Practical Handbook of OCT (Retina, Choroid, Glaucoma) Bruno Lumbroso, Marco Rispoli, Maria Cristina Savastano
INDEX
Note: Page numbers in bold or italic refer to tables or figures respectively.
A
Achromatopsia 69
Acquired immunodeficiency syndrome (AIDS) 143
retinitis 143
Acquired toxoplasmosis 135, 136
Acute central serous chorioretinopathy, evaluation of 119
Acute macular neuroretinopathy (AMN) 103
Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) 29, 86
Acute zonal occult outer retinopathy 29
Adenovirus 136, 143
Adult macular schisis 61, 112
Advanced cystoid edema 59, 60, 60
cavity features 60
Age-related macular degeneration (AMD) 3, 4, 16, 32, 45, 57, 62, 79, 80, 83, 86, 99, 111, 105, 175, 176
new vessels 41
AI see Artificial intelligence (AI)
AIDS see Acquired immunodeficiency syndrome (AIDS)
Albipunctate dystrophy 83, 128
Alkyl nitrite abuse 69
Alzheimer's disease 74, 83, 159, 169
Amacrine cells 10, 16
AMD see Age-related macular degeneration (AMD)
AMN see Acute macular neuroretinopathy (AMN)
Anemia 77, 78
Angiitis 135
Angio-cornea 166
Angioid streaks 55, 79
Angiomatoses 55
Angio-optical coherence tomography scans 4
Angle closure glaucoma 101
secondary 160
Antistreptolysin O 136, 143
Anti-vascular endothelial growth factor (anti-VEGF) 16, 17, 22, 23, 108
Anti-VEGF see Anti-vascular endothelial growth factor (anti-VEGF)
Aortic aneurysms 101
Aqueous humor 159
Arterial macroaneurysm 67
B-scan 66
Arterial occlusions 83
Artificial intelligence (AI) 179
applications of 45
diagnosis assisted by 179
Atrophic choroid 90
Atrophic degeneration 76
Atrophic macula 106
Atrophic macular degeneration 83, 100
treatment of 33
Atrophic retina 111
increased light penetration in 19
Atrophy 49
and dystrophy location 84
complete 176
new terminology for 103
Atrophy-dystrophy 85
shape 85
B
Bacterial endocarditis 77
Batten disease 129
Behçet's disease 100, 120, 136, 143
Bipolar and ganglion cells, connecting 10
Bipolar cells, inner nuclear layer of 10
Birdshot
chorioretinopathy 29, 86
retinopathy 62, 143
Blindness 98
Blood 20
cells 20
dyscrasias 77
Bourneville disease 148, 148
Branch retinal arterial occlusion 100-102
Branch retinal vein
edematous occlusion 98
ischemic occlusion 98
occlusion 40, 97, 99
Brucellosis 100
Bruch's membrane 9, 12, 20, 21, 54, 55, 56, 73, 82, 109, 130, 175
lesions 99
opening minimum rim width (BMO-MRW) 161
B-scan pigment epithelium detachment 56
Buerger's disease 120
Bull's eye maculopathy 129
C
Capillary dropout 39
Cardiac catheterization 101
Cardiac lesions 101
Cardiac valves, artificial 101
Carotid artery occlusion 100
Cartesian method 13
Caucasian population 119
Cavernous sinus thrombosis 100
Cavitation 49, 68, 90, 113
choroidal cavity features 73
CC see Choriocapillaris (CC)
Cell
bipolar 8, 10, 16
layer, bipolar and horizontal 8
lymphoma, large 143
Central retinal artery 97
occlusion 97
Central retinal vein
edematous occlusion 97
ischemic occlusion 98
occlusion 96
Central retinitis pigmentosa 83, 128
Central serous chorioretinopathy (CSC) 4, 39, 45, 50, 84, 89, 115, 117, 176
acute 118
Central serous retinopathy 118120
Central vein occlusion 154
Chloroquine 83
dystrophy 129
Choriocapillaris (CC) 12, 16, 21, 39, 103, 130
layer 55, 56
part of 89
unit 8
Choriocapillaritis 50, 89
Chorioretinal atrophic area 34
Chorioretinal atrophy 87, 91
Chorioretinal diseases 38
Chorioretinal lesions, traumatic 73
Chorioretinitis 131
Choroid 9, 19, 54, 100, 155
alteration 49
lesions 50, 83
measurements, quantitative 23
normal 88
swellings 49
thickness 89
tumors 50, 90
vasculature 39
Choroidal artery occlusion 86
Choroidal cavity 73, 90
Choroidal hemangioma 90
Choroidal inflammations 50, 89
Choroidal layers 16
Choroidal neoformations 55
Choroidal neovascularization (CNV) 57, 176
monitoring of 41
Choroidal nevus 62, 148
Choroidal rupture, traumatic 130, 131, 132
Choroidal structures 3
Choroidal thickness
decreased 50
increased 50, 84
Choroidal tumors 55
Choroidal vessels condition 4
Choroiditis 19, 39, 55, 79, 134
active 134
Choroid-sclera junction 12
Chronic epitheliopathy see Diffuse retinal pigment epitheliopathy
Churg–Strauss syndrome 120
Circumpapillary retinal nerve fiber layer (cpRNFL) 170, 171
CNV see Choroidal neovascularization (CNV)
Coats’ disease 55, 62, 66, 78
Colloid bodies 99
Complete outer retinal atrophy (cORA) 107
