The CLARUS 500 (Carl Zeiss Meditec) is the first fundus imaging system that combines true color with exceptional clarity in an ultrawidefield view. “Early signs of eye disease can often be subtle and occur in the far periphery of the retina,” says Jim Mazzo, global president of ophthalmic devices at Carl Zeiss Meditec. “With this system, practitioners can obtain a better view of the entire fundus.”

Traditional fundus imaging systems have long been the gold standard for macular disease diagnosis and optic nerve evaluation. “Now, ultrawidefield imaging is starting to change this,” Mazzo says. “Clinicians are finding that by imaging a larger area of the retina, they can possibly uncover more pathology, aiding in earlier disease diagnosis and better patient management. With the CLARUS 500, they can better manage a broader range of patients with one fundus imaging system.”

HOW IT WORKS

The CLARUS 500 ultrawidefield imaging system leverages Zeiss’s precision optics to provide high-resolution retinal imaging down to 7 microns across the entire retina — from the macula to the far periphery. In addition to capturing natural-looking images of the fundus, true-color images can be separated into red, green, and blue channel images which enhance the visual contrast of details in certain layers of the retina. According to Zeiss, color accuracy is important in the diagnosis, documentation, and management of ocular diseases. It ensures confidence when evaluating optic disc, nevi, and lesions in which subtle color differences may lead to changes in diagnosis and management.

Roger A. Goldberg, MD, MBA, a retina specialist at Bay Area Retina Associates in Walnut Creek, Califorina and CLARUS user, says, “The 3 broad-spectrum LED light sources combine to produce images that are truly reflective of what I see when using an indirect ophthalmoscope. In addition, the camera’s resolution is comparable to traditional fundus imaging systems. The image captures the far retinal periphery, but I can zoom into a specific area of the retina without compromising the resolution. This is great for getting high-quality photos of the macula, optic nerve, or a lesion in the context of an ultrawidefield image. With previous systems, zooming in led to a loss of resolution and pixilation of the image.”

The CLARUS 500 produces 133-degree high-definition ultrawidefield images, which are automatically merged to achieve a 200-degree ultrawidefield view. “Exceptional clarity from the posterior pole to the periphery, along with intuitive review software, allows clinicians to track subtle changes in pathology,” Mazzo says.

CLINICAL APPLICATIONS

Peripheral imaging plays an important role in managing diabetic retinopathy. According to Zeiss, high-definition ultrawidefield imaging provides a fast, precise, and reliable method for imaging the peripheral retina. Green-channel separation images further highlight hemorrhages and microaneurysms, making visualization of subtle retinopathy easier. For dry AMD, accurate coloration is important for documenting pigment changes and drusen.

Because of the subtle and slow-changing nature of glaucoma, the disease necessitates precise, high-resolution, repeatable documentation of the optic disc, whether it be with OCT, fundus photos, or visual fields. For fundus imaging of glaucoma, a high-quality, true-color image that allows for quantitative measurements is critical, a Zeiss spokesperson says. Specifically, accurate coloration and resolution is important for evaluating focal changes in the rim tissue and nerve pallor. The review software makes it easy to compare images over time, aiding in the detection of early glaucomatous changes.

EASE OF USE

Acquiring images is easy, and doesn’t require a skilled ophthalmic photographer. “Like using a traditional fundus camera, the patient’s head is fixed on a chin rest and forehead bar; the camera moves with a joystick,” Dr. Goldberg explains. “A live infrared preview allows technicians to know exactly what will be captured before pushing the button to acquire the photo. This cuts down the number of photos they need to acquire to obtain a good image.”

Simple, stable, and intuitive technology allows clinicians to easily review and compare high-quality images captured during a single exam while providing annotation and caliper measurement tools that allow in-depth analysis of eye health. CLARUS 500 also works with the Zeiss Forum and Retina Workplace to allow for review with other ophthalmic images and exam data for efficient multimodality analysis.

HOW PATIENTS BENEFIT

The CLARUS 500 was designed to optimize each patient’s experience. Live infrared preview allows technicians to easily ensure optimal patient alignment, creating a comfortable, satisfying patient experience that provides images that are free of obstructions, such as lids and lashes, and requires fewer recaptures.

Dr. Goldberg points out that previously, physicians had to choose between obtaining good images of the optic nerve, macula, or lesion and good imaging of the retinal periphery. With the CLARUS 500, you can obtain both.

From a patient education standpoint, Dr. Goldberg says it’s a fantastic tool. “We can show patients what we see on the images,” he concludes. RP