside surface and from the aqueous humor through the inside surface and also from the neurotrophins supplied by nerve fibres that innervate the cornea.
- the cornea is made up of crosslinks of collagen fibers, which maintain the stability and generate its normal shape.
- cornea is weakened and only having a few cross-links or support beams. This degenerated structure allows the cornea to bulge outwards.
- the cross-linking procedure adds cross-links or“cross beams” to the cornea, making it more stable, holding its shape and focusing power better. These new cross-links aids in strengthening of the cornea which stops the thinning process and further loss of vision.
- Comeal degradation results in several disorders such as keratoconus and pellucid marginal degeneration, where the cornea undergoes physical changes. These changes may be inflammatory, structural and biomechanical in nature.
- Comeal cross-linking is a technique of tissue strengthening that was first used in 1998 to treat patients with a disease called keratoconus.
- comeal cross-linking is achieved with the use of riboflavin or Ultra-Violet (UV)-light enabling ophthalmological surgery on the external surface of the cornea in order to correct vision defects by increasing the formation of intra and interfibrillar covalent bonds by photosensitized oxidation.
- UV-light Ultra-Violet
- the use of only riboflavin may not be an effective strategy during adverse conditions and the use of UV- light may result in irradiation of the non-diseased corneal tissue.
- algorithms are derived, and such algorithms are tailored for each procedure depending on the amount and the shape of corneal tissue removal required to correct the individual refractive error.
- the cornea absorbs approximately 30% of UV-A light while an additional 50% of UV-A absorption occurs in the lens but the corneal UV-A absorption can be considerably increased with a photosensitizer such as riboflavin.
- a photosensitizer such as riboflavin.
- the Chinese Application No. CN109675204A titled“ Ultraviolet light corneal cross-linking device” discloses an ultraviolet light comeal cross-linking device comprising a treatment hot spot emitting module used to form treatment hot spot, including ultraviolet source, smoothing mirror group, DLP mould group and the ultraviolet lens set gradually along the optical path direction, an image collection assembly for acquiring pupil image, a positioning component for positioning eye lesion, including the first cross laser lamp, the second cross laser lamp and Z axis displacement platform.
- the invention can form in real time different shape, various sizes for the treatment of hot spot according to different cornea lesion forms to treat diseases of cornea.
- the scope of application of the device is improved with reduction in the difficulty of the surgical procedure thus promoting therapeutic effect.
- US6520958B1 titled“System and methods for imaging corneal profiles” discloses systems, methods and apparatus for generating images of portions of the patient's eye, such as the anterior surface of the cornea.
- the methods and apparatus of the invention are particularly useful for directly imaging the profile of the ablated region of the cornea during or immediately following a laser ablation procedure, such as photorefractive keratometry (PRK), phototherapeutic keratectomy (PTK), laser in-situ keratomileusis (LASIK) or the like.
- PRK photorefractive keratometry
- PTK phototherapeutic keratectomy
- LASIK laser in-situ keratomileusis
- the invention also discloses the methods and apparatus for generating one or more images depicting the profile of the ablated region of the cornea.
- the profile is registered with a pre-ablation profile to provide feedback regarding the true ablation properties of the eye. This feedback permits the laser system to be programmed with a laser ablation algorithm based on the measured ablation properties of the eye.
- the US Application US9504607B2 titled “Method and device for stabilizing the cornea” discloses a method and device to stabilize cornea.
- a greater stability and shorter treatment time are to be made possible.
- the cornea is locally irradiated successively at different sites so that collagen fibers are indirectly or directly crosslinked at the irradiated sites.
- the collagen fibers are advantageously crosslinked in a spatially resolved manner. Accordingly, the entire eye doesn't need to be irradiated with tissue damaging UV light and the regions with a weaker structure can be locally stabilized.
- the sites of the cornea are preferably irradiated so that the collagen fibers are ionized in each instance by photoabsorption of a plurality of photons which each have an energy below an ionizing energy of a given molecule. After a short treatment period, strong covalent bonds are formed directly between the collagen fibers.
- the Chinese application CN203263631U entitled “ Efficient multi functional cornea UV-blue light phototherapy instrument” discloses an efficient multi-functional cornea UV-blue light phototherapy instrument.
- the UV-blue light phototherapy instrument comprises a control panel display, a power supply unit and a light source unit wherein the spot diameter (0.5-12 mm) of light, the output of the light source unit, and the cornea phototherapy position are controlled by an optics lens.
- the light source unit can be a light emitting diode or a semiconductor laser, the wavelength of the light source unit is 340-480 nm, and the output power of the light source unit is 3-500 mW.
