Ultra-widefield optomap Devices Continue to Set Doctors on the Forefront of Diagnostic Capability

For as long as Dr. David Way, OD, has been in practice, he has endeavored to employ frontline technology in the care of his patients. He explains that it was because of this he was an early adopter of optomap ultra-widefield (UWF™) retinal imaging technology.  Way is a big proponent of thoroughly examining the retina and aims to help patients understand the importance of comprehensive retinal exams.  “I help them to understand that the eye is the only part of the body that we can observe nerves and blood vessels without doing a CRT or an MRI; and that when I am examining them, I am checking ocular health, as well as, indicators of issues such diabetes, glaucoma, macular degeneration or hypertension”, explains Way.

Patients often refuse to be dilated because they are in a hurry, or simply want to avoid the discomfort. An optomap image, which can be obtained in a fraction of a second through an undilated pupil, allows them to receive a retinal exam without the perceived inconvenience. Over the years at Way’s practice, Spring Klein Vision Center, the acceptance rate for optomap is over 70% which has proved to be a revenue generator and a boon to practice flow.

 

Dr. Way started out in his private practice with optomap and later upgraded his device model to the Daytona, which quickly paid for itself. Dr. Way had no intention of upgrading again until he experienced the recently released Monaco, the first and only combined UWF and OCT device.   “When I saw what Monaco could do, I was floored,” Way explains. “I just knew I had to move forward with the purchase when I saw the multi-modality capabilities of Monaco. The fact that I can pull up color, autofluorescence and OCT on both eyes, at the same time, gives me a full spectrum view of the eye. The images are incredibly clear and detailed; even in the far periphery. The decision to purchase was really a no-brainer.”

Dr. Way stresses that the ability to walk into an exam room and immediately see all three modalities represented on the screen, enables him to make a quick initial assessment of how the exam should proceed. Way asserts that optomap technology has differentiated his practice for over a decade and that Monaco will continue to set him at the forefront of diagnostic capability in his area. “Patients notice the difference. If they come in and see our updated technology – and when they see and understand their own eye for the first time, they are probably not going to return to a practice without that capability. They request optomap when they return because they want the reassurance that their eyes are fine. Monaco solidifies that we are the upper echelon of practices that have the capability to image and compare year after year. I feel comfortable and reassured that I have provided the best care possible.”  Read Dr. Way’s full practice testimonial here

Monaco produces a 200° single-capture optomap image in less than ½ second and provides cross-sectional 40° OCT views of retinal structures. Monaco enables a rapid multi-modality capture featuring color, autofluorescence and OCT scans, for both eyes, in as little as two minutes.  UWF with integrated OCT saves time, space, and minimizes patient movement.  optomap images and OCT scans are correlated to facilitate pathology examination. Color, AF, and OCT images are shown in a single, comprehensive view on a single device.

Take advantage of Section 179 tax savings (US-based only) on any Optos ultra-widefield imaging device, including Monaco.  To learn more about Monaco, other ultra-widefield devices from Optos and how you can utilize Section 179 on the purchase of any new optomap device, visit our website.

optomap Aids Eyecare Professionals in Early Detection, Monitoring and Management of Diabetic Eye Disease

November is recognized as American Diabetes Month and Diabetic Eye Disease Awareness Month.  Diabetic Eye Disease Awareness Month aims to increase awareness of diabetes and diabetic eye disease and encourage people with diabetes to seek treatment for related vision problems.   According to Prevent Blindness America, Diabetes is now the leading cause of new cases of blindness in adults, and all people with diabetes are at risk for vision loss and blindness.

Diabetic eye disease refers to a group of eye problems that diabetic persons may face as a complication of this disease including:
Diabetic retinopathy
– A leading cause of blindness in American adults, it is caused by damage to the small blood vessels of the retina – the seeing layer of the eye.
Diabetic macular edema (DME)
 – A complication of diabetes caused by leaking blood vessels, which leads to fluid accumulation in the macula, the center of the retina used for central vision. DME can cause central vision to become blurry.
Cataract
– The clouding of the lens in the eye, which blocks or changes the passage of light into the eye. Cataracts can cause vision to become blurry.
Glaucoma
 – Optic nerve damage and possible loss of side vision, usually caused by increase in fluid pressure inside the eye.

