March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Remote Controlled Stereo Slit-Lamp: Operating With Limited Network Connectivity
Author Affiliations & Notes
  • Alex Gonzalez
    Ophthalmic Biophysics Center,
    Dept. of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
  • Cornelis Rowaan
    Ophthalmic Biophysics Center,
    Dept. of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
  • Derek Nankivil
    Ophthalmic Biophysics Center,
    Dept. of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
  • William Lee
    Ophthalmic Biophysics Center,
    Dept. of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
  • Izuru Nose
    Ophthalmic Biophysics Center,
    Dept. of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
  • Mariela C. Aguilar
    Ophthalmic Biophysics Center,
    Dept. of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
  • Sonia H. Yoo
    Ophthalmic Biophysics Center,
    Dept. of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
  • Andrew A. Moshfeghi
    Dept. of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
  • Donald L. Budenz
    Dept. of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
  • Jean-Marie A. Parel
    Ophthalmic Biophysics Center,
    Dept. of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
  • Footnotes
    Commercial Relationships  Alex Gonzalez, patent assigned to the University of Miami (P); Cornelis Rowaan, patent assigned to the University of Miami (P); Derek Nankivil, patent assigned to the University of Miami (P); William Lee, patent assigned to the University of Miami (P); Izuru Nose, None; Mariela C. Aguilar, patent assigned to the University of Miami (P); Sonia H. Yoo, None; Andrew A. Moshfeghi, None; Donald L. Budenz, patent assigned to the University of Miami (P); Jean-Marie A. Parel, patent assigned to the University of Miami (P)
  • Footnotes
    Support  DOD Grant DAMD-W81XWH-09-1-0675, Florida Lions Eye Bank; NIH Center Grant P30EY14801; unrestricted grant from Research to Prevent Blindness; Henri and Flore Lesieur Foundation (JMP).
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 3634. doi:
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      Alex Gonzalez, Cornelis Rowaan, Derek Nankivil, William Lee, Izuru Nose, Mariela C. Aguilar, Sonia H. Yoo, Andrew A. Moshfeghi, Donald L. Budenz, Jean-Marie A. Parel; Remote Controlled Stereo Slit-Lamp: Operating With Limited Network Connectivity. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3634.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose:
 

To evaluate the feasibility of transmitting live ophthalmic stereoscopic images along with bi-directional audio communication, over a network connection with limited bandwidth while simultaneously controlling the robotized slit-lamp from a remote location.

 
Methods:
 

A custom-made slit-lamp with two high resolution CCD camera (3.1 Mp) and computer controlled motorized magnification (5-30x), X-Y-Z position, slit angle, width, height, and intensity controls that includes clinician-patient audio communication via VoIP technology and a patient overview obtained using an overhead camera (1.3 Mp) was used. A muxed video signal comprised of 2 video streams, external overview video, and user interface indicators was compressed with a hardware encoder, CUBE-200 (Teradek, Irvine, CA). Stereo fusion was facilitated by prismatic spectacles. For cases of sporadic satellite transmission, an autonomous functionality that includes autofocus and preset shortcuts for several of the slit-lamp functions (i.e. slit-width, autoswitch from OD to OS) was designed to permit a complete exam of both eyes. Data is stored for transmission once the satellite link resumes.

 
Results:
 

Under an IRB approved protocol the robotized slit-lamp was remotely operated from the US, Europe and Africa while acquiring high resolution, real-time stereo video and audio in all patients with connection speeds (LAN/internet/satellite) ranging from 20Mbps-307Kbps and a latency range of 1ms to 950ms.

 
Conclusions:
 

Standard ophthalmic slit-lamp exams can be conducted from remote locations using the robotic stereo slit-lamp connected to local area network, internet or satellite with minimal bandwidth.  

 
Keywords: anterior segment • clinical (human) or epidemiologic studies: systems/equipment/techniques • imaging/image analysis: clinical 
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