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Purpose The purpose of this study was to identify quantitatively measurable morphologic optical coherence tomography (OCT) characteristics in patients with an acute episode of central serous chorioretinopathy (CSC) and evaluate their correlation to functional and psychological variables for their use in daily clinical practice. Methods Retinal thickness (RT), the height, area and volume of subretinal fluid (SRF)/pigment epithelium detachments were evaluated using the standardized procedures of the Vienna Reading Center. These morphologic characteristics were compared with functional variables [best-corrected visual acuity (BCVA), contrast sensitivity (CS), retinal sensitivity/microperimetry, fixation stability], and patients' subjective handicap from CSC using the National Eye Institute 25-item Visual Function Questionnaire (NEI VFQ-25). Results Data from 39 CSC patients were included in this analysis. Three different SRF height measures showed a high negative correlation (r = -0.7) to retinal sensitivity within the central 9°, which was also negatively correlated with SRF area and volume (r = -0.6). The CS score and fixation stability (fixation points within 2°) showed a moderate negative correlation (r = -0.4) with SRF height variables. Comparison of the subjective handicap with morphological characteristics in spectral-domain (SD)-OCT showed SRF height had the highest correlation (r = -0.4) with the subjective problems reported and overall NEI VFQ-25 score. Conclusion In conclusion, SRF height measured in SD-OCT showed the best correlation with functional variables and patients' subjective handicap caused by the disease and therefore seems to be the best variable to look at in daily clinical routine. Even though area and volume also show a correlation, these cannot be so easily measured as height and are therefore not suggested for daily clinical routine.

Morphological changes in early and intermediate stages of age-related macular degeneration (AMD), including drusen and pigmentary abnormalities, can nowadays be visualized by a variety of imaging modalities. Findings from optical coherence tomography (OCT) in particular play an important role in the diagnosis and follow-up of patients with AMD. However, color fundus photography (CF), fundus autofluorescence (FAF), near-infrared reflectance (NIR), near-infrared autofluorescence (NIA), fluorescein angiography (FA), and indocyanine green angiography (ICGA) are often needed to complete the information acquired with OCT. Although best-corrected visual acuity (BCVA) is still of major value in monitoring the macular function of patients with AMD, it only measures a single aspect of visual function. Additional microperimetric examinations can help to investigate patient’s comprehensive “quality of vision.” This chapter focuses on the abnormalities seen with different imaging modalities and structure-function correlations and also provides a definition of AMD and a short introduction to the therapeutic options for early and intermediate AMD.

We present a new instrument that is capable of imaging human photoreceptors in three dimensions. To achieve high lateral resolution, the system incorporates an adaptive optics system. The high axial resolution is achieved through the implementation of optical coherence tomography (OCT). The instrument records simultaneously both, scanning laser ophthalmoscope (SLO) and OCT en-face images, with a pixel to pixel correspondence. The information provided by the SLO is used to correct for transverse eye motion in post-processing. In order to correct for axial eye motion, the instrument is equipped with a high speed axial eye tracker. In vivo images of foveal cones as well as images recorded at an eccentricity from the fovea showing cones and rods are presented.

We present an alternative approach for an adaptive optics scanning laser ophthalmoscope (AO-SLO). In contrast to other commonly used AO-SLO instruments, the imaging optics consist of lenses. Images of the fovea region of 5 healthy volunteers are recorded. The system is capable to resolve human foveal cones in 3 out of 5 healthy volunteers. Additionally, we investigated the capability of the system to support larger scanning angles (up to 5°) on the retina. Finally, in order to demonstrate the performance of the instrument images of rod photoreceptors are presented.

In this study we use our previously introduced scanning laser ophthalmoscope (SLO) / transverse scanning optical coherence tomography (TS-OCT) instrument to investigate long term changes in cone photoreceptors. The instrument is capable to provide 3D information of the human cone photoreceptors with negligible eye motion artifacts due to an implemented 3D motion correction on a cellular level. This allows for an in vivo investigation of exactly the same location on the retina with cellular resolution over several days. Temporal changes in the backscattered intensity are observed and quantified within the junction between inner and outer segments of cone photoreceptors, the cone outer segments, the end tips of cone photoreceptors and the retinal pigment epithelium. Furthermore, the length of individual cone outer segments is measured and observed over time. We show, to the best of our knowledge for the first time, that bright reflection spots which are located within the outer segment of cone photoreceptors change their position when observed over extended time periods. The average measured bright reflection spot motion speed corresponds well to the expected cone growth speed. We believe that this observation can be associated with the first direct in vivo imaging of the cone renewal process.