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SD-OCT offers advantages of speed, resolution, sensitivity in imaging dry AMD
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LAS VEGAS — Optical coherence tomography is the future of imaging for dry age-related macular degeneration, one speaker said here.
“The interest in OCT being used for this purpose has been spurred by the widespread availability of SD-OCT instruments that feature advantages in resolution, sensitivity and speed,” SriniVas Sadda, MD, said at the Optical Coherence Tomography and Imaging Panel Experts Review.
SriniVas Sadda
Faster scanning of spectral domain optical coherence tomography (SD-OCT) permits acquisition of dense volume scans of the macula, which enables the quantification of drusen, he said. Furthermore, faster scanning allows frame averaging, which reduces noise artifact, an otherwise major artifact in OCT imaging that produces black spots in areas that should be bright.
Outer retinal substructures, including retinal pigment epithelium, Bruch’s membrane, choriocapillaris and choroid, photoreceptor inner and outer segments, outer nuclear layer and drusen, are more easily seen with SD-OCT, according to Sadda.
Further uses for and advantages of the technology are being explored, including characterizing the internal properties of drusen and identifying pigment migration and early evidence of fibrovascular infiltration, possibly more sensitively than fluorescein angiography does, Sadda said.
“You can use this information to automatically characterize your areas of [retinal pigment epithelium] elevation … to risk stratify [pigment epithelial detachments] and essentially detect early choroidal vascularization or high risk for choroidal vascularization,” Sadda said.
Quantifying drusen burden is also being explored using OCT to segment the retinal pigment epithelium surface and to map volume and area of drusen in three-dimensional relief.
“This is a better descriptor of drusen burden when you talk about volume as opposed to area,” Sadda said. With drusen analysis software, drusen volume can be tracked over time, he said.
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Disclosure: Sadda is a consultant for Heidelberg Engineering and has received research grants from Carl Zeiss Meditec, Optovue and Optos. He previously received royalties from Topcon Medical Systems (licensed to Doheny Eye Institute).