If you continue browsing the site, you agree to the use of cookies on this website. Nonateritic anterior ischemic optic neuropathy is discussed in more detail in chapter 3. Once the patient is aligned with the camera, begin by pushing the base of the camera forward towards the patients pupil. Optical coherence tomography oct is an imaging technique used widely in the management of macular diseases and glaucoma 1 but it is gaining popularity in neurologic and neuroophthalmologic conditions as well 2. Utilizing oct for glaucoma diagnosis and management. Pdf optical coherence tomography in glaucoma researchgate. John lind offers pearls for evaluating cirrus oct scans. Some artifacts seen on retinal nerve fiber layer rnfl scans may be overcome by macular sd oct imaging. Jeroen klevering university medical centre nijmegenthe netherlands interpretation of the oct image and some new developments. Optical coherence tomography oct is a noncontact optical technique that allows imaging and measurement of the retinal nerve fiber layer rnfl. Haynie, od, faao financial disclosure i have received honoraria or am on the advisory board for the following companies. Adams, md, and produced by heidelberg engineering, inc.
To evaluate the current published literature on the use of optic nerve head onh and retinal nerve fiber layer rnfl measurement devices in diagnosing openangle glaucoma and detecting progression. Stratus oct provides a higher level of diagnostic insight a significant contribution to therapeutic confidence across a broad spectrum of ophthalmic diseases. The atlas is not intended as a diagnostic guide and is not a substitute for clinical experience and judgment. Oct images demonstrating retinal nerve fiber layer rnfl segmentation and measurement by the stratus oct in the same eye with signal strength from 5 to 10. Whether looking at the onh and rnfl or the macula and gcc, the rs330 makes progression analysis simple. This monograph aims to give an update on the use of oct in glaucoma and pathologies of the optic nerve. Macular thickness analysis for glaucoma diagnosis and. Oct images demonstrating retinal nerve fiber layer rnfl segmentation and measurement by the stratus oct in the same eye with. With handbook of retinal oct, you can master the latest imaging methods used to evaluate retinal disease, uveitis, and optic nerve disorders. Oct interpretation in retinal disease executive clinical director retina and macula specialists jay m. This book focuses on the practical aspects of optical coherence tomography oct in glaucoma diagnostics offering important theoretical information along with many original cases. Oct software analyses macula thickness retinal nerve fibre layer rnfl optic nerve head onh 4. Chapter 2 general principles for obtaining and interpreting spectral domain oct images.
Optovue oct has a broad range of applications in todays eye care practices. Retinal nerve fiber layer imaging with spectraldomain. The 242 302 and rnfl combined report presents a clinical summary of patient status, as derived from the hfa and the cirrus oct analyses. What oct tells us about progression oct has made strides as an objective measure of progression, but it still has limitations. Features more than 1,000 superb illustrations depicting the full spectrum of retinal diseases using oct scans, supported by clinical photos and ancillary imaging technologies.
Detailed information on the oct imaging and interpretation is provided for the evaluation of disease progression in numerous neurodegenerative. The book presents the diagnosis and management of glaucoma, age related macular degeneration, the integration of oct and fluorescein angiography and the. The content of this book presents the viewpoint of the author and do not necessarily. Oct 05, 2014 optical coherence tomography oct has revolutionized ophthalmology and it has become one of the most important tools in neuroophthalmic practice. This can be extremely helpful in assessing glaucoma suspects whose disease symptoms can resemble those of. Jagdish dukre senior resident, regional institute of ophthalmology, allahabad 2. First, the authors purport to take a systematic approach to sd oct scan interpretation. Viewers are given an overview of scanning protocols on various sd oct systems as lecturers present an organized. A practical guide for interpretation of optical coherence tomography retinal nerve fiber layer measurement 11 fig. Timedomain oct td oct was widely used in clinical practice and currently replaced by the newer spectraldomain oct sd oct technology that offers considerable improvements. Role of optical coherence tomography in the evaluation and.
The report is displayed in a simple, easytounderstand format. Presents images as large as possible on the page with an abundance of arrows, pointers, and. Optical coherence tomography has emerged over the years with the ability to detect changes in the optic nerve head, retinal nerve fiber layer, and currently the ganglion cell layer much earlier than the defects manifest functionally. A significant thickening is showing in rnfl analysis by octcirrus, preventing to. The device generates crosssectional images of in vivo tissue structures by measuring the echo time delay and intensity of backscattered or backreflected light. Posterior segment evaluation with optical coherence tomography oct allows visualization of the vitreous, retinal layers, retinal pigment epithelium rpe and the choroidal layers. Guide to interpreting spectral domain oct by patty seiden. Optical coherence tomography oct optical coherence tomography oct is a noninvasive diagnostic technique that renders an in vivo crosssectional view of the retina, retinal nerve fiber layer, and the optic nerve head. The software even shows a pvalue to flag excessive change. Optical coherence tomography oct is a relatively new technique that produces images of biological tissue by measuring the reflection of light from the structure being examined.
