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

Background/Aims: 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. Methods: 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. Results: 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. Conclusion: 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.