Complete RPE and outer retinal atrophy (cRORA) 90, 107
Cone dystrophy 129
Cone-rod
dystrophy 127, 128, 129
photoreceptor cells 127
Congenital maculopathies see Hereditary maculopathies
Congenital toxoplasmosis 136, 137
CORA see Complete outer retinal atrophy (cORA)
Cotton wool exudate 73, 94
causes of 78
features 78
Coxsackievirus A10 136, 143
CPRNFL see Circumpapillary retinal nerve fiber layer (cpRNFL)
Crohn's disease 136, 143
CRORA see Complete RPE and outer retinal atrophy (cRORA)
Cryoglobulinemia 96, 120
Cuticular drusen 99, 105, 175
Cyst 19
Cystic cavity 60
Cystoid cavities 7
morphology 57
Cystoid cell 58
volume 28
Cystoid edema 4, 16, 20, 50, 57, 111, 112, 128, 135, 176
cavities 58, 59
cell 25, 5860, 154
persists 17
differential diagnosis of 62
forming large cavities 94
in choroiditis and uveitis 60, 176
indicative of 53
Cystoid macular edema 3, 28, 31, 57, 59, 95, 95, 127
after cataract surgery 58, 126
after surgery 128
causes of 60, 62
cavities 31
in macular hole 61
Cytomegalovirus retinitis 136, 143
D
DCP see Deep capillary plexus (DCP)
Deep capillary plexus (DCP) 103
Deep scleral depression 137
Dense formations and deposits 49, 69
Dense tissue produces 20
Dermatomyositis 101
Diabetes 159
Diabetic retinopathy
background 93
hard exudates in 77
Diffuse edema 50, 57
Diffuse macular edema, causes of 61
Diffuse retinal
edema 3, 28, 93, 98
pigment epitheliopathy 115
Diskiform scars, evolution to 110
Disorganization of retinal inner layers (DRIL) 93, 103
Dissociated optical nerve fiber layer (DONFL) 26, 28
DONFL see Dissociated optical nerve fiber layer (DONFL)
Double layer sign 119
DRIL see Disorganization of retinal inner layers (DRIL)
Drusen 54, 82, 83, 99
classification 175
Drusenoid detachment 88
Dubious retinopathies 39
Dysplasia 145
E
Eales’ disease 66, 96, 143
Early cystoid edema 58, 59
cavity features 59
Early treatment diabetic retinopathy study (ETDRS) 165
Eclipse 177
lesion 70
Edema 19, 79
cystoid 19, 49, 57
diffuse 49, 57
localized 49, 57
Edema see also Subretinal fluid
Edematous retina 99
Egg yolk lesion 125
EGS see European Glaucoma Society (EGS)
Elementary lesions 47, 49
Elementary optical coherence tomography lesions 49
Ellipsoid 11, 17, 29
inner segment junction, alterations of 76
junction 55, 87
localized lesions of 86
simulating cavities, lesions of 70
lesions of 177
normal 128
simulating cavities, lesions of 67
zone 8, 9
Emboli 101
En face 149
clinical applications 25
one click mode 4
technique 29
technology 3, 25
En face scan 3, 25, 28, 30, 35, 43, 57
analysis, tridimensional and 25
in cystoid edema 32
of macular pucker 27
Endocarditis 101
Epinephrine 62
Epiretinal membrane (ERM) 3, 95, 155
causes of 51, 52
traction by 61, 62
Epitheliitis, acute 29, 71, 177
Epitheliopathy
acute 134
chronic 50, 83, 86, 89, 115
Epstein–Barr virus 136, 143
infection 151
ERM see Epiretinal membrane (ERM)
ETDRS see Early treatment diabetic retinopathy study (ETDRS)
Ethambutol 83
European Glaucoma Society (EGS) 159
Extensive lesions of photoreceptors, causes of 71
Exudative macular degeneration 103, 109, 110
Eye 44
contralateral 175
glaucomatous 163
movements and blinking 5
right 165
F
FA see Fluorescein angiography (FA)
Fibrin 134
Fibroglial elements 50
Fibrovascular macular degenerations 17
Fibrovascular scars 19, 49, 73
Fibrovascular tissue 20
Flat retinal surface 50
Flu-like symptoms, mild 135
Fluorescein angiography (FA) 39, 41, 136, 141
Focal and diffuse edema 93
Focal choroidal excavation 89, 120, 121, 151
Focal edema see also diffuse edema
Focal frosted branch angiitis 136
Fovea 3, 5, 7, 27, 58
vitreomacular traction 69
Foveal asymmetry, causes of 50
Foveal convexity, causes of 50
Foveal depression 50
loss, causes of 50
Foveal hemorrhage 150
Foveal normal reflectivity 118
Foveal peaked elevation, causes of 51
Foveal profile, changes in 50
Frequent diseases 47
Frontal en face
measurement 22
scans 25
Frosted branch angiitis 142, 143
causes of 143
Frosted branch vasculitis 135
Full retinal map analysis 3
Fundus
and autofluorescence 43
flavimaculatus 83, 127, 128
Fungal granuloma 120
G
Ganglion cell 8, 16
analysis (GCA) 160, 161, 164, 169
complex (GCC) 8, 161, 161, 167, 168, 171
printout of 165
inner plexiform layer (GC-IPL) 170
layer (GCL) 8, 10, 102, 131, 136, 169
Ganglion complex map 43
GCA see Ganglion cell analysis (GCA)
GCC see Ganglion cell complex (GCC)
