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Deeper clinical understanding


Rod Baker

Sunbury VIC


Topcon 3D OCT-1 Maestro


Device Technologies


At Optometry Sunbury, we take therapeutics seriously. It doesn’t simply mean that we have a hypothetical licence to prescribe certain eye-drops. We have many hundreds of active patients with macular disease, glaucoma and diabetes, and we work in a co-operative model with GPs and ophthalmologists.

The Topcon 3D OCT-1 Maestro is easy to use, with touch menus for selecting disc or macular OCT and the required analysis paradigm. It is great having simultaneous retinal photography as well as the OCT for comparison.

The great thing about the Maestro is its small footprint. It can be mounted on the usual chair and stand or, if you choose, on a free-standing table in an ancillary test room. Within a few weeks of installation, and looking down from the peak of a steep learning curve, I don’t know how we ever did without it.

I will leave it to others with more expertise to detail the immense diagnostic capacities of the OCT. I want to give two examples of the practical, everyday benefits of the Maestro OCT for optometrists who may be weighing up whether the purchase of any OCT is worth the investment.

As both case studies below show, it may be true that the patients’ symptoms told me something was wrong—I didn’t ‘need’ the OCT for detection. It may be true that the problem was picked up with the ophthalmoscope—I didn’t ‘need’ the OCT for that. The fact remains that visualising the problem in high detail, in three dimensions and then showing the patient what had happened gave me and the patient a deeper clinical understanding.

Patient A was a 63-year-old male. He had sudden onset central visual disturbance and VA had dropped to 6/24. I could see the abnormal macula with the 78 D lens but the Maestro OCT allowed me to see it in a whole new way. Following same day ophthalmology referral and surgery, Patient A retains a stable 6/7 VA in that eye. (Figure above: macular hole cross sectional image)

Patient B was a five-year-old female who was referred for amblyopia treatment as she had 6/24 VA in the right eye. There was no strabismus or anisometropia, but with the ophthalmoscope I could see signs indicating blunt trauma with abnormal macular architecture and temporal disc pallor. She had been hospitalised at three years of age with concussion not previously mentioned in the history (always ask). Again, with the OCT, I could see the macula in a whole new way.  Incidentally, I still did patching and the vision improved to 6/7.

I haven’t time to tell you that story.

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