Spectral Domain OCT in Diagnosis and Management of Glaucoma NSD Raju Ranjini Eye Hospital (NABH Accredited)
Jan 19, 2015
Spectral Domain OCT in Diagnosis and Management of
Glaucoma NSD Raju
Ranjini Eye Hospital (NABH Accredited)
Introduction
• Advent of OCT• Ophthalmic armamentarium • SAP gold standard • Significant neuronal loss
Quigley et al 2006
• Early Diagnosis
• Detection of progression
Spectral Domain OCT
• Enhanced resolution 3 fold• Scan speed 100 fold• Denser sampling and 3 – dimensional imaging• Improved reproducibility, specificity and
sensitivity for glaucoma detection
Optical Coherence Tomography OCT
• Imaging technologies OCT• RFNL thickness• Quantitatve and qualitative• Healthy and unhealthy tissue• Progression of the disease
OCT in Glaucoma
• Pre perimetric Glaucoma• Initiate earlier treatment • Prevent neuronal loss• Monitor progression of the disease
Spectral Domain OCT
• Faster imaging speeds• 50 times as fast• Increases the resolution of the image• Subtle changes • Qualitative and quantitative assessment
OCT angle Evaluation
• Non invasive• Versus gonioscopy• Closed angle • Open Angle• Gonioscopy contra indicated
ONH Evaluation
• Structural Vs Functional • Optic Nerve head topography• High resolution sharp images • Bruchs membrane rim• Neuroretinal rim• Normative data • Structural damage, progression
A case of Angle closure Glaucoma
• Female 45 yrs Acute Angle closure Glaucoma not responding to medical regimen
• Cornea haze edema gonioscopy not possible• OCT revealed closed angle• Subsequent YAG iridectomy relieved A.closure
A case of Suspected Glaucoma
• Female aged 50 Large disc with 0.7 cup OU• SAP within normal limits • Applanation tension 15 mm Hg OU• ONH topography• RNFL analysis
OCT ONH Topography
OCT RNFL
A Case of Glaucoma Suspect
• Male 51 years a case of glaucoma suspecg• Suspicious cup of Of BE • OCT ONH and RNFL
OCT Clinical Correlation
• Disc changes • Visual field Changes
Summary
• A new era• Structural changes • Functional defects • Early Diagnosis• Early detection of Progression