With a focus on diagnosis of eye disease, particularly glaucoma, the following clinical images demonstrate the importance of performing appropriate functional testing when it is clinically indicated in structural assessment.
Case #3
Case supplied by Kevin Middleton, Specsavers Cranbourne, VIC
Px: 61-year-old female
IOPs: RE 11 mmHg and LE 11mmHg
No remarkable presenting signs or symptoms.
OCT widefield reports:
Consider the structural information provided in the OCT scans above:
- What’s normal?
- What’s abnormal?
- Are there any clinical indications for functional testing?
Discussion
[su_accordion][su_spoiler title=”Click to reveal” open=”no” style=”fancy” icon=”chevron” anchor=”” class=””]
The OCT widefield reports contain the following clinical indicators for functional testing:
- Indistinct disc margins OU
- Superior RNFL defect OU.
Functional testing was conducted and the visual field results are shown below.
Visual field results:
The visual field results show an inferior defect in both eyes, with the RE almost completely respecting the horizontal midline and being more severe and quite significant.
Differential diagnosis:
- Optic atrophy
- Compressive optic neuropathies
- AION / NAION
- Normal-tension glaucoma (advanced)
This patient was referred with some urgency to ophthalmology, with additional patient follow-up to stress the importance of attending for further consultation.
[/su_spoiler][/su_accordion]
More in the ‘OCT clinical indicators for functional testing’ series
Case #1 and series introduction
Case #2
Case #3
Case #4
Case #5
Case #6
Case #7
Case #8
Case #9
Case #10