Early Detection ‘Crucial’ in AMD Patient Management

Shown to occur in 18 percent of patients over a five year period, the development of choroidal neovascularization (CNV) has been determined the cause of vision loss in patients with age-related macular degeneration (AMD). Furthermore, it has been determined that since there are successful treatments available for CNV before there are visual changes, if it is detected early enough, vision loss due to AMD can be mitigated.

 

Source: Attila Barbas via iStock

Source: Attila Barbas via iStock

Since treating CNV once damage and vision loss have occurred is not a successful method of restoring vision or reversing damage to the macula in most people, early detection in AMD patients is crucial to maintaining functional vision. By the time changes in vision are noticed by patients, permanent damage has already occurred. Clinical evidence has sufficiently proven that treatments of small AMD lesions has been highly successful, so the earliest possible detection provides the best outcomes in AMD patient management.

 

Early detection of AMD requires sophisticated equipment and testing processes if sight preservation is to be successful, due to the rapid progression. According to an article published in Retina Today and written by Anat Loewenstein, M.D., early detection “…means a significant gain of vision for most patients.” Not only can this outcome preserve quality of life for the aging population, Loewenstein details that it can generate savings into the billions of dollars annually just in Medicare for people suffering significant vision loss.

 

With early detection being crucial in AMD patient management, incorporating Optos’ ultra-widefield (UWF) retinal imaging technology into your practice can significantly impact the number of patients with vision loss due to AMD. With a view of up to 82 percent of the retina, multiple modalities, non-invasive scan and sophisticated software that enables image tracking for comparison purposes, you will be able to see more, discover more and treat more effectively.

 

View our full line of UWF retinal imaging equipment and contact us to learn more about how we can help your practice provide better patient outcomes.

 

What Causes Ocular Hypertension?

Ocular hypertension is a condition where the interior pressure of your eye is higher than what is considered normal. While some people who suffer from the affliction show no outward signs and maintain their vision, some people develop glaucoma and risk losing their vision. Knowing and understanding the causes of ocular hypertension may help you preserve your vision.

 

Source: monkeybusinessimages via iStock

Source: monkeybusinessimages via iStock

 

Causes of Ocular Hypertension

There are several factors that cause high eye pressure or contribute to the condition and they are closely related to the causes of glaucoma. The main cause of ocular hypertension is an imbalance of the clear fluid (aqueous humor) that flows through your pupil to the front chamber of your eye, between the colored portion (iris) of your eye and the cornea. When too much aqueous humor is produced, or the fluid is not able to drain as it should, the result is ocular hypertension. Other factors that may contribute are:

 

  • – Steroid medications taken orally or by eye drops may increase your eye pressure. If you have to take steroid medications, speak to your doctor about having your intraocular pressure (IOP) tested. Although steroids are most common to affect eye pressure, ask your physician or pharmacist if a higher IOP has been reported with any new medications.
  • – Eye injury or trauma such as an infection can increase the production of fluid or impair the drainage for you eye. If you have suffered either, the ocular hypertension may not be found immediately; it can appear months and even years later. Be sure your ophthalmologist is aware of any injury or trauma to your eyes.
  • – Cataract surgery and other eye diseases may cause increased pressure in your eyes. It is vital to have regularly scheduled with your eye care professional to monitor any conditions you may have.

 

Because ocular hypertension can lead to glaucoma, Optos would like to stress the importance of regular, comprehensive eye exams including optomap® to maintain your vision. While treatment is not always necessary, if it is required, early detection will provide you with the best possible outcome for your sight. Learn more about optomap and protecting your vision.

 

Know the Difference Between Dry and Wet AMD

As the leading cause of blindness in American adults age 65 and older, age-related macular degeneration (AMD) is expected to affect as many as three million people by the year 2020. AMD occurs when the macula, which is responsible for fine detail and central vision, becomes degenerated with age. Dry vs wet AMD are the two forms of the disease and you should know and understand the difference.

 

Wet AMD

Sometimes causing straight lines to appear wavy in its earliest stages, wet AMD is more advanced than dry and can deteriorate your vision rapidly. Wet AMD is caused by abnormal, fragile blood vessels that grow behind the macula. These vessels are often very fragile and tend to leak blood and fluid, causing the macula to raise and become damaged. All patients who develop wet AMD started with the dry form so it is critical to get regularly scheduled comprehensive eye exams including optomap® to detect the disease in its earliest stages to prevent permanent vision loss.

 

Source: michaeljung via iStock

Source: michaeljung via iStock

Dry AMD

The dry version of AMD has three stages which can affect one or both of your eyes. The three stages are defined by the size and number of fatty yellow protein deposits that form under the retina called “dreusen.” While dreusen are not suspected to be the cause of AMD, their existence increases your risk of developing the condition.

