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How do we benefit from OCTA information?
ZEISS AngioPlex is a complete OCT Angiography (OCTA) solution that offers the industry’s most comprehensive tools for assessing and analyzing a range of pathologies. Among others, AngioPlex helps:
- Identify pathology without injections
- Monitor dry-to-wet AMD conversion
- Monitor vascular change before visual loss
- Supports long-term patient management care
- Monitor NV pre and post-treatment
- Track changes over time
- Provide 3D and depth-encoded information for thorough assessment of disease
Can we rely on OCTA to assess retinal ischemia?
Yes, using ZEISS AngioPlex, ischemia can be seen visually via individual 3x3, 6x6, or 8x8* mm scans, or using AngioPlex Montage Widefield OCTA* images with up to a 50 degree field of view. In addition, AngioPlex Metrix®* quantifies vessel density and perfusion, which can be tracked and compared over time with AngioPlex Change Analysis.
Does OCTA provide widefield views of the retina?
Yes, the AngioPlex Montage 14x14 mm Widefield OCTA* —with up to a 50º field of view (FoV)—encompasses the entire posterior pole, revealing macular ischemia, extensive areas of capillary nonperfusion outside the central 8x8 mm* area and any additional areas of neovascularization. ZEISS AngioPlex Montage delivers widefield OCTA in a single imaging sequence, providing visualization of vasculature and detection of diseases that affect the macula and peripheral retina. The detail-rich images enable quick and comprehensive vascular assessment and can be an excellent tool for patient education.
What pathology should we NOT use OCTA for?
OCTA is best for assessing pathology with flow, for e.g. neovasularization, or areas where there is a lack of flow, such as ischemia. OCTA is not suited for assessing pathology without flow such as vitreomacular traction (VMT), epiretinal membrane (ERM), etc., as this may not get picked up on the scan. If leakage information is needed, the standard of care is fluorescein angiography. OCTA is also not ideal for assessing structural issues, for e.g. activity in the choroid or for eyes with poor media such as cataract. However, if you are interested in tracking the foveal avascular zone (FAZ) for these conditions, OCTA may be a good solution.
What pathology is it best for?
OCTA is best utilized when ischemia or neovascularization is suspected. For e.g. Diabetic retinopathy (DR), Macular telangiectasia (MacTel), Age-related macular degeneration (AMD), vascular occlusions, central serous chorioretinopathy (CSCR), etc. OCTA is ideal for visualizing flow and perfusion and for monitoring vascular change over time.
How fast is OCTA, especially in the case of an elderly non-compliant patient?
OCTA images can be taken in just a matter of seconds in most cases. For more challenging patients, FastTrac™, the proprietary retinal tracking system from ZEISS, is particularly helpful in eliminating artifacts from blinks and other eye movement using real-time, active eye tracking technology. With FastTrac, clinicians can scan at the highest resolution without sacrificing patient throughput.
What are the benefits of Fastrac?
Fastrac™, the proprietary retinal tracking system from ZEISS helps make the most of every scan and supports eliminating artifacts from blinks and other eye movement using real-time, active eye tracking technology. With FastTrac, you can scan at the highest resolution without sacrificing patient throughput. In addition the track-to-prior feature on CIRRUS also precisely tracks follow-up scans so that scans can be performed in the same location as previous visits, which results in reliable change analysis from visit-to-visit.
How will we know what are artifacts?
While FastTrac helps eliminate artifacts from blinks and other eye movements, other artifacts may be present. Generally, the easiest artifacts to identify are discontinuous vessels along a horizontal line and other artifacts can be confirmed by looking at both the en face image, and its corresponding B-scan. The new AngioPlex Montage Widefield OCTA* additionally helps in eliminating some types of artifacts. If you would like to learn more about artifacts and how to avoid them, here’s an article that will be useful.
Can we do anterior OCTA?
Currently, there is no commercial anterior segment OCTA product available, but ZEISS has demonstrated in research that this technology is possible. To learn more about this published research, click here.
Where can we get training on interpretation?
Here are two resources that help with OCTA interpretation:
Interpretation Guide: OCT Angiography and Integrated Diagnostic Imaging: This interactive e-book provides a guided walk-through of OCTA interpretation of some typical pathology cases seen in the clinic. To download the ebook on your iPad/tablet, click here.
A structure-oriented introduction to the diagnosis of OCT angiograms
This PDF document provides a deep-dive into OCTA technology and guides readers through interpretation of images in a detailed step-by-step fashion.
* Widefield AngioPlex Montage and AngioPlex Metrix are not available for use or sale in the United States.
* 8x8mm scan may not be available for use in the United States.
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