Microscope integrated realtime 4D MHz-OCT operating at high scanning densities are capable of capturing additional visual contrast resolving depth and tissue. Even within a plain C-scan en-face projection structures are recognizable, that are not visible in a white light camera image. With advanced post processing methods, such as absorbtion coefficient mapping, and morphological classifiers more information is extraced. Presentation to the user in an intuitive way poses practical challenges that go beyond the implementation of a mere overlay display. We present our microscope integrated high speed 4D OCT imaging system, its clinical study use for in-vivo brain tissue imaging, and user feedback on the presentation methods we developed.