High-speed OCT light sources and systems [Invited]

A journey through the world of vitreous

Vitreous, one of the largest components of the human eye, mostly contains water. Despite decades of studying the vitreous structure, numerous unanswered questions still remain, fueling ongoing active research. We attempt to provide a comprehensive overview of the current understanding of the development, morphology, biochemical composition, and function of the vitreous. We emphasize the impact of the vitreous structure and composition on the distribution of drugs. Fast developing imaging technologies, such as modern optical coherence tomography, unlocked multiple new approaches, offering the potential for in vivo study of the vitreous structure. They allowed to analyze in vivo a range of vitreous structures, such as posterior precortical vitreous pockets, Cloquet canal, channels that interconnect them, perivascular vitreous fissures, and cisterns. We provide an overview of such imaging techniques and their principles and of some challenges in visualizing vitreous structures. Finally, it explores the potential of combining the latest technologies and machine learning to enhance our understanding of vitreous structures.

Dynamic contrast optical coherence tomography (DyC-OCT) for label-free live cell imaging

Dynamic contrast optical coherence tomography (DyC-OCT), an emerging imaging method, utilizes fluctuation patterns in OCT signals to enhance contrast, thereby enabling non-invasive label-free volumetric live cell imaging. In this mini review, we explain the core concepts behind DyC-OCT image formation and its system configurations, serving as practical guidance for future DyC-OCT users. Subsequently, we explore its applications in delivering high-quality, contrast-enhanced images of cellular morphology, as well as in monitoring changes in cellular activity/viability assay experiments.

Phase unwrapping for MHz optical coherence elastography and application to brain tumor tissue

During neuro-oncologic surgery, phase-sensitive optical coherence elastography (OCE) can be valuable for distinguishing between healthy and diseased tissue. However, the phase unwrapping process required to retrieve the original phase signal is a challenging and critical task. To address this issue, we demonstrate a one-dimensional unwrapping algorithm that recovers the phase signal from a 3.2 MHz OCE system. With a processing time of approximately 0.11 s per frame on the GPU, multiple 2π wraps are detected and corrected. By utilizing this approach, exact and reproducible information on tissue deformation can be obtained with pixel accuracy over the entire acquisition time. Measurements of brain tumor-mimicking phantoms and human ex vivo brain tumor samples verified the algorithm's reliability. The tissue samples were subjected to a 200 ms short air pulse. A correlation with histological findings confirmed the algorithm's dependability.

Polarization-artifact reduction and accuracy improvement of Jones-matrix polarization-sensitive optical coherence tomography by multi-focus-averaging based multiple scattering reduction

Polarization-sensitive optical coherence tomography (PS-OCT) is a promising biomedical imaging tool for the differentiation of various tissue properties. However, the presence of multiple-scattering (MS) signals can degrade the quantitative polarization measurement accuracy. We demonstrate a method to reduce MS signals and increase the measurement accuracy of Jones matrix PS-OCT. This method suppresses MS signals by averaging multiple Jones matrix volumes measured using different focal positions. The MS signals are decorrelated among the volumes by focus position modulation and are thus reduced by averaging. However, the single scattering signals are kept consistent among the focus-modulated volumes by computational refocusing. We validated the proposed method using a scattering phantom and a postmortem medaka fish. The results showed reduced artifacts in birefringence and degree-of-polarization uniformity measurements, particularly in deeper regions in the samples. This method offers a practical solution to mitigate MS-induced artifacts in PS-OCT imaging and improves quantitative polarization measurement accuracy.

High-speed k-linear swept laser using acousto-optic deflectors with Doppler shift compensation for optical coherence tomography

Swept laser based on the acousto-optic deflector (AOD) is a promising swept source in optical coherence tomography (OCT) applications for its high wavenumber linear sweep without mechanical motion. However, the poor coherence length and the elongated cavity of the laser imposed limitations on the acquisition of high-quality images with adequate imaging depth and high imaging speed. In this Letter, we demonstrate a compact high-speed wavenumber linear swept laser based on AOD using Doppler shift compensation, achieving a high linearity of Pearson's R of 0.999991, a duty cycle of ∼100%, an extended coherence length of 5.7 mm, an output power of 18 mW, and excellent phase stability at a sweep speed of 500 kHz. OCT structural images with a system sensitivity of 103.2 dB and OCT angiography (OCTA) of human palm in vivo have been successfully performed, serving as a compelling demonstration of the excellent performance of this swept laser. We believe that the proposed laser will be of high potential in various clinical and industrial applications in the future.

Pulsed swept-source FDML-MOPA laser with kilowatt picosecond pulses around 1550 nm

Swept-source lasers are versatile light sources for spectroscopy, imaging, and microscopy. Swept-source-powered multiphoton microscopy can achieve high-speed, inertia-free point scanning with MHz line-scan rates. The recently introduced spectro-temporal laser imaging by diffractive excitation (SLIDE) technique employs swept-source lasers to achieve kilohertz imaging rates by using a swept-source laser in combination with a diffraction grating for point scanning. Multiphoton microscopy at a longer wavelength, especially in the shortwave infrared (SWIR) region, can have advantages in deep tissue penetration or applications in light detection and ranging (LiDAR). Here we present a swept-source laser around 1550 nm providing high-speed wavelength agility and high peak power pulses for nonlinear excitation. The swept-source laser is a Fourier-domain mode-locked (FDML) laser operating at 326 kHz sweep rate. For high peak powers, the continuous wave (cw) output is pulse modulated to short picosecond pulses and amplified using erbium-doped fiber amplifiers (EDFAs) to peak powers of several kilowatts. This FDML-master oscillator power amplifier (FDML-MOPA) setup uses reliable, low-cost fiber components. As proof-of-principle measurement, we show third-harmonic generation (THG) using harmonic nanoparticles at the 10 MHz pulse excitation rate. This new, to the best of our knowledge, laser source provides unique performance parameters for applications in nonlinear microscopy, spectroscopy, and ranging.

In vivo volumetric depth-resolved imaging of cilia metachronal waves using dynamic optical coherence tomography

Motile cilia are dynamic hair-like structures covering epithelial surfaces in multiple organs. The periodic coordinated beating of cilia creates waves propagating along the surface, known as the metachronal waves, which transport fluids and mucus along the epithelium. Motile ciliopathies result from disrupted coordinated cilia beating and are associated with serious clinical complications, including reproductive disorders. Despite the recognized clinical significance, research of cilia dynamics is extremely limited. Here, we present quantitative imaging of cilia metachronal waves volumetrically through tissue layers using dynamic optical coherence tomography (OCT). Our method relies on spatiotemporal mapping of the phase of intensity fluctuations in OCT images caused by the ciliary beating. We validated our new method ex vivo and implemented it in vivo to visualize cilia metachronal wave propagation within the mouse fallopian tube. This method can be extended to the assessment of physiological cilia function and ciliary dyskinesias in various organ systems, contributing to better management of pathologies associated with motile ciliopathies.

