Recent developments in the use of optical coherence tomography for glaucoma. 2021

Luis E Vazquez, and Amanda Bye, and Ahmad A Aref
Bascom Palmer Eye Institute and McKnight Vision Research Center, University of Miami Miller School of Medicine, Miami, Florida.

OBJECTIVE The aim of this article is to summarize findings of recent reports highlighting the utility of novel optical coherence tomography (OCT) parameters in the diagnosis and monitoring of glaucomatous optic neuropathy. RESULTS Optic nerve head (ONH), retinal nerve fiber layer (RNFL), and macular parameters show high levels of diagnostic capability. The Bruch's membrane opening-minimum rim width (BMO-MRW) measurement is a novel ONH parameter obtained using the Spectralis SD-OCT device (Heidelberg Engineering, Inc., Heidelberg, Germany). The inferotemporal BMO-MRW sector shows the highest diagnostic performance for this parameter. Minimum ganglion cell and inner plexiform layer thickness shows the highest diagnostic performance among macular parameters obtained with the Cirrus HD-OCT (Carl Zeiss, Inc., Dublin, CA, USA). Optic nerve head, macular, and retinal nerve fiber layer parameters are not interchangeable across protocols generated by varying OCT manufacturers. Novel machine-learning algorithms show promise with regards to achieving higher levels of diagnostic accuracy using OCT imaging platforms. CONCLUSIONS Digital imaging in glaucoma continues to evolve with novel parameters of the optic nerve head, retinal nerve fiber layer, and macula. Diagnostic abilities of these parameters are high and complementary to each other.

UI MeSH Term Description Entries
D009412 Nerve Fibers Slender processes of NEURONS, including the AXONS and their glial envelopes (MYELIN SHEATH). Nerve fibers conduct nerve impulses to and from the CENTRAL NERVOUS SYSTEM. Cerebellar Mossy Fibers,Mossy Fibers, Cerebellar,Cerebellar Mossy Fiber,Mossy Fiber, Cerebellar,Nerve Fiber
D009898 Optic Disk The portion of the optic nerve seen in the fundus with the ophthalmoscope. It is formed by the meeting of all the retinal ganglion cell axons as they enter the optic nerve. Blind Spot,Optic Disc,Optic Nerve Head,Optic Papilla,Blind Spots,Disc, Optic,Disk, Optic,Head, Optic Nerve,Nerve Head, Optic,Optic Discs,Optic Disks,Optic Nerve Heads,Optic Papillas,Papilla, Optic,Papillas, Optic,Spot, Blind
D009901 Optic Nerve Diseases Conditions which produce injury or dysfunction of the second cranial or optic nerve, which is generally considered a component of the central nervous system. Damage to optic nerve fibers may occur at or near their origin in the retina, at the optic disk, or in the nerve, optic chiasm, optic tract, or lateral geniculate nuclei. Clinical manifestations may include decreased visual acuity and contrast sensitivity, impaired color vision, and an afferent pupillary defect. Cranial Nerve II Diseases,Foster-Kennedy Syndrome,Optic Disc Disorders,Optic Disk Disorders,Optic Neuropathy,Second Cranial Nerve Diseases,Cranial Nerve II Disorder,Neural-Optical Lesion,Disc Disorder, Optic,Disk Disorder, Optic,Disorder, Optic Disc,Foster Kennedy Syndrome,Lesion, Neural-Optical,Neural Optical Lesion,Neural-Optical Lesions,Neuropathy, Optic,Optic Disc Disorder,Optic Disk Disorder,Optic Nerve Disease,Optic Neuropathies,Syndrome, Foster-Kennedy
D005901 Glaucoma An ocular disease, occurring in many forms, having as its primary characteristics an unstable or a sustained increase in the intraocular pressure which the eye cannot withstand without damage to its structure or impairment of its function. The consequences of the increased pressure may be manifested in a variety of symptoms, depending upon type and severity, such as excavation of the optic disk, hardness of the eyeball, corneal anesthesia, reduced visual acuity, seeing of colored halos around lights, disturbed dark adaptation, visual field defects, and headaches. (Dictionary of Visual Science, 4th ed) Glaucomas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012165 Retinal Ganglion Cells Neurons of the innermost layer of the retina, the internal plexiform layer. They are of variable sizes and shapes, and their axons project via the OPTIC NERVE to the brain. A small subset of these cells act as photoreceptors with projections to the SUPRACHIASMATIC NUCLEUS, the center for regulating CIRCADIAN RHYTHM. Cell, Retinal Ganglion,Cells, Retinal Ganglion,Ganglion Cell, Retinal,Ganglion Cells, Retinal,Retinal Ganglion Cell
D016570 Bruch Membrane The inner layer of CHOROID, also called the lamina basalis choroideae, located adjacent to the RETINAL PIGMENT EPITHELIUM; (RPE) of the EYE. It is a membrane composed of the basement membranes of the choriocapillaris ENDOTHELIUM and that of the RPE. The membrane stops at the OPTIC NERVE, as does the RPE. Complexus Basalis,Lamina Basalis Choroideae,Bruch's Membrane,Bruchs Membrane,Complexus Basali
D041623 Tomography, Optical Coherence An imaging method using LASERS that is used for mapping subsurface structure. When a reflective site in the sample is at the same optical path length (coherence) as the reference mirror, the detector observes interference fringes. OCT Tomography,Optical Coherence Tomography,Coherence Tomography, Optical,Tomography, OCT

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