September is Healthy Aging month, however despite age related changes to vision, ocular health is often overlooked. As the aging population grows, adding the first influx of generation X to the baby boomers in the over 50 demographics, the incidences of glaucoma and Age-related Macular Degeneration (AMD) are also on the rise.
Recent studies have demonstrated how optomap ultra-widefield™ (UWF) retinal imaging is fulfilling a need in supporting the detection and management of both ocular and systemic diseases associated with aging. UWF imaging provides a high resolution, single-capture image of 82% (or 200 degrees) of the retina. Studies have confirmed that the resolution of the optomap image – is comparable to fundus photography – which captures 11% of the retina, in detection of diseases such as diabetic retinopathy, AMD and uveitis. Additionally, studies have found that the additional area captured by optomap can enhance the ability to detect, diagnose and manage diseases in comparison to fundus photography and be captured more efficiently. UWF is being increasingly used in optometric and ophthalmic settings and enables eye care professionals to detect, diagnose, document and treat ocular pathology including retinal disease that may first present in the periphery.
Age-Related Macular Degeneration (AMD) is the leading cause of severe vision loss in adults over age 50. The Centers for Disease Control and Prevention estimate that by the year 2020, 196 million people worldwide will be living with some form of AMD.
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. Over time the retinal periphery has been able to be more easily studied in early AMD to determine the value in the detection and/or monitoring of the disease. However, with the advent of multi-modality UWF imaging, novel studies are beginning to demonstrate this value. 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. Studies have revealed that 97% of patients with AMD have evidence of the disease in the far periphery.
This outcome demonstrated that drusen 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. Read the Full Article
Glaucoma is another primary cause of blindness worldwide, affecting an estimated 70 million people. 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 diagnosing 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 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. Read the Full Article here….
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