This platform allows clinicians to configure each spectralis to the specific diagnostic workflow in the practice or clinic. Optical coherence tomography is a noninvasive technology for imaging various ocular tissues using light. Spectral domain oct recently, we have seen the emergence of a new technology called fourier domain or spectral. Optical coherence tomography oct imaging has been widely accepted by ophthalmologists as an attractive imaging modality. Macular thickness analysis for glaucoma diagnosis and. This may seem obvious, but just as we learned in medical. Optical coherence tomography in neuroophthalmology. 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. A video showing the most appropriate way of assessing the health of the optic disc when screening for glaucoma. Optical coherence tomography oct has revolutionized the diagnostic field of retina in many different ways.
Normative reference ranges for the retinal nerve fiber layer. Are all retinal nerve fiber layer defects on optic coherence. Based on the principle of lowcoherence interferometry, oct measures the intensity of backscattered infrared light. The diagnosis of glaucoma is currently based on the appearance of the optic disc and standard achromatic perimetry. Oct interpretation in retinal disease executive clinical director retina and macula specialists jay m. T he advent of optical coherence tomography has revolutionized imaging in ophthalmology since its introduction two decades ago. The book presents the diagnosis and management of glaucoma, age related macular degeneration, the integration of oct and fluorescein angiography and the. Feb 26, 2015 a video showing the most appropriate way of assessing the health of the optic disc when screening for glaucoma. 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. Optic nerve and retinal nerve fiber imaging eyewiki. Rnfl thickness maps help track location, patterns of glaucoma. 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. Are all retinal nerve fiber layer defects on optic.
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. Diagnostic imaging devices i oct heidelberg engineering. For example, exudates and drusen often look similar with an. Oct software analyses macula thickness retinal nerve fibre layer rnfl. Guide to interpreting spectral domain oct by patty seiden issuu. Optical coherence tomography oct is a noncontact optical technique that allows imaging and measurement of the retinal nerve fiber layer rnfl. It not only provides a wealth of information, but it is also non invasive and easy to perform.
Retinal nerve fiber layer rnfl thickness maps generated with spectraldomain optical coherence tomography sd oct provide a unique opportunity to track glaucoma progression, christopher kai. Optical coherence tomography casebased neuroophthalmology. We use a logical method for interpreting oct images. The rnfl shaded green is often as bright as the epiretinal membrane erm, but should not be confused with the erm.
Spectral domain oct sdoct has allowed for high resolution imaging of the total macula and macular segments. For the disc, it provides cupdisc ratio, cup volume and cup area. With handbook of retinal oct, you can master the latest imaging methods used to evaluate retinal disease, uveitis, and optic nerve disorders. Eyecarepd has solved this learning challenge with the creation of interpret. Pdf a practical guide for interpretation of optical. Emphasis is placed on proper selection and correct interpretation of the various scan patterns for glaucoma and retinal disease.
Since it is a disease which can be treated but not cured, it is crucial for the treating ophthalmologist to catch the disease as early as possible. Peripapil lary rnfl was imaged with optical coherence tomography oct3 and the thickness of the rnfl around the disc was determined in four quadrants with a 3. Oct, multiple scanning laser fundus imaging modalities, widefield and ultrawidefield, scanning laser angiography and oct. Glaucoma progression analysis by spectraldomain optical. And when it comes to teaching you to read oct images, this course can begin your transformation into an oct expert. Hence, the rnfl is an ideal structure for visualization of any process of neurodegeneration, neuroprotection, or regeneration. Spectral domain oct sd oct has allowed for high resolution imaging of the total macula and macular segments. The atlas is not intended as a diagnostic guide and is not a substitute for clinical experience and judgment. Structural damage in glaucoma often occurs before detectable loss in visual function. The first phase of analysis subdivides each image into its smallest components. Adams, md heidelberg engineering gmbh 11 epiretinal membrane in the oct image below, an epiretinal membrane shaded red is attached to the retina in some areas arrow and separated in others arrowhead.
