oct interpretation ghanbari md this is what we wanted
TRANSCRIPT
![Page 1: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/1.jpg)
![Page 2: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/2.jpg)
Octinterpretation
Ghanbari MD
![Page 3: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/3.jpg)
This is what we wanted
![Page 4: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/4.jpg)
![Page 5: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/5.jpg)
![Page 6: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/6.jpg)
![Page 7: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/7.jpg)
![Page 8: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/8.jpg)
Qualitative analysis of the OCT scan includes observation of the reflective qualities of the retinal structures .
![Page 9: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/9.jpg)
![Page 10: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/10.jpg)
NORMAL MACULA
The OCT image closely approximates the histological appearance of the macula and for this reason it bas been referred to as an in vivo optical biopsy.
![Page 11: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/11.jpg)
Differences in signal intensity are represented by a false color coding system which is represented by the colors of the visible color spectrum.
![Page 12: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/12.jpg)
Highly reflective structures are represented by red.
Medium reflections appear yellow or green structures with low reflectivity are blue Black signal designates the absence of a
reflective signal.
![Page 13: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/13.jpg)
![Page 14: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/14.jpg)
When evaluating an individual radial line scan, the clinician reads the left side of the scan as the beginning of the scan and the right side of the scan as the end.
![Page 15: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/15.jpg)
The top of the scan image corresponds to the vitreous cavity. ln a normal patient (Fig. 87-1), this will be optically silent (black), without any significant reflections being noted except for perhaps identification of the posterior hyaloid face (in a patient with complete posterior vitreous detachment) or normal insertion of the posterior hyaloid near the macula in young patients.
![Page 16: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/16.jpg)
The posterior vitreous face appears as a thin horizontal or oblique line above or inserting in the retina .
![Page 17: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/17.jpg)
The Anterior surface of the retina demonstrates high reflectivity (red) and its horizontal expanse demonstrates the normal contour of the macula with the central foveal depression
![Page 18: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/18.jpg)
The internal structure of the retina consists of heterogeneous reflections, corresponding to varying ultrastructural anatomy.
![Page 19: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/19.jpg)
![Page 20: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/20.jpg)
The horizontally aligned NFL demonstrates a high tissue signal (red) that facilitates its identification.
![Page 21: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/21.jpg)
High-flow intraretinal structures such as retinal blood vessels seen in this layer can result in a focal hyper reflective spot with optical shadowing of the retinal microstructures posterior to the vessele.
![Page 22: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/22.jpg)
The (RPE), Bruch's membrane, and choriocapillaris complex collectively comprises the highly reflective external band
![Page 23: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/23.jpg)
This thick band in the outer retina/anterior choroid appears as a red, linear stripe in OCT images
![Page 24: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/24.jpg)
Just anterior to this band is another highly reflective line representing the junction between the photoreceptors' inner and outer segments
![Page 25: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/25.jpg)
The outer retinal structures are better discriminated via ultra-high-resolution OCT, which is not yet commercially available.
![Page 26: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/26.jpg)
The axially aligned cellular layers of the retina (inner nuclear, outer nuclear, and ganglion cell layers) demonstrate less back-scattering and back-reflection of incident OCT light
![Page 27: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/27.jpg)
This manifests as relatively low tissue signaIs (blue, green, yellow) compared to the horizontally aligned structures( internal limiting membrane, Henle's layer, and NFL).
![Page 28: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/28.jpg)
Reflectivity helps to identify anomalous structures. The sub-retinal fibrosis pictured below is identified by it's location, shape, and highly reflective structure.
![Page 29: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/29.jpg)
Low reflective anomalous structures are areas of edema (fluid). These may be in the form of intraretinal cavities, cysts, diffuse intraretinal edema, or exudative detachments (image below).
![Page 30: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/30.jpg)
Black areas in the OCT scan may also be caused by shadowing. Shadowing occurs when a dense structure prevents light from penetrating below the structure, just like you or I cast a shadow on the ground in bright sunlight.
