Chonnam Med J.  2016 Sep;52(3):194-200. 10.4068/cmj.2016.52.3.194.

Clinical Usefulness of Spectral-Domain Optical Coherence Tomography in Glaucoma and NAION

• Lee TH
• Heo H
• Park SW

• KMID: 2432269
• DOI: http://doi.org/10.4068/cmj.2016.52.3.194

Abstract

The development of optical coherence tomography (OCT) has changed the clinical management of ophthalmic diseases by furthering the understanding of pathogenesis, as well as improving the monitoring of their progression and assisting in quantifying the response to treatment modalities in ophthalmic diseases. Initially, the two-dimensional configuration of the optic nerve head (ONH) and the thickness of the retinal nerve fiber layer (RNFL) were the main OCT structural parameters used in clinical management of optic nerve diseases. Now, with higher resolution power and faster acquisition times, the details of ONH and the retina including the macular area can be measured using spectral domain OCT (SD-OCT) with high reproducibility and increased diagnostic ability. OCT can provide structural information to improve the understanding and management of optic nerve diseases. In this review, we will briefly summarize the clinical applications of SD-OCT in glaucoma and nonarteritic anterior ischemic optic neuropathy, which are two representative optic nerve diseases.

Keyword

Tomography, Optical Coherence; Optic Nerve Diseases; Glaucoma; Optic Neuropathy, Ischemic

MeSH Terms

Glaucoma*
Nerve Fibers
Optic Disk
Optic Nerve Diseases
Optic Neuropathy, Ischemic
Retina
Retinaldehyde
Tomography, Optical Coherence*
Retinaldehyde

Figure

• 

  FIG. 1 Conventional testing images in a normal subject. (A, B) Optic disc photographs in both eyes. (C) 3D visualization mode of optic nerve head (ONH) using SD-OCT. (D) Retinal nerve fiber layer (RNFL) and ONH analyses using SD-OCT. (E) Ganglion cell analysis using SD-OCT.

• 

  FIG. 2 Optic disc photograph and analysis of different scanning regions obtained with SD-OCT in a glaucomatous patient. (A, B) The optic disc photographs show diffuse loss of the neuroretinal rim and enlarged cups in both eyes. (C) Print out of retinal nerve fiber layer (RNFL) and optic nerve head analyses. There is diffuse loss of RNFL in both eyes, as indicated by the parameter average RNFL thickness. There is also neuroretinal rim thinning and enlarged cup, as indicated by the topographic parameters rim area, vertical C/D ratio and average C/D ratio. (D) Ganglion cell analysis provided by the SD-OCT indicating diffuse loss of the thickness of the combined ganglion cell and inner plexiform layers in both eyes.

• 

  FIG. 3 Optic disc photograph and SD-OCT of NAION in the acute stage. (A) The optic disc photograph shows optic disc swelling and hemorrhage in right eye. (B) SD-OCT shows a large optic disc area, increased vertical disc diameter and diffuse thickening of the peripapillary RNFL. (C, D) The OCT shows thinning of GCIPL thickness prior to thinning of RNFL thickness of right eye at 1 month after NAION.

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