VEW 2024: Becoming an expert on your OCT

Danica Marrelli, OD, FAAO, AAO Dip, spoke on all things optical coherence tomography (OCT) and glaucoma at this year's Vision Expo West. She outlines her 2 presentations, "Strategies for Better Diagnosing Glaucoma," and "Putting the 'Oh!' in OCT" in an interview with Optometry Times.

Video Transcript:

Editor's note: The below transcript has been lightly edited for clarity.

Danica Marrelli, OD, FAAO, AAO Dip:

Hi, I'm Danica Marrelli, clinical professor at the University of Houston College of Optometry. So I have 2 presentations that I'm talking about glaucoma. One is called "Putting the 'Oh!' in OCT." It's a 2 hour course, so half of it is retina. Mark Dunbar is doing that and then I'm doing the hour on glaucoma. It's really something that I'm super interested in. We all have OCTs, or so many of us do, and there are some tricks and pearls to really utilize your instrument to its maximum capacity. And then the second glaucoma lecture that I'm doing is just kind of going back to the basics, and what do we need to be able to make a diagnosis of glaucoma. There's some new technology, but we can't forget about kind of the original clinical exam, the history, and a lot of other things, that it's not just about the OCT anymore.

I also am participating in a workshop. There are 4 of us. We have each one will present a little bit about a particular instrument, and then we have those instruments on the floor for participants to go and put their hands on them and and talk to the industry representatives who can tell them, is this going to be the right instrument for you? Would you do better with another one? So that's a really neat one, especially for someone who maybe is looking into getting an OCT in their practice, or maybe they have one, but they need to upgrade, and they're trying to figure out what's the best OCT to meet the needs of my practice.

I think that the instruments have gotten much better, and are in large part, we're able to upgrade them by buying new software or some new version of the actual box. Every once in a while, you're going to need to update your box. I think I have had my OCT for probably about 10 years, and we upgrade it, but we don't have to replace it, which is really nice. I think probably the biggest pitfall is just quickly looking at the reds, yellows and greens, those stop light colors that are supposed to tell us, everything is great, hey, wait a second, or oh boy, this is bad. But those stoplight colors, while they can help us alert to things that might be good or bad, there's some problems with those and that they don't represent everybody in the population. You might be not quite typical, but not necessarily have glaucoma, and so just looking at those reds, yellows and greens can sometimes trick you a little bit.

You want to look for the instrument that has the most up to date image capabilities. You know, it's kind of like buying a house. You want to stretch yourself a little bit, because something new is going to come out right after that. So I would be looking for high definition line scans, OCT-A, the ability to do wide, wide field imaging and anterior segment imaging, which I don't really do any contact lenses, but it's so important for people who are doing specialty lenses like sclerals, to really give them great information about how those lenses are working.

For a practitioner who doesn't have an OCT, maybe they don't really specialize in retina, or specialize in glaucoma, or specialized in specialty contact lenses, you sort of want a workhorse instrument. And there are some really neat instruments right now that save a lot of space by having a fundus camera and an OCT in one. That might not work for a really large practice that has lots and lots of patients that are constantly on those instruments, but for somebody who is in a smaller office and they really need to maximize the space that they have, that could be really helpful. A lot of the OCTs have wellness scans and wellness screenings that people can run on anyone. And it's not how I run my practice because I work in a more medically oriented practice, but there are all kinds of really great programs and protocols that a primary care optometrist can utilize their OCT for.

OCT is such a powerful tool. I think, that it has become so popular and so prevalent in optometric offices but it's really important to learn the very best way to utilize the instrument that you have. There are slight differences between them all. I always say, "Love the one you're with," right? So the instrument that you purchased, learn the very best way to utilize it. Learn all the tools and tricks for that particular instrument.