Intraoperative OCT for surgical microscope with sensitivity drop and depth of focus correction based on variable focus and dynamic reference

We have developed a surgical microscope-integrated optical coherence tomography (MI-OCT) system based on an active feedback method to obtain uniform optimal OCT image contrast along the depth of focus (DOF) of a surgical microscope. Conventional MI-OCT systems use a shorter DOF objective lens than those of surgical microscopes for OCT imaging. The existing MI-OCT system was developed to overcome sensitivity roll-off by using an electrically tunable lens (ETL). However, active change in the focus position through the ETL cannot cope with the sensitivity decrease due to optical path length difference (OPD) mismatch. The proposed active feedback method was able to maintain high sensitivity by actively performing OPD matching using a linear motor in the reference arm while tuning the focal position in the sample arm using the ETL. The optical system designed to maintain the OCT resolution and a retroreflector used for ensuring regular reflection intensity in the reference arm during OPD compensation contributed to the uniform sensitivity and stable OCT imaging performance. The simultaneous and automatic actuation of the ETL and linear motor provided sensitivity variation of 3 dB from 17 dB for 10-mm sample displacement corresponding to the DOF of the surgical microscope used in the MI-OCT system. By using an infrared detection card and a mouse brain tumor model, it was demonstrated that the proposed MI-OCT system could acquire OCT images with optimal sensitivity without the limitations due to short OCT DOF.