Sample records for ophthalmoscopes

  1. Exposure Limits in Ophthalmic Imaging with Scanning Laser Ophthalmoscopes

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    Roque, S.S.L.T.; Bicho, S.A.A. [IBILI-Biomedical Institute for Research on Light and Image, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Celas 3000-354 Coimbra (Portugal); Morgado, A.M.L.S. [IBILI-Biomedical Institute for Research on Light and Image, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Celas 3000-354 Coimbra (Portugal); Department of Physics, Faculty of Science and Technology, University of Coimbra, Rua Larga da Universidade, 3004-516 Coimbra (Portugal)


    We present an analysis of the exposure to laser radiation resulting from the use of scanning laser ophthalmoscopes in ophthalmic imaging of the ocular fundus. Exposures limits are determined, based on the IEC/EN 60825-1 standard. These limits are applied on the safety analysis of a commercial scanning laser ophthalmoscope. (author)

  2. Angiography with a multifunctional line scanning ophthalmoscope (United States)

    Hammer, Daniel X.; Ferguson, R. Daniel; Patel, Ankit H.; Vazquez, Vanessa; Husain, Deeba


    A multifunctional line scanning ophthalmoscope (mLSO) was designed, constructed, and tested on human subjects. The mLSO could sequentially acquire wide-field, confocal, near-infrared reflectance, fluorescein angiography (FA), and indocyanine green angiography (ICGA) retinal images. The system also included a retinal tracker (RT) and a photodynamic therapy laser treatment port. The mLSO was tested in a pilot clinical study on human subjects with and without retinal disease. The instrument exhibited robust retinal tracking and high-contrast line scanning imaging. The FA and ICGA angiograms showed a similar appearance of hyper- and hypo-pigmented disease features and a nearly equivalent resolution of fine capillaries compared to a commercial flood-illumination fundus imager. An mLSO-based platform will enable researchers and clinicians to image human and animal eyes with a variety of modalities and deliver therapeutic beams from a single automated interface. This approach has the potential to improve patient comfort and reduce imaging session times, allowing clinicians to better diagnose, plan, and conduct patient procedures with improved outcomes.

  3. Reflective afocal broadband adaptive optics scanning ophthalmoscope (United States)

    Dubra, Alfredo; Sulai, Yusufu


    A broadband adaptive optics scanning ophthalmoscope (BAOSO) consisting of four afocal telescopes, formed by pairs of off-axis spherical mirrors in a non-planar arrangement, is presented. The non-planar folding of the telescopes is used to simultaneously reduce pupil and image plane astigmatism. The former improves the adaptive optics performance by reducing the root-mean-square (RMS) of the wavefront and the beam wandering due to optical scanning. The latter provides diffraction limited performance over a 3 diopter (D) vergence range. This vergence range allows for the use of any broadband light source(s) in the 450-850 nm wavelength range to simultaneously image any combination of retinal layers. Imaging modalities that could benefit from such a large vergence range are optical coherence tomography (OCT), multi- and hyper-spectral imaging, single- and multi-photon fluorescence. The benefits of the non-planar telescopes in the BAOSO are illustrated by resolving the human foveal photoreceptor mosaic in reflectance using two different superluminescent diodes with 680 and 796 nm peak wavelengths, reaching the eye with a vergence of 0.76 D relative to each other. PMID:21698035

  4. Retinal sensitivity measurement over drusen using scanning laser ophthalmoscope microperimetry. (United States)

    Takamine, Y; Shiraki, K; Moriwaki, M; Yasunari, T; Miki, T


    Retinal sensitivity over drusen was examined using a scanning laser ophthalmoscope to confirm a previous report of no change in sensitivity over drusen. Microperimetry was performed using a scanning laser ophthalmoscope in 23 eyes of 19 subjects. Subject age ranged from 42 to 86 years (mean 68.5 years). Fifty-four drusen bigger than the diameter of a major retinal vein at the optic disc rim were examined, and drusen were classified as soft drusen and other large drusen. Nine eyes of eight subjects showed a decrease in retinal sensitivity over drusen. The decrease in retinal sensitivity was more than 5 dB less than the sensitivity at a peripheral non-drusen area peripheral to the measurement point. The sensitivity decrease was noted over 15 of 29 large drusen and the decrease was statistically significant (P < 0.02). However, no relationship between the size of the drusen and the amount by which sensitivity decreased was found. Nevertheless, a decrease in retinal sensitivity was not seen over any of 25 soft drusen. Large drusen may influence retinal sensitivity and function.

  5. Optical Design and Optimization of Translational Reflective Adaptive Optics Ophthalmoscopes (United States)

    Sulai, Yusufu N. B.

    The retina serves as the primary detector for the biological camera that is the eye. It is composed of numerous classes of neurons and support cells that work together to capture and process an image formed by the eye's optics, which is then transmitted to the brain. Loss of sight due to retinal or neuro-ophthalmic disease can prove devastating to one's quality of life, and the ability to examine the retina in vivo is invaluable in the early detection and monitoring of such diseases. Adaptive optics (AO) ophthalmoscopy is a promising diagnostic tool in early stages of development, still facing significant challenges before it can become a clinical tool. The work in this thesis is a collection of projects with the overarching goal of broadening the scope and applicability of this technology. We begin by providing an optical design approach for AO ophthalmoscopes that reduces the aberrations that degrade the performance of the AO correction. Next, we demonstrate how to further improve image resolution through the use of amplitude pupil apodization and non-common path aberration correction. This is followed by the development of a viewfinder which provides a larger field of view for retinal navigation. Finally, we conclude with the development of an innovative non-confocal light detection scheme which improves the non-invasive visualization of retinal vasculature and reveals the cone photoreceptor inner segments in healthy and diseased eyes.

  6. Binocular eye tracking with the Tracking Scanning Laser Ophthalmoscope. (United States)

    Stevenson, S B; Sheehy, C K; Roorda, A


    The development of high magnification retinal imaging has brought with it the ability to track eye motion with a precision of less than an arc minute. Previously these systems have provided only monocular records. Here we describe a modification to the Tracking Scanning Laser Ophthalmoscope (Sheehy et al., 2012) that splits the optical path in a way that slows the left and right retinas to be scanned almost simultaneously by a single system. A mirror placed at a retinal conjugate point redirects half of each horizontal scan line to the fellow eye. The collected video is a split image with left and right retinas appearing side by side in each frame. Analysis of the retinal motion in the recorded video provides an eye movement trace with very high temporal and spatial resolution. Results are presented from scans of subjects with normal ocular motility that fixated steadily on a green laser dot. The retinas were scanned at 4° eccentricity with a 2° square field. Eye position was extracted offline from recorded videos with an FFT based image analysis program written in Matlab. The noise level of the tracking was estimated to range from 0.25 to 0.5arcmin SD for three subjects. In the binocular recordings, the left eye/right eye difference was 1-2arcmin SD for vertical motion and 10-15arcmin SD for horizontal motion, in agreement with published values from other tracking techniques.

  7. Active eye-tracking for an adaptive optics scanning laser ophthalmoscope (United States)

    Sheehy, Christy K.; Tiruveedhula, Pavan; Sabesan, Ramkumar; Roorda, Austin


    We demonstrate a system that combines a tracking scanning laser ophthalmoscope (TSLO) and an adaptive optics scanning laser ophthalmoscope (AOSLO) system resulting in both optical (hardware) and digital (software) eye-tracking capabilities. The hybrid system employs the TSLO for active eye-tracking at a rate up to 960 Hz for real-time stabilization of the AOSLO system. AOSLO videos with active eye-tracking signals showed, at most, an amplitude of motion of 0.20 arcminutes for horizontal motion and 0.14 arcminutes for vertical motion. Subsequent real-time digital stabilization limited residual motion to an average of only 0.06 arcminutes (a 95% reduction). By correcting for high amplitude, low frequency drifts of the eye, the active TSLO eye-tracking system enabled the AOSLO system to capture high-resolution retinal images over a larger range of motion than previously possible with just the AOSLO imaging system alone. PMID:26203370

  8. Active eye-tracking for an adaptive optics scanning laser ophthalmoscope. (United States)

    Sheehy, Christy K; Tiruveedhula, Pavan; Sabesan, Ramkumar; Roorda, Austin


    We demonstrate a system that combines a tracking scanning laser ophthalmoscope (TSLO) and an adaptive optics scanning laser ophthalmoscope (AOSLO) system resulting in both optical (hardware) and digital (software) eye-tracking capabilities. The hybrid system employs the TSLO for active eye-tracking at a rate up to 960 Hz for real-time stabilization of the AOSLO system. AOSLO videos with active eye-tracking signals showed, at most, an amplitude of motion of 0.20 arcminutes for horizontal motion and 0.14 arcminutes for vertical motion. Subsequent real-time digital stabilization limited residual motion to an average of only 0.06 arcminutes (a 95% reduction). By correcting for high amplitude, low frequency drifts of the eye, the active TSLO eye-tracking system enabled the AOSLO system to capture high-resolution retinal images over a larger range of motion than previously possible with just the AOSLO imaging system alone.

  9. Converting a conventional wired-halogen illuminated indirect ophthalmoscope to a wireless-light emitting diode illuminated indirect ophthalmoscope in less than 1000/- rupees

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    Mihir Kothari


    Full Text Available Aim: To report the "do it yourself" method of converting an existing wired-halogen indirect ophthalmoscope (IO to a wireless-light emitting diode (LED IO and report the preferences of the patients and the ophthalmologists. Subjects and Methods: In this prospective observational study, a conventional IO was converted to wireless-LED IO using easily available, affordable electrical components. Conventional and the converted IO were then used to perform photo-stress test and take the feedback of subjects and the ophthalmologists regarding its handling and illumination characteristics. Results: The cost of conversion to wireless-LED was 815/- rupees. Twenty-nine subjects, mean age 34.3 ΁ 10 years with normal eyes were recruited in the study. Between the two illumination systems, there was no statistical difference in the magnitude of the visual acuity loss and the time to recovery of acuity and the bleached vision on photo-stress test, although the visual recovery was clinically faster with LED illumination. The heat sensation was more with halogen illumination than the LED (P = 0.009. The ophthalmologists rated wireless-LED IO higher than wired-halogen IO on the handling, examination comfort, patient′s visual comfort and quality of the image. Twenty-two (81% ophthalmologists wanted to change over to wireless-LED IO. Conclusions: Converting to wireless-LED IO is easy, cost-effective and preferred over a wired-halogen indirect ophthalmoscope.

  10. Classification of human retinal microaneurysms using adaptive optics scanning light ophthalmoscope fluorescein angiography. (United States)

    Dubow, Michael; Pinhas, Alexander; Shah, Nishit; Cooper, Robert F; Gan, Alexander; Gentile, Ronald C; Hendrix, Vernon; Sulai, Yusufu N; Carroll, Joseph; Chui, Toco Y P; Walsh, Joseph B; Weitz, Rishard; Dubra, Alfredo; Rosen, Richard B


    Microaneurysms (MAs) are considered a hallmark of retinal vascular disease, yet what little is known about them is mostly based upon histology, not clinical observation. Here, we use the recently developed adaptive optics scanning light ophthalmoscope (AOSLO) fluorescein angiography (FA) to image human MAs in vivo and to expand on previously described MA morphologic classification schemes. Patients with vascular retinopathies (diabetic, hypertensive, and branch and central retinal vein occlusion) were imaged with reflectance AOSLO and AOSLO FA. Ninety-three MAs, from 14 eyes, were imaged and classified according to appearance into six morphologic groups: focal bulge, saccular, fusiform, mixed, pedunculated, and irregular. The MA perimeter, area, and feret maximum and minimum were correlated to morphology and retinal pathology. Select MAs were imaged longitudinally in two eyes. Adaptive optics scanning light ophthalmoscope fluorescein angiography imaging revealed microscopic features of MAs not appreciated on conventional images. Saccular MAs were most prevalent (47%). No association was found between the type of retinal pathology and MA morphology (P = 0.44). Pedunculated and irregular MAs were among the largest MAs with average areas of 4188 and 4116 μm(2), respectively. Focal hypofluorescent regions were noted in 30% of MAs and were more likely to be associated with larger MAs (3086 vs. 1448 μm(2), P = 0.0001). Retinal MAs can be classified in vivo into six different morphologic types, according to the geometry of their two-dimensional (2D) en face view. Adaptive optics scanning light ophthalmoscope fluorescein angiography imaging of MAs offers the possibility of studying microvascular change on a histologic scale, which may help our understanding of disease progression and treatment response.

  11. High-resolution adaptive optics scanning laser ophthalmoscope with multiple deformable mirrors (United States)

    Chen, Diana C.; Olivier, Scot S.; Jones; Steven M.


    An adaptive optics scanning laser ophthalmoscopes is introduced to produce non-invasive views of the human retina. The use of dual deformable mirrors improved the dynamic range for correction of the wavefront aberrations compared with the use of the MEMS mirror alone, and improved the quality of the wavefront correction compared with the use of the bimorph mirror alone. The large-stroke bimorph deformable mirror improved the capability for axial sectioning with the confocal imaging system by providing an easier way to move the focus axially through different layers of the retina.

  12. Non-common path aberration correction in an adaptive optics scanning ophthalmoscope. (United States)

    Sulai, Yusufu N; Dubra, Alfredo


    The correction of non-common path aberrations (NCPAs) between the imaging and wavefront sensing channel in a confocal scanning adaptive optics ophthalmoscope is demonstrated. NCPA correction is achieved by maximizing an image sharpness metric while the confocal detection aperture is temporarily removed, effectively minimizing the monochromatic aberrations in the illumination path of the imaging channel. Comparison of NCPA estimated using zonal and modal orthogonal wavefront corrector bases provided wavefronts that differ by ~λ/20 in root-mean-squared (~λ/30 standard deviation). Sequential insertion of a cylindrical lens in the illumination and light collection paths of the imaging channel was used to compare image resolution after changing the wavefront correction to maximize image sharpness and intensity metrics. Finally, the NCPA correction was incorporated into the closed-loop adaptive optics control by biasing the wavefront sensor signals without reducing its bandwidth.

  13. Retinal Image-Based Eye-Tracking Using the Tracking Scanning Laser Ophthalmoscope (United States)

    Sheehy, Christy Kathleen

    The tracking scanning laser ophthalmoscope (TSLO) was designed, built and characterized for high-resolution eye-tracking, imaging, and targeted retinal stimulus delivery. Eye-tracking is done via an image-based software program that monitors the image of the retina over time while simultaneously logging the displacements of the eye. Currently, this system is the most accurate, fast and functional eye-tracking system used in a standard ophthalmic instrument. The TSLO has the ability to non-invasively track the eye at 960 Hz (with an accuracy of 0.2 arcminutes or roughly 1 micron) and present stimuli to the retina at the resolution of single cone photoreceptors (0.66 arcminutes, which is roughly 3 microns). The combination of structural imaging and functional testing allows one to begin to more thoroughly understand retinal disease progression, as well probe specific retinal locations in order to test new treatment efficacies. This level of accuracy is unprecedented in the clinic and is crucial when monitoring minute changes in eye motion, structure, and function. Additionally, the system is capable of providing external eye-tracking for other high-resolution imaging systems, such as optical coherence tomography (OCT) and adaptive optics scanning laser ophthalmoscope (AOSLO) systems through the active steering of an imaging beam. This feature allows the imaging raster or stimuli to stay on target during fixational eye motion. This dissertation steps through all of the above-mentioned uses of the TSLO and further elaborates on the optimal design and system test performance capabilities of the system.

  14. In Vivo Non Linear Optical (NLO) Imaging in Live Rabbit Eyes Using the Heidelberg Two-Photon Laser Ophthalmoscope (United States)

    Hao, Ming; Flynn, Kevin; Nien-Shy, Chyong; Jester, Bryan E.; Winkler, Moritz; Brown, Donald J.; La Schiazza, Olivier; Bille, Josef; Jester, James V.


    Imaging of non-linear optical (NLO) signals generated from the eye using ultrafast pulsed lasers has been limited to the study of ex vivo tissues because of the use of conventional microscopes with slow scan speeds. The purpose of this study was to evaluate the ability of a novel, high scan rate ophthalmoscope to generate NLO signals using an attached femtosecond laser. NLO signals were generated and imaged in live, anesthetized albino rabbits using a newly designed Heidelberg Two-Photon Laser Ophthalmoscope with attached 25 mW femtosecond laser having a central wavelength of 780 nm, pulsewidth of 75 fs, and a repetition rate of 50 MHz. To assess two-photon excited fluorescent (TPEF) signal generation, cultured rabbit corneal fibroblasts (RCF) were first labeled by Blue-green fluorescent FluoSpheres (1 μm diameter) and then cells were micro-injected into the central cornea. Clumps of RCF cells could be detected by both reflectance and TPEF imaging at 6 hours after injection. By 6 days, RCF containing fluorescent microspheres confirmed by TPEF showed a more spread morphology and had migrated from the original injection site. Overall, this study demonstrates the potential of using NLO microscopy to sequentially detect TPEF signals from live, intact corneas. We conclude that further refinement of the Two-photon laser Ophthalmoscope should lead to the development of an important, new clinical instrument capable of detecting NLO signals from patient corneas. PMID:20558159

  15. High-resolution adaptive optics scanning laser ophthalmoscope with dual deformable mirrors for large aberration correction

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    Chen, D; Jones, S M; Silva, D A; Olivier, S S


    Scanning laser ophthalmoscopes with adaptive optics (AOSLO) have been shown previously to provide a noninvasive, cellular-scale view of the living human retina. However, the clinical utility of these systems has been limited by the available deformable mirror technology. In this paper, we demonstrate that the use of dual deformable mirrors can effectively compensate large aberrations in the human retina, making the AOSLO system a viable, non-invasive, high-resolution imaging tool for clinical diagnostics. We used a bimorph deformable mirror to correct low-order aberrations with relatively large amplitudes. The bimorph mirror is manufactured by Aoptix, Inc. with 37 elements and 18 {micro}m stroke in a 10 mm aperture. We used a MEMS deformable mirror to correct high-order aberrations with lower amplitudes. The MEMS mirror is manufactured by Boston Micromachine, Inc with 144 elements and 1.5 {micro}m stroke in a 3 mm aperture. We have achieved near diffraction-limited retina images using the dual deformable mirrors to correct large aberrations up to {+-} 3D of defocus and {+-} 3D of cylindrical aberrations with test subjects. This increases the range of spectacle corrections by the AO systems by a factor of 10, which is crucial for use in the clinical environment. This ability for large phase compensation can eliminate accurate refractive error fitting for the patients, which greatly improves the system ease of use and efficiency in the clinical environment.

  16. High-Resolution Adaptive Optics Scanning Laser Ophthalmoscope with Dual Deformable Mirrors

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    Chen, D C; Jones, S M; Silva, D A; Olivier, S S


    Adaptive optics scanning laser ophthalmoscope (AO SLO) has demonstrated superior optical quality of non-invasive view of the living retina, but with limited capability of aberration compensation. In this paper, we demonstrate that the use of dual deformable mirrors can effectively compensate large aberrations in the human retina. We used a bimorph mirror to correct large-stroke, low-order aberrations and a MEMS mirror to correct low-stroke, high-order aberration. The measured ocular RMS wavefront error of a test subject was 240 nm without AO compensation. We were able to reduce the RMS wavefront error to 90 nm in clinical settings using one deformable mirror for the phase compensation and further reduced the wavefront error to 48 nm using two deformable mirrors. Compared with that of a single-deformable-mirror SLO system, dual AO SLO offers much improved dynamic range and better correction of the wavefront aberrations. The use of large-stroke deformable mirrors provided the system with the capability of axial sectioning different layers of the retina. We have achieved diffraction-limited in-vivo retinal images of targeted retinal layers such as photoreceptor layer, blood vessel layer and nerve fiber layers with the combined phase compensation of the two deformable mirrors in the AO SLO.

  17. Non-mydriatic video ophthalmoscope to measure fast temporal changes of the human retina (United States)

    Tornow, Ralf P.; Kolář, Radim; Odstrčilík, Jan


    The analysis of fast temporal changes of the human retina can be used to get insight to normal physiological behavior and to detect pathological deviations. This can be important for the early detection of glaucoma and other eye diseases. We developed a small, lightweight, USB powered video ophthalmoscope that allows taking video sequences of the human retina with at least 25 frames per second without dilating the pupil. Short sequences (about 10 s) of the optic nerve head (20° x 15°) are recorded from subjects and registered offline using two-stage process (phase correlation and Lucas-Kanade approach) to compensate for eye movements. From registered video sequences, different parameters can be calculated. Two applications are described here: measurement of (i) cardiac cycle induced pulsatile reflection changes and (ii) eye movements and fixation pattern. Cardiac cycle induced pulsatile reflection changes are caused by changing blood volume in the retina. Waveform and pulse parameters like amplitude and rise time can be measured in any selected areas within the retinal image. Fixation pattern ΔY(ΔX) can be assessed from eye movements during video acquisition. The eye movements ΔX[t], ΔY[t] are derived from image registration results with high temporal (40 ms) and spatial (1,86 arcmin) resolution. Parameters of pulsatile reflection changes and fixation pattern can be affected in beginning glaucoma and the method described here may support early detection of glaucoma and other eye disease.

  18. Design of a Compact, Bimorph Deformable Mirror-Based Adaptive Optics Scanning Laser Ophthalmoscope. (United States)

    He, Yi; Deng, Guohua; Wei, Ling; Li, Xiqi; Yang, Jinsheng; Shi, Guohua; Zhang, Yudong


    We have designed, constructed and tested an adaptive optics scanning laser ophthalmoscope (AOSLO) using a bimorph mirror. The simulated AOSLO system achieves diffraction-limited criterion through all the raster scanning fields (6.4 mm pupil, 3° × 3° on pupil). The bimorph mirror-based AOSLO corrected ocular aberrations in model eyes to less than 0.1 μm RMS wavefront error with a closed-loop bandwidth of a few Hz. Facilitated with a bimorph mirror at a stroke of ±15 μm with 35 elements and an aperture of 20 mm, the new AOSLO system has a size only half that of the first-generation AOSLO system. The significant increase in stroke allows for large ocular aberrations such as defocus in the range of ±600° and astigmatism in the range of ±200°, thereby fully exploiting the AO correcting capabilities for diseased human eyes in the future.

  19. Comparison of adaptive optics scanning light ophthalmoscopic fluorescein angiography and offset pinhole imaging. (United States)

    Chui, Toco Y P; Dubow, Michael; Pinhas, Alexander; Shah, Nishit; Gan, Alexander; Weitz, Rishard; Sulai, Yusufu N; Dubra, Alfredo; Rosen, Richard B


    Recent advances to the adaptive optics scanning light ophthalmoscope (AOSLO) have enabled finer in vivo assessment of the human retinal microvasculature. AOSLO confocal reflectance imaging has been coupled with oral fluorescein angiography (FA), enabling simultaneous acquisition of structural and perfusion images. AOSLO offset pinhole (OP) imaging combined with motion contrast post-processing techniques, are able to create a similar set of structural and perfusion images without the use of exogenous contrast agent. In this study, we evaluate the similarities and differences of the structural and perfusion images obtained by either method, in healthy control subjects and in patients with retinal vasculopathy including hypertensive retinopathy, diabetic retinopathy, and retinal vein occlusion. Our results show that AOSLO OP motion contrast provides perfusion maps comparable to those obtained with AOSLO FA, while AOSLO OP reflectance images provide additional information such as vessel wall fine structure not as readily visible in AOSLO confocal reflectance images. AOSLO OP offers a non-invasive alternative to AOSLO FA without the need for any exogenous contrast agent.

  20. Evaluating medical students’ proficiency with a handheld ophthalmoscope: a pilot study

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    Gilmour G


    Full Text Available Gregory Gilmour,1 James McKivigan2 1Physical Medicine and Rehabilitation, Michigan State University, Lansing, MI, 2School of Physical Therapy, Touro University, Henderson, NV, USA Introduction: Historically, testing medical students’ skills using a handheld ophthalmoscope has been difficult to do objectively. Many programs train students using plastic models of the eye which are a very limited fidelity simulator of a real human eye. This makes it difficult to be sure that actual proficiency is attained given the differences between the various models and actual patients. The purpose of this article is to introduce a method of testing where a medical student must match a patient with his/her fundus photo, ensuring objective evaluation as well as developing skills on real patients which are more likely to transfer into clinical practice directly. Presentation of case: Fundus photos from standardized patients (SPs were obtained using a retinal camera and placed into a grid using proprietary software. Medical students were then asked to examine a SP and attempt to match the patient to his/her fundus photo in the grid. Results: Of the 33 medical students tested, only 10 were able to match the SP’s eye to the correct photo in the grid. The average time to correct selection was 175 seconds, and the successful students rated their confidence level at 27.5% (average. The incorrect selection took less time, averaging 118 seconds, yet yielded a higher student-reported confidence level at 34.8% (average. The only noteworthy predictor of success (p<0.05 was the student’s age (p=0.02. Conclusion: It may be determined that there is an apparent gap in the ophthalmoscopy training of the students tested. It may also be of concern that students who selected the incorrect photo were more confident in their selections than students who chose the correct photo. More training may be necessary to close this gap, and future studies should attempt to establish

  1. Tracking features in retinal images of adaptive optics confocal scanning laser ophthalmoscope using KLT-SIFT algorithm. (United States)

    Li, Hao; Lu, Jing; Shi, Guohua; Zhang, Yudong


    With the use of adaptive optics (AO), high-resolution microscopic imaging of living human retina in the single cell level has been achieved. In an adaptive optics confocal scanning laser ophthalmoscope (AOSLO) system, with a small field size (about 1 degree, 280 μm), the motion of the eye severely affects the stabilization of the real-time video images and results in significant distortions of the retina images. In this paper, Scale-Invariant Feature Transform (SIFT) is used to abstract stable point features from the retina images. Kanade-Lucas-Tomasi(KLT) algorithm is applied to track the features. With the tracked features, the image distortion in each frame is removed by the second-order polynomial transformation, and 10 successive frames are co-added to enhance the image quality. Features of special interest in an image can also be selected manually and tracked by KLT. A point on a cone is selected manually, and the cone is tracked from frame to frame.

