For the spectralis oct heidelberg engineering, the quality score should be greater than or equal to 20. Not only does it supply you with barsetting imagery, it delivers detailed diagnostic and change analyses you can rely on time and again. Cirrus hd oct is the spectral domain oct system developed by carl zeiss meditec dublin, ca. Carl zeiss cirrus hd oct have two models, model 400 and model 4000 which capable of anterior segment imaging and offer the same package of glaucoma and retina analyses. Second, none of the figures have identifiers arrows, and the like to identify the features being described. Purpose to compare the quality of four oct angiography oct a modules. Since 1991,1 oct has undergone rapid evolution for use in detection and monitoring of glaucoma and macular diseases.
The devicesoftware generated enface oct a images of the superficial scp and deep. Introduction to oct optical coherence tomography scans. Cirrus hdoct is the spectral domain oct system developed by carl zeiss meditec dublin, ca. For these reasons, we chose to use images rendered with a cirrus 5000 and cirrus photo in this article. All systems inner reference boundary is at the internal limiting membrane, but each varies in the outer reference boundary. How to read printout of cirrus oct and optovue oct glaucoma report. In macular thickness analysis by stratus oct central 3 mm. Ophthalmic professional whats new in oct technology. The most important point here is the ability to perform rnfl analysis with a.
Utilizing oct for glaucoma diagnosis and management. This device is the first fda approved oct angiography technology and is meant for use in diagnosis and testing for patients with ocular diseases such as cataracts or glaucoma. Oct can provide visualization of surgical outcomes, confirming reattachment and normal contour. To help, heres a look at the latest advances from key players in the oct category. Zeiss have agreed to write, publish and distribute this book free of charge. Clinical use of oct in assessing glaucoma progression. Guide to interpreting spectral domain optical coherence. Optical coherence tomography information can be compared from one time instance to the next by repeatedly scanning the same region of tissue. Spectraldomain cirrus highdefinition optical coherence. The first commerically available oct was based on timedomain technology td. Oct is also helpful in distinguishing macular holes from lesions such as epiretinal membrane with a pseudo hole, and it can readily identify stage one macular holes, dr.
Secrets to success knowing the advantages and potential pitfalls of this technology can help you make it an effective diseasemonitoring tool. Interpretation of optic coherence tomography images. However, there is no labelled figure showing the layers of the normal retina and choroid. One of the newer and very promising devices approved by the fda is the zeiss cirrus hd oct for angiography. Technolog today o ptical coherence tomography oct has become an important tool for the clinical evaluation of the optic nerve and retina. Optical coherence tomography angiography operates under the basic assumption, which is an over simplification, that the. A complete list of ocular diseases with optical coherence tomography oct. Retinal oct imaging ophthalmic photographers society. Currently, due to the development of this technology and its wide use, new oct findings have been reported in the literature. Beginning with an introduction to the principles and interpretation of oct angiography, the book covers operating principles, recent advances, the. The current level of medical innovation in the device and drug space is unparalleled and extremely exciting. Finally, he finds oct to be a useful teaching device. The zeiss cirrus hd oct and the zeiss cirrus photo are both straightforward to use but produce high quality and reproducible images.
Oct tutorial on interpreting cirrus oct macular scans lee vien. Optical coherence tomography spectral domain oct interpretation case series. Along with its small footprint and fast capture speeds, cirrus is designed to improve workflow efficiency while helping you deliver better care to. The integrated rnfl thickness deviation map shows deviation from normal rnfl thickness map also displays cup and disc mask optic nerve head calculations are presented in a combined report with rnfl thickness data. Although oct dates to the early 1990s, the introduction of the stratus oct carl zeiss meditec in 2001the original timedomain technologymarks when oct became widely accessible. Oct interpretation jamin brown, md retina vitreous associates of cny december 6th 2014. The book presents the diagnosis and management of glaucoma, age related macular degeneration, the integration of oct and fluorescein angiography and the diagnosis and management of ocular tumors. This new diagnostic tool complements, and in part replaces, fluorescein angiography. Before using the cirrus hdoct, you must fully understand potential safety hazards. Optical coherence tomography in glaucoma a practical guide.
