9.5  Optical Coherence Tomography - Glaucoma

Optical Coherence Tomography (OCT) for glaucomatous disease utilises the same technology as for macula pathology focusing on retinal nerve fibre layer (RNFL) thickness, symmetry and change over time (Guided Progression Analysis – GPA).

The ability for this technology to take multiple subsequent images based on fundal landmarks allows for relatively accurate, objective comparison of the data obtained. In addition to clinical examination, intraocular pressure and automated visual field testing, OCT has proven a strong addition to the surveillance, diagnosis, and assessment of treatment effect for glaucomatous (and other) optic neuropathies.

Figure 9.5.1 Normal OCT RNFL (OCT Zeiss Cirrus 5000®)

Figure 9.5.1
Normal OCT RNFL (OCT Zeiss Cirrus 5000®)

Figure 9.5.2 OCT RNFL – GPA, Inferior temporal retinal nerve fibre layer loss (left)

Figure 9.5.2
OCT RNFL – GPA, Inferior temporal retinal nerve fibre layer loss (left)

GPA showing progressive left optic nerve head inferior temporal RNFL loss (notch)

Figure 9.5.3 OCT RNFL – RNFL Loss (left)

Figure 9.5.3
OCT RNFL – RNFL Loss (left)

OCT RNFL showing advanced left optic nerve head RNFL loss from traumatic glaucoma

Figure 9.5.4 OCT Macula Cube (Ganglion Cell Analysis) – Ganglion Cell Layer Loss (left)

Figure 9.5.4
OCT Macula Cube (Ganglion Cell Analysis) – Ganglion Cell Layer Loss (left)

OCT Macula (Ganglion cell) showing ganglion cell layer loss in keeping with advanced left optic nerve head RNFL loss from traumatic glaucoma (same patient as Fig. 9.5.3)

          

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