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  • Technologies in Optometry: Altris AI for Clare and Illingworth

    technologies in optometry
    Altris Team
    3 min.
    3 min.

    Clare and Illingworth, renowned leaders in the field of optometry, have embraced cutting-edge technology to enhance their Optical Coherence Tomography (OCT) analysis workflow. The introduction of Altris AI at this optometry center marks a significant milestone in their commitment to providing high-quality services to patients.

    According to one of the owners of the optometry center, Richard, “We are adding a new OCT to one of our practices and will benefit from some extra support with AI to speed up the interpretation of results and assist the busy Optometry team.”

    Altris AI, a leading provider of artificial intelligence solutions for healthcare, specializes in developing algorithms and software applications that augment medical imaging analysis. The integration of Altris AI into the British Optometry Center’s OCT workflow brings forth a host of advantages, revolutionizing the way eye conditions are diagnosed and managed.

    FDA-cleared AI for OCT Analysis

    Try it yourself in our Demo Account or get a Brochure

    Demo Account Get brochure

     

    Technologies in Optometry and Ophthalmology: How AI Helps

    One of the key benefits of Altris AI is its ability to automate and expedite the analysis of OCT scans. Traditionally, optometrists spent considerable time manually reviewing and interpreting OCT images.

    FDA-cleared Altris AI is created to make the OCT workflow more effective

    How does it work? Altris AI serves as a copilot, analyzing OCT scans in parallel to the eye care specialist. For instance, on this OCT scan, Altris AI detects Diffuse Edema, Floaters, Intraretinal Hyperreflective Foci, Posterior Hyaloid Membrane Detachment, RPE disruption, Shadowing, Hard Exudates, Intraretinal Cystoid Fluid. 

    • The classification in this case would be Diabetic Retinopathy. 

    AI blindness prevention

    With Altris AI, the process becomes significantly faster and more efficient. The AI algorithms can quickly analyze intricate details within the scans, providing clinicians with accurate and timely insights into the patient’s eye health.

    Moreover, the use of Altris AI contributes to increased diagnostic accuracy. The algorithms are trained on vast datasets, learning to recognize subtle patterns and anomalies that may escape the human eye.

    Thus, Altris AI recognizes 70+ retina pathologies and biomarkers, including DME, DR, GA, AMD, etc. 

    FDA-cleared AI for OCT Analysis

    Try it yourself in our Demo Account or get a Brochure

    Demo Account Get brochure

    Technologies in Optometry are paving the way to a new future where eye care specialists and AI will work together for better patient outcomes.  AI will never be able to substitute eye care specialists because the final diagnosis must include clinical history, results of lab tests, and other diagnostic methods.

     

  • Retina Layers Segmentation on OCT

    Maria Martynova
    5 min.
    5 min.

    The knowledge about macular retinal layer thicknesses and volume is an important diagnostic tool for any eye care professional today.  The information about the macular retinal layers often correlates with the evaluation of severity in many pathologies. 

    Manual segmentation is extremely time-consuming and prone to numerous errors, which is why OCT equipment manufacturers use automatic macular retinal layer thickness segmentation.

    Test FDA-cleared AI for OCT analysis

    Demo Account Get brochure

    Yet, retina layer segmentation in different OCT equipment manufacturers as well as in different OCT models varies significantly. It is sometimes difficult even for an experienced ECP to find the correlations and track the pathology dynamics. The normative bases refer only to the thickness of the entire retina, they are not related to segmentation. However, if the segmentation is performed incorrectly by the machine, it will lead to an incorrect calculation of the thickness of the retina or its layers, and then the assessment will be incorrect.

    At Altris AI we aim to visualize retina layers for a more accurate understanding of pathological process localization.  Such retina layers segmentation allows for defining the localization of the pathological process and tracing in dynamics the spread of the pathological process or the aftermath in the retina structure after its completion.

     

    For instance, the EZ layer is important in terms of vision loss forecasting.

    OCT Manufacturers  & Retina Layers Analysis

    From 2010 most eye care specialists have used the same OCT International Nomenclature for Optical Coherence Tomography. OCT equipment manufacturers rely on this nomenclature for retina layer thickness calculation and most ophthalmologists use it as well.

    Taking into account retina structure, some layers can be united into complexes. For instance, the ganglion complex includes RNFL, ganglion cell layer & OPL. 

    Let’s take a look at various OCT equipment manufacturers and the way they perform retina layer segmentation analysis. 

    For instance, here is how Topcon Advanced Boundary Segmentation (TABSTM) automated segmentation differentiates between nine intraretinal boundaries:

    • ILM
    • NFL/GCL,
    • GCL/IPL, 
    • IPL/INL, 
    • INL/OPL, 
    • ELM
    • EZ
    • OS/RPE
    • BM

    Zeiss CIRRUS uses two approaches to retina layer segmentation.  

    The existing segmentation algorithm (ESA) in CIRRUS estimates the positions of the inner plexiform layer (IPL) and outer plexiform layer (OPL) based on the internal limiting membrane (ILM) and retinal pigment epithelium (RPE). To improve the accuracy of the segmentation of these layers, a multi-layer segmentation algorithm (MLS) was introduced, it truly segments layers instead of estimating their position. 

    Heidelberg Engineering offers to learn about the following inner and outer retina layers on their website. There are 10 retina layers according to Heidelberg, and they are the following:

    • ILM
    • RNFL
    • GCL
    • IPL
    • INL
    • OPL
    • ONL
    • ELM
    • PR
    • RPE
    • BM
    • CC
    • CS

    Why accurate retina layer segmentation is important?

    Retina layers segmentation helps eye care professionals to understand which pathology to consider in the first turn. For instance, changes in RPE and PR signify the development of Macular Degeneration. 

    Often such changes can also inform eye care specialists about the development of pathologies that lead to blindness, such as glaucoma, AMD, and Diabetic Retinopathy. 

     

    • Early Glaucoma Detection

    Historically, evaluation of early glaucomatous change has focused mostly on optic disk changes.  Modalities such as optical coherence tomography (OCT), confocal scanning laser ophthalmoscopy (HRT) or scanning laser polarimetry (GDx) with specially developed software algorithms have been used to quantitatively assess such changes. However, glaucomatous damage is primarily focused on retinal ganglion cells, which are particularly abundant in the peri-macular region (the only retinal area with a ganglion cell layer more than 1 layer thick), constituting, together with the nerve fiber layer, up to 35% of retinal macular thickness.

     Therefore, glaucomatous changes causing ganglion cell death could potentially result in a reduction of retinal macular thickness. Indeed, by employing specially developed algorithms to analyze OCT scans, previous studies have reported that glaucoma, even during the early stage, results in the thinning of inner retinal layers at the macular region.

    According to this study, the RNFL, GCL, and IPL levels out of all the retinal layers, the inner-most layers of the retina: the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and inner plexiform layer (IPL) show the best discriminative power for glaucoma detection. Among these, the RNFL around the circumpapillary region has shown great potential for discrimination. The automatic detection and segmentation of these layers can be approached with different classical digital image processing techniques.

    Test FDA-cleared AI for OCT analysis

    Demo Account Get brochure

     

    • Detection of AMD

    This first population-based study on spectral-domain optical coherence tomography-derived retinal layer thicknesses in a total of ∼1,000 individuals provides insights into the reliability of auto-segmentation and layer-specific reference values for an older population. 

    The findings showed a difference in thicknesses between early AMD and no AMD for some retinal layers, suggesting these as potential imaging biomarkers. When comparing layer thicknesses between early AMD and no AMD (822 eyes, 449 participants), the retinal pigment epithelium/Bruch’s membrane complex demonstrated a statistically significant thickening, and photoreceptor layers showed a significant thinning.

    • Detection of DR

    The depth and spatially resolved retinal thickness and reflectance measurements are potential biomarkers for the assessment and monitoring of Diabetic Retinopathy, one of the key reasons for blindness around the globe.

    For instance, this study confirmed that decreased RNFL thickness and increased INL/OPL thickness in diabetics without DR or with initial DR suggest early alterations in the inner retina. On the contrary, the outer retina seems not to be affected at the early stages of DM. Automatic intraretinal layering by SD-OCT may be a useful tool to diagnose and monitor early intraretinal changes in DR.

    Conclusion:

    Retina layer segmentation is crucial for the accurate detection of pathologies in the eye, especially in the field of ophthalmology and medical imaging. Here are several reasons why it is important:

    Precise Diagnosis: Retina layer segmentation provides a detailed map of the different retinal layers, which helps in the precise diagnosis of various eye conditions. It allows clinicians to identify the exact location of abnormalities, such as cysts, hemorrhages, or lesions, within the retina.

    Quantitative Analysis: It enables quantitative analysis of retinal structures. By measuring the thickness, volume, and other characteristics of specific layers, clinicians can assess the severity and progression of diseases like diabetic retinopathy, macular degeneration, and glaucoma.

    Early Detection: Some retinal pathologies manifest in specific layers of the retina before becoming visible on a fundus photograph. Retina layer segmentation can help detect these changes at an early stage, potentially leading to earlier intervention and improved outcomes.

    Treatment Planning: Knowing the precise location of pathologies within the retina’s layers can aid in the planning of treatment strategies. For example, in cases of macular holes or retinal detachment, surgeons can use this information to guide their procedures.

    Monitoring Disease Progression: Retina layer segmentation is valuable for monitoring how retinal diseases progress over time. Changes in the thickness or integrity of specific layers can be tracked to assess the effectiveness of treatments or the worsening of conditions.

     

popular Posted

  • Technologies in Optometry: Altris AI for Clare and Illingworth

    technologies in optometry
    Altris Team
    3 min.
    3 min.

    Clare and Illingworth, renowned leaders in the field of optometry, have embraced cutting-edge technology to enhance their Optical Coherence Tomography (OCT) analysis workflow. The introduction of Altris AI at this optometry center marks a significant milestone in their commitment to providing high-quality services to patients.

    According to one of the owners of the optometry center, Richard, “We are adding a new OCT to one of our practices and will benefit from some extra support with AI to speed up the interpretation of results and assist the busy Optometry team.”

    Altris AI, a leading provider of artificial intelligence solutions for healthcare, specializes in developing algorithms and software applications that augment medical imaging analysis. The integration of Altris AI into the British Optometry Center’s OCT workflow brings forth a host of advantages, revolutionizing the way eye conditions are diagnosed and managed.

    FDA-cleared AI for OCT Analysis

    Try it yourself in our Demo Account or get a Brochure

    Demo Account Get brochure

     

    Technologies in Optometry and Ophthalmology: How AI Helps

    One of the key benefits of Altris AI is its ability to automate and expedite the analysis of OCT scans. Traditionally, optometrists spent considerable time manually reviewing and interpreting OCT images.

    FDA-cleared Altris AI is created to make the OCT workflow more effective

    How does it work? Altris AI serves as a copilot, analyzing OCT scans in parallel to the eye care specialist. For instance, on this OCT scan, Altris AI detects Diffuse Edema, Floaters, Intraretinal Hyperreflective Foci, Posterior Hyaloid Membrane Detachment, RPE disruption, Shadowing, Hard Exudates, Intraretinal Cystoid Fluid. 

    • The classification in this case would be Diabetic Retinopathy. 

    AI blindness prevention

    With Altris AI, the process becomes significantly faster and more efficient. The AI algorithms can quickly analyze intricate details within the scans, providing clinicians with accurate and timely insights into the patient’s eye health.

    Moreover, the use of Altris AI contributes to increased diagnostic accuracy. The algorithms are trained on vast datasets, learning to recognize subtle patterns and anomalies that may escape the human eye.

    Thus, Altris AI recognizes 70+ retina pathologies and biomarkers, including DME, DR, GA, AMD, etc. 

    FDA-cleared AI for OCT Analysis

    Try it yourself in our Demo Account or get a Brochure

    Demo Account Get brochure

    Technologies in Optometry are paving the way to a new future where eye care specialists and AI will work together for better patient outcomes.  AI will never be able to substitute eye care specialists because the final diagnosis must include clinical history, results of lab tests, and other diagnostic methods.

     

  • Retina Layers Segmentation on OCT

    Maria Martynova
    5 min.
    5 min.

    The knowledge about macular retinal layer thicknesses and volume is an important diagnostic tool for any eye care professional today.  The information about the macular retinal layers often correlates with the evaluation of severity in many pathologies. 

    Manual segmentation is extremely time-consuming and prone to numerous errors, which is why OCT equipment manufacturers use automatic macular retinal layer thickness segmentation.

    Test FDA-cleared AI for OCT analysis

    Demo Account Get brochure

    Yet, retina layer segmentation in different OCT equipment manufacturers as well as in different OCT models varies significantly. It is sometimes difficult even for an experienced ECP to find the correlations and track the pathology dynamics. The normative bases refer only to the thickness of the entire retina, they are not related to segmentation. However, if the segmentation is performed incorrectly by the machine, it will lead to an incorrect calculation of the thickness of the retina or its layers, and then the assessment will be incorrect.

    At Altris AI we aim to visualize retina layers for a more accurate understanding of pathological process localization.  Such retina layers segmentation allows for defining the localization of the pathological process and tracing in dynamics the spread of the pathological process or the aftermath in the retina structure after its completion.

     

    For instance, the EZ layer is important in terms of vision loss forecasting.

    OCT Manufacturers  & Retina Layers Analysis

    From 2010 most eye care specialists have used the same OCT International Nomenclature for Optical Coherence Tomography. OCT equipment manufacturers rely on this nomenclature for retina layer thickness calculation and most ophthalmologists use it as well.

    Taking into account retina structure, some layers can be united into complexes. For instance, the ganglion complex includes RNFL, ganglion cell layer & OPL. 

    Let’s take a look at various OCT equipment manufacturers and the way they perform retina layer segmentation analysis. 

    For instance, here is how Topcon Advanced Boundary Segmentation (TABSTM) automated segmentation differentiates between nine intraretinal boundaries:

    • ILM
    • NFL/GCL,
    • GCL/IPL, 
    • IPL/INL, 
    • INL/OPL, 
    • ELM
    • EZ
    • OS/RPE
    • BM

    Zeiss CIRRUS uses two approaches to retina layer segmentation.  

    The existing segmentation algorithm (ESA) in CIRRUS estimates the positions of the inner plexiform layer (IPL) and outer plexiform layer (OPL) based on the internal limiting membrane (ILM) and retinal pigment epithelium (RPE). To improve the accuracy of the segmentation of these layers, a multi-layer segmentation algorithm (MLS) was introduced, it truly segments layers instead of estimating their position. 

    Heidelberg Engineering offers to learn about the following inner and outer retina layers on their website. There are 10 retina layers according to Heidelberg, and they are the following:

    • ILM
    • RNFL
    • GCL
    • IPL
    • INL
    • OPL
    • ONL
    • ELM
    • PR
    • RPE
    • BM
    • CC
    • CS

    Why accurate retina layer segmentation is important?

    Retina layers segmentation helps eye care professionals to understand which pathology to consider in the first turn. For instance, changes in RPE and PR signify the development of Macular Degeneration. 

    Often such changes can also inform eye care specialists about the development of pathologies that lead to blindness, such as glaucoma, AMD, and Diabetic Retinopathy. 

     

    • Early Glaucoma Detection

    Historically, evaluation of early glaucomatous change has focused mostly on optic disk changes.  Modalities such as optical coherence tomography (OCT), confocal scanning laser ophthalmoscopy (HRT) or scanning laser polarimetry (GDx) with specially developed software algorithms have been used to quantitatively assess such changes. However, glaucomatous damage is primarily focused on retinal ganglion cells, which are particularly abundant in the peri-macular region (the only retinal area with a ganglion cell layer more than 1 layer thick), constituting, together with the nerve fiber layer, up to 35% of retinal macular thickness.

     Therefore, glaucomatous changes causing ganglion cell death could potentially result in a reduction of retinal macular thickness. Indeed, by employing specially developed algorithms to analyze OCT scans, previous studies have reported that glaucoma, even during the early stage, results in the thinning of inner retinal layers at the macular region.

    According to this study, the RNFL, GCL, and IPL levels out of all the retinal layers, the inner-most layers of the retina: the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and inner plexiform layer (IPL) show the best discriminative power for glaucoma detection. Among these, the RNFL around the circumpapillary region has shown great potential for discrimination. The automatic detection and segmentation of these layers can be approached with different classical digital image processing techniques.

    Test FDA-cleared AI for OCT analysis

    Demo Account Get brochure

     

    • Detection of AMD

    This first population-based study on spectral-domain optical coherence tomography-derived retinal layer thicknesses in a total of ∼1,000 individuals provides insights into the reliability of auto-segmentation and layer-specific reference values for an older population. 

