Tomography device enhances detection of retinal abnormalities

November 15, 2009

A newly upgraded spectral-domain, optical coherence tomography (OCT) device with a non-mydriatic, color fundus camera enables clinicians to detect retinal abnormalities often missed during routine patient exams.

A newly upgraded spectral-domain, optical coherence tomography (OCT) device with a non-mydriatic, color fundus camera
(3D OCT-2000, Topcon Medical Systems) enables clinicians to detect retinal abnormalities often missed during routine patient exams.

The new system builds on a predecessor platform (3D OCT-1000, Topcon) with an enhanced fundus camera and automated 3D OCT to produce high-quality OCT B-scan and 3D images.

Shipment of the device, which received 510(k) marketing clearance from the FDA in October, is planned to begin this month.

"I started using it on patients no matter what they came in for, and now it is a situation where I can't get along without it," he said. "It's really become normal for all of our patients."

Such a shift in his procedure happened after he had a patient about 2 years ago who underwent refractive surgery. The topography, slit lamp, and refraction were perfect, Dr. Durrie said, and the patient was seeing 20/20, but he complained that his vision was not crisp and sharp.

Dr. Durrie said he performed OCT and found an epiretinal membrane that he did not realize was there.

"It made me wonder: Wow, am I missing these? Do other patients have these? And the answer is yes, or retinal cysts, or other pathology," he said. "Using standard technology in screening patients, I would have missed it."

He said he has been using the original version of this system, launched in 2007, and he is looking forward to the improvements made in the new version.

Improved diagnostics

The all-in-one instrument's fundus camera features a high-resolution, 12.3-megapixel sensor (Nikon D-90) for high-quality images that allow clinicians to detect small hemangiomas to retinal hemorrhages and white patches, according to a prepared statement issued by the manufacturer.

With proprietary software (FastMap, Topcon), images can be viewed and compared with simultaneous visualization of OCT, fundus, and thickness map imaging for both eyes on the same screen or on serial exams from the same eye, according to the company. The software also can be used to create 2D and 3D videos.

The system also can be integrated with a proprietary ophthalmic image management platform (EyeRoute, Topcon) that allows images to be shared easily with fellow clinicians or viewed from home.

"The [device] was designed to provide the benefits needed in a real-world clinical practice," said Katrin Teigeler, vice president of marketing, Topcon. "It unites superb image quality and high performance with unique practical features to improve workflow while providing deep diagnostic insights."

Since the system combines the fundus camera and OCT, technicians do not have to move patients from device to device, saving time and convenience, Dr. Durrie added.

"People who are doing advanced elective surgery ought to be thinking that this is something that they ought to have," he said.