Single-capture, Ultra-widefield Retinal Imaging Is More Efficient – By Definition

Results from a recent publication call for the use of consistent nomenclature when describing the field of view captured by retinal images. The International Widefield Imaging Study Group has proposed the need for consistent nomenclature for widefield and ultra-widefield imaging based on normal anatomic landmarks. When describing the area captured by an imaging modality, it is important to be consistent in meaning so the capabilities of the technology are clear to the reader.

The panel defines ultra-widefield as images showing retinal anatomy anterior to the vortex vein ampullae in all four quadrants.  Widefield is defined as an image centered on the fovea and includes the retina in all four quadrants posterior to and including the vortex vein ampullae. The panel recommends this standardized nomenclature for use in future publications1.

Over the last decade, many large studies have underlined the importance of appropriately imaging the periphery to support the detection and management of disease in a variety of areas including telemedicine screening2,3,4, diabetic retinopathy5,6, age-related maculardegeneration7, vascular disease8, pediatric retinal disease9, inflammatory disease10,11,12 and even some systemic diseases.  Consistently, optomap imaging has been demonstrated to capture the widest field of view in a single capture of any imaging technology14,15,16,17.

“A single capture image which provides a view of the vortex veins in all four quadrants and beyond, thus meeting the widefield & ultra-widefield definitions, would offer enhanced efficiency in a real-world clinical setting versus a montage image, whether it be manual or automated.”   
— Netan Choudhry M.D. FRCS(C) DABO

Ultra-widefield by definition
optomap color and fa images demonstrating four (4) vortex ampullae which define the boundary between widefield and ultra-widefield.

Based on the panel’s findings, a single capture ultra-widefield (UWF™) retinal image, or an image with “no sweeps” can therefore provide enhanced efficiencies for practices and other clinical settings. As the ONLY single-capture UWF image to meet this definition, optomap, is the best choice for increasing efficiencies in your practice or other clinical settings.

Increase your practice efficiency and increase your revenue with optomap. No Sweeps = Increased Efficiency.

Read the full summary here: https://optos.is/NoSweepsUWF and then contact us to find out how to put optomap into your clinical setting.

Make Vision Expo West More “Efficient” with Optos

As the leaders in ultra-widefield (UWF™) retinal imaging technology, Optos would like to invite you to join us at the International Vision Expo West (VEW) September 18-21 at the Sands Expo in Las Vegas. Explore what’s new at Optos by pre-scheduling your demonstration or stop by booth #MS6051 during the event.

This year Optos is a sponsor of the “Battle at the Sands: Imaging Track” competition where industry leaders, such as Dr. Mo Rafieetary, will present complex patient studies where imaging played a key role in diagnosis and treatment (and compete for bragging rights). After the winner is crowned, please join us at the workshop Wednesday, September 18th from 5-7pm in room 505 at the Sands Convention Center. Seats are limited.

Optos will also be participating in the OCT workshop, and demonstrating the functionality of our Monaco device — the only clinically-validated, 200-degree UWF retinal imaging device with integrated OCT.  Monaco produces a 200-degree, single-capture optomap image in less than ½ second and also provides cross-sectional, 40-degree OCT views of retinal structures. Join us Thursday the 19th from 12:30-2:30pm and Friday the 20th from 12:15-2:15 in room 505 to explore the benefits of Optos UWF and OCT. 

Ultra-widefield with No Sweeps?  Yes, with optomap it can be done. optomap is the only ultra-widefield retinal image that can captures vortex ampullae in all four quadrants in a single-capture UWF image in less than ½ second.  Find us throughout the show at booth #MS6051 to find out how our no sweeps imaging can potentially make your practice more efficient. For more information regarding our offerings at VEW, or if you have any questions about our UWF retinal imaging please call 800-854-3039 or email us!

optomap Assists in Management of Age-related Eye Diseases

Age-related macular degeneration (AMD) is a leading cause of blindness in the United States, affecting most commonly, people over the age of 60 with increasing chances as you age, if you are overweight or if you have a family history of AMD.    

