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Optics Express

Optics Express

  • Editor: C. Martijn de Sterke
  • Vol. 17, Iss. 5 — Mar. 2, 2009
  • pp: 4037–4045
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Three-dimensional high resolution OCT imaging of macular pathology

C. Ahlers and U. Schmidt-Erfurth  »View Author Affiliations


Optics Express, Vol. 17, Issue 5, pp. 4037-4045 (2009)
http://dx.doi.org/10.1364/OE.17.004037


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Abstract

Raster scanning spectral domain optical coherence tomography (SD-OCT) enables realistic three-dimensional (3D) imaging of macular disease. This approach allows the clinician to investigate the diagnostic situation in detail before and during pharmacological or surgical intervention. This study demonstrates the clinical potential of SD-OCT in chorioretinal disease. Selected datasets are presented to visualize typical morphologic findings, which are identified in more than 2700 patients. Scans are presented as online assessable 3D-models. Clinically relevant structures are visualized in macular disease and highlight the importance of precise imaging, which clearly is a clinical necessity to plan and indicate modern therapeutic strategies for our patients.

© 2009 Optical Society of America

Data sets associated with this article are available at http://hdl.handle.net/10376/1266. Links such as View 1 that appear in figure captions and elsewhere will launch custom data views if ISP software is present.

1. Introduction

Imaging of macular disease using optical coherence tomography (OCT) has changed the understanding of many retinal diseases. Since its introduction in 1991, OCT has increasingly been used mainly to identify discrete morphologic features in vitreoretinal disease [1-3

1. M. R. Hee, J. A. Izatt, E. A. Swanson, D. Huang, J. S. Schuman, C. P. Lin, C. A. Puliafito, and J. G. Fujimoto, “Optical coherence tomography of the human retina,” Arch Ophthalmol 113, 325–332 (1995). [PubMed]

].

Before that time, it was impossible to visualize discrete alterations like retinal edema in a cross section [4

4. M. R. Hee, C. A. Puliafito, C. Wong, J. S. Duker, E. Reichel, B. Rutledge, J. S. Schuman, E. A. Swanson, and J. G. Fujimoto, “Quantitative assessment of macular edema with optical coherence tomography,” Arch Ophthalmol 113, 1019–1029 (1995). [PubMed]

]. Studies evaluating the presence of retinal edema in patients with diabetes mellitus using stereo fundus photography (SFA) and angiography show a significant lack of reproducibility in these examinations [5

5. M. Shahidi, Y. Ogura, N. P. Blair, M. M. Rusin, and R. Zeimer, “Retinal thickness analysis for quantitative assessment of diabetic macular edema,” Arch Ophthalmol 109, 1115–1119 (1991). [PubMed]

, 6

6. “Classification of diabetic retinopathy from fluorescein angiograms. ETDRS report number 11. Early Treatment Diabetic Retinopathy Study Research Group,” Ophthalmology98, 807–822 (1991). [PubMed]

]. Identification of distinct morphologic features like edema however is often essential for correct treatment indications. Failures in false positive detection of edema may result in invasive and often irreversible interventions such as argon laser photocoagulation.

Implementing advances of evolving technology, OCT model 2000 (Carl Zeiss Meditec) was the first OCT used for daily patient care in many clinics [7

7. C. S. Yang, C. Y. Cheng, F. L. Lee, W. M. Hsu, and J. H. Liu, “Quantitative assessment of retinal thickness in diabetic patients with and without clinically significant macular edema using optical coherence tomography,” Acta Ophthalmol Scand 79, 266–270 (2001). [CrossRef] [PubMed]

, 8

8. A. Giovannini, G. Amato, and C. Mariotti, “The macular thickness and volume in glaucoma: an analysis in normal and glaucomatous eyes using OCT,” Acta Ophthalmol Scand Suppl 236, 34–36 (2002). [CrossRef] [PubMed]

]. This device was able to measure retinal thickness in an automated process. To acquire this information, the device interpolated retinal thickness data of six scans, which were performed in a radial pattern. Results were visualized in a modified grid according to the experience of the early treatment of diabetic retinopathy study (ETDRS).