Today, 3.6 million Americans age 40 and older suffer from Diabetic Retinopathy (DR), DR in its early stages has no symptoms as it begins to damage the small blood vessels in the retina, causing them to leak fluid and blood. As the disease progresses, blood vessels become blocked and they may rupture, or new vessels will grow on the retina, leading to vision loss. Treatments are available to help prevent and manage long term effects of the disease but are most effective when detected early.

 

David Brown, MD on UWF retinal imaging and its aid to advance the detection and management of diabetic retinopathy

Eyecare professionals can greatly enhance their ability to provide early detection of diabetic retinopathy with the use of ultra-widefield (UWF™) optomap technology.  optomap is specifically designed to provide an UWF image of the retina, and it is the only technology that captures 200-degrees of the retina a single capture and in less than ½ second. Because optomap images so far out in the periphery, where the damage from diabetic retinopathy often begins, it allows a clear look at the health of the retina in order to determine if there are any early warning signs of diabetic retinopathy. optomap can also be used to confirm a diagnosis, allowing eyecare professionals to initiate a plan of care as soon as possible.

In preventing vision loss in people with diabetes, primary interventions include regular, effective screenings to detect diabetic eye disease earlier combined with education to encourage patients to undergo yearly comprehensive eye examinations. Many clinicians agree that UWF is an important part of these examinations, this was discussed in an article by Dr. Paul Tornambe where he calls for the integration UWF imaging as both a practical and clinical asset to the management of patients with diabetes.  UWF continues to evolve to address specific patient requirements, including looking at non-mydriatic imaging alternatives which are also designed to be more time efficient. optomap is clinically proven as a leader in imaging patients with diabetes to support the detection of diabetic retinopathy and related diseases.

Visit our website to learn more about the clinical benefits of utilizing ultra-widefield optomap in your practice or clinic.

 

Sources:
https://www.friendsforsight.org/resources/eye-health-awareness/item/16-diabetic-eye-disease-month-november
https://nei.nih.gov/health/diabetic
https://www.visionaware.org/blog/visionaware-blog/november-is-diabetic-eye-disease-awareness-month-learn-more-about-diabetes-and-your-eyes/12
Paul E. Tornambe, MD, FACS. Cover Story – Ultra-Widefield Imaging: Advancing the Understanding and Management of Diabetic Retinopathy. Retina Today, April 2015 http://retinatoday.com/2015/04/ultra-widefield-imaging-advancing-the-understanding-and-management-of-diabetic-retinopathy

Optos Introduces Monaco – The only clinically-validated, ultra-widefield retinal image with integrated OCT

In 2000, Optos delivered the first and only retinal imaging device that could capture beyond the vortex vessels of the retina. The ability to clearly image that much of the retina—in one capture, and in less than ½ second—significantly influenced the way eye care professionals examined their patients’ eyes. The core technology is based on a scanning laser ophthalmoscope and a unique ellipsoid mirror that create a virtual focal point inside the eye to enable the single capture of the central retina and periphery. For color images, green and red lasers are engaged simultaneously to allow visualization of retinal substructures from the sensory retina and retinal pigment epithelium to the choroid.

Over the years, Optos has continued to develop its hardware and software platforms – most recently delivering Monaco, the newest device providing new ways to enhance clinical exams.  It is the only ultra-widefield (UWF™) retinal imaging device with integrated OCT. Monaco produces a 200° single-capture optomap image in less than ½ second and also provides cross-sectional 40° OCT views of retinal structures. Monaco enables a rapid multi-modality capture featuring color, autofluorescence and OCT scans, for both eyes, in as little as two minutes.  UWF with integrated OCT saves time, space, and minimizes patient movement.  optomap images and OCT scans are correlated to facilitate pathology examination. Color, AF, and OCT images are shown in a single, comprehensive view on a single device.  The introduction of Monaco further differentiates Optos’ products with continued ease of use and speed of capture. OCT scans available with the device are: Line Scan, Raster Scan, Retina Topography Scan, Optic nerve Head (OnH) Topography Scan, and Retinal nerve Fiber layer (RnFl) Scan.

