Rescued eye and yet in danger – ocular melanoma

July 5th, 2015

Eine 50 jährige Frau verlor ihr linkes Auge wegen einer ausgedehneten Netzhautablösung. Am besseren rechten Auge: doppeltes Pech! Sie hatte ein Melanom! Das Auge konnte gerettet werden.  Es wurde erfolgreich mit Protonen bestrahlt, der Tumor schrumpfte. Der Visus verblieb um 0.5, manchmal sogar 0.7, wenn die Sicca nicht ausgeprägt war. Nach Jahren trat dann leider Visusverlus auf 0.3 und Metamorphopsien. Was war passiert?

A female had lost her left eye because of an extended retinal detachment. In her right eye, she had a melanoma, that was cured with proton beam radiation therapy. Years later, loss of visual acuity occured, but why?

>Download PDF Melanoma_Macular edema_Dr Maloca (1.4 MB)

Verlust von Wimpern und Vernarbung des Oberlides nach Protonenbestrahlung. Dennoch: das Auge konnte gerettet werden./ Madarosis (eyelash loss) and scarring of superior eye lid after proton beam radiation therapy of ocular melanoma. Note temporal large vessels (angiektasis). Copyright ©2015 GETOCT™ Ltd. All rights reserved.

Verlust von Wimpern und Vernarbung des Oberlides nach Protonenbestrahlung. Dennoch: das Auge konnte gerettet werden./ Madarosis (eyelash loss) and scarring of superior eye lid after proton beam radiation therapy of ocular melanoma. Note temporal large vessels (angiektasis). Copyright ©2015 GETOCT™ Ltd. All rights reserved.

Conjunctival angiektasis after proton beam radation therapy of ocular melanoma. Copyright ©2015 GETOCT™ Ltd. All rights reserved.

Erweiterte Bindehaut-Gefässe nach Protonen-Bestrahlung eines okulären Melanoms./ Conjunctival angiektasis after proton beam radation therapy of ocular melanoma. Copyright ©2015 GETOCT™ Ltd. All rights reserved.

 

Strahlenretinopathie nach Protonenbestrahlung. Radiation maculopathy after proton beam therapy.  Copyright ©2015 GETOCT™ Ltd. All rights reserved.

Strahlenretinopathie nach Protonenbestrahlung. Radiation maculopathy after proton beam therapy. Copyright ©2015 GETOCT™ Ltd. All rights reserved.

 

Normale Schichtig der retinalen Zonen/regular arrangement of retinal layers (1). Verlust der normalen Retina-Schichten im  Bereich der Bestrahlung sowie Retina-Atrophie/loss of retinal layers (2). Normale äussere Retina-Linien/regular outer retina (3). Praktisch vollständiger Verlust der Retina-Aussenschichten (4). Gefässreiche, normale Choroidea, healthy choroidea (5). Atrophe, gefässarme und vernarbte Choroidea im Bestrahlungsbereich/atrophic and vascular depleted choroid in the area of radiation therapy (6). Exudate (7). Artefakte (8). Foveoläre Depression/edge of foveolar depression (9). Copyright ©2015 GETOCT™ Ltd. All rights reserved.

Normale Schichtig der retinalen Zonen/regular arrangement of retinal layers (1). Verlust der normalen Retina-Schichten im Bereich der Bestrahlung sowie Retina-Atrophie/loss of retinal layers (2). Normale äussere Retina-Linien/regular outer retina (3). Praktisch vollständiger Verlust der Retina-Aussenschichten (4). Gefässreiche, normale Choroidea, healthy choroidea (5). Atrophe, gefässarme und vernarbte Choroidea im Bestrahlungsbereich/atrophic and vascular depleted choroid in the area of radiation therapy (6). Exudate (7). Artefakte (8). Foveoläre Depression/edge of foveolar depression (9). Copyright ©2015 GETOCT™ Ltd. All rights reserved.

 

Macualr edema_radiation maculopathy in ocular melanoma. Copyright ©2015 GETOCT™ Ltd. All rights reserved.