  2. Adaptive optics scanning laser ophthalmoscope using liquid crystal on silicon spatial light modulator: Performance study with involuntary eye movement (United States)

    Huang, Hongxin; Toyoda, Haruyoshi; Inoue, Takashi


    The performance of an adaptive optics scanning laser ophthalmoscope (AO-SLO) using a liquid crystal on silicon spatial light modulator and Shack-Hartmann wavefront sensor was investigated. The system achieved high-resolution and high-contrast images of human retinas by dynamic compensation for the aberrations in the eyes. Retinal structures such as photoreceptor cells, blood vessels, and nerve fiber bundles, as well as blood flow, could be observed in vivo. We also investigated involuntary eye movements and ascertained microsaccades and drifts using both the retinal images and the aberrations recorded simultaneously. Furthermore, we measured the interframe displacement of retinal images and found that during eye drift, the displacement has a linear relationship with the residual low-order aberration. The estimated duration and cumulative displacement of the drift were within the ranges estimated by a video tracking technique. The AO-SLO would not only be used for the early detection of eye diseases, but would also offer a new approach for involuntary eye movement research.

  3. In vivo quantification of microglia dynamics with a scanning laser ophthalmoscope in a mouse model of focal laser injury (United States)

    Alt, Clemens; Lin, Charles P.


    Microglia are the resident immune cells of the central nervous system and play a crucial role in maintaining neuronal health and function. Their dynamic behavior, that is, the constant extension and retraction of microglia processes, is thought to be critical for communication between microglia and their cellular neighbors, such as neurons, astrocytes and vascular endothelial cells. Here, we investigated the morphology and dynamics of retinal microglia in vivo under normal conditions and in response to focal laser injury of blood vessel endothelial wall, using a scanning laser ophthalmoscope (SLO) designed specifically for imaging the retina of live mice. The multichannel confocal imaging system allows retinal microstructure, such as the processes of microglia and retinal vasculature, to be visualized simultaneously. In order to generate focal laser injury, a photocoagulator based on a continuous wave (cw) laser was coupled into the SLO. An acousto-optic modulator chopped pulses from the cw laser. A tip-tilt-scanner was used to direct the laser beam into a blood vessel of interest under SLO image guidance. Mild coagulation was produced using millisecond-long pulses. Microglia react dynamically to focal laser injury of blood vessel endothelial walls. Under normal conditions, microglia somas remain stationary and the processes probe a territory of their immediate environment. In response to local injury, process movement velocity approximately doubles within minutes after injury. Moreover, the previously unpolarized process movement assumes a distinct directionality towards the injury site, indicating signaling between the injured tissue and the microglia. In vivo retinal imaging is a powerful tool for understanding the dynamic behavior of retinal cells.

  4. Cine recording ophthalmoscope (United States)

    Fitzgerald, J. W.


    Camera system provides accurate photographic recording during acceleration of centrifuge and permits immediate observation of dynamic changes in retinal circulation by a closed-circuit television loop. System consists of main camera, remote control unit, and strobe power supply unit, and is used for fluorescein studies and dynamometry sequences.

  5. Integrated adaptive optics optical coherence tomography and adaptive optics scanning laser ophthalmoscope system for simultaneous cellular resolution in vivo retinal imaging. (United States)

    Zawadzki, Robert J; Jones, Steven M; Pilli, Suman; Balderas-Mata, Sandra; Kim, Dae Yu; Olivier, Scot S; Werner, John S


    We describe an ultrahigh-resolution (UHR) retinal imaging system that combines adaptive optics Fourier-domain optical coherence tomography (AO-OCT) with an adaptive optics scanning laser ophthalmoscope (AO-SLO) to allow simultaneous data acquisition by the two modalities. The AO-SLO subsystem was integrated into the previously described AO-UHR OCT instrument with minimal changes to the latter. This was done in order to ensure optimal performance and image quality of the AO- UHR OCT. In this design both imaging modalities share most of the optical components including a common AO-subsystem and vertical scanner. One of the benefits of combining Fd-OCT with SLO includes automatic co-registration between two acquisition channels for direct comparison between retinal structures imaged by both modalities (e.g., photoreceptor mosaics or microvasculature maps). Because of differences in the detection scheme of the two systems, this dual imaging modality instrument can provide insight into retinal morphology and potentially function, that could not be accessed easily by a single system. In this paper we describe details of the components and parameters of the combined instrument, including incorporation of a novel membrane magnetic deformable mirror with increased stroke and actuator count used as a single wavefront corrector. We also discuss laser safety calculations for this multimodal system. Finally, retinal images acquired in vivo with this system are presented.

  6. EYESi ophthalmoscope - a simulator for indirect ophthalmoscopic examinations. (United States)

    Schuppe, Oliver; Wagner, Clemens; Koch, Frank; Männer, Reinhard


    We present a training simulator for indirect ophthalmoscopy. An optical tracking system is used to reconstruct the position of a lens mockup and a model of the patient's face. Refraction and illumination are computed in real-time and displayed on a head-mounted display using augmented reality. A case database completes the training system which allows to practise the examination and to study clinical patterns.

  7. Morphometric Optic Nerve Head Analysis in Glaucoma Patients: A Comparison between the Simultaneous Nonmydriatic Stereoscopic Fundus Camera (Kowa Nonmyd WX3D and the Heidelberg Scanning Laser Ophthalmoscope (HRT III

    Directory of Open Access Journals (Sweden)

    Siegfried Mariacher


    Full Text Available Purpose. To investigate the agreement between morphometric optic nerve head parameters assessed with the confocal laser ophthalmoscope HRT III and the stereoscopic fundus camera Kowa nonmyd WX3D retrospectively. Methods. Morphometric optic nerve head parameters of 40 eyes of 40 patients with primary open angle glaucoma were analyzed regarding their vertical cup-to-disc-ratio (CDR. Vertical CDR, disc area, cup volume, rim volume, and maximum cup depth were assessed with both devices by one examiner. Mean bias and limits of agreement (95% CI were obtained using scatter plots and Bland-Altman analysis. Results. Overall vertical CDR comparison between HRT III and Kowa nonmyd WX3D measurements showed a mean difference (limits of agreement of −0.06 (−0.36 to 0.24. For the CDR < 0.5 group (n=24 mean difference in vertical CDR was −0.14 (−0.34 to 0.06 and for the CDR ≥ 0.5 group (n=16 0.06 (−0.21 to 0.34. Conclusion. This study showed a good agreement between Kowa nonmyd WX3D and HRT III with regard to widely used optic nerve head parameters in patients with glaucomatous optic neuropathy. However, data from Kowa nonmyd WX3D exhibited the tendency to measure larger CDR values than HRT III in the group with CDR < 0.5 group and lower CDR values in the group with CDR ≥ 0.5.

  8. Desenvolvimento e resultados preliminares de um sistema cromático de iluminação para oftalmoscópios indiretos Development and preliminary results of a chromatic illumination system for indirect ophthalmoscopes

    Directory of Open Access Journals (Sweden)

    Thiago Bellini Oliveira


    ção cromático, acreditamos que em uma próxima etapa possamos verificar as vantagens e/ou desvantagem desta técnica no diagnóstico de diferentes patologias da retina.PURPOSE: Chromatic contrast is a technique used in some areas of medicine to provide better visualization of biological tissues. Based on principles of color composition, a new illumination system was constructed using colored emitting diodes to reproduce the spectral range of visible light. This technique was devised to be used in indirect ophthalmoscopes to improve the visualization of the posterior segment of the eye. METHODS: The original illumination system of a general purpose indirect ophthalmoscope was substituted by a system of color-emitting diodes. RESULTS: Using an electronic interface it was possible to control the intensity of the color lights and therefore generate different wavelengths in the visible spectrum of the light. Preliminary tests undertaken in a mechanical model of the human eye generated very clear and homogenous colors. However in vivo examinations with patients were performed in our laboratory at the IFSC-USP and UNIFESP, and obtained the preliminary results show the possibilities of the chromatic contrast technique, and may represent in the future a differential in the analyses of the posterior segment of the eye. CONCLUSION: The use of color-emitting diodes to reproduce the spectral range of the visible light in indirect ophthalmoscopes seems to be a promising technological advance in the fundoscopy of the eye. This is an innovation that can yield better quality examinations with indirect ophthalmoscopes.

  9. Endocular ophthalmoscope: miniaturization and optical imaging quality (United States)

    Rol, Pascal O.; Beck, Dominik; Niederer, Peter F.


    Endoscopy is a novel method of observation in ocular surgery. It allows a direct viewing of certain internal structures of the eye which can not be seen through conventional slit lamp/microscope arrangements like the back side of the iris, the posterior chamber or the fixation area of an IOL. In addition such an instrument is useful in exploratory orbital surgery because it allows for examination of the scleral wall, the 6 motor muscles and the optic nerve sheet with minimal trauma to the eye. An endoscopic system can therefore be helpful to check regions which can not be reached easily during surgery, such as the ciliary body or the pars plana. When a transparent structure of the eye becomes turbid, e.g., a hazy cornea, observation is impaired and endoscopy could also provide a solution though it is an invasive method.

  10. Optimization of confocal scanning laser ophthalmoscope design. (United States)

    LaRocca, Francesco; Dhalla, Al-Hafeez; Kelly, Michael P; Farsiu, Sina; Izatt, Joseph A


    Confocal scanning laser ophthalmoscopy (cSLO) enables high-resolution and high-contrast imaging of the retina by employing spatial filtering for scattered light rejection. However, to obtain optimized image quality, one must design the cSLO around scanner technology limitations and minimize the effects of ocular aberrations and imaging artifacts. We describe a cSLO design methodology resulting in a simple, relatively inexpensive, and compact lens-based cSLO design optimized to balance resolution and throughput for a 20-deg field of view (FOV) with minimal imaging artifacts. We tested the imaging capabilities of our cSLO design with an experimental setup from which we obtained fast and high signal-to-noise ratio (SNR) retinal images. At lower FOVs, we were able to visualize parafoveal cone photoreceptors and nerve fiber bundles even without the use of adaptive optics. Through an experiment comparing our optimized cSLO design to a commercial cSLO system, we show that our design demonstrates a significant improvement in both image quality and resolution.

  11. Adaptive optics scanning laser ophthalmoscope imaging: technology update. (United States)

    Merino, David; Loza-Alvarez, Pablo


    Adaptive optics (AO) retinal imaging has become very popular in the past few years, especially within the ophthalmic research community. Several different retinal techniques, such as fundus imaging cameras or optical coherence tomography systems, have been coupled with AO in order to produce impressive images showing individual cell mosaics over different layers of the in vivo human retina. The combination of AO with scanning laser ophthalmoscopy has been extensively used to generate impressive images of the human retina with unprecedented resolution, showing individual photoreceptor cells, retinal pigment epithelium cells, as well as microscopic capillary vessels, or the nerve fiber layer. Over the past few years, the technique has evolved to develop several different applications not only in the clinic but also in different animal models, thanks to technological developments in the field. These developments have specific applications to different fields of investigation, which are not limited to the study of retinal diseases but also to the understanding of the retinal function and vision science. This review is an attempt to summarize these developments in an understandable and brief manner in order to guide the reader into the possibilities that AO scanning laser ophthalmoscopy offers, as well as its limitations, which should be taken into account when planning on using it.

  12. Adaptive optics scanning laser ophthalmoscope imaging: technology update

    Directory of Open Access Journals (Sweden)

    Merino D


    Full Text Available David Merino, Pablo Loza-Alvarez The Institute of Photonic Sciences (ICFO, The Barcelona Institute of Science and Technology, Castelldefels, Barcelona, Spain Abstract: Adaptive optics (AO retinal imaging has become very popular in the past few years, especially within the ophthalmic research community. Several different retinal techniques, such as fundus imaging cameras or optical coherence tomography systems, have been coupled with AO in order to produce impressive images showing individual cell mosaics over different layers of the in vivo human retina. The combination of AO with scanning laser ophthalmoscopy has been extensively used to generate impressive images of the human retina with unprecedented resolution, showing individual photoreceptor cells, retinal pigment epithelium cells, as well as microscopic capillary vessels, or the nerve fiber layer. Over the past few years, the technique has evolved to develop several different applications not only in the clinic but also in different animal models, thanks to technological developments in the field. These developments have specific applications to different fields of investigation, which are not limited to the study of retinal diseases but also to the understanding of the retinal function and vision science. This review is an attempt to summarize these developments in an understandable and brief manner in order to guide the reader into the possibilities that AO scanning laser ophthalmoscopy offers, as well as its limitations, which should be taken into account when planning on using it. Keywords: high-resolution, in vivo retinal imaging, AOSLO

  13. A confocal scanning laser ophthalmoscope for retinal vessel oximetry (United States)

    Lompado, Arthur

    Measurement of a person's blood oxygen saturation has long been recognized as a useful metric for the characterizing ailments ranging from chronic respiratory disorders to acute, potentially life threatening, traumas. The ubiquity of oxygen saturation monitors in the medical field, including portable pulse oximeters and laboratory based CO-oximeters, is a testament to the importance of this technique. The work presented here documents the design, fabrication and development of a unique type of oxygen saturation monitor, a confocal scanning retinal vessel oximeter, with the potential to expand the usefulness of the present devices. A large part of the knowledge base required to construct the instrument comes from the consideration of light scattering by red blood cells in a blood vessel. Therefore, a substantial portion of this work is devoted to the process of light scattering by whole human blood and its effects on the development of a more accurate oximeter. This light scattering effect has been both measured and modeled stochastically to determine its contribution to the measured oximeter signal. It is shown that, although well accepted in the published literature, the model only correlates marginally to the measurements due to inherent limitations imposed by the model assumptions. Nonetheless, enough material has been learned about the scattering to allow development of a mathematical model for the interaction of light with blood in a vessel, and this knowledge has been applied to the data reduction of the present oximeter. This data reduction technique has been tested in a controlled experiment employing a model eye with a blood filled mock retinal vessel. It will be shown that the presently developed technique exhibited strong correlation between the known blood oxygen saturation and that calculated by the new system.

  14. Precision targeting with a tracking adaptive optics scanning laser ophthalmoscope (United States)

    Hammer, Daniel X.; Ferguson, R. Daniel; Bigelow, Chad E.; Iftimia, Nicusor V.; Ustun, Teoman E.; Noojin, Gary D.; Stolarski, David J.; Hodnett, Harvey M.; Imholte, Michelle L.; Kumru, Semih S.; McCall, Michelle N.; Toth, Cynthia A.; Rockwell, Benjamin A.


    Precise targeting of retinal structures including retinal pigment epithelial cells, feeder vessels, ganglion cells, photoreceptors, and other cells important for light transduction may enable earlier disease intervention with laser therapies and advanced methods for vision studies. A novel imaging system based upon scanning laser ophthalmoscopy (SLO) with adaptive optics (AO) and active image stabilization was designed, developed, and tested in humans and animals. An additional port allows delivery of aberration-corrected therapeutic/stimulus laser sources. The system design includes simultaneous presentation of non-AO, wide-field (~40 deg) and AO, high-magnification (1-2 deg) retinal scans easily positioned anywhere on the retina in a drag-and-drop manner. The AO optical design achieves an error of third generation retinal tracking system achieves a bandwidth of greater than 1 kHz allowing acquisition of stabilized AO images with an accuracy of ~10 μm. Normal adult human volunteers and animals with previously-placed lesions (cynomolgus monkeys) were tested to optimize the tracking instrumentation and to characterize AO imaging performance. Ultrafast laser pulses were delivered to monkeys to characterize the ability to precisely place lesions and stimulus beams. Other advanced features such as real-time image averaging, automatic highresolution mosaic generation, and automatic blink detection and tracking re-lock were also tested. The system has the potential to become an important tool to clinicians and researchers for early detection and treatment of retinal diseases.

  15. Statistical analysis of ocular monochromatic aberrations in Chinese population for adaptive optics ophthalmoscope design

    Directory of Open Access Journals (Sweden)

    Junlei Zhao


    Full Text Available It is necessary to know the distribution of the Chinese eye’s aberrations in clinical environment to guide high-resolution retinal imaging system design for large Chinese population application. We collected the monochromatic wave aberration of 332 healthy eyes and 344 diseased eyes in Chinese population across a 6.0-mm pupil. The aberration statistics of Chinese eyes including healthy eyes and diseased eyes were analyzed, and some differences of aberrations between the Chinese and European race were concluded. On this basis, the requirement for adaptive optics (AO correction of the Chinese eye’s monochromatic aberrations was analyzed. The result showed that a stroke of 20μm and ability to correct aberrations up to the 8th Zernike order were needed for reflective wavefront correctors to achieve near diffraction-limited imaging in both groups for a reference wavelength of 550nm and a pupil diameter of 6.0mm. To verify the analysis mentioned above, an AO flood-illumination system was established, and high-resolution retinal imaging in vivo was achieved for Chinese eye including both healthy and diseased eyes.

  16. De-warping of images and improved eye tracking for the scanning laser ophthalmoscope. (United States)

    Bedggood, Phillip; Metha, Andrew


    A limitation of scanning laser ophthalmoscopy (SLO) is that eye movements during the capture of each frame distort the retinal image. Various sophisticated strategies have been devised to ensure that each acquired frame can be mapped quickly and accurately onto a chosen reference frame, but such methods are blind to distortions in the reference frame itself. Here we explore a method to address this limitation in software, and demonstrate its accuracy. We used high-speed (200 fps), high-resolution (~1 μm), flood-based imaging of the human retina with adaptive optics to obtain "ground truth" information on the retinal image and motion of the eye. This information was used to simulate SLO video sequences at 20 fps, allowing us to compare various methods for eye-motion recovery and subsequent minimization of intra-frame distortion. We show that a) a single frame can be near-perfectly recovered with perfect knowledge of intra-frame eye motion; b) eye motion at a given time point within a frame can be accurately recovered by tracking the same strip of tissue across many frames, due to the stochastic symmetry of fixational eye movements. This approach is similar to, and easily adapted from, previously suggested strip-registration approaches; c) quality of frame recovery decreases with amplitude of eye movements, however, the proposed method is affected less by this than other state-of-the-art methods and so offers even greater advantages when fixation is poor. The new method could easily be integrated into existing image processing software, and we provide an example implementation written in Matlab.

  17. Comparasion of Optic Nerve Head with Stereophotometric and Scanning Laser Ophthalmoscopic Imaging

    Directory of Open Access Journals (Sweden)

    Serek Tekin


    Full Text Available Aim: To compare theevaluation results of two experienced clinicians about examination of optic discs in glaucoma patients and healthy inidividuals by stereophotometry and scanning laser ophthalmoscopy. Material and Method: We studied 116 individuals (217 eyes who were divided as normal, glaucoma and suspected glaucoma in numbers of 54, 42 and 20 respectively. Stereophotometric photographs of optic disc were examined with fundus camera (Zeiss, FF 450 plus. Optic disc was also evaluated with HRT-3 in the same visit. Two experienced clinicians evaluated the cup/disc ratios and whether the optic discs were glaucomatous or not. Evaluation results were analysed and compared with HRT-3 examinations. Results:There were no significant age and gende rdifferences between the groups(p>0.05.Stereophotographic C/D ratio correlations between the clinicians were 0.79 (p

  18. Characterization of single-file flow through human retinal parafoveal capillaries using an adaptive optics scanning laser ophthalmoscope. (United States)

    Tam, Johnny; Tiruveedhula, Pavan; Roorda, Austin


    Adaptive Optics Scanning Laser Ophthalmoscopy was used to noninvasively acquire videos of single-file flow through live human retinal parafoveal capillaries. Videos were analyzed offline to investigate capillary flow dynamics. Certain capillaries accounted for a clear majority of leukocyte traffic (Leukocyte-Preferred-Paths, LPPs), while other capillaries primarily featured plasma gap flow (Plasma-Gap-Capillaries, PGCs). LPPs may serve as a protective mechanism to prevent inactivated leukocytes from entering exchange capillaries, and PGCs may serve as relief valves to minimize flow disruption due to the presence of a leukocyte in a neighboring LPP.

  19. [Cinematography of ocular fundus with a jointed optical system and tv or cine-camera (author's transl)]. (United States)

    Kampik, A; Rapp, J


    A method of Cinematography of the ocular fundus is introduced which--by connecting a camera with an indirect ophthalmoscop--allows to record the monocular picture of the fundus as produced by the ophthalmic lens.

  20. 21 CFR 886.1250 - Euthyscope. (United States)


    ... that is a modified AC-powered or battery-powered ophthalmoscope (a perforated mirror device intended to... the fundus of the eye. The center of the light bundle is blocked by a black disk covering the...

  1. Photoreceptor atrophy in acute zonal occult outer retinopathy

    DEFF Research Database (Denmark)

    Zibrandtsen, N.; Munch, I.C.; Klemp, K.


    PURPOSE: To assess retinal morphology in acute zonal occult outer retinopathy (AZOOR) without ophthalmoscopically visible fundus changes. METHODS: Retrospective case series. Two consecutive patients with bilateral AZOOR with photopsia corresponding to areas of visual field loss and a normal fundus...

  2. Photoreceptor atrophy in acute zonal occult outer retinopathy

    DEFF Research Database (Denmark)

    Zibrandtsen, N.; Munch, I.C.; Klemp, K.


    To assess retinal morphology in acute zonal occult outer retinopathy (AZOOR) without ophthalmoscopically visible fundus changes. Retrospective case series. Two consecutive patients with bilateral AZOOR with photopsia corresponding to areas of visual field loss and a normal fundus appearance were...

  3. Photoreceptor atrophy in acute zonal occult outer retinopathy

    DEFF Research Database (Denmark)

    Zibrandtsen, N.; Munch, I.C.; Klemp, K.


    Purpose: To assess retinal morphology in acute zonal occult outer retinopathy (AZOOR). Methods: Three patients with a normal ophthalmoscopic fundus appearance, a history of photopsia, and visual field loss compatible with AZOOR were examined using optical coherence tomography, automated perimetry...

  4. A slowly progressive retinopathy in the Shetland Sheepdog. (United States)

    Karlstam, Lena; Hertil, Eva; Zeiss, Caroline; Ropstad, Ernst Otto; Bjerkås, Ellen; Dubielzig, Richard R; Ekesten, Björn


    To describe a slowly progressive retinopathy (SPR) in Shetland Sheepdogs. Animals  Forty adult Shetlands Sheepdogs with ophthalmoscopic signs of SPR and six normal Shetland Sheepdogs were included in the study. Ophthalmic examination including slit-lamp biomicroscopy and ophthalmoscopy was performed in all dogs. Electroretinograms and obstacle course-test were performed in 13 affected and 6 normal dogs. The SPR dogs were subdivided into two groups according to their dark-adapted b-wave amplitudes. SPR1-dogs had ophthalmoscopic signs of SPR, but normal dark-adapted b-wave amplitudes. Dogs with both ophthalmoscopic signs and subnormal, dark-adapted b-wave amplitudes were assigned to group SPR2. Eyes from two SPR2 dogs were obtained for microscopic examination. The ophthalmoscopic changes included bilateral, symmetrical, greyish discoloration in the peripheral tapetal fundus with normal or marginally attenuated vessels. Repeated examination showed that the ophthalmoscopic changes slowly spread across the central parts of the tapetal fundus, but did not progress to obvious neuroretinal thinning presenting as tapetal hyper-reflectivity. The dogs did not appear seriously visually impaired. SPR2 showed significantly reduced b-wave amplitudes throughout dark-adaptation. Microscopy showed thinning of the outer nuclear layer and abnormal appearance of rod and cone outer segments. Testing for the progressive rod-cone degeneration ( prcd )-mutation in three dogs with SPR was negative. Slowly progressive retinopathy is a generalized rod-cone degeneration that on ophthalmoscopy looks similar to early stages of progressive retinal atrophy. The ophthalmoscopic findings are slowly progressive without tapetal hyper-reflectivity. Visual impairment is not obvious and the electroretinogram is more subtly altered than in progressive retinal atrophy. The etiology remains unclear. SPR is not caused by the prcd-mutation. © 2011 American College of Veterinary Ophthalmologists.

  5. Thomas Clifford Allbutt and Comparative Pathology (United States)

    Leung, Danny C. K.


    This paper reconceptualizes Thomas Clifford Allbutt's contributions to the making of scientific medicine in late nineteenth-century England. Existing literature on Allbutt usually describes his achievements, such as his design of the pocket thermometer and his advocacy of the use of the ophthalmoscope in general medicine, as independent events;…

  6. Fundus reflectance : historical and present ideas

    NARCIS (Netherlands)

    Berendschot, T.T.J.M.; Delint, P.J.; Norren, D. van


    In 1851 Helmholtz introduced the ophthalmoscope. The instrument allowed the observation of light reflected at the fundus. The development of this device was one of the major advancements in ophthalmology. Yet ophthalmoscopy allows only qualitative observation of the eye. Since 1950 attempts were mad

  7. Methodology for studies on medical therapy of cataracts : cataract II

    Directory of Open Access Journals (Sweden)

    Sharma Y


    Full Text Available The methodology for testing any possible effect of potential anti-cataract agents is described. This is based on slit lamp and ophthalmoscopic cataract classification and on visual acuity. The difficulties encountered in such studies are highlighted. The presented methodology is suggested to be fairly adequate in assessing usefulness of any possible medical therapy of cataracts.

  8. Anatomy of the retinal nerve fiber layer. (United States)

    Radius, R L; de Bruin, J


    Anatomy of the retinal nerve fiber layer in rabbit eyes is studied by light microscopy, transmission electron microscopy, and scanning electron microscopy. It is demonstrated that retinal striations noted ophthalmoscopically in these eyes represent individual fiber bundles, Axon bundles are compartmentalized within tissue tunnels comprised of elongated processes of glial cell origin.

  9. [Sex-linked juvenile retinoschisis]. (United States)

    François, P; Turut, P; Soltysik, C; Hache, J C


    About 13 observations of sexe linked juvenile retinoschisis, the authors describe the ophthalmoscopic, fluorographic and functional aspects of the disease whose caracteristics are:--its sexe linked recessive heredity; --its clinical characterestics associating: a microcystic macular degeneration, peripheral retinal lesions, vitreous body alterations, --an electroretinogram of the negative type.

  10. Spectral domain optical coherence tomography and microperimetry in foveal hypoplasia

    Directory of Open Access Journals (Sweden)

    Swakshyar Saumya Pal


    Full Text Available A case of foveal hypoplasia associated with ocular albinism with anatomic and functional changes by various techniques using spectral domain optical coherence tomography (SD-OCT, microperimeter and confocal scanning laser ophthalmoscope is described. This case highlights the importance of microperimeter in detecting the functional abnormalities of vision and SD-OCT in identifying the retinal laminar abnormalities in foveal hypoplasia.

