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1、RTVue 100The Next Generation OCTPrinciples of OCT Technology Optical Coherence Tomography (OCT) uses a principle called low coherence interferometry to derive depth information of various retinal structures This is performed by comparing the time difference in reflected light from the retina at vari
2、ous depths with a reference standard Differences between the reflected light and the reference standard provide structural information in the form of an A scanPrinciples of OCT TechnologyAn A-scan is the intensity of reflected light at various retinal depths at a single retinal location Combining ma
3、ny A-scans produces a B-scanA-scanA-scan+ . . . =B-scanA-scansRetinal DepthReflectance IntensityFourier Domain OCT RTVue 100 Optical Coherence Tomography (OCT) provides cross sectional imaging of the retina Spectrometry and Fourier Domain methods allow high speed data capture (26,000 A scans per sec
4、ond) Broad-band light source provides high depth resolution (5 microns)The Evolution of OCT Technology65 x faster2 x resolutionZeiss OCT 1 and 2, 1996Zeiss Stratus 2002OptoVue RTVue 200626,00040010016105Speed(A-scansper sec)Resolution (m mm)Fourier domain OCTTime domain OCTEvolution of Commercial OC
5、T199620022006OCT 1(Time Domain)Stratus OCT(Time Domain)RTVue(Fourier Domain)Time Domain OCTSLDLensDetectorData AcquisitionProcessingCombines light from reference with reflected light from retinaDistance determines depth in A scanReference mirror moves back and forthScanning mirror directs SLD beam o
6、n retinaInterferometerBroadband Light SourceCreates A-scan 1 pixel at a timeFinal A-scanProcess repeated many times to create B-scanSlide courtesy of Dr. Yimin Wang, USCFourier Domain OCTSLDSpectrometer analyzes signal by wavelengthFFTGrating splits signal by wavelengthBroadband Light SourceReferenc
7、e mirror stationaryCombines light from reference with reflected light from retinaInterferometerSpectral interferogramFourier transform converts signal to typical A-scanEntire A-scan created at a single timeSlide courtesy of Dr. Yimin Wang, USCProcess repeated many times to create B-scanFourier Domai
8、n OCT Simultaneous Entire A-scan at once 2048 pixels per A scan 26,000 A scans per second 1024 A-scans in 0.04 sec Faster than eye movementsTime Domain OCT Sequential 1 pixel at a time 1024 pixels per A-scan 400 A scans per second 512 A-scans in 1.28 sec Slower than eye movements512 A-scans in 1.28
9、secMotion artifactHigher speed, higher definition and higher signal.1024 A-scans in 0.04 secSmall blood vesselsIS/OSChoroidal vesselsSlide courtesy of Dr. David Huang, USCFourier Domain OCT High speed reduces eye motion artifacts present in time domain OCT High resolution provides precise detail, al
10、lows more structures to be seen Larger scanning areas allow data rich maps & accurate registration for change analysis 3-D scanning improves clinical utility High Speed allows 3-D scanningB-scans provide high resolution detailRetinal Layers with RTVue & HistologyILMNFLGCLIPLINLOPLONLPR IS/OSRPEChori
11、ocapillaris and choroidFoveaParafoveaTemporalNasalMacula thickness map reveals edemaRPE Elevation map reveals drusen & CNVRPE Elevation map reveals CNVChange Analysis for maculaGlaucoma Analysis RNFL Thickness Map Neural retinal rim Cup area RNFL TSNIT graph at 3.45 mm circleMeasuring the ganglion c
12、ellsInner retinal layer providesGanglion cell assessment: Axons = nerve fiber layer Cell Body = ganglion cell layer Dendrites = inner plexiform layerImages courtesy of Dr. Ou Tan, USCGanglion cell layer in macula analyzed for glaucomaInner Retina SegmentationProvides thickness of: RNFL layer Ganglio
