optomap Assists in Management of Age-related Eye Diseases

Age-related macular degeneration (AMD) is a leading cause of blindness in the United States, affecting most commonly, people over the age of 60 with increasing chances as you age, if you are overweight or if you have a family history of AMD.    

As we approach our golden years, we are at a higher risk for particular eye diseases including age-related macular degeneration, cataracts, diabetic retinopathy, glaucoma, as well as eye conditions such as dry eye and low vision.  More than 40 million Americans are currently 65 years or older, this number is expected to grow to more than 88 million by 2050 and not coincidentally, the number of Americans with age-related eye diseases is expected to double.  Early detection and treatment are key to saving sight.

For some, AMD advances so slowly that vision loss does not occur for a long time. In others, the disease progresses faster and may lead to a loss of vision in one or both eyes. The loss of central vision in AMD can interfere with simple everyday activities, such as the ability to see faces, drive, read, write, or do close work, such as cooking or fixing things around the house.

As the disease progresses through the asymptomatic phase, it moves from Dry AMD to Wet AMD. In geographic atrophy (dry AMD), there is a gradual breakdown of the light-sensitive cells in the macula that convey visual information to the brain, and of the supporting tissue beneath the macula. In neovascular AMD (wet AMD), abnormal blood vessels grow underneath the retina. These vessels can leak fluid and blood, which may lead to swelling and damage of the macula. It is important to assess the risk of progression from the dry type to the wet type of the disease.

Although there have been many discoveries in the understanding of the causes of AMD, including links to genetics, there remains much unknown about this complicated, degenerative disease. With the advent of multi-modality ultra-widefield (UWF™) imaging, the retinal periphery has been able to be more easily studied in AMD to determine the value in the detection and/or monitoring of the disease.  Color optomap® imaging captures the structure and fundus autofluorescence (FAF) the function, of the Retinal Pigment Epithelium (RPE) which is where AMD manifests within the eye. Recent studies have revealed that 97% of patients with AMD have evidence of the disease outside of the central pole. This outcome demonstrated that drusen and reticular changes were seen in a majority of eyes, strongly indicating that AMD is more than a macular condition but one that involves the entire retina. This is being investigated in a further study that will determine whether these peripheral changes are associated with the progression of the disease.

optomap af image demonstrating AMD

Glaucoma is another leading cause of irreversible blindness in the US and around the world with more than 3 million Americans living with the disease, 2.7 million of them over the age of 40. While early detection is key to taking steps to prevent vision loss, glaucomatous vision impairment is irreversible.  Unfortunately, glaucoma can be asymptomatic until the late stages, at which time the prognosis is poor. 

The gold standard for detection and diagnosis of glaucoma is a clinical examination with dilated slit lamp biomicroscopy conducted by a glaucoma specialist.  However, this level of expertise is not always feasible or readily available to broadly evaluate an aging population. Exam efficiency has been increasingly addressed via use of color digital stereoscopic photography and/or retinal tomography via SD-OCT.

A recent study explored the potential suitability of ultra-widefield retinal imaging in supporting the diagnosis of glaucoma in situations where slit-lamp biomicroscopy or digital color stereoscopy are not available. The purpose of the study was to evaluate the reproducibility and validity of UWF in estimating Vertical Cup to Disc Ratio (VCDR) measurements and was the first study of its kind to explore whether optomap imaging could be suitable as a diagnostic support tool for glaucoma.

The study evaluated the data from color digital stereoscopic fundus images (CDS) and UWF images.  All the photographs and images were graded by two masked trained graders and one masked glaucoma specialist. The optomap images were graded using the ‘measure distance’ tool on the OptosAdvance™ software, to measure and record cup to disc ratio (CDR).

The study evaluated the data from color digital stereoscopic fundus images (CDS) and UWF images.  All the photographs and images were graded by two masked trained graders and one masked glaucoma specialist. The optomap images were graded using the ‘measure distance’ tool on the OptosAdvance™ software, to measure and record cup to disc ratio (CDR).

