Most patients are re-assured by EyeScan / Macuscope technology
Optometrist David Crystal BSc
(Hons) MCOptom DipTp
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In 1997 we were the first practice in Edinburgh to adopt EyeScan technology which allows a better view of the retina, digital quality image and the ability to store pictures electronically for future comparison. Over 3000 patients routinely benefit from EyeScans that comprehensively check their ocular health. In some cases we have seen early signs of disease, that have been treated, which we felt we would have missed without this technology. Now from May 2007, for the first time in Scotland, we are introducing a new test for the over 30s - A MacuScope is the first commercially available device that can measure and monitor macular pigment density. By investing in this new technology, patients will be able to remove one of the major risk factors of developing macular degeneration, the number one cause of untreatable blindness in the UK.
Age-related macular degeneration (AMD) is the leading cause of irreversible blindness in people over 50 years of age, affecting an estimated 500,000 people in the UK. Of 976 patients aged 75 and over with loss of vision in one eye, the main medical causes were AMD (53%) and cataract (36%). Those who suffer its blinding effects lose their central vision, which is needed for reading, driving, and every day activities. The most important confirmed risk factors are.
With new scientific research, there is compelling evidence that people with low pigment levels are at risk later in life. It has been advised that people have their macula pigment levels checked from the age of 30 years onwards. Any protection that macula pigment may provide against AMD will need to be exerted in the middle years of life because protective macula pigment depletes with age.
The pigment is made up of 3 dietary components, known as lutein, zeaxanthin and meso-zeaxanthin. Macula pigment is yellow in colour and therefore absorbs high-energy blue wavelength light. Lutein and zeaxanthin are potent antioxidants and therefore protect against the damage caused by free radical oxidisation, so it is perhaps unsurprising that this pigment protects the central macula from the ageing process. Why is Meso-Zeaxanthin so vital? Meso-zeaxanthin is the 3rd component of the macula pigment and is only found at the very centre of the macula where vision is sharpest. Meso-zeaxanthin is obtained by the conversion of lutein to meso-zeaxanthin in the macula. It is not found in a typical diet. Meso-zeaxanthin is being recognised as a more powerful neutraliser of free radicals and protector of the central macula than lutein or zeaxanthin. Supplementation with meso-zeaxanthin will ensure that this component of macular pigment accumulates at the target tissue (i.e. the central macula) in a way not dependent on an enzyme to convert lutein to meso-zeaxanthin. Indeed, such an enzyme may be lacking in some individuals.
What does an Eyescan do? Inside and at the back of the eye, the retina is the only place in the body where arteries and veins can be visually inspected. Blood vessels here are branches of the body's larger circulatory tree and are an excellent reflector of general health. For example, life's total accumulation of cholesterol can be seen on the walls of arterioles (small arteries).
Traditionally the optometrist peers through a hand held scope and looks for changes. This is difficult because there's nothing to compare with except written notes or sketches. Even the most diligent record keeper is challenged.
With EyeScan technology, retinal images are digitally stored. By comparing previous images, superb comparisons of eye health can be made...any changes can be detected earlier. In addition the care is portable; a personal copy of an EyeScan can be emailed from our consulting room's broadband connection to allow comparisons to continue if a patient moves away. The retinal fingerprint made by the blood vessels is unique but can change. For example meandering arterioles may indicate high blood pressure. A pattern shift towards the nasal side of the optic nerve may indicate glaucoma. Loss of a defined optic nerve edge may be raised intracranial pressure from a brain tumour. The appearance of red blotches are blood haemorrhages which when dot-like may indicate diabetes or, if flame shaped, high blood pressure. The observation of white dots is fluid leakage from arteries whose walls are losing containment, another possible sign of diabetes.
In the macular zone, acquired yellow dots, called drusen, are piles of dead retinal cells
which should have been chemically marked and absorbed. These can be the first sign of macular degeneration,
sometimes years before
the patient has any symptoms but they are not always present. For a detailed
explanation of macular degeneration go
here. EyeScan and the MacuScope. Digital imaging technology, while incredibly useful for other eye structures, does not assess macular pigment thickness. This means optometrists do not have a predictive test for the disease. This is why the Macuscope is so eagerly awaited.
The Macuscope is a heterochromatic flicker photometer and measures the amount of protective macular pigment by flashing blue and green lights in an alternating flicker pattern. The blue light is absorbed by the macular pigment but not the green. The amount of blue light required to be equally effective as the green yields the pigment density. This simple, none invasive test, which is safe and painless, takes only a few minutes to perform and will save some patients the misery of losing their sight.
Many studies show patients who are low in macula pigment have increased risk for macular degeneration. Studies also show that deficient macula pigment can be restored by dietary supplements. With a new formulation containing Meso-Zeaxanthin, the subjects responded, with macula protective re-pigmentation increases of up to 40% in as little as 140 days of supplementation.
For preventative care we
recommend an EyeScan
/ Macuscope test be performed every two years. Patients low in
macular pigment density should be monitored bi-annually. We at Eyecare-Plus have always invested in the best available technology and used it for our patients. Good preventative care costs, both in time and money but eyesight is priceless. We think the combination of EyeScan / Macuscope greatly enhances the level of care we can offer you and that is why we would encourage you to take advantage of the improvement in technology.
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0131 556 7836
