Principal Optometrist, Flinders Vision Optometry Clinic
Optovue Avanti RTVUE XR
Here at Flinders Vision, we have the luxury of access to three brands of OCT. The Avanti is a device with exceptional posterior eye capabilities, Widefield Enface OCT, multi-layer and 3 mm scanning depth. These features allow high resolution (3 µm digital) and high repeatability through the VTRAC eye tracking.
The Avanti’s anterior eye metrics exceed those of other instruments presently available on the market. It is able to calculate the power of the cornea by measurement of both the anterior and posterior curvatures and produce a 6 mm diameter map of both pachymetry and epithelial thickness. This innovative analysis of scans gives the Avanti a unique role in scleral and orthokeratology lens fitting.
This is before we consider its extensive applications within corneal pathology. Understandably, the Avanti’s primary role at Flinders Vision is in contact lens and anterior eye clinics.
DB, a 55-year-old Caucasian male, presented for a diabetic review. His previous examination had been 18 months prior to this visit and at another location. He presented for a routine review with no specific concerns, history was unremarkable and he denied any change in his vision or symptoms. He had been wearing the same correction for a number of years and at his previous examination had been told that there had not been a significant change in his refraction.
Habitual correction was -2.75/-1.75 × 175 6/12 OD and -2.00/-1.75 × 140 6/6 OS, best corrected was -1.00/-1.50 × 40 6/7.5 OD and -2.25/-1.50 × 140 6/6 OS. The retinoscopy reflex on the right eye was distorted.
The slitlamp examination revealed a subepithelial plaque in the right cornea that extended down from the superior limbus 4 mm and on the leading edge, there were islands of plaques.
When questioned again, DB denied any history of distortion of vision, ‘starry lights’ at night, pain or discomfort in the right eye. The Avanti was able to exquisitely image the plaque as being purely subepithelial with no distortion of the underlying stroma or the epithelium, confirming the diagnosis of Salzmann’s corneal degeneration.
The Avanti’s ability to map the corneal and epithelial thickness allows the practitioner to monitor for corneal changes with a high degree of sensitivity, and the presentation of the scans aids the patient’s understanding of the condition.
Scan shows changes in corneal and epithelial thickness