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Ultra-high resolution OCT yields more answers for RFNL, macula

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MAUI, Hawaii — Ultrahigh-resolution optical coherence tomography represents “a very new technology that can improve the resolution and discriminate the clean layer to the retina by fivefold,” said a physician here at Hawaii 2003: the Royal Hawaiian Eye Meeting.

Ultrahigh-resolution optical coherence tomography (OCT) is a technology that allows high-resolution cross-sectional optical imaging of ocular structures. It is a noncontact, noninvasive technique that utilizes short-wavelength coherent light to achieve improved resolution.

According to Joel S. Schuman, MD, although the technology is now in the laboratory stage and is not commercially available, ultrahigh-resolution OCT will allow better evaluation of retinal anatomy and pathology in vivo.

Although ultrahigh-resolution OCT is not close to commercialization, Dr. Schuman said, there has been an update of OCT technology recently. The currently available OCT 3, also called Stratus OCT, from Carl Zeiss Meditec, is an advancement over earlier versions of OCT because of its ability to achieve higher resolution, he said.

“The OCT 1 and OCT 2 have axial resolution of approximately 10 to 15 µm, but the OCT 3 has resolution of 8 to 10 µm," he said.

“The ultra-high resolution optical coherence tomography is a exciting technique because practitioners have the capability to better view details,” Dr. Schuman said. Although he said optical coherence tomography is in the early stages of development and unlikely to become commercially available in the near future, Dr. Schuman said it will represent a further improvement in resolution of 2 to 3 µm.

Higher longitudinal resolution can enable increased sensitivity and specificity of retinal and retinal nerve fiber layer thickness measurements for early diagnosis of retinal disease, he said. For glaucoma, circular scans around the optic nerve head and linear scans across the optic nerve head have proven to be most valuable, he said.

“The detail with the ultrahigh-resolution OCT allows ophthalmologists to actually see the photoreceptors and the possible abnormalities for each patient,” he said. “This is the first time that we’ve been able to accomplish such detail.”