Since its introduction in the 1960's, fluorescein angiography (FA) has been the gold standard for retinal vascular diagnosis. However, FA is costly, invasive, and time-consuming, which limits its usefulness as a screening tool. As a potential non-invasive alternative to FA for diagnosing retinovascular disease, we have developed an imaging method called phase contrast optical coherence tomography (PC-OCT). Our technology uses specialized software analysis of data acquired from clinically available optical coherence tomography imaging systems to provide an additional functionality of three-dimensional angiography. The majority of eye care in the US is currently performed by optometrists, and in many underserved communities, they are the sole providers. Unfortunately, most optometrists cannot perform FA due to its requirement for intravenous injection. Therefore, retinal vascular diagnostics are limited to clinical exam and fundus photography. Patients receiving optometric care would benefit from a non-invasive alternative to FA for improved screening of retinovascular diseases, especially in these underserved communities. PC-OCT has the potential to provide a low-cost and convenient vascular screening method, which could result in timely referrals to retinal specialists, as well as improved visual outcomes. To advance PC-OCT as a retinovascular imaging tool, we have the following goals: (1) develop PC-OCT software into a faster automated platform for application to commercial spectral domain (SD-OCT) systems;(2) optimize optical scanner performance for imaging both dilated and non-dilated pupils;and (3) demonstrate the feasibility of PC-OCT as a wide-field screening diagnostic for diabetic retinopathy. The visualization capabilities of PC-OCT imaging will be compared directly against fundus photography, the current diagnostic standard for eye care professionals. Successful completion of Phase II will result in an automated software package capable of producing PC-OCT microvascular images from the raw data of a commercial SD-OCT system, allowing for convenient vascular imaging accessible to all eye care practitioners. This could lead to better-quality detection capabilities for retinovascular disease and potentially improved visual outcomes.
This proposal describes a new software product that enhances the diagnostic capability of optical coherence tomography (OCT), the most commonly performed retinal diagnostic test used in the US for evaluation of macular degeneration and diabetic retinopathy. By non- invasively providing high resolution retinovascular imaging, the product, phase contrast OCT (PC-OCT), may potentially replace fluorescein angiography, the current invasive and costly gold standard for retinovascular imaging. The proposed research plan improves the capabilities of PC-OCT and then does a head-to-head comparison with fluorescein angiography in evaluation of patients with wet macular degeneration and diabetic retinopathy.