Wielding the power of OCT

Dr Jesse Gale, an ophthalmologist and glaucoma subspecialist from Wellington, then provided a comprehensive overview of OCT use in the diagnosis and management of glaucoma. He gave many helpful hints about how to maximise the use of OCT in this area and interpret the glaucoma assessment printout. This allows for a much more accurate diagnosis, and thus management of the disease, rather than the simple “red is bad, green is good” guide. Jesse then went on to cover many of the pitfalls of glaucoma and ocular hypertensive monitoring techniques and reinforced appropriate referral guidelines. He discussed the benefits and weaknesses of some scans, including ganglion cell patterns, which are available with some machines such as Zeiss’ Cirrus, and the need to incorporate the information into an overall glaucoma assessment. He ended his presentation with a look at where OCT can be helpful in neuro-ophthalmology diagnosis, such as identifying papilloedema.

This was followed by an hour-long lunch with much socialising and catching up with colleagues from around the country.

I then presented another lecture, this time on the uses of OCT in the anterior segment, discussing the assessment of the angle in multiple axes, which the new swept-source OCT scans do particularly well, and providing some examples of corneal surgery where the depth and accuracy of the incisions can be easily assessed. As an aside, at the request of the CCLS President Jagrut Lallu, I also discussed the current uses of Avastin in the treatment of corneal neovascularisation, which is a very difficult condition to treat. Examples include vascularisation of the cornea from severe limbal vernal keratoconjunctivitis or vascularising hydrops. Avastin is a simple, inexpensive and effective treatment and is now available publicly from many hospital eye departments including Waikato.

The next speaker, Richard Johnson, a well-known optometrist working in the Greenlane Clinical Centre in Auckland, gave an informative and entertaining lecture on OCT uses in medical retina treatment, in particular, macular assessment. He covered many of the common conditions that optometrists are likely to encounter, explaining the “normal range”, which could not be assessed before OCT scans were available.

Complementing Richard’s talk was a presentation by Auckland-based ophthalmologist Dr Andrew Riley, who gave a comprehensive review of medical retina conditions, including macular pathology, treatment and referral guidelines. In a wide-ranging and engaging talk, Andrew also discussed OCT assessment of vitreoretinal conditions and their treatment.

On behalf of the CCLS board, I would like to take this opportunity to thank the speakers for their time and efforts, the Capital Vision Research Trust for the faculty and the 53 attendees for their participation. We hope you found it useful for your continuing clinical practice.

Dr Chris Murphy is a Hamilton-based ophthalmologist and CCLS councillor.