SP0709 DIBG-OMD-0630:OMD-OM DIBG

6-S � JULY 2009

All claims made by manufacturer

views of the macula and periphery, as well as a zoommode for macular angiography. Retina specialists say thetechnology has greatly affected patient care and treat-ment in their practices.

“Ultra-widefield angiography certainly has changedand refined the way I care for patients,” says John W.Kitchens, MD, a retina specialist and partner at RetinaAssociates of Kentucky. “I’ve developed a better under-standing of the patho genesis of disease, and I can detectand treat disease earlier.”

Says Mathew W. MacCumber, MD, PhD, a privatepractitioner at Illinois Retina Associates, and associateprofessor and associate chair for research in the depart-ment of ophthalmology at Rush University MedicalCenter, “Because of this technology, we can appreciatepathology in the peripheral retina that we couldn’tbefore. We can image through an undilated pupil or asmaller pupil, which conventional fundus photographydoesn’t allow us to do. The technology provides excellentimages of the posterior pole, so you don’t need a secondcamera to look at the macula. You can use it as your pri-mary camera even in a small practice setting.”

Diabetes CareUltra-widefield angiography is especially effective in

the diagnosis and management of retinal disease associat-ed with diabetes.

“The technology has had the most impact in diagnos-ing and treating diabetic retinopathy and retinal veinocclusions,” Dr. MacCumber says. “These diseases affectthe peripheral retina as well as the posterior pole. Ultra-widefield photography helps us to better appreciate theextent of these diseases in the periphery.”

Thomas Stone, MD, a retina specialist and partnerwith Dr. Kitchens at Retina Associates of Kentucky, saysultra-widefield angiography, using the Optos P200MA,has changed the way he treats diabetic macular edema.Before ultra-widefield angiography, he’d initiate treat-ment with a focal laser. If unsuccessful, he’d administeran intravitreal injection of off-label bevacizumab

ARTIFICIAL LM/ARINTELLIGENCE SUBJ/UNAIDED

COMPANY MODEL FINAL RX COMPARISON

Marco EPIC yes yes

Marco TRS yes yes

Marco RT-3100 no yes

Right Medical Remote Vision no yes

Topcon CV-5000 suggested final yesMedical Systems Refraction System Rx provided

COMPANY MODEL ALIGNMENT SYSTEM

Canon Medical R-F10 fully automated, Systems Full Autorefractor just press start

Canon Medical RK-F1 Full-auto fully automated,Systems Ref-keratometer just press start

Marco ARK-530A auto align; auto fogging; autotracking; joystick

Marco ARK-560A auto align; joystick; infraredmire alignment; auto fogging

Marco 3D Wave auto align; joystick; auto fogging

Marco Palm AR Handheld handheld; infrared mire alignmentAutorefractor

Marco Palm ARK Handheld handheld; infrared mire alignmentAutorefractor/Keratometer

Marco M3 auto align; joystick; infraredmire alignment; auto fogging

Oculus PARK 1 Joystick w/automatic measurement

Reichert Ophthalmic RK600 Auto Refractor/ joystick Instruments Keratometer

Right Medical Retinomax Series 3 handheld-automatic measurementHandheld Autorefractor

Right Medical Retinomax Series 3 handheld-automatic measurementK-Plus Handheld Autorefractor

Right Medical Speedy-1 Autorefractor joystick & automatic measurement

Right Medical Speedy-K Autorefractor joystick & automatic measurement

Shin-Nippon ACCUREF 8001 joystick w/automaticmeasure

Shin-Nippon ACCUREF 9001 joystick w/automaticmeasure

Shin-Nippon NVISION-K 5001 joystick w/automaticmeasure

Shin-Nippon Accuref-K 9003D hybrid - automatic 3 dimensionalalignment or manual, auto measuring

Tomey USA TR-4000 infrared; joystick; mire alignmentwith dual CCD

Tomey USA RC-5000 fully automatic eye-trackingAutorefractor/Keratometer system

Tomey USA RT-7000 fully automatic eye-trackingAutorefractor/Keratometer system

Topcon Medical RM-8900 joystick; infrared Systems Autorefractometer measuring

Topcon Medical KR-8900 Auto joystick w/auto-firing;Systems Kerato-Refractometer infrared measuring

Topcon Medical KR-8000PA Auto joystick w/auto-firing;Systems Kerato-Refractometer infrared measuring

Topographer

ULTRA-WIDEFIELD IMAGING, CONTINUED FROM PAGE 2

Figure 2. Ultra-widefield technology has changed the way many retinaspecialists treat diabetic macular edema, because they’re able to targettreatment more precisely to produce better visual outcomes.

SP0709 DIBG-OMD-0630:OMD-OM DIBG 7/2/09 9:50 PM Page 6

JULY 2009 � 7-S

R E F R A C T I O N S Y S T E M S

A U T O R E F R A C T O R S

ADJUSTABLE AUTOMATICCONVERGENCE FOR ALIGNMENT W/NEAR AT VARIABLE AUTOMATIC CHART PROJECTIONWORKING DISTANCE INPUT OF VA LINKAGE SYSTEM ADDITIONAL FEATURES

yes yes yes yes Compact refraction system; has a footprint of 22 sq. ft.; reduces refraction time; delegation tool; splitprism Jackson cross; integrates wavefront data into subjective refraction; adjustable motorized table,color touch screen that can be turned to patient for visual acuity education tool, can be networked intopaperless EMR systems.

yes yes yes no (not needed) Compact refraction system used in a tradtional lane; reduces refraction time; delegation tool; split prismJackson cross; can be networked into paperless EMR systems.

yes yes yes no (not needed) Wireless & compact refraction system used in a traditional lane; reduces refraction time; can be networked into paperless EMR systems.

yes n/a yes no (not required) Wireless remote control; wireless integration with Right Medical autorefractors and projector. Programmable for expedited refractions.

yes yes yes yes Incorporates color-coded cylinder refinement aids; can be integrated w/Topcon autorefractors; auto projectors, VisiChart and M&S Smart System as well as many popular EMR systems; automated patient positioning features with the EXAM-5000 desk system.

VISUAL ACUITY GLARE TESTING KERATOMETER ADDITIONAL FEATURES

no no no 2.5-mm minimum pupil size required; Dioptric measurement range of -30D to 22D; PD/VD & IOL; RS232C data output.

no no yes Simultaneous display of referential retro-illuminated image; 2.5-mm minimum pupil size required; corneal diameter measurement; peripheral K reading; PD/VD & IOL;RS232C data output.

no no yes Cataract mark detection; virtual vision comparison; corneal size measurements; Eyetracking system; photopic/scotopic pupil size measurement; measuring range -30D to +25D; interfaces w/EPIC, TRS & Evolution.

yes no yes Auto tracking/firing/alignment measuring; visual acuity; subjective refinement; corneal size measurement; pupil size measurements; interfaces w/EPIC, TRS & Evolution.

no no yes Autorefractor; topographer; wavefront analyzer; OPD; internal OPD; pupillometer; mesopic & photopic pupil displayed; asphericity values (e\Q); XP; Celeron M1.5 GHz Processor; interfaces w/EPIC, TRS & Evolution, the Marco H-D Eye Exam.

no no no Possesses features of tabletop ARs; quick mode; supine mode; interfaces w/EPIC, TRS & Evolution.

no no yes Possesses features of tabletop ARKs; quick mode; supine mode; interfaces w/EPIC, TRS & Evolution.

no no yes Autorefractor/keratometer; mesopic & photopic pupil measurements; corneal size measurements; noncontact tonometer; softerair puff; adjustable monitor; motorized chin rest; high-speed measurements; interfaces w/EPIC, TRS & Evolution.

no no yes Combines a noncontact pachymeter, autorefractor and keratometer into one slim and easy-to-use instrument. 4 scan modes; 2.5 mmminimum pupil size; 5” color LCD monitor, thermal printer; 600 pachymetric points measured; USB connection and can be integratedinto EMR. Dimensions: 20” x 10.2” x 21.7”.

n/a n/a yes Full-color LCD screen, icon-based operating system & built-in printer. 2.3-mm minimum pupil diameter, RS 232C interface & video output terminal. Auto-start function initiates measurements automatically when alignment is achieved. Equipped w/an automatic power save turn off.

no no no Handheld, fully featured. Precise measurements; Super Quick mode for optimal pediatric measurements; 2.5-mm minimum pupil size, retro-illumination to identify cataracts or irregularities in the optical system; melody function assists with small children.

no no yes Handheld, fully featured. Precise measurements; Super Quick mode for optimal pediatric measurements; 2.5-mm minimum pupil size, retro-illumination to identify cataracts or irregularities in the optical system; melody function assists with small children; peripheral keratometry measurements; selectable modes for optimal performance.

no no no The fastest measurement times - 0.01 seconds; precise measurements; 2.5-mm minimum pupil size; medical grade retro-illumination; wireless data transfer to Remote Vision auto-phoropter.

no no yes The fastest measurement times - 0.01 seconds; precise measurements; 2.5-mm minimum pupil size; medical grade retro illumina-tion; wireless data transfer to Remote Vision; peripheral keratometry measurements; selectable modes for optimal performance.

n/a n/a no 2.3-mm pupil; lightweight/compact design; automatic measuring function; IOL mode; continuous, quick measurement feature; data output capable; stand or sit 3-position monitor angle; large, easy read color 5.6-inch LCD monitor.

n/a n/a yes 2.3-mm pupil; corneal radius/refraction readings; compact design; IOL mode; distance & near PD measurements; automatic measuring function; continuous measurement feature; data output capable: 3-position montior angle; easy read, color 5.6-inchLCD monitor; peripheral corneal measurements.

n/a n/a yes 2.3-mm pupil; auto-refraction & auto-K measurement, corneal radius or diopter readouts; near vision testing capable; automatic measuring function; non-accommodating, wide view window technique; IOL mode data output interface large 5.6-inch LCD monitor.

n/a n/a yes Fully automatic eye-tracking capability, quick and easy auto focusing and measurement function, eye-to-eye tracking is fully auto-matic, auto “K” measurement, peripheral “K” measurements possible, 7.5 inch Tilt TFT monitor, the new Photo Mode is standard,compact & silent operation, external output via USB port or RS232C.

yes no no Automatically calculates interpupillary distance based on patient’s alignment; dual CCD cameras; 0.3-second measurement time; built-in printer.

yes no yes Full automatic, touch screen operation; calculates pupillary distance; high-speed built-in printer; power chin rest; 0.3-second measurement time or less; provides recommended list of contact lenses.

yes no yes Full automatic, touch screen operation; cataract & IOL mode; high-resolution color TFT display; 0.3-second measurement time; baseline topographer. Built-in computer & printer.

no no no 2-mm minimum pupil size; color LCD display; auto fogging; rotary prism technology; built-in printer; interfaces w/ Topcon auto lensmeter, CV-5000 refraction system, and today’s most popular EMR systems.

no no yes/std. 2-mm minimum pupil size; central K readings; color LCD display, auto fogging; rotary prism technology; auto-fire mode; built-in printer; corneal pupil diameter measurement; interfaces w/Topcon auto lensmeter, CV-5000 refraction system and today’s mostpopular EMR systems.

no no yes/std. 2-mm minimum pupil size; corneal topography standard; peripheral keratometry; optional color-mapping software available; corneal mapping measurements out to 9.2 mm; interfaces w/Topcon auto lensmeter, CV-5000 refraction system and today’s most popular EMR systems; auto fogging; rotary prism Placido ring technology.


8-S � JULY 2009


(Avastin, Genentech) or triamcinolone acetonide(Kenalog, Bristol-Myers Squibb). If this didn’t resolve theedema, he’d consider vitrectomy surgery. “With this newtechnology, I’m able to look at the peripheral retina,” Dr. Stone says. “If the patient has significant peripheralnonperfusion, I’ll perform panretinal photocoagulationto the nonperfused areas. This reduces macular edema(Figure 2). It’s less invasive than vitrectomy and mayhelp prevent vitrectomy in the future.”

Dr. Kitchens says, “If a patient has diffuse edemawith poor perfusion, I’ll treat him with an intravitrealinjection of off-label bevacizumab. If a patient has dif-fuse edema with good perfusion, I’ll treat him with anintravitreal corticosteroid and consider focal or grid laserphotocoagulation. Before ultra-widefield angiography,my treatment decisions were almost based on trial anderror. This new technology enables me to treat patientsmuch more precisely.”

What’s unique about ultra-widefield angiography isthat it gives physicians the ability to deliver treatmentthat’s targeted only to the areas of the retina that need it,therefore sparing healthy tissue.

“You can take digital images of the peripheral retinain a patient with moderate-to-severe proliferative diabeticretinopathy and conclude that he’d benefit precisely frompanretinal photocoagulation,” Dr. Stone says. “You canmiss an opportunity to make an early diagnosis and amore targeted treatment decision if you use fluoresceinangiography with conventional camera systems.”

Dr. Kitchens agrees. “By having the ability to deter-mine more accurately where the problems are in the reti-na, you can treat the areas that need it and avoid thehealthy areas that don’t.”

Says Dr. MacCumber, “I can direct my laser moreprecisely in diabetes patients who have early proliferativediabetic retinopathy. In some cases, I can avoid perform-ing a complete panretinal photocoagulation treatment,which is something I’ve done routinely in the past whenusing conventional camera systems.”

A Boon in General OphthalmologyWhile ultra-widefield imaging has significance in

diagnosing and treating retinal disease, it also hasimportant applications in the general ophthalmologypractice.

Thomas Henderson, MD, a cataract and refractivesurgeon in private practice at Eye Clinic of Austin inAustin, Texas, uses the Optos P200C primarily to docu-ment and monitor pathology. The optometrist in hispractice uses ultra-widefield imaging as a basic screeningtool for 20% to 30% of healthy, well-vision patients.

