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Surgeon: Technological innovation transformed medicine from art to science
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VIENNA — Recent technological advances are altering how physicians approach a medical diagnosis, transforming medicine "from art into science," according to Steve Ryan, MD. He gave the Retina Key Note Lecture here at the joint meeting of the European Society of Ophthalmology and the American Academy of Ophthalmology.
According to Dr. Ryan, the 20th century witnessed important qualitative developments. But in the 21st century, advances have become quantitative and medicine is now "more science, technology and data-driven," he said.
"Machines have advantages over even the best clinicians. The convergence of digital imaging, optics technology and computer technology extracts more clinically relevant information from fundus images than ever before," Dr. Ryan said.
Fourier-domain optical coherence tomography (OCT) provides a detailed, precisely located, complete picture of the retina, where all retinal layers are visible. It allows the assessment of treatment effects through the exact representation and quantitative measurement of changes.
"The [Carl Zeiss Meditec] OCT1 debuted at 100 axial scans per second. The Stratus quadrupled the speed in 2002 [to] 400 axial scans per second, which was sufficient to make OCT a standard for the diagnosis of many retinal diseases and glaucoma," he said.
Now, OptoVue has introduced the RTVue-100 OCT, which incorporates Fourier-domain technology and generates 26,000 axial scans per second - 65 times faster than the Stratus OCT. This generational leap in speed "is greater than the difference between a 1920 biplane and the latest Boeing jet airliner," Dr. Ryan said.
He also touched on other recent technological advances, including computerized fundus image analysis, adaptive optics imaging and quantitative fluorescein angiography. "There is no way we humans could provide that amount of details," he said.
The clinical implications of these developments are numerous. The diagnosis of the three major causes of blindness - glaucoma, diabetic retinopathy and age-related macular degeneration - will be more accurate and detailed. The effects of treatments will be monitored more precisely and assessed more objectively. Finally, they will also produce radical changes in defining the endpoints of clinical trials, Dr. Ryan said.