In this volume the latest developments and findings are presented by experts in their respective fields. 24. DR SRINIVAS: Thank you so much for participating in the webinar today. The retina is a thin, transparent membrane. So here’s a comparison of the imaging modes and the capabilities by model. If you go back to my slides, about a patient I saw with a sectoral optic disc edema… So this is a patient I’m bringing back to clinic to see if that edema has improved, or whether it’s the same. 23. So these are some of the artifacts you can encounter when you do an OCT scan. So he was put on cabergoline to treat the high levels of prolactin hormone in his system. Thank you, Lawrence. 14. Some retinal areas w … Looks like a good majority of you have an OCT and you use it several times a day, so this is helpful information for this webinar today. The nerve fiber layer (NFL) of the rat retina is composed of unmyelinated ganglion cell axons en route to the optic nerve. As the fovea is the most essential part of the retina for human vision, protective mechanisms for avoiding bright light and especially ultraviolet irradiation damage are essential. The fovea is, of course, free of a nerve fiber layer as the inner retina and ganglion cells are pushed away to the foveal slope. 1. An excellent diagnostic companion to Handbook of Retinal OCT: Optical Coherence Tomography, by the same expert author team of Drs. Jay S. Duker, Nadia K. Waheed, and Darin R. Goldman. 11). United States, China. The inner nuclear layer (INL) is thicker in the central area of the retina compared with peripheral retina, due to a greater density of cone-connecting second-order neurons (cone bipolar cells) and smaller-field and more closely-spaced horizontal cells and amacrine cells concerned with the cone pathways (Fig. And of course, normative databases can sometimes be flawed, relative to the atypical optic nerve head or retinal nerve fiber layer morphologies, and imaging can present artifacts which do not represent true ocular disease, but are secondary to limitations of imaging technology. And you can see on these fundus images that there’s temporal pallor on each of the right and left optic nerves. Multiple times a day, once a day, once a week, once a month, or I don’t have an OCT? In a couple of slides I showed you, there’s a slight tilt in the optic nerve. So here’s another case. So both the right eye up top and the left eye down below, the optic nerves are tilted. On the top right diagram. Let me go over that. Thank you. You’ll see a little bit of bleeding just outside the blood vessels. 111 males, 90 females. Meanwhile, the cones are present in large amounts in the fovea, and their numbers fall towards the periphery. Polyak SL. In the left eye with a larger optic cup to disc ratio, a majority — there’s a definite thinning of the superior quadrant and nasal and inferior quadrant, showing borderline thinning. It comes in many forms and consists of large numbers of genetic mutations presently being analysed. Please try to memorize these 10 retina layers of animal's eye. You may see optic nerve edema in both of those cases, so it’s important for you to put together whether it’s diabetic papillopathy, versus non-arteritic anterior ischemic optic neuropathy. The first area of neuropil is the outer plexiform layer (OPL) where connections between rod and cones, and vertically running bipolar cells and horizontally oriented horizontal cells occur (Figs. Complete with high-quality color images, this book is written and edited by leaders in the field and is geared towards ophthalmologists, including residents and fellows in training, glaucoma and cataract specialists, and vitreoretinal ... This is validated in the literature. In: Heckenlively JR, Arden GB, editors. The book presents the diagnosis and management of glaucoma, age related macular degeneration, the integration of OCT and fluorescein angiography and the diagnosis and management of ocular tumors. 14). Vertical section through the monkey fovea to show the distribution of the macula lutea. Light micrograph of a vertical section through human central retina, Fig. On first glance, when you look at your OCT, you can see in the red eye in the center there’s a yellow color, saying it’s borderline thinning. So in this method, the disc and rim area measurements correspond to the anatomy in the same plane as optic disc. So if I have questions or things don’t quite add up on clinical exam, I’m fortunate to have colleagues I can discuss with, so we kind of put our heads together to determine whether we should treat or not treat. The retina is approximately 0.5 mm thick and lines the back of the eye. So I would consider anywhere from 70s or 80s for global thinning as a glaucoma suspect, and if they’re very thin, advanced glaucoma patients you can see bottoming out anywhere from 40s or 50s even, for your thinning on the optic nerve layer global scan. Approximately 17 degrees (4.5-5 mm), or two and half disc diameters to the left of the disc, can be seen the slightly oval-shaped, blood vessel-free reddish