Download pdf - Stratus OCT

Stratus OCT Software Version 4.0Real Answers in Real Time.

C a t a r a c t l G l a u c o m a l R e t i n a l R e f r a c t i v e

2Stratus OCT provides a higher level of diagnostic insight - a

significant contribution to therapeutic confidence across a

broad spectrum of ophthalmic diseases. Using near-infrared

frequency light, Stratus OCT reveals an in vivo cross-

sectional view with an axial resolution of 10 m, and

quantitative analysis of the retinal layers.

In the Stratus OCT image display, retinal layers with the

highest reflectivity appear red. In a healthy retina, these

include the nerve fiber layer, retinal pigment epithelium

and choriocapillaris. The layers that exhibit minimal

reflectivity appear blue or black, such as the photoreceptor

layer, choroid, vitreous fluid or blood.

Stratus OCTAdd depth to your diagnosis.

Inner Limiting MembraneNerve Fiber Layer

Ganglion Cell Layer

Inner Plexiform Layer

Outer Plexiform Layer

Junction of Inner and OuterPhotoreceptor Segments

Retinal Pigment Epithelium

Choriocapillaris

Junction of Inner and

Outer Photoreceptor

Segments

Retinal Pigment

Epithelium/

Choriocapillaris

Choroid

Inner Limiting

Membrane

Nerve Fiber

Layer

Ganlion Cell

Layer

Inner Plexiform

Layer

Outer Plexiform

Layer

3Stratus OCT reveals the retinal layers in high-resolution, cross-sectional views, offering insight for diagnosis,

therapy and ongoing management of retinal disorders.

Obtain real-time non-invasivehistology of live tissue.

Cystoid Macular Edema Central Serous Chorioretinopathy

Age-related Macular Degeneration

with Overlying Cystoid Macular Edema

Macular Hole with Operculum

Diabetic Macular Edema Epiretinal Membrane with Lamellar Hole and Cystoid Macular Edema

Branch Retinal Vein Occlusion RNFL Loss

Glaucoma Normal

4Diabetic Retinopathy

Stratus OCT reveals and measures diffuse macular thick-

ening and loss of foveal contour

Intraretinal cysts and fluid accumulation are identifiable

as areas of low reflectivity in the cross-sectional scan

Post-treatment resolution of retinal thickening can be

quantified and monitored

Epiretinal Membrane

Stratus OCT scan shows the epiretinal membrane as a

highly reflective band on the inner retinal surface

Separation of the membrane from the retina is visible in

areas

Underlying retina is thickened, with loss of normal foveal

contour

Age-related

Macular Degeneration

Disruption of RPE, caused by neovascularization and

drusen, can be visualized

Pockets of interretinal fluid are visible as areas of reduced

reflectivity

Structural changes resulting from therapy can be quanti-

fied and monitored

Visualize andanalyze retinal disorders.

5Retinal Nerve Fiber

Layer Analysis

Analysis of RNFL aids in identification of early glaucoma-

tous loss

Circular scans of 3.4 mm diameter around optic nerve

head provide measurement of RNFL in the peripapillary

region

RNFL thickness measurement is graphed in a TSNIT orient-

ation and compared to age-matched normative data

Optic Nerve Head Analysis

Radial line scans through optic disc provide cross-

sectional information on cupping and neuroretinal rim

area

Disc margins are objectively identified using signal from

end of RPE

Key parameters include cup-to-disc ratio and horizontal

integrated rim volume1

Macular Thickness Analysis

Thinning of the macula may reflect glaucomatous loss

Structural analysis of retinal sublayers reveals macular

complications

Cross-sectional view provides visualization and measure-

ment of retinal layers

Detect glaucoma damage at anearly stage.

6Retinal Thickness Report

Scan Protocol: Fast Macular Thickness, Macular Thickness, Line, Cross Hair

Used for: Assessment of overall macular region or specific areas of interest

Patient Information

Scan Image The image with the lowestsignal strength or with a datamessage will be shown tofacilitate operator review.

Signal Strength Numbers range from 0 (weak)to 10 (strong). Analysis algo-rithm may fail on scans withlow signal strength; therefore,images with a signal strengthbelow 5 should not be usedfor analysis.

Data Message Scan Too High, Scan TooLow or Missing Data mes-sage will be shown, if appli-cable, regarding placementand completeness of scan.

Retinal Thickness Displayed for A scan indicated. This corresponds to A scan (shown here) selected on thickness chart.

Caliper Length Measurement indicatesdistance between calipers if they are placed on scanimage during analysis.

Scan Information

Fundus ImageScan should be centered on fovea.

LegendArrow indicates direction and angle of individual scandisplayed in scan image.

Normative DataDistribution is indicated by a stoplight color code, described in detail inside back cover.

Thickness ChartGraphic display of retinalthickness. Colored bandsdemonstrate range of normative data.

