Optos, Vision Expo East, Clinical Insights on AMD, and #ProvenUWF

Join Us at VEE

Join Us at VEE!








The leaders in ultra-widefield (UWF™) retinal imaging technology, Optos, invite you to join us at Vision Expo East (VEE) March 15–18 in NYC.

Find out what’s new at Optos by pre-scheduling your demonstration or stop by our booth. Learn about our devices, software and imaging modalities that can help you diagnose and treat more ocular and systemic disease.  Throughout the show, Optos will be at booth MS4849. Be our guest in the exhibit hall at VEE 2018 by clicking this link to receive your complimentary pass.

Getting in early? Join us, Thursday, March 15th at the Lambs Club at 6:30 pm for our Clinical Insights on AMD panel discussion, moderated by Dr. Jeff Gerson, FAAO.

Key topics include:
• The epidemiology of AMD and the global burden of the disease
• Combining traditional retinal exam methods with new technologies to facilitate early AMD detection
• How to customize treatment plans for patients with exudative and non-exudative AMD
• Implementing evidence-based nutritional management when appropriate
• The roles of macular pigment optical density testing, OCT, and dark adaptometry in building a retina/AMD practice

If you have any questions about our UWF retinal imaging or our offerings at VEE, please call 1-800-854-3039. We look forward to seeing you at the show!

Be sure to visit us at other upcoming events this spring!


Ultra-widefield Autofluorescence Imaging: A Game Changer – Webinar Invitation

As an eyecare professional, providing comprehensive exams is tantamount to patient care. By adding tools, such as ultra-widefield (UWF™) retinal imaging with multiple modalities, the ability to detect pathology, which may be missed with single-image modality and/or conventional narrow-field fundus photography, is a game changer.


UWF retinal imaging is performed by a specially designed scanning laser ophthalmoscope (SLO) that generates a high-resolution digital image covering 200 degrees (or about 82 percent) of the retina, in a single capture. By comparison, conventional 7 standard field (7SF) ETDRS and fundus camera photographs produce a relatively narrow view (75 degrees or less) of the retina. The SLO simultaneously scans the retina using two low-power lasers (red – 633 nm and green – 532 nm) that enable high-resolution, color imaging of retinal substructures. The resulting UWF digital image – optomap or optomap af – UWF retinal imaging utilizing fundus autofluorescence (FAF), is produced.


What is Fundus Autofluorescence?


FAF, is an imaging modality used to provide information on the health and function of the retinal pigment epithelium (RPE). Over time, the retinal photoreceptors naturally age and produce a metabolic waste known as lipofuscin. Lipofuscin is the fatty substance found in the retinal pigment epithelium. Excessive amounts can be caused by the aging retina, certain retinal diseases and/or the progression of diseases.1 It has been thought that excessive levels of lipofuscin could affect essential RPE functions that contribute to the progression of age-related macular degeneration (AMD).2 These findings have also been shown to have prognostic value and help to predict which eyes are at greater risk of progression to advanced disease.3 Typically, FAF imaging has clinical applications in AMD, central serous retinopathy, choroidal tumors and nevi, inflammatory diseases, inherited disease, optic nerve head drusen, pattern dystrophies, retinal toxicity and retinal detachments. FAF excitation wavelength is between 480-510 nm, with an emission wavelength from 480-800 nm.4 optomap af uses a wavelength of 532nm to capture an image.


One of the main benefits of using the green wavelength, instead of blue, in FAF is its ability to see additional detail in the fovea, as the blue light tends to be absorbed by the high concentration of xanthophyll pigments. SriniVas Sadda, MD says this about FAF, “One advantage of longer-wavelength [green] light is that there is less absorption by the crystalline lens of the eye, which is quite autofluorescent with blue light, especially in patients with cataracts.”


FAF in Practice


Mr Simon Browning, has used optomap technology for nearly 20 years and was the first optometrist globally to use a Daytona. Since its installation, Simon has lectured at ARVO and the European Academy demonstrating how optomap af may be used to monitor regression of macular drusen in line with lifestyle and dietary changes. Simon believes ‘that optomap af is a game changer in optometry and that ‘optometrists are no longer required to fix a patients vision, but are there to preserve it.’4


Simon goes on to say, ‘Standard fundus imaging of the retina allows eyecare professionals to look at the structure of the retina, whereas optomap af imaging allows you to look at the functionality of the retina, often you will find that FAF imaging will show completely different images to the traditional colour image. Knowing this it allows eyecare professionals to react much faster to changes in the retina at a much earlier stage.’


Join Us for a Complimentary Webinar


optomap af imaging is a vital feature in monitoring and treating pathology in the retina, join us at 7pm AEDT (8am GMT) on Tuesday, 20th February for a free webinar hosted by Simon Browning to find out more about FAF imaging, identifying pathology using the FAF function as well as practice benefits.


Click here to register: http://Optos.is/ImagingEducation

1Holz, F. S.-V. (2010). Atlas of Fundus Autofluorescence Imaging. Heidelberg, Germany: Springer-Verlag.
2Delori, F. G. (2001). Age-Related Accumulation and Spatial Distribution of Lipofuscin in RPE of Normal Subjects. IVOS, 42(8), 1855-1866.
3Sadda, S. (October 2013). Evaluating Age-Related Macular Degeneration With Ultra-widefield Fundus autofluorescence. Retina Today.
4The Nuts and Bolts of Fundus Autofluorescence Imaging, 2017, American Academy of Ophthalmology.

Efficacy of Utilizing Ultra-widefield Retinal Imaging to Detect Peripheral Retinal Changes in Patients with Age-Related Macular Degeneration

A recent study (Friberg, Ophthalmology Retina) evaluated morphologic and angiographic changes in the peripheral retina associated with age-related macular degeneration (AMD) using ultra-widefield (UWF™) retinal imaging.  The purpose was to illuminate the potential value of using UWF optomap® imaging as a potential tool for detecting peripheral changes that could flag the early warning signs and/or progression of AMD.


AMD is a common eye condition that causes damage to the macula, and is a leading cause of vision loss among people age 50 and older. In some people, AMD advances so slowly that vision loss does not occur for a long time. In others, the disease progresses faster and may lead to a loss of vision in one or both eyes. AMD by itself does not lead to complete blindness, with no ability to see. However, the loss of central vision in AMD can interfere with simple everyday activities, such as the ability to see faces, drive, read, write, or do close work, such as cooking or fixing things around the house.1

optomap af image showing Wet AMD – Courtesy of Tim Steffens

As the disease progresses through the asymptomatic phase, it moves from Dry AMD to Wet AMD. In geographic atrophy (dry AMD), there is a gradual breakdown of the light-sensitive cells in the macula that convey visual information to the brain, and of the supporting tissue beneath the macula. In neovascular AMD (wet AMD), abnormal blood vessels grow underneath the retina. These vessels can leak fluid and blood, which may lead to swelling and damage of the macula. It is important to assess the risk of progression from the dry type to the wet type of the disease.


Earlier detection and treatment of AMD can prompt steps to be taken to help reduce vision loss and slow the advance of the disease.  This recent data suggests that the retinal periphery can exhibit some important morphological changes, such as peripheral drusen and reticular pigmentary changes, which are frequently connected with the wet form of AMD. Typically, disease progression has been documented using fundus cameras that image only about 45-50% percent of the retina. By using UWF for AMD evaluation, over 80% of the retina is now analyzed to record peripheral fluorescein angiographic changes in AMD patients.2


This cross-sectional study included:

  • 152 patients with clinical AMD and 150 healthy controls, without AMD.  Patients were 50+ years of age
  • Color optomap images were captured of each group and Fluorescein angiographic images of only the AMD group.
  • Morphological and angiographic peripheral retinal changes were studied per the frequency of their occurrence, the affected peripheral retina, and the localization of peripheral changes with regard to the eye equator.


The purpose of this clinical study was to compare morphological characteristics of peripheral retinal changes between AMD patients and a healthy control group, and to compare the peripheral retinal changes between the two (2) AMD types according to type, frequency, retinal periphery involvement, and localization of observed retinal changes in relation to the equator of the eye.



Color and FA images were graded by masked graders for the presence of:

  • peripheral reticular pigmentary changes
  • peripheral drusen
  • hyperpigmented changes, such as nevi and pigmented clumping
  • hypopigmented changes, such as atrophic areas or retinal pigment epithelium depigmentation.


The observed retinal changes were analyzed according to type, extent as measured in clock hours, and localization of changes with regard to the eye equator. Drusen, reticular pigmentary change, and paving stone degeneration occurred significantly more frequently in the subjects with AMD compared with the healthy eye control group and white without pressure degeneration was present in a high percentage of control subjects.



Retinal changes were observed peripheral to the equator in more than 40% of analyzed eyes in patients with and without AMD. And because of the increased retinal capture, it was demonstrated that 40% of drusen was detected via optomap imaging outside of the equator at 150 degrees, thereby intimating the successful efficacy of the use of UWF for detecting peripheral markers that may lead to AMD.


optomap UWF imaging is a proven tool for effective clinical decision making. More than 400 published and ongoing clinical trials, as well as thousands of case studies and testimonials, show the long-term value of optomap imaging in diagnosis, treatment planning, and patient engagement. optomap is a proven tool for effective clinical decision making. Add optomap to your practice today.

1Age-related Macular Degeneration, National Eye Institute

2Thomas R. Friberg, MS, MD, et al. Morphological and Angiographic Peripheral Retinal Changes in Patients with Age-Related Macular Degeneration. American Academy of Ophthalmology, Ophthalmology Retina Sept 2017

Can Ultra-widefield (UWF™) Retinal Imaging Replace Color Digital Stereoscopy for Glaucoma Detection?

Glaucoma is a degenerative, sight-threatening disease regarded as one of the major causes of blindness, accounting for an estimated 60  million people worldwide. By the year 2020 this number is thought to increase to around 80 million people globally.1

In a recent study2, the potential use of UWF imaging to detect glaucoma, and specifically to evaluate the reproducibility of measures of vertical cup-to-disc ratio (VCDR) using UWF, and the agreement between UWF and standard color digital stereoscopy (CDS), was conducted.

The purpose of this study was to evaluate the reproducibility and validity of UWF imaging in estimating VCDR measurements.

  1. Observational study
  2. 100 eyes from 100 consecutive patients using CDS and UWF
  3. Northern Ireland Cohort for the Longitudinal Study of Aging (NICOLA)
glaucoma, UWF

Glaucoma patient with optomap image (image courtesy of William Lesko, MD)

A factor to consider when estimating VCDRs using different ophthalmic techniques is the dimension of the image it produces. 3D v 2D, as well as image color affecting appearance for interpretation of cup depression and elevation and vessel contours. However, previous studies have reported on the value of non-stereo fundus images to evaluate disc cupping reporting no differences in diagnostic performance between monoscopic and stereoscopic images when detecting glaucoma.3,4

All color fundus disc photographs and UWF retinal images were graded by two masked trained observers and one masked glaucoma specialist. There was approximately one month between grading the first (CDS) and second (UWF) measurements to reduce the possibility of remembering previous data. Observers 1 and 2 regraded 50 optomap images to assess intra-observer reliability independently of each other. The outputs of both the cup and disc measurements were given in pixels. This was then divided in order to give the VCDR value.

The results of the study demonstrated almost perfect agreement between color digital stereoscopy and the optomap, an ultra-widefield imaging technique when assessed by a glaucoma specialist. It also showed the UWF technique was reproducible in VCDR estimates. Our data suggest that UWF imaging may be suitable for diagnosing glaucoma in situations in which slit-lamp biomicroscopy or digital color stereoscopy are not available. While clinical examination with slit-lamp biomicroscopy is the accepted gold standard, many clinics use digital methods for screening efficiency. Further research about the comparative diagnostic performance of UWF and other imaging technologies may be warranted. Read the full paper here

UItra-widefield optomap technology has been used in over 400 clinical research papers and peer-reviewed studies. Previous validation studies have also found clinical equivalence between UWF optomap imaging and traditional fundus imaging for the evaluation of diabetic retinopathy and age-related macular degeneration5,6.  Find out more about the clinical outcomes from optomap technology, on our website.

  1. Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol. 2006;90(3):262– 10.1136/bjo.2005.081224.
  2. Can ultra-wide field retinal imaging replace colour digital stereoscopy for glaucoma detection? Quinn NB, Azuara-Blanco A, Graham K, Hogg RE, Young IS, Kee F.
  3. Hitchings RA, Genio C, Anderton S, Clark P. An optic disc grid: its evaluation in reproducibility studies on the cup/disc ratio. Br J Ophthalmol. 1983;67(6):356– 361. 10.1136/bjo.67.6.356
  4. Sharma NK, Hitchings RA. A comparison of monocular and ‘stereoscopic’ photographs of the optic disc in the identification of glaucomatous visual field defects. Br Ophthalmol. 1983;67(10):677–680. 10.1136/bjo.67.10.677.
  5. Silva et al. Nonmydriatic Ultrawide Field Retinal Imaging Compared with Dilated Standard 7-Field 35-mm Photography and Retinal Specialist Examination for Evaluation of Diabetic Retinopathy. American Journal Of Ophthalmology, 2012
  6. Agreement between image grading of conventional (45°) and ultra wide-angle (200°) digital images in the macula in the Reykjavik eye study. Eye (Lond). 2010 Oct;24(10):1568-75.