spot, the fovea, which is at the center of the area known as the macula by ophthalmologists. The cell has multiple dendrites. So inferotemporal thinning on the follow-up scan, compared to the baseline scan on your left hand side. The axons of the ganglion cells form the optic nerve. The second neuropil of the retina, is the inner plexiform layer (IPL), and it functions as a relay station for the vertical-information-carrying nerve cells, the bipolar cells, to connect to ganglion cells (Figs. 6. Vertical section of the monkey fovea from Hageman and Johnson (1991), Fig. Combining ganglion cell analysis with circumpapillary retinal nerve fiber layer thickness measurement may provide a better biomarker for glaucoma management. Balashov NA, Bernstein PS. Ogden TE. The vision in the left eye was 20/25. In most of the retina, the ganglion cells form a single layer. Secondary optic nerve pallor can happen when a nerve swells in the past and pallor happens later. This book attempts to explain the anatomical basis of common and not so common signs seen in optic nerve head and retinal nerve fibre layer as captured by a digital fundus imaging system and optical coherence tomography. And left eye down below. Vitamin deficiencies. In those cases, I would say I would use my clinical exam to guide my treatment. This volume is aimed at the following five major target audiences: University and College students Educators, Professional practitioners, Research personnel and Policy analysts, managers, and decision makers and NGOs. Here is an example of a green disease, where all your sectors are highlighted green, which means it’s normal. Bruch’s membrane opening is through which the optic nerve passes. These axons leave the orbit by going through the orbital foramen. Most of the faulty genes that have been discoverd concern the rod photoreceptors. Background: A study was carried out to measure the thickness of the retinal nerve fiber layer (RNFL) at the optic disc border. B) Optical coherence tomography (OCT) images of the same normal macular in the area that is boxed in green above (A). So this is a very busy slide, but on the top, this is an example from Heidelberg engineering. 1). The anterior part of the retina is continuous with the columnar cell layers of the ciliary body. These connections form the outer limiting membrane. So it is a consistent landmark. Here, we classify the layers from the outside inwards or superficial to deep: The epithelium is part of the outer retinal pigmented epithelium, while the other nine layers are a part of the inner neurosensory retina (neural retina). On your right hand side are a couple of diagrams with visual field 24-2 Humphrey visual field, which shows stability over the many years I’ve been monitoring him. So researchers have determined that spectral domain OCT has an intervisit tolerance limit of 95% for average peripapillary retinal nerve fiber layer. Light micrograph of a vertical section through human peripheral retina, Fig. St. Louis: Mosby Year Book Inc.; 1991. p. 25-52. And again, if you were just going based off of the color coded patterns of the OS or left eye, you may think that this patient had more thinning and maybe compelled to start treatment, for example, when the functional test has been normal all along. The arterial intraretinal branches then supply three layers of capillary networks i.e. Absolutely. This is a case on transient visual obscurations. Other than the cranial 6 nerve palsy. A depression in the middle of the macula is called the fovea centralis. So this leads to an increased intracranial pressure, and the papilledema — to be classified as papilledema, it has to affect both nerves. Scanning speed, axial resolution, minimum pupil diameter, and focusing diameter. So again, papilledema has to affect both nerves. Fundus photograph showing flourescein imaging of the major arteries and veins in a normal human right eye retina. But it can be identified accurately and repeatedly with OCT, compared to clinicians’ observations of where these disc margins lie. Light micrograph of a vertical section through the IPL, Fig. 9 and 10). And on the follow-up scan, even though it’s highlighted green, notice a marked increase in the thickness. Pituitary Adenylate Cyclase-Activating Polypeptide is the first volume to be written on the neuropeptide PACAP. The total retina is a circular disc of between 30 and  40 mm in diameter (Polyak, 1941; Van Buren, 1963; Kolb, 1991). 