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Three-dimensional ultrahigh resolution optical coherence tomography of retinal pathologies

The clinical feasibility of three-dimensional (3D) ultrahigh resolution (UHR) optical coherence tomography (OCT) has been investigated to visualize macular pathologies in more than 140 eyes. Three-dimensional retinal imaging was performed with high axial resolution of 3 μm employing a compact, commercially available ultrabroad bandwidth (160 nm) Titanium: sapphire laser at video-rate with up to 50 B-scans/second, each tomogram consisting of 512x1024 pixels, resulting in 25 Megavoxels/second. 3D UHR OCT allows identifying the contour of the hyaloid membrane, epiretinal membranes, inner limiting membrane, the topography of tractive forces from the retinal surface down to the level of the photoreceptor segments. Photoreceptor inner and outer segments are clearly delineated in configuration and size in micrometer with a characteristic peak in the subfoveal area. The pattern of the retinal vasculature is distinctly recognized by the hyperreflectivity of the vascular walls and the resulting reflectance shadow exhibiting a three-dimensional angiographic image of the entire vascular net without the use of fluorescent markers. 3D UHR OCT offers unprecedented, realistic threedimensional imaging of pathologies at all epi-, intra- and subretinal levels. Ultrastructural changes are identified and displayed using a dynamic video technique.