Cambridge Ophthalmological Symposium

Eye (2010) 24, 422–427; doi:10.1038/eye.2009.309; published online 11 December 2009

Imaging chorioretinal vascular disease

Presented at the 39th Cambridge Ophthalmological Association Symposium

P A Keane1 and S R Sadda1

1Doheny Image Reading Center, Doheny Eye Institute, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA

Correspondence: SR Sadda, Doheny Image Reading Center, Doheny Eye Institute, DEI 3623, 1450 San Pablo Street, Los Angeles, CA 90033, USA. Tel: +1 323 442 6503; Fax: +1 323 442 6460; E-mail:

Received 13 October 2009; Revised 17 November 2009; Accepted 17 November 2009; Published online 11 December 2009.



Since its first description more than 40 years ago, fluorescein angiography had a crucial role in the diagnosis and management of chorioretinal vascular disorders such as neovascular age-related macular degeneration. Although fluorescein angiography permits visualization of the retinal microcirculation in exquisite detail, visualization of the choroidal circulation is more limited. Moreover, fluorescein angiography provides only minimal information regarding the functional consequences of vascular disease and allows, at best, only semi-quantitative assessment of retinal thickness. In recent years, the development of other chorioretinal imaging modalities, such as indocyanine green angiography, fundus autofluorescence, and optical coherence tomography (OCT), has addressed many of these issues. In particular, OCT has become an integral tool for vitreoretinal specialists as it allows high-resolution cross-sectional images of the neurosensory retina to be obtained in a non-invasive manner. The latest generation of commercial OCT technology—spectral domain OCT—offers high-speed scanning that allows complete coverage of the macular area, generation of three-dimensional retinal reconstructions, and precise image registration for inter-visit comparisons. The high speed of spectral domain OCT also facilitates B-scan averaging, which reduces speckle noise artefact and allows unparalleled visualization of the outer retina and choroid. In the near future, further advances in OCT technology (eg Doppler OCT) are likely to dramatically enhance the diagnosis and management of patients with chorioretinal vascular disease.


fluorescein angiography, indocyanine green angiography, fundus autofluorescence, optical coherence tomography



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