One hundred sixty-seven eyes of 88 subjects with open-angle glaucoma or suspected glaucoma, as determined by the subject's clinician, were tested at Devers Eye Institute. These cross-sectional data were collected in subjects enrolled in the ongoing longitudinal P3 study.17 (link)–19 (link, link) Subjects underwent a set of functional and structural diagnostic tests once every 6 months, including standard automated perimetry (SAP) (HFAII; Carl Zeiss Meditec Inc., Dublin, CA, USA), 24-2 test pattern, and SITA Standard test strategy; optical coherence tomography (Spectralis OCT2; Heidelberg Engineering, Heidelberg, Germany); and systemic blood pressure measurement using an arm cuff. Subjects were excluded if they had significant visual field loss due to causes other than glaucoma or if they had systemic hypertension (based on the same criteria as in the Wien controls, below). If LSFG data were available for more than one time point, the most recent test was used. Both eyes were tested, even if only one had extant glaucomatous loss, on the basis that this implies that the fellow eye could be considered as a “glaucoma suspect” that is at increased risk of developing glaucomatous loss in the future.20 (link)
Spectralis oct2
Manufactured by Heidelberg Engineering
Sourced in Germany
The Spectralis OCT2 is a non-invasive, high-resolution optical coherence tomography (OCT) imaging device developed by Heidelberg Engineering. It captures cross-sectional images of the eye, providing detailed information about the structure of the retina and other ocular tissues.
Automatically generated - may contain errors
Lab products found in correlation
Spectralis flex module, by Heidelberg Engineering (2 mentions)
Ark 560a, by Nidek (2 mentions)
Hfa 2, by Zeiss (1 mentions)
Triton ss oct, by Topcon (1 mentions)
Humphrey field analyzer hfa, by Zeiss (1 mentions)
Dri triton oct device, by Topcon (1 mentions)
Angioplex, by Zeiss (1 mentions)
Spectralis hra oct, by Heidelberg Engineering (1 mentions)
Phenylephrine, by Bioteck (1 mentions)
Spectralis hra2, by Heidelberg Engineering (1 mentions)
Sd oct, by Heidelberg Engineering (1 mentions)
Plex elite 9000, by Zeiss (1 mentions)
15 protocols using spectralis oct2
1
Longitudinal Glaucoma Progression Study
2
Multimodal Retinal Imaging for CNV Detection
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A macular volume scan (49 B-scans within a 30°×20° area) centred on the fovea was acquired with a spectral domain OCT (Spectralis OCT2, Heidelberg Engineering, Heidelberg, Germany).14 (link) OCT-A was obtained with a swept-source OCT device (Triton SS-OCT, Topcon, Tokyo, Japan) on a scanning area of 4.5×4.5 mm and an automatically segmented slab of 30 µm (shaped on RPE profile) was set immediately above the RPE and then moved towards the Bruch’s membrane in order to detect flow signals due to CNVs.11 (link) A manual correction of the segmented boundaries was performed in a limited number of acquired OCT angiograms (less than 5%), especially in case of severe outer retinal/RPE disruption. This process was done by a senior retina specialist (FC), before the OCT-A qualitative grading, in case of incorrect RPE automatic delineation and was performed on structural, cross-sectional OCT scans.
3
Ocular Blood Flow Dynamics Under IOP Elevation
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OCTA was obtained via a spectral-domain OCT device (Spectralis OCT2, Version 1.10.4.0; Heidelberg Engineering, Heidelberg, Germany) set to scan an area of 8.8 × 4.4 mm (30° × 15°). The eye was maintained with the optic nerve head in the lower center of the fundus region, as visualized with the scanning-laser ophthalmoscopy module of the OCT device, and cilioretinal arteries were located in the center of the image (Fig. 6 B). A rigid contact lens (base curve: 9.6) of zero power was applied on the cornea to avoid corneal dryness and haziness during image acquisition. OCTA images were obtained from all pig prior to vitrectomy (control). After vitrectomy as described above, IOP was elevated from 15 to 105 mmHg in 15 mmHg increments, and OCTA imaging was obtained at each IOP after 2 min. After taking OCTA images at 105 mmHg of IOP, the infusion line of the dorsolateral port was removed (reserve dorsolateral port) and the IOP was measured approximately 20 min later. This was defined as “recovery state” and OCTA imaging was re-obtained at this point.
