Handbook of Retinal OCT: Optical Coherence Tomography E-Book

-

English
288 Pages
Read an excerpt
Gain access to the library to view online
Learn more

Description

With Handbook of Retinal OCT, you can master the latest imaging methods used to evaluate retinal disease, uveitis, and optic nerve disorders. Ideal at any stage of your career, this easy-to-use, clinically oriented handbook provides a quick, templated, and portable guide for the interpretation of Optical Coherence Tomography scans.  "My initial impression was that it deserved a score of 5/5 in value for money, and I have had no reservations in affirming this rating after reading the book" Reviewed by: Birmingham Heartlands Hospital   Date: Nov 2014

  • Consult this title on your favorite e-reader, conduct rapid searches, and adjust font sizes for optimal readability. Compatible with Kindle®, nook®, and other popular devices.
  • Locate answers quickly with templated chapters—each focused on one specific diagnosis or group of diagnoses with a particular OCT appearance.
  • Adopt the latest techniques for evaluating age-related macular degeneration, diabetic retinopathy, retinal vein occlusion, and much more.
  • See how the full spectrum of diseases presents through approximately 370 illustrations including the highest-quality spectral-domain OCT images available.
  • Recognize image patterns and get clear visual guidance from multiple arrows and labels used throughout to highlight the key details of each disease.
  • Access the full text online at Expert Consult.

Subjects

Informations

Published by
Published 12 December 2013
Reads 0
EAN13 9780323188852
Language English
Document size 1 MB

Legal information: rental price per page 0.0297€. This information is given for information only in accordance with current legislation.

