Editors: Miguel A. Quiroz-Reyes, Virgilio Lima-Gomez

Optical Coherence Tomography Angiography for Choroidal and Vitreoretinal Disorders – Part 1

eBook: US $69 Special Offer (PDF + Printed Copy): US $126
Printed Copy: US $91
Library License: US $276
ISBN: 978-981-5124-10-1 (Print)
ISBN: 978-981-5124-09-5 (Online)
Year of Publication: 2023
DOI: 10.2174/97898151240951230101

Introduction

This handbook covers Optical Coherence Tomography Angiography (OCT-A) with a specific focus on choroidal and vitreoretinal disorders. It serves as an invaluable resource for teaching and aiding daily clinical decision-making in the field. Book chapters dissect the fundamentals of angiography through OCT, offering guidance on OCT-A and insights into macular perfusional findings across various vitreoretinal and choroidal pathologies. From diabetic retinopathy to autoimmune diseases and neovascularization, the book addresses prevalent vascular entities encountered in routine practice. Furthermore, it explores innovative approaches, including antivascular endothelial growth factor molecules and extended-release delivery devices, contributing significantly to the diagnostic and decision-making processes in clinical and surgical retina care. Each chapter is contributed by experts in the relevant subspecialty.

Key Features:

  • - Practical, patient-centered guide emphasizing a clinical approach.
  • - Demonstrative clinical cases for enhanced understanding.
  • - Evaluation of perfusional indices using noninvasive and noncontact imaging techniques.
  • - High histopathological correlation of structural tissue characterization with microvascular evaluation.
  • - Exploration of new perfusion concepts and their role in disease pathogenesis.

Part 1 of the book focuses on OCT-A principles and applications in ophthalmology. It covers the basics of OCT-A, its contributions to eye disease study and treatment, and a comparative analysis with OCT for choroidal and vitreoretinal diseases. Additional information on nomenclature, normative datasets, and data analysis, presenting indices in different eye conditions is also presented. The emphasis is on macular perfusion in surgically resolved myopic foveoretinal detachment, postoperative evaluation in retinal detachment, and long-term analysis in diabetic retinopathy.

Foreword

There is no doubt that serendipity plays an important role in many scientific developments. One very clear example is the evolution of Ophthalmic Coherence Tomography (OCT) in Ophthalmology.

In the early 1970s, Michel Duguay at the AT & T Bell Laboratories published “Light photographed in flight”, where he proposed that echoes of light could be used to examine biological tissue. In the mid-1970s, Erich Ippen, of Massachusetts Institute of Technology (MIT), further developed femtosecond optics. Both discoveries built the foundation of the concept called optical reflectivity, with the idea that light interference could be used to obtain a non-invasive “biopsy” of translucid tissues. In the late 1980s, corneal refractive surgery was at its summit. It required an accurate measurement of corneal thickness. James Fujimoto of MIT collaborated with Ophthalmologists Joel Schuman, David Huang and Carmen Puliafito to refine this measurement, using low-coherence interferometry with only partial success. Nevertheless, in a poorly focused image of the cornea, Huang noticed what appeared to be an optical section of the retina in the background. Instead of dismissing this poorly defined image as useless, Huang continued experimenting until he was able to obtain an optical transverse image of the retina. Thus, retinal and choroidal OCT was born. Today OCT constitutes the most important ancillary test and standard of care in Ophthalmic practice, not only in vitreoretinal pathology, but also in glaucoma and problems of the anterior segment.

More recently, swept-source OCT, which can produce 500,000 scans per second and OCT angiography, employing motion contrast imaging, allow us to image retinal capillaries and the smallest neo-vessels in the retinal tissues. Also, enhanced penetration has allowed to provide detailed visualization of the choroid. New technologies are in constant development, such as visible light OCT (visOCT) and adaptive optics (AO-OCT) will allow further details and deeper penetration.

In this particular section of the book, after a review of general principles and advances of OCT and OCTa use in vitreoretinal disorders, all the contributors and coauthors engage in describing to us the normal and pathological parameters of macular and choroidal perfusion patterns, followed by a description and findings in several vitreoretinal and choroidal pathological disorders.

There is no doubt that all the new and described findings in this book will widen our knowledge and be of benefit to our ailing patients.

Alexander Dalma M.D.
Mexico City