4
Visual Field and Retinal Layer Analysis
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The VF was tested with the 10–2 pattern of Humphrey Field Analyzer (HFA, Carl Zeiss Meditec, Dublin, CA) which contains 68 test locations 2° apart, both horizontally and vertically, within the central 10° of the VF. The appropriate near correction was used and fixation monitored with the Hejil-Krakau method44 (link). Tests deemed unreliable as noted by the perimetrist and reliability criteria (false positive or false negative rates > 15%, or fixation losses > 33%) were repeated.
OCT examinations were performed with the Spectralis OCT2 (Heidelberg Engineering, Heidelberg, Germany). Images were acquired within the central 30° × 25° (Glaucoma Module Premium Edition software, GMPE, Heidelberg Engineering, v. 6.16) with 61 horizontal B-scans (each containing 768 A-scans) averaged 9 times. Automatic segmentation of the individual retinal layers was carried out to quantify ganglion cell layer (GCL) and inner plexiform layer (IPL) thickness, using the device software. Only scans with high signal strength (> 25 dB) were included in the analysis. All images were checked for segmentation errors and manually corrected by a trained operator when necessary.
OCT examinations were performed with the Spectralis OCT2 (Heidelberg Engineering, Heidelberg, Germany). Images were acquired within the central 30° × 25° (Glaucoma Module Premium Edition software, GMPE, Heidelberg Engineering, v. 6.16) with 61 horizontal B-scans (each containing 768 A-scans) averaged 9 times. Automatic segmentation of the individual retinal layers was carried out to quantify ganglion cell layer (GCL) and inner plexiform layer (IPL) thickness, using the device software. Only scans with high signal strength (> 25 dB) were included in the analysis. All images were checked for segmentation errors and manually corrected by a trained operator when necessary.
5
Macular Status Evaluation in Retinal Detachment
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OCT volume scans were obtained from both the study and fellow eye using a Spectralis OCT2 (Heidelberg Engineering, Heidelberg, Germany) after pupil dilatation with 0.5% tropicamide. The scans were evaluated using Heidelberg Eye Explorer system software. In SLO images of the study eyes, the umbo was identified based on the B scans and an ETDRS grid was overlayed centered on the umbo (Fig. 1 ). All images were classified into six stages according to the extent of macular detachment (Fig. 2 ). We adapted the classification proposed by Klaas et al. (non-published data by J. Klaas, “Prognostic Value of SD-OCT in Patients With Macular Involving Rhegmatogenous Retinal Detachment—A Modified Classification of the Macular Status,” presented at EURETINA Congress, September 22, 2018).
6
High-resolution Optic Nerve Head Imaging
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OCT imaging was performed with second-generation spectral domain OCT/A equipped with research software (Spectralis OCT2; Heidelberg Engineering Inc., Heidelberg, Germany) and modified to mount the imaging head on a custom counterweighted support arm that allows for six-axis fine manipulation (Spectralis Flex Module; Heidelberg Engineering Inc.). With the organ donor in a supine position, baseline and follow-up high-resolution 15° radial scans of the ONH were performed. These consisted of 24 B-scans made up of 768 A-scans with 25 to 30 images averaged/B-scan. The axial scaling factor was 3.87 µm for all the eyes, and the lateral scaling factor was 5.36 µm, on average.