Slow scanning speed and limited resolution were the main drawbacks in conventional OCT technology. Detailed studies have shown that errors in retinal thickness analysis strongly compromise the data of time domain OCT [16-19

16. S. R. Sadda, Z. Wu, A. C. Walsh, L. Richine, J. Dougall, R. Cortez, and L. D. LaBree, “Errors in retinal thickness measurements obtained by optical coherence tomography,” Ophthalmology 113, 285–293 (2006). [CrossRef] [PubMed]

]. Increasing evidence can be found in the literature, showing that interpolating retinal thickness data out of only six scans may be an inappropriate methodology, prone for segmentation artifacts.

Newer OCT generations utilizing spectral domain OCT (SD-OCT) technology may overcome these limitations of the time domain era, since SD-OCT allows for much higher scanning speed, better resolution and, presumably in the near future, deeper penetration and an improved delineation of the RPE [20-24

20. U. Schmidt-Erfurth, R. A. Leitgeb, S. Michels, B. Povazay, S. Sacu, B. Hermann, C. Ahlers, H. Sattmann, C. Scholda, A. F. Fercher, and W. Drexler, “Three-dimensional ultrahigh-resolution optical coherence tomography of macular diseases,” Invest Ophthalmol Vis Sci 46, 3393–3402 (2005). [CrossRef] [PubMed]

]. Retinal thickness, photoreceptor- and nerve fiber layer thickness can now be evaluated in 3D datasets allowing for a realistic localization without interpolation [25-29

25. M. E. van Velthoven, D. J. Faber, F. D. Verbraak, T. G. van Leeuwen, and M. D. de Smet, “Recent developments in optical coherence tomography for imaging the retina,” Prog Retin Eye Res 26, 57–77 (2007). [CrossRef]

]. Novel parameters like the deviation of the pigment epithelium layer, which is a critical structure for many diseases can be evaluated and quantified [30

30. C. Ahlers, C. Simader, W. Geitzenauer, G. Stock, P. Stetson, S. Dastmalchi, and U. Schmidt-Erfurth, “Automatic segmentation in three-dimensional analysis of fibrovascular pigmentepithelial detachment using high-definition optical coherence tomography,” Br J Ophthalmol 92, 197–203 (2008). [CrossRef]

]. Studies are underway investigating the clinical benefit and implications of these parameters.

However, technological parameters do not necessarily lead to advances in clinical management of patients. Therefore, there is a need to identify clinically relevant prognostic factors and critical changes in retinal microstructure able to predict a patient’s individual course under a specific, often expensive, therapy or to actually identify the anatomical reason for visual deficits in patients with macular disease, implicating that current three-dimensional (3D) OCT technology is clearly an enriching diagnostic procedure.

It is the aim of this article to demonstrate the amenities of 3D macular imaging using highresolution spectral domain OCT technology in retinal disease.

2. Methods

2.1 Patients’ inclusion

2.2 Optical coherence tomography

Three-dimensional imaging was performed using a prototype of the Cirrus high resolution OCT (Carl Zeiss Meditec). This device is a spectral domain, high-resolution optical coherence tomography system with an axial resolution of 6 µm and a scanning speed of 25000 AScans/ second. The scanning area covered 6*6 mm within the central retina. Scan depth was 2 mm. Pixel density was 200*200*1024 (number of A-scans/number of B-scans/ pixel number for 2mm of axial depth), 512*128*1024 and 4096*5*1024. All scans were selected for comparison of different scanning patterns.

Patients were scanned with the macular raster scan, before a high density scan comprising 5 scans (4096*5*1024) of the central macula was performed. The 5 Line Raster protocol includes a horizontal scan through the foveal center, with two further horizontal scans on each side. By default, each line is 6 mm in length and separated by 250 µm, so that together the five lines cover 1 mm in height. Patients were encouraged to fixate a target. Scans were repeated when imaging quality was reduced due to significant eye movement or other reasons of compromised image quality. All B-scans were checked for quality using a video function once the scanning process was completed. Patients were scanned at baseline and follow up visits if applicable.

For daily analysis, automatic segmentation and volumetric analysis were performed using previously described [30

30. C. Ahlers, C. Simader, W. Geitzenauer, G. Stock, P. Stetson, S. Dastmalchi, and U. Schmidt-Erfurth, “Automatic segmentation in three-dimensional analysis of fibrovascular pigmentepithelial detachment using high-definition optical coherence tomography,” Br J Ophthalmol 92, 197–203 (2008). [CrossRef]

], proprietary software, designed to automatically delineate retinaland RPE-layers. Carl Zeiss Meditec specially developed this software for the Cirrus SD-OCT.