THE EFFECT OF INCREASING ACQUISITION SPEED ON OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IMAGES: A Qualitative and Quantitative Analysis

PURPOSE

To evaluate the effect of two different A-scan rates on qualitative and quantitative parameters on optical coherence tomography angiography images in a clinical setting.

METHODS

Subjects undergoing a comprehensive ophthalmic examination were scheduled for optical coherence tomography angiography imaging using a new SPECTRALIS device allowing for 85 and 125 kHz scan rate. Consecutive registered 20° × 20° optical coherence tomography angiography images using both speeds were acquired using the follow-up tool. The acquisition time and the quality values of each scan were extracted and analyzed. The image quality was also graded in pairs by two independent graders.

RESULTS

Two-hundred and one eyes of 128 consecutive patients (67 males, 52.3%) were included. Mean acquisition time significantly decreased from 56.92 ± 24.6 seconds on the 85 kHz images to 39.39 ± 15.5 seconds on the 125 kHz images (P < 0.001). The percentage change in acquisition time showed a mean decrease of 28.47%. Mean Q value significantly decreased from 32.97 ± 2.8 dB on the 85 kHz images to 31.43 ± 2.6 dB on the 125 kHz images (P < 0.001). Overall, 92.5% of images were graded as equal or better at 125 kHz A-scan rate.

CONCLUSION

The use of optical coherence tomography angiography in daily clinical practice may require higher A-scan rates for an optimal workflow. Increased speed may also reduce image sensitivity and thus image quality could be compromised. In this study, 125 kHz scan rate using SPECTRALIS showed significant benefit with reduction on the acquisition time and no clinically significant differences on image quality analysis. Further studies evaluating qualitative and quantitative data in specific retinal conditions and using other devices are required to confirm these results.

Broadband wavelength-swept Cr4+:YAG crystal fiber laser

We present a broadband wavelength-swept laser using a 16-µm-core-diameter Cr4+:YAG crystal fiber as the gain medium. The laser-diode-pumped crystal fiber laser has a threshold of only 102 mW due to the low propagation loss and high heat dissipation efficiency. The laser achieves a sweeping wavelength range of 134 nm, centered around 1425 nm, with a scanning speed of 163 k nm/s. Notably, the cross-polarization-coupled excited state absorption of the signal wavelength constrained the long-wavelength lasing limit. This laser has the potential for swept source optical coherence tomography applications, providing an axial resolution of 11.4 µm.

Unleashing the power of optical attenuation coefficients to facilitate segmentation strategies in OCT imaging of age-related macular degeneration: perspective

The use of optical attenuation coefficients (OAC) in optical coherence tomography (OCT) imaging of the retina has improved the segmentation of anatomic layers compared with traditional intensity-based algorithms. Optical attenuation correction has improved our ability to measure the choroidal thickness and choroidal vascularity index using dense volume scans. Algorithms that combine conventional intensity-based segmentation with depth-resolved OAC OCT imaging have been used to detect elevations of the retinal pigment epithelium (RPE) due to drusen and basal laminar deposits, the location of hyperpigmentation within the retina and along the RPE, the identification of macular atrophy, the thickness of the outer retinal (photoreceptor) layer, and the presence of calcified drusen. OAC OCT algorithms can identify the risk-factors that predict disease progression in age-related macular degeneration.

Extended and adjustable field-of-view of variable interscan time analysis by ammonite-scanning swept-source optical coherence tomography angiography

A novel scanning protocol, ammonite scan, is proposed for widefield optical coherence tomography angiography (OCTA) and relative retinal blood flow velocity imaging in the human retina using variable interscan time analysis (VISTA). A repeated circle scan using a 400 kHz swept-source was employed to achieve an interscan time of 1.28 ms. The center of the repeated circular scan continuously moved spirally towards the peripheral region, ensuring an extended and adjustable scan range while preserving the short interscan time. Image artifacts due to eye movement were eliminated via extra motion-correction processing using data redundancy. The relative blood flow velocity in superficial and deep plexus layers was calculated from the VISTA image, and their ratio was used to explore the microvascular flow parameter in the healthy human eye.

Finite-Element Modelling Based on Optical Coherence Tomography and Corresponding X-ray MicroCT Data for Three Human Middle Ears

PURPOSE

Optical coherence tomography (OCT) is an emerging imaging modality which is non-invasive, can be employed in vivo, and can record both anatomy and vibrations. The purpose here is to explore the application of finite-element (FE) modelling to OCT data.

METHODS

We recorded vibrations for three human cadaver middle ears using OCT. We also have X-ray microCT images from the same ears. Three FE models were built based on geometries obtained from the microCT images. The material properties and boundary conditions of the models were obtained from previously reported studies.

RESULTS

Tympanic-membrane (TM) vibration patterns were computed for the three models and compared with the patterns measured using OCT. Frequency responses were also computed for all three models for several locations in the middle ear and compared with the OCT displacements and with the literature. The three models were compared with each other in terms of geometry and function. Parameter sensitivity analyses were done and the results were compared among the models and with the literature. The simulated TM displacement patterns are qualitatively similar to the OCT results. The simulated displacements are closer to the OCT results for 500 Hz and 1 kHz but the differences are greater at 2 kHz.

CONCLUSION

This study provides an initial look at the combined use of OCT measurements and FE modelling based on subject-specific anatomy. The geometries and parameters of the existing FE models could be modified for individual patients in the future to help identify abnormalities in the middle ear.

Effect of fixational eye movements in corneal topography measurements with optical coherence tomography

There is an increasing interest in applying optical coherence tomography (OCT) to quantify the topography of ocular structures. However, in its most usual configuration, OCT data is acquired sequentially while a beam is scanned through the region of interest, and the presence of fixational eye movements can affect the accuracy of the technique. Several scan patterns and motion correction algorithms have been proposed to minimize this effect, but there is no consensus on the ideal parameters to obtain a correct topography. We have acquired corneal OCT images with raster and radial patterns, and modeled the data acquisition in the presence of eye movements. The simulations replicate the experimental variability in shape (radius of curvature and Zernike polynomials), corneal power, astigmatism, and calculated wavefront aberrations. The variability of the Zernike modes is highly dependent on the scan pattern, with higher variability in the direction of the slow scan axis. The model can be a useful tool to design motion correction algorithms and to determine the variability with different scan patterns.