Leung, weinreb, et al have shown that 18% of patients with mild glaucoma have rnfl defects close to the onh within the 3. Macular thickness analysis for glaucoma diagnosis and management. 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. May 01, 2015 successful oct image interpretation depends on multiple factors, the most pertinent of which is a good understanding of retinal histology and histopathology. Utilizing oct for glaucoma diagnosis and management. Optical coherence tomography oct normative data collection study s203 the safety and scientific validity of this study is the responsibility of the study sponsor and investigators.
Use of oct imaging readonly nsu college of optometry. Detailed information on the oct imaging and interpretation is provided for the evaluation of disease progression in numerous neurodegenerative. Chapter 2 general principles for obtaining and interpreting spectral domain oct images. The second phase combines these fine details to arrive at a synthesis. 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. Jagdish dukre senior resident, regional institute of ophthalmology, allahabad 2. Sep 15, 2015 oct basics while the earliest timedomain td oct technology could only acquire 400 scans per second, current sd oct models, depending on the manufacturer, can capture between 26,000 and 70,000 axialscans per second table 1. Guide to interpreting spectral domain oct by patty seiden. Sep 15, 2012 oct, especially highresolution spectraldomain sd oct, permits the visualization of all retinal layers, as well as the vitreous and the choroid. The 3doct 2000 provides trend analysis comparing disc topography and rnfl thickness from a minimum of two visits. 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. The image produced by the oct is a reconstruction of the retina based on light waves, so a thorough understanding of the same is necessary.
Some artifacts seen on retinal nerve fiber layer rnfl scans may be overcome by macular sd oct imaging. This book is to help optical coherence tomography oct users interpret images that, at the beginning, may look very complex and bewildering. The spectralis oct imaging platform combines scanning laser fundus imaging with simultaneously acquired oct as an expandable platform, it can be upgraded with additional scanning laser fundus imaging modalities, such as bluepeak autofluorescence and multicolor, as well as advanced modules such as oct2 and the glaucoma module premium edition. Report 925 scanning computerized ophthalmic diagnostic imaging e. In order to enhance diagnostic oct information for pediatric glaucoma, neuroophthalmology and retinal disorders, a comparison with populationderived normative data is needed to identify deviations from the normal range. Localization of an abnormal finding to a specific layer of the retina often leads to a diagnosis that would not be otherwise possible. The first chapter concerns the principles and interpretation of oct and has a purely practical function, to help the reader understand the results. A complete list of ocular diseases with optical coherence. Adams, md, and produced by heidelberg engineering, inc. Retinal nerve fiber layer rnfl thickness maps generated with spectraldomain optical coherence tomography sdoct provide a unique opportunity to track glaucoma progression, christopher kai. Introducing interpret a smart way to improve your oct interpretation skills.
The optical coherence tomography oct, based on interferometry analysis, is a major achievement particularly for documentation of quantitative changes in the optic nerve head. Enhanced depth imaging optical coherence tomography of retinal pigment epithelial detachment in agerelated macular degeneration. Oct allows to study vision from of the retina to the optic tracts. Glaucoma is obviously an important part of this book, but one part is devoted to other eye diseases and especially. When it comes to advancing oct interpretation skills, books, journal articles, and lectures can only take you so far. Jun 10, 2010 chapter 1 main oct can produce one bscan every 1. Oct and imaging in central nervous system diseases. Retinal axons in the retinal nerve fiber layer rnfl are nonmyelinated until they penetrate the lamina cribrosa. Oct thickness map most useful in detection of early.
Heidelberg engineerings growing product portfolio combines these core technologies. Optical coherence tomograph oct, confocal scanning laser ophthalmoscope cslo and scanning laser polarimeter slp are the 3 commonly used imaging instruments for objective. Advanced interpretation of the cirrus oct anthony b. Optical coherence tomography in neuroophthalmology intechopen. Primary impairment of the optic nerve without impairment of the rnfl page 62. Hence, the rnfl is an ideal structure for visualization of any process of. Since the mid19th century, it has been recognized that changes in the optic nerve appearance correlate with vision and visual field loss in glaucoma. Oct thickness map most useful in detection of early glaucoma.
