En Face Visualization of Layers Based on Retinal Anatomy
Normal Retinal Vasculature
Superficial Capillary Plexus
3µm Below ILM → 15 µm
Below IPL
Deep Capillary Plexus
15µm Below ILM → 70 µm
Below IPL
Outer Retina
70µm Below IPL → 30 µm
Below RPE Reference
Choriocapillaris
30 µm Below RPE Reference → 60 µm
Below RPE Reference
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Wet AMD
What cranial nerve is the Optic Nerve?
Everyone working in the field should know this
Which cranial nerve controls the superior oblique muscle?
Our electrical system – must be plugged in
• The nervous system is a complex collection of nerves and specialized cells known as neurons that transmit signals between different parts of the body. It is essentially the body’s electrical wiring.
9x12mm 3D Widefield Cube- More Than 100 Million Data Points
Use of OCT
• a. Discussion of the structural analysis provided by optical coherence tomography
• b. Understand its importance in understanding the normal versus the abnormal state
• c. Discussion of symmetry and why it is important when differentiating the normal from the abnormal state
Tomography defined
Tomography refers to imaging by sections or sectioning, through the use of any kind of penetrating wave. The method is used in radiology, archaeology, biology, atmospheric science, geophysics, oceanography, plasma physics, materials science, astrophysics, quantum information, and other sciences. Stage 3
Cup & Disc
What disease of the eye primarily focuses on the cup and disc?
Epiretinal membrane is a disease of the eye in response to changes in the vitreous humor or more rarely, diabetes. It is also called macular pucker. Sometimes, as a result of immune system response to protect the retina, cells converge in the macular area as the vitreous ages and pulls away in posterior vitreous detachment. PVD can create minor damage to the retina, stimulating exudate, inflammation, and leucocyte response.
Vitreo-Retinal or Vitreo-Macular Traction (VMT)
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Vitreomacular adhesion
Is a human medical condition where the vitreous gel of the human eye adheres to the retina in an abnormally strong manner. As the eye ages, it is common for the vitreous to separate from the retina. But if this separation is not complete, i.e. there is still an adhesion, this can create pulling forces on the retina that may result in subsequent loss or distortion of vision. The adhesion in of itself is not dangerous, but the resulting pathological vitreomacular traction can cause severe ocular damage.
Posterior Vitreous Detachment (PVD) or Separation
Posterior Vitreous Detachment
• A posterior vitreous detachment is a condition of the eye in which the vitreous membrane separates from the retina. It refers to the separation of the posterior hyaloid membrane from the retina anywhere posterior to the vitreous base.
The Macular Pseudo-Hole
The Macular Pseudo-Hole
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Full Thickness Macular Hole (FTMH) More on Macula Holes…
Neuro-Sensory Retina: Common Diseases Macular Edema
Macular edema occurs when fluid and protein deposits collect on or under the macula of the eye and causes it to thicken and swell. The swelling may distort a person's central vision, because the macula holds tightly packed cones that provide sharp, clear, central vision to enable a person to see detail, form, and color that is directly in the centre of the field of view.
Intraretinal Edema Intraretinal Edema (CME)
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CME – Retinal Map Diabetic Macular Edema with Hard Exudates
Diabetic Macular Edema (DME) with Hard Exudates
• Neurosensory Detachment • CSR - Central Serous Retinopathy
Neuro-Sensory Retina (Bruch’s / RPE): Common Diseases
Neurosensory Detachment and Central Serous Retinopathy
Neurosensory Detachment and Central Serous Retinopathy (CSR)
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Neurosensory Detachment and Central Serous Retinopathy (CSR)
Retinal Pigment Epithelium (RPE:
Common Diseases
• Hard Drusen • RPE Detachment (with fluid) • Scarring • Various Dystrophies • AMD – Age Related Macular Degeneration (Wet and Dry)*
• Every clinic can establish protocols for patients that schedule appoints for visual changes
• If there is no obvious reason for the visual change, the clinical protocol can be: perform OCT so that the results are ready for the provider, increasing clinic efficiency
Establishing Protocols For OCT Use
Establishing protocols for OCT use:
a. Unexplained visual changes
b. Visual changes associated with trauma
c. Disease management with visual changes
Vogt-Koyanagi-Harada
Vogt–Koyanagi–Harada disease, also known as Vogt–Koyanagi–Harada syndrome, uveomeningitis syndrome and uveomeningoencephalitic syndrome, is a multisystem disease of presumed autoimmune cause, that affects pigmented tissues, which have melanin. The most significant manifestation is bilateral, diffuse uveitis, which affects the eye. VKH may variably also involve the inner ear with effects on hearing, the skin, and the meninges of the central nervous system.
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COVID Related Retinal Defects • Now, a new study published in the
journal EClinicalMedicine shows that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes the coronavirus disease (COVID-19), targets the retina.
• "We found that both retinal arteries and veins were larger compared to unexposed subjects. Besides, veins diameter was larger in more severe cases and showed an inverse correlation with time to symptoms onset," the researchers wrote in the paper.
COVID-19 can affect the retina (news-medical.net)
Special Thank You to Optovue for providing the slides for the
