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1、RTVue 100The Next Generation OCT,Principles 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 vario
2、us depths with a reference standard Differences between the reflected light and the reference standard provide structural information in the form of an A scan,Principles of OCT Technology,An A-scan is the intensity of reflected light at various retinal depths at a single retinal location Combining m
3、any A-scans produces a B-scan,A-scan,A-scan,+,+,.,=,B-scan,A-scans,Retinal Depth,Reflectance Intensity,Fourier 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
4、 second)Broad-band light source provides high depth resolution(5 microns),The Evolution of OCT Technology,65 x faster2 x resolution,Zeiss OCT 1 and 2,1996,Zeiss Stratus 2002,OptoVue RTVue 2006,26,000,400,100,16,10,5,Speed(A-scansper sec),Resolution(mm),Fourier domain OCT,Time domain OCT,Evolution of
5、 Commercial OCT,1996,2002,2006,OCT 1(Time Domain),Stratus OCT(Time Domain),RTVue(Fourier Domain),Time Domain OCT,SLD,Lens,Detector,Data AcquisitionProcessing,Combines light from reference with reflected light from retina,Distance determines depth in A scan,Reference mirror moves back and forth,Scann
6、ing mirror directs SLD beam on retina,Interferometer,Broadband Light Source,Creates A-scan 1 pixel at a time,Final A-scan,Process repeated many times to create B-scan,Slide courtesy of Dr.Yimin Wang,USC,Fourier Domain OCT,SLD,Spectrometer analyzes signal by wavelength,FFT,Grating splits signal by wa
7、velength,Broadband Light Source,Reference mirror stationary,Combines light from reference with reflected light from retina,Interferometer,Spectral interferogram,Fourier transform converts signal to typical A-scan,Entire A-scan created at a single time,Slide courtesy of Dr.Yimin Wang,USC,Process repe
8、ated many times to create B-scan,Fourier Domain 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 movements,Time Domain OCT Sequential 1 pixel at a time 1024 pixels per A-scan 400 A scans per second 512 A-scans in 1.28 se
9、c Slower than eye movements,Higher speed,higher definition and higher signal.,1024 A-scans in 0.04 sec,Small blood vessels,IS/OS,Choroidal vessels,Slide courtesy of Dr.David Huang,USC,Fourier Domain OCT,High speed reduces eye motion artifacts present in time domain OCT High resolution provides preci
10、se detail,allows 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 scanning,B-scans provide high resolution detail,Retinal Layers with RTVue&Histology,ILM,NFL,GCL,IPL,INL,OPL,ON
11、L,PR IS/OS,RPE,Choriocapillaris and choroid,Fovea,Parafovea,Temporal,Nasal,Macula thickness map reveals edema,RPE Elevation map reveals drusen&CNV,RPE Elevation map reveals CNV,Change Analysis for macula,Glaucoma Analysis,RNFL Thickness Map Neural retinal rim Cup area RNFL TSNIT graph at 3.45 mm cir
12、cle,Measuring the ganglion cells,Inner retinal layer providesGanglion cell assessment:Axons=nerve fiber layer Cell Body=ganglion cell layer Dendrites=inner plexiform layer,Images courtesy of Dr.Ou Tan,USC,Ganglion cell layer in macula analyzed for glaucoma,Inner Retina SegmentationProvides thickness
13、 of:RNFL layer Ganglion cell layer Innerplexiform layer,Normal vs Glaucoma,Normal,Glaucoma,Cup,Rim,RNFL,Inner RetinaMacula Map,Retina Examples,Normal,Rod cone dystrophy,Images courtesy of Dr.Jennifer Lim,USC,Courtesy:Michael Turano,CRAColumbia University.,Cystoid Macula Edema,Courtesy:Michael Turano
14、,CRAColumbia University.,horizontal,vertical,Diabetic Retinopathy,Images courtesy of Dr.Tano,Osaka University,Central Retinal Vein Occlusion,Images courtesy of Dr.Tano,Osaka University,horizontal,vertical,AMD-Classic CNV,Images courtesy of Dr.Tano,Osaka University,Idiopathic CNV,Images courtesy of D
15、r.Tano,Osaka University,horizontal,vertical,Macula Hole,Images courtesy of Dr.Tano,Osaka University,Courtesy:Michael Turano,CRAColumbia University.,Diabetic Macula Edema with Epiretinal Membrane,Central Serous Chorioretinopathy with PED,early phase FA,56 year old Female,Sub-retinal fluid,PED,Images
16、courtesy of Dr.Tano,Osaka University,Operculum,Courtesy:Michael Turano,CRAColumbia University.,Stage 3 Full Thickness Macular Hole,Central Serous Chorioretinopathy,Images courtesy of Dr.Tano,Osaka University,Epiretinal Membrane,Images courtesy of Dr.Tano,Osaka University,Retinitis Pigmentosa,Images
17、courtesy of Dr.Tano,Osaka University,Courtesy:Michael Turano,CRAColumbia University.,Vitreomacular Traction Syndrome with CME,Patient MB Neovascular AMD,Fundus Photograph,FA,Case courtesy of Dr.Nalin Mehta,Colorado Retina Center,Patient MB Neovascular AMD,Fluid accumulation,CNV,Case courtesy of Dr.N
