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 #4
Case supplied by David Jones, Specsavers Mt Ommaney, QLD
Px: 28-year-old female
IOPs: RE 15mmHg and LE 17mmHg
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
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The OCT widefield reports contain the following clinical indicators for functional testing:
- Superior and inferior thinning of the RNFL OU
- Vertical CD ratio is outside normative limits in LE.
Functional testing was conducted and the visual field results are shown below.
Visual field results:
The visual field results show a left localised infero-nasal step outside normal limits. The probability of the visual field being normal is less than 1%. A milder right superior field loss can also be seen, with the probability of deviation being normal under 5%.
The patient was referred to public ophthalmology and triaged under their guidelines.
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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