High-definition and 3-dimensional imaging of macular pathologies with high-speed ultrahigh-resolution optical coherence tomography.
OBJECTIVE
To assess high-speed ultrahigh-resolution optical coherence tomography (OCT) image resolution, acquisition speed, image quality, and retinal coverage for the visualization of macular pathologies.


METHODS
Retrospective cross-sectional study.


METHODS
Five hundred eighty-eight eyes of 327 patients with various macular pathologies.


METHODS
High-speed ultrahigh-resolution OCT images were obtained in 588 eyes of 327 patients with selected macular diseases. Ultrahigh-resolution OCT using Fourier/spectral domain detection achieves approximately 3-mum axial image resolutions, acquisition speeds of approximately 25 000 axial scans per second, and >3 times finer resolution and >50 times higher speed than standard OCT. Three scan protocols were investigated. The first acquires a small number of high-definition images through the fovea. The second acquires a raster series of high-transverse pixel density images. The third acquires 3-dimensional OCT data using a dense raster pattern. Three-dimensional OCT can generate OCT fundus images that enable precise registration of OCT images with the fundus. Using the OCT fundus images, OCT results were correlated with standard ophthalmoscopic examination techniques.


METHODS
High-definition macular pathologies.


RESULTS
Macular holes, age-related macular degeneration, epiretinal membranes, diabetic retinopathy, retinal dystrophies, central serous chorioretinopathy, and other pathologies were imaged and correlated with ophthalmic examination, standard OCT, fundus photography, and fluorescein angiography, where applicable. High-speed ultrahigh-resolution OCT generates images of retinal pathologies with improved quality, more comprehensive retinal coverage, and more precise registration than standard OCT. The speed preserves retinal topography, thus enabling the visualization of subtle changes associated with disease. High-definition high-transverse pixel density OCT images improve visualization of photoreceptor and pigment epithelial morphology, as well as thin intraretinal and epiretinal structures. Three-dimensional OCT enables comprehensive retinal coverage, reduces sampling errors, and enables assessment of 3-dimensional pathology.


CONCLUSIONS
High-definition 3-dimensional imaging using high-speed ultrahigh-resolution OCT improves image quality, retinal coverage, and registration. This new technology has the potential to become a useful tool for elucidating disease pathogenesis and improving disease diagnosis and management.
Srinivasan
Vivek J
VJ
Department of Electrical Engineering and Computer Science and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA.
Wojtkowski
Maciej
M
Witkin
Andre J
AJ
Duker
Jay S
JS
Ko
Tony H
TH
Carvalho
Mariana
M
Schuman
Joel S
JS
Kowalczyk
Andrzej
A
Fujimoto
James G
JG
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003930:Diabetic Retinopathy / Q000175:diagnosis; D019773:Epiretinal Membrane / Q000175:diagnosis; D005260:Female; D005583:Fourier Analysis; D006801:Humans; D021621:Imaging, Three-Dimensional; D008266:Macula Lutea; D008268:Macular Degeneration / Q000175:diagnosis; D008297:Male; D012164:Retinal Diseases / Q000175:diagnosis*; D012167:Retinal Perforations / Q000175:diagnosis; D012174:Retinitis Pigmentosa / Q000175:diagnosis; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods* / Q000592:standards*