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OCT & Glaucoma: vantaggi e limiti No financial interest.

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Presentation on theme: "OCT & Glaucoma: vantaggi e limiti No financial interest."— Presentation transcript:

1 OCT & Glaucoma: vantaggi e limiti No financial interest

2 RNFL RNFL ONH ONH GCC GCC AS-OCT AS-OCT Combo Report Combo Report AS-OCT AS-OCT Combo Report HD-OCT & Glaucoma: Why? RNFL GCC ONH

3 3 Adapted from Medeiros FA, Lisboa R, Weinreb RN, et al. A combined index of structure and function for staging glaucomatous damage. Arch Ophthalmol. 2012; 130 (5) 5000/9000 Retinal Ganglion Cells/Year RGC & Mean Deviation

4 4 Felipe A. Medeiros, Linda M. Zangwill, Christopher Bowd, Kaweh Mansouri, and Robert N. Weinreb Investigative Ophthalmology & Visual Science, October 2012, Vol. 53, No Atearly stages of damage (high RGC counts), changes in estimated RGC counts correspond to relatively smaller changes in MD (continuous line) and relatively larger changes in average RNFL thickness (dashed line). - At early stages of damage (high RGC counts), changes in estimated RGC counts correspond to relatively smaller changes in MD (continuous line) and relatively larger changes in average RNFL thickness (dashed line). - Atadvanced stages of damage (low RGC counts), changes in estimatedRGC counts correspond to relatively large changes in MDbutonlysmall changes in average RNFL thickness. - At advanced stages of damage (low RGC counts), changes in estimated RGC counts correspond to relatively large changes in MD, but only small changes in average RNFL thickness. MD CV HFA Thickness μm HD-OCT Cirrus Mean Deviation MD (dB) Average Thickness (µm) Average Thickness (µm) Estimated RCG count (x cells)

5 CSFI Combined Structure Function Index 5 Felipe A. Medeiros, Renato Lisboa, Robert N. Weinreb, Christopher A. Girkin, Jeffrey M. Liebmann, Linda M. Zangwill. Arch Ophthalmol Douglas GR, Drance SM, Schulzer M. A correlation of fields and discs in open angle glaucoma. Can J. O. 1974

6 6 IOL AS HD-OCT

7 7 LOOP acqueo AS HD-OCT

8 8 FORUM Zeiss Cirrus & Humphrey con FORUM HEYEX Heidelberg Spectralis & HEP con HEYEX Bundle Haag-Streit * Optovue & Octopus Bundle Haag-Streit * Piattaforme Multimediali & Combo Report

9 relationship between Standard Automated Perimetry OCT scan circle work of Garway-Heath et al between areas of the visual field and peripapillary retinal nerve fiber layer Map representing the relationship between Standard Automated Perimetry visual field sectors and sections of the peripapillary OCT scan circle. This map is based on the work of Garway-Heath et al and shows the correspondence between areas of the visual field and peripapillary retinal nerve fiber layer due to the anatomical configuration of the retinal nerve fiber bundles. First Release : Presented in part at the Glaucoma Society (UK & Eire) Annual Meeting, London, England, November 1998 Garway-Heath, Moorfields Eye Hospital London

10 Six corresponding regions of neuroretinal rim area (A), peripapillary retinal nerve fiber layer (B), and visual field (C), used to measure the structure–function relationship (based on structure–function map introduced by Garway-Heath et al.) Nilforushan N et al. Invest Ophthalmol Vis Sci May 10 ST + SN : 80°+ ST + SN : 80°+ Nasal : 110° + Nasal : 110° + IN + IT : 80° + Temporal : 90° = A = Rim Area B = RNFL B = RNFL C = CV C = CV Rim / RNFL: 360°

11 11 Combined structure and function reports A. Lucente Database HFA : 422 ≥ 18aa età ≤ 89aa + 5D ≥ Range ≤ + 5D Database HFA : 422 ≥ 18aa età ≤ 89aa + 5D ≥ Range ≤ + 5D Forum Glaucoma Workplace

12 12 A. Lucente Forum Glaucoma Workplace Combined structure and function reports

13 Limits HD-OCT Opacity Range Tilting retina Resolution Deep Resolution Agreement Database High Costs In the later stages of glaucoma OCT measurements appear to reach a plateau 13

14 Grazie per l’attenzione 14


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