Agreement of Anterior Segment Parameters Obtained From Swept-Source Fourier-Domain and Time-Domain Anterior Segment Optical Coherence Tomography.

PurposeTo assess the interdevice agreement between swept-source Fourier-domain and time-domain anterior segment optical coherence tomography (AS-OCT).MethodsFifty-three eyes from 41 subjects underwent CASIA2 and Visante OCT imaging. One hundred eighty-degree axis images were measured with the built-in two-dimensional analysis software for the swept-source Fourier-domain AS-OCT (CASIA2) and a customized program for the time-domain AS-OCT (Visante OCT). In both devices, we examined the angle opening distance (AOD), trabecular iris space area (TISA), angle recess area (ARA), anterior chamber depth (ACD), anterior chamber width (ACW), and lens vault (LV). Bland-Altman plots and intraclass correlation (ICC) were performed. Orthogonal linear regression assessed any proportional bias.ResultsICC showed strong correlation for LV (0.925) and ACD (0.992) and moderate agreement for ACW (0.801). ICC suggested good agreement for all angle parameters (0.771-0.878) except temporal AOD500 (0.743) and ARA750 (nasal 0.481; temporal 0.481). There was a proportional bias in nasal ARA750 (slope 2.44, 95% confidence interval [CI]: 1.95-3.18), temporal ARA750 (slope 2.57, 95% CI: 2.04-3.40), and nasal TISA500 (slope 1.30, 95% CI: 1.12-1.54). Bland-Altman plots demonstrated in all measured parameters a minimal mean difference between the two devices (-0.089 to 0.063); however, evidence of constant bias was found in nasal AOD250, nasal AOD500, nasal AOD750, nasal ARA750, temporal AOD500, temporal AOD750, temporal ARA750, and ACD. Among the parameters with constant biases, CASIA2 tends to give the larger numbers.ConclusionsBoth devices had generally good agreement. However, there were proportional and constant biases in most angle parameters. Thus, it is not recommended that values be used interchangeably

Optical Coherence Tomography Angiography Vessel Density in Healthy, Glaucoma Suspect, and Glaucoma Eyes.

PurposeThe purpose of this study was to compare retinal nerve fiber layer (RNFL) thickness and optical coherence tomography angiography (OCT-A) retinal vasculature measurements in healthy, glaucoma suspect, and glaucoma patients.MethodsTwo hundred sixty-one eyes of 164 healthy, glaucoma suspect, and open-angle glaucoma (OAG) participants from the Diagnostic Innovations in Glaucoma Study with good quality OCT-A images were included. Retinal vasculature information was summarized as a vessel density map and as vessel density (%), which is the proportion of flowing vessel area over the total area evaluated. Two vessel density measurements extracted from the RNFL were analyzed: (1) circumpapillary vessel density (cpVD) measured in a 750-μm-wide elliptical annulus around the disc and (2) whole image vessel density (wiVD) measured over the entire image. Areas under the receiver operating characteristic curves (AUROC) were used to evaluate diagnostic accuracy.ResultsAge-adjusted mean vessel density was significantly lower in OAG eyes compared with glaucoma suspects and healthy eyes. (cpVD: 55.1 ± 7%, 60.3 ± 5%, and 64.2 ± 3%, respectively; P < 0.001; and wiVD: 46.2 ± 6%, 51.3 ± 5%, and 56.6 ± 3%, respectively; P < 0.001). For differentiating between glaucoma and healthy eyes, the age-adjusted AUROC was highest for wiVD (0.94), followed by RNFL thickness (0.92) and cpVD (0.83). The AUROCs for differentiating between healthy and glaucoma suspect eyes were highest for wiVD (0.70), followed by cpVD (0.65) and RNFL thickness (0.65).ConclusionsOptical coherence tomography angiography vessel density had similar diagnostic accuracy to RNFL thickness measurements for differentiating between healthy and glaucoma eyes. These results suggest that OCT-A measurements reflect damage to tissues relevant to the pathophysiology of OAG

Ultrahigh speed 1050nm swept source / Fourier domain OCT retinal and anterior segment imaging at 100,000 to 400,000 axial scans per second

