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Diagnosis certainty


John Boulos
BOptom GradCertOcTher MBA
OPSM, Roselands NSW 

Topcon Maestro OCT

Device Technologies


I purchased the Topcon Maestro OCT in late 2014. My motivation was to have an imaging device that allowed both quantitative and qualitative assessment of the retina and optic nerve in order to differentiate lesions and pathology observed during fundus examination.

Having spent many years assessing fundus photos that documented lesions but lacking the normative comparison, change analysis and anatomical views afforded by the OCT, for my practice the Maestro has been a game changer.

What struck me initially and continues to surprise is the high prevalence of retinal pigment epithelium detachment in otherwise asymptomatic patients.

The imaging capabilities of the Maestro have allowed me to monitor early onset macular and optic nerve disease without unnecessary referrals to ophthalmology. Anterior segment imaging, including pachymetry and irido-corneal angle measurement, has added more diagnostic certainty to glaucoma suspects and precision in scleral lens fitting.

The Maestro has increased patient loyalty, with patients referring family and friends to my practice to be screened.

The macula scans provide quantitative assessment of both overall retinal thickness and ganglion cell layer integrity as compared to a normative database. Optic nerve scans do a similar assessment with the ability to compare both nerves on the same screen to rule out asymmetry, the hallmark of glaucoma.

A recent software upgrade allows one 3-D wide scan to image and compare both macula and optic nerve to normals. This single scan has been a big time-saver and importantly, can avoid miotic pupils and subsequent image degradation from repeated light flashes. In my practice this impacts only younger patients as we routinely dilate older patients.

Service and follow-up by the Device Technologies crew has been superb. Brian, Chris and colleagues have always been available to answer any queries.

I look forward to the next software upgrade to obtain the same sequential change analysis of 3-D wide scans as is currently available for the individual optic nerve and 3-D macula V scans.

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