Goebel W.

Department of Opthalmology, University of Wuerzburg, Germany

Introduction: Optical coherence tomography (OCT) is based on the interference of low-coherence infrared laser light between a measurement beam, which is partly reflected by the retinal structures, and a reference beam with known spatial position. The axial resolution of this technique is 10-20µm. In the past few years, OCT has found its way into the clinical practice for the diagnosis and follow-up of macular diseases.
Clinical applications: The diagnosis and follow-up of macular edema is one of the most important applications of this method. Patients with nondiabetic macular edema due to uveitis, vascular occlusion or Irvine-Gass syndrome may be followed-up objectively and non-invasively during therapy, thus making repeated fluorescein angiography dispensable. In diabetic macular edema, success or failure of focal laser therapy can be documented objectively so that further measures (e.g. repeated treatment or vitrectomy) can be planned. OCT is also a valuable tool in the management of central serous retinopathy, because patients have to be followed-up closely over a longer period of time and repeated angiographies are usually not indicated unless laser therapy is planned. Diseases of the vitreoretinal interface are another major field of application for optical coherence tomography. Macular traction syndrome can be diagnosed reliably. Furthermore, the stage and differential diagnosis as well as the successful treatment of macular holes can be established.
Future applications: OCT will gain further importance in the management of age-related macular degeneration. As OCT is able to show and monitor the degree of exudative changes in the retina due to subretinal neovascularization, this technique may provide a non-invasive diagnostic option in the follow-up of photodynamic therapy and transpupillary thermotherapy.

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