Supplementary Material for: Optical Coherence Tomography: Clinicopathologic Correlations - The 2016 Gordon K. Klintworth Lecture

<b><i>Background/Aims:</i></b> Spectral domain optical coherence tomography (SD-OCT) has become a mainstay of ophthalmic practice that has revolutionized the assessment and treatment of a variety of ocular disorders. Studies that directly correlate SD-OCT and histopathology are necessary to demonstrate the actual nature of the retinal pathology responsible for the images that resemble histologic sections, but are generated by mathematical algorithms. <b><i>Methods:</i></b> Careful correlative light microscopy was performed on a small number of eyes undergoing enucleation for intraocular tumors that had pertinent findings imaged by SD-OCT. Expeditious processing and a fixation technique that prevented retinal detachment minimized tissue distortion and sectioning artifact. <b><i>Results:</i></b> The retinal layers disclosed by SD-OCT images do not correspond directly to light microscopy. Photoreceptor ellipsoids can persist in foveal detachments without a distinct ellipsoid band in corresponding SD-OCT images. Lipidized histiocytes can appear as bright hyperreflective spots, and clumps of subretinal macrophages as “shaggy photoreceptors” overlying choroidal tumors. <b><i>Conclusion:</i></b> The meaningful interpretation of SD-OCT's striking visual imagery requires a firm foundation in ocular histology and pathology. The accuracy of interpretation can be improved by correlative studies that directly compare OCT and histopathology.

<b><i>背景与目的：</i></b> 频域光学相干断层扫描（Spectral Domain Optical Coherence Tomography, SD-OCT）现已成为眼科临床的主流检查手段，彻底革新了多种眼部疾病的评估与诊疗流程。当前亟需开展将SD-OCT与组织病理学直接关联的研究，以明确那些外观类似组织学切片、实则由数学算法生成的SD-OCT影像所对应的视网膜病变的真实本质。<b><i>方法：</i></b> 本研究针对因眼内肿瘤行眼球摘除术的少量眼球（其术前经SD-OCT成像检出具有相关病变特征）开展了细致的相关性光学显微镜检查。采用快速处理流程与可有效预防视网膜脱离的固定技术，最大程度降低了组织变形与切片伪影的产生。<b><i>结果：</i></b> SD-OCT影像所显示的视网膜层结构与光学显微镜下的观测结果并不完全对应。在黄斑脱离病例中，感光细胞椭圆体可依然存在，但对应SD-OCT影像中却无清晰的椭圆体带。脂化组织细胞可表现为明亮的高反射斑点，而脉络膜肿瘤上方的视网膜下巨噬细胞团则可被误判为“蓬乱状感光受体”。<b><i>结论：</i></b> 要对SD-OCT极具辨识度的视觉影像做出准确解读，必须具备扎实的眼部组织学与病理学基础。通过直接对比OCT与组织病理学的相关性研究，可显著提升影像解读的准确性。