We use a logical method for interpreting oct images. Advanced interpretation of the cirrus oct anthony b. The stratus td oct also called oct 3 has been implemented in many. Optical coherence tomography this is what we got 5. Page 1 cirrus hd oct 5000 and 500 technical specifications. However, as with any new technology, analysis of the results of oct requires. Clinical interpretation of oct in glaucoma diagnosis. Overall, for all grades of media clarity, the macula was interpreted as normal in 30 eyes 58. With handbook of retinal oct, you can master the latest imaging methods used to evaluate retinal disease, uveitis, and optic nerve disorders. Currently, due to the development of this technology and its wide use, new oct findings have been reported in the literature.
Oct tutorial on interpreting cirrus oct macular scans lee vien. With guided progression analysis gpa, cirrus hdoct can aid in the identification of glaucoma progression through rnfl thickness event analysis and trend analysis. Signal strength important factor when analyzing oct scans. This book is to help optical coherence tomography oct users interpret images that, at the beginning, may look very complex and bewildering. Role of optical coherence tomography in the evaluation and. Redfree digital photograph of a left eye with a rnfl defect located superior. This new diagnostic tool complements, and in part replaces, fluorescein angiography. Optical coherence tomography in glaucoma a practical guide. Method the retina of nineteen healthy volunteers were scanned with four oct devices topcon dri oct triton sweptsource oct, optovue rtvuexr, a prototype spectralis oct2, heidelbergengineering and zeiss cirrus 5000hd oct. Spectraldomain cirrus highdefinition optical coherence. The integrated rnfl thickness deviation map shows deviation from normal rnfl thickness map also displays cup and disc mask optic nerve head calculations are presented in a combined report with rnfl thickness data. The first phase of analysis subdivides each image into its smallest components. This interpretation guide explains various areas of each report and the valuable information they provide for a doctors clinical assessment.
This monograph aims to give an update on the use of oct in glaucoma and pathologies of the optic nerve. History optical coherence tomography was first introduced commerically by carl zeiss in 1996. Comparison of automated analysis of cirrus hdoct spectral. The clinical findings by oct in these pathologies are well known. Event analysis assesses change from baseline compared to expected variability. Physicians should begin by assessing the retinal nerve fiber layer rnfl thickness map, which should ideally show butterfly wings with red spots to indicate adequate thickness. Retinal oct imaging ophthalmic photographers society. Beginning with an introduction to the principles and interpretation of oct angiography, the book covers operating principles, recent advances, the.
Focusing on three commonly used oct platforms in the united states, a signal strength equal to or above 6 is desirable for the cirrus hd oct carl zeiss meditechowever, an 8 or above is even better, he said. Oct today for now, oct is most useful when a patient is either a glaucoma suspect or has earlytomoderate disease, as a tool for helping to detect damage and progression or conversion from glaucoma suspect or ocular hypertensive to glaucoma. Though not a replacement, when using oct for glaucoma diagnosis and management, it can aid in the detection of angle closure and does provide several novel parameters which cannot be evaluated with gonioscopy. Advanced rpe analysis with cirrus oct tracking of drusen and disease of the rpe as well as atrophy july 2011 july 2012.
Secrets to success knowing the advantages and potential pitfalls of this technology can help you make it an effective diseasemonitoring tool. The zeiss cirrus hd oct and the zeiss cirrus photo are both straightforward to use but produce high quality and reproducible images. Optical coherence tomography spectral domain oct interpretation case series. Oct in glaucoma diagnosis, detection and screening intechopen. Zeiss have agreed to write, publish and distribute this book free of charge. Retinal nerve fiber layer imaging with spectraldomain. Perform a variety of scan types using techniques to optimise clinical workflow and scan quality. Optical coherence tomography oct is a noncontact optical technique that allows imaging and measurement of the retinal nerve fiber layer rnfl. Use of diagnostic imaging in glaucoma 2015 michael chaglasian, od 5 cirrus rnfl and onh analysis elements oct en face fundus image shows boundaries of. The current version was introduced in 2007 and has evolved over the last 10 years with hardware and software upgrades such as macular. One of the newer and very promising devices approved by the fda is the zeiss cirrus hd oct for angiography.