- the UV-blue light phototherapy instrument can also achieve multi-channel output and can also comprise a light source unit fixing support, wherein the light source unit fixing support comprises a vertical support, a horizontal support, and a floor lamp host support or an M-shaped support.
- the light source unit can also be fixed in a handheld mode.
- the light can be output in a single-wavelength (340-480 nm) mode or in a dual-wavelength mode.
- the dual wavelength can be a combination of 340-380 nm and 381-480 nm.
- the efficient multi-functional cornea UV-blue light phototherapy instrument can be used for treating keratopathy and can also be used for stabilizing the corneal surface curvature after laser vision correction surgery.
- the invention discloses a device to generate customizable light patterns to cure adhesives for ophthalmic applications. Accordingly, the invention discloses the device with three different design options to produce customized corneal crosslinking using a light source of desired wavelength.
- the first option of customized comeal crosslinking is a time integrated design based on a Digital Light Processing (DLP) mirror array.
- the second option is a time integrated design based on an amplitude Spatial Light Modulator (SLM) and the third option is the design based on a phase-only SLM.
- DLP Digital Light Processing
- SLM Spatial Light Modulator
- the device is configured to produce a customized corneal crosslinking using a wavelength of any choice without restricting to ultraviolet range.
- the device comprises a light source to produce a light of a desired wavelength, a light modulation unit, collimating or imaging optics to produce a beam of uniform intensity, a fixation target, a verification arm, a pupil target, a control unit and manipulation hardware.
- the modulation unit receives the light generated from the light source and allows the light beam to be spatially uniform and collimated with appropriate dimensions.
- the modulation unit also manipulates the light beam in a pixeled matter either in transmission or in reflection.
- the imaging optics is optionally used in the device, which comprises of optics to image the modulation plane on to the exit pupil. The imaging optics anticipates the refractive error to avoid focusing of the excess of illumination light onto the retina of the patient.
- the fixation target comprises a Light Emitting Diode (LED), LED array, illuminated image or a display, which generates a stimulus for the patient under test to focus on during the procedure of corneal cross-linking.
- LED Light Emitting Diode
- the verification arm comprises of sampling optics to allow a proportion of the whole light beam into the verification arm and an attenuation optics to adjust the amount of light in the verification arm to avoid any noise affecting the readings.
- the pupil tracker comprises an array of LEDs to illuminate the patient’s eye. The wavelength of the LEDs is in Near Infra-Red (NIR) spectrum or in visible spectrum based on the desired impact on the pupil size.
- the control unit is a configured electronic device such as a desktop computer or a laptop or a personalized PCB.
- the device of the invention to generate customizable light patterns is useful in treatments of various ophthalmic conditions such as corneal degenerated conditions, comeal infections (bacterial or viral) and also to detect biomechanical stability of cornea after refractory surgeries.
- the device can also be used for customized corneal crosslinking for specialized treatment of myopia (with and without astigmatism) and presbyopia.
- Myopia can be treated by crosslinking of the central cornea.
- Presbyopia can be treated by crosslinking of the mid to peripheral cornea. This can also have application for treatment of pure hyperopia.
- the light power, shape and size of the treatment zone can be titrated to achieve the desired change in refractive power of the eye.
- the device can be used both with the epithelium on and off from the patient cornea.
- the light power can be adjusted accordingly to achieve desired efficacy in patients.
- FIG 1 illustrates a device for generation of customized corneal cross- linking.
- FIG 2 illustrates a device of corneal crosslinking using Digital Light Processing (DLP) as a modulator.
- DLP Digital Light Processing
- Corneal Crosslinking refers to a technique of comeal tissue strengthening by using riboflavin and UVA to increase the formation of intra and interfibrillar covalent bonds by photosensitized oxidation.
- the invention discloses the device to generate customizable light patterns to cure adhesives for ophthalmic applications. More particularly, the invention relates to the device with three different design options that produce customized corneal crosslinking using light source of any wavelength.
- the device is configured with three different design options to achieve the corneal crosslinking.
- the first option of customized comeal crosslinking is a time integrated design based on a DLP mirror array.
- the second option is a time integrated design based on an amplitude SLM and the third option is the design based on a phase-only SLM.
- the device is configured to produce a customized corneal crosslinking using a wavelength of any choice without restricting to ultraviolet range.
- the device comprises a light source of desired wavelength, a light modulation unit, collimating or imaging optics to produce a beam of uniform intensity, a fixation target, a verification arm, a pupil target, a control unit and manipulation hardware.
- the device further comprises of imaging optics to adjust the beam location depending on cyclotorsion of the eye and/or eye movement.
- the device also comprises a display with a camera for real time monitoring of the irradiation and for planning of the crosslinking procedure.
