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    OCTA system offers exquisite views

    New technology provides elegant look at retinal microvasculature without fluorescein dye

     

    Closer follow-up

    “Clinicians can evaluate the choroidal neovascular lesion at every follow-up visit if they so desire, which has given us a way to evaluate and follow these patients a bit more closely and in a way that increases the convenience to the patients by requiring less time,” Dr. Esmaili said.

    The safety profile is also improved due to the non-invasive nature of OCTA. Any risk of a dye reaction is eliminated, he pointed out.

    An OCTA overview report of the left eye of a patient with diabetic retinopathy. The structural OCT images (horizontal and vertical B-scans) are presented with the four primary OCTA “slabs.” The superficial plexus is enlarged for easier viewing at the lower left. An irregular foveal avascular zone and focal areas of capillary non-perfusion are visualized. (Courtesy of Daniel D. Esmaili, MD.) 

    A limitation of this technology is that the range of view of the retina has not been increased in contrast to the view available when using widefield fluorescein angiography, Dr. Esmaili commented.

    “In its current form, OCTA provides a view of the macula and the optic nerve and not the peripheral retina,” he noted.

    When using OCTA, the clinician has the freedom to choose a particular size image, large or small. The clinician can obtain the maximum density of b-scans in, for example, a 3-mm × 3-mm box, versus an 8-mm × 8-mm box in which the b-scans will provide a larger area of view albeit with less definition, according to Dr. Esmaili.

    The company has provided an update to the technology and has introduced a 6-mm × 6-mm HD algorithm that gives both excellent definition and a useful area of evaluation. Software updates also allow for a montage composite view to be obtained by combining optic nerve and macula images.

    Patients with AMD who are being followed have a substantial treatment burden. These patients may be asked to undergo monthly evaluations that include imaging, dilated eye examinations, and perhaps an injection if needed. An important consideration is that many patients are elderly and many require that they be transported to these evaluations by family members who may have other obligations.

    “The feedback from our patients is that the non-invasive and rapid acquisition time of OCTA is creating shorter visits that are safer and more comfortable. Our patients are appreciative of this and have really embraced this technology,” he said.

    Detailed imaging

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