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  • FDA Conference Report: Ophthalmic Laser-Based Imaging

    By Jean Shaw
    Selected and Reviewed By: Neil M. Bressler, MD, and Deputy Editors
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    Journal Highlights

    JAMA Ophthalmology, January 2021

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    In April 2019, the FDA convened a fo­rum on optical coherence tomography (OCT) and other laser-based imaging, including adaptive optics (AO) and scanning laser ophthalmoscopy (SLO). Highlights of the forum, as summarized in a special report by Brodie et al., include the following:

    • Overview: OCT has become a valuable tool, furthering the diagnosis, management, and understanding of eye disease. FDA officials noted that efforts to streamline premarket evaluation of OCT devices are underway.

    Clinical applications: Applications of OCT technology to anterior segment disease include the use of intraoperative OCT (iOCT) during surgery and the use of OCT to provide prognostic information on intraocular pressure changes following surgical procedures and to aid in intraoperative assessment of challenging corneal transplant cases. For posterior segment disease, present­ers emphasized that the influence of OCT is impossible to overstate, as it has revolutionized the evaluation and man­agement of many vitreoretinal diseases. 

    • Emerging technologies: Advances in OCT angiography, visible-light OCT, and iOCT were discussed, as was the use of artificial intelligence in conjunc­tion with OCT in both the anterior and posterior segments.
    • Current challenges: On the clinical side, the pursuit of greater accuracy and precision continues, as does the need for greater understanding of normal variance across age, race, and sex as well as variance that can be attributed to a particular device or to environ­mental factors. On the nonclinical side, imaging reimbursement continues to present a considerable challenge.
    • Adaptive optics: At present, AO remains in the vision research domain. It can be used with OCT as well as with SLO. AO allows for dynamic sensing and correction of the optical aber­rations in an individual’s eye as well as aberrations that may arise in an individual imaging system. Although AO shows potential for tracking disease progression and treatment response, more research is needed on accuracy and safety, the presenters said.

    The original article can be found here.