Enhance Patient Care and Practice Revenue with Optical Coherence Tomography (OCT) Wellness Screening
by Glenda Aleman Moheeputh, OD
"The eyes are the window to the soul" is a common saying, but as an eye care professional, I prefer to say that, “The retina is the window to eye health.” Comprehensive eye exams that include color fundus photography and OCT provide the eye care provider with invaluable information for early diagnosis of ocular diseases such as age-related macular degeneration (AMD), diabetic retinopathy (DR), macular edema, hypertensive retinopathy and glaucoma, just to name a few. These conditions are some of the leading causes of blindness worldwide and optometrists are often the first line of defense against vision loss from these conditions.
Having the Maestro2 OCT Fundus Camera in my practice has made it easy for me to identify early signs of AMD, DR, hypertensive retinopathy and glaucoma. I offer my patients a screening scan, which combines a 12x9mm rectangular cube (512 A-scans x 128 B scans) of the posterior pole and a color fundus photo – both of which can be captured in roughly three seconds. The scan gives me a one-page, 3D Wide Report (A) that utilizes an age-adjusted reference database for the retinal nerve fiber layer (RNFL), optic nerve, ganglion cell layer (GCL) and macular thickness ETDRS values. I can quickly spot areas of retinal thickening or thinning that may indicate retinal disease or GCC/RNFL loss that may be associated with glaucoma.
My Maestro2 also has the Hood Report for glaucoma (B), which allows me to analyze structure and function in glaucoma suspects and patients by using retinal/RNFL thickness and GCL probability maps overlayed on visual field test locations.
I was motivated to start offering OCT Fundus wellness screening by the alarming number of diabetic patients I was seeing. Over 34.2 million Americans are living with diabetes, which is equivalent to one in ten individuals1. Furthermore, it is estimated that about 88 million Americans are pre-diabetic2. Ocular complications of diabetes include diabetic retinopathy, macular edema, cataracts, glaucoma and changes in refractive error making early detection of ocular changes critical to preserving visual function.
Another area that I focus on is AMD, as it is three to four times more prevalent than glaucoma. With my Maestro2, I can manage and retain most of these patients within the practice. Many AMD patients have the dry form that I can follow and manage with a minimum of two OCT scans per year. The retina reports make it easy to differentiate between wet and dry AMD, which increases my confidence in keeping these patients in my practice as long as possible. Certainly, if they present with signs of wet AMD, I quickly refer them to the retina specialist.
OCT reports are an excellent tool for patient education that help me explain what is going on in the eye and how we’re going to manage the condition(s). I routinely bring patients back to monitor the progression of AMD or glaucoma or to observe mild DR and hypertensive retinopathy. These patients always return for their scheduled OCT follow-ups, and often, they bring a family member for an eye exam. For a primary care practice with a complete optical service, this translates into more optical sales and increased revenue.
My Maestro2 is fully automated, making it incredibly easy to use. I can capture a scan in less than three seconds or delegate the scan acquisition to a staff member. It’s such an easy test to perform that we don’t hesitate to offer it to all our adult patients.
In conclusion, adding the Maestro2 OCT Fundus Camera to my practice has been one of the most rewarding experiences both clinically and financially. It has enhanced my clinical skills and allows me to provide more comprehensive care to my patients while also being a financial asset to my practice.
*Donald C. Hood PhD, Translational Vision Science & Technology No.6 Vol.3 2014: Evaluation of a One-Page Report to Aid in Detecting Glaucomatous Damage.
1,2 Source: National Diabetes Statistics Report, 2020. Estimates of diabetes and its burden in the United States. Centers for Disease Control and Prevention (CDC).
Dr. Moheeputh is the owner of iSmart Vision Care in Miami, Florida.