1. Introduction
In recent years, an increasing number of studies have focused on heat transfer within the human eye, driven by the growing use of lasers in various ophthalmological procedures [
1,
2,
3]. Advancement of these techniques requires an understanding of the effects that electromagnetic radiation may have on the human eye. Due to the limited amount of blood flow in ocular tissue, and the required stationary position of the eye during surgical procedures, cooling is restricted during procedures such as transpupillary thermotherapy (TTT), a laser treatment that targets choroidal melanomas. The choroid is the second most common sign of malignant melanoma in the body, and choroidal melanomas are the most common intraocular malignant tumor [
4]. As the laser beam is directed to these malignant tumors in the vascular layer of the posterior wall of the eye, there is a higher risk of thermal damage to the non-malignant regions it traverses [
1]. Despite the advantageous absence of ionizing radioactive exposure used in brachytherapy, when TTT is used to treat larger tumors, it is more likely to result in relapse than brachytherapy and other alternative procedures [
1]. Moreover, potential adverse outcomes of TTT include protein denaturation, changes in the optical properties of the VH, and the formation of new blood vessels in the eye that can cause pressure buildup and, in some cases, the need for the eye to be surgically removed [
1].
A factor that may be valuable in determining patient eligibility for TTT is vitreous humor (VH) viscosity. The viscosity of VH often decreases with age as VH liquifies [
1,
5,
6]. Kleinberg et al. report postnatal changes in VH show a positive correlation between age and VH liquefaction [
5]. At birth, the human VH is in an entirely gel state due to the collagen fibril network. With age, however, the collagen fibrils aggregate as they degrade, contributing to VH liquefaction. Consequently, the total viscosity of VH decreases as collagen concentration decreases [
6]. Autopsies have shown that the liquid portion in the VH increases from 0 mL at birth to about 2 mL by age 80 [
5]. That is about 45% of the total volume of VH that liquefies throughout the human lifespan. The liquefaction process contributes to alterations in constituent concentrations. A decrease in viscosity is likely to result in a higher degree of convective heat transfer and a lower degree of conductive heat transfer. This concept is illustrated visually in Figure 9 of the work by Garcia et al. who examined computational models of laser-induced heat transfer within the VH [
1].
To better understand the effectiveness of TTT and similar procedures, it is necessary to elucidate not only the contributions of viscosity to convective movement within the VH, but also the effects of variances in the chemical composition of the VH on heat transfer. There is a scarcity of research that analyzes VH in vivo. Consequently, a majority of the literature on the chemical makeup of VH is based on the examination of post-mortem VH. The components determined to be the most abundant in the VH from the literature and the dominant contributors to its physical properties include water; hyaluronic acid (HA); collagens I, II, III, V, X; albumin; ascorbic acid (AA); lactic acid (LA); and glucose [
5,
6,
7,
8,
9]. Although the constituents that make up the VH are highly conserved, the concentration of each constituent varies widely by age, sex, health status, and location in the VH. For example, collagen and HA concentrations are higher in the posterior region of the eye compared to anterior regions [
5,
6,
7]; AA and albumin concentrations differ by sex with AA higher in females and albumin higher in males [
9]; glucose and LA concentrations have been reported as higher in individuals with diabetes compared to healthy individuals [
10].
Despite the challenges posed by the variety in VH chemical makeup and lack of in vivo analysis, and to maintain focus, the range of concentrations for each individual constituent of artificial VH examined in this study was established by identifying the most valid parameters based on known physiological values and components used in artificial vitreous substitutes [
5,
11,
12]. Several mixtures containing various artificial VH components were also analyzed, with the concentrations of each constituent selected to reflect young, middle-aged, and older male and female adults, and those with high blood glucose levels. In addition to these complex mixtures, a simplified series consisting solely of collagen and HA was also examined. This pair was selected due to its prominence in the VH and its key role in determining VH structural integrity, viscosity, and optical properties. Prior studies have shown that HA and collagen interact to form three-dimensional networks that significantly influence the optical characteristics of the VH [
5,
13]. These endogenous interactions were not reproducible using the artificial vitreous components of this study. VH from a deer eye was obtained as an endogenous biological sample comparison to the artificial VH components.
To supplement existing computational data [
1], this paper contributes experimental findings using a photothermal spectroscopic technique recently developed by Lopez et al. [
14] and Biebighauser et al. [
15], allowing for the visualization of laser-induced convective and conductive heat transfer within various artificial VH components, component mixtures, and an endogenous sample of cervine (deer) VH. Photothermal spectroscopy is a broad category of methods that utilize the conversion of light (typically laser light) into heat energy for chemical and physical characterization of liquids [
16,
17,
18,
19]. This technique is similar to one recently employed by Singhal and Goswami [
20] and is utilized in the current work to measure the heat transfer within the VH. The principal physical phenomenon exploited is thermal lensing [
21] in which heat is transferred into the third harmonic of the C–H and O–H stretching modes [
22,
23,
24,
25]. The thermal lensing technique works by using an externally focused laser to create spatially non-uniform heating within the sample, which generates a local refractive index gradient that acts like a lens.
