Faculty Bibliography

Optical coherence tomography has allowed unprecedented visualization of ocular structures, but the identity of some visible objects within slices remains unknown. This study reconstructs a number of those objects in 3D space, allowing their identification by observation of their 3D morphology. In the case mottling deep within image slices through the optic disc, C-mode imaging provided visualization of the appearance and distribution of laminar pores. In the case of white spots and streaks sometimes observed in image slices through the cornea, C-mode imaging contoured to the path of those white spots allowed their visual identification as nerves extending radially into the cornea from the limbus. White spots observed in ultra-high resolution retinal image slices were identified as blood within retinal capillaries. C-mode contour-corrected imaging of three dimensional structures provided the identification of previously unidentified structures visible in cross-sectional image slices.

The Optical Society (OSA) is pleased to present this special issue of Optics Express on "Optical Coherence Tomography (OCT) in Ophthalmology" as part of the new Interactive Science Publishing (ISP) project. The project is being performed in collaboration with the National Library of Medicine and represents a new paradigm for the publication of digital image and large dataset information.

PURPOSE: To develop a semiautomated method to visualize structures of interest (SoIs) along their contour within three-dimensional, spectral domain optical coherence tomography (3D SD-OCT) data, without the need for segmentation. METHODS: With the use of two SD-OCT devices, the authors obtained 3D SD-OCT data within 6 x 6 x 1.4-mm and 6 x 6 x 2-mm volumes, respectively, centered on the fovea in healthy eyes and in eyes with retinal pathology. C-mode images were generated by sampling a variable thickness plane semiautomatically modeled to fit the contour of the SoI. Unlike published and commercialized methods, this method did not require retinal layer segmentation, which is known to fail frequently in the presence of retinal pathology. Four SoIs were visualized for healthy eyes: striation of retinal nerve fiber (RNF), retinal capillary network (RCN), choroidal capillary network (CCN), and major choroidal vasculature (CV). Various SoIs were visualized for eyes with retinal pathology. RESULTS: Seven healthy eyes and seven eyes with retinal pathology (cystoid macular edema, central serous retinopathy, vitreoretinal traction, and age-related macular degeneration) were imaged. CCN and CV were successfully visualized in all eyes, whereas RNF and RCN were visualized in all healthy eyes and in 42.8% of eyes with pathologies. Various SoIs were successfully visualized in all eyes with retinal pathology. CONCLUSIONS: The proposed C-mode contour modeling may provide clinically useful images of SoIs even in eyes with severe pathologic changes in which segmentation algorithms fail.

BACKGROUND AND OBJECTIVE: A retrospective cross-sectional study was conducted to demonstrate an analysis of an outer retinal layer reconstructed by the three-dimensional and high-speed spectral domain optical coherence tomography (SD-OCT) instrument. PATIENTS AND METHODS: New measurement protocols for SD-OCT and methods of analysis and visualization of the individual segmented retinal layer reconstructed by SD-OCT were proposed. Three contour maps representing mutual distances between the basal part of the retinal pigment epithelium, the junction between the inner and outer segments of photoreceptors, and a reference contour representing the shape of a healthy retina were introduced. RESULTS: The analysis of the outer retina was performed on pathological eyes. Three cases of central serous chorioretinopathy, age-related macular degeneration, and acute zonal occult outer retinopathy are demonstrated. CONCLUSION: Three contour maps reconstructed for clinical cases demonstrate high variability of observed patterns depending on analyzed pathology. The authors believe this can help to present OCT data simultaneously in a more comprehensive and convenient way to assist in everyday clinical diagnosis.

PURPOSE: To validate velocity measurements produced by spectral domain optical coherence tomography (SD-OCT) in an in vitro laminar flow model. METHODS: A 30-mL syringe filled with skim milk was inserted into a syringe pump. Intravenous (i.v.) tubing connected the syringe within the pump to a glass capillary tube (internal diameter, 0.579 mm) shallowly embedded in agarose gel, then to a collection reservoir. SD-OCT imaging was performed with an anterior segment eye scanner and optics engine coupled with a 100-nm bandwidth broadband superluminescent diode. Scan density of 128 x 128 A-scans was spread over a 4 x 4 mm area, and each A-scan was 2 mm in length. Fifteen sequential stationary A-scans were obtained at each 128 x 128 position, and Doppler shifts were calculated from temporal changes in phase. The beam-to-flow vector Doppler angle was determined from three-dimensional scans. RESULTS: In all reflectance and Doppler images, a clear laminar flow pattern was observed, with v(max) appearing in the center of the flow column. Phase wrapping was observed at all measured flow velocities, and fringe washout progressively shattered reflectance and phase signals beyond the Nyquist limit. The observed percentages of the velocity profile at or below Nyquist frequency was highly correlated with the predicted percentages (R(2)=0.934; P=0.007). CONCLUSIONS: SD-OCT provides objective Doppler measurements of laminar fluid flow in an in vitro flow system in a range up to the Nyquist limit.

PURPOSE: To evaluate whether dexamethasone injected intracamerally at the conclusion of surgery can safely and effectively reduce postoperative inflammation and improve surgical outcomes in eyes with and without glaucoma. METHODS: Retrospective chart review of 176 consecutive eyes from 146 patients receiving uncomplicated phacoemulsification (PE) (n = 118 total, 82 with glaucoma), glaucoma drainage device (GDD) (n = 35), combined PE/GDD (n = 11) and combined PE/endoscopic cyclophotocoagulation (n = 12). Ninety-one eyes from 76 patients were injected with 0.4 mg dexamethasone intracamerally at the conclusion of surgery. All eyes received standard postoperative prednisolone and ketorolac eyedrops. Outcomes were measured for four to eight weeks by subjective complaints, visual acuity (VA), slit-lamp biomicroscopy, intraocular pressure (IOP) and postoperative complications. RESULTS: Dexamethasone significantly reduced the odds of having an increased anterior chamber (AC) cell score after PE (p = 0.0013). Mean AC cell score +/- SD in nonglaucomatous eyes was 1.3 +/- 0.8 in control and 0.8 +/- 0.7 with dexamethasone; scores in glaucomatous eyes were 1.3 +/- 0.7 in control and 0.9 +/- 0.8 with dexamethasone. Treated nonglaucomatous eyes had significantly fewer subjective complaints after PE (22.2% vs 64.7% in control; p = 0.0083). Dexamethasone had no significant effects on VA, corneal changes, IOP one day and one month after surgery, or long-term complications. CONCLUSIONS: Intracameral dexamethasone given at the end of cataract surgery significantly reduces postoperative AC cells in eyes with and without glaucoma, and improves subjective reports of recovery in nonglaucomatous eyes. There were no statistically significant risks of IOP elevation or other complications in glaucomatous eyes.