Handbook of Retinal OCT: Optical Coherence Tomography, 1e

191 Pages·2014·43.093 MB·English

by  Jay S. Duker MD, Nadia K Waheed MD MPH, Darin Goldman MD

HANDBOOK of

RETINAL OCT
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HANDBOOK of
RETINAL OCT

Lead Editor Associate Editors
Jay S. Duker MD Nadia K. Waheed MD MPH
Director, New England Eye Center Assistant Professor of Ophthalmology
Professor and Chairman, New England Eye Center
Department of Ophthalmology Tufts Medical Center
Tufts Medical Center Tufts University School of Medicine
Tufts University School of Medicine Boston, MA, USA
Boston, MA, USA
Darin R. Goldman MD
Vitreoretinal Surgeon
Retina Group of Florida
Fort Lauderdale, FL, USA
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Copyright © 2014 by Saunders, an imprint of Elsevier Inc.
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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
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Contents
Preface..........................................................................................................................viii
List of Contributors........................................................................................................ix
Acknowledgements........................................................................................................x
Dedications.....................................................................................................................x
Glossary..........................................................................................................................xi
Part 1: Introduction to OCT..........................................................................................1
Section 1:. OCT: What It Is...............................................................................2
Chapter 1.1. Scanning Principles...................................................2
Chapter 1.2. Basic Scan Patterns and OCT Output.......................4
Section 2:. OCT Interpretation..........................................................................8
Chapter 2.1. OCT Interpretation.....................................................8
Section 3:. OCT Artifacts................................................................................10
Chapter 3.1. Artifacts on OCT......................................................10
Section 4:. Normal Retinal Anatomy and Basic
Pathologic Appearances..............................................................14
Chapter 4.1. Normal Retinal Anatomy and Basic
Pathologic Appearances..........................................14
Part 2: Optic Nerve Disorders.....................................................................................23
Section 5:. Interpretation of Optic Nerve OCTs............................................24
Chapter 5.1. Basic Optic Nerve Scan Patterns and Output.........24
Daniela Ferrara
Section 6:. Optic Nerve Disorders..................................................................28
Chapter 6.1. Glaucoma................................................................28
Daniela Ferrara and Alexandre S.C. Reis
Chapter 6.2. Optic Neuropathies and Papilledema.......................30
Daniela Ferrara and Alexandre S.C. Reis
Chapter 6.3. Congenital Optic Nerve Head Abnormalities............32
Daniela Ferrara and Alexandre S.C. Reis
Part 3: Macular Disorders...........................................................................................35
Section 7:. Dry Age-Related Macular Degeneration.....................................36
Chapter 7.1. Dry Age-Related Macular Degeneration...................36
Section 8:. Wet Age-Related Macular Degeneration....................................38
Chapter 8.1. Wet Age-Related Macular Degeneration..................38
Section 9:. Macular Pathology Associated with Myopia..............................46
Chapter 9.1. Posterior Staphyloma..............................................46
Chapter 9.2. Myopic Choroidal Neovascular Membrane..............48
Chapter 9.3. Myopic Macular Schisis...........................................50
Chapter 9.4. Dome-Shaped Macula.............................................52
Chapter 9.5. Myopic Tractional Retinal Detachment.....................53
v
Section 10:.Vitreomacular Interface Disorders...............................................54
Chapter 10.1. Vitreomacular Adhesion and
Vitreomacular Traction.............................................54
Chapter 10.2. Full-Thickness Macular Hole....................................56
Chapter 10.3. Epiretinal Membrane................................................58
s Section 11:.Miscellaneous Causes of Macular Edema..................................60
nt
e Chapter 11.1. Postoperative Cystoid Macular Edema....................60
nt Chapter 11.2. Macular Telangiectasia............................................62
o
C Chapter 11.3. Uveitis......................................................................68
Section 12:.Miscellaneous Macular Disorders...............................................70
Chapter 12.1. Central Serous Chorioretinopathy............................70
Chapter 12.2. Hydroxychloroquine Toxicity....................................72
Chapter 12.3. Pattern Dystrophy....................................................74
Chapter 12.4. Oculocutaneous Albinism........................................76
Chapter 12.5. Subretinal Perfluorocarbon......................................78
Chapter 12.6. X-Linked Juvenile Retinoschisis...............................80
Part 4: Retinal Vascular Disorders.............................................................................83
Section 13:.Diabetic Retinopathy....................................................................84
Chapter 13.1. Non-Proliferative Diabetic
Retinopathy.............................................................84
Chapter 13.2. Diabetic Macular Edema..........................................88
Chapter 13.3. Proliferative Diabetic Retinopathy.............................90
