Spotlight ON TECHNOLOGY & TECHNIQUE

Piecing Together the Retinal Puzzle

By Samantha Stahl, Assistant Editor

It's a tedious process, meticulously laboring over an assortment of fundus images and trying to weave them together like puzzle pieces to create a retina montage. Using a program like Adobe Photoshop or Illustrator — the software most often used to create mosaic images — leaves a lot of potential for error and drains quite a bit of time.

Now, thanks to the release of Topcon's new i2k Retina software, that process is about to get easier. The program automates the creation of mosaics by scanning and aligning each image's common structures.

Joseph Carroll, PhD, associate professor of ophthalmology at the Wisconsin College of Medicine's Eye Institute, says the program has become a staple amongst his colleagues. “As a researcher, I really like that the program can tell me exactly what it did to each image — how it was warped or rotated. For clinical use, physicians like that it can just give you the end result,” he says.

Before i2k Retina, Dr. Carroll says similar image montages were a chore to create. “Someone who was really well trained could put together a mosaic of fundus images in 20 minutes. To manually do something similar to the program's alignment mode, though, that's where it can get ugly.” There are many confounding variables, he says, especially differences in magnification level and the patient's head positioning. “It was a really subjective process. i2k Retina is an objective, quantitative approach to the same problem.”

This retinal montage was created from eight original fundus photos by using Topcon's i2k Retina software, which automates the image alignment process to save time and avoid error.

i2k Retina has the ability to composite images, regardless of their origin, in under a minute. “I think the biggest benefit of the software is that it's not device-dependent,” says Dr. Carroll. “We have patients coming in from all over the world, and they usually have images of their own. With this program, that doesn't matter — we can still integrate their images with ours, even though they were taken on a different machine by a different operator at a different magnification.”

The versatility of the software is especially appealing, he says. “It works for OCT scans, fundus photos, fluorescein angiograms — you could even use it to align photos of your garden if you wanted. It's that multimodal view of pathology that we really enjoy most,” he says. Also, the software's seamless creations are a vast improvement over the sequential image viewing that most ophthalmologists currently rely on, he says.

Dr. Carroll notes that, in his experience, the software is unable to automatically composite images in about 5% of cases. “That needs to be kept in context for a practice that's seeing 20,000 patients a year, but for a first release it's fantastic.”

Practices interested in testing out the program can download a free trial on the company's Web site. “When we did a trial of the software, we were so impressed that we bought nine copies that day. It's very intuitive and quick,” Dr. Carroll says.

Robert Gibson, Topcon's senior director of marketing, says the software is $995 standalone, but is free with the purchase of a Topcon camera. The program is also being incorporated with Topcon's other image management software, ImageNet and EyeRoute, which allow remote access to a patient's information.

Topcon offers online training for the standalone product and onsite training with a camera purchase. “The software is really easy to pick up,” Mr. Gibson says. “With our systems, all you have to do is push a button.” OM

For more information, visit www.topconmedical.com.