OCT Diagnosis of Ocular Torsion

Measurement of ocular torsion in patients with strabismus assists in the differential diagnosis and management. Conventionally, the double Maddox rod test (DMRT) and dilated fundus photography are used to measure ocular torsion (1,2). DMRT depends upon reliable patient response, while dilated fundus photography requires additional time for dilation and analysis. Heidelberg optical coherence tomography (OCT) infrared images provide an assessment of torsion as a disc foveal angle (DFA) and can be easily obtained without dilation. However, this has not been clinically validated. A previous case report describes a method for estimating torsion using OCT images but provides no comparisons to measurements found on DMRT or fundus photography (3). The aim of this study is to describe the correlation between DMRT, fundus photography, and OCT methods of measuring torsion.