ARVO 2014 Annual Meeting Abstracts 225 New OCT technologies for opthalmic imaging Monday, May 05, 2014 8:30 AM–10:15 AM Exhibit/Poster Hall SA Poster Session Program #/Board # Range: 1615–1637/D0030–D0052 Organizing Section: Multidisciplinary Ophthalmic Imaging Program Number: 1615 Poster Board Number: D0030 Presentation Time: 8:30 AM–10:15 AM Noncontact Ultra-wide field Lens system by Heidelberg Spectralis Mark Espina, Giulio Barteselli, Feiyan Ma, Cheryl A. Arcinue, Natalia Camacho, William R. Freeman, Dirk-Uwe G. Bartsch. Jacobs Retina Center, UCSD, La jolla, CA. Purpose: To evaluate imaging including Ultra-wide field Fluorescein angiography and Indocyanine Green angiography using a modified Heidelberg Spectralis with noncontact ultra-widefield lens system. Methods: 35 eyes underwent fluorescein angiography using the Heidelberg Spectralis noncontact ultra-wide field lens 105 degree diagonal system. Central images were initially obtained centered on the fovea. Views of the far periphery were obtained of the areas of interest, by directing the camera (non-contact) in the appropriate direction. Imaging modalities included infrared, intravenous fluorescein or oral fluorescein and indocyanine green angiography as well as autofluoresence, red free and infrared images. The digital images were then evaluated and compared to the images taken by the same machine using the 30 degrees and the 55 degree wide angle lens system. Results: : 35 eyes were evaluated. Using directional Ultra-wide field view and auto-montaging software, we could image the retina for a diameter of 28mm allowing a field of view to include the equator and some structures anterior to it. The native resolution of 1536x1536 was sufficient to see important retinal details including vascular abnormalities and far peripheral non-perfusion and neovascularization. An advantage of using the Specralis over a dedicated wide angle device is that higher resolution image of an area of interest can be obtained by switching to the standard Spectralis lens (5 microns/pixel) versus the low nominal resolution of the usable wide-angle lens of the Spectralis (10 microns/pixel with 55° degree lens) or Optos (14 microns/pixel on standard view and 11 microns/ pixel on high-resolution view) system lenses. The lens could be used for oral or intravenous fluorescein angiography and other imaging modalities. Conclusions: Images taken from Ultra-wide field noncontact lens system of Heidelberg Spectralis permits a 105 degrees field of view covering which can be easily montaged to cover equator to equator of the retina. . The device allows for AF, IR, IVFA, Oral FA and ICG ultra-wide field views enabling visualization and localization of important choroidal and retinal structures from equator to equator.

Commercial Relationships: Mark Espina, None; Giulio Barteselli, None; Feiyan Ma, None; Cheryl A. Arcinue, None; Natalia Camacho, None; William R. Freeman, NEI (F), RPB inc (F), UCSD (F); Dirk-Uwe G. Bartsch, NEI (F), RPB inc (F), UCSD (F) Support: NEI grants to Drs William Freeman and Dirk Bartsch, an unrestricted grant to the UCSD Jacbos retina center and RPB inc and a core grant from the NEI. Program Number: 1616 Poster Board Number: D0031 Presentation Time: 8:30 AM–10:15 AM WIDE-FIELD SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY Francesca Gilardoni, Francesco Pichi, Francesco Bonsignore, Paolo Nucci. San Giuseppe hospital, Milano, Italy. Purpose: To describe an innovative technique for wide-field spectraldomain optical coherence tomography B-scans of the vitreous, retina and choroid and examine the morphologic relationships between these structures in healthy and pathological eyes. Methods: All SD-OCT examinations were performed using SDOCT (Spectralis; Heidelberg Engineering, Vista, CA). Standardized horizontal, vertical, and 2 oblique (supertemporal to inferonasal and supranasal to inferotemporal) sections were collected for each patient. For extramacular imaging, images were obtained from 8 locations: (1) nasal to the optic disc, (2) extreme nasal periphery, (3) superior to the superotemporal vascular arcade, (4) extreme superior periphery, (5) inferior to the inferotemporal vascular arcade, (6) extreme inferior periphery, (7) temporal to the macula, and (8) extreme temporal periphery. To examine the morphologic features of the entire vitreoretinal interface, retina and choroid, wide-angle montage images of OCT from the macula to the periphery (approximately the equator) were composed with an experimental software. Results: Wide-field SD-OCT scans that extended from the macula to the equator, measuring 30 mm, were obtained in 10 healthy subjects, in 10 patients with central serous chorioretinopathy, in 10 patients with wet age-related macular degenerations, in 10 patients with dry age-related macular degenerations, in 10 patients with diabetic retinopathy, in 10 patients with macular pucker, and in 10 patients with macular hole

©2014, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected].

ARVO 2014 Annual Meeting Abstracts Conclusions: The novel approach of montaging SD-OCT images to examine relationships between the choroid, retina, and associated structures adjacent to and outside of the macula may have a number of relevant applications in the study of vitreoretinal interface, paramacular, and macular pathologic features.