2.3 Data export and visualization

Datasets comprising all B-Scans of a macular raster scan were exported from the system using bitmap file format after the datasets were corrected for motion artefacts using public domain Image J software (Version1.4d, http://rsb.info.nih.gov/ij). Only data for Interactive Science Publication (ISP) presentation was corrected for motion artefacts. 3D-models were created using current 3D-rendering software (OSA ISP version 2.0, Kitware Inc., kitware@kitware.com). This software allows for free manipulation and visualization of 3Ddatasets by the reader and is a novel approach to publish original data. Please note that arrows, belonging to a single B-scan image only, frequently mark two-dimensional data. Please scroll the dataset to find the image, matching to the landmarks (the correct image numbers are given in the comments section for each landmark).

Raw data of the acquired scans were saved in a database including patients’ personal data, diagnosis, and -if appropriate- considered treatment. For evaluation and documentation of patient data, Excel databases (Microsoft) were used.

3. Results

Case 1: Macular Pucker

This case of a 58-year-old woman’s right eye demonstrates a macular pucker with central macular edema and folds due to retinal traction. Epiretinal membranes are a relatively common disorder with a prevalence of approximately 2% in people aged 50 years and 20% in people older than 75 years of age. Slicing the dataset in the z-axis precisely shows the traction lines, which can be followed from the center to the arcades peripherally. Cysts become visible within the central edematous zone when subsequent B-scans are evaluated indicating that traction forces have already lead to significant intraretinal edema. A broader adhesion can be observed in the temporal lower part.

Fig. 1. Macular Pucker. The configuration of retinal traction and folds can be visualized in 2d and 3d images. The retinal pigment epithelium (RPE) and the external limiting membrane (ELM) are of regular shape. 3D data is available in View 1.

Case 2: Macular hole

This SD-OCT examination of a 61 years old male patient presenting with sudden onset central scotoma revealed a full-thickness macular hole. Macular holes were lately shown to have a prevalence of 0,17% in a population in south India [31

31. P Sen, A Bhargava, L Vijaya, and R George, “Prevalence of idiopathic macular hole in adult rural and urban south Indian population,” Clin Experiment Ophthalmol. 36, 257–260 (2008). [CrossRef] [PubMed]

]. A symmetric pattern of cystic spaces can be visualized surrounding the central gap. The external limiting membrane is not affected in the periphery of the lesion and can be followed until close to the center, where the macular hole results in a circular defect in the ELM. Even though the defect in the ELM is clearly circumscribed it is significantly larger than the defect in the tissue itself. 3D datasets allow measuring and visualization of this defect with previously unknown accuracy. Most interestingly, cysts can only be found below the level of the inner nuclear layer in this patient. An operculum can be visualized above the inner surface of the macular hole. The precise morphologic configuration of the hole can be displayed three-dimensionally and shows a biconcave structure with its thinnest diameter at the anatomical level of the outer plexiform layer.

Fig. 2. Macular hole. Details are visualized in View 2. Figure 2a shows the 3D-image, whereas 2b shows the symmetric arrangement of cysts around the macular hole. 3c nicely shows the operculum attached to the vitreus and the central gap in the intraretinal structure. High resolution of SD-OCT imaging allows visualizing discrete features like the external limiting membrane (ELM).

Case 3: Age-related macular degeneration (AMDI)

Fig. 3. This figure shows a large detachment of the retinal pigment epithelium (PED). The basis of this PED is of irregular shape (View 3). Zones of significant pigment epithelial atrophy can be observed in View 4.

Case 4: Age-related macular degeneration (AMDII)

This case of neovascular AMD shows less detachment to the pigment epithelium and less atrophic zones indicating less severe damage to the retina. However, typical alterations can be found in this example, too. A broad hyperreflective signal at the level of the outer plexiform/outer nuclear layer is clearly present and typical for close presence of subretinal fluid. Diffuse hyperreflectivity of the outer photoreceptor elements can also be observed near subretinal fluid and indicate stress on one of the critical structures of the photoreceptor.

