Clinical imaging: OCT clinical indicators for functional testing – Case #4

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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.

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

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