Report a problem

Handbook of Retinal
OCT
Optical Coherence Tomography
Jay S. Duker, MD
Director, New England Eye Center, Professor and Chairman, Department of
Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA,
USA
Nadia K. Waheed, MD MPH
Assistant Professor of Ophthalmology, New England Eye Center, Tufts Medical Center,
Tufts University School of Medicine, Boston, MA, USA
Darin R. Goldman, MD
Vitreoretinal Surgeon, Retina Group of Florida, Fort Lauderdale, FL, USATable of Contents
Cover image
Title page
Copyright
Preface
List of Contributors
Acknowledgements
Dedications
Part 1: Introduction to OCT
Section 1: OCT: What It Is
Chapter 1: Scanning Principles
Time Domain OCT
Spectral Domain OCT
Swept Source OCT
Chapter 2: Basic Scan Patterns and OCT Output
Macular Cube Scan
Line, Cross-Line and Raster Scans
Enhanced Depth Imaging
Macular Maps
C-Scans (En Face Images), OCT Fundus Image (Rendered Fundus Image,
Summed Voxel Projection [SVP])Topographical maps
Nerve Fiber Layer Map
Section 2: OCT Interpretation
Chapter 3: OCT Interpretation
Qualitative Interpretation
Quantitative Interpretation
Section 3: OCT Artifacts
Chapter 4: Artifacts on OCT
Section 4: Normal Retinal Anatomy and Basic Pathologic Appearances
Chapter 5: Normal Retinal Anatomy and Basic Pathologic Appearances
Normal Retinal Anatomy
General Appearance of Retinal Pathology on SD-OCT
Part 2: Optic Nerve Disorders
Section 5: Interpretation of Optic Nerve OCTs
Chapter 6: Basic Optic Nerve Scan Patterns and Output
Retinal Nerve Fiber Layer (RNFL) Thickness
Optic Nerve Morphology
Ganglion Cell Complex (GCC)
Section 6: Optic Nerve Disorders
Chapter 7: Glaucoma
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:Chapter 8: Optic Neuropathies and Papilledema
Chapter 9: Congenital Optic Nerve Head Abnormalities
Part 3: Macular Disorders
Section 7: Dry Age-Related Macular Degeneration
Chapter 10: Dry Age-Related Macular Degeneration
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Section 8: Wet Age-Related Macular Degeneration
Chapter 11: Wet Age-Related Macular Degeneration
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Section 9: Macular Pathology Associated with Myopia
Chapter 12: Posterior Staphyloma
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 13: Myopic Choroidal Neovascular Membrane
Introduction:Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 14: Myopic Macular Schisis
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 15: Dome-Shaped Macula
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 16: Myopic Tractional Retinal Detachment
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Section 10: Vitreomacular Interface Disorders
Chapter 17: Vitreomacular Adhesion and Vitreomacular Traction
Introduction:
Clinical Features:
OCT Diagnosis:
Ancillary Testing:Treatment:
Chapter 18: Full-Thickness Macular Hole
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Management:
Chapter 19: Epiretinal Membrane
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Section 11: Miscellaneous Causes of Macular Edema
Chapter 20: Postoperative Cystoid Macular Edema
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 21: Macular Telangiectasia
Introduction:
Clinical Features:
OCT Features
Ancillary Testing:
Treatment:
Chapter 22: UveitisIntroduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Section 12: Miscellaneous Macular Disorders
Chapter 23: Central Serous Chorioretinopathy
Introduction:
Clinical Features:
OCT Features
Ancillary Testing:
Treatment:
Chapter 24: Hydroxychloroquine Toxicity
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 25: Pattern Dystrophy
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 26: Oculocutaneous Albinism
Introduction:
Clinical Features:
OCT Features:Ancillary Testing:
Treatment:
Chapter 27: Subretinal Perfluorocarbon
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 28: X-Linked Juvenile Retinoschisis
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Part 4: Retinal Vascular Disorders
Section 13: Diabetic Retinopathy
Chapter 29: Non-Proliferative Diabetic Retinopathy
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 30: Diabetic Macular Edema
Introduction:
Clinical Features:
OCT Features (Figs 13.2.2 and 13.2.3):
Ancillary Testing:Treatment:
Chapter 31: Proliferative Diabetic Retinopathy
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Section 14: Retinal Vein Occlusion
Chapter 32: Branch Retinal Vein Occlusion
Introduction:
Epidemiology:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 33: Central Retinal Vein Occlusion
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Section 15: Retinal Artery Occlusion
Chapter 34: Branch Retinal Artery Occlusion
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:Treatment:
Chapter 35: Central Retinal Artery Occlusion
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 36: Cilioretinal Artery Occlusion
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Part 5: Inherited Retinal Degenerations
Section 16: Inherited Retinal Degenerations
Chapter 37: Retinitis Pigmentosa
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 38: Stargardt Disease
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:Chapter 39: Best Disease
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 40: Cone Dystrophy
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Part 6: Uveitis and Inflammatory Diseases
Section 17: Posterior Non-Infectious Uveitis
Chapter 41: Multifocal Choroiditis
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 42: Birdshot Chorioretinopathy
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 43: Serpiginous ChoroiditisIntroduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 44: Vogt–Koyanagi–Harada Disease
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 45: Sympathetic Ophthalmia
Introduction:
Epidemiology:
Clinical Features:
OCT Features:
Treatment:
Chapter 46: Posterior Scleritis
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Section 18: Posterior Infectious Uveitis
Chapter 47: Toxoplasmic Chorioretinitis