Fig. 4. This figure demonstrates the typical intraretinal changes in neovascular age-related macular degeneration (nAMD). Subretinal fluid (SRF) has been proven to be a relevant marker for prognosis of nAMD disease and can be observed in distinct locations. 3D-data is available in View 5.

4. Discussion

This manuscript presents complete and full functioning 3D-SD-OCT datasets to demonstrate the potential of current SD-OCT technology to enhance our pathophysiologic understanding of macular disease. Features like subretinal fluid which are known to have prognostic impact on functional outcome can clearly be identified in the data [32

32. C. Ahlers, I. Golbaz, G. Stock, A. Fous, S. Kolar, C. Pruente, and U. Schmidt-Erfurth, “Time course of morphologic effects on different retinal compartments after ranibizumab therapy in age-related macular degeneration,” Ophthalmology 115, e39–46 (2008). [CrossRef] [PubMed]

].

Diseases of the vitreoretinal interface like macular pucker could be visualized with great morphologic precision. Retinal folds were identified and showed a distinct traction orientation, which might be important for the surgical approach and the peeling process. Moreover, photoreceptor damage can be evaluated in detail allowing the vitreoretinal surgeon to analyze the severity of the disease on an objective anatomical basis All location mapping of the retinal surface prevents to overlook small macular holes in pericentral localization, which could easily be missed using the former macular mapping mode comprising only six radial scans to represent the entire macular region [33

33. J. Michalewski, Z. Michalewska, S. Cisiecki, and J. Nawrocki, “Morphologically functional correlations of macular pathology connected with epiretinal membrane formation in spectral optical coherence tomography (SOCT),” Graefes Arch Clin Exp Ophthalmol 245, 1623–1631 (2007). [CrossRef] [PubMed]

].

In exudative central retinal disease like central serous chorioretinopathy, precise SD-OCT imaging helped to identify pathophysiologic findings like PED which appear to be much more frequent than suggested in the pre-OCT or even time-domain OCT era [22

22. Y. Ojima, M. Hangai, M. Sasahara, N. Gotoh, R. Inoue, Y. Yasuno, S. Makita, T. Yatagai, A. Tsujikawa, and N. Yoshimura, “Three-dimensional imaging of the foveal photoreceptor layer in central serous chorioretinopathy using high-speed optical coherence tomography,” Ophthalmology 114, 2197–2207 (2007). [CrossRef] [PubMed]

]. Such distinct morphologic features could be identified and helped to better classify and understand the underlying disease process.

Meanwhile, alternative imaging techniques combining advantages of a scanning laser ophthalmoscope with angiography, measurements of fundus autofluorescence and current SDOCT technology have also become available and have contributed to a better understanding of macular disease [35

35. UE Wolf-Schnurrbusch, V Enzmann, CK Brinkmann, and S Wolf “Morphologic changes in patients with geographic atrophy assessed with a novel spectral OCT-SLO combination” Invest Ophthalmol Vis Sci. 49, 3095–3099 (2008). Epub 2008 Mar 31. [CrossRef] [PubMed]

, 36

36. M Fleckenstein, P Charbel Issa, HM Helb, S Schmitz-Valckenberg, RP Finger, HP Scholl, KU Loeffler, and FG Holz. “High-resolution spectral domain-OCT imaging in geographic atrophy associated with age-related macular degeneration” Invest Ophthalmol Vis Sci. 49, 4137–4144 (2008). Epub 2008 May 16. [CrossRef] [PubMed]

].

5. Conclusions

In conclusion, precise 3D retinal imaging in modern SD-OCT technology was shown to optimize correct diagnosis recently. Further developments of this evolving technology will consequently lead to optimized therapeutic strategies such as minimally invasive, targetorientated and thereby cost-efficient treatment options for patients with macular pathology.

Acknowledgements

The authors gratefully acknowledge Dres. Christopher Schütze, Isabelle Golbaz, Wolfgang Geitzenauer and Prof. Christoph Hitzenberger for supporting this project.

References and links

1.

M. R. Hee, J. A. Izatt, E. A. Swanson, D. Huang, J. S. Schuman, C. P. Lin, C. A. Puliafito, and J. G. Fujimoto, “Optical coherence tomography of the human retina,” Arch Ophthalmol 113, 325–332 (1995). [PubMed]

2.

