Optical Coherence Tomography Angiography of the Eye: OCT Angiography

David Huang, MD, PhD; Bruno Lumbroso, MD; Yali Jia, PhD; Nadia K. Waheed, MD, MPH
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Book Description

Optical coherence tomography (OCT) angiography is an important new imaging modality that is already being used by ophthalmologists in retina centers worldwide. It uses motion as intrinsic contrast, thus obviating the need to inject any intravenous dye. It uses infrared light that is invisible to the patient, and only requires few seconds per scan.  This makes it both easier to use and much better tolerated by patients than traditional dye-based fluorescein angiography (FA) and indocyanine green (ICG) angiography.

Inside Optical Coherence Tomography Angiography of the Eye Drs. David Huang, Bruno Lumbroso, Yali Jia, and Nadia Waheed include detailed information on clinical applications and fundamental principles needed to understand and use this new technology. This includes information on high-speed OCT systems, algorithms to extract flow contrast, the appearance of the normal eye, the findings in myriad diseases, and tips on how to deal with artifact and pitfalls. 
The 3-dimensional nature of OCT angiography provides visualization that was not possible before with either FA or ICG and readers will come to appreciate how this enables the visualization of previously difficult to image vascular beds such as the 4 retinal vascular plexuses (radial peripapillary, superficial, intermediate, and deep), the choriocapillaris, and the deeper choroidal vessels.

Given its noninvasive nature and ease of use, OCT angiography imaging is rapidly taking an important place in everyday ophthalmology and may soon replace fluorescein angiography in everyday practice.

Optical Coherence Tomography Angiography of the Eye is designed to be the definitive text on this cutting-edge technology for the retina specialist and comprehensive ophthalmologist.

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About the Editors

Contributing Authors


Part I: Principles and Methods

Chapter 1             Optical Coherence Tomography Systems for Angiography

                                Gangjun Liu, PhD; Alex D. Pechauer, BS; David Huang, MD, PhD; and James G. Fujimoto, PhD

Chapter 2             Optical Coherence Tomography Angiography Algorithms

                                Yali Jia, PhD; Simon S. Gao, PhD; and David Huang, MD, PhD

Chapter 3             Cross-Sectional and En Face Visualization of Posterior Eye Circulations

                                Yali Jia, PhD; Bruno Lumbroso, MD; Simon S. Gao, PhD; David Huang, MD, PhD;
                                and David J. Wilson, MD

Chapter 4             Cross-Sectional and En Face Visualization of Normal Anterior Eye Circulations

                                Yan Li, PhD; Yali Jia, PhD; David Huang, MD, PhD; and Alison H. Skalet, MD, PhD

Chapter 5             Artifacts in Optical Coherence Tomography Angiography

                                Simon S. Gao, PhD; Yali Jia, PhD; and David Huang, MD, PhD

Chapter 6             Quantification

                                Yali Jia, PhD; Acner Camino, PhD; Miao Zhang, PhD; Simon S. Gao, PhD;
                                and David Huang, MD, PhD

Chapter 7             Optical Coherence Tomography Angiography: Terminology

                               David Huang, MD, PhD and Simon S. Gao, PhD

Chapter 8             Optical Coherence Tomography Angiography on the Optovue AngioVue With
                                Split-Spectrum Amplitude-Decorrelation Angiography and DualTrac Motion Correction

                                Tony Ko, PhD and Jay Wei, MS

Chapter 9             Optical Coherence Tomography Angiography: Optical Microangiography

                                Ruikang K. Wang, PhD; Qinqin Zhang, PhD; Giovanni Gregori, PhD;
                                and Philip J. Rosenfeld, MD, PhD

Chapter 10           Optical Coherence Tomography Angiography Imaging With Topcon’s One-Micrometer
                                Wavelength Swept Source Optical Coherence Tomography

                               Charles Reisman, MS; Atsushi Kubota, MS; Masahiro Akiba, PhD;
                                Catharine Chisholm, PhD; and Michael J. Sinai, PhD

Chapter 11           Spectral Domain Optical Coherence Tomography
                                Angiography Using NIDEK RS-3000 Advance

                               Mayss Al-Sheikh, MD and SriniVas R. Sadda, MD

Part II: Retinal Diseases

Chapter 12           Exudative Neovascular Age-Related Macular Degeneration
                                Type 1, 2, and Mixed Choroidal Neovascularization

