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OCT during routine eye exams may uncover undiagnosed conditions

Healio Optometry1d ago1 min read

PHOENIX — Screening healthy patients for glaucoma during routine eye exams led to glaucoma referrals that would not have been made otherwise, according to a prospective study presented at Optometry’s Meeting.Out of 104 patients, 13 were referred for further glaucoma evaluation, and one was diagnosed with active disease. The study was presented by Michael Chaglasian, OD, FAAO, of Illinois College of Optometry.During routine eye exams at Illinois Eye Institute, 104 patients aged 35 years or older were offered free spectral-domain OCT imaging using Maestro2 (Topcon Healthcare).The average age of

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AI Summary

Quick Take

A prospective study of 104 asymptomatic patients aged 35 and older found that routine SD-OCT screening during standard eye exams led to 13 referrals for glaucoma evaluation and one confirmed diagnosis of active disease. These cases would likely have been missed without the use of Topcon’s Maestro2 imaging, highlighting the potential for OCT to identify subclinical pathology in supposedly healthy populations.

Why It Matters

The debate over 'screening' versus 'diagnostic' OCT in routine care is ongoing, particularly regarding the balance between early detection and the risk of over-referral. This study suggests a significant yield—nearly 13% of a healthy cohort required further workup—which supports the argument for integrating advanced imaging earlier in the patient journey. For practice owners, this data reinforces the clinical value of wellness scans, though it also underscores the need for careful interpretation to manage the resulting diagnostic workload.

Key Findings

Out of 104 asymptomatic patients aged 35 or older, 13 (12.5%) were referred for a formal glaucoma evaluation based on OCT findings.
One patient (approximately 1% of the study population) was definitively diagnosed with active glaucoma that would have otherwise gone undetected during a routine exam.
The study utilized spectral-domain OCT (Topcon Maestro2) as a screening tool integrated into routine comprehensive eye examinations at the Illinois Eye Institute.
The findings suggest that standard clinical examination techniques alone may be insufficient for detecting early-stage glaucomatous changes in a significant subset of patients.

Study Snapshot

Design

Prospective screening study

Population

Healthy patients aged 35 years or older presenting for routine eye exams

Sample Size

104 patients

Practice Implications

Clinicians should consider the relatively high rate of incidental findings when implementing routine OCT screening for patients over 35, even in the absence of elevated IOP or suspicious disc appearance. While the yield for confirmed active disease was 1%, the 12.5% referral rate suggests that wellness scans can significantly shift a practice's diagnostic focus toward early intervention.

Who's Affected

OptometristsComprehensive OphthalmologistsPractice Owners

Evidence StrengthPreliminary

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