Section 14:.Retinal Vein Occlusion.................................................................92
Chapter 14.1. Branch Retinal Vein Occlusion.................................92
Chapter 14.2. Central Retinal Vein Occlusion.................................94
Section 15:.Retinal Artery Occlusion..............................................................96
Chapter 15.1. Branch Retinal Artery Occlusion..............................96
Chapter 15.2. Central Retinal Artery Occlusion..............................98
Chapter 15.3. Cilioretinal Artery Occlusion...................................100
Part 5: Inherited Retinal Degenerations..................................................................103
Section 16:.Inherited Retinal Degenerations................................................104
Chapter 16.1. Retinitis Pigmentosa..............................................104
Chapter 16.2. Stargardt Disease..................................................106
Chapter 16.3. Best Disease.........................................................108
Chapter 16.4. Cone Dystrophy.....................................................110
Part 6: Uveitis And Inflammatory Diseases.............................................................113
Section 17:.Posterior Non-Infectious Uveitis................................................114
Chapter 17.1. Multifocal Choroiditis..............................................114
Sana Nadeem
Chapter 17.2. Birdshot Chorioretinopathy....................................116
Sana Nadeem
Chapter 17.3. Serpiginous Choroiditis..........................................118
Sana Nadeem
Chapter 17.4. Vogt–Koyanagi–Harada Disease............................120
Sana Nadeem
Chapter 17.5. Sympathetic Ophthalmia........................................122
Sana Nadeem
Chapter 17.6. Posterior Scleritis...................................................124
Sana Nadeem
vi
Section 18:.Posterior Infectious Uveitis........................................................126
Chapter 18.1. Toxoplasma Chorioretinitis.....................................126
Chapter 18.2. Tuberculosis..........................................................128
Chapter 18.3. Acute Syphilitic Posterior Placoid
Chorioretinitis.........................................................130
Chapter 18.4. Candida Albicans Endogenous s
nt
Endophthalmitis.....................................................132 e
Chapter 18.5. Acute Retinal Necrosis Syndrome.........................134 nt
o
C
Part 7: Trauma............................................................................................................137
Section 19:.Physical Trauma.........................................................................138
Chapter 19.1. Commotio Retinae.................................................138
Chapter 19.2. Choroidal Rupture and Subretinal Hemorrhage.....140
Chapter 19.3. Valsalva Retinopathy..............................................142
Section 20:.Photothermal, Photomechanical, and Photochemical
Trauma........................................................................................144
Chapter 20.1. Laser Injury (Photothermal and
Photomechanical)..................................................144
Chapter 20.2. Retinal Light Toxicity (Photochemical)....................146
Part 8: Tumors............................................................................................................149
Section 21:.Choroidal Tumors.......................................................................150
Chapter 21.1. Choroidal Nevus....................................................150
Chapter 21.2. Choroidal Melanoma..............................................152
Chapter 21.3. Choroidal Hemangioma.........................................154
Section 22:.Retinal Tumors............................................................................156
Chapter 22.1. Retinal Capillary Hemangioma...............................156
Chapter 22.2. Retinoblastoma......................................................158
Section 23:.Other Tumors..............................................................................160
Chapter 23.1. Metastatic Choroidal Tumor..................................160
Chapter 23.2. Vitreoretinal Lymphoma.........................................162
Part 9: Peripheral Retinal Abnormalities.................................................................165
Section 24:.Retinal Detachment....................................................................166
Chapter 24.1. Retinal Detachment...............................................166
Section 25:.Retinoschisis...............................................................................168
Chapter 25.1. Retinoschisis..........................................................168
Section 26:.Lattice Degeneration..................................................................170
Chapter 26.1. Lattice Degeneration.............................................170
Index............................................................................................................................173
vii
Preface
Optical coherence tomography (OCT) was ‘discovered’ in an optics lab at the Massachu-
setts Institute of Technology in the late 1980s by James Fujimoto and his collaborators:
Carmen Puliafito, Joel Schuman, David Huang, Eric Swanson and Mike Hee. It 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 Science in 1991 and by 1996 the technology was transferred to a commercial
company and soon thereafter commercial devices began to be sold.
In 2013, it is safe to say that OCT is one of the most important ancillary tests in oph-
thalmology 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 con-
cluded 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.
viii
List of Contributors
Daniela Ferrara MD PhD Alexandre S.C. Reis MD
Researcher Department of Ophthalmology
New England Eye Center University of São Paulo
Tufts University School of Medicine São Paulo, SP, Brazil
Boston, MA, USA
Sana Nadeem MBBS FCPS
Senior Registrar
Ophthalmology Department
Fauji Foundation Hospital
Rawalpindi, Pakistan
ix