We demonstrate ultrahigh speed swept source/Fourier domain ophthalmic OCT imaging using a short cavity swept laser at 100,000 – 400,000 axial scan rates. Several design configurations illustrate tradeoffs in imaging speed, sensitivity, axial resolution, and imaging depth. Variable rate A/D optical clocking is used to acquire linear-in-k OCT fringe data at 100kHz axial scan rate with 5.3um axial resolution in tissue. Fixed rate sampling at 1 GSPS achieves a 7.5mm imaging range in tissue with 6.0um axial resolution at 100kHz axial scan rate. A 200kHz axial scan rate with 5.3um axial resolution over 4mm imaging range is achieved by buffering the laser sweep. Dual spot OCT using two parallel interferometers achieves 400kHz axial scan rate, almost 2X faster than previous 1050nm ophthalmic results and 20X faster than current commercial instruments. Superior sensitivity roll-off performance is shown. Imaging is demonstrated in the human retina and anterior segment. Wide field 12×12mm data sets include the macula and optic nerve head. Small area, high density imaging shows individual cone photoreceptors. The 7.5mm imaging range configuration can show the cornea, iris, and anterior lens in a single image. These improvements in imaging speed and depth range provide important advantages for ophthalmic imaging. The ability to rapidly acquire 3D-OCT data over a wide field of view promises to simplify examination protocols. The ability to image fine structures can provide detailed information on focal pathologies. The large imaging range and improved image penetration at 1050nm wavelengths promises to improve performance for instrumentation which images both the retina and anterior eye. These advantages suggest that swept source OCT at 1050nm wavelengths will play an important role in future ophthalmic instrumentation.National Institutes of Health (U.S.) (5R01-EY011289-23)National Institutes of Health (U.S.) (5R01-EY013178-10)National Institutes of Health (U.S.) (2R01-EY013516-07)National Institutes of Health (U.S.) (1R01-EY019029-02)United States. Air Force Office of Scientific Research (Contract Number FA9550-07-1-0014)United States. Dept. of Defense. Medical Free Electron Laser Program (Contract Number FA9550-07-1-0101

Investigation of post-glaucoma-surgery structures by three-dimensional and polarization sensitive anterior eye segment optical coherence tomography

A sequential case series of post-glaucoma-surgery structures examined by three-dimensional corneal and anterior eye segment optical coherence tomography (3D-CASOCT) and 3D polarization sensitive CASOCT (PS-CASOCT) is presented. A total of 5 patients who underwent glaucoma surgery were included in this study. Of these, 1, 1, and 3 patient underwent trabeculotomy, laser iridotomy, and trabeculectomy respectively. One patient each who had undergone trabeculotomy or laser iridotomy was examined using a prototype 3D-CASOCT. This prototype is based on swept-source OCT technology, uses a probe beam with a center wavelength of 1.31 μm, and has an axial resolution of 11.6 μm and a scanning speed of 20,000 A lines/s. All 3 patients who underwent trabeculectomy were examined by PS-CASOCT, which has similar specifications to those of 3DCASOCT, measures the depth-resolved birefringence of a specimen, and yields conventional OCT images. Detailed 3D visualization of the incision site of trabeculotomy and the ablation site of laser iridotomy was achieved using 3D-CASOCT. PS-CASOCT revealed, in addition to the structural details, the birefringent properties of the tissues of the trabeculectomy bleb. Some blebs showed abnormal birefringence in the conjunctiva and in a remnant fluid pool. This may indicate the existence of fibrosis in these regions. Both 3D-CASOCT and PS-CASOCT provide clinically significant information for the postoperative assessment of structures created during glaucoma surgery. Interactive 3D datasets of all cases are provided for interactive clinical review. Complex raw 3D OCT volumes are also provided as a reference dataset for the development of PS-OCT algorithms.This paper was published in Optics Express and is made available as an electronic reprint with the permission of OSA. The paper can be found at the following URL on the OSA website: http://www.opticsinfobase.org/abstract.cfm?uri=oe-17-5-3980. Systematic or multiple reproduction or distribution to multiple locations via electronic or other means is prohibited and is subject to penalties under law

Role of Optical Coherence Tomography on Corneal Surface Laser Ablation

This paper focuses on reviewing the roles of optical coherence tomography (OCT) on corneal surface laser ablation procedures. OCT is an optical imaging modality that uses low-coherence interferometry to provide noninvasive cross-sectional imaging of tissue microstructure in vivo. There are two types of OCTs, each with transverse and axial spatial resolutions of a few micrometers: the time-domain and the fourier-domain OCTs. Both have been increasingly used by refractive surgeons and have specific advantages. Which of the current imaging instruments is a better choice depends on the specific application. in laser in situ keratomileusis (LASIK) and in excimer laser phototherapeutic keratectomy (PTK), OCT can be used to assess corneal characteristics and guide treatment decisions. OCT accurately measures central corneal thickness, evaluates the regularity of LASIK flaps, and quantifies flap and residual stromal bed thickness. When evaluating the ablation depth accuracy by subtracting preoperative from postoperative measurements, OCT pachymetry correlates well with laser ablation settings. in addition, OCT can be used to provide precise information on the morphology and depth of corneal pathologic abnormalities, such as corneal degenerations, dystrophies, and opacities, correlating with histopathologic findings.Cleveland Clin Fdn, Cole Eye Inst, Cleveland, OH 44114 USAAltino Ventura Fdn, Dept Ophthalmol, Recife, PE, BrazilUniv Fed Rio de Janeiro, Dept Ophthalmol, Rio de Janeiro, RJ, BrazilUniversidade Federal de São Paulo, Dept Ophthalmol, São Paulo, SP, BrazilUniversidade Federal de São Paulo, Dept Ophthalmol, São Paulo, SP, BrazilWeb of Scienc

