However, it was not until 1991 that the first B-scans of human tissue were published using OCT technology. With modification and the use of superluminescent diodes, the technology was then applied to in vivo axial length measures (A-scans) with accuracy of 0.03 mm. In the late 1980s, Fujimoto and colleagues were the pioneers in using light energy to image biological tissues, using femtosecond pulsed lasers to image the cornea with 15 μm resolution. The basic principles of OCT technology can be compared with those of ultrasonography, in which the backscatter is used to generate images. OCT of the optic nerve gives a morphological view of the optic nerve as well as certain measurements that are helpful to follow over time. The OCT average retinal nerve fiber analysis is a helpful technique in monitoring disc edema over time. The OCT average retinal nerve fiber analysis is very helpful in following optic nerve pathologies, for example glaucoma, MS, compressive optic neuropathies, however this technique does not distinguish between swollen and normal nerves, therefore, one may be given a false sense that the nerve is normal, when it fact it is swollen, thus missing that there is a reduced complement of retinal nerve fibers. OCT of the retina quantitates the thickness of the retinal nerve fiber layer (average retinal nerve fiber analysis), which is adjacent to the optic nerve (known as the circumpapillary retinal nerve fiber layer), and this is an indirect quantitative analysis of one’s complement of optic nerve fibers. OCT of the retina simulates to some degree an anatomic replica of a histological section of the retina treatment of macular degeneration, diabetic macular edema amongst other pathologies. Optical Coherence Tomography (OCT) has revolutionized imaging of the retina and optic nerve and has enhanced our ability to diagnose and manage patients.
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