![Page 31: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/31.jpg)
RETINAL THICKNESS ASSESSMENT
The OCT unit determines the anterior and posterior surface of the retina in order to calculate retinal thickness
![Page 32: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/32.jpg)
![Page 33: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/33.jpg)
![Page 34: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/34.jpg)
![Page 35: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/35.jpg)
![Page 36: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/36.jpg)
![Page 37: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/37.jpg)
![Page 38: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/38.jpg)
![Page 39: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/39.jpg)
![Page 40: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/40.jpg)
flat spreading PED (arrowhead) with irregularities of the retinal pigment epithelium (RPE) band, CME, subretinal fluid
![Page 41: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/41.jpg)
The PED is prominent, bulging, regular, and smooth. (Bottom left) Fluorescein angiogram (FA) showing smooth and regular PED with accentuated hyperfluorescence (dotted arrow) associated with an ill-delimited hyperfluorescent area of occult choroidal neovascularization
![Page 42: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/42.jpg)
(PED) with chorioretinal anastomosis
![Page 43: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/43.jpg)
![Page 44: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/44.jpg)
![Page 45: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/45.jpg)
![Page 46: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/46.jpg)
![Page 47: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/47.jpg)
![Page 48: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/48.jpg)
![Page 49: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/49.jpg)
![Page 50: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/50.jpg)
![Page 51: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/51.jpg)
![Page 52: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/52.jpg)
![Page 53: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/53.jpg)
![Page 54: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/54.jpg)
![Page 55: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/55.jpg)
![Page 56: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/56.jpg)
![Page 57: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/57.jpg)
![Page 58: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/58.jpg)
![Page 59: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/59.jpg)
Two types of epiretinal macular membrane seen on OCT—one adherent to the retinal surface and one separated with a focal point of adhesion and traction
![Page 60: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/60.jpg)
Vitreomacular traction syndrome on OCT. The vitreous, strongly adherent to the macular surface only, is highly reflective (white color).
![Page 61: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/61.jpg)
![Page 62: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/62.jpg)
Rop foveal hypoplasia
![Page 63: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/63.jpg)
![Page 64: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/64.jpg)
Optical coherence tomography: coloboma and glaucoma Shown is a comparison of optical coherence tomography image of disc with (a) coloboma and one with (b) glaucoma. Arrow shows the glial tissue in colobomatous disc. Reprinted with permission from Ophthalmology (A clinical and optical coherence tomography study of the margins of choroidal colobomas, 2007;114: page 579, Fig. 8).
![Page 65: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/65.jpg)
![Page 66: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/66.jpg)
![Page 67: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/67.jpg)
![Page 68: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/68.jpg)
![Page 69: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/69.jpg)
![Page 70: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/70.jpg)
![Page 71: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/71.jpg)
![Page 72: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/72.jpg)
![Page 73: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/73.jpg)
![Page 74: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/74.jpg)
limitations of OCT
Corneal opacity Cataract Vitreous hemorrhage Uncooperative patients
![Page 75: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/75.jpg)
Artifacts
Artifacts in the OCT scan are anomalies in the scan that are not accurate images of actual physical structures, but are rather the result of an external agent or action.
![Page 76: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/76.jpg)
large gap in the middle of the scan below. This is an artifact caused by a blink during scan acquisition. The was a high resolution scan, which takes about a second for the scan pass, which is plenty of time to record a blink.
![Page 77: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/77.jpg)
The scan below has waves in the retinal contour. These are not retinal folds, but rather movement of the eye during the scan pass.
![Page 78: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/78.jpg)
This scan has reduced brightness and detail on the right side. This is not intra-retinal edema. This is caused by a blockage of the light as it passes into the eye. The OCT was not centered well in the pupil, with some of the light striking the edge of the pupil.
![Page 79: Oct interpretation Ghanbari MD This is what we wanted](https://reader038.vdocument.in/reader038/viewer/2022103122/56649cda5503460f949a416a/html5/thumbnails/79.jpg)