Conclusions: Methods have been described to obtain OCT scans with wide field of view by combining multiple OCT cube scans. The combined image allows visualization of OCT features over a larger field of view than previously available, showing peripheral anatomy and putting macular observations into a more complete anatomical context.

Figure 1: Widefield OCT enface image for an eye with Diabetic Retonopathy Commercial Relationships: Harihar Narasimha-Iyer, Carl Zeiss Meditec Inc (E); Michal Laron, Carl Zeiss Meditec Inc (E); Mary K. Durbin, Carl Zeiss Meditec Inc (E); Sowmya Srinivas, Carl Zeiss Meditec (F); Srinivas R. Sadda, Carl Zeiss Meditec Inc (F); Giovanni Gregori, Carl Zeiss Meditec Inc (F); Philip J. Rosenfeld, Carl Zeiss Meditec Inc (F)

Commercial Relationships: Francesca Gilardoni, None; Francesco Pichi, None; Francesco Bonsignore, None; Paolo Nucci, None Program Number: 1617 Poster Board Number: D0032 Presentation Time: 8:30 AM–10:15 AM Widefield Imaging of the retina using Swept Source OCT Harihar Narasimha-Iyer1, Michal Laron2, Mary K. Durbin1, Sowmya Srinivas3, Srinivas R. Sadda3, Giovanni Gregori4, Philip J. Rosenfeld4. 1Advanced Development, Carl Zeiss Meditec Inc, Dublin, CA; 2Clinical Affairs, Carl Zeiss Meditec Inc, Dublin, CA; 3Doheny Eye Institute, Los Angeles, CA; 4Bascom Palmer Eye Institute, Miami, FL. Purpose: To obtain OCT images with field of view greater than possible with individual OCT cube scans. Methods: Ten eyes including normal eyes and eyes with different retinal pathologies were imaged using a custom prototype swept source OCT system. The system supported acquisition of 12mmx9mmx3mm cube OCT scans. In one protocol, the subjects were asked to fixate centrally and then at a position temporal from the central location. In another protocol, the subjects were asked to fixate on fixation locations superior and inferior to the fovea. The fixation locations were chosen such that there was some overlap between the OCT scan regions for the two scans. The corresponding pair of OCT scans were then registered using custom software and information available from both of the scans. Results: OCT images with a field of view of ~19mmx10mmx4.5mm and ~12mmx13.5mmx4.5mm were obtained allowing visualization of widefield OCT B-Scans. Using the same registration software, we generated widefield retinal thickness maps as well as OCT slab images to better visualize the retinal anatomy and pathologies. An example is shown in Figure 1, showing peripheral lesions.

Program Number: 1618 Poster Board Number: D0033 Presentation Time: 8:30 AM–10:15 AM Widefield Choroidal Thickness Maps Giovanni Gregori, Mariana Rossi Thorell, Zohar Yehoshua, Philip J. Rosenfeld. Ophthalmology, Bascom Palmer Eye Institute, Miami, FL. Purpose: To obtain choroidal thickness maps over extended retinal regions. Methods: Ten eyes including normal eyes and eyes with different retinal pathologies were imaged using a custom prototype swept source OCT system. The system supported acquisition of 12mmx9mmx3mm cube OCT scans. A novel algorithm was developed to segment the anterior a posterior boundaries of the choroid over the full OCT datasets. Results: Pointwise thickness maps of the choroid were obtained over the scan area using the automated algorithm. Using the associated OCT fundus images, choroidal thickness information can be correlated to en face retinal landmarks. Conclusions: Measurements of choroidal thickness at the fovea have been used to assess and summarize the appearance of the choroid in eyes with different retinal diseases. However choroidal thickness can vary significantly across the retina and detailed quantitative descriptions over extended regions have the potential to improve our understanding of various retinal pathologies. Commercial Relationships: Giovanni Gregori, Carl Zeiss Meditec (F), Carl Zeiss Meditec (P); Mariana Rossi Thorell, Carl Zeiss Meditec (F); Zohar Yehoshua, None; Philip J. Rosenfeld, Carl Zeiss Meditec (F) Support: Research Grant Carl Zeiss Meditec

©2014, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected].

