Swept Source Enhanced Depth Imaging Optical Coherence Tomography

Shaare Zedek Medical Center

Status: Unknown

Conditions: Retina, Choroid, Sclera

Treatments: Device: DRI-1 Swept source OCT, Atlantis, Topcon

Study type: Interventional

Funder types: Other

Identifiers

NCT02443129

185/14

Details and patient eligibility

About

The investigators would be interested in applying the enhanced depth imaging technique to swept source optical coherence tomography, by modifying the acquisition protocol. Doing so, the investigators hope to improve the visualization of the choroid and perhaps even of the sclera.

Full description

A structurally and functionally normal choroidal vasculature is essential for retinal function. The status of the choroid appears to be a crucial determinant in the pathogenesis of diseases such as age-related choroidal atrophy, myopic chorioretinal atrophy, central serous chorioretinopathy, chorioretinal inflammatory diseases, and tumors.

The in vivo structure of the choroid in health and disease is incompletely visualized with traditional imaging modalities, including indocyanine green angiography and ultrasonography.

Optical coherence tomography (OCT) is an established medical imaging technique that uses light to capture micrometer-resolution, three-dimensional images from within optical scattering media. OCT is based on low-coherence interferometry. Nowadays, it is essential for managing retinal conditions.

Unfortunately, standard spectral domain optic coherence tomography (SD-OCT) is of limited use in imaging choroidal morphology.

A modification to the standard technique, termed enhanced depth imaging optical coherence tomography (EDI-OCT), is able to image the choroid with better clarity using commercial SD-OCTs.

With the advent of enhanced depth imaging optical coherence tomography (EDI-OCT), detailed visualisation of the choroid in vivo has been made possible possible. Measurements of choroidal thickness (CT) have also enabled new directions in research to study normal and pathological processes within the choroid.

However, EDI-OCT has its own limitations: the outer choroidal border cannot always be visualized and choroidal details sometime lack clarity.

A new generation of OCTs has been made available, based on swept-source technology.

Swept source OCT (SS-OCT) has been shown to be more precise than spectral domain EDI-OCT in measuring choroidal thickness.

Our department is now using two OCTs, one is a SD- OCT (Canon HS-100), the other one a SS- OCT (Topcon DRI Atlantis).

The investigators would be interested in applying the EDI technique to SS- OCT, by modifying the acquisition protocol. Doing so, the investigators hope to improve the visualization of the choroid and perhaps even of the sclera.

This modification is based on the technique described by Spaide for SD-OCT.

From the patient's perspective, it only involves spending more time fixing the green stimulus (about 4 minutes instead of 2, in order to follow the swept-source EDI protocol in addition to standard swept source).

Enrollment: 120 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Ability to sit for OCT

Exclusion criteria

• Media opacities precluding fundus view

Trial design

Primary purpose: Basic Science

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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120 participants in 9 patient groups

control group

Experimental group

Description:

18-99 year old male + female Intervention: DRI-1 Swept source OCT, Atlantis, Topcon

Treatment:

Device: DRI-1 Swept source OCT, Atlantis, Topcon

mydramide only

Experimental group

Description:

Patients in the clinics undergoing pupil dilation Intervention: Tropicamide instillation to both eyes DRI-1 Swept source OCT, Atlantis, Topcon

Treatment:

Device: DRI-1 Swept source OCT, Atlantis, Topcon

mydramide and ephrine 10%

Experimental group

Description:

Patients in the clinics undergoing pupil dilation Intervention: Tropicamide and ephrine 10% instillation to both eyes DRI-1 Swept source OCT, Atlantis, Topcon

Treatment:

Device: DRI-1 Swept source OCT, Atlantis, Topcon

All patients presenting with RD

Experimental group

Description:

Patients with retinal detachment Intervention: RD surgery DRI-1 Swept source OCT, Atlantis, Topcon

Treatment:

Device: DRI-1 Swept source OCT, Atlantis, Topcon

Impact of previous grid treatment

Experimental group

Description:

Patients after grid laser Intervention: DRI-1 Swept source OCT, Atlantis, Topcon

Treatment:

Device: DRI-1 Swept source OCT, Atlantis, Topcon

Effect of glaucoma medications

Experimental group

Description:

Patients requiring new intraocular presssur (IOP)-lowering treatment Patients with long-term IOP-lowering treatment Intervention: If needed, start of new IOP-lowering treatment DRI-1 Swept source OCT, Atlantis, Topcon

Treatment:

Device: DRI-1 Swept source OCT, Atlantis, Topcon

Effect of arteritic/non-arteritic AION

Experimental group

Description:

About 180 living patients diagnosed at ShaareZedek with anterior ischemic optic neuropathy (AION). Longitudinal arm with newly diagnosed patients for 2 years follow-up Intervention: DRI-1 Swept source OCT, Atlantis, Topcon

Treatment:

Device: DRI-1 Swept source OCT, Atlantis, Topcon

NVAMD poorly responsive to Rx

Experimental group

Description:

Patients with neovascular age-related macular degeneration and epiretinal membreane/vitreomacular traction who do not respond to first course of Avastin Intervention: DRI-1 Swept source OCT, Atlantis, Topcon

Treatment:

Device: DRI-1 Swept source OCT, Atlantis, Topcon

Retrospective analysis

Experimental group

Description:

All patients pictured with DRI-OCT Intervention: DRI-1 Swept source OCT, Atlantis, Topcon

Treatment:

Device: DRI-1 Swept source OCT, Atlantis, Topcon