2. ď§ Make valued judgements whilst scanning
ď§ Utilise the fundus reference image
ď§ Understand the significance OCT image
ď§ Identify pathology & link to visual
symptoms
21. Inner segment
ď§ Ellipsoid zone
ď§ Mitochondria
ď§ ATP production â chemical energy
ď§ Myoid zone
ď§ Golgi apparatus
ď§ Protein synthesis
Ellipsoid zone
Myoid zone
22. Evaluating OCT images
1. Determine scan quality
2. Rate overall scan profile
3. Evaluate foveal profile
4. Identify foveal cut
5. Carry out structured assessment
ď§ Observe alteration of layers
ď§ Identify additional structures
ď§ Pre retinal
ď§ Epiretinal
ď§ Intraretinal
ď§ Subretinal
ď§ Sub RPE
25. Qualitative assessment
Step 1
ď§ Scan quality
ď§ Identify inner and outer retinal band
ď§ Good signal to noise ratio
ď§ Truncated
ď§ Shadowing
29. Qualitative assessment
Step 2. Rate the over-all retinal scan profile
ď§ The normal over-all retinal profile has a slightly
concave curvature.
ď§ Abnormal profiles would include exaggerated
concavity and convexity or retinal folds.
37. Qualitative Assessment
Step 5. Carry out a structural assessment
a) Observe alteration of layers
b) Identify additional structures
⢠Pre-retinal
⢠Epiretinal
⢠Intra-retinal
⢠Sub-retinal
⢠Sub RPE
40. Qualitative assessment
ď§ Pre-retinal
ď§ A normal pre-retinal profile is displayed as
a black or white space.
ď§ Prepapilla/prefoveal lacunae (premacula
bursa) may be visible
59. Hyperreflective Zone in inner layers
Intraretinal Cysts (in 2 layers)
Increased retinal thickness
Large Hyperreflective Precipitates
Hyperreflective Punctiform Precipitates
Dense Areas anterior to RPE
Interruption of ELM & Elipsoid Zone
Identify RPE
Examine
RPE
Retinal Angiomatous Profliferation
(RAP)
Posterio
rto RPE
Examine
anterior to
RPE
Intra & subretinal fluid
60. Final thoughtsâŚ
ď§ Know your chorio retinal anatomy
ď§ Familiarise yourself with normal variation in OCT
recordings
ď§ Adopt a systematic approach to evaluating OCT images
ď§ Familiarise yourself with the aetiology of macular
disease
ď§ Donât forget vision, signs/symptoms, history and fundus
appearance