Sir Isaac Newton was the first to establish the technique of low coherence white light interferometry. Following on from this, the principle of laser interferometry as an imaging modality for retina was applied by David Huang and his associates in 1991. Today, ocular coherence tomography (OCT) is widely used as a diagnostic tool and prognostic indicator across a range of ocular pathology. It is non-invasive, fast and possesses high resolution imaging.
This book enhances our understanding of the fundamentals and applications of this imaging tool. The introductory section highlights the history, basic optical principle and instrumentation of OCT. Ultrahigh resolution OCT to evaluate ocular surface neoplasms, and the future potential use of phase variance OCT to create three dimensional angiographic images of retinal and choroidal vasculature are highlighted. The latter is a promising future alternative to fundus fluorescein angiography (FFA) and indocyanine green (ICG) angiography. The section on anterior segment OCT covers the static and dynamic evaluation of the anterior segment morphology. OCT and its role in refractive surgery, corneal inflammation, ectasias and cross-linking; OCT directed evaluation of phakic IOLs on the endothelial count; management of descemets membrane detachment; and different types of keratoplasty are further explained.
The advent of OCT has truly revolutionised the diagnosis and management of retinal disease and has taken the medical retina and anti-VEGF services to a whole new level. It has become a potent diagnostic tool and prognostic indicator of various pathologies associated with the disruption of normal retinal architecture and accumulation of macular fluid. It is now a major armamentarium in the management of diabetic retinopathies, age-related macular degeneration (AMD) and vascular occlusions.
OCT based classification and grading of retinal conditions like macular hole, pucker, vitreoretinal traction and retinal schisis, are elucidated well. The book discusses retinal pathology and the role of OCT in its management in depth. The book further highlights the vital role of OCT in the early diagnosis of glaucoma and how peripapillary and the macular zone thickness can be utilised to generate maps showing loss of ganglion cells and their axons. The reader learns how the technology can equally be effective in differentiating the glaucoma masqueraders which cause a diffuse loss, of the nerve fibre layer as opposed to the superior and inferior quadrantic pattern loss in glaucoma.
The role of non-invasive anterior segment OCT for evaluation of angle, peripheral synechiae and plateau iris is elucidated. The book includes an interesting description of intraoperative and interventional use of OCT for sub-tenon injections, cataract, glaucoma and corneal surgery. It explains how the analytical potential of OCT can revolutionise the outcome of surgery by audit of wound architecture: lens positioning and tilt in glued intraocular lenses (IOLs), and the usefulness of the technique in femtosecond laser-assisted cataract surgery (FLACS) where OCT augmented video microscope can enable image guided femto application. This technology is likely to open up a whole new world of future possibilities in interventional therapeutics and the use of microscope mounted OCT to monitor surgical manoeuvres, which can be modified accordingly and used by the surgeon to optimise outcome.
The text, although lengthy and detailed, is lucid and well structured. It is accompanied by excellent quality images and clear tables. The book is accompanied by procedural online videos via MediaCenter.thieme.com