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    Opportunities and challenges in the world of ophthalmology in 2018


    Thoughts on optical coherence tomography (OCT)

    Dr Augustin: The eye is a window to the brain. The relationship between neurodegenerative diseases and ocular structures such as the optic nerve and retina is well established for many disease entities, such as multiple sclerosis (MS).

    Optical coherence tomography (OCT) provides an important tool to accurately analyse modifications in the eye that have been induced by inflammation and neurodegeneration. Using the new OCT software platforms we can evaluate every single retinal layer and, above all, ganglion cells layer.

    Taking MS as an example, several studies have demonstrated the correlations between GCL and clinical disability in this disease. The value of OCT is currently evaluated in many neurological diseases for both diagnosis and follow-up. The major challenge will therefore be the establishment of a network between neurologists, specialists in internal medicine and ophthalmologists.

    Dr Kermani: Cataract and refractive imaging platforms based on swept-source OCT will increase confidence in the measurements, since this technology enables you to actually see what you measure and measure what you see. In 2018 we can expect IOL biometry (including axial length measurement), corneal topography/tomography, anterior segment biometry and anterior segment imaging to be combined in one instrument. 

    Productivity is one of the central challenges in today’s cataract and refractive world.  An important characteristic of the new platforms is the fact that all measurements and analysis are based on high-resolution diagnostic images. This mitigates the effects of confounding factors such as coexisting abnormalities, which often cannot unambiguously be identified without diagnostic imaging. 

    Processing the ray tracing algorithm with valid patient data is also near to hand. I am sure this will lift us to an even higher level of predictability and success. Such technology should be available in 2018. 

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