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S. Sacu, R. Leitgeb, S. Michels, B. Hermann, C. Ahlers, B. Povazay, H. Sattmann, W. Drexler, U. Schmidt–Erfurth; Imaging of Pigment Epithelial Disease Using Threedimensional (3D) Ultrahigh Resolution (UHR) Optical Coherence Tomography (OCT) . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2563.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:To demonstrate the potential of in vivo three dimensional imaging of the retinal pigment epithelium (RPE) in the central macula by high speed ultra–high resolution optical coherence tomography (3D UHR–OCT). Methods: Patients with distinct pathologies of the RPE e.g. central serous retinopathy, macular dystrophy and areolar atrophies were evaluated using a second generation UHR–OCT system for three–dimensional video–rate retinal imaging employing a compact, commercially available ultrabroad bandwidth (160 nm) Titanium:shappire laser. Three dimensional retinal imaging can be performed with high axial resolution of 3µm and up to 25 B–scans/second, each tomogram consisting of 1024x1024 pixels, resulting in 25 Megavoxels/second. Results: 3D UHR–OCT enables unprecedented in–vivo identification of all major retinal layers including inner and outer photoreceptors and the retinal pigment epithelium (RPE). In patients with acute central serous retinopathy and a single hot–spot angiographically multiple focal RPE alterations are documented, in addition to the characteristic findings such as a serous retinal detachment. Photoreceptor outer and inner segments are well preserved in the majority of patients. In patients with areolar atrophy there is a defined border between normal appearing and affected RPE. Photoreceptor outer and inner segments are missing or sparse overlying the area of affected RPE. In addition, RPE loss allows a precise visualisation of choriocapillary structures demonstrating significant atrophy and larger choroidal vessels. In bull’s eye dystrophy a characteristic hyperreflective circular thickening of the RPE band reaching into the outer retina as well as into the choroid allows to identify the intensity and distribution of RPE disease. The overlying photoreceptor layer is severely disturbed or missing. 3D UHR–OCT was further useful in imaging other RPE pathologies such as Stargardt dystrophy or retinopathia pigmentosa. Conclusions: 3D UHR–OCT has the potential to substantially enhance the sensitivity in early diagnosis and differential diagnosis of RPE disease. The modality allows to precisely identify areas of affected RPE and to quantify the resulting photoreceptor damage.
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