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Combined imaging techniques aid identification of occult retinal disease
Invest Ophthalmol Vis Sci. 2009;50(2):851-860.
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Functional and anatomic studies using combined imaging techniques offered thorough analyses of various retinal pathologies.
The study included 30 eyes scanned for classic and occult neovascular membranes, vascularized retinal pigmented epithelium, polypoidal choroidal vasculopathy, traumatic choroidal rupture, diabetic maculopathy, central serous retinopathy and macular drusen.
Investigators used combined coronal optical coherence tomography, confocal scanning laser ophthalmoscopy and indocyanine green (ICG) dye angiography. They aimed to identify unique relationships between morphology and function.
Study results showed that simultaneous and superimposed visualization of a coronal OCT image and an ICG angiogram allowed accurate analysis of the retinal surface and retina-choroid interface. The combined imaging techniques enabled multiplanar analysis of retinal pathology.
“Incorporation of OCT structural imaging onto ICG angiography provides an anatomic frame of reference for late (ICG) leaks and reveals the flow characteristics of specific anatomic features,” the study authors said. “In summary, the value of combined OCT/ICG imaging appears best suited to the management of occult disease.”
This study examined 30 eyes of 30 patients using a unique prototype imaging system consisting of confocal [scanning laser ophthalmoscopy], OCT, along with ICG angiography, with the capability of displaying all three modalities simultaneously. The study eyes exhibited a variety of exudative macular pathology. By simultaneously imaging macular pathology with both B scans and coronal C scans with three different “channels,” additional structural information may be obtained. As a research device, this prototype shows considerable potential. Given that, currently, most exudative macular disease is treated diffusely with intravitreal injections, as opposed to focally, it is not clear that clinical applications for patient care now exist.
– Jay S. Duker, MD
OSN Retina/Vitreous Board Member