Author: Professor Christopher Leung

The advent of swept-source optical coherence tomography (OCT) has substantially increased the scan speed for retinal imaging. With wide-field imaging combining both the macular and the optic nerve head regions, the sensitivity and specificity for detection of RNFL abnormalities and their progression can be improved. Recently, we developed a new technique – retinal nerve fiber layer optical texture analysis (ROTA) – integrating both the RNFL thickness and RNFL reflectance data to generate RNFL optical texture signature to visualize RNFL abnormalities in glaucoma and other forms of optic neuropathies. ROTA is sensitive to reveal localized RNFL abnormalities missed by conventional OCT RNFL thickness analysis and red-free RNFL photography. Further, ROTA is also able to discern different levels of RNFL damage in advanced optic neuropathies that would otherwise be impossible to discriminate with the currently available clinical tools. The implementation of ROTA in wide-field RNFL imaging has the potential to transform the paradigm of diagnostic evaluation of glaucoma.