High-speed broadband absorption spectroscopy enabled by cascaded frequency shifting loops

Frequency shifting loops, consisting of a fiber optic ring cavity, a frequency modulator, and an amplifier to compensate for loss, enable high-speed frequency scanning with precise and easily controlled frequency steps. This platform is particularly attractive for applications in spectroscopy and optical ranging. However, amplified spontaneous emission noise accumulates due to the repeated amplification of light circulating in the cavity, limiting the frequency scanning range of existing frequency shifting loops (FSLs). Here, we introduce a cascaded approach which addresses this basic limitation. By cascading multiple FSLs in series with different frequency shifts we are able to dramatically increase the accessible scanning range. We present modeling showing the potential for this approach to enable scanning over ranges up to 1 THz-a tenfold increase compared with the state-of-the-art. Experimentally, we constructed a pair of cascaded FSLs capable of scanning a 200 GHz range with 100 MHz steps in 10 ms and used this platform to perform absorption spectroscopy measurements of an H¹³C¹⁴N cell. By increasing the operating bandwidth of FSLs, the cascaded approach introduced in this work could enable new applications requiring precise and high-speed frequency scanning.

Deep learning empowered highly compressive SS-OCT via learnable spectral-spatial sub-sampling

With the rapid advances of light source technology, the A-line imaging rate of swept-source optical coherence tomography (SS-OCT) has experienced a great increase in the past three decades. The bandwidths of data acquisition, data transfer, and data storage, which can easily reach several hundred megabytes per second, have now been considered major bottlenecks for modern SS-OCT system design. To address these issues, various compression schemes have been previously proposed. However, most of the current methods focus on enhancing the capability of the reconstruction algorithm and can only provide a data compression ratio (DCR) up to 4 without impairing the image quality. In this Letter, we proposed a novel design paradigm, in which the sub-sampling pattern for interferogram acquisition is jointly optimized with the reconstruction algorithm in an end-to-end manner. To validate the idea, we retrospectively apply the proposed method on an ex vivo human coronary optical coherence tomography (OCT) dataset. The proposed method could reach a maximum DCR of ∼62.5 with peak signal-to-noise ratio (PSNR) of 24.2 dB, while a DCR of ∼27.78 could yield a visually pleasant image with a PSNR of ∼24.6 dB. We believe the proposed system could be a viable remedy for the ever-growing data issue in SS-OCT.

1.7 THz tuning range pivot-point-independent mode-hop-free external cavity diode laser

A novel mode-hop-free (MHF) tunable external cavity diode laser (ECDL) is demonstrated without mechanical pivot-point tuning. By corotating a periscope with an etalon and a narrow band pass (NBP) filter inside an external cavity, the cavity single longitudinal mode selection can be maintained, and continuous tuning can be achieved with optimal synchronization. A MHF continuous tuning range of 1.7 THz has been achieved with a semiconductor gain chip at the wavelength of 652 ± 2 nm experimentally, and the theoretical tuning range can reach over 4.8 THz. The laser linewidth is estimated to be less than 1 MHz (FWHM) by a scanning Fabry-Perot (F-P) and a Michelson interferometer. 1 mW output power with variation of less than 10% in the tuning region of roughly 1.7 THz has been demonstrated.

High speed, high power 2D beam steering for mitigation of optomechanical parametric instability in gravitational wave detectors

In this paper, we propose what we believe to be a novel strategy to control optomechanical parametric instability (PI) in gravitational wave (GW) detectors based on radiation pressure. The fast deflection of a high-power beam is the key element of our approach. We built a 2D deflection system based on a pair of acousto-optic modulators (AOMs) that combines high rapidity and a large scan range. As a fast frequency switching configurable AOM driver, we used a Universal Software Radio Peripheral (USRP) combined with a high-performance personal computer (PC). In this way, we demonstrate a 2D beam steering system with flat efficiency over the whole scan range and with a transition time of 50 ns between two arbitrary consecutive deflection positions for a beam power of 3.6 W.

Label-free full-field Doppler phase microscopy based on optical computation

The capability to image subtle mechanical motion at cellular and sub-cellular scales can be used to study how extracellular particles interact with cultured cells and, more generally, how cells interact with their environment. However, current technologies need to provide sufficient spatial resolution, temporal resolution, and motion sensitivity to image cellular and sub-cellular motion in the en face plane. To address this unmet need, we investigate a full-field Doppler phase microscopy (FF-DPM) technology based on an innovative optical computation strategy that enables depth-resolved imaging and phase quantification. In this study, we validated the motion tracking (displacements and velocities) capability of FF-DPM by imaging samples actuated by a piezo transducer (PZT). We demonstrated FF-DPM imaging of magnetic particles under different conditions with different motion characteristics. Our results show that free particles (suspended in a cell culture medium) had a significantly larger magnitude of motion than particles adhered to a cell. The key innovation of this study is the use of an optical computation strategy to perform depth-resolved phase quantification and Doppler measurement. The FF-DPM will have a significant impact, as it provides a unique capability to quantitatively measure subtle motion for models based on cultured cells.

Dual-comb based time-stretch optical coherence tomography for large and segmental imaging depth

Optical coherence tomography based on time-stretch enables high frame rate and high-resolution imaging for the inertia-free wavelength-swept mechanism. The fundamental obstacle is still the acquisition bandwidth's restriction on imaging depth. By introducing dual-comb with slightly different repetition rates, the induced Vernier effect is found to be capable of relieving the problem. In our work, a dual-comb based time-stretch optical coherence tomography is proposed and experimentally demonstrated, achieving a 1.5-m imaging depth and 200-kHz A-scan rate. Moreover, about a 33.4-µm resolution and 25-µm accuracy are achieved. In addition, by adjusting the frequency detuning of the dual-comb, the A-scan rate can be further boosted to video-rate imaging. With enlarged imaging depth, this scheme is promising for a wide range of applications, including light detection and ranging.

