Rohit Varma, MD, professor of ophthalmology and preventive medicine, University of Southern California, worries that physicians may be relying too much on overly simplified, and sometimes erroneous, computer-generated interpretations of the scans. Included are the latest generations of advanced imaging instruments: optical coherence tomography (OCT), scanning laser polarimetry (GDx) and scanning laser tomography (HRT). Measuring corneal thickness (pachymetry) 5. Side effects requiring immediate medical attention. Patient education. It’s quick and painless. Dr. Moya finds OCT most useful with glaucoma suspects who may not have obvious field defects on standard perimetry. I am a 64 years old man who had an eye test done recently, which indicated no evidence of diabetic retinopathy in my right eye. Because I did have an abnormal VEP in my right eye, he therefore declined to order an OCT test. Ophthalmic photographer Marshall Tyler, CRA, FOPS, places OCT in the pantheon of retinal imaging devices. However, we have recently seen two cases of dry eye syndrome associated with Accutane therapy that have persisted for more than two years. But “OCT images are so intuitive that most patients will understand what I’m talking about when I show them the images,” Dr. Ip said. Setting target pressures. He regards OCT as “quite an advance from when we just had fluorescein angiography and fundus photography. To take the test, I peered into a hole in the side of the Optomap machine. Financial interests: None.Frank J. Moya, MD, consulting assistant professor of ophthalmology, Duke University. It is quick and painless, nothing touches your eye at all - it is just like having an x-ray taken and takes a few seconds additional to your usual eye test. This detailed image of the retina allows your doctor to see the retina at a microscopic level and detect swelling in the retina. It also shows the anatomical changes that can occur in a way that fluorescein angiography does not. None. Optical coherence tomography (OCT) was only recently approved for use in the United States, but its use in Europe has demonstrated minimal risk for patients. Here is what the experts advise on getting the most from OCT. Rohit Varma, MD:“If it’s not good quality, and you think you have a good chance of getting a good image, then repeat the OCT. We do repeat testing for visual fields. Talk to your doctor if you are worried. “Not every OCT is a revelation. “We still need more experience to know when you see a defect on these imaging tests, whether it’s an artifact or correlates with visual field loss now or in the future.” Dr. Huang is associate professor of ophthalmology, University of Southern California. Arch Ophthalmol 2004;122(6):827–837. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. New OCT Enhanced Eye Test As well as our normal eye tests, we now offer enhanced OCT tests as well. Light waves from the machine will scan across your retina, and produce an image for your doctor to interpret. Because OCT can detect the vitreoretinal interface with good resolution, it makes it easy to document and follow conditions such as epiretinal membranes and secondary thickening. “It can be used in synergy with visual field so you don’t have to repeat the field multiple times.”, While the utility of OCT may be uncertain in detecting progression, Dr. Schuman noted that there’s also a lot of variability in the gold standard—visual field testing. “In general, patients with less pathology have a better chance of getting a good OCT scan.”. In particular, if he observes thinning or defects of the nerve fiber layer and then sees corresponding abnormalities on other tests, he is more confident of a diagnosis. As the OCT eye test works by emitting light waves, it is not effective for diagnosing any eye condition that interferes with light passing through the eye, such as cataracts. What is OCT? Blurred vision may occur in the first few weeks . OCT cannot make that call. Is treatment warranted? He is now working with a prototype that is 73 times faster than the current model and should provide more detailed anatomic information for both glaucoma and retina applications. “In a way, we’re searching for the truth and we don’t know which device is giving that to us.”. According to Dr. Varma, some eye care providers are making treatment decisions based on overly simplified, and often unreliable, interpretative information generated by OCT (and other optic nerve imaging devices, too). For instance, the potential side effects associated with intravenous fluorescein use, and the injection procedure itself, no longer exist. Written By: Miriam Karmel, Contributing Writer, Instruction Courses and Skills Transfer Labs, Program Participant and Faculty Guidelines, LEO Continuing Education Recognition Award, What Practices Are Saying About the Registry, Provider Enrollment, Chain and Ownership System (PECOS), Practice Forms Library - Job Descriptions, MIPS Solo and Small Practice Survival Guide, 2020 MIPS Payments: Understanding Remittance Advice Codes, Final Checklist for EHR/Non-EHR 2019 MIPS Reporting, Subspecialty/Specialized Interest Society Directory, Subspecialty/Specialized Interest Society Meetings, Global Programs and Resources for National Societies, Dr. Richard Mills' Opinions, 2002 to 2016, International Society of Refractive Surgery. But OCT is not a magic bullet, and it cannot stand alone. But this can pose health risks, especially if repeated. The first opinion was based on an abnormal OCT reading, but another OCT scan was normal. Optical Coherence Tomography (OCT) is a very detailed non-contact eye scan. It is important to establish the actual cause of the scotomas. “It’s one more important tool in your armamentarium. The macular thickness test is not as sensitive as the nerve fiber thinning test for detection of glaucoma, he explained. The photographer needs the working diagnosis, as well as the type of scan that’s desired. hydroxychloroquine is on the eye. Similar to ultrasound, OCT uses light rather than sound waves to illustrate the different layers that make up the back of your eye. The oct is a magnificent piece of equipment that is capable of many uses. How can two doctors use the same device and come up with two completely different readings? Optical coherence tomography (OCT) is a non-invasive imaging test. “I have found that larger optic nerves have correspondingly thicker nerve fiber layers, as the testing occurs closer to the optic nerve, where we know the nerve fiber layer is thicker,” he said. 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