“We perform basic screenings for patients who arehealthy and for their convenience,” Dr. Henderson says.“With one ultra-widefield image, you can see most ofwhat you’d see with a full dilated exam. But instead ofallocating 30 minutes to dilate a patient, 5 minutes toexamine him and then 4 hours for the patient to recover,you spend 2 minutes taking the image and 2 minutesreviewing it with the patient. Plus, it takes 100 viewswith a direct ophthalmoscope to cover the area you seein one ultra-widefield image. Even then, you couldn’t

COMPANY MODEL ALIGNMENT SYSTEM

Topcon Medical KR-9000PW joystick w/auto-firing;Systems Wavefront Analyzer infrared measuring

Tracey Technologies iTrace Combo Visual auto-align, auto-captureFunction Analyzer auto-fogging

Welch Allyn 14010 direct view/data acquisitionSureSight Autorefractor

MEASURINGCOMPANY MODEL PRINCIPLE METHOD

Marco 3D Wave dynamic spatial optical path skiascopy difference

Ophthonix Inc. Z-View holographic binoculargrating viewing,

monocularmeasurement

Topcon Medical KR-9000PW Hartmann-Shack n/aSystems

Tracey iTrace Combo Infrared laser Auto-capture with Technologies Visual Function ray tracing monocular/binocular

Analyzer open-field and Badal Optometer fixation

COMPANY MODEL STIMULUS AREA OF FIELD

Carl Zeiss Humphrey Field Goldmann std. 90°Meditec Analyzer II-i proj. size III only;

Model 720i Heijl-Krakau fixationmonitor & video eye monitor

Carl Zeiss Humphrey Field Goldmann std. proj. 90°Meditec Analyzer II-i size I, II, III, IV, V;

Model 740i Heijl-Krakau fixationmonitor & video eye monitor; gaze tracking

Carl Zeiss Humphrey Field Goldmann std. proj. 90°Meditec Analyzer II-i size I, II, III, IV, V; Heijl-Krakau

Model 745i fixation monitor & video eyemonitor; gaze tracking

Carl Zeiss Humphrey Field Goldmann std. proj. 90°Meditec Analyzer II-i size I, II, III, IV, V; Heijl-Krakau

Model 750i fixation monitor & video eyemonitor; head tracking;vertex monitor; gaze tracking

Carl Zeiss Humphrey FDT frequency doubled 30°Meditec Visual Field sinusoidal gratings

Instrument (0.25 cpd; 25 Hz)with frequency doubling

Carl Zeiss Humphrey frequency doubled 30°Meditec Matrix Visual sinusoidal gratings

Field Instrumentwith frequencydoubling

Carl Zeiss SITA SWAP blue light; Goldmann n/aMeditec std. proj. size V stimulus

Haag-Streit Octopus 900 100% total fixation control; 90º in USA BASIC no fixation losses on printouts; Goldmann

video eye monitor and chin rest spherical bowlsensor; Goldmann standard projection I, II, III, IV, V

Haag-Streit Octopus 900 Same as BASIC + unique auto 90° inUSA PRO eye tracking; one system Goldmann

offering standard static spherical bowl.white/white + blue/yellow + Flicker + TRUE GoldmannKinetic + low vision + red/white.


JULY 2009 � 9-S

A U T O R E F R A C T O R S

WAV E F R O N T A B E R R O M E T E R S

VISUAL ACUITY GLARE TESTING KERATOMETER ADDITIONAL FEATURES

no no yes/std. Corneal topography standard; color-mapping software; corneal-mapping measurements out to 10 mm; Hartmann-Shack wavefront analysis; Placido ring corneal measurements; 2-mm minimum pupil size; modular transfer function; point spread function.

no no yes Integrated ray-tracing aberrometry, corneal topography, auto-refractometry, auto-keratometry, pupillometry in one device;multi-zonal refraction analysis at user-defined zone sizes for assessing photopic and scotopic vision.

no no no Features Wavefront Sensing Technology; less than 5 seconds per eye test time; data acquisition from 14”; child-friendly; battery operated and portable; weighs 2 lbs.; IR data transfer to cordless printer.

INTERNAL OPD/NUMBER OF POINT SPREAD LENTICULAR ZERNIKE DATA POINTS FUNCTION DIFFERENCE OUTPUT ADDITIONAL FEATURES

1,440 yes yes WF Refraction & RMS value Topographer; Wavefront analyzer; OPD; internal OPD; pupillometer; mesopic & on thermal tape. Zernike map photopic pupil displayed; combined w/automated phoropter performs the Marco displays bar graphs, WF H-D Eye Exam; XP; Celeron M1.5 GHz Processor.error & RMS values given.

>10,000 over displayed & no 2nd to 6th order The Z-View is designed specifically for dispensing practitioners to prescribe iZon 6 mm pupil printed as wavefront-guided lenses; wholly contained; ultramodern design; non-Hartmann-

convolved image Shack; contemporary design; compact size.

3,960 corneal yes no yes Combined autorefraction, corneal mapping and wavefront aberrometer measurements; point spread and modulation transfer functions; Landolt simulation; extensive +22D to -25D refractive measuring range; auto-fogging fixation target; axial & instantaneous power maps; mesopic and photopic measurements.

256 rapid sequential true, yes yes; including multizonal 5-in-1 functionality also includes corneal topography, auto-refraction w/multi-zone points through directly-measured Zernike displayed as bar analysis for photopic and scotopic conditions, pupillometry and keratometry; 2 mm-8 mm pupils PSF graphs, coefficients, or binocular open-field fixation; accommodation volume; VFA Summary display;

combined RMS and computer independent.individual RMS term

P E R I M E T E R SSTANDARD TESTS PRINTER TEST STRATEGIES ADDITIONAL FEATURES

threshold: 3 central, 1 periph. built-in thermal; can be threshold: SITA, FastPac; Now with VFI, EasyConnect and HFA-Net Pro standard. Computerized silent pattern; 4 screening central, hooked up to HP full screen: age ref. strategy; projection system; reduces threshold testing by up to 70%; 12 test patterns 3 full-field periph. patterns LaserJet threshold-related; 2-zone, w/static threshold & screening strategies to 90º; STATPAC2 software compares

3-zone & quantify defects results w/age-matched normative data; CRT touch screen; wheelchair-accessible table w/built-in printer avail. DICOM Gateway compatible (optional).

threshold: 4 central, built-in thermal; threshold: SITA, FastPac; Now with VFI, EasyConnect and HFA-Net Pro standard.19 test patterns;2 periph. patterns; can be hooked full screen: age ref. strategy; user-designed custom testing w/range to 90º; patented gaze-tracking system;screening: 5 central up to HP LaserJet threshold-related; 2-zone, built-in 40 GB data storage; compares multiple STATPAC results via print-out;screening, 7 full-field/ 3-zone & quantify defects Goldmann I-V foveal threshold testing; red/blue testing; custom testing avail.;periph. patterns built-in VGA monitor hookup for remote viewing. DICOM Gateway compatible (optional).

threshold: 4 central, built-in thermal; threshold: SITA, FastPac; Now with VFI, EasyConnect and HFA-Net Pro standard. Includes all features of 2 periph. patterns: can be hooked full screen: age ref strategy; 740i; STATPAC for blue/yellow perimetry. DICOM Gateway compatible (optional).screening: 5 central, up to HP LaserJet threshold-related; 2-zone, 7 full-field/periph patterns 3-zone & quantity defects

threshold: 4 central, built-in thermal; threshold: SITA, FastPac; Now with VFI, EasyConnect and HFA-Net Pro standard. Model 750i includes all2 periph. patterns; can be hooked full screen: age ref. strategy; of the previous features plus head tracking; automatic vertex monitoring;screening: 5 central, up to HP LaserJet threshold-related; 2-zone, automatic pupil measurement; std. blue/yellow testing; kinetic testing 7 full-field/periph. 3-zone & quantify defects and keyboard; all models upgradable. DICOM Gateway compatible (optional).patterns

screening: C-20 n/a n/a 45-second screening; 4-minute threshold; 19 lbs.; easy to use; age-related full threshold: C-20, normative database.N-30

screening: N-30,24-2 external 8.5 x 11 screening: MOBS Fast screen <45 seconds; 20GB HD; CD RW drive; floppy drive; external keyboard; threshold: N-30-F, color printer threshold: Zest, MOBS small footprint; statistical analysis w/age-related normative database; serial field, 24-2 FDT, 30-2 FDT video eye monitoring; no eye patch needed; no trial lens needed out to ± 3.00D; Macula: 10-2, Macula ambient light testing.Threshold (4°)

threshold; single field n/a 24-2 Available as a licensed option on all HFA II & II-i models; 745-750; blue-yellow analysis report threshold testing in 3 to 6 minutes per eye. Makes blue-yellow testing a

clinically practical tool for early detection of glaucoma. Improved reproducibility;larger dynamic range & higher sensitivity than other SWAP tests.

diagnostic thresholds for Perimeter controlled by TOP (tendency oriented Automatic pupil measurement; automated lens holder; stimuli presentations are glaucoma & macula; linear PC/monitor & ink jet perimetry) for thresholds adaptive to patient responses; easily upgraded to 900 PRO series; wheelchair- 32 & macula threshold; low printer (all provided); in just over 2.5 minutes per accessible table provided; easily integrated with electronic medical records.vision; neurological; diabetes EyeSuite Lite Software eye; dynamic; normal - all blepharoptosis; multiple provided for long-term age related; 1 and 2 level screening tests, including storage & data analysis; screening tests with glaucoma & 130 point easily networked; viewing supra-thresholdscreenings stations - no charge. EZ

to read 7 in 1 printout.

Same as BASIC + unique Same as BASIC + Same as BASIC Same as BASIC custom testing allows you Full 3-level EyeSuiteto build what you want software provided for where you want it. long-term storage

and data analysis.


10-S � JULY 2009


cover the same area with the direct ophthalmoscope —even in a dilated eye.”

Moreover, ultra-widefield imaging plays an impor-tant role in anterior segment patient care. The technolo-gy doesn’t allow doctors to examine the anatomy of theanterior segment, such as the crystalline lens or cornea,but it enables them to use it in presurgical and postsurgi-cal applications in cataract and refractive surgerypatients.

“Ultra-widefield imaging is a competent way ofdetecting presurgical risk factors and postsurgical com-plications because you can view nearly the whole retina,”Mr. Anderson says. “For example, if a patient hadperipheral retinal breaks, you’d want to know this beforecataract surgery. If the patient doesn’t have retinalbreaks, you’d want to know if he developed them aftersurgery. The Optos technology enables you to image themajority of the retina and even see through cataracts.”

Peyton Neatrour, MD, a cataract and refractive sur-geon at Beach Eye Care/Neatrour Eye Institute inVirginia Beach, Va., says he uses the Optos P200C tofind and document abnormalities that would identify cer-tain patients as being poor candidates for cataract andrefractive surgery. “Ultra-widefield imaging enables meto image and document pathology in the retina that maylimit a patient’s return of vision following cataractsurgery. It also gives me a more targeted prognosis of apatient’s visual outcomes post cataract surgery,” he says.In potential cataract surgery patients, he looks for retinalpathology such as macular holes, AMD, epiretinal mem-brane and macular puckering. “The ability of the tech-nology to detect subtle choroidal nevi with the green fil-tered view is impressive as well,” he adds.

Dr. Neatrour also uses the technology for presurgicalevaluations in LASIK, CK, ICL and PRK candidates.“Patients who have myopia greater than –5 are at a higher risk for peripheral retinal pathology. Using ultra-

COMPANY MODEL STIMULUS AREA OF FIELD

Haag-Streit Octopus 300 100% total fixation control - 30º directUSA BASIC no fixation losses on printouts; projection;

video eye monitor and forehead far distance rest sensor; Goldmann standard correction projection III, V; operates in only needed.diffused room lighting

Haag-Streit Octopus 300 Same as BASIC + unique auto Same as BASICUSA PRO eye tracking; one system offering

standardized static white/white +blue/yellow + Flicker + low vision

Haag-Streit Goldmann True Goldmann I thru V + 1-4/a-e. Software package USA Kinetic Control speed of 0 (static) or to 900 Basic (option)

2/3/4/5/10 degree per second or & Pro (standard).free form

Haag-Streit EyeSuite EyeSuite Lite; Archive perimetryUSA Software EyeSuite Advanced; data with single

Analysis EyeSuite Pro field analysis.program

Kowa AP-5000C Goldmann std. proj. size 80ºOptimed Inc. II-V, Heijl-Krakau Eye fixation

monitor

Sightpath Foresee PHP Dot deviation signal flashed Central visualMedical over macular Ioci field - 14º

Oculus Inc. Centerfield II Goldmann size II; Heijl-Krakau 70°& central fixation; video eye monitor; static white-on-white & blue-on-yellow; auto kinetic

Oculus Inc. Twinfield Goldmann size I–III; Heijl-Krakau 90°& central fixation; video eye monitor; static white-on-white, blue-on-yellow & red-on-white;auto & manual kinetic

Oculus Inc. Easyfield Goldmann size III; Heijl-Krakau 30°& central fixation; video eye monitor; static white-on-white

OPTOPOL PTS 1000 Goldmann size I-V white, blue, 100º (160 withTechnology S.A. red, green fixation shift(distributed by Canon horizontally)Medical Systems)

Paradigm Medical TKS 5000 static w/kinetic ±90°Industries Inc. autoperimeter fixation; Heijl-Krakau Dicon Inc. fixation monitor

Paradigm Medical LD 400 static w/kinetic ±60°Industries Inc. autoperimeter fixation; Heijl-Krakau Dicon Inc. fixation monitor.

Paradigm Medical FieldLink static w/kinetic ±60°Industries Inc. Automated fixation; Heijl-Krakau Dicon Inc. Perimetry fixation monitor.

System

Paradigm Medical LD 700 Goldmann size III; 30°Industries Inc. Heijl-Krakau; red LEDDicon Inc. fixation targets, static

Woodlyn/Medmont M700 Goldmann Size III - pale 80ºgreen rear projection LED(red macula stimulus optional)15 points x 3dB steps / 45 points x 1dB steps - video fixation monitoring feature

Figure 3. Ophthalmologists use ultra-widefield imaging to find and document abnormalities, such as wet AMD (shown here), that mightidentify certain patients as being poor candidates for cataract and refractive surgery.


JULY 2009 � 11-S

P E R I M E T E R SSTANDARD TESTS PRINTER TEST STRATEGIES ADDITIONAL FEATURES

Diagnostic thresholds for No outdated processor built in; TOP (Tendency Oriented Perimetry) Automatic pupil measurement; stimuli presentations are adaptive to patient glaucoma and macula; easy to read 7-in-1 printout; for thresholds in just over 2.5 responses; easily upgraded to 300 PRO series; wheelchair-accessible table linear 32 threshold; low auto print and/or export to minutes per eye; dynamic; normal (either compact or universal sized) available; easily integrated with vision; multiple screening our EyeSuite Lite/Advanced/Pro - all age related; 1 and 2 level electronic medical records using available EyeSuite Software package.tests, including 30 second (available) to your own screening tests withper eye; 1 minute per eye PC for long-term storage supra-threshold

& data analysis; easilynetworked; no add’lcharges for viewing stations.