C. A. Puliafito, M. R. Hee, C. P. Lin, E. Reichel, J. S. Schuman, J. S. Duker, J. A. Izatt, E. A. Swanson, and J. G. Fujimoto, “Imaging of macular diseases with optical coherence tomography,” Ophthalmology 102, 217–229 (1995). [PubMed]

3.

D. Huang, E. A. Swanson, C. P. Lin, J. S. Schuman, W. G. Stinson, W. Chang, M. R. Hee, T. Flotte, K. Gregory, and C. A. Puliafito, and et al., “Optical coherence tomography,” Science 254, 1178–1181 (1991). [CrossRef] [PubMed]

4.

M. R. Hee, C. A. Puliafito, C. Wong, J. S. Duker, E. Reichel, B. Rutledge, J. S. Schuman, E. A. Swanson, and J. G. Fujimoto, “Quantitative assessment of macular edema with optical coherence tomography,” Arch Ophthalmol 113, 1019–1029 (1995). [PubMed]

5.

M. Shahidi, Y. Ogura, N. P. Blair, M. M. Rusin, and R. Zeimer, “Retinal thickness analysis for quantitative assessment of diabetic macular edema,” Arch Ophthalmol 109, 1115–1119 (1991). [PubMed]

6.

“Classification of diabetic retinopathy from fluorescein angiograms. ETDRS report number 11. Early Treatment Diabetic Retinopathy Study Research Group,” Ophthalmology98, 807–822 (1991). [PubMed]

7.

C. S. Yang, C. Y. Cheng, F. L. Lee, W. M. Hsu, and J. H. Liu, “Quantitative assessment of retinal thickness in diabetic patients with and without clinically significant macular edema using optical coherence tomography,” Acta Ophthalmol Scand 79, 266–270 (2001). [CrossRef] [PubMed]

8.

A. Giovannini, G. Amato, and C. Mariotti, “The macular thickness and volume in glaucoma: an analysis in normal and glaucomatous eyes using OCT,” Acta Ophthalmol Scand Suppl 236, 34–36 (2002). [CrossRef] [PubMed]

9.

A. Polito, S. M. Shah, J. A. Haller, I. Zimmer-Galler, R. Zeimer, P. A. Campochiaro, and S. Vitale, “Comparison between retinal thickness analyzer and optical coherence tomography for assessment of foveal thickness in eyes with macular disease,” Am J Ophthalmol 134, 240–251 (2002). [CrossRef] [PubMed]

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D. M. Brown, P. K. Kaiser, M. Michels, G. Soubrane, J. S. Heier, R. Y. Kim, J. P. Sy, and S. Schneider, “Ranibizumab versus verteporfin for neovascular age-related macular degeneration,” N Engl J Med 355, 1432–1444 (2006). [CrossRef] [PubMed]

12.

P. J. Rosenfeld, D. M. Brown, J. S. Heier, D. S. Boyer, P. K. Kaiser, C. Y. Chung, and R. Y. Kim, “Ranibizumab for neovascular age-related macular degeneration,” N Engl J Med 355, 1419–1431 (2006). [CrossRef] [PubMed]

13.

U. M. Schmidt-Erfurth and C. Pruente, “Management of neovascular age-related macular degeneration,” Prog Retin Eye Res 26, 437–451 (2007). [CrossRef] [PubMed]

14.

U. M. Schmidt-Erfurth, G. Richard, A. Augustin, W. G. Aylward, F. Bandello, B. Corcostegui, J. Cunha-Vaz, A. Gaudric, A. Leys, and R. O. Schlingemann, “Guidance for the treatment of neovascular age-related macular degeneration,” Acta Ophthalmol Scand 85, 486–494 (2007). [CrossRef] [PubMed]

15.

A. E. Fung, G. A. Lalwani, P. J. Rosenfeld, S. R. Dubovy, S. Michels, W. J. Feuer, C. A. Puliafito, J. L. Davis, H. W. Flynn, Jr., and M. Esquiabro, “An optical coherence tomography-guided, variable dosing regimen with intravitreal ranibizumab (Lucentis) for neovascular age-related macular degeneration,” Am J Ophthalmol 143, 566–583 (2007). [CrossRef] [PubMed]

16.

