Spectral-Domain Optical Coherence Tomography: A Comparison of Modern High-Resolution Retinal Imaging Systems

PURPOSE: To provide a review of commercially available spectral-domain optical coherence tomography (SD OCT) systems in clinical ophthalmology. DESIGN: Perspective. METHODS: Review of current manufacturer information, selected articles from the literature, and the authors' clinical experience. RESULTS: Because the premise of SD OCT technology is the nonproprietary mathematical formula of Fourier transformation, 9 different SD OCT systems currently are or soon will be commercially available. Also demonstrated are Cirrus en face C-scan visualization of photo, receptor attenuation resulting from acute zonal occult outer retinopathy and Spectral OCT/scanning laser ophthalmoscopy microperimetric analysis of a macular caldera lesion resulting from North Carolina macular dystrophy. CONCLUSIONS: Advances in high-resolution imaging of the anterior and posterior segment have revealed new in vivo details of anatomic, physiologic, and pathologic data for the practice of ophthalmology. Compared with time,domain OCT, SD OCT tends to derive increased retinal thickness and decreased nerve fiber layer thickness measurements. This is likely because of increased depth of resolution and greater volume of data acquired with each scan. Interdevice comparison is not practical because of differences in individual segment boundary algorithms. Improvements in photoreceptor inner segment-outer segment layer visualization should aid our understanding of visual dysfunction in a variety of retinal pathologic features. As the technology develops, SD OCT will continue to provide new insights about ocular structure and disease. (Am J Ophthalmol 2010;149: 18-31. (c) 2010 by Elsevier Inc. All rights reserved.)