Imaging technologies in ophthalmology offer the ability to objectively quantify various diagnostic parameters for the assessment and management of glaucoma. The diagnostic parameters provided by these technologies offer clinicians objective and precise methods to aid their decision in the diagnosis and management of the disease. High-resolution imaging of ONH anatomic features that are affected in glaucoma provide clinicians with the ability to visualize optic nerve structures such as the anterior and posterior lamina cribrosa surfaces, Bruch’s membrane-retinal pigment epithelium complex and its termination within the ONH border, tissue of Elschnig, and the scleral canal opening. These imaging techniques also allow for assessment of the circumpapillary RNFL and macula regions, thereby providing a holistic diagnostic approach that enables clinicians to make more confident diagnostic decisions.
A newer development in OCT technology, OCT Angiography (OCTA), has sparked interest in evaluating vascular alterations in the retina and ONH for diagnosis, staging, and monitoring in glaucoma. While findings from the literature comparing OCTA and structural OCT measurements for the detection of glaucoma and evaluation of structure-function association are divergent, the potential ability to elucidate the temporal sequence of vascular changes and optic nerve damage in glaucoma may pave the way for better understanding and management of the disease and for new targets for glaucoma therapy.
Copyright 2019, The Author(s).