  11. [Difficulties of diagnosis in a case of optic nerve drusen]. (United States)

    Munteanu, M; Munteanu, G


    This paper presents a particullary case of optic nervue drusen. Ophthalmoscopic features (superficial drusen in one eye and deep drusen in another), clinical association with anisometropia and ambliopia, wrong interpretation of PEV and tomodensitometry mod to diagnostic confusion, supplementary investigations, prolonged and expensive treatment.

  12. Congenital optic tract hypoplasia. (United States)

    Hatsukawa, Yoshikazu; Fujio, Takahiro; Nishikawa, Masanori; Taylor, David


    We report a case of isolated unilateral optic tract hypoplasia, described only twice previously. Bilateral optic disk hypoplasia was seen ophthalmoscopically and visual field studies showed an incongruous right homonymous hemianopia. Magnetic resonance imaging showed bilateral hypoplasia of both optic nerves and the left optic tract. Spectral domain optical coherence tomography mapping correlated well with the visual field studies.

  13. Seeing for People Who Are Blind. (United States)

    Goldring, Elizabeth


    Describes the Scanning Laser Ophthalmoscope (SLO) and how it can help people who are visually challenged use their sense of sight. Suggests uses in higher education where it can be modified to individual needs; explains the language of seeing; discusses the use of virtual reality to create spatial animation; and outlines future developments. (LRW)

  14. Simultaneous dual wavelength eye-tracked ultrahigh resolution retinal and choroidal optical coherence tomography

    DEFF Research Database (Denmark)

    Unterhuber, A.; Povaay, B.; Müller, André;


    We demonstrate an optical coherence tomography device that simultaneously combines different novel ultrabroad bandwidth light sources centered in the 800 and 1060 nm regions, operating at 66 kHz depth scan rate, and a confocal laser scanning ophthalmoscope-based eye tracker to permit motion-artif...

  15. Peripheral Exudative Hemorrhagic Chorioretinopathy: A Variant of Polypoidal Choroidal Vasculopathy?

    Directory of Open Access Journals (Sweden)

    Arman Mashayekhi


    Full Text Available Purpose: To report a case of peripheral exudative hemorrhagic chorioretinopathy (PEHCR in an elderly patient. Case Report: A 74-year-old Caucasian woman, with a 20-year history of a stable choroidal nevus in her right eye, was referred for evaluation of two small hemorrhagic pigment epithelial detachments (PEDs affecting the temporal peripheral fundus of the same eye. Nine months later, the lesions became larger and indocyanine green angiography revealed polypoidal choroidal vascular changes corresponding to the location of the ophthalmoscopically visible PEDs. Despite one session of verteporfin photodynamic therapy, the lesions continued to enlarge eventually resulting in the development of a large hemorrhagic PED, which failed to respond to two subsequent injections of intravitreal bevacizumab. The final ophthalmoscopic appearance of the large hemorrhagic PED was typical of PEHCR. Conclusion: This case suggests that polypoidal choroidal vascular changes similar to that seen in our patient may underlie the development of PEHCR in some cases.

  16. Fundus imaging with a mobile phone: A review of techniques

    Directory of Open Access Journals (Sweden)

    Mahesh P Shanmugam


    Full Text Available Fundus imaging with a fundus camera is an essential part of ophthalmic practice. A mobile phone with its in-built camera and flash can be used to obtain fundus images of reasonable quality. The mobile phone can be used as an indirect ophthalmoscope when coupled with a condensing lens. It can be used as a direct ophthalmoscope after minimal modification, wherein the fundus can be viewed without an intervening lens in young patients with dilated pupils. Employing the ubiquitous mobile phone to obtain fundus images has the potential for mass screening, enables ophthalmologists without a fundus camera to document and share findings, is a tool for telemedicine and is rather inexpensive.

  17. Differentiating full thickness macular holes from impending macular holes and macular pseudoholes


    Tsujikawa, M; Ohji, M; Fujikado, T.; Saito, Y.; Motokura, M.; Ishimoto, I.; Tano, Y.


    AIMS—The reliability of scanning laser ophthalmoscope (SLO) microperimetry in differentiating full thickness macular holes from macular pseudoholes and impending macular holes was evaluated.
METHODS—106 eyes with the clinical diagnosis of full thickness macular holes, macular pseudoholes, and impending (stage 1) macular holes were examined for the presence of deep or relative scotoma using SLO microperimetry. The relation between these scotomas and the clinical diagnosis was studied.

  18. Nocturnal Visual Orientation in Flying Insects: A Benchmark for the Design of Vision-Based Sensors in Micro-Aerial Vehicles (United States)


    motor video camera specimen worm gear light source An ophthalmoscope consisting of a video camera with an attached light source is mounted on a cardan ...Fig. 45), covering 75 , such that their optical axes intersected at the centre of the circle. The arrangement is attached to a cardan arm, allowing...on a cardan arm that allowed manual adjustment to the maximum response in elevation, prior to application of the stimulus. Analogous

  19. Hvid pupil hos børn kan være tegn på alvorlig øjensygdom

    DEFF Research Database (Denmark)

    Hansen, Michael Stormly; Ostri, Christoffer


    A whitish pupillary reflex (leukocoria) indicates abnormal reflection from intraocular pathology. In a child, leukocoria may be a sign of serious and even life-threatening eye disease (retinoblastoma), but the most common cause is congenital cataract. Both diagnoses require immediate referral to ...... to an ophthalmologist. Leukocoria is best detected by evaluating the reflex from the pupil with a handheld ophthalmoscope. We here present a case story of an infant with leukocoria that proved to be caused by unilateral congenital cataract....

  20. Red blood cell antioxidant enzymes in age-related macular degeneration.


    De La Paz, M A; Zhang, J; Fridovich, I


    AIMS/BACKGROUND: Oxidative damage has been proposed to be involved in the pathogenesis of age-related macular degeneration (ARMD). The purpose of this study was to evaluate whether red blood cell antioxidant enzyme activity correlates with severity of aging maculopathy in affected individuals. METHODS: Blood samples were obtained from 54 patients with varying severity of aging maculopathy and 12 similarly aged individuals with normal ophthalmoscopic examination. Macular findings were graded a...

  1. Reading strategies in Stargardt's disease with foveal sparing


    Goldschmidt, Mira; Déruaz, Anouk; Lorincz, Erika N; Whatham, Andrew R; Mermoud, Christophe; Safran, Avinoam B


    ABSTRACT: BACKGROUND: Subjects with a ring scotoma can use two retinal loci, a foveal and a peripheral, for reading. Our aim was to investigate the relative use of both retinal loci as a function of the spared foveal area size and the spatial resolution at both retinal loci. FINDINGS: Two patients with Stargardt's disease and ring scotomas read through a scanning laser ophthalmoscope a series of letters and words at various character sizes. The number of fixations made using each retinal locu...

  2. Reading strategies in Stargardt's disease with foveal sparing


    Whatham Andrew R; Lorincz Erika N; Déruaz Anouk; Goldschmidt Mira; Mermoud Christophe; Safran Avinoam B


    Abstract Background Subjects with a ring scotoma can use two retinal loci, a foveal and a peripheral, for reading. Our aim was to investigate the relative use of both retinal loci as a function of the spared foveal area size and the spatial resolution at both retinal loci. Findings Two patients with Stargardt's disease and ring scotomas read through a scanning laser ophthalmoscope a series of letters and words at various character sizes. The number of fixations made using each retinal locus w...

  3. Retinopathy of prematurity in a Danish neonatal intensive care unit, 1985-1991

    DEFF Research Database (Denmark)

    Arrøe, M; Peitersen, Birgit


    During the 7 year period 1985 to 1991, 170 infants born in Hvidovre Hospital, Denmark, with birthweight out. Forty-five infants had ophthalmoscopic evidence of retinopathy......, or mode of delivery. Significant difference was found in gestational age, asphyxia, intensive treatment and complications. Particularly infants with ROP born with gestational age 27 to 29 weeks needed prolonged and more intensive treatment than infants without ROP. Infants with ROP had more frequently...

  4. [Heterotopic fundus (author's transl)]. (United States)

    Denden, A


    Fundus heterotopicus is the term used to describe a rare, non-hereditary curvature anomaly of the fundus in the non-myopic eye, which is characterized: 1. functionally, by a slowly increasing myopic-astigmatic refractive error, 2. by correctable bitemporal or binasal refractionscomata and 3. ophthalmoscopically by a posterior out-pouching of the nasal or temporal fundus portions, and including the optic disc and macula in the obliquely descending wall of the extasis.

  5. Simple, Inexpensive Technique for High-Quality Smartphone Fundus Photography in Human and Animal Eyes


    Haddock, Luis J.; Kim, David Y.; Shizuo Mukai


    Purpose. We describe in detail a relatively simple technique of fundus photography in human and rabbit eyes using a smartphone, an inexpensive app for the smartphone, and instruments that are readily available in an ophthalmic practice. Methods:. Fundus images were captured with a smartphone and a 20D lens with or without a Koeppe lens. By using the coaxial light source of the phone, this system works as an indirect ophthalmoscope that creates a digital image of the fundus. The application wh...

  6. Interactive segmentation for geographic atrophy in retinal fundus images


    Lee, Noah; SMITH, R. THEODORE; Laine, Andrew F.


    Fundus auto-fluorescence (FAF) imaging is a non-invasive technique for in vivo ophthalmoscopic inspection of age-related macular degeneration (AMD), the most common cause of blindness in developed countries. Geographic atrophy (GA) is an advanced form of AMD and accounts for 12–21% of severe visual loss in this disorder [3]. Automatic quantification of GA is important for determining disease progression and facilitating clinical diagnosis of AMD. The problem of automatic segmentation of patho...

  7. Holographic laser Doppler ophthalmoscopy

    CERN Document Server

    Simonutti, Manuel; Sahel, J A; Gross, Michel; Samson, Benjamin; Magnain, Caroline; Atlan, Michael; 10.1364/OL.35.001941


    We report laser Doppler ophthalmoscopic fundus imaging in the rat eye with near-IR heterodyne holography. Sequential sampling of the beat of the reflected radiation against a frequency-shifted optical local oscillator is made onto an array detector. Wide-field maps of fluctuation spectra in the 10 Hz to 25 kHz band exhibit angiographic contrasts in the retinal vascular tree without requirement of an exogenous marker.

  8. Accidental human laser retinal injuries from military laser systems (United States)

    Stuck, Bruce E.; Zwick, Harry; Molchany, Jerome W.; Lund, David J.; Gagliano, Donald A.


    The time course of the ophthalmoscopic and functional consequences of eight human laser accident cases from military laser systems is described. All patients reported subjective vision loss with ophthalmoscopic evidence of retinal alteration ranging from vitreous hemorrhage to retinal burn. Five of the cases involved single or multiple exposures to Q-switched neodymium radiation at close range whereas the other three incidents occur over large ranges. Most exposures were within 5 degrees of the foveola, yet none directly in the foveola. High contrast visual activity improved with time except in the cases with progressive retinal fibrosis between lesion sites or retinal hole formation encroaching the fovea. In one patient the visual acuity recovered from 20/60 at one week to 20/25 in four months with minimal central visual field loss. Most cases showed suppression of high and low spatial frequency contrast sensitivity. Visual field measurements were enlarged relative to ophthalmoscopic lesion size observations. Deep retinal scar formation and retinal traction were evident in two of the three cases with vitreous hemorrhage. In one patient, nerve fiber layer damage to the papillo-macular bundle was clearly evident. Visual performance measured with a pursuit tracking task revealed significant performance loss relative to normal tracking observers even in cases where acuity returned to near normal levels. These functional and performance deficits may reflect secondary effects of parafoveal laser injury.

  9. Imaging of long-term retinal damage after resolved cotton wool spots (United States)

    Gomez, Maria Laura; Mojana, Francesca; Bartsch, Dirk-Uwe; Freeman, William R.


    Purpose Human Immunodeficiency Virus (HIV) patients develop non-infectious retinopathy characterized by retinal cotton wool spots (CWS) and micro vascular abnormalities. Ophthalmoscopically CWS fade with time. We hypothesized that structural changes should be permanent and possibly visible well after ophthalmoscopic resolution. We used simultaneous spectral domain optical coherence tomography/ scanning laser ophthalmoscope (SD-OCT/SLO) to allow co-localization of the lesions and determine the extent and location of residual damage after ophthalmoscopic resolution of the lesions. Design Retrospective, non-interventional case series. Participants Eight eyes of seven human immunodeficiency virus (HIV) patients with nineteen resolved retinal cotton wool spots. Methods Nineteen retinal cotton wool spots were imaged between 2 and 16 (median 7.84) years after the acute lesions using simultaneous SD-OCT and scanning laser ophthalmoscope (SLO) examinations. The areas of the previous CWS were scanned by overlaying the color retinal image over the SLO image and scanning at high resolution in the horizontal plane thru the resolved lesion. Each CWS lesion had a control area taken from the same eye within 2 disc diameters of the lesion. The thickness of each of the retinal layers was compared between lesions and control areas using a paired t-test using multi-test correction. Main Outcome Measures Thickness of the retinal nerve fiber layer (NFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL) and outer nuclear (ONL) layers. Results The largest loss of thickness was seen in the retinal GCL with a 43% reduction in thickness. There was a statistically significant thinning of the retinal NFL, GCL, IPL, INL and OPL. The median thickness differences ranged from 5 to 7 microns. This difference was highly statistically significant. Another striking finding was the displacement of the ONL towards the retinal surface

  10. Threshold determinations for selective retinal pigment epithelium damage with repetitive pulsed microsecond laser systems in rabbits. (United States)

    Framme, Carsten; Schuele, Georg; Roider, Johann; Kracht, Dietmar; Birngruber, Reginald; Brinkmann, Ralf


    In both clinical and animal studies, it has been shown that repetitive short laser pulses can cause selective retinal pigment epithelium damage (RPE) with sparing of photoreceptors. Our purpose was to determine the ophthalmoscopic and angiographic damage thresholds as a function of pulse durations by using different pulsed laser systems to optimize treatment modalities. Chinchilla-breed rabbits were narcotized and placed in a special holding system. Laser lesions were applied using a commercial laser slit lamp, contact lens, and irradiation with a frequency-doubled Nd:YLF laser (wave-length: 527 nm; repetition rate: 500 Hz; number of pulses: 100; pulse duration: 5 micros, 1.7 micros, 200 ns) and an argon-ion laser (514 nm, 500 Hz, 100 pulses, 5 micros and 200 ms). In all eyes, spots with different energies were placed into the regio macularis with a diameter of 102 microm (tophat profile). After treatment, fundus photography and fluorescein angiography were performed and radiant exposure for ED50 damage determined. Speckle measurements at the fiber tips were performed to determine intensity peaks in the beam profile. Using the Nd:YLF laser system, the ophthalmoscopic ED50 threshold energies were 25.4 microJ (5 micros), 32 microJ (1.7 micros), and 30 microJ (200 ns). The angiographic ED50 thresholds were 13.4 microJ (5 micros), 9.2 microJ (1.7 micros), and 6.7 microJ (200 ns). With the argon laser, the angiographic threshold for 5 micros pulses was 5.5 microJ. The ophthalmoscopic threshold could not be determined because of a lack of power; however, it was > 12 microJ. For 200 ms, the ED50 radiant exposures were 20.4 mW ophthalmoscopically and 19.2 mW angiographically. Speckle factors were found to be 1.225 for the Nd:YLF and 3.180 for the argon laser. Thus, the maximal ED50 -threshold radiant exposures for the Nd:YLF were calculated to be 362 mJ/cM2 (5 micros), 478 mJ/cm2 (1.7 micros), and 438 mJ/cm2 (200 ns) ophthalmoscopically. Angiographically, the thresholds

  11. [Developments and inventions from Germany : Influence on international ophthalmology]. (United States)

    Müller, M; Pavlovic, I; Schmack, I; Ohrloff, C; Kohnen, T


    There are various developments and inventions from Germany that have influenced not only the domestic but also the international field of ophthalmology. Beginning with the invention of the ophthalmoscope by Hermann von Helmholtz in 1850, to the establishment of the "Archives of Ophthalmology" medical journal, a publication founded by Albrecht von Graefe in 1854, through to the development of the retinal chip by Eberhart Zrenner and colleagues with the first clinical data collected in 2007. The abovenamed and further developments and the German ophthalmologists behind these inventions are discussed in more detail.

  12. Science & Technology Review October 2007

    Energy Technology Data Exchange (ETDEWEB)

    Chinn, D J


    Livermore researchers won five R&D 100 awards in R&D Magazine's annual competition for the top 100 industrial innovations worldwide. This issue of Science & Technology Review highlights the award-winning technologies: noninvasive pneumothorax detector, microelectromechanical system-based adaptive optics scanning laser ophthalmoscope, large-area imager, hyper library of linear solvers, and continuous-phase-plate optics system manufactured using magnetorheological finishing. Since 1978, Laboratory researchers have received 118 R&D 100 awards. The R&D 100 logo (on the cover and p 1) is reprinted courtesy of R&D Magazine.

  13. Ocular Onchocerciasis in the Yanomami Communities from Brazilian Amazon: Effects on Intraocular Pressure (United States)

    Herzog-Neto, Guilherme; Jaegger, Karen; do Nascimento, Erika S.; Marchon-Silva, Verônica; Banic, Dalma M.; Maia-Herzog, Marilza


    To determine the influence of onchocercal eye disease on the intraocular pressure of the Yanomami Tribe Aratha-ú of Roraima State, Brazil, considered endemic for onchocerciasis, a total of 86 patients were submitted to an ophthalmologic exam that included external examination, slit lamp examination, intraocular pressure measurement, and a fundus ophthalmoscope examination. A high prevalence of onchocerciasis-related eye lesions was encountered in 68.6% of the patients. Punctate keratitis and microfilariae in the anterior chamber were found in ∼28%. The mean of intraocular eye pressure found was 10.47 mm of Hg. PMID:24297812

  14. Nevus of Ota: clinical-ophthalmological findings


    Sebastião Cronemberger; Nassim Calixto; Henrique Leite Freitas


    OBJECTIVE: To analyze the clinical and ophthalmological findings of patients with nevus of Ota. METHODS: Retrospective analysis of patients' charts with nevus of Ota. We registered the demographic data, location of the nevus and date of appearance, family history of similar spots, biomicroscopic, gonioscopic, tonometric, ophthalmoscopic and perimetric findings. RESULTS: We included 14 patients, six (43.0%) men and eight (57.0%) women, with a mean age of 21.7±17.5 years. Ten (71%) were mulatt...

  15. Replication of the Scrapie Agent in Ocular Neural Tissues (United States)

    Buyukmihci, Ned; Rorvik, Marie; Marsh, Richard F.


    Optic nerves and retinas removed from hamsters experimentally inoculated with the scrapie agent contain a high titer of infectivity. Ophthalmoscopic examination of these animals revealed gross lesions of retinopathy as early as 3 weeks before the onset of clinical signs of brain degeneration. These results suggest that the scrapie agent may spread centrifugally in nerve fibers after intracerebral inoculation and that the scrapie-associated retinopathy seen in hamsters is directly induced by the agent rather than the result of retrograde degeneration from central neural damage.

  16. Eye-tracking technology for real-time monitoring of transverse chromatic aberration (United States)

    Privitera, Claudio M.; Sabesan, Ramkumar; Winter, Simon; Tiruveedhula, Pavan; Roorda, Austin


    Objective measurements of transverse chromatic aberration (TCA) between two or more wavelengths with an adaptive optics scanning laser ophthalmoscope (AOSLO) are very accurate, but frequent measurements are impractical in many experimental settings. Here, we demonstrate a pupil-tracker that can accurately measure relative changes in TCA that are caused by small shifts in the pupil relative to the AOSLO imaging beam. Corrections for TCA caused by these shifts improve the measurement of TCA as a function of eccentricity, revealing a strong linear relationship. We propose that pupil tracking be integrated into AOSLO systems where robust and unobtrusive control of TCA is required. PMID:27082330

  17. Optical Coherence Tomography Imaging of Choroidal Abnormalities in Neurofibromatosis Type 1

    Directory of Open Access Journals (Sweden)

    Shinji Makino


    Full Text Available We report a case of neurofibromatosis type 1 (NF1 examined by infrared fundus autofluorescence (IR-FAF and optical coherence tomography (OCT to characterize the associated choroidal abnormalities. The conventional ophthalmoscopic findings were unremarkable. However, IR-FAF revealed multiple bright patchy lesions in the choroid of the posterior pole, in both eyes. OCT demonstrated irregular hyperreflectivity at the sites of these lesions. Patients with NF1 may have typical choroidal lesions that are visible on IR-FAF, which can be confirmed through OCT.

  18. Retinal nerve fiber layer thickness is associated with lesion length in acute optic neuritis

    DEFF Research Database (Denmark)

    Kallenbach, K; Simonsen, Helle Juhl; Sander, B


    included 41 patients with unilateral optic neuritis and 19 healthy volunteers. All patients were evaluated and examined within 28 days of onset of symptoms. The peripapillary retinal nerve fiber layer thickness (RNFLT), an objective quantitative measure of optic nerve head edema, was measured by optical...... coherence tomography and the length and location of the inflammatory optic nerve lesion were evaluated using MRI. RESULTS: Ophthalmoscopically, 34% of the patients had papillitis. The retinal nerve fiber layer in affected eyes (mean 123.1 microm) was higher during the acute phase than that of fellow eyes...... (mean 98.1 microm, p eyes (mean 97.1 microm, p

  19. Automatic cone photoreceptor segmentation using graph theory and dynamic programming. (United States)

    Chiu, Stephanie J; Lokhnygina, Yuliya; Dubis, Adam M; Dubra, Alfredo; Carroll, Joseph; Izatt, Joseph A; Farsiu, Sina


    Geometrical analysis of the photoreceptor mosaic can reveal subclinical ocular pathologies. In this paper, we describe a fully automatic algorithm to identify and segment photoreceptors in adaptive optics ophthalmoscope images of the photoreceptor mosaic. This method is an extension of our previously described closed contour segmentation framework based on graph theory and dynamic programming (GTDP). We validated the performance of the proposed algorithm by comparing it to the state-of-the-art technique on a large data set consisting of over 200,000 cones and posted the results online. We found that the GTDP method achieved a higher detection rate, decreasing the cone miss rate by over a factor of five.

  20. Adaptive optics parallel near-confocal scanning ophthalmoscopy. (United States)

    Lu, Jing; Gu, Boyu; Wang, Xiaolin; Zhang, Yuhua


    We present an adaptive optics parallel near-confocal scanning ophthalmoscope (AOPCSO) using a digital micromirror device (DMD). The imaging light is modulated to be a line of point sources by the DMD, illuminating the retina simultaneously. By using a high-speed line camera to acquire the image and using adaptive optics to compensate the ocular wave aberration, the AOPCSO can image the living human eye with cellular level resolution at the frame rate of 100 Hz. AOPCSO has been demonstrated with improved spatial resolution in imaging of the living human retina compared with adaptive optics line scan ophthalmoscopy.

  1. Modulation of retinal image vasculature analysis to extend utility and provide secondary value from optical coherence tomography imaging. (United States)

    Cameron, James R; Ballerini, Lucia; Langan, Clare; Warren, Claire; Denholm, Nicholas; Smart, Katie; MacGillivray, Thomas J


    Retinal image analysis is emerging as a key source of biomarkers of chronic systemic conditions affecting the cardiovascular system and brain. The rapid development and increasing diversity of commercial retinal imaging systems present a challenge to image analysis software providers. In addition, clinicians are looking to extract maximum value from the clinical imaging taking place. We describe how existing and well-established retinal vasculature segmentation and measurement software for fundus camera images has been modulated to analyze scanning laser ophthalmoscope retinal images generated by the dual-modality Heidelberg SPECTRALIS(®) instrument, which also features optical coherence tomography.

  2. Unilateral Optic Nerve Hypoplasia with Contralateral Optic Pathway Hypoplasia: A Case Report. (United States)

    Nishi, Tomo; Yukawa, Eiichi; Taoka, Toshiaki; Ogata, Nahoko


    Optic nerve hypoplasia is diagnosed by the ophthalmoscopic appearance of the fundus of the eye and by standard magnetic resonance imaging of the brain. The ability to study eyes with optic nerve hypoplasia by magnetic resonance diffusion tensor imaging has improved the evaluation of the optic pathways. The authors report a case of unilateral optic nerve hypoplasia with hypoplasia of the contralateral optic pathway. The entire visual pathway of this patient was examined by magnetic resonance and magnetic resonance diffusion tensor imaging. The images show a decrease of the volume of the optic radiation contralateral to the optic nerve abnormality and also pre- and post-chiasmal abnormalities.

  3. Unusual intraocular foreign bodies after an explosion: patient's hand bone fragments. (United States)

    Sonmez, Murat; Duzgun, E; Yildirim, Y; Ayata, A; Unal, M H


    A 26-year-old Turkish Army soldier underwent full ophthalmoscopic examination after a penetrating ocular injury in the left eye due to the accidental explosion of a detonating fuse during handling. Visual acuity of the left eye was hand motion level. Funduscopy revealed foreign bodies suspended in the vitreous gel and accompanying vitreous haemorrhage. B-scan ultrasonography, CT of the orbits and microscopic examination of the intraocular foreign bodies (IOFBs) were performed prior to removal of bone fragments and pars plana vitrectomy. The IOFBs were fragments of the patients' bone tissue. Bone fragments from victim's body may cause IOFBs after an explosion in military personnel.