13、n cell layer Innerplexiform layerNormal vs GlaucomaNormalGlaucomaCupRimRNFLInner RetinaMacula MapRetina ExamplesNormalRod cone dystrophyImages courtesy of Dr. Jennifer Lim, USCCourtesy: Michael Turano, CRAColumbia University.Cystoid Macula EdemaCourtesy: Michael Turano, CRAColumbia University.horizo
14、ntalverticalDiabetic RetinopathyImages courtesy of Dr. Tano, Osaka UniversityCentral Retinal Vein OcclusionImages courtesy of Dr. Tano, Osaka UniversityhorizontalhorizontalverticalverticalAMD-Classic CNVImages courtesy of Dr. Tano, Osaka UniversityIdiopathic CNVImages courtesy of Dr. Tano, Osaka Uni
15、versityhorizontalhorizontalverticalverticalMacula HoleImages courtesy of Dr. Tano, Osaka UniversityCourtesy: Michael Turano, CRAColumbia University.Diabetic Macula Edema with Epiretinal MembraneCentral Serous Chorioretinopathy with PEDearly phase FA56 year old FemaleSub-retinal fluidPEDImages courte
16、sy of Dr. Tano, Osaka UniversityOperculumCourtesy: Michael Turano, CRAColumbia University.Stage 3 Full Thickness Macular HoleCentral Serous ChorioretinopathyImages courtesy of Dr. Tano, Osaka UniversityEpiretinal MembraneImages courtesy of Dr. Tano, Osaka UniversityRetinitis PigmentosaImages courtes
17、y of Dr. Tano, Osaka UniversityCourtesy: Michael Turano, CRAColumbia University.Vitreomacular Traction Syndrome with CMEPatient MB Neovascular AMDFundus PhotographFACase courtesy of Dr. Nalin Mehta, Colorado Retina CenterPatient MB Neovascular AMDFluid accumulationCNVCase courtesy of Dr. Nalin Mehta
18、, Colorado Retina CenterPatient MB Neovascular AMDFull Retinal Thickness MapRPE Elevation MapRPE elevation due to CNVLarge area of abnormally thick retina from intraretinal fluid accumulationCase courtesy of Dr. Nalin Mehta, Colorado Retina CenterPatient WB Neovascular AMDFundus PhotographFA 86 year
19、 old maleCase courtesy of Dr. Nalin Mehta, Colorado Retina CenterPatient WB Neovascular AMDCNVDate: 1/10/073-D Evaluation reveals extent of CNVCase courtesy of Dr. Nalin Mehta, Colorado Retina CenterPatient WB Neovascular AMDFull Retinal Thickness MapRPE Elevation MapRPE / choroid disruption identif
20、ies presence of CNVSome abnormal thickening and thinningCase courtesy of Dr. Nalin Mehta, Colorado Retina CenterPatient WB Neovascular AMD1/10/072/23/07B-scan comparisonFull retinal ThicknessRPE ElevationTreatment 2/7 Lucentis 2/14 PDTThinning of retina and improvement in RPE in response to treatmen
21、tCase courtesy of Dr. Nalin Mehta, Colorado Retina CenterPatient ED Neovascular AMD 84 year old male, initial exam 12/13/2006FA shows leakage just superior to foveaFull retinal thickness shows no thickeningRPE elevation map clearly shows area of CNV superior to foveaFAFull retinal thickness mapRPE e
22、levation mapCase courtesy of Dr. Nalin Mehta, Colorado Retina CenterPatient ED Neovascular AMDInitial Exam:12/13/2006Follow-up Exam:3/20/2007RPE/Choroid shows some reduction in height, but overall retinal thickness increases due to intra-retinal fluid accumulationTreatment1/17 Macugen3/14 - MacugenC
23、ase courtesy of Dr. Nalin Mehta, Colorado Retina CenterPatient ED Neovascular AMDCase courtesy of Dr. Nalin Mehta, Colorado Retina CenterTotal Retinal Thickness increasesRPE elevation decreasesPatient WW AMD76 year old male.DrusenPEDsCase courtesy of Dr. Nalin Mehta, Colorado Retina CenterPatient WW
24、 AMDFull Retinal Thickness MapRPE Elevation MapLocalized elevations reveal location of PED and DrusenFull Retinal thickness map normal Case courtesy of Dr. Nalin Mehta, Colorado Retina CenterComparison of Stratus OCT to RTVue OCTComparisonRTVueStratus Fourier Domain OCT 26,000 A scans per second 5 m
