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Case Reports
. 2006 Aug;113(8):1425-31.
doi: 10.1016/j.ophtha.2006.03.020. Epub 2006 Jun 12.

Clinical application of rapid serial fourier-domain optical coherence tomography for macular imaging

Suhail Alam  1 , Robert J Zawadzki, Stacey Choi, Christina Gerth, Susanna S Park, Lawrence Morse, John S Werner
Affiliations
Case Reports

Clinical application of rapid serial fourier-domain optical coherence tomography for macular imaging

Suhail Alam et al. Ophthalmology. 2006 Aug.

Abstract

Purpose: To introduce and examine the utility of a retinal imaging technique using high-speed optical coherence tomography (OCT) for creating a more complete retinal structural map to aid in the evaluation of patients with macular pathology.

Design: Prospective observational case series.

Participants: Five patients with a variety of macular pathologies.

Methods: Patients were imaged with a Fourier-domain high-speed high-resolution OCT system built at our institution. A sweeping serial OCT B-scan of the macula was acquired to create a detailed retinal structural map. The data were then used to make individual clinical observations.

Results: Rapid serial OCT B-scans produced detailed macular maps for all 5 patients. Diagnoses of imaged patients included macular hole, lamellar macular hole, regressed macular hole or macular microhole, choroidal neovascular membrane (CNV) from age-related macular degeneration, and CNV from presumed ocular histoplasmosis syndrome. Reconstructed B-scans and C-scans are shown for selected patients to illustrate the additional perspectives gained by obtaining a detailed retinal map.

Conclusions: Rapid serial Fourier-domain OCT B-scanning can be used to create a detailed retinal structural map. This technique provides additional information that can be missed on single OCT images and provides an accurate way to image large or complex lesions, and allows B-scan and C-scan reconstructions to be made that provide additional perspectives into retinal structures that may be missed using traditional imaging methods.

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Figures

Figure 1
Figure 1
A, Black-and-white Fourier-domain optical coherence tomography image of normal retina. CL = connecting cilia; GCL = ganglion cell layer; ILM/NFL = internal limiting membrane/nerve fiber layer; INL = inner nuclear layer; IPL = inner plexiform layer; ISL = inner segment layer; OLM = outer limiting membrane; ONL = outer nuclear layer; OPL = outer plexiform layer; OSL = outer segment layer; RPE/BM = retinal pigment epithelium/Bruch’s membrane; VM = Verhoeff’s membrane. B, Same image displayed in false color.
Figure 2
Figure 2
Full-thickness macular hole. A, Selected images from 100 B-scans, horizontal direction showing a full-thickness macular hole (arrowhead). B, Selected images from reconstructed B-scans, vertical direction, showing a full-thickness macular hole (arrowhead). C, Selected images from reconstructed C-scans (en face slices).
Figure 3
Figure 3
A, Lamellar macular hole. Selected images from 100 B-scans, horizontal direction, showing outer retinal structural changes (arrowhead). B, Selected image of reconstructed B-scan, perpendicular direction.
Figure 4
Figure 4
Regressed macular hole. Selected images from 100 B-scans showing an operculum (arrowhead) and an outer retinal defect in photoreceptor layers (arrow).
Figure 5
Figure 5
Choroidal neovascular membrane (CNV) in age-related macular degeneration. Selected images from 100 B-scans. A, Fluorescein angiogram showing extrafoveal classic CNV. B, Enlarged image of B-scan through CNV. C, Reconstructed C-scan through CNV with surrounding subretinal fluid. The arrowhead in A–C points to the hypofluorescent border of CNV, possible unrecognized CNV component. D, Montage of selected images from a single sweeping optical coherence tomography (OCT) scan showing hypofluorescent angiographic halo (arrowhead) and corresponding subretinal OCT structure.
Figure 6
Figure 6
A, Late-phase fluorescein angiogram of a recurrent choroidal neovascular membrane (CNV) (red arrowheads) in presumed ocular histoplasmosis syndrome after thermal laser. B, C-scan (en face) image demonstrating lesion seen on angiogram (red arrowheads), additional unspecified subretinal structure (blue arrowheads), and surrounding subretinal fluid. B1, B-scan of CNV (red arrowhead) and adjacent subretinal lesion (blue arrowhead). B2, B-scan showing broad extent of unspecified subretinal lesion. B3, B-scan showing surrounding subretinal fluid. C, Fluorescein angiogram at 3-month follow-up visit showing progression of CNV, possibly correlating with subretinal lesion identified 3 months earlier on optical coherence tomography.
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