Same as BASIC + custom Same as BASIC + all 3 Same as BASIC Same as BASICtesting to build muliple levels of EyeSuiteexaminations (Lite/Advanced/Pro) are

provided.

Build ANY kinetic test needed & n/a Manual or automated Goldmann Quantification of kinetic isoptors for easy comparison; field correction based on save to library for perfectly Kinetic; use of automated, reaction time of patients response; zoom function to plot selected areas repeated tests every time guided or free vectors that can be used in combination with static perimetry.

EyeSuite Lite standard on n/a n/a Easily networked w/no extra charges for viewing stations; easily integrated 900 Basic & 300 basic; w/electronic medical records. Archive perimetry data w/single-field analysis-lite EyeSuite Lite, Advanced & Pro + cluster trend analysis structure function graph + pro superposition standard on 900 & 300 Pro images/fields. New cluster and polar graphs.

25 test programs including External PC threshold: IQAC aged reference In ocular fundus perimetry, the visual field is examined w/an ocular fundus image threshold: Center 1 & 2, macula, connected screening 2,3,4 zone & quantify displayed on screen. System offers capability to overlap ocular fundus image periphery & meridian; screen- defects & perimetry result so physician can better understand the retinal function.ing: standard or precision; isopter: Goldmann & automatic perimeteris combined

Central visual field test for External color inkjet n/a Normative database; easy to interpret report w/mapping, change-over-time CNV determination. analysis & reliability indices.

30°; 10° macula; 30°course; optional 3 suprathreshold; new CLIP Portable; compares exams; stats pkg.; progressive display; combo stats & kinetic 36°–70°; 70°; 0°– 36°; threshold; fast threshold; 1 full display; color display; exam indep. of room light; free software upgrd.; sgl. pts. -36°; sgl. pts.-70°; threshold 4/2; qdrnts; sgl. pts.; adj. test pt. duration & intervals; 30-cm radius bowl; Goldmann std.; measures 36° sectors; 10-2; 24-2; user-defined pupil size; trial lens holder.30-2 quick screen

all of the above plus optional 3 suprathreshold; new CLIP Compares exams; stats pkg.; progressive display; combo stats & kinetic disp.; colorindiv. test pts.; central threshold; fast threshold; 1 full of room light; free software upgrade; adj. test pt. duration & intervals; 30-cm radius & entire field threshold 4/2; qdrnts; sgl. pts.; bowl; Goldmann std.; measures pupil size; trial lens holder.

user-defined

10-2; 24-2; 30-2; built-in 3 suprathreshold; fast Less than 12 lbs; portable; stats pkg.; CCD camera; moveable headrest & cone/bowl; preprogrammed threshold; full color LCD display; stores 40,000 exams; screening rslts. 50–70 secs.; 30-cm radius quick tests threshold 4/2; qdrnts; bowl; free software upgrds.; exam indep. of room light; measures pupil size.;

sgl. pts. trial lens holder; two models; built-in console/computer; can use newer model w/own PC or laptop.

Accurate threshold, Intelligent Printout manager with Kinetic, screening, threshold, Eye monitoring by means of built-in video camera. Advanced auto-detection of eye advanced threshold, screening predefined printout 3-zone, fast threshold, BSV (binocular position. Automatic pupil diameter measurement. Automatically controlled chin-restand quick 3-zone styles single vision), flicker (critical fusion enables you to set proper patient’s position precisely and easily. Printout manager

frequency), blue on yellow (SWAP), with predefined printout styles. Network capabilities (remote database, networkedBDT (Binocular Drivers Test), advanced review stations). Direct database back-up. Special ventilation system is used to keep- reduced field option fresh air throughout examination inside stimulation bowl.- neurological defects option

10°, 30° & 60° Inkjet std.; color threshold-related suprathreshold Supported by Adv. FieldView Omega Analysis software; disk storage; FieldLink field patterns; printer support w/ screening; quantify missed pts.; upgradable; voice recognition; voice prompts.13 programs std. Fieldview. full threshold; HT

10°, 30° & 60° Inkjet std.; color threshold-related suprathreshold Half the size of TKS 5000 w/full-field capability; fits on rotating table; supported by field patterns; printer support w/ screening; quantify missed pts.; FieldView Analysis software; disk storage; voice management; voice prompts; 13 programs std. Adv. FieldView. full threshold; HT Advanced FieldView w/Fieldview download to PC.

10°, 30° & 60° Inkjet std.; threshold-related suprathreshold Includes FieldView Omega Analysis software; FieldLink communications software; field patterns; color printer screening; quantify missed pts.; laptop computer; deluxe table; voice recognition; voice prompts; Advanced 13 programs std. support w/ full threshold; HT FieldView.

FieldView.

screening 30°, central optional printer threshold-related suprathreshold; 11 lbs., compact, easy to use; connects to any PC or purchase w/touch screen field, suprathreshold, full full threshold; fast threshold controller; full database for patient management, output range 540-590nm, & fast threshold alignment controls for patient comfort.

central 30º, full 50°, use any printer via PC central threshold, Instrument is controlled via PC, which allows for easy networking in your office andperipheral 30º - 50º, macula 10º, Medmont Flicker Perimetry integration with your EMR or PM software. Software allows you to view exams in 2Dglaucoma 22º/50º, or 3D, in color or greyscale, overlay retinal images over visual field exams (optional). neurological 50º, quickscan 22º/30º, Utilizes previous exams from patients to reduce test time and gives detailed driving 50º/80º, binocular 30º/40º, regression reports or patient history. Customize printouts for your need.binocular driving test 160º, spatially adaptivetest 50º; customize any test or build your own


12-S � JULY 2009


widefield technology provides a thorough view of theireyes, which complements the dilated indirect exam,” hesays.

Utility in GlaucomaPhysicians also use ultra-widefield imaging to more

accurately diagnose and manage glaucoma. Doctors canget a clear view of the optic nerve, measure it and exam-ine it in both eyes side by side. In addition, clinicians canmeasure the ISNT rule and examine the remaining fun-dus to determine if any retinal pathology exists well intothe periphery that might be affecting the optic nerve.These views help confirm whether or not a patient is aglaucoma suspect. “Our technology enables you to pin-point glaucoma indicators, such as defects in the superiorarcade and breaks in the retinal nerve fiber layer, whichare linked to an early indication of glaucoma risk,” Mr. Anderson says. “Looking at the optic discs on screenside by side is the fastest way to find asymmetry, whichis one of the biggest risk factors in determining a glauco-ma suspect. You can zoom in on the discs so they takeup 90% of the screen.”

According to Dr. Neatrour, ultra-widefield imagingenables him to see the optic nerve more clearly and docu-ment damage that occurs over time due to glaucoma pro-gression (Figure 4).

Pictures Worth a Million Words Because of the clarity of the digital images that show

the posterior segment in great detail, doctors have theability to educate patients about their eyes and eye dis-ease like never before.

“Patients are blown away by the images,” Dr.Henderson says. “You can paint a picture with yourwords and sometimes patients will understand. You candraw a picture with your pen, and patients may under-stand a little better,” he says. “But when you take a pic-ture of their eyes and show them exactly what’s goingon, there’s no doubt they understand what’s right orwrong with their eyes. This helps me forge a better thera-peutic bond with my patients. I can’t emphasize strongly

PROCESSING NUMBERCOMPANY MODEL RESOLUTION TIME OF RINGS

Carl Zeiss ATLAS 0.01D; less than 22Meditec Model 9000 submicron 1 second

Carl Zeiss Visante omni 0.01D; seconds 22Meditec (linking ATLAS submicron (ATLAS

with Visante OCT) Placido), OCTpachymetry

EyeQuip Piccolo < 1 micron < 3 seconds 28Topographer

EyeQuip Scout < 1 micron < 3 seconds; 28Topographer depends on

computer

EyeSys System 3000 high res computer 40Vison, Inc. dependent

EyeSys Vista Portable high res computer 25Vison, Inc. CT dependent

Haag-Streit CTK-922 ± 0.10 instant 22

Marco 3D Wave high res 0.4 seconds 19 vertical;23 horizontal

Nidek Inc. OPD-Scan II, Optical high res 0.4 seconds 19 vertical;Path Difference Diag. 23 horizontalSystem, ARK-10000

Nidek Inc. Magellan high res; < 1 second 60Mapper ± .03 mm

Oculus Inc. Easygraph ± 0.20D 1 second 22; high-resCCD camera

Oculus Inc. Keratograph ± 0.10D 1 second 22; high-resCCD camera

Oculus Inc. Pentacam ± 0.25D max. 2 no rings;seconds Scheimpflug

camera

Oculus Inc. Pentacam HR +/- 0.1D 1 second no rings;(High Resolution) Scheimpflug

camera

Shin-Nippon CT-1000 High res < 2 seconds, 20± 1.25D depends on CPU

Tomey USA TMS-4 800 x 600 3 seconds 25 & 31pixels

Topcon Medical KR-8000PA n/a n/a 10Systems

Topcon Medical KR-9000PW n/a n/a 11Systems

Tracey iTrace Combo .01 diopter/1µ instant 25Technologies Visual Functional

Analyzer

Woodlyn/Medmont E300 High resolution none/instant 32

Figure 4. With ultra-widefield imaging, physicians can pinpoint glaucoma indicators, such as defects in the retinal nerve fiber layer(shown here), which are linked to an early indication of glaucoma risk.They can view optic discs on screen side by side to find asymmetries — one of the biggest risk factors in determining a glaucoma suspect.


JULY 2009 � 13-S

C O R N E A L T O P O G R A P H E R SNUMBER OF WORKING FOCUSINGDATA POINTS DISTANCE MECHANISM ADDITIONAL FEATURES

thousands 70 mm Joystick with patented Proven Placido disk technology and Arc-Step Algorithm for submicron elevation accuracy. Zernike corneal wavefront analysis for Cone of Focus™ aspheric IOL selection, image simulation of higher order corneal aberrations, invisible ring illumination for patient comfort; auto alignment system pupillometry (scoptopic & photopic) and white to white (HVID) measurement. PathFinder II Corneal Analysis Software screens for 5and Smart Capture™ different corneal conditions with >92% accuracy. MasterFit II CL fitting module. Small footprint, integrated Win XP computer withTechnology DVD-ROM/ethernet/USB.

thousands 47 mm V-Trac™ Only combined Placido + OCT system for anterior and posterior corneal topography including the Holladay Report; complete Registration System anterior segment imaging with full pachymetry map, anterior chamber angle and diameter measurements, corneal flap

thickness measurement; Refractive Tools Software for surgical planning; Irido-Corneal Tools Software to quantify angle anatomy; Topography Link Software compatible with ZEISS ATLAS Models 993, 995, and 9000.

7,168 measured <10 mm patented infrared Corneal wavefront mapping clearly displays corneal spherical aberration and low and high order aberrations that can be 75,000 analyzed vertex detector removed from the map individually; slit lamp or table top mount; use your laptop or desktop computer; Exclusive Wave

Contact Lens Design Software included.

7,168 measured <10 mm patented infrared Std. corneal wavefront mapping clearly displays low & high-order aberrations that can be removed from the map individually; 75,000 analyzed vertex detector opt. IR pupillometry; three interchangeable opt. IR pupillometry; three interchangeable Scout models; portable w/battery; slit lamp

mounted or table-based w/a permanent headrest; use your laptop or desktop computer; exclusive Wave Contact Lens software designs custom RGP & soft lenses .

up to 14,400 125 mm 3 camera apex New desktop topographer/pupillometer. Solid state USB 2.0 digital design, patented high-resolution, 3-camera technology anddetection with patented multi-resolution, adaptable ring placido. Many options include corneal wavefront high-order aberration map, auto-capture Holladay diagnostics, etc.

9,000 70 mm image sequence Newly updated for 2008. Portable, fast and easy-to-use, solid state USB 2.0 digital design, no moving parts, automatic exam through focus acquisition, map options include corneal wavefront high order aberration map, Holladay diagnostics, etc.auto-capture

22,000 80 mm joystick Keratometer built-in; contact lens software; 3-D image; keratoconus detection; Fourier and Zernike analysis.

6,480 75 mm XYZ axis fully Diopter range is on Ct. 10 to 100D out to 11 mm; includes: axial, tangential, refractive & elevation maps; ARK; automatic alignment wavefront analyzer; OPD; internal OPD; pupillometer; mesopic & photopic pupil displayed; XP; Celeron M1.5 GHzProcessor.

6,480 or more 75 mm XYZ axis fully Diopter range is on Ct.10 to 100D out to 11 mm; includes: axial, tangential, refractive & elevation maps; objective autorefraction & automatic alignment wavefront analysis technology via dynamic skiascopy; wavefront maps include: OPD, Zernike polynomial graphs, total

wavefront aberration & wavefront higher-order aberration.

21,600 1.5 mm XYZ joystick w/auto- Klyce Corneal Navigator Screening Program aiding in the detection of nine corneal conditions; Corneal Aberrometry Software; offset correction NAVIS EMR included.

22,000 40 mm automatic focusing; Exclusive “REAL” keratometer built in; image data transferred digitally to computer; Windows-compatible software; manual override 3-D; overview image; Fourier analysis; height & refractive maps std.; keratoconus detection software;

Zernike analysis software & contact lens fitting software opt.; contact lens software includes 35,000 lens database & fluor. image-simulation; ortho-k software also available.

22,000 80 mm automatic focusing; Exclusive “REAL” keratometer built in; image data transferred digitally to computer; Windows-compatible software; 3-D; manual override overview image; Fourier analysis; height & refractive maps std; keratoconus detection software & Zernike analysis software;

contact lens software includes 35,000 lens database & fluor. image simulation; refractive comparison software for corneal refractive therapy; opt. pupillometry software avail.

25,000 true 80 mm automatic focusing; The Pentacam is a rotating Scheimpflug camera system; anterior & posterior corneal topography; anterior segment/chamber elevation pts. manual override analysis; calculates chamber angle in degrees, camera chamber volume, diameter & height; creates moveable 3-D model;

images anterior & posterior corneal surfaces, iris & the lens; quantifies & diplays crystalline lens opacifications; measures IOL vault distance from any eye surface; detects optimal focus for anterior chamber imaging, Holladay Report with Equivalent KReadings for better IOL Calculation; 1 year free software upgrades.

