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Purpose: The purpose is to evaluate the interdevice and interobserver agreements between the SL SCAN-1 (a FD-OCT integrated into a common slit lamp) and a standard stand-alone FD-OCT device (the Cirrus) with regard to the presence or absence of signs of leakage in the retina in patients with exudative AMD and treated with anti-VEGF. Methods: Fifty-six patients, known to have exudative AMD and under treatment with anti-VEGF agents, were included. During a regular follow-up, OCT scans were made with the Cirrus (macular-cube pattern) and the SL SCAN-1 (radial-scan pattern). All scans were graded by two medical retina specialists for signs of intraretinal cysts, subretinal fluid accumulation, and thickening of the neurosensory retina. Presence of signs of leakage was concluded if one or more of the three signs were present. Results: In 91 % of the patients, the observers made identical conclusions for both devices of the presence of signs of leakage, resulting in an interdevice Kappa coefficient of 0.87. For the scans with disagreement about the presence or absence of signs of leakage, positive and negative conclusions were equally distributed between both devices, and differences were restricted to more subtle signs of leakage. Conclusion: The interdevice Kappa coefficient of 0.87 shows a high agreement between the SL SCAN-1 and the Cirrus in grading signs of leakage in exudative AMD. OCT images play a pivotal role in the diagnosis and management of exudative diseases like AMD, and the SL SCAN-1 provides a very efficient approach to these patients with the integration of the FD-OCT device into a common slit lamp. [ABSTRACT FROM AUTHOR]

PurposeWith a new Fourier domain optical coherence tomography (FD OCT) device, SL SCAN-1 (Topcon Europe Medical BV, Capelle a/d IJssel, The Netherlands), integrated into a slit-lamp OCT, scans can be obtained through a handheld lens. The necessary adjustment of the reference arm is possible by fast Z-alignment. This study was performed to prove the capability of SL SCAN-1 to scan through a three-mirror contact lens, scanning the peripheral retina and anterior chamber angle.MethodsDifferent representative pathologies of the peripheral retina and anterior chamber were simultaneously observed and scanned with the SL SCAN-1. The scans of peripheral retinal lesions were obtained both through a handheld lens and through a three-mirror contact lens. The anterior chamber angle was scanned directly with the SL SCAN-1 in anterior mode, and through the gonio-mirror of a three-mirror contact lens with the SL SCAN-1 in posterior mode.ResultsOCT scans could be obtained with the SL SCAN-1 of the peripheral retina through both, a common handheld lens and a three-mirror contact lens. The scans obtained through a three-mirror contact lens were of better quality, visualizing details of the different layers of the retina more clearly. The scans of the anterior chamber, obtained through the gonio-mirror of a three-mirror contact lens, visualized the open anterior chamber angle, with details of fine structures.ConclusionsThe SL SCAN-1 is a unique FD OCT system, which is able to scan not only the posterior pole and anterior segment but also the anterior chamber angle and the more peripheral retina. These four modalities combined into one device could make the SL SCAN-1 a very powerful aid in daily practice. [ABSTRACT FROM AUTHOR]

PurposeFourier Domain Optical Coherence Tomography (FD-OCT) provides high resolution cross-sectional images of the retina and the anterior segment. It has become an important tool in ophthalmology in the examination, diagnosis, and treatment of important and common diseases. Present OCT imaging systems are stand-alone devices. The aim of this paper is to show the quality of images made with a prototype of a Fourier Domain (FD-) OCT imaging system (SLSCAN-1) integrated into a slit lamp.MethodsDifferent representative pathologies of the posterior and anterior segment were observed with the slit lamp and simultaneously scanned with a prototype of the slit lamp-integrated FD-OCT system. The clinical interpretation of posterior segment images made with the prototype were compared to those obtained with a stand-alone FD-system (3D-OCT-1000 Mark II, Topcon).ResultsImages made with the slit lamp-integrated FD-OCT were of sufficient quality to allow for a correct interpretation of the observed pathological conditions. Conclusions based on the images of the posterior segment of the prototype were identical to the conclusions based on the images of a stand-alone FD-system (3D-OCT-1000 Mark II, Topcon). In addition to the images of the posterior segment, images could be made of the anterior segment. The OCT system did not interfere with the normal functionality of the slit lamp.ConclusionThe slit lamp-integrated FD-OCT system provided high quality images of both the anterior and the posterior segment. Scans made with the slit lamp-integrated FD-OCT system could be of use in clinical practice. [ABSTRACT FROM AUTHOR]

Objective To compare a continuous suture technique with interrupted stitches using inverted knots for postpartum perineal repair of second-degree lacerations and episiotomies. Design A double-blind randomised controlled trial. Setting A Danish university hospital with more than 4800 deliveries annually. Population A total of 400 healthy primiparous women with a vaginal delivery at term. Method Randomisation was computer-controlled. Structured interviews and systematic assessment of perineal healing were performed by research midwives blinded to treatment allocation at 24–48 hours, 10 days and 6 months postpartum. Pain was evaluated using a visual analogue scale and the McGill Pain Questionnaire. Wound healing was evaluated using the REEDA scale and by assessment of gaping wounds >0.5 cm. Analysis complied with the intention-to-treat principle. Main outcome measures The primary outcome was perineal pain 10 days after delivery. Secondary outcomes were wound healing, patient satisfaction, dyspareunia, need for resuturing, time elapsed during repair and amount of suture material used. Results A total of 400 women were randomised; 5 women withdrew their consent, leaving 395 for follow up. The follow-up rate was 98% for all assessments after delivery. No difference was seen in perineal pain 10 days after delivery. No difference was seen in wound healing, patient satisfaction, dyspareunia or need for resuturing. The continuous suture technique was significantly faster (15 versus 17 minutes, P = 0.03) and less suture material was used (one versus two packets, P < 0.01). Conclusion Interrupted, inverted stitches for perineal repair leaving the skin unsutured appear to be equivalent to the continuous suture technique in relation to perineal pain, wound healing, patient satisfaction, dyspareunia and need for resuturing. The continuous technique, however, is faster and requires less suture material, thus leaving it the more cost-effective of the two techniques evaluated. [ABSTRACT FROM AUTHOR]