International Conference on Ophthalmic Photography

Organized by
Australian Institute of Medical and Biological Illustration
Japanese Ophthalmic Photographers' Society
Ophthalmic Imaging Association
Ophthalmic Photographers' Society

Previous Page | Next Page

Friday, 19 May 2006
Plenary Session 4
Optical Coherence Tomography
1.75 OPS Continuing Education Credits
08:15 Introduction By Moderator
Paul R. Montague
University of Iowa
Iowa City, Iowa, USA
08:20 Optical Coherence Tomography's Role In Following Patients With Age Related Macular Degeneration Being Treated With Off Label Avastin
Carrie E. Chaffin, Michael A. Bloome¹
Houston Eye Associates¹
Houston, Texas, USA
Purpose: To demonstrate the role of Optical Coherence Tomography (OCT) in evaluating possible benefits of using off label Avastin for treatment of age related macular degeneration.
Materials and Methods: Zeiss OCT III was used over five months to follow 120 eyes being treated with off label Avastin for age related macular degeneration. Eyes were given 0.05 mL Avastin (Bevacizumab) injected directly into the vitreous through the sclera at two to three millimeters temporal to the limbus using a 30 gauge ½ inch needle. Patients were seen for follow up at four to six week intervals; the OCT fast macular thickness scan was used to measure central foveal thickness, and visual acuity (VA) was measured on a standard Snellen acuity chart at twenty feet at each visit. Fluorescein angiography was not performed.
Results: OCT was found to be an effective tool for following patients with age related macular degeneration. Furthermore, foveal thickness as a measurement of retinal health has been an endpoint of interest for this investigator in documenting treatment with off-label Avastin in eyes with macular edema secondary to age related macular degeneration.
Conclusions: Endpoints of interest in this study were VA as measured on a standard Snellen acuity chart at twenty feet and central foveal thickness as measured by the fast macular thickness scan on the Zeiss OCT III. However, variations in repeatability of foveal thickness occur between patients and even between consecutive OCT captures in the same patient. As with any imaging modality, the OCT is best used as a tool along with clinical observation. This investigator concludes that central foveal thickness is a good indicator of improved retinal health when following patients with age related macular degeneration, and that OCT has a viable role in determining this measurement.

08:35 Survey Results: Task Analysis On The Role Of OCT Imagers
Beth Ann M. Benetz¹, Kate Windom², Reed Castle², Tim Bennett³, Members of the OCT Test Development Task Force
Case Western Reserve University¹
Schroeder Measurement Technologies, Inc.²
Penn State University³
Purpose: The goal of the survey was to gather information regarding the tasks today’s OCT Imagers perform and identify a core set of tasks describing the knowledge, skills, and abilities representing competent practice.
Materials and Methods: The Ophthalmic Photographers’ Society (OPS) Board of Certification (BOC), with the assistance of Subject Matter Experts, developed a comprehensive task outline that was translated into a survey to analyze the importance and frequency of tasks and knowledge required for competent practice as an OCT Imager. The BOC released the questionnaire in the form of a Web survey to the OPS Members List (707 active email addresses) and OPTIMAL (358 subscribers, many of whom are also on the OPS members’ email list) in January of 2006. Vendors forwarded email announcements to their user lists. The BOC sent postcards to all OPS members in February of 2006, and invited OCT vendors to request postcards to mail to a random selection of their OCT user lists. In total, the BOC mailed 3,000 postcard invitations. Schroeder Measurement Technologies, Inc. performed psychometric analysis of the survey data results.
Results: The authors will report the percentage of imagers responding to the survey related to the number of invitations. The authors will detail the demographics of respondents. The authors will outline the key findings of the survey response data including sub-group analysis.
Conclusions: The survey results identify a core set of tasks describing competent practice of today’s OCT imager. The authors will highlight the significance of the key findings described in the results. The authors will draw conclusions on whether the identified core tasks can be tested in an examination environment, and whether the survey results support the pursuit of the development of OCT certification.

