Peter Holm
Experiences of imaging in the NHS and in private care will be the focus for an Ophthalmic Imaging Association poster this November as London Medical’s expert draws conclusions from his time at Moorfields and latterly at the London Medical clinic.
“Essential to accurate, and early, diagnosis is the BluePeak autofluorescence and MultiColor Module of the Heidelberg Engineering Spectralis OCT, combined with the new Widefield Imaging Module for 55 degree scanning”, believes Peter Holm, Senior Ophthalmic Technician at London Medical.
“I carry out the majority of this scanning, and the fluorescein and ICG angiography, and then go through each one with the consultants who will talk through the pathology. Since we have been trialling the SPECTRALIS OCT the consultants have graduated to preferring the fluorescein angiography, largely because of the very important manual over-ride option of the 30 second frame film. Being able to change the focus as the scan takes place is very valuable. And it is quick: normally taking about a minute per eye to perform the scan, with autofluorescence taking just three minutes. The HEYEX software is very intuitive and can easily backdate and compare to other scans.
Additionally, the new widefield lens, giving 55 degree scanning, has allowed us to look more widely for haemorrhages on the peripheral for ARMD and diabetic patients. In the past we tended to not know from where the bleed was coming - from the choroid or from another vessel. Based on this, the decision will be made as to the treatment regime – laser or injections. It is so much easier, as before we just didn’t have that degree of information,” added Peter, who has a degree in Clinical Photography.
“HEYEX movie capture for transit and stereo FFA/ICG revolutionised capture and diagnosis of studies like Polypoidal Choroidal Vasculopathy as you can see how quickly the polyps lights up. Now with the addition of 55 degree scanning this will be very useful in peripheral pathology cases of sickle cell retinopathy (SCR) and ocular oncology,” he added.
“Having been looking at retinal scans for four years – three years at Moorfields and a year at London Medical - I recognise many of the symptoms, and have learned so much about the treatment process. It is always good to stay one step ahead with technology and we are very pleased to be upgrading to the OCT2 module. With added scanning speed and features it is a great diagnostic tool and the patients find the technology fascinating.”
London Medical, in Marylebone – originally the London Diabetes and Lipids Centre – has extensive medical retina experience in treating diabetic retinopathy, macular oedema, BRVO, CNV, CSR and ARMD. Some 50 patients are scanned each week on the Spectralis. Many are referred from the NHS because they do not want to wait too long, while others come from abroad, particularly the Middle East and East Africa.
Peter Holm, Senior Ophthalmic Technician
London Medical
SPECTRALIS owner since 2014