OCT angiography (OCTA) has recently garnered immense interest in clinical ophthalmology, permitting ocular vasculature to be viewed in exquisite detail, in vivo, and without the injection of exogenous dyes. However, commercial OCTA systems provide little information about actual erythrocyte speeds; instead, OCTA is typically used to visualize the presence and/or absence of vasculature. This is an important limitation because in many ocular diseases, including diabetic retinopathy (DR) and age-related macular degeneration (AMD), alterations in blood flow, but not necessarily only the presence or absence of vasculature, are thought to be important in understanding pathogenesis. To address this limitation, we have developed an algorithm, variable interscan time analysis (VISTA), which is capable of resolving different erythrocyte speeds. VISTA works by acquiring >2 repeated B-scans, and then computing multiple OCTA signals corresponding to different effective interscan times. The OCTA signals corresponding to different effective interscan times contain independent information about erythrocyte speed. In this study we provide a theoretical overview of VISTA, and investigate the utility of VISTA in studying blood flow alterations in ocular disease. OCTA-VISTA images of eyes with choroidal neovascularization, geographic atrophy, and diabetic retinopathy are presented.
Since the first demonstration of swept source optical coherence tomography (SS-OCT) imaging using widely tunable micro-electromechanical systems vertical cavity surface-emitting lasers (MEMS-VCSELs) in 2011, VCSEL-based SSOCT has advanced in both device and system performance. These advances include extension of MEMS-VCSEL center wavelength to both 1060nm and 1300nm, improved tuning range and tuning speed, new SS-OCT imaging modes, and demonstration of the first electrically pumped devices. Optically pumped devices have demonstrated continuous singlemode tuning range of 150nm at 1300nm and 122nm at 1060nm, representing a fractional tuning range of 11.5%, which is nearly a factor of 3 greater than the best reported MEMS-VCSEL tuning ranges prior to 2011. These tuning ranges have also been achieved with wavelength modulation rates of >500kHz, enabling >1 MHz axial scan rates. In addition, recent electrically pumped devices have exhibited 48.5nm continuous tuning range around 1060nm with 890kHz axial scan rate, representing a factor of two increase in tuning over previously reported electrically pumped MEMS-VCSELs in this wavelength range. New imaging modes enabled by optically pumped devices at 1060nm and 1300nm include full eye length imaging, pulsatile Doppler blood flow imaging, high-speed endoscopic imaging, and hand-held wide-field retinal imaging.
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