Optical Coherance Tomography (OCT) in Vitreo Retina and Choroid
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This document discusses optical coherence tomography (OCT) and its use in retinal imaging. OCT has become the most important test for diagnosing and managing retinal diseases. Several improvements to OCT technology over time, including Fourier domain detection and swept-source OCT, have provided faster scanning speeds and better visualization of the choroid and sclera. Both structural and quantitative analysis of OCT scans provide valuable information. While artifacts can occur, OCT remains a non-invasive and repeatable tool that will continue improving with advances in software.
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Ultrasound is useful for evaluating ocular structures. It uses sound waves above the audible range that are reflected by tissues. The transducer produces pulses and detects echoes to create images. Different scan types provide 1D (A-scan) or 2D (B-scan) views. A-scans show acoustic density as spikes while B-scans show shape, location and extent of structures. Proper technique and interpretation of features like reflectivity, mobility and shadowing allow ultrasound to diagnose conditions like retinal detachment, tumors, inflammation and optic nerve diseases.
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UBM and ASOCT provide high-resolution cross-sectional images of the anterior segment including the cornea, anterior chamber, angle, and iris. ASOCT uses optical coherence tomography with a wavelength of 1310nm for improved penetration and reduced retinal damage compared to posterior segment OCT. It allows high-speed imaging of dynamic structures. ASOCT has applications in assessing corneal diseases and procedures, glaucoma (including angle anatomy and iridotomy evaluation), and intraocular lens implantation. Measurements of angle width parameters help evaluate angle closure risk. While valuable for objective angle assessment, ASOCT cannot image all anatomical structures involved in glaucoma.
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1. The Pentacam exam provides detailed 3D analysis of the cornea and anterior segment using over 100,000 data points to evaluate curvature, thickness, and refractive powers.
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Test for stereopsis
This document discusses various tests used to evaluate stereopsis and depth perception. It describes:
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Ultrasound is useful for evaluating ocular structures. It uses sound waves above the audible range that are reflected by tissues. The transducer produces pulses and detects echoes to create images. Different scan types provide 1D (A-scan) or 2D (B-scan) views. A-scans show acoustic density as spikes while B-scans show shape, location and extent of structures. Proper technique and interpretation of features like reflectivity, mobility and shadowing allow ultrasound to diagnose conditions like retinal detachment, tumors, inflammation and optic nerve diseases.
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UBM and ASOCT provide high-resolution cross-sectional images of the anterior segment including the cornea, anterior chamber, angle, and iris. ASOCT uses optical coherence tomography with a wavelength of 1310nm for improved penetration and reduced retinal damage compared to posterior segment OCT. It allows high-speed imaging of dynamic structures. ASOCT has applications in assessing corneal diseases and procedures, glaucoma (including angle anatomy and iridotomy evaluation), and intraocular lens implantation. Measurements of angle width parameters help evaluate angle closure risk. While valuable for objective angle assessment, ASOCT cannot image all anatomical structures involved in glaucoma.
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2. The exam generates various corneal power and elevation maps to detect ectatic conditions like keratoconus by comparing indices like curvature asymmetry, elevation-based BCV, and notable point values to normal population percentiles.
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Pigment epithelial detachment (PED) occurs when the retinal pigment epithelium separates from the underlying Bruch's membrane, usually due to fluid accumulation. There are several types of PED including drusenoid, serous, and vascularized PEDs. PEDs can be caused by conditions like age-related macular degeneration and central serous choroidopathy. Optical coherence tomography is used to characterize the type and contents of the PED. Treatment depends on the specific cause and characteristics of the PED.
B SCAN
B-scan ultrasonography uses high frequency sound waves to produce 2D images of ocular structures. It can be used to evaluate the anterior segment, posterior segment, tumors, vitreous pathology, retinal detachments, and more. The probe transmits sound waves which bounce off tissues and return echoes that are amplified and displayed. This allows visualization of the retina, choroid, lens, vitreous humor and other structures. B-scan is useful for diagnosing and monitoring many ocular conditions.
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1. Tests of gross stereopsis like the pencil test that evaluate the ability to perceive depth with both eyes open versus monocularly.
2. The Frisby and Randot stereotests that use displaced shapes or dots seen through polarized lenses to test fine stereopsis.
3. Administration and passing criteria for the TNO and Lang stereotests which use random dot patterns to evaluate minimum stereoacuity.