Automatic and quantitative measurement of alveolar bone level in OCT images using deep learning

We propose a method to automatically segment the periodontal structures of the tooth enamel and the alveolar bone using convolutional neural network (CNN) and to measure quantitatively and automatically the alveolar bone level (ABL) by detecting the cemento-enamel junction and the alveolar bone crest in optical coherence tomography (OCT) images. The tooth enamel and the alveolar bone regions were automatically segmented using U-Net, Dense-UNet, and U²-Net, and the ABL was quantitatively measured as the distance between the cemento-enamel junction and the alveolar bone crest using image processing. The mean distance difference (MDD) measured by our suggested method ranged from 0.19 to 0.22 mm for the alveolar bone crest (ABC) and from 0.18 to 0.32 mm for the cemento-enamel junction (CEJ). All CNN models showed the mean absolute error (MAE) of less than 0.25 mm in the x and y coordinates and greater than 90% successful detection rate (SDR) at 0.5 mm for both the ABC and the CEJ. The CNN models showed high segmentation accuracies in the tooth enamel and the alveolar bone regions, and the ABL measurements at the incisors by detected results from CNN predictions demonstrated high correlation and reliability with the ground truth in OCT images.

Measuring collagen injury depth for burn severity determination using polarization sensitive optical coherence tomography

Determining the optimal treatment course for a dermatologic burn wound requires knowledge of the wound’s severity, as quantified by the depth of thermal damage. In current clinical practice, burn depth is inferred based exclusively on superficial visual assessment, a method which is subject to substantial error rates in the classification of partial thickness (second degree) burns. Here, we present methods for direct, quantitative determination of the depth extent of injury to the dermal collagen matrix using polarization-sensitive optical coherence tomography (PS-OCT). By visualizing the depth-dependence of the degree of polarization of light in the tissue, rather than cumulative retardation, we enable direct and volumetric assessment of local collagen status. We further augment our PS-OCT measurements by visualizing adnexal structures such as hair follicles to relay overall dermal viability in the wounded region. Our methods, which we have validated ex vivo with matched histology, offer an information-rich tool for precise interrogation of burn wound severity and healing potential in both research and clinical settings.

Light-sheet photonic force optical coherence elastography for high-throughput quantitative 3D micromechanical imaging

Quantitative characterisation of micro-scale mechanical properties of the extracellular matrix (ECM) and dynamic cell-ECM interactions can significantly enhance fundamental discoveries and their translational potential in the rapidly growing field of mechanobiology. However, quantitative 3D imaging of ECM mechanics with cellular-scale resolution and dynamic monitoring of cell-mediated changes to pericellular viscoelasticity remain a challenge for existing mechanical characterisation methods. Here, we present light-sheet photonic force optical coherence elastography (LS-pfOCE) to address this need by leveraging a light-sheet for parallelised, non-invasive, and localised mechanical loading. We demonstrate the capabilities of LS-pfOCE by imaging the micromechanical heterogeneity of fibrous collagen matrices and perform live-cell imaging of cell-mediated ECM micromechanical dynamics. By providing access to 4D spatiotemporal variations in the micromechanical properties of 3D biopolymer constructs and engineered cellular systems, LS-pfOCE has the potential to drive new discoveries in mechanobiology and contribute to the development of novel biomechanics-based clinical diagnostics and therapies.

Ultra-broadband wavelength-swept Ti:sapphire crystal fiber laser

An ultra-broadband wavelength-swept laser (WSL) was generated using glass-clad Ti:sapphire crystal fiber as the gain media. Due to the low signal propagation loss of the crystal fiber, the swept laser has a tuning bandwidth of 250 nm (i.e., 683 nm to 933 nm) at a repetition rate of 1200 Hz. The steady-state and pulsed dynamics of the WSL were analyzed. The 0.018-nm instantaneous linewidth corresponds to a 3-dB coherence roll-off of 7 mm. When using the laser for swept-source optical coherence tomography, an estimated axial resolution of 1.8 µm can be achieved.

Spectral Interferometry with Frequency Combs

In this review paper, we provide an overview of the state of the art in linear interferometric techniques using laser frequency comb sources. Diverse techniques including Fourier transform spectroscopy, linear spectral interferometry and swept-wavelength interferometry are covered in detail. The unique features brought by laser frequency comb sources are shown, and specific applications highlighted in molecular spectroscopy, optical coherence tomography and the characterization of photonic integrated devices and components. Finally, the possibilities enabled by advances in chip scale swept sources and frequency combs are discussed.

Non-destructive characterization of adult zebrafish models using Jones matrix optical coherence tomography

The zebrafish is a valuable vertebrate animal model in pre-clinical cancer research. A Jones matrix optical coherence tomography (JM-OCT) prototype operating at 1310 nm and an intensity-based spectral-domain OCT setup at 840 nm were utilized to investigate adult wildtype and a tumor-developing zebrafish model. Various anatomical features were characterized based on their inherent scattering and polarization signature. A motorized translation stage in combination with the JM-OCT prototype enabled large field-of-view imaging to investigate adult zebrafish in a non-destructive way. The diseased animals exhibited tumor-related abnormalities in the brain and near the eye region. The scatter intensity, the attenuation coefficients and local polarization parameters such as the birefringence and the degree of polarization uniformity were analyzed to quantify differences in tumor versus control regions. The proof-of-concept study in a limited number of animals revealed a significant decrease in birefringence in tumors found in the brain and near the eye compared to control regions. The presented work showed the potential of OCT and JM-OCT as non-destructive, high-resolution, and real-time imaging modalities for pre-clinical research based on zebrafish.

High-speed wavelength-swept femtosecond source from 1055 to 1300 nm using a GHz femtosecond fiber laser

In this Letter, we demonstrate a high-speed broadband wavelength-swept femtosecond source (WFS) that leverages the soliton self-frequency shift (SSFS) and intensity-wavelength encoding technologies. The optical wavelength of the high-speed WFS can be continuously swept from 1055 nm to nearly 1300 nm at a sweeping rate of 100 kHz. This WFS is especially seeded by a femtosecond mode-locked all-fiber laser at 1055 nm that has a fundamental repetition rate of ∼1.0 GHz, a maximum output power of 7 W, and a compressed pulse width of 220 fs. It is anticipated that this high-speed broadband WFS can be a promising source for applications that require fast wavelength scanning and high-speed data processing.

Introduction to optical coherence elastography: tutorial

Optical coherence elastography (OCE) has seen rapid growth since its introduction in 1998. The past few decades have seen tremendous advancements in the development of OCE technology and a wide range of applications, including the first clinical applications. This tutorial introduces the basics of solid mechanics, which form the foundation of all elastography methods. We then describe how OCE measurements of tissue motion can be used to quantify tissue biomechanical parameters. We also detail various types of excitation methods, imaging systems, acquisition schemes, and data processing algorithms and how various parameters associated with each step of OCE imaging can affect the final quantitation of biomechanical properties. Finally, we discuss the future of OCE, its potential, and the next steps required for OCE to become an established medical imaging technology.