138,000 true 80 mm automatic focusing; The Pentacam HR is a rotating Scheimpflug camera system; anterior & posterior corneal topography; anterior segment/chamber elevation pts. manual override analysis; calculates chamber angle in degrees, camera chamber volume, diameter & height; creates moveable 3D model;

images anterior & posterior corneal surfaces, iris & the lens; quantifies & displays crystalline lens opacifications; measures IOL vault distance from any eye surface; detects optimal focus for anterior chamber imaging, Holladay Report with Equivalent K Readings for better IOL Calculation; 1 year free software upgrades.

6,344 6 mm joystick w/automatic Joystick alignment w/automatic measurement; compact design; user-friendly; easily updated software; axial, tangential, measurement elevation, refractive, multiple, 3-D maps; comparison maps; small cone/larger measuring zone; contact lens fitting

software with fluoro image stimulation.

8,000 70 mm joystick Provides spherical equivalent, regular astigmatism, asymmetry & higher-order alignment; provides refractive information w/3-mm &6-mm diameter range; keratoconus screening; Klyce statistics; enhanced height & height change maps; contact lens software included.

3,600 85 mm automatic alignment Tri-functional autorefractor/keratometer w/corneal mapping & contact lens fluorescein simulation fitting program; interfaces w/manual override w/Topcon computerized lensmeters and CV-5000 vision tester.

3,960 85 mm automatic alignment Combined autorefraction; corneal mapping & wavefront aberrometer measurements.w/manual overdrive

9,000 20 mm laser vertex 5-in-1 functionality including ray tracing wavefront aberrometry, multi-zone auto refraction, auto-keratometry, pupillometry; topography enabled by EyeSys Vision; provides corneal spherical aberration measurement for IOL selection; measures lenticular aberrations; keratoconus screening; asphericity index; computer-independent.

15,000 30 mm joystick with progressive Instrument is controlled via PC, which allows for easy networking in your office and integration with your EMR or PM software.measured points auto capture and 4 Software allows you to view exams in 2D or 3D. Fully automatic image capture keeps patient testing both fast and simple.

simultaneous captures Images are captured automatically with a simple built-in alignment system. Simply position the instrument, guided by theso you never have to intuitive 3D focusing target, and let the software do the rest.repeat the test


enough how much this technology reinforces the doctor-patient relationship.”

Dr. Stone has had and continues to have similarexperiences. “Patients are fascinated with the technology.They can see their eyes in a way they’ve never seen thembefore,” he says. “When I show patients before and aftertreatment photos, their reactions are positive. I give themconfidence about how I take care of them, and it meansa lot to them.”

Ultra-widefield imaging provides a big wow factorfor patients, Dr. Neatrour says. He often uses the 3DWrap Patient Orientation tool that creates a 3-D modelof patients’ eyes with the Optomap image in the correctposition. The feature provides a virtual tour of patients’eyes to educate them about the anatomy of the eye. “Thevirtual tour takes patients through the cornea, pupil, thecrystalline lens to the back of the eye. This helps them tounderstand how their condition is affecting their vision.”

Another feature of the 3D Wrap is the modelingcapability (Figure 5) that allows doctors to illustrate thedetails of IOL placement in cataract and refractivesurgery patients. “Within this model, doctors can simu-late the insertion of different types of lenses, whileexplaining the benefits of monofocal and multifocalIOLs. This is shown on screen in a very graphic andeasy-to-understand manner. It’s very exciting forpatients,” Mr. Anderson says.

Affordable, Profitable InvestmentDespite the many invaluable features of the Optos

ultra-widefield digital imaging systems, the technology isaffordable for retina specialists and general ophthalmolo-gists who have small, medium or large practices.

Unlike some of the more common financing options,such as monthly lease agreements or upfront cash pur-chases that manufacturers offer physicians to implementnew technology, Optos provides an operating lease pro-gram called Access Technology NOW (ATN), which cov-

14-S � JULY 2009


NAME MODEL TYPE WEIGHT RANGEAccutome AccuPach VI desktop 3.1 lbs. 300µ to 999µ

Accutome PachPen handheld 3 oz. 300µ to 999µ

DGH Technology Inc. DGH-55 handheld 3.6 oz. 200µ to 1100µ, flap Pachmate option 95µ to 1100µ

DGH Technology Inc. DGH-550 desktop 4 lbs. 200µ to 1100µ, flap Pachette 2 option 95µ to 1100µ

DGH Technology Inc. DGH-555 desktop 1.4 lbs. 200µ to 1100µ flap Pachette 3 option 95µ to 1100µ

Haag-Streit USA OLCR slit lamp please call please callmounted

Micro Medical P2000 handheld 8 oz. 90µ to 1200µDevices FastPach

Micro Medical P2000 handheld 8 oz. 90µ to 1200µDevices Pachymeter

Paradigm Medical P-2200 desktop 3.6 lbs. 200µ to 1200µIndustries, Inc.Dicon Inc.

Paradigm Medical P-2500 P/A desktop 3.6 lbs. 120µ to 1200µIndustries, Inc.Dicon Inc.

Reichert Ophthalmic ATP Auto desktop 30 lbs. tonometer: Instruments NCT/ 0 to 60 mm Hg

Pachymeter pachymeter:200µ to 999µ

Reichert Ophthalmic IOPac handheld 7 oz. 300 - 1000 micronsInstruments Standard

Reichert Ophthalmic IOPac handheld 7 oz. 300 - 1000 micronsInstruments Advanced

Sonomed Inc. 300AP desktop 3.25 lbs./ 100µ to 1000µ1.4 kg.

Sonomed Inc. 300P desktop 3.25 lbs./ 100-1000µ1.4 kg

Tomey USA SP-100 handheld 1.17 lbs. 150-1200µ

Tomey USA SP-3000 compact/ 8.8 lbs. 3 ranges: 150-desktop 350µ, 399-1000µ

& 900-1500µ

COMPANY MODEL TYPE SPOT SIZE

Heine SIGMA 150 S-Frame Spectacle small & large

Heine SIGMA 150 K headmount small & large

Heine SIGMA 150 KC headmount small & large

Heine OMEGA 500 headmount small, medium& large

Heine OMEGA 200 headmount small, medium& large

Keeler Instruments All Pupil II headmount with small; Wired exclusive headband medium;

dimmer control large

Keeler Instruments All Pupil II headmount with small; Wireless exclusive headband medium;


Keeler Instruments Fison Wired headmount large

Keeler Instruments Spectra Plus exclusive sport largeLED frame red, light blue

blue, black

Keeler Instruments Vantage Plus headmount with Intelligent optics: Bulb Wired exclusive headband small, medium,


Figure 5. The 3D Wrap modeling capability feature of the OptomapP200C imaging system creates a 3-D model of patients’ eyes, enablingdoctors to illustrate the details of IOL placement in cataract and refractive surgery candidates. Doctors can simulate the insertion of different types of lenses, while explaining the benefits of monofocal and multifocal IOLs.

SP0709 DIBG-OMD-0630:OMD-OM DIBG 7/3/09 12:40 AM Page 14

JULY 2009 � 15-S

PA C H Y M E T E R SBUILT-IN IOP POWERCALCULATOR PORTABILITY SOURCE ADDITIONAL FEATURESyes yes universal Voice output; gentle touch probe; easy-to-use touch screen; new Digital Signal Analysis for accuracy.

yes yes lithium battery Ergonomically designed to fit comfortably in hand; gentle touch probe; can store & average nine measurements; new Digital Signal Analysisfor accuracy.

yes yes two AAA Carrying case; extra charger; extra batteries included; bilateral mode; totally portable.batteries

yes yes A/C Carrying case; extra charger; extra batteries included; bilateral mode; totally portable.

yes yes two AA Carrying case; extra charger; extra batteries included; bilateral mode; totally portable.batteries

no no please call 1µ, real-time continuous readouts; PC, laptop, printer & ethernet.

yes yes dual rechargeable Easy one-touch operation; auto data capture; advanced pattern batteries recognition; automatic IOP adjustment; corneal waveform batteries display; hi-res color LCD and touch screen controls; wireless print; upgradeable to AP2000 (A-scan and pachymeter); ADA; 200+ patient

scans on single charge.yes yes dual rechargeable Automatic IOP adjustment; corneal waveform technology batteries (A-scan of cornea); choice of 20 or 50 MHz probe; corneal mapping;

batteries FemtoScan flap measurement mode; patient database integrated desktop software; wireless sync/print, hi-res LCD touch screen controls; LRI software.

yes yes A/C Pachymeter system w/LCD monitor; 20 MHz P-probe, probe holder; calibration cylinder; foot switch; A/C adapter; built-in thermal printer.

yes yes A/C A-scan pachymeter combination; portable & sleek; 10 MHz A-scan probe & 20 MHz P-probe large LED Display w/auto gain control, 8 axialreadings; 6 IOL calculations; built-in thermal printer.

yes no 100V to 240V Fully integrated tonometer/pachymeter combining the measurement of IOP & CCT in one instrument; designed in response to numerous clinical studies; presents measurements on simple-to-read color display; automatically computes adjusted IOP value w/out additional data entry.

no yes 5V dc 300mA One-touch measurement; automatically averages readings; built-in calibration; platform based on Palm Powered technology; straight or 45° angled probe.

yes yes 5V dc 300mA Glaucoma Risk Calculator derived from the OHTS study. One-touch measurement; storage for up to 1,000 patients; refractive model for accurate measurements in multiple zones; infrared printing; color; backlit screen, straight or 45° angled probe.

yes yes A/C A-scan & pachymeter in one unit; small footprint, portable w/touch-screen user interface; built-in probe sensitivity test & auto calibrationcheck; straight or 45°.

yes yes A/C Small footprint, portable, w/touchscreen user interface; built-in probe sensitivity test & automatic calibration check; straight or 45° angled 20 MHz probe.

yes yes lithium rechargeable Handheld with built-in printer; IOP calculations and network ready; simple to use and highly accurate; user programmable nomograms.battery

no yes 100 to 240V Color touch screen; tone-assisted measurement & auto-averaging up to 20 readings per location; results of 10 discreet points or up to 25 map points can be displayed, stored or printed.

FILTERS POWER SOURCE PORTABILITY ADDITIONAL FEATURES

integrated red free; mPACK lithium ion yes with mPACK Mounted to lightweight, fully adjustable S-Frame — weighs a mere 5.2 oz. Variable pupil cobalt, yellow and portable power source portable power source scope (for optimized views in pupils 10mm-2mm); carbon fiber frame for durability. Xenon diffuser available halogen bulb offers a CRI Rating of 98.5 for accurate color rendering. 100% dust-proof.

Guaranteed for life.

integrated red free; wired to stand, desktop, yes with mPACK Variable pupil scope (for optimized views in pupils 10mm-2mm); carbon fiber frame for cobalt, yellow and wall-mount and mPACK portable power source durability. Xenon halogen bulb offers a CRI Rating of 98.5 for accurate color rendering. diffuser available portable power source 100% dust-proof. Guaranteed for life.

integrated red free; wired to stand, desktop, yes with mPACK Variable pupil scope (for optimized views in pupils 10mm-2mm); carbon fiber frame for cobalt, yellow and wall-mount and mPACK portable power source durability. Xenon halogen bulb offers a CRI Rating of 98.5 for accurate color rendering.diffuser available portable power source 100% dust-proof. Guaranteed for life.

integrated red free, wired to stand, wall-mount, and yes with mPACK Variable pupil scope (for optimized views in pupils 10mm-2mm); aluminum chassiscobalt, yellow and mPACK portable power source or portable power source mounting for all optical components for durability. All features fully integrated.diffuser unplugged wireless with mobile or unplugged wireless Xenon halogen bulb offers a CRI Rating of 98.5 for accurate color rendering.

transformer or wall charger 100% dust-proof guaranteed.

integrated red free wired to stand, desktop, yes with mPACK The choice for teaching and operating rooms. Integrated teaching mirrors on the left and and cobalt; yellow wall-mount and mPACK portable power source right. Variable pupil scope (for optimized views in pupils 8mm-1.2mm); aluminum chassisavailable as substitution portable power source mounting for all optical components for durability.

built-in UV/safety filter; 3 options in 1: Smart Pack Convertible yes/Smart Pack Lightweight; less than 500 grams; easy to use; brightest; PD range 47 mm-75 mm.red free; diffuser (mobile, wall or desk) or Wall Pack

built-in UV/safety filter; standard wireless; lithium ion battery; yes, wireless lithium Lightweight; less than 500 grams; easy to use; brightest; PD range 47 mm-75 mm.red-free; diffuser comes with two batteries ion battery

safety filter; desk or wall-mountable nored-free; cobalt blue transformer

red-free; cobalt blue lithium ion battery yes, lithium ion battery LED illumination: 10,000 hours of use. 6 hours of on time. PD range 48 mm-76 mm.

built-in UV/safety filter, 3 options in 1: Smart Pack yes/Smart Pack IOS Optics w/single step spot & convergence for maximum 3D steropsis; Hi-Mag Retina red-free, cobalt blue Convertible (mobile, wall or desk) Lens to enhance visualization of the fundus; PD range 52 mm-76 mm.diffuser or Wall Pack

B I N O C U L A R I N D I R E C T S


16-S � JULY 2009


ers basic screenings, advanced imaging procedures and/orfundus photography and fluorescein angiography.

The company offers each ATN model with a monthlylease plan that includes service, upgrades and a pay-per-procedure payment plan. “Our most popular financingoption is the operating lease model,” says Thomas G.Daniells, global vice president of marketing at Optos.“The doctor pays for the Optomap service on a per-pro-cedure pricing basis, so there’s no capital outlay.”

Once physicians introduce the technology, they soonrealize its profit potential. However, slight differencesexist between retina and general ophthalmology practiceswhen it comes to profitability and sources of revenue.

• Retina. The primary source of revenue from the useof ultra-widefield imaging in retina practices comes frommedically necessary reimbursable procedures, such asfundus photography and fluorescein angiography. “Thefinancial benefit comes from the incremental use of thetechnology,” Mr. Daniells says.

At Retina Associates of Kentucky, Drs. Kitchens andStone perform approximately 27 fundus photographyand 47 fluorescein angiography procedures per month,generating around $130,000 a year. Dr. Stone says thatwhile high-quality patient care is the chief reason forimplementing ultra-widefield technology, the system hasincreased revenue for certain procedures.

“Since we’ve had this technology, I’ve performed30% more medically necessary fluorescein angiographyexams and probably about 10% to 20% more Optomapfluorescein angiography-driven laser surgeries,” he says.

