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Interpretation of The OCT Image: B. Jeroen Klevering

The document discusses interpretation of optical coherence tomography (OCT) images of the retina. It describes the layers of the normal retina that can be visualized on OCT, including the outer retinal layers, photoreceptor inner and outer segments, and retinal pigment epithelium. Key retinal pathologies that affect the outer, middle, and vitreo-retinal interface are shown. New developments in OCT imaging including anterior segment OCT, spectral domain analysis, and multimodal imaging systems from Heidelberg and Zeiss are also summarized.

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Carlos Ortega
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115 views27 pages

Interpretation of The OCT Image: B. Jeroen Klevering

The document discusses interpretation of optical coherence tomography (OCT) images of the retina. It describes the layers of the normal retina that can be visualized on OCT, including the outer retinal layers, photoreceptor inner and outer segments, and retinal pigment epithelium. Key retinal pathologies that affect the outer, middle, and vitreo-retinal interface are shown. New developments in OCT imaging including anterior segment OCT, spectral domain analysis, and multimodal imaging systems from Heidelberg and Zeiss are also summarized.

Uploaded by

Carlos Ortega
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Interpretation of the OCT Image

(and some new developments)

B. Jeroen Klevering

University Medical Centre Nijmegen


-
The Netherlands
Topics

• The OCT image


─ Normal retina and key retinal pathologies
a. outer retina
b. middle retina
c. vitreo-retinal interface
─ New developments
Optical Coherence Tomography

This is what we wanted…


Optical Coherence Tomography

…this is what we got…


Interpretation of OCT images
Outer retina

250 !m 500 !m

• The OCT image is expanded in the axial direction


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
Interpretation of OCT images
Outer retina

High resolution
Spectral Domain
(Fourier
Domain OCT)
Key retinal pathologies – outer retina
Key retinal pathologies – outer retina
Key retinal pathologies – outer retina
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
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
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


Key retinal pathologies – middle retina
Key retinal pathologies – middle retina
Key retinal pathologies – middle retina
Key retinal pathologies – vitreo-retinal interface

VA 20/40 following
cataract surgery
Key retinal pathologies – vitreo-retinal interface
Key retinal pathologies – vitreo-retinal interface
Artefacts in OCT imaging

Image of good quality

Out of focus

Vignetted image

Fixation error
Kwalitative measurements

─ Retinal thickness measurement

─ Retinal nerve fiber layer thickness

─ Optic nerve head analysis


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
New developments – Spectral (Fourier) Domain Analysis
New developments – Heidelbergs Spectralis

Geographic atrophy and drusen


Infrared and OCT

Occult CNV with PED


Fluorescein angiography and OCT

Dry AMD
Autofluorescence and OCT
New developments – Zeiss Cirrus
New developments – Zeiss Cirrus
The End

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