Research published today in the Proceedings of the National Academy of Sciences (PNAS) demonstrates that technology invented by researchers at Oregon Health & Science University’s Casey Eye Institute can improve the clinical management of the leading causes of blindness. Optical coherence tomography (OCT) angiography could largely replace current dye-based angiography in the management of these diseases.
OHSU researchers found that OCT angiography has considerable advantages over conventional techniques for the diagnosis and management of macular degeneration, diabetic eye disease and glaucoma, the leading causes of blindness in the United States.
“This is a significant breakthrough technology that could fundamentally change the way ophthalmologists diagnose and care for patients with retinal vascular diseases that cause blindness,” said David Wilson, M.D., Director of the OHSU Casey Eye Institute and Chair of the Department of Ophthalmology in the OHSU School of Medicine. “It will also allow us to diagnose patients earlier, permitting more timely treatment to avoid irreversible loss of vision.”
OCT angiography has been in development for several years in a few centers around the world. The key breakthrough that Yali Jia, Ph.D., study investigator and Assistant Professor of Ophthalmology at OHSU School of Medicine, OHSU Casey Eye Institute, and David Huang, M.D., Ph.D., study investigator and Peterson Professor of Ophthalmology, OHSU School of Medicine, OHSU Casey Eye Institute achieved was an algorithm called “split-spectrum amplitude-decorrelation angiography” (SSADA) that improved the quality of OCT angiography.
OHSU has filed patent applications for this invention and has licensed these patent rights to an OCT company. Utilizing SSADA, the scientists developed new methods in OCT angiography segmentation, visualization and quantification. OHSU has also filed for patent protection over these new angiography methods. These new methods, powered by SSADA, yield the exceptional results.
“We worked very hard to bring this new technology to clinical use only three years after its invention,” said Dr. Jia. “We are thrilled that its initial clinical demonstrations in a number of important eye diseases could be made public in a prestigious journal such as PNAS.”
The OCT angiography used in the study is a noninvasive three-dimensional alternative to conventional angiography. It does not require injections and allows clinicians to measure vascular density and blood flow in vessels in a quantitative manner. This provides new information that is very useful for clinical diagnosis and management.
Conventional dye-based angiography produces a two-dimensional image that cannot be evaluated quantitatively. It also is an invasive procedure in which orange dye (fluorescein) is intravenously injected to illuminate the blood vessels. This procedure can cause nausea and vomiting, and, rarely anaphylaxis, which is a serious allergic reaction.
“The new OCT angiography will be much less invasive for patients. As a result, it is ideal for screening patients for disease and routine checkups to see if treatments are working,” said Dr. Huang. “I believe this technology will be used much more frequently than conventional dye-based angiography because it is faster, better, safer and cheaper. This will also surely lead to better management of eye diseases.”
The paper, “Quantitative Optical Coherence Tomography Angiography of Vascular Abnormalities in the Living Human Eye,” was authored by a team of researchers at OHSU’s Casey Eye Institute, including Yali Jia, Ph.D.; David Huang, M.D. Ph.D.; Steven T. Bailey, M.D.; Thomas S. Hwang, M.D.; Mark E. Pennesi, M.D.; David Wilson, M.D.; Scott M. McClintic, M.D., Ph.D.; Christina J. Flaxel, M.D.; and Andreas K. Lauer, M.D. Co-authors include Joachim Hornegger, PhD at Pattern Recognition Lab and School of Advanced Optical Technologies (SAOT) at University Erlangen-Nuremberg, Germany, and James G. Fujimoto, PhD with the Department of Electrical Engineering & Computer Science and Research Laboratory of Electronics at Massachusetts Institute of Technology, Cambridge, Massachusetts.
This work was supported by NIH Grants R01-EY023285, R01-EY024544, DP3 DK104397, R01-EY11289, K08-EY021186, P30-EY010572, Clinical and Translational Science Award Grant (UL1TR000128), an unrestricted grant and career development award from Research to Prevent Blindness, CD-NMT-0914-0659-OHSU (Enhanced career development award from Foundation Fighting Blindness), AFOSR FA9550-10-1-0551, German Research Foundation DFG-HO-1791/11-1 and DFG-GSC80-SAOT.
In regards to this research project, Drs. Huang and Jia (OHSU) and Dr. Fujimoto (MIT) have a financial interest in Optovue, a company that may have a commercial interest in the results of this research. The SSADA software algorithm is patent pending and those patent rights are licensed to an OCT company. The new angiography methods are patent pending and presently available for licensing. In our interest of ensuring the integrity of our research and as part of our commitment to public transparency, OHSU has reviewed and managed this conflict of interest. OHSU actively tracks and manages the relationships that our researchers hold with entities outside of OHSU. Read more information on OHSU's conflict of interest policies and/or management of these business relationships.