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SD-OCT favored among imaging devices for detecting glaucoma progression
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CHICAGO — Spectral-domain optical coherence tomography is preferable to time-domain OCT for diagnosing glaucoma progression, according to two glaucoma specialists here.
Scanning laser polarimetry, OCT, and Heidelberg retinal tomography all have advantages and disadvantages, Robert J. Noecker, MD, said at Glaucoma Day preceding the American Society of Cataract and Refractive Surgery meeting.
“For example, [Heidelberg retinal tomography] looks at the optic nerve, and I think that’s helpful in assessing disc size and the contour of the nerve, but the speed of acquisition that is possible with spectral-domain OCT cannot be minimized. The time-domain [OCT] was rather slow and the source of artifacts frequently. … Now we can manipulate the data post-processing.”
The evolution and introduction of progression software has been the greatest advancement, Dr. Noecker said, and spectral-domain OCT is a reliable means of image registration in which each image can be superimposed on the prior one.
“The biggest disadvantage is that there are a lot of manufacturers now; there are a lot of different platforms,” he said. “But they all do a pretty good job. Spectral-domain OCT is a much better technology.”
“I have access to all of them, but I primarily use spectral-domain OCT,” Angelo Tanna, MD, said. “In terms of its potential advantages over time-domain OCT is that the reproducibility is better, so it might be possible to detect progression a little earlier. The downside of spectral-domain vs. time-domain OCT is that it’s actually more sensitive to the impact of progressive lens opacity, surprisingly. So that could have impact in the opposite direction in our ability to monitor progression over time.”
- Disclosures: Dr. Noecker has financial interests in Alcon Laboratories, Allergan, Aton, Glaukos Corporation, Lumenis, Merck and Ocular Therapeutics. Dr. Tanna has financial interests in Alcon Laboratories, Apotex, Merck, Sandoz and Watson Laboratories.