GC-IPL see Ganglion cell-inner plexiform layer (GC-IPL)
GCL see Ganglion cell layer (GCL)
Geographic atrophy 102
and drusen 33
classification 175
Geographic macular degeneration see also Atrophic macular degeneration
Geographic retinal atrophy 83, 86
Ghost drusen 100, 105, 175
Giant cell arteritis 120
Glaucoma 45, 83, 159, 163, 165, 165
classification 159
secondary 160
corticosteroid 160
damage 167
diagnosis of 159, 161
diagnostic flowchart 161
exfoliative 160
iatrogenic 160
imaging of 160, 166
lens-induced 160
pathophysiology of 159
pigmentary 160
postsurgical 160
post-traumatic 160
preperimetric 161
progression 159
secondary 159, 160
treatment of 74
uveitic 160
vascular 98
Glaucomatous optic disk 12
Glial tissue 134
Glymphatic system 159
Goldmann-Favre vitreotapetoretinal degeneration 65
Graefe's disk 9
Granulomatosis with polyangiitis 120
Griseofulvin 83
H
Haller's layer 12, 38
large vessel 84
Hamartoma 62
Harada's disease 55
Hard drusen 59, 175
Hard retinal exudate
causes of 78
features 78
Hardware evolution 179
Heidelberg retinal tomography (HRT) 161, 161
Hemorrhage 7, 49, 69, 77, 94
causes of
deep 77
superficial 77
dense 130
retinal 3
subarachnoid 77
subdural 77
superficial 18
Hemorrhagic fevers 100
Hemorrhagic retinal pigment epithelium detachment 109
Henle fibers 7, 11, 58, 62, 65
Henoch–Schönlein purpura 120
Hereditary ataxia 129
Hereditary drusen 128
Hereditary macular
atrophies and dystrophies 83
dystrophies 128
Hereditary maculopathies 126
Herpes simplex virus (HSV) 136
Hodgkin's disease 78
HRT see Heidelberg retinal tomography (HRT)
HSV see Herpes simplex virus (HSV)
Huntington's disease 169, 170
Hutchinson–Tay disease 83, 128
Hydroxychloroquine dystrophy 129
Hypermetropia 11, 89
Hyperplasia 82
Hyper-reflective formations and deposits 81, 82
I
ICG see Indocyanine green (ICG)
ICGA see Indocyanine green angiography (ICGA)
ICP see Intermediate capillary plexus (ICP)
IDE see Initial demyelinating event (IDE)
Idiopathic polypoidal vasculopathy (IPV) 109, 113, 114, 115
ILM see Inner limiting membrane (ILM)
Incomplete atrophy see also Complete atrophy
Incomplete outer retinal atrophy (iORA) 107
Incomplete RPE and outer retinal atrophy (iRORA) 107
Indocyanine green (ICG) 135, 137
angiography (ICGA) 41
Indomethacin 83
Infarct of nerve fiber layer (INFL) 103
Infection 100
general 143
INFL see Infarct of nerve fiber layer (INFL)
Inflammatory choroidal thickening, causes of 120
Inflammatory disorders, thick choroid in 121
Inflammatory lesions 83
Inherited retinal dystrophies 127, 130
Initial demyelinating event (IDE) 169
INL see Inner nuclear layer (INL)
Inner limiting membrane (ILM) 8, 16
Inner nuclear layer (INL) 169
Inner retina
atrophy, causes of 83
causes of 76
Interdigitation zone 12
Intermediate capillary plexus (ICP) 103
Internal limiting membrane (ILM) 28
Intraocular lens (IOL) 160
Intraocular pressure (IOP) 159, 161, 161
Intraretinal cavities 41
without leakage in fluorescein angiography 69
Intraretinal microvascular abnormalities 94
Intravitreal antiangiogenic drugs 95
Intravitreal treatment 45
Invasive dye angiography, use of 41
Inverse pigmentary dystrophy 83
IOL see Intraocular lens (IOL)
IOP see Intraocular pressure (IOP)
IORA see Incomplete outer retinal atrophy (iORA)
IPV see Idiopathic polypoidal vasculopathy (IPV)
Iris 95
angiography 166
assessment of 168
IRORA see Incomplete RPE and outer retinal atrophy (iRORA)
Irreversible visual loss, causes of 159
Irvine–Gass syndrome 126, 127
Ischemic diabetic retinopathy 17
Ischemic vascular alterations 95
Ischemic vein occlusions 97
J
Juvenile retinoschisis cavity features 63
Juvenile X-linked
macular retinoschisis 49, 61
retinoschisis, advanced 64
Juxtafoveal macular telangiectasia 69
K
Kala-azar 78
Kawasaki disease 120
L
Lamellar hole 121, 175
Lamina cribrosa, level of 159
Lamina fusca 11, 89
Laser photocoagulation, complications of 79
Laurence–Moon–Bardet–Biedl syndrome 129
Leptospirosis 78
Lesions, extensive 86
Less frequent disorders 125
Leukemia 77, 96, 136, 143
Limited lesions of photoreceptors, causes of 71
Lipofuscin deposit features 79
Low reflectivity 19
Lupus 120
erythematosus 78
Lymphoblastic leukemia, acute 143
Lymphoma 136
M
Macroaneurysm 62
causes of 66
cavity features 67
Macula 7
anatomy of 7
before treatment 144
diagonal microstructure of 26
dome-shaped 11, 15, 49, 54, 54, 91, 113, 155, 177