Stratus OCT Printout Software Version 4.0

7Retinal Thickness Tabular Output

Scan Protocol: Radial Lines, Fast Macular Thickness, Macular Thickness

Used for: Imaging and measurement of macular pathology

Patient Information

Scan Image The image with the lowestsignal strength or with a datamessage will be shown tofacilitate operator review.Fundus ImageScan should be centered on the fovea.

Signal Strength Numbers range from 0 (weak)to 10 (strong). Analysis algo-rithm may fail for scans withlow signal strength; therefore,images with a signal strengthbelow 5 should not be usedfor analysis.Data Message Scan Too High, Scan TooLow or Missing Data mes-sage will be shown, if appli-cable, regarding placementand completeness of scan.Map Thickness is displayed using acolor scale. A normal eye willbe displayed as blue centrally.Orange and red indicate greater thickness. Legend for color scale appears near bottom right of page.Sector AveragesNumerical values indicateaverage thickness of eachsector. Colors within each sector indicate comparison to normative data.Scans Used If any of the 6 radial linescans has been deselected,analysis might be incomplete.

Scan Information

Map DiametersDiameters at which sector averages are calculated. Can be 1.0, 2.22 and 3.45 mm diameters or 1.0, 3.0 and 6.0 mm diameters as shown here.

Legend Normative data is displayed in stoplight color code, described in detail inside back page.

Color Scale For thickness maps.

Normal distribution,macula thickness normative data,Carl Zeiss Meditec.

Parameter Normal RangeFovea Minimum: 135 215 mMeasurement at center of fovea where radial scan lines intersect

Average ThicknessFovea 168 239 mTemporal Inner Macula 240 294 mSuperior Inner Macula 243 296 mNasal Inner Macula 240 297 mInferior Inner Macula 246 297 mTemporal Outer Macula 199 276 mSuperior Outer Macula 207 256 mNasal Outer Macula 198 274 mInferior Outer Macula 207 256 m

RatiosSuperior/Inferior Outer 0.832 1.222Temporal/Nasal Inner 0.800 1.227Temporal/Nasal Outer 0.557 1.845

VolumeFovea 0.13 0.19 cubic mmTemporal Inner Macula 0.38 0.46 cubic mmSuperior Inner Macula 0.38 0.46 cubic mmNasal Inner Macula 0.38 0.47 cubic mmInferior Inner Macula 0.39 0.46 cubic mmTemporal Outer Macula 1.06 1.46 cubic mmSuperior Outer Macula 1.10 1.36 cubic mmNasal Outer Macula 1.05 1.45 cubic mmInferior Outer Macula 1.10 1.35 cubic mmTotal Macula Volume 6.18 7.42 cubic mm

8CompositeDiagramYellow line indicatesindividual scan selectedand displayed above.

Fundus ImageCan be used to verify scan placement.

Scan List For each of the 6 radial line scans,this indicates thedate when the scanwas last adjustedand saved.

Cup Area The area within the green outlineon the composite diagram.

Cup Volume Volume of cup areaon the topographicdisplay.

Cup Offsetfor TopoDefault is 150 manterior to disc.Represents edge of blue shading ontopographic display -the surface of the cup as if it were filled with water.

Optic Nerve Head Analysis Report

Scan Protocol: Optic Disc, Fast Optic Disc

Used for: Evaluation of the optic disc

Patient Information

Cup MarkersThe edge of the cup is indicatedwith a green dot on the scanimage and a green x on thecomposite diagram.RPE MarkersThe end of the RPE is indicated.Shown blue on the scan image,red on the composite diagram.Signal Strength Numbers range from 0 (weak)to 10 (strong). Analysis algo-rithm may fail on scans withlow signal strength; therefore,images with a signal strengthbelow 5 should not be used foranalysis.Optic Nerve HeadResultsData are derived from the 6 radial line scans.Vertical Integrated Rim AreaTotal volume of RNFL tissue inthe rim is obtained by multiply-ing the average of the 6 indivi-dual rim areas by the circumfe-rence of the disc. Normal valuesare 0.36 0.08 cubic mm.2Horizontal Integrated Rim Width Total rim area is obtained bymultiplying the average of the 6 individual nerve widths by thecircumference of the disc.Disc Area The area within the red outlineon the composite diagram.Cup Area The area within the green outli-ne on the composite diagram.Rim AreaDisc area minus cup area.Cup/Disc Area Ratio Ratio of cup area to disc area.Cup/DiscHorizontal RatioRatio of the longest horizontalline across the cup to the longest horizontal line acrossthe disc.Cup/Disc Vertical RatioRatio of the longest vertical line across the cup to the

longest vertical line acrossthe disc.