08:50 OCT Imaging Of Retinal Pathology Utilizing The Topcon 3D-OCT System
Dennis A. Orlock¹, Cindy Novalis¹, Robert Curtin², JS Slakter³, LA Yannuzzi³, YL Fisher
Retinal Research Meeth¹
Digital Angiographic Reading Center²
Vitreous-Retina-Macula Consultants³
New York, New York, USA
Purpose: To evaluate the utility of Topcon 3D-OCT (Topcon Corp., Tokyo, Japan), Fourier Domain OCT for clinical evaluation of retinal pathology.
Methods: The Topcon 3D-OCT Fourier domain optical coherence tomography machine records the interferometric information using a spectrometer approach instead of moving mirrors used in conventional OCT systems, allowing for an increase in both the scanning speed (25,000 A-scan/sec) and imaging sensitivity (>92 dB). Through an integration with the Topcon non-mydratic retinal camera, the Topcon 3D OCT provides high resolution cross sectional (B-scan) and coronal (C-scan) images of the posterior fundus.
In addition, the system utilizes a near-infrared, low coherence solid-state light source, achieving excellent axial (6 µ) and lateral (10 µ) resolution. In the cross-sectional (2D) imaging mode, an OCT image can be obtained <0.027 seconds, reducing potential eye movement artifact.
Results: 15 eyes with retinal disease were imaged with the Topcon 3D-OCT using cross sectional scans . The authors reviewed the images with respect to their subjective and objective quality. The images of these patients were compared to images from the Stratus OCT (Carl Zeiss Meditec Inc. ) and found to be of similar diagnostic value. Ten eyes of 10 patients were scanned using the volumetric (3D) imaging mode, used to evaluate retinal thickness. A 10o x10o retinal area was scanned, and 3D volumetric retinal reconstructions of the area were obtained using comprehensive 3D data rendering software. This approach was useful in visualizing and measuring the retinal thickness.
Conclusions: The Topcon 3D-OCT provided useful OCT imaging in retinal diseases in both the cross sectional (B-scan ) and the coronal (C-scan) modes. Further clinical studies are planned to determine the clinical utility of this instrument.

09:05 Complimentary Use Of OCT Imaging And Digital Stereo Photography
Chika Kanagami¹, Sadao Kanagami²
Tokyo, Japan¹
Kitazato University,Kanagawa Japan²
Purpose: Optical Coherence Tomography (OCT) produces various sectional information of the retina. On the other hand, the scan it produces is confined within narrow limits.
For many years, stereo retinal photography has played an important role in ophthalmic imaging, offering a wider, three-dimensional view of the retina. This presentation will show the complementary nature of these two modalities.
Materials and Methods: Traditional stereo retinal imaging has been used in ophthalmic photography for decades to help illustrate the 3-dimensional aspects of ocular structures both in color and in dynamic-flow angiography.
With the advent of the OCT and its ability to produce various sectional layers of the retinal structures, it is now possible to better establish ocular changes as seen in macular holes or macular elevations. The limitation of this technology is it's narrow geographical view and abstract representation of the ocular image.
Results: Images from both types of imaging will be presented, showing the different nature of the results and their complementary nature.
Conclusions: Combining both of these established technologies; traditional stereo imagery with OCT imagery, results in a better understanding of the ocular structures and may lead to a more comprehensive diagnosis.

09:20 Intravitreal Triamcinolone For Different Types Of Macular Edema: An OCT Study
Suqin Yu, Zhang Xi, Xu Xun
Shanghai First People's Hospital
Shanghai, China
Purpose: To discuss the efficacy of intravireal Triamcinolone Acetonide (IVTA) on different types of macular edema based on OCT classification.
Methods: A retrospective, non-comparative case series with 118 eyes of 106 patients underwent IVTA at the dose of 4mg in 0.1ml. OCT was used to identify the morphology of macular edema and vitreoretinal interface. Best corrected visual acuity (BCVA), intraocular pressure (IOP), fundus images, and OCT images were observed before and after treatment to estimate the influence of OCT classification on therapeutic effect.
Results: We found four patterns of macular edema based on OCT scans among 118 study eyes before treatment.
They are: (1) increased retina thickness (15 eyes, 12.7%), (2) increased retina thickness + subretinal fluid (13 eyes, 11%), (3) increased retina thickness + cystoid macular edema (42 eyes, 35.6%), (4) increased retina thickness + cystoid macular edema + subretinal fluid (48 eyes, 40.7%).
The OCT scans showed immediate improvement one week after IVTA, but without statistical significance within each group.
The Vitreoretinal interface was studied, and the following findings were noted: (1) without PVD (63eyes, 53.4%), (2) partial PVD vitreous traction at posterior pole (17eyes, 14.4%), (3) complete PVD (38eyes, 32.2%).
One month after treatment, group 1 and 3 showed great improvement in both OCT and VA. But six month later VA regression was found in group 1 and only stable in group 3. In addition, macular pucker was found in 36 eyes (30.5%) with no improvement in VA and retinal thickness six months after IVTA.
Conclusions: IVTA is a less effective treatment in macular edema with vitreoretinal interface problems. OCT can help to better diagnose and classify macular edema, thus assisting in the prediction of treatment efficacy.

