The Fusion of Imaging Technologies INTRODUCING. Spectralis is more than resolution … Time Domain OCT SPECTRALIS.

The Fusion of Imaging TechnologiesThe Fusion of Imaging Technologies

INTRODUCINGINTRODUCING

Spectralis is more than resolution …

Time Domain OCT SPECTRALIS

Spectralis is more than fast …

0 10000 20000 30000 40000

Time Domain

"3D OCT"

"FD OCT"

"HD OCT"

Spectralis 40 kHz = 100x Faster than time domain OCT

Spectralis is more then SD-OCT… Dual laser scanning system for

simultaneous imaging: Confocal Scanning Laser Ophthalmoscope (cSLO)

with up to 5 imaging modes: IR, FA, ICGA, AF, Red-free

Spectral Domain Optical Coherence Tomograph (SD-OCT)

Eye tracking: cSLO recognizes eye movements and guides

SD-OCT scanner to follow Allows repeat scans at exact same location

Spectralis is more than one view …ICGA Polypoidal Lesion

Spectralis is more than 3D …

Spectralis is knowing locationCross section scanReference scan

Eye MovementThe reference image tracks eye movement, and the cross section is moved to match

EYE TRACKING

Spectralis Tracks Change Over Time

Exam 1 Exam 2

Real-time alignmentCross section

scanned at same location

• Real-time alignmentCross section scanReference scan

EYE TRACKING• Accurate change measurement

Heidelberg Noise Reduction Technology

Multiple images are captured at the same location

“Noise” is identified as points not common to the set of images

The noise is filtered from the final image

Image 1 Image 2

Heidelberg Noise Reduction Technology produces high resolution, high contrast images with less “speckle”.

Simultaneous Imaging with Eye Tracking

What’s wrong with the old OCT?

Hidden artifact – structure may be different than presented

Not simultaneous – B-Scan may be in different location than reference image

No eye tracking – Not good for LASIK, not good for diagnostics

(S)low resolution – Layers hard to identify for computer algorithms

Old OCT Does Not Stop Eye Movement

While Time Domain OCT scans, the eye keeps moving

The black line is the camera’s perspective

The white line is the actual scan path

“Tracking the Optic Nervehead in OCT Video…” Koozekanani, et al, 2003

© 2003 IEEE

Old OCT Does Not Register Images

As the eye moves, so does the scan location

Software algorithms reconstruct the data

Software assumes the lines are straight and intersecting

Increasing Reports of OCT Artifact

Study % Artifact/Error

UCSD: Bartsch (2004) 42%

Duke: Ray (2005) 43%

USC: Sadda (2006) 92%

Bartsch et al. Optical Coherence Tomography: Interpretation Artifacts and New Algorithm. Proc. of SPIE. 2004 5370; 2140-2150.

Ray et al. Evaluation of image artifact produced by optical coherence tomography of retinal pathology. Am J Ophthalmol. 2005 Jan;139(1):18-29.

Sadda et al. Errors in retinal thickness measurements obtained by optical coherence tomography. Ophthalmology. 2006 Feb;113(2):285-93.

Eye Tracking Stops 3D Motion Artifact

Artificial ripples due to eye movements

Without Eye Tracker

True anatomic structure

With Eye Tracker

Spectralis Advantages

Eye Tracking – Every B-scan is simultaneously locked to a reference image

Up to 6 modes – Multiple perspectives of the anatomy from multiple wavelengths

40 kHz scanning – High speed helps overcome eye movement artifact and increases patient comfort

TruTrack™ – Image alignment compares reference location at baseline to follow-up

Heidelberg Noise Reduction Technology – Overcomes the limits of “resolution”

AF – Occult CNV

IR – Central Serous Chorioretinopathy

ICGA – RAP

ICGA – CNV with Choroidal Hemangioma

AF – Occult CNV

AF – Diabetic Retinopathy

6 Billing Codes (example for United States)

92135 Scanning Diagnostic Imaging 92235 Fluorescein Angiography 92240 ICG Angiography 92250 Red Free Fundus Photography 92285 External Ocular Photography 92287 Internal Eye Photography (Iris

Angiography)

Select From Three Versions

6 modes

SD-OCT

Infrared

Autofluorescence

Fluorescein Angiography

ICG Angiography

Red Free Photography

2 modes

SD-OCT

Infrared

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5 modes

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Infrared

Autofluorescence

Fluorescein Angiography

ICG Angiography

Red Free Photography

HEYEX Database

HEYEX Network Solution

IR FA IR OCT

HEYEX

Registration Link

Heidelberg Engineering Imaging Suite

IR IR OCT

HEYEX

FA Fundus

Registation Link

OCT

Red Free Autofluorescence

Infrared

ICG Angiography

Fluorescein Angiography

The Fusion of Imaging TechnologiesThe Fusion of Imaging Technologies