Improvements in imaging, corneal biomechanics take center stage

December 1, 2014

Retina surgeons look forward to the future potential that optical coherence tomography holds for the clinical setting.

 

Take home

Retina surgeons look forward to the future potential that optical coherence tomography holds for the clinical setting.

 

By Lynda Charters; Reviewed by Michael S. Ip, MD, and Pravin U. Dugel, MD

Advances in optical coherence tomography (OCT) are among the most noted clinical diagnostic technology cited during 2014.

“The abilities of optical coherence tomography (OCT) technology have become much more well defined and better able to visualize the different retinal layers,” said Pravin U. Dugel, MD.

“We have progressed from time-domain OCT to spectral-domain OCT,” said Dr. Dugel, managing partner, Retinal Consultants of Arizona, Phoenix and clinical professor of ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles. “The current iteration is swept-source OCT, which will provide more structural definition in the images.”

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The next step for the technology has already been taken in that OCT can look at retinal blood flow.

“If we can capture blood flow, we will be able to simulate fluorescein angiography on the OCT,” he explained.

Swept-source OCT is not yet FDA-approved for clinical use in the United States, but it is anticipated to provide higher-quality images with visualization of new structures and details not previously available compared with the last generation of OCT technology, noted Michael Ip, MD, associate professor, Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison.

He looks forward to incorporating it into his clinical practice. Dr. Ip also believes that OCT angiography has the potential to be a revolutionary technology. Although, it may not yet allow for assessment to vascular leakage, the ability to non-invasively assess retinal vasculature could be very important in the clinical setting.

 

The potential to use OCT intraoperatively is very exciting for retina surgeons.

“Bioptigen Inc. recently unveiled its unit, Envisu IntraSurgical OCT, that provides real-time imaging of structures from the cornea to the retina during ophthalmic surgeries. This is a very interesting advance in diagnostic technology that will allow improved visualization of epiretinal membranes (ERMs), abnormalities in the interface, and macular holes, and help surgeons to better delaminate ERMs during vitreoretinal surgery,” Dr. Ip explained.

The first clinical evaluations were performed using the Bioptigen unit at Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, during Descemet’s stripping automated endothelial keratoplasty and deep anterior lamellar keratoplasty.

Dr. Dugel foresees multi-spectral imaging in which different wavelengths of light are used to optically dissect different areas of tissue.

“This technology is currently under development,” Dr. Dugel said.

 

Pravin U. Dugel, MD

E: pdugel@gmail.com

Dr. Dugel is a consultant to Alcon Laboratories, Novartis, Acucela, Allergan, Alimera, and Genentech and is a consultant to and a minor shareholder in Ophthotech and Aerpio.

 

Michael S. Ip, MD

E: msip@wisc.edu

Dr. Ip has no financial interest in any aspect of this report.