    The findings showed a difference in thicknesses between early AMD and no AMD for some retinal layers, suggesting these as potential imaging biomarkers. When comparing layer thicknesses between early AMD and no AMD (822 eyes, 449 participants), the retinal pigment epithelium/Bruch’s membrane complex demonstrated a statistically significant thickening, and photoreceptor layers showed a significant thinning.

    • Detection of DR

    The depth and spatially resolved retinal thickness and reflectance measurements are potential biomarkers for the assessment and monitoring of Diabetic Retinopathy, one of the key reasons for blindness around the globe.

    For instance, this study confirmed that decreased RNFL thickness and increased INL/OPL thickness in diabetics without DR or with initial DR suggest early alterations in the inner retina. On the contrary, the outer retina seems not to be affected at the early stages of DM. Automatic intraretinal layering by SD-OCT may be a useful tool to diagnose and monitor early intraretinal changes in DR.

    Conclusion:

    Retina layer segmentation is crucial for the accurate detection of pathologies in the eye, especially in the field of ophthalmology and medical imaging. Here are several reasons why it is important:

    Precise Diagnosis: Retina layer segmentation provides a detailed map of the different retinal layers, which helps in the precise diagnosis of various eye conditions. It allows clinicians to identify the exact location of abnormalities, such as cysts, hemorrhages, or lesions, within the retina.

    Quantitative Analysis: It enables quantitative analysis of retinal structures. By measuring the thickness, volume, and other characteristics of specific layers, clinicians can assess the severity and progression of diseases like diabetic retinopathy, macular degeneration, and glaucoma.

    Early Detection: Some retinal pathologies manifest in specific layers of the retina before becoming visible on a fundus photograph. Retina layer segmentation can help detect these changes at an early stage, potentially leading to earlier intervention and improved outcomes.

    Treatment Planning: Knowing the precise location of pathologies within the retina’s layers can aid in the planning of treatment strategies. For example, in cases of macular holes or retinal detachment, surgeons can use this information to guide their procedures.

    Monitoring Disease Progression: Retina layer segmentation is valuable for monitoring how retinal diseases progress over time. Changes in the thickness or integrity of specific layers can be tracked to assess the effectiveness of treatments or the worsening of conditions.

     

  • Altris AI for Buckingham and Hickson Optometry, the UK

    Altris Team
    1 min.

    The Client: Buckingham and Hickson is a family-run optometry practice that was established in 1960 in the United Kingdom. The optometry practice offers a number of services:

    • Wide range of spectacle frames and lenses.
    • Contact lenses.
    • Glaucoma referral refinement.
    • Cataract choice referral.
    • OCT examination.
    • NHS and private eye tests.
    See how it works

    FDA approved AI for OCT scan analysis

    Demo Account Get brochure

     

    The challenge: The optometry owners wanted to test how Artificial Intelligence can assist them in OCT examination or, to be more precise, in providing a second opinion regarding OCT scans.

    OCT examination is one of the best retina diagnostics methods, however in many cases OCT scan interpretation can be really challenging for several reasons:

    1. Variability in Anatomy: There is significant natural anatomical variation among individuals. What may be considered normal for one person may be abnormal for another. Eye care specialists need to account for these variations when interpreting OCT scans, but this often requires years of experience.
    2. Various Eye Conditions: Eye care specialists use OCT scans to diagnose and monitor a wide range of eye conditions, including macular degeneration, diabetic retinopathy, and retinal detachment, among others. Each of these conditions can manifest in different ways on OCT scans, making interpretation challenging.
    3. Progression Monitoring: Ophthalmologists often use OCT to monitor disease progression and the effectiveness of treatment. Tracking subtle changes over time can be difficult, as it requires precise comparisons of multiple scans.
    4. Artifacts: OCT scans are susceptible to artifacts, such as shadowing, motion artifacts, and signal dropout, which can obscure or distort the image. Recognizing and mitigating these artifacts is essential for accurate interpretation.
    5. Experience and Training: Accurate interpretation of OCT scans in optometry and ophthalmology requires specialized training and experience.
    6. Evolving Technology: OCT technology continues to advance, introducing new techniques and capabilities. Staying current with these advancements and understanding their clinical implications is an ongoing challenge for ophthalmologists.

    The solution: Artificial intelligence (AI) can play a significant role in OCT (Optical Coherence Tomography) scan interpretation for ophthalmologists and optometrists in various ways. Artificial Intelligence (AI) provides eye care specialists with more accurate results, severity level detection ( to work only with pathological scans), and assists in early pathologies detection.
    According Ian, one of the owners of Buckingham and Hickson optometry, “they are using Altris AI to get a second opinion on OCT scans.”
    According to Altris AI Medical Director, Maria Znamenska, who is MD, Ph.D., Associate Professor of Ophthalmology, “It is getting more common to double-check the interpretation of OCT scans ( and other medical images) with modern AI tools as they are getting safer and more efficient. Altris AI has received FDA clearance recently apart from having a CE certificate.”
  • 8 Reasons why Optometry Groups Invest in Artificial Intelligence for OCT Scan Analysis

    Mark Braddon
    5 min.

    Optometry chains offer a wide range of eye care services, making it convenient for patients to access eye care locally. 

    However, the widespread accessibility of optometry chains has a reverse side for them. The shortage of employees, new unfamiliar equipment for diagnostics, and a large number of patients create an extremely challenging workflow for many optometrists. This, in turn, creates a number of challenges that can be more familiar to Optometry chains: low optometrist recruitment and retention, inconsistent quality of examination throughout the practices, lack of communication with patients, etc. 

    Automation of routine processes and digitalization have always served as answers to challenges like these in any industry, and healthcare is no exception. Luckily, automation of one of the most complex tasks for optometrists – OCT examination is already available to optometry chains with Artificial Intelligence (AI).   

    OCT proves to be one of the most efficient diagnostic tools for many modern top-notch optometry practices, however, mastering it requires skills and time. Artificial intelligence tools, such as AI for OCT analysis platform, can automate many routine processes which will have enormous benefits for any optometry chain. The top 8 benefits are the following: 

    • #1 AI for OCT increases clinical efficiencies

    Automating OCT scan analysis through AI reduces the time optometrists spend on image interpretation. This allows optometrists to focus on more complex cases, patient interactions, and personalized treatment plans. For any large optometry chain, saving time means providing more patients with high-quality service. 

    How does it work in practice?

    For instance, Altris AI has a severity grading of b-scans. Severity grading means that it is easy to see if the eye is healthy ​(removing any need to spend time interpreting) or highlight ​where the pathology is and the degree of severity. ​

    • Green- no pathology detected
    • Yellow- mild to medium level of severity
    • Red – severe pathology detected

    • #2 AI for OCT provides consistently high standard of quality throughout the chain

    AI algorithms provide consistent and standardized analysis regardless of the individual interpreting OCT scans. This reduces variability in diagnoses and ensures that patients receive uniform care across different clinics and practitioners within the optometry chain.

    AI algorithms can analyze OCT scans with incredible precision and consistency. They can detect subtle changes in retinal structures that might be missed by human observers, leading to earlier and more accurate diagnoses of various eye conditions such as macular degeneration, glaucoma, diabetic retinopathy, and more.

    This will help younger less experienced optometrists and will serve as a second opinion tool for more experienced specialists. 

    Test how Altris AI analyzes OCT

    Demo Account Get brochure

    • #3  AI for OCT enables better retention of employees

    The shortage of optometrists in the world is staggering. 14 million optometry specialists are needed worldwide according to the WHO, while today there are only 331K ready to work.

     It is equally difficult to hire and retain a good optometrist for a company in 2023. However, more and more young optometrists choose innovative businesses that use technology to improve the workflow. Top-notch equipment, convenient scheduling tools, and of course, Artificial Intelligence for OCT & fundus photo analysis might be the perks that will help optometrists to choose your optometry business. 

    Fresh from college optometrists feel more confident when they know that they will have a backup when reviewing OCT scans

    • #4 Reduced Workload Burden

    Optometrists often have heavy workloads, and AI can help alleviate some of this burden by handling routine tasks like initial image analysis. This enables optometrists to spend more time on patient consultations and treatment planning.

    According to a survey by the General Optical Council, 57% of optometrists worked beyond their hours in 2022. Optometrists were more likely to be working beyond their hours (60%) or finding it difficult to provide patients with the sufficient level of care they needed (34%) when compared to other registration types.

    It is possible to outsource preliminary image analysis to Artificial Intelligence tools but communication and empathy are human tasks only. 

    • # 5 AI promotes enhanced patient education

    Let’s not forget about the patients. AI-generated OCT reports can help explain complex medical conditions to patients in a more understandable, visual way. After all 80% of all the information we receive is visual: imagine your optometrists not only telling but also showing what is going on with patients.  

    Comprehensive, color-coded OCT reports may improve patient education and engagement, leading to better treatment adherence and loyalty. 

    When patients don’t understand what they are paying for they are not likely to return for annual checkups. At Altris AI we created smart OCT reports that are comprehensible for patients as well as optometrists. We visualize all the pathologies and the patients can trace the dynamics of 

    #6 Reducing a clinical risk. No chances of getting a legal inquiry because of a pathology missed

    Optometry chains can perform around 40K OCT scans a week. Statistically speaking, the chance of missing a minor early pathology is huge simply because of the big number.

    With the double-check that AI for OCT scan analysis provides, It is not possible to wipe the risk out for 100%, but it is possible to diminish the risk to the absolute minimum. 

    For the optometry chain, it might mean no bad PR and weird stories in the papers and subsequently, a better brand image.

    • #7 AI makes early detection of pathologies possible on OCT

    AI algorithms can identify early signs of eye diseases that might not be easily recognizable in their early stage. This early detection can lead to timely interventions, preventing or minimizing patient vision loss.

    Glaucoma, Wet AMD, Diabetic Retinopathy, and genetic diseases are among the pathologies that lead to blindness if not detected in time. Detecting pathological signs and pathologies related to these disorders in time can literally save patients from future blindness.

    Early detection of pathologies means that it is possible to stop or reduce the risk of total blindness which is the best result in any sense. Early detection will allow optometrists to give valid recommendations, and advise on dieting and supplements right at the optical store. 

    • #8 Competitive Edge

    AI is a buzzword, and it’s not accidental. All major players understand its enormous value and invest in it. During the last presentation, the CEO of Google said “AI” 140 times, and let’s be honest, it is not to show off. It is because AI can actually make changes in business: automation of repetitive processes, workflow optimization, and human error reduction. 

    Adopting AI technology for OCT analysis showcases the optometry chain’s commitment to staying at the forefront of technological advancements in healthcare. Gaining a real competitive edge is another big goal. 

    This can attract patients who value cutting-edge approaches to diagnosis and treatment. A younger generation of patients are curious about new technologies, and this can be an additional lead magnet for them.

    Conclusion

    Incorporating AI for OCT analysis into optometry chains can enhance patient outcomes, make the workflow more efficient, and improve the performance of each optometry center. However, it’s important to ensure that the AI systems are properly validated, integrated into clinical workflows, and monitored to maintain their accuracy and effectiveness. More than that, it should complement, not replace, the expertise of optometrists. The technology should be used as a tool to aid optometrists and make OCT examination more effective.

     

  • Why Eye Care Specialists Consider Innovative Tools in Addition to Normative Database

    Normative database OCT
    Maria Martynova
    06.09.2023
    6 min read

    The first normative database for OCT was created in the early 2000s and were based on small studies of mostly white patients. However, as OCT technology has evolved, so too have the normative databases. Recent databases are larger and more diverse, reflecting the increasing ethnic and racial diversity of the population.

    FDA-cleared AI for OCT

    Make your eye care business technological

    Demo Account Get brochure

    Nowadays, eye care specialists use normative database to compare the characteristics of a patient to a population-wide norm. This allows them to quickly and easily assess whether a patient’s retinal dimensions fall within normal limits. According to our survey, 79% of eye care specialists rely on the normative databases for OCT verdict with every patient.

    Normative database OCT

    However, despite the fact that normative databases are very widespread among specialists worldwide, they are not perfect. They can be affected by factors such as age, gender, axial length, and refractive error.

    They can be influenced by low image quality due to different eye pathologies. It is essential to be aware of these limitations when interpreting normative data OCT parameters. That is why, in this article, we will discuss the benefits of the collaboration between AI decision-making tools and normative databases to improve patient outcomes.

    What is a normative database, and is there a difference between normative databases for different devices? 

    Before diving into the subject of the benefits and limitations of normative databases, we would like to remind you what a normative database is. From the moment of its invention, the OCT exam has rapidly gained widespread adoption and has become indispensable in the eye care practice. Critical to this success has been the ability of software to automatically produce important measurements, such as the thickness of the peripapillary retinal nerve fiber layer (RNFL) in tracking glaucoma progression or the total retinal thickness in the assessment of macular diseases. 

    In order to accurately interpret OCT scans, normative databases were created. These databases are now built into almost all commercial OCT devices, allowing eye care specialists to view colored reports and progression maps that assist in the rapid recognition and tracking of pathology.

    Summing up, a normative database for OCT is a set of data that provides references for OCT thickness measurements in a healthy population. These databases are used to compare the OCT measurements of your patient to a population-wide norm. 

    Here are some of the OCT parameters that are commonly measured and compared to normative databases:

    • Retinal nerve fiber layer (RNFL) thickness: the RNFL is a retinal layer that is measured around the optic nerve. This measurement is important for diagnosing optic nerve atrophy.
    • Macular thickness: the macula is responsible for sharp central vision.
    • Ganglion cell complex thickness: the ganglion cell complex is a group of cells in the retina that are responsible for transmitting visual information to the brain.
    • Cup-to-disc ratio, neuroretinal rim, and other optic nerve parameters: are very important for diagnosing glaucoma and other optic nerve pathologies

    These are just a few of the OCT parameters that are commonly measured in normative databases. The specific parameters that are measured can vary depending on the type of OCT device and the clinical application. 

    In addition, different OCT devices can have different measurement capabilities and resolutions. For example, a device that uses time-domain OCT (TD-OCT) technology may have a lower resolution than a device that uses spectral-domain or swept-source OCT (SD or SS-OCT) technology. This means that the normative database for a TD-OCT device may not be as accurate as the normative database for an SD or SS-OCT device.

    What is more, the normative database for a particular device may be based on a specific population of patients. What are the benefits and limitations of normative databases?

    Now that we have highlighted different aspects of the normative database definition let us discuss the benefits and limitations of this tool. Normative databases can sometimes be very helpful for eye care specialists in diagnosis, decision-making, and creating a treatment strategy for eye diseases such as glaucoma and macular degeneration.

    • The measurement provided by the normative database can be used as a baseline for tracking a patient’s response to medication or other treatment. Eye care specialists can track changes between a few visits and determine the impact on the patient.
    • Normative databases show deviations from the norm, which may be a reason for a more comprehensive examination.
    • Eye care specialists can also use normative databases to compare the results of different OCT devices. This can help to ensure that they are using the most accurate device for their patients.

    There are still challenges that must be overcome to develop normative databases sufficient for use in clinical trials. That is why current normative databases also have a lot of limitations.

    Does not detect pathology

    The normative database works only with the thickness of the retina and does not detect what is inside the retina. Therefore, it cannot detect all pathologies where there is no change in retinal thickness. In the early stages, these are absolutely all diseases. We can see deviations from the normative base only when the disease progresses to a later and more severe stage when the retinal thickness decreases or increases.

    Limited diversity

    Normative databases can be limited by factors like age, gender, and ethnicity of the population used to create them. This can result in reduced accuracy for patients who are not well-represented in the database.

    Population variation

    Even healthy patients can have some anatomical variations that fall within the range of normal. These variations may be falsely flagged as abnormalities when compared to the database.

    How Altris AI platform can complement the information provided by the normative database

    Normative databases in OCT play a crucial role in aiding diagnosis and treatment planning, but they also have limitations related to representation, disease progression, and data quality. Eye care specialists need to interpret the results in the context of the patient’s individual characteristics and other clinical information, using additional tools for scan interpretations.

    Sometimes, low-quality OCT scans can be inaccurately interpreted by the eye care specialist, and the normative database can showcase inaccurate measurements. Altris AI platform detects low-quality scans automatically and warns about the possibility of inaccurate results. In addition, the platform automates the detection of 70+ pathologies and pathological signs. Once the user uploads the scan, they can see visualized and highlighted pathological areas and pathology classification that the algorithm has detected. The user can also calculate the area and volume of detected biomarkers.