- FIG 1 illustrates the device for customized comeal cross-linking.
- the device (100) comprises a light source (101), a light modulation unit (102), imaging optics (103), a fixation target (104), a verification arm (105), a pupil tracker (106) and a control unit (107).
- the light source (101) of the device (100) comprises of an array of Light Emitting Diodes (LEDs) or a laser emitting polychromatic light of the wavelength necessary to cure the adhesive.
- the device can perform temporal multiplexing generating different profiles for different wavelengths.
- the device can also use multiple monochromatic light sources for therapeutic application with multiple wavelengths and appropriate photosensitizer agent.
- the light source (101) generates the input lighting of any wavelength.
- the light modulation unit (102) further comprises an electro-optical device to manipulate the light beam in a pixeled matter either in transmission or in reflection and also the optics such as a (polarizing) beam splitter to allow the light into the modulation unit (102) and move towards the eye.
- the light modulation unit (102) receives the light generated from the light source (101) and allows the light beam to be spatially uniform and collimated with appropriate dimensions.
- the imaging optics (103) is an optional embodiment in the device (100), which comprises of optics to image the modulation plane on to the exit pupil.
- the imaging is achieved with or without magnification using one or more lenses.
- the imaging optics can (103) anticipate on the refractive error to avoid focusing of the excess of illumination light onto the retina of the patient.
- the imaging optics (103) also comprises a diaphragm, which functions either in manual mode or supported by a motor.
- the fixation target (104) comprises of an LED, LED array, illuminated image or a display, which generates a stimulus for the patient under test to focus during the procedure of comeal cross-linking.
- the verification arm (105) comprises of sampling optics, which allows a proportion of the whole light beam into the verification arm (105) and attenuation / spectral filtering optics to adjust the amount of light in the verification arm (105) to avoid any noise affecting the readings.
- the verification arm (105) is also used as calibration arm and a feedback loop between the verification arm (105), the light source (101) and the light modulation unit (102) is established to ensure that the objected output is achieved or anticipated.
- the pupil tracker (106) comprises an array of LEDs to illuminate the patient’s eye. The wavelength of the LEDs is in Near Infrared spectrum or in visible spectrum based on the desired impact on the pupil size. The pattern of the array is chosen to improve the determination of the size, position of the pupil and gaze direction. At least one camera is used and focused on patient’s eye to acquire the images that are processed to calculate the mentioned metrics.
- the eye tracker works in a feedback loop to control the positioning of the device (100) with respect to the eye in X, Y or Z position.
- the control unit (107) is a configured electronic device such as a desktop computer or a laptop or a personalized PCB with processing capacities. The control unit (107) is configured to drive the device (100) and to control the electronical components of the device (100).
- the device (100) is mounted on a manipulation stage that allows for change in the position of the device (100) with respect to the position of the patient’s eye.
- the manipulation stage also allows for the change of the position of the parts of the device (100) with respect to each other to control the characteristics of the imaging optics or the position of the exit pupil with respect to patient’s eye.
- the device is configured with three different design options to achieve the corneal crosslinking.
- the first option of customized comeal crosslinking is a time integrated design based on a Digital Light Processing (DLP) mirror array.
- DLP Digital Light Processing
- FIG 2 illustrates the device of corneal crosslinking using DLP as a modulator.
- the device (200) further comprises a light source (101) such as LED, LED array, laser or similar sources, which emits monochromatic light in ultraviolet, visible or infrared spectrum, polychromatic light or multiple monochromatic light sources.
- the light emitted by the light source (101) passes through a spatial filter (201) which is a pinhole, a diffuser, a rotating diffuser and collimating optics (202).
- the beam splitter 1 (203) receives the collimated light and reflects a portion of light towards a DLP mirror (204).
- An aperture (205) is placed after the DLP mirror (204), which receives the modulated light and ensures the vignetting of the unwanted reflected light i.e. the light reflected by the DLP under a tilt.
- the imaging optics (103) is an optional embodiment in the device (200), as most of the light is absorbed by the adhesive component and therefore is not focused on the retina. The imaging optics (103) anticipates on the refractive error to avoid focusing of the excess of illumination light onto the retina of the patient.
- a beam splitter 2 (206) allows a small proportion of the whole light beam to enter the verification arm.
- a detector (207) is placed in a conjugated plane with the exit pupil to analyze the time integrated spatial pattern of the illumination.
- the detector (207) used is a scanning diode, diode array, Charge-Coupled Device (CCD) or a Complementary Metal-Oxide-Semiconductor (CMOS) and is connected to the control unit (107).
