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Good results, great value for money

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Dr Leo Hartley
MBBS DipApScOptom FACO FACBO GCOT GCHPE
Associate Professor, University of Melbourne
H2 Vision Centres, Sippy Downs QLD

Product
Optovue iScan

Supplier
BOC Instruments

 

First and most importantly, it should be said that the Optovue iScan delivers good clinical results that enable accurate diagnoses and ongoing management of macula and optic nerve pathologies.

In Australia, the iScan is supplied with the Comprehensive package with a broad range of scan options. This review is of the iScan Comprehensive.

Operator ease of use and patient comfort

The Optovue iScan is designed to ‘plug and play,’ which is ideal for non-technical staff. It doesn’t take a highly-skilled operator to obtain quality images, just sit the patient at the instrument and the tests as designated by the operator are performed automatically by a voice-guided system.

The instrument does this very well with co-operative patients. It takes a bit longer than manual operator systems to get through standard macula and optic nerve tests. The instrument has a manual override if full control or peripheral scans are required.

Time to perform the test

Compared to other manually-operated OCT instruments, the iScan automated features seem to take longer to find the patient’s eye and perform the test.

Patient - standard/difficult/child

As with all OCT instruments, media opacities can affect the results of the tests. The iScan is about equal to all other OCTs I’ve used in the past in this respect. As with other instruments, we have been able to collect good OCT scans from co-operative children as young as five years.

Patient comfort

There is no chin rest, just a forehead rest that also inconveniently pushes against the patient’s cheeks. Essentially, the instrument needs to be slightly lower than the operator would expect. The iScan requires the patient to look slightly upwards, which some elderly patients may find tiring.

Reader/interpreter

The iScan provides excellent OCT scans of good resolution allowing accurate differential diagnosis of retinal lesions and optic nerve disease. The scans are also easy to read.

Macular pathology/optic nerve pathology/optic nerve drusen/GCC

The iScan provides good scans of all the above conditions and allows accurate, reproducible scans of the ganglion cell complex (GCC), which is very helpful in the diagnosis and management of glaucoma.

Tracking changes over time

The iScan allows the clinician to accurately track changes in the macular thickness, retinal nerve fibre layer, GCC and ONH over time. It graphically displays the rate of change over time in microns and also indicates if this rate of change is significant. It does not provide overlays of the visual fields.

Using data in the consulting room

The iScan can be networked for remote viewing with optional ReVue licences or linked via computer-to-computer software (Team Viewer) allowing the clinician to view the data collected from the pre-test area by the staff.

After-sales service

BOC really excels in this department. It is responsive and technically excellent in its after-sales service of all the instruments it has supplied.

Value for money

For what it does and its accuracy, the iScan is very good value.

Overall best for ...

The Optovue iScan is an excellent instrument for a moderately-busy clinician who does not want to be bothered to operate the instrument themselves. Its operation can be easily taught to a non-technical staff member in a few minutes, freeing technical staff as well as the clinician.

 

EQ-100-Figure -1 - Online

iScan assessment. All ratings out of 10.

 

Not ideal for ...

If you enjoy doing the OCTs yourself, or you or your trained staff members are extremely busy, I would not recommend this instrument because of the slightly longer time to perform the test.

Our practice, H2 Vision Centres, draws on the vision I share with my brother Mark, a director and dispenser. Prior to seeing me, every patient has OCT and ultra-wide field imaging performed as well as the usual automated retinoscopy, IOPs, keratometry and CCTs. Being a medical practitioner as well as an optometrist facilitates a very holistic approach to patient care.



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