We used multi-contrast OCT (MC-OCT), which is capable of the simultaneous measurement of OCT angiography, degree of polarization uniformity and intensity OCT, to evaluate retinal pigment epithelium (RPE) changes. MC-OCT system was operated at an axial scan speed of 100,000 A-scans/s, using a swept-source laser at a central wavelength of 1,048 nm. From the dataset of MC-OCT, a pixel-wise segmentation method for RPE-melanin was developed and used to create RPE-melanin-specific contrast images to evaluate RPE-melanin changes. The RPE-melanin cross-sectional images were generated to evaluate the depth-resolved distribution of RPE-melanin. RPE-melanin thickness maps were created by counting the number of pixels with RPE-melanin at each A-line in the 3D dataset. An RPE-melanin thickness map represents the en face distribution of the thickness of RPE-melanin. We evaluated 37 eyes with age-related macular degeneration (AMD) with serous retinal pigment epithelium detachment, and 24 eyes with chronic Vogt-Koyanagi- Harada (VKH) disease. In these cases, RPE-melanin thickness maps showed similarities to the near infrared autofluorescence (NIR-AF; excitation 780 nm) images. In the eyes with AMD, focal RPE damages could be readily detected with RPE-melanin thickness map. RPE-melanin cross-sectional images were more sensitive for the damage at RPE-Bruch’s membrane band than intensity OCT images. In the eyes with VKH disease, RPE-melanin-specific contrast images clearly showed focal RPE-melanin accumulation at granular hyper NIR-AF lesions. In conclusion, this study demonstrated the clinical usefulness of RPE-melanin specific contrast OCT imaging for evaluating RPE changes in retinal diseases.
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