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Novel perspectives on swept-source optical coherence tomography

, 1 , 2 , 3 , 2

International Journal of Retina and Vitreous

BioMed Central

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      Abstract

      Technologies for multimodal digital imaging of vitreoretinal diseases have improved the accuracy of diagnosis and the depth of the knowledge of the mechanisms of disease and their response to treatments. Optic coherence tomography (OCT) has become a mandatory tool for the management and for the follow-up of retinal pathologies. OCT technology evolved in the last two decades from time-domain to spectral domain and recently to the swept-source OCTs (SS-OCT). SS-OCT improved the depth of imaging and the scan speed, thus adding novel algorithms and features such as for vitreous and vitreoretinal interface evaluation, choroid segmentation and mapping, OCT angiography and En-face OCT. The multimodal approach using SS-OCT is expected to advance the understanding of retinal pathologies such as age related macular degeneration, diabetic maculopathy, central serous chorioretinopathy, the pachychoroid spectrum and macular telangiectasia. Surgical vitreoretinal diseases such as vitreo-macular traction syndrome, epiretinal membrane, retinal detachment, proliferative vitreoretinal retinopathy and diabetic traction retinal detachment also will be better understood and documented with SS-OCT. This technology also provides great utility for a broad spectrum of ophthalmic pathologies including glaucoma, uveitis, tumors and anterior segment evaluation.

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      Optical coherence tomography.

      A technique called optical coherence tomography (OCT) has been developed for noninvasive cross-sectional imaging in biological systems. OCT uses low-coherence interferometry to produce a two-dimensional image of optical scattering from internal tissue microstructures in a way that is analogous to ultrasonic pulse-echo imaging. OCT has longitudinal and lateral spatial resolutions of a few micrometers and can detect reflected signals as small as approximately 10(-10) of the incident optical power. Tomographic imaging is demonstrated in vitro in the peripapillary area of the retina and in the coronary artery, two clinically relevant examples that are representative of transparent and turbid media, respectively.
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        Enhanced depth imaging spectral-domain optical coherence tomography.

        To describe a method to obtain images of the choroid using conventional spectral-domain (SD) optical coherence tomography (OCT) and to evaluate choroidal thickness measurements using these images. Observational case series. The images were obtained by positioning the SD OCT device close enough to the eye to obtain an inverted representation of the fundus in healthy volunteers who did not have pupillary dilation. Seven sections, each comprised of 100 averaged scans, were obtained within a 5- x 15-degree rectangle centered on the fovea. The choroidal thickness under the fovea in each image was measured by independent observers. The choroidal thickness could be evaluated in every subject's choroidal image. The mean choroidal thickness under the fovea was 318 microm in the right eye and 335 microm in the left eye. The choroidal thickness showed a high correlation in both eyes (r = 0.82; P < .001). The correlation between the measurements performed by the independent observers was highly significant (right eye, r = 0.93; left eye, r = 0.97; P < .001 for both). This method provides detailed, measurable images from the choroid, a structure that heretofore has been difficult to image in clinical practice.
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          A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes.

          To measure macular choroidal thickness in normal eyes at different points using enhanced depth imaging (EDI) optical coherence tomography (OCT) and to evaluate the association of choroidal thickness and age. Retrospective, observational case series. EDI OCT images were obtained in patients without significant retinal or choroidal pathologic features. The images were obtained by positioning a spectral-domain OCT device close enough to the eye to acquire an inverted image. Seven sections were obtained within a 5 x 30-degree area centered at the fovea, with 100 scans averaged for each section. The choroid was measured from the outer border of the retinal pigment epithelium to the inner scleral border at 500-microm intervals of a horizontal section from 3 mm temporal to the fovea to 3 mm nasal to the fovea. Statistical analysis was performed to evaluate variations of choroidal thickness at each location and to correlate choroidal thickness and patient age. The mean age of the 30 patients (54 eyes) was 50.4 years (range, 19 to 85 years), and 14 patients (46.7%) were female. The choroid was thickest underneath the fovea (mean, 287 microm; standard deviation, +/- 76 microm). Choroidal thickness decreased rapidly in the nasal direction and averaged 145 microm (+/- 57 microm) at 3 mm nasal to the fovea. Increasing age was correlated significantly with decreasing choroidal thickness at all points measured. Regression analysis suggested that the subfoveal choroidal thickness decreased by 15.6 microm for each decade of life. Choroidal thickness seems to vary topographically within the posterior pole. The thickness of the choroid showed a negative correlation with age. The decrease in the thickness of the choroid may play a role in the pathophysiologic features of various age-related ocular conditions.
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            Author and article information

            Affiliations
            [1 ]Department of Ophthalmology, Paulista School of Medicine, São Paulo Hospital, Federal University of São Paulo, São Paulo, Brazil
            [2 ]Department of Ophthalmology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
            [3 ]Department of Ophthalmology, Instituto de Oftalmologia Lavinsky, Rua Quintino Bocaiuva 673, Porto Alegre, RS 90410-140 Brazil
            Contributors
            ORCID: http://orcid.org/0000-0002-6925-1794, 55-51-81528587 , lavafabiomed@gmail.com
            daniellavinsky@gmail.com
            Journal
            Int J Retina Vitreous
            Int J Retina Vitreous
            International Journal of Retina and Vitreous
            BioMed Central (London )
            2056-9920
            1 November 2016
            1 November 2016
            2016
            : 2
            5088466
            50
            10.1186/s40942-016-0050-y
            © The Author(s) 2016

            Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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