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Spectral Domain OCT in Diagnosis and Management of
Glaucoma NSD Raju
Ranjini Eye Hospital (NABH Accredited)
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Introduction
• Advent of OCT• Ophthalmic armamentarium • SAP gold standard • Significant neuronal loss
Quigley et al 2006
• Early Diagnosis
• Detection of progression
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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
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Optical Coherence Tomography OCT
• Imaging technologies OCT• RFNL thickness• Quantitatve and qualitative• Healthy and unhealthy tissue• Progression of the disease
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OCT in Glaucoma
• Pre perimetric Glaucoma• Initiate earlier treatment • Prevent neuronal loss• Monitor progression of the disease
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Spectral Domain OCT
• Faster imaging speeds• 50 times as fast• Increases the resolution of the image• Subtle changes • Qualitative and quantitative assessment
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OCT angle Evaluation
• Non invasive• Versus gonioscopy• Closed angle • Open Angle• Gonioscopy contra indicated
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ONH Evaluation
• Structural Vs Functional • Optic Nerve head topography• High resolution sharp images • Bruchs membrane rim• Neuroretinal rim• Normative data • Structural damage, progression
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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
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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
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OCT ONH Topography
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OCT RNFL
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A Case of Glaucoma Suspect
• Male 51 years a case of glaucoma suspecg• Suspicious cup of Of BE • OCT ONH and RNFL
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OCT Clinical Correlation
• Disc changes • Visual field Changes
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Summary
• A new era• Structural changes • Functional defects • Early Diagnosis• Early detection of Progression