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Van C Lansingh, Bethania Lopez-Star, Felipe de Jesus Ramirez Solis, Luis Andrés Ochoa-Ramirez, Ellery Marino Lopez-Star; Evaluation of the effectiveness of using OCT during the initial assessment to detect glaucoma and macular conditions. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2552.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate whether the use of OCT during first-time ophthalmic examination is effective in increasing the rate of early detection of glaucoma and retinal disorders, when compared to traditional clinical examination, as they are a major cause of blindness.
Clinical, observational, prospective study including 96 first time patients aged 40 or older, with no disabilities or mental disorders, and who underwent a complete ophthalmological examination by the primary-care ophthalmologist. Color 45-degree retinal imaging was performed with the HOCT-1/1F (Huvitz Co.) Two images were taken of each eye (one centered on the macula area, and another of the optic nerve). The images were evaluated in a blinded manner by glaucoma and retina specialists using the digital platform of the MAILOR (Mexican Advanced Imaging for Ocular Research) reading center. Diagnoses included atrophy of the pigmentary epithelium of the retina, atrophy of external layers, vitreomacular adhesion, or drusen, as well as macrodisc, glaucoma or suspected glaucoma.
96 patients were examined, with a mean age of 57 years. Among the patients with macular abnormalities, 38 eyes were diagnosed through OCT, among which a clinical diagnosis of macular abnormality was made in only 15. Sensitivity was 39.5% and specificity 91.4%, with a Z of 2.89 and CI 0.5063 to 0.7020. Optic Nerve abnormalities were detected in 19 patients with OCT, of these, clinical examination detected only 9. Sensitivity was 55% and specificity 74%, with p<0.01 (Z of 4.46 and CI 0.3419 to 0.5405).
The use of OCT of the macula and optic nerve demonstrated increased sensitivity in detecting pathological changes to the macula or the optic nerve during a first-time ophthalmological examination, compared to a conventional ophthalmological clinical examination. Early and timely detection of macular and glaucomatous changes can assist with early diagnosis and treatment, potentially avoiding low vision and blindness.
This is a 2020 ARVO Annual Meeting abstract.
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