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Optometry

OCT use in optometry practice results in timely glaucoma detection

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Optometry practices that utilize optical coherence tomography (OCT) can improve the timeliness of glaucoma detection and may prevent vision loss, according to a study.

“Early detection of glaucoma is key to preserving visual function and quality of life,” the authors noted. Optometry practices using OCT on a routine basis were 34% more likely to refer patients to an ophthalmologist for evaluation of glaucoma.

Researchers retrospectively assessed electronic medical records from 331 optometry practices in Australia to identify adult patients who attended a practice between January 1 and July 31, 2019.

Researchers assessed glaucoma referrals to an ophthalmologist in optometry practices performing routine OCT (n=175) versus those that did not (n=20).

Among 994,461 patient records included (59% female; median age, 52 years), 10,475 (1.1%) were referred to an ophthalmologist for glaucoma assessment. These referrals occurred more often in practices utilizing OCT (n=9,719; 1.1%) compared with those that did not utilize OCT (n=756; 0.8%). This finding was maintained after adjusting for age, sex, and location (odds ratio, 1.39; 95% CI, 1.10-1.76).

Among those who were referred to an ophthalmologist, 318 patients had ophthalmologist feedback available (all referred by OCT-using optometry practices): 129 (41%) were diagnosed with glaucoma, 121 (38%) had suspected glaucoma, and 68 (21%) were deemed not to have glaucoma.

Ophthalmologist feedback was only available for a small subset of referrals, which limits the study’s findings, and estimates of false positive referral rates should be interpreted with caution, the authors noted.

“Adoption of OCT as a routine clinical tool in optometry, rather than an on-indication test, may significantly reduce the burden of undiagnosed glaucoma in the population and ultimately lead to improved visual outcomes,” the researchers concluded.

Reference

Paul JP, McGuinness MB, Ashby BD, et al. Increased glaucoma case-finding through routine optical coherence tomography in optometry practice. J Glaucoma. 2024;33(5):347-354.

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