Optical Coherence Tomography Flashcards

1
Q

What is an example where OCT is used in day to day life?

A

Opticians

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2
Q

What does optical refer to in OCT?

A

Visable light (400-700nm)

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3
Q

What does coherence refer to in OCT?

A

Waves that move together and the specific properties that some light sensors have

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4
Q

What does tomography refer to in OCT?

A

Takes 3D images that we an slice at any dimension to give a full overview of the body

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5
Q

Generally, how does OCT work?

A

Similar to ultrasound, there is relfection from boundaris in tissues where the refractive index changes

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6
Q

What is refractive index?

A

Is a material property that describes how the material affects the speed of light travelling through it

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7
Q

What is the refractive index dependent on?

A
  • Speed of light
  • Phase velocity of light
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8
Q

What is a temporally coherent source?

A

Over a time period, points on the wave move together

The source is monochromatic (a single wavelength)

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9
Q

What is a temporally incoherent source?

A

Changing wavelength/combination of wavelengths over time

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10
Q

What is a spatially coherent source?

A

In a set time, points on the wavelength move together

They are ‘in phase’, related to size of emitter, distance from source, wavelength

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11
Q

What is a spatially incoherent source?

A

Points on the wavefront do not move together

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12
Q

Which coherence is important for OCT?

A

Temporal coherence

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13
Q

What is the resolution range of OCT?

A

1-10micrometers

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14
Q

What is the penetration range of OCT and why?

A
  • Relatively narrow (between 1 mm and 1cm)
  • Light goes through and gets absorbed by chromophores such as Hb and meltatonin
  • Anything in the yellow or green range gets absorbed and scattered- can therefore only penetrate red
  • Fujimoto J.G, Schmitt J et al 2020
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15
Q

What are the three relevant properties of loght for OCT?

A
  • Coherence
  • Wavelength (relates to penetration depth in the tissue and how to maximise this)
  • Power (energy/unit of time) (want to stay within the damage threshold of the tissue)
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16
Q

What is the temporal coherence for monochromatic light and what is an example of a light source?

A
  • Temporal coherence is strong
  • A laser
  • Singular wavelength
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17
Q

What is the temporal coherence for ‘white’ light?

A
  • Contains all wavelengths
  • Has low/no coherence
  • Huge spectral bandwidth
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18
Q

What is the spectral brandwidth?

A
  • The width of frequency distribution
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19
Q

What is the perfect temporal coherence for OCT?

A
  • Need a medium amount of wavelengths
  • Medium spectral bandwidth
  • Complicated envelope of waves
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20
Q

What is the wave envelope?

A

The line over the top of the waves

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21
Q

What does coherence length (cl) tell us?

A

Tells us how coherent the light source is

This is proportional to the wavelength spread and the bandwidth of the light source

Also relates to the resolution

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22
Q

What are the basic components within an OCT?

A
  • 2 ‘arms’
  • Light source
  • Beam splitter (semi silvered mirror)- allows light to pass through in both directions
  • Mirror that can move backwards and forwards
  • Detector
  • Huang D, Wand J et al 1991
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23
Q

What does the michaelson interferometer do?

A
  • At the detector the light sources recomvine and interfere if the path length of the two arms is within the coherence length of the source
  • If the coherence length of the light source is small then this only occurs for a small distance
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24
Q

How can you work out the depth probed in the sample using OCT michaelson interferometer?

A

Can determine the depth to a high accuracy if you know the mirror scan distance

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25
Q

What are some inefficiencies with the classic michaelson interferometer OCT?

A
  • Most tissue is turbid (scatters the light)
  • Reflection is therefore poor- signal to noise ratio is not good
  • Ideally the signals to the detector would be balanced
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26
Q

How can you get around the inefficiencies of the classic Michaelson interferometer OCT?

A

Use a fibre based systom with a circulator

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27
Q

What does a circulator do in OCT?

A
  • Light goes from the laser to the centre
  • It ensures that light from only one way can go into a specific junction
  • 1 goes into 2, and 2 into 3
  • Therefore 90% goes into the tissue and 10% to the mirror
  • Better signal to noise ratio
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28
Q

What is axial resolution in terms of imaging resolution?