Continuous spectral zooming for in vivo live 4D-OCT with MHz A-scan rates and long coherence

We present continuous three-dimensional spectral zooming in live 4D-OCT using a home-built FDML based OCT system with 3.28 MHz A-scan rate. Improved coherence characteristics of the FDML laser allow for imaging ranges up to 10 cm. For the axial spectral zoom feature, we switch between high resolution and long imaging range by adjusting the sweep range of our laser. We present a new imaging setup allowing for synchronized adjustments of the imaging range and lateral field of view during live OCT imaging. For this, a novel inline recalibration algorithm was implemented that enables numerical k-linearization of the raw OCT fringes for every frame instead of every volume. This is realized by acquiring recalibration data within the dead time of the raster scan at the turning points of the fast axis scanner. We demonstrate in vivo OCT images of fingers and hands at different resolution modes and show real three-dimensional zooming during live 4D-OCT. A three-dimensional spectral zooming feature for live 4D-OCT is expected to be a useful tool for a wide range of biomedical, scientific and research applications, especially in OCT guided surgery.

Pulsatile tissue deformation dynamics of the murine retina and choroid mapped by 4D optical coherence tomography

Irregular ocular pulsatility and altered mechanical tissue properties are associated with some of the most sight-threatening eye diseases. Here we present 4D optical coherence tomography (OCT) for the quantitative assessment and depth-resolved mapping of pulsatile dynamics in the murine retina and choroid. Through a pixel-wise analysis of phase changes of the complex OCT signal, we reveal spatiotemporal displacement characteristics across repeated frame acquisitions. We demonstrate in vivo fundus elastography (FUEL) imaging in wildtype mouse retinas and in a mouse model of retinal neovascularization and uncover subtle structural deformations related to ocular pulsation. Our data in mouse eyes hold promise for a powerful retinal elastography technique that may enable a new paradigm of OCT-based measurements and image contrast.

Reconstruction of visible light optical coherence tomography images retrieved from discontinuous spectral data using a conditional generative adversarial network

Achieving high resolution in optical coherence tomography typically requires the continuous extension of the spectral bandwidth of the light source. This work demonstrates an alternative approach: combining two discrete spectral windows located in the visible spectrum with a trained conditional generative adversarial network (cGAN) to reconstruct a high-resolution image equivalent to that generated using a continuous spectral band. The cGAN was trained using OCT image pairs acquired with the continuous and discontinuous visible range spectra to learn the relation between low- and high-resolution data. The reconstruction performance was tested using 6000 B-scans of a layered phantom, micro-beads and ex-vivo mouse ear tissue. The resultant cGAN-generated images demonstrate an image quality and axial resolution which approaches that of the high-resolution system.

Temporal phase evolution OCT for measurement of tissue deformation in the human retina in-vivo

We demonstrate the use of temporal phase evolution (TPE-) OCT methods to evaluate retinal tissue deformation in-vivo over time periods of several seconds. A custom built spectral domain (SD)-OCT system with an integrated retinal tracker, ensuring stable imaging with sub-speckle precision, was used for imaging. TPE-OCT measures and images phase differences between an initial reference B-scan and each of the subsequent B-scans of the evaluated temporal sequence. In order to demonstrate the precision and repeatability of the measurements, retinal nerve fiber (RNF) tissue deformations induced by retinal vessels pulsating with the heartbeat were analyzed in several healthy subjects. We show TPE maps (M-scans of phase evolution as a function of position along B-scan trace vs. time) of wrapped phase data and corresponding deformation maps in selected regions of the RNF layer (RNFL) over the course of several cardiac cycles. A reproducible phase pattern is seen at each heartbeat cycle for all imaged volunteers. RNF tissue deformations near arteries and veins up to ∼ 1.6 µm were obtained with an average precision for a single pixel of about 30 nm. Differences of motion induced by arteries and veins are also investigated.

Resolution-enhanced OCT and expanded framework of information capacity and resolution in coherent imaging

Spatial resolution in conventional optical microscopy has traditionally been treated as a fixed parameter of the optical system. Here, we present an approach to enhance transverse resolution in beam-scanned optical coherence tomography (OCT) beyond its aberration-free resolution limit, without any modification to the optical system. Based on the theorem of invariance of information capacity, resolution-enhanced (RE)-OCT navigates the exchange of information between resolution and signal-to-noise ratio (SNR) by exploiting efficient noise suppression via coherent averaging and a simple computational bandwidth expansion procedure. We demonstrate a resolution enhancement of 1.5 × relative to the aberration-free limit while maintaining comparable SNR in silicone phantom. We show that RE-OCT can significantly enhance the visualization of fine microstructural features in collagen gel and ex vivo mouse brain. Beyond RE-OCT, our analysis in the spatial-frequency domain leads to an expanded framework of information capacity and resolution in coherent imaging that contributes new implications to the theory of coherent imaging. RE-OCT can be readily implemented on most OCT systems worldwide, immediately unlocking information that is beyond their current imaging capabilities, and so has the potential for widespread impact in the numerous areas in which OCT is utilized, including the basic sciences and translational medicine.

Evaluating posterior vitreous detachment by widefield 23-mm swept-source optical coherence tomography imaging in healthy subjects

Posterior vitreous detachment (PVD) is a separation between the posterior vitreous cortex and internal limiting membrane. Although PVD was historically considered an acute event, recent studies using spectral-domain optical coherence tomography (SD-OCT) revealed a gradual progression of PVD in healthy subjects. Although SD-OCT improved PVD studies, the narrow imaging angle and long examination time were problematic to allow wide angle capture. The Xephilio OCT-S1 (Canon), a swept-source OCT (SS-OCT) device, can obtain up to 23-mm of widefield B-scan images in a single acquisition. We used this widefield SS-OCT to quantitatively evaluate the PVD stage in 214 healthy subjects aged 4–89 years and determine whether PVD stages differ between the bilateral eyes of each patient. Age was significantly positively correlated with the overall PVD stage (ρ = 0.7520, P < 0.001). Interestingly, partial PVD occurred in children as young as 5 years, indicating that initial PVD onset may occur much earlier than previously reported. Furthermore, PVD stages of the bilateral eyes were highly consistent in 183 subjects (85.5%). Widefield 23-mm SS-OCT thus revealed that PVD started earlier than anticipated, and age was correlated with the symmetry of PVD stage. Widefield 23-mm SS-OCT may also be clinically useful for the evaluation of diseased eyes.

