The development of compact akinetic high-speed swept source technology in MOON already represents a significant step beyond state of the art. Fast and phase stable light sources especially at the longer wavelength of 1060nm with the potential to become cheaper at large numbers are the key elements for the next generation optical coherence tomography (OCT) platforms. Wide field OCT angiography over a large field of view, that was up to recent only possible with planar fundus imaging techniques, is now recorded in a few seconds in 3D, with diagnostic image quality. This can further minimize the need for invasive, laborious, and risky fluorescein angiography. The retinal periphery has gained large clinical interest today, as early onset of diseases such as diabetic retinopathy but also signs of age related macula degeneration may be seen only in such enlarged field of view settings. This has immediate implications on the socio-economic system, as pathologic changes can be treated early on.
The most intriguing advancement through MOON is to pave the way for obtaining molecular fingerprinting in the living human retina by using Raman spectroscopy. Combining Raman spectroscopy with OCT will on the one hand provide highly sensitive morphological features with OCT, on the other hand it is possible to target specific disease biomarkers by Raman spectroscopy. So far, standard Raman spectroscopy has not been shown in the human eye. Identifying molecular biomarkers of the selected diseases and setting up the protocol for establishing a reference data base sets a standard operation procedure for clinical Raman spectroscopy, that can be followed by addressing other major diseases after MOON.
The multimodal MOON 2 platform is supported by a multimodal eye phantom, that has been developed within the MOON project. This eye phantom is not only a key asset for the MOON project, but might be of value for various other ophthalmic imaging platforms on the market. Especially also in view of the strict medical device regulations, having a phantom mimicking the optical properties of the human eye, simulating as well ametropic eye conditions, allows for validation but also as reference of commercial imaging platforms.
If successfully translated, MOON provides diagnostic tools to the clinician that are easy to operate, easy to access, cost-effective, and allow for early diagnosis of disease onset, before the quality of life has been already reduced, irreversible damages are done, and treatment becomes ineffective. Already by delaying the onset of wet AMD or hospitalization for dementia patients by early diagnosis based on MOON there is an enormous cost saving potential for the European economy.
