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, reevaluation of the clinical fundus examination should be considered in any patient in whom OCT findings do not appear consistent with the initial clinical findings.