Enhanced vitreous imaging in healthy eyes using swept source optical coherence tomography.

Jonathan J Liu,Jay S Duker,Ireneusz Grulkowski,Andre J Witkin,Chen D Lu,Martin F Kraus,Joachim Hornegger,Mehreen Adhi,James G Fujimoto,Al-Hafeez Dhalla

doi:10.1371/journal.pone.0102950

Jonathan J Liu, Jay S Duker + Show 8 more

Open Access

https://doi.org/10.1371/journal.pone.0102950

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Abstract

PurposeTo describe enhanced vitreous imaging for visualization of anatomic features and microstructures within the posterior vitreous and vitreoretinal interface in healthy eyes using swept-source optical coherence tomography (SS-OCT). The study hypothesis was that long-wavelength, high-speed, volumetric SS-OCT with software registration motion correction and vitreous window display or high-dynamic-range (HDR) display improves detection sensitivity of posterior vitreous and vitreoretinal features compared to standard OCT logarithmic scale display.DesignObservational prospective cross-sectional study.MethodsMultiple wide-field three-dimensional SS-OCT scans (500×500A-scans over 12×12 mm2) were obtained using a prototype instrument in 22 eyes of 22 healthy volunteers. A registration motion-correction algorithm was applied to compensate motion and generate a single volumetric dataset. Each volumetric dataset was displayed in three forms: (1) standard logarithmic scale display, enhanced vitreous imaging using (2) vitreous window display and (3) HDR display. Each dataset was reviewed independently by three readers to identify features of the posterior vitreous and vitreoretinal interface. Detection sensitivities for these features were measured for each display method.ResultsFeatures observed included the bursa premacularis (BPM), area of Martegiani, Cloquet's/BPM septum, Bergmeister papilla, posterior cortical vitreous (hyaloid) detachment, papillomacular hyaloid detachment, hyaloid attachment to retinal vessel(s), and granular opacities within vitreous cortex, Cloquet's canal, and BPM. The detection sensitivity for these features was 75.0% (95%CI: 67.8%–81.1%) using standard logarithmic scale display, 80.6% (95%CI: 73.8%–86.0%) using HDR display, and 91.9% (95%CI: 86.6%–95.2%) using vitreous window display.ConclusionsSS-OCT provides non-invasive, volumetric and measurable in vivo visualization of the anatomic microstructural features of the posterior vitreous and vitreoretinal interface. The vitreous window display provides the highest sensitivity for posterior vitreous and vitreoretinal interface analysis when compared to HDR and standard OCT logarithmic scale display. Enhanced vitreous imaging with SS-OCT may help assess the natural history and treatment response in vitreoretinal interface diseases.

Highlights

The vitreous is a transparent hydrophilic gel, principally composed of water, occupying the space between the lens at the front of the eye and the retina lining the back of the eye
The vitreous window display provides the highest sensitivity for posterior vitreous and vitreoretinal interface analysis when compared to HDR and standard optical coherence tomography (OCT) logarithmic scale display
spectral-domain OCT (SD-OCT) is being widely used to diagnose and manage a variety of macular diseases, including vitreoretinal interface disease processes such as vitreomacular traction (VMT), epiretinal membrane (ERM), lamellar holes, pseudoholes, and full thickness macular holes (FTMH). [5,6,7,8]

Summary

Introduction

The vitreous is a transparent hydrophilic gel, principally composed of water, occupying the space between the lens at the front of the eye and the retina lining the back of the eye. [1] In vivo imaging of the vitreous can be performed using ophthalmoscopy, slit lamp biomicroscopy, scanning laser ophthalmoscopy, ultrasonography, and optical coherence tomography (OCT). [2] due to its transparency, it remains difficult to reliably image the vitreous except in advanced disease. [3] Time-domain OCT has been used in the past to examine the vitreous in a number of diseases of the vitreomacular interface. [4] The advent of spectral-domain OCT (SD-OCT) technology has allowed better visualization of the vitreoretinal interface and posterior vitreous cortex through improved axial resolution, imaging speed, and signal-to-noise ratio. SD-OCT is being widely used to diagnose and manage a variety of macular diseases, including vitreoretinal interface disease processes such as vitreomacular traction (VMT), epiretinal membrane (ERM), lamellar holes, pseudoholes, and full thickness macular holes (FTMH). SD-OCT is being widely used to diagnose and manage a variety of macular diseases, including vitreoretinal interface disease processes such as vitreomacular traction (VMT), epiretinal membrane (ERM), lamellar holes, pseudoholes, and full thickness macular holes (FTMH). [5,6,7,8]

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