Recommendation ID

Optical coherence tomography for glaucoma:- What is the effectiveness and cost effectiveness of optical coherence tomography (OCT) for diagnosing and monitoring glaucoma?

Any explanatory notes
(if applicable)

Why this is important:- Glaucoma is an age-related chronic condition and the second leading cause of blindness in the UK. Once detected, glaucoma care usually takes place in hospital eye services, where patients are monitored for the rest of their life. There are over 1 million visits per year for glaucoma care in the NHS in England. This is predicted to increase substantially as a result of an ageing population and better detection in the community.
For diagnosis and monitoring, patients have an examination of the optic nerve and a review of visual field test results. Visual field testing has potential limitations: there is a learning effect and variability, it involves considerable patient effort, it is influenced by comorbidities, and in some people results are not reliable. Automated imaging with OCT overcomes many of these limitations.
OCT is an imaging technology that has evolved over the past 2 decades and is currently used in all NHS departments for the diagnosis and management of retinal diseases. However, current use of OCT and imaging technologies in glaucoma is highly variable.
It is possible the addition of OCT for diagnosing and monitoring glaucoma may enable earlier detection of disease and progression than when visual field testing is used alone. This could lead to escalation of treatment with less visual loss and blindness. However, it is possible that OCT may detect structural changes that will not be translated into functional loss, and may lead to unnecessary treatment. Overtreatment is likely to be associated with side effects and increased healthcare costs.

Source guidance details

Comes from guidance
Glaucoma: diagnosis and management
Date issued
November 2017

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 30/11/2017