With a focus on diagnosis of eye disease, the following clinical images demonstrate the importance of performing appropriate functional testing when it is clinically indicated in structural assessment.
Case supplied by Melina D’Agostini, Specsavers Tea Tree Plaza, SA
Px: 35-year-old female attending for routine check-up. No diplopia, flashes / floaters or other remarkable symptoms. Some trouble with seeing high-contrast print.
IOPs: RE 12mmHg and LE 11mmHg
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?
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The OCT widefield reports contain the following clinical indicators for functional testing:
- Thinning of the RNFL layers outside normative limits, as well as nasal ganglion cell layer (GCL) thinning outside normative limits in the RE
- Generalised loss of RNFL and GCL, more infero-temporally
- Asymmetric retinal nerve fibre presentation between the two eyes.
Visual field results:
The visual field results show a right defect localised to the upper supero-temporal quadrant and a left defect also localised largely to the upper supero-temporal quadrant.
The patient was referred urgently to an ophthalmologist for a homonymous superior quadrantanopia. The ophthalmologist agreed with the diagnosis and ordered further MRI imaging.