Focused Ultrasound Therapy
Focused ultrasound is a noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with retinal injury. This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the brain without damaging surrounding normal tissue.
How it Works
Where the beams converge, focused ultrasound produces several therapeutic effects that are being evaluated. One mechanism is to temporarily open the blood-brain barrier, which can be used to allow genetic material or therapeutic agents to enter the region. A second mechanism is using focused ultrasound for neuromodulation of the retinal ganglion cells. While significant preclinical work has been accomplished, there is still much to be done before this technology will be widely available.
Advantages
The primary options for treatment of retinal injury are primarily surgical.
For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications – such as surgical wound healing or infection – at a lower cost. It can reach the desired target without damaging surrounding tissue and is repeatable, if necessary.
Clinical Trials
At the present time, there are no clinical trials recruiting patients for focused ultrasound treatment of retinal injury.
Regulatory Approval and Reimbursement
Focused ultrasound treatment for retinal injury is not yet approved by regulatory bodies or covered by medical insurance companies.
Notable Papers
Park Y, Shin J, Park J, Kim S, Park JH, Kim J, Kim CS, Chang JW, Schuurmans C, Aubert I, Chang WS, Eom K. Focused Ultrasound as a Novel Non-Invasive Method for the Delivery of Gold Nanoparticles to Retinal Ganglion Cells. Transl Vis Sci Technol. 2024 May 1;13(5):5. doi: 10.1167/tvst.13.5.5. PMID: 38713474
Bourdin A, Ortoli M, Karadayi R, Przegralek L, Sennlaub F, Bodaghi B, Guillonneau X, Carpentier A, Touhami S. Efficacy and Safety of Low-Intensity Pulsed Ultrasound-Induced Blood-Retinal Barrier Opening in Mice. Pharmaceutics. 2023 Jul 6;15(7):1896. doi: 10.3390/pharmaceutics15071896. PMID: 37514082
Xu C, Lu G, Kang H, Humayun MS, Zhou Q. Design and Simulation of a Ring Transducer Array for Ultrasound Retinal Stimulation. Micromachines (Basel). 2022 Sep 16;13(9):1536. doi: 10.3390/mi13091536.
Lu G, Qian X, Castillo J, Li R, Jiang L, Lu H, Kirk Shung K, Humayun MS, Thomas BB, Zhou Q. Transcranial Focused Ultrasound for Noninvasive Neuromodulation of the Visual Cortex. IEEE Trans Ultrason Ferroelectr Freq Control. 2021 Jan;68(1):21-28. doi: 10.1109/TUFFC.2020.3005670. Epub 2020 Dec 23.
Touahri Y, Dixit R, Kofoed RH, Miloska K, Park E, Raeisossadati R, Markham-Coultes K, David LA, Rijal H, Zhao J, Lynch M, Hynynen K, Aubert I, Schuurmans C. Focused ultrasound as a novel strategy for noninvasive gene delivery to retinal Müller glia. Theranostics. 2020 Feb 10;10(7):2982-2999. doi: 10.7150/thno.42611. eCollection 2020.
Menz MD, Ye P, Firouzi K, Nikoozadeh A, Pauly KB, Khuri-Yakub P, Baccus SA. Radiation Force as a Physical Mechanism for Ultrasonic Neurostimulation of the Ex Vivo Retina. J Neurosci. 2019 Aug 7;39(32):6251-6264. doi: 10.1523/JNEUROSCI.2394-18.2019. Epub 2019 Jun 13.
Jiang Q, Li G, Zhao H, Sheng W, Yue L, Su M, Weng S, Chan LL, Zhou Q, Humayun MS, Qiu W, Zheng H. Temporal Neuromodulation of Retinal Ganglion Cells by Low-Frequency Focused Ultrasound Stimulation. IEEE Trans Neural Syst Rehabil Eng. 2018 May;26(5):969-976. doi: 10.1109/TNSRE.2018.2821194.
Menz MD, Oralkan O, Khuri-Yakub PT, Baccus SA. Precise neural stimulation in the retina using focused ultrasound. J Neurosci. 2013 Mar 6;33(10):4550-60. doi: 10.1523/JNEUROSCI.3521-12.2013.
Park J, Zhang Y, Vykhodtseva N, Akula JD, McDannold NJ. Targeted and reversible blood-retinal barrier disruption via focused ultrasound and microbubbles. PLoS One. 2012;7(8):e42754. doi: 10.1371/journal.pone.0042754. Epub 2012 Aug 13.
Wang S, Mahesh SP, Liu J, Geist C, Zderic V. Focused ultrasound facilitated thermo-chemotherapy for targeted retinoblastoma treatment: a modeling study. Exp Eye Res. 2012 Jul;100:17-25. doi: 10.1016/j.exer.2012.04.009. Epub 2012 Apr 28.
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