Best OCT Machines: Which Machine to Buy and Why?

Optical Coherence Tomography (OCT) is a noninvasive imaging technology Utilized to obtain high-resolution cross-sectional retina pictures to capture micrometer-resolution, two- and three-dimensional Pictures from Inside optical scattering media. (e.g., biological tissue)

One of the biggest fears for someone who has had sight all their lives is to lose it, whether gradually or at once. More and more people are losing their eyesight due to preventable conditions.  

Many issues can contribute to loss of eyesight, including age, cataracts, corneal dystrophy, diabetes, and glaucoma. Fortunately, with technological advances, doctors can detect and arrest the progression of diseases early enough to save the patient’s eyesight. Optical coherence tomography (OCT) is one such technology.

What is an Optical Coherence Tomography (OCT)

Optical Coherence Tomography (OCT) is a procedure that uses light waves to take detailed 3D images of the retina in a non-invasive manner and provides essential information on the state of the eyes. The retina layers provide crucial data that can help diagnose glaucoma and retinal diseases.

The information received also helps determine courses of treatment specific to the diagnosed condition. The process takes a short time; in less than 15 seconds, the optometrist will have the 3D image, interpret and discuss the results, and move forward with the patient almost immediately.

What should the patient know about the examination?

The doctor will walk the patient through the steps he will take before the eye examination begins. The first is dilating the pupils to ensure that the light from the Optical Coherence Tomography (OCT) machine does not cause them to become smaller.

The doctor will use dilating eye drops to achieve this. You will then ‘rest’ your eyes for approximately 30 minutes to allow the pupils to open up fully. The procedure is painless, although there may be an initial sting. Once the pupils dilate, you will experience blurring and have difficulty focusing.

The process may be traumatic to younger children, who will not understand what is happening, so the caretaker may not provide some reassurance. You may need sunglasses to protect your eyes due to light sensitivity for a few hours afterward. The OCT will scan the eyes for about 5-10 minutes.

Are there advantages and disadvantages to the Optical Coherence Tomography

Like any other medical test, there are pros and cons. These include:-

Advantages

• The OCT scan provides early detection/diagnosis of eye diseases, thereby preventing sight loss.
• The automated process is quick and produces instant results and large amounts of data.
• It allows for increased diagnosis, management, and patient follow-up efficiency, thus an excellent benefit for both patients and doctors.
• Communication tool: The OCT is an excellent tool for doctor-patient education where the doctor explains what is wrong using actual images, thus creating a better understanding of the patient. It also aids in doctor-doctor communication and co-management. Sharing information between and among peers by the consulting doctor occurs over emails or smartphones without travel distances for consultation.
• The technology opens up new revenue streams, such as consultation costs assuring return on investment. It is possible to recover the money used to buy the machine within a year or two, making it a worthwhile investment for a business.
• Some companies are offering leasing options or purchase plans for the OCT equipment. This can help smaller practices acquire quite expensive machines. The leasing option becomes cheaper for smaller businesses as they must continually update the software.
• The more modern OCT versions are easy to use and do not require extensive training to master.
• OCT technology is on an upward trajectory in terms of improvements, including size reduction to make them more portable, the software is continually evolving, and the efficiency of the machines in terms of speed and quality of the resolution is improving.

Disadvantage

• Optical Coherence Tomography technology is expensive, making it nearly impossible to purchase, especially for smaller clinics.
• Because it depends on light waves, it is unsuitable for patients with cataracts or those experiencing bleeding in the vitreous. Children may not understand the process and become traumatized, and difficult to assess accurately because of movement.
• Technology should not be a substitute for a clinical examination of the patient. The fact that it is a relatively new and continually evolving technology means the doctor must be careful about interpreting the data received. It is important not to rely too much on computer-generated interpretations of the scans.

What is the Best OCT Machines technology available in the market?

Since the introduction of the Optical Coherence Tomography technology in 1991, the technology has undergone massive improvement and technological updates by manufacturing companies. We will review some of the latest OCT technology currently available.

Each of these machines offers unique advantages, making them suitable for various optometry practices. The choice of the best OCT machine depends on specific requirements, such as the level of detail needed, space considerations, budget, and the specific conditions that need diagnosis and monitoring.

Here are the Best OCT Machines in 2023 for optometrists.

