OCT in assessing glaucoma progression

OCT imaging enables the measurement of various structures in the optic nerve head (ONH) and retina which may be progressively damaged in glaucoma. Examples include the neural rim and lamina cribrosa at the ONH and the retinal nerve fibre layer (RNFL) in the peripapillary region of the retina and ganglion cell layer (and associated structures) in the macula. Most of these can be measured with high precision (low variability), which makes them good candidates for identifying progression and quantifying rates of progression. The presentation will provide a critical review of the literature for the application of OCT imaging to measure progression in glaucoma, considering the various potential anatomical targets. The application of OCT imaging in clinical practice will be discussed, including pitfalls in relation to image quality and artifacts. The presentation will also discuss the clinical relevance of OCT-measured change in relation to vision function and how imaging outcomes should be interpreted.