    Normative database OCT

    Artificial intelligence-based tools for OCT interpretation used along with normative databases can play a crucial role in clinical eye care. Altris AI, for example, can provide eye care specialists with additional and more precise information about separate retinal layer thickness. The system analyzes the thickness of each retina layer or several layers combined.

    Normative database OCT

    While normative databases provide information only about the thickness, AI tools equipped with deep learning models can detect pathological signs in OCT scans that might be missed by the normative database or the human eye, enhancing diagnostic accuracy. Altris AI algorithm classifies the OCT scans based on the degree of pathology found. It can distinguish green concern, which indicates normal retina, yellow – moderate with slight deviations, and red concern, which means high severity level.

    Normative database OCT

    Summing up

    Despite their limitations, normative databases are an essential tool for the clinical use of OCT. They provide a valuable reference point for assessing patients and can help to identify some diseases. However, the normative database measures only the thickness, which is not enough to accurately diagnose the patient and create a treatment plan.

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    That is why incorporating AI into OCT interpretation streamlines the decision-making process. By automating the initial analysis of OCT scans, specialists can focus their attention on more complex cases, making the best use of their skills and experience. Moreover, embracing AI technologies empowers eye care specialists to personalize patient care with greater precision.

  • AI Blindness Prevention: How We Can Use Artificial Intelligence to Help Prevent Blindness

    AI blindness prevention
    Maria Martynova
    07.08.2023
    9 min read

    The total number of people with near or distant vision impairment reaches 2.2 billion worldwide. Of these, 43 million people are blind, and 295 million are suffering from moderate to severe visual impairment. Although the numbers are constantly changing as new research is conducted, the global burden of blindness and visual impairment remains a significant problem of humanity in the fight against which specialists combine their forces with AI technologies.

    AI blindness prevention

    AI blindness prevention tools are being actively developed to transform the landscape of vision care in many ways. Eye care specialists use AI systems for screening and detecting diseases that lead to vision loss. AI-powered smart monitors assist specialists in finding proper contact lenses and glasses. In addition, many researches are held with the help of AI algorithms, as they are able to process vast amounts of data.

    In this article, we will discuss different applications of AI in blindness prevention, specifically how artificial intelligence tools can empower eye care specialists and extend beyond the clinical setting. 

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    Today’s conditions and risk factors of blindness you should pay attention to

    Before talking about the developments in the AI sector toward blindness prevention, we would like to discuss the most common causes and risk factors of this impairment. Many health and lifestyle factors can influence the risk of vision loss. Smoking, excessive alcohol consumption, sun exposure, and poor nutrition can contribute to diseases that lead to vision loss. 

    In addition, there are many conditions that can lead to blindness if left with no proper treatment, among which are the following. 

    Age-related eye diseases

    The global population is aging rapidly. The number of people aged 65 and over is projected to triple from 1 billion in 2020 to 2.1 billion in 2050. Considering this fact, age-related eye diseases have become a prominent cause of blindness. Such diseases as age-related macular degeneration (AMD), cataract, and glaucoma are more prevalent in older patients, and if left untreated, they can lead to fast and significant vision loss. Regular eye check-ups and timely interventions are crucial in managing these diseases and preventing severe visual impairment.

    AI blindness prevention

    Besides AMD, there are a lot of age-related conditions which can be a red flag when examining the patient. Among these are macular holes, mactel, and vascular diseases, for example,  central retinal vein occlusion (CRVO) and central retinal artery occlusion (CRAO). Detecting even one of these pathological conditions in the early stages of their development is crucial for preventing vision loss. 

    However, many eye care specialists sometimes don’t have enough resources to dedicate more time to analyzing patients’ images. Our recent survey detected that among more than 300 participating optometrists, 40% of them have more than 10 OCT exams per day. Meanwhile, 35% of eye care specialists have 5-10 OCT examinations per day. The greater the number of patients per day, the greater the likelihood that eye care specialists may miss some minor, rare, or early conditions.

    AI blindness prevention

    Fortunately, nowadays, there are a lot of ways to empower the clinical workflow, and AI blindness prevention tools are gaining popularity. Artificial intelligence systems like Altris AI can analyze retinal images and other diagnostic data to detect early signs of age-related eye diseases. Altris AI platform, for example, can detect 70+ pathologies and pathological signs, including the ones, that refer to age-related diseases.

    AI blindness prevention

    Altris AI platform allows eye care specialists to rely on its disease classification when diagnosing a patient. It detects all the most common age-related pathologies, such as AMD, mactel, and vascular diseases – CRVO, CRAO.

    AI blindness prevention

    Diabetes and diabetic retinopathy

    Diabetes and related conditions are also common causes of vision loss. In the United States, about 12% of all new cases of blindness are caused due to diabetes. Globally, diabetes is estimated to cause 4.8% of all blindness. In addition, the risk of blindness from diabetes increases with the duration of diabetes. People with untreated diabetes for years are 25 times more likely to be blind than people without diabetes.

    AI blindness prevention

    The complication of diabetes, called Diabetic retinopathy (DR), affects the blood vessels of the retina and can lead to impaired vision or blindness. With the rising prevalence of diabetes worldwide, DR has become a significant problem. Early detection, proper control of diabetes, and regular eye exams are essential to prevent vision loss. 

    The American diabetes association (ADA) recommends that people with diabetes have an OCT scan of their eyes every year. This is because OCT can help to detect early signs of DR with high precision. In some cases, eye care specialists may recommend more frequent OCT scans. This may be the case if the patient has advanced diabetic retinopathy or a family history of diabetic retinopathy.

    AI blindness prevention

    AI algorithms such as Altris AI can assist in detecting the pathological signs of diabetic retinopathy or diabetic macular edema. Our web platform differentiates certain pathological signs that indicate diabetes-related diseases. Among these are:

    • Intraretinal fluid
    • Subretinal fluid
    • Hard exudates
    • Hyperreflective foci
    • Epiretinal fibrosis

    Genetic and inherited conditions

    Some patients are at a greater risk of developing visual impairment due to genetic factors or the inheritance of certain conditions. For example, retinitis pigmentosa is an inherited disease that affects the photoreceptor cells in the retina and gradually leads to night blindness and loss of peripheral vision. Genetic testing and counseling can help identify people at risk and provide early intervention.

    AI blindness prevention

    Some genetic eye conditions, such as myopia, vitelliform dystrophy, or retinoschisis, can be detected in the early stages with the help of OCT examination and artificial intelligence systems. Altris AI platform can help eye care specialists in their daily practice and make eye care more accessible, allowing specialists to perform regular eye check-ups, and provide timely treatment of genetic conditions.

    AI blindness prevention

    Current ways to prevent blindness with AI 

    As you can see, blindness risk factors encompass a wide range of conditions, pathologies, and circumstances that can significantly impact a patient’s health and increase the likelihood of severe visual impairment. Poorly managed age-related eye diseases, genetic and hereditary factors, and chronic health conditions can lead to eye-related complications, further elevating the risk of blindness.

    AI blindness prevention

    In the following paragraphs, we will describe in detail the modern ways of using artificial intelligence to detect and prevent blindness: from AI-based retinal imaging for early detection of eye diseases to personalized treatment recommendations and remote patient monitoring.

    AI for image interpretation

    AI blindness prevention

    It is important to understand that the timely detection of eye diseases is key to the effective treatment of visual impairments. However, today we have an unfortunate tendency to diagnose severe forms of disease too late. A large-scale survey by Eyewire conducted in 2021 found that about 40% of people in the USA said they had not had an eye exam in more than a year, and 10% said they had not had one in more than five years. 

    In addition, recent research by the British Journal of Ophthalmology found that 25.3% of people in Europe over the age of 60 have early signs of AMD. In the UK, about 200 people a day are affected by a severe form of AMD (wet AMD), which can cause severe blindness. 

    These studies show us that while eye care specialists around the world are trying to treat as many patients as possible, unfortunately, many patients are going blind due to delays in diagnosis. However, using advanced AI-based image analysis systems can speed up the detection of warning signs, allowing you to reach more patients.

    One of the advantages of AI for image analysis is its assistance in decision-making. Altris AI is a great example of how an image analysis system can help prevent blindness with AI. The platform allows eye care specialists to detect 74 retina pathologies and pathological signs, including risk conditions for vision loss, like AMD, Diabetic retinopathy, Vascular diseases of the retina, and others. 

    Diagnosing eye disease in children

    AI blindness prevention

    Today, one of the most important AI blindness prevention research is focused on teaching artificial intelligence algorithms to detect retinopathy in premature infants. Retinopathy of prematurity is the main cause of childhood blindness in middle-income countries. Some researches show that around 50,000 children all over the world are blind due to the disease.

    Unfortunately, experts’ forecasts show that these figures are likely to grow. Retinopathy of prematurity is becoming more and more common, especially in African countries. About 30% of children born in sub-Saharan Africa have this disease and, due to late detection and insufficient attention due to the lack of eye care specialists, can also go blind.

    An artificial intelligence model developed by an international team of scientists from the UK, Brazil, Egypt, and the US, with support from leading healthcare institutions, is able to identify children who are at risk of blindness if left untreated. The team of scientists hopes that this AI system will make access to screening and monitoring of young patients more affordable in many regions with limited eye care services and few qualified eye care specialists.

    AI monitors for eye strain control

    Another interesting application of AI to prevent blindness is eye care monitors. They are planned to be used to avoid eye strain due to prolonged computer work. Such monitors will be programmed to monitor the user’s facial expressions, blinks, and eye movements. They will also be able to assess the level of light in the room, and artificial intelligence will automatically adjust the screen brightness and image contrast.

    Since a huge number of the world’s population has switched to remote work since the pandemic and spends almost all day at the computer, such AI monitors are considered a huge help for users in preventing eye diseases that can lead to visual impairment.

    AI to determine better glasses or contact lenses

    AI blindness prevention

    In the field of developing and calculating suitable lenses, there are also a number of companies that have joined the development of AI tools. AI monitors will collect important information about the patient’s eye condition, analyze it, and prescribe suitable contact lenses or glasses. 

    In addition, these monitors will be able to analyze the patient’s medical history, including medical images, and create the most suitable treatment strategy to maximize visual acuity.

    AI for studying the human eye

    AI blindness prevention

    Today, AI is a promising tool for studying human eye tissue and developing new tools for diagnosing and treating eye diseases, including those that lead to vision loss. Artificial intelligence tools are used to analyze OCT images of the eye to detect changes that may indicate diseases such as diabetic retinopathy, macular degeneration, and glaucoma. AI is also used to predict the development of eye diseases based on genetic or risk factors. This is expected to help doctors identify people at risk of developing eye diseases at an early stage and prevent the progression of the disease.

    Summing up

    Today AI blindness prevention tools are already developing by many leading companies and institutions, and some companies, like Altris AI, are already using the potential of artificial intelligence to provide early detection and diagnostic advice for eye care specialists. But it’s worth noting that AI tools are not capable of coming up with innovative solutions for blindness prevention.

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    Only in close cooperation with eye care specialists AI blindness prevention tools can help in many ways, like early detection, providing access to medical care in underserved regions, detecting minor or rare conditions, and allowing to focus on personalized care and treatment of patients.

  • 5 Tips When Introducing the OCT Eye Exam to Patients

    OCT eye exam
    Mark Braddon
    24.07.2023
    8 min read

    As optometry technology evolves, many optometrists predict that utilizing OCT eye exam in practice will be vital in maximizing patient care. That is why successfully integrating an OCT device into your optometry practice workflow is instrumental to its clinical and commercial success.

    Optometrists from different countries often have the same questions about how to successfully integrate an OCT device into an Optometrist Practice, regardless of practice size or experience level. How to make patients feel comfortable? How to explain the importance of regular OCT scans? Will patients understand what is an OCT scan of the eye? How do we avoid patients thinking we want to perform OCT eye exams just to earn more money? The process of introducing OCT to patients is complex and covers many areas. 

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    If we speak to optometry practices, both those who are new to OCT and those who have had the OCT device for many years, most of them will want to improve the ROI and ensure the patients are gaining the full value of the OCT eye test. This article will show you 5 tips for successfully introducing the OCT eye exam to your patients.

    Remember why you invested in the OCT technology

    One may think that only novice optometrists tend to underestimate their work or do not feel confident about the value they give to patients. However, some experienced clinicians also avoid offering OCT eye tests because they think they are ‘overselling’ with additional fees for OCT, Optos, or other diagnostic exams. 

    That is why it is important to remember why you invested in OCT technology in the first place. In almost all cases, this is to improve the clinical standard of eye care that you offer to your patients. In fact, when I ask some optometrists if they want a member of their families to have an OCT eye exam, the answer is always ‘Yes, of course!’. So if you strongly recommend undergoing an examination to your relatives, why would you not recommend an OCT eye test for your patients?

    OCT eye exam

    Before a patient comes into the practice, one of the most important things you need to do is not undervalue your time, skills, and experience when charging for the additional time the OCT exam takes to interpret and discuss. 

    Implementing an OCT eye exam into regular practice improves clinical care and can generate a commercial benefit as well by increasing revenue through fees, patient retention, and loyalty. Moreover, word of mouth is often the most significant source of new patients for optometrists. If the patient feels you are confident in everything you do, it will make them more likely to recommend you to friends and family

    Explain the importance of OCT eye exam for early detection 

    From the first touch point, the patient should understand that your optometric practice takes its business seriously and provides additional diagnostic examinations, such as the OCT, to improve the quality of care. The first impression of your approach is very important, so it is crucial to start introducing the technology to the potential patient from the first point of contact. 

    As a rule, the beginning of a patient’s introduction to the OCT eye exam starts with several touch points. Whether they make their appointment for the eye examination through your website, mobile application, in person, or by phone, the most important thing you can do is create an integrated and comfortable patient journey.

    OCT eye exam

    Before a patient comes into the practice, you should explain the importance of the OCT device and its benefits compared to the standard examination. Even when the patient is fully acquainted with the OCT eye exam, they may still need help understanding why this particular imaging method is necessary. The ability of OCT eye exam to detect diseases in the early stages makes this technology indispensable for optometrists and patients and this is why it is such an excellent tool for diagnosing eye diseases. 

    More importantly, avoid frightening patients with stories about difficult-to-treat rare pathologies. Instead of talking about the pathology consequences, say that the OCT eye exam scan provides a clear map that helps locate areas of the eye with abnormalities or early changes.

    Understand the importance of a healthy-eye-as-a-baseline concept

    In this section, I want to discuss the concept of a healthy eye in more detail. When a patient comes to you for an examination, it is essential to use the correct narrative that the optometrist should use when discussing the results of an OCT eye exam with patients. It is important to emphasize that we are not looking for pathology but a healthy eye.

    We know that we will detect pathology in certain patients. The number of patients likely to have at least one pathology increases if you work with an older population. However, finding a healthy baseline scan is an important part of monitoring the long-term eye health of the patient.

    OCT eye exam

    Talking about baseline, make sure to emphasize how great it is to find a healthy eye in a patient. Explain that together you found a nice, healthy eye so you have the baseline to compare with the patient’s future scans. Emphasize that, hopefully, you will find a healthy eye at the next eye examination, but if anything does start to change, then with the help of an OCT eye exam, you will be able to detect these early and minor changes as you have the healthy baseline scan to compare to.

    It is necessary to develop your patient’s understanding through appropriate teaching and discussion. Giving the value of the baseline OCT eye exam to your patients is very important. Notice the difference between “We found nothing” and “We found a healthy eye”. The first statement is negative and undermines the reason for the scanning of patients for a healthy eye baseline. Meanwhile, the second statement is positive and clearly gives your patient more value as you have found what you are looking for.

    Integrate the OCT eye exam into the patient workflow

    Another one of my recommendations is to call the eye examination that includes the OCT eye exam the Advanced or Comprehensive Eye Examination. It is important to make sure all the staff members use the same terminology and your message to a patient is consistent from first contact to the end of the practice visit. The eye examination without the OCT exam can be called the ‘Standard Examination’ as we are not trying to make the ‘normal’ eye examination appear below standard, what we are trying to do is explain that the practice is invested in the latest technology to offer the most advanced (or comprehensive) examination for your patients benefit.

    OCT eye exam

    For example, when a patient books an appointment, make sure that the support staff uses the same terminology as written throughout the website, reminder letter/email, or mobile app if you have one.  

    When you review the OCT images with the patient, explain that you are going to look at the OCT images of the retina, which is part of the ‘Advanced examination’. When a patient pays at the end of the customer journey, make sure that the ‘Advanced Examination’ is mentioned again. When a patient rings up or books online for the next OCT eye exam, then they will understand what the ‘Advanced examination’  means and are more likely to select this option straight away for future examinations.