1. PRIMUS 200 from Zeiss– Simple and intuitive ($19,999.00)

Do you have a small practice that could benefit from owning your own OCT machine?

Then the PRIMUS 200 from Zeiss is one of the Best OCT Machines you may want to consider. Not only will the device improve efficiency in your practice, but you will no longer need to send your patients to other places for scans.

Your communication with your patients will significantly improve. You will enhance the management of your records, and best of all; you will have a new revenue stream in your business.

High-definition B-scans and fundus imaging

When an optometrist faces challenges when examining the eye, there are situations usually due to obstructions caused by certain conditions like cataracts. The B-scan can deliver scans from a closed eye and provides two-dimensional cross-sectional views of the eye and orbit. It is instrumental in diagnosing retinal detachment. On the other hand, fundus imaging offers interior shots of the eye.

Minimal chin time

The OCT machine requires a patient to sit facing the device with the chin supporting the head. Due to its wide refraction range for high myopia patients and the ability to scan as small as 2mm pupils without dilation, the patient sits comfortably throughout the process.

Report driven workflow

The machine allows you to complete the scan in 3 simple steps.

1. To get the required scan select the desired report, which will generate automatically.
2. To get quality scans with real-time feedback, use system-guided navigation.
3. The machine will automatically pre-select reports that you can scan with a button.

Key features

• Automatically locates the fovea using the Auto FoveaFinder and AutoCenter.
• Joystick operation
• Friendly user interface

2. OCT cirrus 5000 from Zeiss ($15,999.00)

The OCT Cirrus 5000 has high-resolution capabilities and advanced clinical applications that easily track  FastMap™ epithelial integration and ganglion cell analysis. The FDA-approved OCT Cirrus has the CE Mark and uses normative data comparison and RNFL analysis in its measurements.

The OCT Cirrus helps doctors make an accurate diagnosis because of the detail and high-definition imaging it produces. OCT Cirrus 5000 also saves time on rescans because it gets it right the first time by accurately focusing on the fovea.  

The resulting high-resolution image simultaneously highlights the vitreous, retina, and choroid detail.

Features

• FastTrac™ retinal tracking
• Ganglion cell analyses
• Advanced RPE tracking
• Wide-field structural damage assessment glaucoma

3. Topcon OCT 2000 ($7,500.00)

Most OCT machines are big and require a lot of set-up space. The Topcon OCT 2000 is the first of its kind due to its compact design that saves space.  

Topcon OCT 2000 is suitable for all levels of practice, from small clinics to large hospitals.

The Topcon OCT 2000 has a user-friendly color touchscreen and a high-resolution 12.3-megapixel automated color fundus camera, thus quickening the image acquisition process.

FastMap software aids in patient comfort.

The FastMap software is easy to use and simultaneously provides 2D, 3D, and fundus images. The compare function allows for a side-by-side comparison of serial exams. It also has a noise reduction algorithm and overlapping scanning technology for high-resolution images that are available almost immediately, thereby increased efficiency and enhancing patient comfort due to less chair time.

PinPoint registration

It features enhanced 50,000-A-scans per second. This produces clear retinal images because it minimizes artifacts generated by eye movement. The Topcon OCT 2000 is also easy to use due to its friendly interface.

Remote access

The 3D OCT 2000 has an Ethernet connection that allows remote access for software updates and minimizes instrument downtime. Images are virtually accessible anywhere and anytime, as long as you have an internet connection and laptops or smartphones.

Ergonomic Control functions

The machine is so easy to use that even an entry-level technician can comfortably use it. It has ergonomic controls, including the directional control stick, capture button, electric chin control, and fixation adjustments.

Features

• Auto center detection of the fovea and optic discs
• IR tracking functions
• Circle scan diameter correction

4. DRI OCT Triton from Topcon ($12,900.00)

The DRI OCT Triton is the first machine to utilize Swept-source technology.

Swept-source OCT

The DRI Triton utilizes the Swept-source technology, which uses long wavelength scanning light (1,050nm) to penetrate the eye’s layers better. It can cut through cataracts, hemorrhages, blood vessels, and sclera. The scanning light does not distract patients and is especially useful for elderly and young patients.

The Swept Source technology also visualizes the vitreous and choroid in a single scan, thus eliminating the need for two separate scans.  

Speed

The DRI Triton is currently the world’s fastest OCT scanner at 100,000 A-Scans per second. This allows for the collection of more data in the shortest time possible.

