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Reading Optical Coherence Tomography: For Glaucoma

Optical coherence tomography (OCT) is a non-invasive imaging technique that uses light waves to capture cross-sectional pictures of the retina. OCT can quantitatively measure the thickness of distinct retinal layers. It is very sensitive for detecting retinal nerve fiber layer thinning caused by glaucoma. OCT can analyze the retinal nerve fiber layer, optic nerve head, ganglion cell complex, and perform angiography. The retinal nerve fiber layer thickness measured by OCT is compared to age-matched normative data. Thinner retinal nerve fiber layer values shown in yellow or red indicate higher risk of glaucoma. OCT is a useful tool for diagnosing and monitoring glaucoma due to its ability to quantitatively analyze retinal layers over time.

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357 views25 pages

Reading Optical Coherence Tomography: For Glaucoma

Optical coherence tomography (OCT) is a non-invasive imaging technique that uses light waves to capture cross-sectional pictures of the retina. OCT can quantitatively measure the thickness of distinct retinal layers. It is very sensitive for detecting retinal nerve fiber layer thinning caused by glaucoma. OCT can analyze the retinal nerve fiber layer, optic nerve head, ganglion cell complex, and perform angiography. The retinal nerve fiber layer thickness measured by OCT is compared to age-matched normative data. Thinner retinal nerve fiber layer values shown in yellow or red indicate higher risk of glaucoma. OCT is a useful tool for diagnosing and monitoring glaucoma due to its ability to quantitatively analyze retinal layers over time.

Uploaded by

Dilly Niza
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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Reading

Optical Coherence Tomography


for glaucoma

Aulia Abdul Hamid, MD


FKUB / RSSA, Malang
What is OCT
• Optical coherence tomography (OCT) is:
– a non-invasive imaging
– uses light waves
– cross-section pictures of retina

• Distinct retinal layer,  measure their thickness

• Quantitative
OCT is available for
• Retinal / Macular analysis
• Retinal nerve fiber layer analysis
• Optic nerve head analysis
• Ganglion cell complex
• Anterior segment image
• OCT Angiography
Why OCT
• OCT is very sensitive to detect RNFL thinning
• Easy to perform, easy for patients
• Easy to read and interpret
Basic rules

• Identity
• Signal strength
• Test type
• Centration
• Alignment
Retinal Nerve Fiber Layer
• RGC death causes thinning of the layer

• OCT identify circumferential RNFL around optic nerve

• 3.4 mm diameter circle of RNFL data  TSNIT map


Good to know some values

• Mean value for RNFL thickness is 92.9 +/- 9.4 µm


• Non-glaucomatous eye: RNFL thickness of > 80 µm
• RNFL 70 to 79 µm  suspicious for glaucoma
• Average thickness of 60 to 69 µm indicative glaucoma

Budenz DL, Anderson DR, Varma R, et al. Ophthalmology. 2007;114(6):1046-52.


Budenz DL, Anderson DR, Varma R, et al. Ophthalmology. 2007;114(6):1046-52.
Budenz DL, Anderson DR, Varma R, et al. Ophthalmology. 2007;114(6):1046-52.
Shading of RNFL values
• Green  95%
• Yellow  < 5%
• Red  < 1%

(compared with normative database)


Sensitivity / Specificity
YELLOW
• RNFL thickness at the 5% level
• sensitivity of 83% , specificity 88%

RED
• RNFL thickness at the 1% level
• sensitivity of 65% , specificity 100%
Normative Database:
SD-OCT measurements are compared (age-matched)
The normative database for the Cirrus SD-OCT:
• 284 healthy individuals
• Age range18 and 84 years (mean of 46.5 years)

• Race: 43% Caucasian, 24% Asians, 18% African American, 12%


Hispanic, 1% Indian, and 6% mixed ethnicity.
• Refractive error ranged from -12.00 D to +8.00 D.
Interpretation

Correlate with:

• Clinical Setting, IOP, etc.


• Visual Field
• Fundus Examination / Image
False red in a
myopic patient

Diagnostic Accuracy of Three-Dimensional Neuroretinal Rim Thickness


for Differentiation of Myopic Glaucoma From Myopia.
Yong Woo Kim, Ki Ho Park iovs.18-24283
Be aware of
• Media opacities
• Miotic pupil
• Peripapillary atrophy
• Other artifacts e.g blinks, pvd
Ganglion cell complex analysis
• In macular cube

• Usefull in
advanced cases
to avoid “floor
effect”
OCT for anterior segment

• Corneal thickness
• AC & angle visualization
Thank You
Quiz
1. For follow up of advanced glaucoma the better tool is:
a. OCT
b. Automated Visual Field
c. 3D Optic nerve head photo

2. The most valuable data in OCT optic nerve cube analysis is:
a. RNFL thickness analysis
b. Optic nerve vertical cup / disc ratio
c. Ganglion cell complex analysis

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