Visualize. Analyze. Personalize. OCT + OCTA

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Philippa Willis
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1 Visualize. Analyze. Personalize. OCT + OCTA

A New Approach to Protecting Vision AngioVue OCT Angiography brings valuable new information to clinical practice. Non-invasive visualization of retinal vasculature.

2 A New Approach to Protecting Vision AngioVue OCT Angiography brings valuable new information to clinical practice. Non-invasive visualization of retinal vasculature. Depth resolved imaging displays individual layers of the retina to isolate specific areas of interest and reveal microvasculature that is not easily seen with FA/ICG. Pathology is not obscured by fluorescein staining or pooling. Image acquisition requires less time than a dye-based procedure and can be accomplished by a technician. AngioVue TM allows more frequent imaging to better follow disease progression and treatment response. Fluorescein Angiography Introduced in 1961

3 Superficial Capillary Plexus AngioVue OCT Angiography The Future of Retinal Imaging Deep Capillary Plexus Outer Retina Choriocapillaris

Introducing the AngioVue Imaging System Comprehensive Imaging from Anterior Segment to the Choroid in a Single Platform The AngioVue Imaging System, installed in more than 550 ophthalmic practices

4 Introducing the AngioVue Imaging System Comprehensive Imaging from Anterior Segment to the Choroid in a Single Platform The AngioVue Imaging System, installed in more than 550 ophthalmic practices worldwide, is a dual-modality OCT+OCTA system capable of imaging both structure and function of the ocular tissue. AngioVue enables personalized management of disease progression non-invasively, without the use of dye, and with image acquisition in under three seconds. Structure Enhanced HD B-Scan

Outer Retina and Choriocapillaris Function Abnormal vasculature of Type II CNV is

Superficial Capillary Plexus Optic Disc Proliferative diabetic retinopathy displays

Regions of non-perfusion visualized in the superficial capillary plexus near the

5 Outer Retina and Choriocapillaris Function Abnormal vasculature of Type II CNV is visualized in the outer retinal layer, as indicated by the yellow vessels. Superficial Capillary Plexus Optic Disc Proliferative diabetic retinopathy displays regions of impaired perfusion and microaneurysms in the superficial plexus. Regions of non-perfusion visualized in the superficial capillary plexus near the optic disc in diabetic retinopathy. Patients previously diagnosed. Images courtesy of Pravin Dugel, MD.

6 AngioVue Clinical Applications: Retina Visualize Widefield views of retinal anatomy and individual layers of vasculature. Others 6x6 mm Scan 9x12 mm Widefield IPL Layer RPE Layer En Face View Analyze Retinal structures with comprehensive reports. Retina Map Report OCTA OverVue Report Personalize Patient care with real-time information. CNV Patient Baseline 24 Hours Post-injection 7 Days Post-injection 30 Days Post-injection Images courtesy of Bruno Lumbroso, MD

Visualize Superficial Capillary Plexus Deep

Choriocapillaris OCT Angiogram Analyze OCT

Report Personalize I have had patients in

neovascularization, but where traditional

The AngioVue Imaging System allowed me to

definitively, which gave me the information

7 Visualize Superficial Capillary Plexus Deep Capillary Plexus Outer Retina Choriocapillaris OCT Angiogram Analyze OCT OverVue Report Change and Trend Analysis Report Personalize I have had patients in whom I suspected choroidal neovascularization, but where traditional OCT was not very diagnostic. The AngioVue Imaging System allowed me to visualize choroidal neovascularization definitively, which gave me the information I needed to treat those patients earlier. David Boyer, MD, Retina-Vireous Associates Medical Group

8 AngioVue Clinical Applications: Glaucoma Visualize Images courtesy of Michel Puech, MD, Paris, France Radial peripapillary capillary dropout in known glaucoma patients. Normal Optic Disc Moderate Glaucoma Severe Glaucoma Analyze Structure and function with comprehensive reporting. ONH/GCC OU Report AngioDisc Report Personalize Treatment protocols with trend analysis reports displaying disease progression. Rapidly Progressing Patient Slowly Progressing Patient

AngioVue Clinical Applications: Anterior Segment

information that increases diagnostic confidence.

Corneal Thickness Analyze Corneal structures and

Cornea Angles OU Report Pachymetry Change Analysis

$post-refractive surgery patients.$ quantification of the corneal power by measuring

9 AngioVue Clinical Applications: Anterior Segment Visualize Anterior segment anatomy to gain new information that increases diagnostic confidence. Anterior Chamber Angles Corneal Cross-Sections Corneal Thickness Analyze Corneal structures and thickness. Cornea Angles OU Report Pachymetry Change Analysis Personalize IOL power calculation for post-refractive surgery patients. TCP Total Cornea Power (TCP) Provides direct quantification of the corneal power by measuring both the front and back surfaces of the cornea. IOL Scan acquisition takes less than two seconds and reduces reliance on historical data.