The study demonstrated an almost perfect agreement between CDS and optomap when assessed by the glaucoma specialist.   The study concludes that optomap imaging has a high reproducibility in evaluating VCDR and agreement with stereoscopic optic disc imaging and indicates that UWF imaging may be suitable for glaucoma evaluation in settings where CDS is not available.

Glaucoma optomap image courtesy of William Lesko, MD

Visit our website to review additional clinical studies and learn more about utilizing sight-saving optomap technology.

https://nei.nih.gov/nehep/ham

https://www.brightfocus.org/glaucoma/article/glaucoma-facts-figures

Children’s Eye Health and Safety Month – optomap Making a Difference

As we continue to recognize August as Children’s Eye Health and Safety month, it’s important to understand the importance of eye exams, and the utilization of the highest-level technology in pediatric screening.  Optos ultra-widefield (UWF™) imaging technology is making great strides in diagnosing and treating eye problems in children and infants. Due to the cutting-edge modalities and ease-of-operation with an optomap® exam, signs of retinal disease can be found in the periphery, often before children and infants become symptomatic.
 
Many vision problems begin at an early age, so it’s important for children to receive proper eye care.   optomap was founded by Douglas Anderson after his then five-year-old son Leif went blind in one eye when a retinal detachment was detected too late. Although his son was having regular eye exams, routine exams were uncomfortable, especially for a child, which made it impossible for the doctor to conduct a complete exam and view the entire retina. He set out to create a way of non-invasively capturing as much of the retina as possible.in a single capture. 


Results from several published clinical studies suggest that optomap is an essential element to the screening and management of pediatric patients.  While traditional fundus imaging is a multi-stage effort made more complicated by children and babies’ natural tendencies to become impatient during exams, an optomap images provides a view beyond the vortex vessels into the periphery in a single capture and without dilation, making the imaging process easier and faster.
According to a study published, as the leading cause of blindness in in babies and children, retinopathy of prematurity (ROP) is gaining the most advantage with the implementation of UWF technology. ROP generally occurs in premature babies (born at 31 weeks or less) that have extremely low birth weights (2 3/4 pounds or less). With advances in medicine, more premature babies are being saved earlier in the gestation period. The ease of obtaining high definition images and the ability to compare and contrast the findings remotely proved to be beneficial in clinical trials.  Optomap has been shown to capture up to 75% more abnormal pathology in pediatric patients unseen by traditional fundus imaging methods in ROP, uveitis, retinal vascular diseases as well as infection or trauma.  For additional information as well as continued study results.


For more information on Optos technology, we invite you to visit our website to learn how partnering with Optos can help your practice, contact us.

Back to School Checklist: Don’t Forget the Eye Exam!

With school starting up again, and lists including everything from the essential newest styles to school supplies – one item to make sure is on the list is your child’s comprehensive eye exam.  While we may notice subtle changes in appearance as our children grow and develop, there are many changes also occurring within the eye that are unseen.  This marks the importance of annual eye exams that will assist in monitoring the development of your child’s vision as they grow.  Routine vision screening or eye examination at an early age is very important to detect risk factors, such as lazy eye, crossed eyes, and color blindness that can potentially cause irreversible loss of vision or blindness.  A majority of vision impairment issues go undetected since young children with impaired vision are often unaware of their vision issues—it is, after all, how they’ve always seen things. It is on us as parents and educators to look for signs of visual impairment.

Although schools generally do some basic testing of children’s vision, there is no doctor to perform a comprehensive exam or diagnose problems with your child’s eyesight.  According to experts, nearly 90 percent of what is taught in school is done so visually, therefore without excellent vision, children are left at a disadvantage.  Those with poor eyesight may struggle with school and learning, leaving them unable to reach their maximum potential.  A yearly comprehensive eye exam can not only ensure your child’s vision is healthy or corrected, but also rule out diseases that can potentially lead to vision loss.

Many vision problems begin at an early age, so it’s important for children to receive proper eye care.  In addition to changes in the front of the eye, the back of the eye (the retina) should also be examined in order to rule out signs of damage or disease.  Many conditions, such as retinal detachments and retinal holes can be treated successfully if diagnosed early. 