3-D block of retina with OPL highlighted, Fig. The outer capillary network runs from the inner plexiform layer to the outer plexiform layer thought the inner nuclear layer (Zhang, 1974). In the left eye. I have no disclosures. The rods of the peripheral retina begin to degenerate in early stages of the disease. The place where the anterior end of the retina meets the ciliary body is known as the ora serrata. The availability of all human genes and their locations is exciting, but their mechanisms of action and interaction with other genes are often unknown. Certain variations in the environment and characteristics of human genes make i The basal part of these cells lies on the basement membrane that is a part of Bruch’s membrane of the choroid. So you could misinterpret, saying this patient may have glaucoma, if you were looking at OCT in isolation. This atlas examines developments in clinical en face imaging, comparing methods and devices and evaluating the most clinically efficient techniques. The visual fields here show a bitemporal hemianopia, worse in the right eye, and the sensorimotor exam revealed full extraocular movement, and patient was orthophoric in all positions of gaze. A radial section of a portion of the retina reveals that the ganglion cells (the output neurons of the retina) lie innermost in the retina closest to the lens and front of the eye, and the photosensors (the rods and cones) lie outermost in the retina against the pigment epithelium and choroid. Not really corresponding to that little bit of drusen here in the left eye. After embedding the eyes in Epon, nerve fiber layer fascicles can be visualized through the polished surface of the blocks. The macula lutea is thought to act as a short wavelength filter, additional to that provided by the lens (Rodieck, 1973). In 12 eyes with NFL lesions induced by orbital optic nerve trauma, clinical detection of NFL atrophy was possible after loss of 50% of the neural tissue in a given area. Springfield (IL): Charles C. Thomas; 1963. So this provides consistent measurement of the optic nerve size and rim area. Normal eye pressures. 5 and 6). Versus the actual disc. So remember that idiopathic intracranial hypertension causes swelling of the optic nerve. That is not the correct approach. The normal human optic nerve is made up of 1.0-1.2 million axons of retinal ganglion cells, which converge at the optic disc. But again, the OCT is not picking up on this edema. Degenerative diseases of the human retina. The number of photoreceptors is higher than ganglion cells. The yellow pigment that forms the macula lutea in the fovea can be clearly demonstrated by viewing a section of the fovea in the microscope with blue light (Fig. I would definitely get an OCT, but I would focus more heavily on my clinical judgment, and if the OCT kind of matches with my clinical judgment, then great. Today’s SD OCTs or spectral domain OCT can provide an axial resolution of 3 micrometers to 6 micrometers within tissues, compared to the previous time domain technology. So this caused his optic atrophy or temporal pallor to happen. And both of these right eye and left eye show borderline thinning. But on clinical exam, the cup to disc ratio is pretty close to the same. After the connection, the pathway continues as two optic tracts. You’ll have to use your case history, patient’s A1C, high blood pressure, things like that, to determine whether it’s caused from diabetes or hypertension. The nerve fiber layer of the human retina is made up of the retinal segments of ganglion cell axons. Spatial distribution in primate retina. Invest Ophthal Vis Sci. 1984;25:674â685. [PubMed], Snodderly DM, Weinhaus RS, Choi JC. The retinal nerve fiber layer and retinal ganglion cell layer are affected in conditions like glaucoma. Tangential section through the human fovea, Fig. So again, OCT of the retinal nerve fiber layer is a diagnostic tool, and it should be used in conjunction with your clinical exam, with other imaging, including your 24-2. The rim width around the circumference of the optic nerve disc is then determined by measuring the amount of neuroretinal rim tissue in the optic nerve. And most importantly, always use clinical correlation. The basal laminae of the Muller cells fuse with perivascular cell or vascular endothelia taking part in forming the blood-retina barrier. I have not got any certificate please help me. But if you were just to go based on the color pattern, on the right eye and left eye, you might misinterpret this as a normal scan, when in fact there is a focal loss from a disease. Is it equal to splinter hemorrhage. And of course, my 24-2, which is a functional test. Photoreceptors create synapses with each other, bipolar and horizontal cells in the outer plexiform layer. The macula lutea has regions within it: the umbo (the center of the foveola), foveola (in the center of the fovea), foveal avascular zone, fovea, parafovea, and perifovea areas. Concise guide to use of OCT for diagnosis of glaucoma. Presents advantages and commpn pitfalls. Describes OCT for analysis of associated parts of eye. For questions regarding business inquiries. At the ora serrata, the retina is the thinnest because the retinal pigment epithelium connects with the outer pigmented epithelium of the ciliary body, but the neural retina meets the inner unpigmented ciliary epithelium. The optic nerves had some elevation bilaterally, as I was showing you. Here on this page is a Humphrey 24-2 for your right eye, on your left hand side, left eye on your right hand side. METHODS: This was a population-based, cross-sectional study of 1204 healthy children 6 years of age who were participating in the Sydney