1. Spectral Domain OCT in
Diagnosis and Management of
Glaucoma
NSD Raju
Ranjini Eye Hospital (NABH
Accredited)

2. Introduction
• Advent of OCT
• Ophthalmic armamentarium
• SAP gold standard
• Significant neuronal loss
Quigley et al 2006
• Early Diagnosis
• Detection of progression

3. Spectral Domain OCT
• Enhanced resolution 3 fold
• Scan speed 100 fold
• Denser sampling and 3 – dimensional imaging
• Improved reproducibility, specificity and
sensitivity for glaucoma detection

4. Optical Coherence Tomography
OCT
• Imaging technologies OCT
• RFNL thickness
• Quantitatve and qualitative
• Healthy and unhealthy tissue
• Progression of the disease

5. OCT in Glaucoma
• Pre perimetric Glaucoma
• Initiate earlier treatment
• Prevent neuronal loss
• Monitor progression of the disease

6. Spectral Domain OCT
• Faster imaging speeds
• 50 times as fast
• Increases the resolution of the image
• Subtle changes
• Qualitative and quantitative assessment

7. OCT angle Evaluation
• Non invasive
• Versus gonioscopy
• Closed angle
• Open Angle
• Gonioscopy contra indicated

8. ONH Evaluation
• Structural Vs Functional
• Optic Nerve head topography
• High resolution sharp images
• Bruchs membrane rim
• Neuroretinal rim
• Normative data
• Structural damage, progression

9. A case of Angle closure Glaucoma
• Female 45 yrs Acute Angle closure Glaucoma
not responding to medical regimen
• Cornea haze edema gonioscopy not possible
• OCT revealed closed angle
• Subsequent YAG iridectomy relieved A.closure

10. A case of Suspected Glaucoma
• Female aged 50 Large disc with 0.7 cup OU
• SAP within normal limits
• Applanation tension 15 mm Hg OU
• ONH topography
• RNFL analysis

11. OCT ONH Topography

12. OCT RNFL

13. A Case of Glaucoma Suspect
• Male 51 years a case of glaucoma suspecg
• Suspicious cup of Of BE
• OCT ONH and RNFL

14. OCT Clinical Correlation
• Disc changes
• Visual field Changes

15. Summary
• A new era
• Structural changes
• Functional defects
• Early Diagnosis
• Early detection of Progression