For years, doctors have asked for the operational capability to analyze data from their humphrey field analyzer hfa using a mac or pc. Cirrus oct sensitivity and speci city for average rnfl. Cirrus hd oct analysis reports offer clinically relevant qualitative and quantitative information in an easytoread format. Focusing on three commonly used oct platforms in the united states, a signal strength equal to or above 6 is desirable for the cirrus hd oct carl zeiss meditechowever, an 8 or above is even better, he said. There are normals for ocular structures deviation from the norm abnormality pathology being able to discern differences in reflectivity, morphology and qualitative measures either from normals or from previous scans is the essence of oct interpretation. Carl zeiss cirrus hd oct 4000 analyses glaucoma and retina with modern integrated design, ease of use, and small footprint with the smaller budget designed cirrus hd oct 4000 focused on the essential core oct functionality. Oct scanning northern eye surgeons uses the stateoftheart spectral domain zeiss cirrus oct scanner. Perform a variety of scan types using techniques to optimise clinical workflow and scan quality. Interpretation of oct differentiate between inner and outer retinal disease as first step interpretation of oct. Have a basic understanding of spectral domain oct technology. This interpretation guide explains various areas of each report and the valuable information they provide for a doctors clinical assessment. Redfree fundus photographs of the posterior pole by stereobiomicroscopy or with digital redfree photography can aid in evaluating the rnfl.
Immediate postsurgical imaging can sometimes be challenging due to ocular turbidity that can result in significantly reduced oct signal strength. Redfree digital photograph of a left eye with a rnfl defect located superior. Ideal at any stage of your career, this easytouse, clinically oriented handbook provides a quick, templated, and portable guide for the interpretation of optical coherence tomography scans. We use a logical method for interpreting oct images. First, the authors purport to take a systematic approach to sd oct scan interpretation. Cirrus hd oct, spectralis, 3d oct, rtvue100, spectral oct slo and soct copernicus hr. Understand the various analyses of the cirrus hd oct and how they can be applied for different patient types and investigations. Clinical interpretation of oct in glaucoma diagnosis. Today, optical coherence tomography has become a standard tool for diagnosing and monitoring glaucoma. Overall, for all grades of media clarity, the macula was interpreted as normal in 30 eyes 58. Optical coherence tomography oct is a noncontact optical technique that allows imaging and measurement of the retinal nerve fiber layer rnfl. Advanced rpe analysis with cirrus oct tracking of drusen and disease of the rpe as well as atrophy july 2011 july 2012.
If change is outside the range of expected variability, it is identified as progression. The stratus td oct also called oct 3 has been implemented in many. Spectral domain optical coherence tomography sd oct is a common useful noninvasive imaging instrument which is used for the diagnosis and followup of macular disorders. Guide on how to interpret cirrus oct macular scans. The analysis report varies with different oct systems. Pdf optical coherence tomography in glaucoma researchgate. This monograph aims to give an update on the use of oct in glaucoma and pathologies of the optic nerve. What oct tells us about progression oct has made strides as an objective measure of progression, but it still has limitations. To evaluate a new automated analysis of optic disc images obtained by spectral domain optical coherence tomography sdoct. Use of diagnostic imaging in glaucoma 2015 michael chaglasian, od 5 cirrus rnfl and onh analysis elements oct en face fundus image shows boundaries of. Next, the rnfl deviation map is examined for signs of thinning emanating from the superior and inferior poles of the optic nerve. The clinical findings by oct in these pathologies are well known. The cirrus oct s guided progression analysis feature attempts to highlight significant variances in key structures over time in an effort to detect glaucomatous damage.