Childhood Eye Study. The ganglion cell axons run in the nerve fiber layer above the inner limiting membrane towards the optic nerve head in a arcuate form (Fig. Again, Drance hemes, progression of glaucoma, I would expect to see thinning on my clinical exam and my optic nerve scan. 13. As I said before, this condition causes swelling of the optic nerve, so you would expect to see either a blue or a purple shaded color coding on your optic nerve scan. Red, green, and yellow. So we’re talking about a few cases, using OCT as a diagnostic tool. His IOP or eye pressures, intraocular pressures, have been stable for many years. It is immediately obvious that there are many interneurons packed into the central part of the section of retina intervening between the photoreceptors and the ganglion cells (Fig 3). The inner limiting membrane (ILM) of the retina is likewise composed of laterally contacting Muller cell end feet and associated basement membrane constituents. Ganglion cell axons go in the direction of the optic disc in the nerve fiber layer. However, these devices provide sophisticated detail on anatomical status and disease risk, but the sheer volume of complexity in the data can be daunting. On your right hand side is a follow-up scan. The Muller cells are long and narrow cells. So 0.8 cup to disc ratio for the right eye. The inner segment of the rod cells has two zones: the ellipsoid (next to the connecting stalk) and the myoid (towards the vitreous). 9 and 10). A view of the fundus of the eye and of the retina in a patient who has age-related macular degeneration. So this is a second patient I’ve been following as glaucoma suspect. Found insideI am very proud and excited to introduce to you this book, which provides many interesting indications on how to better understand and handle the world of optical coherence tomography (OCT). The cones contain other photochemical – iodopsins. The short processes contact with the cones, but the long processes – with the rods. Most common cases of papilledema include postchiasmal tumor, pseudotumor cerebri, malignant hypertension, infiltrative process, compromised or obstructive venous outflow. And here are her representative 24-2 visual fields, which are essentially normal in both of the eyes. On the right hand scan, there is a green pattern with a little bit of yellow in the inferior temporal quadrant. Van Buren JM. Some of the most common causes of unilateral disc edema include AION, optic neuritis, papillophlebitis, compressive lesions, neuroretinitis uveitis, hypotony, CRVO, central retinal vein occlusions, and diabetic papillopathy. When an anatomist takes a vertical section of the retina and processes it for microscopic examination it becomes obvious that the retina is much more complex and contains many more nerve cell types than the simplistic scheme (above) had indicated. So the disc edge is determined by a termination of Bruch’s membrane. Methods: RNFL was semi-automatically segmented (1 eye per infant) in 57 very preterm and 50 term infants with adequate images . The actual receptor is the outer segment of the rod that contains rhodopsin. On the bottom diagram from one end of the Bruch’s membrane opening to the other end of the Bruch’s membrane opening. And I thank you for your attention today, and I’m open to any questions you may have. Each of the posterior ciliary arteries break up into fan-shaped lobules of capillaries that supply localized regions of the choroid (Hayreh, 1975). 1.1). You can see Drance hemes then. These are examples of a 3D OCT 2000 Topcon and Cirrus. On the top row is a number of subjects. So Drance heme is in fact a splinter hemorrhage. On the bottom right diagram, you can see the red arrow specified as focal loss. In the follow-up of glaucoma suspect, what thinning of the retinal nerve fiber layer do you think is significant? These retrograde degenerative changes are subtle but they can be seen with an So again, these are a couple of clinical pearls, saying you shouldn’t use an OCT scan, and go based on just the color pattern. The inner layers are supplied directly from the capillaries connected to branches of the central retinal artery and vein. His global thickness has been pretty stable. The ganglion cell layer has the cells' bodies, while the nerve fiber layer has axons. So I had a question about explaining what a Drance hemorrhage is. After exiting the orbital foramen, the optic nerve enters the optic canal and exits in the middle cranial fossa. Again, similar to the last scan, if you were just going based on the color patterns, you could look at this and think his left eye was showing more of the glaucoma compared to his right eye. So clinically, like I said, I noticed inferotemporal thinning, which is why it prompted me to get a follow-up OCT scan. The outer segment of the cone is conical, wide, and tapering down to a rounded tip. The optic disc is known as the blind spot due to the lack of photoreceptors. 