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Clinical evaluation of simultaneous confocal scanning laser ophthalmoscopy imaging combined with high‐resolution, spectral‐domain optical coherence tomography
Author(s) -
Helb HansMartin,
Issa Peter Charbel,
Fleckenstein Monika,
SchmitzValckenberg Steffen,
Scholl Hendrik P. N.,
Meyer Carsten H.,
Eter Nicole,
Holz Frank G.
Publication year - 2010
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2009.01602.x
Subject(s) - optical coherence tomography , fluorescein angiography , medicine , scanning laser ophthalmoscopy , fundus photography , ophthalmoscopy , indocyanine green , angiography , fundus (uterus) , optics , nuclear medicine , ophthalmology , materials science , retinal , radiology , pathology , physics
Acta Ophthalmol. 2010: 88: 842–849 Abstract. Purpose: To evaluate the clinical relevance of a new diagnostic modality, simultaneous confocal scanning laser ophthalmoscopy (cSLO) and high‐speed, high‐resolution, spectral‐domain optical coherence tomography (OCT), for the visualization of macular pathologies. Methods: OCT images and simultaneous recording of fluorescein angiography, indocyanine green (ICG) angiography, infrared, and blue reflectance (‘red‐free’) or fundus autofluorecence (FAF) images were obtained with a novel imaging device (Spectralis HRA + OCT; Heidelberg Engineering, Heidelberg, Germany). An optically pumped solid‐state laser generated the excitation wavelength (488 nm) required for blue reflectance, FAF and fluorescein angiography images. For ICG angiography and infrared imaging, diode laser sources at 790 and 815 nm were used. For OCT, 40 000 A‐scans per second were acquired with 7 μm axial and 14 μm lateral optical resolution. The B‐scans covering a transversal range of 30° had a scan width up to 1.536 A‐scans with a digital lateral resolution of 5 μm/pixel, a scan depth of 1.8 mm with 3.5 μm/pixel digital axial resolution and a scan rate of up to 48 B‐scans/second. In addition, volume scans could be obtained at 15, 20 and 30° fields of view. An integrated eye tracking allowed for live averaging of cSLO images as well as OCT B‐scans. Results: Early, neovascular and atrophic age‐related macular degeneration, macular telangiectasia, retinal arterial, branch vein occlusion and other pathologies were imaged, and cSLO and OCT frames correlated. Fluorescein and ICG angiographic phenomena recorded in cSLO images could be analysed accurately in corresponding OCT cross‐sections. Abnormal FAF signals were correlated to alterations at the outer retinal/retinal pigment epithelial cell layer in high‐resolution OCT scans. Three‐dimensional OCT enabled comprehensive retinal coverage. The imaging software tracked eye movements accurately. Averaging of live B‐scans enhanced image quality considerably. Conclusion: The combined cSLO/OCT system allowed for simultaneous recordings of topographic and tomographic images with accurate correlation between the confocal angiograms, FAF images as well as other imaging modes with the OCT scans. The instrument thus provides simultaneous multi‐modal imaging of retinal pathologies and disease.