and its data-intensive challenges
Dr Jano van Hemert
jvanhemert@optos.com
1
Thursday, 4 November 2010
1
About Optos
 Founded in 1992
 FDA and EU CE approval in 1999
 To market in 2000
 On London Stock Exchange since Feb 2006
 Global company, operating in USA, Canada, UK, several
EU countries, Korea, Japan and China
2
Thursday, 4 November 2010
2
Main product
3
Thursday, 4 November 2010
3
Technology
Scans Two Different Frequencies of Laser Light Simultaneously
The ellipsoidal mirror
scans two different
frequencies of Laser Light
simultaneously
The scanning laser light is focused through one point while the patient’s
eye is positioned to be coincident with the other focal point
8
Thursday, 4 November 2010
4
Main eye diseases
Age Related Macular Degeneration
A leading cause of blindness in older people. The macula is
located in the center of the retina (back of the eye)
and is responsible for the sharp, central vision needed
to see straight ahead. Aging can cause the macula to
slowly degenerate and reduce central vision in people
over 50 years of age. It is estimated that 8.5% of
individuals between 43-54 years and 36.8% of those
over 75 years have some degree of macular
degeneration.
Diabetic Retinopathy
Approximately 5.7 million people in the United States have
diabetes, which is a leading cause of blindness, yet
only half of these individuals know they have the
disease. Bleeding inside the eye may be the first sign
of its presence. The major cause of blindness in
people with diabetes is called diabetic retinopathy, a
term used for all the abnormalities of the small blood
vessels of the retina caused by diabetes.
Glaucoma
An estimated 1.6 million individuals over 40 years of age in
the United States have glaucoma, and the risk
increases significantly with age. Sadly, approximately
half of these people don’t know they have the disease.
Almost every case of glaucoma develops without
symptoms. Long-standing glaucoma without treatment
can lead to severe vision loss. Early detection and
5
Thursday, 4 November 2010
5
Benefits of optomap®
Optos technology: P200
 0.25 second
 Digital record
 No dilation required
 Scan the periperhy
Routine Examination
 Manual
 No record
 Dilation required
6
Thursday, 4 November 2010
6
Compared to other techniques
http://www.optos.com/en-gb/Professionals/Ophthalmology/Ultra-widefield-advantages/
7
Thursday, 4 November 2010
7
Image product - autofluorescence
HRA AF
Optomap® UltraWidefield AF
7
Thursday, 4 November 2010
8
Optomap® image enhancement
Optomap® Image
Lighting Balance
Colour Enhance
4
Thursday, 4 November 2010
9
Image enhancement – decision support
Derived Vasculature
Colour enhancement
& vessel highlighting
Vessel Detail
Feature detection
5
Thursday, 4 November 2010
10
Image enhancement - disease tracking
Feature Measurement
Haemorrhage
Enhancement
Image Registration
Disease
Tracking
Measures
Vessel Thickness
Optomap
Vessel Tortuosity
Optomap® fa
6
Thursday, 4 November 2010
11
The Image in 3D
7
Thursday, 4 November 2010
12
Challenge 1: models
 Sequences per diagnosis
(source: Fundus Fluorescein
and Indocyanine Green
Angiography: A Textbook
and Atlas By Amar Agarwal)
 Sequences of follow-up diagnoses
 Multiple modalities: wavelengths and
types of diagnoses
(source: Pető T, Rath P, Jenkins S and Bird)
red free
(green layer)
Thursday, 4 November 2010
red layer
13
13
Challenge 2: technical access
Manual Data Entry
Image Management System
Secure Storage
Archived Data
Images
Retrieved Data
optoNET
Worklist or Pa@ent Details
Images
Referral Request
Pa@ent Medical Record
Electronic Medical Records
Thursday, 4 November 2010
Referral Response
Review Sta@on
Remote Reviewer
10
14
Challenge 3: legal access
15
Thursday, 4 November 2010
15
Challenge 4: volume / demand
16
Thursday, 4 November 2010
16