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Q&A with Dr. Rosen on the OCT

Q&A with Dr. Rosen on the OCT:

Please describe what the OCT is used for and give a basic sense of how it works.

OCT stands for Optical Coherence Tomography.  It works similar to ultrasound but uses light instead of sound.  It is used to image and measure the tissue structures of the eye.

What components, or how much of the surface of the cornea, does the OCT map? Why is this critical for eye health?

The OCT can create cross sectional and 3D views of the macula, the optic nerve, and other areas of the retina. It can also image the cornea. By getting extreme close-ups of ocular tissue, we can detect disease in at earlier and take the appropriate measures to deal with it.  In addition to better views, the OCT can measure thicknesses, and compare these measurements with norms that have been established which can also be used to differentiate disease from normal.

What types of eye diseases and disorders can be discovered?

The OCT is useful in diagnosing and following glaucoma, borderline glaucoma, dry and wet macular degeneration, macular edema, diabetic macular edema, optic nerve edema, vitreous detachment, retinal detachment, retinal layer separation, and macular holes.  It is also useful in diagnosing and following corneal dystrophies such as keratoconus as well as working with complicated contact lens cases.

What is it about this particular technology that you find most exciting? What is the component that made you feel you need to invest in this for your practice?

I have spent my entire career managing conditions by looking at the overall clinical picture. This hasn't changed, but with this technology, it is possible to see the structures involved which has deepened my understanding of how these conditions progress and affect vision. The OCT helps me make clinical decisions on when it is best to treat or refer a patient at an early stage and when it is fine to avoid a treatment in favor of continued monitoring.

Why did you choose this particular equipment from this supplier?

We chose the RTVue from Optovue because Optovue has always been the regognized leader in this field. The RTVue has advanced Glaucoma detection abilities by not only testing around the optic nerve but by measuring an even earlier indicator found in the macula.  This instrument also offered anterior/corneal imaging in addition to retinal/optic nerve imaging. It has impressive imaging abilities due to its resolving power down to 5 microns.

Can you describe the patient experience when using the OCT?

Having an OCT test is very simple.  The patient places their chin onto a chinrest and is instructed to look at a blue light. In a few seconds, the OCT gets all the images needed.  In fact, the RTVue can accomplish 26,000 scans each second.

Do your patients appreciate the upgrade in technology?

Patients appreciate that our practice stays up to date with modern technology. They understand that newer instrumentation allows for more exactness in their care.

How does this technology improve comprehensive eye exams compared to the days before you had an OCT in your office?

At times, we run a screening scans for glaucoma and macular degeneration, but usually the OCT is used if a condition is known or suspected.

To what patients do you recommend using the OCT?

We recommend using the OCT for patients with glaucoma or when we suspect glaucoma, when a patient has dry macular degeneration, and especially when a patient has diabetes.  We also use it if a patient has poor vision that cannot be explained by cataracts or helped by changing their glasses.

Can you share a particular story in which, by using the OCT, you were able to detect and treat a disease that would have otherwise gone undetected?

I had a patient with diabetes who was having trouble seeing as well as she thought she should.  The OCT indicated there was swelling in the macula, but she and the retinal specialist she had recently seen thought this unlikely as she had only recently been seen by this doctor. I was able to transmit the results of the test to the specialist who agreed that the situation had changed since the recent visit. From this, she got the treatments needed to reduce the swelling.