Microscopic optical coherence tomography (mOCT) at 600 kHz for 4D volumetric imaging and dynamic contrast

Volumetric imaging of dynamic processes with microscopic resolution holds a huge potential in biomedical research and clinical diagnosis. Using supercontinuum light sources and high numerical aperture (NA) objectives, optical coherence tomography (OCT) achieves microscopic resolution and is well suited for imaging cellular and subcellular structures of biological tissues. Currently, the imaging speed of microscopic OCT (mOCT) is limited by the line-scan rate of the spectrometer camera and ranges from 30 to 250 kHz. This is not fast enough for volumetric imaging of dynamic processes in vivo and limits endoscopic application. Using a novel CMOS camera, we demonstrate fast 3-dimensional OCT imaging with 600,000 A-scans/s at 1.8 µm axial and 1.1 µm lateral resolution. The improved speed is used for imaging of ciliary motion and particle transport in ex vivo mouse trachea. Furthermore, we demonstrate dynamic contrast OCT by evaluating the recorded volumes rather than en face planes or B-scans. High-speed volumetric mOCT will enable the correction of global tissue motion and is a prerequisite for applying dynamic contrast mOCT in vivo. With further increase in imaging speed and integration in flexible endoscopes, volumetric mOCT may be used to complement or partly replace biopsies.

Investigation of the scattering and attenuation properties of cataracts formed in mouse eyes with 1060-nm and 1310-nm swept-source optical coherence tomography

Cataracts are the leading cause of blindness worldwide. Here we propose optical coherence tomography (OCT) as a quantitative method for investigating cataracts. OCT provides volumetric and non-invasive access to the lens and makes it possible to rapidly observe the formation of opacifications in animal models such as mice. We compared the performance of two different wavelengths - 1060 nm and 1310 nm - for OCT imaging in cataract research. In addition, we present multi-contrast OCT capable of mapping depth-resolved scattering and average anterior cortical attenuation properties of the crystalline lens and quantitatively characterize induced cataract development in the mouse eye. Lastly, we also propose a novel method based on the retinal OCT projection image for quantifying and mapping opacifications in the lens, which showed a good correlation with scattering and attenuation characteristics simultaneously analyzed during the process of cataract formation in the lens.

Ultra-fast dynamic line-field optical coherence elastography

In this work, we present an ultra-fast line-field optical coherence elastography system (LF-OCE) with an 11.5 MHz equivalent A-line rate. The system was composed of a line-field spectral domain optical coherence tomography system based on a supercontinuum light source, Michelson-type interferometer, and a high-speed 2D spectrometer. The system performed ultra-fast imaging of elastic waves in tissue-mimicking phantoms of various elasticities. The results corroborated well with mechanical testing. Following validation, LF-OCE measurements were made in in situ and in in vivo rabbit corneas under various conditions. The results show the capability of the system to rapidly image elastic waves in tissues.

Wide-Field Swept-Source OCT Analysis of Interocular Symmetry of Choroidal Thickness in Subjects with Uncomplicated Pachychoroid

BACKGROUND

We aimed to study the bilateral choroidal thickness (CT) symmetry and difference in uncomplicated pachychoroid subjects using wide-field swept-source optical coherence tomography (SS-OCT).

METHODS

All subjects underwent a wide-field 16-mm one-line scan using SS-OCT. Bilateral CT was measured at, and compared among, the following 12 points: three points at 900-µm intervals from the nasal optic disc margin (nasal peripapillary area), one point at the subfovea, six points at 900-µm intervals from the fovea to the nasal and temporal areas (macular area), and two peripheral points 5400 and 8100 µm from the fovea (peripheral area).

RESULTS

There were no statistically significant differences in CT between the right and left eyes in any area (all p > 0.05); they all showed significant positive correlations (all p < 0.01). However, the correlation coefficients (ρ) were smaller for the nasal peripapillary and peripheral areas compared to the macular area.

CONCLUSIONS

The CTs in each region were bilaterally symmetrical in subjects with uncomplicated pachychoroid. However, interocular difference in CT increased from the center to the periphery, indicating that the anatomical variation of the nasal peripapillary and peripheral choroid was greater than that of the macula.

Identification of oral precancerous and cancerous tissue by swept source optical coherence tomography

BACKGROUND AND OBJECTIVES

Distinguishing cancer from precancerous lesions is critical and challenging in oral medicine. As a noninvasive method, optical coherence tomography (OCT) has the advantages of real-time, in vivo, and large-depth imaging. Texture information hidden in OCT images can provide an important auxiliary effect for improving diagnostic accuracy. The aim of this study is to explore a reliable and accurate OCT-based method for the screening and diagnosis of human oral diseases, especially oral cancer.

MATERIALS AND METHODS

Fresh ex vivo oral tissues including normal mucosa, leukoplakia with epithelial hyperplasia (LEH), and oral squamous cell carcinoma (OSCC) were imaged intraoperatively by a homemade OCT system, and 58 texture features were extracted to create computational models of these tissues. A principal component analysis algorithm was employed to optimize the combination of texture feature vectors. The identification based on artificial neural network (ANN) was proposed and the sensitivity/specificity was calculated statistically to evaluate the classification performance.

RESULTS

A total of 71 sites of three types of oral tissues were measured, and 5176 OCT images of three types of oral tissues were used in this study. The superior classification result based on ANN was obtained with an average accuracy of 98.17%. The sensitivity and specificity of normal mucosa, LEH, and OSCC are 98.17% / 98.38%, 93.81% / 98.54%, and 98.11% / 99.04%, respectively.

CONCLUSION

It is demonstrated from the high accuracies, sensitivities, and specificities that texture-based analysis can be used to identify oral precancerous and cancerous tissue in OCT images, and it has the potential to help surgeons in diseases screening and diagnosis effectively.

