Transverse Axial / en Face OCT in the Assessment of Optic Disc Edema and Pseudopapilledma

OCT is capable of the highest resolution images of the retina and optic nerve clinically available of the eye, yet when clinicians examine its output, they frequently rely upon a few quantitative measures to determine whether the nerve fiber layer or ganglion cell complex is thinning or thickening. Reviewing the automated segmentation, signal strength and centering of the study and how they may compare to prior studies is critical, as is looking at where the retinal vessels enter the disc when trying to understand local nerve fiber layer thickness as the nerve fiber layer follows the retinal vessels embryologically. The examination of the visual field side by side with the OCT of the nerve fiber layer and ganglion cell complex lends authority to conclusions when they reinforce one another. The recognition of papilledema from its OCT appearance and its separation from other causes of disc swelling e.g. drusen, NAION, optic nerve menigioma and hypotony will be addressed and the importance of the peripapillary RPE Burch's membrane conformation on axial OCTs and the recognition of folds on in face images. Upon completion of this session, participants should be able to: 1) read an OCT like a radiologist reads an MRI 2) distinguish amongst swollen discs when interpreting an OCT and 3) recognize retinal patterns in an OCT.