Clinical imaging: OCT clinical indicators for functional testing – Case #3

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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.

Case #3

Case supplied by Kevin Middleton, Specsavers Cranbourne, VIC

Px: 61-year-old female
IOPs: RE 11 mmHg and LE 11mmHg
No remarkable presenting signs or symptoms.

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 contain the following clinical indicators for functional testing:

  • Indistinct disc margins OU
  • Superior RNFL defect OU.

Functional testing was conducted and the visual field results are shown below.

Visual field results:

The visual field results show an inferior defect in both eyes, with the RE almost completely respecting the horizontal midline and being more severe and quite significant.

Differential diagnosis:

  • Optic atrophy
  • Compressive optic neuropathies
  • AION / NAION
  • Normal-tension glaucoma (advanced)

This patient was referred with some urgency to ophthalmology, with additional patient follow-up to stress the importance of attending for further consultation.

More in the ‘OCT clinical indicators for functional testing’ series
Case #1 and series introduction
Case #2
Case #3
Case #4
Case #5

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