The value of OCT for detecting macular pathology depends on the quality of the imaging and proper interpretation, Dr. Charles said. He emphasized that a swept-source or spectral-domain OCT system must be used and that the interpretation should be based on review of all B-scan slices in gray scale.
“Time-domain OCT is obsolete, and do not look at pseudo-color images or 3-dimensional renderings because those software tools hide crucial details,” Dr. Charles pointed out. “In addition, do not let the technician pick a single image to put in the electronic medical record for you to review. OCT is not lab work.
“It is an examination that requires expert interpretation,” he added. “Looking through all of the grayscale images takes no more than 15 seconds… so the objection that OCT adds too much time to the surgeon’s exam and decreases efficiency is a false argument.”
Dr. Charles also observed that some electronic medical record systems allow uploading of a single OCT image into the record. “That capability addresses coding, billing, and compliance issues, but it does not serve to support quality medical care,” he added.