Neural network-based image reconstruction in swept-source optical coherence tomography using undersampled spectral data

Optical coherence tomography (OCT) is a widely used non-invasive biomedical imaging modality that can rapidly provide volumetric images of samples. Here, we present a deep learning-based image reconstruction framework that can generate swept-source OCT (SS-OCT) images using undersampled spectral data, without any spatial aliasing artifacts. This neural network-based image reconstruction does not require any hardware changes to the optical setup and can be easily integrated with existing swept-source or spectral-domain OCT systems to reduce the amount of raw spectral data to be acquired. To show the efficacy of this framework, we trained and blindly tested a deep neural network using mouse embryo samples imaged by an SS-OCT system. Using 2-fold undersampled spectral data (i.e., 640 spectral points per A-line), the trained neural network can blindly reconstruct 512 A-lines in 0.59 ms using multiple graphics-processing units (GPUs), removing spatial aliasing artifacts due to spectral undersampling, also presenting a very good match to the images of the same samples, reconstructed using the full spectral OCT data (i.e., 1280 spectral points per A-line). We also successfully demonstrate that this framework can be further extended to process 3× undersampled spectral data per A-line, with some performance degradation in the reconstructed image quality compared to 2× spectral undersampling. Furthermore, an A-line-optimized undersampling method is presented by jointly optimizing the spectral sampling locations and the corresponding image reconstruction network, which improved the overall imaging performance using less spectral data points per A-line compared to 2× or 3× spectral undersampling results. This deep learning-enabled image reconstruction approach can be broadly used in various forms of spectral-domain OCT systems, helping to increase their imaging speed without sacrificing image resolution and signal-to-noise ratio.

Rapid chemically selective 3D imaging in the mid-infrared

The emerging technique of mid-infrared optical coherence tomography (MIR-OCT) takes advantage of the reduced scattering of MIR light in various materials and devices, enabling tomographic imaging at deeper penetration depths. Because of challenges in MIR detection technology, the image acquisition time is, however, significantly longer than for tomographic imaging methods in the visible/near-infrared. Here we demonstrate an alternative approach to MIR tomography with high-speed imaging capabilities. Through femtosecond nondegenerate two-photon absorption of MIR light in a conventional Si-based CCD camera, we achieve wide-field, high-definition tomographic imaging with chemical selectivity of structured materials and biological samples in mere seconds.

Frequency-comb-calibrated swept-wavelength interferometry

Lasers are often used to characterize samples in a non-destructive manner and retrieve sensing information transduced in changes in amplitude and phase. In swept wavelength interferometry, a wavelength-tunable laser is used to measure the complex response (i.e. in amplitude and phase) of an optical sample. This technique leverages continuous advances in rapidly tunable lasers and is widely used for sensing, bioimaging and testing of photonic integrated components. However, the tunable laser requires an additional calibration step because, in practice, it does not tune at a constant rate. In this work, we use a self-referenced frequency comb as an optical ruler to calibrate the laser used in swept-wavelength interferometry and optical frequency domain reflectometry. This allows for realizing high-resolution complex spectroscopy over a bandwidth exceeding 10 THz. We apply the technique to the characterization of low-loss integrated photonic devices and demonstrate that the phase information can disentangle intrinsic from coupling losses in the characterization of high-Q microresonators. We also demonstrate the technique in reflection mode, where it can resolve attenuation and dispersion characteristics in integrated long spiral waveguides.

Time-encoded stimulated Raman scattering microscopy of tumorous human pharynx tissue in the fingerprint region from 1500-1800 cm-1

Stimulated Raman scattering (SRS) microscopy for biomedical analysis can provide a molecular localization map to infer pathological tissue changes. Compared to spontaneous Raman, SRS achieves much faster imaging speeds at reduced spectral coverage. By targeting spectral features in the information dense fingerprint region, SRS allows fast and reliable imaging. We present time-encoded (TICO) SRS microscopy of unstained head-and-neck biopsies in the fingerprint region with molecular contrast. We combine a Fourier-domain mode-locked (FDML) laser with a master oscillator power amplifier (MOPA) to cover Raman transitions from 1500-1800cm^-1. Both lasers are fiber-based and electronically programmable making this fingerprint TICO system robust and reliable. The results of our TICO approach were cross-checked with a spontaneous Raman micro-spectrometer and show good agreement, paving the way toward clinical applications.

Quantitative spectroscopic comparison of the optical properties of mouse cochlea microstructures using optical coherence tomography at 1.06 µm and 1.3 µm wavelengths

Currently, the cochlear implantation procedure mainly relies on using a hand lens or surgical microscope, where the success rate and surgery time strongly depend on the surgeon's experience. Therefore, a real-time image guidance tool may facilitate the implantation procedure. In this study, we performed a systematic and quantitative analysis on the optical characterization of ex vivo mouse cochlear samples using two swept-source optical coherence tomography (OCT) systems operating at the 1.06-µm and 1.3-µm wavelengths. The analysis results demonstrated that the 1.06-µm OCT imaging system performed better than the 1.3-µm OCT imaging system in terms of the image contrast between the cochlear conduits and the neighboring cochlear bony wall structure. However, the 1.3-µm OCT imaging system allowed for greater imaging depth of the cochlear samples because of decreased tissue scattering. In addition, we have investigated the feasibility of identifying the electrode of the cochlear implant within the ex vivo cochlear sample with the 1.06-µm OCT imaging. The study results demonstrated the potential of developing an image guidance tool for the cochlea implantation procedure as well as other otorhinolaryngology applications.

Multi-MHz MEMS-VCSEL swept-source optical coherence tomography for endoscopic structural and angiographic imaging with miniaturized brushless motor probes

Swept source optical coherence tomography (SS-OCT) enables volumetric imaging of subsurface structure. However, applications requiring wide fields of view (FOV), rapid imaging, and higher resolutions have been challenging because multi-MHz axial scan (A-scan) rates are needed. We describe a microelectromechanical systems vertical cavity surface-emitting laser (MEMS-VCSEL) SS-OCT technology for A-scan rates of 2.4 and 3.0 MHz. Sweep to sweep calibration and resampling are performed using dual channel acquisition of the OCT signal and a Mach Zehnder interferometer signal, overcoming inherent optical clock limitations and enabling higher performance. We demonstrate ultrahigh speed structural SS-OCT and OCT angiography (OCTA) imaging of the swine gastrointestinal tract using a suite of miniaturized brushless motor probes, including a 3.2 mm diameter micromotor OCT catheter, a 12 mm diameter tethered OCT capsule, and a 12 mm diameter widefield OCTA probe. MEMS-VCSELs promise to enable ultrahigh speed SS-OCT with a scalable, low cost, and manufacturable technology, suitable for a diverse range of imaging applications.

Wide-Field Swept-Source Optical Coherence Tomography Analysis of Interocular Symmetry of Choroidal Thickness in Healthy Young Individuals

Purpose

The purpose of this paper was to study the bilateral choroidal thickness (CT) symmetry and differences in healthy individuals using wide-field swept-source optical coherence tomography (SS-OCT).

