First Author: J.Mentes TURKEY
Co Author(s): Z. Oztas H. Ates S. Nalcacı 0 0 0 0 0 0 0 0 0
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To visualize the glaucomatous structural changes in the optic nerve (ON) head in cases with advanced glaucoma using three-dimensional (3D) spectral-domain optical coherence tomography (SD-OCT) and determine its relationship with schisis-like maculopathy.
Ege University Faculty of Medicine, Department of Ophthalmology, Izmir, Turkey
Single, observational case report. Patient underwent complete ophthalmological examination including anamnesis, best corrected visual acuity (BCVA), slit-lamp biomicroscopy, Goldmann applanation tonometry, fundus photography (FP) and flourescein angiography (FA). In addition, horizontal, vertical B-scan and 3D SD-OCT images of the ON head, the peripapillary retina and the macula were obtained and scrutinized.
A 30-year-old male was referred for retinoschisis in his right macula. He had previously underwent a bilateral trabeculectomy operation 6 years ago for primary closed angle glaucoma. BCVA was 2/10 in the right eye, and 10/10 in the left eye. Intraocular pressure (IOP) was 12 mmHg in the right eye, and 13 mmHg in the left eye with Latanoprost 0.005%. Fundus examination showed serous elevation in both papillomacular areas and in the right macula, as well as a large excavation and increased cup/disc ratio in the ON head (1.0 and 0.9 in the right and left eye respectively). B-scan SD-OCT demonstrated only typical retinoschisis findings with cystic changes and separation between the outer retinal layers extending from the temporal ON margin towards the macular areas. However, 3D SD-OCT images clearly revealed glaucomatous neuroretinal rim loss and the forementioned excavation in the ON head as well as defects of various sizes, shapes and depths at the superior, temporal and inferior outer wall of prelaminar and laminar region of the ON canal. The 3D images were further able to establish that these defects were both adjacent and interconnected to the retinal layers.
3D SD-OCT is an extremely important imaging technique that enables the identification of structural damages in the ON head in cases with advanced glaucoma, as well as its etiology in relation to schisis-like maculopathy.