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O. Puzyeyeva, J. Flanagan, W.-C. Lam, G. Trope, M. Brent, Y. M. Buys, M. Mandelcorn, R. Devenyi, C. Hudson; High Resolution, Non-Invasive Spectral Domain OCT Imaging of Retinal and Optic Nerve Head Disease; A Case Series Illustrating Potential and Limitations. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1082.
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© ARVO (1962-2015); The Authors (2016-present)
To report a series of patients with retinal and optic nerve head disease who were imaged by spectral domain optical coherence tomography (SD-OCT) in order to illustrate the potential and limitations of this new imaging modality.
The sample comprised 20 patients; four cases with age-related macular degeneration (ARMD); seven cases with diabetic retinopathy (DR); four cases with primary open angle glaucoma (POAG) ; two optic pit cases; and one case each of central artery occlusion, central vein occlusion, and branch retinal vein occlusion. Patients were imaged using Heidelberg Spectralis HRA + OCT (Heidelberg Engineering, Heidelberg, Germany) using the SD-OCT mode, a scan field of 30 degrees horizontally on 15 degrees vertically and 19 OCT horizontal sections (one section every 240µm). Patients also underwent digital fundus photography and clinical assessment.
SD-OCT of a case of age-related macular degeneration revealed a subfoveal choroidal neovascular membrane with retinal pigment epithelium (RPE) and neurosensory retina detachment with apparent thickening and wrinkling of a Bruch’s membrane and the RPE. A case of diabetic retinopathy and a case of branch retinal vein occlusion both displayed a cystoid pattern of macular edema with cystoid spaces visible in the outer retina. Cases of diabetic retinopathy undergoing laser treatment showed localized loss of RPE and inner retinal swelling post-laser. A case of POAG showed structural changes to ONH and peripapillary retina following reduction in IOP. Hyper-reflective lesions, such as hemorrhages, exudates, and major retinal vessels resulted in shadowing of the underlying retina. Automated segmentation of the retina sometimes requires manual adjustment prior to analysis.
SD-OCT demonstrated patho-physiological detail of retinal and optic nerve head diseases that are not visible using clinical techniques. However, SD-OCT images need to be carefully evaluated to exclude the influence of artifacts.
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