Macular atrophies 83
acquired 83
Macular cavities, outer 69
Macular cube 26
Macular cube acquisition 25
Macular degeneration 45, 71, 78
Macular degeneration with type 1 neovascularization 154
Macular disorders 99
Macular dystrophies 83
acquired 83
Macular edema 45
chronic 17
Macular hole 50, 121, 175
after surgery, closed 69
based on optical coherence tomography, classification of 51, 124
classification of 121, 175
en face scan 62
stage 52
with operculum 53
Macular lamellar hole 52, 53
Macular Müller cells 7
Macular pseudohole 54, 54, 175
Macular pucker 17, 50, 62, 120, 121, 122
Macular retina 131
Macular retinoschisis 50, 147
Macular sclera 117
Macular telangiectasia 63, 71, 78, 86
Macular vitreous
interface 51
traction 27
Maculopathies 125
diabetic 96
Malattia leventinese 83
MCI see Mild cognitive impairment (MCI)
Measles 136, 143
Melanoma 62, 90
Membrane features
type 1 79
type 2 80
Metastatic tumor 62
MEWDS see Multiple evanescent white dot syndrome (MEWDS)
Microaneurysm
causes of 66
cavity features 66
Micro-invasive glaucoma surgery (MIGS) 168
Microperimetry maps 23
Microvascular occlusions 98
Migraine 101
MIGS see Micro-invasive glaucoma surgery (MIGS)
Mild cognitive impairment (MCI) 169
Mini-mental state examination (MMSE) 169
Mitral valve lesions 101
MMSE see Mini-mental state examination (MMSE)
Morning glory syndrome 145, 146, 147
Morphology 14
MS see Multiple sclerosis (MS)
Müller cell 7, 7, 8, 9, 28, 58, 65, 95
alterations 27
fibrils 10
framework 58
histology 94
microstructure 62, 64
nuclei of 8, 10
topography 63
weakness of 7
Müller fibers 7, 9
Müller's end-feet cellular processes 26
Multifocal choroiditis 29, 86
Multifocal inflammatory chorioretinal lesions 29
Multiple cross-section scan 3
Multiple evanescent white dot syndrome (MEWDS) 29, 68, 70
Multiple myeloma 96
Multiple pseudovitelliform macular degeneration 126
Multiple sclerosis (MS) 143, 169, 74, 83
Multipolar cells 8
Myopia 9, 11, 55, 89, 90, 93, 111-113, 159
B-scan, small posterior staphyloma in 91
cavitation space in high 72
high 90, 155, 161
macular
acute-onset retinoschisis in 66
retinoschisis in 65
schisis in 49, 61
pathological 111, 116
posterior staphyloma in 49, 91, 91, 177
retinoschisis in high 65
Myopic eyes 73
Myopic retinoschisis 112
cavity features 65
Myopic staphyloma, posterior 116
Myopic traction maculopathy 113
N
Nausea 39
Neovascular endothelial cells 39
Neovascular membranes 73, 108, 155
classification 176
evolution of 45, 111
in myopia, type 2 109
type 1 80, 108
type 2 80, 111
type 3 112
Neovascularization (NV) 39, 45, 99
classification of 41
Nerve fiber layer (NFL) 7, 93, 102
thinning or atrophy, causes of 83
Neural retina 15
Neurodegenerative diseases 169
Neuroepithelium 22
Neurological disorders 177
Neurosensory retinal detachments 110
Nevus 83, 90
NFL see Nerve fiber layer (NFL)
Nicotinic acid maculopathy 67, 69, 177
Nidek technologies 5
Nonexudative neovascularization 113
Nonproliferative diabetic retinopathy 93, 94, 94, 95
evolution of 95
Normal-tension glaucoma (NTG) 159
NTG see Normal-tension glaucoma (NTG)
Nuclear and plexiform layers 21
Nuclear layer, outer 11
NV see Neovascularization (NV)
O
OCT see Optical coherence tomography (OCT)
OCTA see Optical coherence tomography angiography (OCTA)
Ocular causes, frequent 100
Ocular contusions 130
Ocular diseases 45
Ocular examination, complete 43
Ocular high pressure 101
Ocular hypertension (OHT) 161, 161
Ocular imaging interpretation, stage of 43
Ocular inflammations 131
Ocular syndromes and disorders 93, 125
Ocular trauma 101
direct 77
indirect 77
OHT see Ocular hypertension (OHT)
ON see Optic neuritis (ON)
ONH see Optic nerve head (ONH)
Open-angle glaucoma 159
secondary 160
Ophthalmology 39
Optic disk 11, 74
disorders 137
drusen 145, 145
evaluation 43
normal 11
papillitis 145
Optic fiber layer 10
Optic nerve
atrophies 83
coloboma of 52
fiber layer 10
head (ONH) 164, 168
tumors 100
Optic neuritis (ON) 169
without 170
Optic pit 137, 144
differential diagnosis 144
Optical coherence tomography (OCT) 7, 13, 16, 25, 39, 41, 43, 49, 93, 101, 103, 105, 107, 108, 112, 115, 137, 141, 153, 161, 161, 169, 177
analysis 13
and synthesis 179
standard 3
angiography (OCTA) 39, 41, 115, 165, 165
advantage of 41
normal subjects 39
scans 4
anterior segment 160
classification of retinal holes 52
