I have not worked with this API before, but I found this website: Adobe Photoshop CS5 Object Library.
I did some looking and there is a SaveAs method that can be used on the Document object. You can use this method to save the document as an image (let's say a BITMAP).
From there, you can use several sources online that show how to extract pixel information quickly from a BMP.
Here is one particular article: Work with Bitmaps faster in C#
I realize that I am not providing copy/pasteable code for you to use, but I hope this points you in the correct direction.