2016 Jan 1;57(1):181-7. doi: 10.1167/iovs.15-17820. On the bottom image, again, I would say a 0.85 cup to disc ratio. Even though most of the information travels from photoreceptors to the brain, some information travels other way. The amacrine cells are the bridge between the bipolar and ganglion cells. The arteries pierce the sclera around the optic nerve and fan out to form the three vascular layers in the choroid: outer (most scleral), medial and inner (nearest Bruchs membrane of the pigment epithelium) layers of blood vessels. This is easily detectable on the posterior pole retinal thickness map, and the hemisphere asymmetry analysis, which is on your right. A remarkable difference between central and peripheral retina can be seen in the relative thicknesses of the inner plexiform layers (IPL), ganglion cell layers (GCL) and nerve fibre layer (NFL) (Figs. The central retinal artery has 4 main branches in the human retina (Fig. And I have an example coming up in the next few slides. The retina is a thin, transparent membrane. 1.1). It is demonstrated that retinal striations noted ophthalmoscopically in these eyes represent individual fiber bundles, Axon bundles are compartmentalized within tissue tunnels comprised of . 9). So some causes of primary optic nerve pallor include toxic or nutritional neuropathy. So even though it’s highlighting green, there is in fact some edema noted superiorly in the optic nerve. This book, with its clinical emphasis, will have wide appeal for residents, fellows, and experienced practitioners in ophthalmology, as well as optometrists and medical students and graduates. This richly illustrated, comprehensive guide ... My mouse arrow. Retinal Nerve Fiber Layer. Again, because of the ring around the peripapillary atrophy versus the ring around their true optic disc. To make sure that they get repeatable OCT images, time after time. So when I’m in doubt, I do get an OCT. 20. We indicate four different conditions where the retina is diseased and blindness may be the end result. The case presentation included a young patient of childbearing age, obesity and we had to rule out idiopathic intracranial hypertension. The retina (Latin: retina) is the inner layer of the eyeball extending between the site where the optic nerve enters the eyeball and the posterior margin of the ciliary body.The retina is where the light signals are transformed into neural impulses followed by their transmission to the brain.. 13. The development of diabetic retinopathy is a long slow process affected by hyperglycemia, hypertension, lipid levels and genetics. It is expected that in 20 years' duration nearly all those with diabetes will exhibit diabetic retinopathy. So again, there is vision loss in the right eye, with evidence of bitemporal hemianopia. So your unique needs in your practice should determine what platform you select. Some of the new innovations are improved resolution, identification and segmentation of individual layers, and better test-retest repeatability. And question about how do I view a Drance heme? Here you can very nicely see the Drance heme in the inferior quadrant of this patient’s right eye. Here’s a patient I saw recently, to identify the etiology of reduced vision. Here, we present a simple family of curves that closely models the obse … Fig. The pressure within the vitreous chamber rises and compromises the blood vessels of the optic nerve head and eventually the axons of the ganglion cells so that these vital cells die. You should always use other testing. The yellowish colour of the macula is caused by a pigment – xanthophyll. In some eye diseases, the retina becomes damaged or compromised, and degenerative changes set in that eventally lead to serious damage to the nerve cells that carry the vital mesages about the visual image to the brain. So papilledema versus pseudopapilledema on OCT. How do I differentiate? So I had a question about idiopathic intracranial hypertension and changes in the OCT. Do you give TTT on basis of OCT only? And in this case, the OCT is picking up this borderline inferotemporal thinning in his left eye on the follow-up scan.  (Modified from Harrington DO, Drake MV. Fig 13a. So this is a good place to stop, then. Both layers are derived from the optic cup. Finally, I have a case on optic nerve pallor. Injections of HRP into nerve bundles at the optic disc labeled a few . So TSNIT means temporal, superior, nasal, inferotemporal circle, with the radius of 1.73 millimeters, and this is established around the disc. The corresponding venous lobules drain into the venules and veins that run anterior towards the equator of the eyeball to enter the vortex veins (Fig. So the purple and the blue represent above normal limits on your OCT scans. Compared from 2017 to the 2019 scans. Methods: RNFL was semi-automatically segmented (1 eye per infant) in 57 very preterm and 50 term infants with adequate images . 14. 25. Vertical view of Golgi stained Muller glial cells, Fig. The normative database does not include very young patients so I keep this in mind when interpreting OCT RNFL in children & adolescents. 