[optimal] Re: question about OCT-C Certification

  • From: CPMC Ophthalmic Diagnostic Center <cpmceyelab@xxxxxxxxxxxxxxxx>
  • To: "'optimal@xxxxxxxxxxxxx'" <optimal@xxxxxxxxxxxxx>
  • Date: Wed, 13 Aug 2014 12:42:29 -0700

As we say in my household "Embrace the Chaos!!"

Denice Barsness, CRA, COMT, ROUB, CDOS, FOPS
Ophthalmic Diagnostic Center
CPMC Department of Ophthalmology
2100 Webster Street Suite 212
San Francisco CA 94115
(415) 600-3937   FAX (415) 600-6563

From: optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx] On 
Behalf Of Peterson John C
Sent: Wednesday, August 13, 2014 12:40 PM
To: 'optimal@xxxxxxxxxxxxx'
Subject: [optimal] Re: question about OCT-C Certification

Agreed!

Denice, for your part, you've come up with a great name for a band: "The Chaos 
of Normal"

-jcp

********
John C. Peterson, MBA-ITM
Senior Ophthalmic Photographer
UW Health Eye Clinic
2880 University Ave., Rm. 246
Madison, WI 53705
(608) 263-7163

From: optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx> 
[mailto:optimal-bounce@xxxxxxxxxxxxx] On Behalf Of CPMC Ophthalmic Diagnostic 
Center
Sent: Wednesday, August 13, 2014 2:37 PM
To: 'optimal@xxxxxxxxxxxxx'
Subject: [optimal] Re: question about OCT-C Certification

Tim, one of the clearest, most rational explanations of the chaos of "normal' I 
have heard in a long long time.
Thank you

Denice Barsness, CRA, COMT, ROUB, CDOS, FOPS
Ophthalmic Diagnostic Center
CPMC Department of Ophthalmology
2100 Webster Street Suite 212
San Francisco CA 94115
(415) 600-3937   FAX (415) 600-6563

From: optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx> 
[mailto:optimal-bounce@xxxxxxxxxxxxx] On Behalf Of Steffens, Timothy
Sent: Wednesday, August 13, 2014 12:27 PM
To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>
Subject: [optimal] Re: question about OCT-C Certification

Normative databases are interesting. Personally, I don't care for them. 
Everybody wants them but they only mean something on the first visit. I want to 
see change over time.

We are born and die with a certain number of nerve fibers. For every decade of 
life a "normal" person loses 1 micron of nerve fiber, no matter their age, race 
or gender.  So if you live to be 100 you'll loss 10 microns of nerve fiber. 
Gary....that explains only the slight change.

When reviewing RNFL scans, physicians want to see where the patient falls in 
the "normal" range on the first visit. After that, they are looking for change 
over time. Someone can be in the normal range and stay there their entire life 
but still have glaucoma. If the graph is trending down (RNFL loss) only a few 
extra microns over decades and there is evidence of VF loss, and high pressures 
or other factors they can potentially stay in the normal range even though they 
have glaucoma. Especially if it's managed well.

So in the Spectralis it's important to do a Posterior Pole (P.Pole) scan and 
Asymmetry report for glaucoma and a GPA report on the Cirrus. You will need 
three scans to on interments to see real change.

I hope this helps and make sense.
Tim


From: "<Miller CRA>", <OCT-C>, PA 
<GMILLER@xxxxxxxxxxxxx<mailto:GMILLER@xxxxxxxxxxxxx>>
Reply-To: "optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>" 
<optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>>
Date: Wednesday, August 13, 2014 at 1:53 PM
To: "optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>" 
<optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>>
Subject: [optimal] Re: question about OCT-C Certification


Well, I did a 'quick and dirty' experiment on our Cirrus. I had one of my 
coworkers do RNFL measurements on my eye.  We compared my scans by changing the 
DOB to 1928 and then to 1995. (neither of which is my real birthday!)