S. R. Sadda, Z. Wu, A. C. Walsh, L. Richine, J. Dougall, R. Cortez, and L. D. LaBree, “Errors in retinal thickness measurements obtained by optical coherence tomography,” Ophthalmology 113, 285–293 (2006). [CrossRef] [PubMed]

17.

P. J. Patel, F. K. Chen, F. Ikeji, W. Xing, C. Bunce, L. Da Cruz, and A. Tufail, “Repeatability of stratus optical coherence tomography measures in neovascular age-related macular degeneration,” Invest Ophthalmol Vis Sci 49, 1084–1088 (2008). [CrossRef] [PubMed]

18.

G. M. Somfai, H. M. Salinas, C. A. Puliafito, and D. C. Fernandez, “Evaluation of potential image acquisition pitfalls during optical coherence tomography and their influence on retinal image segmentation,” J Biomed Opt 12, 041209 (2007). [CrossRef] [PubMed]

19.

P. J. Patel, F. K. Chen, L. da Cruz, and A. Tufail, “Segmentation Error in Stratus Optical Coherence Tomography for Neovascular Age-related Macular Degeneration,” Invest Ophthalmol Vis Sci. 50, 399–404 (2008). [CrossRef] [PubMed]

20.

U. Schmidt-Erfurth, R. A. Leitgeb, S. Michels, B. Povazay, S. Sacu, B. Hermann, C. Ahlers, H. Sattmann, C. Scholda, A. F. Fercher, and W. Drexler, “Three-dimensional ultrahigh-resolution optical coherence tomography of macular diseases,” Invest Ophthalmol Vis Sci 46, 3393–3402 (2005). [CrossRef] [PubMed]

21.

T. H. Ko, J. G. Fujimoto, J. S. Schuman, L. A. Paunescu, A. M. Kowalevicz, I. Hartl, W. Drexler, G. Wollstein, H. Ishikawa, and J. S. Duker, “Comparison of ultrahigh- and standard-resolution optical coherence tomography for imaging macular pathology,” Ophthalmology 112, 1922 e1921–1915 (2005). [CrossRef]

22.

Y. Ojima, M. Hangai, M. Sasahara, N. Gotoh, R. Inoue, Y. Yasuno, S. Makita, T. Yatagai, A. Tsujikawa, and N. Yoshimura, “Three-dimensional imaging of the foveal photoreceptor layer in central serous chorioretinopathy using high-speed optical coherence tomography,” Ophthalmology 114, 2197–2207 (2007). [CrossRef] [PubMed]

23.

C. G. Pieroni, A. J. Witkin, T. H. Ko, J. G. Fujimoto, A. Chan, J. S. Schuman, H. Ishikawa, E. Reichel, and J. S. Duker, “Ultrahigh resolution optical coherence tomography in non-exudative age related macular degeneration,” Br J Ophthalmol 90, 191–197 (2006). [CrossRef] [PubMed]

24.

V. J. Srinivasan, M. Wojtkowski, A. J. Witkin, J. S. Duker, T. H. Ko, M. Carvalho, J. S. Schuman, A. Kowalczyk, and J. G. Fujimoto, “High-definition and 3-dimensional imaging of macular pathologies with high-speed ultrahigh-resolution optical coherence tomography,” Ophthalmology 113, 2054 e2051–2014 (2006). [CrossRef]

25.

M. E. van Velthoven, D. J. Faber, F. D. Verbraak, T. G. van Leeuwen, and M. D. de Smet, “Recent developments in optical coherence tomography for imaging the retina,” Prog Retin Eye Res 26, 57–77 (2007). [CrossRef]

26.

M. L. Gabriele, H. Ishikawa, G. Wollstein, R. A. Bilonick, L. Kagemann, M. Wojtkowski, V. J. Srinivasan, J. G. Fujimoto, J. S. Duker, and J. S. Schuman, “Peripapillary nerve fiber layer thickness profile determined with high speed, ultrahigh resolution optical coherence tomography high-density scanning,” Invest Ophthalmol Vis Sci 48, 3154–3160 (2007). [CrossRef] [PubMed]

27.

W. Drexler and J. G. Fujimoto, “State-of-the-art retinal optical coherence tomography,” Prog Retin Eye Res 27, 45–88 (2008). [CrossRef]

28.

