optical coherence tomography

Non-Arteritic Anterior Ischemic Optic Neuropathy

NAION 4a - OD.jpg
NAION 4b - OS.jpg

Optic atrophy following non-arteritic anterior ischemic optic neuropathy, right eye.

Left: Patient’s right eye. Note the pale color of the superior aspect of the optic nerve with loss of the peripapillary capillary network.

Right: Patient’s left eye. The optic nerve is crowded (no discernable cup-to-disc ratio). The optic nerve color is generally normal.

NAION 4d - GVF OS.jpg

Goldmann (top) and automated (bottom) perimetry of the same patient demonstrating an incomplete inferior altitudinal visual field defect in the right eye and a mild inferotemporal visual field defect in the left eye. Although the left optic nerve appeared grossly normal, it was hypothesized that the left optic nerve may have suffered a mild injury, resulting in the reproducible visual field defect.

NAION 4e - OCT macula.jpg

Optical coherence tomography of the macula demonstrating an essentially normal fovea in each eye. This patient presented with optic atrophy, but with a history of optic nerve edema noted by an outside ophthalmologist. Because a branch retinal artery occlusion can also result in similar visual field defects and sectoral optic atrophy, an OCT of the macula helped confirm the preservation of the inner retina, which supports the diagnosis of NAION.

Optical coherence tomography of the macula showing loss of the inner retina in branch retinal artery occlusion (different patient, left eye). In contrast to the previous OCT, there is a complete loss of the foveal contour and the inner layers of the…

Optical coherence tomography of the macula showing loss of the inner retina in branch retinal artery occlusion (different patient, left eye). In contrast to the previous OCT, there is a complete loss of the foveal contour and the inner layers of the retina are thinned and less defined than the normal right eye.

Vitreopapillary Traction

Vitreopapillary traction 4 - color fundus photos (Houle and Miller).jpg

Vitreopapillary traction. Note the mild peripheral obscuration of retinal vessels in both eyes with relative preservation of the optic disc margins.

Vitreopapillary traction 5 - OCT OD (Houle and Miller).jpg

Optical coherence tomography of vitreopapillary traction (same patient). Bilateral vitreopapillary traction noted.

Vitreopapillary traction 7 - FA OD (Houle and Miller).jpg
Vitreopapillary traction 8 - FA OS (Houle and Miller).jpg

Fluorescein angiography of vitreopapillary traction (same patient). Note the mild focal leakage seen in both eyes (perhaps slightly more prominent in the left eye).

Image credit: Houle E, Miller NR. Bilateral vitreopapillary traction demonstrated by optical coherence tomography mistaken for papilledema. Case Rep Ophthalmol Med 2012;2012:682659. doi: 10.1155/2012/682659. Available online. Used for educational purposes.

Vitreopapillary Traction

Vitreopapillary traction. A, Photograph of the right optic nerve shows disc elevation, blurred margins, and obscuration of nasal vessels. B, Transverse optical coherence tomography reveals peripapillary vitreous adhesion and traction, resulting in elevation of the optic disc and peripapillary retina.

Image credit: Simonett JM, Winges KM. Vitreopapillary traction detected by optical coherence tomography. JAMA Ophthalmol 2018;136(5):e180727. doi: 10.1001/jamaophthalmol.2018.0727. Available online. Used for educational purposes.

Vitreopapillary Traction

Vitreopapillary traction (ASRS-RIB-Image-2916).jpg

Vitreopapillary traction. The condensation of vitreous over the optic nerve can cause the optic nerve to look blurred, and the traction itself can result in elevation of the optic nerve and blur the edges of the optic nerve.

Image credit: Courtesy of Alex P. Hunyor, M.D. Retina Image Bank. American Society of Retina Specialists. Available online. Used for educational purposes.