Optical Coherence Tomography

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1 Optical Coherence Tomography

2 ESASO Course Series Vol. 4 Series Editor F. Bandello Milan B. Corcóstegui Barcelona

3 Optical Coherence Tomography Volume Editors Gabriel Coscas Créteil/Paris Anat Loewenstein Tel Aviv Francesco Bandello Milan 137 figures, 97 in color, and 9 tables, 2014 Basel Freiburg Paris London New York Chennai New Delhi Bangkok Beijing Shanghai Tokyo Kuala Lumpur Singapore Sydney

4 Gabriel Coscas University of Paris Est Créteil Centre Hospitalier Intercommunal de Créteil 40, avenue de Verdun FR Créteil (France) Anat Loewenstein Tel Aviv Medical Center 6 Weizmann Street IL Tel Aviv (Israel) Francesco Bandello Library of Congress Cataloging-in-Publication Data Optical coherence tomography (Coscas) Optical coherence tomography / volume editors Gabriel Coscas, Anat Loewenstein, Francesco Bandello. p. ; cm. -- (ESASO course series, ISSN X ; vol. 4) Includes bibliographical references and index. ISBN (hard cover : alk. paper) -- ISBN (electronic) I. Coscas, Gabriel, editor of compilation. II. Loewenstein, Anat, editor of compilation. III. Bandello, F. (Francesco), editor of compilation. IV. Title. V. Series: ESASO course series ; v X. [DNLM: 1. Tomography, Optical Coherence. WN 206] RC78.7.T dc Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents. Disclaimer. The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements. Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Copyright 2014 by S. Karger AG, P.O. Box, CH 4009 Basel (Switzerland) Printed in Germany on acid-free and non-aging paper (ISO 9706) by Kraft Druck, Ettlingen ISSN X e-issn ISBN eisbn

5 Contents VII List of Contributors X Foreword Bandello, F. (Milan) XI Preface Coscas, G. (Créteil/Paris); Loewenstein, A. (Tel Aviv ) 1 Evolution of Optical Coherence Tomography Technology Comparison of Commercially Available Instruments Pierro, L.; Gagliardi, M. (Milan) 9 Optical Coherence Tomography Pathologic Findings in the Vitreoretinal and Macular Interface Goldenberg, D.; Schwartz, R.; Loewenstein, A. (Tel Aviv) 17 Optical Coherence Tomography in the Inner Retinal Layers Giraud, J.M. (Toulon); El Chehab, H.; Francoz, M.; Fenolland, J.R.; Delbarre, M.; May, F.; Renard, J.P. (Paris) 26 Optical Coherence Tomography of the Outer Retinal Layers Koh, A. (Singapore) 34 Optical Coherence Tomography Findings in the Choroid Coscas, G.; Coscas, F. (Créteil/Paris) 46 Pre- and Postsurgical Evaluation of the Retina by Optical Coherence Tomography Pellegrini, M.; Bottoni, F.; Cereda, M.G.; Staurenghi, G. (Milan) 54 Optical Coherence Tomography in the Diagnosis of Challenging Macular Disorders Querques, G. (Créteil/Milan); Borrelli, E. (Milan); Georges, A.; Souied, E.H. (Créteil) 62 Optical Coherence Tomography in the Management of Diabetic Macular Edema Erginay, A.; Massin, P. (Paris) 76 Swept Source Optical Coherence Tomography versus Enhanced Depth Imaging-Spectral Domain Optical Coherence Tomography in Age-Related Macular Degeneration Coscas, F.; Coscas, G. (Val de Marne/Paris) 93 En Face Optical Coherence Tomography with Enhanced Depth Imaging of Different Patterns of the Choroidal Neovascular Network in Age-Related Macular Degeneration Coscas, G.; Coscas, F. (Paris) 101 En Face Optical Coherence Tomography Scan Applications in the Inner Retina Lumbroso, B.; Rispoli, M. (Rome); Le Rouic, J.F. (Nantes); Savastano, M.C. (Rome) V