To my surprise, there was only a slight difference when comparing my RNFL 
between the two 'normaltive' database readings. I did get into the yellow 
readings in a few quadrants in  the one scan, but was all green in the other.



For what it's worth...



Gary

________________________________
From: optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx> 
[optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx>] on behalf 
of Steffens, Timothy [tjsteffe@xxxxxxxxxxxxx<mailto:tjsteffe@xxxxxxxxxxxxx>]
Sent: Wednesday, August 13, 2014 1:22 PM
To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>
Subject: [optimal] Re: question about OCT-C Certification
Any instrument that has an age matched normative database, Cirrus, Stratus and 
Heidelberg. I'm not sure about Optovue and Topcon.

Thanks,
Tim


From: "<Miller CRA>", <OCT-C>, PA 
<GMILLER@xxxxxxxxxxxxx<mailto:GMILLER@xxxxxxxxxxxxx>>
Reply-To: "optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>" 
<optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>>
Date: Wednesday, August 13, 2014 at 1:17 PM
To: "optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>" 
<optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>>
Subject: [optimal] Re: question about OCT-C Certification


I know it could matter on the Cirrus. An incorrect birth date could throw of 
what would be 'normal' to someone of that age. y that, I suspect comparing a 
scan from a 30 year old against the normative database of a 60 year old could 
be an issue... and visa versa.



But now that my curiosity is peeked, I will have to run a little test and see.



Gary

________________________________
From:optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx> 
[optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx>] on behalf 
of Tom Steele [tsteele@xxxxxxxxxxxxxx<mailto:tsteele@xxxxxxxxxxxxxx>]
Sent: Wednesday, August 13, 2014 1:14 PM
To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>
Subject: [optimal] Re: question about OCT-C Certification
Steven,

Which devices would this still be an issue.

Thank You,

Tom Steele, CRA
Midwest Eye Institute
200 West 103rd Street
Indianapolis, Indiana 46290
317.817.1018
tsteele@xxxxxxxxxxxxxx<mailto:tsteele@xxxxxxxxxxxxxx>

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From:optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx> 
[mailto:optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx>] On 
Behalf Of Stephen Travers
Sent: Wednesday, August 13, 2014 1:02 PM
To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>
Subject: [optimal] Re: question about OCT-C Certification

Hi Steve

Regarding the naming convention for entering the patients birthday into the OCT 
unit, remember that some OCT units use the patients birthday to assist in 
determining if that patients OCT results fall within the "Normal" range 
expected from the OCT normative database . If you do not enter the correct 
birthday this may result in a false positive or negative when compared with the 
Normative values of the specific database .

Hope this helps

Stephen


Stephen Travers
Manager Clinical Affairs
Heidelberg Engineering,Inc
1808 Aston Ave | Suite 130 | Carlsbad, CA |  92008

Tel:         760-536-7000 | 800-931-2230
Fax:        760-536-7100
Mobile:    817-716-2699
Email: 
stravers@xxxxxxxxxxxxxxxxxxxxxxxxx<mailto:stravers@xxxxxxxxxxxxxxxxxxxxxxxxx>



From:optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx> 
[mailto:optimal-bounce@xxxxxxxxxxxxx] On Behalf Of Steve Lusk
Sent: Wednesday, August 13, 2014 9:53 AM
To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>
Subject: [optimal] Re: question about OCT-C Certification

Great thanks for the info. I do have one other question. I know there is the 
exam fee for OPS, do we have to pay an additional fee to the company who comes 
to our locality to administer the written exam?


Steve Lusk, CRA
Vistar Eye Center Retina Consultants
5296 Peters Creek Road
Roanoke, VA 24019
Phone: (540) 342-3400 ext. 4731
Fax: (540) 362-1155
slusk@xxxxxxxxxxxxx<mailto:slusk@xxxxxxxxxxxxx>
www.vistareye.com<http://www.vistareye.com/>

The information contained in this email may contain confidential health
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________________________________
From:optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx> on 
behalf of Miller CRA, OCT-C, Gary E.
Sent: Wed 8/13/2014 10:05 AM
To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>
Subject: [optimal] Re: question about OCT-C Certification

Great! You are welcome, Steve.