A
  • Resolution in the depth of the tissue
  • Axial resolution is dependent on the bandwidth (and hence coherence length) of the light source
  • Axial resolution is inversely proportional to the bandwidth of the light source
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29
Q

What is lateral resolution in terms of imaging resolution?

A
  • Resolution across the surface
  • Lateral resolution is dependent on the optics of the system (lens properties) and the wavelength (as per optical microscopy-related to the diffraction limit)
  • Lateral resolution is proportional to wavelength and focal distance of the lens and inversely proportional to the siameter of the light souce incident on the lens
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30
Q

What determines the choice of wavelength when considering imaging a tissue?

A
  • Predetermined due to available wavelength of sources deliverable by fibre, designed for telecoms
  • Absorbancy of the molecule
  • Optical window (to get deeper into the tissues and avoid damage)
  • Scattering in the tissue (want to avoid this)
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31
Q

What are some different absorbing molecule wavelengths?

A
  • Melanin, water and Hb are strong absorbers
  • Hb has two peaks 500-600nm
  • They drop down as we go into the infrared side
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32
Q

What is the most common wavelength/light source used in OCT and what are the values associated with it?

A
  • Superluminescent diodes (or other broadband light sources)
  • GaAs: 800nm
  • Bandwidths: 30nm
  • Axial resolution: 10 micrometers in tissue
  • Drexler w, Fujimoto JG, Springer 2013
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33
Q

What does a larger bandwidth mean in terms of reslution

A

Higher resolution

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34
Q

Which light source produces the largest bandwidth?

A
  • Femtosecond (10^-15) lasers
  • Near IR bandwidths (800nm-1micrometer)
  • Drexler w, Fujimoto JG, Springer 2013
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35
Q

What is a 1D image in terms of OCT?

A
  • Is an A-mode scan (amplitude) and is a depth profile of the sample
  • Dingle point measure into depth of tissue, showing boundaries as peaks in reflected signal
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36
Q

What is a 2D image in terms of OCT?

A
  • B-mode/2D is made up of a series of z-axis scans into depth resolution of microns into tissues.
  • Single plane, cross-section through sample
  • ‘Optical biopsy’
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37
Q

What is a 3D image in terms of OCT?

A
  • En-Face/3D builds up 2D scans by raster scanning over the surface
  • X-Y scan of the surface of the tissue, surface reflection, surface topography
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38
Q

What is a spectral/fourier domain set up of OCT?

A
  • Can be higher speed (100x)
  • Higher resolution and have better signal to noise than michaelson interferometer
  • Reflectance interference between the reference arm and the tissue is calculated simultaneously at all points along the depth of the A-scan
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39
Q

What does spectral/fourier domain OCT rely on?

A

Obtaining the spectrum of reflected light

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40
Q

What is the most common commercial OCT set up?

A

Spectral/fourier domain

41
Q

What is the michaelson interferometer OCT set up?

A
  • ‘Time domain’
  • Most basic
42
Q

See page 31 of OCT lecture to see time vs spectral domain depiction

A
43
Q

Outline how the spectral/fourier domain OCT works?

A
  • No moving mirror
  • The signal from different depths in the tissue has a different time delay
  • Leads to different interference signal depending on the depth in the tissue
  • Possible to tell from the different ‘echo’ delays (measures by spectrometer in frequency (not wavelength) the magnitude of the axial measurements).
44
Q

What is polarization used for in functional OCT imaging?

A
  • Birefringence in tissues- e.g. scarring
45
Q

What is spectroscopy used for in functional OCT imaging?

A
  • Differences in tissue bonding (identification of different material in the tissue)
  • Uses absorbance curves without dyes- different properties in terms of the spectrum
46
Q

What is doppler/speckle used for in functional OCT imaging?

A
  • Blood flow
  • Look at the speed of tissues
47
Q

Are functional or structural changes better for noticing disease?

A

Functional changes are often a precursor to structural changes in disease

48
Q

What is bireringence property?

A

The refractive index of the material differs depending on the pathway and polarisation of light

49
Q

How does polarisation sensitive OCT work?

