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Subspecialties Imaging & Diagnostics

The Beauty of Choroidal Clarity

By Rubens Belfort, with Eduardo A. Novais, Andre Romano, Heloisa Nascimento and João Rafael Dias

For a retina specialist, accurately diagnosing and effectively managing conditions of the choroid is, in many ways, the “final frontier” of posterior segment diseases treatment. Understanding the nuances and impact of choroidal diseases is crucial to our understanding of broader intraocular health, however, until recently, our working knowledge of this pivotal area has been relatively limited by the imaging technologies available to us. Swept-source optical coherence tomography (SS-OCT) is a new and exciting technology that offers us the ability to better visualize the choroid, as well as other “deep” physiological structures in the posterior segment with remarkable clarity. SS-OCT is also advantageous when cataract, vitreous haze, hemorrhages, and other opaque media are present, as it can produce a high-fidelity image under challenging conditions. Commercially available SS-OCT technology uses a longer, ~1050 nm wavelength and has less variation in sensitivity with depth (sensitivity roll-off) compared with spectral-domain (SD) OCT. This improved immunity to ocular opacity and deeper penetration into the choroid (1, 2) allows improved visualization of the choroid, both on cross-sectional as well as en face OCTA imaging (3, 4).

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About the Author

Rubens Belfort

Head Professor of Ophthalmology at the Federal University of Sao Paulo, Brazil. Belfort is a member of the National Academy of Medicine in Brazil and directs the Philanthropic Vision Institute.

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