Author(s): Pearse A. Keane

Affiliation(s):
Moorfields Eye Hospital NHS Foundation Trust

Purpose:
Swept source OCT is the next generation of retinal imaging. With its greatly increased image acquisition speed, it allows wide-field imaging of the posterior pole, and with its longer wavelength light source, it provides greatly enhanced depth penetration. In addition, it provides advanced OCT angiography (OCTA) for non-invasive mapping of the retinal and choroidal circulations. Taken together, these features are likely to lead to major changes in routine clinic practice for retinal specialists. In this talk, I will describe a new paradigm shift for the assessment of patients with proliferative diabetic retinopathy (PDR), including  specific practical tips. 

Methods:
I will present a series of cases of patients with PDR that have been imaged with swept source OCTA, and in each case highlight practical lessons and new insights that can be derived. 

Results:
Swept source OCTA has the potential to greatly improve our practical management of patients with PDR, including early detection of retinal neovascularization of the disc (NVD) and elsewhere (NVE), monitoring of disease activity and neovascular regression, and determining objectively the need for surgical intervention. 

Conclusions:
Swept source OCTA is an exciting technology which is rapidly maturing. In addition to providing beautiful images, it can now provide clinical insights that will directly affect decision making in PDR, both for medical retinal, vitreoretinal, and general ophthalmologists. 

Financial disclosure:
Dr. Keane has received speaker fees for Topcon, Heidelberg, Haag-Streit, Allergan, Novartis, and Bayer. He is an external consultant for DeepMind and Optos. He has served on advisory boards for Novartis and Bayer.