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Neueste technologische Entwicklungen in der ophthalmologischen optischen Kohärenztomographie

Latest technological developments in ophthalmic OCT

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Zusammenfassung

Fundamental neue Signaldetektionstechniken ('Frequency Domain' oder 'Spectral Domain') sowie Entwicklungen breitbandiger (polychromatischer), kostengünstiger Lichtquellen ermöglichten jüngst dreidimensionale, hochauflösende ophthalmologische optische Kohärenztomographie (Optical Coherence Tomography, OCT) der lebenden menschlichen Netzhaut. Damit besitzt OCT das Potential eine optische Biopsietechnik darzustellen, bei der Gewebe ohne Entnahme berührungslos mit einer Auflösung untersucht werden kann, die nahezu jener entspricht, die mit herkömmlicher Histopathologie erreicht wird. Dreidimensionale hochauflösende OCT könnte dadurch die frühzeitige Diagnose von weltweit zu Erblindung führenden Augenerkrankungen sowie die Verlaufskontrolle neuester ophthalmologischer Therapien ermöglichen und außerdem signifikant zum besseren Verständnis der Pathogenese beitragen. Neue Lasertechnologie ermöglicht erstmals den Einsatz von OCT in alternativen Wellenlängenbereichen zur verbesserten Visualisierung der Aderhaut. Die Kombination hochauflösender OCT mit adaptiver Optik zur verbesserten transversalen Auflösung stellt einen wesentlichen Schritt in Richtung retinaler Bildgebung mit zellulärer Auflösung dar. Weitere Entwicklungen sehen OCT-Erweiterungen vor, bei denen tiefenaufgelöst funktionelle Netzhauteigenschaften berührungslos ermittelt werden können. Die ophthalmologische optische Kohärenztomographie besitzt aufgrund der neuesten technologischen Entwicklungen somit das Potential, als berührungslose optische Biopsiemethode in Zukunft ortsaufgelöste funktionelle Gewebseigenschaften auf zellulärem Niveau zu ermitteln.

Summary

Recent developments of ultrabroad bandwidth light sources and detection technology have enabled significant improvement of ophthalmic axial OCT imaging resolution, demonstrating the potential of ultrahigh resolution OCT (UHR OCT) to perform three-dimensional non-invasive optical biopsy, i. e. the in vivo visualization of microstructural morphology in situ, which had previously only been possible with histopathology. Therefore UHR OCT allows detection of intraretinal changes that can be used for diagnosis of retinal disease in its early stages, when treatment is most effective and irreversible damage can be prevented or delayed. Furthermore it may provide a better understanding of the pathogenesis of several macular pathologies as well as the development of new therapy approaches. Other recent developments of ophthalmic OCT include nearly cellular level resolution, depth resolved functional imaging of the living human retina as well as OCT imaging with enhanced penetration into the choroid by employing novel wavelength regions. Using adaptive optics to correct higher order aberrations of the human eye in combination with high speed, three-dimensional UHR OCT enables unprecedented in vivo volumetric visualization of intraretinal morphology. Preliminary results demonstrate visualization of retinal features that might correspond to the terminal bars of photoreceptors at the external limiting membrane. In addition, extensions of UHR OCT are developed that should provide non-invasive depth resolved functional imaging of the retina, including spectroscopic, blood flow or physiologic tissue information. These extensions of OCT should not only improve image contrast, but should also enable the differentiation of retinal pathologies via localized spectroscopic properties or functional state.

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Authors and Affiliations

  1. Department of Optometry and Vision Sciences, Cardiff University, Wales, UK

    W. Drexler

  2. Zentrum für Biomedizinische Technik und Physik, Medizinische Universität, Wien, Austria

    W. Drexler

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  1. W. Drexler
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Correspondence to W. Drexler.

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Drexler, W. Neueste technologische Entwicklungen in der ophthalmologischen optischen Kohärenztomographie. Spektrum Augenheilkd. 21, 3–12 (2007). https://doi.org/10.1007/s00717-006-0173-x

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