Australian Government - Department of Health

Medical Services Advisory Committee (MSAC)

1310- Optical Coherence Tomography

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Assessment No1310
Application NameOptical coherence tomography, for the diagnosis and monitoring of treatment effectiveness with aflibercept in patients with central retinal vein occlusion (co-dependent)
Assessment TypeSubmission based assessment
Description Of Medical ServiceOptical coherence tomography (OCT) is a non-contact, non-invasive high resolution imaging technique that provides cross-sectional tomographic images of the ocular microstructure
through the thickness of the retina. It is analogous to ultrasound, measuring the back-reflection intensity of infrared light rather than sound.

An OCT image is a two-dimensional data set that represents differences in optical back-scattering or back-reflection in a cross-sectional plane. For the purpose of visualisation, OCT data are acquired by computer and displayed as a two-dimensional grey scale or false colour image. OCT images can be analysed qualitatively or quantitatively to detect retinal abnormalities. As a result of providing detailed information on the architectural morphology of the retina on the level of individual retinal layers, OCT has been proposed to detect early pathological changes, even before clinical signs or visual symptoms occur . OCT has been proposed as a new ‘gold standard’ structural test for retinal abnormalities.
Description Of Medical ConditionThe medical condition is central retinal vein occlusion (CRVO). Retinal vein occlusion (RVO) is a common cause of visual loss, caused by an obstruction of the retinal venous system, most commonly involving occlusion of a branch retinal vein (BRVO) or the central retinal vein (CRVO) (Laouri et al 2011). Thrombus formation may be the primary cause of occlusion however other possible causes include external compression or disease of the vein wall e.g. vasculitis (Laouri et al 2011). Secondary to vein obstruction, retinal ischemia occurs and signals the release of vascular endothelial growth factor (VEGF), which in turn destabilizes the endothelial tight junctions and promotes endothelial cell proliferation. CRVO is classically characterised by macular oedema, increased dilation and tortuosity of all retinal veins, retinal oedema cotton wool spots, areas of capillary non-perfusion, widespread deep and superficial haemorrhages (Coscas et al 2011).
Pre Assessment Meeting10 May 2012
Stage 2 – Suitability for Assessment15 May 2012
Lodgment of Proposed DAP 17 May 2012
Stage 3 - 1st PASC
(Draft DAP considered)
16 - 17 August 2012
Stage 3 – Release for Public Comment
(Consultation DAP)
2 October - 9 November 2012
PDF version Consultation Decision Analytic Protocol (DAP) (PDF 592 KB)
Word version Consultation Decision Analytic Protocol (DAP) (Word 1658 KB)
Stage 3 - 2nd PASC
(Final DAP)
13 - 14 December 2012
PDF version Consultation Decision Analytic Protocol (DAP) (PDF 478 KB)
Word version Final Decision Analytic Protocol (DAP) (Word 396 KB)
Stage 4 - Submission of Collated EvidenceFebruary 2013
Stage 5 - ESC evaluation13 - 14 June 2013
Stage 6 - MSAC Appraisal1 August 2013
Stage 6 - MSAC advicePDF version Public Summary Document - August 2013 (PDF 144 KB)
Word version Public Summary Document - August 2013 (Word 96 KB)
Stage 7 - Noting by Minister -
Stage 8 - Implementation-

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