What if? Ophthalmology without OCT – Part 2

In celebration of Ophthalmology Times' 50th anniversary, we asked leading experts what the practice would look like today had optical coherence tomography (OCT), one of the biggest innovations in the field, never been invented.

Video Transcript:

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

Justis Ehlers, MD, FASRS:

It would be horrible, you know, probably something else would have slipped into its place. And it's hard to imagine exactly, you know, what that is. We were, I was at an imaging meeting last night, and we talked about how in many diseases, like macular degeneration, fluorescein, used to be the workhorse, and now we hardly use it at all. Now I personally think, for example, in diabetic retinopathy, ultra-widefield, angiography is really important. But I think that from an understanding aspect of the disease, as well as how we're now targeting therapeutics, for example, with OCT, it's really the only way to look at photoreceptor integrity, such as looking at the ellipsoid zone, and we now have therapeutics that are targeting that. Without OCT, we wouldn't have any of that right now.

Matthew Starr, MD:

It definitely wouldn't be where it is today. Injections wouldn't be where they are today. It was, you know, you hear all the people in these legends talk about the advent of OCT with the take off of individual injections, they were simultaneous, hand-in-hand, and without them, I don't think we'd be where we are today. Without OCT., I think we would have to be master clinicians, or have to be, because we rely on it so much to see anything and everything in the retina. Honestly, if we didn't have it, I know there probably some other technology that was been invented to come and do with it. But I think, who knows where we would be.

Ella H Leung, MD:

Honestly, I hope that we would all be as amazing at being physical examiners as you know the venerable Donald Gass, and still be able to see all the CME super well and be able to have this great care of our patients, but I do think OCTs, with their ability to look at micron thick edema, really does help us. So I think we would be a lot further behind, in terms of our ability to treat patients and try to prevent worsening without OCTs, if just by relying on the human, naked human eye to see it, rather than on all this fancy technology that really does make an impact for our patients.

Danny A Mammo, MD:

I don't like to imagine a world where we didn't have OCT. We'd be using our naked eye to try to diagnose conditions. I think patients would unfortunately be losing vision. We would have a lot of patients kind of, maybe being forced out of the workforce that shouldn't be. A lot of older patients living longer, they're not seeing as well. So it doesn't seem like it would be a very happy world.