Meeting Minutes
for the
DICOM WG 9 Meeting
on 11/9/2007, New Orleans
Attendees:
Noam Allon
Vendor Co-Chair of WG9, Ophthalmic Imaging Systems
Eric Andersen
Accutome
Michael Boland
Johns Hopkins University Wilmer Ophthalmology Institute
Paul Bryar
Northwestern University
Shawnnah Castillo Carl Zeiss Meditec
Ronald Danis
University of Wisconsin
Adam Darmstadt
Carl Zeiss Meditec
Dieru Derscheid
Integration AG
Anatoly Griublat
DMS/ifa systems AG
Daniel Gurvis
Marco Ophthalmic
Lloyd Hildebrand
Clinical Co-Chair of WG9
Jeff Homan
ifa systems AG
Mark Horton
Indian Health Service
Yujun Huang
Topcon
Sascha Gros
ifa systems AG
James Jarmusch
Topcon
Chris Johnson
University of Oregon
Zyg Kuncynski
Carl Zeiss Meditec
Tobias Kurzke
Carl Zeiss Meditec
Ian Lane
Officemate Software
Paul Latkany
Veterans Administration
Matthias Monhart
Haag-Streit
Ryoichi Nadachi
Topcon
Michael Neider
University of Wisconsin
Kaoru Nihei
Topcon
Justin Pedro
Ophthalmic Technologies Inc.
Ken Pearson
Kowa Optimed Inc.
Jim Riggi
Medflow
Heiko Roesch
Heidelberg Engineering
Michael Schmidt
Medflow
Takashi Shioiri
Topcon
Mayah Shurbet
Marco Ophthalmic
Sascha Stops
Integration AG
Rudolf von Buenan Carl Zeiss Meditec
Alex Walsh
University of Southern California
Linda Wedemeyer
Department of Veterans Affairs
Claudia Wente-Waedlich
ifa systems AG
Rainer Waedlich
ifa systems AG
Roberto Witt
Carl Zeiss Meditec
Brad Yates
Ophthalmic Imaging Systems
Staff:
Flora Lum
American Academy of Ophthalmology
I. Welcome and Introductory Remarks; Introduction of Participants
Dr Lloyd Hildebrand and Noam Allon welcomed the participants. Everyone introduced
themselves and described their interest in a special interest workgroup.
II. Approval of Previous Meeting Minutes
The minutes of the November 2006 WG9 meeting in Las Vegas were approved.
III. Summary of Activities of DICOM and SNOMED
Dr. Hildebrand summarized some of the important progress in DICOM and IHE Eye
Care. About twelve years ago, the Academy began its standard setting activities. This
was a chicken-and-egg situation because vendors did not perceive a market demand, and
customers (ophthalmologists) could not imagine the benefits of standards. In 1996,
digital imaging standards setting opened up to other specialties in medicine. The
Academy realized that digital imaging standards could not be done in isolation, but
instead be accompanied by standards for terminology. The Academy employed
ophthalmologists to model and add new concepts to SNOMED. The governance of
SNOMED has changed over the years from the College of American Pathologists to an
International Health Standards Development Organization. This organization is governed
by national governments which license SNOMED on a national basis, such as the United
States and the United Kingdom. In September, the Academy’s Board of Trustees passed
a resolution affirming that SNOMED has been adopted as its official clinical
terminology. There also have been significant steps made in incorporating SNOMED
into the infrastructure of the Academy’s educational website, known as Ophthalmic News
and Education
In DICOM, there has been significant progress made on two supplements. Supplement
110, Ophthalmic Tomography, was approved in September 2007 and is posted on the
DICOM website. This is due to the hard work and persistent efforts of Justin Pedro,
Adam Darmstadt and others. Supplement 130, Refractive Data, was sent out for a second
letter ballot and should hopefully be approved by November 13th. This supplement
covers the following devices: lensometers, keratometers, autorefractors, autoprojectors
and a structured report for prescription data. Linda Wedemeyer, M.D. did a yeoman’s
job in championing this supplement and attending meetings to support this supplement.
Existing DICOM supplementst that are applicable to eye care include: ultrasound, CT,
MRI, visible light such as for surgical microscope and ophthalmic photography with stero
representation.
IHE has provided a real-life demonstration of standards and brought the standards to life.
We have come a long way in these several years. Now, DICOM, SNOMED and IHE are
all in the daily vocabulary.
IV.
Summary of Activities in IHE Eye Care
The previous year was a successful Year 1 of IHE Eye Care Connectathon and Showcase,
with 10 vendors. This year, there were 12 vendors who participated in the October
Connectathon and Showcase, including 3 new vendors. There are educational materials
on the Academy’s website to provide guidance to ophthalmologists on IHE compliance
and DICOM conformance statements. For Year 3, there will be an emphasis on
implementing new standards (refractive data and ophthalmic tomography).
V.
Visual Field Subgroup
The visual field subgroup has already accomplished a lot during previous teleconferences
prior to the Annual Meeting. At the Meeting, they discussed the list of data elements that
has been designated by clinicians as relevant and which appear to be commonly reported
by the major visual field device vendors. Dr. Paul Bryar will create a spreadsheet which
summarizes the discussion. In the spreadsheet, each data element, its definition, its data
type (1--mandatory; 2--encouraged but optional; 3--optional), and units are listed. Next
to each item is a column labeled "comments." Dr. Bryar will circulate this after the
Meeting and highlight issues where we need vendor input specifically related to their
particular devices. Dr. Paul Bryar will be responsible for the future steps.
VI.
Macular Thickness Report Subgroup
The group discussed at length the various data elements that needed to be included in the
proposed supplement. They will model their work after the recently approved
Supplement 130 for Refractive Data. The group thought that they could write up case
studies that would help explain the clinical circumstances for when macular thickness
reports were needed. Mr. Michael Neider will be responsible for the future steps and Dr.
Ronald Danis will work with other clinicians to develop the case studies which will be
circulated to the larger group.
VII.
Ophthalmic Mapping Subgroup
The group discussed at length the advantages and disadvantages of combining different
modalities, corneal topography, wavefront technology, retinal nerve fiber layer thickness
analyzer and optic nerve head analyzer. After much deliberation, the group decided that
the advantages outweighed the disadvantages and it would be advantageous to provide a
generic module to cover the function of mapping: a set of measures that are distributed
topographically and are typically presented in pseudo-color representation.
The group developed a listing of vendors and clinicians that are involved with these four
technologies. The group also discussed different data elements to be included or deleted
in the ophthalmic mapping image module and the ophthalmic mapping acquisition
parameters module. The next steps are for Flora to edit the draft supplement based on the
group’s discussion and to send to the group for additional discussion. The group plans to
meet by conference call in January 2008.
VIII.
Biometry Subgroup
The group discussed at length the various data elements that needed to be included in the
proposed supplement. They will model their work after the recently approved
Supplement 130 for Refractive Data. The group thought that they could develop a draft
version soon to be able to be circulated to a larger group of vendors. Dr. Linda
Wedemeyer will be responsible for the future steps.
IX.
Next Meetings of the Working Group 9
A. Possible venues
o ASCRS
o ARVO (April 28 – May 1)
B. Friday, November 8, Atlanta, Academy Annual Meeting
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December 21, 2007