Will OCT Angiography replaces Fundus Fluorescein Angiography and ICG ?
After a Month of using this new Test the answer is simply YES.
Astonishing levels of detail and pictures, Mr Lee is simply blow away by the quality of the images and how useful they are.
Fundus Fluorescein Angiography is unpleasant at the best of times as it involves injection of fluorescein Dye and then 30+ photographs. It takes over a hour and involves nurses and photographers. This on the other hand requires no dye, no risk to the patient at all, is far quicker and the results are instantly available.
In a simple study of asking whether on 6 consecutive Fundus Fluorescein Angiographs done the new OCT based Angiogram would give the same information, the answer was YES to all.
It is one of those Milestones in Ophthalmology he Feels, a major step forward that has sent him back to the books to study the new information the test gives.
Mr Lee has purchased one of the first Zeiss AngioPlex OCT machines in the UK. It replaces his trusted K9 OCT machine of 6 years. It takes OCT images to the next level producing high level of detail of the retina.
But it is the OCT based Fundal Angiogram called AngioPlex that is really new and exciting. This new modality is able to look at the blood vessels in the eye just as Fundus Fluorescein Angiography does, but without the need for injections or Fundus Fluorescein Angiography. So far his experiences are that it can replace around 80% or more of the Fundus Fluorescein Angiography performed.
Below Is stunning image of the retinal Circulation in this case Normal.
Fundus Fluorescein Angiography is a very traditional way of looking at the retina but is quite an unpleasant test to have done and has risks of and allergic reaction which are not uncommon. This is a major step forward in imaging of the eye.
Angiographic OCT uses high speed scanning laser ophthalmoscope and doppler shifts to measure the flow of blood in the vessels in eye and with confocal type optics able to image individual layers and separate the circulation of the superficial and deep layers.
The images are far better than on expected and giving a level of detail that is very surprising. In the first 10 cases Fundus Fluorescein Angiography was not needed all the information necessary was available from the OCT angiography.
This truly is ground breaking technology.
A further comment "The new angiography shows a classic single sub retinal neovascular membrane in a flower petal formation. For the 1st time we can see in detail the size and extent of the membrane itself. This will give us far better information about whether the lesion is growing and whether or not treatment is required. Previously we have been only able to make decisions upon treating according to the subretinal fluid. Now we can decide upon treatment based upon the actual sub retinal neovascular membrane size and whether it is actually growing. This is a significant step forward in medical retina imaging"
The good news is that it comes in a highly portable format and AngioPlex replaces Mr Lee’s well know K9 OCT machine which is now 6 years old. K9 will act as a back up resting at home.
Mr Lee has added wheels to AngioPlex and he will ride on K9’s table and in Mr Lee’s shogun bringing this ground breaking technology to the various hospitals he works at including The Bishops Wood Hospital, The Clementine Churchill Hospital and The Hillingdon Hospital.
This is truly a new era of imaging. The good news is that it is cheaper than traditional Fundus Fluorescein Angiography as well as complete safe. BUPA has already signed a contract with Mr Lee for provision of this new technology and is a test that is being covered by insurance companies already. The Additional cost is only £91.00 over a standard OCT scan when done at the same time.
This is K9 meeting AngioPlex. Mr Lee made AngioPlex wheels to enable him to be moved around just like K9.
AngioPlex is on the right.