Macular edema after radiation therapy of an ocular melanoma. Healthy retina (1), foveolar depression (2), macular edema (3), atrophic retina after proton beam radiation of ocular melanoma. Copyright ©2015 GETOCT™ Ltd. All rights reserved.

Godzilla has conquered Switzerland – Future King of the OCT Monsters?

May 21st, 2015

Be the first…?

We are very proud to be the first in Switzerland to say: the Japanese company Topcon has announced a new OCT device: TRITON.  The ancient Greeks called a god of the sea Triton. He was blowing on a snail shell to reignite hurricanes and to dominate the sea and all mariner. He could steer ships by his wish and thanks to his exceptional power.

Triton, the God of the Sea? We will see! Copyright ©2015 GETOCT™ Ltd. All rights reserved.

Triton, the God of the Sea? We will see! (Click to enlarge). Copyright ©2015 GETOCT™ Ltd. All rights reserved.

 

Well, you may think, who should care,  just another OCT machine, again? But this time, stay still for some seconds and listen to the promising possibilities of  future OCTs, for the benefit of all ophthalmologists and patients.

On the first impression, well, it is just an ordinary medtech box, nice designed, compact and easy to operate. What else? Below the surface, as in the sea, a real treasure could be hidden. Japanese are world famous for their delicate fine arts and they may hide the true value.

TRITON seems to be very powerful, because it promises so much:

  • fastest OCT technology using 1050 nanometer SWEPT SOURCE OCT (SSOCT),
  • oversampling line scan 128 (!)
  • deep range imaging
  • en face OCT
  • vitreous visualization
  • accurate registration and tracking
  • standard color fundus imaging
  • Dye-free AngioOCT (angiography without fluorescein)
  • fundus autofluorescence (AF)
  • fluorescence angiography (FA)
  • anterior segment imaging with anterior segment lens
  • DICOM connectivity for a paperless office

If an OCT scanner in 2015 should have all these magic medtech tools by today, then it would be a monster like the famous Godzilla. Maybe, in some decades, we will say to our children: “… that once upon, there was a time, when ophthalmologists used a separate device for all their needs”.

Godzilla could not talk in the films, so, even we leave the words aside and show you brand new images from the very first “Swiss TRITON SSOCT” and the first AngioOCT images. Triton seems to be not a Swiss knife but an united origami of the most modern eye technology.

Dr. med. Peter Maloca, Lucerne & Basel, Switzerland.

TRITON_Dr med Peter Maloca_02 . Copyright ©2015 GETOCT™ Ltd. All rights reserved.

TRITON Dr med Peter Maloca, Switzerland. Plenty of  functions, but still small size. Copyright ©2015 GETOCT™ Ltd. All rights reserved.

Compact design, fast electro-magnetic handle:

TRITON SSOCT_Dr med Peter Maloca. Copyright ©2015 GETOCT™ Ltd. All rights reserved.

TRITON SSOCT Dr med Peter Maloca, Switzerland. Copyright ©2015 GETOCT™ Ltd. All rights reserved.

Integrated color fundus imaging:

Retinal detachmant in SSOCT Color fundus imaging. Copyright ©2015 GETOCT™ Ltd. All rights reserved.

Retinal detachment in SSOCT with integrated Color Fundus Imaging (CFI), obtained automatically at the end of the SSOCT scanning (original image, click to enlarge). Copyright ©2015 GETOCT™ Ltd. All rights reserved.

 

Retinal detachment, red free fundus imaging. Retinal detachmant in SSOCT Color fundus imaging. Copyright ©2015 GETOCT™ Ltd. All rights reserved.02_Dr Peter Maloca

Retinal detachment, red free fundus imaging with built-in fundus camera.  Copyright ©2015 GETOCT™ Ltd. All rights reserved.

 Fast 1050nm SSOCT with 128 x oversampling:

Retinal detachment in Topcon  SSOCT, color mode .Copyright ©2015 GETOCT™ Ltd. All rights reserved.02_Dr Peter Maloca

Retinal detachment in Topcon SSOCT, color mode. Copyright ©2015 GETOCT™ Ltd. All rights reserved.