6 110 Optical Coherence Tomography Findings in Acute Macular Neuroretinopathy Battaglia Parodi, M.; Iacono, P.; Panico, D.; Cascavilla, M.L.; Bolognesi, G.; Bandello, F. (Milan) 117 Optical Coherence Tomography in Myopic Choroidal Neovascularization Battaglia Parodi, M.; Iacono, P.; Bolognesi, G.; Bandello, F. (Milan) 123 Ganglion Cell Complex and Visual Recovery after Surgical Removal of Idiopathic Epiretinal Membranes Pierro, L.; Codenotti, M.; Iuliano, L. (Milan) 127 Choroidal Changes in Patients with Raynaud s Phenomenon Secondary to a Connective Tissue Disease: Study of Vascular Eye Involvement in Patients Affected by Raynaud s Phenomenon with in vivo Noninvasive EDI-OCT Pierro, L.; Del Turco, C.; Miserocchi, E.; Ingegnoli, F. (Milan) 131 Subject Index VI Contents

7 List of Contributors Francesco Bandello Maurizio Battaglia Parodi Gianluigi Bolognesi Enrico Borrelli Ferdinando Bottoni Eye Clinic, Luigi Sacco Hospital, University of Milan Via G.B. Grassi 74 IT Milan (Italy) Maria Lucia Cascavilla Matteo Giuseppe Cereda Eye Clinic, Luigi Sacco Hospital, University of Milan Via G.B. Grassi 74 IT Milan (Italy) Marco Codenotti Florence Coscas University of Paris Est Créteil Centre Hospitalier Intercommunal de Créteil 40, avenue de Verdun FR Créteil (France) Gabriel Coscas University of Paris Est Créteil Centre Hospitalier Intercommunal de Créteil 40, avenue de Verdun FR Créteil (France) VII

8 Maxime Delbarre Hôpital d Instruction des Armées du Val de Grâce 74, boulevard de Port Royal FR Paris (France) maximedelbarre@yahoo.fr Claudia Del Turco delturco.claudia@hsr.it Hussam El Chehab Hôpital d Instruction des Armées du Val de Grâce 74, boulevard de Port Royal FR Paris (France) elchehab_hussam@hotmail.fr Ali Erginay Hôpital Lariboisière AP-HP, Université Paris 7 Sorbonne Paris Cité 2, rue Ambroise Paré FR Paris Cedex 10 (France) ali.erginay@lrb.aphp.fr Jean Remi Fenolland Hôpital d Instruction des Armées du Val de Grâce 74, boulevard de Port Royal FR Paris (France) fenolland@gmail.com Marlène Francoz Hôpital d Instruction des Armées du Val de Grâce 74, boulevard de Port Royal FR Paris (France) francozmarlene@yahoo.fr Marco Gagliardi Gagliardi.marco@hsr.it Anouk Georges University of Paris Est Créteil Centre Hospitalier Intercommunal de Créteil 40, avenue de Verdun FR Créteil (France) ageorges@student.ulg.ac.be Jean-Marie Giraud Hôpital d Instruction des Armées Sainte Anne Boulevard Sainte Anne FR Toulon (France) jean-marie-giraud@wanadoo.fr Dafna Goldenberg Tel Aviv Medical Center, 6 Weizmann Street IL Tel Aviv (Israel) dafnagoldenberg@gmail.com Pierluigi Iacono, pierluigi.iacono@libero.it Francesca Ingegnoli Gaetano Pini Piazza Cardinale Andrea Ferrari, 1 IT Milan (Italy) francesca.ingegnoli@unimi.it Lorenzo Iuliano iuliano.lorenzo@hsr.it Adrian Koh Eye & Retina Surgeons Camden Medical Centre #13-03, 1 Orchard Boulevard Singapore (Singapore) dradriankoh@eyeretinasurgeons.com Jean Francois Le Rouic Clinique Sourdille 3 place Anatole France FR Nantes (France) jflerouic@gmail.com VIII List of Contributors

