Objective:

To explore the role of optical coherence tomography (OCT) in understanding and monitoring central nervous system (CNS) diseases through retinal imaging.

Approach:

• Introduction to OCT: OCT provides a non-invasive view into CNS health by examining retinal structures that reflect neurodegeneration.
• Comparison with Traditional Imaging: Unlike MRI and PET, which show macrostructural changes, OCT reveals cellular and microstructural damage in the retina.
• Oculomics: The emerging field of oculomics uses retinal biomarkers to predict and monitor neurological diseases.
• Integration with Other Imaging: Combining OCT with MRI or PET helps map retinal changes to brain networks.
• Barriers to Adoption: Challenges include standardization, interpretation complexity, regulatory uncertainty, and data diversity.
• Future Directions: Enhancing interdisciplinary training and developing standardized imaging protocols are essential for integrating OCT into neurology.

Key Findings:

• Retinal thinning correlates with CNS neuronal loss and is prognostically relevant.
• OCT can serve as predictive and monitoring tools for neurodegenerative diseases.
• AI models using OCT can detect neurodegenerative changes earlier than traditional clinical examinations.

Interpretation:

The eye serves as a measurable and clinically actionable window into brain health, with OCT playing a crucial role in early detection and monitoring of CNS diseases.

Limitations:

• Variability across OCT platforms and algorithms.
• Neurologists may lack training in OCT interpretation.
• Regulatory uncertainties regarding OCT as a biomarker.

Conclusion:

As OCT technology advances, it will enhance early detection and monitoring of CNS diseases, contributing to preventive care and improved patient quality of life.

Sources:

• OCT and Imaging in Central Nervous System Diseases