Methods

All participants underwent a wide-field 16-mm 1-line scan using SS-OCT. CTs were measured at the following 12 points: 3 points at 900 µm, 1800 µm, and 2700 µm away from the nasal optic disc margin (nasal peripapillary area), 1 point at the subfovea, 6 points at 900 µm, 1800 µm, and 2700 µm away from the subfovea to the nasal and temporal areas (macular area), and 2 peripheral points at 2700 and 5400 µm from temporal point 3 (peripheral area). Bilateral CTs were measured; their correlations and differences in the corresponding regions were analyzed.

Results

There were no statistically significant differences in CTs between the right and left eyes in all corresponding areas (all P > 0.05); they all showed significant positive correlation coefficients (r) (all P < 0.001). However, the nasal peripapillary and peripheral areas had relatively low correlation coefficients, compared to the macular areas. In addition, the bilateral CT differences were 32.60 ± 25.80 µm in the macular area, 40.67 ± 30.58 µm in the nasal peripapillary area, and 56.03 ± 45.73 µm in the peripheral area (all P < 0.001).

Conclusions

Overall, the CTs of each region were bilaterally symmetrical. However, the differences in CTs increased from the center to the periphery, which indicated that the anatomic variation of the nasal peripapillary and peripheral choroid was greater than that of the macula.

Whole anterior segment and retinal swept source OCT for comprehensive ocular screening

Whole eye visualization and morphometry are of high relevance in clinical practice. However, most standard ophthalmic OCT instruments are dedicated either to retinal or to anterior segment imaging. We demonstrate a swept source optical coherence tomography system (SS-OCT) that images both the whole anterior segment and the retina alternately using a single source and detector. A pilot population was imaged with the proof of concept prototype. We demonstrate the clinical potential of whole eye OCT screening for the description and early detection of relevant clinical features in the anterior segment and retina of several patients.

Improved sensitivity roll-off in dual reference, buffered spectral-domain optical coherence tomography

SIGNIFICANCE

While spectral-domain optical coherence tomography (SD-OCT) is a preferred form of OCT imaging, sensitivity roll-off limits its applicability for certain biomedical imaging applications.

AIM

The aim of this work is to extend the imaging range of conventional SD-OCT systems for imaging large luminal organs such as the gastrointestinal tract.

APPROACH

We present an SD-OCT system operating at a center wavelength of 1300 nm that uses two delayed reference arms to reduce sensitivity roll-off and an optical switch and a fiber optic delay line to ensure that the interference spectra are acquired from the same sample time window.

RESULT

The proposed system was used to image swine colon ex vivo and duodenum in vivo, demonstrating improved image quality due to a ∼14  dB increase in sensitivity at the edges of the ranging depth.

CONCLUSION

The proposed system requires modest hardware implementation and is compatible with catheter-based endoscopic helical scanning with enhanced sensitivity for the samples at a distance of ∼6  mm from the zero delay point.

Retinal applications of swept source optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA)

The advent of optical coherence tomography (OCT) revolutionized both clinical assessment and research of vitreoretinal conditions. Since then, extraordinary advances have been made in this imaging technology, including the relatively recent development of swept-source OCT (SS-OCT). SS-OCT enables a fast scan rate and utilizes a tunable swept laser, thus enabling the incorporation of longer wavelengths than conventional spectral-domain devices. These features enable imaging of larger areas with reduced motion artifact, and a better visualization of the choroidal vasculature, respectively. Building on the principles of OCT, swept-source OCT has also been applied to OCT angiography (SS-OCTA), thus enabling a non-invasive in depth-resolved imaging of the retinal and choroidal microvasculature. Despite their advantages, the widespread use of SS-OCT and SS-OCTA remains relatively limited. In this review, we summarize the technical details, advantages and limitations of SS-OCT and SS-OCTA, with a particular emphasis on their relevance for the study of retinal conditions. Additionally, we comprehensively review relevant studies performed to date to the study of retinal health and disease, and highlight current gaps in knowledge and opportunities to take advantage of swept source technology to improve our current understanding of many medical and surgical chorioretinal conditions. We anticipate that SS-OCT and SS-OCTA will continue to evolve rapidly, contributing to a paradigm shift to more widespread adoption of new imaging technology to clinical practice.

Efficient and high accuracy 3-D OCT angiography motion correction in pathology

We describe a novel method for non-rigid 3-D motion correction of orthogonally raster-scanned optical coherence tomography angiography volumes. This is the first approach that aligns predominantly axial structural features such as retinal layers as well as transverse angiographic vascular features in a joint optimization. Combined with orthogonal scanning and favorization of kinematically more plausible displacements, subpixel alignment and micrometer-scale distortion correction is achieved in all 3 dimensions. As no specific structures are segmented, the method is by design robust to pathologic changes. Furthermore, the method is designed for highly parallel implementation and short runtime, allowing its integration into clinical workflow even for high density or wide-field scans. We evaluated the algorithm with metrics related to clinically relevant features in an extensive quantitative evaluation based on 204 volumetric scans of 17 subjects, including patients with diverse pathologies and healthy controls. Using this method, we achieve state-of-the-art axial motion correction and show significant advances in both transverse co-alignment and distortion correction, especially in the subgroup with pathology.

Imaging Motion: A Comprehensive Review of Optical Coherence Tomography Angiography

Optical coherence tomography (OCT) is a three-dimensional (3-D) optical imaging technology that provides noninvasive, micrometer resolution images of structural interiors within biological samples with an approximately 1 ~ 2 mm penetration depth. Over the last decades, advances in OCT have revolutionized biomedical imaging by demonstrating a potential of optical biopsy in preclinical and clinical settings. Recently, functional OCT imaging has shown a promise as angiography to visualize cell-perfused vasculatures in the tissue bed in vivo without requiring any exogenous contrast agents. This new technology termed OCT angiography (OCTA) possesses a unique imaging capability of delineating tissue morphology and blood or lymphatic vessels down to capillaries at real-time acquisition rates. For the past 10 years since 2007, OCTA has been proven to be a useful tool to identify disorder or dysfunction in tissue microcirculation from both experimental animal studies and clinical studies in ophthalmology and dermatology. In this section, we overview about OCTA including a basic principle of OCTA explained with simple optical physics, and its scan protocols and post-processing algorithms for acquisition of angiography. Then, potential and challenge of OCTA for clinical settings are shown with outcomes of human studies.