Comparison of ultrahigh- and standard-resolution optical coherence tomography for imaging macular hole pathology and repair

Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States
Ophthalmology (Impact Factor: 6.17). 12/2004; 111(11):2033-43. DOI: 10.1016/j.ophtha.2004.05.021
Source: PubMed

ABSTRACT To compare ultrahigh-resolution optical coherence tomography (UHR-OCT) technology to a standard-resolution OCT instrument for the imaging of macular hole pathology and repair; to identify situations where UHR-OCT provides additional information on disease morphology, pathogenesis, and management; and to use UHR-OCT as a baseline for improving the interpretation of the standard-resolution images.
Observational and interventional case series.
Twenty-nine eyes of 24 patients clinically diagnosed with macular hole in at least one eye.
A UHR-OCT system has been developed and employed in a tertiary-care ophthalmology clinic. Using a femtosecond laser as the low-coherence light source, this new UHR-OCT system can achieve an unprecedented 3-mum axial resolution for retinal OCT imaging. Comparative imaging was performed with UHR-OCT and standard 10-mum resolution OCT in 29 eyes of 24 patients with various stages of macular holes. Imaging was also performed on a subset of the population before and after macular hole surgery.
Ultrahigh- and standard-resolution cross-sectional OCT images of macular hole pathologies.
Both UHR-OCT and standard-resolution OCT exhibited comparable performance in differentiating various stages of macular holes. The UHR-OCT provided improved imaging of finer intraretinal structures, such as the external limiting membrane and photoreceptor inner segment (IS) and outer segment (OS), and identification of the anatomy of successful surgical repair. The improved resolution of UHR-OCT enabled imaging of previously unidentified changes in photoreceptor morphology associated with macular hole pathology and postoperative repair. Visualization of the junction between the photoreceptor IS and OS was found to be an important indicator of photoreceptor integrity for both standard-resolution and UHR-OCT images.
Ultrahigh-resolution optical coherence tomography improves the visualization of the macular hole architectural morphology. The increased resolution of UHR-OCT enables the visualization of photoreceptor morphology associated with macular holes. This promises to lead to a better understanding of the pathogenesis of macular holes, the causes of visual loss secondary to macular holes, the timing of surgical repair, and the evaluation of postsurgical outcome. Ultrahigh-resolution optical coherence tomography imaging of macular holes that correspond to known alterations in retinal morphology can be used to interpret retinal morphology in UHR-OCT images. Comparisons of UHR-OCT images with standard-resolution OCT images can establish a baseline for the better interpretation of clinical standard-resolution OCT images. The ability to visualize photoreceptors and their integrity or impairment is an indicator of macular hole progression and surgical outcome.

Download full-text


Available from: Jay Duker, Jul 21, 2015
  • Source
    • "By using an optical interferometer in conjunction with a low-coherence light source, OCT detects light reflections within a tissue and provides in vivo cross-sectional images at near microscopic resolution (Hrynchak & Simpson, 2000; Huang et al., 1991). Recent advances in OCT allow differentiation of major retinal layers and analysis of tissue thickness and volume with a resolution of about 3 μm (Ko et al., 2004). Because the retina is the only place where a tissue layer made up of axons can be imaged directly, and the retina and optic nerve are often affected by MS, OCT can be used to assess the impact of MS on the retina by measuring the RNFL thickness and macular volume. "
    Neuroimaging - Clinical Applications, 03/2012; , ISBN: 978-953-51-0200-7
  • Source
    • "Hence, 3-D in vivo imaging is difficult to accomplish with time-domain systems. As an alternative approach, frequency-domain OCT, also referred to as Fourier Domain OCT or Spectral Domain OCT in literature (Fercher, Hitzenberger, Kamp, & El-Zaiat, 1995) allows the retrieval of tomograms without necessity of a moving mirror in the reference arm for depth scanning, allowing higher sampling speeds and signal to noise ratios compared to the original OCT technique, called time-domain OCT (Cense et al., 2004; Leitgeb et al., 2004; Wojtkowski et al., 2004). This enables the acquisition of B-scans with high transverse sampling almost free of artifacts associated to eye movements, and allows the recording of 3-D tomograms within in a short time. "
    [Show abstract] [Hide abstract]
    ABSTRACT: A liquid crystal programmable phase modulator (PPM) is used as correcting device in an adaptive optics system for three-dimensional ultrahigh-resolution optical coherence tomography (UHR OCT). The feasibility of the PPM to correct high order aberrations even when using polychromatic light is studied, showing potential for future clinical use. Volumetric UHR OCT of the living retina, obtained with up 25,000A-scans/s and high resolution enables visualization of retinal features that might correspond to groups of terminal bars of photoreceptors at the external limiting membrane.
    Vision Research 01/2006; 45(28):3432-44. DOI:10.1016/j.visres.2005.08.028 · 2.38 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A retrospective cross-sectional study was conducted to demonstrate an analysis of an outer retinal layer reconstructed by the three-dimensional and high-speed spectral domain optical coherence tomography (SD-OCT) instrument. New measurement protocols for SD-OCT and methods of analysis and visualization of the individual segmented retinal layer reconstructed by SD-OCT were proposed. Three contour maps representing mutual distances between the basal part of the retinal pigment epithelium, the junction between the inner and outer segments of photoreceptors, and a reference contour representing the shape of a healthy retina were introduced. The analysis of the outer retina was performed on pathological eyes. Three cases of central serous chorioretinopathy, age-related macular degeneration, and acute zonal occult outer retinopathy are demonstrated. Three contour maps reconstructed for clinical cases demonstrate high variability of observed patterns depending on analyzed pathology. The authors believe this can help to present OCT data simultaneously in a more comprehensive and convenient way to assist in everyday clinical diagnosis.
    Ophthalmic Surgery Lasers and Imaging 03/2009; 40(2):102-8. DOI:10.3928/15428877-20090301-10 · 1.32 Impact Factor
Show more