Spektrum der Augenheilkunde

, Volume 21, Issue 1, pp 17-28

First online:

Ultrahigh-Resolution Combined Coronal Optical Coherence Tomography Confocal Scanning Ophthalmoscope (OCT/SLO): A pilot study

  • R. B. RosenAffiliated withAdvanced Retinal Imaging Laboratory, New York Eye and Ear Infirmary Email author 
  • , M. E. J. van VelthovenAffiliated withDepartment of Ophthalmology, Academic Medical CenterAdvanced Retinal Imaging Laboratory, New York Eye and Ear Infirmary
  • , P. M. T. GarciaAffiliated withAdvanced Retinal Imaging Laboratory, New York Eye and Ear Infirmary
  • , R. G. CucuAffiliated withApplied Optics Group, University of Kent
  • , M. D. de SmetAffiliated withDepartment of Ophthalmology, Academic Medical Center
  • , T. O. MuldoonAffiliated withAdvanced Retinal Imaging Laboratory, New York Eye and Ear Infirmary
  • , A. Gh. PodoleanuAffiliated withApplied Optics Group, University of Kent

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OBJECTIVE: To evaluate clinical images from a prototype ultrahigh resolution (UHR) combined coronal optical coherence tomography/confocal scanning ophthalmoscope (OCT/SLO) and to compare them to standard-resolution OCT/SLO images on the same patients. DESIGN: Cross-sectional pilot-study. PARTICIPANTS: Sixty-six eyes of 42 patients with various macular pathologies, such as age-related macular degeneration, macular edema, macular hole, central serous retinopathy, epiretinal membrane and posterior vitreous traction syndrome. METHODS: Each subject was first scanned with a standard-resolution OCT/SLO that has an axial resolution of ∼10 micron. Immediately following, patients were scanned with the prototype UHR OCT/SLO device. The UHR system employs a compact super luminescent diode (SLD) with a 150 nm bandwidth centered at 890 nm, which allows imaging of the retina with an axial resolution of 3 microns. Both coronal and longitudinal OCT scans were acquired with each system, and compared side-by-side. Scan quality was assessed for the observer's ability to visualize the vitreo-retinal interface and retinal layers – in particular of the outer retina/RPE/choroidal interface, increased discrimination of pathological changes, and better signal intensity. MAIN OUTCOME MEASURES: Ultrahigh and standard-resolution coronal and longitudinal OCT/SLO images of macular pathologies. RESULTS: In the side-by-side comparison with the commercial standard-resolution OCT/SLO images, the scans in the Ultrahigh resolution OCT/SLO images were superior in 85% of cases. Relatively poor quality images were attributed to lower signal-to-noise ratio, limited focusing, or media opacities. Several images that had a better signal intensity in the standard-resolution OCT/SLO system were found to show more retinal detail in the UHR system. In general, intraretinal layers in the UHR OCT/SLO images were better delineated in both coronal and longitudinal scans. Enhanced details were also seen in the outer retina/RPE/choroidal complex. The UHR OCT/SLO system produced better definition of morphological changes in several macular pathologies. CONCLUSIONS: Broadband SLD-based UHR OCT/SLO offers a compact, efficient, and economic enhancement to the currently available clinical OCT imaging systems. UHR OCT/SLO imaging enhanced the quality of the OCT C-scans, facilitated appreciation of vitreo-retinal pathologies, and improved sensitivity to small changes in the retina, and the outer retina/RPE/choroidal interface.

Key words

OCT ophthalmoscope OCT/SLO Ultrahigh resolution OCT Coronal OCT