Complex or customizable scanning patterns along with wider fields of view are available on some instruments. “It is important to consider the resolution of scanning patterns that you will be using frequently ( Figure 3).”įig. “Some instruments offer more densely spaced scans with lower resolution alongside higher resolution raster type scans,” says Dr. Scan resolution is another important consideration. “They offer complex or even customizable scanning patterns of the macula, optic nerve, mid-peripheral and even peripheral retina,” explains Dr. While these scan types are an important component of patient care, many devices can now go beyond basic scanning patterns. Haynes, who notes that OCT is classically thought about in terms of scans of the macula or scans of the optic nerve, with the typical macula scan being a “cube scan centered on the macula and the optic nerve scan showing the temporal superior nasal inferior temporal (TSNIT) or NITSN curve measurement of the retinal nerve fiber layer (RNFL).” Today, optometrists can use OCT to image a variety of structures in the eye, according to Dr. This has opened the door to a plethora of new uses however, it has also made deciding which option is best for your clinical needs more complex. Since the first commercial OCT device came on the market in 1996, the technology has evolved exponentially. These types of scans may also provide deviation plots to compare your patient to a normative database. Basic scanning patterns such as the optic disc cube (left) and macular cube (right) can be used to extrapolate a wealth of information such as RNFL thickness maps (top left) and RNFL TSNIT curves (bottom left), macular thickness maps (top right) and ganglion cell complex thickness maps (bottom right). We spoke with several experts to gain their insights on best practices as well as challenges and missteps to avoid.įig. Whether an OD is preparing to invest in their first OCT or is ready to upgrade their current device, it is important they have a clear picture of their needs and how the available options on the market can support their clinical practice. “Are you interested in retina (age-related macular degeneration and diabetic retinopathy), optic nerve, ganglion cell and angle (glaucoma) or cornea (keratoconus scleral fits and refractive surgery)? Each manufacturer has strengths and weaknesses-you want to choose the company that matches well with you and your interests.” “What specialty are you in or what clinical interest would you like to explore?” asks Michael Cymbor, OD, a partner at Nittany Eye Associates in State College, PA. “These two physicians may have very different ideas about what instrument is necessary for their practices.” “Others may want to diagnose and manage a larger range of disease and send patients to specialists only when they require surgical interventions not within the optometrist’s scope of practice,” she continues. “For example, some may want to integrate OCT imaging into their practice primarily as a screening tool, referring patients to a specialist when abnormalities are detected. “When first deciding how to proceed with purchasing an OCT, a good place to start is to consider your patient population and what you want to achieve,” notes Jessica Haynes, OD, of the Charles Retina Institute in Memphis. However, as technology evolves and the number of available options continues to grow, determining the best device to invest in comes with a host of considerations. Optical coherence tomography (OCT) is a valuable tool in optometric practice that plays a key role in various aspects of care, including managing posterior segment disease, glaucoma and even some anterior segment conditions. Six Questions About the Role of OCT in Neuro Evaluations.OCT: An Indispensable Tool in Retina Care.Check out the other articles featured in this OCT-themed issue:
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