Article Date: 6/1/2002

Instrumental Strategies
Technology to Save the Future
Catch glaucoma light years ahead of traditional testing with this tool.
By Gregg Ossip, O.D.

We've all spent what seems like an eternity trying to explain glaucoma to our patients. We want to inform them of their options and educate them about the details of their condition as well as the importance of annual check ups because they're more likely to comply with therapy when they understand.

Unfortunately, many patients don't understand what glaucoma is and don't comply with treatment or follow up until they've lost vision in one eye and panic at the thought of going completely blind. Now we can stop fretting about this issue, because the printouts from the Heidelberg's Heidelberg Retina Tomograph II (HRT II) really grab the patient's attention and help you convince them about the seriousness of the disease.

The HRT II is a confocal scanning laser tomograph that doesn't require dilation.

The technology

The HRT II is a system that combines a laser-scanning camera with specialized software that evaluates the optic nerve. It gives measurements of size, depth and shape of the optic nerve and is especially useful at detecting small changes over time.

An accurate measurement of the cup size, volume and shape, as well as other structural parameters, is a clinically useful complement to intraocular pressures, visual fields, family history and other risk factors that contribute to a diagnosis of glaucoma. Compared to the painstaking attention demanded of an automated visual fields test, using the HRT II is a pleasure.

You can use the HRT II to scan 64 images of a patient's optic nerve head in 2 seconds. It automatically takes three sets of 15-degree scans to create a 3-D image.

What it tells you

The HRT II combines the laser-scanning camera with specialized software that evaluates the optic nerve. The software is comprised of two parts. The first part is called the Moorfields Regression Analysis, which compares your patient to a normative database and provides an initial analysis and classification for glaucoma.

The second part of the software, called the Progression and Change Probability Map Analysis, lets you automatically and objectively track your patient for fine structural changes in the optic nerve and nerve fiber layer over time. It's especially useful early in the disease process when subtle structural changes of the optic nerve precede IOP elevation or visual field defects. For patients already on treatment, the HRT II helps you monitor its effectiveness.

System benefits

The HRT II -- particularly the progression analysis software -- helps differentiate between a physiologically large but healthy cup and a cup that's excavating because of glaucoma. The HRT II is easy to administer and is consistent from one visit to the next. Your techs can learn to use this technology very quickly and accurately.

Don't miss out

The HRT II will change the way you practice optometry. It'll help you reinforce regular eye exams and patients will develop more confidence and trust in you when it comes time to recommend therapeutic measures. Plus, it'll create a high-tech image of your office.



Optometric Management, Issue: June 2002