A
  • Polarised light can be used to detect changes in the birefringence of tissues caused by disease
  • Birefringence is a property of tissue because it is often composed of long chain molecules e.g. collagen
  • Chain become disrupted due to damage
  • CHanges in structure and orientation of the chains lead to different optical properties in the tissue including birefringence
  • Need polarised light source and optics
50
Q

How does spectroscopic OCT work?

A
  • Utilises the absorbtion spectrum by comparing what we expect the seen absorbtion
  • Can be used to contrast enhancement and to measure the concentration of tissue chromophores such as Hb
51
Q

What is the doppler principle?

A
  • When light backscattered from a moving particle interferes with the reference beam, a doppler frequency shift occurs in the interference fringe
  • Shift in frequency is proportional to the velocity of the moving molecule
52
Q

Where anatomically is OCT normally used?

A
  • Eye
  • Skin- easy to get at and test
  • Heart-easy if already imaging inside vessels, can get an optical fibre into the heart
  • Gut- is easy to get a camera into
53
Q

What is the fundus of the eye?

A

Composed of the retina, macula, opic disc, fovea, vasculature

54
Q

What is the fovea of the eye?

A

Small depression in the retina, located in the macula, aids vision

55
Q

Where is the choroid thin located?

A

Between the retina and the sclera

56
Q

Why is the eye perfect for OCT?

A

The front section is transparent so easy to get light into the retina for optical imaging

57
Q

What are the two main structures visable in a OCT of the eye?

A
  • Macula
  • Optic nerve
58
Q

What is the macula?

A

Controls central vision, colour vision and fine detail

59
Q

What is the optic nerve?

A

Is a fibre bundle which carries visual information from the retina to the brain

60
Q

What is the health of eye vessels indicitive of?

A
  • Eye disease
  • Systemic diseases
61
Q

Outline how light is transmitted into the eye and the different absorption properties of the tissues

A
  • Light travels through the cornea and the lens to get to the retina (350-700nm)
  • UVB light (<315) is absorbed bbyb the cornea
  • UVA light (315-400) is absorbed mostly by the lens
62
Q

What alters the absorption spectrum of the lens?

A

Ageing, causing a greater increase in blue light absorption

63
Q

What is OCT angiography (OCTA)?

A
  • Looks into small vessels (no dye needed)
  • Analogous to dopper- uses speckle
64
Q

What causes microvascular changes in the angiography of an eye?

A
  • Diabetes
  • Hypertension
  • Cardiovascular diseases
  • Neurodegenerative diseases
65
Q

What is healthy perfusion density of the eye?

A

45%

66
Q

What types of OCTA can be imaged?

A
  • En face small field images (on the face of the tissue)
  • Superficial and deeper vessels resolved into layers
  • Choriocapillaris
  • Cross section of structure and function (overlay blood vessels on top)
  • Widefield image
  • Widefield image with superficial and deeper vessels resolved into layers
67
Q

What is the choriocapillaris?

A

Network of capillaries that supply oxygen and nutrients to the retina (the innermost layer of the choroid)

68
Q

What are three common conditions of the eye diagnosed by OCT?

A
  • Diabetic retinopathy
  • Glaucoma
  • Age related macular degeneration (wet/dry)
69
Q

What is the cause of diabetic retinopathy?

A

High blood glucose levels damage the retinal vessels

70
Q

What are the consequences and observed outcomes of diabetic retinopathy?

A
  • The vessel walls weaken causig protrusions in vessel walls.
  • This increases the permeability causing leaking and oedema in retinal tissues
  • Causes blurred vision and floater
71
Q

What are two treatment options for diabetic retinopathy?

A
  • Anti VEGF
  • Laser surgery
71
Q

What is the cause of glaucoma?

A

Increased pressure in the eye due to an excess of aqueous humor (drainage blocked)

72
Q

What are the observed outcomes and consequences of glaucoma?

A
  • Pressure leads to compression (thinning of layers) and loss of nerve fibres
  • Initially peripheral vision loss, then central
73
Q

What are the 3 treatment options for glaucoma?

