IMAGING USEFUL IN GLAUCOMA BUT IS NOT THE ANSWER TO EVERYTHING

While quantitative imaging is useful in helping clinicians make a diagnosis of glaucoma, awareness of its limitations and ensuring usage of other clinical data is equally 

important. During a session at ESCRS Glaucoma Day exploring the evolution of imaging in glaucoma management, Ted Garway-Heath MD, UK, queried whether ophthalmology is any better off with all the sophisticated imaging technology, such as spectral domain-optical coherence tomography (SD-OCT), that is now available.“It does not have a brain; it just provides data, you must use yours,” he said.

He stressed that clinicians need to be aware of sources of error when interpreting imaging reports and must consider the clinical context. For example, the age and health/risk factors of the patient are important, as is other clinical data. “In addition, poor image quality can result in a different classification,” Dr Garway-Heath said. However, in future it should be possible to better map function and structure better, he added.

Reviewing the literature, he reported that quantitative imaging provides at least as good evidence of the progression status of patients as experts assessing monoscopic 

photographs. “So imaging devices are a useful adjunct to the ophthalmologist in making clinical decisions, according to the literature,” he said.Dr Garway-Heath reminded the audience that an abnormal scan does not necessarily mean a patient has glaucoma – it depends how likely glaucoma was before the scan.

“So to conclude, imaging can support but not make your decision for you.”