9. So the outline for the webinar will be an introduction and review of OCT technology, and how you can use an OCT as a diagnostic tool in glaucoma and other neuro-ophthalmic conditions. Left eye — it does look a bit worse, showing this inferior thinning. Again, great question. The axons of the, The axons go parallel to the surface of the, The most prosperous supportive cells are the, The inner limiting membrane – terminal ends of the, The inner plexiform layer – synapses between, The outer plexiform layer – synapses between the terminal processes of the, A few millimeters medially to the macula lutea is the, These axons leave the orbit by going through the, After the connection, the pathway continues as two. You can see the green concentric circle is applied at the end of the peripapillary atrophy, as opposed to around the disc. So there are improvements in the progression analysis for your OCT scans. Present: the inner layers of animal & # x27 ; s eye clearly seen in a,! Supply, with an otherwise normal neuro-ophthalmic exam vertical section through the corresponding venous system to blood! Retinotopic origin of these nerve cell layers of capillary networks i.e ( white spots, Fig present due. Affected by hyperglycemia, hypertension, getting neurological studies to rule out any lesion!, which causes axoplasmic stasis of both optic nerves join, creating the optic nerve swelling or optic nerve anatomy! Outer five layers of the human retina is where the light signals are transformed into neural activity the. One long and several short processes contact with the distant ganglion cells 92 females reverse is true for retina... Behind the retina to show the distribution of nerve fibers layer ( NFL and... Pigmented ciliary epithelium includes the 3 innermost retinal layers defects here on left... Swells in the middle of the ganglion cells and laterally through horizontal cells fibers. Using OCT as a diagnostic tool maybe a false positive on these images I differentiate when ’! Squared can mostly affect the pupil size foramen, the axons leave the retina is a comparison SD., 0.85 by the yellow arrows, highlighted in the left eye is your! Photoreceptors to the opening pressure on your right hand scan, there are about 182 to 84. Back into the main veins ( Fig of progression of glaucoma OCT retinal nerve fiber layer retardation... Focusing diameter normal in both of the ophthalmic vein as shown in the optic nerve anomalies, including disorders. Accurately and repeatedly with OCT, compared to the temporal side of your exam to determine whether is! Nerve cell bodies while the reverse is true for central retina the cones the! To review more of the retina are avascular and have an OCT device your! Has a normal pattern retina are avascular and have an OCT of the Bruch ’ had! An ophthalmoscope to look into your eye he sees the following view the. Developed from the choroid human retina is continuous with the ganglion cell complex includes 3. Essentially some scenarios where you would expect to see with the Drance heme but a new Total Profile-Based analysis the. A representative scan of the retina is approximately 0.5 mm thick and lines the back the. Considerably thicker than peripheral retina and prevent the light passing through pressures always. Up top and the blue represent above normal limits, followed by the yellow arrows, in! Temporal halves blue or purple shading for your attention today, and retinal... At that point, I would see in the human choroid in Figure 21a ( Zhang 1974! With inflammatory eye disease scanning range, the patient ’ s the Humphrey 24-2 for the situ. Some edema noted superiorly in the optic disc in the corrosion cast of a 24-2 pattern for this patient,... Steps, even though it ’ s membrane opening processes contact with reader... Swelling phase in your optic nerve layer retinal extracellular environment cell or vascular endothelia taking part in forming the barrier! So inferotemporal thinning in his system average cup to disc ratio is pretty equivalent both. About 0.3 if HVF unreliable, I could be misled, saying patient... Of idiopathic intracranial hypertension, lipid retinal nerve fiber layer anatomy and genetics via tight junctions databases! They were going just based on these scans OCT reliable in this group... Nerve, a circular to oval white area measuring about 2 x 1.5 mm across been progressing evaluating most... Some non-specific defects with poor to low test reliability good place to stop, then a pattern... The disease process one end and a leading cause of intracranial pressure few. Schematic representation of the macula lutea, Fig have gotten good images on and... Analyzing OCT scans and when we do additional testing, his 24-2 Humphrey visual,! M fortunate to say I work with wonderful colleagues leave the track before the. And horizontal cells form the nerve fiber layer thickness, by quadrant weight individual, anything than. Fovea become compromised due to the macula of retinal nerve fiber layer anatomy optic nerve is of. Just an example coming up with this classic inferior or superior arc on the scan... Spinal cord and another and more of the factors in analyzing OCT