In a recent optomap-related patient story, Dr. Nicolas Belill’s dedication to provide the utmost care to all of his patients by offering an optomap screening as a part of every exam, is highlighted.  A young patient, Josh and his mother went to see Dr. Belill for a routine eye exam, spurred only by Josh’s difficulty reading small print.  Josh showed no other symptoms, had no previous ocular issues and was in overall good health for a child of his age.

The optomap image revealed extensive hemorrhages and exudates in the periphery as well as very unusual looking vessels.  Dr. Belill initially suspected Coats’ Disease, a rare retinal disease that manifests in macular damage and vision loss, usually not caught until very late in the disease process.  Josh was immediately referred to a retinal specialist who confirmed the diagnosis.  Coats’ Disease tends to have a very poor vision prognosis, very often leading to eye enucleation.  In this case, where the evidence resided in the periphery, it could have been missed had the optomap not been done, potentially saving Josh’s vision.  Read the entirety of Josh’s story here.

Patient Story - Josh

Talk to your eye care professional about including optomap as part of the exam – it is a non-invasive option for your child and takes only seconds to get a highly-detailed view of the retina, which is critical for early disease detection.  The optomap image provides your doctor with an overview of approximately 200° or 82% of your child’s retina in a single capture, giving them a more detailed view than can be achieved by other means.   We all know children can be squirmy and may have difficulty sitting still for an eye exam, optomap exams are quick, easy and cause no discomfort on a child who would much rather be picking out his or her favorite back to school sneakers! 

Ultraviolet Radiation and Your Eyes: Get Sun Smart!

As the summer heats up many of us are eager to enjoy the warmth of the sun and the activities that go along with it.  While continued awareness of the importance of UV protective clothing and sunscreen exists, there is a lack of emphasis on the impacts the sun and UV exposure has on the eyes.  UV damage to the eyes is known as the “invisible threat” and its impacts are measured and classified by the strength of the UV ray in nanometers (nm).  

UVC: These rays are below 280 nm. The upper atmosphere absorbs these, so they do not reach us, therefore protection from these rays is not overly necessary.

UVB: These are between 315 – 380 nm. These manage to make it to the earth’s surface and are notorious for damaging sight. They can cause snow blindness but are notably responsible for sunburn and several types of skin cancer. Research has shown that these rays are strongest during the summer and at higher altitudes.

UVA: These are the most dangerous being 315 – 380 nm. They are known for causing chronic eye damage. Studies have indicated that these rays get absorbed by the lenses of our eyes leading to damage of the retina. They contribute to the occurrence of cataracts, are also a major cause of aging and unfortunately can pass through clouds, glass, water and clothing.

In order to keep eyes protected from solar radiation, 100% UV block sunglasses should be worn anytime outdoors in daylight.  Even on cloudy days, damaging UV rays can penetrate the cloud coverage. 

Who is at Risk?

Everyone (including children) is at risk for eye damage from UV radiation that can lead to vision loss. Any factor that increases the amount of time you spend in the sun will increase your risk.

People who work or play in the sun for long periods of time are at the greatest risk.

The risk of sun related eye problems is higher for people who:

  • spend long hours in the sun
  • have had cataract surgery or have certain retina disorders
  • are on certain medicines, such as tetracycline, sulfa drugs, birth control pills, diuretics and tranquilizers that increase the eye’s sensitivity to light 

Additionally, extended UV exposure has been linked to significant eye problems, including cataracts, macular degeneration, pingueculae, pterygia and photokeratitis.   Many skin cancers can occur on the eyelids and external features of the eye.  Additionally, while ocular melanoma is rare it is the most common eye cancer in adults, because of the increasing number of UV related cataracts and eye cancers; Prevent Blindness, and many other organizations, strongly recommend that everyone utilize UV protection eyewear, not only those who engage in outdoor disciplines and recreation.

