It is very difficult to speak about OCT without mentioning these two guys. OCT started, thanks to these two men, Professor Fujimoto and David Huang, who was a medical student at Harvard Medical School and a Ph.D. candidate at the MIT.

And they started as a Ph.D. thesis. All started like that. And later, it spreaded into different areas of medicine such as cardiology, dentistry, dermatology, neurology, and also in art, to detect fraud. So, it's very interesting.

So, the first OTC prototype evaluated more than 5,000 patients at the New England Eye Center. In '94 or '95 we saw the first cornea retina [unintelligible] published in literature. And later on, in 2006, we--in 2000, we had OTC II, in 2003 you had OCT III, and in 2006 we had introduction of a new technology called Spectral Domain OTC. After--by Optovue.

So, after that, we had a lot of commercially available OCT in the market, such as the one that we see here from Optovue, Topcon, Nidek. So, we have a bunch of new technologies coming into the market.

So, today, there's actually a lot of talk about what is the next technology? Will that come with a lower resolution three, four microns? Three microns? Two microns? But, does resolution really matters? Does that--is that really important? So, I'm going to show you some examples in here.

So, if we look at the--some of the slides in here, we see Optovue, we see Spectralis, and we see an image from Cirrus. If you look at those image, we're--we look at the Spectralis in here, Spectralis looks to have a much better quality in the image. However, if we look at the--this slide in here, we're going to notice that Spectralis has the lowest resolution. So, what is going on? If Spectralis has a better image, is resolution really important?

So, maybe there's something else. Maybe it's getting the speed of the A scan in the OCT. So, again, we look at this graphic in here, look at scanning speed, and we see that all the machines have around--most of the machines have around 25, 26, 27. Spectralis has 48 scans at 48,000 A scans per second, so maybe it's scanning speed.

However, if you look at the literature, we're going to see some publications of ultra high resolution. Ultra high resolution has two micron and 200,000 A scans per second. If you look at Spectralis, Spectralis has seven microns and 40,000 A scans per second. But, if you look at the image itself, it seems that we see better details with Spectralis, so what's going on?

So, let me shift a little bit the idea here. We all know--most of us know about Dolby and bangalosen [sp]. We have--all have been to a movie, and we saw--we see this Dolby at the beginning of--you know, of every movie, in most of the movies, and we wondered why Dolby is there? Because Dolby has something called speckle noise reduction technology, and it does--it works that same way as a bangalosen.

If you compare Sony, if you compare Yamaha, if you compare, you know, lot of stereos, and you compare it to bangalosen, you're going to see details in the quality of the sound in bangalosen. So, there's really something behind that, and this technology is called noise reduction technology.

So, in OTC, we do the same thing. In images of high scattering technology tissue such as in OTC, speckle has a dual role: the source of noise and a carrier of information about the microstructure that we assess.

And there are several methods of reducing this noise. We have polarization diversity, spatial compounding, frequency compounding, and digital signing processing and others, but I'm not going to talk about it. I'm just going to discuss one in particular.

Signal averaging, a common method of reducing artifacts is signal averaging. This improves signal to noise levels, and in OTC this mean averaging multiple A scans and B scans from a given location to suppress this noise, and this will improve structural definition.

So, actually what it is done, they will assess some points at the A scan and B scan, and all of the--by powerful algorithms, and these aligned A scans and B scan corresponds from retinal locations in a series of stacks of B scans, and the scans are misaligned and transverse are thrown away. We just leave the ones that are good.

And here's the results. Let's compare this. If you look at the image on the top here, they're the same images, same speed, same resolution. If you look at it in this one, you see the difference in quality. And here, we see much crisper details. Much better than the one on the top.

We can all appreciate the details in here compared to here. So, signal averaging is the way to go, and Optovue started working this technology and now there's a new technology behind that. It's called--a new algorithm that allows us to see very, very nice details and appreciate the details such as in patient with drusen.

We don't only see--we not only see the fine details, we see the features in here. We can see the choroid order as well. In relation to choroid, we begin to also appreciate the drusen anatomy very well.

So, the image quality in here allows us to see, for example, the external limiting membrane very well. So, this gives us a fantastic way of analyzing the patient in a much better way.

This is just to give you an example. This is a picture from Heidelberg Web site, [unintelligible] we're talking about, that Spectralis is such a good image. And this is the new Optovue speckle noise reduction. So, we see this patient has a lot of fine details and a very good stratification of their retina in here.

So, let me give you a couple of examples. So, maybe you can get another--so, in here, we can see this patients with centrous choroidal retinopathy. We can see the details very well. We can--if you pay attention--sorry. If you pay attention to this, this is the onfoss [sp] of this patient. Unfoss is like--imagine that you could--onfoss [sp] is a new technology.

Imagine that you decide to assess the retina with a fundus camera, but you want to assess a specific area of the retina. You want to assess, let's say, the RB. So, you want to evaluate RB. So, there is an example here. So, here is the onfoss and here is the FA. You're going to see the FA here, in this slide here, that the linkage point in the FA corresponds to the linked site at onfoss. It's called [unintelligible] OCT, and we--and this is very interesting, because we don't need to inject any eye.

