Spotlight ON TECHNOLOGY & TECHNIQUE

SD-OCT That Goes From Exam Room to OR

By Samantha Stahl, Assistant Editor

When spectral-domain OCT debuted a few years ago, many comprehensive ophthalmologists, especially those in small practices, likely were wowed by the capabilities but balked at the idea of buying one. High price, bulky equipment, questionable need in a general practice. Strike one, strike two, strike three.

As OCT continues to mature, prices are coming down — just as clinical indications are accumulating. New uses abound in glaucoma and refractive surgery, and more general ophthalmologists are using OCT to improve their retinal disease screening and referrals.

For those reconsidering such an investment, the new iVue from Optovue may make it more feasible to take the plunge. Though it lacks some of the high-end features of its counterpart the RTVue, its technical specs — 5 micron resolution and 26,000 A-scans per second, to name a few — compare favorably with other SD-OCTs. Moreover, this affordable, portable scanner is making it possible for generalists to obtain state-of-the-art ocular imaging right in house.

The space-saving iVue SD-OCT.

Physician Feedback

Stephen Prepas, MD, a pediatric ophthalmologist in Newport Beach, Calif., recently added iVue to his practice. He contemplated purchasing an OCT for quite a while, but felt it was impractical in his circumstances to acquire one of the conventional SD-OCT devices.

Like many solo practitioners, Dr. Prepas usually referred patients to a nearby colleague for OCT scans prior to acquiring iVue. While this worked fine for his needs, Dr. Prepas sensed that OCT will eventually be standard equipment in most offices, not just universities and retina specialists. He didn't want to be behind the curve and at a disadvantage relative to larger practices in his community.

"Of all the recent new technologies, an OCT is profoundly beneficial," says Dr. Prepas. After speaking with other physicians who had purchased scanners, he concluded that the newer spectral-domain equipment would be the smartest move.

In addition to finding a device that would ease his cost apprehensions, Dr. Prepas felt it was critical to purchase something portable. "Size was the biggest issue for me. I needed something that I could take from our office into the operating room for examining under anesthesia, which we frequently do with little kids." iVue's compact packaging and small foot-switch fit the bill, he says.

Though iVue has valuable features for any small practice, Dr. Prepas found that the machine was especially useful in pediatrics. "Because the machine is so small, it's not as foreboding to young kids as a larger OCT," he says. The retina and cornea scans also allow him to diagnose diseases before children are old enough to read a Snellen chart.

A retinal SD-OCT obtained by the iVue.

Dr. Prepas also says his patients' parents appreciate the opportunity to see visual evidence of his findings. He often has children come to his office claiming they can't see well, but in reality are shy during their school eye exams or don't want to get glasses. By running an OCT on these patients, he can confirm that they are healthy — limiting further referrals for more advanced testing. "This reassures parents. I can say, ‘The retina is fine,’ but being able to show them that the retina is fine is a great supplement," Dr. Prepas says.

He says that his staff had no trouble learning how to do procedures with iVue and that the more they use it, the easier it gets. The machine uses an LCD touch screen and creates live video and en face images. "It's pretty straightforward," he says.

"iVue has actually added even more to my practice than I expected," Dr. Prepas says. "I can make timely referrals. I can diagnose a two- or three-year-old with early optic nerve hypoplasia. I see some adults and can detect early glaucoma." Clearly, good things come in small packages. OM

For more information, visit www.ivueoct.com.