Optical Coherence Tomography

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Optical Coherence Tomography

• Diana Semmonds
• Ophthalmologist
• St Leonards

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OCT

• Optical Coherence Tomography
• Uses light to produce a cross-sectional image of
  the macula

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Retinal OCT From Carl Zeiss Meditec
Stratus OCT
CirrusHD-OCT
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What does OCT do?

• Provides high resolution cross sectional images
  of
• Retina (Macula)
• Vitreous
• -- Optic Nerve
• Cornea
• Ant Segment

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OCT3 Normal Macular Scan
OCT 3
UHR OCT
Ko T et al Ophthalmology 2004111(11) 2033-2043
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HIGH reflectivity lesions

• Scar
• Exudate
• Inflammatory infiltrate
• Haemorrhage
• More cellular structures
• Shadowing

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Metallic Intraocular Foreign Body
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LOW reflectivity

• Fluid (optically transparent)
• Less cellular, less reflectivity

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Case 1 Normal Male
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Normal Male
Yellow square on LSLO fundus image represents the
6mm x 6mm margins of the scanned macular cube
Adjustable cross hair on fundus image shows
precise location of the horizontal and vertical
scans selected.
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Normal Male
Precise location of raster lines indicated on
LSLO fundus image
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Normal Male

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Clinical applications

• CSR
• Macular Hole
• ERM VMTS
• AMD
• Macular Oedema (diabetic, RVO)
• Retinal dystrophies
• Optic nerve abnormalities
• Tumours

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Central Serous Retinopathy
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• 34 year old male
• Stressed
• Smoker
• 3/52 history blurred central vision

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CSR
Precise location of raster lines indicated on
LSLO fundus image
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CSR
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CSR
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Macula Hole
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• 65 year old male
• 9/12 history of central blur
• VA 6/60 RE

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FTMH
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Macula Hole
Precise location of raster lines indicated on
LSLO fundus image
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Macula Hole Surgery
Kang HK, Chang AA, Beaumont PE. The macular hole
report of an Australian surgical series and
meta-analysis of the literature. Clin Experiment
Ophthalmol. 2000 28(4)298-308.
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Epiretinal Membrane
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ERM

• 54 year old male
• 5/12 history of metamorphopsia RE
• general health good
• VA 6/24 RE

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• 63 year old male
• 4/12 history mild central distortion
• VA 6/12 LE

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Vitreomacular Traction Syndrome (VMTS)
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Age Related Macular Degeneration
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• 76 year old female
• 1 week history LE central distortion
• VA 6/15 LE

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AMD CNV with SRF
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• 81 year old female
• 3/12 history LE central blur and distortion
• VA 6/6 RE 6/18 LE

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RE VMTS (asymptomatic)
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LE Subfoveal Occult CNV VMTS
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• 6 weeks after LE intravitreal Avastin

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Macular Oedema
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• 65 year old male
• NIDDM
• Gradual deterioration of vision to 6/12

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Diabetic Macular Oedema
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VA 6/24
1 week after IVTA
VA 6/12
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Tumours
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46 year old femaleProgressive reduction VA BE
2/12VA RE6/9VA LE6/12
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Further Medical History

• 2002 bilateral mastectomy for breast
  CaDiagnosis bilateral choroidal metastases

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Disorders of the Optic Nerve
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• 33 year old male
• 2/12 history of reduced L VA
• VA RE6/6VA LE6/36

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2/52 Post-op vitrectomy and gas VA 6/9
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Glaucoma
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Anterior Segment Imaging

• 2 new scan patterns
• AS 512x128 4mm square
• AS 5 line raster 4 mm long, variable angle
  spacing
• CCT measurement caliper