OCT surgery: questions and answers

A patient attended for a low vision assessment and has a cone dystrophy (Figure 1). Is OCT of any value in establishing a management plan, such as, for example, establishing a preferred retinal locus (PRL) to help with eccentric viewing training?

Answer: OCT is useful for progression monitoring, but patients with loss of foveal function inevitably establish a new loci of eccentric fixation with time. Blue laser fundus autofluorescence imaging (Figure 2) provides a better assessment of RPE damage/health and may give more information relating to visual performance.

A colleague is worried about this recent scan (Figure 3). The patient is male, 47 years old, has full fields, and negligible refraction. He is of Indian ethnicity, has no known systemic or ocular history of relevance and no other signs of note. Is the superior thinning revealed (and repeatable) of any concern?