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The Fusion of Imaging TechnologiesThe Fusion of Imaging Technologies
INTRODUCINGINTRODUCING
Spectralis is more than resolution …
Time Domain OCT SPECTRALIS
Spectralis is more than fast …
0 10000 20000 30000 40000
Time Domain
"3D OCT"
"FD OCT"
"HD OCT"
Spectralis 40 kHz = 100x Faster than time domain OCT
Spectralis is more then SD-OCT… Dual laser scanning system for
simultaneous imaging: Confocal Scanning Laser Ophthalmoscope (cSLO)
with up to 5 imaging modes: IR, FA, ICGA, AF, Red-free
Spectral Domain Optical Coherence Tomograph (SD-OCT)
Eye tracking: cSLO recognizes eye movements and guides
SD-OCT scanner to follow Allows repeat scans at exact same location
Spectralis is more than one view …ICGA Polypoidal Lesion
Spectralis is more than 3D …
Spectralis is knowing locationCross section scanReference scan
Eye MovementThe reference image tracks eye movement, and the cross section is moved to match
EYE TRACKING
Spectralis Tracks Change Over Time
Exam 1 Exam 2
Real-time alignmentCross section
scanned at same location
• Real-time alignmentCross section scanReference scan
EYE TRACKING• Accurate change measurement
Heidelberg Noise Reduction Technology
Multiple images are captured at the same location
“Noise” is identified as points not common to the set of images
The noise is filtered from the final image
Image 1 Image 2
Heidelberg Noise Reduction Technology produces high resolution, high contrast images with less “speckle”.
Simultaneous Imaging with Eye Tracking
What’s wrong with the old OCT?
Hidden artifact – structure may be different than presented
Not simultaneous – B-Scan may be in different location than reference image
No eye tracking – Not good for LASIK, not good for diagnostics
(S)low resolution – Layers hard to identify for computer algorithms
Old OCT Does Not Stop Eye Movement
While Time Domain OCT scans, the eye keeps moving
The black line is the camera’s perspective
The white line is the actual scan path
“Tracking the Optic Nervehead in OCT Video…” Koozekanani, et al, 2003
© 2003 IEEE
Old OCT Does Not Register Images
As the eye moves, so does the scan location
Software algorithms reconstruct the data
Software assumes the lines are straight and intersecting
Increasing Reports of OCT Artifact
Study % Artifact/Error
UCSD: Bartsch (2004) 42%
Duke: Ray (2005) 43%
USC: Sadda (2006) 92%
Bartsch et al. Optical Coherence Tomography: Interpretation Artifacts and New Algorithm. Proc. of SPIE. 2004 5370; 2140-2150.
Ray et al. Evaluation of image artifact produced by optical coherence tomography of retinal pathology. Am J Ophthalmol. 2005 Jan;139(1):18-29.
Sadda et al. Errors in retinal thickness measurements obtained by optical coherence tomography. Ophthalmology. 2006 Feb;113(2):285-93.
Eye Tracking Stops 3D Motion Artifact
Artificial ripples due to eye movements
Without Eye Tracker
True anatomic structure
With Eye Tracker
Spectralis Advantages
Eye Tracking – Every B-scan is simultaneously locked to a reference image
Up to 6 modes – Multiple perspectives of the anatomy from multiple wavelengths
40 kHz scanning – High speed helps overcome eye movement artifact and increases patient comfort
TruTrack™ – Image alignment compares reference location at baseline to follow-up
Heidelberg Noise Reduction Technology – Overcomes the limits of “resolution”
AF – Occult CNV
IR – Central Serous Chorioretinopathy
ICGA – RAP
ICGA – CNV with Choroidal Hemangioma
AF – Occult CNV
AF – Diabetic Retinopathy
6 Billing Codes (example for United States)
92135 Scanning Diagnostic Imaging 92235 Fluorescein Angiography 92240 ICG Angiography 92250 Red Free Fundus Photography 92285 External Ocular Photography 92287 Internal Eye Photography (Iris
Angiography)
Select From Three Versions
6 modes
SD-OCT
Infrared
Autofluorescence
Fluorescein Angiography
ICG Angiography
Red Free Photography
2 modes
SD-OCT
Infrared
-
-
-
-
5 modes
-
Infrared
Autofluorescence
Fluorescein Angiography
ICG Angiography
Red Free Photography
HEYEX Database
HEYEX Network Solution
IR FA IR OCT
HEYEX
Registration Link
Heidelberg Engineering Imaging Suite
IR IR OCT
HEYEX
FA Fundus
Registation Link
OCT
Red Free Autofluorescence
Infrared
ICG Angiography
Fluorescein Angiography
The Fusion of Imaging TechnologiesThe Fusion of Imaging Technologies