 

Retinal detachment in Topcon  SSOCT, color mode .Copyright ©2015 GETOCT™ Ltd. All rights reserved.02_Dr Peter Maloca

Retinal detachment in SSOCT: (1) vitreous, (2) detached and thickened retina with gliosis, (3) subretinal space, (4) optic disc, (5) gliosis, (6) cystoid retinal edema, (7) attached retina (Click to enlarge). Copyright ©2015 GETOCT™ Ltd. All rights reserved.

 

Retinal detachment in Topcon  SSOCT, color fundus image, vertical scan. Copyright ©2015 GETOCT™ Ltd. All rights reserved.02_Dr Peter Maloca

Retinal detachment in Topcon SSOCT, color fundus image, vertical line indicates co-registrated SSOCT B-scan. Copyright ©2015 GETOCT™ Ltd. All rights reserved.

 

Retinal detachment in Topcon  SSOCT, color fundus image, vertical scan. Copyright ©2015 GETOCT™ Ltd. All rights reserved.02_Dr Peter Maloca

Detached retina, vertical SSOCT cross scan. Copyright ©2015 GETOCT™ Ltd. All rights reserved.

 

Cross B-scan trough detached retina. Copyright ©2015 GETOCT™ Ltd. All rights reserved.

Cross B-SSOCT-scan through detached retina: (1) vitreous, (2) dense posterior vitreal cortex and border (3), subhyaloidal space, (4) undulating retinal surface because of epiretinal gliosis, (5) thickened retina with intraretinal, cystoid spaces, (6) “outer retinal tubulation”, (7) subretinal space. Copyright ©2015 GETOCT™ Ltd. All rights reserved.

AngioOCT of different levels (dye free angiography; click to enlarge):

SSOCT AngioOCT_Dr Maloca. Copyright ©2015 GETOCT™ Ltd. All rights reserved.

Small branch venous occlusion imaged with SSOCT AngioOCT_Dr Maloca. Color fundus imaging with central exudates (A), AngioOCT with no dye-injection of superficial retinal vessels and superior vessel occlusion (B), medium-deep capillary complex (DCP) with superior occlusion and edema (C), AngioOCT of choriocapillaris (D). Copyright ©2015 GETOCT™ Ltd. All rights reserved.

 

AngioOCT using advanced swept source 1050nm OCT. Dye-free AngioOCT of superficial retinal vessels in case of small branch venous occlusion: large retinal vessel (1), normal capillary network (2), site of vessel occlusion with loss of filigrane capillary network (3, dark area), central avascular zone (4).  Copyright ©2015 GETOCT™ Ltd. All rights reserved.

AngioOCT using advanced swept source 1050nm OCT. Dye-free AngioOCT of superficial retinal vessels in case of small branch venous occlusion: large retinal vessel (1), normal capillary network (2), site of vessel occlusion with loss of filigrane capillary network (3, dark area), central avascular zone (4). Copyright ©2015 GETOCT™ Ltd. All rights reserved.

Autofluorescence Age related Macular degeneration (AMD):

 

AMD Color fundus image. Copyright ©2015 GETOCT™ Ltd. All rights reserved.

AMD Color fundus image shows a relative normal fundus with minor irregularities and a central light reflex from the flash. Next to the optc disc, a greyish puckering is visible. Copyright ©2015 GETOCT™ Ltd. All rights reserved.

 

AMD_Autofluorescence imaging (AF). AMD Color fundus image. Copyright ©2015 GETOCT™ Ltd. All rights reserved.

Impressing Autofluorescence imaging (AF) of AMD depicts a juxtafoveolar, dark area of RPE loss and hyperfluorescent, finger-like extensions. Copyright ©2015 GETOCT™ Ltd. All rights reserved.

 

AMD_SSOCT. AMD_Autofluorescence imaging (AF). AMD Color fundus image. Copyright ©2015 GETOCT™ Ltd. All rights reserved.

Cross sectional high resolution SSOCT of dry AMD shows RPE loss with enhanced visualization of the choroid and sclera (red arrows, click to enlarge). Epiretinal gliosis. Central fovea seems not affected with regular outer retinal zones.  AMD Color fundus image. Copyright ©2015 GETOCT™ Ltd. All rights reserved.