  4. Trends in Retinal Damage Thresholds from 100-Millisecond Near-Infrared Laser Radiation Exposures: A Study at 1,110, 1,130, 1,150, and 1,319 nm (United States)


    Laboratory; 2004. Report no. AFRL-HE-BR-TR- 2004–0187. pp. 1–16. 5. Zuclich JA, Schuschereba ST, Zwick H, Boppart SA, Fujimoto JG, Cheney FE, Stuck...Zuclich JA, Zwick HT, Schuschureba ST, Stuck BE, Cheney FE. Ophthalmoscopic and pathologic description of ocular damage induced by infrared laser...Ophthalmol Vis Sci 2003;44(6): 2373–2380. 17. Li G, Zwick H, Stuck B, Lund DJ. On the use of schematic eye models to estimate retinal image quality. J

  5. High-Resolution In Vivo Imaging of Regimes of Laser Damage to the Primate Retina

    Directory of Open Access Journals (Sweden)

    Ginger M. Pocock


    Full Text Available Purpose. To investigate fundamental mechanisms of regimes of laser induced damage to the retina and the morphological changes associated with the damage response. Methods. Varying grades of photothermal, photochemical, and photomechanical retinal laser damage were produced in eyes of eight cynomolgus monkeys. An adaptive optics confocal scanning laser ophthalmoscope and spectral domain optical coherence tomographer were combined to simultaneously collect complementary in vivo images of retinal laser damage during and following exposure. Baseline color fundus photography was performed to complement high-resolution imaging. Monkeys were perfused with 10% buffered formalin and eyes were enucleated for histological analysis. Results. Laser energies for visible retinal damage in this study were consistent with previously reported damage thresholds. Lesions were identified in OCT images that were not visible in direct ophthalmoscopic examination or fundus photos. Unique diagnostic characteristics, specific to each damage regime, were identified and associated with shape and localization of lesions to specific retinal layers. Previously undocumented retinal healing response to blue continuous wave laser exposure was recorded through a novel experimental methodology. Conclusion. This study revealed increased sensitivity of lesion detection and improved specificity to the laser of origin utilizing high-resolution imaging when compared to traditional ophthalmic imaging techniques in the retina.

  6. Noninvasive dosimetry and monitoring of TTT using spectral imaging (United States)

    Schuele, G.; Molnar, F. E.; Yellachich, D.; Vitkin, E.; Perelman, L. T.; Palanker, D.


    Transpupillary thermo therapy (TTT) is a slow (60 seconds) photothermal treatment of the fundus with a near-infrared (780-810nm) laser irradiating a large spot (0.5- 1. mm) on the retina. Due to high variability in ocular tissue properties and the lack of immediately observable outcome of the therapy, a real-time dosimetry is highly desirable. We found that fundus spectroscopy and spectrally-resolved imaging allow for non-invasive real-time monitoring and dosimetry of TTT. A 795nm laser was applied in rabbit eyes for 60 seconds using a 0.86mm retinal spot diameter. The fundus was illuminated with a broadband polarized light, and its reflectance spectra were measured in parallel and cross-polarizations. The fundus was also imaged in selected spectral domains. At irradiances that do not create ophthalmoscopically visible lesions the fundus reflectance increases at the wavelengths corresponding to absorption of the oxygenated blood indicating the reduced concentration of blood in the choroid. Vasoconstrictive response of the choroidal and retinal vasculature during TTT was also directly observed using spectrally-resolved imaging. At irradiances that produce ophthalmoscopically visible lesions a rapid reduction of the fundus reflectance was observed within the first 5-10 seconds of the exposure even when the visible lesions developed only by the end of the 60 second exposure. No visible lesions were produced where the laser was terminated after detection of the reduced scattering but prior to appearance of the enhanced scattering.

  7. Navigated Pattern Laser System versus Single-Spot Laser System for Postoperative 360-Degree Laser Retinopexy

    Directory of Open Access Journals (Sweden)

    Alexei N. Kulikov


    Full Text Available Purpose. To compare three 360°-laser retinopexy (LRP approaches (using navigated pattern laser system, single-spot slit-lamp (SL laser delivery, and single-spot indirect ophthalmoscope (IO laser delivery in regard to procedure duration, procedural pain score, technical difficulties, and the ability to achieve surgical goals. Material and Methods. Eighty-six rhegmatogenous retinal detachment patients (86 eyes were included in this prospective randomized study. The mean procedural time, procedural pain score (using 4-point Verbal Rating Scale, number of laser burns, and achievement of the surgical goals were compared between three groups (pattern LRP (Navilas® laser system, 36 patients; SL-LRP, 28 patients; and IO-LRP, 22 patients. Results. In the pattern LRP group, the amount of time needed for LRP and pain level were statistically significantly lower, whereas the number of applied laser burns was higher compared to those in the SL-LRP group and in the IO-LRP group. In the pattern LRP, SL-LRP, and IO-LRP groups, surgical goals were fully achieved in 28 (77.8%, 17 (60.7%, and 13 patients (59.1%, respectively (p>0.05. Conclusion. The navigated pattern approach allows improving the treatment time and pain in postoperative 360° LRP. Moreover, 360° pattern LRP is at least as effective in achieving the surgical goal as the conventional (slit-lamp or indirect ophthalmoscope approaches with a single-spot laser.

  8. Accidental bilateral Q-switched neodymium laser exposure: treatment and recovery of visual function (United States)

    Zwick, Harry; Stuck, Bruce E.; Dunlap, Weldon; Scales, David K.; Lund, David J.; Ness, James W.


    A 21 year old female was accidentally exposed in both eyes when she looked into the 10 cm exit aperture of a military laser designator emitting 1064 nm q-switched (30 ns) pulses at a 10 pulse per second rate. Steroid therapy (methylprednisolone sodium succinate) was initiated within 6 hours post exposure. Initial ophthalmoscopic observation revealed small contained macular hemorrhages in each eye. Fluorescein angiography (FA) showed minimal leakage. Visual acuity was 20/100 and 20/60 in OD and OS respectively. Contrast sensitivity in both eyes was depressed across all spatial frequencies by more than 1.5 log units. At four weeks post exposure, no significant macular scarring was apparent and visual acuity returned to 20/25 in both eyes. Contrast sensitivity had improved to normal levels with a peak at 3 cycles/degree. At one year post exposure, visual acuity was 20/13 in both eyes and measures of contrast sensitivity were within normal limits. During the course of recovery, the patient's fixation shifted from a slightly superior temporal site back to the central foveal region. The foveal lesion sites were still evident by ophthalmoscopy and Amsler grid measurements but were deemed functional when the patient placed small targets generated by the scanning laser ophthalmoscope in the lesion site for discrimination. This outcome indicates remarkable recovery of visual function and suggests that early administration of steroids may assist in preserving the natural neural recovery process of the photoreceptor matrix by minimizing intraretinal scar formation.

  9. Characterization of an Early-Onset, Autosomal Recessive, Progressive Retinal Degeneration in Bengal Cats (United States)

    Ofri, Ron; Reilly, Christopher M.; Maggs, David J.; Fitzgerald, Paul G.; Shilo-Benjamini, Yael; Good, Kathryn L.; Grahn, Robert A.; Splawski, Danielle D.; Lyons, Leslie A.


    Purpose A form of retinal degeneration suspected to be hereditary was discovered in a family of Bengal cats. A breeding colony was established to characterize disease progression clinically, electrophysiologically, and morphologically, and to investigate the mode of inheritance. Methods Affected and related cats were donated by owners for breeding trials and pedigree analysis. Kittens from test and complementation breedings underwent ophthalmic and neuro-ophthalmic examinations and ERG, and globes were evaluated using light microscopy. Results Pedigree analysis, along with test and complementation breedings, indicated autosomal recessive inheritance and suggested that this disease is nonallelic to a retinal degeneration found in Persian cats. Mutation analysis confirmed the disease is not caused by CEP290 or CRX variants found predominantly in Abyssinian and Siamese cats. Ophthalmoscopic signs of retinal degeneration were noted at 9 weeks of age and became more noticeable over the next 4 months. Visual deficits were behaviorally evident by 1 year of age. Electroretinogram demonstrated reduced rod and cone function at 7 and 9 weeks of age, respectively. Rod responses were mostly extinguished at 14 weeks of age; cone responses were minimal by 26 weeks. Histologic degeneration was first observed at 8 weeks, evidenced by reduced photoreceptor numbers, then rapid deterioration of the photoreceptor layer and, subsequently, severe outer retinal degeneration. Conclusions A recessively inherited primary photoreceptor degeneration was characterized in the Bengal cat. The disease is characterized by early onset, with histologic, ophthalmoscopic, and electrophysiological signs evident by 2 months of age, and rapid progression to blindness. PMID:26258614


    Directory of Open Access Journals (Sweden)

    Rashmi Nagaraju


    Full Text Available BACKGRO UND: The superficial location of the eye, its cystic composition, and the advent of high - frequency ultrasound make sonography ideal for imaging the eye. Ultrasonography is a simple, readily available, non - invasive, non - ionizing, highly accurate, real time and cost effective modality . OBJECTIVES: 1 To evaluate the accuracy of high resolution B - mode ultrasonography in the diagnosis of posterior segment lesions of eye as compared to ophthalmoscopic examination particularly in cases of opaque conducting media . 2 To evaluate sonographic appearances of various posterior segment lesions of the eye . MATERIALS AND METHODS: 1 A prospective study was carried out on 62 cases with suspected posterior segment lesions of eye. All patients clinically suspected to have p osterior segment lesions in the presence of opaque conducting media were included in the study. Cases suspected to have isolated anterior segmental and extra ocular lesions were excluded. 2 HRUS was performed with Philips IU22 using high frequency probe ( 5 to 17 MHz utilizing contact method. 3 Sonological diagnosis was made based on sonographic features such as location, morphology, echo pattern, color Doppler characteristics, kinetics of the lesion with eye movements and acoustic characteristics of the lesion. 4 Subsequent clinical, lab investigations, surgical and histopathological examinations were carried out as applicable and final diagnosis was made which was correlated with the sonological diagnosis. Sonological diagnosis was also compared with op hthalmoscopic diagnosis. STATISTICAL ANALYSES: The validities and diagnostic accuracies of high resolution ultrasound and ophthalmoscopic examinations were calculated and compared. RESULTS AND CONCLUSIONS: 1 Ultrasound was the initial imaging modality opt ed in most of the cases as it was readily available, simple and cost effective modality. It establishes the diagnosis in significant number of cases superseding the accuracy

  11. Retinopatia diabética: estudo de uma associação de diabéticos Diabetic retinopathy: study from a Diabetic Association

    Directory of Open Access Journals (Sweden)

    Sílvia Regina Ramos


    Full Text Available Objetivo: Avaliar a prevalência de retinopatia diabética (RD em uma associação de diabéticos, bem como o nível de informação dos pacientes a respeito desta doença. Métodos: O estudo avaliou, aleatoriamente, 46 pacientes de uma associação de diabéticos que responderam a perguntas sobre conhecimento da RD e avaliação oftalmoscópica prévia e foram submetidos à exame de fundo de olho por oftalmoscopia binocular indireta. Resultados: Entre os diabéticos tipo 1, o estudo encontrou 44,44% dos pacientes com RD e um caso de RD proliferativa; entre os diabéticos tipo 2, 24,3% possuíam RD; 65,22% dos indivíduos avaliados nunca haviam feito exame de oftalmoscopia, embora 80,43% já haviam tido alguma informação sobre RD. Conclusões: Concluímos que há baixa cobertura em termos de prevenção e detecção da RD nesta associação de diabéticos, o que contrasta com o nível de informação dos pacientes sobre a doença e com o fato de ser uma entidade voltada exclusivamente para o tratamento do diabete.Purpose: To evaluate the prevalence of diabetic retinopathy (DR in a diabetic association, as well the level of knowledge about the entity among patients. Methods: This study included 46 patients, at random, from a diabetic association that answered questions about DR and previous ophthalmoscopic examination. Then, they were submitted to indirect ophthalmoscopic evaluation. Results: Among type 1 diabetic patients, the study found 44.44% of patients with DR and one case of proliferative retinopathy; among type 2, 24.3% of pacients with DR; 65.22% of the total had never been submitted to ophthalmoscopic examination, although 80.43% had already received some information about DR. Conclusions: This study shows that there is low coverage of preventive and detection examinations for DR in this diabetic association, which contrasts with the acceptable level of the patients knowledge, besides being an association directed only to diabetic

  12. A Case of Expansion of Traumatic Choroidal Rupture with Delayed-Developed Outer Retinal Changes

    Directory of Open Access Journals (Sweden)

    Kun Moon


    Full Text Available Background: This study aims to report the expansion of a choroidal rupture site caused by blunt ocular trauma using scanning laser ophthalmoscope-optical coherence tomography. Case Report: The clinical course of a 15-year-old girl with a traumatic ocular injury after being hit in the eye by an elbow was evaluated. Upon the first examination, the best-corrected visual acuity was 16/20. The findings were subretinal pigment epithelial hemorrhage and vertical choroidal rupture. Three weeks after the trauma, the patient's visual acuity was reduced to counting fingers at 30 cm. On fundus examination and fluorescein angiography subretinal pigment epithelial hemorrhage decreased, while the choroidal rupture expanded; on optical coherence tomography outer retinal changes in the adjacent area were detected. Discussion: This study reveals that the delayed expansion of a choroidal rupture site and the delayed change of the adjacent outer retina improved.

  13. Experimental Study of Effect of Perfluorohexyloctane to Retina

    Institute of Scientific and Technical Information of China (English)

    Chunfang Li; Xiaoyan Ding; Lin Lu; Guanguang Feng; Huling Zheng


    Objective: To investigate the effect of perfluorohexvloctane to the retina of rabbit eyes.Methods: Perfluoroh-exyloctane (experimental group) or BSS(control group) intovitreous cavities of fifteen vitrectomized New Zealand white rabbits. A slit-lampbiomicroscope and an indirect ophthalmoscope were used to examine all the eyes pre- andpostoperation. Histopathological examination was performed after the rabbits weresacrificed. Results:Perfluorohexyloctane was injected into the vitreous cavity forming a single largeclear globe. No retinal detachment and cataract were found. The edema of outer plexiformlayer was significant, and then get thin, inner nuclear layer and ganglion cell bodies hada darker cytop: lasm and nucleoplasm. Conclusions: Perfluorohexyloctane in vitreous cavity had significant side effects on retinaAs a silicone solvent, it should be removed out completely after injection. We don′trecommend to use it as a new intraocular temponade.

  14. Vitreal syneresis in rhesus monkeys. (United States)

    Stuck, B E; Talsma, D M; Beatrice, E S


    The eyes of 15 rhesus monkeys were evaluated. Various degrees of vitreal syneresis were observed in 28 of the 30 eyes. The observed vitreal structures varied from fine strands randomly spaced throughout the vitreous to thick, intertwining, fibrous networks with some clumping of the collagenous condensate at the fiber junctions. Qualitatively, the degree of syneresis was slightly more extensive in the eight older mature males than in the seven younger animals. In all animals a clear view of the fundus could be obtained with the ophthalmoscope. The vitreous structures may be one cause of variability in ocular dose-response relationships for exposure to laser radiation. The effect on retinal exposure experiments of the finer vitreal structure is considered minimal.

  15. Persistent hyperplastic primary vitreous (PHPV) in two Siberian husky dogs. (United States)

    Ori, J; Yoshikai, T; Yoshimura, S; Takenaka, S


    Three eyes in two Siberian husky dogs were clinically diagnosed as persistent hyperplastic primary vitreous (PHPV) by means of ophthalmoscopy and ultrasonography (USG). Examination of mildly affected PHPV eyes with an ophthalmoscope showed the axial part of the posterior capsule to be opaque. The central lesion of the posterior capsule in severely affected eyes had been opaque with many blood vessels. Echographic changes in mild cases of PHPV were outside of the lens, linearly hyperechoic, parallel to the posterior lens capsule. In a severely affected eyeball, funnel-shaped hyperechoic change was noted in the retrolental space. Two months later, phacoemulsification was performed for diagnostic treatment of PHPV since progressive cataract was observed in this eye.

  16. Retinal locus for scanning text. (United States)

    Timberlake, George T; Sharma, Manoj K; Grose, Susan A; Maino, Joseph H


    A method of mapping the retinal location of text during reading is described in which text position is plotted cumulatively on scanning laser ophthalmoscope retinal images. Retinal locations that contain text most often are the brightest in the cumulative plot, and locations that contain text least often are the darkest. In this way, the retinal area that most often contains text is determined. Text maps were plotted for eight control subjects without vision loss and eight subjects with central scotomas from macular degeneration. Control subjects' text maps showed that the fovea contained text most often. Text maps of five of the subjects with scotomas showed that they used the same peripheral retinal area to scan text and fixate. Text maps of the other three subjects with scotomas showed that they used separate areas to scan text and fixate. Retinal text maps may help evaluate rehabilitative strategies for training individuals with central scotomas to use a particular retinal area to scan text.

  17. Effects of preferred retinal locus placement on text navigation and development of advantageous trained retinal locus. (United States)

    Watson, Gale R; Schuchard, Ronald A; De l'Aune, William R; Watkins, Erica


    Sixty readers were evaluated for visual function and text-navigation ability. The visual field and preferred retinal locus (PRL) were measured with a scanning laser ophthalmoscope (SLO). We found significant differences in text-navigation ability based on scotoma and PRL placement. Readers with a PRL to the left of or above a scotoma had significantly less text-navigation abilities. Readers with a PRL to the left of a scotoma tended to misread words with similar beginnings and omit the last word on a line. Readers with a PRL above a scotoma tended to skip a line or reread the same line twice. In a follow-up study, seven subjects with a nonadvantageous PRL quickly developed a trained retinal locus (TRL) during instruction with an SLO. Although the readers developed the TRL in about 15 minutes, they read slower with the TRL than the PRL. This TRL research provides promising pilot data.

  18. Diagnostics of anterior eye segment in cats and dogs

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    Hadži-Milić Milan


    Full Text Available Diagnostics of the anterior segment of the eye present the most frequent diagnostics implemented in ophthalmology and by most veterinary practicians as well. This paper presents the complete diagnostics in the most concise form possible. The procedure with animals is presented first, followed by the equipment, and then anamnesis. The following diagnostic methods are presented: examination in a lighted room which include an examination from a distance, taking a smear, the Schirmer tear test (STT, an examination from close by, examination in a dark room which comprises the elementary examinations, such as the use of focal lighting and examination using a direct ophthalmoscope, and special examination in a dark room, such as biomicroscopy, gonioscopy and keratoscopy. Additional examination methods are also included.

  19. Topical sulindac therapy in diabetic senile cataracts : cataract IV

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    Sharma Y


    Full Text Available Sulindac, a non-steroidal anti-inflammatory drug has been found to be a potent inhibitor of enzyme aldose reductase. We used sulindac topically in diabetic senile cataract patients to note if it effects the progression of cataracts. More of sulindac treated eyes maintained initial vision and fewer eyes had visual loss of up to two lines or more as compared to control eyes. The extent and density of different opacities showed less progression in sulindac treated eyes but it was not statistically significant except that the ophthalmoscopically observed density of opacity showed statistically very significant lesser mean increase in sulindac treated eyes. We suggest that sulindac is a potential drug which should be further evaluated in large double blind photodocumented studies in diabetic senile cataracts.

  20. Head injury management guidelines for general practitioners

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    Jeremy C Ganz


    Full Text Available A complete examination of a head injured patient in the hospital requires a number of instruments. These include a stethoscope, sphygmomanometer, ophthalmoscope, otoscope, cotton wool, safety pin, tuning fork, reflex hammer and a small key to test the plantar response. Few of these are required at the accident scene. This is because, in the hospital, the aim is optimal definitive treatment. At the accident scene, the aim is prevention of secondary injury, rapid recording of the most important findings and safe efficient transport to the hospital. This short paper reviews how the local doctor should undertake a neurosurgical assessment of traumatic brain injury patients. Moreover, the primary management at accident scenes is described and the rationale behind the approach is outlined

  1. Head injury management guidelines for general practitioners. (United States)

    Ganz, Jeremy C


    A complete examination of a head injured patient in the hospital requires a number of instruments. These include a stethoscope, sphygmomanometer, ophthalmoscope, otoscope, cotton wool, safety pin, tuning fork, reflex hammer and a small key to test the plantar response. Few of these are required at the accident scene. This is because, in the hospital, the aim is optimal definitive treatment. At the accident scene, the aim is prevention of secondary injury, rapid recording of the most important findings and safe efficient transport to the hospital. This short paper reviews how the local doctor should undertake a neurosurgical assessment of traumatic brain injury patients. Moreover, the primary management at accident scenes is described and the rationale behind the approach is outlined.

  2. High-performance adaptive optics system with long-term stability using liquid-crystal-on-silicon spatial light modulator for high-resolution retinal imaging (United States)

    Huang, Hongxin; Inoue, Takashi; Toyoda, Haruyoshi; Hara, Tsutomu


    An adaptive optics scanning laser ophthalmoscope (AO-SLO) using a liquid-crystal spatial light modulator was developed. For routine clinical applications, long-term stability of the AO system is very important because unavoidable eye movement may degrade the instrument's performance. We studied the long-term performance of the aberration correction with healthy human eyes. Retinal image acquisition and AO data collection were performed simultaneously for periods of several minutes. We confirmed that, for more than 90% of the periods, the root-mean-square errors of residual wavefront were below the Marechal criterion. Drifts and microsaccades of fixational eye movement were examined using retinal images and residual aberrations. The results showed significant correlation between the transverse shift of retinal image and the low-order residual wavefront aberration during the drifts.

  3. Optimal area of retinal photocoagulation necessary for suppressing active iris neovascularisation associated with diabetic retinopathy. (United States)

    Shiraya, Tomoyasu; Kato, Satoshi; Shigeeda, Takashi


    To determine the optimal area of retinal photocoagulation required for suppressing active neovascularisation (NVI) associated with diabetic retinopathy. We studied 1 eye each of 4 patients in whom active NVI was ophthalmoscopically shown to have been suppressed by additional photocoagulation. These patients initially underwent pan-retinal photocoagulation for diabetic retinopathy at another hospital, but NVI developed subsequently. We compared the areas of photocoagulation before and after additional photocoagulation and compared the area of retinal photocoagulation. The photocoagulated areas before and after additional photocoagulation in the four eyes were 20.7 and 45.2, 36.6 and 56.3, 30.4 and 67.4, and 11.7 and 53.4 %, respectively. The area of retinal photocoagulation required to suppress active NVI is calculated to be ~50 %.

  4. Action spectrum for retinal injury from near-ultraviolet radiation in the aphakic monkey. (United States)

    Ham, W T; Mueller, H A; Ruffolo, J J; Guerry, D; Guerry, R K


    We found that the action spectrum for retinal damage (determined by the fundus photographic appearance of a minimal lesion immediately after exposure) extends into the near-ultraviolet by exposing three aphakic eyes from rhesus monkeys to 405-, 380-, 350-, and 320-nm wavelengths produced by a 2,500-W xenon lamp equipped with quartz optics and 10-nm interference filters. Exposure times were 100 and 1,000 seconds and the spot diameter on the retina was 500 micrometers. The retina was six times more sensitive to 350- and 325-nm wavelengths than to blue light (441 nm). Both ophthalmoscopic and histologic data showed that near-ultraviolet lesions differed in important respects from blue-light lesions. Near-ultraviolet produced irreparable damage to rod and cone photoreceptors.


    Institute of Scientific and Technical Information of China (English)

    SHEN Xi; XU Ge-zhi; JIAO Qin; LI Xia; SHI Ruo-fei


    Objective To describe the ocular complications of 62 patients with active atopic dermatitis( AD) during the period of 2003 2006. Methods Routine ophthalmic examinations, including slit-lamp microscope, indirect ophthalmoscope or Goldmann three-mirror lens, A-scan and B-scan ultrasound, ultrasound biomicroscope (UBM) and corneal topography, as well as tear film break-up time (BUT) and Schirmer tests were carried out. Results Cataract (28 eyes), keratoconjunctivitis (42 eyes), superficial punctate keratopathy (45 eyes) and tear function abnormality ( 76 eyes) were major ocular complications in AD patients. Retinal detachment (6 eyes) was the most severe ocular complication in the AD patients. Conclusion Ocular complications are common in AD patients and a very careful examination of eyes is essential in treating AD patients. If the eyes can be examed carefully and in time, some operations and severe complications can be avoidable, especially for the patients with retinal breaks or retinal detachment.

  6. Achromatopsia in three sibling Labrador Retrievers in the UK. (United States)

    Dixon, Christopher J


    Achromatopsia was identified in three Labrador Retriever littermates. The dogs demonstrated day blindness, negotiating obstacles under low-light conditions, but apparently blind when outdoors. One of the dogs presented with immature bilateral diffuse posterior cortical cataracts and clinical signs of day blindness became apparent following cataract extraction surgery. Electroretinography demonstrated an absence of a cone photoreceptor response to a bright stimulus and a flicker response of 30 Hz in all three dogs. No fundic lesions have been apparent ophthalmoscopically in any of the dogs as the initial presentation of each case. No abnormalities were detected with DNA screening for known mutations of the CNGB3 gene in any of the dogs. © 2015 American College of Veterinary Ophthalmologists.

  7. Real-time eye motion compensation for OCT imaging with tracking SLO (United States)

    Vienola, Kari V.; Braaf, Boy; Sheehy, Christy K.; Yang, Qiang; Tiruveedhula, Pavan; Arathorn, David W.; de Boer, Johannes F.; Roorda, Austin


    Fixational eye movements remain a major cause of artifacts in optical coherence tomography (OCT) images despite the increases in acquisition speeds. One approach to eliminate the eye motion is to stabilize the ophthalmic imaging system in real-time. This paper describes and quantifies the performance of a tracking OCT system, which combines a phase-stabilized optical frequency domain imaging (OFDI) system and an eye tracking scanning laser ophthalmoscope (TSLO). We show that active eye tracking minimizes artifacts caused by eye drift and micro saccades. The remaining tracking lock failures caused by blinks and large saccades generate a trigger signal which signals the OCT system to rescan corrupted B-scans. Residual motion artifacts in the OCT B-scans are reduced to 0.32 minutes of arc (~1.6 µm) in an in vivo human eye enabling acquisition of high quality images from the optic nerve head and lamina cribrosa pore structure. PMID:23162731

  8. Isolated cotton-wool spots of unknown etiology: management and sequential spectral domain optical coherence tomography documentation (United States)

    Ioannides, Antonis; Georgakarakos, Nikolaos D; Elaroud, Ibrahim; Andreou, Petros


    Cotton-wool spots (CWSs) are common retinal manifestations of many diseases including diabetes mellitus, systemic hypertension, and acquired immunodeficiency syndrome. Clinically they appear as whitish, fluffy patches on the retina and eventually fade with time. In this study, spectral domain optical coherence tomography (SD-OCT) with mapping was used to demonstrate in vivo the characteristics of an isolated CWS in a 59-year-old patient as well as its appearance immediately after ophthalmoscopic resolution. Presented here is the work-up and management of this clinical problem for the ophthalmologist. The authors propose that SD-OCT could be a valuable research tool in characterizing and following the dynamic CWS changes at individual retinal layer level, with potential clinical applications as a screening or diagnostic tool in CWS-related diseases. PMID:22034565

  9. Nonmydriatic ultra-wide-field scanning laser ophthalmoscopy (Optomap) versus two-field fundus photography in diabetic retinopathy. (United States)

    Liegl, Raffael; Liegl, Kristine; Ceklic, Lala; Haritoglou, Christos; Kampik, Anselm; Ulbig, Michael W; Kernt, Marcus; Neubauer, Aljoscha S


    The purpose of this study was to investigate the diagnostic properties of a 2-laser wavelength nonmydriatic 200° ultra-wide-field scanning laser ophthalmoscope (SLO) versus mydriatic 2-field 45° color fundus photography (EURODIAB standard) for assessing diabetic retinopathy (DR). A total of 143 consecutive eyes of patients with different levels of DR were graded regarding DR level and macular edema based on 2-field color photographs or 1 Optomap Panoramic 200 SLO image. All SLO images were nonmydriatic and all photographs mydriatic. Grading was performed masked to patient and clinical data. Based on photography, 20 eyes had no DR, 44 had mild, 18 moderate and 42 severe nonproliferative DR, and 19 eyes had proliferative DR. Overall correlation for grading DR level compared to Optomap SLO was moderate with kappa 0.54 (p photography need to be confirmed in further studies.