09:35 Panel Discussion On OCT

Previous Page | Next Page

ICOP Home Page | Schedule of Events

Friday, 19 May 2006 Plenary Session 4 Optical Coherence Tomography 1.75 OPS Continuing Education Credits
08:15	Introduction By Moderator Paul R. Montague University of Iowa Iowa City, Iowa, USA
08:20	Optical Coherence Tomography's Role In Following Patients With Age Related Macular Degeneration Being Treated With Off Label Avastin Carrie E. Chaffin, Michael A. Bloome¹ Houston Eye Associates¹ Houston, Texas, USA Purpose: To demonstrate the role of Optical Coherence Tomography (OCT) in evaluating possible benefits of using off label Avastin for treatment of age related macular degeneration. Materials and Methods: Zeiss OCT III was used over five months to follow 120 eyes being treated with off label Avastin for age related macular degeneration. Eyes were given 0.05 mL Avastin (Bevacizumab) injected directly into the vitreous through the sclera at two to three millimeters temporal to the limbus using a 30 gauge ½ inch needle. Patients were seen for follow up at four to six week intervals; the OCT fast macular thickness scan was used to measure central foveal thickness, and visual acuity (VA) was measured on a standard Snellen acuity chart at twenty feet at each visit. Fluorescein angiography was not performed. Results: OCT was found to be an effective tool for following patients with age related macular degeneration. Furthermore, foveal thickness as a measurement of retinal health has been an endpoint of interest for this investigator in documenting treatment with off-label Avastin in eyes with macular edema secondary to age related macular degeneration. Conclusions: Endpoints of interest in this study were VA as measured on a standard Snellen acuity chart at twenty feet and central foveal thickness as measured by the fast macular thickness scan on the Zeiss OCT III. However, variations in repeatability of foveal thickness occur between patients and even between consecutive OCT captures in the same patient. As with any imaging modality, the OCT is best used as a tool along with clinical observation. This investigator concludes that central foveal thickness is a good indicator of improved retinal health when following patients with age related macular degeneration, and that OCT has a viable role in determining this measurement.
08:35	Survey Results: Task Analysis On The Role Of OCT Imagers Beth Ann M. Benetz¹, Kate Windom², Reed Castle², Tim Bennett³, Members of the OCT Test Development Task Force Case Western Reserve University¹ Schroeder Measurement Technologies, Inc.² Penn State University³ Purpose: The goal of the survey was to gather information regarding the tasks today’s OCT Imagers perform and identify a core set of tasks describing the knowledge, skills, and abilities representing competent practice. Materials and Methods: The Ophthalmic Photographers’ Society (OPS) Board of Certification (BOC), with the assistance of Subject Matter Experts, developed a comprehensive task outline that was translated into a survey to analyze the importance and frequency of tasks and knowledge required for competent practice as an OCT Imager. The BOC released the questionnaire in the form of a Web survey to the OPS Members List (707 active email addresses) and OPTIMAL (358 subscribers, many of whom are also on the OPS members’ email list) in January of 2006. Vendors forwarded email announcements to their user lists. The BOC sent postcards to all OPS members in February of 2006, and invited OCT vendors to request postcards to mail to a random selection of their OCT user lists. In total, the BOC mailed 3,000 postcard invitations. Schroeder Measurement Technologies, Inc. performed psychometric analysis of the survey data results. Results: The authors will report the percentage of imagers responding to the survey related to the number of invitations. The authors will detail the demographics of respondents. The authors will outline the key findings of the survey response data including sub-group analysis. Conclusions: The survey results identify a core set of tasks describing competent practice of today’s OCT imager. The authors will highlight the significance of the key findings described in the results. The authors will draw conclusions on whether the identified core tasks can be tested in an examination environment, and whether the survey results support the pursuit of the development of OCT certification.