 

  • – Early AMD causes no noticeable symptoms or vision loss. An optomap will show several small dreusen or a few medium-sized ones.
  • – Intermediate will show many medium or more than one large dreusen. At this stage, you may notice some blurring in your central vision and some people need more light for reading and other close tasks.
  • – Advanced dry AMD not only shows evidence of dreusen, photosensitive cells and other tissues will show degeneration. You may notice a blurred spot in the middle of your vision that increases in size and darkness over a brief period of time and you may have trouble reading and distinguishing faces unless they are very close to you.

 

At this time there is no treatment for dry or wet AMD. But regular comprehensive eye exams, including optomap, may help to stop or delay the progression of dry and wet AMD. Visit the optomap site to learn more about early eye disease detection.

 

UWF Retinal Imaging Can Detect Melanoma

According to the American Cancer Society, there will be an estimated 2,580 eye cancers diagnosed in 2015 with most of them occurring as melanoma of the eye. While this number is not staggering when compared to the overall population, melanoma can be fatal. As with most cancers, Cancer Research UK has published stats indicating that early detection is your best chance at survival if you are diagnosed with ocular melanoma.

 

Source: Jovanmandic via iStock

Source: Jovanmandic via iStock

What is Melanoma of the Eye?

Melanoma is an aggressive cancer that forms in the cells responsible for skin pigmentation through the production of melanin. Since your eyes also have melanin-producing cells, melanoma tumors can form in various parts of your eye. Although the choroid layer is the likely site for ocular melanoma, the following parts may also be affected:

 

  • – Ciliary body
  • – Iris
  • – Conjunctiva
  • – Orbit
  • – Eyelid

What Causes Ocular Melanoma?

While an exact cause is not known, the Mayo Clinic describes ocular melanoma as a DNA error that prevents cells from shedding in their typical life cycle. Cells grow uncontrollably and mutated cells accumulate rather than dying off and form melanoma. Despite the notion that it caused by a problem with DNA, there are risk factors that may increase the odds of contracting the disease:

 

  • – Exposure to the sun’s harmful rays
  • – Persons with green or blue eyes
  • – Caucasians are generally more susceptible
  • – Skin conditions related to pigmentation or excessive mole growth

What Symptoms May Occur?

Even though everyone may not experience symptoms, you should see your eye care professional immediately if you experience bulging of one or both of your eyes, a change in the color of your iris, reduced vision, painful and red eye or noticeable defects.

 

What is my Best Defense?

Your best defense is to have a regularly scheduled comprehensive eye exam including optomap® ultra-widefield (UWF™) retinal imaging. Due to the high resolution images and unprecedented 200 degree view of the retina, optomap has been clinically proven to be effective as a diagnostic tool for early detection of melanoma of the eye.

 

To learn more about Optos and our UWF retinal display imaging technology, please visit our website or contact us.

UWF Retinal Imaging Helps Manage Diabetic Retinopathy

According to an article written by Paul E. Tornambe, MD, FACS and appearing in the April 2015 issue of Retina Today, Optos’ ultra-widefield (UWF™) retinal imaging is helping manage and advance knowledge in diabetic retinopathy (DR). In fact, Tornambe can be quoted as saying UWF retinal imaging “…will facilitate earlier diagnosis, more accurate evaluation and better treatment outcomes.”

 

Source: michaeljung via iStock

Source: michaeljung via iStock

How UWF is Improving Diagnosis

Several studies have been conducted and indicate that UWF imaging has the potential to improve diagnosis and management of DR. In the article, Tornambe references several studies that show, compared to standard technology, optomap® provides high resolution images that allow for a much larger view into the periphery of the retina (200 degrees), the images are acquired rapidly and often, the patients’ eyes do not have to be dilated. Not only are the images much higher quality, it stands to reason patients are more likely to maintain a proper diagnostic schedule if they do not have to undergo dilation.

 

With multiple modalities such as fluorescein angiography and red-free color imaging, Optos UWF technology consistently reveals more pathology if present than other diagnostic tools are able, leading to earlier diagnosis in some cases and more advanced disease progression in others who were previously diagnosed with DR.

 

UWF’s Contribution to DR Management

While a number of results have already been published as evidenced by the article, there are still active studies being performed to determine the effect of UWF retinal imaging on prognosis for patients with DR. To date, strong correlations between peripheral retinal ischemia and diabetic macular edema have been formed, allowing earlier diagnosis and targeted treatment options to mitigate vision loss. Findings have also indicated additional treatment to prevent postvitrectomy diabetic vitreous hemorrhage, a basis for creating an ischemic index to determine the severity of DME and several other insights that are contributing to improving patient care. For the complete article, including references for the clinical testing, click here.

 

Partnering with Optos can elevate your practice to the highest standard in diabetic retinopathy management for your patients. View our UWF retinal imaging devices and contact us to learn more.