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optical coherence tomography interprentation
1.
Interpretation of the
OCT Image (and some new developments) B. Jeroen Klevering University Medical Centre Nijmegen - The Netherlands
2.
Topics •
The OCT image ─ Normal retina and key retinal pathologies a. outer retina b. middle retina c. vitreo-retinal interface ─ New developments
3.
Optical Coherence Tomography
This is what we wanted…
4.
Optical Coherence Tomography
…this is what we got…
5.
Interpretation of OCT
images Outer retina 250 !m 500 !m • The OCT image is expanded in the axial direction
6.
Interpretation of OCT
images Outer 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.
Interpretation of OCT
images Outer retina High resolution Spectral Domain (Fourier Domain OCT)
8.
Key retinal pathologies
- outer retina
9.
Key retinal pathologies
- outer retina
10.
Key retinal pathologies
- outer retina
11.
internal limiting membrane nerve
fiber layer ganglion cell layer inner plexiform layer inner nuclear layer outer plexiform layer outer nuclear layer outer limiting membrane photoreceptor inner segments photoreceptor outer segments retinal pigment epithelium choriocapillaris
12.
Interpretation of OCT
images Layers 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.
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 vessels 300 !m____ High resolution spectral OCT
14.
Key retinal pathologies
- middle retina
15.
Key retinal pathologies
- middle retina
16.
Key retinal pathologies
- middle retina
17.
Key retinal pathologies
- vitreo-retinal interface VA 20/40 following cataract surgery
18.
Key retinal pathologies
- vitreo-retinal interface
19.
Key retinal pathologies
- vitreo-retinal interface
20.
Artefacts in OCT
imaging Image of good quality Out of focus Vignetted image Fixation error
21.
Kwalitative measurements
─ Retinal thickness measurement ─ Retinal nerve fiber layer thickness ─ Optic nerve head analysis
22.
New developments -
Anterior segment OCT Myopia claw lens Arows = epithelialized drainage channels Arrowheads = non-epithelialized drainage slits E = conjunctival epithelium L = lamina propria conjunctivae T = tenons layer S = sclera
23.
New developments -
Spectral (Fourier) Domain Analysis
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.
New developments -
Zeiss Cirrus
26.
New developments -
Zeiss Cirrus
27.
The End
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