You may never look at an OCT image the same way again.

Every day, ophthalmologists rely on OCT to diagnose disease, monitor progression and guide treatment. But have we ever stopped to ask a simple question?

Does the image displayed on the screen truly represent retinal anatomy?

Our answer, surprisingly, is no.

In this article, recently published in Ophta – Swiss Journal of Ophthalmology, we explore how the geometry of OCT image display can influence our perception of retinal morphology. While OCT measurements are highly accurate, the way images are displayed may alter the apparent shape, height and spatial relationships of retinal lesions.

To help translate these concepts into everyday clinical practice:

• Table 1 summarizes how the morphology of common retinal lesions changes when OCT images are viewed using a true 1:1 anatomical scale.

• Table 2 explains how OCT-A should be interpreted, emphasizing that it is primarily a functional imaging modality rather than a direct anatomical representation.

• Table 3 highlights the potential clinical consequences of overlooking display geometry during routine OCT interpretation.

Rather than discussing theory alone, we illustrate every concept with real clinical cases from our daily practice, making these principles immediately applicable to everyday patient care.

I hope you will find the paper both useful and thought-provoking.

When Seeing Is Not Measuring
How OCT Display Geometry Influences the Interpretation of Retinal Disease – A Practical Guide for Everyday Clinical Interpretation by Filippo “Pippo” Simona,PaxEyeCenter, Locarno, Switzerland,Federica Fossataro,Ospedale Fatebenefratelli e Oftalmico, Milan,Italy,Alfredo Pece,Centro Oculistico Retina 3000, Milan, Italy

If OCT is our most trusted imaging modality, should we also rethink how we look at it? I’d be delighted to hear your thoughts.