The Early Development of Optical Coherence Tomography: From Concept to Reality

Optical coherence tomography (OCT) has revolutionized the field of ophthalmology by providing high-resolution images of the eye's internal structures. But how did this technology come to be? Let's take a journey through its early development, from concept to reality.

In the late 1970s and early 1980s, researchers at Bell Laboratories (AT&T) began exploring the idea of using light interference to produce non-invasive optical imaging. This concept, known as optical reflectivity, was built upon by Drs. Duguay and Ippen. However, it wasn't until the late 1980s that a team led by Dr. James Fujimoto at the Massachusetts Institute of Technology (MIT) began to develop OCT technology.

The early prototype OCT machine used at the New England Eye Center in 1993 was a significant breakthrough, allowing researchers to produce quantitative data such as peripapillary nerve fiber layer thickness. This was made possible using an early Macintosh Apple computer. During this period, Michael Hee, M.D., Ph.D., collaborated with Eric Swanson of MIT Lincoln Laboratories to make rapid advances in OCT technology.

In 1991, Huang et al. published the very first retinal OCT images of an ex-vivo human eye, paving the way for further development. The team's work was groundbreaking, as it demonstrated the potential of OCT imaging for diagnosing and monitoring a range of ocular conditions.

The early 'protozoal' period of OCT development was marked by limited success, but it laid the foundation for future innovations. In 1996, the first OCT atlas was published, providing a framework for OCT image interpretation. This milestone was followed by the publication of the very first in-vivo human retina images outside of a laboratory just two years later.

The application of fiber optic and intersatellite communication technology shrunk lab-based mega-OCTs into an instrument that was only 19 inches wide and 100 times faster. OCT imaging using this prototype device was performed on over 5,000 out-patients at the New England Eye Center at Tufts Medical Center with support from the National Institutes of Health.

Today, OCT technology is widely used in ophthalmic clinics around the world to diagnose and treat a range of conditions, including cystoid macular edema. The development of OCT has been a long and winding road, but its impact on our understanding of the eye's internal structures and its potential for improving patient care make it an invaluable tool in the field of ophthalmology.

In conclusion, the history of OCT is a testament to the power of collaboration and innovation. From its humble beginnings in the late 1970s to its current widespread use in clinical settings, OCT has come a long way. As researchers continue to refine and improve this technology, we can expect even greater breakthroughs in the field of ophthalmology.

Oct of normal retina