{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T23:49:34Z","timestamp":1783036174639,"version":"3.54.6"},"reference-count":79,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T00:00:00Z","timestamp":1754092800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Optical Coherence Tomography (OCT) has evolved from a breakthrough ophthalmologic imaging tool into a cornerstone technology in interventional cardiology. After its initial applications in retinal imaging in the early 1990s, OCT was subsequently envisioned for cardiovascular use. In 1995, its ability to visualize atherosclerotic plaques was demonstrated in an in vitro study, and the following year marked the acquisition of the first in vivo OCT image of a human coronary artery. A major milestone followed in 2000, with the first intracoronary imaging in a living patient using time-domain OCT. However, the real inflection point came in 2006 with the advent of frequency-domain OCT, which dramatically improved acquisition speed and image quality, enabling safe and routine imaging in the catheterization lab. With the advent of high-resolution, second-generation frequency-domain systems, OCT has become clinically practical and widely adopted in catheterization laboratories. OCT progressively entered interventional cardiology, first proving its safety and feasibility, then demonstrating superiority over angiography alone in guiding percutaneous coronary interventions and improving outcomes. Today, it plays a central role not only in clinical practice but also in cardiovascular research, enabling precise assessment of plaque biology and response to therapy. With the advent of artificial intelligence and hybrid imaging systems, OCT is now evolving into a true precision-medicine tool\u2014one that not only guides today\u2019s therapies but also opens new frontiers for discovery, with vast potential still waiting to be explored. Tracing its historical evolution from ophthalmology to cardiology, this narrative review highlights the key technological milestones, clinical insights, and future perspectives that position OCT as an indispensable modality in contemporary interventional cardiology. As a guiding thread, the myth of Prometheus is used to symbolize the evolution of OCT\u2014from its illuminating beginnings in ophthalmology to its transformative role in cardiology\u2014as a metaphor for how light, innovation, and knowledge can reveal what was once hidden and redefine clinical practice.<\/jats:p>","DOI":"10.3390\/jcm14155451","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T08:46:55Z","timestamp":1754383615000},"page":"5451","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["From Vision to Illumination: The Promethean Journey of Optical Coherence Tomography in Cardiology"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8438-1004","authenticated-orcid":false,"given":"Angela","family":"Buonpane","sequence":"first","affiliation":[{"name":"Center of Excellence for Cardiovascular Sciences, Isola Tiberina-Gemelli Isola Hospital, 00186 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9165-7732","authenticated-orcid":false,"given":"Giancarlo","family":"Trimarchi","sequence":"additional","affiliation":[{"name":"Cardiothoracic Department, Fondazione Toscana G. Monasterio, G. Pasquinucci Heart Hospital, 54100 Massa, Italy"},{"name":"Interdisciplinary Center for Health Sciences, Scuola Superiore Sant\u2019Anna, 56100 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca Maria","family":"Di Muro","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8144-0117","authenticated-orcid":false,"given":"Giulia","family":"Nardi","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Sciences, Careggi University Hospital, 50124 Firenze, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Ciardetti","sequence":"additional","affiliation":[{"name":"Cardiothoracic Department, Fondazione Toscana G. Monasterio, G. Pasquinucci Heart Hospital, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele Alessandro","family":"Coceani","sequence":"additional","affiliation":[{"name":"Cardiothoracic Department, Fondazione Toscana G. Monasterio, G. Pasquinucci Heart Hospital, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi Emilio","family":"Pastormerlo","sequence":"additional","affiliation":[{"name":"Cardiothoracic Department, Fondazione Toscana G. Monasterio, G. Pasquinucci Heart Hospital, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4100-4732","authenticated-orcid":false,"given":"Umberto","family":"Paradossi","sequence":"additional","affiliation":[{"name":"Cardiothoracic Department, Fondazione Toscana G. Monasterio, G. Pasquinucci Heart Hospital, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5244-0556","authenticated-orcid":false,"given":"Sergio","family":"Berti","sequence":"additional","affiliation":[{"name":"Cardiothoracic Department, Fondazione Toscana G. Monasterio, G. Pasquinucci Heart Hospital, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Trani","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli, Scientific Institute for Research, Hospitalization and Healthcare, Universit\u00e0 Cattolica Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Liuzzo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli, Scientific Institute for Research, Hospitalization and Healthcare, Universit\u00e0 Cattolica Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Italo","family":"Porto","sequence":"additional","affiliation":[{"name":"Scientific Institute for Research, Hospitalization and Healthcare, Ospedale Policlinico San Martino, Universit\u00e0 di Genova, 16162 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1276-9883","authenticated-orcid":false,"given":"Antonio Maria","family":"Leone","sequence":"additional","affiliation":[{"name":"Center of Excellence for Cardiovascular Sciences, Isola Tiberina-Gemelli Isola Hospital, 00186 Rome, Italy"},{"name":"Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli, Scientific Institute for Research, Hospitalization and Healthcare, Universit\u00e0 Cattolica Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Crea","sequence":"additional","affiliation":[{"name":"Center of Excellence for Cardiovascular Sciences, Isola Tiberina-Gemelli Isola Hospital, 00186 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6569-9401","authenticated-orcid":false,"given":"Francesco","family":"Burzotta","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli, Scientific Institute for Research, Hospitalization and Healthcare, Universit\u00e0 Cattolica Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco","family":"Vergallo","sequence":"additional","affiliation":[{"name":"Scientific Institute for Research, Hospitalization and Healthcare, Ospedale Policlinico San Martino, Universit\u00e0 di Genova, 16162 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto Ranieri","family":"De Caterina","sequence":"additional","affiliation":[{"name":"Cardiothoracic Department, Fondazione Toscana G. Monasterio, G. Pasquinucci Heart Hospital, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,2]]},"reference":[{"key":"ref_1","first-page":"157","article-title":"Light Photographed in Flight [Am. Scientist 59, 551 (1971)]","volume":"16","author":"Duguay","year":"1973","journal-title":"Sov. 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