                                Bruno Lumbroso, MD; Steven T. Bailey, MD; Yali Jia, PhD; Marco Rispoli, MD;
                                and Maria Cristina Savastano, MD

Chapter 13           Short- and Long-Term Response of Choroidal
                                Neovascularization to Anti-Angiogenic Treatment

                                Bruno Lumbroso, MD; Steven T. Bailey, MD; Yali Jia, PhD; Marco Rispoli, MD;
                                and Maria Cristina Savastano, MD

Chapter 14           Nonexudative Neovascular Age-Related Macular Degeneration

                                Steven T. Bailey, MD; Ching J. Chen, MD; and Yali Jia, PhD

Chapter 15           Type 3 Neovascularization—Retinal Angiomatous Proliferation

                               Anna C.S. Tan, MBBS, FRCSED; Kunal K. Dansingani, MA, FRCOphth;
                                and K. Bailey Freund, MD

Chapter 16           Non-Neovascular Age-Related Macular Degeneration

                               Ricardo N. Louzada, MD; Nadia K. Waheed, MD, MPH; Jay S. Duker, MD;
                                and Mark Lane, MBBS Honors

Chapter 17           Polypoidal Choroidal Vasculopathy

                                Min Wang, MD, PhD; Simon S. Gao, PhD; and Yali Jia, PhD

Chapter 18           Optical Coherence Tomography Angiography of Macular Telangiectasia Type 2

                                Ching J. Chen, MD; Brian Tieu, MD, PhD; and Matthew Olson, CRA

Chapter 19           Central Serous Chorioretinopathy

                                Eduardo A. Novais, MD; Mark Lane, MBBS Honors;
                                Nadia K. Waheed, MD, MPH; and Jay S. Duker, MD

Chapter 20           Choroidal Neovascularization of Other Causes

                                Brian K. Do, MD; Richard I. Kaplan, MD; Patricia Garcia, MD;
                                Andre Romano, MD; and Richard Rosen, MD;

Chapter 21           Nonproliferative Diabetic Retinopathy

                                Thomas Hwang, MD; Yali Jia, PhD; Miao Zhang, PhD; and David J. Wilson, MD

Chapter 22           Proliferative Diabetic Retinopathy

                                Emily D. Cole, BS; Nadia K. Waheed, MD, MPH; and Jay S. Duker, MD

Chapter 23           Retinal Venous Occlusion

                                Marco Rispoli, MD and Bruno Lumbroso, MD

Chapter 24           Retinal Arterial Occlusion

                                Xiaogang Wang, MD, PhD; Jing Dong, MS; and Yading Jia, BS

Chapter 25           Inherited Retinal Degenerations

                                Rachel Patel, MD; Simon S. Gao, PhD; Paul Yang, MD, PhD; Richard G. Weleber, MD;
                                David J. Wilson, MD; and Mark Pennesi, MD, PhD

Chapter 26           Pathological Myopia

                               Leonardo Mastropasqua, MD and Luca Di Antonio, MD, PhD

Chapter 27           Flow Characteristics in Retinal Vasculitis Using
                                Optical Coherence Tomography Angiography

                               Phoebe Lin, MD, PhD; Miao Zhang, PhD; and Liang Liu, MD

Chapter 28           White Dot Syndromes

                                Philipp K. Roberts, MD; Lee Jampol, MD; and Amani A. Fawzi, MD

Chapter 29           Optical Coherence Tomography Angiography in
                                Choroiditis, Retinitis, and Vasculitis

                                Andre Romano, MD; Rubens Belfort Jr, MD, PhD; and Daniela Ferrara, MD, PhD

Chapter 30           Melanocytic Tumors

                               Alison H. Skalet, MD, PhD; David Huang, MD, PhD; Yali Jia, PhD; and Yan Li, PhD

Chapter 31           Radiation Maculopathy

                                Alexandre Matet, MD; Aude Ambresin, MD; Gilda Cennamo, MD; and Leonidas Zografos, MD

Part III: Optic Nerve Diseases

Chapter 32           Optical Coherence Tomography Angiography in Primary Open-Angle Glaucoma

