I am careful, and when performing the scans check to make sure that the overall scan is centered in the monitor, and the smaller circle is dead center on the neural rim, taking multiple scans. But, having said that, I don’t generally monkey with the segmentation unless it is grossly off. I was surprised to see how easy it was, with a very minute change in only ONE segmentation dot, I was able to shift the balance from yellow to Red. Also, I have NOT been checking EACH scan to make sure that the green plus sign is DEAD center in the entrance of the central retinal artery. Should I? Case in point, had I shifted this green circle a “smidge” to the left, I could have arguably really influenced the outcome. See attached. Denice 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 copcphotography@xxxxxxxxxxxxxxxxx Sent: Friday, September 20, 2013 11:19 AM To: optimal@xxxxxxxxxxxxx Subject: [optimal] Re: From Denice re Spectralis Segmentation Hi Denise I use the Cirrus here, and know that you have to look at the placement of each RNFL crosshair placement for just that reason, the machine can place the ON center so far off that you end up with really bad results! I know to look for that problem, but the fill-in techs that are just thrown into the camera room have no clue-even tho samples are posted about what to look for. Lori -----Original Message----- From: "CPMC Ophthalmic Diagnostic Center" <cpmceyelab@xxxxxxxxxxxxxxxx<mailto:cpmceyelab@xxxxxxxxxxxxxxxx>> Sent: Friday, September 20, 2013 1:49pm To: "'optimal@xxxxxxxxxxxxx'" <optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>> Cc: "'spectralis-user-group@xxxxxxxxxxxxxxxx'" <spectralis-user-group@xxxxxxxxxxxxxxxx<mailto:spectralis-user-group@xxxxxxxxxxxxxxxx>> Subject: [optimal] From Denice re Spectralis Segmentation Somewhat alarmed to see today that two separate RNFL scans, seemingly reasonable well centered, can show such different results based on where the instrument choses to segment. A very slight, nearly inperceptable adjustment on my part took this patient out of the red zone and back into borderline. Your thoughts? ART set at 16. Too much? Too little? 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
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