OCT Refresher day with Nidek & Birmingham Optical


What a day!

The OCT refresher course with Nidek and Birmingham optical was fab. There were such a mix of Optometrists; some having had an OCT in practice for over 5 years to others who are preparing to receive one. It made for a great selection of questions and discussions. On a side note, the venue was such a fantastic choice. The ABDO centre in Birmingham was optometry through and through. Each room named after different parts of the eye and tables made in the shape of spectacles!

There were 2 separate tracks running alongside each other, one being more hands on and practical, sprinkled with some business guidance. The other, looking at case studies, scans from research and a little dash of theory. 

As you know, I was looking forward to Dr Louise Terry’s talk on AMD and OCT. The future is looking bright with an inspiring talk, Dr Terry (who, claim to fame, supervised me in 3rd year primary care at university) spoke about the development of artificial intelligence, AI, and its role in healthcare. Many professionals fear the machines will take over our positions or monopoly what we do, but they are proving to act as an invaluable aid in diagnosing. In streamlining and triaging patients, the deep learning from case to case in the programmes allow the computers to determine who’s need is greatest and where treatment and attention will be most effective. 

Going forward, we move past SD scanning and into movement. Across the world the tool kit of the optometrist varies, being able to use FA could be so useful, but without the ability to inject intravenously it is inaccessible. Newer OCT models, using OCT-A, angiography give us this ability, without the need to be invasive. By looking at the movement of blood over time, scanning and comparing images, the computer knows movement can only be attributed to blood. So you can see, this new form of imaging could be used in Wet AMD and to further investigate CNV, again streamlining referrals, where a patient wouldn't need to be scheduled for FA in the HES. 

It’s always good to broaden your knowledge, although the Nidek, Retina Duo is not one I currently use in practice it may come in handy for outside referrals. Even in the shared care of glaucoma patients, if they're referring practice was using a different OCT. The anatomic interpretation is the same, though some computer analysis and scans differ. The Retina Duo has fantastic En Face imagining, so you can ‘peel away’ layers of the retina and see exactly where your feature lies. 

From the building blocks of retina anatomy, to posterior b-scans, 3d cube scans and anterior chamber scans the day ran through the full breadth of OCTs. Dr Sandip Doshi, in Hove has been using the anterior chamber segment scan to aid scleral contact lens fitting. Alongside a fluorescein stain, real time imaging can show the exact position of the lens and it's vault over the corneal surface. Which actually is a very clever way to utilise OCT in practice, allowing us to enhance our testing with new imaging, documenting and monitoring. 

Another pearl I gleamed from the day, was using OCT images, as well as fundus photos, along side referrals. They make the referral more completing and compelling for the medical practitioner that needs to forward this patient onto ophthalmology or for cardiovascular work up. Rather than giving subjective or descriptive information, a picture really does paint a thousand words. 

Birmingham Optical also have an OCT forum, where you can share pictures and discuss possible diagnoses and management plans. There are more OCT and CET days coming up with Birmingham Optical in the future. 

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