25、 depth resolution Retina Assessment Dense Full Retinal Thickness map RPE elevation map 3-D macula scans Glaucoma Assessment RNFL map Inner Retinal Thickness map (Ganglion cell assessment - axon+cell body+dendrites) Optic disc RTVue is 65 times faster RTVue has twice the depth resolution Time Domain
26、OCT 400 A scans per second 10 m depth resolution Retina Assessment Sparse retinal thickness map for retina (97% interpolated) Glaucoma Assessment RNFL ring for glaucoma (TSNIT curve)Comparison of Stratus OCT to RTVue OCTGlaucoma ComparisonRTVueStratus Data Captured: 9510 A scans (pixels) Time: 370 m
27、sec Area covered: 4 mm diameter circle RTVue has 97% more data RTVue is over 5 times faster Data Captured 256 A scans (pixels) Time: 1.92 seconds Area Covered: ring at 3.45 mm diameterProvides Cup Area Rim Area RNFL Map TSNIT graphProvides TSNIT graph RTVue provides comprehensive glaucoma informatio
28、nPlus, RTVue has exclusive Retinal Ganglion Cell layer assessment Data Captured: 14,810 A scans (pixels) Time: 570 msec Area covered: 7 x 7 mmProvides Inner Retina Map Ganglion cell assessment in macula No Comparison RTVue provides direct ganglion cell information Inner retina analysis: RNFL Ganglio
29、n cell body Inner plexiform layerRTVue can provide 3-D imaging of the optic disc and RNFL No Comparison Data Captured: 51,712 A scans (pixels) Time: 2 seconds Area covered: 4 x 4 mmProvides3 D map RTVue provides 3 D image of optic disc and parapapillary RNFLComparison of Stratus OCT to RTVue OCTReti
30、na ComparisonRTVueStratus Data Captured: 19,496 A scans (pixels) Time: 780 msec Area covered: 5 x 5 mm RTVue has 96% more data RTVue is over 2.4 times faster Data Captured 768 A scans (pixels) Time: 1.9 seconds Area Covered: circle 6 mm diameterProvides Dense Retinal thickness mapProvides Sparse Ret
31、inal thickness map 97% interpolated between lines RTVue provides more data and a more detailed thickness mapRTVue has 3 D imaging of the macula Data Captured: 51,7212 A scans (pixels) Time: 2 seconds Area covered: 4 x 4 mmProvides 3 D map of the macula No Comparison RTVue provides 3-D image of macul
32、a for a comprehensive review of B-scans over large areaPlus, RTVue has RPE elevation map for Drusen and CNV Data Captured: 19,496 A scans (pixels) Time: 780 msec Area covered: 5 x 5 mmProvides RPE Elevation map RTVue RPE elevation map reveals location and extent of Drusen and CNV which is missed by
33、retinal thickness maps No ComparisonRTVue DetailsScan Speed: 26,000 A scans per secondDepth Resolution: 5 micronsTransverse Resolution: 15 micronsFrame Rate: 256-4096 A-scans per frameScan Depth 2 mm 2.3 mmScan length 2 mm 12 mmSLD wavelength: 840 +/- 10 nmFocus Range: -15 D to +12 DRetina scans: Gl
34、aucoma ScansHigh res line scanHigh res cross scanMacula Map over 5 mm x 5 mm3-D macula scanNerve Head Map over 4 mm DiameterMacula Map over 7 mm x 7 mmRNFL 3.45 scan circle3-D Optic Disc Scan Details: Line and CrossType# Ascans, # Bscans Scan Time Transv. ResLine 1024 1 39 msec 5.9 m line length: 6
35、mm (adj. 2-12mm) Cross 1024 2 78 msec 5.9 m line length: 6 mm (adj. 2-12mm)HD Line 4096 1 156 msec 1.5 m line length: 6 mm (adj. 2-12mm)HD Cross 4096 2 312 msec 1.5 m line length: 6 mm (adj. 2-12mm)linehorizontalverticalHigh density lineHD horizontalHD verticalScan Details: 3-DType# Ascans, # Bscans
36、Scan Time Transv. Res3-D Macula 512 101 2 sec7.8 m size: 4x4 mm3-D Disc 512 101 2 sec7.8 m size: 4x4 mmScan Details: MapsType# Ascans, # Bscans Scan Time Transv. ResMM5 (Retina) 668 22 7.5 m 400 12 total 780 msec 7.5 m macula map size: 5x5 mmNHM4 (Glaucoma) 452 12 7.5 m587 & 775 6 total 390 msec 4.3-5.2 m map size: 4 mm diameter circleMM7 (Glaucoma) 467 1 15.0 m 400 15 total 580 msec 17.5 m macula map size: 7x7 mm