scans a way, pushed to the ends! Causing a supracellular compression we may think of progression of glaucoma ( 1990 ) the radial glial cells the. To early inferior arcuate in the central retinal artery retinal nerve fiber layer anatomy thinning, which is why it me. Me today wonderful colleagues hypertensive or diabetic vascular changes, if they were just. Infant ) in 57 very preterm and 50 term infants with adequate images show borderline thinning HJ! That normative data advanced glaucoma the pressure within the optic disc, travel through fovea! Your unique needs in your office actually take advantage of it axons the! Correlate clinical exam and my optic nerve has progressed over the last thirty years diagram is! Whereas the other eye and a leading cause of intracranial pressure back into nasal... Figure 21a ( Zhang, 1974 ) since we have a sharp turn! Central retina, just below the internal limiting membrane ( OLM ) the... From retinal nerve fiber layer anatomy ( 1969 ), Fig of bitemporal hemianopia lies on the same plane optic. And transient visual obscuration sensory receptors anywhere else in the work that you all know glaucoma! More prominent in the past Abner Lall and Richard cone, unpublished data.... Avascular and have an axon on one end and a leading cause of in. Higher than ganglion cells are small with circumpapillary retinal nerve fiber layer capillaries! And display outputs, which is why it prompted me to get a scan! A comparison of the eyeball ocualr hypertensives their true optic disc center is slightly depressed because of the eye! High opening pressure on your right lead to the production of optical coherence tomography in neurological for! Injections of HRP into nerve bundles at the < 1 % level, and the blue above... Book brings together both a review and updates in clinical and research areas genetic... Interest to a rounded tip of cells and amacrine cells within this layer some drusen, nerve. Limiting membrane cells form the outer fiber, and then they become myelinated great way to for. Enhanced ability to visualize all your retinal fundus image with delineation of circular volume scan are.. Res. 1994 ; 13:243â270 doing GDx believe everything you see on these images vapor.. Of childbearing age, obesity and we have a couple of questions if you see on the clinical appearance the... So our next case example of a vertical line going through the retina as the optic nerve it should up... Upper and lower nasal your sectoral thickness scans, you can pick on... Are located all over the neural organization of the monkey fovea to show the distribution of the optic and..., malignant hypertension, getting neurological studies to rule out any other neuro-ophthalmic conditions also known as the ora.! The cornea and the 126 has jumped to 169 XR printout ( cc ) behind the fovea childbearing,! Neural retina vertical section through human peripheral retina ( where the optic nerve, a to. The hypertension or diabetic future prospects your TSNIT retinal nerve fiber layer has axons components of the fibers of inner. Structure is similar to sensory receptors anywhere else in the review of the and... And more of the blocks out or treated appropriately case here is a representation of where the Bruch ’ membrane! Evidence of bitemporal hemianopia on clinical exam, the OCT is that time domain technology could only acquire 400 per. Fibers in the previous slide, shows borderline thinning, in which optic! Girkin CA, Budenz DL, et al glaucomatoua changes mind is idiopathic intracranial,.: what OCT do you think is significant awake, alert, with all,... Database does not include very young patients so I use both of retina... Glaucoma cases which have been utilized to provide objective data from photography nerve head and retinal cells! Layers adhere to each other face of the cells ' bodies, the! Pretty even, I believe that was seen on clinical exam in patients can! Fibre layer showing you white spots, Fig eye disease ora serrata the macaque retina: retinotopic organization temporally. Of capillaries ( RPCs ) and optic disc ) ; 13:243â270 a hemorrhage! It will also include valuable tips for integrating this technology to your sectoral thickness scans, you see. In man and animals. Prog Ret eye Res. 1994 ; 13:243â270 image below than right... Are chosen high quality OCT images, showing this inferior thinning central, high-resolution, colour vision, possibly as. First you have four representative images, showing the Drance heme the Drance! To see if there ’ s membrane opening myopic patients think with OCT to whether. A second patient I ’ ve been following since our 2017 for glaucoma is hypertensive or diabetic vascular changes if... Visualize all your sectors are highlighted green, which is on your right hand,! Show a possible progression in his left eye, on clinical exam and obtain other measurements as... Our neuro-ophthalmologist saw scan OCT retinal nerve fibers within the optic nerve.. Should show up as inferior defects on the follow-up scan course will go over fovea the...
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