• General ophthalmology. Revenue from the use ofthis technology in general ophthalmology practicescomes from reimbursable procedures for diagnosing andmonitoring retinal pathology and glaucoma, as well asfrom annual basic screenings that patients pay for out ofpocket. This is the case in Dr. Henderson’s practice. Heperforms approximately 86 fundus photography proce-dures and 80 basic screenings per month, averaging$109,000 a year.

“I do anywhere from two to 10 ultra-widefield imag-ing exams a day, so most busy comprehensive ophthal-mologists will find this technology to be profitable andpractice building,” Dr. Henderson says.

Basic screenings are an important revenue stream forgeneral ophthalmology practices, Mr. Daniells says.“Because basic screenings are done annually, physicianscan compare images year after year,” he adds. “If youcan do 100 or more of these procedures and charge $50to $100 a patient per month, you can bring in an addi-tional $5,000 to $10,000 per month. Many practices canbring in an extra $100,000 per year.”

Dr. Neatrour says his practice, which has three loca-tions, expects to perform approximately 394 basicscreenings per month, or 4,728 per year, and 297 fundusphotography procedures per month, or 3,568 per year.As a result, projected annual revenue from the machineis $460,880.

“We believe the Optos technology provides a 4-to-1return on investment to the practice,” Dr. Neatrour says.“It’s such an incredible technology for you and thepatient. You’ll ask yourself why you didn’t introduce itsooner.” OM

COMPANY MODEL TYPE SPOT SIZE

Keeler Instruments Vantage Plus headmount with Intelligent optics: Bulb Wireless exclusive headband small, medium,Standard dimmer control large

Keeler Instruments Vantage Plus headmount with Intelligent optics: Bulb Wireless exclusive headband small, medium,Slimline dimmer control large

Keeler Instruments Vantage Plus headmount with Intelligent optics:LED Wired exclusive headband small, medium,


Keeler Instruments Vantage Plus headmount with Intelligent optics:LED Wireless exclusive headband small, medium,Standard dimmer control large

Keeler Instruments Vantage Plus headmount with Intelligent optics:LED Wireless exclusive headband small, medium,Slimline dimmer control large

Keeler Instruments Vantage Plus headmount with Intelligent optics:LED Digital USB interface small, medium,

large

Kowa/Neitz IO-Alpha small pupil small (19 mm);med. (50 mm);large (80 mm)

Kowa/Neitz IO-H BIO medium

Kowa/Neitz IO-TV video BIO; small; small pupil medium;

large

Welch Allyn 12500 headmount small; Binocular medium;Indirect large

Welch Allyn 12500-D headmount small; Binocular medium;Indirect large

FIELDCOMPANY MODEL TYPE OF VIEW

Canon Medical CR-1 non-mydriatic digital 45°Systems Mark II fundus camera

Canon Medical CF-1 mydriatic digital 50°Systems fundus camera

Carl Zeiss FF450 Plus full-feature fundus camera 50°, 30°, 20°Meditec for color, red free, FA,

autofluorescence, and ICG. Designed for digital interface.

Carl Zeiss VISUCAM PRO NM non-mydriatic digital 45°, 30°Meditec fundus camera

for color and red free

Carl Zeiss VISUCAM NM/FA non-mydriatic digital 45°, 30°Meditec fundus camera for color,

red free and FA

Carl Zeiss VISUCAM NM/FA FAF non-mydriatic digital 45°, 30°Meditec fundus camera for color,

red free, FA, autofluorescenceand ICG

Carl Zeiss VISUPAC Digital digital imaging and 50°, 30°, 20°Meditec Imaging and Archive archive system

Management System

Clarity Medical RetCam 3 digital: premature 30º, 80º, 120º,Systems infant, children & 130º

adult anterior chamber

Clarity Medical RetCam Shuttle digital: premature infant, 30º, 80º, 120ºSystems children & adult 130º

anterior chamber

Escalon Digital E5 digital conversion of anySolutions mydriatic fundus

camera


JULY 2009 � 17-S

B I N O C U L A R I N D I R E C T SFILTERS POWER SOURCE PORTABILITY ADDITIONAL FEATURES

built-in UV/safety filter, standard wireless; lithium ion battery; yes, w/wireless lithium IOS Optics w/single step spot & convergence for maximum 3D steropsis; hi-mag retinal lensred-free, cobalt blue comes with two batteries ion battery to enhance visualization of fundus; PD range 52 mm-76 mm.diffuser

built-in UV/safety filter, slimline wireless - lithium polymer yes, w/wireless lithium IOS Optics w/single step spot & convergence for maximum 3D steropsis; hi-mag retinal red-free, cobalt blue battery; comes with two batteries polymer battery lens to enhance visualization of fundus; PD range 52 mm-76 mm.diffuser

built-in UV/safety filter, 3 options in 1: Smart Pack yes/Smart Pack LED illumination:10,000 hours of use; 17 hours of on time; IOS Optics w/single step red-free, cobalt blue Convertible (mobile, wall or desk) spot & convergence for maximum 3D steropsis; hi-mag retinal lens to enhance visualization diffuser or Wall Pack of fundus; PD range 52 mm-76 mm

built-in UV/safety filter, standard wireless lithium ion yes/wireless lithium ion LED illumination: 10,000 hours of use; 11 hours of on time; IOS optics with single red-free; cobalt blue battery; comes with two batteries battery step spot & convergence of maximum 3D steropsis, hi-mag retinal lensdiffuser to enhance visualization of fundus. PD range 52 mm-76 mm.

built-in UV/safety filter, slimline wireless lithium polymer yes/wireless lithium LED illumination: 10,000 hours of use; 6 hours of on time; IOS optics with single step red-free, cobalt blue battery; comes with two batteries polymer battery spot & convergence of maximum 3D steropsis, hi-mag retinal lens to enhance visualization diffuser of fundus. PD range 52 mm-76 mm.

built-in UV/safety filter, wireless slimline polymer battery; yes/first digital First digital binocular indirect system. Not old analog. Utilize Vantage Plus LED Digitalred-free, cobalt blue comes with two batteries ophthalmoscope Wireless in your office, operating room, and teaching facility or anywhere you want todiffuser with USB interface capture digital images.

UV; blue; red-free opt. cordless rechargeable AC power wall- or Continuously adjustable observation angle; teaching mirror; video capability.battery pack; carrying case desk-mount; portable,

rechargeable battery

blue; red-free opt. cordless rechargeable AC power wall- or Lightweight; halogen illumination.battery pack; carrying case desk-mount; portable,


UV; blue; red-free requires AC power source for AC power wall- or Color CCD camera; continuous NTSC output.CCD camera; carrying case desk-mount; portable,


cobalt blue or portable power pack; yes Video-aligned optics for crystal clear views; lightweight comfort; true small pupil yellow; red-free wall- or desk-mount capability; UV/IR filter; 100 hrs. lamp life; widest PD range (49 mm to 74 mm),

leather padded headband.

diffuser; cobalt portable power pack; yes (w/portable Diffuser filter expands illuminated area; video-aligned optics; for crystal blue or yellow; wall- or desk-mount power source) clear views; lightweight comfort; true small pupil capability; widest PD range red-free (49 mm to 79 mm); leather-padded headband.

R E T I N A L C A M E R A SANGIO- NUMBER/TYPE FLASH VIDEOGRAPHY OF PORTS STIMULUS CAPACITY ADDITIONAL FEATURES

no digital n/a n/a Full 45-degree retinal images, 2x magnification, 1/4 flash intensinty of the CR-1, illuminated operation panel, Swivel, 5.7” LCD monitor, single joystick operation, 15.1 MP EOS digital SLR camera back, optional imageSPECTRUM software and DICOM software.

yes digital n/a n/a Small-diameter mode; color photography; red free photography; fluorescein angiography (FA); proprietary control software outputs retinal imaging information into optional imageSPECTRUM software; 10.1 MP EOS digital SLR camera back; 2X magnification and DICOM software.

yes 2 main interface ports; 360 W/s yes High resolution Zeiss optics. Each angle of view has its own “telescope” lens to optimize image quality at all three4 digital, video and/or Max magnifications; upper camera port optimized for digital interface.film cameras possiblesimultaneously

no internal digital sensor; Xenon flash no All-integrated design with onboard database system. Auto-flash, auto-focus, 3.3mm small pupil mode, various preset USB and ethernet ports lamp; 16 steps internal fixation points and stereo capture mode. Large LCD monitor for patient management; alignment, capture and

review. Network ready and DICOM conform. Telemedicine ready.

yes internal digital sensor; Xenon flash no All-integrated design with onboard database system. Auto-flash, auto-focus, 3.3mm small pupil mode, various preset USB and ethernet ports lamp; 20 steps internal fixation points and stereo capture mode. Large LCD monitor for patient management; alignment, capture and

depending on mode review. Network ready and DICOM conform. Telemedicine ready.

yes internal digital sensor; Xenon flash no All-integrated design with onboard database system. Auto-flash, auto-focus, 3.3mm small pupil mode, external fixation USB and ethernet ports lamp; 24 steps and stereo capture mode. Large LCD monitor for patient management; alignment, capture and review. Network ready and

depending on mode DICOM conform. Telemedicine ready.

yes 4 digital sensors available; n/a import, store Relational database for complete image management, documentation, progression viewing and image enhancement. USB and ethernet ports & play video Integrated report generator. Attaches to VISUPAC STAR network, integrates with other ZEISS instrument modalities.

Network ready and DICOM conform.

FA option 2 USB 2.0; no flash yes Fully integrated imaging system that delivers the next generation of ophthalmic visualization, photo documentation and1 primary; ease of use with a new user interface, redesigned cart and ergonomic hand piece. This advanced system incorporates 1 Ethernet port DICOM compatibility and image annotation feature. Brilliant, full-color images can be captured for immediate

assessment of the retina and anterior chamber; digital images can also be sent electronically to the ophthalmologistfor immediate evaluation and longitudinal tracking over time. The RetCam 3 Digital Imaging System makes it possibleto facilitate ophthalmic care in the hospital NICU, PICU and operating room.

no 2 USB 2.0; no flash yes RetCam Shuttle enables ophthalmic imaging with a convenient, mobile system that can be easily maneuvered into 1 primary; tight spaces and transported to affiliate hospitals. The Shuttle system enables on-site or remote documentation 1 Ethernet port of the pediatric retina and pediatric or adult anterior chamber. Network capability allows transfer of images to any

networked system or to a physician for remote evaluation.

yes n/a n/a n/a Digital imaging for most mydriatic fundus camera; 5 MP CCR sensor; calibrated measurement tools; Auto Eye-Map montage feature; DICOM-compliant; integrates with PACS and OphthaVision AXIS for side-by-side review of images from different modalities.


18-S � JULY 2009


she’s an anterior segment, cornea and external diseasespecialist. She and Dr. Masket use the UBM Plus(Accutome, Malvern, Pa.) for many treatments, includ-ing anterior segment reconstruction and IOL exchange.

“The UBM reveals the position of the optic, hapticsand relationship to the iris, posterior chamber and cil-iary body. This helps pre- and postoperatively inpatients with malpositioned IOLs requiring exchange,”Dr. Fram says. “The UBM also may be an excellent toolfor evaluating pseudo-accommodating lenses and clarify-ing the anatomical reasons for phenomena, such as neg-ative dysphotopsia, after uneventful cataract surgery.”

Comparing UBMs In addition to comparing UBM features side by side

(See “What Are Your Choices?” on page 24-S), practi-tioners may consider the qualities that manufacturerssay differentiate their devices.

Cheng-ning Chang, principal software engineer forAccutome, explains, “The UBM Plus design is totallydifferent from other UBMs. Like Accutome’s B-ScanPlus, the UBM Plus is a fully USB device. All of theultrasound parts except the display are inside theprobe.”

Jim O’Connor, marketing manager at Accutomeadds, “We developed a self-contained UBM probe. Adoctor or tech hooks it to a laptop and it’s ready to go.”

FIELDCOMPANY MODEL TYPE OF VIEW

Escalon Digital E6 Single digital conversion of anySolutions mydriatic fundus

camera

Escalon Digital E6 Dual digital conversion of anySolutions mydriatic fundus

camera

Escalon Digital E11 digital conversion of anySolutions mydriatic fundus

camera

Kowa Genesis D joystick w/auto- 30° horizontalOptimed Inc. Handheld Fundus firing and infrared

Camera measuring

Kowa nonMyd 7 compact; tabletop; nonmydriatic Optimed Inc. Fundus Camera nonmydriatic color 45°/20˚

Kowa nonMyd compact; tabletop; nonmydriatic Optimed Inc. Alpha-D III nonmydriatic color 45°/30˚

Retinal Camera

Kowa VX-10 compact tabletop; mydriatic: Optimed Inc. Two-in-One mydriatic; 50°/25°

Fundus Camera nonmydriatic color/FA

Marco RTA-5 digital composite 72x60°Retinal ThicknessAnalyzer with DigitalFundus Imaging

Nidek Inc. AFC-210/230 table top, 45°Pro Photographer non-mydriatic

OIS Winstation digital conversion of anyEssential mydriatic fundus

camera

OIS Winstation digital conversion of anyRetina mydriatic fundus

camera

OIS Winstation digital conversion of any5000 mydriatic fundus

camera

OIS Winstation digital conversion of any11K mydriatic fundus

Topcon Medical TRC-NW8 nonmydriatic 45°Systems

Topcon Medical TRC-NW300 nonmydriatic 45°Systems

Topcon Medical TRC-50DX/ digital/film 20°; 35°; 50°Systems TRC-50DX ICG mydriatic

Visual ARIS 110 digital; autostereo; non & twenty-six Pathways Inc. mydriatic retinal imaging 30º fields=120º

system (4.0 mm pupil for on retina“semi-auto” mode)

Visual ARIS 70 digital; autostereo; non & eleven 30º Pathways Inc. mydriatic retinal imaging fields=80º

Visual ARIS RSVP Remote Stereo Viewing n/aPathways Inc. Platform

COMPANY MODEL DESIGN

AMA Optics Inc. Retinal Acuity Meter-RAM Handheld, stand alone

CONTINUED FROM PAGE 5

Figure 1. VuMax-II from Sonomed


JULY 2009 � 19-S

R E T I N A L C A M E R A SANGIO- NUMBER/TYPE FLASH VIDEOGRAPHY OF PORTS STIMULUS CAPACITY ADDITIONAL FEATURES

yes n/a n/a n/a Digital imaging for most mydriatic fundus camera; 6 MP CCR sensor for excellent image quality in a single cameraback; calibrated measurement tools; Auto Eye-Map montage feature; DICOM-compliant; integrates with PACS and OphthaVision AXIS for side-by-side review of images from different modalities.

