Faculty Bibliography

PURPOSE: Optic nerve head (ONH) structural imaging with state-of-the-art, high-speed, ultra-high-resolution optical coherence tomography (hsUHR-OCT). DESIGN: Observational cohort study. METHODS: ONH centered 3-dimensional (94,371,840 voxel measurements in a 6- x 6- x 1.4-mm tissue volume) hsUHR-OCT data were obtained in one eye from each of six males and nine females normal healthy volunteers (40 +/- 9 years of age). The presence of structures projecting anteriorly from the disk into the vitreous was noted. RESULTS: Structures were noted in 14 of 15 (93%) examined eyes, emanating from the rim of the ONH at the nasal inferior sector, presenting as thin tissue meandering into the vitreous. CONCLUSIONS: Previous technologies provided limited visualization of ONH structures. The ability to scan the entire disk using 3-dimensional OCT (3D-OCT) in a high-density raster pattern reveals a high frequency of persistence of Cloquet's canal in the normal healthy eye.

PURPOSE: To determine the effect of corneal drying on the outcome of optical coherence tomography (OCT). DESIGN: Cohort study. PARTICIPANTS: Seventeen normal participants (mean age, 39+/-12 years). METHODS: Subjects underwent a series of peripapillary circular StratusOCT scans (version 3.0; Carl Zeiss Meditec, Inc., Dublin, CA) in a randomly selected eye. Baseline scan sets were acquired, and thereafter, blinking was prevented by taping the eyelid. Eyelid taping was immediately followed by 6 to 8 serial scan sets, each separated by 20 seconds. After removing the eyelid tape, 3 additional scans were acquired at 1, 2, and 4 minutes of blinking freely. MAIN OUTCOME MEASURES: The analyzed outcome measures were scan quality as defined by signal-to-noise ratio (SNR) and signal strength (SS) provided by the built-in OCT software and mean nerve fiber layer (NFL) thickness. RESULTS: Significant reductions in SNR, SS, and NFL were noted at each scanning point in the drying phase (for each, P<0.015, paired t test) except for NFL thickness measurements acquired at 140 and 160 seconds. The reduction in NFL thickness exceeded the 95% confidence limit of the reported reproducibility error of StratusOCT after 15 seconds of corneal drying. After 1 and 2 minutes of blinking freely, there was still a significant reduction in NFL thickness compared with the baseline value, which was no longer evident at the 4-minute scan. CONCLUSIONS: Corneal dryness affects OCT scan quality and measured NFL thickness after a short exposure time. It is recommended to instruct those who are scanned to blink frequently or to instill artificial tears.

PURPOSE: To develop an eye-motion-tracking optical coherence tomographic (OCT) method and assess its effect on image registration and nerve fiber layer (NFL) thickness measurement reproducibility. METHODS: A system capable of tracking common fundus features based on reflectance changes was integrated into a commercial OCT unit (OCT II; Carl Zeiss Meditec, Inc., Dublin, CA) and tested on healthy subjects and patients with glaucoma. Twenty successive peripapillary NFL scans were obtained with tracking and 20 without tracking, for 40 images in each session for each eye. Subjects participated in one session on three different days. Composite OCT scans and composite fundus images were generated for assessment of eye tracking. NFL thickness measurement reproducibility was also assessed. RESULTS: Seven healthy and nine glaucomatous eyes of 16 subjects were recruited. A qualitative assessment of composite OCT scans and composite fundus images showed little motion artifact or blurring along edges and blood vessels during tracking; however, those structures were less clearly defined when tracking was disengaged. There was no significant reproducibility difference with and without tracking in both intra- and intersession NFL measurement SD calculations in any location. The mean retinal pixel SD was significantly smaller with tracking than without (490.9 +/- 19.3 microm vs. 506.4 +/- 31.8 microm, P = 0.005, paired t-test). CONCLUSIONS: A retinal-tracking system was successfully developed and integrated into a commercial OCT unit. Tracking OCT improved the consistency of scan registration, but did not influence NFL thickness measurement reproducibility in this small sample study.

An upgraded optical coherence tomography system with integrated retinal tracker (TOCT) was developed. The upgraded system uses improved components to extend the tracking bandwidth, fully integrates the tracking hardware into the optical head of the clinical OCT system, and operates from a single software platform. The system was able to achieve transverse scan registration with sub-pixel accuracy (~10 microm). We demonstrate several advanced scan sequences with the TOCT, including composite scans averaged (co-added) from multiple B-scans taken consecutively and several hours apart, en face images collected by summing the A-scans of circular, line, and raster scans, and three-dimensional (3D) retinal maps of the fovea and optic disc. The new system achieves highly accurate OCT scan registration yielding composite images with significantly improved spatial resolution, increased signal-to-noise ratio, and reduced speckle while maintaining well-defined boundaries and sharp fine structure compared to single scans. Precise re-registration of multiple scans over separate imaging sessions demonstrates TOCT utility for longitudinal studies. En face images and 3D data cubes generated from these data reveal high fidelity image registration with tracking, despite scan durations of more than one minute.