Optical Coherence Tomography in Neurological Disorders (OCT)

As part of the Sastry Foundation Advanced Imaging, the Optical Coherence Tomography (OCT) has been implemented into the Neurology department. We use the Heidelberg Spectralis SD OCT as an up and coming technique in the neurological field used to gain insight into the retinal structure and to assess atrophy of the nerves in relation to many neurological conditions. While the main focus has been on Multiple Sclerosis, the high resolution and high reproducibility of the OCT holds the potential to increase our understanding of Parkinson's disease, Alzheimer's disease and other conditions seen in clinical Neurology.

Optical Coherence Tomography (OCT) is a noninvasive and quick cross-sectional imaging technique that uses low-coherence interferometry, which is similar to ultrasound imaging except that it uses light instead of sound, to obtain images of the retina. The OCT functions as a type of optical biopsy to produce either a single line two dimensional image of the 10 layers of the retina and part of the choroid, or a multiple line three dimensional image of the macula to assess anatomical changes or of the optic nerve head to determine if there is swelling.  This high resolution reconstruction of retinal anatomy takes minimal time to acquire and can be reviewed within minutes.  The Spectralis OCT contains a TruTrack active eye tracker which reduces noise to improve the image quality and also allows for AutoRescan, which automatically places follow up scans directly in the same location as the original image, improving our ability to track changes within a patient's retina and bypassing operator variability.

Axonal and neuronal degeneration are commonly associated with a variety of disabilities in many neurological disorders.  Within the central nervous system, the retina is unique in that it contains axons and glia, but no myelin and therefore holds the potential to give insight into the effects of neurodegeneration, neuroprotection and possibly neurorestoration. Having this quick processing tool holds the potential for increasing our comprehension of neurodegeneration and its association with specific disabilities in neurological diseases.