Cirrus zeiss tm hdoct is an advanced technology in glaucoma research which is. To evaluate a new automated analysis of optic disc images obtained by spectral domain optical coherence tomography sdoct. Cirrus oct sensitivity and speci city for average rnfl. Redfree fundus photographs of the posterior pole by stereobiomicroscopy or with digital redfree photography can aid in evaluating the rnfl. Technolog today o ptical coherence tomography oct has become an important tool for the clinical evaluation of the optic nerve and retina. Have a basic understanding of spectral domain oct technology. Optical coherence tomography information can be compared from one time instance to the next by repeatedly scanning the same region of tissue. Through acquisition software and more advanced hardware, oct angiography enables imaging of the retinal vascular flow. Optical coherence tomography for glaucoma diagnosis. Spectral domain optical coherence tomography sd oct is a common useful noninvasive imaging instrument which is used for the diagnosis and followup of macular disorders.
Understand the various analyses of the cirrus hd oct and how they can be applied for different patient types and investigations. The cirrus oct s guided progression analysis feature attempts to highlight significant variances in key structures over time in an effort to detect glaucomatous damage. Cirrus hd oct offers a glaucoma progression algorithm based on both event and trend analyses. Finally, he finds oct to be a useful teaching device. This book is a practical guide to the revolutionary technique of noninvasive, dyeless oct angiography imaging.
Utilizing oct for glaucoma diagnosis and management. Today, optical coherence tomography has become a standard tool for diagnosing and monitoring glaucoma. Interpretation of optic coherence tomography images. Based on the principle of lowcoherence interferometry, oct measures the intensity of backscattered infrared light. The second phase combines these fine details to arrive at a synthesis. The first commerically available oct was based on timedomain technology td. What oct tells us about progression oct has made strides as an objective measure of progression, but it still has limitations.
Oct scanning northern eye surgeons uses the stateoftheart spectral domain zeiss cirrus oct scanner. Interpretation of oct differentiate between inner and outer retinal disease as first step interpretation of oct. This device is the first fda approved oct angiography technology and is meant for use in diagnosis and testing for patients with ocular diseases such as cataracts or glaucoma. The stratus td oct carl zeiss meditec, usa can scan resolutions up to 10 microns. Although oct dates to the early 1990s, the introduction of the stratus oct carl zeiss meditec in 2001the original timedomain technologymarks when oct became widely accessible. Next, the rnfl deviation map is examined for signs of thinning emanating from the superior and inferior poles of the optic nerve. New landmarks, signs, and findings in optical coherence. Litwak, od, faao va medical center baltimore, maryland glaucoma 101 glaucoma is a disease of the ganglion cell axons damage occurs at the level of the lamina cribrosa selective damage to the superior and inferior poles of the optic nerve. This book focuses on the practical aspects of optical coherence tomography oct used for glaucoma. Cirrus hd oct analysis reports offer clinically relevant qualitative and quantitative information in an easytoread format. For the spectralis oct heidelberg engineering, the quality score should be greater than or equal to 20. The analysis report varies with different oct systems. Studies indicate that rnfl thickness parameters measured on cirrus oct are reproducible and have. Not only does it supply you with barsetting imagery, it delivers detailed diagnostic and change analyses you can rely on time and again.