yes n/a n/a n/a Digital imaging for most mydriatic fundus camera; Dual 6MP CCR sensors dedicated for color and monochromatic to provide the highest quality color images and angiograms; calibrated measurement tools; Auto Eye-Map montage feature; DICOM-compliant; integrates with PACS and OphthaVision AXIS for side-by-side review of images from different modalities.

yes n/a n/a n/a Digital imaging for most mydriatic fundus camera; 11 MP CCR sensor for specialized settings; calibrated measurement tools; Auto Eye-Map montage feature; DICOM-compliant; integrates with PACS and OphthaVision AXIS for side-by-side review of images from different modalities.

yes 1 primary port; USB 2.0 n/a no still; Compact flash memory; LCD monitor for picture review; color mydriatic photography; indirect lens holder digital interface digital only accessory; VK-2 digital imaging system; EMR connectivity; DICOM; JPG and BMP export for telemedicine;

connection to portable notebook computer as well as desktop.

yes 1 primary port; 1-6.1 n/a no still; LCD monitor for alignment and focusing; small-pupil mode; preset flash exposures; nonmydriatic color photography; mega pixel camera back digital only camera has internal working distance and focusing dots; with VK-2 digital imaging system; EMR connectivity; DICOM; w/USB 2.0 digital interface JPG and BMP export for telemedicine; offers connections for both portable notebook and desktop computers.

yes 1 primary port; 1 USB n/a no still; LCD monitor for alignment and focusing; small-pupil mode; preset flash exposures; color photography; 2.0 digital interface digital only nonmydriatic color photography; fluorescein angiography (FA) photography; red-free photography; camera has

internal working distance and focusing dots; VK-2 digital imaging system; EMR connectivity; DICOM; JPS and BMP export for telemedicine. Ideal for telemedicine applications as it offers connections to both portable notebook and desktop computers.

yes 2 primary ports; n/a no still; LCD monitor for alignment and focusing; small-pupil mode; preset flash exposures; color photography; nonmydriatic Upper = digital digital only color photography; fluorescein angiography (FA) photography; red-free photography; camera has internal working interface/35 mm/ distance and focusing dots; VK-2 digital imaging system; EMR connectivity; DICOM; JPG and BMP export for Polaroid telemedicine.

no digital n/a yes Versatile and modular imaging system offers a wide range of comprehensive diagnostic testing for early detection and effective monitoring of diabetic retinopathy, AMD, other retinal pathologies, and glaucoma. Capabilities include: retina & disc imaging with individual slit-analysis, quantified topography and 3D disc topography, thickness analysis and RNFL thickness measurement, objective progression analysis with automated image registration for consistent comparative analysis, Dynamic 3-D anatomy imager across full scan area with video presentation capture, and a wellness screening program. Upgrades include: Remote RTA viewer stations and extended customer support programs.

no 2 USB 1 W/s to 25 W/s yes 12.8 megapixels for detection of diabetic retinopathy, auto-focus & auto alignment on y-axis or x-y-z axis.1 RGB Small-pupil mode, stereo mode, montage capability.

yes n/a n/a n/a Designed to meet the needs of general ophthalmologists by delivering a good quality image ideal for primary documentation purposes through the use of its 3.2 megapixel sensor. Using OIS Symphony, images can be enhanced and reviewed side by side with imported ophthalmic diagnostic reports produced by other devices in the clinic. Single- click integration with different EMR systems can be provided.

yes n/a n/a n/a With its 5.3 megapixel sensor, it’s designed to meet the needs of retina specialists who require excellent image quality with more detail for a higher level of diagnostic ability than general ophthalmologists require. Using OIS Symphony, images can be enhanced and reviewed side by side with imported ophthalmic diagnostic reports produced by other devices in the clinic. Single click integration with different EMR systems can be provided.

yes n/a n/a n/a With its 35-mm, 6-megapixel CCD, it’s designed to meet the needs of more demanding retina specialists who require the best image quality available. Using OIS Symphony, images can be enhancedand reviewed side by side with imported ophthalmic diagnostic reports produced by other devices in the clinic. Single-click integration with different EMR systems can be provided.

yes n/a n/a n/a With its 35-mm, 11-megapixel CCD, it’s designed for research & teaching institutions that demand the most detailed images on the market today. Using OIS Symphony, images can be enhanced and reviewed side by side with imported ophthalmicdiagnostic reports produced by other devices in the clinic. Single-click integration with different EMR systems can be provided.

no 1 std: digital CCD 6 W/s to 27 W/s yes Color fundus with unique red-free imaging. High quality 10.1 megapixel images with Nikon digital camera. Auto focus, auto capture, auto small pupil detector, stereo mode, and Auto Mosaic™. Can be combined with Topcon’s IMAGEnet™ Liteand EyeRoute® Systems for image management and networking. Compatible with today’s most popular EMR systems.

no digital CCD 3.3 W/s to 13 W/s yes 8 megapixel built-in capture device; auto focus, auto exposure and auto shoot; direct printout to digital printer; can be built-in combined with Topcon’s IMAGEnet™ Lite and EyeRoute® Systems for image management and networking. Compatible

with today’s most popular EMR systems.

yes 2 std: 35 mm 12 W/s to 300 W/s Digital-ready; can accept a variety of photo devices; Color fundus, red-free & fluorescein filters. Autofluorescence & ICG or digital CCD filters also included on TRC-50DX ICG. Touch-screen control panel; 21 flash settings; small pupil mode; can be connected to

Topcon’s IMAGEnet system.

no 4 USB; RS232; ethernet; 35 W/s to 40 W/s no Fully automated; pupil-tracking; exposure & focus; telecentric optics; Constant Base Stereo; filter selection for IR, red 1, printer; sound card red 2, red-free & color images; BichromaticImage Navigation; optional glaucoma detection & evaluation S/W internet ready.

New automatic glaucoma detection & evaluation (GDE) software module available as option, featuring Constant Base Stereo™.

no 4 USB; RS232; ethernet; 35 W/s to 40 W/s no Fully automated; pupil-tracking; exposure & focus; telecentric optics; new automatic glaucoma detection, evaluation (GDE) printer; sound card software module available as option, featuring Constant Base Stereo; filter selection for IR, red 1, red 2, red-free and color

images; BichromaticImage Navigation; optional glaucoma detection & evaluation S/W internet ready.

n/a n/a n/a n/a Includes PC, monitor, ArisWare software; stereo emitter & two pair viewing glasses for hands-free stereo viewing of ARIS™ stereo images.

R E T I N A L A C U I T Y M E T E RILLUMINATION OPTICS CALIBRATION COMPONENTS SPECIAL FEATURES

High illumination CCFT Automatic Meter, Carrier Frames The RAM uses bright, calibrated illumination,Convergent light Pinhole Clip, Occluder exact distance & 1-mm pinhole apertures to

accurately measure retinal acuity; assessesmacular function & forecasts postoperative vision.Prevents unnecessary surgeries & reduces unexpected poor outcomes. Reproducible & easy.


20-S � JULY 2009


The self-contained probe design offers economicadvantages, as well as portability, according to Mr.Chang. “We ensure that your hardware isn’t fallingbehind,” he says. “If you watch the PCs on the market,you know that every 6 months, the capacity doubles andthe price drops. Because the UBM Plus (Figure 2) systemsimply includes software and a plug-in probe for yourcomputer, you can upgrade your laptop, desktop ormonitor relatively inexpensively any time you like, andyou won’t need to replace your entire UBM system.”

Barry Durante, president of Sonomed, explains whatsets apart his company’s VuMax-II. “With proprietaryimage-enhancing software, the VuMax-II provides thehighest image quality available for the widest range ofapplications, and the software capabilities and userinterface are unmatched in the industry,” he says.“Doctors can clearly visualize structures that, until now,they’d only seen in textbooks or in the anatomy lab.”

At Quantel, national sales manager KennethDickerson explains the advantages of the Aviso UBM.“Quantel offers true 25 MHz and 50 MHz linear scan-ning probes,” he explains. “The display is unparalleled,and you can readily resize onscreen, not just to one ortwo fixed magnifications. Doctors are impressed withthe DICOM-compatible resolution of the Aviso andwith the ClearScan cover (ESI, Inc., Plymouth, Minn.),which provides improved ease and comfort when exam-ining the side of the eye.”

Finally, Mark Zamorski, marketing specialist atReichert, Inc., Depew, N.Y., highlights the flexibility ofthe Reflex UBM (Figure 3). “The Reichert Reflex is trulycompact, requiring no added hardware to conduct orreview an exam, and the space-saving instrument allowsdoctors to perform procedures in their offices they previ-ously sent elsewhere,” he says. “Users can put the Reflexon the table stand, mount it flush on a wall, or use amultiposition monitor mount. This flexibility means theunit fits into any practice, and the touch screen permitseasy navigation of the Reflex’s intuitive software.”

Gaining MomentumThe use of UBMs is increasingly common among

doctors who need to see behind the iris. They’re usually

FIELDCOMPANY MODEL TYPE OF LASER OF VIEW

Bioptigen, Inc. HHP SDOCT, 840 nm SLD, standard 2° x 2°-60° x 60°Adult Human or broadband

Bioptigen, Inc. HHP SDOCT, 840 nm SLD, standard 2° x 2°-70° x 70°Pediatric or broadband

Bioptigen, Inc. HHP SDOCT, 840 nm SLD, standard 0.4° x 0.4°-50° x 50°Preclinical or broadband

Carl Zeiss Cirrus HD-OCT 840 nm 36º x 30ºMeditec superluminescent

diode

Carl Zeiss GDx portable scanning 20º x 20ºMeditec laser

polarimeter

Carl Zeiss Stratus OCT 820 nm 26º vertical Meditec superluminescent x 20.5º

diode horizontal

Heidelberg HRT3 with Confocal scanning 15° x 15°Engineering Glaucoma laser ophthalmoscope;Inc. Module 670 nm diode laser

Heidelberg HRT3 with Confocal scanning 15° x 15°Engineering Retina Module laser ophthalmoscope; Inc. 670 nm diode laser

Heidelberg HRT3 with Confocal scanning 400 µm x 400 µmEngineering Cornea Module laser ophthalmoscope;Inc. 670 nm diode laser

Heidelberg Spectralis® OCT 820 nm diode laser; 30º, 20º, 15ºEngineering 870 nm SLDInc.

Heidelberg Spectralis® OCTPLUS 820 nm diode laser; 55°, 35°, 30°, 25°,Engineering 870 nm SLD 20°, 15°; composite Inc. images up to 120°

Heidelberg Spectralis® HRA 488 nm OPS laser; 55°, 35°, 30°, 25°,Engineering 790 nm diode laser; 20°, 15°; compositeInc. 820 nm diode laser images up to 120°

Heidelberg Spectralis® FA+OCT 488 nm OPS laser; 55°, 35°, 30°, 25°,Engineering 820 nm diode laser; 20°, 15°; compositeInc. 870 nm SLD images up to 120°

Heidelberg Spectralis® 488 nm OPS laser; 55°, 35°, 30°, 25°,Engineering HRA + OCT 790 nm diode laser; 20°, 15°; compositeInc. 820 nm diode laser; images up to 120°

870 nm SLD

Marco RTA 5 scanning laser posterior pole;Retinal technology; 20x20°; Peripapillary Thickness Class II; (inc. post. pole);Analyzer Solid State; 35x20°; Optic Disc w/Digital 532 wavelength; 10x10°; Fundus Fundus Imaging Laser imaging to 40x60°

or 60x72°

Opko Spectral OCT/SLO 830 nm variable up to Instrumentation superluminescent 31 degrees

diode

Figure 2. UBM Plus from Accutome


JULY 2009 � 21-S

R E T I N A L S C A N N E R SAREA OF RETINA PRINTOUTANALYZED DETAIL ADDITIONAL FEATURES

Full retinal thickness SDOCT image, study information HHP SDOCT provides high-resolution, high-speed SDOCT imaging in a hand-held, robust, and easily transportableand RNFL; contoured solution that is ideal for clinical, bedside, and operating room imaging. Advanced spectrometer design permitsC-slices of retinal layers; single-shot, falloff-mitigated imaging at 17 frames per second. Standard resolution approaches 4.5 µm in tissuevessel flow using Doppler and the broadband option affords < 3 µm ultra-high resolution imaging. Fully customizable scan geometry and

density enable pathology-targeted imaging. Registration, averaging, and volume rendering ehance data display.On-screen calipers provide manual distance measurements. Open access to both raw and processed data. Optional accessories include the telecentric cornea bore, HHP microscope base, and chin-rest mounted scanner.

Full retinal thickness SDOCT image, study information HHP SDOCT provides high-resolution, high-speed SDOCT imaging in a hand-held, robust, and easily transportableand RNFL; contoured solution that is uniquely designed for pediatric imaging. Custom imaging bore optics provide unparalleled reso-C-slices of retinal layers; lution in premies, neonates, infants, toddlers, and children. Advanced spectrometer design permits single-shot,vessel flow using Doppler falloff-mitigated imaging at 17 frames per second for fast alignment and imaging in uncooperative patients.

Standard resolution approaches 4.5 µm in tissue and the broadband option affords < 3 µm ultra-high resolutionimaging. Fully customizable scan geometry and density enable pathology-targeted imaging. Open access to bothraw and processed data. Optional accessories include the telecentric cornea bore, HHP microscope base, and chin-rest mounted scanner.

Contoured C-slices SDOCT image, study information HHP SDOCT provides high-resolution, high-speed SDOCT imaging in a hand-held, robust, and easily transportableof retinal layers; solution that is uniquely designed for preclinical research, enabling true bench-to-bedside imaging with onevessel flow using system. Optimized imaging optics are available for mouse (FOV given here, lateral resolution less than 3 µm), Doppler rat, and macaque. Uniquely designed small-animal imaging mount enables high throughput imaging of mouse

and rat models with rapid, accurate alignment every time. All benefits of the HHP SDOCT Adult Retina system plus solutions for preclinical research. Optional accessories include mouse or rat bite bars for fine alignementand motion reduction, telecentric cornea bore, and HHP imaging base.