9 Anat Loewenstein Tel Aviv Medical Center 6 Weizmann Street IL Tel Aviv (Israel) anatlow@netvision.net.il Bruno Lumbroso Centro Oftalmologico Mediterraneo Via Brofferio 7 IT Rome (Italy) bruno.lumbroso@gmail.com Pascale Massin Hôpital Lariboisière AP-HP, Université Paris 7 Sorbonne FR Paris Cité (France) pascale.massin@lrb.aphp.fr Franck May Hôpital d Instruction des Armées du Val de Grâce 74, boulevard de Port Royal FR Paris (France) ophtimum@aol.com Elisabetta Miserocchi miserocchi.elisabetta@hsr.it Davide Panico davidepaniko@libero.it Marco Pellegrini Eye Clinic, Luigi Sacco Hospital, University of Milan Via G.B. Grassi 74 IT Milan (Italy) mar.pellegrini@gmail.com Luisa Pierro, pierro.luisa@hsr.it Giuseppe Querques University of Paris Est Créteil Centre Hospitalier Intercommunal de Créteil 40, avenue de Verdun FR Créteil (France) giuseppe.querques@hotmail.it Jean-Paul Renard Hôpital d Instruction des Armées du Val de Grâce 74, boulevard de Port Royal FR Paris (France) pr_renard@yahoo.fr Marco Rispoli Centro Oftalmologico Mediterraneo Via Brofferio 7 IT Rome (Italy) rispolimarco@gmail.com Maria Cristina Savastano Department Ophthalmology, Catholic University Largo Agostino Gemelli 8 IT Rome (Italy) crisav8@virgilio.it Roy Schwartz Tel Aviv Medical Center, 6 Weizmann Street IL Tel Aviv (Israel) royschwartz@gmail.com Eric H. Souied, University of Paris Est Créteil Centre Hospitalier Intercommunal de Créteil 40, avenue de Verdun FR Créteil (France) eric.souied@chicreteil.fr Giovanni Staurenghi Eye Clinic, Luigi Sacco Hospital, University of Milan Via G.B. Grassi 74 IT Milan (Italy) giovanni.staurenghi@unimi.it List of Contributors IX

10 Foreword The innovation of no other diagnostic technique in the field of ophthalmology has had a greater impact on the management of patients than optical coherence tomography (OCT). Clinical activities, diagnostic guidelines, and multicenter trial protocols have been substantially modified by the introduction of OCT in the last 20 years. The reasons for this success lie in the numerous advantages granted by the use of OCT compared with the other older techniques: simplicity, quickness of execution, noninvasiveness, reliability, repeatability and quantification of measures, and results which are easy to read and understand are only a few of these advantages; these explain well the planetary success obtained in only a few years. More recently, OCT has also been useful to allow a different interpretation of some retinal diseases, and in the future the contribution of OCT images to the knowledge of pathogenic mechanisms involved in many retinal diseases will certainly be useful. For some time after its introduction, OCT had only been used in highly specialized centers, but after a while it started to be offered in any outpatient service; the only limitation for its wider distribution was the relatively high costs. Recently, thanks to the availability of several machines on the market, the costs have been reduced, and the number of available instruments is continuing to increase. Another important factor which contributed to the great success of OCT was the introduction of the intravitreous approach to the therapy of many retinal diseases. OCT is in fact able to detect a very small amount of fluid inside or under the retina, and this helps a lot when deciding whether intravitreous injections are needed or not. The combination of a new diagnostic tool with a new therapy is comparable to what happened in the 1970s and 1980s when fluorescein angiography and laser photocoagulation were introduced into the clinical practice. Also, at that time the interpretation and the therapies of many retinal diseases improved a lot, and for many patients the prognosis changed significantly. This new volume in the ESASO Course Series is published thanks to the enthusiasm of Professor Gabriel Coscas and Professor Anat Lowenstein who recently chaired an ESASO Course on new developments in the use of OCT and who were able to collect the contributions from all the speakers in a very short period of time. I hope that you will enjoy reading these contributions as much as they enjoyed working on the project. Francesco Bandello, Milan X

11 Preface Optical coherence tomography (OCT) is a noninvasive, patient-friendly imaging modality for eye structures. Thanks to recent advances in the technology with its ensuing increasing specificity and sensitivity, OCT has become the modality of choice in visualizing retinal pathologies as well as response to treatment. The role of OCT has been dramatically enlarging in the last decade, suffice would be to say that it has revolutionized the way we screen, manage and monitor the treatment of retinal disease. The ESASO intensive course in OCT is a must for any ophthalmologist as well as ophthalmologist in training. After a swift tour of the equipment available and basic techniques, the participants will learn the imaging features of pathological findings in retinal diseases starting with the outer layers including new modalities for choroid imaging, out-layer disease such as various types of macular degeneration, retinal disease such as diabetic retinopathy and vascular occlusion, and retina-vitreous interface pathologies. Special lectures are dedicated to teaching the practicality of using OCT in pre- and postsurgical evaluation of the posterior segment, in the differential diagnosis of vitreoretinal diseases and in the management of patients with retinal and neuro-ophthalmological diseases. Pre- and post-treatment cases are presented in a didactical manner. This is followed by a special case presentation elaborating on diagnosis and management. Gabriel Coscas, Créteil/Paris Anat Loewenstein, Tel Aviv XI

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