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. 2023 Sep 26;120(39):e2311129120.
doi: 10.1073/pnas.2311129120. Epub 2023 Sep 21.

Seeing is believing: The development of optical coherence tomography

Jeremy Nathans  1   2   3   4
Affiliations

Seeing is believing: The development of optical coherence tomography

Jeremy Nathans. Proc Natl Acad Sci U S A. .

Abstract

The 2023 Lasker-DeBakey Clinical Medical Research Award is being presented to James Fujimoto, David Huang, and Eric Swanson for their invention and development of optical coherence tomography (OCT), an imaging technology that uses light to visualize microscopic structures within tissues such as the retina. OCT has dramatically changed the practice of ophthalmology and improved the lives of millions of people. It also has great potential in a wide range of other medical fields.

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Conflict of interest statement

The author declares no competing interest.

Figures

Fig. 1.
Fig. 1.
Interferometry and the three strategies for OCT signal processing. (A) Thomas Young’s diagram of his two-slit experiment (1). The slits are at positions A and B (Left), which are the sources of two outwardly propagating circular waves. Positions C, D, E, and F (Right) mark the peaks of constructive interference. Image credit: Reprinted from ref. . (B) One of Albert Michelson’s early interferometers. The light source is at the far left (arm 1), the half-silvered mirrors are in the center, and the detector is at the end of the arm closest to the viewer (arm 4). The arms are approximately one meter in length. Image credit: Reprinted from ref. . (C–E) Schematic diagrams of the three basic types of OCT systems: time-domain OCT (C), spectral-domain OCT (D), and frequency-domain OCT (E).
Fig. 2.
Fig. 2.
OCT in medical practice. (A) OCT imaging of the retina. Image credit: Alamy Stock Photo/agefotostock. (B and C) The human fovea, as seen with immunohistochemistry (B) and OCT (C). Each image is oriented with the inner retina (i.e., the part closest to the front of the eye) facing up. In the foveal pit, at the center of each image, the inner two layers of neurons are pushed to the side and the retina is correspondingly thinner. In the OCT image, the bright white zone at the inner-most edge of the retina is from the nerve fiber layer. The three bright white zones at the outer edge of the retina are (from top to bottom) the mitochondria-rich photoreceptor inner segments, the apical phagocytic region of the retinal pigment epithelium (RPE), and the basal mitochondrial-rich region of the RPE. Cellular retinaldehyde binding protein (CRALBP) localizes to Muller glia and the RPE; Cytochrome C (CytC), a mitochondrial marker, is enriched in photoreceptor inner segments, the basal RPE, and at lower density in inner retinal neurons; and G-protein beta-subunit 3 (GNB3) localizes to cones and ON-bipolar cells. (Scale bars, 500 μm.) Image credit: Reprinted from ref. , with permission from Elsevier. (D) OCT angiography of a retina with choroidal neovascularization (CNV). A fundus image (a). The square zone represents the regions shown in the fluorescein angiogram (b) and the en face OCT angiogram (c) in which the CNV tuft is shown in yellow. In the cross-sectional OCT angiogram (d), the retina is oriented as in (C) and the different vascular beds are color coded, as defined in the box below. Image credit: Reprinted with permission from ref. . (E) Catheter-based OCT imaging of a coronary artery. An angiogram (a) shows an abrupt narrowing of the artery lumen starting near the base of the lower yellow arrow. In the two OCT images (b and c) obtained at the locations indicated by the yellow arrows, the central ring represents the catheter and asterisks represent regions of the artery wall that were not imaged. In (c), the narrow and irregular vessel lumen is clearly delineated. Image credit: Reprinted from ref. , with permission from Elsevier.
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References

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