I agree with Eric's assessments 100%. Each device has their own pros & cons
and I'm glad he also mentioned trial study acceptance as my primary job for one
of the major Reading Centers is to import & QC OCTA files.
Spectralis definitely slower to acquire & longer to export or reopen images,
esp if you don't let them save all the way after acquisition. You also have to
do OCTA separate from other imaging (SD-OCT, FAF, etc...) or you'll run out of
memory before last scan is completed.Cirrus tends to have more motion
artifacts, especially if you're impatient & you remove tracking or there's a
lot of pt movement & fixation issues.OptoVue does a horizontal scan followed by
a separate vertical scan so it takes a few seconds longer & a lot of times you
have to manually move the scan to the center of the fovea prior to acquisition.
You also have to do them separate from other modalities & delete out the poor
images prior to study exports or all images saved will be export whether good
or poor, 2 or 20 images were taken (as far as I've heard).
You might also want to check out Topcon Maestro2 SD-OCT & Triton SS-OCT.
Although I don't believe their OCTA has been approved yet in the US (It is
everywhere else tho).
In general, the higher the speed the better the rez. Swept Source & other
higher speed SD-OCT devices are much better quality but then there's the price
and not sure which, if any of them are used or approved outside of research
centers.
Overall tho' it doesn't really matter which device you choose as long as you
learn to use it properly keeping quality over quantity in mind. Especially for
study subjects. They take more time to do OCTA so take your time.
Related note:Kudos to Eric & most other certified Imagers. I have seen his
study submissions & always a great job no matter which device he uses. We
generally can tell the diff in quality from certified vs non-cert Imagers vs
Drs who do it themselves in a hurry or Sally the doughnut girl that the Drs
think can just push a button to get an image.
My $.02Paul Paquette
On Wednesday, March 27, 2024, 7:20:55 AM PDT, Eric Kegley
<eric.kegley@xxxxxxxxxxxxxxxxxxxxxxxxxx> wrote:
Sandie,
We have an Optovue Avanti (not being made any longer), an Optovue Solix, a
Heidelberg Spectralis, a Zeiss Cirrus 4000 (at another satellite), and a Zeiss
PlexElite. While I love my Heidelberg as a regular OCT, I do not like it as
much as an OCTA device. It is much slower than all of my other devices and
seems to be a little more sensitive to motion artifacts. That being said,
Heidelberg has a 125kHz scan speed in Europe, which I would assume that they
are trying to get approved here in the states (though I have no insider
knowledge), that should make acquisition faster and I also believe that version
7 of the capture software also speeds up scanning speed due to a change in the
tracking algorithm. Regarding the PlexElite, if it is able to track (and that
is a big if in my experience) it is hard to beat the image quality. It will
also scan a 15 mm x 15 mm area with the montage feature. If you are using it
for clinical trials, several of the reading centers that we use will not accept
images form the device. Regarding the Cirrus 5000, I find that I get a lot of
motion artifacts and I am not pleased with my scans, though it is the device I
have the least experience with. Regarding the Optovue devices, if I remember
correctly, they have had OCTA approved software longer than anyone, barely
beating Zeiss out. In my judgment, they are my favorite OCTA devices. The scans
are typically very fast and look pretty good. The Avanti is not being made any
longer and the Solix is very similar with almost the same scan patterns and
using the software is very familiar if one is used to using the Avanti product.
We do a large number of clinical trials and we are still in the process of
seeing what reading centers will accept images form the Solix for new trials
that we are starting.. Again, all of this information is in my experience and I
am not “dogging” any of these systems, just sharing my thoughts.
Thank You,
Eric Kegley, CRA, OCT-C, FOPS, COT
Director of Imaging
Upcoming OOO: 29MAR2024, 01APR2024, 08APR2024
Retina Consultants of Texas Research Centers
4460 Bissonnet St, Ste 200
Bellaire, TX 77401
O: 713.524.3434 ext. 1460
D: 713.394-7531
C: 281.236.0215
F: 713.795.4552
RetinaConsultantsTexas.com
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From: optimal-bounce@xxxxxxxxxxxxx <optimal-bounce@xxxxxxxxxxxxx>On Behalf Of
Paul Crown
Sent: Monday, March 25, 2024 9:00 AM
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: OCT-A
[EXTERNAL EMAIL]PLEASE DO NOT CLICK links or attachments unless you recognize
the sender and know the content is safe.
I know this is still a ways out, but from what I understand is that there will
be CPT codes for OCT-A come 2025. I agree with the Cirrus limitations, but the
benefit for OCT-A as I understand it is that it takes something like 7 seconds.
The Spectralis from Heidelberg takes significantly longer than that, but
depending on the model could be better for your peripheral imaging (though,
their fixed-head systems are just kind of trash for peripheral IMO).
Best Regards,
Paul D. Crown, MA, CRA, OCT-C
On Fri, Mar 22, 2024 at 10:47 AM Merritt Gammage <fmgam@xxxxxxxxxxx> wrote:
Sandie,
We have a Zeiss 5000 OCT-A. Private Practice with Zeiss Forum. Zeiss scans 3x3.
Ok but not sure I would have purchased it, however we upgraded the 5000 OCT to
OCT-A. Not good for periphery imaging. Not even close to a good filling on
IVFA etc. No ICD codes for OCT-A, just add to your MAC Scans for billing &
education purposes.
Good Luck.
Get Outlook for iOS
From:optimal-bounce@xxxxxxxxxxxxx <optimal-bounce@xxxxxxxxxxxxx> on behalf of
Reed, Sandra L <SReed@xxxxxxxxxxxx>
Sent: Friday, March 22, 2024 8:23:18 AM
To: optimal@xxxxxxxxxxxxx <optimal@xxxxxxxxxxxxx>
Subject: [optimal] Re: OCT-A
Hi Everyone,
Looking for your opinion.
We are looking to purchase a new OCT-A. What are you using? Preference in
instrument? Why?
Appreciate any help you can give,
Sandie Reed, COT, CDOS
UW Health, Madison, WI