By the way, I am not sure if you or others out there are aware, but the OPS 
Board of Certification has just launched their new, updated OCT-C exam which 
now includes Spectral Domain technology. Also, the cost of the exam has been 
dropped to $200 for those taking the exam before September 28, 2014!! The only 
thing to be aware of is the scores for those taking the exam during this 
special pricing period will be held until mid October. So you would need to 
wait until then to hear if you passed.



Let me know if you have any other questions, Steve...



Gary



________________________________
From:optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx> 
[optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx>] on behalf 
of Steve Lusk [slusk@xxxxxxxxxxxxx<mailto:slusk@xxxxxxxxxxxxx>]
Sent: Wednesday, August 13, 2014 9:24 AM
To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>
Subject: [optimal] Re: question about OCT-C Certification
Excellent. That is what I was looking for.
Thanks!



Steve Lusk, CRA
Vistar Eye Center Retina Consultants
5296 Peters Creek Road
Roanoke, VA 24019
Phone: (540) 342-3400 ext. 4731
Fax: (540) 362-1155
slusk@xxxxxxxxxxxxx<mailto:slusk@xxxxxxxxxxxxx>
www.vistareye.com<http://www.vistareye.com/>

The information contained in this email may contain confidential health
information that is privileged and legally protected from disclosure by
federal law, the Health Insurance Portability and Accountability Act
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Thank you.

________________________________
From:optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx> on 
behalf of Cornelia Beyer
Sent: Wed 8/13/2014 2:36 AM
To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>
Subject: [optimal] Re: question about OCT-C Certification
Agee with Gary , we only use 1/1/1990 for OCT-Portfolio and Clinical Trial 
purposes

On Tue, Aug 12, 2014 at 1:51 PM, Steve Lusk 
<slusk@xxxxxxxxxxxxx<mailto:slusk@xxxxxxxxxxxxx>> wrote:
I have quite a mundane question that as a group, we are split on. Under the 
naming convention for OCT, do we enter the applicants birthday or is 1-1-1900 
simply used as a signifier to satisfy the software requirements.
Thanks

Steve Lusk, CRA
Vistar Eye Center Retina Consultants
5296 Peters Creek Road
Roanoke, VA 24019
Phone: (540) 342-3400 ext. 
4731<https://outlook.geisinger.edu/owa/UrlBlockedError.aspx>
Fax: (540) 362-1155<https://outlook.geisinger.edu/owa/UrlBlockedError.aspx>
slusk@xxxxxxxxxxxxx<mailto:slusk@xxxxxxxxxxxxx>
www.vistareye.com<http://www.vistareye.com/>

The information contained in this email may contain confidential health
information that is privileged and legally protected from disclosure by
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-----Original Message-----
From: optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx> on 
behalf of aissa9400@xxxxxxxxx<mailto:aissa9400@xxxxxxxxx>
Sent: Sun 8/10/2014 10:00 AM
To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>
Subject: [optimal] Re: Photographing techniques using a Zeiss 2x magnification 
lens

James,

I figured that. I'm going to try everyone's suggestions this week and hopefully 
my eyes will cooperate.