 

 

You tell me, you don’t love OCT.

 

 

 

Fallbeispiele – Cases to master OCT

May 10th, 2015

Anbei finden Sie einen typischen Fall zum Üben der retinalen Zonen. Please find enclosed a typical case to improve your OCT skills.

> Download Cases 01_Dr Maloca (Film)

> Download  Cases 01_Dr Maloca (PDF)

PDF

PDF

 

Rumors: Primus OCT 200: low cost OCT for everybody ?

May 6th, 2015

Zeiss India makes a great promise: an new OCT system that is cheap, easy to use and accessible for the small wallet. Well, everybody wants a cheap and easy to use OCT. Daniel Sims, Managing Director, Carl Zeiss India announced to the OCT world,  that Zeiss will offer a system with no gimmick,  that is focused on the OCT essentials. Thus, no run for the high end machines, but rather basics.

Primus OCT

Primus OCT. (C) Zeiss.

We will see,  if “Primus” will defeat his competitors and will be the first choice.

>Source of information and image: Doctorpulse.co

ZEISS Academy Praxisworkshop, Wien 25.4.2015: Effizienz in der Praxis „SMART OFFICE”

April 20th, 2015

Dieser Workshop dient dem Erfahrungsaustausch und der Wissenserweiterung im Hinblick auf diese Herausforderungen. Die bewährte Kombination aus Vorträgen und praxisnahem Erfahrungsaustausch durch die gemeinsame Diskussion von wirklichen Fällen macht den großen Erfolg der ZEISS Academy aus. Schicken Sie uns daher schon vorab Ihre Anregungen, damit wir diese thematisieren und diskutieren können.

wien (c) www.umfragenvergleich.at

OCT Workshop Wien 2015

Die Optische Kohärenztomographie ist bei Erkrankungen des hinteren Augenabschnitts aus unserem Ordinationsalltag nicht mehr wegzudenken. Der Schwerpunkt unserer täglichen Leistungen liegt auf der individuellen Beratung und Betreuung unserer Patienten.

Viele stellen sich die Fragen:
•    Wie gehe ich mit meinen Glaukom- und Retinapatienten um und wie schleuse ich sie in einem effizienten Ablauf ein?
•    Welche praktischen Hilfsmittel gibt es bereits, um unseren Patienten eine personalisierte Versorgung zu ermöglichen und mir als Arzt und meinem Personal den Arbeitsablauf in meiner Ordination zu erleichtern?
•    Wo und wie bekomme ich Tipps und Tricks von erfahrenen Kollegen?

Vortrag Dr. med. Peter Maloca

>Download: Smart Office_Wien_2015 – OCT Workshop

PDF

 

 

Floating in 3D-GETOCT 3D fanatasy is for you!

January 8th, 2015

Sie denken, das, was Ihre Augen Ihnen zeigen, ist wahr? Wirklich? Die richtige Welt ist aber gar nicht so, wie wir sie sehen. Die Welt “innen und aussen” ändern sich stets und Sie müssen eine Verbindung herstellen.

Schauen sie meinen Film und halten Sie den Atem an. Diese 3D GETOCT Phanatasie ist für Sie! 3D Phantasien sind “in” dieses Jahr. Schauen Sie, was vor Ihren Augen fliegt und sogar in Sie hineinrast, das es gar nicht gibt. Ihr Hirn betrügt Sie. Beachte: nichts, was Sie sehen ist wirklich wahr.

Genau so ist es mit den OCT-Bildern als Augenarzt: das Hirn diagnostiziert die Bilder sofort und Sie können sich vor einer “Diagnose” fast nicht wehren. Darum gibt es bei allen OCT-Bildern einen guten Tipp von Dr. Maloca: zurücklehnen, geniessen und warten bis die “OCT-Wahrheit” erscheint!

>Geniessen Sie (mit einer Rot-Cyan-Brille) und lachen Sie über Ihre Augen und Ihr Hirn und über dieses Wunder. /Watch (with Red-Cyan glasses)  and hold your breath. Just enjoy and smile about your eyes and brain showing you a miracle.