  10. Wide-field optical coherence tomography based microangiography for retinal imaging (United States)

    Zhang, Qinqin; Lee, Cecilia S.; Chao, Jennifer; Chen, Chieh-Li; Zhang, Thomas; Sharma, Utkarsh; Zhang, Anqi; Liu, Jin; Rezaei, Kasra; Pepple, Kathryn L.; Munsen, Richard; Kinyoun, James; Johnstone, Murray; van Gelder, Russell N.; Wang, Ruikang K.


    Optical coherence tomography angiography (OCTA) allows for the evaluation of functional retinal vascular networks without a need for contrast dyes. For sophisticated monitoring and diagnosis of retinal diseases, OCTA capable of providing wide-field and high definition images of retinal vasculature in a single image is desirable. We report OCTA with motion tracking through an auxiliary real-time line scan ophthalmoscope that is clinically feasible to image functional retinal vasculature in patients, with a coverage of more than 60 degrees of retina while still maintaining high definition and resolution. We demonstrate six illustrative cases with unprecedented details of vascular involvement in retinal diseases. In each case, OCTA yields images of the normal and diseased microvasculature at all levels of the retina, with higher resolution than observed with fluorescein angiography. Wide-field OCTA technology will be an important next step in augmenting the utility of OCT technology in clinical practice.

  11. A dual-modal retinal imaging system with adaptive optics. (United States)

    Meadway, Alexander; Girkin, Christopher A; Zhang, Yuhua


    An adaptive optics scanning laser ophthalmoscope (AO-SLO) is adapted to provide optical coherence tomography (OCT) imaging. The AO-SLO function is unchanged. The system uses the same light source, scanning optics, and adaptive optics in both imaging modes. The result is a dual-modal system that can acquire retinal images in both en face and cross-section planes at the single cell level. A new spectral shaping method is developed to reduce the large sidelobes in the coherence profile of the OCT imaging when a non-ideal source is used with a minimal introduction of noise. The technique uses a combination of two existing digital techniques. The thickness and position of the traditionally named inner segment/outer segment junction are measured from individual photoreceptors. In-vivo images of healthy and diseased human retinas are demonstrated.

  12. Magnetic resonance imaging of optic nerve

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    Foram Gala


    Full Text Available Optic nerves are the second pair of cranial nerves and are unique as they represent an extension of the central nervous system. Apart from clinical and ophthalmoscopic evaluation, imaging, especially magnetic resonance imaging (MRI, plays an important role in the complete evaluation of optic nerve and the entire visual pathway. In this pictorial essay, the authors describe segmental anatomy of the optic nerve and review the imaging findings of various conditions affecting the optic nerves. MRI allows excellent depiction of the intricate anatomy of optic nerves due to its excellent soft tissue contrast without exposure to ionizing radiation, better delineation of the entire visual pathway, and accurate evaluation of associated intracranial pathologies.

  13. Bilateral Choroidal Metastases as Presentation of Dissemination of Cutaneous Malignant Melanoma

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    S. Fernandez-Perez


    Full Text Available Case Report. A 47-year-old man presented with blurred vision in the right eye. Ophthalmoscopic examination showed several placoid, pigmented lesions in the posterior pole and midperiphery of the retina of both eyes. Results. Patient referred a cutaneous malignant melanoma on the back skin removed 6 years ago. A systemic workup revealed multiple metastases in liver and spleen. After an exhaustive study we concluded that it was a dissemination of a cutaneous malignant melanoma with bilateral choroidal metastases, liver and spleen metastases. The patient obtained clinical ocular improvement after palliative chemotherapy, although he died in the following months. Pathological examination of the lesions confirmed the diagnosis of choroidal metastases from a malignant cutaneous melanoma. Conclusions. Monitoring patients who have had cutaneous malignant melanoma is very important, since melanoma metastases may occur even many years after the diagnosis of the primary tumor. Choroidal metastases from cutaneous melanoma are uncommon but we should be aware because their appearance worsens prognosis.

  14. Skin microvascular function in patients with type 1 diabetes: An observational study from the onset of diabetes. (United States)

    Santesson, Pia; Lins, Per-Eric; Kalani, Majid; Adamson, Ulf; Lelic, Isak; von Wendt, Gunvor; Fagrell, Bengt; Jörneskog, Gun


    The development of disturbances in skin microcirculation in type 1 diabetes is not well characterised. We assessed skin microcirculation longitudinally from the onset of diabetes up to 29 years of duration to investigate when such disturbances start. Seventeen adult patients with type 1 diabetes participated. Skin microvascular function in digit IV of the left hand was investigated by laser Doppler fluxmetry (LDF, arbitrary units [AU]). LDF was carried out at rest and following one-min arterial occlusion. Time to peak LDF (s) and percentage increase of LDF (post-occlusive reactive hyperaemia, PRH%) were determined. Retinopathy was assessed from fundus photographs or ophthalmoscopic recordings. Skin microvascular function remained normal during the first five years. Compared with baseline and a non-diabetic reference group, time to peak LDF was prolonged after 7-9 years of diabetes ( p type 1 diabetes and preceded diabetic complications such as retinopathy.

  15. Ocular fundus pathology and chronic kidney disease in a Chinese population

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    Gao Bixia


    Full Text Available Abstract Background Previous study indicated a high prevalence of ocular fundus pathology among patients with chronic kidney disease (CKD, while the relationship between them has never been explored in a Chinese Population. Methods This cross-sectional study included 9 670 participants enrolled in a medical screening program. Ocular fundus examination was performed by ophthalmologists using ophthalmoscopes. The presence of eGFR less than 60 mL/min/1.73 m2 and/or proteinuria was defined as CKD. Results Compared to participants without CKD, participants with CKD had higher prevalence of retinopathy (28.5% vs. 16.3%, P Conclusions Ocular fundus pathology is common among Chinese patients with CKD. Regular eye exam among persons with proteinuria is warranted.

  16. Oral 4-week and 13-week toxicity studies of polyvinyl acetate vinyl laurate copolymer in rats. (United States)

    Messinger, Horst; Bär, Albert


    Polyvinyl acetate vinyl laurate copolymer (PVAcVL) is a useful component of gum base for chewing gum production. The safety of PVAcVL was examined in a 4-week and a 13-week oral toxicity study in rats. Finely powdered PVAcVL was administered with the diet at levels of 1.25%, 2.0% and 5% in the 4-week study and 1.25%, 2.5% and 5% in the 13-week study. There were no treatment related effects on mortality, bodyweight gains feed efficiency, ophthalmoscopic findings, hematological and clinical chemical parameters, neurobehavioral observations as well as gross and histopathological changes of standard organs and tissues. The highest dose tested in the 13-week study (3783 and 4396mg/kgbw/d for males and females, respectively) proved to be a NOAEL.

  17. Prevention of cataract in diabetic mice by topical pyruvate

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    Hegde KR


    Full Text Available KR Hegde1,3, S Kovtun1, SD Varma1,21Ophthalmology and Visual Sciences, 2Biochemistry and Molecular Biology, University of Maryland School of Medicine, 3Coppin State University, Department of Natural Sciences, Baltimore, MD, USABackground: It has been previously reported that oral administration of sodium pyruvate inhibits oxidative stress and cataract formation in diabetic animals. With a view to exploring the clinical usefulness of these findings, this study examined its preventive effect when administered topically as an eye drop.Methods: Diabetes was induced by intraperitoneal injections of streptozotocin. At the onset of diabetes, an eye drop preparation containing 2.5% sodium pyruvate was administered six times a day at 90-minute intervals. Treatment was continued for 6 weeks. Cataract formation was monitored ophthalmoscopically after mydriasis with 1% tropicamide eye drops. Subsequently, the treated and untreated diabetic animals and the age-matched normal controls were euthanized, their eyes enucleated, and the lenses isolated for biochemical assessment of protein glycation and glutathione levels.Results: Treatment with pyruvate eye drops was found to be significantly effective in inhibiting protein glycation. Glutathione levels were also better maintained. In addition, ophthalmoscopic examination revealed that the incidence of cataract in the pyruvate-treated group was only 12% as compared with the untreated diabetics in whom the incidence was 73%. Cataracts at this stage were largely equatorial.Conclusion: The results demonstrate that topical application of pyruvate can potentially be useful in attenuating or preventing cataract formation induced by diabetes and other conditions of oxidative stress.Keywords: pyruvate eye drops, diabetic cataract, protein glycation, oxidative stress

  18. Pain and stress assessment after retinopathy of prematurity screening examination: Indirect ophthalmoscopy versus digital retinal imaging

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    Moral-Pumarega M


    Full Text Available Abstract Background Increasingly, neonatal clinics seek to minimize painful experiences and stress for premature infants. Fundoscopy performed with a binocular indirect ophthalmoscope is the reference examination technique for screening of retinopathy of prematurity (ROP, and it is associated with pain and stress. Wide-field digital retinal imaging is a recent technique that should be evaluated for minimizing infant pain and stress. Methods The purpose of the study was to assess and compare the impact of using a binocular indirect ophthalmoscope (BIO, or wide-field digital retinal imaging (WFDRI on pain and stress in infants undergoing ROP screening examination. This was a comparative evaluation study of two screening procedures. Ophthalmologic examinations (N = 70 were performed on 24 infants with both BIO and WFDRI. Pain assessments were performed with two specific neonatal scales (Crying, requires oxygen, increased vital signs, expression and sleeplessness, CRIES and, Premature infant pain profile, PIPP just prior to the examination, and 30 seconds, 1 hour, and 24 hours later after ending the examination. Results Changes over time were significantly different between BIO and WFDRI with both scales (PIPP score, p = .007, and CRIES score, p = .001. Median PIPP score (interquartile interval at baseline was 4 (3–5. At 30 seconds the score was 8 (6–9 for BIO and 6 (5–7 for WFDRI, respectively. The increase in PIPP score between baseline and 30 seconds was significantly lower with WFDRI (p = .006. The median increase in CRIES score from baseline to 30 seconds was 1 point lower for WFDRI than for BIO (p  Conclusions A transient short-term pain and stress response occurs with both BIO and WFDRI. Infants examined for screening of ROP with digital retinal imaging present less pain and stress at 30 seconds following completion of the exam when compared with binocular indirect ophthalmoscopy.

  19. Prevalence of disc cupping in non-glaucomatous eyes

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    José Pablo Chiappe


    Full Text Available This study assessed optic disc size and cupping, using a commercially available ophthalmoscope, in order to show norms of these values for clinical practice. Subjects were office-workers referred from their respective workplaces for a routine medical examination, which included eye examination. The optic disc size was classified as small, medium or large, for having a diameter 1.5 times (respectively the diameter of the ophthalmoscope's selected light spot on the posterior pole. The cupping was classified as the ratio of the vertical cupping diameter and the vertical disc diameter on a relative decimal scale from 0.0 to 1.0.This study included 184 subjects with a mean age of 40.5 ± 9.5 years; 149 (81% were males. Their mean ocular pressure was 12.4 ± 1.5 mmHg (range 10-17 mmHg. There was a high correlation between optic disc sizes and cupping in the right and left eyes (Pearson Correlation r = 0.866, p < 0.001; therefore, for simplicity only the data for right eyes are presented. According to our definition, the optic discs in these eyes comprised 27 (14.7% small, 141 (76.6% medium and 16 (8.7% large. The small optic discs were rarely cupped, and the large optic discs were always cupped. Optic disc cupping greater than 0.7 was rarely found and should be suspect of glaucoma. Clinical doctors should be aware of this and refer those subjects with abnormal cupping to the specialist.


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    Surya Chandra


    Full Text Available OBJECTIVE: assessment of the prevalence of diabetic retinopathy among people staying in Srikakulam MATERIAL AND METHOD S : A cross - sectional hospital based study was done for 500 patients with established diabetes who came to eye OPD at Rajiv Gandhi Institute of medical Sciences, Srikakulam. T hey were evaluated for the presence or absence of retinopathy caused by the underlyin g Diabetes. Necessary clinical examination was done and the findings were noted separately. No follow - up was done in this study. Indirect Ophthalmoscope, Direct Ophthalmoscope 90D Lens, slit lamp bio - microscope and Fundus Photography were used for examinat ion. Statistical package for Social Sciences (SPSS was taken for statistical analysis. p60 yrs of age and 49 patients (32.03% wer e between 40 - 60 yrs of age. 51 (33.33% were males and 102 (66.67% were females. Mild DR was present in 154 (15.4% eyes, moderate to severe DR in 94 (9.4% eyes, proliferative DR in 17(1.7% eyes and diabetic maculopathy in 41(4.1% eyes. 38 patients (2 4.8% with diabetes of = 15 yr. Patients who were on irregular or inadequate treatment with OHA, insulin or both and with improper adher ence to medication had more prevalence of DR. CONCLUSION: The study concluded that Diabetic Retinopathy is highly prevalent in Srikakulam district Andhra P radesh and necessary steps should be taken for early detection of the disease and appropriate treatment to prevent blindness which can be caused by this disease .

  1. Improving the likelihood of neurology patients being examined using patient feedback. (United States)

    Appleton, Jason Philip; Ilinca, Andreea; Lindgren, Arne; Puschmann, Andreas; Hbahbih, Majed; A Siddiqui, Khurram; de Silva, Rajith; Jones, Matthew; Butterworth, Richard; Willmot, Mark; Hayton, Tom; Lunn, Michael; Nicholl, David


    We aimed to establish whether recall of elements of the neurological examination can be improved by use of a simple patient assessment score. In a previous study we demonstrated that in-patients referred to neurology at two United Kingdom (UK) hospitals were not fully examined prior to referral; we therefore designed a larger quality improvement report with 80% power to detect a 10% increase in tendon hammer or ophthalmoscope use following an educational intervention. In-patients referred to neurology over a four month period (in hospitals in the UK (10), Jordan (1), Sweden (2), and the United Arab Emirates (1)) were asked whether they recalled being examined with a tendon hammer (T), ophthalmoscope (O), and stethoscope (S) since admission. The results were disseminated to local medical teams using various techniques (including Grand Round presentations, email, posters, discounted equipment). Data were then collected for a further four month period post-intervention. Pre-intervention and post-intervention data were available for 11 centres with 407 & 391 patients in each arm respectively. Median age of patients was 51 (range 13-100) and 49 (range 16-95) years respectively, with 44.72% and 44.76% being male in each group. 264 patients (64.86%) recalled being examined with a tendon hammer in the pre-intervention arm, which significantly improved to 298 (76.21%) (pneurology referral yet a simple assessment score and educational intervention can improve recall of elements of the neurological examination and thus the likelihood of patients being examined neurologically. This is the largest and - to our knowledge - only study to assess this issue. This has implications for national neurological educators.

  2. Adaptive optics scanning ophthalmoscopy with annular pupils. (United States)

    Sulai, Yusufu N; Dubra, Alfredo


    Annular apodization of the illumination and/or imaging pupils of an adaptive optics scanning light ophthalmoscope (AOSLO) for improving transverse resolution was evaluated using three different normalized inner radii (0.26, 0.39 and 0.52). In vivo imaging of the human photoreceptor mosaic at 0.5 and 10° from fixation indicates that the use of an annular illumination pupil and a circular imaging pupil provides the most benefit of all configurations when using a one Airy disk diameter pinhole, in agreement with the paraxial confocal microscopy theory. Annular illumination pupils with 0.26 and 0.39 normalized inner radii performed best in terms of the narrowing of the autocorrelation central lobe (between 7 and 12%), and the increase in manual and automated photoreceptor counts (8 to 20% more cones and 11 to 29% more rods). It was observed that the use of annular pupils with large inner radii can result in multi-modal cone photoreceptor intensity profiles. The effect of the annular masks on the average photoreceptor intensity is consistent with the Stiles-Crawford effect (SCE). This indicates that combinations of images of the same photoreceptors with different apodization configurations and/or annular masks can be used to distinguish cones from rods, even when the former have complex multi-modal intensity profiles. In addition to narrowing the point spread function transversally, the use of annular apodizing masks also elongates it axially, a fact that can be used for extending the depth of focus of techniques such as adaptive optics optical coherence tomography (AOOCT). Finally, the positive results from this work suggest that annular pupil apodization could be used in refractive or catadioptric adaptive optics ophthalmoscopes to mitigate undesired back-reflections.

  3. Comparison of non-mydriatic retinal photography with ophthalmoscopy in 2159 patients: mobile retinal camera study. (United States)

    Taylor, R; Lovelock, L; Tunbridge, W M; Alberti, K G; Brackenridge, R G; Stephenson, P; Young, E


    OBJECTIVE--To determine whether non-mydriatic Polaroid retinal photography was comparable to ophthalmoscopy with mydriasis in routine clinic screening for early, treatable diabetic retinopathy. DESIGN--Prospective study of ophthalmoscopic findings according to retinal camera screening and ophthalmoscopy and outcome of referral to ophthalmologist. SETTING--Outpatient diabetic clinics of three teaching hospitals and three district general hospitals. PATIENTS--2159 Adults selected randomly from the diabetic clinics, excluding only those registered as blind or those in wheelchairs and unable to enter the screening vehicle. MAIN OUTCOME MEASURES--Numbers of patients and eyes correctly identified by each technique as requiring referral with potentially treatable retinopathy (new vessel formation and maculopathy) and congruence in numbers of microaneurysms, haemorrhages, and exudates reported. RESULTS--Camera screening missed two cases of new vessel formation and did not identify a further 12 but indicated a need for referral. Ophthalmoscopy missed five cases of new vessel formation and indicated a need for referral in another four for other reasons. Maculopathy was reported in 147 eyes with camera screening alone and 95 eyes by ophthalmoscopy only (chi 2 = 11.2; p less than 0.001), in 66 and 29 of which respectively maculopathy was subsequently confirmed. Overall, 38 eyes received laser treatment for maculopathy after detection by camera screening compared with 17 after ophthalmoscopic detection (chi 2 = 8.0; p less than 0.01). Camera screening underestimated numbers of microaneurysms (chi 2 = 12.9; p less than 0.001) and haemorrhages (chi 2 = 7.4; p less than 0.01) and ophthalmoscopy underestimated hard exudates (chi 2 = 48.2; p less than 0.001). CONCLUSIONS--Non-mydriatic Polaroid retinal photography is at least as good as ophthalmoscopy with mydriasis in routine diabetic clinics in identifying new vessel formation and absence of retinopathy and is significantly better

  4. Frequency of choroidal abnormalities in neurofibromatosis type 1. (United States)

    Yasunari, T; Shiraki, K; Hattori, H; Miki, T


    Choroidal neurofibromatosis is thought to be a rare form of neurofibromatosis that involves the eyes. The development of infrared light examination with a scanning laser ophthalmoscope (SLO) and indocyanine-green fundus angiography has allowed examination of the choroid. We studied choroidal abnormalities in patients with neurofibromatosis 1 and compared their frequency with that of other ocular abnormalities. We examined 33 eyes of 17 consecutive patients diagnosed with neurofibromatosis 1 by conventional ophthalmoscopy and by non-invasive infrared monochromatic light with confocal SLO. 76 eyes of 39 age-matched controls were examined similarly by confocal SLO. 21 digital fluorescein and indocyanine-green angiographies were obtained from 11 adult patients, and 77 angiograms were obtained from age-matched controls. Infrared monochromatic light examination by confocal SLO showed bright multiple patchy regions at and around the entire posterior pole of all 33 eyes examined. All bright patchy regions seen in adult patients corresponded to hypofluorescent areas on their indocyanine-green angiograms. However, no abnormalities were noted in any patient at corresponding areas under conventional ophthalmoscopic examination or fluorescein angiography. In SLO and indocyanine-green studies, controls and control angiograms showed no choroidal abnormalities. Iris nodules were noted in 25 eyes (76%) of 14 patients (82%) and eyelid neurofibroma in five patients (29%). The bright patchy regions noted under infrared fundus examination and the corresponding hypofluorescent areas seen on indocyanine-green angiograms are probably of choroidal origin. The high frequency (100%) of these abnormalities suggests that the choroid is one of the structures most commonly affected by neurofibromatosis 1.

  5. Objective analyses of tessellated fundi and significant correlation between degree of tessellation and choroidal thickness in healthy eyes.

    Directory of Open Access Journals (Sweden)

    Naoya Yoshihara

    Full Text Available A tessellated fundus is a common characteristic of myopic eyes and is an important clinical marker for the development of retinochoroidal changes. However, the exact cause and significance of tessellated fundi have not been definitively determined. We determined the degree of tessellation in fundi objectively in normal, non-pathological myopic eyes, and correlated the degree of tessellation and the choroidal thickness (CT and axial length (AL. This was a prospective observational cross sectional study. The eyes were classified subjectively into three groups based on the degree of tessellation observed ophthalmoscopically. Digital color fundus photographs were assessed for the degree of tessellation by ImageJ, an image processing program. Three tessellated fundus indices (TFIs were calculated and were compared to the three subjectively-determined groups. The subfoveal and nasal CTs were measured in the optical coherence tomographic images. The correlations between the TFIs and the CT were calculated. Additionally, the correlation between the TFIs and the AL was calculated. One hundred right eyes of 100 healthy volunteers (mean age 25.8±3.9 years were studied. Ophthalmoscopically, 57 eyes were placed in the non-tessellated group, 27 eyes into the weakly tessellated group, and 16 eyes into the strongly tessellated group. There was a significant correlation between the subjective classifications and the TFI values (P<0.05, Kruskal-Wallis test. All of the TFIs were significantly associated with the subfoveal and nasal CT (R = -0.20 to -0.24, P<0.05. The TFIs were not significantly correlated with the ALs. In conclusion, the significant correlation between the subjective and objective classifications of the degree of tessellation indicates that TFIs can be used to classify the degree of tessellation. The results indicate that the differences in the CT account for the degree of tessellation.

  6. Evaluation of Medical Effects and Risks of Mobile Flashlight%手机闪光灯医用价值和风险评估

    Institute of Scientific and Technical Information of China (English)

    王浩; 孟祥峰; 刘艳珍; 任海萍


    目的:从医疗器械质量控制的视角来评价手机闪光灯用于医疗用途的有效性和安全性,探讨手机在移动医疗领域的潜力。方法把闪光灯当作检眼镜的光源,对其光辐射安全性进行评价。以闪光灯为光源,光纤光谱仪为探测器,进行反射式血氧测量,分析获得的信号特征。结果手机检眼镜的光辐射风险主要取决于蓝光,本文手机检眼镜的应用情景根据ISO15004-2:2007标准应属于2类设备,手机闪光灯在组织中产生的信号可用于反射式血氧测量。结论手机作为日常生活广泛普及的个人物品和移动医疗的重要节点,其闪光灯本身具有医用价值和安全风险,有必要对它的研发和监管继续深入研究。%Objective To evaluate the effectiveness and safety of mobile lfashlight from the perspective of medical device quality control so as to explore its potential in mobile health. Methods Taking mobile lfashlight as the light source of ophthalmoscope, its optical radiation risks were evaluated. Using lfashlight as the light source and a ifber optical spectrometer as the detector, measurement of relfective oximetry was made to analyze the signal. Results The optical radiation risk of mobile ophthalmoscope mainly depended on the blue light, and the application scenario in this paper was considered as Class 2 equipment according to ISO 15004-2:2007. The relfectance signal on tissue generated by the lfashlight was useful for oximetry measurement. Conclusion As a common personal belonging and basic element in mobile health, the lfashlight in cell phones had medical application effects and security risks, which should draw more attention from the research&development departments to the regulation authorities.