- the part of light passing through the beam splitter 2 (206) passes through to the exit pupil.
- the pupil tracker (106) comprises of a camera (208) with an array of LEDs to illuminate the patient’s eye.
- the pattern of the array is chosen to improve the determination of the size, position of the pupil and gaze direction, which is used in a feedback loop to obtain proper measures to ensure the correct treatment.
- the fixation target (104), a light pattern, LED configuration or single LED or screen is coupled into the optical path through a beam splitter 3 (209) and enters the light path in the same direction or in a different direction with respect to the imaging optics (103). Additional imaging optics 2 (210) is added to ensure that the subject can see the target properly. The combination of imaging optics 2 (210) and the imaging optics 1 (103) is useful to anticipate on the refractive error of the subject.
- the second option of customized comeal crosslinking is the time integrated design based on an amplitude spatial light modulator.
- the normal beam splitter 1 (203) of the device (200) is replaced with a polarized beam splitter (211).
- the linear polarized light reflected by the beam splitter polarized beam splitter (211) is passed to the amplitude SLM, which changes the orientation of the polarization in function of the pattern causing the light that passes through the pixels and continues the path towards the exit pupil while the other light is reflected in the second pass through the polarizing beam splitter (211).
- the third option is the design based on a phase-only SLM.
- phase-only SLM the polarizing beam splitter (211) is used and a grey scale pattern is generated without the on-off pattern. Hence, the generation of high frequent variation is not required.
- phase- only SLM it is preferred to use a small inclination angle instead of using a polarizing cube beam splitter in which the incident light and the exiting light pass along the same optical axis and it is important that the linear polarizer, which is located in the incident arm and the linear polarizer located in the exiting arm are crossed. Further, it is required to consider the alignment of the beam splitters with respect to the polarization angle of the SLM.
- the optical part of the device for analysis of corneal crosslinking is mounted in a head mounted unit.
- the head mounted unit is worn by the patient onto his head making the alignment comfortable and stable.
- the device is also useful as table-top version.
- it is difficult to maintain the fixation of the eye with respect to the exit pupil and is overcome by the use of a head strap or a bite bar.
- the device of the invention to generate customizable light patterns is useful in treatment of various ophthalmic conditions.
- the main advantage of device is the use of light source which produces light of any wavelength without restricting to any specific wavelength especially ultraviolet rays.
- the device is useful to analyze corneal degenerated conditions, corneal infections and also to detect biomechanical stability of the cornea after refractory surgeries.
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Abstract
L'invention concerne un dispositif de génération de motifs lumineux personnalisables servant à durcir des adhésifs pour des applications ophtalmiques. Le dispositif est conçu avec trois options fonctionnelles différentes qui produisent une réticulation cornéenne personnalisée à l'aide d'une source lumineuse de n'importe quelle longueur d'onde sans restriction de la plage des ultraviolets. Le dispositif comprend une source lumineuse de longueur d'onde souhaitée, une unité de modulation de lumière, une optique de collimation ou d'imagerie servant à produire un faisceau d'intensité uniforme, une cible de fixation, un bras de vérification, une cible de pupille, une unité de commande et un matériel de manipulation. Pendant la réticulation cornéenne, des zones de traitement personnalisées d'intensité lumineuse sont créées sur la base de caractéristiques de patient et de caractéristiques de surface de maladie telles que la topographie de la cornée. Le dispositif est utile pour analyser des états dégénérés de la cornée, des infections cornéennes, mais aussi pour détecter la stabilité biomécanique de la cornée après des chirurgies réfractaires
Applications Claiming Priority (2)
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IN201941028875 | 2019-07-18 | ||
IN201941028875 | 2019-07-18 |
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WO2021009570A1 true WO2021009570A1 (fr) | 2021-01-21 |
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Citations (2)
Publication number | Priority date | Publication date | Assignee | Title |
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US20120302862A1 (en) * | 2011-04-29 | 2012-11-29 | The General Hospital Corporation | Methods and arrangements for obtaining information and providing analysis for biological tissues |
US20140333898A1 (en) * | 2011-09-16 | 2014-11-13 | Annidis Corporation | System and method for assessing retinal functionality |
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- 2020-01-27 WO PCT/IB2020/050596 patent/WO2021009570A1/fr active Application Filing
Patent Citations (2)
Publication number | Priority date | Publication date | Assignee | Title |
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US20120302862A1 (en) * | 2011-04-29 | 2012-11-29 | The General Hospital Corporation | Methods and arrangements for obtaining information and providing analysis for biological tissues |
US20140333898A1 (en) * | 2011-09-16 | 2014-11-13 | Annidis Corporation | System and method for assessing retinal functionality |
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