Optos technology has been a valuable asset to Werner Optometry in El Cajon, California for some time now.  Aaron Werner, OD joined his father, Rex Werner, OD, in the practice and has watched the technology improve immensely over time.  When given the opportunity to present Monaco in their practice, Dr. Werner knew this was the technology they had always wanted.

Dr. Werner was most surprised by how much time he saved in the exam room.  “There were efficiency scales that I never realized I could reach.  Think of the time it takes to settle a patient for an optomap, then walk the patient over to the OCT, re-enter data and then re position the patient.  It took about five minutes per patient,” he says, noting those some often take longer.  Dr. Werner adds that saving several minutes per patient allows space for an additional exam slot or two in a busy practice, but he himself appreciates the more advanced diagnostics he can get for all patients.

Dr. Werner, among many others, often feel there is never enough time to do everything the doctor wants to do during a visit.  “That’s at the top of the list.  We all think that if we had more time, we’d be able to do more.  The genius of combining and OCT with optomap imaging is really the way to get that time.”

Monaco, he says, is that rare combination of equipment that helps the staff save office time without compromising any of the quality or value of the exam.  In fact, it heightens it because it provides him with so much data before he even enters the exam room.  Monaco has also provided Dr. Werner with an excellent education tool.  “I am no longer a data collector in the exam room.  I have the data presented to me so that I can look at the results, interpret them and make a professional judgement on which direction we’re going to go. “Patients appreciate learning not only their retina anatomy but are also intrigued that the eyes can give so much data about their overall health.   Read Dr. Werner’s full testimonial here

To learn more about Monaco and other ultra-widefield devices from Optos, visit our website or contact us to discuss offerings with your local Optos representative.

The Retina – A Window to Alzheimer’s Disease

In a novel study from Queen’s University Belfast, researchers demonstrate that the eye could be a window to the brain. The results of the study, recently published in the Journal of Ophthalmic Research, show how degenerative brain diseases such as Alzheimer’s Disease (AD) can be monitored via ultra-widefield (UWF) retinal imaging.  The retina is a part of the central nervous system and shares structural and functional features with the brain. Altogether 59 AD patients and 48 controls were entered into the study.  They were imaged utilizing ultra-widefield imaging from Optos.  This advanced technology, using red and green lasers, captures a 200 degree, high-resolution digital image of the retina in less than ½  second, reaching regions of the retina that have been previously inaccessible with other methods of imaging.

Measuring biomarkers, such as drusen and vasculature width gradients in delineated quadrants of the retina, the researchers found that these changes, particularly in the peripheral retina, could be associated with degenerative brain conditions such as AD. Specifically, the markers that were chiefly considered were drusen and vasculature changes. Drusen are deposits of fats, minerals, and proteins and are normal symptoms of aging that appear as yellowish spots in the layer beneath the retina.  While they are harmless and typically begin to appear after the age of 40, an increased occurrence in number and size can contribute to the degeneration of the retina.  In the study, at baseline and follow up, the optomap images revealed that drusen accumulation, particularly in the superior nasal quadrant, were increased and significantly associated with positive AD status as compared to the number of drusen that would be normally expected in the control group. An additional novel element of the study was that by utilizing the UWF view of optomap, the width gradient of the vasculature could be observed in entirety from the macula to the far retinal periphery.  The study found that people with AD have blood vessels that are wider closer to the macula and thin as they progress further into the periphery.  This can impede the flow of blood and the essential delivery of nutrients and oxygen in the periphery, leading to further damage.