  7. Contribution and significance of Heidelberg retinal tomography II in diagnostics of ocular hypertension and its conversion into primary open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    Marković Vujica


    Full Text Available Background/Aim. A term 'ocular hypertension' is used when IOP is found to be > 21 mmHg on two consecutive occasions, in the absence of detectable glaucomatous damage. The aim of this study was to determine the significance and contribution of Heidelberg Retinal Tomography II (HRT II results that show very early, subtle changes in retinal neurofibre layers (RNFL in the optic nerve head that are specific for glaucoma itself (the loss of neuroretinal rim area and an increase of Cup/Disc ratio, but are not possible to register by an ophthalmoscope. Also, when the results of the functional tests remain unchanged, that confirms the conversion of ocular hypertension into glaucoma. Methods. During a 5-year study period (2002-2007, 29 patients with ocular hypertension were examined. The frequency of control examinations, based on the presence of risk factors for glaucoma development, was 3-6 months. The examination also included IOP measurements with Goldmann Applanation Tonometry (GAT, central corneal thickness (CCT determination by pachymetry, the examination of chamber angle using indirect gonioscopy, visual field tests by computerized perimetry and also papillae nervi optici (PNO examination by using HRT II. The application of HRT II enables a great number of stereometric parameters of optic disc, the most important being the rim area and Cup/Disc (C/D ratio, which was followed during the control examination by each segment, as well as PNO in global. Results. In the examination period, three cases of conversion of ocular hypertension into a primary open-angle glaucoma were found. In the group of patients with ocular hypertension, HRT II results after six months did not show a significant increase in C/D ratio. No significant loss of rim area or rim volume was found either. In three cases of conversion, HRT II results after 3 months showed an increase of C/D ratio and also a significant loss in rim volume at first examination (0.413 comparing to the

  8. Comparison of the diagnostic value of MR imaging and ophthalmoscopy for the staging of retinoblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Khurana, Aman; Wan, Wenshuai; Yeom, Kristen [Stanford University, Department of Radiology, Stanford, CA (United States); Eisenhut, Christina A. [Technical University of Munich, Department of Radiology, Munich (Germany); Ebrahimi, Katayoon B. [Johns Hopkins University, Department of Ocular Oncology, Baltimore, MD (United States); Patel, Chirag [University of California Davis, Department of Radiology, Davis, CA (United States); O' Brien, Joan M. [University of Pennsylvania, Department of Ophthalmology, Philadelphia, PA (United States); Daldrup-Link, Heike E. [Stanford University, Department of Radiology, Stanford, CA (United States); Stanford University, Department of Radiology, Pediatric Radiology Section, Lucile Packard Children' s Hospital, Stanford, CA (United States)


    To compare the diagnostic value of magnetic resonance (MR) imaging and ophthalmoscopy for staging of retinoblastoma. MR and ophthalmoscopic images of 36 patients who underwent enucleation were evaluated retrospectively following institutional review board approval. Histopathology being the standard of reference, the sensitivity and specificity of both diagnostic modalities were compared regarding growth pattern, iris neoangiogenesis, retinal detachment, vitreous seeds and optic nerve invasion. Data were analysed via McNemar's test. Both investigations showed no significant difference in accuracy for the detection of different tumour growth patterns (P = 0.80). Vitreous seeding detection was superior by ophthalmoscopy (P < 0.001). For prelaminar optic nerve invasion, MR imaging showed similar sensitivity as ophthalmoscopy but increased specificity of 40 % (CI 0.12-0.74) vs. 20 % (0.03-0.56). MR detected optic nerve involvement past the lamina cribrosa with a sensitivity of 80 % (0.28-0.99) and a specificity of 74 % (0.55-0.88). The absence of optic nerve enhancement excluded histopathological infiltration, but the presence of optic nerve enhancement included a high number of false positives (22-24 %). Ophthalmoscopy remains the method of choice for determining extent within the globe while MR imaging is useful for evaluating extraocular tumour extension. Thus, both have their own strengths and contribute uniquely to the staging of retinoblastoma. (orig.)

  9. [Follicular conjunctivitis due to Chlamydia trachomatis]. (United States)

    Basualdo, J A; Huarte, L; Bautista, E; Niedfeld, G; Alfonso, G; Rosso, N; Geronés, M; Galeppi, I


    During two years (1997-1999) an investigation of possible infections of chlamydial etiology in outpatients with follicular conjunctivitis was carried out, through the use of specific assays. Fifty-seven selected patients with presumptive inclusion conjunctivitis were diagnosed by means of ophthalmoscopic examination and bilateral tarsal-conjunctiva swabbing for microorganisms. The possible presence of Chlamydia trachomatis was tested by immunofluorescence microscopy and isolation in cell culture of McCoy line. Of the 57 conjunctivitis patients screened, 37 (65%) proved to be positive by cell culture (CC) and 27 (47%) by direct immunofluorescence (IFD). A good agreement between the two assays was observed, where the CC was more sensitive than IFD. Of these 37 patients with chlamydial conjunctivitis, 23 (62%) were women, with over one-third of them ranging in age from 45 to 65 years. Their clinical records revealed an evolution period of 1 to 12 months. Eighteen (78%) of these women reported previous genital pathology, while 4 (29%) of the 14 men had a history of urethritis by Chlamydia trachomatis. A high frequency of follicular conjunctivitis by Chlamydia (65%) in the screened patients was observed, without any evidence of urogenital signs and symptoms at the moment of the study.

  10. Closed-loop optical stabilization and digital image registration in adaptive optics scanning light ophthalmoscopy. (United States)

    Yang, Qiang; Zhang, Jie; Nozato, Koji; Saito, Kenichi; Williams, David R; Roorda, Austin; Rossi, Ethan A


    Eye motion is a major impediment to the efficient acquisition of high resolution retinal images with the adaptive optics (AO) scanning light ophthalmoscope (AOSLO). Here we demonstrate a solution to this problem by implementing both optical stabilization and digital image registration in an AOSLO. We replaced the slow scanning mirror with a two-axis tip/tilt mirror for the dual functions of slow scanning and optical stabilization. Closed-loop optical stabilization reduced the amplitude of eye-movement related-image motion by a factor of 10-15. The residual RMS error after optical stabilization alone was on the order of the size of foveal cones: ~1.66-2.56 μm or ~0.34-0.53 arcmin with typical fixational eye motion for normal observers. The full implementation, with real-time digital image registration, corrected the residual eye motion after optical stabilization with an accuracy of ~0.20-0.25 μm or ~0.04-0.05 arcmin RMS, which to our knowledge is more accurate than any method previously reported.

  11. In vivo visualizing the dynamics of bone marrow stem cells in mouse retina and choroidal-retinal circulation (United States)

    Wang, Heuy-Ching H.; Zwick, Harry; Edsall, Peter R.; Cheramie, Rachel D.; Lund, David J.; Stuck, Bruce


    It has recently been shown that bone marrow cells can differentiate into various lineage cells including neural cells in vitro and in vivo. Therefore it is an attractive therapeutic intervention to apply autologous bone marrow-derived stem cells that may offer neuroprotection to laser-induced retinal injuries. The purpose of this study is to develop a method with which to visualize bone marrow stem cells dynamics in mouse retinal circulation. We have used a physiological method, confocal scanning laser ophthalmoscope (SLO), to track the highly enriched stem/progenitor cells circulating in the retina. Stem cells were enriched by immunomagnetic depletion of cells committed to the T- and B lymphocytic, myeloid and erythorid lineages. CellTracker TM Green-labeled stem cells were injected into the tail veins of mice with laser-induced focal retinal injuries. Bone marrow stem cells labeled with CellTracker TM Green were visible in the retinal circulation for as long as 1 hour and 30 minutes. These studies suggest that stem cell-enriched bone marrow cells may have the ability to mobilize into laser-induced retinal injuries and possibly further proliferate, differentiate and functionally integrate into the retina.

  12. Differentiating full thickness macular holes from impending macular holes and macular pseudoholes (United States)

    Tsujikawa, M.; Ohji, M.; Fujikado, T.; Saito, Y.; Motokura, M.; Ishimoto, I.; Tano, Y.


    AIMS—The reliability of scanning laser ophthalmoscope (SLO) microperimetry in differentiating full thickness macular holes from macular pseudoholes and impending macular holes was evaluated.
METHODS—106 eyes with the clinical diagnosis of full thickness macular holes, macular pseudoholes, and impending (stage 1) macular holes were examined for the presence of deep or relative scotoma using SLO microperimetry. The relation between these scotomas and the clinical diagnosis was studied.
RESULTS—Deep and relative scotomas were detected in all 57 eyes with clinically defined full thickness macular holes. In contrast, among 49 eyes diagnosed with macular pseudoholes or impending macular holes, no deep and only one relative scotoma was observed. The sensitivity of the presence of a deep scotoma as an indicator of the clinical diagnosis of a full thickness macular hole was 100% (57 of 57), and the specificity was 100% (49 of 49). The sensitivity of the presence of a relative scotoma was 100% (57 of 57) and the specificity was 98.0% (48 of 49).
CONCLUSION—With SLO microperimetry, full thickness macular holes can be precisely and objectively distinguished from other conditions that mimic macular holes.


  13. Attention attraction in an ophthalmic diagnostic device using sound-modulated fixation targets. (United States)

    Gramatikov, Boris I; Rangarajan, Shreya; Irsch, Kristina; Guyton, David L


    This study relates to eye fixation systems with combined optical and audio systems. Many devices for eye diagnostics and some devices for eye therapeutics require the patient to fixate on a small target for a certain period of time, during which the eyes do not move and data from substructures of one or both eyes are acquired and analyzed. With young pediatric patients, a monotonously blinking target is not sufficient to retain attention steadily. We developed a method for modulating the intensity of a point fixation target using sounds appropriate to the child's age and preference. The method was realized as a subsystem of a Pediatric Vision Screener which employs retinal birefringence scanning for detection of central fixation. Twenty-one children, age 2-18, were studied. Modulation of the fixation target using sounds ensured the eye fixated on the target, and with appropriate choice of sounds, performed significantly better than a monotonously blinking target accompanied by a plain beep. The method was particularly effective with children of ages up to 10, after which its benefit disappeared. Typical applications of target modulation would be as supplemental subsystems in pediatric ophthalmic diagnostic devices, such as scanning laser ophthalmoscopes, optical coherence tomography units, retinal birefringence scanners, fundus cameras, and perimeters. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

  14. Optic Nerve Injury in a Patient with Chronic Allergic Conjunctivitis

    Directory of Open Access Journals (Sweden)

    Ribhi Hazin


    Full Text Available Manipulation of the optic nerve can lead to irreversible vision changes. We present a patient with a past medical history of skin allergy and allergic conjunctivitis (AC who presented with insidious unexplained unilateral vision loss. Physical exam revealed significant blepharospasm, mild lid edema, bulbar conjunctival hyperemia, afferent pupillary defect, and slight papillary hypertrophy. Slit lamp examination demonstrated superior and inferior conjunctival scarring as well as superior corneal scarring but no signs of external trauma or neurological damage were noted. Conjunctival cultures and cytologic evaluation demonstrated significant eosinophilic infiltration. Subsequent ophthalmoscopic examination revealed optic nerve atrophy. Upon further questioning, the patient admitted to vigorous itching of the affected eye for many months. Given the presenting symptoms, history, and negative ophthalmological workup, it was determined that the optic nerve atrophy was likely secondary to digital pressure from vigorous itching. Although AC can be a significant source of decreased vision via corneal ulceration, no reported cases have ever described AC-induced vision loss of this degree from vigorous itching and chronic pressure leading to optic nerve damage. Despite being self-limiting in nature, allergic conjunctivitis should be properly managed as extreme cases can result in mechanical compression of the optic nerve and compromise vision.

  15. Prevalence of Preventable Causes of Low Vision in Different Ages and Genders

    Directory of Open Access Journals (Sweden)

    Mohsen Akhgary


    Full Text Available Background: Much of the vision loss from age-related eye disease can be prevented. The purpose of this study is to determine 5Tthe prevalence5T 5Tof preventable5T 5Tcauses5T 5Tof low5T 5Tvision. Materials and Methods: In this study, files of 204 patients were evaluated5T.5T Low vision was defined as best-corrected visual acuity in the better eye between 20/70 to 20/200. Diagnosis of anterior and posterior segment disease was based on the eye examination that performed with Topcon slit-lamp biomicroscope and direct and indirect ophthalmoscope examination7T. Results: The prevalence of 5Tpreventable5T 5Tcauses of5T 5Tlow 5Twas respectively:5T diabetic retinopathy,5T 5Tin 335T 5Tpatients (5T16.18%, 5Tglaucoma 5Tin 6 5Tpatients (5T2.94%, 5Tand amblyopia5T in 5T2 patients (1%5T. Conclusion: The majority of cases have treatable and/or preventable causes; reduction of low vision or blindness can be achieved by appropriate screening strategies.

  16. Retinal venous pulsation: Expanding our understanding and use of this enigmatic phenomenon. (United States)

    Morgan, William H; Hazelton, Martin L; Yu, Dao-Yi


    Retinal vein pulsation was first noted soon after the invention of the ophthalmoscope 170 years ago and was seen to change with cerebrospinal fluid pressure (CSFP) variation in the 1920s. The classical explanation for vein pulsation was that the cardiac cycle induced systolic peak in intraocular pressure (IOP) tended to intermittently collapse the retinal vein close to its exit in the central optic disk, causing pulsation to be counter-phase to IOP. Recently, improved ophthalmodynamometry and video recording techniques have allowed us to explore the fundamentals of retinal vein pulsation. This demonstrates that retinal venous collapse is in phase with both IOP and CSFP diastole, indicating the dependence upon CSFP pulse. We describe in some detail the mathematical and physical models of Starling resistors and how their results can be applied to understand the physiology of retinal vein pulsation. We discuss various techniques for measuring retinal venous pulsation, including a novel modified photo-plethysmographic technique developed in our laboratory. With these techniques, non-invasive measurement of CSFP is beginning to look feasible. Venous pulsation properties also have significant prognostic value in predicting long-term outcomes for both glaucoma and central retinal vein occlusion, as well as utility in other retinal vasculopathies and orbital disease. We demonstrate the potential use of modified photo-plethysmographic images in assessing these various disorders. A revised understanding of retinal vein pulse wave transmission along with improved measurement techniques may generate useful clinical tools for assessing these disorders. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Calibration-free sinusoidal rectification and uniform retinal irradiance in scanning light ophthalmoscopy. (United States)

    Yang, Qiang; Yin, Lu; Nozato, Koji; Zhang, Jie; Saito, Kenichi; Merigan, William H; Williams, David R; Rossi, Ethan A


    Sinusoidal rectification (i.e., desinusoiding) is necessary for scanning imaging systems and is typically achieved by calculating a rectification transform from a calibration image such as a regular grid. This approach is susceptible to error due to electronic or mechanical instability that can alter the phase of the imaging window with respect to the calibration transform. Here, we show a calibration-free rectification method implemented from live video of a scanning light ophthalmoscope (SLO) with or without adaptive optics (AO). This approach, which capitalizes on positional differences in the images obtained in the forward and backward scan directions, dynamically keeps the imaging window in phase with the motion of the sinusoidal resonant scanner, preventing errors from signal drift over time. A benefit of this approach is that it allows the light power across the field-of-view (FOV) to be modulated inversely to achieve uniform irradiance on the retina, a feature desirable for functional imaging methods and light safety in SLOs.

  18. In vivo imaging of retinal pigment epithelium cells in age related macular degeneration. (United States)

    Rossi, Ethan A; Rangel-Fonseca, Piero; Parkins, Keith; Fischer, William; Latchney, Lisa R; Folwell, Margaret A; Williams, David R; Dubra, Alfredo; Chung, Mina M


    Morgan and colleagues demonstrated that the RPE cell mosaic can be resolved in the living human eye non-invasively by imaging the short-wavelength autofluorescence using an adaptive optics (AO) ophthalmoscope. This method, based on the assumption that all subjects have the same longitudinal chromatic aberration (LCA) correction, has proved difficult to use in diseased eyes, and in particular those affected by age-related macular degeneration (AMD). In this work, we improve Morgan's method by accounting for chromatic aberration variations by optimizing the confocal aperture axial and transverse placement through an automated iterative maximization of image intensity. The increase in image intensity after algorithmic aperture placement varied depending upon patient and aperture position prior to optimization but increases as large as a factor of 10 were observed. When using a confocal aperture of 3.4 Airy disks in diameter, images were obtained using retinal radiant exposures of less than 2.44 J/cm(2), which is ~22 times below the current ANSI maximum permissible exposure. RPE cell morphologies that were strikingly similar to those seen in postmortem histological studies were observed in AMD eyes, even in areas where the pattern of fluorescence appeared normal in commercial fundus autofluorescence (FAF) images. This new method can be used to study RPE morphology in AMD and other diseases, providing a powerful tool for understanding disease pathogenesis and progression, and offering a new means to assess the efficacy of treatments designed to restore RPE health.

  19. Role of wide-field autofluorescence imaging and scanning laser ophthalmoscopy in differentiation of choroidal pigmented lesions

    Institute of Scientific and Technical Information of China (English)

    Lukas; Reznicek; Carmen; Stumpf; Florian; Seidensticker; Anselm; Kampik; Aljoscha; S; Neubauer; Marcus; Kernt


    ·AIM:Toevaluatethe diagnostic properties of wide-field fundus autofluorescence(FAF) scanning laser ophthalmoscope(SLO) imaging for differentiating choroidal pigmented lesions.·METHODS: A consecutive series of 139 patients were included, 101 had established choroidal melanoma with13 untreated lesions and 98 treated with radiotherapy.Thirty-eight had choroidal nevi. All patients underwent a full ophthalmological examination, undilated wide-field imaging, FAF and standardized US examination. FAF images and imaging characteristics from SLO were correlated with the structural findings in the two patient groups.·RESULTS: Mean FAF intensity of melanomas was significantly lower than the FAF of choroidal nevi. Only 1out of 38 included eyes with nevi touched the optic disc compared to 31 out of 101 eyes with melanomas. In 18 out of 101 melanomas subretinal fluid was seen at the pigmented lesion compared to none seen in eyes with confirmed choroidal nevi. In "green laser separation", a trend towards more mixed FAF appearance of melanomas compared to nevi was observed. The mean maximal and minimal transverse and longitudinal diameters of melanomas were significantly higher than those of nevi.·CONCLUSION: Wide-field SLO and FAF imaging may be an appropriate non-invasive diagnostic screening tool to differentiate benign from malign pigmented choroidal lesions.

  20. Ocular injuries in industrial technical workers in Delta State, Nigeria

    Institute of Scientific and Technical Information of China (English)

    O.T.Edema; A.E.Omoti; F.B.Akinsola; P.A.Aigbotsua


    Objective: To identify the types and causes of eye injury in industrial workers. Methods: A cross sectional study of the pattern of ocular injuries in Delta state of Nigeria was carried out over 3 months. Five hundred workers were interviewed and examined using the Snellen's chart, pen-torch, direct ophthalmoscope, magnifying loupe and the Perkin's hand-held applanation tonometer. Results: All the 500 workers were males. One hundred and twenty-three workers (24.6%) reported a history of ocular injury at work. The most common causative agents were sand dust, 53 workers (25.1%); cake dust, 27 workers (12.8%) and chemicals, 32 workers (15.1%). The main types of ocular injury were corneal/ conjunctival foreign bodies, 79 workers (64.2%); burns, 35 workers (28.5%) and blunt injury, 9 workers (7.3%). Only 36 (7.2%) workers used protective eye devices at work. Thirteen workers (2.6%) developed monocular blindness from ocular injury. Conclusion: Ocular injury at work is common and few workers wear protective devices at work in industries in Delta state, Nigeria. Industrial workers should have regular eye services and wear eye safety devices at work.

  1. Eye movements during saccadic and fixation tasks in patients with homonymous hemianopia. (United States)

    Reinhard, Jens I; Damm, Ingelene; Ivanov, Iliya V; Trauzettel-Klosinski, Susanne


    The aim of our study was to quantify ocular motor performance in patients with homonymous hemianopia and in healthy controls during saccadic and fixation tasks and to detect potential spontaneous adaptive mechanisms in the hemianopic patients. Eye movements were recorded in 33 hemianopic patients (15 right, 18 left; disease duration, 0.2-29 years) and 14 healthy subjects by scanning laser ophthalmoscope allowing determination of the absolute fovea position relative to the stimulus without calibration. Landing accuracy of saccades was determined for 5° saccades, indicated by the number of dysmetric saccades (DS), and fixation stability (FS) after landing. In addition, during continuous fixation of a central cross, FS, and distribution of fixational eye movements (FEMs) were measured. Size of macular sparing was determined using custom microperimetry software (stimulus grid, 0.5°). Compared with controls, landing accuracy was decreased in hemianopic patients, indicated by significantly more DS (hypometric and hypermetric) to the blind side compared with the seeing side. The number of DS was greater in patients with macular sparing of FEM during continuous fixation was asymmetrically shifted to the blind side, especially in cases of macular sparing of FEMs during continuous fixation indicate an advantageous adaptive mechanism to shift the visual field border towards the hemianopic side.

  2. Automated circumferential construction of first-order aqueous humor outflow pathways using spectral-domain optical coherence tomography (United States)

    Huang, Alex S.; Belghith, Akram; Dastiridou, Anna; Chopra, Vikas; Zangwill, Linda M.; Weinreb, Robert N.


    The purpose was to create a three-dimensional (3-D) model of circumferential aqueous humor outflow (AHO) in a living human eye with an automated detection algorithm for Schlemm's canal (SC) and first-order collector channels (CC) applied to spectral-domain optical coherence tomography (SD-OCT). Anterior segment SD-OCT scans from a subject were acquired circumferentially around the limbus. A Bayesian Ridge method was used to approximate the location of the SC on infrared confocal laser scanning ophthalmoscopic images with a cross multiplication tool developed to initiate SC/CC detection automated through a fuzzy hidden Markov Chain approach. Automatic segmentation of SC and initial CC's was manually confirmed by two masked graders. Outflow pathways detected by the segmentation algorithm were reconstructed into a 3-D representation of AHO. Overall, only <1% of images (5114 total B-scans) were ungradable. Automatic segmentation algorithm performed well with SC detection 98.3% of the time and <0.1% false positive detection compared to expert grader consensus. CC was detected 84.2% of the time with 1.4% false positive detection. 3-D representation of AHO pathways demonstrated variably thicker and thinner SC with some clear CC roots. Circumferential (360 deg), automated, and validated AHO detection of angle structures in the living human eye with reconstruction was possible.

  3. Transverse chromatic aberration across the visual field of the human eye. (United States)

    Winter, Simon; Sabesan, Ramkumar; Tiruveedhula, Pavan; Privitera, Claudio; Unsbo, Peter; Lundström, Linda; Roorda, Austin


    The purpose of this study was to measure the transverse chromatic aberration (TCA) across the visual field of the human eye objectively. TCA was measured at horizontal and vertical field angles out to ±15° from foveal fixation in the right eye of four subjects. Interleaved retinal images were taken at wavelengths 543 nm and 842 nm in an adaptive optics scanning laser ophthalmoscope (AOSLO). To obtain true measures of the human eye's TCA, the contributions of the AOSLO system's TCA were measured using an on-axis aligned model eye and subtracted from the ocular data. The increase in TCA was found to be linear with eccentricity, with an average slope of 0.21 arcmin/degree of visual field angle (corresponding to 0.41 arcmin/degree for 430 nm to 770 nm). The absolute magnitude of ocular TCA varied between subjects, but was similar to the resolution acuity at 10° in the nasal visual field, encompassing three to four cones. Therefore, TCA can be visually significant. Furthermore, for high-resolution imaging applications, whether visualizing or stimulating cellular features in the retina, it is important to consider the lateral displacements between wavelengths and the variation in blur over the visual field.

  4. Simultaneous OCT/confocal-OCT/ICG system for imaging the eye (United States)

    Podoleanu, Adrian G.; Rosen, Richard B.; Dobre, George; Rogers, John A.; Garcia, Patricia; Pedro, Justin; Dunne, Shane; Jackson, David A.; Weitz, Rishard


    En-face OCT acquired simultaneously with paired confocal ophthalmoscopic (CO) images provides unprecedented point-to-point correlation between surface and subsurface anatomy of the retina. An advanced prototype of a dual channel OCT/CO instrument was developed in terms of signal to noise ratio and image size. The system can operate in A, B and C-scan regimes. The design is such that there is a strict pixel to pixel correspondence between the OCT and confocal images. An extensive array of clinic pathologies were studied including macular degeneration, central serous retinopathy (CSR), macular hole, macular pucker, cystoid macular edema (CME), diabetic maculopathy, and macular trauma. We report observation of reoccurring patterns in the en-face OCT images which could be identified with different diseases. The system can also simultaneously produce en-face OCT and indocyanine green (ICG) fluorescence images where the same source is used to produce the OCT image and excite the ICG. The system is compact and assembled on a chin rest and it enables the clinician to visualise the same area of the eye fundus in terms of both en face OCT slices and ICG angiograms, displayed side by side. The images are collected by fast en-face scanning (T-scan) followed by slower scanning along a transverse direction and depth scanning. The system is capable of providing chosen OCT B-scans at selected points from the ICG image.

  5. Reading strategies in Stargardt's disease with foveal sparing

    Directory of Open Access Journals (Sweden)

    Whatham Andrew R


    Full Text Available Abstract Background Subjects with a ring scotoma can use two retinal loci, a foveal and a peripheral, for reading. Our aim was to investigate the relative use of both retinal loci as a function of the spared foveal area size and the spatial resolution at both retinal loci. Findings Two patients with Stargardt's disease and ring scotomas read through a scanning laser ophthalmoscope a series of letters and words at various character sizes. The number of fixations made using each retinal locus was quantified. The relative use of each retinal locus depended on character size of the stimulus. Both patients used exclusively the eccentric retinal locus to read words of large character sizes. At small character sizes, the central retinal locus was predominantly used. For reading letters or words, once foveal fixation was used, patients did not shift back to the eccentric retinal locus. When spatial resolution allowed deciphering at both the eccentric and the central areas, patients consistently fixated with the eccentric retinal locus. Conclusions Spatial resolution at the eccentric locus appears as a determinant factor to select the retinal area for reading. Reading strategies in patients with Stargardt's disease and a ring scotoma demonstrate a pattern of coordination of both eccentric and central retinal loci, reflecting a high degree of adaptation.

  6. Uses of the word "macula" in written English, 1400-present. (United States)

    Schwartz, Stephen G; Leffler, Christopher T


    We compiled uses of the word "macula" in written English by searching multiple databases, including the Early English Books Online Text Creation Partnership, America's Historical Newspapers, the Gale Cengage Collections, and others. "Macula" has been used: as a non-medical "spot" or "stain", literal or figurative, including in astronomy and in Shakespeare; as a medical skin lesion, occasionally with a following descriptive adjective, such as a color (macula alba); as a corneal lesion, including the earliest identified use in English, circa 1400; and to describe the center of the retina. Francesco Buzzi described a yellow color in the posterior pole ("retina tinta di un color giallo") in 1782, but did not use the word "macula". "Macula lutea" was published by Samuel Thomas von Sömmering by 1799, and subsequently used in 1818 by James Wardrop, which appears to be the first known use in English. The Google n-gram database shows a marked increase in the frequencies of both "macula" and "macula lutea" following the introduction of the ophthalmoscope in 1850. "Macula" has been used in multiple contexts in written English. Modern databases provide powerful tools to explore historical uses of this word, which may be underappreciated by contemporary ophthalmologists.