Imaging

It offers full color, high-resolution fundus imaging, FA and FAF photography, and wide-field imaging using a very low-intensity flash.

Features

• SMARTTrackTM   New tracking system – detects and compensates for involuntary eye movement.  
• PinPoint registration
• Monochrome sensor
• Anterior segment analysis

5. ivue OCT from Optovue ($9,999.00) – Complete retinal imaging

The Ivue OCT is a portable OCT machine that allows for flexible configurations. You can use it as a stand-alone or with the icam fundus camera for enhanced access to the retina, never fiber layer, and anterior segments of the eyes. To help diagnose disease, it can quantify results, track changes, and predict trends.

Ease of use

The streamlined interface makes the scanner quick and easy to use. The Optovue Academy also offers training online for technicians.

Features

• Epithelial (GCC and RNFL)  thickness mapping
• Focal and Global Loss volume analysis
• Slit-lamp design

6. iScan OCT from Optovue ($12,000.00) – Simplified operations

The iscan OCT provides all the functions of a traditional OCT machine with the added benefit of simplified procedures that make it incredibly user-friendly.

Process

Looking for a machine that sets the standards in simplicity. The method of operating it is as simple as pushing a button due to the user-friendly interface. The iscan automatically aligns the camera for scanner acquisition due to the pupil alignment technology.

Voice-guided OCT

The iscan vocally guides the patient through the process in 12 languages; all you need to do is select your preferred language and guide the patient.

Size

Truly portable, the iscan is as small as a desktop computer, thus space-saving. All you need to do is plug it in, switch it on, and start scanning.

Iwellness exam

This is a standard feature in the iscan. The iwellness retinal exam will help identify signs of disease even before the doctor does a clinical examination. The patient is, therefore, educated and involved in the treatment and management process. The separate billing will generate a new revenue stream for your business.

Features

• OCT fundus image
• 26,000 A-scan per second
• Minimum pupil diameter 2.5mm

Is Optical Coherence Tomography (OCT) a good investment for my practice?

We would venture a yes to that question. Considering the pros and cons, the most important should be the need to increase efficiency and efficacy in diagnosing and managing eye conditions. The fact that you can establish a diagnosis and treatment center for your patients in the comfort of your practice without referring them to another facility is a big plus.

The patient can also ‘see what is wrong and better understand whatever you are trying to explain. Further, not only does it bolster patient confidence in you as the doctor, but it also helps you communicate better with the patients and also impart invaluable knowledge to them. Most patients are more willing to adhere to what the doctor prescribes once they clearly understand what is ailing them.

The OCT technology enhances records, which assists in follow-up and managing the condition.

However, it is essential to note that you will have to continually invest in improving the software other than the initial cost of purchasing the hardware. The team will require expert training on using the OCT machine and the steadily growing software and how to interpret the data and images, which takes practice and skill development.

So, answering whether the OCT technology would be a good investment for your practice is a decision you can arrive at only after carefully weighing the pros and cons and whether what you currently have worked for you.

The world is evolving rapidly regarding technology, and it would be a good idea to keep up with the changing trends.

Conclusion

Optical coherence tomography (OCT) is, therefore, a method that has gained momentum and has significantly contributed to reducing the cases of loss of eyesight because it allows for the early detection and treatment of diseases.

The world cannot overlook the increased efficiency due to OCT technology. The machine scans and generates reports in seconds, all within the confines of your practice. Gone are when a doctor would need to send the patient to an expert to do and interpret the scans. The improved patient-doctor communication facilitated by the machines is also a significant plus.

Doctors must move away from traditional examining eyes and embrace the available technology. The use of OCT can help in the diagnosis and care of eye conditions. Find the Best OCT Machines at Ophthalmicmart.com

Dr. Nannette E Crowell, MD

Ophthalmology at Cascadia Eye | Website | + posts

Celebrating over 30 years! Since its establishment by Dr. Nannette Crowell in 1985, Cascadia Eye has been dedicated to providing the highest quality of personal eye care, the best-proven technology, and the most comprehensive coverage for your vision. With award-winning doctors, a fully-accredited eye surgery center, and six beautiful clinics, we provide complete eye care for every aspect of your vision health.

source: https://www.ncascade.com/about/

• Dr. Nannette E Crowell, MD

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