Improved Visualization of Glaucomatous Retinal Damage Using High-speed Ultrahigh-Resolution Optical Coherence Tomography
Presented in part at: American Glaucoma Society Annual Meeting, March 2006, Charleston, South Carolina, and International Society for Imaging of the Eye Annual Meeting, May 2006, Ft. Lauderdale, Florida.
Received 8 February 2007; received in revised form 21 June 2007; accepted 26 June 2007. published online 20 September 2007.
Purpose
To test if improving optical coherence tomography (OCT) resolution and scanning speed improves the visualization of glaucomatous structural changes as compared with conventional OCT.
Design
Prospective observational case series.
Participants
Healthy and glaucomatous subjects in various stages of disease.
Methods
Subjects were scanned at a single visit with commercially available OCT (StratusOCT) and high-speed ultrahigh-resolution (hsUHR) OCT. The prototype hsUHR OCT had an axial resolution of 3.4 μm (3 times higher than StratusOCT), with an A-scan rate of 24 000 hertz (60 times faster than StratusOCT). The fast scanning rate allowed the acquisition of novel scanning patterns such as raster scanning, which provided dense coverage of the retina and optic nerve head.
Main Outcome Measures
Discrimination of retinal tissue layers and detailed visualization of retinal structures.
Results
High-speed UHR OCT provided a marked improvement in tissue visualization as compared with StratusOCT. This allowed the identification of numerous retinal layers, including the ganglion cell layer, which is specifically prone to glaucomatous damage. Fast scanning and the enhanced A-scan registration properties of hsUHR OCT provided maps of the macula and optic nerve head with unprecedented detail, including en face OCT fundus images and retinal nerve fiber layer thickness maps.
Conclusion
High-speed UHR OCT improves visualization of the tissues relevant to the detection and management of glaucoma.
Available online: September 20, 2007.
1University of Pittsburgh Medical Center Eye Center, Ophthalmology and Visual Science Research Center, Eye and Ear Institute, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
2Department of Electrical Engineering and Computer Science and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts.
3Institute of Physics, Nicolaus Copernicus University, Torun, Poland.
4Department of Bioengineering, University of Pittsburgh School of Engineering, Pittsburgh, Pennsylvania.
5New England Eye Center, Tufts–New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
Correspondence to Joel S. Schuman, MD, UPMC Eye Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, 203 Lothrop Street, Eye and Ear Institute, Suite 816, Pittsburgh, PA 15213.
Manuscript no. 2007-185.
The first 2 authors contributed equally to the preparation of the manuscript.
Drs Schuman and Fujimoto receive royalties for intellectual property licensed by Massachusetts Institute of Technology to Carl Zeiss Meditec.
Supported in part by the National Institutes of Health, Bethesda, Maryland (grant nos. R01-EY013178-7, RO1-EY11289-21, P30-EY008098); National Science Foundation, Arlington, Virginia (grant no. BES-0522845); Air Force Office of Scientific Research and Medical Free Electron Laser Program, Arlington, Virginia (contract no. FA9550-040-1-0046); and unrestricted grants from Research to Prevent Blindness, Inc., New York, New York, and the Eye and Ear Foundation, Pittsburgh, Pennsylvania.
ABSTRACT