Ihr Dr. med. Peter Maloca, Luzern/Augenklinik Universität Basel

You think, what your eyes are showing you is true? Really? The world seems not to be what it is. The “inner” and “outer” world change and you have to connect.

This GETOCT 3D fanatasy is for you. 3D fantasies are in this year. Watch, what is passing before your eyes, that even does not exist. Your brain is fooling you. Realize: it is not really true what they say to you.  Still, this is the stuff your world is made off.

Not every OCT image is “true”.  The brain diagnoses the OCT  images immediately and you can almost not defend yourselve against a “diagnosis”. But there is a good and simple tipp from Dr. Maloca: sit back, relax and wait and wait until the ” OCT truth” appears!

Download for personal use (Copyright ©2015 GETOCT™ Ltd. All rights reserved.) > 3D Tri Schwarm Red-Cyan

3D Red Cyan Glasses/3D Rot Cyan Brille + Bonus “GETOCT 3D Intro Booklet” (PDF)

January 5th, 2015

3D kann günstig sein: Bestellen Sie Ihre Rot-Cyan 3D Brille per e Mail: Preis nur 13.55 CHF/Stück (inkl. MWSt, Porto und Verpackungsmaterial). Hohe und einfache 3DOCT Qualität für GETOCT 3D-Bilder, Filme, Spiele und TV. Zusätzlich erhalten Sie als Bonusmaterial das “GETOCT 3D Intro Booklet (PDF)”.

>Bestellung Rot-Cyan 3D Brille/Order Red-Cyan 3D Glasses.

3DOCT Intro warp 1. Order your own Red Cyan Anaglyphes. Copyright ©2015 GETOCT™ Ltd. All rights reserved.

GETOCT 3D Intro Booklet: Order your own Red Cyan Anaglyphes get the brand new “GETOCT 3D Intro Booklet” as Bonus! Copyright ©2015 GETOCT™ Ltd. All rights reserved.

3D can be cheap and easy:  order the Red-Cyan 3D Glasses to get the best OCT3D impression. Prize: only 13.55 CHF per unit (incl. VAT/postage/packaging material). High quality paper glasses for GETOCT 3D-images, movies, games and TV. In addition, you will receive the “GETOCT 3D Intro Booklet (PDF)”.

Zahlungsangaben/Payment details:

Online Paypal: Secure order online via Paypal./Sichere Bestellung/Zahlung via Paypal oder Kreditkarte online:


Bank: Blue Eye Vision Tech GmbH, Dr. med. Peter Maloca, Huobmattstrasse 9, 6045 Meggen, Bankverbindung: Luzerner Kantonalbank, Pilatusstrasse 12, 6002 Luzern, Konto 01-00-664426-07, IBAN: CH96 0077 8010 0664 4260 7, BC (SIC): 00778, BIC/SWIFT: LUKBCH2260A, MWST: 727 888.

3D optical illusion from a doctor

December 30th, 2014

Dank unseren Augen, welche die Welt jeweils aus einem etwas anderen Winkel sehen,  können wir einen Raum in seiner Tiefe erfassen und uns darin problemlos orientieren. Spannend wird es, wenn dem Hirn etwas vorgegaukelt wird, das gar nicht räumlich gar existiert. Sie benötigen für diese otpische Illsuon eine Rpt-Cyan-Brille./

Thanks to our eyes, which see the world from a slightly different angle,  we can enter a space in its depth and orient ourselves in it easily. It is exciting, when our brain is faked with something that does not even exist. You will need red cyan 3D glasses for this optical illusion.

  

Copyright ©2014 GETOCT™ Ltd. All rights reserved.

Download: 3D Tristar single. Optical illusion from a doctor ©2014 GETOCT™ Ltd

The 3DOCT Atlas Project 1 (PDF)

December 24th, 2014

The fist high resolution 3D-OCT PDF-booklet from our OCTLab, University of Basel, is available at only CHF 30.- incl. MWST/VAT. The money will be used to 100 percent for the scientific work at the OCTlab of the University of Basel. You will receive the password to open the PDF-book after  you paid. Thank you! Kind regards, Dr. med. Peter Maloca, Co-Founder of OCTlab, www.octlab.ch.

