Anterior Segment of Eye
Conditions
Keywords
Slit-lamp photograph
Brief summary
This study evaluated the feasibility of performing automated anterior segment imaging using the Lightfield Medical Vscan001, a novel automated slit lamp camera. The device uses high-speed liquid lens technology to capture slit-illuminated images of the eye that would otherwise require a trained physician or ophthalmic photographer. Adult patients were enrolled at a single ophthalmic practice. The primary objective was to determine what proportion of patients could be successfully imaged with the device in a clinical setting.
Detailed description
The standard ophthalmic slit lamp has remained largely unchanged for over 75 years. Anterior segment photography using conventional slit lamp cameras is limited in practice because it requires a highly trained physician or specialized ophthalmic photographer, captures only a small portion of the exam, and is hindered by difficulty with focus, lighting, and glare artifacts. The Lightfield Medical Vscan001 was developed to address these limitations through automation. The Vscan001 is a semi-portable, joystick-mounted device with a form factor similar to a conventional slit lamp. It incorporates a 5-megapixel primary camera sensor coupled to a high-speed liquid lens capable of refocusing every 4 milliseconds, enabling automated focus control across the z-axis of the eye. A wide-angle 5-megapixel auxiliary camera provides overview imaging and assists with focus. An LED-based slit projector mounted on a rotating arm illuminates the eye from multiple angles; the projector incorporates a synchronized liquid lens to maintain a focused slit image on ocular structures throughout image acquisition. A microprocessor controls slit movement, slit width, and illumination parameters. Images are stored as Raw and JPEG files on an encrypted hard drive connected via USB to a Windows computer. The device's light energy output meets Group 1 radiant exposure limits as defined by ANSI Z80.36-2016 and qualifies as an FDA Class II exempt device under the PJZ slit lamp camera classification (21 CFR 886.1120). It meets FDA criteria for a non-significant risk (NSR) device under 21 CFR 812.3(m). The study was conducted in two sequential phases. The Optimization/Calibration Phase involved 5-10 subjects, primarily study personnel and clinic staff volunteers, who underwent longer imaging sessions (5-20 minutes) to optimize camera parameters including shutter speed, aperture, sensor gain, illumination angle, and slit width. The General Recruitment Phase enrolled a larger cohort of adult patients (target 50-200) from Northwest Eye Clinic and its affiliate Minnesota Eye Consultants (Unifeye Vision Partners), Golden Valley, Minnesota. Patients with a range of anterior segment pathology and normal eyes were included to assess feasibility across a broad clinical population. The primary endpoint was the proportion of enrolled patients who could be successfully imaged with the Vscan001 compared to those who could not - expressed as a simple percentage. A stopping rule was pre-specified: the study would be halted if fewer than 50% of patients could be adequately imaged. Exploratory endpoints included subjective assessment of image quality across varying photographic parameter combinations, with the intent of informing optimal settings for a subsequent pivotal study. No diagnostic or treatment decisions were made based on device output; the device was used solely for photographic documentation. No randomization, blinding, or control group was employed. Statistical analysis was limited to computation of the primary feasibility proportion. The study was conducted under IRB review by Salus IRB (Austin, TX) and complied with FDA regulations governing non-significant risk device investigations under 21 CFR Part 812.2(b).
Interventions
The Vscan001 is a semi-portable automated slit lamp camera that captures anterior segment images using high-speed liquid lens technology. The device incorporates a 5-megapixel primary camera sensor with a liquid lens capable of refocusing every 4 milliseconds, a wide-angle 5-megapixel auxiliary camera, and an LED-based slit projector mounted on a rotating arm. A microprocessor controls slit movement, width, and illumination parameters. Participants were seated at the device in a manner similar to a conventional slit lamp examination. The operator obtained initial focus via joystick and activated the automated imaging sequence, manually positioning the illumination arm through multiple preset angles. Images were stored as Raw and JPEG files on an encrypted hard drive. The device qualifies as an FDA Class II exempt device under the PJZ slit lamp camera classification (21 CFR 886.1120) and meets FDA non-significant risk criteria under 21 CFR 812.3(m).
Sponsors
Study design
Intervention model description
All enrolled participants underwent anterior segment imaging with the Lightfield Medical Vscan001 automated slit lamp camera. No comparator device, control group, or randomization was employed. Participants were assessed solely on their ability to be successfully imaged with the device. This study was conducted to evaluate the clinical feasibility of automated anterior segment imaging using an investigational slit lamp camera across a range of patients with and without ocular pathology. The objective was to determine the proportion of patients who could be successfully imaged in a real-world clinical setting and to optimize photographic parameters for use in future studies. While the study is exploratory in nature, it exceeds the participant threshold for the "Device Feasibility" designation and is not a pivotal efficacy or diagnostic accuracy trial.
Eligibility
Inclusion criteria
* Adults 18 years of age or older * Ability to position at the device (i.e., ability to rest chin on chinrest and forehead against forehead rest) * Willingness to provide informed consent * Patients with or without ocular pathology are eligible
Exclusion criteria
* Age younger than 18 years * Physical inability to position at the device * Movement disorders that would preclude stable positioning at the device * Significant photophobia
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility of Automated Slit-lamp imaging | During imaging sessions of 5-20 minute duration | The proportion of enrolled participants who could be successfully imaged with the Vscan001 compared to the total number of participants in the General Recruitment phase, expressed as a percentage. Successful imaging was defined as completion of the automated slit lamp imaging sequence with acquisition of usable anterior segment images. |
Countries
United States