The clinical evaluation of a widefield lens to expand the field of view in optical coherence tomography (OCT-A).

This study aimed to evaluate the clinical benefits of incorporating a widefield lens (WFL) in optical coherence tomography angiography (OCT-A) in patients with retinal vascular diseases in comparison to standard single-shot OCT-A scans. Sixty patients with retinal vascular diseases including diabetic retinopathy (DR) and retinal vein occlusion (RVO) were recruited. OCT-A imaging (PlexElite 9000) with and without WFL was performed in randomized order. The assessment included patient comfort, time, field of view (FoV), image quality and pathology detection. Statistical analysis included paired t-tests, Mann-Whitney U-tests and Bonferroni correction for multiple tests, with inter-grader agreement using the kappa coefficient. Using a WFL did not lead to statistically significant differences in DR and RVO group test times. Patient comfort remained high, with similar responses for WFL and non-WFL measurements. The WFL notably expanded the scan field (1.6× FoV increase), enhancing peripheral retinal visibility. However, image quality varied due to pathology and eye dominance, affecting the detection of peripheral issues in RVO and DR cases. The use of a WFL widens the scan field, aiding vascular retinal disease imaging with minor effects on comfort, time, and image quality. Further enhancements are needed for broader view angles, enabling improved quantification of non-perfused areas and more reliable peripheral proliferation detection.

Quantifying lipofuscin in retinal pigment epithelium in vivo by visible-light optical coherence tomography-based multimodal imaging.

Lipofuscin in the retinal pigment epithelium (RPE) is the major source of fundus autofluorescence (FAF). A technical challenge to accurately quantify the FAF intensities, thus the lipofuscin concentration, is to compensate the light attenuation of RPE melanin. We developed the VIS-OCT-FAF technology to accomplish optical coherence tomography (OCT) and FAF simultaneously with a single broadband visible light source. We demonstrated that light attenuation by RPE melanin can be assessed and corrected using the depth-resolved OCT signals. FAF images from albino and pigmented rats showed that without compensation, FAF signals from pigmented rats are lower than that from albinos. After compensation, however, FAF signals from pigmented rats are higher. This finding is supported by measurements of lipofuscin fluorophore A2E in the RPE using liquid chromatography/mass spectrometry (LC/MS) showing that compensated FAF intensities correlate linearly with A2E contents. The present work represents an important step toward accurately assessing RPE lipofuscin concentrations by FAF.

Visible-light optical coherence tomography-based multimodal system for quantitative fundus autofluorescence imaging.

IMPACT STATEMENT: Quantitative fundus autofluorescence imaging with simultaneous visible-light optical coherence tomography-based multimodal technology has potential significant impact on the diagnosis and monitoring the progression of retinal diseases.

Visible light OCT-based quantitative imaging of lipofuscin in the retinal pigment epithelium with standard reference targets.

We developed a technology for quantitative retinal autofluorescence (AF, or FAF for fundus AF) imaging for quantifying lipofuscin in the retinal pigment epithelium (RPE). The technology is based on simultaneous visible light optical coherence tomography (VIS-OCT) and AF imaging of the retina and a pair of reference standard targets at the intermediate retinal imaging plane with known reflectivity for the OCT and fluorescence efficiency for the FAF. The technology is able to eliminate the pre-RPE attenuation in FAF imaging by using the simultaneously acquired VIS-OCT image. With the OCT and fluorescence images of the reference targets, the effects of illumination power and detector sensitivity can be eliminated.

Visible-light optical coherence tomography-based multimodal retinal imaging for improvement of fluorescent intensity quantification.

We developed a spectral-domain visible-light optical coherence tomography (VIS-OCT) based multimodal imaging technique which can accomplish simultaneous OCT and fluorescence imaging with a single broadband light source. Phantom experiments showed that by using the simultaneously acquired OCT images as a reference, the effect of light attenuation on the intensity of the fluorescent images by materials in front of the fluorescent target can be compensated. This capability of the multimodal imaging technique is of high importance for achieving quantification of the true intensities of autofluorescence (AF) imaging of the retina. We applied the technique in retinal imaging including AF imaging of the retinal pigment epithelium and fluorescein angiography (FA). We successfully demonstrated the effect of compensation on AF and FA images with the simultaneously acquired VIS-OCT images.