Optical coherence tomography (OCT) allows for micron scale imaging of the human retina and cornea. Previous research and commercial intraoperative OCT prototypes have been limited to live B-scan imaging because they were based on previous-generation spectral domain OCT systems. Our group has developed and reported on an intraoperative microscope integrated OCT system based on a 100 kHz commercial swept source laser. This system is capable of live 4D imaging, and with a heads up display allows for dynamic intraoperative visualization of retinal structures, tool tissue interaction, and surgical maneuvers. OCT angiography (OCTA) is an emerging OCT technology that allows for imaging of retinal vasculature without the use of potentially harmful contrast agents. This structural information can provide insights into the state and development of a wide range of ophthalmic pathologies. The addition of OCTA into intraoperative OCT could allow for monitoring of changes in retinal vasculature during surgery and imaging of traditionally non-compliant patients. In this work we provide a brief update of intraoperative 4D MIOCT across a range of pathologies, and demonstrate intraoperative OCTA for the first time. To the best of knowledge, this is the first report of intraoperative OCTA, as well as the first OCTA images ever acquired in an infant.
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