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It discusses that AS-OCT provides non-contact, high resolution cross-sectional imaging of the anterior segment structures without touching the eye. UBM uses high frequency ultrasound to generate detailed 2D images of the anterior segment, allowing visualization of structures like the iris and angle.
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AS OCT & UBM - Dr Shylesh B Dabke
This document compares and contrasts AS-OCT (anterior segment optical coherence tomography) and ultrasound biomicroscopy (UBM) imaging techniques for evaluating the anterior eye segment.
It discusses that AS-OCT provides non-contact, high resolution cross-sectional imaging of the anterior segment structures without touching the eye. UBM uses high frequency ultrasound to generate detailed 2D images of the anterior segment, allowing visualization of structures like the iris and angle.
While both techniques allow qualitative and quantitative assessment of the anterior chamber angle and structures, AS-OCT has advantages of being non-contact, faster imaging, and less operator dependency compared to UBM. However, UBM can image deeper into the posterior iris and has greater penetration than
Macular disorders best disease
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is a hereditary retinal dystrophy involving the retinal pigment epithelium (RPE), and leads to a characteristic bilateral yellow “egg-yolk” appearance of the macula
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Interventions to Reduce Myopia Progression in Children (Journal Club) (health...
DIRECT DOWNLOAD LINK ❤❤https://healthkura.com/reduce-myopia/❤❤
Dear viewers Check Out my other piece of works at___ https://healthkura.com
Interventions to Reduce Myopia Progression in Children (Journal Club)
Objectives:
- To discuss about the different interventions to reduce myopia progression in children
- To determine the effectiveness of different interventions to slow down the progression of myopia in children
Interventions to Reduce Myopia Progression:
Environmental Considerations
- Time Spent Outdoors
- Near-Vision Activities
Spectacles & Contact Lenses
- Gas-Permeable Contact Lens Wear
- Bifocal & Multifocal Spectacles
- Soft Bifocal Contact Lenses
- Orthokeratology
Pharmacological Therapies
- Antimuscarinic Agents: Atropine & Pirenzepine
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Synaptophore in ophthalmology
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OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY
OCT angiography allows visualization of the retinal and choroidal vasculature without dye injection. It uses amplitude decorrelation and phase variance techniques to detect blood flow. The retina and choroid can be segmented into different en face slabs. The superficial, deep, and outer retinal plexuses as well as the choriocapillaris can be visualized. OCTA is useful for diagnosing wet AMD by detecting type 1 CNV beneath the RPE that may not be clearly seen on FA. It can help classify CNV shape and branching patterns. Motion artifacts and projection artifacts can occur but many devices have correction software.
Post operative astigmatism
This document discusses sources and management of postoperative astigmatism after cataract surgery. It notes that the main sources of astigmatism are preexisting astigmatism, incision characteristics like length and location, and suture characteristics like type, tension, and placement. Larger or superior incisions, and sutures that degrade quickly or are placed unevenly, tend to cause more astigmatism. Managing factors like smaller incisions, frown-shape cuts, posterior placement, uniform tension, and non-degrading suture material can help minimize postoperative astigmatism. Precise suture removal timing and selective cutting can further refine astigmatism outcomes after surgery.
Jackson cross cylinder
The document discusses the Jackson Cross Cylinder (JCC) test, which is used during refraction to detect and refine astigmatism. The JCC is a combination of two cylinders of equal strength but opposite signs, placed at right angles to each other. During the test, the JCC is held in different positions before the eye to see if there is a change in visual acuity. If a position is clearer, it indicates the axis of astigmatism. The test is then used to refine the axis and power of any astigmatic correction.
Indirect ophthalmoscopy
This document provides an overview of indirect ophthalmoscopy. It describes how indirect ophthalmoscopy works by using a strong convex lens to make the eye highly myopic and form a real, inverted image of the fundus. The key components of an indirect ophthalmoscope include binocular viewing systems and adjustable lighting. Indirect ophthalmoscopy allows examination of the posterior segment up to the ora serrata and provides a larger field of view compared to direct ophthalmoscopy. While it provides less magnification, indirect ophthalmoscopy is useful for examining patients with hazy media and during retinal surgery.
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18 08 14
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JBO_19_11_116011
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2. **Clogged Pores:** When dead skin cells and oil block hair follicles, bacteria (usually Propionibacterium acnes) can thrive, causing inflammation and acne lesions.
