optical coherence tomography interprentation

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optical coherence tomography interprentation

  1. 1. Interpretation of the OCT Image (and some new developments) B. Jeroen Klevering University Medical Centre Nijmegen - The Netherlands
  2. 2. Topics• The OCT image ─ Normal retina and key retinal pathologies a. outer retina b. middle retina c. vitreo-retinal interface ─ New developments
  3. 3. Optical Coherence Tomography This is what we wanted…
  4. 4. Optical Coherence Tomography …this is what we got…
  5. 5. Interpretation of OCT imagesOuter retina 250 !m 500 !m • The OCT image is expanded in the axial direction
  6. 6. Interpretation of OCT imagesOuter retina Inner HRL Outer HRL • Inner HRL: junction between inner and outer photoreceptor segments • Outer HRL: retinal pigment epithelium (probably with choriocapillaris) • Fovea: ─ absence of inner retinal layers ─ increased thickness of the photoreceptor layer
  7. 7. Interpretation of OCT imagesOuter retina High resolution Spectral Domain (Fourier Domain OCT)
  8. 8. Key retinal pathologies - outer retina
  9. 9. Key retinal pathologies - outer retina
  10. 10. Key retinal pathologies - outer retina
  11. 11. internal limiting membranenerve fiber layerganglion cell layerinner plexiform layerinner nuclear layerouter plexiform layerouter nuclear layerouter limiting membranephotoreceptor inner segmentsphotoreceptor outer segmentsretinal pigment epitheliumchoriocapillaris
  12. 12. Interpretation of OCT imagesLayers of the retina Nerve fiber layer Ganglion cell layer Inner plexiform layer Inner nuclear layer RPE and choriocapillaris Outer and inner External limiting Outer Outer photoreceptor membrane nuclear plexiform segments layer layer
  13. 13. Interpretation of OCT images Layers of the retina Nerve fiber layer Ganglion cell layer Inner plexiform layer Inner Nuclear layer Outer plexiform layer Outer nuclear layer External limiting membrane Inner/outer segment junction RPE Larger choroidal vessels300 !m____High resolution spectral OCT
  14. 14. Key retinal pathologies - middle retina
  15. 15. Key retinal pathologies - middle retina
  16. 16. Key retinal pathologies - middle retina
  17. 17. Key retinal pathologies - vitreo-retinal interface VA 20/40 following cataract surgery
  18. 18. Key retinal pathologies - vitreo-retinal interface
  19. 19. Key retinal pathologies - vitreo-retinal interface
  20. 20. Artefacts in OCT imaging Image of good quality Out of focus Vignetted image Fixation error
  21. 21. Kwalitative measurements ─ Retinal thickness measurement ─ Retinal nerve fiber layer thickness ─ Optic nerve head analysis
  22. 22. New developments - Anterior segment OCT Myopia claw lensArows = epithelialized drainagechannelsArrowheads = non-epithelialized drainage slitsE = conjunctival epitheliumL = lamina propria conjunctivaeT = tenons layerS = sclera
  23. 23. New developments - Spectral (Fourier) Domain Analysis
  24. 24. New developments - Heidelbergs Spectralis Geographic atrophy and drusen Infrared and OCT Occult CNV with PED Fluorescein angiography and OCT Dry AMD Autofluorescence and OCT
  25. 25. New developments - Zeiss Cirrus
  26. 26. New developments - Zeiss Cirrus
  27. 27. The End

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