[optimal] Re: anterior heidelberg, viewing thru hazy cornea
- From: Sandor Ferenczy <sandorferenczy@xxxxxxxxx>
- To: optimal@xxxxxxxxxxxxx
- Date: Fri, 19 Jul 2013 11:51:30 -0400
this is part of the reason we still use the Visante AS-OCT over the
adapted posterior seg OCTs (we have lenses for the Spectralis and the
RTVue and the iVue)
The longer wavelength and higher power output of the Visante (not to
mention the limbus-to-limbus imaging) make it a far more capable
imager than the others. Though, as always, with drawbacks. The Visante
may be able to fully image the IPE cyst that the Spectralis cannot
even "see" but the details in the conjunctival squamous cell ca on the
Spectralis make the Visante images look like pastel drawings.
Proper tools for the job, etc.
And John, in terms of using the anterior segment lenses, it is pretty
easy. I would spend 10 minutes testing it on a co-worker (or on
yourself - it is possible) and just get comfortable. Especially when
you are dealing with a poor view, think outside the box, and just try
different imaging angles and settings until you get the best looking
image on screen. "Normal" doesnt always work when you are
photographing "abnormal".
-sandor
On Fri, Jul 19, 2013 at 11:23 AM, CPMC Ophthalmic Diagnostic Center
<cpmceyelab@xxxxxxxxxxxxxxxx> wrote:
> Ah, the elusive “Gray zone” of the sulcus, sclera spur and beyond. UBM works
> great, to a point. AS-OCT has it’s shining moments. Gonio can make pretty
> pictures. We’re all looking for the Holy Grail- easy, high resolution
> images of the iris and beyond. Something that can slice through pigment,
> yet penetrate deep enough for the Glaucoma guys.
>
>
>
> Sometimes, it’s having the confidence to know that it’s the technology
> failing you, not your skills. Just as you get to the Angle and beyond,
> things start to fall apart. UBM or at least 20MHz US works pretty well for
> the lens, at least anteriorly, but depending on the eye, the depth of the
> AC, yadayadayada, really getting enough information deep enough into the
> anterior posterior chamber is tricky….
>
>
>
> Don’t even get me started about reproducible metrics!
>
>
>
> D.
>
>
>
> 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 John Head
> Sent: Friday, July 19, 2013 7:04 AM
> To: optimal@xxxxxxxxxxxxx
> Subject: [optimal] anterior heidelberg, viewing thru hazy cornea
>
>
>
> We have a new anterior lens and module for the Hedelberg Spectralis at a
> second site, but not much experience using it. As a photographer familiar
> with the other Heidelberg functions, how much differnet is the anterior
> scanning methodology? trying it a couple times, it seems that fixation can
> be an issue? are there any optimal scan settings, ie ART levels, HS or HR?
>
>
>
> basically I'm looking for some pointers, because an MD wishes to see the
> angle for possible peripheral anterior synchiae, or a "mass blocking" which
> may be causing a "malpositioned ACIOL in the chamber."
>
>
>
> the trouble is, I don't know enough about the machines capability,
> especially when the MD says she cannot see the angle due to a "hazy cornea."
>
>
>
> any suggestions or comments would be appreciated.
>
>
>
> Thanks,
>
> John Head, CRA
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