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    Reading An OCT Image-The Basics

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    Alejandro Lalama Guerrero
    OCT works by measuring the delay of light reflected back from retinal tissues to create cross-sectional images. It can visualize the intricate layers of the retina. A healthy retina shows clearly delineated nerve fiber, ganglion cell, plexiform and nuclear layers, as well as the photoreceptor inner and outer segments and retinal pigment epithelium. Common pathologies seen on OCT include epiretinal membranes, drusen, macular edema, hard exudates, macular holes and vitreomacular traction.

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    Reading An OCT Image-The Basics

    Uploaded by

    Alejandro Lalama Guerrero
    81 views37 pages
    OCT works by measuring the delay of light reflected back from retinal tissues to create cross-sectional images. It can visualize the intricate layers of the retina. A healthy retina shows clearly delineated nerve fiber, ganglion cell, plexiform and nuclear layers, as well as the photoreceptor inner and outer segments and retinal pigment epithelium. Common pathologies seen on OCT include epiretinal membranes, drusen, macular edema, hard exudates, macular holes and vitreomacular traction.

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    How-to-read-an-OCT-Image

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    OCT works by measuring the delay of light reflected back from retinal tissues to create cross-sectional images. It can visualize the intricate layers of the retina. A healthy retina shows clearly delineated nerve fiber, ganglion cell, plexiform and nuclear layers, as well as the photoreceptor inner and outer segments and retinal pigment epithelium. Common pathologies seen on OCT include epiretinal membranes, drusen, macular edema, hard exudates, macular holes and vitreomacular traction.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    81 views37 pages

    Reading An OCT Image-The Basics

    Uploaded by

    Alejandro Lalama Guerrero
    OCT works by measuring the delay of light reflected back from retinal tissues to create cross-sectional images. It can visualize the intricate layers of the retina. A healthy retina shows clearly delineated nerve fiber, ganglion cell, plexiform and nuclear layers, as well as the photoreceptor inner and outer segments and retinal pigment epithelium. Common pathologies seen on OCT include epiretinal membranes, drusen, macular edema, hard exudates, macular holes and vitreomacular traction.

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    Reading an OCT image- The

    Basics
    What we will cover
    • How OCT works
    • Layers of the retina
    • 3D OCT Tips
    • Healthy retina architecture
    • Pathology
    • Q&A
    Seeing better with OCT
    Light passing through Measurement of this
    tissue is delayed ‘delay’ provides
    before it is reflected cross-sectional
    back to the information about the
    camera structure of the tissue
    being imaged

    OCT is able to see the intricate and delicate layers of the


    retina, optic nerve and other ocular tissues (e.g. the RPE).
    OCT image of the retina

    Topcon 3D OCT 1000 Image


    Layers of the Retina

    Source: Optical Coherence Tomography of


    Ocular Diseases, Schuman, JA, et al, 2004
    Layers of the Retina

    Nerve Fibre Layer


    Ganglion Cell Layer
    Inner Plexiform Layer
    Inner Nuclear Layer
    Outer Plexiform Layer
    Outer Nuclear Layer
    Ex. Limiting Membrane
    Photoreceptor IS/OS
    Retinal Pigment Epithelium

    Topcon 3D OCT 2000 Image


    3D OCT Tips
    Scanning Protocol

    • Trade off of scanning


    area vs. image quality
    • Typical Pre sets
    – 8.2 mm x 3 mm @ 1,024 x
    32 b scans (better image)
    – 6 mm x 6 mm box @ 512
    x 128 b scans (better
    coverage)
    Patient preparation
    • Pupil size
    – Min pupil size is 3.7 mm
    – Slightly dilated pupils will improve OCT and fundus image
    quality
    • Dry cornea
    – A dry cornea will reduce the OCT image quality
    – Make sure that your technicians tell the patient to blink
    before the capture procedure
    – Use drops if needed
    • Fixation
    Viewing Techniques
    • View in Black and White
    to provide better
    contrast
    • Use OCT image
    adjustment bar
    Healthy Retinal Architecture
    Healthy Retina Architecture

    Nerve Fibre Layer


    Ganglion Cell Layer
    Inner Plexiform Layer
    Inner Nuclear Layer
    Outer Plexiform Layer
    Outer Nuclear Layer
    Ex. Limiting Membrane
    Photoreceptor IS/OS
    Retinal Pigment Epithelium

    Topcon 3D OCT 2000 Image


    Healthy Retina Architecture

    Topcon 3D OCT 1000 Image


    Healthy Retina Architecture

    Topcon 3D OCT 1000 Image


    Pathology
    Pathology
    • Reported incidence of pathology detected with
    Topcon 3D OCT in a Lasik population during pre-
    treatment evaluation was 1.6%
    • Typical pathologies
    – Epiretinal membrane
    – Drusen
    – Macular Edema
    – Hard Exudates
    – Macular Holes
    – Vitromacular Traction
    Epiretinal Membrane
    • Incidence is 6% of patients over 60 yrs*.
    • Appearance
    – Rippling of ILM which can extend over the fovea resulting
    of the loss of the normal foveal contour.

    *Source: Optical Coherence Tomography of Ocular Diseases,


    Schuman, JA, et al, 2004
    Epiretinal Membrane

    Topcon 3D OCT 1000 Image


    Epiretinal Membrane

    Topcon 3D OCT 1000 Image


    Epiretinal Membrane
    Case 2

    Topcon 3D OCT 1000 Image


    Epiretinal Membrane
    Case 3 with Pseudo Hole

    Topcon 3D OCT 1000 Image


    Drusen
    • Reported incidence of drusen in patients 43 to 54
    was 2.2% (soft) and 3.3% (large)*
    • Appearance
    – Localized highly reflective area under Bruch’s membrane,
    you may also see a slight flattening of the foveal contour.

    *Source: Beaver Dam Eye Study


    Ophthalmology. 2003 Oct: 109 (10): 1767-79.
    Drusen

    Topcon 3D OCT 1000 Image


    Drusen

    *Source: Optical Coherence Tomography of Ocular Diseases,


    Schuman, JA, et al, 2004
    Drusen

    *Source: Optical Coherence Tomography of Ocular Diseases,


    Schuman, JA, et al, 2004
    Drusen

    Topcon 3D OCT 2000


    Macular Edema
    • Appearance
    – Hypo echoic areas in the retina. Can be associated with
    Diabetes (Diabetic Macular Edema- DME), cystic in
    appearance (Cystoid Macular Edema- CME)
    Macular Edema

    Topcon 3D OCT 2000


    CME

    Topcon 3D OCT 1000 Image


    Hard Exudates
    • Can be seen in any conditions that are associated
    with vascular leakage
    – Diabetic retinopathy
    – Hypertensive retinopathy
    • Appearance
    – Focal hyper echoic areas in the ONL
    Hard Exudates

    Topcon 3D OCT 1000 Image


    Macular Holes
    • Extremely rare in patients under except you can see
    in the case of trauma. Various types
    – Lamellar (partial macular hole)
    – Full thickness macular hole

    • Appearance
    – Lamellar hole- pit/opening from ILM but not down to the RPE
    – Full thickness macular hole- Opening down to the RPE, volcano
    appeareance
    Macular Hole

    *Source: Optical Coherence Tomography of Ocular Diseases,


    Schuman, JA, et al, 2004
    Macular Hole

    Topcon 3D OCT 1000 Image


    Vitromacular Traction (VMT)
    • Extremely rare
    • Appearance
    – Perifoveal vitreous detachment with focal adhesion to the fovea
    VMT

    Topcon 3D OCT 1000 Image


    VMT

    Topcon 3D OCT 1000 Image

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