In this study, a collimated high-energy IR laser produces a thermal cylindrical lens that passes through the sample cuvette. As heat is transferred from the excitation beam into the sample, a temperature gradient is generated within the sample. This temperature gradient, in turn, leads to a change in the refractive index of the medium which is illuminated by a probe beam passing through the sample perpendicular to the excitation beam. The change in refractive index is captured on a camera facing the probe beam on the opposite side of the sample. The probe beam illuminates the sample by passing a visible, red divergent laser through the cuvette containing the sample. The probe beam diverges enough to illuminate the entire length of the excitation beam within the sample and multiple millimeters above and below the beam. The refracted light allows for visualization of the changes in refractive index and thus heat within the sample over time.
2. Methods
2.1. Experimental Setup
The experimental setup follows that used in a work by Biebighauser et al. [
15]. The details most relevant to the current study are reviewed here.
Figure 1 displays a schematic of the photothermal system utilized in this study. The excitation laser in this experiment was the QSL103A Q-Switched Picosecond Microchip Laser System by Thorlabs (Newton, NJ, USA) emitting light at a 1030 nm wavelength (note: TTT typically employs an 810 nm laser [
3]). The contact time the laser had with each sample was regulated by a computer-controlled solenoid-actuated shutter.
A low-power diode laser from HiLetgo (Shenzhen, China) generated the probe beam at a wavelength of 650 nm. An Arducam (Kowloon, Hong Kong, China) camera equipped with a 5 MP OmniVision OV5647 sensor (OmniVision Technologies, Santa Clara, CA, USA) served as the principal component of the imaging system. To increase the frame rate of the camera to 97.1 frames per second, it was configured to function at a resolution of pixels, giving 7.71 m/pixel resolution.
The coordination of the shutter mechanism and storage of camera data were controlled by a Raspberry Pi 4 microcomputer (Raspberry Pi Holdings PLC, Pencoed, Wales). This microcomputer ran custom-designed software modified to fit this experiment. This software can be accessed through
https://github.com/ulnessd (accessed on 10 October 2024) [
15].
2.2. Sample Preparation
To model age-related and regional variations in collagen concentration within the VH, collagen was tested across a range of 25–500
g/mL using commercial collagen I, II, III, V, X supplements (Revive Naturals LLC, Suffern, NY, USA) as a substitute for endogenous collagen. The concentrations of commercial sodium hyaluronic acid (Micro Ingredients, Montclair, CA, USA) varied from 25 to 530
g/mL to reflect the wide range reported in the literature [
5,
6,
7]. L-ascorbic acid (Fisher Scientific, A61, Waltham, MA, USA) was examined over a range of 66–500
g/mL to capture possible physiological concentrations in the VH. Bovine serum albumin (Fisher BioReagents, BP9706, Fair Lawn, NJ, USA) was used in place of human albumin and tested at concentrations between 80 and 5600
g/mL. To represent glucose levels in the VH, D-(+)-glucose (Sigma-Aldrich, G8270, St. Louis, MO, USA) was examined at concentrations ranging from 90 to 2430
g/mL. All listed constituents were diluted to their target concentrations using serial dilution with reverse osmosis water, as detailed in
Table 1. Additionally, lactic acid (85% FCC, Sigma-Aldrich, W261106, St. Louis, MO, USA)/Na-DL-lactate (60% (
w/
w), Sigma-Aldrich, L1375, St. Louis, MO, USA) samples were prepared, including 0.1 M lactate (approximately
M LA), 60% stock Na-DL-lactate, and 85% stock LA. The 0.1 M lactate sample is listed in
Table 1, with its concentration partitioned into acidic (LA) and basic (lactate) components.
HA and collagen were mixed in various concentrations as listed in
Table 1. The concentrations of the more complex artificial VH mixtures are listed in the
Supplementary Materials.
Whole globe enucleation was performed on female white-tailed deer (Odocoileus virginianus) specimens shortly after ethical harvest by licensed hunters in hunting zone 260 of MN, USA. The specimens were field-dressed and transported to a cold, indoor location within 30 min after time of death for the collection of ocular samples. The palpebral tissues were resected to expose the ocular adnexa. The bulbar conjunctiva was incised at the limbus and the Tenon’s capsule was dissected to expose the surface of the sclera. A spoon was inserted between the sclera and the orbit to apply posterior-to-anterior leverage, allowing controlled rotation of the globe while preserving the integrity of the eye. This manipulation exposed the extraocular attachments for transection, with a short segment of each insertion preserved to maintain scleral integrity. The optic nerve was visualized and transected with minimal residual attachment to the globe using an anterior approach. Each globe was removed from the orbit, rinsed in cold saline and placed in a bag of cold saline (4 °C) packed on ice to preserve the physiological state of the vitreous body.