ARVO 2014 Annual Meeting Abstracts Program Number: 1619 Poster Board Number: D0034 Presentation Time: 8:30 AM–10:15 AM Wide Field MHz OCT imaging of the vitreoretinal interface Karsten U. Kortuem1, Jan Philip Kolb2, Thomas Klein2, Kathrin Mohler2, Anselm Kampik1, Aljoscha S. Neubauer1, Wolfgang Wieser2, Robert Huber2, 3, Christos Haritoglou1. 1Ophthalmology, Ludwig-Maximilians-University, Munich, Germany; 2Institute for Biomolecular Optics, Faculty of Physics, Ludwig-MaximiliansUniversity, Munich, Germany; 3Institute of Biomedical Optics, Universität zu Lübeck, Lubeck, Germany. Purpose: To investigate changes caused by vitreoretinal interface disease with a multi-MHz OCT over a wide field of view of 60°. Methods: We used custom swept-source OCT device with a 1060nm Fourier-domain mode-locked laser source achieving a line rate of 1.68MHz. Within 1.82s datasets consisting of 2088x1024 A-scans over 60° were acquired from 5 patients with vitreoretinal traction due to VMTS and 3 patients with vascular pathology. The densely sampled three dimensional datasets were investigated in B-Scan cross-sections as well as en-face images and 3D reconstructions. Results: Vitreoretinal traction could be imaged well in most of the cases, although the current sensitivity of the system limited image quality. Across the whole 60° field of view in the OCT datasets vitreoretinal tractions could be topographically assessed, always including the macula and optic disc, where vitreous anchorage could be shown. By means of the depth-scans as part of the 3D OCT volume we could image traction-associated retinal changes such as retinal elevation or RPE detachment. Conclusions: This unique three dimensional visualization of the retina over 60° field of view with a MHz OCT is feasible in patients with vitreoretinal interface disease and might offer additional clinical insights on the three-dimensional topology of tractional changes.

Program Number: 1620 Poster Board Number: D0035 Presentation Time: 8:30 AM–10:15 AM Wide-field choroidal thickness and en-face maps of patients created with MHz-OCT Thomas Klein1, Wolfgang Draxinger1, Kathrin Mohler1, Jan Philip Kolb1, Wolfgang Wieser1, Anselm Kampik3, Aljoscha S. Neubauer3, Armin Wolf3, Robert Huber1, 2. 1Faculty of Physics, LMU München, Munich, Germany; 2Institute of Biomedical Optics, Universität zu Lübeck, Lübeck, Germany; 3Ophthalmology, LMU München, Munich, Germany. Purpose: To study the feasibility of simultaneous peripheral and central choroidal thickness measurement and en-face visualization in patients with a variety of diseases, using a single high-resolution wide-field MHz-OCT dataset spanning more than 50 degrees field of view. Methods: In this retrospective study, choroidal morphology of 29 patients imaged with MHz-OCT was assessed. MHz-OCT is a custom SS-OCT operating at 1060nm and an axial line rate of 1.68MHz. The high speed, more than 30 times faster than current commercial devices, enabled a very high resolution scan protocol of 2088x1024 A-scans over a wide field of ~60 degrees. However, due to the very high speed, signal strength is lower compared to slower devices. Hence, thickness and structure maps were only created for selected datasets: The positions of Bruch’s membrane and choroid sclera junction were determined manually by a trained observer a subset of all A-scans, from which thickness and intensity maps were created. Results: Despite relative low signal strength, the choroid sclera junction could be clearly observed over the entire unshadowed image area in 15 of 29 patients. Apart from shadowing, visibility of this junction shows strong variation even within a single dataset due to varying retinal thickness, eye-blinks, saccades and retinal curvature. Thus, thickness could be evaluated at least in some areas for all 29 patients, especially in the periphery. Moreover, choroidal thickness varied considerably intra- and interindividually. In two patients, abrupt changes of the choroid were observed in the temporal periphery, which may resemble morphology or imaging artifact. In addition to thickness, en-face choroidal structure maps were extracted from the segmented OCT datasets. Visibility of choroidal vasculature in these maps correlates with choroidal thickness. Conclusions: Choroidal thickness and structure in patients could be visualized over large areas for the first time. Due to focal choroidal thickness changes with large thickness gradients, high-density scan protocols may be favorable for OCT-based investigations of the choroid. En-face images of the choroid can be extracted from these high-resolution datasets, but the influence of choroidal thickness on the image information should be taken into account.

Three dimensional Wide Field MHz OCT retinal and vitreous visualization. Commercial Relationships: Karsten U. Kortuem, None; Jan Philip Kolb, None; Thomas Klein, None; Kathrin Mohler, None; Anselm Kampik, None; Aljoscha S. Neubauer, None; Wolfgang Wieser, None; Robert Huber, None; Christos Haritoglou, None Support: Freunde und Förderer der Augenklinik der LMU; ERC, contract number 259158 Clinical Trial: DRKS00005173

©2014, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected].

ARVO 2014 Annual Meeting Abstracts Methods: Retrospective, comparative and non-interventional study. One hundred and thirteen (113) consecutive patients underwent 1,050nm SS-OCT (Atlantis DRI-OCT1®, Topcon Corp, Japan). The prevalence of the BPM and SM was assessed in HE and MD. Macular CT was determined by measuring the distance between the RPE and the choroid/sclera junction at three sites along a 500mm line centred on the fovea of 53 HE and 138 MD. Patients were categorised into 8 groups; Diabetic Retinopathy (DR) (19), Cystoid Macular Oedema (CMO) (26), Age-Related Macular Degeneration (AMD) (32), High Myopia (HM) (22), Vitreomacular Adhesion (VMA) and/ or Epiretinal Membrane (ERM) (11), Central Serous Retinopathy (CSR) (9), Retinitis Pigmentosa (RP) (9) and Miscellaneous (10). Results: Mean age was 47±23 years for HE versus 57±22 years for MD (p