TOKYO — The latest developments in optical coherence tomography technology have the potential to unveil features and monitor changes of the lamina cribrosa, the primary site of glaucoma-related axonal injury.
“OCT imaging of the lamina cribrosa is challenging and has limitations. The posterior surface is difficult to see. The anterior is visible but in some cases obscured by prelaminar neuronal tissue,” Joel S. Schuman, MD, said at the World Ophthalmology Congress.
Advancements in technology are progressively allowing better penetration of the tissue.
“The longer wavelength of swept-source OCT has helped us to go deeper, but up to now most of the lamina imaging has been cross-sectional, and the lamina changes from one cross-sectional scan to the next,” he said.
Three-dimensional evaluation has been a step forward, allowing observation of the whole-volume microarchitecture rather than the anterior-posterior border and surface contour of the lamina.
“We can visualize the beams and pores of the [lamina cribrosa] and have published some data on how the beams and pores are different in glaucomatous eyes compared to healthy eyes,” Schuman said.
Polarization-sensitive OCT technology, another new development, allows assessment of blood flow and tissue oxygenation, which are also crucial in the diagnosis and monitoring of glaucoma as well as retinal diseases.
“It is a further area that’s moving very fast. There is a bright future for OCT,” he said.
Disclosure: Schuman receives OCT-related patent royalties from Carl Zeiss Meditec.