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    #1 – OCT as a Diagnostic Tool

    Top 25 Innovations in Eye Care

    In 1991, David Huang, MD, PhD, of the Massachusetts Institute of Technology described the first use of optical coherence tomography (OCT) for noninvasive cross-sectional imaging in biological systems. When the first commercial time-domain OCT (TD-OCT) debuted 5 years later, it was able to acquire data at a rate of only 100 axial scans per second. Six years later, this speed had quadrupled to 400 axial scans per second. As improvements in speed and quality persisted, OCT became the gold standard for diagnosis of many retinal diseases such as age-related macular degeneration and diabetic eye disease.

    OCT is based on similar principles to ultrasound, using low-coherent light waves to produce cross-sectional 3-dimensional images based on optical reflectivity and scattering properties of tissue. As a noninvasive, rapidly responsive tool (taking only a few minutes to obtain excellent quality images of both eyes), OCT is used in most ophthalmology practices worldwide to diagnose and track disease.

    It is important to note that OCT is not a standalone diagnostic tool. OCT is just one mechanism commonly used to diagnose and track ocular disease along with fluorescein angiography, biomicrosscopy, and patient history.

    The SPECTRALIS(R) multi-modal imaging platform combines high-resolution OCT imaging with confocal scanning laser ophthalmoscopy for applications in retina, glaucoma and anterior segment.

    Today’s spectral-domain OCTs (SD-OCTs) are approximately 100 times faster than TD-OCT units, providing higher resolution scans that allow ophthalmologists to identify early disease with greater precision. SD-OCTs can be used to evaluate both the anterior and posterior segments of the eye. More recent OCT platforms have been combined with other modalities such as confocal scanning laser ophthalmoscopy to capture multiple perspectives of the retina and support differential diagnosis in a single exam.

    Further innovations in both the hardware and software of OCT technologies are underway to allow for high resolution dye-less OCT angiography.

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