Analysis of the Human Macula by Confocal Laser Tomography

Abstract

Laser scanning tomography was used to study the surface of the diseased and normal macula in the human eye. The confocal arrangement of the laser tomographic scanner permits the examination of the retinal topography in the axis perpendicular to the retinal surface. It was found that the normal macular surface as seen in histological preparations can be reconstructed in humans with the laser tomographic scanner. A polarization pattern can be observed in the area of Henle's fiber layer. We were able to reproducibly image a brush-like pattern with the circular polarized laser light in healthy eyes of 25 patients. In contrast, we did not observe it in eyes with structural changes of the macular tissue, indicating that loss of the brush-like phenomena may be an early and sensitive indication of macular diseases. In diseased eyes we were able to assess structural abnormalities, such as macular holes, laser scars, macular branch vein occlusion and macular edema. The laser tomographic scanner offers a new method to determine the topography of the internal limiting membrane in the macular area.