Optical coherence tomographic artefacts in diseases of the retinal pigment epithelium.

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.