Imaging of the Lamina Cribrosa using Swept-Source Optical Coherence Tomography.

The lamina cribrosa (LC) is the presumed site of axonal injury in glaucoma. Its deformation has been suggested to contribute to optic neuropathy by impeding axoplasmic flow within the optic nerve fibers, leading to apoptosis of retinal ganglion cells. To visualize the LC in vivo, optical coherence tomography (OCT) has been applied. Spectral domain (SD)-OCT, used in conjunction with recently introduced enhanced depth imaging (EDI)-OCT, has improved visualization of deeper ocular layers, but in many individuals it is still limited by inadequate resolution, poor image contrast and insufficient depth penetrance. The posterior laminar surface especially is not viewed clearly using these methods. New generation high-penetration (HP)-OCTs, also known as swept-source (SS)-OCT, are capable to evaluate the choroid in vivo to a remarkable level of detail. SS-OCTs use a longer wavelength (1,050 nm instead of 840 nm) compared to the conventional techniques. We review current knowledge of the LC, findings from trials that use SD-OCT and EDI-OCT, and our experience with a prototype SS-OCT to visualize the LC in its entirety. Key Points What is known? •     The LC is the presumed site of axonal injury in glaucoma •     Compared to spectral domain-OCT, enhanced depth imaging-OCT improves imaging of the LC •     Even so, currently used SD-OCT techniques are restricted by poor wavelength penetrance of the deeper ocular layers What our findings add? •    SS-OCT may be a superior imaging modality for deep ocular structures •    Prior studies used SS-OCT to evaluate choroidal thickness in both healthy and 'normal tension glaucoma' eyes •    SS-OCT enables good evaluation of three-dimension (3D) lamina cribrosa morphology. How to cite this article: Nuyen B, Mansouri K, Weinreb RN. Imaging of the Lamina Cribrosa using Swept-Source Optical Coherence Tomography. J Current Glau Prac 2012;6(3): 113-119

In Vivo Human Choroidal Vascular Pattern Visualization Using High-Speed Swept-Source Optical Coherence Tomography at 1060 nm

Purpose. To investigate the retinal and choroidal vascular pattern, structure, and thickness using high-speed, high axial resolution, swept-source optical coherence tomography (SS-OCT) at 1060 nm, demonstrating enhanced penetration through all choroidal layers. Methods. An ophthalmic SS-OCT system was developed operating at 57,000 A-lines/s with 5.9 μm axial resolution and was used to collect 3D images with scanning angles up to ∼70° × 35°. The similar features were observed in the choroidal layers by imaging three healthy volunteers. En face images, extracted at different depths, capture features of the retinal and choroidal vasculature networks and substructure. Retinal and choroidal thicknesses were measured over scanning angles of ∼14° × 14°, yielding retinal and choroidal thickness maps. Results. The retinal layers, choriocapillaris (CC), Sattler's layer (SL), Haller's layer (HL), and the lamina suprachoroid layer (LSL) were delineated in 2D sagittal tomograms. The sagittal tomograms and en face reflectance images over a 2-cm^2 field of view captured the paraoptic, lateral and medial distal short posterior ciliary artery (SPCA) branches as well as the two lateral and medial long posterior ciliary arteries (LPCAs). En face images in the HL revealed the superotemporal, inferotemporal, superonasal, and inferonasal major choroidal vessels. Conclusions. High-speed, high-resolution SS-OCT centered at 1060 nm enables retinal and choroidal vasculature networks visualization, including retina vessels, posterior ciliary artery (PCA) branches, and venous vascular patterns. This technology offers diagnostic opportunities by monitoring change in these networks, substructure, and retinal and choroidal thicknesses during disease initiation and progression

Development of high-speed swept source optical coherence tomography system and three-dimensional analysis of anterior eye segment structure

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