Ocular Stethoscope: Auditory Support for Retinal Membrane Peeling

The peeling of an epiretinal membrane (ERM) is a complex procedure wherein a membrane, only a few micrometers thick, that develops on the retinal surface is delicately removed using microsurgical forceps. Insights regarding small gaps between the ERM and the retinal tissue are valuable for surgical decision-making, particularly in determining a suitable location to initiate the peeling. Depth-resolved imaging of the retina provided by intraoperative Optical Coherence Tomography (iOCT) enables visualization of this gap and supports decision-making. The common presentation of iOCT images during surgery in juxtaposition with the microscope view however requires surgeons to move their gaze from the surgical site, affecting proprioception and cognitive load. In this work, we introduce an alternative method utilizing auditory feedback as a sensory channel, designed to intuitively enhance the perception of ERM elevations. Our approach establishes an unsupervised innovative mapping between real-time OCT A-scans and the parameters of an acoustic model. This acoustic model conveys the physical characteristics of tissue structure through distinctive sound textures, at microtemporal resolution. Our experiments show that even subtle ERM elevations can be sonified. Expert clinician feedback confirms the impact of our method and an initial user study with 15 participants demonstrates the potential to perceive the gap between the ERM and the retinal tissue exclusively through auditory cues.