Optical Coherence Tomography in Neuro-Ophthalmology Introduction and Overview

Optical coherence tomography (OCT) is a sensitive method of identifying and documenting subtle abnormalities within and under the retina in patients thought to have possible optic neuropathy. OCT, especially of the retinal nerve fiber layer, has been shown to be very reproducible (1,2). OCT can identify nerve fiber layer loss that may be difficult to document photographically in patients with compressive optic neuropathy and other forms of optic atrophy. OCT can be used to identify, document and measure retinal nerve fiber layer thickening from papilledema and other conditions in which there is swelling of the optic nerve and the nerve fiber layer. OCT demonstrates secondary retinal effects from optic neuropathy. The technical aspects of OCT have been well described elsewhere (3). The clinical application of OCT in neuro-ophthalmology will be reviewed here.