Closed-loop regulation of subretinal blebs via OCT speckle dynamics tracking

In ophthalmology, subretinal injection is essential for treating retinal diseases like AMD and inherited disorders, but current pressure modulation relies on surgeons' manual control and visual interpretation, which is highly variable. To address this, we developed a real-time closed-loop control system using OCT speckle dynamics to dynamically adjust injection pressure. The system detects retinal-RPE separation through speckle decorrelation and displacement, switching from high-pressure injection to low-pressure expansion based on tissue-specific feedback. Experiments on ex vivo porcine eyes revealed a three-phase speckle pattern, confirming OCT speckle dynamics as a reliable real-time indicator of tissue separation. This closed-loop system enhances subretinal therapy precision and safety by preventing overexpansion and integrating seamlessly with surgical workflows.