Optical coherence tomography: its clinical use for the diagnosis, pathogenesis, and management of macular conditions

Optical coherence tomography (OCT) is a noninvasive, noncontact transpupillary imaging technology that can image retinal structures in vive with a resolution of up to 10 microns. Anatomic layers within the retina can be differentiated and retinal thickness measured. The objective is to demonstrate clinical viability and useful interpretation of macular images derived from a commercially available OCT instrument.

A Stratus OCT (Zeiss-Humphrey, Dublin, California) imaging system was used to evaluate several pathological presentations of the macula in selected patients. Conditions illustrated in this case series were macular holes, epiretinal membranes, macular edema, idiopathic central serous choroidopathy, detachments of pigment epithelium and sensory retina, choroidal neovascular membranes, and retinal vascular occlusions.

Acquired OCT images achieved structural information regarding anatomical characteristics of the conditions scanned. A cross-sectional resolution of 10 microns was accomplished, which is 10 times greater than current ultrasound. OCT provides important information that may be critical in the diagnosis and management of some ocular conditions. Its high-resolution scans may contribute to the better understanding of disease pathogenesis, as well as assistance in or confirmation of a diagnosis. This imaging technology provides important information beyond what can be seen on clinical examination, and offers a useful adjunct to other diagnostic imaging tools such as fundus photography, fluorescein angiography, and indocyanine green angiography.