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L. Barker, N. Patel, L. Solebo, H. O'Keeffe, M. Minihan, C. Egan; Spectral Domain Optical Coherence Tomography: Vascular Lesions of the Optic Disc. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3681.
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Ocular coherence tomography (OCT) has become one of the most important established tools for retinal and glaucoma disease management by evaluation of the macula and optic nerve head characteristics. Spectral Domain OCT has evolved from previous older generations recently and newer machines are capable of better resolution and improved quality of scans. Our purpose was to evaluate the use of 3D OCT machines in analysis of vascular lesions of the optic disc to determine if this technology can differentiate the anatomy of four unique causes of abnormal vasculature. Such knowledge could provide clinicians with a non-invasive means of providing the diagnosis of suspicious lesions.
Patients from the medical retina clinic at Moorfields Eye Hospital with physiological and pathological vascular disc changes were invited to undergo a routine Spectral domain OCT (SD OCT) scan using the Topcon 3D-1000 OCT machine. The images were correlated with colour photos and flourescein angiography images (using Topcon Imagenet software) when available.
Fundal and fluorescein angiogram images of congenital vascular loops, disc collateral vessels secondary to resolved non-ischaemic retinal vein occlusion, neovascularisation of the disc from proliferative diabetic retinopathy and haemangiomas of the optic disc clearly showed a distinct two dimensional appearance. This method was particularly relevant in showing areas of leakage in the proliferative lesions. SD OCT images produced both transverse and three dimension images of each type of lesion with projections into the vitreous space, which correlated well with angiographic findings.
Spectral Domain OCT using TopCon 3D-1000 produces three dimensional imaging with comprehensive coverage of the retina. This enables detailed visualization of retinal structure allowing non-invasive, repeated imaging to show retinal physiological and pathological changes. The software produces virtual reconstructions that could have different applications such as monitoring of glaucoma, diabetic maculopathy and proliferative vessels at the optic disc. It may be useful in differentiating pathological disc and retinal nerve changes such as thinning of retinal nerve fibre layer, particularly in monitoring progression and response to existing and novel therapy.
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