contribution of 175
disorders, frequent 93
dyeless angiography 39
elementary lesions 43
gray scale 3
images assessment 43
imaging, artifacts in 5
in inherited retinal dystrophies 129
interpretation, methods of 1
morphological interpretation of 15
posterior segment 160
prints, standard 5
qualitative analysis 14, 14
quantitative
analysis 22
segmentation 23
segmentation 4
structural 119
synthesis and deduction 14
systems 4, 16
technology 5
Orbit tumors 100
Orbital cellulitis 101
Osteoma 62, 90
Outer macular cavities, conditions simulating 69
Outer retina 8, 30, 67
and pigment epithelium lesions 49
and retinal pigment epithelium lesions 76
atrophy 176
idiopathic lamellar defects 30
lesions localized to photoreceptors, causes of 86
outline modifications 49
Outer retinal tubulation 34, 37, 60, 67, 69, 69, 176
cavity features 69
P
PACG see Primary angle-closure glaucoma (PACG)
Pachychoroid 89
classification 176
disorders 11
neovasculopathy (PNV) 89, 119, 176
pigment epitheliopathy (PPE) 89
spectrum 84, 89, 93, 115, 120
disorders 84
Pachychoroid-related disorders 89
classification of 115
Pachydrusen 100, 106
PAMM see Paracentral acute middle maculopathy (PAMM)
Papilla 72
Papilledema 145
choked disk 137
Paracentral acute middle maculopathy (PAMM) 102
Parallel retinal layers 54
Parasitosis 131
Parkinson's disease 159, 169, 170
Pars planitis 62
Pattern dystrophy 83
PCV see Polypoidal choroidal vasculopathy (PCV)
PED see Pigment epithelium detachment (PED)
Peripapillary choroidal cavities 68
Peripapillary pachychoroid syndrome 89, 120
Phenothiazine 83
Photoreceptor layer 8
Photoreceptor tips 55
PIC see Punctate inner choroidopathy (PIC)
Pigment epithelium 7, 19, 51, 54, 55, 56
abnormalities of 25
alterations 49, 50, 54, 79
and external retina, complete atrophy of 175
atrophy 82, 87
below 20
cells 9
complete atrophy of 106
concavity of 25, 25
detachment of 35
hypertrophy of 82
incomplete atrophy of 176
tears 110
Pigment epithelium detachment (PED) 3, 20, 28, 34, 45, 49, 50, 55, 108, 109, 112, 115, 118, 119, 176
causes of 57
en face morphology and contents 55
features 57
in central serous chorioretinopathy 34
in polypoidal choroidal vasculopathy 38
Pigment migration 103
Pigmentation anomalies 50, 82
Plexiform layer
inner 7, 8, 10
outer 7, 8, 10, 11
PNV see Pachychoroid neovasculopathy (PNV)
POAG see Primary open-angle glaucoma (POAG)
Polyarteritis nodosa 143
Polypoid dilations 120
Polypoidal choroidal vascular disease 119
Polypoidal choroidal vasculopathy (PCV) 49, 89, 100, 106, 176
Postcataract surgery syndrome 62
PPE see Pachychoroid pigment epitheliopathy (PPE)
Pre-eclampsia 120
Pre-epithelial neovascular membranes 19
Preretinal and epiretinal membrane 50, 120
Preretinal and papillary neovascularization, causes of 96
Preretinal hemorrhages, causes of 77
Primary angle-closure glaucoma (PACG) 159, 162
Primary glaucoma 159
classification 159
Primary open-angle glaucoma (POAG) 159, 165
Progression analysis software 5, 23
Proliferative diabetic retinopathy 95, 96, 96, 97
Pseudocell contents 60
Pseudodrusen 99, 105, 175
Pseudoholes 121
Pseudohypopyon stage 125, 125
Pseudovitelliform dystrophy 83, 125, 128
Pseudovitelliform macular
degeneration 126
dystrophy 125, 125
Pseudovitelliform maculopathy 79, 86
Punctate inner choroidopathy (PIC) 29, 86
Purtscher syndrome 78
R
Radial macular cysts 61
Radial peripapillary capillary (RPC) 160, 161, 161, 165, 168
plexus (RPCP) 103
Radiation retinopathy 62, 71, 78, 86
RAPs see Retinal angiomatous proliferations (RAPs)
Reflectivity 17, 18, 112
Refraction 45
Regional causes, rare 100
Regressed cystoid edema 60, 61, 176
causes of 62
cavity features 61
Residual retinal tissue 59
Residual tissue granulation 29, 30
Reticular dystrophy see also Sjögren syndrome
Retina 22, 25, 29, 39, 54, 95, 96, 155
and choroid cavities 49, 54
and subretinal cystic mass 139
cavities in outer 49, 67, 176, 177
deformation of posterior 15
detached 55, 95
external 175, 106, 176
features, serous elevation of 55
framework 7, 7
vertical and horizontal structures 7
horizontal structures 7, 8
inner 8, 15, 25, 135
layers of 150
layers 9
inner 112
lesions inside outer layer of 28
neovascular proliferation on 98
normal 10, 13, 21, 99
posterior face of 140
retinal layers in normal 4
structures of 59
studying inner 28
swelling of 97, 98, 128
thickness of 58, 130
