Combined coaxial optical coherence tomography to identify and evaluate abnormal tissue deposits in retinal diseases

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Retinal diseases are the most common cause of legal blindness in developed countries. In the view of ongoing and upcoming therapeutic trials, validated biomarkers are required. Using the first innovative combined coaxial optical coherence tomography (OCT) imaging device, the submitted project targets to evaluate potential new readouts for clinical studies, facilitate differential diagnosis and improve knowledge of pathogenic pathways of retinal diseases. The combined coaxial OCT uses different wavelengths of laser light sources in order to enable optimal visualisation of intraretinal as well as subretinal structures without temporal or spatial separation. This is a unique and promising feature as many retinal diseases involve both the retina and choroid as a coadjutant functional complex. Three subprojects are included. As the combined coaxial OCT device just recently has been built and installed at the Moorfields Eye Hospital, the aim of the first subproject is to establish the innovative device by investigating healthy eyes and providing a normative database. In the second subproject, eyes with different retinal diseases will be assessed. Qualitative and quantitative examination of retina and choroid obtained by the combined coaxial OCT system in comparison to a conventional OCT device as well as the normative database received by the first subproject is aspired. Novel and known disease-related alterations, particularly in the interface between retina and choroid, will be investigated. Changes in the molecular composition of tissue lead to different reflective properties dependent on the light wavelength visualized by the combined coaxial OCT. These molecular changes might be the first detectable disease alterations. The third subproject therefore aims to analyse the reflective properties of abnormal deposits in the retina under different wavelengths through post-processing of data. Differences in the reflective properties of tissue might not only serve as innovative morphologic in-vivo surrogate marker, but also enable an insight into the pathogenesis of retinal diseases and a more sophisticated differential diagnosis of patients. This could further enable successful visual impairment treatment and prevention strategies targeting specific pathways in retinal diseases. All collaborating scientists and technical devices required for the submitted project are uniquely available and ready for use in the Prof Adnan Tufail research group at the Moorfields Eye Hospital and the UCL Institute of Ophthalmology.