7
Retinal Examination Using Spectral Domain OCT
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The retinal examination used spectral domain optical coherence tomography (OCT)
with eye tracking technology (SPECTRALIS OCT2, Heidelberg Engineering, Germany)
with both left and right eyes imaged.18 (link)
We recorded self-declared eye disease (diabetic retinopathy, glaucoma,
and age-related macular degeneration) which we checked against our
ophthalmological graded assessments of the images. Queries were resolved by an
ophthalmologist (B.D.).
with eye tracking technology (SPECTRALIS OCT2, Heidelberg Engineering, Germany)
with both left and right eyes imaged.18 (link)
We recorded self-declared eye disease (diabetic retinopathy, glaucoma,
and age-related macular degeneration) which we checked against our
ophthalmological graded assessments of the images. Queries were resolved by an
ophthalmologist (B.D.).
8
Comprehensive Retinal Imaging Evaluation for MNV
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A comprehensive retinal imaging evaluation consisting of FA, ICGA (HRA2; Heidelberg Engineering, Heidelberg, Germany), OCT (Spectralis HRA-OCT; Heidelberg Engineering), and OCTA was performed. The OCTA images were captured using a DRI-OCT Triton device (Topcon, Tokyo, Japan), Spectralis OCT 2 (Heidelberg Engineering), or AngioPlex (Carl Zeiss Meditec, Dublin, California, USA) to scan a foveal area of 4.5×4.5 mm or 6×6 mm. An artefact removal option was used for this study. Three-dimensional angiographic images were obtained after the instrument was aligned with the macula, and then the four vascular slabs, including the superficial retina, deep retina, outer retina and choriocapillaris, were segmented automatically. Sequentially, MNV was confirmed as evidence of abnormal signals consistent with the pathological vascular component at the level of the outer retinal slab or choriocapillaris slab.
9
Retinal Imaging with SD-OCT and Fluorescein
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SD-OCT imaging was performed using a Spectralis OCT2 (Heidelberg Engineering, Inc, Heidelberg, Germany) as described in (45 (link)). Animals were anesthetized with ketamine and xylazine as described above. One drop of topical 2.5% phenylephrine (Paragon BioTeck, Inc) was used to dilate the iris. SD-OCT horizontal B-scans were performed to detect changes in the retinal angiography using the sodium fluorescein dye. The Micron IV imaging system (Phoenix Technology Group, LLC) was used to register retinal blood-vessel leakage. To that end, anesthetized animals received IP injections of sodium fluorescein and the imaging was processed as described in (44 (link)).
10
IOP-Induced Retinal Vascular Changes
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Following vitreous chamber cannulation, IOP was set to 10 mm Hg as baseline. A baseline OCTA volume was recorded using a spectral domain OCT/OCTA system (Spectralis OCT2; Heidelberg Engineering, Heidelberg, Germany) with the aid of a rodent objective lens attachment (25D, Heidelberg Engineering). Images were acquired with a volume scan pattern of 20° × 10° (5.4 × 2.7 mm) starting at one-disc diameter from the optic nerve head (see Fig. 1 ). Each volume consisted of 256 vertical B-scans (5 repeats) each consisting of 512 A-scans.
For each eye, the baseline volume was processed and set as the reference volume. IOP was then elevated in steps of 10 mm Hg up to 110 mm Hg, each step lasting 3 minutes. At the two-minute mark into each IOP level, the OCTA volume was recorded. After the last step (110 mm Hg) IOP was gradually returned (approximately 10 seconds) to 10 mm Hg by lowering the fluid reservoir back to baseline. A final OCTA recording was obtained 2 minutes after IOP normalization to baseline to assess recovery of the vasculature.
For each eye, the baseline volume was processed and set as the reference volume. IOP was then elevated in steps of 10 mm Hg up to 110 mm Hg, each step lasting 3 minutes. At the two-minute mark into each IOP level, the OCTA volume was recorded. After the last step (110 mm Hg) IOP was gradually returned (approximately 10 seconds) to 10 mm Hg by lowering the fluid reservoir back to baseline. A final OCTA recording was obtained 2 minutes after IOP normalization to baseline to assess recovery of the vasculature.
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