vitreous interface alterations 4
Retinal and choroidal
shape 14
volume 23
Retinal and papillary vascular nets, levels of 41
Retinal angioma 62
Retinal angiomatous proliferations (RAPs) 73, 79, 112, 176
Retinal architecture 14
Retinal arterial occlusion 101, 102
causes of 101
Retinal boundaries, delineating 4
Retinal cavities 7375
fluid 176
Retinal cells 9
Retinal cystoid edema 111
Retinal deep hemorrhage 76
Retinal detachment 45, 50
ring of 125
Retinal diffuse edema 112
Retinal diseases
advanced 16
chronic 16, 17
diagnosis of 4, 5
management of 4, 5
Retinal disorders 29
Retinal edema 135
cystoid 28
Retinal epitheliopathy, chronic diffuse 62
Retinal extramacular framework 7
Retinal folds 1, 51
Retinal ganglion cells (RGCs) 159, 161
Retinal hamartoma 52
Retinal hole
Gass classification of 52
surgery 86
traumatic 131, 132
Retinal inflammations 39
Retinal ischemia 83
extensive 96
types of isolated 103
Retinal layers 8
boundaries, delineation of 3
variations in thickness of 49, 74
Retinal lesions, causes of outer 76, 86
Retinal mapping 23, 43
Retinal microcirculation, model of 103
Retinal midperiphery, causes of decreased thickness in 83
Retinal nerve fiber layer (RNFL) 8, 160, 161, 163, 163165, 168, 169
thickness of 74, 161
Retinal outline
alterations of 112
elementary lesions 49, 50
modifications, inner 49
Retinal periphery 129
Retinal pigment epitheliitis, acute 69, 86
Retinal pigment epithelium (RPE) 4, 4, 8, 15, 16, 25, 49, 57, 90, 99, 103, 105, 107, 108, 115, 118, 119, 125, 130, 133, 175
cavities below 76
detachments 32, 33
fit Zeiss cirrus 25
tears 110
Retinal profile 99
deformation of 116
irregular 9698, 101, 128
Retinal scars, causes of 81
Retinal segmentation 26
Retinal serous detachment 19, 56
Retinal splitting in myopia 61
Retinal structure 21
assessing 15
framework 15
Retinal surface 50
irregularities, causes of 51
outline, deformations of 15
Retinal surgery 62
Retinal swellings 49
Retinal telangiectasia, cavities in 63, 176
Retinal thickness 16, 21, 43
increased 128
Retinal tissue 16, 60
Retinal traction 45
Retinal vascularization 39, 41
Retinal vein
and arteries 7
occlusions, causes of 100
Retinal vessels 63
Retinal volume 43
Retinitis 39, 134
acute 29, 69, 86, 177
pigmentosa 31, 61, 62, 69, 83, 127, 129
B-scan 130
Retinopathy 68
acute 86
advanced 16
chronic 86
diabetic 4, 16, 17, 28, 50-52, 62, 66, 71, 77, 78, 78, 93
background 93
hypertensive 52, 66, 71, 77, 78
traumatic 86
vascular 93
Retinoschisis 19
causes of 65
peripheral 49
Retrobulbar treatments 45
Retroepithelial neovascular membranes 19
RGCs see Retinal ganglion cells (RGCs)
Rickettsia 100
RNFL see Retinal nerve fiber layer (RNFL)
Rod-cone dystrophy 129
RPCP see Radial peripapillary capillary plexus (RPCP)
RPCs see Radial peripapillary capillaries (RPCs)
RPE see Retinal pigment epithelium (RPE)
Rubella 136, 143
S
Sarcoidosis 120, 143
Sattler and Haller layers 9, 100
Sattler's layer 12, 38
Sclera 11, 54
alteration 49
behind 117
Scleral channels 177
Scleral depression 91
Scleral disorders 177
Scleral lesions 91
Scleritis 134
posterior 120
Scleroderma 101
SCP see Superficial capillary plexus (SCP)
Scrambled egg 125, 125
SD-OCT see Spectral domain optical coherence tomography (SD-OCT)
Serous central chorioretinopathy 89
Serous chorioretinopathy, acute 89
Serous detachment 95
Serous elevation of retina, causes of 55
Serous fluid 20
Serous retinal detachment 54, 94
Sickle cell
anemia 96
disease 66
Sildenafil 89, 90
Single genetic deficit 127
SITA see Swedish interactive threshold algorithm (SITA)
Sjögren syndrome 83
Small cystoid edema cavities 19
Small retinal pigment epithelium elevation, differential diagnosis of 57
Soft drusen 104, 175
in age-related macular degeneration 87, 88
Solar maculopathy 69
Solar retinopathy 30, 33
lesions 30
Spectral domain optical coherence tomography (SD-OCT) 163, 168, 170, 171
Spherical cells, clusters of 60
Spondylitis and familiar mediterranean fever 120
Spongy edema 95
Staphyloma 113, 137
localized 91, 177
Stargardt's disease 69, 83, 126-128, 128, 129, 129
Stroma, disaggregated 29
Subretinal cavities 41
Subretinal cysticercosis 135, 139, 140
three-dimensional 138
Subretinal deposits 49, 73
causes of 73, 78
Subretinal fluid 79
Subretinal formation, differential diagnosis of 141
Subretinal injections 45
Subretinal neovascular membranes, causes of 79
