Abstract
Purpose :
To assess the utility and diagnostic indications for testing with an automated optical coherence tomographer (OCT) in a high-volume urgent care center within an eye institute.
Methods :
OCT (Optovue) images of macula, nerves, or anterior segments obtained over a period of 15 months were reviewed in the context of electronic patient records. Data were collected on chief complaints, OCT findings, and final diagnosis. Residents and fellows were surveyed regarding their experience with the OCT and its value in emergency patient management.
Results :
359 eyes of 202 patients were examined. Average age of patients was 49 years old, 112 (55%) were men, and 90 (45%) were men. Emergency presentations prompting OCT imaging included new scotomas (n=21, 10%), metamorphopsia (n=10, 5%), decreased vision (n=120, 59%), flashes/floaters (n=32, 16%), and pain (6, 3%). Diagnoses confirmed or rejected included new onset of vascular occlusion (n=13, 16%), choroidal neovascularization (n=25,12%), retinal detachment (n=44, 22%), macular hole (n=6, 3%), cystoid macular edema (n=6, 3%) and central serous retinopathy (n=14,7%). 20 residents and 4 fellows were surveyed. All agreed that the OCT was helpful in clarifying the diagnosis, and 75% agreed that it facilitated delivery of optimal urgent management.
Conclusions :
OCT has become a mainstay in providing the best patient care. Access to definitive diagnostic equipment and skilled imaging personnel in the acute setting is often limited. Normal findings are often as important as detection of occult pathology, since they can redirect investigative efforts. Expanded access to automated OCT in the urgent care setting shows promise for improving the accuracy and timeliness of diagnosis, which can be critical for optimizing patient outcomes.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.