Sep 15, 2015 the anatomy of an oct scan octsand their printoutscan be tough to understand. Redfree digital photograph of a left eye with a rnfl defect located superior. The first chapter concerns the principles and interpretation of oct and has a purely practical function, to help the reader understand the results. Interpretation of the optical coherence tomography image. Optical coherence tomography atlas and text covers the multiple uses and interpretation of oct and its various applications in ophthalmology related to the posterior segment and the retina. Once the oct goes live, select a preset scan pattern fast, rnfl, etc. Optical coherence tomography in neuroophthalmology eyewiki. Thus, the image is subject to the characteristics of light waves, and one can see reflections, attenuations, interfaces, and shadows in the image due to this property of light. Optical coherence tomography has emerged over the years with the ability to. This scan was acquired with the cirrus sd oct with. Optic nerve head and retinal nerve fiber layer analysis. This book is to help optical coherence tomography oct users interpret images that, at the beginning, may look very complex and bewildering.
Carl zeiss meditec advanced ocular care arctic dx macula risk genentech lampa advisory oct cross section of retinal. The double hump is a graphic plot of the rnfl thickness around the optic nerve that is observed in most normal individuals, with the superior and inferior poles having the greatest rnfl thickness compared with the nasal and temporal poles. Rnfl thickness average analysis report stratus oct. Spectral domain oct sd oct has allowed for high resolution imaging of the total macula and macular segments. With the oct, rnfl and onh scans outperform the macular scan. Oct in diagnosis state university of new york college of. Based on the principle of lowcoherence interferometry, oct measures the intensity of backscattered infrared light. Guide to interpreting spectral domain optical coherence tomo. Retinal physician appropriate interpretation of oct imaging.
It maps the anatomical relationship between visual. We use a logical method for interpreting oct images. Interpretation of oct american academy of ophthalmology. Litwak, od, faao va medical center baltimore, maryland glaucoma 101 glaucoma is a disease of the ganglion cell axons damage occurs at the level of the lamina cribrosa selective damage to the superior and inferior poles of the optic nerve. Redfree fundus photographs of the posterior pole by stereobiomicroscopy or with digital redfree photography can aid in evaluating the rnfl. Oct utilizes a concept known as low coherence interferometry. Glaucoma today rnfl analysis in the diagnosis of glaucoma. For now, oct is most useful when a patient is either a glaucoma suspect or has earlytomoderate disease, as a tool for helping to detect damage and progression or conversion from glaucoma suspect or ocular hypertensive to glaucoma. Normative reference ranges for the retinal nerve fiber layer, macula, and retinal layer thicknesses in children. In the second part of her series about use of an oct, dr rachel hiscox discusses assessment of the optic disc. There are normals for ocular structures deviation from the norm abnormality pathology being able to discern differences in reflectivity, morphology and qualitative measures either from normals or from previous scans is the essence of oct interpretation. T he advent of optical coherence tomography has revolutionized imaging in ophthalmology since its introduction two decades ago. Ideal at any stage of your career, this easytouse, clinically oriented handbook provides a quick, templated, and portable guide for the interpretation of optical coherence tomography scans. However, as with any new technology, analysis of the results of oct requires.
Physicians should begin by assessing the retinal nerve fiber layer rnfl thickness map, which should ideally show butterfly wings with red spots to indicate adequate thickness. As the rs330 features both a high resolution digital retinal camera and a sd oct the onh analysis brings together all of the relevant information into one place. Chapter 3 interpretation of the pathological crosssectional oct. These results suggest that measuring the rate of sdoct rnfl loss may be a useful tool to help identify patients who are at a high. Oct and imaging in central nervous system diseases. Second, none of the figures have identifiers arrows, and the like to identify the features being described. The second edition of oct and imaging in central nervous system diseases offers updated stateoftheart advances using optical coherence tomography oct regrading neuronal loss within the retina. The optical coherence tomography oct, based on interferometry analysis, is a. Viewers are given an overview of scanning protocols on various sd oct systems as lecturers present an organized method for analysis of images and identification of pathology. As our knowledge of glaucoma has evolved, so have our tools. The optical coherence tomography oct, based on interferometry analysis, is a major achievement particularly for documentation of quantitative changes in the optic nerve head.
Interpretation and terminology of oct for retina christopher mody clinical programme manager heidelberg engineering ltd. The vitreous, retinal layers and choroidal layers are visible. Rnfl analysis in the diagnosis of glaucoma measuring peripapillary retinal nerve fiber layer thickness with spectraldomain optical coherence tomography provides an objective and reliable estimate of glaucomatous optic nerve damage. Rnfl thickness measurement is graphed in a tsnit orientation and compared to. Optical coherence tomography oct provides noncontact, realtime, and highresolution imaging of the eye. Oct technology generates highresolution, crosssectional and threedimensional 3d images of the retina, optic disc and anterior segment, to give you valuable information that aids in the diagnosis and management of a range of ocular diseases. However, there is no labelled figure showing the layers of the normal retina and choroid. Optical coherence tomography is therefore expected to show superior rnfl and macular gcc thinning due to retinal ganglion cell axon and cell body death, respectively. After showing you how to find pathology in oct images, we challenge you to spot them in hundreds of samples. Event analysis assesses change from baseline compared to expected variability. Depending on the wavelength used, the resolution is in the range of 1 to 15 m, which is at least twice as high as can be achieved. Advanced interpretation of the cirrus oct anthony b.
