Table e-1. Comparison of Optical Coherence Tomography Systems.

“First Generation”

Time-Domain OCT

“Second

Generation”

Spectral Domain

OCT

“Third Generation”

Swept-Source

OCT

Signal-to-Noise +++ ++ +

Speed of image

acquisition 1X 50X 100X

A-scans/sec 400 16K-55K 100K-400K

Motion Artifacts +++ + -

Volumetric scans No Yes Yes

Axial Resolution

(microns) 7-10 3.26 - 7 5-8

Lateral Resolution

(microns)

20-30 6.5-10 10-12

Comments - Needs pupillary

dilation.

- Only one

commercially

available unit

available. Not

currently

marketed.

- No pupillary

dilation needed.

- Multiple

commercial

systems available

on the market.

- No pupillary

dilation needed

- Deeper

penetration, good

for choroid and

optic nerve lamina

cribosa

FIGURE LEGENDS (SUPPLEMENTAL FIGURES)

Figure e-1

Figure e-1. Three OCT modalities currently commercially available. From left to

right: In Time-Domain OCT, the low coherence light is divided by the splitter in to two phase-

matched arms one to the eye and the other to the reference arm. The backscattered light from

both paths interfere constructively and this signal is measured by the detector utilizing the

principle of interferometry. In Spectral-Domain OCT, the backscattered light is combined by a

spectrometer using a Fourier-Domain algorithm. In swept-source OCT, the backscattered laser

light merges and is read at a photodiode detector. In all three modalities, the data from the

detector is inputted into a computer with software that converts the A-scans into readable

images.

Figure e-2

Figure e-2. Optic nerve head drusen. A. Fundoscopic image obtained with scanning laser

ophthalmoscope showing optic nerve head elevation suspicious for papilledema. B. OCT color

thickness maps shows in white color the area of optic nerve elevation. C. Cross sectional image

of the optic nerve shows the optic nerve head drusen as a hyperreflective structure underneath

the elevated tissue (arrow), suggesting pseudopapilledema.

Figure e-3

Figure e-3. Neuroretinitis observed by OCT. A. Color fundus photograph demonstrating optic

nerve edema with a normal macular appearance. B. OCT circular scan showing retinal nerve

fiber layer thickening (with a green color thickness showing values above the normal limit). C.

OCT scan through the macula demonstrates hyperreflective spots (green line) and subretinal

fluid (white line) consistent with an exudative process. These macular OCT findings preceded

the classic appearance of a macular star.

Figure e-4

Figure e-4. Recovery of visual field following resection of pituitary adenoma. A 44 year-old

man presented with complaints of blurred vision in both eyes. Visual acuity was 20/20 in each

eye. Visual field testing demonstrated a bitemporal heminaopsia. Pre-operatively, the optic

nerves appeared normal and the measurements of the RNFL were within normal limits. Post-

operatively, visual fields showed marked improvement, despite the RNFL measurements

demonstrating global thinning.

Figure e-5

Figure e-5. Fingolimod associated macular edema. Severe macular edema of the left eye in a

patient being treated with fingolimod. Macular edema developed 2.5 months into therapy. White

arrow indicates area or intraretinal cystoid spaces characteristic of macular edema.