While our thoughts go out to those thwarted by a local spike in the city of Richard III’s final resting place, the general positive trend in infection rates this week deserves, I thought, an otherwise Covid-free comment. Instead, I will mention two recent findings that may well have slipped through our attention but have potential implications for future primary care practice.
Firstly, a team from China has studied over 4,000 children using OCT and found a possible diagnostic tool for amblyopia.1 Until now, confirmation of amblyopia has been ‘a diagnosis of exclusion’, reliant upon subjective acuity measurement. Using OCT-angiography, it now appears that those children with amblyopia have a measurable reduction in blood flow in one of the layers imaged by OCT-A, and that the reduction correlates well with the level of amblyopia suggested by acuity levels. Many OCTs are upgradeable to include OCT-A and, if studies of other ethnic populations find the same result, then it appears that a repeatable and easy to use objective test for amblyopia may be within sight.
The second finding I discovered via a Heidelberg-organised webinar last week, during which eminent ophthalmologist Professor Francesca Cordeiro described the latest findings in her DARC study. This, as I have previously mentioned, looks at the use of an injected fluorescent dye which detects apoptotic retinal cells (hence the acronym), allowing easy visualisation of dying ganglion cells. This means that glaucoma may be detected way before any other structural or functional changes are found. Injecting dye is not useful for us in community practice, but Cordeiro told me that they were well on the way to developing a nasal spray application of the dye which, in a few years, should make DARC a procedure available to any primary care optometrists with a decent retinal imaging system.
References
- doi:10.1001/jamaophthalmol.2020.2220