A
  • Eye drops
  • Trabeculoplasty (holes to unblock)
  • Iridotomy (holes in the eye)
74
Q

What causes dry age-related macular degeneration?

A
  • (80%)
  • Macula thins with age, protein accumulation
75
Q

What causes wet age-related macula degeneration?

A

Angiogenesis (formation of new leaky vessels) of permeable vessels leading to scarring of the macula (oedema)

76
Q

What is the observed outcome and consequences for both age-related macula degeneration?

A
  • Dry- macula holes
  • Wet- similar to diabetic retinopathy
  • Central vision loss, blurred vision
77
Q

What is the treatment for dry age-related macula degeneration?

A

Eye injections to delay loss of vision

78
Q

What is the treatment for wet age-related macula degeneration?

A
  • Anti VEGF treatments
  • Laser surgery
79
Q

What two locations is eye OCT taken in?

A
  • Looking straight ahead to see for retinopathy/macula degeneration
  • To the side to see for glaucoma and the optic nerve cup
80
Q

What does a retinal photograph of diabetic retinopathy show?

A
  • Microaneurysms
  • Harmorrhages
  • Hard exudates (protein build ups)
81
Q

What does an en face OCT mage of diabetic retinopathy show?

A
  • Microaneurysms
  • Areas of capillary nonperfusion
82
Q

What does an OCT of a glaucoma show?

A

Cup of the optic nerve increases relative to the optic disc

83
Q

What aids the diagnosis of a glaucoma?

A

Ratio of cup/disc (C/D)

84
Q

What is seen on a dry age-related macular degeneration OCT?

A
  • Ischaemic ares (no perfusion)
  • Protein disrupting the underlying layers
  • No signs of fluid
  • Foveal contour is intact
85
Q

What is seen on a wet age-related macular degeneration OCT?

A
  • Haemorrhages
  • Subretinal fluid and intraretinal fluid
86
Q

What other functional measures of OCT can be used to image the eye more for research?

A
  • Doppler OCT- Can image the direction of blood flow
  • Polarisation- can see glaucoma (loss of birefringence is indicative of damage)
  • Spectral OCT- measurement of O2 in vessels based on oxyHb and deoxyHb absorption spectra
87
Q

What are the main absorbers in the skin called and what are they?

A

Chromophores

  • Haemoglobin
  • Melanin
  • Water
88
Q

What are the 4 layers of the skin?

A
  • Epidermis
  • Dermal epidermal
  • Junction
  • Dermis
89
Q

What is a limitation of the different layers of the skin for OCT?

A

Limitation on depth of penetration due to scattering and light

90
Q

Outline layer by layer OCT structural images of the skin

A
  • Bright initial surface reflection (change in refractive index)- stratum corneum
  • Dark band- epidermis
  • bright band at boundary epudermis to dermis
  • Dermis gradually becomes darker as light is absorbed and signal is lost
  • Can often visualise hair roots, sweat glands
91
Q

What is an important thing to consider about different skin tissues?

A

They are all different

92
Q

What are 4 examples of skin conditions studies in OCT?

A
  • Skin cancers
  • Inflammatory skin conditions such as psoriasis (hyperkeratosis- extra layers of tissue) and dermatitis
  • Vascular structural abnormalities e.g. hemangioma
  • Diabetes

HOWEVER, tends to more research than clinical

93
Q

When used clinically, how is OCT used in skin conditions?

A

Image before and after treatment to see id there are differences

94
Q

What is high resolution OCT imaging similar to?

A

Microscopy and the corresponding histology of spectometry

95
Q

Explain a polarisation OCT skin experiment

A
  • Mice given injections to induce diabetes
  • Skin imaged over 4 weeks
  • See different interpretations of birefringence of the polarisation signal
  • Assocaited changes in skin collagen with time
96
Q

What are 3 key points for skin and eye OCT?

A
  • Interpretation is complex
  • AI technology may play a role in identifying changes/diseases
  • Multimodal imaging aids diagnosis
97
Q

Which OCT- eye or skin is further along the clinical line?

A
  • Eye
  • Skin is at a much more immature stage (mostly research)