You need to be good at oct interpretation to be good at your job. Optical coherence tomography in healthy subjects the oct examination is based on the lightreflecting properties of the retinal tissue. Pdf the optic disk and the rnfl are the principal sites of apparent glaucomatous. The complete idiots guide to macular oct interpretation. The first phase of analysis subdivides each image into its smallest components. In macular thickness analysis by stratus oct central 3 mm.
Macula thickness analysis ganglion cells 3035% of total retinal thickness at macula upto 50%of ganglion cells in macula glaucoma preferentially involves the ganglion cell complex gcc. Oct thickness map most useful in detection of early glaucoma rnfl defects classification based on a normative database comparison leads to false readings because topographic distribution of rnfl. Its usefulness stems from a single, comprehensive report that depicts. Peri papilary nerve fiber layer macular thickness optic nerve head 3. This remodeling of the foveal architecture raises a novel concept and may. And when it comes to teaching you to read oct images, this course can begin your transformation into an oct expert. Jun 10, 2010 chapter 2 general principles for obtaining and interpreting spectral domain oct images. Clinical interpretation of oct in glaucoma diagnosis.
Role of oct in glaucoma dr samarth mishra slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. If golf were simple, youd only need one club to work your way through a course. Since optical coherence tomography oct s first demonstration in 1991 by huang et al. Role of ganglion cell complex gcc in evaluation of glaucoma. Guide to interpreting spectral domain optical coherence. Optical coherence tomography in neuroophthalmology intechopen. Journal of current glaucoma practice, januaryapril 2009. Interpretation of the oct image requires understanding that the image was based on light waves. Normative reference ranges for the retinal nerve fiber. Since 1991,1 oct has undergone rapid evolution for use in detection and monitoring of glaucoma and macular diseases. Optical coherence tomography oct is a noncontact medical imaging technology similar to xray. With guided progression analysis gpa, cirrus hdoct can aid in the identification of glaucoma progression through rnfl thickness event analysis and trend analysis.
Heres a howto on differentiating oct models and reading their scans. Retinal nerve fiber layer rnfl evaluation is an essential component of a comprehensive glaucoma evaluation. Oct thickness map most useful in detection of early. Optic nerve and retinal nerve fiber imaging eyewiki. Yao liu discusses retinal nerve fiber layer rnfl oct in pediatric glaucoma.
Secrets to success knowing the advantages and potential pitfalls of this technology can help you make it an effective diseasemonitoring tool. Today, optical coherence tomography has become a standard tool for diagnosing and monitoring glaucoma. Guide to interpreting spectral domain oct by patty seiden issuu. The transverse sections obtained using the latest generation machines have an axial resolution of around 3 to 8 microns and a transverse resolution of 15 to 20 microns.
Spectralis oct rnfl measurements demonstrate higher sensitivity than hrt. The major achievement of oct is by documentation of quantitative changes in the optic nerve head atrophy, edema or normal. Make sure you read this indepth overview on utilizing oct to treat and manage retinal pathology. The double hump is a graphic plot of the rnfl thickness around the optic nerve that is observed. This little book aims to simply give an update on oct in glaucoma and pathologies of the optic nerve. Optical coherence tomography in neuroophthalmology. Next, the rnfl deviation map is examined for signs of thinning emanating from the superior and inferior poles of the optic nerve. Oct in glaucoma diagnosis, detection and screening. This is part of the spectral domain oct interpretation for the general ophthalmologist series, which focuses on use of sd oct in patients with glaucoma and retinal disease. First, the authors purport to take a systematic approach to sdoct scan interpretation. In clinical practice, combining fundus photography and oct imaging can help in the differential diagnosis of retinal, macular, chorioretinal lesions, anomalies at the vitreoretinal interface, and choroidal disease.
New perspectives in neuroophthalmology sciencedirect. The rnfl deviation map is overlaid on the oct fundus image to illustrate precisely where rnfl thickness deviates from a normal range glaucoma rnfl thickness analysis a tsnit temporalsuperiornasalinferiortemporal circle, with a radius of 1. Duker md, nadia k waheed md mph, darin goldman md isbn. Everyday low prices and free delivery on eligible orders. With the use of asymmetry analysis, macular thickness is a measurement that can be used for the detection and progression of glaucoma. The first chapter covers the basic principles and interpretation of oct and is intended to help the reader interpret oct images.
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