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Technology Insider

Swept source OCT . . . and more

Topcon’s DRI OCT Triton offers multi-modal imaging capabilities.

Topcon’s DRI OCT Triton is a multi-modal imaging device that includes swept source optical coherence tomography (SS-OCT) among other OCT capabilities, such as angiography, and innovative technologies, such as eye tracking.

In this article, Victor H. Gonzalez, MD, managing partner, Valley Retina Institute, McAllen, Texas, and Yesenia Salinas, director of clinical research, Valley Retina Institute, relate their experience using the DRI OCT Triton. Further insights are provided by Carl Glittenberg, global medical director, MD, FEBO, Topcon Medical Systems, Oakland, NJ.

Overview

The Triton received FDA clearance in January as a multi-modal fundus SS-OCT instrument. SS-OCT is used to visualize the eye’s anatomy (both anterior and posterior) to detect and monitor disease.

“Mechanically, OCT is like ultrasound, except it uses light to map anatomical structures instead of sound,” explains Dr. Glittenberg. “SS technology penetrates the eye’s structures using a longer wavelength than spectral domain OCT (SD-OCT), the current standard of OCT.”

The depth of penetration achieved via the increased wavelength, at 1,050 nm, provides users with a view of the vitreous, retina, choroid, and sclera. This is useful when obstacles, such as blood, gas, cataracts, or hemorrhages, are in the eye making image capture difficult. These impediments are common in patients with serious or advanced disease, such as diabetic retinopathy and exudative macular degeneration.

Additional features and their benefits include:

  • The eye-tracking tool, which provides clarity in images, even if patients move during imaging, says Dr. Glittenberg.
  • Fixation target, which patients are able to concentrate on unimpeded because the light’s wavelength (1,050nm) is invisible to the human eye. This can reduce involuntary eye movement and eye fatigue, reducing the need to re-scan, Dr. Glittenberg says.
  • Triton can also capture a 3D scan, with or without color fundus photography, to avoid constricting the pupil or meet the needs of patients with small pupils.
  • Comprehensive data analysis options, allows the practice to compare individual measurement data to corresponding normative data. Dr. Glittenberg says this gives doctors support to diagnose, treat, and manage patients with glaucoma and macular degeneration, as well as other conditions.

Additionally, the system can be upgraded as software advances.

DRI OCT Triton, from Topcon, is a multi-modal imaging technology that includes SS-OCT.

Operating the device

Minimal training is needed to operate Triton, says Ms. Salinas.

“It has been fairly simple to operate the equipment and capture images using its multi-modal settings, as well as to get the research staff certified through different reading centers for clinical studies,” she says.

“Staff have found that learning to use the Triton is simple and logical,” says Dr. Gonzalez. “They can easily and quickly use the software to properly perform and analyze studies. Physicians can remotely review studies with a patient, allowing the unit to continue to be used to evaluate other patients. This can translate into an important increase in revenue for the practice.”

The system’s joystick allows users to easily maneuver the device and take an image with one click of a button, located on top, Ms. Salinas says. Focusing circles on the screen align, confirming when a good image is captured. A touchscreen allows users to choose custom settings for image sizes.

Practice benefits

Due to the multi-modal nature of the DRI OCT Triton, it can save time for the technician and the patient, something specifically evident for those who require multiple tests to help manage their condition, as is the case with exudative macular degeneration.

“By delivering rapid results, physicians can quickly evaluate, diagnose, and choose the best treatment option for their patients,” Ms. Salinas says. With regards to speed, SS-OCT imaging scan has a speed of 100,000 A-scan/second, according to the company.

When using the Triton, Ms. Salinas says she can perform more diagnostic exams per day. Having the review station set up in the exam room helps with patient flow as the testing room is not occupied for more than the time required for testing.

“This is ideal when more than one provider practices in a facility,” she says.

Additionally, results can be uploaded directly to health records.

Future management

As a researcher, Dr. Gonzalez says he needs to be able to evaluate patients’ pathology with diagnostic tests that are widely available and those that will be important for future management, such as OCT angiography, to properly evaluate the benefit of future therapeutic options.

The Triton, Ms. Salinas points out, specifically has aided in the practice’s participation in clinical trials: “It has allowed us to stay abreast in our industry by allowing us to set guidelines or references on diagnostic tests that assist our specialists when diagnosing and managing ocular diseases.” OP