Enhanced Vitreous Imaging in Healthy Eyes Using Swept Source Optical Coherence Tomography

Abstract

PurposeTo describe enhanced vitreous imaging for visualization of anatomic features and microstructures within the posterior vitreous and vitreoretinal interface in healthy eyes using swept-source optical coherence tomography (SS-OCT). The study hypothesis was that long-wavelength, high-speed, volumetric SS-OCT with software registration motion correction and vitreous window display or high-dynamic-range (HDR) display improves detection sensitivity of posterior vitreous and vitreoretinal features compared to standard OCT logarithmic scale display.DesignObservational prospective cross-sectional study.MethodsMultiple wide-field three-dimensional SS-OCT scans (500×500A-scans over 12×12 mm2) were obtained using a prototype instrument in 22 eyes of 22 healthy volunteers. A registration motion-correction algorithm was applied to compensate motion and generate a single volumetric dataset. Each volumetric dataset was displayed in three forms: (1) standard logarithmic scale display, enhanced vitreous imaging using (2) vitreous window display and (3) HDR display. Each dataset was reviewed independently by three readers to identify features of the posterior vitreous and vitreoretinal interface. Detection sensitivities for these features were measured for each display method.ResultsFeatures observed included the bursa premacularis (BPM), area of Martegiani, Cloquet's/BPM septum, Bergmeister papilla, posterior cortical vitreous (hyaloid) detachment, papillomacular hyaloid detachment, hyaloid attachment to retinal vessel(s), and granular opacities within vitreous cortex, Cloquet's canal, and BPM. The detection sensitivity for these features was 75.0% (95%CI: 67.8%–81.1%) using standard logarithmic scale display, 80.6% (95%CI: 73.8%–86.0%) using HDR display, and 91.9% (95%CI: 86.6%–95.2%) using vitreous window display.ConclusionsSS-OCT provides non-invasive, volumetric and measurable in vivo visualization of the anatomic microstructural features of the posterior vitreous and vitreoretinal interface. The vitreous window display provides the highest sensitivity for posterior vitreous and vitreoretinal interface analysis when compared to HDR and standard OCT logarithmic scale display. Enhanced vitreous imaging with SS-OCT may help assess the natural history and treatment response in vitreoretinal interface diseases.

Association of Prevascular Vitreous Fissures and Cisterns With Vitreous Degeneration as Assessed by Swept Source Optical Coherence Tomography

“…Since then, several publications have used SS-OCT to examine the vitreous in health and disease. [9][10][11][12][13][14] However, although the premacular bursa and its relationship to Cloquet's canal have been the subject of relatively intense study, 2,9,10 PVF and vitreous cisterns have not been described using this noninvasive imaging method. The aim of this study was to characterize PVF and vitreous cisternal spaces in vivo with SS-OCT imaging, which may be relevant to vitreoretinal interface diseases and vitreous pharmacodynamics.…”

Optical Coherence Tomography and Optic Nerve Edema

“…The recent use of wide fi eld three-dimensional swept source OCT (SS-OCT), which utilizes better sensitivity with imaging depth and longer imaging range, has enabled enhanced imaging of vitreous and vitreo-retinal interface. SS-OCT can offer superior resolution of vitreo-retinal entities, such as Bergmeister's papillae that may simulate papilledema [ 67 ].…”

Three-Dimensional Enhanced Imaging of Vitreoretinal Interface in Diabetic Retinopathy Using Swept-Source Optical Coherence Tomography

“…22 Using SS-OCT, recent studies demonstrated an ability to better visualize the posterior vitreous and vitreoretinal interface in healthy eyes and determined the prevalence and described the dimensions and shapes of the bursa premacularis and area of Martegiani. 23–25 A more detailed three-dimensional analysis of the posterior vitreous and vitreoretinal interface using volumetric SS-OCT with a high A-scan density acquired over a wide field of the retina covering the fovea and the optic nerve head regions was recently demonstrated by Liu JJ et al 26 In this study, 26 a vitreous windowing method was employed to enhance the details of the vitreous, and various features of the posterior vitreous and vitreoretinal interface in young healthy eyes were described. Another recent SS-OCT study examined the vitreoretinal interface in 4 patients with PDR and described features such as neovascularization and vitreoschisis.…”