3-D reconstruction of blood vessels in the ocular fundus from confocal scanning laser ophthalmoscope ICG angiography

Dirk-Uwe Bartsch, Arthur J. Mueller, Nathan J. O'Connor, Timothy J. Holmes, M. D. Freeman

Abstract: The authors developed and tested a method to calculate three-dimensional image information of blood vessels in the living human eye. Their second aim was to elucidate the possibility of simultaneous angiography using two different fluorescent dyes. The authors used a confocal scanning laser ophthalmoscope for confocal sectioning of the posterior pole and simultaneous angiography with indocyanine green and fluorescein. They examined patients with different diseases. The authors used blind deconvolution to improve axial resolution. The results showed that indocyanine green angiography is able to visualize retinal and choroidal vessels in the posterior pole. Axial resolution can be improved using blind deconvolution methods. Simultaneous ICG and FA angiography allows quick and safe image acquisition. A direct comparison of pathologies with both dyes is possible. Color-coded dual dye display adds a new dimension to confocal imaging. It is concluded that 3-D vessel reconstruction allows a better appreciation of the complex vessel structure in the posterior pole of the human eye. Confocal angiography allows visualization of tumor vessels, differentiation between retinal and choroidal circulation. Simultaneous ICG and FA angiography offers easy and direct comparison of ICG and FA angiographies without artifacts due to operator handling, patient movement or other parameters.