V. J. Srinivasan, T. H. Ko, M. Wojtkowski, M. Carvalho, A. Clermont, S. E. Bursell, Q. H. Song, J. Lem, J. S. Duker, J. S. Schuman, and J. G. Fujimoto, “Noninvasive volumetric imaging and morphometry of the rodent retina with high-speed, ultrahigh-resolution optical coherence tomography,” Invest Ophthalmol Vis Sci 47, 5522–5528 (2006). [CrossRef] [PubMed]

29.

M. Wojtkowski, V. Srinivasan, J. G. Fujimoto, T. Ko, J. S. Schuman, A. Kowalczyk, and J. S. Duker, “Three-dimensional retinal imaging with high-speed ultrahigh-resolution optical coherence tomography,” Ophthalmology 112, 1734–1746 (2005). [CrossRef] [PubMed]

30.

C. Ahlers, C. Simader, W. Geitzenauer, G. Stock, P. Stetson, S. Dastmalchi, and U. Schmidt-Erfurth, “Automatic segmentation in three-dimensional analysis of fibrovascular pigmentepithelial detachment using high-definition optical coherence tomography,” Br J Ophthalmol 92, 197–203 (2008). [CrossRef]

31.

P Sen, A Bhargava, L Vijaya, and R George, “Prevalence of idiopathic macular hole in adult rural and urban south Indian population,” Clin Experiment Ophthalmol. 36, 257–260 (2008). [CrossRef] [PubMed]

32.

C. Ahlers, I. Golbaz, G. Stock, A. Fous, S. Kolar, C. Pruente, and U. Schmidt-Erfurth, “Time course of morphologic effects on different retinal compartments after ranibizumab therapy in age-related macular degeneration,” Ophthalmology 115, e39–46 (2008). [CrossRef] [PubMed]

33.

J. Michalewski, Z. Michalewska, S. Cisiecki, and J. Nawrocki, “Morphologically functional correlations of macular pathology connected with epiretinal membrane formation in spectral optical coherence tomography (SOCT),” Graefes Arch Clin Exp Ophthalmol 245, 1623–1631 (2007). [CrossRef] [PubMed]

34.

N. Villate, J. E. Lee, A. Venkatraman, and W. E. Smiddy, “Photoreceptor layer features in eyes with closed macular holes: optical coherence tomography findings and correlation with visual outcomes,” Am J Ophthalmol 139, 280–289 (2005). [CrossRef] [PubMed]

35.

UE Wolf-Schnurrbusch, V Enzmann, CK Brinkmann, and S Wolf “Morphologic changes in patients with geographic atrophy assessed with a novel spectral OCT-SLO combination” Invest Ophthalmol Vis Sci. 49, 3095–3099 (2008). Epub 2008 Mar 31. [CrossRef] [PubMed]

36.

M Fleckenstein, P Charbel Issa, HM Helb, S Schmitz-Valckenberg, RP Finger, HP Scholl, KU Loeffler, and FG Holz. “High-resolution spectral domain-OCT imaging in geographic atrophy associated with age-related macular degeneration” Invest Ophthalmol Vis Sci. 49, 4137–4144 (2008). Epub 2008 May 16. [CrossRef] [PubMed]

OCIS Codes
(030.1670) Coherence and statistical optics : Coherent optical effects
(170.1610) Medical optics and biotechnology : Clinical applications

ToC Category:
OCT in Retinal Disease

History
Original Manuscript: November 10, 2008
Revised Manuscript: January 29, 2009
Manuscript Accepted: February 19, 2009
Published: March 2, 2009

Virtual Issues
Vol. 4, Iss. 5 Virtual Journal for Biomedical Optics
Interactive Science Publishing Focus Issue: Optical Coherence Tomography (OCT) (2009) Optics Express

Citation
C. Ahlers and U. Schmidt-Erfurth, "Three-dimensional high resolution OCT imaging of macular pathology," Opt. Express 17, 4037-4045 (2009)
http://www.opticsinfobase.org/oe/abstract.cfm?URI=oe-17-5-4037


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References

  1. M. R. Hee, J. A. Izatt, E. A. Swanson, D. Huang, J. S. Schuman, C. P. Lin, C. A. Puliafito, and J. G. Fujimoto, "Optical coherence tomography of the human retina," Arch Ophthalmol 113,325-332 (1995). [PubMed]
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