Visualization of the Vitreoretinal Interface Using Three–Dimensional Ultrahigh Resolution Optical Coherence Tomography

Abstract

Abstract: : Purpose: To evaluate the clinical feasibility of three–dimensional ultrahigh resolution optical coherence tomography (3D UHR–OCT) in the evaluation and quantification of changes at the vitreoretinal interface. Methods: A second generation ultrahigh resolution OCT system has been developed for in vivo three dimensional retinal imaging employing a compact ultrabroad bandwidth (160 nm) Titanium–sapphire laser. Three dimensional retinal imaging can be performed with high axial resolution (3µm) in video–rate, i.e. with up to 25 B–scans/second, each tomogram consisting of 1024x1024 pixels, resulting in 25 Megavoxels/second. More than 70 eyes of 35 patients with diseases of the macular vitreoretinal interface such as vitreomacular traction syndromes, epiretinal gliosis and macular holes have been investigated using 3D UHR OCT. Results: 3D UHR–OCT enabled unprecedented visualization of the interaction between the posterior vitreous and the retinal surface. The effect, amount and areal extension of vitreoretinal traction can be evaluated in three dimensions. Lacerations of inner retinal layers due to vitreoretinal traction can be detected and quantified in size. The traction force is effective down to the outer retinal structures and causes alterations in the photoreceptor inner and outer segment layers. Surgical intervention leads to release of the traction forces with restoration of retinal morphology. Conclusions: Three–dimensional ultrahigh resolution optical coherence tomography of the vitreoretinal interface allows for unprecedented evaluation of effect and extension of vitreoretinal traction. Three–dimensional imaging of alterations at the vitreoretinal interface allow for better understanding of the impacts on retinal morphology and function, as well as for evaluation of the effect of surgical intervention.

Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • macula/fovea • retinal adhesion