Optical Coherence Tomography (Optische Kohärenztomographie, OCT): Time ist so short to do only routine work, you can be sure that there must be something more to be discovered. What should you say? There are sufficiently OCT scanner and the market is saturated. The poor ophthalmologists should not be plagued with all with the machines. Are you still waiting for the right OCT scanner to buy or to work with? Are you waiting for the 100 procent machine? This device doesn’t exist!
View user video about OptosOCT SLO:
Yet! Optos has dared, and it is amazing what their brand new OCT scanner is capable. As a world first blog we are reporting about a new all-in-one device suitable for nearly every purpose: OptosOCT SLO.
Components of the System
The device is comparable to the other OCT scanner with a dual setup: a scanner unit and a separate aquisition/analysis standard PC system (a screen and keyboard with mouse).
As a separate part a frontlens is included for anterior segment imaging which must be screwed to the anterior part of the optical head.
Start the OCT Engines
Compared with other OCT’s the launch of the system is very simple, very smooth and user friendly. One must press only two buttons on the main power switch/PC, the system starts by itself and is ready, no separate configuration is needed.
The input of patient data is a bit a cumbersome solution. In particular, the birth date is inconvenient to enter. The patient screen has a bit a confusing design, because it is mixed up with different tabs of patient data, acquisition protocols and analysis.
A standard manually adjustable head rest is offered to ensure a good positioning of the patient. Once the alignment is carried out correctly the OCT scanner is guided by using the operator’s controls.
A special feature is that the live image of the CCD camera on the screen is to be find unobtrusively at the right bottom corner. For beginners, this may be somewhat confusing, because the fast exact focusing is regarded as the primary key setting. The workflow would be more intuitive if the eye of the examiner is guided in a serial way on the screen.
Once the three presented white dots are displayed sharp, clear and at a minimum size the measurement can begin. On the screen a relative nice infrared image of the fundus is projected. Fine adjustment of lateral and axial movements are corrected using the joystick.
For larger corrections the chinrest is moved by using the up / down buttons. A little disadvantage is that the patient’s head behind the scanning unit virtually disappears so that one has not always a direct visual control on the positioning and the patient’s condition.
Potpurry of Scan Protocols
The OptosOCT SLO system shows its strengths: a whole potpurry of acquisitions protocols is disclosed. The tomographic imaging contains all standard protocols by means of Line Scanning, Raster Scanning, Radial Scanning, 3D Retinal Topography, RNFL Scannning, Optic nerve Topography.
Those who still want more can use the Cornea-Lens-Module: a separate lens has to be screwed on the optical head of the scanner. It takes a little finesse, because the grooves of the anterior chamber lens are a little too fine shot, but it goes pretty fast.
This extension includes a relative detailed imaging of the cornea, the anterior chamber and even the angle. The quality of no current OCT system at 800nm is outstanding in relation to the cross sectional imaging. But the OptosOCT SLO is moving in the medium quality range. Therefore, it is still a gift without being asked for: corneal pachymetry may be performed as well. That might be a very nice additional bonus in patients with corneal pathologies or glaucoma.
Fast and easy Signal Centration
An ideal solution is to center the OCT signal. In other OCT devices with buttons, the signal must be moved gradually into the lower third of the scanning window. Some OCT machines have an auto adjust button which sometimes fires beyond the objective. With OptosOCT SLO a cross-sectional image on the screen is simply packed with the mouse and brought out where you want it. Very comfortable. Then comes the ready for take off: aquistion of the OCT signal! For this you press the button “AUTO” next to the joystick or on the screen.
Then something strange happenes. Nothing happens! Because the OptosOCT SLO , uses only one light source it has a “break”, which is uncommon when compared with other devices that have a permanent live SLO scan. On the screen it is shown that the system has to run a “warm-up”.
This auto reference is found in other scanners, too, and is called calibration for example, but it interferes less, because the live-SLO image always allowes to control the patient’s eye. This is a pure matter of habit and of no further importance.
Additional capabilities: OCT viewer
There is a primarily viewer software on the PCand it is easy to use. But there is a very comfortable, additional support from Optos: an external OCT data viewer software is available, you just have to unzip it , double click only, and voilà, all your recorded OCT data can be imported to any PC and be considered whenever you have time and desire.
In comparison with other OCT viewer installations, it is solved in an very elegant way and even inexperienced PC user will enjoy it. It just works!
The OptosOCT SLO is an eye catcher, is beautifully designed and very well made. It leaves a good impression, is relatively easy to use and to delegate. The presentation of the OCT scans is good compared to other standard OCT systems and is certainly sufficient for everyday clinical practice, but it is not enough to the absolute top of OCT quality. On the technical side the user interface may be simplificated to improve the workflow, but one gets along well. Very surprising are the many possibilities: cornea, anterior chamber, retina, glaucoma. As only OCT device, it provides a built-in micro-perimeter with many simulations. This can be helpful in the combined analysis of morphology and function in case of glaucoma, macular degeneration or in central serous retinopathy (CSR).
What is extremely encouraging is the price! For about 62 000 Swiss Francs as an introduction package in Switzerland one can get an exceptionally good equipped OCT system, even including the cornea module and micro-perimetry and possibly even the external viewer software and one-year-full range service.
Of course that’s a lot of money. But for this you nearly get a “Swiss Army Knife OCT” with lots of possibilities and one may ask: healthy vision, what is it really worth?