Macula and retinal Data from single macula cube scan provides: high resolution Designed for efficiency. Easy and fast scan acquisition. Small footprint. Modern integrated design fits in thelayers; segmented cross-hair image; 3D layer map of ILM and RPE; 3D corner of a room. Anterior segment imaging provides visualization of the angle and central corneal thicknessRPE and ILM retinal thickness map; 3D cube image; LSO fundus image; measurement. No add-on lens is required. Auto-center feature aligns peripapillary circle for RNFL analysis.layers; RNFL OCT fundus image with overlay of thickness map, OCT fundus RNFL repeatability SD of 1.3 µm in normal subjects and 1.2 µm in patient eyes. Unique Fovea Finder function

or slab. Comparison to normative data. Adjustable five-line raster ensures accurate registration and excellent repeatability of macular thickness measurements. Central Subfieldscan provides exquisite high-definition B-scan images. Optic disc Macula Thickness repeatability SD of 2.2 µm.scan provides RNFL thickness map and deviation map with comparison to normative data, TSNIT graph and OU analysis.GPA analysis shows comparison of RNFL thickness measurementsfrom the Optic Disc Cube scan over time and determines ifstatistically significant change has occurred. The results showevent analysis, trend analysis and a quantified rate of change.

nerve fiber layer Deviation map; thickness map; NFI score; TSNIT Operator independent; has intuitive printout; no dilation required; less sensitive to variations in disc parameters; TSNIT graph; quality score; patient & size than are other instruments. Ideally suited for those specializing in glaucoma or building a practice information; single & serial analysis formats. glaucoma practice.

Macula and retinal Objective RNFL & retinal thickness; normative Provides direct cross-sectional images & retinal measurements; images & analyzes macular thickness, layers, RNFL and data comparison for RNFL & macula thickness; optic nerve retinal nerve fiber layer (RNFL) & optic disc; FDA-cleared normative data for RNFL & macula provide optic nerve head. head analysis w/disc, cup & rim measurements & age-matched reference values for comparison w/normal population. Now GPA Advanced Serial Analysis

ratios. GPA Advanced Serial Analysis for RNFL. identifies statistically significant change and rate of change to RNFL.

optic nerve head; Comprehensive optic nerve reports: OU w/cup, rim, RNFL & The HRT Glaucoma Module with TruTrack™ Image Alignment Technology provides clinicians with a powerful RNFL asymmetry analysis option for management of the glaucoma patient. Use in combination with other HRT modules for retina and

cornea applications.

macula & peripheral Retina reports: Graphic & statistical analysis Proprietary TruTrack™ Image Alignment Technology enables repeat scanning and alignment of images essential retina of retina with 2D & 3D topography; thickness for tracking change with retinopathies, such as DME, CME, AMD. Network applications and viewing licenses

and reflectance maps and trend analysis. available.

anterior segment & In-vivo histology & semi-automatic endothelial cell The Rostock Cornea Module adds confocal laser microscopy to the HRT system, enabling capture and review corneal layers; epithelium count analysis; live movie capture of finely detailed images of the cornea’s cellular structure, from epithelium to endothelium.to endothelium

retinal layers, RNFL, Displays infrared, OCT, posterior pole At 40 kHz, Spectralis® OCT scans 100 times faster than time-domain OCT. Proprietary TruTrack™ active eyeposterior pole and RNFL analyses. tracking enables precise repeat scanning and noise reduction.

retinal layers, RNFL, Displays infrared, OCT, posterior pole At 40 kHz, Spectralis® OCTPLUS scans 100 times faster than time-domain OCT. Proprietary TruTrack™ active eyeposterior pole & wide- and RNFL analysis. tracking enables precise repeat scanning, noise reduction and widefield imaging. Upgradable to FA+OCT andangle fundus images HRA+OCT models.

posterior pole & wide- Displays infrared, red-free, fundus TruTrack™ Image Alignment Technology enables precise tracking over time, noise reduction, and stunning angle fundus images autofluorescence, FA, ICGA images widefield pan-retinal images in real time. It produces fundus images of the retina and choroid unseen in digital

or film photography.

retinal layers, RNFL, Displays infrared, red-free, fundus At 40 kHz, Spectralis® FA+OCT scans 100 times faster than time-domain OCT. Proprietary TruTrack™ active eyeposterior pole & wide autofluorescence, FA, OCT, posterior tracking enables precise repeat scanning, noise reduction and widefield imaging. Upgradable to HRA+OCT angle fundus images pole & RNFL analysis model.

retinal layers, RNFL, Displays infrared, red-free, fundus autofluorescence, Spectralis® HRA+OCT is the ultimate combination platform. It combines the best of cSLO fundus imaging and posterior pole & FA, ICGA, OCT, posterior pole & RNFL analysis. angiography with SD-OCT. It is the only SD-OCT with TruTrack™ active eye tracking, which enables precisewide-angle fundus repeat scanning, noise reduction and widefield imaging.images

posterior pole; optic Fundus imaging; retinal thickness w/actual retinal image Versatile & modular imaging system; wide range of comprehensive diagnostic testing for early detection & nerve head and peri- slits; topography; optic nerve head mapping; color effective monitoring of diabetic retinopathy, AMD, other retinal pathologies & glaucoma. Capabilities papillary; fundus & fundus images; 2D & 3D thickness maps; topography include: retina & disc imaging w/individual slit analysis; quantified topography & 3D disc topography; perimacular; macular printouts; RNFL cross-section charts; horiz./vert. cross- thickness analysis & RNFL thickness measurement; objective progression analysis w/automated image thickness w/actual section graphs/normative probability maps; progression registration for consistent comparative analysis; dynamic 3D anatomy image across full scan area 3D anatomical cross- analysis w/deviation indices; Dynamic 3D anatomical w/video presentation capture & wellness screening program.sectioning cross-sections.

fovea, retina, Combined OCT B-Scan and confocal SLO images with exact Fully automated Auto-focusing and Auto Coherence for quick and easy operation; 27,000 A-scan/sec,inner/outer location/orientation of the OCT image on the SLO Fundus image, “RETEST” feature automatically ensures repeated location of the OCT scans and microperimetry testing.retinal layers, RPE, Combined topography thickness report with up to 6 high Optional - microperimetry retinal function with real-time SLO tracking. Optional cornea/anterior segment posterior pole, optic resolution radial B-Scan OCT images, “Auto-Compare” report OCT imaging and analysis of cornea and anterior segment. nerve, RNFL of multiple topography maps (progression/regression plot)

including location of retinal thickness changes overlaid on theSLO Fundus image. High resolution raster OCT scan and macula scan. Optic nerve head & RNFL analysis including (over time) “Auto-Compare” regression map of multiple scans. User selected “customize reports.”


22-S � JULY 2009


FIELDCOMPANY MODEL TYPE OF LASER OF VIEW

Optos P200 scanning laser 200°technology; low-powered red (633 nm) and green (532 nm) lasers

Optos P200C scanning laser 200°technology; low-powered red (633 nm) and green (532 nm) lasers

Optos P200MA scanning laser 200°technology; low-powered red (633 nm); green (532 nm) and blue (488 nm) lasers

Optos North Optomap scanning laser 200°America Retinal Exam technology;

low-powered (633 nm) and (532 nm) lasers

Optovue, Inc. RTVue 840 nm 32 degrees x 23 degreessuperluminescent diode

Topcon Medical 3D OCT-1000 840 nm 45ºSystems superluminescent

diode

ALIGNMENTCOMPANY MODEL TYPE MONITOR

Marco SSC-350 stand alone; 1.1 meter n/atest distance from exam chair

M&S HACSS-Holladay Automated CSF system, n/aTechnologies Inc. Automated Contrast including hardware &

Sensitivity System software. Can be integrated with Smart System 2020 visualacuity system.

Precision Vision Chart (Cat. No. 2126) translucent letter n/aGlare Filter (Cat. No. 2147) chart; back-illuminatedLow Photopic Filter in portable(Cat. No. 2148) fluorescent light box

Precision Vision Portable Illuminated Cabinet back illuminated portable n/a(Cat. No. 914) fluorescent light boxETDRS Illuminator Cabinet(Cat. No. 2425)

Precision Vision Rabin Super Vision Chart Translucent letter chart, back- n/a(Cat. No. 2128) illuminated must be used withNVG Filter (Cat. No. 932) Cat. No. 914 cabinet. NVG filter

is used to simulate military night vision goggles.

Precision Vision Colenbrander Mixed Contrast Chart 4071 is a translucent letter n/aChart (Cat No. 4071) and chart, back-illuminated to be usedColenbrander Mixed Contrast with Cat. No. 2425 Cabinet. ChartChart (Cat. No. 4070) 4070 is an opaque mixed contrast

letter and text chart in near, computerand intermediate distance test

Precision Vision PVVAT (Cat. No. 6001 - 6008) Computerized Visual Acuity n/aSoftware with Contrast Sensitivity testing

Precision Vision IVA (Cat. No. 6100) Interactive Computerized n/aVisual Acuity Software withContrast Sensitivity testing

Stereo Optical Functional Vision Analyzer closed vision yesCo. Inc. tester w/EyeView

software

attracted by UBM studies and then won over by theimages. Manufacturers and users alike predict that UBMuse will increase as more doctors are exposed to thetechnology.

“This technology is the first and only complete ante-rior segment imaging device to evaluate anterior cham-ber anatomy, as well as the sulcus and ciliary body —places we can’t normally see,” Dr. Ahmed says.

“It’s become a very valuable and easy adjunct in sur-gical assessment. And the ClearScan cover has been ahuge improvement in convenience and patient comfort.”

Mr. Durante explains, “Differential diagnosis is easi-ly accomplished with UBM. The devices have becomemuch more user-friendly in the last 2 to 5 years, and thedevice’s multiple capabilities for many specialties areattractive to large and small practices alike.”

Mr. Dickerson agrees, adding that enhanced ease ofuse and financial incentives will give UBMs a boost.“The new ClearScan cover eliminates the drawbacks ofthe old scleral shell, or shell-and-gel technique, in termsof setup, patient comfort, procedure time, safety andsterility,” he says.

“And not only is this a Medicare-reimbursable pro-cedure, it also will help doctors better determine if andwhen they should refer patients.”

Dr. Fram has seen that UBM technology helps keeppatients — and billable services — inside her doors. “It’samazing to have this technology,” she says. “Previously,we’d have to send these cases to a university for testing.However, now we can provide this state-of-the-art carein the private office setting.” OM

Figure 3. Reflex UBM from Reichert

For information on the latest OCT advances and h


JULY 2009 � 23-S

R E T I N A L S C A N N E R S

C O N T R A S T S E N S I T I V I T Y T E S T S

AREA OF RETINA PRINTOUTANALYZED DETAIL ADDITIONAL FEATURES

central pole & periphery; Includes image enhancements, such as area of interest Green laser scans from sensory retina to RPE; red laser scans from RPE to choroid; Proprietary review up to 200° internal scan; magnified; individual laser separations; image annotations software enables image magnification; contrast, brightness and gamma adjustment; annotation, notes; more than 80% of the & gray scale detail views, ResMax mode for enhanced individual laser separation views; P200 produces optomap® Retinal Exam procedures to support screening and retina w/standard gaze; central pole detail, as well as 3D Wrap patient orientaton wellness examinations (20 microns) and optomap® plus Medical Retinal Exam (17 microns) with enhanced up to 90% of the retina tool for enhanced patient education features supporting medically necessary reimbursable procedures.w/eye steering

central pole & periphery; Includes image enhancements, such as area of interest Green laser scans from sensory retina to RPE; red laser scans from RPE to choroid; Proprietary review software up to 200° internal scan; magnified; individual laser separations; image annotations & enables image magnification; contrast, brightness and gamma adjustment; annotation, notes; individual more than 80% of the gray scale detail views, ResMax mode for enhanced central laser separation views; P200 produces optomap® Retinal Exam procedures to support screening andretina w/standard gaze; pole detail, as well as 3D Wrap patient orientaton tool for wellness examinations (20 microns) and optomap®plus Medical Retinal Exam (14 microns, RexMax = 11 microns) up to 90% of the retina enhanced patient education with enhanced features supporting medically necessary reimbursable procedures.w/eye steering

central pole & periphery; Includes image enhancements, such as area of interest Green laser scans from sensory retina to RPE; red laser scans from RPE to choroid; Proprietary review software up to 200° internal scan; magnified; individual laser separations; image annotations & enables image magnification; contrast, brightness and gamma adjustment; annotation, notes; individual laser more than 80% of the grayscale detail views, ResMax mode for enhanced central separation views; P200 produces optomap® Retinal Exam procedures to support screening and wellness retina w/standard gaze; pole detail, as well as 3D Wrap patient orientaton tool for examinations (20 microns); optomap® plus Medical Retinal Exam (14 microns, RexMax = 11 microns) up to 90% of the retina enhanced patient education with enhanced features supporting medically necessary reimbursable procedures, and optomap® fa w/eye steering Angiography Procedure.

central pole & periphery; Includes image enhancements, such as area of interest Green laser scans from sensory retina to RPE; red laser scans from RPE to choroid; v2.1 software enables up to 200° internal scan; magnified; individual laser separations; image annotations image magnification; contrast; brightness & gamma adjustment; annotation, notes; individual laser separation more than 80% of the & grayscale detail views; Optomap® plus Medical Retinal Exam for reimbursable procedures.retina w/standard green gaze; up to 90% of theretina w/eye steering

Ganglion Cell Complex, Ganglion cell complex analysis, progression analysis, symmetry RTVue comes with the largest OCT normative database for glaucoma and retina, and with the exclusive RNFL, ppRNFL, retinal layers, analysis, retinal thickness, retinal layer segmentation, optic Ganglion Cell Complex (GCC) analysis. In addition to imaging and analyzing the posterior pole, the RTVue also optic nerve head, macula, nerve head analysis with parameters, 3D imaging, Normative images the cornea and anterior segment — all in one device.posterior pole Database comparison

Macula and retinal layers; Retinal thickness map; 3D; B scan; compare; fundus image; Only SD-OCT with an integrated non-mydriatic retinal camera. True 3-D view of the retina, featuring Topcon’sRNFL; RPE; ILM; IS/OS; retinal layer segmentation TrueMap™ software. Pin-point Registration™ allows doctor to map exact location of the OCT image with the Bruch’s membrane the fundus image. Comes with EyeRoute® On Board, Topcon’s image management system, pre-loaded on it.

CONTRAST DAY/NIGHT TARGET DAY/NIGHT GLARE SENSITIVITY TYPE ILLUMINATION LUMINANCE ADDITIONAL FEATURES

4 contrast levels on all available optotypes yes; normal and low Day & Night Monocular Wireless remote control; 27 chart types: letter, numbers, tumbling “E,” ETDRS, (Snellen, ETDRS, numbers, tumbling E and photopic luminance and Binocular glare; color, stereo, phorias, binocular balance children’s charts: ability to isolate single children’s charts) viewing conditions 3 glare levels character, horizontal line and vertical line on all. Compatible with EPIC or TRS

refraction system.

