1.
Dr. Jagdish Dukre
Senior Resident,
Regional Institute Of Ophthalmology, Allahabad

2.
Peri papilary
Nerve fiber layer
Macular thickness
Optic nerve
head

3.
OCT Software analyses-
Macula Thickness
Retinal Nerve Fibre Layer (RNFL)
Optic Nerve Head (ONH)

4.
Macula Thickness Analysis
Ganglion cells- 30-35% of total retinal thickness at macula
upto 50%of ganglion cells in macula
glaucoma preferentially involves the ganglion cell complex (GCC).
Normal
Glaucoma with thinner GCC

5.
RNFL analysis
 Circular scanning
around ONH at a radius
of 1. 73mm
 Three scans are acquired
and data is averaged and
compared with
normative data base of
age matched subjects
 Scan begins temporally

6.
RNFL thickness average analysis printout -7
zones
 Zone -1-Pt. I.D
 Zone -2-TSNIT with age matched normative data base
 Zone-3-TSNIT overlap of two eyes
 Zone -4-circular scan-quadrant/clockwise
 Zone-5-DATA TABLE-ratio/average
 Zone-6-RED FREE PHOTOGRAPH-position
 Zone-7-PERCENTILE COLOR CODING

7.
7
6
5
4
3
2
1

8.
Optic nerve head analysis
Optic nerve head scans are
composed of six linear
scans in a spoke pattern
separated by 30-degree
intervals centered on the
ONH

9.
Cup/disk ratios and cup Volumes
Disc size:
 by measuring the distance
between the terminal ends of
the choriod at the level of the
pigment epithelium (green
line)
Cup:
 determined by drawing a line
b/w both sides of the cup at a
point 140um above the green
line.
 Area below the line is cup and
above is neuroretinal rim

10.
Case 1-(Structure Function Correlation)
 56 year old female with open angle glaucoma
 NFL lesion at inferior pole of ONH
 Superior defect in perimetry
 Thinning of RNFL in OCT

11.
Case 2 (early glaucoma)
 59 year old male with suspicious optic nerve
 Normal perimetry
 Normal IOP
 No positive family history
 Thinning of NRR clinically
 Nasal step in SWAP
 RNFL thinning in OCT

12.
Case 3-(Unilateral Open Angle Glaucoma)
 54 year old female
 Unilateral exfoliative glaucoma
 IOP- 33 mmHg
 Thinning of NRR in sup, inf and temporal
 Inferior arcuate defect in perimetry
 RNFL thinning in sup and inf pole in OCT

13.
Case 4-Glaucoma suspect
 62 year old female
 Large C:D ratio
 B/L with positive family history
 Normal IOP
 Normal achromatic and FDP
 Normal RNFL and large disc area and increased C:D
ratio on OCT

14.
Case 5 (Ocular Hypertension)
 Suspicious optic nerve head
 Perimetry normal
 Borderline FDP
 Borderline thickness values with more thinning at
superior and inferior pole on OCT

15.
DOPPLER OCT(F-Domain)
Retinal blood flow measurement with Doppler OCT may help
us understand the role of perfusion in the causation and treatment
of glaucoma, other optic neuropathies and retinal diseases