                                David Huang, MD, PhD; Liang Liu, MD; and Michel Puech, MD, MSC

Chapter 33           Primary Angle-Closure Glaucoma

                               Chunhui Jiang, MD, PhD and Xinghuai Sun, MD, PhD

Chapter 34           Neurodegenerative Diseases

                               Albert J. Augustin, MD and Christian Dempe

Part IV: Anterior Diseases

Chapter 35           Angiography of the Cornea Using Optical Coherence Tomography

                                Winston Chamberlain, MD, PhD; Afshan Nanji, MD, MPH; David Huang, MD, PhD;
                                and Yan Li, PhD

Financial Disclosures


About the Editors

David Huang, MD, PhD is the Peterson Professor of Ophthalmology and Professor of Biomedical Engineering at the Oregon Health & Science University (Portland, Oregon). Dr. Huang received an MD from Harvard University (Cambridge, Massachusetts) and a PhD from Massachusetts Institute of Technology (Cambridge, Massachusetts). He completed an ophthalmology residency at the Doheny Eye Institute/University of Southern California (Los Angeles, California) and cornea fellowship at Emory University (Atlanta, Georgia). Dr. Huang is a co-inventor of optical coherence tomography (OCT), which is the most commonly used ophthalmic imaging technology at 30 million procedures per year. More recently he has pioneered anterior segment OCT and OCT angiography. His seminal article on OCT, published in Science in 1991, has been cited more than 11,000 times. He has 19 issued patents and 18 pending patents in the areas of OCT, mobile health testing, tissue engineering and corneal laser surgery. He has been the principal investigator of 5 NIH research grants totaling over $20 million. He has published more than 200 peer-reviewed articles with nearly 40,000 citations. He has edited 8 books. Dr. Huang has received the Champalimaud Vision Award, the Jonas Friedenwald Award, the David Epstein Award from the Association for Research in Vision & Ophthalmology, the Senior Achievement Award from the American Academy of Ophthalmology, and the Fritz & Dolores Russ Award from the National Academy of Engineering (USA). He is a fellow of the American Academy of Inventors and American Ophthalmological Society. Dr. Huang leads the Center for Ophthalmic Optics and Lasers (www.COOLLab.net). He is a founder of Gobiquity Mobile Health, Inc. (www.gobiquity.com), a maker of mobile diagnostic apps.
Bruno Lumbroso, MD has been Director of the Department of Ophthalmology of the Rome Eye Hospital (Rome, Italy) and Professor LD of Clinical Ophthalmology at the University of Rome La Sapienza (Rome, Italy) for more than 35 years. He is now Directorof the private Centro Italiano Macula in Rome, Italy. He was a pioneer in the development of clinical applications for en face OCT and OCT angiography. He is co-founder and General Secretary of the Societa Italiana di Angiografia OCT and of the Societa Italiana di Laser in Oftalmologia. His main interests are in logical methods of retinal imaging analysis and interpretation, and in clinical applications of OCT and OCT angiography technology for retinal disorders.
Yali Jia, PhD is an Assistant Professor of Ophthalmology and Biomedical Engineering at the Oregon Health & Science University (OHSU) in Portland, Oregon. Dr. Jia earned her PhD in Biomedical Engineering from OHSU in 2010 under the guidance of Dr. Ruikang Wang. Dr. Jia completed her post-doctoral training with Dr. David Huang at Casey Eye Institute in 2013. She developed split-spectrum amplitude de-correlation angiography (SSADA), a highly efficient optical coherence tomography angiography (OCTA) algorithm that made clinical OCTA practical. Her article on SSADA, published in Optics Express in 2012, has been cited more than 430 times. Dr. Jia was awarded 3 National Institute of Health research project grants that supported the initial works that demonstrated clinical applications of OCTA in retinal diseases. She is the technical leader in Casey Reading Center. Her OCTA reading software (COOL-ART) has been used by several large clinical studies and many international collaborators. She has published 75 peer-reviewed journal articles and 25 book chapters; and co-edited 3 books. Her major contributions to the OCTA community are: efficient OCTA, quantitative OCTA, projection-resolved OCTA and motion-free OCTA.
Nadia K. Waheed, MD, MPH is Director of the Boston Image Reading Center and Associate Professor in Ophthalmology at the Tufts University School of Medicine (Boston, Massachusetts). She specializes in clinical and clinical trial applications of optical coherence tomography and optical coherence tomography angiography.