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Glaucoma/Stargardt’s
Sanjeev Nath, M.D.
Eye Institute and Laser Center
New York, NY
A 37-year-old Hispanic female presented 5 years ago with a 20-year history of an “untreatable” retinal degeneration. At presentation, with high plus reading glasses, our patient was able to read magazine print at about 4 inches, but with some difficulty, and felt that her ability to read was worsening. The patient also complained of difficulty seeing at night.
Examination
optomap® plus image of left eye. Numerous pisciform
Unaided vision was 10/400 in each eye. Goldmann IOP’s were 23 OD and 24 OS. On flecks throughout the retina and maculopathy-charac- viewing the fundus with a slit lamp its appearance explained the visual difficulties. Further teristic of Stargardt’s disease. Also seen are severallarge floaters.
testing was performed; Pachymetry was 498u OD and 505u OS. Threshold fields revealed central Scotomas about 12x15 degrees in size OU, but fixation was erratic. Flash ERG’s The pisciform flecks and the appearance of the macula define the full presentation of Stargardt's disease. Since the Flash ERG was normal, we need to consider another diagnosis to explain her peripheral and night vision problems. Another important observation is that the discs appear to have asymmetric cupping, glaucoma is obviously indicated. High IOP’s Conclusion
Although there is no known treatment for Stargardt’s, glaucoma is treatable. The recognition that a patient can have more than one disorder, some of which are treatable and others not, must be considered. We have been seeing this patient over the last 5 years and controlling IOP has proven challenging. She has had several selective laser trabeculectomies in each eye ResMax™ image of the right eye. In this view the and is presently taking Alphagan and Travatan. Fortunately, there is no evidence that either “beaten bronze” appearing maculopathy associated disorder has progressed while she has been under our care. The ability to capture in one high with Stargardt’s and the asymmetric cupping seen in resolution image, the total extent of the damage to the retina caused by the two conditions in glaucoma are clearly viewed. NFL in the superior this case, is unique to the Optos imaging platform contained within the P200®C.
Although the patient is dilated yearly, optomap® images are obtained twice a year when the
patient is not dilated and allow us to monitor for change in the posterior pole as well as in the mid and far peripheral retina in a highly efficient manner.
Optos plc is a leading and rapidly growing medical technology company for the design, development, manufacturing and marketing of devices that image the retina. The Company has gained regulatory clearance (CE and FDA 510(k)) to market itsthird device - P200®C. The P200®C is aimed at practices looking for advanced clinical capabilities. With a view up to 82% of Zoomed view of ResMax™ image of the left eye. the retina in a simultaneous, single image, Optos’ technology provides an unequalled combination of wide-field retinal imaging, Here the cupping of the optic disc and an inferior speed and convenience for both practitioner and patient.

Source: http://optos.com/Global/documents/CaseStudies_GlaucomaStargardtsNath.pdf