Spectral domain OCT in ophthalmology – 3D high resolution imaging of the retina

Institute Quantivision (IQ) success story

Optical coherence tomography (OCT) is a high-resolution optical imaging technique analogous to ultrasound imaging. OCT provides cross sectional and 3D images of tissue up to a depth of 1.5 – 2 mm in scattering structures such as tissue. Ten years ago the first video rate images of the retina were acquired in the lab of IQ member prof J.F. de Boer, then at Harvard Medical School, by a technique called Spectral Domain OCT (SD-OCT). 1) SD-OCT technology was orders of magnitude faster, while providing the same image quality as previous technology. This marked a paradigm shift in retinal imaging, enabling full 3D imaging of the retina within a few seconds. Since then, SD-OCT has been developed and improved with many different scientific and commercial partners and become a dominant imaging technology in ophthalmology, due to its non-invasive nature and exquisite detail of retinal structure. The clinical success is also evident by the emergence of more than 10 companies marketing imaging devices based on SD-OCT. Annual sales are estimated at 10.000 systems per year, with a market value of 500M euro per year.

The impact on clinical care is significant and still growing, providing clinicians with a detailed 3D representation of retinal pathology. OCT provides such value in its unique diagnostic ability that it is becoming an essential tool for patient care. SD-OCT is expected develop in a screening and monitoring entity for long term management of glaucoma and a replacement technology for invasive procedures such as fluorescein angiography. In the coming 10 years, patients will be able to have their eyes examined at a local optometrist, where the data will be send to data centers and evaluated, such that patients that need follow up visits at their ophthalmologists will be flagged and alerted to a change in the development of the chronic eye disease. This means a significant shift of eye disease diagnostics from intramural care to extramural care.

As the retina is part of the brain, SD-OCT could even be developed as a first line screening device for neurodegenerative diseases such as Alzheimer and Multiple Sclerosis.

 

1) N. Nassif, B. Cense, B. H. Park, S. H. Yun, T. C. Chen, B. E. Bouma, G. J. Tearney, J. F. de Boer, “In-vivo Human Retinal Imaging by Ultra High-Speed Spectral Domain Optical Coherence Tomography.” Optics Letters 29 (5), 480-482 (2004).