08:50	OCT Imaging Of Retinal Pathology Utilizing The Topcon 3D-OCT System Dennis A. Orlock¹, Cindy Novalis¹, Robert Curtin², JS Slakter³, LA Yannuzzi³, YL Fisher Retinal Research Meeth¹ Digital Angiographic Reading Center² Vitreous-Retina-Macula Consultants³ New York, New York, USA Purpose: To evaluate the utility of Topcon 3D-OCT (Topcon Corp., Tokyo, Japan), Fourier Domain OCT for clinical evaluation of retinal pathology. Methods: The Topcon 3D-OCT Fourier domain optical coherence tomography machine records the interferometric information using a spectrometer approach instead of moving mirrors used in conventional OCT systems, allowing for an increase in both the scanning speed (25,000 A-scan/sec) and imaging sensitivity (>92 dB). Through an integration with the Topcon non-mydratic retinal camera, the Topcon 3D OCT provides high resolution cross sectional (B-scan) and coronal (C-scan) images of the posterior fundus. In addition, the system utilizes a near-infrared, low coherence solid-state light source, achieving excellent axial (6 µ) and lateral (10 µ) resolution. In the cross-sectional (2D) imaging mode, an OCT image can be obtained <0.027 seconds, reducing potential eye movement artifact. Results: 15 eyes with retinal disease were imaged with the Topcon 3D-OCT using cross sectional scans . The authors reviewed the images with respect to their subjective and objective quality. The images of these patients were compared to images from the Stratus OCT (Carl Zeiss Meditec Inc. ) and found to be of similar diagnostic value. Ten eyes of 10 patients were scanned using the volumetric (3D) imaging mode, used to evaluate retinal thickness. A 10o x10o retinal area was scanned, and 3D volumetric retinal reconstructions of the area were obtained using comprehensive 3D data rendering software. This approach was useful in visualizing and measuring the retinal thickness. Conclusions: The Topcon 3D-OCT provided useful OCT imaging in retinal diseases in both the cross sectional (B-scan ) and the coronal (C-scan) modes. Further clinical studies are planned to determine the clinical utility of this instrument.
09:05	Complimentary Use Of OCT Imaging And Digital Stereo Photography Chika Kanagami¹, Sadao Kanagami² Tokyo, Japan¹ Kitazato University,Kanagawa Japan² Purpose: Optical Coherence Tomography (OCT) produces various sectional information of the retina. On the other hand, the scan it produces is confined within narrow limits. For many years, stereo retinal photography has played an important role in ophthalmic imaging, offering a wider, three-dimensional view of the retina. This presentation will show the complementary nature of these two modalities. Materials and Methods: Traditional stereo retinal imaging has been used in ophthalmic photography for decades to help illustrate the 3-dimensional aspects of ocular structures both in color and in dynamic-flow angiography. With the advent of the OCT and its ability to produce various sectional layers of the retinal structures, it is now possible to better establish ocular changes as seen in macular holes or macular elevations. The limitation of this technology is it's narrow geographical view and abstract representation of the ocular image. Results: Images from both types of imaging will be presented, showing the different nature of the results and their complementary nature. Conclusions: Combining both of these established technologies; traditional stereo imagery with OCT imagery, results in a better understanding of the ocular structures and may lead to a more comprehensive diagnosis.
09:20	Intravitreal Triamcinolone For Different Types Of Macular Edema: An OCT Study Suqin Yu, Zhang Xi, Xu Xun Shanghai First People's Hospital Shanghai, China Purpose: To discuss the efficacy of intravireal Triamcinolone Acetonide (IVTA) on different types of macular edema based on OCT classification. Methods: A retrospective, non-comparative case series with 118 eyes of 106 patients underwent IVTA at the dose of 4mg in 0.1ml. OCT was used to identify the morphology of macular edema and vitreoretinal interface. Best corrected visual acuity (BCVA), intraocular pressure (IOP), fundus images, and OCT images were observed before and after treatment to estimate the influence of OCT classification on therapeutic effect. Results: We found four patterns of macular edema based on OCT scans among 118 study eyes before treatment. They are: (1) increased retina thickness (15 eyes, 12.7%), (2) increased retina thickness + subretinal fluid (13 eyes, 11%), (3) increased retina thickness + cystoid macular edema (42 eyes, 35.6%), (4) increased retina thickness + cystoid macular edema + subretinal fluid (48 eyes, 40.7%). The OCT scans showed immediate improvement one week after IVTA, but without statistical significance within each group. The Vitreoretinal interface was studied, and the following findings were noted: (1) without PVD (63eyes, 53.4%), (2) partial PVD vitreous traction at posterior pole (17eyes, 14.4%), (3) complete PVD (38eyes, 32.2%). One month after treatment, group 1 and 3 showed great improvement in both OCT and VA. But six month later VA regression was found in group 1 and only stable in group 3. In addition, macular pucker was found in 36 eyes (30.5%) with no improvement in VA and retinal thickness six months after IVTA. Conclusions: IVTA is a less effective treatment in macular edema with vitreoretinal interface problems. OCT can help to better diagnose and classify macular edema, thus assisting in the prediction of treatment efficacy.
09:35	Panel Discussion On OCT