Imaging chorioretinal vascular disease

Abstract

Since its first description more than 40 years ago, fluorescein angiography had a crucial role in the diagnosis and management of chorioretinal vascular disorders such as neovascular agerelated macular degeneration. Although fluorescein angiography permits visualization of the retinal microcirculation in exquisite detail, visualization of the choroidal circulation is more limited. Moreover, fluorescein angiography provides only minimal information regarding the functional consequences of vascular disease and allows, at best, only semi-quantitative assessment of retinal thickness. In recent years, the development of other chorioretinal imaging modalities, such as indocyanine green angiography, fundus autofluorescence, and optical coherence tomography (OCT), has addressed many of these issues. In particular, OCT has become an integral tool for vitreoretinal specialists as it allows highresolution cross-sectional images of the neurosensory retina to be obtained in a non-invasive manner. The latest generation of commercial OCT technologyFspectral domain OCTFoffers high-speed scanning that allows complete coverage of the macular area, generation of three-dimensional retinal reconstructions, and precise image registration for inter-visit comparisons. The high speed of spectral domain OCT also facilitates B-scan averaging, which reduces speckle noise artefact and allows unparalleled visualization of the outer retina and choroid. In the near future, further advances in OCT technology (eg Doppler OCT) are likely to dramatically enhance the diagnosis and management of patients with chorioretinal vascular disease.

Retinal vessel structure measurement using spectral-domain optical coherence tomography

“…OCT technologies have greatly improved; however, future OCT technologies such as the combination of adaptive optics and OCT will have a higher resolution that will enable observation at the cellular level in the near future. 21 Vessel measurement via fundus photography also has advantages, including simple and semiautomated measurement. However, the accuracy of fundus photography may be lower compared with that of OCT. 22 Our new methodology involving intensity graph-assisted vessel measurements using SD-OCT may provide a new direction for future software development, which may in turn lead to automated vessel wall quantification on intensity graphs from SD-OCT scans.…”

Assessment of Differential Pharmacodynamic Effects Using Optical Coherence Tomography in Neovascular Age-Related Macular Degeneration

“…4 -6 In addition, the application of OCT to clinical research has elucidated many hitherto unrecognized disease characteristics and clarified many aspects of disease pathophysiology. 7 The advent of OCT has also allowed objective, quantitative assessment of morphologic parameters, 8,9 with OCT-derived measurements of retinal thickness commonly used for both clinical and research purposes. 10,11 As our knowledge of OCT image analysis has grown, however, it has become increasingly clear that even accurate measurements of retinal thickness may fail to predict visual outcomes.…”

Evaluation of the Axial Location of Cystoid Spaces in Retinal Vein Occlusion Using Optical Coherence Tomography

“…10,11 In patients with retinal vascular disease, OCT has typically been used as an adjunct to the biomicroscopic diagnosis of CME, and then, through measurements of retinal thickness, as a means of monitoring treatment response. 12,13 However, recent advances in OCT technology have greatly extended our ability to visualize the cross-sectional anatomy of the retina. 14 Furthermore, our understanding of OCT image interpretation, for both "normal" and disease states, has evolved considerably.…”