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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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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.
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.
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.
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.
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