The team, led by Dr. Imre Lengyel of Queen’s University, hypothesized that changes in the peripheral retina could be important to explore the association between the eye and the brain. They concluded that their research supported their original hypothesis and that UWF retinal imaging has significant potential for monitoring AD and other degenerative brain diseases via the eye.  Utilizing optomap to evaluate progression of AD may bring important value to this effort because changes in the eye are easier to measure in relation to other methods necessary to evaluate the health of the brain.  Establishing an evidential correlation between the eye and the brain would suggest that utilizing UWF imaging could provide an easier, more expedient access to that information.  Furthermore, UWF imaging provides a much less expensive option to other methods of evaluation, such as brain scans. The researchers demonstrated that by utilizing optomap, they were able to identify early markers that could manifest many years before dementia develops as well as high risk groups who would benefit from preventative guidance. The study notes that to be a reasonable marker of early disease, pre-symptomatic, or early symptomatic patients would need to be followed up over several years to determine the predictive value of the peripheral findings.  Routine optomap exams could prove to be an earlier, easier and more cost-effective method for monitoring the progression of AD, and identifying individuals at high-risk of developing AD.

Grading of vascular parameters on UWF imaging.

Read the Full Article here….
Or visit our website to learn more about clinical studies utilizing optomap technology.

 

optomap Screening Reveals Cataract in Unsuspecting Doctor

While the exact causes of cataracts are still not entirely understood, annual eye exams are still important for the diagnoses and treatment of their formation.  Even with precautions and regular exams, by the year 2020, more than 30 million Americans are expected to develop cataracts.

Most cataracts occur gradually as we age and don’t become bothersome until after age 55. However, cataracts can also be present at birth (congenital cataracts) or occur at any age as the result of an injury to the eye (traumatic cataracts). Cataracts can also be caused by diseases such as diabetes or can occur as the result of long-term use of certain medications.  While typically forming in both eyes, cataracts may not grow at the same rate. They can develop slowly or quickly, or progress to a certain point, then not get any worse. As a result, one may not notice substantial changes in their sight. Sometimes they can significantly precede symptoms and can be so subtle as to go unnoticed without a comprehensive eye exam.

Read Dr. Young’s full testimonial by clicking on the image above.

When Vince Young, OD introduced Daytona, into his practice, he volunteered to be the imaging guinea pig while his staff trained on the device.  He was unnerved when he reviewed his images and somewhat uncertain about what he was seeing.  He knew what a posterior subcapsular cataract (PSC) looked like through the slit lamp but was surprised by what the optomap image revealed. Concerned, Young sent the image to his wife, Lindsey Brewer Young, OD. When she reviewed the image on her phone she immediately responded, questioning whose eye she was reviewing.  Learning it was her husband’s image she returned to the clinic, conducted a dilated exam, and confirmed that it was indeed a PSC that had been revealed in the optomap image.

At 40 years old, Dr. Young had no reason to suspect he would have cataracts as they are more typically associated with the elderly population. He also exhibited no symptoms or clouded vision.  A subcapsular cataract occurs at the back of the lens and can be caused by a variety of circumstances such as systemic issues and some forms of medication. PSCs are also more difficult to remove due to adhesion of the cataract to the lens capsule as well as an increased risk of capsule rupture during removal. However, Young’s cataract surgery on both eyes was successful and today his vision is fine.

Young reports that while this initial training episode was distressing, the image itself has become an excellent tool in communicating the importance of optomap and comprehensive exams to his patients.  The image hangs in the exam room and Young and his staff frequently share the story. “If the doctor didn’t know he had a cataract, how would anyone else know?” they say, underscoring the value of retinal screening. The unusual story has assisted with the elevated level of acceptance the optomap imaging has had in Young’s office.

Young stresses that the exam experience has changed with optomap in an extremely valuable way when it comes to patient education. optomap enables him to help his patients understand exactly what is occurring in their eye, or even just to provide reassurance that all is well. “Even if there is no pathology, patients want me to take the images every year. They want to see what I see.”

Dr. Young’s story demonstrates that it is not only possible for practitioners to image themselves and discover retinal pathology but also discover if significant opacities reside in the media as well.  The importance of regular, annual comprehensive eye exams cannot be expressed enough in the discussion of eye and systemic health. Visit our website to learn more about the benefits of optomap in protecting your eye health and to find an eyecare provider who used optomap technology in their practice.