July/August 2018 Image of the Month

Image of the Month, a recurring feature in Retinal Physician since 2006, spotlights diagnostic images captured by industry practitioners using innovative technology and diagnostic instruments.

Swept Source OCT and OCT-A1 of Suspected Fresh CRVO

TOPCON

BACKGROUND

This case is of a middle aged man who came into the clinic with an acute loss of visual acuity. The fundus photo shows flame shaped intraretinally hemorrhages indicative of a very fresh central retinal vein occlusion. The B-scan clearly shows intraretinal hemorrhages as well. The interesting aspect of this case is that because of the use of Swept Source OCT and OCT-A it is possible for the signal to penetrate through the blood in order to visualize the structures beneath. In the B-scan the signal clearly penetrates through the blood, the retina, the RPE, the choroid and all the way down to the choroidal scleral interface. This is due to the use of 1050nm wavelength in the Swept Source OCT. The signal is in fact so good that it is possible to acquire a high quality OCT-A even of the peripapillary region where there is a lot of blood. Due to the pattern of the hemorrhages, further blood work to rule out systemic involvement is of course warranted.

The opinions, ideas, views and assumptions expressed are the author’s own and do not necessarily represent the views of Topcon, nor do they constitute advice from Topcon.

1. OCT Angiography is not available for sale in the U.S.

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