Enhanced depth imaging in swept-source optical coherence tomography: Improving visibility of choroid and sclera, a masked study

Purpose: To compare enhanced depth imaging in swept-source optical coherence tomography and non–enhanced depth imaging optical coherence tomography in their ability to capture choroidal and scleral details. Methods: Averaged foveal B-Scans were obtained from 40 eyes of 20 healthy volunteers by swept-source optical coherence tomography with and without enhanced depth imaging. Visibility and contrast of vascular details within the choroid, choroidoscleral junction, and sclera were evaluated by masked readers using an ordinal scoring scale. Outcomes were analyzed using the Wilcoxon signed rank-sum test. Results: Visibility of the choroidal vascular details (Z = 5.94, p <.001), the choroidoscleral junction (Z = 5.85, p <.001), and the sclera (Z = 6.80, p <.001) was significantly higher with enhanced depth imaging than with non–enhanced depth imaging swept-source optical coherence tomography. Similarly, image contrast was significantly higher with enhanced depth imaging than with non–enhanced depth imaging swept-source optical coherence tomography for the choroidal vascular details (Z = 9.47, p <.001), for the choroidoscleral junction (Z = 9.28, p <.001), and for the sclera (Z = 9.42, p <.001). Conclusion: Enhanced depth imaging applied to swept-source optical coherence tomography–averaged foveal B-scans enhances visualization of the choroidal details, of the choroidoscleral junction, and of the sclera. This novel modality can easily be implemented in clinics and could improve our understanding of conditions involving the choroid or the sclera.