2. Make valued judgements whilst scanning
Utilise the fundus reference image
Understand the significance OCT image
Identify pathology & link to visual
symptoms
21. Inner segment
Ellipsoid zone
Mitochondria
ATP production – chemical energy
Myoid zone
Golgi apparatus
Protein synthesis
Ellipsoid zone
Myoid zone
22. Evaluating OCT images
1. Determine scan quality
2. Rate overall scan profile
3. Evaluate foveal profile
4. Identify foveal cut
5. Carry out structured assessment
Observe alteration of layers
Identify additional structures
Pre retinal
Epiretinal
Intraretinal
Subretinal
Sub RPE
29. Qualitative assessment
Step 2. Rate the over-all retinal scan profile
The normal over-all retinal profile has a slightly
concave curvature.
Abnormal profiles would include exaggerated
concavity and convexity or retinal folds.
37. Qualitative Assessment
Step 5. Carry out a structural assessment
a) Observe alteration of layers
b) Identify additional structures
• Pre-retinal
• Epiretinal
• Intra-retinal
• Sub-retinal
• Sub RPE
40. Qualitative assessment
Pre-retinal
A normal pre-retinal profile is displayed as
a black or white space.
Prepapilla/prefoveal lacunae (premacula
bursa) may be visible
59. Hyperreflective Zone in inner layers
Intraretinal Cysts (in 2 layers)
Increased retinal thickness
Large Hyperreflective Precipitates
Hyperreflective Punctiform Precipitates
Dense Areas anterior to RPE
Interruption of ELM & Elipsoid Zone
Identify RPE
Examine
RPE
Retinal Angiomatous Profliferation
(RAP)
Posterio
rto RPE
Examine
anterior to
RPE
Intra & subretinal fluid
60. Final thoughts…
Know your chorio retinal anatomy
Familiarise yourself with normal variation in OCT
recordings
Adopt a systematic approach to evaluating OCT images
Familiarise yourself with the aetiology of macular
disease
Don’t forget vision, signs/symptoms, history and fundus
appearance