Thanks to Dr Abdul Sami Memon for sharing such knowledgeable presentation.

1. Optical CoherenceTomography (OCT)
InVitreo Retina and Choroid
where we are and where we are going in 2017.
Dr. Abdul Sami Memon
MD. FCPS. MCPS.
Fellow of University of California Irvine , USA (Vitreo Retina)
Assistant Professor Isra Postgraduate Institute of Ophthalmology, Karachi.
Consultant Eye Surgeon , Hashmanies Hospital , Karachi.
Clinical and Academic Coordinator Isra Postgraduate Institute of Ophthalmology,
Karachi.

2.  No financial disclosure/Interest

3.  Jay S. Duker , M.D.
 Baruch D . Kuppermann M.D.
 Prof P.S. Mahar
 Dr. Rehman Siddique
 Dr. Nasir Memon
 Bruno Lumbroso, MD, Marco Rispoli, M.D
 Adil El Maftouhi, Lyon, France
 NICOLAS IAFE M.D
 NOPASAK PHASUKKIJWATANA M.D
 Richard Rosen, MD
 Mrs. Fender and Mrs. Dutch UCI, UCLA
 Optuvue

4. Retinal imaging – Where we stand in 2017
 Color Fundus Photography – great for documentation.
 Fluorescein Angiography – utility in common macular diseases
questionable – has evolved to be largely a test of the retinal
periphery
 ICG Angiography – limited availability and utility

5.  OCT –The most important ancillary test in the diagnosis and
management of retinal diseases
OCTA -The most important ancillary test in the
diagnosis and management of retinal diseases also.

6.  Time domain (TD) detection (400 A-scans/sec)
 Fourier domain (FD) detection
 Spectral domain (SD))
▪ 68000 to 85000 A-scans/sec
 Swept source (SS) (or optical frequency domain)
▪ 100,000 A-scans/sec

7. SS OCT
 The swept-source is unique light source,
has a wavelength centered at 1 µm that
sweeps across a narrow band of light
source
 The SS-OCT utilizes a point
Photodetector, to detect the light waves
returning to the device
 Longer wavelength : 1050Nm
 Improved immunity in media opacity
 Improved visualization of choroid, Sclera
 Uniform image quality
SDOCT
 The spectral-domain devices utilize a
broadband light source
 The SD-OCT uses a spectrometer,
Fourier transform lens, and a line
scan camera.
 Enhanced depth imaging : using
image averaging

8. SD

11.  Macular cube scan
Raster Scans:
Radial Scans:
Mesh scan ( vertical and horizontal scan over the area of interest )
 Line scan
Line, Cross-Line and Raster Scans, multiline,
 Macular Maps (cube scan data or radial scans).
Numeric displays
Color-coded displays
 Topographical maps

12.  C-Scans (En Face Images),This image looks like a red-free
image of the retina and is obtained by summation of data
from all the B-scans.
MICHAEL HEIFERMAN, MD • JOSEPH SIMONETT, BS • AMANI FAWZI, MD
June 1, 2015

15.  Qualitative Interpretation
 Quantitative Interpretation

21. Hyper Reflective Rim
PFCL

22. Vitritis

24. Subretinal fluid

25. Retina. Author manuscript; available in PMC 2012 Jul 10.

26. Retina. Author manuscript; available in PMC 2012 Jul 10.

28. ERM
VMT
FTMH
LMH

31. Courtesy of Mrs. Fender
RPE tear

32. Courtesy of Mrs. Fender

33.  Mirror artifact
 Vignetting
 Misalignment
 Software breakdown
 Out of range error
 Motion and Blink artifact

34.  Mirror artifact

35.  Vignetting :This occurs
when a part of the OCT
beam is blocked
 Misalignment :This occurs
when the fovea is not
properly aligned during a
volumetric scan.
Fovea

36.  Software breakdown :
Software breakdown results
from misidentification of the
inner or outer retinal
boundaries.

37.  Blink artifact :
 Motion artifact :
 Out of range :
Blink
Double
fovea
Out of range

38.  OCT –The most important ancillary test in the diagnosis and
management of retinal diseases

39. Summary
 Non- invasive , fast and repeatable
 Software enhancement in the future will increase the sensivity and
specificity of OCT
 SS- OCT will allow for increased field of view and wide field imaging

40. Thanks