  7. Advanced capabilities of the multimodal adaptive optics imager (United States)

    Hammer, Daniel X.; Ferguson, R. D.; Mujat, Mircea; Biss, David P.; Iftimia, Nicusor V.; Patel, Ankit H.; Plumb, Emily; Campbell, Melanie; Norris, Jennifer L.; Dubra, Alfredo; Chui, Toco Y. P.; Akula, James D.; Fulton, Anne B.


    We recently developed several versions of a multimodal adaptive optics (AO) retinal imager, which includes highresolution scanning laser ophthalmoscopy (SLO) and Fourier domain optical coherence tomography (FDOCT) imaging channels as well as an auxiliary wide-field line scanning ophthalmoscope (LSO). Some versions have also been equipped with a fluorescence channel and a retinal tracker. We describe the performance of three key features of the multimodal AO system including: simultaneous SLO/OCT imaging, which allows SLO/OCT co-registration; a small animal imaging port, which adjusts the beam diameter at the pupil from 7.5 to 2.5 mm for use with small animals ubiquitous in biological research or for extended depth-of-focus imaging in humans; and slow scan Doppler flowmetry imaging using the wide field auxiliary LSO imaging channel. The systems are currently deployed in several ophthalmology clinics and research laboratories and several investigations have commenced on patients with a variety of retinal diseases and animals in vision research.


    Ajvazi, Alil; Lutaj, Pajtim; Goranci, Ilhami


    To ascertain the prevalence of diabetic retinopathy--DR, based on the duration of the diabetes mellitus--DM and to compare it with data from relevant literature and other referent clinics. In this study are included the patients with diabetes mellitus type 1 insulin-dependent--DMID and diabetes mellitus type 2 non-insulin-dependent--DMNID. The duration of diabetes in the examined patients varied from 5 till 30 years. We have applied examination by ophthalmoscope, slit lamp bio-microscopy with Volk and Goldman lens, optical coherence tomography--OCT as well as fluorescein angiography--FAG. Have been included the treated patients with DR, from September 2004-2014. In diabetic patients suffering for a period of 5 years, the prevalence of DR is 10%. In diabetic patients suffering over 30 years, the prevalence of DR is varied from 82% until 97%. Diabetic retinopathy, undertakes a multidisciplinary approach in all patients with diabetes to achieve optimal blood glucose control HbA1c levels 7.0% or lower and to adequately manage systolic blood pressure less than 140 mmHg and serum LDL cholesterol of less than 2.5 mmol/L and triglycerides of less than 2.0 mmol/L. Always should be assessed visual acuity at the time of DR examination.

  9. Clinical and ultrasonographic findings of some ocular conditions in sheep and goats

    Directory of Open Access Journals (Sweden)

    O. El-Tookhy


    Full Text Available This study was carried out to describe the ultrasonographic findings in relation to the clinical symptoms of some common ocular conditions in sheep and goats. Fifty animals (32 goats and 18 sheep with different ocular problems were examined. Ultrasonographic examination was performed using a B-mode ocular ultrasound unit, and the structure of the globe was evaluated at a depth of 4-6 cm. Early cases (n=35, 70% showed varying ocular conditions; hypopyon, (n=8, 16%, stromal abscesses, (n=4, 8%, and anterior uveitis (n=23, 46%. Hypopyon appeared clinically as a white or yellowish material in the anterior chamber, and ultrasonographically as a hyperechoic mass in the anterior chamber. Severe iridocyclitis was noticed in acute cases of infectious keratoconjunctivitis (IKC accompanied by blepharospasm, photophobia, excessive tearing and eyelid margin crust formation. Ultrasonographically, the pupil appeared constricted with increased hyperechoic thickening of the ciliary body. In chronic cases of IKC, corneal pigmentation (n=5, 10% and cataract (n=10, 20% were seen. Ultrasonographically the type and degree of cataract were diagnosed. The present study provides an inside view of the inner ocular structures during the course of certain eye diseases where ophthalmoscopic examination is not possible. Our findings, although preliminary, are relevant for the more complete diagnosis of certain external ocular conditions in sheep and goat herds.

  10. Ability of spectral domain optical coherence tomography peripapillary retinal nerve fiber layer thickness measurements to identify early glaucoma

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    Tarannum Mansoori


    Full Text Available Purpose : To evaluate the ability of spectral domain optical coherence tomography (OCT peripapillary retinal nerve fiber layer thickness (RNFLT parameters to distinguish normal eyes from those with early glaucoma in Asian Indian eyes. Design : Observational cross-sectional study. Materials and Methods : One hundred and seventy eight eyes (83 glaucoma patients and 95 age matched healthy subjects of subjects more than 40 years of age were included in the study. All subjects underwent RNFLT measurement with spectral OCT/ scanning laser ophthalmoscope (SLO after dilatation. Sensitivity, specificity and area under the receiving operating characteristic curve (AROC were calculated for various OCT peripapillary RNFL parameters. Results: The mean RNFLT in healthy subjects and patients with early glaucoma were 105.7 ± 5.1 μm and 90.7 ± 7.5 μm, respectively. The largest AROC was found for 12 o′clock- hour (0.98, average (0.96 and superior quadrant RNFLT (0.9. When target specificity was set at ≥ 90% and ≥ 80%, the parameters with highest sensitivity were 12 o′clock -hour (91.6%, average RNFLT (85.3% and 12 o′ clock- hour (96.8 %, average RNFLT (94.7% respectively. Conclusion : Our study showed good ability of spectral OCT/ SLO to differentiate normal eyes from patients with early glaucoma and hence it may serve as an useful adjunct for early diagnosis of glaucoma.

  11. Progress on Developing Adaptive Optics-Optical Coherence Tomography for In Vivo Retinal Imaging: Monitoring and Correction of Eye Motion Artifacts. (United States)

    Zawadzki, Robert J; Capps, Arlie G; Kim, Dae Yu; Panorgias, Athanasios; Stevenson, Scott B; Hamann, Bernd; Werner, John S


    Recent progress in retinal image acquisition techniques, including optical coherence tomography (OCT) and scanning laser ophthalmoscopy (SLO), combined with improved performance of adaptive optics (AO) instrumentation, has resulted in improvement in the quality of in vivo images of cellular structures in the human retina. Here, we present a short review of progress on developing AO-OCT instruments. Despite significant progress in imaging speed and resolution, eye movements present during acquisition of a retinal image with OCT introduce motion artifacts into the image, complicating analysis and registration. This effect is especially pronounced in high-resolution datasets acquired with AO-OCT instruments. Several retinal tracking systems have been introduced to correct retinal motion during data acquisition. We present a method for correcting motion artifacts in AO-OCT volume data after acquisition using simultaneously captured adaptive optics-scanning laser ophthalmoscope (AO-SLO) images. We extract transverse eye motion data from the AO-SLO images, assign a motion adjustment vector to each AO-OCT A-scan, and re-sample from the scattered data back onto a regular grid. The corrected volume data improve the accuracy of quantitative analyses of microscopic structures.

  12. Progress on Developing Adaptive Optics–Optical Coherence Tomography for In Vivo Retinal Imaging: Monitoring and Correction of Eye Motion Artifacts (United States)

    Zawadzki, Robert J.; Capps, Arlie G.; Kim, Dae Yu; Panorgias, Athanasios; Stevenson, Scott B.; Hamann, Bernd; Werner, John S.


    Recent progress in retinal image acquisition techniques, including optical coherence tomography (OCT) and scanning laser ophthalmoscopy (SLO), combined with improved performance of adaptive optics (AO) instrumentation, has resulted in improvement in the quality of in vivo images of cellular structures in the human retina. Here, we present a short review of progress on developing AO-OCT instruments. Despite significant progress in imaging speed and resolution, eye movements present during acquisition of a retinal image with OCT introduce motion artifacts into the image, complicating analysis and registration. This effect is especially pronounced in high-resolution datasets acquired with AO-OCT instruments. Several retinal tracking systems have been introduced to correct retinal motion during data acquisition. We present a method for correcting motion artifacts in AO-OCT volume data after acquisition using simultaneously captured adaptive optics-scanning laser ophthalmoscope (AO-SLO) images. We extract transverse eye motion data from the AO-SLO images, assign a motion adjustment vector to each AO-OCT A-scan, and re-sample from the scattered data back onto a regular grid. The corrected volume data improve the accuracy of quantitative analyses of microscopic structures. PMID:25544826

  13. Adaptive optics ophthalmologic systems using dual deformable mirrors

    Energy Technology Data Exchange (ETDEWEB)

    Jones, S; Olivier, S; Chen, D; Sadda, S; Joeres, S; Zawadzki, R; Werner, J S; Miller, D


    Adaptive Optics (AO) have been increasingly combined with a variety of ophthalmic instruments over the last decade to provide cellular-level, in-vivo images of the eye. The use of MEMS deformable mirrors in these instruments has recently been demonstrated to reduce system size and cost while improving performance. However, currently available MEMS mirrors lack the required range of motion for correcting large ocular aberrations, such as defocus and astigmatism. In order to address this problem, we have developed an AO system architecture that uses two deformable mirrors, in a woofer/tweeter arrangement, with a bimorph mirror as the woofer and a MEMS mirror as the tweeter. This setup provides several advantages, including extended aberration correction range, due to the large stroke of the bimorph mirror, high order aberration correction using the MEMS mirror, and additionally, the ability to ''focus'' through the retina. This AO system architecture is currently being used in four instruments, including an Optical Coherence Tomography (OCT) system and a retinal flood-illuminated imaging system at the UC Davis Medical Center, a Scanning Laser Ophthalmoscope (SLO) at the Doheny Eye Institute, and an OCT system at Indiana University. The design, operation and evaluation of this type of AO system architecture will be presented.

  14. Vision, touch and object manipulation in Senegal parrots Poicephalus senegalus. (United States)

    Demery, Zoe P; Chappell, Jackie; Martin, Graham R


    Parrots are exceptional among birds for their high levels of exploratory behaviour and manipulatory abilities. It has been argued that foraging method is the prime determinant of a bird's visual field configuration. However, here we argue that the topography of visual fields in parrots is related to their playful dexterity, unique anatomy and particularly the tactile information that is gained through their bill tip organ during object manipulation. We measured the visual fields of Senegal parrots Poicephalus senegalus using the ophthalmoscopic reflex technique and also report some preliminary observations on the bill tip organ in this species. We found that the visual fields of Senegal parrots are unlike those described hitherto in any other bird species, with both a relatively broad frontal binocular field and a near comprehensive field of view around the head. The behavioural implications are discussed and we consider how extractive foraging and object exploration, mediated in part by tactile cues from the bill, has led to the absence of visual coverage of the region below the bill in favour of more comprehensive visual coverage above the head.

  15. Macular Retinal Ganglion Cell Complex Thickness and Its Relationship to the Optic Nerve Head Topography in Glaucomatous Eyes with Hemifield Defects

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    Seiji T. Takagi


    Full Text Available Purpose. To evaluate the relationship between the macular ganglion cell complex (mGCC thickness, which is the sum of the retinal nerve fiber, ganglion cell, and inner plexiform layers, measured with a spectral-domain optical coherence tomograph and the optic nerve head topography measured with a confocal scanning laser ophthalmoscope in glaucomatous eyes with visual field defects localized predominantly to either hemifield. Materials and Methods. The correlation between the mGCC thickness in hemispheres corresponding to hemifields with and without defects (damaged and intact hemispheres, respectively and the optic nerve head topography corresponding to the respective hemispheres was evaluated in 18 glaucomatous eyes. Results. The mGCC thickness was significantly correlated with the rim volume, mean retinal nerve fiber layer thickness, and cross-sectional area of the retinal nerve fiber layer in both the intact and the damaged hemispheres (P<.05. Discussion. For detecting very early glaucomatous damage of the optic nerve, changes in the thicknesses of the inner retina in the macular area and peripapillary RNFL as well as rim volume changes in the optic nerve head are target parameters that should be carefully monitored.

  16. [Tay-Sachs disease in non-Jewish infant in Israel]. (United States)

    Nadim, Nasser


    Tay-Sachs disease, also known as GM2 gangliosidosis or Hexosaminidase A deficiency is an autosomal recessive genetic fatal disorder. The disease is known to appear in East European Ashkenazi Jews, North African Jews, and Quebec French Canadians exclusively, but, with different frequency and type of mutation. Its most common variant is the infantile type Tay-Sachs disease. Juvenile and late-onset forms of the disease are infrequent and slowly progressive. At nearly 3 to 6 months old, a baby with Tay-Sachs progressively loses his motor skills and attentiveness. Startle responses and hyperreflexia become prominent, especially on eliciting deep patellar and Achilles reflexes, as a consequence of neurodegeneration of the upper motor neuron. Other systemic damage ensues gradually; seizures, blindness, spasticity of limbs, inability to swallow and breathe, and eventually the baby dies at 1-4 years of age. All Tay-Sachs patients have a "cherry red spot", easily seen in the macula area of the retina, using an ophthalmoscope. The "cherry red spot" is the only normal part of the retina in these sick babies. The case presented here emphasizes that Tay-Sachs disease is sometimes misdiagnosed at first visits even by an experienced clinician, because of his lack of awareness that this disease is not exclusively a Jewish disease.

  17. Intraocular Silicone Oil Masquerading as Terson Syndrome

    Directory of Open Access Journals (Sweden)

    Navid Elmi Sadr


    Full Text Available Introduction. Terson syndrome is described as intraocular hemorrhage in association with any type of intracranial hemorrhage and is associated with higher mortality rate and vision loss. Intraocular hemorrhage in Terson syndrome may be diagnosed using computed tomography but there are false positive results. Silicone oil which is widely used for internal tamponade of complicated retinal detachments has high attenuation on computed tomography and hyperintensity on T1-weighted magnetic resonance imaging that can mimic intraocular hemorrhage. This report shows that silicone oil is another origin of false positive results in interpreting CT findings for detecting Terson syndrome. Case Report. A 71-year-old diabetic woman presented with loss of consciousness. Brain computed tomography revealed right cerebellar hemorrhage and ventricular hemorrhage and hyperdensity in vitreous cavity of the left eye that was initially interpreted as vitreous hemorrhage. Terson syndrome was the initial diagnosis but ophthalmoscopic examination and brain MRI showed that the left eye had silicone oil tamponade. Conclusion. Without knowing the history of previous vitreoretinal surgery, CT scan findings of intraocular silicone oil may be interpreted as vitreous hemorrhage. In patients with concomitant intracranial hemorrhage, it can masquerade as Terson syndrome.

  18. Automatic irradiation control by an optical feedback technique for selective retina treatment (SRT) in a rabbit model (United States)

    Seifert, Eric; Roh, Young-Jung; Fritz, Andreas; Park, Young Gun; Kang, Seungbum; Theisen-Kunde, Dirk; Brinkmann, Ralf


    Selective Retina Therapy (SRT) targets the Retinal Pigment Epithelium (RPE) without effecting neighboring layers as the photoreceptors or the choroid. SRT related RPE defects are ophthalmoscopically invisible. Owing to this invisibility and the variation of the threshold radiant exposure for RPE damage the treating physician does not know whether the treatment was successful or not. Thus measurement techniques enabling a correct dosing are a demanded element in SRT devices. The acquired signal can be used for monitoring or automatic irradiation control. Existing monitoring techniques are based on the detection of micro-bubbles. These bubbles are the origin of RPE cell damage for pulse durations in the ns and μs time regime 5μs. The detection can be performed by optical or acoustical approaches. Monitoring based on an acoustical approach has already been used to study the beneficial effects of SRT on diabetic macula edema and central serous retinopathy. We have developed a first real time feedback technique able to detect micro-bubble induced characteristics in the backscattered laser light fast enough to cease the laser irradiation within a burst. Therefore the laser energy within a burst of at most 30 pulses is increased linearly with every pulse. The laser irradiation is ceased as soon as micro-bubbles are detected. With this automatic approach it was possible to observe invisible lesions, an intact photoreceptor layer and a reconstruction of the RPE within one week.

  19. Transconjunctival retinopexy with active external drainage of subretinal fluid: a prospective pilot study of eight consecutive cases. (United States)

    Siqueira, Rubens Camargo; Jorge, Rodrigo; Scott, Ingrid Ursula


    To describe an alternative surgical technique for the management of retinal detachment with no or minimal proliferative vitreoretinopathy (grade B) using transconjunctival retinopexy with active external drainage of subretinal fluid. In a prospective, interventional study, eight consecutive patients with retinal detachment with no or minimal proliferative vitreoretinopathy (grade B) underwent transconjunctival retinopexy with active external drainage of subretinal fluid. Transconjunctival external drainage of subretinal fluid was achieved by using a 29 gauge needle placed in the subretinal space under indirect ophthalmoscopic monitoring. Active suction was performed (500 mmHg vacuum) using a vitrectomy line coupled to the needle. After retinal reattachment, cryotherapy was applied to the scleral region corresponding to the area of the retinal break(s). In all cases there was retinal attachment at the end of surgery. Retinal redetachment occurred in four pseudophakic patients who then underwent pars plana vitrectomy. The four phakic patients maintained retinal attachment during follow-up (13-20 months). Transconjunctival retinopexy with active external drainage of subretinal fluid represents a useful, faster, and cheaper alternative to scleral buckling for retinal detachments with no or minimal proliferative retinopathy in phakic patients and, unlike scleral buckling, is not associated with induced myopia.

  20. Retinochoroidal changes after severe brain impact injury in rabbits

    Institute of Scientific and Technical Information of China (English)


    Objective: To investigate retinochoroidal changes and establisheye damage model after brain impact injury.Methods: An eye damage model after brain impact injury was established by striking the frontoparietal zone in rabbits with BIM-Ⅱ bioimpact machine. Seventeen rabbits were killed at 4 different intervals after injury. The pathological characteristics of the retinal and choroid damages were observed.Results: All the rabbits had severe brain injury with subarachnoid hemorrhage and brain contusion. The eye damage occurred in all of the 17 rabbits. Hemorrhage in optic nerve sheaths was observed and retinal edema and bleeding was discovered with ophthalmoscope. Histopathologic study displayed subarachnoid hemorrhage in the retrobulbar portion of the retinal nerve, general choroid blood vessel dilatation, retinal nerve fibre swelling within 6 hours after injury, and flat retinal detachment with subretinal proteinoid exudation, and degeneration and disappearance of the outer segment of the optic cell over 6 hours after injury.Conclusions: The pathological characteristic of the eye damage at early stage following brain impact injury is local circulation disturbance. At late stage, it features in retinal detachment, and optic cellular degeneration and necrosis.

  1. Comprehensive Detection, Grading, and Growth Behavior Evaluation of Subthreshold and Low Intensity Photocoagulation Lesions by Optical Coherence Tomographic and Infrared Image Analysis

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    Stefan Koinzer


    Full Text Available Purpose. To correlate the long-term clinical effect of photocoagulation lesions after 6 months, as measured by their retinal damage size, to exposure parameters. We used optical coherence tomographic (OCT-based lesion classes in order to detect and assess clinically invisible and mild lesions. Methods. In this prospective study, 488 photocoagulation lesions were imaged in 20 patients. We varied irradiation diameters (100/300 µm, exposure-times (20–200 ms, and power. Intensities were classified in OCT images after one hour, and we evaluated OCT and infrared (IR images over six months after exposure. Results. For six consecutive OCT-based lesion classes, the following parameters increased with the class: ophthalmoscopic, OCT and IR visibility rate, fundus and OCT diameter, and IR area, but not irradiation power. OCT diameters correlated with exposure-time, irradiation diameter, and OCT class. OCT classes discriminated the largest bandwidth of OCT diameters. Conclusion. OCT classes represent objective and valid endpoints of photocoagulation intensity even for “subthreshold” intensities. They are suitable to calculate the treated retinal area. As the area is critical for treatment efficacy, OCT classes are useful to define treatment intensity, calculate necessary lesion numbers, and universally categorize lesions in clinical studies.

  2. Simple, inexpensive technique for high-quality smartphone fundus photography in human and animal eyes. (United States)

    Haddock, Luis J; Kim, David Y; Mukai, Shizuo


    Purpose. We describe in detail a relatively simple technique of fundus photography in human and rabbit eyes using a smartphone, an inexpensive app for the smartphone, and instruments that are readily available in an ophthalmic practice. Methods. Fundus images were captured with a smartphone and a 20D lens with or without a Koeppe lens. By using the coaxial light source of the phone, this system works as an indirect ophthalmoscope that creates a digital image of the fundus. The application whose software allows for independent control of focus, exposure, and light intensity during video filming was used. With this app, we recorded high-definition videos of the fundus and subsequently extracted high-quality, still images from the video clip. Results. The described technique of smartphone fundus photography was able to capture excellent high-quality fundus images in both children under anesthesia and in awake adults. Excellent images were acquired with the 20D lens alone in the clinic, and the addition of the Koeppe lens in the operating room resulted in the best quality images. Successful photodocumentation of rabbit fundus was achieved in control and experimental eyes. Conclusion. The currently described system was able to take consistently high-quality fundus photographs in patients and in animals using readily available instruments that are portable with simple power sources. It is relatively simple to master, is relatively inexpensive, and can take advantage of the expanding mobile-telephone networks for telemedicine.

  3. [Bilateral acute retrobulbar space-occupying lesion within the scope of thrombolytic therapy in myocardial infarct--a case report]. (United States)

    Vécsei, P V; Domanovits, H; Kircher, K; Egger, S F; Turetschek, K


    A 51-year-old male patient with circulatory arrest and ventricular fibrillation was brought to the emergency department after restoration of spontaneous circulation. ECG presented signs of acute anterolateral myocardial infarction. Thrombolytic therapy according to the Neuhaus scheme was initiated. After administration of 60 mg rt-PA continuously increasing protrusion and hyposphagma of both eyes (left > right) and left-sided monocle-hematoma was observed. CCT showed shadowing of sinus ethmoidales frontales, broadening of the left lateral rectus muscle and retrobulbar volume increase without any signs of recent bleeding. The ophthalmologist had to answer the question if there was, in spite of the massive retrobulbar volume increase, a sufficient blood supply for both eyes. Ophthalmoscopically there were no signs of intraretinal bleeding or retinal ischemia. Intraocular circulation was checked by color Doppler sonography: Ophthalmic artery, the short posterior ciliary arteries and central retinal artery of both eyes showed very low, but definitely positive bloodflow. Further course showed a constant trend towards higher systolic bloodflow velocities in all eye vessels, verified by color Doppler sonography. Computer perimetry, performed after the recovery of the patient, revealed a visual field defect, which was related to a breakdown of the flow in a ciliary artery rather than to damage due to compression of the optic nerve. Possible reasons of the retrobulbar volume increase under thrombolytic therapy are discussed.

  4. Lesion strength control by automatic temperature guided retinal photocoagulation (United States)

    Schlott, Kerstin; Koinzer, Stefan; Baade, Alexander; Birngruber, Reginald; Roider, Johann; Brinkmann, Ralf


    Laser photocoagulation is an established treatment for a variety of retinal diseases. However, when using the same irradiation parameter, the size and strength of the lesions are unpredictable due to unknown inter- and intraindividual optical properties of the fundus layers. The aim of this work is to investigate a feedback system to generate desired lesions of preselectable strengths by automatically controlling the irradiation time. Optoacoustics were used for retinal temperature monitoring. A 532-nm continuous wave Nd:YAG laser was used for photocoagulation. A 75-ns/523-nm Q-switched Nd:YLF laser simultaneously excited temperature-dependent pressure transients, which were detected at the cornea by an ultrasonic transducer embedded in a contact lens. The temperature data were analyzed during the irradiation by a LabVIEW routine. The treatment laser was switched off automatically when the required lesion strength was achieved. Five different feedback control algorithms for different lesion sizes were developed and tested on rabbits in vivo. With a laser spot diameter of 133 μm, five different lesion types with ophthalmoscopically visible diameters ranging mostly between 100 and 200 μm, and different appearances were achieved by automatic exposure time control. The automatically controlled lesions were widely independent of the treatment laser power and the retinal pigmentation.

  5. Psychophysical function in age-related maculopathy.

    LENUS (Irish Health Repository)

    Neelam, Kumari


    Age-related macular degeneration (AMD), the late stage of age-related maculopathy (ARM), is the leading cause of blind registration in developed countries. The visual loss in AMD occurs due to dysfunction and death of photoreceptors (rods and cones) secondary to an atrophic or a neovascular event. The psychophysical tests of vision, which depend on the functional status of the photoreceptors, may detect subtle alterations in the macula before morphological fundus changes are apparent ophthalmoscopically, and before traditional measures of visual acuity exhibit deterioration, and may be a useful tool for assessing and monitoring patients with ARM. Furthermore, worsening of these visual functions over time may reflect disease progression, and some of these, alone or in combination with other parameters, may act as a prognostic indicator for identifying eyes at risk for developing neovascular AMD. Lastly, psychophysical tests often correlate with subjective and relatively undefined symptoms in patients with early ARM, and may reflect limitation of daily activities for ARM patients. However, clinical studies investigating psychophysical function have largely been cross-sectional in nature, with small sample sizes, and lack consistency in terms of the grading and classification of ARM. This article aims to comprehensively review the literature germane to psychophysical tests in ARM, and to furnish the reader with an insight into this complex area of research.

  6. NF-kB activation as a biomarker of light injury using a transgenic mouse model (United States)

    Pocock, Ginger M.; Boretsky, Adam; Wang, Heuy-Ching; Golden, Dallas; Gupta, Praveena; Vargas, Gracie; Oliver, Jeffrey W.; Motamedi, Massoud


    The spatial and temporal activation of NF-kB (p65) was monitored in the retina of a transgenic mouse model (cis-NFkB-EGFP) in vivo after receiving varying grades of laser induced thermal injury in one eye. Baseline images of the retinas from 26 mice were collected prior to injury and up to five months post-exposure using a Heidelberg Spectralis HRA confocal scanning laser ophthalmoscope (cSLO) with a spectral domain optical coherence tomographer (SDOCT). Injured and control eyes were enucleated at discrete time points following laser exposure for cryosectioning to determine localization of NF-kB dependent enhanced green fluorescent protein (EGFP) reporter gene expression within the retina using fluorescence microscopy. In addition, EGFP basal expression in brain and retinal tissue from the cis-NFkB-EGFP was characterized using two-photon imaging. Regions of the retina exposed to threshold and supra-threshold laser damage evaluated using fluorescence cSLO showed increased EGFP fluorescence localized to the exposed region for a duration that was dependent upon the degree of injury. Fluorescence microscopy of threshold damage revealed EGFP localized to the outer nuclear region and retinal pigment epithelial layer. Basal expression of EGFP imaged using two-photon microscopy was heterogeneously distributed throughout brain tissue and confined to the inner retina. Results show cis-NF-kB-EGFP reporter mouse can be used for in vivo studies of light induced injury to the retina and possibly brain injury.