    Concentrate on giving more value to your patients

    Review the results with the patient to give them the actual value of an OCT scan. This will allow you to establish communication with the patient and improve their perception. Give them the “theatre” around the additional diagnostic testing so they understand how it applies to them and feel valued.

    OCT eye exam

    Remember that your knowledge, enthusiasm, and the extent to which the patient is involved in the process directly affect the clinical and commercial success. Dedicate time to each patient, involve them in the diagnostic process, and explain the OCT scans of their eyes on the screen.

    How can Altris AI help with introducing OCT Eye Exam

    OCT eye test

    When talking about improving the clinical standard of care your practice offers to your patients, the Altris AI platform can also improve the standard of care you offer to your patients. The platform helps to quickly determine if the eye is healthy. If pathology is detected, then Altris AI identifies the very early, rare, or minor changes that can be the start of something more severe. Altris AI detects over 70 pathologies and pathological signs. If early pathology is identified, then the Altris AI platform can help educate the patient by clearly highlighting the areas of concern and then giving you the opportunity to discuss lifestyle changes, over-the-counter medications, or supplements, which may help the patient now rather than just monitoring until it is time to refer. 

    The Altris AI platform can improve the patient’s understanding of the OCT exam and add value to the Advanced Eye Examination.

    OCT eye test

    All you need to do is to upload an OCT macula exam to the platform and Altris AI will assess the exam by severity differentiating the b-scans between high, medium, and low severity levels.  The segmentation/classification module will highlight pathological signs on the OCT scan one by one and give the classification/s of any pathology found to support you with the diagnosis. Meanwhile, in the Comparison module of the platform, you are able to compare the baseline scan with the current one. 

    Summing Up

    Remember why you invested in the OCT technology in the first place — usually, this is to improve the clinical standard of care you can offer to your patients. The improvement in clinical care can also generate a commercial benefit as well by increasing revenue through OCT exam fees, patient satisfaction, patient retention and loyalty, and an increase in recommendations of friends and family. 

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    Build a patient journey in such a way that, at each stage, they know that they have received a new, exciting, and, important part for the most comprehensive examination you offer. Remember that the more skill and enthusiasm you show, the more you can interest the patient and increase the probability that they will return for their next examination with OCT.

    In addition, consider using modern AI tools to help you with decision-making. Image management systems like Altris AI can help you interpret the OCT scans faster and with more confidence. This will leave more time to add value for your patient, and integrating AI into practice can be another example of how you are investing in the latest technology to benefit your patients.

  • Business Case: Lux Zir Ophthalmic Clinic

    Altris Team
    11.07.2023
    2 min read

    The Client: Lux Zir is one of the best-known ophthalmic clinics in Ukraine which provides retina diagnostics and eye treatment services. The clinic currently employs 3 full-time eye practitioners 2 general ophthalmologists and a pediatric retina expert.

    The clinic normally sees between 15-20 per day with up to 10 OCT examinations performed.

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    The Problem:

    Luxzir uses Optical Coherence Tomography as one of its core diagnostic methods because of its high level of accuracy and non-invasiveness. However, the clinic needed to solve several typical problems related to OCT.

    • Some ECPs have less experience with OCT interpretation than others and this creates an inconsistent standard of care throughout the clinic.
    • Some ophthalmologists come across complex OCT scans that they are unable to interpret without the help of their more experienced colleagues.
    • It is difficult to maintain a high standard of care for diagnostics when the CMO is absent during the period of vacation or sick leave.
    • Take out wrong and start with an inaccurate diagnosis on the basis of OCT of the patients who are referred to the clinic from other eye care centers. 

    The Solution:

    Lux Zir Ophthalmic Clinic decided to implement the Altris AI platform as they understood how it can help resolve their problems. The results have been very positive with improvements with all issues above problems, and received very positive results.

    According to Marta Shchur, Chief Medical Officer at Lux Zir clinic, the implementation of the Altris AI system improved the level of OCT diagnostics inside the clinic or if to be precise:

    • OCT interpretation is now considerably faster allowing the ECPs to see 10% more patients per day.
    • OCT diagnostics has become much more efficient: supported by Altris AI, ophthalmologists now have confidence when diagnosing pathologies and pathological signs, even rare ones.
    • The quality of diagnostics is consistent regardless of the experience of the specialists.
  • Business Case: Altris AI for Jeff Sciberras Optometry

    Altris AI Team
    10.07.2023
    1 min read

    The Client: Canadian Optometry Clinic

    Jeff Sciberras Optometry Clinic is an established eye care facility in Mississauga, Canada. They have been recognized as the Top Choice Optometry Clinic for the past five years running in this large Canadian city. Dr. Jeff Sciberras is proud of his high patient satisfaction rate: 92% of those surveyed would refer a friend, colleague, or family member to this establishment.

    Dr. Sciberras aims to provide comprehensive eye care, with a desire to utilize leading technologies and the delivery of premium eye care products.

    Recent technology investments include OCT, which allows earlier diagnosis and greater in-house management capabilities.

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    The Challenge:

    The optometry clinic has just purchased a brand new Optopol Revo OCT equipment and the support was needed in OCT scan interpretation. OCT is one of the most accurate methods of retina diagnostics  however, the interpretation of OCT scans can be challenging and time-consuming,  for both doctor and patient.

    The Result:

    Dr. Sciberras has been extremely satisfied with the support that the Altris AI platform provides:

    • Increased confidence when working with the new OCT device · more profound analysis of OCT scans
    • More adequate referral of complex cases.
    • Scan summaries for the patient.
    • Earning patient confidence and trust: The image of the innovative optometry center is enhanced to their patients and families.
    • The AI Segmentation/Classification Module is invaluable for the optometry center as this module helps in the identification of 70+ pathologies and pathological signs.

    The introduction of OCT with Altris AI has transformed my practice literally overnight. The integration was seamless and Altris customer support has been outstanding.

    Overall, Dr. Sciberras has been impressed with the experience and support Altris AI provides and is happy to have chosen to partner with them for his leading eye care center.

  • DICOM File Format: Benefits of Managing DICOM images

    DICOM file format
    Mark Braddon
    31.05.2023
    6 min read

    DICOM file format (Digital Imaging and Communications in Medicine) was developed by the American College of Radiology (ACR) and the National Electrical Manufacturers Association (NEMA) as a standard for exchanging medical images and related information across different healthcare systems. It serves as a universal language for medical imaging, enabling interoperability between various imaging devices and systems. DICOM ensures that medical images can be exchanged and viewed consistently regardless of the manufacturer or modality.

    DICOM image format supports a broad range of medical imaging modalities, including X-ray, MRI, OCT, ultrasound, nuclear medicine, and more. It also covers related data, such as patient information, study details, image annotations, and results.

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    As the DICOM format continues to evolve to keep up with advancements in medical imaging technology, our article aims to raise awareness among ophthalmologists and optometrists about the DICOM file format.

    You can also watch a short video about DICOM and non-DICOM file formats.

    What is DICOM file format?

    Image files that adhere to part 10 of the DICOM standard are commonly known as “DICOM format files” or simply “DICOM files,” and their file extension is “.dcm.” In ophthalmology, DICOM is a widely used file format for storing and transmitting medical images. DICOM files are used to store various types of ophthalmic images as well, including retinal images, optical coherence tomography (OCT) scans, visual field tests, and angiography images.

    DICOM files consist of two main components: the header and the image data. The header contains metadata that describes the patient, study, series, and image acquisition parameters.

    DICOM image format

    This metadata includes information such as patient demographics, image acquisition parameters (e.g., imaging modality, image orientation, pixel spacing), and any annotations or measurements made on the image. The image data itself is typically stored in a compressed format, such as JPEG or JPEG 2000, within the DICOM file.

    DICOM files also support the exchange of images and associated data between different medical imaging devices and systems. This enables eye care specialists to easily share and access ophthalmic images across different platforms, such as picture archiving and communication systems (PACS), ophthalmic imaging devices, and electronic health record (EHR) systems.

    By using DICOM, ophthalmologists and optometrists can efficiently store, retrieve, and analyze ophthalmic images, ensuring accurate diagnoses and effective patient care. In the next paragraphs, we will tell you more about the benefits of the DICOM file format for eye care specialists.

     

    Benefits of DICOM file format

    The DICOM standard ensures interoperability between different vendors’ OCT devices and facilitates seamless data sharing and analysis. The main difference between DICOM and other image formats is that it groups information into data sets. A DICOM file consists of several tags, all packed into a single file. It stores such info as:

    • demographic details about the patient
    • imaging study’s acquisition parameters
    • image dimensions
    • matrix size
    • color space
    • an array of additional non-intensity information necessary for accurate image display by computers.

    If you have to enter the patient’s information manually, there’s always a chance you can misspell the name or other information. However, when using a DICOM file to store patients’ information and monitor patients’ health, eye care specialists can be sure the chance of human bias is much lower.

    When you work in an optometry practice or a clinic, you may spend a lot of time filling in the details every time you upload a file. And if your clinic is busy and you do 30-50 uploads daily, it could take hours. Using DICOM image format significantly speeds up the process and reduces errors.   

    DICOM file format

    Another benefit of the DICOM image format is that the header data information is encoded within the file so that it cannot be accidentally separated from the image data. 

    DICOM files can be stored in a DICOM server or transmitted between DICOM-compliant systems using the DICOM network protocol (DICOM C-STORE or DICOMweb). DICOM SR (structure reporting) allows for the structured representation of measurement data and annotations in OCT images. It enables the storage of quantitative measurements, such as retinal thickness or optic nerve parameters, as structured data within the DICOM file.

    In addition, eye care specialists are able to manipulate the brightness of the image when using the DICOM viewing software. Some areas of an image can be increased or decreased for a better viewing and diagnostic experience.

    Is DICOM file format popular among OCT providers?

    When it comes to optical coherence tomography, many OCT device manufacturers and software providers support the DICOM standard for storing and exchanging OCT images. Some of the prominent OCT providers that offer DICOM support include:

    • Heidelberg Engineering is a well-known provider of OCT devices and software solutions for ophthalmology. They offer OCT devices like the Spectralis OCT, which supports DICOM connectivity. The DICOM capabilities of their systems enable seamless integration with PACS and other healthcare systems.
    • Carl Zeiss Meditec is a leading manufacturer of ophthalmic devices, including OCT systems. Their OCT devices, such as the Cirrus OCT, are DICOM-compatible, allowing for efficient storage and sharing of OCT images with other DICOM-compliant systems.
    • Topcon Medical Systems is another prominent provider of OCT devices. Their OCT systems, such as the Topcon 3D OCT, support DICOM connectivity, enabling interoperability with other DICOM-enabled devices and systems.
    • NIDEK offers a range of ophthalmic imaging devices, including OCT systems. Their OCT platforms, such as the NIDEK RS-3000, support DICOM, allowing for seamless integration with DICOM-compliant infrastructure, such as PACS and EHR systems.
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    These are just a few examples of OCT providers that support the DICOM standard. It’s important to note that DICOM support may vary among different models and versions of OCT devices from each manufacturer. We recommend you consult with the specific manufacturer or review their product documentation to confirm the DICOM capabilities of their OCT systems.

    Why do we recommend using DICOM file format with Altris AI?

    Modern DICOM viewer software extends beyond simple viewing. It can enhance image quality, generate additional data, take measurements, and more, and Altris AI is no exception. Using the DICOM image file gives you more opportunities within the platform.

    Such features as

    • retina layers thickness and linear measurements

    DICOM file format

    • area and volume calculations

    DICOM file format

    are only available when using the DICOM file format. This is because it contains the original image pixel data without modifying the study metadata. In case you upload an image, retina layers thickness won’t be available, as well as the measurements.

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    Another advantage of the DICOM format is that you can add patient and examination details in a few clicks by just uploading a DICOM file since this information is being pulled out automatically. 

    DICOM file format

    In the case of other image formats, when uploading an examination, you would have to manually fill in a bunch of information such as scan widths, eye type, etc.

    Considering all mentioned above, using DICOM format files saves time, increases efficiency, and gives you more opportunities within the Altris AI platform.

    Summing up

    In conclusion, the DICOM file format proves to be a valuable asset for eye care specialists. Its unique characteristics, such as grouping information into data sets and incorporating standardized tags within a single file, offer many advantages. 

    This format ensures the preservation of accurate and comprehensive data, reducing the potential for human error and minimizing the risk of data loss or misinterpretation. The DICOM file format streamlines the archival, organization, and display of images, optimizing the workflow of eye care specialists. 

    By adhering to the DICOM standard, OCT devices and software solutions ensure compatibility, interoperability, and consistent data representation across different platforms. This enables efficient communication and collaboration among healthcare professionals, enhances research capabilities, and promotes the broader use and exchange of OCT imaging data.

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    With its widespread adoption and compatibility with various medical imaging systems, DICOM empowers ophthalmologists and optometrists to provide efficient and high-quality care while promoting seamless collaboration and knowledge sharing within the field. Ultimately, the DICOM file format plays a vital role in enhancing patient care, advancing research, and fostering innovation in the field of eye care.

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  • AI medical image analysis

    AI for Reading Centers: How it Boosts Workflow and Efficiency

    Mark Braddon
    05.10.2022
    7 min read

    In recent years reading centers have become an essential resource for facilitating imaging research in many fields, including clinical trials of ophthalmology drugs. And their importance will continue to grow

    Reading centers provide crucial information by evaluating images. That is why for conducting accurate clinical trials, they must hire ophthalmologists of high qualification. Moreover, to ensure consistent analysis, the materials that graders use for the research (be it fundus photographs, fluorescein angiograms, or OCT scans) must also undergo quality control. However, even such measures can’t completely exclude errors or biases.

    Meanwhile, recent developments in the field of AI medical image analysis revolutionized the approach to clinical trials, which makes it possible to boost the workflow of reading centers. AI image analysis software works with thousands of images, efficiently providing the large amount of data needed to analyze the patient’s condition. In addition, evaluating images with AI is faster, cheaper, and more effective

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    In this article, we will discuss the top 5 benefits of AI medical image analysis software for reading centers and the way AI improves the image interpretation process.

    Limitations of the manual evaluating procedure

    Although several reading centers have already implemented AI for image analysis in their workflow, most organizations are far from evaluating automation and prefer classic image interpretation methods.

    AI medical image analysis

    In most reading centers, ophthalmologists manually evaluate ocular images for drug safety studies, compile the images, and perform statistical analysis of the data. Research sizes for reading centers can range from 50 images to 3000 or more, and dozen of separate sets of images can be collected per research subject. Therefore reading centers have many obstacles to a quality evaluation process and accurate results.

    • Large amount of images is hard to proceed

    The vast number of images that need to be processed in the short term usually leads to the main problem for reading centers — most hire outsourced ophthalmologists to speed up the image grading and evaluation process. Outsourced specialists have different levels of qualification and different evaluating methods, which may lead to decreased accuracy. In addition, outsourced eye care specialists are not always interested in performing the work at the highest level. 

    • Human resources are expensive

    Another limitation of the standard evaluating procedure is the high сost spent on ophthalmologists. Human resources are usually quite expensive and associated with the risk of staff turnover. 

    • High probability of human bias

    Besides, hours spent in front of a computer screen evaluating thousands of images create a stressful environment for ophthalmologists and cause many errors, affecting the accuracy of the clinical trials. Even the FDA recognizes grader fatigue and its impact on potential errors in image interpretation. 

    • Inaccurate labeling

    In addition, administrative problems also occur quite often. This happens due to deviations from study protocols and incorrect labeling of images, which can compromise the integrity of the analyses.

    Fortunately, the pace of digitalization in reading centers is accelerating. Here is how AI medical image analysis can help reading centers cope with the growing workload. 

    The importance of implementing AI medical image analysis for reading centers

    Usually, AI image analysis is made through a pattern recognition process that involves scanning images for specific pathological signs to interpret the patient’s condition. The AI image analysis software has precise and efficient evaluation protocols that allow the analysis and interpretation of images in terms of a variety of qualitative morphological parameters. For example, when analyzing images of a patient with diabetic retinopathy, the AI models recognize microaneurysms or hemorrhages.

    AI medical image analysis

    AI algorithms allow reading centers to conduct trials of any size and duration, including various treatments for various eye diseases. Moreover, unlike the standard image interpretation process, which requires significant human resources, the introduction of AI for image analysis into the workflow of reading centers has many advantages. 

