Malcolm Gin Optometrists, Wonthaggi VIC
CIRRUS photo 600 OCT
My clinic is in a coastal area with a high retiree population with a disproportionate amount of ocular disease. I have been involved in comanaging patients with ophthalmologists and an OCT has been on my wish list for many years. In May 2013, I purchased a Zeiss CIRRUS photo 600 OCT.
The combination of camera and OCT seems logical as both scans can be explained to the patient in the one review module. The combination also means that the instrument has a smaller footprint within the clinic and time is saved by not switching patients between instruments. The camera can capture images with several filters and I have found the fundus autofluorescence to be particularly useful, especially when demonstrating pathology such as geographic atrophy and optic nerve head drusen.
The CIRRUS photo 600 complements my HFA 740i visual field analyser and together with the Forum package, they allow me to produce combined reports which have both visual field and OCT retinal nerve fibre analysis on the one page. Forum software is accessible remotely from the server. This means that when I am at the satellite clinic, I can also view the OCT scans and retinal digital images previously obtained.
The addition of the CIRRUS photo 600 OCT has revolutionised my optometric practice. It’s wonderful for monitoring macular, retinal and anterior eye changes. I have found the most used tool is the optic nerve head analysis. At my clinic, there are many people who are glaucoma suspects, and the optic disc scan with its normative data comparison immediately allows me to reassure patients of their risk.
My patients love new technology and the CIRRUS photo 600 OCT is a real showpiece. There has been no resistance to the charge for the service and it has become a point of difference between my clinic and those of others.
A 19-year-old Caucasian female presented for routine optometric examination and bilateral elevated optic nerve heads were discovered. Unaided vision of R and L 6/6 was noted; both colour vision and intraocular pressures were normal. She had a slim build and no significant general health issues. There was no family history of blindness and she denied headaches.
OCT details the elevated optic nerve head but fundus autofluorescence confirms the presence of buried optic nerve head drusen. Buried drusen have a very diffuse, less-intensive autofluorescence whereas superficial optic disc drusen demonstrate a brighter nodular glow. The definitive test for optic nerve head drusen is certainly B scan ultrasonography. The main thing is to rule out papilloedema to ascertain the urgency of the referral. Intuitively, the peripapillary RNFL should be thicker in papilloedema; however, the literature neither supports nor denies this, and the presence of autofluorescent bodies assists in the differential diagnosis.