18、alin Mehta,Colorado Retina Center,Patient MB Neovascular AMD,Full Retinal Thickness Map,RPE Elevation Map,RPE elevation due to CNV,Large area of abnormally thick retina from intraretinal fluid accumulation,Case courtesy of Dr.Nalin Mehta,Colorado Retina Center,Patient WB Neovascular AMD,Fundus Photo
19、graph,FA,86 year old male,Case courtesy of Dr.Nalin Mehta,Colorado Retina Center,Patient WB Neovascular AMD,CNV,Date:1/10/07,3-D Evaluation reveals extent of CNV,Case courtesy of Dr.Nalin Mehta,Colorado Retina Center,Patient WB Neovascular AMD,Full Retinal Thickness Map,RPE Elevation Map,RPE/choroid
20、 disruption identifies presence of CNV,Some abnormal thickening and thinning,Case courtesy of Dr.Nalin Mehta,Colorado Retina Center,Patient WB Neovascular AMD,1/10/07,2/23/07,B-scan comparison,Full retinal Thickness,RPE Elevation,Treatment 2/7 Lucentis 2/14 PDT,Thinning of retina and improvement in
21、RPE in response to treatment,Case courtesy of Dr.Nalin Mehta,Colorado Retina Center,Patient ED Neovascular AMD,84 year old male,initial exam 12/13/2006,FA shows leakage just superior to fovea,Full retinal thickness shows no thickening,RPE elevation map clearly shows area of CNV superior to fovea,FA,
22、Full retinal thickness map,RPE elevation map,Case courtesy of Dr.Nalin Mehta,Colorado Retina Center,Patient ED Neovascular AMD,Initial Exam:12/13/2006,Follow-up Exam:3/20/2007,RPE/Choroid shows some reduction in height,but overall retinal thickness increases due to intra-retinal fluid accumulation,T
23、reatment1/17 Macugen3/14-Macugen,Case courtesy of Dr.Nalin Mehta,Colorado Retina Center,Patient ED Neovascular AMD,Case courtesy of Dr.Nalin Mehta,Colorado Retina Center,Total Retinal Thickness increases,RPE elevation decreases,Patient WW AMD,76 year old male.,Drusen,PEDs,Case courtesy of Dr.Nalin M
24、ehta,Colorado Retina Center,Patient WW AMD,Full Retinal Thickness Map,RPE Elevation Map,Localized elevations reveal location of PED and Drusen,Full Retinal thickness map normal,Case courtesy of Dr.Nalin Mehta,Colorado Retina Center,Comparison of Stratus OCT to RTVue OCT,Comparison,RTVue,Stratus,Four
25、ier Domain OCT 26,000 A scans per second 5 m 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
26、 twice the depth resolution,Time Domain 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 OCT,Glaucoma Comparison,RTVue,Stratus,Data Cap
27、tured:9510 A scans(pixels)Time:370 msec 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 diameter,Provides Cup Area Rim Area RNFL Map TSNIT graph,Provides TSNIT graph,RTVue provides c
28、omprehensive glaucoma information,Plus,RTVue has exclusive Retinal Ganglion Cell layer assessment,Data Captured:14,810 A scans(pixels)Time:570 msec Area covered:7 x 7 mm,Provides Inner Retina Map Ganglion cell assessment in macula,No Comparison,RTVue provides direct ganglion cell information Inner r
29、etina analysis:RNFL Ganglion cell body Inner plexiform layer,RTVue 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 mm,Provides3 D map,RTVue provides 3 D image of optic disc and parapapillary RNFL,Comparison of Str
30、atus OCT to RTVue OCT,Retina Comparison,RTVue,Stratus,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 diameter,Provides Dense Retinal thickness map
31、,Provides Sparse Retinal thickness map 97%interpolated between lines,RTVue provides more data and a more detailed thickness map,RTVue has 3 D imaging of the macula,Data Captured:51,7212 A scans(pixels)Time:2 seconds Area covered:4 x 4 mm,Provides 3 D map of the macula,No Comparison,RTVue provides 3-
32、D image of macula for a comprehensive review of B-scans over large area,Plus,RTVue has RPE elevation map for Drusen and CNV,Data Captured:19,496 A scans(pixels)Time:780 msec Area covered:5 x 5 mm,Provides RPE Elevation map,RTVue RPE elevation map reveals location and extent of Drusen and CNV which i
33、s missed by retinal thickness maps,No Comparison,RTVue Details,Scan 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 scan
34、s:Glaucoma Scans,High res line scanHigh res cross scanMacula Map over 5 mm x 5 mm3-D macula scan,Nerve Head Map over 4 mm DiameterMacula Map over 7 mm x 7 mmRNFL 3.45 scan circle3-D Optic Disc,Scan Details:Line and Cross,Type#Ascans,#BscansScan 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),line,horizontal,vertical,High density line,HD horizontal,HD vertical,Scan Details:3-D,Type#Ascans,#BscansScan Tim
36、e Transv.Res3-D Macula 512 101 2 sec7.8 m size:4x4 mm3-D Disc 512 101 2 sec7.8 m size:4x4 mm,Scan Details:Maps,Type#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,
