CenterVue’s Eidon is the first confocal imaging system that uses a white light source to illuminate the retina, combining the superior resolution and contrast typical of scanning laser ophthalmoscopy with the fidelity of true-color imaging.
The device provides a 60-degree field in a single exposure; a unique, live, confocal view of the retina; 3 different imaging modalities; and dilation-free operation, all integrated into a versatile system that provides new opportunities in retinal diagnostics, says Giuliano Barbaro, MSc, head of research and development and director of CenterVue.
Because fundus examination is a crucial part of the eye exams he performs, Richard Lewis, MD, clinician, consultant, and co-founder, Sacramento Eye Consultants in Sacramento, California, was prompted to try the Eidon. “The system’s nonmydriatic camera provides accurate images of the central and peripheral retina—it doesn’t change the color or tone,” he says.
K. Bailey Freund, MD, clinical professor at New York University School of Medicine, and senior partner, Vitreous Retina Macula Consultants, both in New York, New York, has also found many advantages to using the Eidon. Because it produces highly resolved images, he can enlarge and crop them and still have high-quality images when zooming in; images don’t become pixelated like low-resolution images. This is because the device has a high-resolution sensor and uses a confocal scanning slit aperture which helps eliminate scattered light. The Eidon can automatically montage images taken in different fields by automatically stitching images together following acquisition.
Dr. Freund, who has no financial affiliations with CenterVue, has found the Eidon’s flicker mode to be particularly beneficial. “When I review images of the same eye having the same field of view acquired at different patient encounters, the system precisely aligns the 2 images,” he says. “I can enable a flicker function to compare findings instead of placing them side by side. It’s much easier to detect very subtle changes using this feature.”
Currently, Dr. Freund is following a patient with cancer-associated retinopathy. “It’s important to monitor her closely and detect any minor changes, which are best seen with fundus autofluorescence imaging, one of Eidon’s other features,” he says.
As a multimodal imaging device, Eidon can aid in the diagnosis and monitoring of most retinal diseases by providing high-quality images of the central and peripheral retina. Dr. Freund uses the device for any pathology for which he would use standard fundus imaging, such as diabetic retinopathy, macular degeneration, retinal vascular disease, and inherited retinal diseases. The device detects disease at an early stage and can image through cataract and media opacities.
EASE OF OPERATION
Users operate the Eidon via a tablet with a multitouch, high-resolution color display. It works with a dedicated software application and operates as a standalone unit. A joystick can be used for manual operation.
The system is easy to use, Barbaro says. No operator involvement is needed during the entire capture process, and images are automatically captured and stored, so the system requires no special skills or medical knowledge to consistently capture high-quality images.
Training technicians to acquire the images is straightforward and can be mastered in minutes, Dr. Lewis adds.
The Eidon automatically aligns to a subject’s eye and adjusts the focus. It also offers other imaging modalities, such as infrared imaging and autofluorescence imaging, Barbaro says. Retinal coverage can be expanded up to 110 degrees by 90 degrees.
Dr. Freund says the Eidon has an intuitive interface that guides the patient and operator. Physicians can review images on any computer using a web browser; no special review software is needed. The Eidon easily integrates with an office network or medical record system, making the images easily accessible to review.
The Eidon offers advantages for patients as well, such as improving patient flow. “You don’t need a skilled photographer to take the images, so patients don’t have to wait in the photography department,” Dr. Freund says. By taking images himself, he is sure to get the right image with the desired quality — enabling him to document what he wanted to document. He can review images right away.
Dr. Lewis has found the scanner to be a great teaching tool for patients. “By having a computer in the exam room, I can easily share images with patients and explain them,” he says. “This enables patients to gain a better understanding of their disease, and become more engaged in managing it.”
Another advantage of confocal scanning systems is that they can operate with pupils as small as 2.5 mm, which is much smaller than conventional fundus cameras, Barbaro says. Furthermore, patients can avoid the nuisance of dilation. Finally, the Eidon’s light source is more comfortable for patients when compared to older fundus imaging technologies that require more light energy. RP