    • Quality control. Using AI algorithms ensures no errors in OCT scan analysis. AI image analysis software ensures that the desired parameters are classified based on certified imaging protocols.
    • Less money spent. Implementing AI-assisted OCT analysis is less expensive than hiring outsourced ophthalmologists. 
    • Accurate quantification. AI in medical image analysis does not depend on patient characteristics or treatment group assignment knowledge, so the machine provides the most objective and accurate assessment possible.
    • Increased efficiency. Improving the reading centers workflow with AI provides an objective and standardized classification of images. It means that any human bias is excluded, which increases the reputation of clinical research.
    • No time wasted — no more hours spent at a computer screen. Evaluating images with AI medical image analysis provides faster and more sensitive identification of the patient’s condition, which can positively impact decision-making.
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    How reading centers will benefit from AI image analysis software

    In short, image evaluation with algorithms is fast, less expensive, and more reproducible. However, many companies that perform clinical trials in cooperation with reading centers are still afraid of implementing AI in medical image analysis and evaluating processes. Modern AI-based image management systems, such as Altris AI, unlike their predecessors, allow reading centers to overcome the challenges of the manual image interpretation process.

    A lot of data available to train an algorithm 

    The more images with various pathological features the algorithm has for training, the more accurately it will detect the diagnosis. Modern AI image analysis software has the ability to obtain thousands of OCT images from different models of devices for comprehensive and correct training of algorithms. Although many medical centers keep their clinical practice confidential, many ophthalmic cases and images with various pathological signs in the public domain allow the training of AI algorithms.  

    For example, the Altris AI medical image analysis software was trained on 5 million unique OCT scans obtained in 11 practicing ophthalmology clinics through the years. Our retina experts took a responsible approach to annotating and labeling images for algorithm training. A thorough error detection and correction procedure gave our algorithm 91% accuracy. 

    Constant quality control

    The responsibilities of the modern algorithms developers include not only the release of the model but also further diagnostics, which allows avoiding the problem of reproducibility. After all, constant quality control is necessary for algorithm development environments. Understanding the importance of quality control, the Altris AI team constantly tests the reproducibility of AI medical image analysis model diagnostics.

    Collection of rare diseases

    According to our research, ​25% of ophthalmologists, on average, miss rare pathologies 3 times a week.​ However, modern AI image analysis software allows overcoming this challenge. For example, Altris AI excludes missing minor, early, rare pathologies. Our team created an algorithm that automates the detection of 54 pathological signs and 49 pathologies.

    High percentage of algorithmic bias is avoided

    Algorithmic bias is one of the biggest challenges in AI. Although algorithms themselves do not have biases, they inherit them from humans. However, today, AI for image analysis has learned how to overcome the lack of interoperability between medical record systems. 

    Although it is impossible to avoid algorithmic bias completely, as it can appear at any stage of the algorithm creation process, from study design and data collection to algorithm development and model selection, modern developers take a direction to fair AI. By using a technical and regulatory framework that provides the diverse data needed to train AI algorithms, the Altris AI team makes modern technologies inclusive and ensures algorithmic bias can be excluded.

    The future of AI medical image analysis in reading centers

    The ultimate goal of the ophthalmic AI system for reading centers is to improve the grading and evaluating process and obtain more accurate research results. However, instead of fully digitalizing image assessment, the ideal approach to analysis is integration — where the benefits of AI algorithms and human skills can be combined.

    Technology will never fully replace humans, but it is already improving their work efficiency. For example, by taking over more routine and monotonous tasks, algorithms allow ophthalmologists to focus on specific eye areas and increase the evaluation speed. AI medical image analysis software can also be effective in determining compliance with the standardization of feature interpretation and determining image quality for requesting more images. 

    There are undoubtedly many challenges to integrating AI for image analysis into the workflow of reading centers. However, modern AI technologies can already overcome almost all of them. Altris AI image interpretation system is changing the future of clinical research by helping to classify images faster and increasing the efficiency, accuracy, and reproducibility of clinical trial data.

    You can watch a short video of how Altris AI platform assists eye care specialists in detecting pathological signs on the OCT scans:

  • The use of AI for image analysis

    The Role of AI Image Interpretation for Ocular Pathologies Detection

    Maria Znamenska
    28.09.2022
    20 min read

    The burden of timely diagnostics lies on the shoulders of eye care specialists: ophthalmologists and optometrists worldwide. According to the International Agency for the Prevention of Blindness, over 1 billion people live with preventable blindness because they can’t access the proper diagnostics and treatment. Almost everyone needs access to eye care services during their lifetime. Unfortunately, there are only 331K optometrists worldwide, while 14M optometrists are required to provide effective and adequate eye care services. 

    With the high prevalence of the population that needs eye care services and the lack of specialists, the goal of timely and accurate diagnostics and treatment seems unachievable. 

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    However, the empowerment of eye care specialists with Artificial Intelligence (AI) can be a real solution to this problem. As the larger part of the work of eye care specialists relies on retina image assessment and analysis, the support of this process can unburden ophthalmologists and optometrists all over the world. Modern AI image interpretation algorithms, such as Altris AI, can discover patterns among millions of pixels with high speed, accuracy, and zero human errors because of tiredness. 

    You can watch a short video of how Altris AI can assist you in detecting pathological signs on the OCT scans:

    https://www.youtube.com/watch?v=Ehhwl6Q0O-A&ab_channel=Altris

    In this article, we will talk about the capabilities of AI image interpretation for Optical Coherence Tomography (OCT) in detecting common pathologies, such as AMD or glaucoma, and less prevalent, such as Choroidal Melanoma. Despite the skepticism of the eye care community towards AI, multiple research works mentioned in this article prove the efficiency of AI. Moreover, there are market tools, capable of detecting 49 eye pathologies with 91% accumulative accuracy. Altris, the SaaS created by a team of retina experts based on 5 million OCT scans obtained in 11 clinics, is such a tool. 

    AI image interpretation for Asteroid Hyalosis

    Asteroid hyalosis is a clinical condition in which calcium-lipid complexes are suspended throughout the vitreous collagen fibrils. Although it is a rare disease (​​1.2% prevalence according to the U.S. Beaver Dam Eye Study), it also may lead to unpleasant consequences, such as surface calcifications of intraocular lenses. Today OCT can help with the detection of this degenerative condition. For a higher confidence level, eye care specialists may use Altris AI image interpretation for OCT analysis to detect asteroid hyalosis.

    AI for Central Retinal Artery Occlusion (CRAO)

    Central Retinal Artery Occlusion (CRAO) presents as unilateral, acute, persistent, painless vision loss. It can be bilateral in 2% of the population. The vision loss is abrupt, and the treatment is only effective during the first hours. CRAO resembles a cerebral stroke. Therefore, its treatment should be similar to any acute event treatment: detecting the occlusion site and ensuring it won’t occur again. AI image interpretation models, such as Altris AI, can assist eye care specialists in detecting CRAO today. 

    AI for Central Retinal Vein Occlusion (RVO)

    AI image interpretation

    CRVO is one of the most widespread vascular diseases that affect the population over 45. There are two distinct types of CRVO: perfused (nonischemic) and nonperfused (ischemic). Each of these types has its symptoms and treatment prognosis. For instance, ischemic CRVO leads to sudden visual impairment, while nonischemic CRVO development takes time to develop mildly. The detection of CRVO is now done with the help of OCT predominately, and AI image interpretation systems shows promising results in spotting its symptoms, such as nonperfusion. Altris AI system defines CRVO with 91+% accumulative accuracy in detecting pathological signs that indicate the CRVO.

    AI for Central Serous Chorioretinopathy (CSC)

    Accumulation of fluid under the central retina is called central serous chorioretinopathy. Over time, this disease can lead to the distortion of vision. Fortunately, available AI models for OCT scan analysis show high accuracy in detecting CSC. This and other AI image interpretation models effectively discriminate between acute and chronic CSC, and their performance can be comparable to the performance of ophthalmologists. Altris AI is already helping eye care specialists worldwide to diagnose CSC cases.

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    AI for Chorioretinal Scar

    Chorioretinal scars are tiny scars in the back of the eye, the size of which may vary from 0,5mm to 2mm. In most cases, the chorioretinal scar appears as the result of virus infection, such as toxoplasmosis and toxocariasis, or trauma. It usually has no malignant potential. Modern AI image interpretation algorithms allow ophthalmologists and optometrists to diagnose chorioretinal scars more accurately by relying on OCT images.

    AI image interpretation for Chorioretinitis

    The inflammation of the choroid is called chorioretinitis. Often, the inflammatory process can be caused by congenital viral, bacterial, or protozoan infections. Chorioretinitis is characterized by vitreous haze, fine punctate gray to yellow exudation areas, pigment accumulation along the optic nerve and blood vessels, and flame-shaped hemorrhages with chorioretinal edema. The goal of the eye care specialist is to detect chorioretinitis which can potentially lead to blindness, and to eliminate inflammation. Altris AI image interpretation system can be an excellent decision-making support tool in detecting chorioretinitis.

    AI image interpretation for Choroidal Melanoma

    Today, choroidal melanoma is the second most common intraocular tumor in the adult population. Patients with choroidal melanoma don’t have distinct symptoms but can have impaired visual acuity, visual field defects (scotomas), metamorphopsia, photopsia, and floaters.

    OCT is a relatively new method for the detection of choroidal melanoma, which is nevertheless gaining popularity. OCT cannot be the only diagnostic method for melanoma detection – FA is also needed for final diagnosis. However, optical shadowing, thinning of overlying choriocapillaris, subretinal fluid, retina local elevation, subretinal lipofuscin deposits, and disrupted photoreceptors can be detected with the help of OCT.

    Such pathological signs will indicate possible choroidal melanoma. Altris AI image interpretation system can assist eye care specialists with detecting pathological b-scans and locating this disease.

    AI for Choroidal Neovascularization (CNV)

    AI image interpretation

    Choroidal neovascularization (CNV) is part of the spectrum of exudative age-related macular degeneration (AMD) and some other conditions. CNV is an abnormal growth of vessels from the choroidal vasculature to the neurosensory retina through Bruch’s membrane.

    Modern OCT systems can detect even a tiny amount of fluid leaking into the retina. Empowered by Altris AI image interpretation algorithm, eye care specialists can spot pathological signs of choroidal neovascularization much faster or detect the pathologies that accompany CNV, resulting in better patient outcomes.

    AI image interpretation for Choroidal Rupture

    Traumatic choroidal rupture is common after blunt ocular trauma (5 to 10%). It is a defect in the Bruch membrane, the choroid, and the retinal pigment epithelium. The location of the choroidal rupture will define the symptoms: if the fovea and parafoveal retina are included in the rupture area, patients experience impaired vision. In other cases, the rupture can be asymptomatic. OCT is used to diagnose choroidal rupture as it can show the loss of continuity of the RPE layer and the thinning of the choroid. AI image interpretation is exceptionally accurate in layers segmentation and volume/area calculation, so missing the symptom of choroidal rupture with AI is almost impossible.

    AI image interpretation for Choroidal Nevus

    AI image interpretation

    Choroidal nevus is a benign melanocytic tumor of the choroid and is found in 5 to 30% of white people. It can be found accidentally because it is asymptomatic. Artificial intelligence methods are used not only for identifying choroidal nevus but also for early signs of its transformation into malignant melanoma. The earlier the small melanoma is detected, the better the treatment prognosis is for the patient. Altris AI image interpretation system is one of the systems capable of detecting choroidal nevus before its transformation into melanoma. 

    AI for Cone-Rod Dystrophy (CORD)

    CORD is an inherited retinal disease caused by a genetic mutation characterized by cone photoreceptor degeneration. It may be followed by subsequent rod photoreceptor loss. CORD symptoms include loss of central vision, photophobia, and progressive loss of colored vision. OCT diagnostics help to diagnose CORD by pointing at the absent interdigitation zone and progressive disruption and loss of the ellipsoid zone (EZ). Today AI image interpretation is helping to detect Cone-Rod Dystropthy to eye care specialists more confidently, even in controversial cases.

    AI for Cystoid Macular Edema (СME)

    AI image interpretation

    Cystoid macular edema (CME) is a painless condition in which cystic swelling or thickening occurs of the central retina (macula) and is usually associated with blurred or distorted vision. CME can be caused by many factors, including diabetic retinopathy and age-related macular degeneration (AMD). OCT diagnostics help to spot СME by detecting retinal thickening with the depiction of the intraretinal cystic areas. CME is not irreversible. Vision loss caused by macular edema can be reversed if detected early. Combining OCT diagnostics with AI image interpretation, eye care specialists can detect CME with higher accuracy at an earlier stage.

    AI image interpretation for Degenerative Myopia

    AI image interpretation

    Degenerative or pathological myopia is the condition during which axial lengthening occurs, especially in the posterior pole. It leads to retina stretching, the sclera’s thinning, choroidal degeneration, and potential loss of vision. AI image interpretation systems have demonstrated excellent results in detecting pathologic myopia and identifying myopia-associated complications on OCT. AI helps ophthalmologists improve the monitoring of pathology treatment and classify different cases of myopia.

    AI for Diabetic Macular Edema

    ​​Diabetic macular edema (DME) is the presence of excess fluid in the extracellular space within the retina in the macular area, typically in the inner nuclear, outer plexiform, Henle’s fiber layer, and subretinal space. DME can develop during any stage of diabetic retinopathy in patients with diabetes.

    Unfortunately, the early symptoms of DME can be unnoticeable or include impaired vision and reading and color perception problems, which some people may ignore. Taking into account its asymptomatic nature, patients with diabetes need regular OCT examinations to determine the presence of DME. OCT has become a golden standard in DME detection within the last few years, and AI can be an excellent decision-making support tool in OCT scans interpretation. According to recent research, AI-powered OCT analysis provides an accurate diagnosis of DME with a cumulative accuracy of over 92%. 

    AI image interpretation systems can unburden ophthalmologists and optometrists who have a lot of patients due to their convenience and can be used in remote regions of the world in the future.

    AI image interpretation for Diabetic Retinopathy

    AI image interpretation

    Diabetes can affect the eyes in various ways, most commonly corneal abnormalities, glaucoma, iris neovascularization, cataracts, and neuropathies. However, diabetic retinopathy (DR) is the most common and potentially the most blinding of these complications. Early treatment of both proliferative and non-proliferative DR can improve patient outcomes significantly. OCT is a common diagnostic method for diabetic retinopathy. It relies on the localization of intraretinal and/or subretinal fluid and can help to diagnose diabetic retinopathy through pathological signs detection and layer thickness measurement. 

    AI image interpretation is a step in the future of detection that shows high sensitivity in identifying DR, and studies prove its effectiveness. AI-assisted analysis of OCT scans helps eye care specialists today and will definitely be more widespread tomorrow.

    AI image interpretation for Dry AMD

    Dry AMD is a more common type of AMD (80% of people have this type), during which patients slowly lose their central vision. It is the aging of the macula and the appearance of deposits called drusen. There is no treatment for Dry AMD yet. However, early detection can help patients to change their lifestyles and slow down the development of this disease. Modern AI solutions make it possible to diagnose Dry AMD faster and develop successful methods of treating the disease. AI image interpretation systems also exclude the possibility of human error.

    AI for Dry AMD – Geographic Atrophy

    Geographic atrophy is an advanced form of the late stage of Dry AMD development. In this condition, retina cells will degenerate and finally die, leading to the patient’s central vision loss.

    AI image interpretation is being widely used to detect Geographic Atrophy with the help of OCT. In this meta research, there are numerous studies that focus on lesion segmentation, detection, and classification of geographic atrophy and even its prediction. They vary in accuracy, but the overall trend of AI for geographic atrophy detection is very positive. The use of artificial intelligence has several advantages, including improved diagnostic accuracy and higher processing speed. 

    AI for ERM or Epiretinal Fibrosis

    AI image interpretation

    Epiretinal fibrosis (epiretinal membrane or macular puckering) is a treatable cause of visual impairment. It is a macula disease caused by fibrous tissue growth on the retina surface. AI image interpretation model for detecting ERM on OCT can outperform non-retinal eye care specialists with a cumulative accuracy of 98+%. For more professional retina experts, AI can be a decision-support tool. Early detection and treatment of this disease are crucial to prevent the ​​growth of fibrous tissue and the worsening of the patient’s condition.

    AI image interpretation for Epiretinal Hemorrhage

    Epiretinal hemorrhages result from a serious trauma: car or sports accidents, falls, and direct physical impact. Mild hemorrhages unrelated to a serious traumatic event can disappear on their own, but they can be a symptom of a more complex pathology. Epiretinal hemorrhages can be detected with the help of OCT, and AI image interpretation systems can make this process more accurate.

    AI for MTM (Foveoschisis)

    Myopic foveoschisis or myopic traction maculopathy is the thickening of the retina that reminds schisis in patients with high myopia with posterior staphyloma.