>Order “OCT Atlas Project 1″ (CHF 30.- incl. MWST/VAT. You will receive the password to open the book after you have paid): Email “I order OCT Atlas Project 1″

OCT Atlas Project 1 Cover. Copyright ©2014 GETOCT™ Ltd. All rights reserved.

OCT Atlas Project 1 Cover. Copyright ©2014 GETOCT™ Ltd. All rights reserved.

>> Download OCT Atlas Project 1 (60MB, High Resolution PDF):  GETOCT Atlas Project 1

 

Billing adress:

FO139970 “OCTIab UAK Basel”,  Universitätsspital Basel,  Fonds/Drittmittel,  Hebelstrasse 36,  4031 Basel,
Banking details:
Basler Kantonalbank, Spiegelgasse 1, CH-4001 Basel SIC 770 / Swift BKBBCHBB
CHF: IBAN: CH76 0077 0016 0477 3360 9
EURO: IBAN: CH62 0077 0016 0636 4380 1

Content OCT Project 1:
Anterior Segment High Resolution OCT 3D
Normal Iris Lens Diaphragma 3D
Pseudo Exfoliation, PEX – Cataracta senilis in 3D
Partial Detachment of Posterior Vitreous, PVD
Vitreomacular Adhesion, VMA – Cross Sectional OCT
Detached Vitreous
Posterior Vitreous Detachment – Symptomatic Posterior Vitreous Detachment, sVMT
Posterior Vitreous Detachment – Close up – Cross Sectional OCT
Small Symptomatic Vitreomacular Traction sVMT
Macular Hole – Overview
Macular Hole – Cross Sectional OCT
Macular Hole – Close Up View

 

Red Cyan Anaglyphe. Red Cyan Anaglyphe.Copyright ©2014 GETOCT™ Ltd. All rights reserved.

For best results use Red Cyan Anaglyphes. Red Cyan Anaglyphes. Copyright ©2014 GETOCT™ Ltd. All rights reserved.

 

 

> Download OCT Atlas Project 1 (60MB, you will receive the password to open the book after  you paid): The GETOCT Atlas Project 1
>>Order “OCT Atlas Project 1″ (CHF 30.- incl. MWST/VAT.):  info@getoct.ch.

GETOCT OCT3D – Epiretinal Gliosis in 3D OCT

December 22nd, 2014

We are able to move in three dimensions, but we feel to be delivered to the fourth dimension of time. No one would prefer a world which is based only on two dimensions. Still, most users of OCT base their diagnosis in the cross sectional images only, called B-Scans and take no care about the third dimension. This space may be very helpful to detect a disease in all its severity. Explore this 3D OCT world with us! Enjoy the images and find more at the member section after login, kind regards Dr. med. Peter Maloca.

Red Cyan Anaglyphe. Red Cyan Anaglyphe.Copyright ©2014 GETOCT™ Ltd. All rights reserved.

Please use Red Cyan Anaglyphe. Copyright ©2014 GETOCT™ Ltd. All rights reserved.

Epiretinal Gliosis 3D_GETOCT. Copyright ©2014 GETOCT™ Ltd. All rights reserved.

Epiretinal Gliosis 3D_GETOCT. Copyright ©2014 GETOCT™ Ltd. All rights reserved. (Click to enlarge)

Cross Setion: Epiretinal Gliosis 3D_GETOCT. Copyright ©2014 GETOCT™ Ltd. All rights reserved.

Cross Setion: Epiretinal Gliosis 3D_GETOCT. Copyright ©2014 GETOCT™ Ltd. All rights reserved. (Click to enlarge).

Epiretinal Gliosis 3D _GETPCT_close up.. Copyright ©2014 GETOCT™ Ltd. All rights reserved.

Epiretinal Gliosis 3D _GETOCT_close up.. Copyright ©2014 GETOCT™ Ltd. All rights reserved.