Event analysis assesses change from baseline compared to expected variability. Signal strength important factor when analyzing oct scans. The current version was introduced in 2007 and has evolved over the last 10 years with hardware and software upgrades such as macular. The second phase combines these fine details to arrive at a synthesis. The aim of this study is to determine which parameter of cirrus and rtvue optical coherence tomography oct has the highest. The stratus td oct carl zeiss meditec, usa can scan resolutions up to 10 microns. Cirrus zeiss tm hdoct is an advanced technology in glaucoma research which is. A complete list of ocular diseases with optical coherence. Oct today for now, oct is most useful when a patient is either a glaucoma suspect or has earlytomoderate disease, as a tool for helping to detect damage and progression or conversion from glaucoma suspect or ocular hypertensive to glaucoma. Retinal nerve fiber layer imaging with spectraldomain. Through acquisition software and more advanced hardware, oct angiography enables imaging of the retinal vascular flow. Optical coherence tomography this is what we got 5. Of these two devices, only the cirrus hd oct provides statistical analyses for progression detection. Signal strength and must be greater than 610 with the cirrus hdoct.
The content of this book presents the viewpoint of the author and do not necessarily. Comparison of automated analysis of cirrus hdoct spectral. The fundus image acquired with the model 500 will be captured at. Page 1 cirrus hd oct 5000 and 500 technical specifications. Retinal nerve fiber layer rnfl evaluation is an essential component of a comprehensive glaucoma evaluation. Oct in glaucoma diagnosis, detection and screening intechopen. Role of optical coherence tomography in the evaluation and. They have also requested greater integration of hfa and cirrus analysis data in a single report. With guided progression analysis gpa, cirrus hdoct can aid in the identification of glaucoma progression through rnfl thickness event analysis and trend analysis. Optical coherence tomography for glaucoma diagnosis. Physicians should begin by assessing the retinal nerve fiber layer rnfl thickness map, which should ideally show butterfly wings with red spots to indicate adequate thickness. Based on the principle of lowcoherence interferometry, oct measures the intensity of backscattered infrared light. New landmarks, signs, and findings in optical coherence. History optical coherence tomography was first introduced commerically by carl zeiss in 1996.
Carl zeiss cirrus hdoct 4000 for sale ophthalmetry. Though not a replacement, when using oct for glaucoma diagnosis and management, it can aid in the detection of angle closure and does provide several novel parameters which cannot be evaluated with gonioscopy. Advanced interpretation of the cirrus oct anthony b. Optical coherence tomography this is what we wanted 4. Studies indicate that rnfl thickness parameters measured on cirrus oct are reproducible and have. This book is to help optical coherence tomography oct users interpret images that, at the beginning, may look very complex and bewildering. Interpretation of oct images high resolution spectral oct nerve fiber layer. The report is displayed in a simple, easytounderstand format. The first chapter covers the basic principles and interpretation of oct and is intended to help the reader interpret oct images. Method the retina of nineteen healthy volunteers were scanned with four oct devices topcon dri oct triton sweptsource oct, optovue rtvuexr, a prototype spectralis oct2, heidelbergengineering and zeiss cirrus 5000hd oct. This book focuses on the practical aspects of optical coherence tomography oct used for glaucoma. Peripapillary rnfl analysis is the most commonly used scanning protocol for glaucoma. This book is a practical guide to the revolutionary technique of noninvasive, dyeless oct angiography imaging. Zeiss cirrus hdoct 5000 technical specifications pdf.
The current version was introduced in 2007 and has evolved over the last 10 years with hardware and software upgrades such as macular ganglion cell analysis and guided progression analysis. Cirrus hd oct offers a glaucoma progression algorithm based on both event and trend analyses. This book introduces the latest optical coherence tomography oct imaging and computerized automatic image analysis techniques, and their applications in. As optical coherence tomography oct technology continues to advance, it has an everincreasing impact on the treatment of eye disease and the way anatomy and pathology are viewed keeping pace with this evolving technology can be challenging. Litwak, od, faao va medical center baltimore, maryland glaucoma 101 glaucoma is a disease of the ganglion cell axons damage occurs at the level of the lamina cribrosa selective damage to the superior and inferior poles of the optic nerve. Oct tutorial on interpreting cirrus oct macular scans. Oct angiography is a new, noninvasive diagnostic method through which the vascular structures of the retina and choroid may be visualized in three dimensions without the need for contrast agent injection.