So, if you look at before treatment and after treatment, we can see it in here. Here, we can see very well the detachment of the retina that corresponds to the B scans, right? And we can see that here--the attachment of the RP. And in here later, we can see the detachment is only in the secure area on the crossline B scan.

So, this will--gives us a much better understanding of the whole area of the retina. So, there's something else very new that is coming out. It's something called deep choroidal imaging or DCI. This will allow us, with its new algorithms, to see a much better penetration of the retina.

Here, a case of optic pit. We can see it very well, the choroid. We can see that--the choroid vessels in here, with the [unintelligible] and a very nice stratification of the retina in here. And we can appreciate here the pit. So, meaning that we can go deep in and analyze much better without also losing the interior part in here in the vitreous

So, here is another example of a patient with branch vein occlusion. We can appreciate the distribution of the drusen inside of the eye. Here is the distribution--I'm sorry, the hard exudates. So, here, we see the distribution, and this distribution corresponds to the location in the B scan. So, the [unintelligible] is very nice, so we can appreciate that very well. So, here is another example. Patient with drusen. We can do the onfoss, we can see the B scan. And what is very interesting in this situation here is that there's a possibility that using onfoss to assess both inner and outer layers of the retina.

For example, on this patient here, we don't--we--if you look at it here, you may see that this patient has epiretinal membrane, but if you look at the onfoss OCT, the epiretinal membrane seems to be much defined and much bigger than we thought in the B scan.

And it's also interesting, in the same patient, that we can see the drusen very well. And this will give us rise for a new technology that is coming out from Optovue, which is analyzing the progression of drusen and geographic atrophy. This is very nice.

So, one technology that is coming out, it's called the tracking system. I'm going to show it to you. This tracking system is very nice. This will allow us to see or to evaluate, for example, in this patient, patient with cone dystrophy that didn't fixate very well, and we have this kind of incredible image. We can see very well the choroid in here, and we can see the vitreous very well in a patient. But, we had a very hard time to evaluate.

These quality is a combination of this--of the quality of this technology--this image is a combination of these two technology: speckle noise reduction and tracking technology.

In tracking, it's very interesting, tracking will improve this visit-to-visit reproducibility. And different from other companies that have tracking technology, they have 15 frames per second. For example, Spectralis has a 15 frames per second tracking technology incorporated, and Optovue is coming out with a twice as fast technology, and this will give us a much better quality in the image. And not only that, but improving our visit-to-visit reproducibility.

Here's some of the interior segment imaging. In the past, we only had [unintelligible] of OCT which had 2,000 A scans per second, 15 times slower than the current technology in Artevue [sp]. We can see the resolution is much better in five microns rather than 18 microns. This will allowed us to see a very nice details of the cornea. Very, very nice details of the cornea. Here's some high resolution--here's the epithelial--I mean, the epithelium and the flat of the Lasik. Here a patient with acanthamoeba. But, what I really like to introduce it to you is the implementation is the use of this new technologies, new Optovue speckle noise reduction inside of the cornea as well.

So, the capability will change, and this is the result. So, we can see it very well, the cornea. We can see the flat in a much better manner than we saw before. So, we can see it black and white, color or negative. We can see, for example, Bowman's layer. I don't know if you can see there, but it looks like a double layer at the Bowman's location in here.

So, just the comparison of the current Artevue and then your technology and then your speckle noise reduction from Optovue. This allows us to see a much better and finer details in here. So, let me give you other examples. Here another patient with a pinguecula. Here, another patient with conjunctivochalasis. You can see the tear film in here very well and the conjunctiva--detachment of the conjunctiva. And we can also measure the volume of the tear film. Here, the tear film. Very nice. Here, we can measure the volume of the tear film.

So, one new technology that will come out is a new software for cornea and sclera. And this will us these kind of results. We can--we are now able to see not only the tear chamber, you know, the [unintelligible] lines and so on, but we can also see the conjunctiva epithelium, the cornea epithelium, the cornea's trauma. Very--the rectus muscles and so on. Things that we can never imagine before.

And this is really fantastic. I was very impressed when I started working with that, because I--when I started looking at patients with scleritis, I noticed, for example, in these patients, we are--we're able to see some collagen fibers in these patients, something that I could never understand. I've never seen that, even in pathology or in histologies.

See, here are some blood vessels here in a patient with a [unintelligible] tearing scleritis. Very nice imaging. Here is another patient with necrotizing scleritis. We can see a thinning here. We can measure the posterior surface of the sclera in here as well as the interior part of the sclera.

And we can see, for example--in this patient here, we can see the tear film. Look at the tear film. This is not the epithelium. This is the tear film. Here is the epithelium--cornea epithelium. Here is the conjunctiva epithelium, and here is the tear film, and here is the scleral nodule. And we can assume here that we can see--it's very hard to say that--but, we can assume there is some blood vessels in there.

So, I was very impressed with this new technology incorporated in the OCT, bringing us finer details never seen before. And apparently, this is just the beginning, just the tip of the iceberg, and the light of the end of the tunnel that is about to come in 2012. And this justifies the development of this technology, a new technology coming in 2012 that will justify all of these technologies coming into Artevue.

Thank you very much.