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Optical Coherance Tomography (OCT) in Vitreo Retina and Choroid
- 1. Optical CoherenceTomography (OCT) InVitreo Retina and Choroid where we are and where we are going in 2017. Dr. Abdul Sami Memon MD. FCPS. MCPS. Fellow of University of California Irvine , USA (Vitreo Retina) Assistant Professor Isra Postgraduate Institute of Ophthalmology, Karachi. Consultant Eye Surgeon , Hashmanies Hospital , Karachi. Clinical and Academic Coordinator Isra Postgraduate Institute of Ophthalmology, Karachi.
- 2. No financial disclosure/Interest
- 3. Jay S. Duker , M.D. Baruch D . Kuppermann M.D. Prof P.S. Mahar Dr. Rehman Siddique Dr. Nasir Memon Bruno Lumbroso, MD, Marco Rispoli, M.D Adil El Maftouhi, Lyon, France NICOLAS IAFE M.D NOPASAK PHASUKKIJWATANA M.D Richard Rosen, MD Mrs. Fender and Mrs. Dutch UCI, UCLA Optuvue
- 4. Retinal imaging – Where we stand in 2017 Color Fundus Photography – great for documentation. Fluorescein Angiography – utility in common macular diseases questionable – has evolved to be largely a test of the retinal periphery ICG Angiography – limited availability and utility
- 5. OCT –The most important ancillary test in the diagnosis and management of retinal diseases OCTA -The most important ancillary test in the diagnosis and management of retinal diseases also.
- 6. Time domain (TD) detection (400 A-scans/sec) Fourier domain (FD) detection Spectral domain (SD)) ▪ 68000 to 85000 A-scans/sec Swept source (SS) (or optical frequency domain) ▪ 100,000 A-scans/sec
- 7. SS OCT The swept-source is unique light source, has a wavelength centered at 1 µm that sweeps across a narrow band of light source The SS-OCT utilizes a point Photodetector, to detect the light waves returning to the device Longer wavelength : 1050Nm Improved immunity in media opacity Improved visualization of choroid, Sclera Uniform image quality SDOCT The spectral-domain devices utilize a broadband light source The SD-OCT uses a spectrometer, Fourier transform lens, and a line scan camera. Enhanced depth imaging : using image averaging
- 8. SD
- 11. Macular cube scan Raster Scans: Radial Scans: Mesh scan ( vertical and horizontal scan over the area of interest ) Line scan Line, Cross-Line and Raster Scans, multiline, Macular Maps (cube scan data or radial scans). Numeric displays Color-coded displays Topographical maps
- 12. C-Scans (En Face Images),This image looks like a red-free image of the retina and is obtained by summation of data from all the B-scans. MICHAEL HEIFERMAN, MD • JOSEPH SIMONETT, BS • AMANI FAWZI, MD June 1, 2015
- 15. Qualitative Interpretation Quantitative Interpretation
- 22. Vitritis
- 24. Subretinal fluid
- 25. Retina. Author manuscript; available in PMC 2012 Jul 10.
- 26. Retina. Author manuscript; available in PMC 2012 Jul 10.
- 28. ERM VMT FTMH LMH
- 31. Courtesy of Mrs. Fender RPE tear
- 32. Courtesy of Mrs. Fender
- 33. Mirror artifact Vignetting Misalignment Software breakdown Out of range error Motion and Blink artifact
- 35. Vignetting :This occurs when a part of the OCT beam is blocked Misalignment :This occurs when the fovea is not properly aligned during a volumetric scan. Fovea
- 36. Software breakdown : Software breakdown results from misidentification of the inner or outer retinal boundaries.
- 37. Blink artifact : Motion artifact : Out of range : Blink Double fovea Out of range
- 38. OCT –The most important ancillary test in the diagnosis and management of retinal diseases
- 39. Summary Non- invasive , fast and repeatable Software enhancement in the future will increase the sensivity and specificity of OCT SS- OCT will allow for increased field of view and wide field imaging
- 40. Thanks
Editor's Notes
- homogeneous infiltration of the choroid causing an irregular, dome-shaped elevation of the overlying retinal pigment epithelium and retina. There is also infiltration of the subretinal space with a homogeneous material of medium reflectivity and associated subretinal fluid.