Clinical imaging: OCT clinical indicators for functional testing – Case #1

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With a focus on diagnosis of eye disease, particularly glaucoma, the following clinical images demonstrate the importance of performing appropriate functional testing when it is clinically indicated in structural assessment.

Introduction

The use of multimodal imaging technology, such as OCT, in primary eye care is becoming increasingly prevalent, and the methods clinicians are using to assess ocular structures are evolving. It is important for clinicians to understand the novel ways in which this technology images the structures of the eye, and how this may differ from their traditional approach to clinical assessment.

It is well established that correlation of functional and structural assessment improves the detection and accurate diagnosis of eye diseases. Over the coming months, Spectrum will publish a series of cases featuring OCT scans with clinical indicators for functional testing. These are designed to help clinicians gain an awareness of what to look out for, so that they may more confidently and consistently perform functional testing when it is clinically indicated.

Case #1

Case supplied by Andrew Arnell, Specsavers Taylors Lakes, VIC

Px: 31-year-old female
IOPs: RE 14mmHg and LE 15mmHg

OCT widefield reports:

Consider the structural information provided in the OCT scans above:

  • What’s normal?
  • What’s abnormal?
  • Are there any clinical indications for functional testing?

Discussion

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The OCT widefield reports contained the following clinical indicators for functional testing:

  • RE – Nasal RNFL sector 5% probability of being within normal limits
  • LE – Temporal quadrant 1-5% probability of being within normal limits

Visual field results:

The visual field results show superior nasal defects that are outside normal limits, especially in the left eye.

The patient was referred to ophthalmology as a glaucoma suspect.

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