With a focus on diagnosis of eye disease, the following clinical images demonstrate the importance of performing appropriate functional testing when it is clinically indicated in structural assessment.
Case #9
Case supplied by Melina D’Agostini, Specsavers Tea Tree Plaza, SA
Px: 35-year-old female attending for routine check-up. No diplopia, flashes / floaters or other remarkable symptoms. Some trouble with seeing high-contrast print.
IOPs: RE 12mmHg and LE 11mmHg
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
The OCT widefield reports contain the following clinical indicators for functional testing:
- Thinning of the RNFL layers outside normative limits, as well as nasal ganglion cell layer (GCL) thinning outside normative limits in the RE
- Generalised loss of RNFL and GCL, more infero-temporally
- Asymmetric retinal nerve fibre presentation between the two eyes.
Visual field results:
The visual field results show a right defect localised to the upper supero-temporal quadrant and a left defect also localised largely to the upper supero-temporal quadrant.
The patient was referred urgently to an ophthalmologist for a homonymous superior quadrantanopia. The ophthalmologist agreed with the diagnosis and ordered further MRI imaging.
More in the ‘OCT clinical indicators for functional testing’ series
Case #1 and series introduction
Case #2
Case #3
Case #4
Case #5
Case #6
Case #7
Case #8
Case #9
Case #10
