The Department of Ophthalmology recently acquired two new pieces of equipment. Both are state-of-the-art‚ providing information that is light years beyond what previous tools could provide.
The confocal microscope and the Spectralis™ HRA+OCT‚ also known as the Heidelberg Spectralis‚ are currently being used in only a few ophthalmology centers around the country‚ and the University of Minnesota is one of them.
One type of medical confocal microscope was developed for ophthalmic use by Stephen Kaufman, M.D., Ph.D., when he was working toward his doctorate. Now a professor and director of cornea and refractive surgery in the Department of Ophthalmology‚ Kaufman perceived early on that this powerful‚ specialized microscope would make it possible to see cellular detail in the cornea and other parts of the eye. All five layers of the cornea can be seen through this instrument—without stains or dyes—via a video camera and television monitor.
“With this microscope‚ you can differentiate between an infection and swelling of the cornea‚” Kaufman says. “This makes it an invaluable tool when you’re dealing with corneal graft rejection. You can also identify bacteria‚ fungi‚ and amoebas with this microscope‚ saving the expense and time it takes to send a culture to the lab and wait for results.”
In his capacity as a professor‚ Kaufman also is training residents and fellows to use the confocal microscope‚ which arrived at the University last fall. Because cells don’t look the same under a confocal microscope as they do under a standard microscope‚ first-time users need some time to adjust to the new equipment‚ he says.
Other faculty members in the department are using the Heidelberg Spectralis‚ which was acquired in December. This instrument provides 95-percent coverage of the retinal surface instead of the 5-percent coverage (and interpolation of the remaining 95 percent) typically provided by the instrument it replaced.
Assistant professor of retina Todd Klesert, M.D., Ph.D., compares this dramatic increase in detail to the landmark advances in radiology—from X-ray to CT scans to MRI.
“While it’s hard to say exactly how the information we receive will manifest itself‚ this machine is certain to make a difference in our understanding and treatment of macular degeneration‚” says Klesert‚ who conducts research on age-related macular degeneration. “We know a lot already‚ and with the old technology we saw just a fraction of what we can see with the Heidelberg Spectralis.”
The Heidelberg Spectralis combines the functions of two existing instruments—the spectral domain optical coherence tomograph (OCT) and the HRA laser angiography—and performs both functions simultaneously.
The new instrument scans the retina 100 times faster than time domain OCT technology‚ and the 40‚000 scans per second create highly detailed images of the retinal structure. This high-resolution scanning can be used with any of four imaging modalities: autofluorescence‚ infrared‚ fluorescein angiography‚ or ICG angiography.
There’s no doubt in Klesert’s mind that this new technology will allow ophthalmologists to make major strides.
“When we understand more in a few years‚” he says‚ “this is going to make a very big difference‚ both in doing research and in caring for patients.”