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Insights on Acute and Chronic Lacquer Cracks as Imaged with Visible Light OCT
Galen Hu1, Rouyu Meng2, Vivek Srinivasan1,2,3
1Department of Ophthalmology, New York University Grossman School of Medicine, New York, New York.
Purpose:
We aim to study a case of pathologic myopia with visible light OCT.
Design:
Case report.
Subjects:
We recruit 1 patient with pathologic myopia presenting with an acute lacquer crack with submacular hemorrhage (SMH) in the right eye and a chronic lacquer crack in the left eye.
Methods:
We acquire visible light OCT images with 1 μm axial resolution. Images are processed to depict spectral centroid shift, and spectral fitting is performed to determine oxygen saturation. Results are compared to clinical imaging.
Main Outcome Measures:
Visible light OCT images, spectral centroid shift (redshift), oximetry, and spectral fitting.
Results:
Departures from the moderate retinal pigment epithelium (RPE) redshift, characteristic of a healthy macula, were observed. In the acute phase, we observe a further RPE redshift correlating with SMH. Spectra were mostly consistent with oxyhemoglobin. In the chronic lacquer crack, we demonstrated focal Bruch's membrane (BM) changes in vivo with spectral evidence of an overlying RPE deficit (deficient red shift) and photoreceptor abnormalities.
Conclusions:
As visible light OCT technology advances, its application toward well-characterized human retinal pathology can clarify its utility. We describe the first case of visible light OCT applied to pathologic myopia, a primary RPE-BM-choriocapillaris interface disease. We confirm that extravascular hemoglobin can be subject to spectral fitting, and we quantify the oxygen saturation of acute SMH. We further show that structural changes in chronic lacquer cracks can be characterized with this new technology.
Financial Disclosures:
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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