Macula Clinic and Optical coherence tomography (OCT)
Optical coherence tomography (OCT) is the latest imaging technique that produces high resolution cross sectional images of the retina and helps in the diagnosis, treatment-planning and post-treatment evaluation of macular conditions like diabetic macular edema, ARMD(wet or dry), Juxta-foveal telengiectasia, Macular edema due to CRVO/BRVO, CSR and many others. OCT has revolutionized the study and treatment of macular diseases.
It is based on the principle of low-coherence interferometry. To facilitate interpretation a color scheme is added in which bright colors such as red and white correspond to highly reflective areas and darker colors such as blue and black correspond to areas of lower reflectivity.
High-resolution spectral domain-OCT
The latest version of OCT is High-resolution spectral domain-OCT. MANSAROVAR IS THE FIRST IN UTTAR PRADESH TO ACQUIRE THIS SOPHISTICATED MACHINE. We have been using this machine for over 1 year now.
The improved resolution PROVIDED BY THIS MACHINE allows us to distinguish delicate retinal abnormalities which were earlier not seen at-all, so were never treated. Moreover, the analysis of multiple consecutive B-scans covering a large area of the macula (3-dimensional imaging) improves the chances of spotting very small defects and allows volumetric measurements of retinal structure. In the conventional OCT machine just a line scan of a specific pre-determined suspicious area was possible. Thus adjacent areas with subtle changes were TOTALLY MISSED AND NOT SEEN AT-ALL. Spectral OCT on the other hand completely scans a 7X7 mm area around the fovea giving hundreds of high resolution cuts at intervals of a few microns. The time taken to acquire the images is very short: less than 2 seconds in the highest resolution mnode.
Higher resolution imaging also enables detection of vitreo-macular traction or fine epi-retinal membranes on the retina surface. In cases of lamellar macular hole, small opercula over the hole and many other abnormalities that could not be 'seen' by the conventional OCT become visible thus changing the line of management completely.
A FEW EXAMPLES ARE SHOWN BELOW:
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PRE AND POST TREATMENT SEROUS NEURO-SENSORY RD IN A CASE OF SEVERE DIABETIC MACULAR EDEMA |
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PRE AND POST-OP MACULAR HOLE SHOWING COMPLETE CLOSURE AFTER MACULAR HOLE SURGERY WITH I.L.M. PEELING |
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SEROUS RETINAL DETACHMENT IN C.S.R. |
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OPTIC PIT A RARE CONDITION LARGE CHOROIDAL NEO-VASCULAR MEMBRANE |
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PRE-OP & POST-OP EPI-RETINAL MEMBRANE IN DIABETIC RETINOPATHY SHOWING THE AREA OF CLEAVAGE – HELPFUL IN PLANNING THE SURGERY |
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PRE AND POST-TREATMENT MASSIVE MACULAR EDEMA IN CENTRAL RETINAL VEIN OCCLUSION |
OCT IS USEFUL FOR THE FOLLOWING:
- High Resolution 3D- OCT FOR DIAGNOSIS
- OCT guided intra-vitreal injections of triamcinalone/anti-VEG-F
- Planning of various operations like Macular hole surgery, Epi-retinal membrane /macular pucker surgery,Vitreo-macular traction (VMT) surgery in diabetics, Combined cataract plus above procedures,Vitrectomy for diabetic vitreous hemorrhage or traction retina detachments
- Assesment of response to treatment
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