When we are caught up in the delights of summer we tend to overlook the simple proactive measures that we can take to protect against vision loss and UV related eye damage and even life-threatening ocular cancers.  In addition to taking a few extra moments to protect yourself and your loved ones before rushing out into the sunshine, it is imperative that people take the time for annual eye exams. An optomap screening is an excellent, expedient way to get a comprehensive view of the retina and to gain essential information about one’s ocular health. optomap is the only proven, clinically-validated, ultra-widefield retinal image that can capture 82% or 200⁰ of the retina, which can reveal incredibly subtle changes from the central pole to the far periphery of the retina in a single capture – and in a fraction of a second – so you can get out there (well-protected, of course) and enjoy that summer sun.

Celebrate Safely and Protect your Eyes this Summer

One of our favorite times of the year in the United States surrounded by cookouts, pool parties, friends and family, the 4th of July is upon us.  In addition to all the splendor, the month surrounding July 4th festivities also brings an increase of fireworks displays as well as an increase in firework-related injuries.  Prevent Blindness America and the American Academy of Blindness sponsor June and July as Fireworks Eye Safety Months to raise awareness of the dangers, as well as, the safe protocols for viewing or handling pyrotechnic displays or devices. Most fireworks-related injuries occur during the month of July, and according to the most recent Consumer Product Safety Commission report, 14% of fireworks injuries have been eye injuries occurring mostly in children between the ages of 10 and 14.   It is easy for any of us to get caught up in all the excitement and activity or become distracted by hosting responsibilities, conversations, and crowds.  Take into consideration, as well, that these festivities and shows are generally conducted past dusk and simply navigating an event with numerous people and smoke can become challenging, let alone successfully dodging the sparkler-wielding children. Keep yourself, your children and your eyes safe this summer and enjoy holiday traditions with some important safety tips provided by the American Academy of Ophthalmology.

Fireworks Eye Safety Tips

For those who attend professional fireworks displays and/or live in communities surrounding the shows:

  • Respect safety barriers at fireworks shows and view fireworks from at least 500 feet away.
  • Do not touch unexploded fireworks; instead, immediately contact local fire or police departments to help.

For those who decide to purchase consumer fireworks because they live in states where they are legal, the Academy recommends the following safety tips to prevent eye injuries:

  • Always have an adult supervise children, even sparklers! Sparklers burn up to 1800°F
  • Ensure everyone is a safe distance of at least 500 feet when setting off fireworks.
  • Never point or throw fireworks at another person
  • Don’t shoot fireworks out of a glass or metal container. The explosion could shatter and expel glass or metal shards!
  • Don’t hover. Never have any part of the body directly over a firework when lighting
  • Firework didn’t ignite the first time? Soak it in water and discard it. Serious eye trauma and other injuries can occur when people mistake a firework for a “dud” or think that it’s no longer active or hot.
  • Importantly, protect your eyes and wear safety glasses when setting off fireworks

The people injured by fireworks aren’t necessarily handling the explosives themselves. In fact, 65% of people injured by fireworks were bystanders, according to another study.  This goes to show that children and people not handling fireworks themselves are in as much danger as the people actually lighting fireworks.

What to Do for a Fireworks Eye Injury

Fireworks-related eye injuries can combine blunt force trauma, heat burns, and chemical exposure. If an eye injury from fireworks occurs, it should be considered a medical emergency.

  • Seek medical attention immediately.
  • Do not rub your eyes.
  • Do not rinse your eyes.
  • Do not apply pressure.
  • Do not remove any objects that are stuck in the eye.
  • Do not apply ointments or take any blood-thinning pain medications such as aspirin or ibuprofen unless directed by a doctor.

If you or a loved one has sustained an eye injury related to a fireworks display, seek medical attention immediately. Depending on the extent of the injury, the emergency team may recommend that you consult with your local eye doctor for continued care.

Additionally, the summer season is an excellent time of year to schedule a comprehensive eye exam with your eye doctor. With a more flexible schedule and perhaps some time off, it’s probably easier to get you in to have your eyes thoroughly evaluated.

optomap offers a comprehensive view of the retina to gain essential information about ocular health. It is the only proven, clinically-validated, ultra-widefield retinal image capturing 82% or 200⁰ of the retina. optomap can help eye doctors in detecting potential issues before symptoms even begin to develop, which can improve patient outcomes in the long run by allowing for earlier treatment. Visit our website prior to scheduling your next eye exam to locate an optomap provider near you.