Zeiss Medical Technology’s newest optical coherence tomography (OCT) device, the Cirrus 6000, provides an efficient and data-driven workflow for ophthalmologists, supported by the largest OCT reference database in the US market, as well as newly enhanced cybersecurity features, says Anuj Kalra, head of the business sector for chronic disease management at Carl Zeiss Meditec in Dublin, California.
The device helps support informed, data-driven patient care decisions across ophthalmic workflows, from disease diagnosis to treatment and ongoing management.
The device can be used to diagnose and manage diseases such as age-related macular degeneration, diabetic retinopathies, retinal vein occlusion, and posterior uveitis diseases, says Jesse J. Jung, MD, a vitreoretinal specialist and partner at East Bay Retina Consultants in Oakland, California, who worked with Zeiss to help develop the product’s software and hardware, and who uses the Cirrus 6000 at his practice. The Cirrus 6000 can also be used to document the status of vitreous and vitreoretinal interface disorders, such as vitreomacular traction, epiretinal membrane, and macular hole.
How it Works
The Cirrus 6000 is a spectral domain OCT capable of both anterior and posterior scans. The device’s capture rate optimizes both structural and vasculature OCT imaging capabilities when compared to previous models, Kalra says. For example, the Cirrus 6000’s average OCT angiography capture takes less than 10 seconds, and structural dense data cubes can be acquired in less than a second.
Compared to its predecessor, the Cirrus 5000, the new device can capture larger fields of view because of the Cirrus 6000’s increased speed when acquiring images. The Cirrus 6000 also introduced high-definition OCT angiography (OCTA) scans, as the higher capture rate allows for greater sampling capabilities, Kalra says. Faster acquisition speeds negate motion artifacts caused by microsaccades in the eye, which in turn negates the need for repeat captures and leads to a higher output performance.
Dr. Jung says the software’s review algorithms include several previous algorithms such as the dense volumetric macular cube scan and high-definition line and radial scans. Several other algorithms, including the en face OCT and retinal pigment epithelium analysis, can be used to image geographic atrophy.
Furthermore, Dr. Jung says the en face, high-definition 6×6 mm OCTA can clearly show the vasculature structure of preretinal neovascularization in proliferative diabetic retinopathy; microvascular capillary dropout of the foveal avascular zone; and superficial and deep capillary networks in macular ischemia, and can be used to image the choriocapillaris and choroid to determine if there is macular neovascularization or other vascular pathology with the macula.
Other Perks
Kalra believes that the device’s OCT reference database of 870 patients is the largest available from public data—it sets the bar with a greater diversity of patients than previous databases. The database has more patients aged 50 and older and 3 different optic disc sizes, which provides a more individualized approach to patient screening.
Transitioning from the Cirrus 5000 to Cirrus 6000 is simplified because both devices are similar in appearance and operation, Kalra says. Automated alignment, mouse-driven capture, and a large display all add to a user’s experience. A unique feature of Cirrus’s design is that it can be positioned in a corner. The side-mounted monitor and fully integrated personal computer make the device’s total footprint the smallest in its class.
The device’s enhanced cybersecurity features are designed to meet evolving compliance and security needs, Kalra says. New features include enhanced password security, enterprise-scale security requirements, Bitlocker encryption, and a new IntraBase ultra-fast embedded database.
Images taken by the device meet the Digital Imaging and Communications in Medicine (DICOM) standard and can be shared with Zeiss Forum, an ophthalmic data management solution, and electronic medical records systems, making it easier for physicians to access available data about a patient and build a treatment plan that better fits a patient’s needs.
Improving Patient Outcomes
The bottom line is that early diagnosis leads to early treatment, and in many cases a higher percentage of success in reducing or eradicating the effects of certain conditions, Kalra says. Once diagnosed, OCT can actively monitor a treatment’s effects, and in some cases flag any side effects or successes.
Furthermore, Dr. Jung says that accurately monitoring disease activity can help determine treatment intervals with anti-VEGF agents for vascular diseases. Additionally, the device can be used to monitor the progression of epiretinal membrane, including the stages of epiretinal membrane and OCT biomarkers such as disorganization of the retinal inner layers or vitreomacular traction, and can determine when surgical intervention may be indicated. High-definition OCT can also be used to evaluate conditions after surgery, such as outcomes after macular hole and retinal detachment surgeries, including evaluating the integrity of the ellipsoid zone, which often correlates to vision.
Dr. Jung also uses the Cirrus 6000’s review software to discuss OCT images with patients before making treatment decisions. “I can provide direct feedback and educate them on the status of their retinal conditions,” he says. RP
