OCT for macular changes and glaucoma assessment
Optical Coherence Tomography for the investigation of eye problems:
The OCT scan below is showing a normal scan of the central part if the vision, the macula. Some patients have changes in the structure of this area which can affect the central vision. The bright white line at the bottom of the image is the retinal pigment epithelium (RPE) this is elevated in macular degeneration, in dry and in wet macular changes. The treatment for dry and wet is very different, it is critical to differentiate between the two conditions. Dry macular changes are slow and can benefit from macusave or similar tables. Wet macular changes have to be treated asap at the eye clinic. OCT is the perfect instrument to quickly, painlessly and accurately differentiate dry from wet macular changes.
Epiretinal Membrane (ERM)
OCT scan below is showing an epiretinal membrane (ERM), that is the thin bright line at the top of the scan. these are more common in nearsighted eyes and can pull on the macula leading to distortion of the central vision. ERMs tend to be slow in developing and some do not require treatment.
Dry Macular Changes
The OCT scans below show a normal macula on the left hand side and dry macular changes on the right hand side.
The RPE is elevated, but there is no fluid above the RPE. this condition generally has slow progression and benefits from ocular supplements such as macusave.
An Amsler chart is often used for home monitoring of macular change. this should be used every week, one eye at a time whilst wearing reading glasses. if distortion is noticed please call us asap as dry macular change can escalate to wet macular changes.
OCT Showing A Macular Hole
OCT scan below is showing a macular hole, this is caused by traction from the vitreous gel pulling the macula out of shape. This condition can be treated, if there is significant vision loss, very successfully if diagnosed in time.
OCT Scan Showing Wet Exudative Macular Change
the OCT scan below is showing wet exudative macular change, the RPE is elevated and there is fluid just above it, either under the photoreceptors, in this case or also fluild higher up in the retina.
Wet Exudative Macular Change Fluid Reduction
The OCT scan below is showing wet exudative macular change on the first image, there is a black space just above the RPE, this is fluid and has been treated at the eye clinic. the second image shows a significant reduction in fluid and will result in the preservation of vision. Macular degeneration has a genetic component, and is also linked with older age, obesity and poor blood flow – e.g. high cholesterol and circulation disorders.
Topcon Maestro2 OCT-Angiography
ACT-A (Angiography) is most useful in detecting the eaerliest neovascular membrane and associated neovascular changes leading to fluid build up at the macular area.
The image below shows a normal macula using OCT-A (Angiography):
ACT-A (Angiography) is most useful in detecting early neovascular membrane and associated neovascular changes leading to fluid build up at the macular area.
The image below shows a very early neovascular membrane leading to wet macular changes in the future, the standard OCT sections bottom right appear virtually normal / dry no obvisous fluid:
ACT-A (Angiography) is most useful in detecting an early neovascular membrane and associated neovascular changes leading to fluid build up at the macular area.
The image below shows a significant neovascular membrane and looping neovascular changes in the choriocapilaris, confirming active wet macular changes, the standard OCT sections bottom right still show no obvious fluid:
Below is a video showing further OCT-A details
Glaucoma is often a slowly progressive condition and it can be difficult to decide when to refer some one to the eye clinic. OCT is very helpful in deciding who would benefit from a consultant opinion at the eye clinic. An objective OCT reading is often more reliable than a subjective field of vision test.
The display below shows a red / yellow / green ‘mountain scape’ and ‘pizza wedges’, giving a good indication of the normality or not of an eye nerve. The pie chart just below shows different colors, again indicating possible abnormality of an eye nerve. This is available in both our practices.
The green blue rectangles on the right show the macular thickness, especially the thickness of the ganglion layer. Significant thinning of the macular ganglion layer is indicative of eye nerve damage, possibly glaucoma. We have different OCT scanners, the Maestro2 OCT in Frinton is more recent and is capable of measuring the macular ganglion thickness.
The image below is our Zeiss OCT in Earls Colne. The camera does not flash and we can often take good quality images from the centre of your eye without using eye drops, so you can drive back home after the examination. There is a flat screen display by our OCT so you can see the results straight away.
Topcon Maestro2 OCT
The image below is our Topcon OCT in Frinton on Sea. The camera does not flash and we can often take good quality images from the centre of your eye, usually without using eye drops, so you can drive back home after the examination. The Maestro2 takes thickness measurements of the ganglion cell layer, this is an excelent further scan to assess the health of the eye nerve. There is a flat screen display in the consulting room, so you can see the results straight away.
Topcon Maestro2 OCT-A for glaucoma
The image below shows two sections, an OCT-A (Angiography) scan of a normal eye nerve with no blood flow reduction, Fig 3.
And Fig 4, showing a color change due to blood flow reduction leading to nerve damage and thus glaucoma.
further OCT-A (Angiography) glaucoma information is on this great EyeWiki page.
Where To Get Your OCT Scan
Our OCT scanners are in the Earls Colne and the Frinton on Sea practice and are on the ground floor.
What Is OCT?
With OCT, your optometrist can see each of the retina’s distinctive layers. This allows us to map and measure their thickness. These measurements help with diagnosis. They also provide treatment guidance for glaucoma and diseases of the retina. These retinal diseases include age-related macular degeneration (AMD) and diabetic eye changes.
Our Topcon Maestro2 OCT in the Frinton on Sea Practice
Our Zeiss Cirrus OCT in the Earls Colne Practice
When To See Simon Kleyn Optician - Optometrist
Make an appointment for an eye test / examination if you notice any changes in your vision. If you develop sudden vision changes, such as double vision or flashes of light, sudden eye pain, or sudden headache, call us straight away.
Speak To Simon Kleyn Today
Speak to Simon Kleyn Optician – Optometrist to find out how we can help you find the best solution to your eye problems.