Subretinal neovascularization 52
Superficial capillary plexus (SCP) 103, 166, 167
Swedish interactive threshold algorithm (SITA) 161, 161
Sympathetic ophthalmia 120, 134
Syncope 39
Synthesis process 43
Systemic autoimmune diseases, stages of 121
Systemic blood pressures 159
Systemic causes
frequent 100
rare 100
Systemic diseases 136, 143
Systemic lupus erythematosus 136, 143
Systemic sclerosis 120
Systemic vascular alterations 159
T
Takayasu arteritis 120
Takayasu syndrome 101
Tamoxifen 129
deposits 78
lesions 71
retinopathy 69
therapy lesions 29
Tangential traction retinal folds 51
Tapetoretinal degeneration 83
TD-OCT see Time domain optical coherence tomography (TD-OCT)
Telangiectasia 62, 68
cavity 69
features 67
peripheral 66
Temporal artery, superior 100
Tenon's capsule 9
structures 117
Terson syndrome 77
Thalassemia 96
Therapeutic intravitreal implants 45
Thick inflammatory choroid 120
Tilted disk 145
Tilted optic disk 146
Time domain optical coherence tomography (TD-OCT) 163, 163
Tissue damage 34
Toxic lesions 83
Toxocara canis 134
Toxoplasmosis 134
Traction edema 95
Traction maculopathy 96
Traction retinal detachment 98
Translaminar pressure gradient 159
Trauma 130
Tuberculosis 136
Tuberous sclerosis see also Bourneville disease
U
Unified Parkinson's disease rating scale (UPDRS) 170
UPDRS see Unified Parkinson's disease rating scale (UPDRS)
Uveitis 39, 51, 131, 135, 143
and choroiditis 62
and iridocyclitis 61
V
Varicella zoster virus (VZV) 136
Vascular cavities 63
macroaneurysms 63
microaneurysms 63
Vascular tissue see also Fibrovascular tissue 20
Vascularized drusen 100, 175
Vasculitis, causes of 143
Venous occlusion 52, 66, 71
Vitelliform macular degeneration 52
Vitelliform stage 125
Vitreal tractions 50
Vitreoretinal interface
lesions 3
syndrome 17
Vitreoretinal surgery 86
indications for 45
Vitreoretinal traction 50
Vitreous detachment, posterior 77, 111
Vitreous macular adhesion 175
Vogt–Koyanagi–Harada disease 50, 89, 120, 121, 131, 133, 133, 134
differential diagnosis of 134
fluorescein angiography 134
Vomit 39
VZV see Varicella zoster virus (VZV)
W
Waldenström disease 96
Wegener's granulomatosis 101
Welder's maculopathy 69
White dot syndrome 3, 29, 32, 86, 120, 135, 137, 138
qualitative analysis 137
×
Chapter Notes

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_fm1PRACTICAL HANDBOOK OF OCT (RETINA, CHOROID, GLAUCOMA)
_fm3PRACTICAL HANDBOOK OF OCT (RETINA, CHOROID, GLAUCOMA)
THIRD EDITION
Marco Rispoli MD Surgery and Emergency Unit, Rome Eye Hospital Centro Italiano Macula, Rome, Italy Maria Cristina Savastano MD, PhD Clinical Research Coordinator, Ophthalmology Unit Policlinico Universitario A Gemelli (IRCS), Catholic University, Rome Centro Italiano Macula, Rome, Italy Bruno Lumbroso MD Centro Italiano Macula, Rome, Italy bruno.lumbroso@gmail.com With the collaboration of Luca Di Antonio MD, Gilda Cennamo MD Drawings by Donata Piccioli
_fm4
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Practical Handbook of OCT (Retina, Choroid, Glaucoma) / Marco Rispoli, Maria Cristina Savastano, Bruno Lumbroso
First Edition: 2012
Third Edition: 2021
9789390281350
Printed at:
_fm5Preface to the third edition
Since this handbook's first two editions, optical coherence tomography (OCT) has seen new and revolutionary developments. OCT is recognized all over the world as an indispensable device for diagnosis, assessment, and follow-up of retinal diseases and glaucoma in everyday clinical work and in research. OCT angiography (OCTA) appeared that it has replaced in many fields the invasive dye angiography.
This handbook's new edition is divided in three parts:
In the first part, we describe the logical method we use for OCT imaging interpretation and that we have taught, we offer a step-by-step guide for interpreting data acquired by OCT, “en face” OCT, and OCT A. As in all the handbooks, we have written, we applied a logical method for interpreting ophthalmic images. The first step is analytic: It subdivides each image into its smallest elementary parts. The second step combines these elementary components to synthesize the result, allowing an accurate diagnosis and treatment decision.
In the second part, we describe and update the structural OCT aspects of the most frequent retinal disorders and then of the less frequent retinal disorders.