Case Studies Choroidal Neovascularization

Abnormal vasculature is seen in the outer

10 Case Studies Choroidal Neovascularization CNV as visualized with FA and OCTA. Abnormal vasculature is seen in the outer retina layer of the OCT angiogram. Fluorescein Angiography AngioVue: Outer Retina AngioVue: Superifical Capillary Plexus, Outer Retina, Choriocapillaris Choroidal Neovascularization CNV as visualized with FA and OCTA. Abnormal vasculature is seen in the outer retina and choriocapillaris layers of the OCT angiogram. Fluorescein Angiography Patients previously diagnosed. Images courtesy of Pravin Dugel MD. AngioVue: Choriocapillaris AngioVue: Outer Retina and Choriocapillaris

Proliferative Diabetic Retinopathy Yellow dashed

The AngioVue image (center) provides a detailed

Fluorescein Angiography AngioVue: Superficial

Macular Telangiectasia 2 Red dashed lines

plexus and deep plexus separately for closer

11 Proliferative Diabetic Retinopathy Yellow dashed lines indicate regions of non-perfusion. The AngioVue image (center) provides a detailed view of the of the superficial capillary plexus. Fluorescein Angiography AngioVue: Superficial Capillary Plexus AngioVue: Choriocapillaris Macular Telangiectasia 2 Red dashed lines highlight areas of dilated capillaries and capillary dropout. AngioVue allows visualization of the superficial plexus and deep plexus separately for closer observation. Fluorescein Angiography AngioVue: Superficial Capillary Plexus AngioVue: Deep Capillary Plexus

AngioVue Technology SSADA: Split-Spectrum Amplitude Decorrelation Angiography SSADA is a proprietary algorithm used to detect motion

It acquires sequential OCT B-scans at a single cross-section of the retina and compares the scans against one another.

This unique technology elevates image quality by optimizing signal-to-noise ratio while minimizing scan acquisition time.

SSADA was developed by David Huang, MD, PhD at Oregon Health Sciences.

12 AngioVue Technology SSADA: Split-Spectrum Amplitude Decorrelation Angiography SSADA is a proprietary algorithm used to detect motion in the vessels. It acquires sequential OCT B-scans at a single cross-section of the retina and compares the scans against one another. The differences between scans indicate the presence of flow. This unique technology elevates image quality by optimizing signal-to-noise ratio while minimizing scan acquisition time. With SSADA Without SSADA SSADA images display less noise and a more detailed microvascular network. SSADA was developed by David Huang, MD, PhD at Oregon Health Sciences. En Face Visualization En face technology separates the retina into distinct structural layers for assessment of microvascular changes. En face colorization uses a standard color scheme for rapid identification of the different retinal layers. The en face layer indicator icon provides a reference to the retinal layers displayed. Red: Choriocapillaris Yellow: Outer Retina White: Superficial Capillary Plexus Purple: Deep Capillary Plexus

MCT: Motion Correction Technology MCT TM minimizes

MCT is done as part of the post-scan processing to

Fast X Scan Fast Y Scan MCT Scan MCT employs two 3D

The two scans are then merged to remove artifacts

MCT was developed by MIT and the University of Erlangen.

13 MCT: Motion Correction Technology MCT TM minimizes saccadic motion and increases the image intensity. MCT is done as part of the post-scan processing to minimize scan acquisition time. Fast X Scan Fast Y Scan MCT Scan MCT employs two 3D raster scans: one horizontal and one vertical. The two scans are then merged to remove artifacts caused by motion. MCT was developed by MIT and the University of Erlangen. AngioMontage See a wider field of view with AngioMontage TM, which combines two 6x6 mm images for a widefield view of the retinal vasculature.

Technical Specifications OCT scanning speed Optical axial resolution Optical transverse resolution OCT axial imaging depth AngioVue imaging volume Acquisition time per imaging volume AngioVue imaging

B-scan) (209K / 70K) ~3 seconds 3x3, 6x6, 8x8 mm 3x3, 4.5 x 4.

14 Technical Specifications OCT scanning speed Optical axial resolution Optical transverse resolution OCT axial imaging depth AngioVue imaging volume Acquisition time per imaging volume AngioVue imaging size (retina) AngioVue imaging size (optic disc) 70,000 A-scans per second ~5 microns (digital pixel sampling = 3 µm) ~15 microns 2 to 3 mm (dependent on scan protocol) 304 x 304 A-lines (2 repeats / B-scan) (209K / 70K) ~3 seconds 3x3, 6x6, 8x8 mm 3x3, 4.5 x 4.5 mm Recommended Networking Specifications Operating System Processor Speed Network Bandwidth Computer RAM Monitor Resolution Windows 7, 8 and 10; 64-bit OS compatible 3.0 GHz; Intel Quad core (desktop); Core 2 (laptop) 1 Gbps or higher 4 GB or higher 1920 x 1080 at 32-bit color Optovue, Inc Bayview Drive Fremont, CA Phone: Optovue, the Optovue logo, TCP, AngioMontage, AngioVue, and MCT are either registered tradesmarks or trademarks of Optovue, Inc Rev. A

Visualize. Analyze. Personalize. OCT + OCTA. with

Visualize. Analyze. Personalize. OCT + OCTA with Avanti Widefield OCT with AngioVue OCTA Imaging Comprehensive Structural and Functional Imaging in a Single Imaging Platform Comprehensive OCT Imaging The