    Untreated foveoschisis often leads to vision loss due to secondary complications, which is why this disease should be detected in time. Today when OCT is becoming more widespread, detection of foveoschisis is more common and accurate. More than that, the studies show that combining the power of AI image interpretation and OCT diagnostics for MTM detection is equal to the junior ophthalmologist’s knowledge. Using AI-powered OCT, it is possible to deal with the shortage of specialists that can guarantee timely diagnostics.

    AI for Full-thickness Macular Hole

    AI image interpretation

    A macular hole is a full-thickness defect of the retina involving the foveal region. Patients usually present a reduction of central visual acuity. A complete ophthalmic examination, including OCT, should be performed to diagnose a full-thickness macular hole. So far, the research of AI image interpretation algorithms for a full-thickness macular hole is dedicated to OCT(A), but there are available tools on the market that can help define full-thickness macular hole on OCT scans as well. Altris AI is one of them.

    AI for Hypertensive Retinopathy

    People with high blood pressure, older people, and patients with diabetes often develop hypertensive retinopathy. OCT examination can be used for the detection of hypertensive retinopathy.

    AI-based OCT analysis shows promising results in detecting hypertensive retinopathy by defining retinal vessels and other pathological signs in the retina.

    AI for Intraretinal Hemorrhage

    AI image interpretation

    Among patients with DR, RVO, or ocular ischemic syndrome, there are often those who develop side pathologies. One of these pathologies is intraretinal hemorrhage. AI image interpretation systems help ophthalmologists and optometrists identify intraretinal hemorrhages in the retina.

    AI image interpretation for Vitreous Hemorrhage

    Vitreous hemorrhage results from bleeding into one of the several potential spaces formed around and within the vitreous body. This condition can follow injuries to the retina and uveal tract and their associated vascular structures. Eye care specialists should perform a complete eye examination, including OCT, slit lamp examination, intraocular pressure measurement, and dilated fundus evaluation. Timely diagnosis and treatment are essential: it can significantly reduce concomitant diseases of intravitreal hemorrhage. AI image interpretation systems can help eye care specialists detect vitreous hemorrhage supporting them in case of controversial OCT scans.

    AI for Lamellar Macular Hole (LMH)

    AI image interpretation

    Lamellar macular hole is one of the types of macular holes known in eye care practice. The problem is that the stage 0 macular hole is a clinically silent finding detected on OCT where a parafoveal posterior hyaloid separation is present and a minimally reflective preretinal band is obliquely inserted at one end of the fovea. Eye care specialists may have problems identifying lamellar macular hole on OCT. That is where AI image interpretation models can come into play.

    AI for Laser-induced Maculopathy

    Since 2014, the number of laser injuries reported worldwide has more than doubled because of the widespread use of laser technologies. Depending on the damage, the patient may have a quick recovery or long-term vision loss with the development of diseases such as photoreceptor’s damage, macular hole, ERM, or others. OCT is one of the methods that help to detect laser-induced maculopathy without human errors and doubts. AI image interpretation models have a reasonable prospect of helping eye care specialists define laser-induced maculopathy based on OCT scans.

    AI for Age-related Macular Degeneration (ARMD)

    Age-related macular degeneration is one of the leading reasons for blindness in people of older age, especially among women and people with obesity. Patients usually present with a gradual, painless vision loss associated with delayed dark adaptation, severe metamorphopsia, and field loss. In other words, in the early stages of AMD, patients may not have any signs or symptoms, so they may not even know they have the disease. Regular OCT screening (among other diagnostic methods) can be a life-saving vest for older people.

    AI image interpretation has shown great promise in detecting AMD, and research papers show that its capabilities are similar to those of ophthalmologists. AI-powered automated tools provide significant benefits for AMD screening and diagnosis.

    AI for Macular Telangiectasia Type 2

    Macular telangiectasia (Mac Tel) results from the capillaries abnormalities of the fovea or perifoveal region related to the retina nuclear layers and ellipsoid zone.

    Macular Telangiectasia Type 2 can have negative consequences and develop into cystic cavitation-like changes in all the layers of the retina or even transform into a full-thickness macular hole. OCT is an effective diagnostic method of macular telangiectasia type 2 as the tomograph can localize foveal pit enlargement. Which is a result of secondary loss of the outer nuclear layer and ellipsoid zone that can progress into large cysts (often called ‘cavitation’) that can encompass all retinal layers.

    Automating the detection of macular telangiectasia type 2 with the help of AI image interpretation systems for OCT scan analysis is already possible thanks to Altris AI.

    AI for Myelinated Retinal Nerve Fiber Layer

    Myelinated nerve fiber layer (MRNF) is a disease that occurs in 1%. It is a benign clinical condition that results from an embryologic developmental anomaly whereby focal areas of the retinal nerve fiber layer fail to lose their myelin sheath.

    OCT is an effective method of MRNF detection with the help of the detection of the RNFL layer. Such tools as Altris AI image interpretation models are even more accurate in retina layers detection and volume measurement thanks to their growing level of accuracy.

    AI image interpretation for Myopia

    AI image interpretation

    Myopia is not an eye disease. It is an eye-focusing disorder that affects 25% of the world population at a younger age. There are 2 distinct types of myopia: pathological and non-pathological — each of the types has its symptoms and treatment prognosis. The visual function of the patients, as well as the high quality of life, can be preserved if myopia is detected early enough and treated appropriately. Myopia is often diagnosed by ophthalmologists and optometrists with the help of OCT, thanks to its fine cross-sectional imagery of retinal structures. Unlike biomicroscopy, angiography, or ultrasonography, OCT can reveal undetectable retinal changes in asymptomatic patients with myopia.

    Current AI image interpretation models show great promise in detecting myopia on OCT scans, and their results can be compared to the results of junior retina specialists. Altris AI is an accurate AI tool for myopia.

    AI for Pigment Epithelium Detachment

    Retinal pigment epithelial detachment (PED) is often observed in Wet AMD and other conditions. It is determined as a separation of the RPE layer from the inner collagenous layer of Bruch’s membrane. With its capability to visualize retinal layers, OCT helps eye care specialists with timely PED diagnostics. Powered with AI image interpretation systems, OCT diagnostics can promise zero human errors and exceptional accuracy.

    AI for Polypoidal Choroidal Vasculopathy (PCV)

    Polypoid Choroidal Vasculopathy is a disease of the choroidal vasculature. Serosanguineous detachments of the pigmented epithelium and exudative changes that can commonly lead to subretinal fibrosis are the main OCT signs of PCV. AI image interpretation systems show great potential in establishing a difference in diagnostics between PCV and AMD.

    AI for Preretinal Hemorrhage

    AI image interpretation

    Preretinal hemorrhage is a complication of many pathologies, such as leukemia or ocular/head trauma. Missing preretinal hemorrhage means putting a patient at risk. Preretinal hemorrhage can be a presenting sign of some systemic diseases. In any case, OCT diagnostics are performed to determine preretinal hemorrhage and its real reason.

    AI image interpretation for Pseudohole

    Sometimes the pulling or wrinkling of the epiretinal membrane (ERM) can result in a gap called a pseudohole. A pseudohole can look like a macular hole; sometimes, it can turn into one, so it is essential to distinguish between these two phenomena. Optical coherence tomography can accurately determine a pseudohole revealing an epiretinal membrane with contraction of the retina or suppression of retinal layers. Combined with AI image interpretation, OCT diagnosis can guarantee higher accuracy in pseudohole detection.

    AI for Retinal Angiomatous Proliferation (RAP)

    RAP is a subtype of AMD, which is neovascularization that starts at the retina and progresses posteriorly into subretinal space. There are 3 stages of RAP: intraretinal neovascularization (IRN), subretinal neovascularization (SRN), and choroidal neovascularization (CNV). OCT is effective for detecting IRN only since changes beneath the pigment epithelium are challenging to assess. AI image interpretation models effectively differentiate between RAP and polypoidal choroidal vasculopathy (PCV), comparable to the performance of eight ophthalmologists. AI cannot substitute eye care specialists but can be an excellent decision-making support tool.

    AI for Retinal Detachment

    Retinal detachment is a serious eye condition that happens when the retina pulls away from the tissue around it. It can be a result of trauma or another disease. OCT has become a new standard for detecting early retinal detachment and defining the best time for surgical operation, for example. OCT powered with AI image interpretation systems can give eye care specialists the confidence they need to determine the degree of detachment and make the correct prognosis.

    AI for Retinitis Pigmentosa

    RP is a hereditary diffuse pigment retinal dystrophy characterized by the absence of inflammation, progressive field loss, and abnormal ERG. OCT diagnostics allows assessing morphological abnormalities in RP, providing insights into the pathology of RP and helping to make a good prognosis. AI image interpretation applied for the OCT analysis shows promising results in Inherited Retinal Diseases detection and future management.

    AI image interpretation for Retinoschisis

    AI image interpretation

    Retinoschisis is an eye condition characterized by a peripheral splitting of retinal layers. OCT is an effective method of retinoschisis diagnostic. The application of AI image interpretation tools for OCT analysis for identifying retinoschisis (among other myopia conditions) is comparable to the performance of experienced ophthalmologists.

    AI for Retinal Pigment Epithelial (RPE) Tears (Rupture)

    RPE rupture or RPE tears is the condition when this retinal layer acutely tears from itself and retracts in an area of a retina, usually overlying a pigment epithelial detachment (PED). OCT is an effective method of diagnostics of RPE tears. OCT scans will show a discontinuity of the hyperreflective RPE band, with a free edge of RPE usually wavy and scrolled up overlying the PED, contracted back towards the CNVM.

    AI image interpretation systems can provide eye care specialists with confidence when detecting RPE tears. Systems such as Altris AI can distinguish between retinal layers with exceptional accuracy, exceeding the accuracy of eye care specialists.

    AI for Solar Retinopathy (Maculopathy)

    Solar retinopathy is photochemical toxicity and the consequent injury to retinal tissues located in the fovea in most cases. OCT helps to diagnose solar retinopathy by indicating changes and focal disruption at the level of the subfoveal RPE and outer retinal bands. The overall retinal architecture remains intact. AI image interpretation models can confidently assist eye care specialists in detecting solar retinopathy, even when they are in doubt.

    AI for Subhyaloid Hemorrhage

    Subhyaloid hemorrhage is diagnosed when the vitreous is detached from the retina because of blood accumulation. This type of hemorrhage is rare and is different from intraretinal hemorrhage caused by trauma or diabetes. OCT helps to detect subhyaloid hemorrhage. For eye care specialists who don’t have experience in detecting subhyaloid hemorrhage, the AI image interpretation model can become a great support tool.

    AI for Subretinal Fibrosis

    Subretinal fibrosis appears due to wound healing reaction to the choroidal neovascularization in nAMD or other conditions. Early diagnostics of subretinal fibrosis are critical because a neovascular lesion’s transformation into a fibrotic lesion can be very rapid. OCT is regarded as the most accurate method of diagnostics today.

    AI image interpretation systems can help eye care specialists who use OCT with early diagnostics of subretinal fibrosis and improve patient outcomes.

    AI for Subretinal Hemorrhage

    Subretinal hemorrhages are a complication of various diseases which arise from the choroidal or retinal circulation. It is most often caused by AMD, trauma, and retinal arterial macroaneurysm. OCT will be an effective tool for determining the level at which subretinal hemorrhage occurred. Powered with AI image interpretation models, OCT can become the decision-making support tool eye care specialists need for subretinal hemorrhage identification.

    AI for Sub-RPE (Retinal Pigment Epithelial) Hemorrhage

    Sub-RPE (retinal pigment epithelium) hemorrhage is located between the RPE and Bruch’s membrane. OCT is an essential tool for validating the hemorrhage’s diagnosis and localization. AI image interpretation tools, such as Altris AI, will ensure that Sub-RPE hemorrhage is not missed.

    AI for Tapetoretinal degeneration or dystrophy

    Tapetoretinal dystrophy or tapetoretinal degeneration (TD) is exogenous destruction of the retina caused by a genetic mutation. Eye care specialists might easily miss such rare conditions as tapetoretinal degeneration. It is often advisable to have AI image interpretation systems as a decision-making support tool not to miss TD or other uncommon diseases.

    AI image interpretation for Vitelliform Dystrophy

    It is autosomal dominant degenerative maculopathy wherein a mutation in the bestrophin gene leads to lipofuscin accumulation in RPE cells manifested in a yellow spot. Detecting vitelliform dystrophy is critical at the early stages as it can lead to vision loss. OCT provides essential information on the lesion’s morphology, location, and dynamics. Empowered with AI image interpretation tools, such as Altris AI, eye care specialists won’t miss such a rare disease as vitelliform dystrophy at the early stage.

    AI for Vitreomacular Traction Syndrome

    Vitreomacular traction syndrome is a pathological condition characterized by a posterior vitreous detachment that leads to blurred vision or serious vision impairment. OCT is an essential method of diagnostics of vitreomacular traction syndrome as it can show the amount of involvement and tension on the macula caused by VMT. Combined with AI image interpretation tools, OCT analysis can give incredible results.

    AI image interpretation for Wet AMD

    AI image interpretation

    Wet AMD is the most widespread disease among the elderly population in developing countries. It is a disease characterized by abnormal blood vessel growth under the retina. Understanding that this disease can lead to rapid and severe vision loss, its early detection and treatment are very important. OCT is a golden standard for the diagnostics of wet AMD as it shows fluid or blood underneath the retina without dye, among other pathological signs.

    Today AI shows promising results in predicting the development of wet AMD based on OCT images. For instance, the DARC algorithm designed for detecting apoptosing retinal cells could predict new wet-AMD activity. Another effective AI image interpretation algorithm determines the location and volumetric information of macular fluid within different tissue compartments in wet AMD, providing eye care specialists with the ability to predict visual acuity changes.

    AI for X-linked Juvenile Retinoschisis (XLRS)

    XLRS is a rare congenital retina disease caused by mutations in the RS1 gene, which encodes retinoschisin, a protein involved in intercellular adhesion and likely retinal cellular organization. The disease usually affects younger males in their teenage years who complain about blurred vision. OCT is used to detect schisis in the superficial neural retina and thinning of the retina. Despite the lack of research articles on AI in OCT diagnostics of XLRS, there are AI image interpretation tools that already cope with this task effectively.

    Final Words

    Artificial intelligence can identify, localize, and quantify pathological signs in almost every disease of the macula and retina. That is how AI image interpretation systems can provide decision-making support with the pathologies at their early stages or rare pathologies. AI can help to detect many pathologies that are invisible to the human eye because of their size or that are at their early stage. 

    The overall potential of artificial intelligence for ophthalmologists and optometrists is enormous and includes pathological scan selection and scan analysis with the probability of existing pathologies and pathological signs. One trial is worth a thousand words in the case of AI tools for ophthalmologists and optometrists.

  • types of optometry practices

    Types of Optometry Practices & the Role of OCT

    Mark Braddon
    14.09.2022
    7 min. read

    Various types of optometry practices have always played a crucial role in diagnosing many eye diseases and promptly referring to a retinal expert. According to Essilor International research, poor vision is the most common disability in the world today. The good news is that 90% of vision loss cases are treatable or preventable if discovered in their early stages.

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    However, by performing only traditional types of optometry practices, such as anterior and posterior segment examinations, optometrists may miss the complete picture of a patient’s eyes. That is why optometry specialists are embracing a new technique: optical coherence tomography (OCT) examination. 

    Optometry OCT practice helps go beyond standard eye examination procedure by better visualizing the eye’s structures and providing an additional quantitative assessment.

    In this article, I will discuss the most important types of optometry practices and emphasize the role of OCT scan interpretation in optometry.

    Types of optometry practices

    When performing a full optometric examination, the optometrist should not only assess the visual acuity with an eye chart but also check their eye health. The types of optometry practices and tools are now very diverse and depend on the application field and the qualification level. Nowadays, there are a few eye examination techniques, although they may vary from country to country, that help diagnose a patient more accurately and improve follow-up care.

    Ophthalmoscope eye examination 

    types of optometry practices

    Ophthalmoscopy plays a crucial role in detecting the conditions of the retina, blood vessels, and optic disc. This is a basic eye examination procedure that optometrists usually perform to evaluate many diseases, such as diabetic retinopathy or retinal vein occlusion. 

    During the direct ophthalmoscopy, the optometrist shines a light into the patient’s eyes to see the inside. Binocular indirect ophthalmoscopy also involves shining a light into the patient’s eyes, however, it allows eye care specialists to take a better look at the retina and its parts that are difficult to see with other eye examination techniques. The indirect ophthalmoscopy is usually combined with pupil dilation and another optometry practice called scleral depression.

