Optical Coherence Tomography (OCT) uses a non-invasive, safe beam of light to look at the structures within the retina in very high detail.  This diagnostic technique provides a cross-sectional view of the retina.  The anatomic features visible with OCT are much more detailed than that seen by normal examination. Seeing the retina from this viewpoint enhances our ability to detect, diagnose, and treat retinal disease.  Developed in the early 1990s at MIT and Tufts, this technology has enabled us to better understand and treat diseases such as macular degeneration, diabetic retinopathy, central serous retinopathy, and many other diseases and disorders.  OCT is also imperative in measuring deeper layers, such as the choroid, which can be affected in many ocular and systemic diseases. 

Until very recently it was nearly impossible to photograph anything outside the central retina. However retinal changes can sometimes extend beyond what can be visualized with a standard fundus photography camera. Ultra widefield cameras allow us to visualize, study and document the peripheral retina. This has revolutionized the diagnosis, treatment, and monitoring of conditions of disease affecting the periphery of the retina, such as retinal detachments, uveitis (inflammation of the eye), vascular disorders and tumors. It has also greatly helped in patient education, as patients can often now “see” into their own eyes and see the diseases that previously only their ophthalmologist could observe. 

Fundus Photography allows us to photograph the back of the eye, an area more specifically called the retina and macula. This allows us to document any present disease as well as track the progress of retinal disease over time.  Furthermore, a technique called autofluorescence allows us to evaluate certain molecules that can accumulate in the unhealthy retina. By imaging the amount of these molecules we can learn about the functioning of the cells in the eye. 

Angiography is a decades-old photographic procedure used to view the blood circulation and leaking or damaged blood vessels in the retina, which commonly occur in diseases such as diabetic retinopathy, vascular occlusions, age-related macular degeneration, central serous chorioretinopathy, and hypertensive retinopathy. Fluorescein angiography (FA), which uses a bright yellow dye, highlights the circulation of the retinal blood vessels.  Indocyanine Green (ICG) angiography uses a green-colored dye that highlights the choroid, a layer deeper than the retina. The dye is injected into the arm, and a rapid sequence of pictures are taken to view the dye as it flows into the eye. The test only takes a few minutes and provides vital information for the physician to decide the best course of treatment. 

OCT Angiography (OCTA) is a new, state-of-the-art technology that uses OCT scans that detects the motion of flowing blood cells. OCTA creates an image similar intravenous angiography but without the injection of contrast dye, making this a non-invasive alternative to the traditional procedure.  Dr. Smith has published on OCTA and continues to contribute to the further understanding and development of this technology to benefit patients. 

Sometimes, opacities in the eye such as scar tissue or bleeding can limit our ability to see to the back of the eye.  In these cases, ultrasound probes can non-invasively help us determine what is behind these opacities.