Technology helping glaucoma diagnosis

SES, 27 June 2021

Heidelberg Spectralis OCT in the spotlight at SES

 

In June we were lucky to host Dr Rahul Dwivedi for his astute presentation on glaucoma diagnosis and how new technology is leading the way in early detection and diagnosis. 

After training in Liverpool and undertaking a 12-month glaucoma fellowship in Auckland’s Greenlane Eye Centre, Dr Dwivedi has recently arrived here to work as a consultant at Christchurch Public Hospital.

His talk focused on how using the Heidelberg Spectralis OCT (Optical Coherence Tomography) has markedly improved how doctors are now diagnosing glaucoma.

“Glaucoma can be difficult to diagnose based on the automated visual field test and clinical examination findings – the type of information we’ll get from measuring eye pressure and looking at the appearance of the optic nerves,” says Dr Logan Robinson. “Traditionally we would only diagnose glaucoma after a patient developed some loss of peripheral vision on a visual field test”.

Accurate and highly detailed OCT scans can diagnose the structural changes in the optic nerve that often occur well before any loss of peripheral vision.

The presentation provided solid evidence to show how useful the Heidelberg Spectralis can be in the early diagnosis of glaucoma. This is due to the anatomical landmarks it uses to measure the nerve, which are more accurate and reliable than some other devices. 

Accurate and highly detailed OCT scans can diagnose the structural changes in the optic nerve that often occur well before any loss of peripheral vision. Dr Dwivedi also provided a number of helpful tips for how to make the most of the technology.

Dr Dwivedi also reinforced how important it was to always check the scan quality, alignment and segmentation prior to delving into the finer details.

“One tip was to make use of the scans of the macula, especially looking at the ganglion cell layer, to help confirm the diagnosis,” says Dr Robinson. “Another great point was that the normative database used as a reference to determine whether a patient’s scan is “normal” or “abnormal”, is not always going to be applicable to the patient sitting in front of you – for example high myopes (patients who are very short sighted), as this group wasn’t included in the normative database.” 

Dr Dwivedi also reinforced how important it was to always check the scan quality, alignment and segmentation prior to delving into the finer details. This is crucial for avoiding a decision based on inaccurate or incorrect information. So too is it important to look at ‘the big picture’ of information when making a diagnosis, ensuring results from other tests and other factors are taken into account.

“This means we can diagnose glaucoma and start treatment earlier than in the past,” says Dr Robinson. “And, because vision loss in glaucoma is irreversible, early diagnosis is essential.”

The event was well attended, with guests enjoying both the insightful presentation and a nourishing start to the day.

“We had ophthalmology registrars from Christchurch Public Hospital plus a good turnout of SES doctors, nurses and technicians,” says Dr Robinson. “While everyone had to brave the cold and a frosty early start, the delicious breakfast and great presentation proved well worth it.”

 

Dr Dwivedi talking to Dr Jo Pon and Dr Allan Simpson after the presentation.