    Slit lamp optometric examination

    types of optometry practices

    A slit lamp consists of a microscope, light source, and frame on which a patient lies their head. This regular eye examination procedure lets an optometrist focus on the eye by working with the light: expand or narrow it, increase brightness, and filter with colors. Sometimes the procedure also includes putting a few dye drops in a patient’s eye to examine some of its parts.

    Slit lamp examination is pain-free and allows an optometrist to view the sclera, iris, or cornea to detect diseases related to allergies, autoimmune disorders, gout, or even melanoma. Such eye examination procedure also allows to view the retina of the eye to detect the pathological signs of diabetes. Optometrists usually use a slit lamp along with an ophthalmoscope examination.

    Refraction eye examination procedure

    types of optometry practices

    One more type of types of optometry practices is a refraction test, usually performed to detect if a patient needs glasses or contact lenses. This test made with a phoropter is quick and painless. During the optometric examination, the optometrist adjusts the power of the lenses by moving or turning them back and forth until a patient can clearly see the letters on the chart.

    An optimal value of 20/20 is considered ideal vision, while a deviation means a refractive error. This may indicate that when light passes through the lens of the patient’s eye, it is not refracted properly. An optometrist can detect astigmatism, myopia, presbyopia, and a refractive eye problem during a refraction test. This, in turn, helps detect macular degeneration, retinal vein occlusion, retinitis pigmentosa, and retinal detachment.

    • Cycloplegic refraction

    Sometimes the optometrist may decide that the normal refraction is insufficient or inaccurate due to error. During refraction, the patient may unconsciously focus, affecting the test result and showing nearsightedness or farsightedness.

    Then the optometrist performs cycloplegic refraction using cycloplegic eye drops. This eye examination procedure paralyzes the muscles that focus the eye to determine the refractive error. Сycloplegic refraction exam is especially useful for children, patients with pre-presbyopia, and LASIK patients.

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    • Autorefraction

    Autorefraction is an eye examination procedure performed using a special autorefractor device, also called an optometer. This exam automates the estimation of refraction and determines its error. Usually, the indications for the procedure are myopia, farsightedness, astigmatism, presbyopia, and prescription of glasses and contact lenses.

    Retinoscopy optometric examination

    types of optometry practices

    Among different types of optometry practices usually performed to detect farsighted, nearsighted, or astigmatism, and the need for glasses is retinoscopy. This procedure is pain-free and quick. Using a retinoscope, the optometrist projects a beam of light into the patient’s eye. This light moves along a horizontal and vertical trajectory, reflecting off the back of the eye. The eye care practitioner observes the movement of light with the help of lenses they place in front of the eye. Then the optometrist changes the lens’s power and tracks the reflection’s direction and pattern. This test is performed to find a possible anomaly.

    Role of optometry OCT practice 

    The types of optometry eye examination techniques described above are fundamental for any diagnosis. However, adopting modern optometry OCT practice systems already complements clinical practice perfectly and has the prospect of widespread distribution among optometrists worldwide. 

    Knowing that the prevalence of some eye conditions, such as Myopia or Dry AMD, has increased with the pandemic, specialists need to implement modern methods and eye examination techniques in their clinical practice. Current optical coherence tomography devices allow optometrists to perform consistent analysis and furthermore have special software and a database for storing patient information. Compared to other retinal examination methods, such as fundus photography, OCT scan interpretation enhances patient care by improving the quality of diagnosis.

    High-quality information provided

    Modern optometry OCT diagnostics allow optometrists to quickly obtain a huge amount of information about the patient’s eye. Built-in software collects images and compares results to normative databases. This allows optometrists to easily track patient progress or regression and generate reports that ophthalmologists or surgeons may need for follow-up treatment.

    For example, suppose a patient has a disorder with the optic nerve, macula, or vascular system. In that case, the optometrist can send data to the ophthalmologist promptly, highlight important aspects of the patient’s condition, and provide abnormal OCT scan results for additional clarity. 

    No missed pathologies

    Optometry OCT practice provides higher diagnostic standards, ensuring fewer pathologies or pathological signs are missed. OCT scan interpretation helps detect early vision-threatening eye conditions. For example, the system can detect AMD in the early stages, which is crucial for preventing vision loss due to subretinal fibrosis. With optometry OCT practice, the thickness of the retina over the macula and posterior pole can be analyzed to detect retinal edema or atrophy. Optometrists can also confirm diabetic macular edema (DME) and decide on further treatment based on the results of its examination. In addition, OCT perfectly visualizes the retinal pigment epithelium (RPE) and choroid.

    More patients served with comfort

    By better visualization of the eye structures, optometrists provide each patient with an individual approach. This level of service ensures comfort for patients and trust for a specialist. Optometry OCT practice allows optometrists to avoid routine work and devote more time and energy to patients. More importantly, the OCT scan interpretation helps establish contact, allowing patients to understand the examination and treatment plan.

    Impact of AI on optometry OCT practice

    OCT scanning allows optometrists to accumulate large amounts of patient data. However, a large amount of information can be difficult and time-consuming to process, even for experienced specialists. The collaboration of optometry OCT practice and artificial intelligence (AI) gives optometrists a unique opportunity to analyze a large amount of data and make better clinical decisions. Here are 4 key benefits of AI which completely transform the OCT scan interpretation process for optometrists:

    • Gaining confidence. 16.3% of interviewed eye care practitioners still avoid using OCT in their daily practice because of the lack of confidence in their interpretation skills. However, with AI, this problem will be solved.
    • Fast examination. Implementing AI-powered management systems in daily clinical practice reduces the time optometrists have to spend on non-pathological scans.
    • Clear diagnosis. 59% of specialists acknowledge that they have to interpret controversial scans around 1-3 times a week. AI helps optometrists with controversial and abnormal OCT scans, so they don’t need to guess the diagnosis.
    • High diagnostic standards. 30,5% of interviewed ECPs admit they are unsure how often they miss pathologies. When working with OCT, AI systems ensure no minor, early, rare pathologies are missed.

    OCT scanning allows specialists to easily, quickly, and safely obtain many images, producing a lot of data. As AI aims to work with large volumes of data, more and more AI models are being created to help optometrists.

    types of optometry practices

    Altris AI has developed an artificial intelligence platform to assist ECPs during their optometric examination and already plays a significant role in diagnosing and treating eye diseases using optometry OCT techniques. We have trained an AI algorithm on 5 million OCT scans collected in 11 ophthalmic clinics with a 91% accuracy. Watch a short video to see how to detect pathological signs with Altris AI:

    https://www.youtube.com/watch?v=Ehhwl6Q0O-A&ab_channel=Altris

    Future of optometry oct practices

    The integration of OCT into the clinical practice of optometrists is beneficial and shows great promise. However, to gain the most accurate diagnosis, the interpretation of scans should be carried out in cooperation with other optometry eye examination tools. Optical coherence tomography implemented with other eye examination techniques, including gonioscopy or slit lamp biomicroscopy, boosts diagnostic performance and provides valuable data.

    Optometry oct practices are becoming routine for providing improved examination and patient care. This technology can also improve the confidence of eye care specialists. Detecting many pathologies using optical coherence tomography has an immediate practical benefit. Due to its high resolution, it defines and identifies early pathological signs before patients even notice any symptoms. 

  • ophthalmology mobile apps

    Top 11 Optometry & Ophthalmology Mobile Apps for Eye Care Specialists

    Maria Znamenska
    15.08.2022
    10 min. read

    Today, there are hundreds of ophthalmology mobile apps available to both experienced eye care specialists and beginners. Some of them assist in learning and practice as clinical tools, and some of them are educational apps for opticians. Some mobile applications are basically a database of useful materials, ophthalmic atlases, so to say.

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    In this post, I will focus on educational ophthalmology and optometry apps and highlight their main features and functions.

    Altris Education OCT

    Altris Education OCT is a unique free ophthalmology mobile app that contains millions of OCT scans labeled by a team of retina experts. More than 9000 eye care specialists have already joined the application.

    The app is interactive, which means that eye care specialists can highlight pathological signs on the scan 1 by 1 to learn about their location. The database of OCT scans is updated every day with a new labeled OCT scan, so users can gather their library right within the app. 

    Watch a short video and learn how to interpret scans with Altris Education OCT ophthalmology mobile app:

    Interactive eye atlas 

    The home page of the Altris Education OCT ophthalmology mobile app consists of 4 sections: 

    • In the Feed section, users will find millions of OCT scans of the retina to practice and improve their skills. 
    • In the Folders sections, there are 41 folders with various hereditary diseases, pathologies, and pathological signs. If an eye care specialist uploads the app for a specific reason, for example, to learn how to detect Epiretinal Fibrosis, he/she can easily find a folder with needed scans and work on them.
    • In the News section, users can find recent news from the OCT world and current researches.  
    • In the Community section, a user can create a post and discuss curious cases with their colleagues. 

    Community interaction

    A team of Altirs Education OCT has the aim to build a real community of ophthalmologists and optometrists worldwide who share their passion for learning. Most eye care specialists often face difficulty while interpreting OCT scans in their everyday clinical practice. We created a community where each app user can discuss problematic scans or ask OCT-related questions ( what OCT equipment to choose?). 

    Moreover, the Altris team will engage experienced OCT experts in the forums to give a professional assessment of the scans. 

    In addition, the Altris ophthalmology mobile app allows its users to like, comment and share OCT scans, as well as save them in a personal library. 

    Special features

    In Altis ophthalmology mobile app, each pathological sign is highlighted with a different color so eye care specialists can easily learn how to interpret OCT scans. Each scan contains two tabs: pathologies and diagnosis, so users are able to highlight the pathologies in the first place and then guess the diagnosis. To check himself/herself, a user switches to the diagnosis tab and finds out the name of the disease. What is more, he/she can zoom in on OCT scans to view pathological signs in detail.

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    Membership options/perks

    Altris ophthalmology mobile app not only provides its users with a huge database of educational materials. It also engages eye care specialists to invite friends, gain budges and upgrade their level. To reach the next level, there are tasks like “Search your first scan” or “Learn 5 scans in detail”. When a user level up, he/she gets access to new folders with pathological scans. 

    Another great feature of the app is that it constantly sends its users an unfamiliar OCT scan, so they can explore something new on a daily basis. The basic functionality of the app is completely free. However, ophthalmologists and optometrists can also become Pro users of Altris Education OCT and unlock more scans and app features for  $4 monthly or $25 annually.

    Please upload this FREE app if you are interested:

    👉 Android link: https://bit.ly/3YarBQa
    👉iOS link: https://apple.co/3NLyPZ7

    Eye Handbook

    mobile ophthalmology app

    Being on the market since 2010, Eye Handbook is well known and loved by many ophthalmologists and optometrists. Eye Handbook is used worldwide for both diagnosis and treatment, as the app provides eye care professionals with tools for acuity testing, children’s target fixation, or color vision testing. Now let’s take a closer look at the app’s functionality.

    Eye atlas 

    The overview of diseases in the mobile ophthalmology app begins with the Eye Atlas tab, which is a database of various pathologies arranged in alphabetical order. The description of each disease is accompanied by fundus photos, OCT images, or fluorescein angiography. Users can sort pathologies by category choosing, for example, retinal diseases, glaucoma, or oculoplastics. 

    Moreover, with the Eye Handbook ophthalmology mobile app, users can view videos of ophthalmic surgeries, such as posterior polar cataract surgery, and many more. Users are also able to sort videos by most relevant or ranked. In addition to videos, the application provides ophthalmologists and optometrists with access to audio materials, flash cards, and slides.

    Community interaction

    The Eye Handbook mobile ophthalmology app has a forum with topics open for discussion. Users can become a part of the community, add their posts, choose the appropriate category and invite like-minded eye care specialists to discuss the latest news in the field of ophthalmology. 

    Educational materials

    The Eye Handbook is a very useful application not only for ophthalmologists but also for optometrists. Not to mention a bunch of study materials, the application has collected a large number of vision tests such as Amsler grids, duo-chrome test, OKN drum, and a lot more.

    The ophthalmology mobile app contains a variety of calculators, like the Glaucoma risk calculator, which eye care specialists can use in their clinical practice right from their smartphones. Eye Handbook gathered even coding, like ICD-10 or CPT. In the app, they are also able to find detailed information about ophthalmic meds, check the EHB manual, and get access to a constantly updating news feed.

    Eye Emergency Manual

    mobile ophthalmology app

    Eye Emergency Manual mobile ophthalmology app is a great emergency aid because it quickly provides basic information about eye diseases. The application has several features, which I will explain in more detail below.

    Eye atlas

    This mobile ophthalmology app provides structured and detailed information about many eye traumas and treatments. Users can find fundus photos, photographs of real people’s eyes, or scans of each trauma and read about their initial treatment. In some cases, the developers even created Eye Trauma Communication Checklists to help eye care specialists come to a medical conclusion many times faster. 

    The Eye Emergency Manual app also contains a database of acute red eye or eyelid cases. All the information is presented clearly and plainly.

    Special features

    Each pathology overview can be saved so the app users can later explore their favorite pages or favorite glossary terms. The app also provides eye care professionals with the ability to search for a needed term, pathology, or assessment.

    Educational materials

    One of the unique features of the Eye Emergency Manual app is a variety of checklists, both for a certain pathology or a patient in general. In the app, users can find a comprehensive list of questions to ask their patients, which is useful both for ophthalmologists and optometrists. Eye Manual also contains pediatric assessment and injured patient assessment.

    What is more, the app developers created a diagnostic tree that is aimed to help users by suggesting diagnoses. After answering a few questions, the app showcases a few diseases and suggests reading about them in the eye atlas.

    OCTaVIA

    mobile ophthalmology app

    One of the main differences between the OCTaVIA mobile ophthalmology app and other apps is the fact that it isn’t free. Some other apps for opticians, which I mention in this article, have a paid subscription, but OCTaVIA itself costs $5.99 yearly. However, it is interesting to explore how this price is justified. 

    Eye atlas

    This ophthalmology app contains a constantly updated database of diseases from A to Z. Needless to mention that the application covers only retinal pathologies and provides information about retinal diseases, from Chorioretinal scars to VMT (Vitreo-Macular Traction).

    Educational materials

    One of the advantages of the OCTaVIA mobile ophthalmology app is that for each pathology it provides two views — fundus photo and OCT scan. They may be colored or not, but each fundus photo and OCT scan contains markers, which are explained in the text. What is curious, there are always a few useful links, so users can discover more trustworthy information about the disease.

    Atlas of Ophthalmology Onjoph

    mobile ophthalmology app

    The Atlas of Ophthalmology Onjoph app offers a clinical picture for almost all eye diagnoses. It includes more than 6,000 pathologies, from glaucoma to macular degeneration, and even includes such rare diseases as Stargardt syndrome. The image database is constantly being expanded and updated to include other eye diseases.

    Eye atlas

    Using the search function, eye care specialists can find specific clinical pictures and display them in lists based on diagnoses, ICD-10 code, or keywords. In the Atlas of Ophthalmology Onjoph, users will also find:

    • accompanying diagnosis;
    • code according to ICD-10;
    • brief comment.

    Atlas users can also change the font size, save essential images, or forward images by email.

    Educational materials

    The mobile ophthalmology app has a clear structure for all images. All pathological cases are arranged according to eye regions (conjunctiva, cornea, retina, lens, etc.). Within the eye area, the images are listed according to the type of disease (degeneration, inflammation, tumors, etc.).

    Membership options

    The mobile application also allows its users to save their favorite articles in the Favorites folder, but this feature is paid and has two types of subscription:

    • $3.99 for a Silver plan
    • $29.99 for a Gold plan 

    Other ophthalmology & optometry apps tools worth mentioning

    Ophthalmology Guide

    mobile ophthalmology app

    In case an eye care specialist needs a topic-oriented mobile ophthalmology app, they may check Ophthalmology Guide. Its users are allowed to choose the desired topic and find out the key characteristics of pathologies. In addition, they can also find several fundus photos, scans, and pathology charts.

    Unfortunately, I can’t say that the Ophthalmology Guide app is user-friendly. It contains a few bugs and lacks some additional options, like eye atlases or lectures.

    However, the app is promising thanks to the clear categorization of topics, it can be very convenient for ophthalmologists and optometrists to quickly find specific information about examination and management of the pathology.

    Easy Ophthalmology Atlas

    mobile ophthalmology app

    Easy Ophthalmology Atlas is one of those ophthalmology and optometry apps that are also worth mentioning. It is an offline color atlas of the most common eye diseases. The app contains 13 chapters, where users can find clinical features, diagnosis, and treatment management for different pathologies.