As we approach our golden years, we are at a higher risk for particular eye diseases including age-related macular degeneration, cataracts, diabetic retinopathy, glaucoma, as well as eye conditions such as dry eye and low vision.  More than 40 million Americans are currently 65 years or older, this number is expected to grow to more than 88 million by 2050 and not coincidentally, the number of Americans with age-related eye diseases is expected to double.  Early detection and treatment are key to saving sight.

For some, 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. 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.

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.

Although there have been many discoveries in the understanding of the causes of AMD, including links to genetics, there remains much unknown about this complicated, degenerative disease. With the advent of multi-modality ultra-widefield (UWF™) imaging, the retinal periphery has been able to be more easily studied in AMD to determine the value in the detection and/or monitoring of the disease.  Color optomap® imaging captures the structure and fundus autofluorescence (FAF) the function, of the Retinal Pigment Epithelium (RPE) which is where AMD manifests within the eye. Recent studies have revealed that 97% of patients with AMD have evidence of the disease outside of the central pole. This outcome demonstrated that drusen and reticular changes were seen in a majority of eyes, strongly indicating that AMD is more than a macular condition but one that involves the entire retina. This is being investigated in a further study that will determine whether these peripheral changes are associated with the progression of the disease.

optomap af image demonstrating AMD

Glaucoma is another leading cause of irreversible blindness in the US and around the world with more than 3 million Americans living with the disease, 2.7 million of them over the age of 40. While early detection is key to taking steps to prevent vision loss, glaucomatous vision impairment is irreversible.  Unfortunately, glaucoma can be asymptomatic until the late stages, at which time the prognosis is poor. 

The gold standard for detection and diagnosis of glaucoma is a clinical examination with dilated slit lamp biomicroscopy conducted by a glaucoma specialist.  However, this level of expertise is not always feasible or readily available to broadly evaluate an aging population. Exam efficiency has been increasingly addressed via use of color digital stereoscopic photography and/or retinal tomography via SD-OCT.

A recent study explored the potential suitability of ultra-widefield retinal imaging in supporting the diagnosis of glaucoma in situations where slit-lamp biomicroscopy or digital color stereoscopy are not available. The purpose of the study was to evaluate the reproducibility and validity of UWF in estimating Vertical Cup to Disc Ratio (VCDR) measurements and was the first study of its kind to explore whether optomap imaging could be suitable as a diagnostic support tool for glaucoma.

The study evaluated the data from color digital stereoscopic fundus images (CDS) and UWF images.  All the photographs and images were graded by two masked trained graders and one masked glaucoma specialist. The optomap images were graded using the ‘measure distance’ tool on the OptosAdvance™ software, to measure and record cup to disc ratio (CDR).

The study evaluated the data from color digital stereoscopic fundus images (CDS) and UWF images.  All the photographs and images were graded by two masked trained graders and one masked glaucoma specialist. The optomap images were graded using the ‘measure distance’ tool on the OptosAdvance™ software, to measure and record cup to disc ratio (CDR).

The study demonstrated an almost perfect agreement between CDS and optomap when assessed by the glaucoma specialist.   The study concludes that optomap imaging has a high reproducibility in evaluating VCDR and agreement with stereoscopic optic disc imaging and indicates that UWF imaging may be suitable for glaucoma evaluation in settings where CDS is not available.

Glaucoma optomap image courtesy of William Lesko, MD

Visit our website to review additional clinical studies and learn more about utilizing sight-saving optomap technology.

https://nei.nih.gov/nehep/ham

https://www.brightfocus.org/glaucoma/article/glaucoma-facts-figures

Children’s Eye Health and Safety Month – optomap Making a Difference

As we continue to recognize August as Children’s Eye Health and Safety month, it’s important to understand the importance of eye exams, and the utilization of the highest-level technology in pediatric screening.  Optos ultra-widefield (UWF™) imaging technology is making great strides in diagnosing and treating eye problems in children and infants. Due to the cutting-edge modalities and ease-of-operation with an optomap® exam, signs of retinal disease can be found in the periphery, often before children and infants become symptomatic.
 
Many vision problems begin at an early age, so it’s important for children to receive proper eye care.   optomap was founded by Douglas Anderson after his then five-year-old son Leif went blind in one eye when a retinal detachment was detected too late. Although his son was having regular eye exams, routine exams were uncomfortable, especially for a child, which made it impossible for the doctor to conduct a complete exam and view the entire retina. He set out to create a way of non-invasively capturing as much of the retina as possible.in a single capture. 


Results from several published clinical studies suggest that optomap is an essential element to the screening and management of pediatric patients.  While traditional fundus imaging is a multi-stage effort made more complicated by children and babies’ natural tendencies to become impatient during exams, an optomap images provides a view beyond the vortex vessels into the periphery in a single capture and without dilation, making the imaging process easier and faster.
According to a study published, as the leading cause of blindness in in babies and children, retinopathy of prematurity (ROP) is gaining the most advantage with the implementation of UWF technology. ROP generally occurs in premature babies (born at 31 weeks or less) that have extremely low birth weights (2 3/4 pounds or less). With advances in medicine, more premature babies are being saved earlier in the gestation period. The ease of obtaining high definition images and the ability to compare and contrast the findings remotely proved to be beneficial in clinical trials.  Optomap has been shown to capture up to 75% more abnormal pathology in pediatric patients unseen by traditional fundus imaging methods in ROP, uveitis, retinal vascular diseases as well as infection or trauma.  For additional information as well as continued study results.


For more information on Optos technology, we invite you to visit our website to learn how partnering with Optos can help your practice, contact us.

Back to School Checklist: Don’t Forget the Eye Exam!

With school starting up again, and lists including everything from the essential newest styles to school supplies – one item to make sure is on the list is your child’s comprehensive eye exam.  While we may notice subtle changes in appearance as our children grow and develop, there are many changes also occurring within the eye that are unseen.  This marks the importance of annual eye exams that will assist in monitoring the development of your child’s vision as they grow.  Routine vision screening or eye examination at an early age is very important to detect risk factors, such as lazy eye, crossed eyes, and color blindness that can potentially cause irreversible loss of vision or blindness.  A majority of vision impairment issues go undetected since young children with impaired vision are often unaware of their vision issues—it is, after all, how they’ve always seen things. It is on us as parents and educators to look for signs of visual impairment.

Although schools generally do some basic testing of children’s vision, there is no doctor to perform a comprehensive exam or diagnose problems with your child’s eyesight.  According to experts, nearly 90 percent of what is taught in school is done so visually, therefore without excellent vision, children are left at a disadvantage.  Those with poor eyesight may struggle with school and learning, leaving them unable to reach their maximum potential.  A yearly comprehensive eye exam can not only ensure your child’s vision is healthy or corrected, but also rule out diseases that can potentially lead to vision loss.

Many vision problems begin at an early age, so it’s important for children to receive proper eye care.  In addition to changes in the front of the eye, the back of the eye (the retina) should also be examined in order to rule out signs of damage or disease.  Many conditions, such as retinal detachments and retinal holes can be treated successfully if diagnosed early. 

In a recent optomap-related patient story, Dr. Nicolas Belill’s dedication to provide the utmost care to all of his patients by offering an optomap screening as a part of every exam, is highlighted.  A young patient, Josh and his mother went to see Dr. Belill for a routine eye exam, spurred only by Josh’s difficulty reading small print.  Josh showed no other symptoms, had no previous ocular issues and was in overall good health for a child of his age.

The optomap image revealed extensive hemorrhages and exudates in the periphery as well as very unusual looking vessels.  Dr. Belill initially suspected Coats’ Disease, a rare retinal disease that manifests in macular damage and vision loss, usually not caught until very late in the disease process.  Josh was immediately referred to a retinal specialist who confirmed the diagnosis.  Coats’ Disease tends to have a very poor vision prognosis, very often leading to eye enucleation.  In this case, where the evidence resided in the periphery, it could have been missed had the optomap not been done, potentially saving Josh’s vision.  Read the entirety of Josh’s story here.

Patient Story - Josh

Talk to your eye care professional about including optomap as part of the exam – it is a non-invasive option for your child and takes only seconds to get a highly-detailed view of the retina, which is critical for early disease detection.  The optomap image provides your doctor with an overview of approximately 200° or 82% of your child’s retina in a single capture, giving them a more detailed view than can be achieved by other means.   We all know children can be squirmy and may have difficulty sitting still for an eye exam, optomap exams are quick, easy and cause no discomfort on a child who would much rather be picking out his or her favorite back to school sneakers!