Which OCT machine?

[Eyefixer]

Hello everyone,

Our practice is looking to purchase an OCT machince in the next 6 months. Zeiss immidiately comes to mind, but upon further research I am finding that there may be better alternatives out there for a general ophthalmology practice (difficulties with network connectivity, cost, etc. ). We are looking at the Topcon machine as well; it has better network interface, cheaper, does anterior segment without extra cost, etc. What do you guys think?

---

Members don't see this ad.

 

[Andrew_Doan]

Zeiss is the leader, and that's what we use.

 

[Eyefixer]

Zeiss is the leader, and that's what we use.

Well, they may be the leader now but we are trying to look towards the future. Zeiss make it very difficult integrating their equipment with various EHR systems requiring proprietary modules to make this work. We are also looking at cost of long term service contracts, anterior segment OCT availability, patient comfort with scanning, etc. Optovue makes a machine that seems less costly and more user friendly. Anyone has experience with Optovue?

 

[orbitsurgMD]

Look at the Heidelberg Spectralis as well.

 

[Visionary]

If you want anterior and posterior segment imaging, go with Optovue. The Topcon unit is garbage. Spectralis doesn't do anterior segment, but it's a great machine. I have a six mode that I use for OCT and angiography. Love it.

Sent from my HTC Incredible using SDN Mobile

 

[guttata]

Check out sermo.com There is a small discussion there (not many Zeiss supporters - mainly due to integration issues and the fact that they make it impossible to maintain older machines like the Stratus - forcing you to upgrade).

I have a question about the Heidelberg Spectralis. On the website, it lists fundus photography as a feature. Can the spectralis take color fundus photos and double as a nonmydriatic camera? I assume that if you get the FA add-on, you would need a color photo comparison?

If so, can it also take stereo optic disc photos?

If it cannot take color photos, have you been using red-free/autofluorescence photos to document retinal pathology (is it reimbursed by insurance)? In other words, have you used the spectralis for 92550, fundus photography, without performing an FA/ICG?

 

[Visionary]

I have a question about the Heidelberg Spectralis. On the website, it lists fundus photography as a feature. Can the spectralis take color fundus photos and double as a nonmydriatic camera? I assume that if you get the FA add-on, you would need a color photo comparison?

If so, can it also take stereo optic disc photos?

If it cannot take color photos, have you been using red-free/autofluorescence photos to document retinal pathology (is it reimbursed by insurance)? In other words, have you used the spectralis for 92550, fundus photography, without performing an FA/ICG?

It does not take color photos. It will do red-free, IR, and autofluorescence. All of those can be billed as fundus photos. Unless a choroidal nevus is very peripheral, we can usually capture it. It's good to get all 3 types of photos, especially AF--lipofuscin will light up. Spectralis will do stereo disc photos, which you can free-fuse at the monitor--no slides. I would recommend just using the RNFL analyzer software, though. Much more objective than grading changes in stereo disc photos. To be honest, there has not been a single case in my 2.5 years of practice where I thought a color photo was needed. I've had residents/fellows present some of my cases at the university, and the old guard will often gripe about the lack of colors. Has no bearing on the day-to-day management of patients, though. I may upgrade our old non-digital fundus camera one day...or maybe not.

 

[cme2c]

Curious is anyone knows how much the anterior segment module for the spectralis costs.

 

[Visionary]

Curious is anyone knows how much the anterior segment module for the spectralis costs.

Hmm, I'd heard they were working on an anterior segment module, but didn't know it was out yet. Don't know the price, but seems it involves another lens attachment with additional software. If I were to guess, I'd say somewhere around $15k, since it's an add-on to an existing system. The 55 deg lens, which is sold separately for wider field imaging, runs around $5k. I would imaging the ant seg lens would be about the same. Software is where the main cost will be. May have to look into it.

 

[guttata]

It does not take color photos. It will do red-free, IR, and autofluorescence. All of those can be billed as fundus photos. Unless a choroidal nevus is very peripheral, we can usually capture it. It's good to get all 3 types of photos, especially AF--lipofuscin will light up. Spectralis will do stereo disc photos, which you can free-fuse at the monitor--no slides. I would recommend just using the RNFL analyzer software, though. Much more objective than grading changes in stereo disc photos. To be honest, there has not been a single case in my 2.5 years of practice where I thought a color photo was needed. I've had residents/fellows present some of my cases at the university, and the old guard will often gripe about the lack of colors. Has no bearing on the day-to-day management of patients, though. I may upgrade our old non-digital fundus camera one day...or maybe not.

I will demo the unit soon, but just curious...

So, in the FA mode, you cannot take a comparison color photo?
Wouldn't this be helpful for treatment, especially with targeting leaking MAs?

 

[Visionary]

I will demo the unit soon, but just curious...

So, in the FA mode, you cannot take a comparison color photo?
Wouldn't this be helpful for treatment, especially with targeting leaking MAs?

No, you can't; however, I honestly don't feel it adds anything. I have always used vascular markings for focal/PDT. The dye contrast highlights the pathology better. I think there was a recent paper on microaneurysm appearance on FA versus clinical exam. Much more numerous and obvious on FA.