The devicesoftware generated enface oct a images of the superficial scp and deep. Signal strength and must be greater than 610 with the cirrus hdoct. Interpretation of oct differentiate between inner and outer retinal disease as first step interpretation of oct differentiate between inner and outer retinal disease as first step inner retina most common vascular disease htn and dm interpretation of oct differentiate between inner and outer retinal disease as first step outer retina. Cirrus hd oct, spectralis, 3d oct, rtvue100, spectral oct slo and soct copernicus hr. If change is outside the range of expected variability, it is identified as progression. For example, he can show a patient a scan of an eye with a macular hole and a normal eye, and. Ophthalmic professional whats new in oct technology. As optical coherence tomography oct technology continues to advance, it has an everincreasing impact on the treatment of eye disease and the way anatomy and pathology are viewed keeping pace with this evolving technology can be challenging. Oct is also helpful in distinguishing macular holes from lesions such as epiretinal membrane with a pseudo hole, and it can readily identify stage one macular holes, dr. However, there is no labelled figure showing the layers of the normal retina and choroid. The book presents the diagnosis and management of glaucoma, age related macular degeneration, the integration of oct and fluorescein angiography and the diagnosis and management of ocular tumors. First, the authors purport to take a systematic approach to sd oct scan interpretation.
They have also requested greater integration of hfa and cirrus analysis data in a single report. Before using the cirrus hdoct, you must fully understand potential safety hazards. Oct tutorial on interpreting cirrus oct macular scans. Carl zeiss cirrus hd oct 4000 analyses glaucoma and retina with modern integrated design, ease of use, and small footprint with the smaller budget designed cirrus hd oct 4000 focused on the essential core oct functionality. Second, none of the figures have identifiers arrows, and the like to identify the features being described.
To help, heres a look at the latest advances from key players in the oct category. The fundus image acquired with the model 500 will be captured at. Introduction to oct optical coherence tomography scans. Oct interpretation jamin brown, md retina vitreous associates of cny december 6th 2014. All systems inner reference boundary is at the internal limiting membrane, but each varies in the outer reference boundary. John lind offers pearls for evaluating cirrus oct scans. Zeiss cirrus hdoct 5000 technical specifications pdf. Retinal nerve fiber layer rnfl evaluation is an essential component of a comprehensive glaucoma evaluation. The current version was introduced in 2007 and has evolved over the last 10 years with hardware and software upgrades such as macular ganglion cell analysis and guided progression analysis.
A complete list of ocular diseases with optical coherence tomography oct. The most important point here is the ability to perform rnfl analysis with a. Peripapillary rnfl analysis is the most commonly used scanning protocol for glaucoma. Optical coherence tomography angiography operates under the basic assumption, which is an over simplification, that the. Immediate postsurgical imaging can sometimes be challenging due to ocular turbidity that can result in significantly reduced oct signal strength. Oct angiography is a new, noninvasive diagnostic method through which the vascular structures of the retina and choroid may be visualized in three dimensions without the need for contrast agent injection. A complete list of ocular diseases with optical coherence. The aim of this study is to determine which parameter of cirrus and rtvue optical coherence tomography oct has the highest. Optical coherence tomography this is what we wanted 4.
Carl zeiss cirrus hd oct have two models, model 400 and model 4000 which capable of anterior segment imaging and offer the same package of glaucoma and retina analyses. Oct can provide visualization of surgical outcomes, confirming reattachment and normal contour. The current level of medical innovation in the device and drug space is unparalleled and extremely exciting. Clinical use of oct in assessing glaucoma progression. Guide on how to interpret cirrus oct macular scans.
The first chapter covers the basic principles and interpretation of oct and is intended to help the reader interpret oct images. Ideal at any stage of your career, this easytouse, clinically oriented handbook provides a quick, templated, and portable guide for the interpretation of optical coherence tomography scans. Dr johnson delivers presentations to optometrists and ophthalmologists about the use and interpretation of oct scans. Pdf optical coherence tomography in glaucoma researchgate. For years, doctors have asked for the operational capability to analyze data from their humphrey field analyzer hfa using a mac or pc. Cirrus rnfl and onh analysis elements oct en face fundus image shows boundaries of the cup and disc and the rnfl calculation circle. Of these two devices, only the cirrus hd oct provides statistical analyses for progression detection. Interpretation of oct images high resolution spectral oct nerve fiber layer. There are normals for ocular structures deviation from the norm abnormality pathology being able to discern differences in reflectivity, morphology and qualitative measures either from normals or from previous scans is the essence of oct interpretation.
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