    Easy Ophthalmology Atlas lacks quite a lot of features compared to other ophthalmologist tools on the list. 

    However, this mobile ophthalmology app has the potential to replace the heavy paper versions of the ophthalmology guides if the information is updated regularly in it.

    Ophthalmology & Optometry Guide

    mobile ophthalmology app

    Another representative of ophthalmology and optometry apps was created to assist students in learning the clinical signs, symptoms, and complications of different pathologies. It provides users with basic knowledge of eye diseases and pathologies, their causes, and treatment.  

    Ophthalmology & Optometry Guide has up to 18 sections, each stands for a specific eye region (conjunctiva, cornea, retina, optic nerve, pupil, etc.). Each section explains the importance of eye region examination and highlights various abnormalities.

    I would recommend this ophthalmology mobile app for beginners or students of the 1st course because it contains a lot of general information that can be useful for those who have just started their careers. However, in the long run, the app lacks media content, real-life examples, and other important features.

    Ophthalmology Atlas

    mobile ophthalmology app

    Ophthalmology Atlas is a database for ophthalmologists and optometrists, showcasing up to 12 areas of eye diseases from A to Z. 

    Here users can find diseases of the cornea, lens, retina, and 9 more. The app is a digital variant of a paper atlas with a bunch of real photos and a lot of complicated cases, which is great for beginners. 

    Clinical Ophthalmology

    mobile ophthalmology app

    The Clinical Ophthalmology mobile app has a very simple interface and a list of 20 pathologies to read about. Although the application has only one feature and lacks media content, the team has provided users with the ability to share content. 

    3D Atlas of Ophthalmology

    mobile ophthalmology app

    The app is a collection of various 3D photos and videos, mostly created by Dr. John Davis. One of the distinctive features of the app is that to watch media content users will need to wear Red-Blue 3D glasses or VR Headset.  

    Will Ophthalmology Mobile Apps Replace Webinars and Conferences?

    According to our research on OCT education, 36% of optometrists and ophthalmologists around the world choose webinars to study OCT interpretation. 36% prefer conferences as the source of new information, 18% choose atlases, and only 11% of eye care specialists trust ophthalmology mobile apps.  

    On the one hand, mobile ophthalmology app cannot replace atlases, webinars, internships, and clinical practice. On the other hand, interactive mobile application contribute to the assimilation of information much better than printed materials and have unlimited data storage capacity. Another of their advantages is that users can learn on the go for little money, while internships and clinical practice takes much time and can be expensive. 

    Summing up, any ophthalmologist and optometrist who has worked at least a little with OCT knows that practical skills are more important than theory. That is why our team believes that ophthalmology mobile apps will inevitably become an additional effective tool for learning OCT interpretation.

  • OCT interpretation

    OCT Interpretation & Eye Examination: How AI can Solve 4 main Problems

    Maria Znamenska
    10 July 2022
    5 min. read

    OCT imaging system is a highly informative non-invasive method of retinal examination, and because of its resolution, it is called histology or microscopy. Usually, thinking of the benefits of OCT eye examination and OCT interpretation, eye care specialists talk about three key points: high scanning speed, non-invasiveness, and the absence of contact.

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    How do eye care specialists learn the interpretation of OCT?

    However, learning OCT interpretation is challenging. It takes time and money to master OCT interpretation skills and become a professional.  Most often, ophthalmologists and optometrists choose one of the following methods of education when it comes to OCT scan interpretation, according to our survey.

    • Webinars. They have become popular with the Covid epidemic. Now there are plenty of various educational webinars where less experienced eye care specialists can obtain useful knowledge.
    • Conferences. Unfortunately, travel restrictions made it impossible to travel much, but before the pandemic, eye care specialists could learn by visiting various conferences.
    • Atlases are still quite popular, but unfortunately, it is impossible to update information in them often.
    • Mobile apps are a new educational tool that is gaining popularity among eye care specialists.

    OCT interpretation

    Because OCT interpretation education requires a lot of resources from eye care specialists, ophthalmologists and optometrists may lack the experience that they need so much to feel 100% confident with OCT eye examination.

    Poor knowledge of OCT interpretation results in problems

    At Altris Education OCT, we decided to talk to optometrists and ophthalmologists who use our application about the most common problems with OCT eye examinations.  That is what we’ve learned, receiving 1034 answers from eye care specialists from all over the world. There are 4 main problems connected with OCT:

    • No interpretation of OCT

    This problem with OCT interpretation can be hidden, but it turns out that  16, 3 % of eye care specialists avoid offering OCT eye examinations to their clients because they are not sure about their interpretation skills. 

    • Slow OCT

    OCT eye examination takes time and practice to master before an eye care specialist will be able to perform a high-quality OCT examination fast. Some eye care specialists can spend up to 40 minutes on OCT, which will result negatively on the quality of the service of the clinic or individual optometry. On average, eye care specialists spend 10 minutes on 1 OCT eye examination. 

    OCT interpretation

    • Minor, early, rare pathologies missed.

    Another common problem in OCT scan interpretation is missing minor, early, rare pathologies on OCT scans. It turns out that 20,2% of eye care specialists miss them 1-3 times a week, while 4,4% miss them even more frequently: 3-5 times a week. What is most surprising is how often eye care specialists are not aware of their ignorance at all. 30,5% of ophthalmologists and optometrists admit that they have no idea if they miss any minor, early or rare pathologies at all. 

    If an eye care specialist misses early signs of glaucoma, it can lead to irreversible blindness.

    Why is that so important? Missing pathologies at their early stage can have serious negative consequences for patients. For instance, missing glaucoma, which is irreversible, can lead to blindness. Missing rare and minor pathologies can result in inadequate follow-up and treatment of a patient, which can make the situation worse. Accurate interpretation of OCT scans and diagnosis is the main condition of positive patient outcomes.

    • Controversial Scans 

    It turned out that a majority of eye care specialists come across controversial scans they don’t know how to interpret. It is difficult to determine the right diagnosis on such scans and additional time is needed to interpret them.

    In the majority of cases ( 99% to be precise) eye care specialists consult their colleagues when they come across a scan they do not know how to interpret. They can ask their colleagues personally, in groups on Social Media or create special chats in messengers.

    How Altris AI solves most problems of OCT interpretation

    With Altris AI, a standalone SaaS for the decision-making support of ophthalmologists and optometrists, all these problems will be solved. Altris AI provides:

    • Fast differentiation between pathological and non-pathological scans
    • Identification of minor, early, and rare pathologies
    • Second opinion when working with the interpretation of OCT scans
    • Confidence when coming across controversial OCT scans

    Our web platform is capable of accurate b-scans severity differentiation. After OCT scans are uploaded inside the system, the AI model assesses them ( up to 512 b-scans) and differentiates between normal scans and scans with moderate and severe pathology.

    The most helpful module of our platform is called Classification/Segmentation. Inside this module, an eye care specialist can analyze any OCT scan on the absence/presence of more than 70 retina pathologies and pathological signs. It excludes the possibility of missing some rare pathologies.

    The system is already available for a free trial to anyone who wants to try to solve the main OCT scan interpretation pain points.

     

  • OCT Examination VS Fundus

    OCT Examination vs Fundus Photo: Which Method to Choose

    Maria Znamenska
    26 July 2022
    9 min. read

    Before talking about the difference between OCT Examination and fundus photography (FP), we need to note that modern technologies, such as FP and optical coherence tomography imaging, have a positive effect on the daily practice of ophthalmologists and optometrists, facilitate early diagnosis and allow better management of eye disorders. Currently, special attention is paid to these two methods and their ability to provide a comprehensive description of the morphology and function of the retina.

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    At first glance, both methods have great potential for effective screening of retinal abnormalities. However, OCT images of the retina provide an improved diagnosis of many diseases, and the role of FP as the gold standard is losing popularity. In this post, we will look at the critical limitations of fundus photography and explore why the OCT imaging system is gaining credibility among ophthalmologists and optometrists worldwide.

    What are the benefits and limitations of fundus photography?

    To expand on the topic of fundus photography vs OCT, we need to talk about the benefits and limitations of FP. Being widely available, the fundus imaging system is vital for visualization of retinal and optic nerve conditions. Fundus photography is easy to use and cost-effective, contributing to its rapid spread over the past few years. However, this method also has a few disadvantages which make it less effective than OCT examination. Let’s take a closer look at the benefits and limitations of fundus imaging systems.

    The benefits of the fundus photo

    Fundus photography is a quick and simple non-invasive technique that allows eye care specialists to visualize the retina and provide the accurate diagnosis. FP shows the landmarks of the eye. In addition, fundus photo provides an early and accurate diagnosis, which is highly important for timely treatment and improved therapy. 

    Fundus photography helps ophthalmologists and optometrists not only identify retinal abnormalities and pathologies but also to monitor the progression of eye diseases. In this way, any eye care specialist can develop an effective treatment plan for different people with different eye types.

    The limitations of the fundus photo

    Despite all the benefits of the fundus photo, this technology also has some disadvantages. FP allows eye care specialists to examine the retina by looking at it from above. They may see an uneven retinal surface or curvature. However, FP does not allow observing the microscopic changes inside the retina which correspond to early stages of the disease. It, therefore, can be obtained with OCT image interpretation.

    oct examination

    Taking about fundus photography vs OCT, the key disadvantage of FP compared to optical coherence tomography imaging is its lower resolution. Thus, the pathology size detected in the fundus photography is larger. The FP is unable to detect the invisible pathologies on different retinal layers, which usually present at the stage when the patient does not even have any complaints. In fact, the fundus imaging system sees what the human eye can see. With this technology, an ophthalmologist or optometrist detects only pathologies that are visible to human eyes.

    What are the main principles of OCT examination?

    OCT examination has revolutionized retinal research, allowing doctors to review the pathophysiology of many diseases. But what is the main difference between OCT and fundus photography? FP is the process of photographing the back of the eye using a specialized camera consisting of a microscope attached to a camera with a flash. In contrast, optical coherence tomography imaging estimates the depth at which a particular backscatter occurred by measuring its flight time

    The reflection of light allows determining exactly from what retinal layer the signal is coming. As we know that it takes more time for the light to return from deeper layers. The physical principle of OCT examination is similar to ultrasound. The only difference is that the OCT does not use acoustic waves but near-infrared optical wavelength radiation.

    oct examination

    Modern OCT examination allows doctors to get images with a reasonably high resolution, ranging from 1 to 10 μm. In fact, optical coherence tomography is also called an optical retinal biopsy. The architecture of the retinal structure in the images is very close to the histological structure of the retina. Histologically, the retina consists of 10 layers, but OCT technology allows anyone to assess the retina itself and the structures surrounding it. The modern classification has 18 zones (layers), which can be estimated and described using this technology.

    How does the OCT examination boost your working process?

    Modern equipment allows patients to undergo both OCT and fundus photography quite comfortably – without dilation of the pupil and through a non-contact method of research. But optical coherence tomography imaging has many advantages that make this method the most progressive, leaving all competitors behind. 

    OCT imaging system is a highly informative method of retinal examination, and because of its resolution, it is called histology or microscopy. With this technology, ophthalmologists see what could only be seen under a microscope without OCT.

    Advantages of oct examination

    Usually, thinking of the benefits of OCT, eye care specialists  talk about three key points:

    • High scanning speed
    • Non-invasiveness
    • Contactless

    However, experienced ophthalmologists and optometrists know these are not the only advantages. Let’s discuss how OCT image interpretation helps examine the layers of the retina and determine the causes of eye diseases.

    Determining pathologies at early stages

    Many diseases at the early stages are almost invisible to even an experienced optometrist or ophthalmologist. Most retinal abnormalities progress with age and develop slowly and gradually, so diagnosing them is pretty difficult. However, modern OCT image interpretation allows physicians to detect the warning signs of the disease, classify hundreds of pathologies, and re-monitor images to track the progression of pathologies.

    Moreover, OCT image interpretation helps ophthalmologists understand the pathophysiology of retinal diseases, for example, how macular holes arose. This discovery showed doctors that they often misdiagnosed fluid location in the retina. Modern OCT examination help determine the location of abnormal new blood vessels, which is especially important when working with patients suffering from wet AMD.

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    oct examination

    Measuring thickness

    OCT imaging allows eye care specialists to measure the retina’s thickness and the magnitude of the pathological process in μm. It is advantageous for the diseases that cause fluid accumulation, such as retinal vein occlusion (RVO) and diabetic macular edema (DME).

    oct examination

    Fundus photography does not provide such an opportunity because the supervision of the dynamics is unavailable in FP. Because OCT imaging allows the retina to be examined in layers, any eye care specialist can detect changes in the structure of the eye that will never be able to be tracked by the FP. 

    In addition, creating a map of the total thickness of the retina or its layers is crucial for monitoring patients with glaucoma, for example. The retinal nerve fiber thickness in such patients becomes thinner as the disease progresses so it is vital to monitor it.

    Determining the severity of eye disease

    Well-made retinal images allow to determine the severity and stage of the disease, compare images after examination with documented results, and track disease progression. Moreover, obtaining clear images of the retina helps different eye care specialists who monitor the same patient to choose the most accurate diagnosis.

    Providing high patient tolerance

    Needless to say that patient cooperation is highly important while performing any type of diagnosis. If a patient moves during the procedure, the quality of the image may deteriorate significantly. However, with modern optical coherence tomography principles, the acquisition time is shorter which results in fewer motion-related artifacts. 

    OCT uses completely safe laser light, avoiding all the side effects or risks. Moreover, with its scanning speed, the process becomes comfortable and effortless both for the ophthalmologist/optometrist and the patient.

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    Disadvantages of OCT examination

    Despite the high-quality information provided with optical coherence tomography imaging, the technology also has a few limitations. As OCT uses light waves, some images can contain media opacities. Thus, the OCT scan can be limited by staging a hemorrhage in the vitreous body, a dense cataract, or clouding of the cornea.

    Current use of OCT examination

    Although standard fundus imaging is widely used, more and more eye care specialists are switching to modern OCT systems that provide more detailed information about various retinal abnormalities.

    Today, the commercially available and clinical standard of choice for most specialists is SD-OCT (spectral-domain OCT) systems, which provide volumetric images of the human retina with a lateral resolution of better than 20 μm. Current SD-OCT devices use retinal images to re-trace the same image area during several subsequent examinations to monitor treatment progress.

    The ophthalmological practice also uses SS-OCT (swept-source OCT) systems, which provide access to a large number of parameters of the eye, which is important for measurements through dense cataracts. SS-OCT supports high image speed and a large scanning depth range compared to SD-OCT. However, the cost of SS-OCT devices is much higher than their counterparts, so these systems have not yet gained widespread clinical implementation. Assuming that the cost of lasers will decrease, it is likely that SS-OCT will eventually also replace SD-OCT in most daily clinical practice.

    In general, the modern OCT devices available today, whether SS-OCT or SD-OCT, are multimodal, which means that ophthalmologists can quickly and easily acquire an incredible amount of information. In addition to image acquisition, modern OCT imagin systems are equipped with special software. It collects retinal images and compares the results to regulatory databases. This allows doctors to make better patient treatment decisions.

    The future of retinal imaging with OCT examination

    Coming back to the topic of fundus photography vs OCT, these two methods are pretty difficult to compare because these are completely different technologies. OCT and FP carry different information and can sometimes even complement each other. After many years of using the fundus imaging system, this method has been perfected, the quality of cameras has increased, and it has become possible to take pictures without dilating the pupil. 

    For example, FP is a great method for revealing vascular diseases of the eye. However, in most cases, the resolution of OCT is much higher than the resolution of fundus photography. FP will never be able to track invisible changes in the retina structure that OCT can track.

    oct examination

    OCT image interpretation makes it possible to examine 18 zones of the retina, which allows ophthalmologists and optometrists to investigate pathologies in the early stages and detect foci of diseases up to 20 μm. That is why both young specialists and experienced professionals should choose OCT to examine the patient’s retina.

    The future of OCT examination is definitely connected to technologies. 

    For instance, mobile apps for ophthalmologists, such as Altris Education OCT, help eye care specialists learn OCT image interpretation on millions of labeled scans.

    Altris AI web platform supports ophthalmologists and optometrists in decision-making: the system detects 54 pathologies and 49 pathological signs on OCT  providing eye care specialists with a higher level of confidence in diagnostics. 

    The combination of the knowledge of eye care specialists powered by AI technologies will result in higher diagnostic standards for the industry and better patient outcomes. Imagine how many diseases can be prevented if detected at early stages! Watch a short and useful video about the main features of Altris AI platform: