MEMS for Diabetic Retinopathy

As the worldwide prevalence of diabetes mellitus continues to increase, diabetic retinopathy remains the leading cause of visual impairment and blindness in many developed countries. Between 32 to 40 percent of about 246 million people with diabetes develop diabetic retinopathy. Approximately 4.1 million American adults 40 years and older are affected by diabetic retinopathy. This glucose-induced microvascular disease progressively damages the tiny blood vessels that nourish the retina, the light-sensitive tissue at the back of the eye, leading to retinal ischemia (i.e., inadequate blood flow), retinal hypoxia (i.e., oxygen deprivation), and retinal nerve cell degeneration or death. It is a most serious sight-threatening complication of diabetes, resulting in significant irreversible vision loss, and even total blindness.

Unfortunately, although current treatments of diabetic retinopathy (i.e., laser therapy, vitrectomy surgery and anti-VEGF therapy) can reduce vision loss, they only slow down but cannot stop the degradation of the retina. Patients require repeated treatment to protect their sight. The current treatments also have significant drawbacks. Laser therapy is focused on preserving the macula, the area of the retina that is responsible for sharp, clear, central vision, by sacrificing the peripheral retina since there is only limited oxygen supply. Therefore, laser therapy results in a constricted peripheral visual field, reduced color vision, delayed dark adaptation, and weakened night vision. Vitrectomy surgery increases the risk of neovascular glaucoma, another devastating ocular disease, characterized by the proliferation of fibrovascular tissue in the anterior chamber angle. Anti-VEGF agents have potential adverse effects, and currently there is insufficient evidence to recommend their routine use.

In this work, for the first time, a paradigm shift in the treatment of diabetic retinopathy is proposed: providing localized, supplemental oxygen to the ischemic tissue via an implantable MEMS device. The retinal architecture (e.g., thickness, cell densities, layered structure, etc.) of the rabbit eye exposed to ischemic hypoxic injuries was well preserved after targeted oxygen delivery to the hypoxic tissue, showing that the use of an external source of oxygen could improve the retinal oxygenation and prevent the progression of the ischemic cascade.

The proposed MEMS device transports oxygen from an oxygen-rich space to the oxygen-deficient vitreous, the gel-like fluid that fills the inside of the eye, and then to the ischemic retina. This oxygen transport process is purely passive and completely driven by the gradient of oxygen partial pressure (pO₂). Two types of devices were designed. For the first type, the oxygen-rich space is underneath the conjunctiva, a membrane covering the sclera (white part of the eye), beneath the eyelids and highly permeable to oxygen in the atmosphere when the eye is open. Therefore, sub-conjunctival pO₂ is very high during the daytime. For the second type, the oxygen-rich space is inside the device since pure oxygen is needle-injected into the device on a regular basis.

To prevent too fast or too slow permeation of oxygen through the device that is made of parylene and silicone (two widely used biocompatible polymers in medical devices), the material properties of the hybrid parylene/silicone were investigated, including mechanical behaviors, permeation rates, and adhesive forces. Then the thicknesses of parylene and silicone became important design parameters that were fine-tuned to reach the optimal oxygen permeation rate.

The passive MEMS oxygen transporter devices were designed, built, and tested in both bench-top artificial eye models and in-vitro porcine cadaver eyes. The 3D unsteady saccade-induced laminar flow of water inside the eye model was modeled by computational fluid dynamics to study the convective transport of oxygen inside the eye induced by saccade (rapid eye movement). The saccade-enhanced transport effect was also demonstrated experimentally. Acute in-vivo animal experiments were performed in rabbits and dogs to verify the surgical procedure and the device functionality. Various hypotheses were confirmed both experimentally and computationally, suggesting that both the two types of devices are very promising to cure diabetic retinopathy. The chronic implantation of devices in ischemic dog eyes is still underway.

The proposed MEMS oxygen transporter devices can be also applied to treat other ocular and systemic diseases accompanied by retinal ischemia, such as central retinal artery occlusion, carotid artery disease, and some form of glaucoma.

Parylene-C as a new piezoelectric material

The goal of this thesis is to develop a proper microelectromechanical systems (MEMS) process to manufacture piezoelectric Parylene-C (PA-C), which is famous for its chemical inertness, mechanical and thermal properties and electrical insulation. Furthermore, piezoelectric PA-C is used to build miniature, inexpensive, non-biased piezoelectric microphones.

These piezoelectric PA-C MEMS microphones are to be used in any application where a conventional piezoelectric and electret microphone can be used, such as in cell phones and hearing aids. However, they have the advantage of a simplified fabrication process compared with existing technology. In addition, as a piezoelectric polymer, PA-C has varieties of applications due to its low dielectric constant, low elastic stiffness, low density, high voltage sensitivity, high temperature stability and low acoustic and mechanical impedance. Furthermore, PA-C is an FDA approved biocompatible material and is able to maintain operate at a high temperature.

To accomplish piezoelectric PA-C, a MEMS-compatible poling technology has been developed. The PA-C film is poled by applying electrical field during heating. The piezoelectric coefficient, -3.75pC/N, is obtained without film stretching.

The millimeter-scale piezoelectric PA-C microphone is fabricated with an in-plane spiral arrangement of two electrodes. The dynamic range is from less than 30 dB to above 110 dB SPL (referenced 20 µPa) and the open-circuit sensitivities are from 0.001 – 0.11 mV/Pa over a frequency range of 1 - 10 kHz. The total harmonic distortion of the device is less than 20% at 110 dB SPL and 1 kHz.

Optomechanical Inertial Sensors and Feedback Cooling

The optomechanical interaction is an extremely powerful tool with which to measure mechanical motion. The displacement resolution of chip-scale optomechanical systems has been measured on the order of 1⁄10th of a proton radius. So strong is this optomechanical interaction that it has recently been used to remove almost all thermal noise from a mechanical resonator and observe its quantum ground-state of motion starting from cryogenic temperatures.

In this work, chapter 1 describes the basic physics of the canonical optomechanical system, optical measurement techniques, and how the optomechanical interaction affects the coupled mechanical resonator. In chapter 2, we describe our techniques for realizing this canonical optomechanical system in a chip-scale form factor.

In chapter 3, we describe an experiment where we used radiation pressure feedback to cool a mesoscopic mechanical resonator near its quantum ground-state from room-temperature. We cooled the resonator from a room temperature phonon occupation of <n> = 6.5 million to an occupation of <n> = 66, which means the resonator is in its ground state approximately 2% of the time, while being coupled to a room-temperature thermal environment. At the time of this work, this is the closest a mesoscopic mechanical resonator has been to its ground-state of motion at room temperature, and this work begins to open the door to room-temperature quantum control of mechanical objects.

Chapter 4 begins with the realization that the displacement resolutions achieved by optomechanical systems can surpass those of conventional MEMS sensors by an order of magnitude or more. This provides the motivation to develop and calibrate an optomechanical accelerometer with a resolution of approximately 10 micro-g/rt-Hz over a bandwidth of approximately 30 kHz. In chapter 5, we improve upon the performance and practicality of this sensor by greatly increasing the test mass size, investigating and reducing low-frequency noise, and incorporating more robust optical coupling techniques and capacitive wavelength tuning. Finally, in chapter 6 we present our progress towards developing another optomechanical inertial sensor - a gyroscope.