A simple yet elegant solution that removes one of the major barriers for translation of Adaptive Optics Optical Coherence Tomography (AO-OCT) to clinical retinal imaging has been proposed and validated in the latest paper authored by Masato Tamura et al. Specifically, they successfully evaluated a variable cross-cylinder (VCC) comprising a pair of cylindrical lenses (originally proposed by Alvarez over 50 years ago) as a low-cost astigmatism compensator without sacrificing the OCT system field-of-view. As expected, a lateral resolution twice higher than most commercial OCT systems has been achieved in their VCC-equipped ophthalmic wavefront sensorless AO-OCT system utilizing a 3 mm pupil diameter. Retinal imaging with AO-OCT over modest pupil sizes has been previously suggested by others. It offers clear improvement in images of capillaries acquired with OCT angiography and visualizations of photoreceptors mosaic, without the need to correct for higher-order aberration (which greatly simplifies the AO implementation). The proposed VCC is arguably the simplest and most cost-effective way to achieve astigmatism correction in high-resolution retinal OCT imaging so far. We can be sure that this approach will find its way into future commercial lower-end AO-OCT systems relying on low-order ocular aberrations correction only.

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