Introduction:
Clinical Features:
OCT Features:Ancillary Testing:
Treatment:
Chapter 48: Tuberculosis
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 49: Acute Syphilitic Posterior Placoid Chorioretinitis
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 50: Candida Albicans Endogenous Endophthalmitis
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 51: Acute Retinal Necrosis Syndrome
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Part 7: TraumaSection 19: Physical Trauma
Chapter 52: Commotio Retinae
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 53: Choroidal Rupture and Subretinal Hemorrhage
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 54: Valsalva Retinopathy
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Section 20: Photothermal, Photomechanical, and Photochemical Trauma
Chapter 55: Laser Injury (Photothermal and Photomechanical)
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 56: Retinal Light Toxicity (Photochemical)Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Part 8: Tumors
Section 21: Choroidal Tumors
Chapter 57: Choroidal Nevus
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 58: Choroidal Melanoma
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 59: Choroidal Hemangioma
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Section 22: Retinal Tumors
Chapter 60: Retinal Capillary HemangiomaIntroduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 61: Retinoblastoma
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Section 23: Other Tumors
Chapter 62: Metastatic Choroidal Tumor
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Chapter 63: Vitreoretinal Lymphoma
Introduction:
Clinical Features:
OCT Features:
Ancillary Testing:
Treatment:
Part 9: Peripheral Retinal Abnormalities
Section 24: Retinal Detachment
Chapter 64: Retinal DetachmentIntroduction:
Clinical features:
OCT Features:
Ancillary Testing:
Management:
Section 25: Retinoschisis
Chapter 65: Retinoschisis
Introduction:
Clinical Presentation:
OCT Features:
Ancillary Testing:
Treatment:
Section 26: Peripheral Lattice Degeneration
Chapter 66: Lattice Degeneration
Introduction:
Clinical Findings:
OCT Features:
Ancillary Testing:
Treatment:
Glossary
IndexCopyright
Copyright © 2014 by Saunders, an imprint of Elsevier Inc.
All rights reserved.
No part of this publication may be reproduced or transmitted in any form or by any
means, electronic or mechanical, including photocopying, recording, or any
information storage and retrieval system, without permission in writing from the
publisher. Details on how to seek permission, further information about the
Publisher's permissions policies and our arrangements with organizations such as the
Copyright Clearance Center and the Copyright Licensing Agency, can be found at our
website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under
copyright by the Publisher (other than as may be noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new
research and experience broaden our understanding, changes in research
methods, professional practices, or medical treatment may become
necessary.
Practitioners and researchers must always rely on their own experience
and knowledge in evaluating and using any information, methods,
compounds, or experiments described herein. In using such information
or methods they should be mindful of their own safety and the safety of
others, including parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers
are advised to check the most current information provided (i) on
procedures featured or (ii) by the manufacturer of each product to be
administered, to verify the recommended dose or formula, the method
and duration of administration, and contraindications. It is the
responsibility of practitioners, relying on their own experience and
knowledge of their patients, to make diagnoses, to determine dosages and
the best treatment for each individual patient, and to take all appropriate
safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors,
contributors, or editors, assume any liability for any injury and/or damage
to persons or property as a matter of products liability, negligence or
otherwise, or from any use or operation of any methods, products,instructions, or ideas contained in the material herein.
ISBN: 978-0-323-18884-5
e-book ISBN: 978-0-323-18885-2
Printed in China
Last digit is the print number: 9 8 7 6 5 4 3 2 1
P r e f a c e
Optical coherence tomography (OCT) was ‘discovered’ in an optics lab at the
Massachuse s I nstitute of Technology in the late 1980s by J ames Fujimoto and his
collaborators: Carmen Puliafito, J oel S chuman, D avid Huang, Eric S wanson and Mike
Hee. I t began as an effort to experimentally measure excimer laser corneal ablation in
real time. While it failed in that regard, the founders quickly identified the possibility
that OCT could be employed to measure static ocular tissue thickness in real time.
The first publication on OCT was in S c i e n c e in 1991 and by 1996 the technology was
transferred to a commercial company and soon thereafter commercial devices began
to be sold.
I n 2013, it is safe to say that OCT is one of the most important ancillary tests in
ophthalmology and it is indisputably THE most important ancillary test in the
subspecialty of the retina. We set out to produce an easy-to-read, brief but complete
handbook of OCT images that was disease-based. Given the importance of OCT in
our practices, we concluded that the OCT images should be the major focus of the
book. Consistency of chapter layout, excellent images, and well-documented
pathologic features were all goals. This book has minimal clinical description of the
pathologic entities. There are plenty of excellent textbooks that cover these entities in
more depth. We hope you find this handbook useful in your clinical practice on a
daily basis.List of Contributors
Daniela Ferrara, MD PhD, Researcher
New England Eye Center
Tufts University School of Medicine
Boston, MA, USA
