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Only time will tell for OCT and clinical utility

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Jay S. Duker

KAANAPALI, Hawaii — As optical coherence tomography continues to evolve, it is not yet clear whether benefits of the newest prototypes will balance the costs of making such technology commercially available, according to a presenter here.

Jay S. Duker, MD, discussed the latest breakthroughs in OCT technology at the Retina 2011 meeting.

The newest versions of OCT fall under the category of Fourier-domain detection: spectral-domain OCT (SD-OCT) and swept source OCT (SS-OCT). However, SS-OCT is currently only being tested for research purposes, Dr. Duker said.

The scan quality of SD-OCT is much higher than previously available versions, according to Dr. Duker. The fastest machine clinically available can produce 52,000 A-scans per second, with resolutions between 4 µm and 7 µm.

Advantages of the SD-OCT include precise point-to-point registration, although this is less important for retina specialists because of the types of diseases currently being treated, according to Dr. Duker.

Other advantages include 3-D imaging and the elimination of motion artifacts due to speed of acquisition.

One disadvantage of SD-OCT is the large data set it produces, Dr. Duker said.

Additionally, the SD-OCT devices are expensive, and there is no algorithm for comparing data between newer and older devices.

Dr. Duker said he expects that spectral-domain machines will be faster and better in the future.

"You're going to see companies apply this faster speed associated with new software innovations to allow you to Doppler blood flow, perhaps look at cones in a mosaic and eliminate the need for tracking with a mechanical device," he said. "But if the prototypes do not help us clinically, it is not going to be worth it for commercially available companies to develop the technology. Only time will tell."

• Disclosure: Jay S. Duker, MD, receives research support from Carl Zeiss Meditec, Optovue and TopCon.

Hawaiian Eye and Retina 2012 will be held January 15-20 at the Grand Wailea Resort & Spa in Maui. Learn more at OSNHawaiianEye.com or RetinaMeeting.com.