US Patent Number: 7,354,155.Sinusoidal day & night includes yes, 3 glare levels Fully automated system eliminates technician bias; includes Quick Test bulls-eye displayed at photopic (85cd/m2) NDF filter to reduce program for repeat patient screening thereby minimizing test time; automatic & mesopic (3cd/m2) levels. FDA luminance levels from data collection & export feature into M&S DataRight Services. Complies required protocol from 18 down to 85 cd/m2 to 3cd/m2. w/ANSI & ISO standards, FDA guidelines. Test time 5 minutes per eye.1.5 cycles per degree.

letter chart consisting of 20/50 letter yes; includes normal & yes; includes glare filter w/central Includes normative values & by-letter score sheet size at 13.1 ft.; contrast decreases low photopic luminance low luminance target surrounded for precise clinical & research applications.by row in 0.25 logarithmic steps viewing conditions by higher luminance glare

Wide selection of high and low The 914 Cabinet is self no glare Precision Vision’s 914 Cabinet is approved and presently the only illuminatedcontrast charts sold separately illuminated with ND filters cabinet used by all branches of the US Armed Forces. Portable and storage

available. The 2425 ETDRS pockets in back with an optional adjustable base. The ETDRS 2425 is usedCabinet is self illuminated at by the National Eye Institute and FDA-approved as the world’s first ETDRS160 cd/m2 with available illuminated cabinet for full and low contrast testing. Can be wall mounted or mesopic filter for 3 cd/m2. used with an optional adjustable base.

8 different Log CS levels plus no glare Developed by Jeff Rabin, OD, PhD, LTC US Army (Ret.). Charts are useful in high contrast acuity general practice and research.

High contrast (black) and Intended for use in no glare Developed by August Colenbrander, MD, this test provides high-contrast targets20% Weber low contrast well-lit offices on left and low-contrast targets on the right for fast and effective contrast

testing with uniform illumination and distance.

Highly adjustable contrast levels Self illuminated for use Glare source Precise calibration of contrast levels, brightness, sizes, and spacing in select-in 6 different optotypes crowded with or without lights sold separately able progression; logarithmic ETDRS or traditional Snellen on a high qualityor uncrowded in single presentation, display/computer. Complies with ANSI & ISO standards.one line or ETDRS chart layout

Multiple contrast levels in 6 different Self illuminated for use Glare source Automated, interactive computer program for determination of peak contrastoptotypes crowded or uncrowded in with or without lights sold separately sensitivity and a low contrast acuity at various contrast levels. A high qualitysingle presentation, one line or ETDRS display that is calibrated for low-contrast testing. Complies with ANSI & ISO chart layout standards.

3-choice, 5-frequency day & night homogenous day & night binocular glare testing Features distance/near lens system; new unsurpassed homogenous sine-wave (FACT) or illumination (continually 2 glare levels (continually calibrated illumination; only new vision tester that complies w/American National low-contrast letters (CAT) calibrated to ensure accuracy) to ensure accuracy) Standards Institute std. Z80.21-1992 (R1998); includes EyeView software

demonstrating contrast sensitivity results by pictures.

nd how to incorporate this technology into your practice, see article beginning on page 20


MEASUREMENTCOMPANY MODEL TYPE RANGE

Canon Medical TX-F Full Auto fully auto- 0 to 60 mm HgSystems Tonometer mated; just

press start

Gulden Schiotz contact 0 to 127.5 mm HgOphthalmics

Haag-Streit USA Goldmann Applanation applanation 0 to 80 mm HgTonometer AT 870

Haag-Streit USA Goldmann Applanation applanation 0 to 80 mm HgTonometer AT 900

Haag-Streit USA Perkins Mk2 Handheld applanation n/aApplanation Tonometer

Keeler Pulsair Easy Eye noncontact 7 to 50 mm HgInstruments Noncontact Tonometer

Kowa KT-800 Noncontact noncontact 0 to 60 mm HgOptimed Inc. Tonometer

Kowa HA-2 applanation 0 to 60 mm HgOptimed Inc.

Marco M3 noncontact 0 to 60 mm Hg

Marco NT-510 noncontact 0 to 60 mm Hg

Paradigm Medical Ocular Blood applanation IOP measurement: 6Industries Flow Analyzer high: no upper limit

(BFA)

Reichert Model 30 contact 5 to 80 mm HgOphthalmic Pneumatonometer applanationInstruments

Reichert Ophthalmic Tono-Pen XL contact 5 to 80 mm HgInstruments applanation

Reichert Ophthalmic PT100 Portable noncontact 0 to 60 mm HgInstruments NTC

Reichert Ophthalmic ATP Auto noncontact 0 to 60 mm HgInstruments NCT/Pachymeter

Reichert Ophthalmic Ocular Response noncontact 1 to 60 mm HgInstruments Analyzer

Reichert Ophthalmic Tono-Pen AVIA contact 5 to 55 mm HgInstruments applanation

Reichert Ophthalmic Reichert 7 noncontact 7 to 60 mm HgInstruments (ISO 8612 tonometer standard)

Shin-Nippon B-45 applanation 0 to 80 mm Hg

Shin-Nippon C-84 applanation 0 to 80 mm Hg

Topcon Medical CT-80 noncontact 0 to 60 mm HgSystems

Woodlyn Inc. #44000 R900 applanation/ 0 to 80 mm HgGoldmann

Ziemer Ophthalmic PASCAL Dynamic contact dynamic 5 to 200 mm HgSystems Contour Tonometer color

Ziemer Ophthalmic Wireless PASCAL contact dynamic 5 to 200 mm HgSystems Dynamic Contour color

Tonometer

24-S � JULY 2009


ALIGNMENTCOMPANY MODEL TYPE MONITOR

Stereo Optical Optec 5500(P) stand-alone yesCo. Inc. vision tester;

requires 2 sq. ft.

Stereo Optical Optec 5000(P) stand-alone yesCo. Inc. vision tester;

requires 2 sq ft.

Stereo Optical Optec 1000P stand-alone yesCo. Inc

VectorVision Inc. CSV-1OOO stand-alone; 8 to 4 meter 3 choice;test distance from exam 4 frequencychair; non-view-in sine wave

Several ultrasound biomicroscopes (UBMs) are currently on the market, providing variety in terms ofportability and features.

• Aviso (Quantel). The Aviso has many ergonomicfeatures to facilitate image acquisition, such as theintuitive, accessible controls and a touch screen. Itssoftware also helps technicians make measurements,marks and comments.

Two proprietary software features, Cineloop andVarigain, provide automatic image recording andadjustable gain on images, respectively. The Aviso isalso portable, so eyecare practitioners can move itbetween clinics if necessary.

• Reflex UBM (Reichert). Reichert describes theReflex as “ultra-compact” and “ultra-easy.” Theseterms reflect the device’s compact size and easysetup, as well as its touch-screen interface for analysistools (a keyboard and mouse are also included). Likemany new devices, the Reflex has software toolsdesigned to make data and measurement acquisitionachievable without extensive training.

The probe design of the Reflex enables techni-cians to perform the scan without a water bath,while the patient sits or reclines, and a foot pedalenables hands-free image acquisition. The Reflexhas a 35 MHz or 50 MHz transducer. The Reflexrecords 60 seconds of data per eye and six imagesper scan, and users can export files in AVI, JPEG orDICOM formats.

• UBM Plus (Accutome). Most UBMs have a cart,an arm and a monitor, but in the UBM Plus, all of theultrasound technology is contained in the freehandprobe, which connects by wire to a laptop or desktopcomputer. According to the manufacturer, this elimi-nates signal loss for sharper images, and the device’s15-micron electronic resolution is the highest available.

The UBM Plus utilizes what Accutome calls SmoothZoom technology, which performs 2x full image zoomeither during a scan or when you review the imageslater. You can also capture 34-second film loops.

Doctors can use built-in report templates, easilyprint or share information, and store images compact-ly. Accutome continually enriches its software andworks to make the UBM Plus easy to use.

• VuMax-II UBM (Sonomed). The PC-basedVuMax-II system has an 18.5-mm x 14-mm deepscanning field to capture the entire anterior segmentin one scan, which enhances intraocular measuring.Technicians can take 45-second video, adjustingfeatures, such as gain, TGC, contrast, zoom andfreeze. The UBM also exports both AVI and JPEG fileformats.

Like all imaging devices today, UBMs require theright software to help doctors interpret vast amountsof data. For the VuMax-II, this includes software,such as post-processing tools, auto measuring andimage-enhancing focus software. In addition, theVuMax-II’s handpiece can be used with a 35 MHz or50 MHz transducer.

What Are Your Choices?


ALIGNMENT PORTABILITY/WEIGHT OPTIONS SPECIAL FEATURES

full auto/ 45.2 lbs. Up to 10 measurements per eye; includes automatic shifting between 30/60 mm Hg; IOP warning; extremely manual soft air puff; RS232C data output.

manual 0.5 lbs. Very portable; lightweight; great for emergency use; inexpensive; durable.

manual slit lamp mounted

manual slit lamp mounted

manual handheld

manual yes, weighs less carrying case; Wall, desk or slit-lamp mountable; accuracy within ±0.6 mm Hg Goldmann, Soft Puff technology &than 9 lbs. rechargeable battery built-in printer.

3D automatic tabletop/instrument optional 3x long eye relief 3-D auto alignment function; soft airflow, no measurement range switching; eyelid obstructionalignment stand 39.6 lbs. for presbyopic users monitor; electronically operated chin rest; built-in video camera & TFT color 5.6 monitor for ease of use.

manual handheld/battery optional 3x long eyeoperated 0.53 lbs. relief for presbyopic users

manual or desktop unit Softer air puff; measures pupil size & corneal size; autorefractor/keratometer, adjustable monitor; motorized automatic automatic (55 lbs.) chin rest; high speed measurements; interfaces w/EPIC, TRS & Evolution.

manual or desktop unit (42 lbs.) printer, rechargeable Advanced soft-air pulse control; automatic safety lock.automatic battery comes std.

manual portable; console: 12 lbs. printer; slit-lamp Identify POAG & NT; identify glaucoma suspects w/low pulsatile ocular blood flow (POBF); identify central retinal workstation: 23 lbs. adaptability vein occlusions; monitor & quantify the effect of glaucoma treatment plans; measure IOPs & POBF by volume;

monitor & manage current systemic drug therapy.

manual 12 lbs. tonography An easy-to-use instrument providing fast accurate tonometry & opt. tonography functions. The system measuresIOP in the range of 5 to 80 mm Hg. Forty readings per second are recorded & charted, including ocular pulse. The chart recorder produces a permanent printout of the desired test for patient files.

manual 2.25 oz. An easy-to-use portable, handheld instrument providing fast & accurate intraocular pressure readings w/accuracy comparable to the Goldmann tonometer. Harvesting data at a rate of 500 samples per second, the Tono-Pen gently contacts the cornea & displays the average of four independent readings, along w/a statistical coefficient.

manual handheld/portable; wireless IR printer; Cordless, wireless data transmission; patient eye illumination; demo puff; icon-based operating system; 2.7 lbs. carrying case; re- macroview of eye.

chargeable battery;charging base

automatic tabletop/instrument internal printer Includes built-in ultrasound pachymeter.stand 30 lbs.

automatic tabletop/instrument Measures IOP & Corneal Hysteresis (CH), the world’s first indicator of corneal biomechanical properties, & IOPccstand 30 lbs. (corneal compensated IOP), which is less affected by corneal properties than traditional methods

of tonometry.

manual handheld, portable n/a Portable, light & user-friendly. Provides fast measurements, strongly correlated w/Goldmann tonometry. 71 g. Long battery life, w/no need for calibration. Ergonomic design provides maximum comfort & ease

of use & large LCD screen display readings on both sides of instrument.

automatic tabletop/instrument internal printer Demo puff, icon-based operating system, softest puff in the industry, full auto-alignment and 1-touch operation.) stand 30 lbs.

manual slit lamp accessory, n/a Fits most tower-type slit lamps.1.42 lbs.

manual slit lamp accessory, n/a Fits most compact-type slit lamps.1.4 lbs.

manual/ about 18 kg or optional adjustable Built-in video camera & monitor; auto measurement, digital display & built-in printer; triple safety function; automatic 39.7 lbs. instrument table dual sensor system & 30% faster interval time.

manual mounts to slit lamp;1.33 lbs.

manual 1 lb. carrying case; rechargeable Provides highly accurate IOP; Ocular Pulse Amplitude & Quality score; IOP not affected by corneal biomechanical batteries properties; validated in in-vivo clinical trials; easy to use; www.pascal-tonometer.com

manual 1 lb. wireless printer; carrying Provides highly accurate IOP; Ocular Pulse Amplitude & Quality score; IOP not affected by corneal biomechanical case; rechargeable properties; validated in in-vivo clinical trials; easy to use; digital display w/option of using wireless printer; batteries EMR ready.

JULY 2009 � 25-S

T O N O M E T E R S & B L O O D F L O W A N A LY Z E R S

C O N T R A S T S E N S I T I V I T Y T E S T SCONTRAST DAY/NIGHT TARGET DAY/NIGHT GLARE SENSITIVITY TYPE ILLUMINATION LUMINANCE ADDITIONAL FEATURES

3-choice, 5-frequency sine-wave day only (factory calibrated); no glare Features distance/near lens system; choose from 150 different tests (FACT) or low-contrast letters (CAT) homogenous illumination that can include distance/near Snellen acuity (ETDRS format) color,

stereo test, lateral/vertical phoria & potential acuity.

3-choice, 5-frequency day only (factory no glare Features distance/near lens system; choose from 150 different tests sine-wave (FACT) or calibrated); homogenous that can include distance/near Snellen acuity (ETDRS format) color, low-contrast letters (CAT) illumination stereo test, lateral/vertical phoria & potential acuity.

3-choice, 5-frequency (FACT) day only (factory no glare Distance only w/Snellen acuity.or low-contrast letters (CAT) calibrated)

self-calibrated light self-calibrated light yes Wireless remote control; interchangeable test faces; everything instrument (patented) box (patented) from contrast gratings to pediatric symbols; ETDRS acuity.


Documents

SP0709 DIBG-OMD-0630:OMD-OM DIBG