Ultra-widefield Imaging Supports Practice Efficiency Across All Eyecare Settings

Ultra-widefield (UWF™) technology supports and enables practice efficiency for eyecare professionals across all settings1. The integration of optomap® technology as a routine diagnostic and screening tool has shown to improve workflow and increase service capacity within a very short time, according to many eyecare professionals. Its ease of use makes for a smooth implementation process, and clinically, optomap has been found valuable as documented in over 400 peer-reviewed papers. Further, optomap can facilitate timely referrals for clinical opinions, supporting earlier treatment interventions and promoting collaboration between a variety of healthcare professionals and eyecare professionals alike. These all equate to improved patient workflow, clinical accuracy, and timely diagnosis and treatment for patients2.

Practice Efficiency in all Eye Care Settings

In an attempt to improve patient flow in his practice, optometrist David Anderson (Miamisburg Vision Care, Ohio) invested in a Daytona from Optos and, found his expectations exceeded for efficiency and as a diagnostic tool. Dr. Anderson noticed that the addition of the optomap allowed for more proficient patient service, from start to finish. Likewise, ophthalmologist, Scott Segal, MD started using optomap imaging in his practice (Pasadena Eye Associates, Texas) four years ago. Within the first two weeks, it became an integral part of his practice and had positively impacted how he practiced medicine.

For the ophthalmology practice of Paul E. Tornambe (Retina Consultants, California), first-year incorporation of UWF into the practice resulted in a 4.4% increase in patient volume over the previous, which translated to $40,000 in incremental revenue; the second year by 7%. Ultimately, the total incremental revenue realized with the integration of UWF equated to roughly $76,000 per year.

Per Dr. Segal, from a practice efficiency standpoint, optomap technology is able to capture a “wealth of information in the shortest amount of time3.” The UWF™ imaging capability of the optomap has “…proven exceptional for acquiring images of peripheral pathology.” In less than a second, optomap is able to generate a 200° (82%), accurate, high-resolution image of the retina, through an undilated pupil in a single capture. From a clinical outcomes vantage point, optomap offers multi-modal functionalities that are able to characterize subtle retinal pathologies, which may have been missed using traditional retinal imaging modalities.

optomap provides consistency for accurate documentation, disease tracking and pre- and post-treatment imaging, across all eye care settings. By using UWF imaging, it is possible to follow disease progression over time, and when patients require a treatment such as photocoagulation, it allows the doctor to target specific areas rather than using the less effective type of blanket laser coverage.

Many eyecare professionals comment on the ease of use of optomap. Operating this technology requires minimal training, and images can be captured quickly and efficiently and then networked to a consulting room, ready for review. Optometrist Aaron Werner has a practice in San Diego where he utilizes his Daytona as part of his “pre-testing protocol with all patients”. This means that their images are ready to view as soon as the patients walk into the examination room. He adds that “The Daytona allows us to do a quick and thorough screening and assessment of the retina and decide if it requires further attention.” optomap facilitates a streamlined approach, and according to Dr. Anderson, “…allows patients to be seen in one seamless swoop.”

Dr. Anderson and his team encourage all patients to have optomap imaging. His practice has a 92% opt-in rate, which has had a significant, positive impact on patient flow, boosting practice capacity an extra five patients per day. With this increase in patient flow, there has been a correlated rise in pathology detection, particularly in asymptomatic patients.

UWF images can be transmitted in a matter of seconds, which makes for prompt clinical decision-making and disease management. Ophthalmologist Dr. Nikolas London and Dr. Werner both practice in the San Diego, California, area, and both use UWF imaging. They understand the value of working together to benefit their patients. Dr. Werner is confident that, should he find anything that may warrant referral, he “…can send him [Dr. London] a picture of the retinal image and get quick feedback.” If Dr. London feels the condition is urgent, they can “…start formulating a treatment plan before the patient even walks through his door.”

As a practice efficient technology, optomap is a win-win option for all eyecare professionals and their patients and, according to Dr. Tornambe, it delivers “…clinically-relevant information, more rapidly, in a more patient-friendly manner, and can make important contributions to multiple aspects of the efficiency challenge.” 

Increase patient throughput and practice efficiency in less than half a second, with optomap. Visit our website to learn more!


  1. Brian Kim MD, Kenneth A. Fukuda, OD, Karen P. Skvarna, OD – Ultra-Widefield Retinal Imaging Facilitates Integrated Eye Care. Use of optomap can identify more pathology and support efficient collaboration. Advanced Ocular Care, March 2017
  2. Paul E. Tornambe, The Impact of Ultra-Widefield Retinal Imaging on Practice Efficiency, USOR 2017;10(1):27–30
  3. Nikolas London, MD, Aaron Werner, OD, Tech Spotlight: Optos Ultra-Widefield Imaging Devices, July 6, 2016 – http://www.opthalmologyweb.com/Tech-Spotlights/188712-Optos-Ultra-Widefield-Imaging-Devices/