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Optical coherence tomographic artefacts in diseases of the retinal pigment epithelium
Emely Z Karam1, Ernesto Ramirez, Paula L Arreaza
1Unidad Oftalmologica de Caracas, Calle Circunvalación del Sol, Centro Profesional Sta Paula, Torre B, PB Caracas 1080, Venezuela. eka@cantv.net
Aims:
To show optical coherence tomography (OCT) artefacts in images from patients with retinal pigment epithelium detachment and retinal laser scars when OCT protocol analyses were applied.
Methods:
All OCT retinal scans using OCT-3000 (software 4.02) were reviewed over a three-month period. 13 eyes of 11 patients were selected for this study. 10 eyes had retinal pigment epithelial detachments and 3 had retinal laser scars. All patients had ophthalmic examination, fluorescein angiography (one had indocyanine green angiography) and OCT. All OCT processing and analysis protocols were applied in each case.
Results:
10 eyes of 8 patients with retinal pigment epithelial detachments showed flattening of the retinal pigment epithelium and apparent inversion of the dome of the detachment when scan protocol analyses were applied. 3 eyes with retinal laser scars displayed thinning of the retinal pigment epithelium without changes behind the scar. The retinal tissues around the lesions did not show any alteration.
Conclusions:
OCT scan analysis is an excellent method to obtain specific information about the retina. However, some lesions that cause disruption of external reflectivity (retinal pigment epithelium) can cause software-related artefacts when analysis protocols are applied. To prevent diagnostic error, re-evaluation of the clinical fundus examination should be considered in any patient in whom OCT findings do not appear consistent with the initial clinical findings.
