The second National OCT conference, organised by Topcon UK, provided two days of lectures and workshops delivered by key leaders and experts from the ophthalmology and optometry worlds. Along with the plethora of CET points available, delegates also had the opportunity to attend the conference dinner which included stand-up from optometrist Sarah Morgan.
Health assessment
The breadth of clinical uses for OCT was a key theme at this year’s conference. OCT is now being used in practically every element of ophthalmology, from anterior or posterior tumour assessment to neuro-ophthalmology, paediatric eye care and general medical retina. Typically, OCT provides an additional source of information to add to the clinical picture and is less seen now as a stand-alone tool.
OCT is also beneficial in a large proportion of primary care patients, to aid differential diagnosis, for record keeping, or monitoring changes over time. In one lecture, ophthalmologist Ted Garway Heath (Moorfields) explained how trend analysis over time in relation to the retinal nerve fibre layer (RNFL) and ganglion cell layer is useful in glaucoma and has been shown to aid the earlier diagnosis of glaucoma compared to visual fields.
Collection of data over time is likely to become all the more important as studies are showing that certain systemic diseases have an effect on the RNFL in the early stages. Such diseases include multiple sclerosis and Alzheimer’s, as was explained by ophthalmologist Anna Gruener (Manchester). OCT is very useful in children, explained ophthalmologist Irina Gout (Windsor). She found swept source OCT particularly useful since capture is ‘superfast’ and the scan line is invisible.
OCT angiography
OCT Angiography (OCTA) is as much of a game changer as OCT was 25 years ago. This technology will not replace fluorescein angiography (FA) completely – it does not show leakage, but does show features that are not seen by FA such as the depth of new vessels, where the feeder vessel is located precisely and so on. It is likely to be optometrists that will be undertaking regular OCTA assessments as a way of monitoring patients and reducing numbers in the unnecessarily referred.
For OCTA to be successful, it is important to have a very high scan rate (such as 100,000 A scans per second) as you need to take four scans at every B scan location in order to be able to see change (red blood cell movement) between scans. There is still a lot to learn about OCTA – physicians do not fully understand what they are seeing. It is certain that much more will be known when this essential conference returns next autumn.