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Final spectral oct_in_diagnosis_and_management_of_glaucoma
1. Spectral Domain OCT in
Diagnosis and Management of
Glaucoma
NSD Raju
Ranjini Eye Hospital (NABH
Accredited)
2. Introduction
• Advent of OCT
• Ophthalmic armamentarium
• SAP gold standard
• Significant neuronal loss
Quigley et al 2006
• Early Diagnosis
• Detection of progression
3. 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
4. Optical Coherence Tomography
OCT
• Imaging technologies OCT
• RFNL thickness
• Quantitatve and qualitative
• Healthy and unhealthy tissue
• Progression of the disease
5. OCT in Glaucoma
• Pre perimetric Glaucoma
• Initiate earlier treatment
• Prevent neuronal loss
• Monitor progression of the disease
6. Spectral Domain OCT
• Faster imaging speeds
• 50 times as fast
• Increases the resolution of the image
• Subtle changes
• Qualitative and quantitative assessment
7. OCT angle Evaluation
• Non invasive
• Versus gonioscopy
• Closed angle
• Open Angle
• Gonioscopy contra indicated
8. ONH Evaluation
• Structural Vs Functional
• Optic Nerve head topography
• High resolution sharp images
• Bruchs membrane rim
• Neuroretinal rim
• Normative data
• Structural damage, progression
9. 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
10. 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