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Jessica Taibl, Samir I Sayegh; Dynamic OCT vs Ultrasound in retinal detachment and hypotony maculopathy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2305.
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Previous work has shown that cSLO/SD-OCT can be an excellent alternative to B-mode ultrasound in cases of inferior recurrent retinal detachment with silicone oil tamponade. Using ultra-widefield non-contact cSLO imaging in combination with Dynamic cSLO/SD-OCT allows for unique and complicated retinal conditions to be examined and progression to be monitored closely. This provides more detail and information than ultrasonography alone. Inferior retinal detachment, with or without silicone oil tamponade, peripheral retinal lesions, and hypotony maculopathy are all conditions in which this imaging methodology has proved extremely useful.
Patients with rhegmatogenous inferior retinal detachments and hypotony maculopathy were imaged using both B-mode ultrasound and Spectralis HRA/OCT (Heidelberg Engineering). Spectralis is capable of both ultra-widefield cSLO imaging and cSLO/SD-OCT imaging. Dynamic imaging, where a technician moves the OCT line scan to anywhere on the en face image, allows the precise real time delineation of the areas of reattachment, re-detachment or suspect detachment, with the ability to follow them and evaluate the retinal architecture. This “live viewing” approach can sometimes be more beneficial than capturing a raster scan.
The combined use of Dynamic OCT and ultra-widefield imaging can delineate the origin of detachment and characterize the extent and amount of fluid behind it. It is beneficial in elucidating hypotony maculopathy, when ultrasound may suggest a possible detachment. Images can be viewed live, captured in standard mode through use of the manufacturer provided software, or live video can be recorded of the session of patients who are difficult to image, or where a dynamic record is desired.
The combined use of Dynamic OCT and ultra-widefield imaging to monitor retinal integrity in eyes with potential retinal detachments with or without silicone oil tamponade, or hypotony maculopathy, is highly beneficial as a complement or alternative to ultrasound. Dynamic OCT and ultra-widefield imaging provide more diagnostic information than ultrasonography alone, allow better resolution, and work in difficult to image patients providing increased comfort and exposure to a single instrument.
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