Sana Nadeem, MBBS FCPS, Senior Registrar
Ophthalmology Department
Fauji Foundation Hospital
Rawalpindi, Pakistan
Alexandre S.C. Reis, MD, Department of Ophthalmology
University of São Paulo
São Paulo, SP, BrazilA c k n o w l e d g e m e n t s
The development of optical coherence tomography and its emergence as the most
important ancillary test in ophthalmology is inextricably linked to the N ew England
Eye Center at Tufts Medical Center and its physicians. The clinical experiences
summarized in this book are based on the collective expertise gained at the Eye
Center over the past two decades and we are very grateful to our colleagues Caroline
Baumal, Elias Reichel, Chris Robinson, A dam Rogers and A ndre Witkin, with whom
we are privileged to share patients and who have been an inexhaustible resource for
this endeavor. We would also like to acknowledge the unparalleled ophthalmic
imaging department at the N ew England Eye Center whose members acquired most
of the images included in this book. Thanks also go out to the contributing authors
and to our production team at Elsevier who worked on a very tight schedule to get the
book published in just over six months. Our fellows and residents, whose questions
provide constant intellectual challenge, also deserve acknowledgement. A nd last but
perhaps most importantly, we would like to thank our families for their patience and
support.D e d i c a t i o n s
To my wife Julie and my children, Jake, Bear, Sam and Elly whose support, love,
patience and understanding allow me to pursue projects like this book. Also, to
Carmen Puliafito, Joel Schuman and Jim Fujimoto – without them OCT would not
exist and without their mentorship and collaboration I would never have been
immersed in it.
Jay S. Duker
To Khadija and Ahmed, for their patience, generosity and encouragement. To my
mother, the constant inspiration, without whom none of this would be possible. To
my mentors past and present, and to my co-authors who made the process of writing
this book such a phenomenally enjoyable and educational experience.
Nadia K. Waheed
To my wife Robin, whose constant love and encouragement allow me to pursue my
passions, and to my parents Marisse and Tony and sister Candice, whose support I
am forever grateful to have.
Darin GoldmanPA RT 1
Introduction to OCTS E C T I ON 1
OCT: What It Is"
"
"
"
1 . 1
Scanning Principles
Optical coherence tomography (OCT) is a medical diagnostic imaging technology that
captures micron resolution three-dimensional images. I t is based on the principle of
optical reflectometry, which involves the measurement of light back-sca ering
through transparent or semi-transparent media such as biological tissues. I t achieves
this by measuring the intensity and the echo time delay of light that is sca ered from
the tissues of interest. Light from a broadband light source is broken into two arms, a
reference arm and a sample arm that is reflected back from structures at various
depths within the posterior pole of the eye.
There are two main ways in which the backscattered light can be detected:
▶ Time domain (TD) detection
▶ Fourier domain (FD) detection – which is further broken down into:
• Spectral domain (SD)
• Swept source (SS)
Time Domain OCT
I n time domain OCT scanning, light from the reference arm and light reflected back
from the sample undergo interference, and the interference over time is used to
generate an ‘A -scan’ depth resolved image of the retina at a single point. Moving the
sample and the light source with respect to each other generates multiple A -scans
that are combined into a cross-sectional linear image called the B-scan or ‘line scan’.
S canning speeds of TD -OCTs are typically around 400 A -scans/second. The primary
commercially available TD -OCT device is the S tratus OCTTM made by Carl Zeiss
Meditech.
Spectral Domain OCT
I n this technology, the spectral interference pa ern between the reference beam and
the sample beam is dispersed by a spectrometer and collected simultaneously with an
array detector. This simultaneous collection allows for much faster scanning speeds
than the traditional time domain devices where a mechanically moving
interferometer gathers the data over time. A n A -scan is then generated using an
inverse Fourier transform on the simultaneously gathered data. Commercially
available SD-OCT devices have scanning rates of 18,000–70,000 A-scans/second.
Higher scan speeds in the S D -OCT faster acquisition time, which minimizes the
chance of eye movements during acquisition, especially in patients with poor fixation.
Both hardware and software enhancements permit precise image registration which
allows for more reliable comparison between visits. Faster acquisition speeds also
mean a higher sampling density of the macula, minimizing the chances of missing
pathology. The higher speeds allow for the production of three-dimensional OCT
scans. The broader light sources of S D -OCT devices achieve a higher axial resolution
than TD -OCT, allowing be er visualization of retinal anatomy. Commercially"
"
"
"
available S D -OCT devices include: the Cirrus OCT made by Carl Zeiss Meditech, the
S pectralis OCT made by Heidelberg Engineering, 3D -OCT 1000 (Topcon), Bioptigen
SD OCT (Bioptogen) and the RT-Vue (Optovue).
Swept Source OCT
I n swept source (or optical frequency domain) OCT scanning, the light source is
rapidly swept in wavelength and the spectral interference pa ern is detected on a
single or small number of receivers as a function of time. The spectral interference
pa erns obtained as a function of time then undergo a reverse Fourier transform to
generate an A -scan image. Higher scanning speeds allow for denser sampling and
be er registration. The swept source OCT also has less sensitivity roll-off with depth,
allowing be er visualization of structures deep to the retina. At present, swept source
OCT is not widely available commercially with the D RI -OCT 1 (Topcon) being the
only commercially available device.