| Identifier |
oct_in_neuroophthalmology |
| Title |
Optical Coherence Tomography (OCT) in Neuro-Ophthalmology |
| Creator |
Andrew G. Lee, MD; Jason Zehden |
| Affiliation |
(AGL) Chairman, Department of Ophthalmology, The Methodist Hospital, Houston, Texas; Professor of Ophthalmology, Weill Cornell Medicine, New York City, New York; (JZ) Class of 2021, Baylor College of Medicine, Houston, Texas |
| Subject |
Optical Coherence Tomography (OCT); Papilledema; Fiber; Thickening |
| Description |
Summary: • Optical Coherence Tomography (OCT) in Neuro-ophthalmology o Measures peripapillary retinal nerve fiber layer thickness o Scale is color coded and the black line represents the patient's peripapillary retinal nerve fiber layer thickness -Green zone is good • 5th to 95th percentile by age matched controls • Black line in green zone represents normal peripapillary retinal nerve fiber layer thickness -Yellow zone is borderline •1st to 5th percentile by age matched controls • Black line in this zone represents borderline peripapillary retinal nerve fiber layer thickness -Red zone is bad • Below 1st percentile by age matched controls • Black line in red zone represents optic atrophy o If the black line is above the green zone, this is considered the white zone -If the black line is way above the green zone, it represents true disc swelling from thickening of the peripapillary retinal nerve fiber layer in papilledema -If the black line is borderline above the top of the green zone, it may or may not represent true papilledema |
| Transcript |
So, today we're going to talk about how we use the OCT in neuro-ophthalmology. And as by convention OD is on the right side and OS on the left side. And there's this wonderful little color coding here: green is good, yellow is borderline, and red is bad. What we're measuring here is peripapillary retinal nerve fiber layer thickness. So, if we're inside the green zone (and this black line represents the patient), if we're inside of the green zone then we're between the fifth and the 95th percentile for age matched controls. If we're in the yellow zone, we're borderline. And if we're in the red zone, we're the 99th percent outlier. And so just with a quick glance we can see the machine says we're in the green zone, within normal limits. However, you notice that the black line is a little bit above the green and the machine cannot register when it's above the green. So, when it's above the green, that would be white if they had a color scheme for white, but they don't. Some machines actually do do this but ours doesn't. So, when we see that line above the green zone that's one of the things we're looking for when we're looking for papilledema. So, we're looking for thickening of the nerve fiber layer. So, if the black line was way off the scale [above the green], that would be very convincing for true disc swelling from thickening of the nerve fiber layer. When it's just borderline like this, it could, or it could not be true edema. Normally the global in the center here is 100 microns plus or minus 10, which is one standard deviation. So in this particular patient we're looking at signal strength, we're looking at the centration of the circle, we're seeing if the segmentation line has been drawn in the right place, we're looking to see if we're in the green zone, the yellow zone, or the red zone. If we're in the red zone it's optic atrophy, if we're in the yellow it's borderline, and if it's in the green zone we're normally good. But you have to make sure the line is not above the green zone which would normally be the white zone and that would be thickening. So, in this particular case I think these are pretty much within normal limits. So that's how we interpret and look at the OCT very quickly for the retinal nerve fiber layer in the peripapillary zone for patients who have optic atrophy or who have disc swelling. |
| Date |
2019-10 |
| Language |
eng |
| Format |
video/mp4 |
| Type |
Image/MovingImage |
| Collection |
Neuro-Ophthalmology Virtual Education Library: Andrew G. Lee Collection: https://novel.utah.edu/Lee/ |
| Publisher |
North American Neuro-Ophthalmology Society |
| Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah |
| Rights Management |
Copyright 2019. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6gv0crw |
| Setname |
ehsl_novel_lee |
| ID |
1469311 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6gv0crw |