Scan Information

Individual Radial Scan AnalysisData relates only to the indi-vidual scan image displayed.Rim Area Indicated with red shading onscan image, this area is bound-ed by the cup diameter line anda line from the RPE marker tothe anterior surface of the disc,at a 90-degree angle to the cupdiameter line. Average NerveWidth@Disc The average of the nerve bund-le widths at the disc on eachside. Nerve bundle width indi-cated by yellow line from RPEmarker to anterior surface.Disc Diameter Illustrated and measured on a straight line between the 2 RPE markers. Blue line onscan image.Cup Diameter Illustrated and measured on a straight line parallel to, and150 m anterior to, the discdiameter line. Red on image,green on diagram, this line isadjustable.Legend Arrow indicates direction and angle of individual scandisplayed in scan image.Horizontal Rim Length Disc diameter minus the cupdiameter.Plot BackgroundThere are 3 optional back-grounds; two are similar to atopographic map. Aligned andShaded (default) provides ashaded relief topographic mapand corrects for patient motion.Absolute provides a non-shadedtopographic map with no correction for movement. Noneshows a solid gray backgroundwith no appearance of depth.Cup Offset Point at which cup diameter is measured. Default placementis 150 m anterior to the RPEmarkers; this point is adjustable.


9Comparison Average RatiosImax/Smax 0.80 1.25Thickest points in inferior and superior quadrantsSmax/Imax 0.77 1.25Thickest points in superior and inferior quadrantsSmax/Tavg 1.70 3.06Thickest point in superior quadrant to average in temporalImax/Tavg 1.69 3.12Thickest point in inferior quadrant to average in temporalSmax/Navg 1.37 2.93Thickest point in superior quadrant to average in nasal

Measurement Average Values

Min-Max 96 154 mDifference between minimum and maximum measurementsSmax 124 189 mThickest measurement in superior quadrantImax 125 194 mThickest measurement in inferior quadrantSavg 97 152 mAverage measurement in superior quadrantIavg 98 156 mAverage thickness in inferior quadrant

Average Thickness 82 118 m

RNFL Thickness Average Analysis

Scan Protocol: RNFL 3.4 mm, Fast RNFL 3.4 mm

Used for: Retinal nerve fiber layer thickness assessment and comparison to normative database

Patient Information

RNFL Thickness ChartPeripapillary RNFL thickness is displayed in TSNIT format.Colored bands demonstraterange of normative data.

Sector AveragesComparison to normative datain each sector is indicated with stoplight colorscheme. Values are displayednumerically.

Quadrant Averages Comparison to normative datain each quadrant is indicated with stoplight colorscheme. Values are displayednumerically.

OD/OS GraphTSNIT line graph displays RNFLthickness in both eyes.Asymmetry may be indicative ofglaucomatous loss.

Scans Used If any of the 3 circular scanshas been deselected, analysismight be incomplete and forthe fast RNFL scan, normativedata will not be displayed.

Legend Normative data is displayed in stoplight color code, described in detail on insideback cover.

Scan Information

Fundus Image To verify scan placement.

Scan Image The image with the lowest sig-nal strength or with a data message will be shown tofacilitate operator review.

Signal Strength Numbers range from 0 (weak)to 10 (strong). Analysis algo-rithm may fail on scans withlow signal strength; therefore,images with a signal strengthbelow 5 should not be used foranalysis.

Data MessageScan Too High, Scan Too Low or Missing Data message will beshown, if applicable, regardingplacement and completeness ofscan.

Tabular Data For each eye, values are compared to normative data and displayed instoplight color code, described in detailon inside back cover.

Normal distribution, RNFL normative data, Carl Zeiss Meditec.

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Color Legend and Exam Dates

OD

OS

Scan Type:

Scan Date:

Scan Length:

STRATUS OCTRNFL Thickness Serial Analysis Report - 4.0.1 (0056)

DOB: 7/12/1968, ID: NA, Male

Fast RNFL Thickness (3.4)Multiple, See Table

10.87 mm

Signature:

Physician:

RNFL Thickness Serial Analysis

Scan Protocol: Fast RNFL Thickness (3.4), RNFL Thickness (2.27 x disc)

Used for: Comparative analysis of RNFL thickness over time. Can be applied to up to 4 OD and/or 4 OS scan groups

Patient Information

TSNIT Graph Peripapillary RNFL thickness is displayed in TSNIT format.Colors distinguish lines byscan date.

Color Legend and Exam Dates Shows dates of selected scansand corresponding line colors.

Scan Information

Fundus ImageShows most recent scan. Can be used to verify scanplacement.

Scan Image For most recent scan data, the image with the lowestsignal strength or with a datamessage will be shown tofacilitate operator review.

Signal Strength Numbers range from 0 (weak)to 10 (strong). Analysis algorithm may fail on scanswith low signal strength; therefore, images with a signal strength below 5 should not be used for analysis.

Data MessageScan Too High, Scan Too Low or Missing Data message will be shown, if applicable,regarding placement andcompleteness of scan.


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Stratus OCT Normative Data.

Stoplight Color Scheme

RNFL Normative Data Display RNFL Normative Distribution

Macula Normative Display Macula Normative Distribution

Of the normal population:

5%

90%

4%

1%

5% fall within the white band

95% fall within or below the green band90% fall within the green band

5% fall within or below the yellow band

1% fall within the red band; considered outside the normal limit

100%

95%

5%

1%

0%