Using aseptic technique, VH extraction was performed in a tissue culture hood. The sample was rinsed with saline and excess tissue was removed to expose the sclera. A longitudinal incision was made along the coronal plane of the globe. The VH was collected, along with the attached lens and iris pigment epithelium (IPE). Due to the viscoelastic properties of the VH, forceps were used to grasp the lens for purchase and the majority of the vitreous body was separated from the IPE and the lens using dissecting scissors. With minimal loss of VH, sample purity was prioritized during separation to ensure exclusion of IPE. VH was transferred to a fluorimeter cuvette, with care taken to prevent disruption of the hyaluronic acid-collagen fibril network.
Each sample was pipetted into a 1 cm × 1 cm fluorimeter cuvette. The cuvette was then placed into an in-house constructed brass jacket. An FTS model RS33AL10 heater/chiller (FTS Systems Inc., Marbletown, NY, USA) enabled the thermoregulation of the sample by heating/cooling the ethylene glycol flowing through the jacket. Relative to the reservoir temperatures, the sample temperatures were calibrated from 0 °C to 70 °C with a ±0.5 °C stability during the data acquisition [
15].
2.3. Data Collection and Analysis
The following experimental protocol was applied to all the samples run throughout this investigation. The samples were run 15 times at 20 °C (room temperature) and 15 times at 37 °C (human body temperature). Individual runs consisted of an initial background collection phase of 2.0 s where the shutter was closed. Following this, there was an active phase of 12.0 s where the shutter was open, and the laser passed through the sample. Finally, there was a 120 s or 60.0 s recovery time when the shutter was closed before the next run began. Glucose and AA samples had a 60.0-s recovery time due to their less viscous nature and faster restoration to their initial state.
Each run was followed by a 4.0 s delay before beginning the subsequent run. This continued until all 15 runs of a given constituent, concentration, and temperature were complete.
A collection of custom-written programs was utilized to conduct data analysis. These programs can be accessed at
https://github.com/ulnessd (accessed on 11 October 2024). The first step in data analysis was to process the video data captured by the camera into a heat map. Heatmaps were then visually examined across component concentrations to identify trends. The details for video processing can be found in reference [
15].
4. Conclusions
Despite the various computational models of laser-induced heat transfer in human VH in the literature, there are limited experimental data supporting these models. The methods of this study describe a photothermal spectroscopy system that can be successfully utilized to generate experimental data. Additionally, the results of this experiment reveal the contributions of individual components to the overall heat transfer within the VH.
Some notable findings presented include the influence of component concentrations and temperature on heat transfer within artificial VH. Through the analysis of heat maps, the concentration of HA is recognized as the most significant influence on the extent of conductive heat transfer within artificial VH. However, increasing collagen concentration in the presence of HA in the VH may, in some cases, reduce relative conductive heat transfer from an external laser source. This effect is hypothesized to result from greater disruption of HA molecular entanglement as collagen concentration increases, leading to reduced viscosity [
13]. The temperature of these samples also appears to significantly affect the extent of conductive movement. Another interesting finding was an increase in observed convective movement when the concentration of AA was increased. Based on the literature [
15], it is hypothesized that this is due to the acidic nature of AA and its molecular characteristic of absorbing light more effectively than water.
The findings mentioned contribute applicable knowledge to ocular procedures involving lasers in the medical field. These findings will improve the understanding of thermal damage and the success of ocular laser procedures, in particular the practice of transpupillary thermotherapy (TTT) to target choroidal melanomas. A better understanding of the influence of the various physiological components on cooling through convection in the VH during TTT informs physicians on patient eligibility criteria for these procedures. A situation that limits the direction application of this work to TTT is the difference in wavelength of the laser, and the amount of energy transfer from the laser to the samples can depend strongly on wavelength. A future direction is to examine the heat transfer profiles within samples using different wavelengths.
This study also suggests a number of other potential directions for future investigations. The most evident is running additional combinations of the individual VH components to further observe the summation of the effects the physiological components have on heat transfer. This would allow for further analysis of samples modeling complete artificial VH to compare to computational models in the literature [
1,
2]. The complexity of endogenous VH in artificial samples could be better modeled by incorporating additional macromolecular components or matrix structuring. Moreover, testing additional endogenous VH samples would provide stronger biological validation of observed trends. It may also be beneficial to examine endogenous VH from humans or from species with VH composition more similar to humans than white-tailed deer, in order to obtain more representative data. Additionally, more work is needed to quantitatively convert the signal to directly determine the ratio of conductive heat flow to convective heat flow. Finally, this study also demonstrates how photothermal spectroscopy can be employed to examine heat transfer in biological fluids. In future work, the photothermal system described can be applied to examine the effects of laser-induced heating on individual biological fluids throughout the body.