A.D. sent by iPhone


> On Aug 10, 2014, at 9:00 AM, JamesStrong 
> <jamesdstrong@xxxxxxxxx<mailto:jamesdstrong@xxxxxxxxx>> wrote:
>
> FWIW - changing settings on the camera body will have no affect on 
> focus/parfocality - it's an optics issues.
>
> j-
>
>
>> On Sat, Aug 9, 2014 at 11:22 AM, Eric Kegley 
>> <ekegley@xxxxxxxxxxxxxxxxx<mailto:ekegley@xxxxxxxxxxxxxxxxx>> wrote:
>> Because the mag is higher, it is very important that your image is as sharp 
>> as possible trough the eyepiece. Also, you said something about the diopter 
>> compensation wheel being as plus as possible.  You shouldn't have to change 
>> that unless your subject is very hyperopic. My advice would be to make sure 
>> your reticle is very well focused and then focus carefully on the center of 
>> the frame.
>>
>> Thanks,
>> EK
>>
>> Eric Kegley, CRA, COA
>> Director of Ophthalmic Imaging
>> 6560 Fannin St., Suite 750
>> Houston, TX 77030
>> Main 713 524-3434<https://outlook.geisinger.edu/owa/UrlBlockedError.aspx>
>>
>> Sent from my iPhone
>>
>>> On Aug 9, 2014, at 9:31 AM, Marshall Tyler 
>>> <marshalletyler@xxxxxxxxx<mailto:marshalletyler@xxxxxxxxx>> wrote:
>>>
>>> Are the eyepiece sharp at the same time as the image is sharp?
>>> Try a test target of a ruler or sm as 'll printed text which you tilt 
>>> relative to the plane of focus. It should be sharp in the center. If sharp 
>>> closer or further away you have a focusing problem. If is not sharp 
>>> anywhere you may have a lens/system problem.
>>>
>>> Thank you,
>>> Marshall
>>> Marshall E Tyler
>>>
>>>> On Aug 8, 2014 11:09 PM, <aissa9400@xxxxxxxxx<mailto:aissa9400@xxxxxxxxx>> 
>>>> wrote:
>>>> Thanks Jeremy for the eye opener. I hope it's not a waste $ for the lens.
>>>>
>>>> I've changed the compensation lens to the highest plus mag on the FF4 and 
>>>> turn the dial all the way. The image looked clearer but no cigar. I'm 
>>>> going to try and change the setting on the 6D itself to macro, not sure 
>>>> what will happen and if it will even let me change the setting while it's 
>>>> connected to the PC.
>>>>
>>>> I would like more input on my thoughts if possible.
>>>>
>>>> Aissa
>>>>
>>>> A.D. sent by iPhone
>>>>
>>>>
>>>>> On Aug 8, 2014, at 10:16 PM, Jeremy Pantell 
>>>>> <jpantell@xxxxxxxxxxxxx<mailto:jpantell@xxxxxxxxxxxxx>> wrote:
>>>>>
>>>>> HI AISSA!  I guess the question is whether the Canon 6D/Zeiss 2X adapter 
>>>>> will "parfocal" with the Zeiss eyepiece.  I would focus off your monitor 
>>>>> while trying to come up with a better solution.  When using the 2X with a 
>>>>> film setup there was no particular magic about it.  Just focus very 
>>>>> carefully and compose within the viewfinder grid.  Good patients would 
>>>>> yield very nice results.
>>>>>
>>>>> sincerely, jeremy p. pantell bfa cra
>>>>>
>>>>>
>>>>> On Friday, August 8, 2014 4:06 PM, Aissa Dirawatun 
>>>>> <aissa9400@xxxxxxxxx<mailto:aissa9400@xxxxxxxxx>> wrote:
>>>>>
>>>>>
>>>>> Hello everyone,
>>>>>
>>>>> Our practice purchased a Zeiss 2x lens adapter for our FF4 (w/ Canon 6D) 
>>>>> camera to use for ONH pictures. I'm having trouble focusing the image. I 
>>>>> need your advice.
>>>>>
>>>>> Thank you!
>>>>>
>>>>> Aissa Dirawatun, COA
>>>>> Ophthalmic Photographer/Technician
>>>>> Virginia Retina Center
>>>>> 20 Rock Pointe Lane Suite 20
>>>>> Warrenton, VA 20155
>>>>>
>>>>> --
>>>>> "Reading makes immigrants of us all. It takes us away from home, but more 
>>>>> important, it finds homes for us everywhere." ~ Jean Rhys 1890-1979
>


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