Optical coherence tomography of retinal and choroidal tumors. Tutorials spectralis oct the modular imaging platform. Jeanphilippe nordmann glaucoma centre hopital des quinzevingts, paris. Enhanced depth imaging optical coherence tomography of intraocular tumors. Rnfl thickness maps help track location, patterns of. Nonateritic anterior ischemic optic neuropathy is discussed in more detail in chapter 3. Listing a study does not mean it has been evaluated by. Carl zeiss meditec advanced ocular care arctic dx macula risk genentech lampa advisory oct cross section of retinal. After showing you how to find pathology in oct images, we challenge you to spot them in hundreds of samples. Therefore, rnfl thickness map of cirrus hdoct may be a useful tool for the detection of rnfl defect, young hoon hwang, md, the corresponding author, said in an email interview. Oct is a well known and frequently used technology to image the posterior segment. Interpretation of oct american academy of ophthalmology. 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.
Detailed information on the oct imaging and interpretation is provided for the evaluation of disease progression in numerous neurodegenerative disorders and as a biological marker of. Some artifacts seen on retinal nerve fiber layer rnfl scans may be overcome by macular sdoct imaging. Journal of current glaucoma practice, januaryapril 2009. Retinal nerve fiber layer imaging with spectraldomain.
Oct software analyses macula thickness retinal nerve fibre layer rnfl optic nerve head onh 4. 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. Today, optical coherence tomography has become a standard tool for diagnosing and monitoring glaucoma. Introducing interpret a smart way to improve your oct interpretation skills when it comes to advancing oct interpretation skills, books, journal articles, and lectures can only take you so far. Modern day oct allows indirect visualization of the posterior vitreous, retina, retinal pigment epithelium rpe, and choroid. The complete idiots guide to macular oct interpretation. Each will include an oct scan that illuminates a particular clinical condition. A practical guide for interpretation of optical coherence tomography retinal nerve fiber layer measurement 11 fig. Role of optical coherence tomography in the evaluation and. 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. 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. You need to be good at oct interpretation to be good at your job. Pdf retinal nerve fiber layer thickness in indian eyes with.
Since 1991,1 oct has undergone rapid evolution for use in detection and monitoring of glaucoma and macular diseases. With the use of asymmetry analysis, macular thickness is a measurement that can be used for the detection and progression of glaucoma. Optical coherence tomography oct and neuroprotection by srna. Chapter 3 interpretation of the pathological crosssectional oct. For the rnfl, it gives the average thickness of inferior rnfl, superior rnfl and the average of the total rnfl. Oct is a noninvasive system that allows for crosssectional imaging in vivo, using light waves, which are akin to the sound. Oct in glaucoma and pathologies of the optic nerve. Glaucoma is the leading cause of irreversible, yet preventable, blindness throughout the world. This is part of the spectral domain oct interpretation for the general ophthalmologist series, which focuses on use of sdoct in patients with glaucoma and retinal disease.
Tdoct rnfl thickness measurements have been shown to discriminate well between normal and glaucomatous eyes. Secrets to success knowing the advantages and potential pitfalls of this technology can help you make it an effective diseasemonitoring tool. Although there have been variations in the definition of glaucoma over time, increased attention to the structure and appearance of the optic nerve has been a hallmark in understanding glaucoma. Retinal physician appropriate interpretation of oct imaging. The book presents the diagnosis and management of glaucoma, age related macular degeneration, the integration of oct and fluorescein angiography and the diagnosis and.
Normative reference ranges for the retinal nerve fiber. Haynie, od, faao financial disclosure i have received honoraria or am on the advisory board for the following companies. The metaanalysis of studies on normative data of rnfl thickness and optic nerve head parameters and interocular asymmetry and. 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.
1289 302 868 471 120 485 923 434 338 415 691 738 515 752 26 1578 103 796 227 815 1349 1450 546 373 955 864 263 1554 1321 1260 233 409 1016 915 1286 67 1239 1427 1268