The third part reports the great advances that OCT has obtained in the clinical field: All the new syndromes, disorders, and diseases that OCT has revealed and precised and new classification that OCT has suggested. OCT allowed to understand new syndromes, to recognize new pathologies, expand or limit diagnoses, organize disorders in new classifications, and detect imaging elements by the OCT. Known diseases have been better understood and different diseases and morphologies have been described and identified after the introduction of structural OCT and OCTA.
We will not discuss OCTA in this handbook. This new, noninvasive, and dyeless OCTA has already taken a central place as diagnostic tool, in part replacing dye angiography. Its importance is so great that we have contributed to it in two separate handbooks.
We trust this handbook will help ophthalmologists, residents, ophthalmic technicians, orthoptists, and optometrists understand, analyze, and appreciate the complex imaging offered by OCT devices.
Marco Rispoli,
Maria Cristina Savastano,
Bruno Lumbroso
May 2020_fm6
_fm7Preface to the second edition
In the few years since this handbook's first edition, optical coherence tomography (OCT) technology has seen new and revolutionary developments. OCT is, by now, essential for diagnosis, assessment, and follow-up of retinal diseases and glaucoma.
We believe this handbook's new edition will inform clinicians and technicians on the recent advances in OCT imaging.
Modern OCT devices offer new possibilities such as:
In this second edition of the “Practical Handbook of OCT”, we offer a step-by-step guide for interpreting images and data acquired by OCT, “en face” OCT, and OCT A. In these pages, as in all the handbooks, we have written on ocular imaging, we have applied a logical method for interpreting ophthalmic images. The first phase is analytic: It subdivides each image into its smallest parts. The second phase of this method combines these elementary components to synthesize the data, allowing an accurate diagnosis and treatment decision.
We trust this handbook will help ophthalmologists, residents, ophthalmic technicians, and optometrists understand and appreciate the new possibilities offered by latest OCT devices.
Bruno Lumbroso
Marco Rispoli_fm8
_fm9Preface to the first edition
After its first use in ophthalmology 20 years ago, optical coherence tomography (OCT) was rapidly adopted by an increasing number of ophthalmologists. OCT devices have now their place beside the slit lamp in a hospital or at the clinician's office for everyday clinical examination. The retinal and choroidal layers of the eye are easily explored. The method with which these images can be acquired has modified the diagnostic strategy. OCT is useful for better diagnosis and management of ocular conditions. Modern OCT generates high-quality images and improves visualization of outer retina and choroid. Three-dimensional OCT enables assessment of multidimensional pathology.
Optical coherence tomography technology presents us today with an exponential increase of the quantity of data we have to classify, shift, assess, count, and preserve. Most operators in everyday work use only a small part of OCT possibilities. “At present, OCT devices technical evolution begins to exceed the interpretation and analytic abilities of the specialists to which they are entrusted with”.
Assessment and interpretation activity involves both a technical dimension and an intellectual aspect. We have written the present handbook with these facts in mind. We tried to teach a logical method of analysis and interpretation of the clinical images to help and guide clinicians in assessing, classifying, and selecting information.
We would like to thank Donata Piccioli, the artist, who illustrated all our scientific works for her beautiful drawings and the collaboration in making wonderful artwork out of our rudimentary schematic outlines.
Bruno Lumbroso
Marco Rispoli
_fm13Practical handbook presentation
We wrote this book as a practical and concrete manual to be used in everyday clinical work. It is a teaching tool to explain the contents of the complex images produced by the modern optical coherence tomography (OCT). It is not an atlas. We did not aim to amass the highest number of OCT images. We desired to help clinicians find their ways in the jungle of data by giving them a clinical pragmatic guide to transfer clinically useful notions, understanding better the meaning of OCT images, and preventing diagnostic errors.
This manual applies the classical Cartesian method of analysis followed by synthesis to OCT to teach how to disentangle the complex web of information.
Optical coherence tomography logical analysis must subdivide images into their basic elements, morphology, structure, architecture, framework, and stratification. Each scan will be assessed according to its morphology, high or low reflectivity. Structure, texture, and morphology are tightly interwoven with reflectivity variations and abnormal formations (cavities, deposits, fluid accumulations, exudates, hemorrhages, etc.). Image deconstruction is not easy. The basic elements are sometimes very difficult to highlight and separate. In fact, the images obtained with OCT are so complex and intricate that they cannot be simply considered a puzzle solved only by sorting.
If the basic principles of analysis are respected, reconstruction and synthesis are easier and it will be possible to reach the correct diagnosis._fm14
_fm15Handbook organization
After explaining the analysis and synthesis method, we describe separately the elementary OCT lesions. Then we show how these elementary lesions combine together to form the most frequent and less frequent clinical syndromes and situations. We also outline some rare syndromes and after that describe how to face complex cases that involved two or three different affections. In the last section, we report the new syndromes, disorders, and diseases that OCT has revealed and new classifications that OCT has suggested. OCT allowed to understand better old syndromes, to recognize new pathologies, and organize disorders in new classifications. We now better understand known diseases.
Our figures were obtained mainly by Optovue OCT, but also by Zeiss and Topcon devices. We used most of the time grayscale rather than conventional pseudocolors to make out details that could be easy to miss.
This manual is thus organized in:
For this we prepared:
Marco Rispoli,
Maria Cristina Savastano,
Bruno Lumbroso