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    Optical coherence tomography angiography: Technical principles and clinical applications in ophthalmology

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        Abstract

        Optical coherence tomography angiography (OCTA) is a functional extension of OCT that provides information on retinal and choroidal circulations without the need for dye injections. With the recent development of high-speed OCT systems and efficient algorithms, OCTA has become clinically feasible. In this review article, we discuss the technical principles of OCTA, including image processing and artifacts, and its clinical applications in ophthalmology. We summarize recent studies which qualitatively or quantitatively assess disease presentation, progression, and/or response to treatment.

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        Optical coherence tomography.

         Melissa K. Gregory,  J. Swanson,  S. Lin … (1991)
        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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          The pathophysiology and treatment of glaucoma: a review.

           Felipe Medeiros,  Robert N. Weinreb,  Tin Aung (2014)
          Glaucoma is a worldwide leading cause of irreversible vision loss. Because it may be asymptomatic until a relatively late stage, diagnosis is frequently delayed. A general understanding of the disease pathophysiology, diagnosis, and treatment may assist primary care physicians in referring high-risk patients for comprehensive ophthalmologic examination and in more actively participating in the care of patients affected by this condition. To describe current evidence regarding the pathophysiology and treatment of open-angle glaucoma and angle-closure glaucoma. A literature search was conducted using MEDLINE, the Cochrane Library, and manuscript references for studies published in English between January 2000 and September 2013 on the topics open-angle glaucoma and angle-closure glaucoma. From the 4334 abstracts screened, 210 articles were selected that contained information on pathophysiology and treatment with relevance to primary care physicians. The glaucomas are a group of progressive optic neuropathies characterized by degeneration of retinal ganglion cells and resulting changes in the optic nerve head. Loss of ganglion cells is related to the level of intraocular pressure, but other factors may also play a role. Reduction of intraocular pressure is the only proven method to treat the disease. Although treatment is usually initiated with ocular hypotensive drops, laser trabeculoplasty and surgery may also be used to slow disease progression. Primary care physicians can play an important role in the diagnosis of glaucoma by referring patients with positive family history or with suspicious optic nerve head findings for complete ophthalmologic examination. They can improve treatment outcomes by reinforcing the importance of medication adherence and persistence and by recognizing adverse reactions from glaucoma medications and surgeries.
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            Split-spectrum amplitude-decorrelation angiography with optical coherence tomography

             Yali Jia,  Ou Tan,  Jason Tokayer … (2012)
            Amplitude decorrelation measurement is sensitive to transverse flow and immune to phase noise in comparison to Doppler and other phase-based approaches. However, the high axial resolution of OCT makes it very sensitive to the pulsatile bulk motion noise in the axial direction. To overcome this limitation, we developed split-spectrum amplitude-decorrelation angiography (SSADA) to improve the signal-to-noise ratio (SNR) of flow detection. The full OCT spectrum was split into several narrower bands. Inter-B-scan decorrelation was computed using the spectral bands separately and then averaged. The SSADA algorithm was tested on in vivo images of the human macula and optic nerve head. It significantly improved both SNR for flow detection and connectivity of microvascular network when compared to other amplitude-decorrelation algorithms.
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              Author and article information

              Affiliations
              Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA
              Author notes
              Address for correspondence: Dr. David Huang, Casey Eye Institute, Oregon Health and Science University, Portland, OR 97239, USA. davidhuang@ 123456alum.mit.edu
              Journal
              Journal ID (nlm-journal-id): 101582127
              Journal ID (pubmed-jr-id): 41305
              Journal ID (nlm-ta): Taiwan J Ophthalmol
              Journal ID (iso-abbrev): Taiwan J Ophthalmol
              Title: Taiwan journal of ophthalmology
              ISSN (Print): 2211-5056
              ISSN (Electronic): 2211-5072
              Publication date Nihms-submitted 22 September 2017
              Publication date (Electronic): 19 September 2017
              Publication date (Print): Jul-Sep 2017
              Publication date PMC-release 27 September 2017
              Volume: 7
              Issue: 3
              Pages: 115-129
              PMC ID: 5617355
              DOI: 10.4103/tjo.tjo_31_17
              Manuscript ID: NIHMS907299

              License:

              This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

              For reprints contact: reprints@ 123456medknow.com

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              Keywords: retina, diabetic retinopathy, glaucoma, optic disc, optical coherence tomography angiography, choroidal neovascularization

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