  7. Compensation for retinal vessel density reduces the variation of circumpapillary RNFL in healthy subjects.

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    Ivania Pereira

    Full Text Available This work intends to assess circumpapillary retinal vessel density (RVD at a 3.46 mm diameter circle and correlate it with circumpapillary retinal nerve fiber layer (RNFL thickness measured with Fourier-Domain Optical Coherence Tomography. Furthermore, it aims to evaluate the reduction of intersubject variability of RNFL when considering RVD as a source of information for RNFL distribution. For that, 106 healthy subjects underwent circumpapillary RNFL measurement. Using the scanning laser ophthalmoscope fundus image, thickness and position of retinal vessels were assessed and integrated in a 256-sector RVD profile. The relationship between local RVD value and local RNFL thickness was modeled by linear regression. RNFL was then compensated for RVD variation by regression formulas. A strong statistically significant intrasubject correlation was found for all subjects between RVD and RNFL profiles (mean R = 0.769. In the intersubject regression analysis, 247 of 256 RNFL sectors showed a statistically significant positive correlation with RVD (mean R = 0.423. RVD compensation of RNFL resulted in a relative reduction of up to 20% of the intersubject variance. In conclusion, RVD in a 3.46 mm circle has a clinically relevant influence on the RNFL distribution. RVD may be used to develop more individualized normative values for RNFL measurement, which might improve early diagnosis of glaucoma.

  8. Optic Coherence Tomography of Idiopathic Macular Epiretinal Membranes

    Institute of Scientific and Technical Information of China (English)

    Xing Liu; Yunlan Ling; Jingjing Huang; Xiaoping Zheng


    bjectives: To study the characteristics of optical coherence tomography (OCT)inopathic macular epiretinal membranes (IMEM) and the relationship between thethickness offovea and the vision of affected eyes.Methods:A total of 67 cases (73 eyes) with clinical diagnosis of IMEM using direct,indirect ophthalmoscope, three mirror contact lens, fundus color photography or fundusfluorescein angiography (FFA)were examined with OCTResults: Epiretinal membranes (ERMs) with macular edema were found in 32 eyes,proliferative ERMs in 20 eyes, ERMs with macular pseudoholes in 14 eyes and ERMswith laminar macular holes in 7 eyes. Based on OCT, the ERMs were clearly andpartially seperated from the retinal (27 eyes, 38.36% ), the retinal thickness of thefovea was the thickest in the proliferative ERMs and the thinnest in the ERMs withlaminar macular holes. The statistical analysis showed there was a negative correlationbetween the thickness of fovea and visual acuity ( r = - 0. 454, P = 0. 000).Conclusion:There were four types of images of OCT in IMEM: ERMs with macularedema, proliferative ERMs, ERMs with macular pseudohole and ERMs with laminarmacular hole; and the thicker the fovea under the OCT, the poorer the vision acuity in the affected eyes with ERMs.

  9. Benefits of retinal image motion at the limits of spatial vision. (United States)

    Ratnam, Kavitha; Domdei, Niklas; Harmening, Wolf M; Roorda, Austin


    Even during fixation, our eyes are constantly in motion, creating an ever-changing signal in each photoreceptor. Neuronal processes can exploit such transient signals to serve spatial vision, but it is not known how our finest visual acuity-one that we use for deciphering small letters or identifying distant faces and objects-is maintained when confronted with such change. We used an adaptive optics scanning laser ophthalmoscope to precisely control the spatiotemporal input on a photoreceptor scale in human observers during a visual discrimination task under conditions with habitual, cancelled or otherwise manipulated retinal image motion. We found that when stimuli moved, acuities were about 25% better than when no motion occurred, regardless of whether that motion was self-induced, a playback of similar motion, or an external simulation. We argue that in our particular experimental condition, the visual system is able to synthesize a higher resolution percept from multiple views of a poorly resolved image, a hypothesis that might extend the current understanding of how fixational eye motion serves high acuity vision.

  10. TeleOph: a secure real-time teleophthalmology system. (United States)

    Wu, Yongdong; Wei, Zhou; Yao, Haixia; Zhao, Zhigang; Ngoh, Lek Heng; Deng, Robert H; Yu, Shengsheng


    Teleophthalmology (TeleOph) is an electronic counterpart of today's face-to-face, patient-to-specialist ophthalmology system. It enables one or more ophthalmologists to remotely examine a patient's condition via a confidential and authentic communication channel. Specifically, TeleOph allows a trained nonspecialist in a primary clinic to screen the patients with digital instruments (e.g., camera, ophthalmoscope). The acquired medical data are delivered to the hospital where an ophthalmologist will review the data collected and, if required, provide further consultation for the patient through a real-time secure channel established over a public Internet network. If necessary, the ophthalmologist is able to further sample the images/video of the patient's eyes remotely. In order to increase the productivity of the ophthalmologist in terms of number of patients reviewed, and to increase the efficiency of network resource, we manage the network bandwidth based on a Poisson model to estimate patient arrival at the clinics, and the rate of ophthalmologist consultation service for better overall system efficiency. The main objective of TeleOph is therefore to provide the remote patients with a cost-effective access to specialist's eye checkups at primary healthcare clinics, and at the same time, minimize unnecessary face-to-face consultation at the hospital specialist's center.

  11. Isolated cotton-wool spots of unknown etiology: management and sequential spectral domain optical coherence tomography documentation

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    Ioannides A


    Full Text Available Antonis Ioannides1, Nikolaos D Georgakarakos2, Ibrahim Elaroud3, Petros Andreou1 1Ophthalmology Department, Mid-Essex Hospitals NHS Trust, Chelmsford, 2Institute of Ophthalmology, University College London, London, 3Ophthalmology Department, Mid-Yorkshire Hospitals NHS Trust, Yorkshire, UK Abstract: Cotton-wool spots (CWSs are common retinal manifestations of many diseases including diabetes mellitus, systemic hypertension, and acquired immunodeficiency syndrome. Clinically they appear as whitish, fluffy patches on the retina and eventually fade with time. In this study, spectral domain optical coherence tomography (SD-OCT with mapping was used to demonstrate in vivo the characteristics of an isolated CWS in a 59-year-old patient as well as its appearance immediately after ophthalmoscopic resolution. Presented here is the work-up and management of this clinical problem for the ophthalmologist. The authors propose that SD-OCT could be a valuable research tool in characterizing and following the dynamic CWS changes at individual retinal layer level, with potential clinical applications as a screening or diagnostic tool in CWS-related diseases. Keywords: SD-OCT, spectral domain optical coherence tomography, retinal lesion

  12. Single Cotton Wool Spot as a Late Manifestation of Head Trauma

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    Mohsen Gohari


    Full Text Available Purpose: To report a patient with a single cotton wool spot (CWS following head trauma. Case Report: A 37-year-old male electrician presented with painless paracentral blurred vision in his left eye of one month duration together with three transient episodes of obscuration of vision in the same eye lasting for 10 minutes. He reported blunt head trauma due to a fall 40 days before referral. Fundus examination at presentation was normal but after 4 months, revealed the appearance of a white spot along the superotemporal arcade in the absence of other fundus lesions. A comprehensive systemic workup was performed revealing no specific findings. Ophthalmoscopic examination after 6 weeks disclosed resolution of the CWS with no intervention. The patient′s complaint of paracentral visual field defect improved and subsequent optical coherence tomography showed retinal thinning in that area. Conclusion: Herein, we report a patient with a single CWS near the optic disc four months after head trauma along with normal systemic and paraclinical evaluations. Head trauma may thus be considered as a cause of CWS.

  13. Prevalence of Vitamin-A deficiency AND refractive errors in primary school-going children

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    Rupali Darpan Maheshgauri


    To assess refractive errors in primary school-going children. To critically analyze the need for supplementation of Vitamin A, to children of low socioeconomic strata. Methods: Students were examined from 2 primary schools. Visual acuity was tested using Snellen's chart, Pictogram and Landolt C chart. Detailed anterior and posterior segment examination using Binocular loop, Ophthalmoscope and Streak retinoscope. RESULTS: Total no of 560 children of age 3 to 13yr were screened from 2 primary schools.Statistically significant difference was found in the age of the study subject and presence of refractive errors. Percentage of students having Refractive error: myopia (29.64% is the major cause of refractive error, followed by astigmatism (4.28% hypermetropia (3.25% and amblyopia (1.25%. Conclusion: It was observed that many children had high refractive error and were undiagnosed. The possible reason could be ignorance on the part of teachers and parents, even when the children have vision related complains. Also the children in the younger age-group lack the acumen to judge whether they can see clearly or not. Prevalence of Vitamin A deficiency appears reduced in urban areas. [Natl J Med Res 2016; 6(1.000: 23-27

  14. Visual abilities in two raptors with different ecology. (United States)

    Potier, Simon; Bonadonna, Francesco; Kelber, Almut; Martin, Graham R; Isard, Pierre-François; Dulaurent, Thomas; Duriez, Olivier


    Differences in visual capabilities are known to reflect differences in foraging behaviour even among closely related species. Among birds, the foraging of diurnal raptors is assumed to be guided mainly by vision but their foraging tactics include both scavenging upon immobile prey and the aerial pursuit of highly mobile prey. We studied how visual capabilities differ between two diurnal raptor species of similar size: Harris's hawks, Parabuteo unicinctus, which take mobile prey, and black kites, Milvus migrans, which are primarily carrion eaters. We measured visual acuity, foveal characteristics and visual fields in both species. Visual acuity was determined using a behavioural training technique; foveal characteristics were determined using ultra-high resolution spectral-domain optical coherence tomography (OCT); and visual field parameters were determined using an ophthalmoscopic reflex technique. We found that these two raptors differ in their visual capacities. Harris's hawks have a visual acuity slightly higher than that of black kites. Among the five Harris's hawks tested, individuals with higher estimated visual acuity made more horizontal head movements before making a decision. This may reflect an increase in the use of monocular vision. Harris's hawks have two foveas (one central and one temporal), while black kites have only one central fovea and a temporal area. Black kites have a wider visual field than Harris's hawks. This may facilitate the detection of conspecifics when they are scavenging. These differences in the visual capabilities of these two raptors may reflect differences in the perceptual demands of their foraging behaviours.

  15. Septo-optic dysplasia: case report Displasia septo-óptica: relato de caso

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    Paulo de Tarso P. Pierre Filho


    Full Text Available The clinical triad of septo-optic dysplasia (SOD comprises the absence of the septum pellucidum, congenital optic nerve dysplasia, and multiple endocrine disorders. When any two of these factors are present, the condition is defined as an incomplete form of SOD. The authors report the case of an incomplete form of SOD in a 9-year-old boy with low vision and nystagmus present from birth. The bilateral ophthalmoscopic examination revealed small papillae with double contour images. Magnetic resonance imaging showed hypoplasia of the optic nerve bilaterally, chiasm and absence of the septum pellucidum.A tríade clínica da displasia septo-óptica (DSO compreende a ausência de septo pelúcido, displasia congênita do nervo óptico e múltiplos defeitos endócrinos. Uma forma incompleta de DSO tem sido reconhecida com dois dos três elementos. Os autores relatam um caso de displasia septo-óptica na forma incompleta em um garoto de 9 anos com baixa visão e nistagmo presentes desde o nascimento. O exame oftalmoscópico revelou papila pequena com imagem em duplo contorno bilateralmente. Ressonância magnética mostrou hipoplasia dos nervos ópticos, quiasma e ausência do septo pelúcido.

  16. Persistent hyperplastic primary vitreous: imaging evaluation; Persistencia hiperplastica do vitreo primitivo: avaliacao por metodos de imagem

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    Jacob, Beatriz Mahmud; Teixeira, Kim-Ir-Sen Santos; Figueiredo, Sizenildo da Silva; Nobrega, Bruno Barcelos da [Universidade Federal de Goias, Goiania (Brazil). Hospital das Clinicas. Dept. de Diagnostico por Imagem]. E-mail:


    Persistent hyperplastic primary vitreous (PHPV) is a congenital developmental anomaly of the eye that primarily affects premature infants. PHPV results from failure of regression of the embryogenic primary vitreous and hyaloid vasculature, and proliferation of connective tissue. Three types of PHPV may be found: anterior, posterior and a combination of anterior and posterior. The clinical findings include leukocoria (white pupillary reflex) and microphthalmic eye. This anomaly is usually unilateral and unassociated with other systemic findings. The differential diagnosis between PHPV and other ocular diseases may be difficult due to similar features such as leukocoria, detached retina, retinal folds and cataract. Other diseases with similar features include retinoblastoma, isolated congenital cataract, retinopathy of prematurity and pseudo gliomas or leukocorias. Direct visualization of the remnants of the fetal hyaloid vascular system offers the best evidence of PHPV. However, diagnosis using the ophthalmoscope is sometimes impossible because of opaque tissues. In this circumstance an indirect visualization by ultrasound, computed tomography or magnetic resonance imaging may be useful. These imaging methods provide valuable information for the differentiation from other diseases, particularly retinoblastoma. The authors present a review of the literature and an iconographic study of the imaging findings in patients with PHPV. (author)

  17. A study on early detection of changes in visual pathway due to Diabetes mellitus by visual evoked potential

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    Rajesh Kumar, Sundararajan D, Rajvin Samuel Ponraj, M Srinivasan


    Full Text Available Electrical potentials have been recorded by surface Evoked Potentials namely the Somatosensory Evoked Potential, Auditory Brainstem Response and Visual Evoked Potential [VEP]. Visual conduction disturbance can be evaluated by these instruments. A mass response of cortical and possibly subcortical may be represented, visual areas to visual stimuli. Diabetic patients without a past history of cerebrovascular accidents diagnosed with Non- Proliferative Diabetic retinopathy[DR] with a best corrected visual acuity at least 6/9.This study was done to assess whether a delay in VEP latency observed in diagnosed type II DM patients could be ascribed to dysfunction of the retinal or post retinal structures or by both. It is to find out whether the VEP latencies are altered in diabetes or not, if altered and to correlate duration of the diabetes mellitus with visual evoked potential changes. Visual evoked potentials are useful as a non invasive investigatory method in establishing central nervous system neuropathy developing in diabetes. This study clearly shows that changes in VEP may be detected in diabetics before the onset of retinopathy. Future studies should be focused on evaluation of the time that elapses between the appearance of the first detectable pathologic electrophysiologic changes and the first ophthalmoscopically detectable retinal changes in patients with Diabetes Mellitus [DM].

  18. A simple method for in vivo labelling of infiltrating leukocytes in the mouse retina using indocyanine green dye

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    Dawn A. Sim


    Full Text Available We have developed a method to label and image myeloid cells infiltrating the mouse retina and choroid in vivo, using a single depot injection of indocyanine green dye (ICG. This was demonstrated using the following ocular models of inflammation and angiogenesis: endotoxin-induced uveitis, experimental autoimmune uveoretinitis and laser-induced choroidal neovascularization model. A near-infrared scanning ophthalmoscope was used for in vivo imaging of the eye, and flow cytometry was used on blood and spleen to assess the number and phenotype of labelled cells. ICG was administered 72 h before the induction of inflammation to ensure clearance from the systemic circulation. We found that in vivo intravenous administration failed to label any leukocytes, whereas depot injection, either intraperitoneal or subcutaneous, was successful in labelling leukocytes infiltrating into the retina. Progression of inflammation in the retina could be traced over a period of 14 days following a single depot injection of ICG. Additionally, bright-field microscopy, spectrophotometry and flow cytometric analysis suggest that the predominant population of cells stained by ICG are circulating myeloid cells. The translation of this approach into clinical practice would enable visualization of immune cells in situ. This will not only provide a greater understanding of pathogenesis, monitoring and assessment of therapy in many human ocular diseases but might also open the ability to image immunity live for neurodegenerative disorders, cardiovascular disease and systemic immune-mediated disorders.

  19. Ocular toxoplasmosis in immunosuppressed nonhuman primates

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    Holland, G.N.; O' Connor, G.R.; Diaz, R.F.; Minasi, P.; Wara, W.M.


    To investigate the role of cellular immunodeficiency in recurrent toxoplasmic retinochoroiditis, six Cynomolgus monkeys (Macaca fascicularis) with healed toxoplasmic lesions of the retina were immunosuppressed by total lymphoid irradiation. Three months prior to irradiation 30,000 Toxoplasma gondii organisms of the Beverley strain had been inoculated onto the macula of eye in each monkey via a pars plana approach. Toxoplasmic retinochoroiditis developed in each animal, and lesions were allowed to heal without treatment. During total lymphoid irradiation animals received 2000 centigrays (cGy) over a 7-week period. Irradiation resulted in an immediate drop in total lymphocyte counts and decreased ability to stimulate lymphocytes by phytohemagglutinin. Weekly ophthalmoscopic examinations following irradiation failed to show evidence of recurrent ocular disease despite persistent immunodeficiency. Four months after irradiation live organisms were reinoculated onto the nasal retina of the same eye in each animal. Retinochoroidal lesions identical to those seen in primary disease developed in five of six animals. Toxoplasma organisms therefore were able to proliferate in ocular tissue following the administration of immunosuppressive therapy. This study fails to support the hypothesis that cellular immunodeficiency alone will initiate recurrent toxoplasmic retinochoroiditis. Results suggest that reactivation of disease from encysted organisms involves factors other than suppression of Toxoplasma proliferation. If reactivation occurs by other mechanisms, however, cellular immunodeficiency then may allow development of extensive disease.

  20. Interactive segmentation for geographic atrophy in retinal fundus images. (United States)

    Lee, Noah; Smith, R Theodore; Laine, Andrew F


    Fundus auto-fluorescence (FAF) imaging is a non-invasive technique for in vivo ophthalmoscopic inspection of age-related macular degeneration (AMD), the most common cause of blindness in developed countries. Geographic atrophy (GA) is an advanced form of AMD and accounts for 12-21% of severe visual loss in this disorder [3]. Automatic quantification of GA is important for determining disease progression and facilitating clinical diagnosis of AMD. The problem of automatic segmentation of pathological images still remains an unsolved problem. In this paper we leverage the watershed transform and generalized non-linear gradient operators for interactive segmentation and present an intuitive and simple approach for geographic atrophy segmentation. We compare our approach with the state of the art random walker [5] algorithm for interactive segmentation using ROC statistics. Quantitative evaluation experiments on 100 FAF images show a mean sensitivity/specificity of 98.3/97.7% for our approach and a mean sensitivity/specificity of 88.2/96.6% for the random walker algorithm.

  1. Student attitudes regarding the educational value and welfare implications in the use of model eyes and live dogs in teaching practical fundus examination: evaluation of responses from 40 students

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    D.L. Williams


    Full Text Available This study sought to document student opinions on the educational value and welfare implications of use of artificial model eyes and live dogs in the training of veterinary students in examination of the canine fundus. Forty students who had undertaken a practical class on canine fundoscopy involving both use of artificial model eyes and live dogs were asked to complete a short questionnaire using a Likert scale to gauge their opinion on whether the use of live dogs and artificial eyes was very valuable (scoring 2, valuable (1, a neutral response (0, not particularly valuable (-1 or not at all valuable (-2 and to write a free text response on their views of the educational value and welfare implications of using artificial model eyes or live dogs in training for ophthalmic examination of the canine ocular fundus. Likert responses were 1.84±0.37 for using live greyhounds and 0.58±0.79 for using simulator eyes (p<0.0001. Thematic analysis of the written responses showed that while the artificial eyes were considered somewhat valuable in initial training, the live dogs were significantly preferred for their realism and the opportunity to examine the eye while handling a live animal. In conclusion, while model eyes are valuable initial training in use of the ophthalmoscope for funduscopic examination, students consider that examining the eye in the live dog is significantly more valuable and that the welfare of dogs thus used is not in their view unduly compromised.

  2. [The role of ultrasonography exam in orbital-ocular tumors]. (United States)

    Ciocâlteu, Alina Mihaela; Ardeleanu, S; Checheriţă, I A


    Ophthalmology is one of the specialties that have particularly benefited from the contribution of ultrasonography exam as a method of investigation. Ultrasonography is very much essential for diagnostic to complement other clinical and laboratory investigations, providing images in real time. The basic principle of diagnostic ultrasound is to study and to interpret the changes they undergo when crossing ultrasonic waves diverse biological properties different sound, and such injuries can be traced in the dynamics or can be documented on photographic paper and thus can diagnose correct certain eye diseases. The indications for performing ultrasound consist in: measurement of distances and volumes, examine difficult or inaccessible case of opaque media; ophthalmoscopic view of a mass lesion, examine the orbit or optic nerve. The advantages of ultrasound for orbital-ocular tumors are represented by the fact that ultrasound is a noninvasive method, safe, well tolerated, less expensive that the advantage of determining the position and distance from structures ocular tumor. High frequency ultrasound provides excellent resolution of 0-1 to 0.01 mm, and serial scans allow tracking progress and measuring lesion diameters tumor while allowing monitoring and evaluation of stereotactic radiation treatments applied to small tumors. In conclusion ultrasound allows not only early diagnosis of eye tumors, but accurate assessment of the proposed therapy and of the evolution of detected mass lesions or tumors.


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    Yu. I. Khoroshikh


    Full Text Available The results of clinical trial of various approaches in treatment the exudative forms of macular degenerations, including age-related, against chronic slow intensity inflammatory process on the extreme retinal periphery of an eye are described in represented material. There were 91 patients (105 eyes in the research with different types of an exudative macular degeneration. The general criteria of inclusion were: age of 18–80 years old, complaints to discomfort in eyes, a spot before an eye, distortions and decrease in the central sight, ophthalmoscopic symptoms of hypostasis in the central and peripheral areas of a retina. It is analyzed the general criteria of diagnostics and treatment of the disease in the article. Considering defeat of the chorioretinal structures located near the ora serrata at persons of young and advanced age. Practical recommendations to a choice of methods of diagnostics and treatment of various clinical and morphological forms of the disease are made. Screening methods of identification of patients with the peripheral uveitis are offered. The scheme of risk calculation of development the macular pathology at persons with changes on the extreme periphery of a retina, that can be used as a method of prevention of development predictively adverse of “wet" forms of an age-related macular degeneration, by means of timely sparing treatment at patients with chronic inflammatory diseases of eyes is given.

  4. Simple, Inexpensive Technique for High-Quality Smartphone Fundus Photography in Human and Animal Eyes

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    Luis J. Haddock


    Full Text Available Purpose. We describe in detail a relatively simple technique of fundus photography in human and rabbit eyes using a smartphone, an inexpensive app for the smartphone, and instruments that are readily available in an ophthalmic practice. Methods. Fundus images were captured with a smartphone and a 20D lens with or without a Koeppe lens. By using the coaxial light source of the phone, this system works as an indirect ophthalmoscope that creates a digital image of the fundus. The application whose software allows for independent control of focus, exposure, and light intensity during video filming was used. With this app, we recorded high-definition videos of the fundus and subsequently extracted high-quality, still images from the video clip. Results. The described technique of smartphone fundus photography was able to capture excellent high-quality fundus images in both children under anesthesia and in awake adults. Excellent images were acquired with the 20D lens alone in the clinic, and the addition of the Koeppe lens in the operating room resulted in the best quality images. Successful photodocumentation of rabbit fundus was achieved in control and experimental eyes. Conclusion. The currently described system was able to take consistently high-quality fundus photographs in patients and in animals using readily available instruments that are portable with simple power sources. It is relatively simple to master, is relatively inexpensive, and can take advantage of the expanding mobile-telephone networks for telemedicine.

  5. Quantification and anatomic distribution of choroidal abnormalities in patients with type I neurofibromatosis. (United States)

    Nakakura, Shunsuke; Shiraki, Kunihiko; Yasunari, Takaharu; Hayashi, Yoko; Ataka, Shinsuke; Kohno, Takeya


    Choroidal abnormality manifesting as a bright patchy lesion under infrared monochromatic light has previously been described in neurofibromatosis type I patients in whom the choroid appears normal under conventional ophthalmoscopic examination or on the fluorescein angiogram. We investigated the correlation between patient age and the number of choroidal abnormalities, as well as the anatomic distribution of choroidal abnormalities in the fundus. We examined the fundus of 28 eyes in 14 patients with neurofibromatosis type I. Patients ranged in age from 2 to 38 years and were examined between April 2001 and April 2002 by confocal scanning laser ophthalmoscopy with infrared monochromatic light (780 nm wavelength). We divided the fundus into five regions (one within the retinal vascular arcade and those supero-temporal, infero-temporal, supero-nasal, and infero-nasal to it), and lesions on the border between regions were assigned to the region containing the greater part of the lesion. We studied the total number of choroidal abnormalities and the correlation between the total number and age. A positive correlation was found between the total number of choroidal abnormalities and age (Spearman rank correlation coefficient, r=0.6209, P=0.0178). There was a significantly greater number of choroidal abnormalities in the arcade region than in the other four regions (ANOVA, P<0.001). Choroidal abnormalities tend to increase with age and are most often observed within the vascular arcade.

  6. Subchronic (13-week) oral toxicity of neohesperidin dihydrochalcone in rats. (United States)

    Lina, B A; Dreef-van der Meulen, H C; Leegwater, D C


    Neohesperidin dihydrochalcone was administered to groups of 20 male and 20 female Wistar rats at dietary levels of 0, 0.2, 1.0 and 5.0% for 91 days. No treatment-related ophthalmoscopical, haematological or histopathological effects were observed. In the high-dose group, a marked caecal enlargement occurred in both sexes, accompanied by soft stools in the early stages of the study, somewhat lower plasma urea concentrations and increased plasma alkaline phosphatase activity and a decreased urinary pH. This group also showed slight growth depression accompanied by transient reduction in food intake; in males the body weights remained relatively low throughout the experimental period. Furthermore, bilirubin level was increased in females and total protein level was decreased in males of the high-dose group. The above changes were considered adaptive responses or chance effects rather than manifestations of clear toxicity. The low-and intermediate- dose groups did not show any compound-related untoward effect. It was concluded that the intermediate dose, providing an overall intake of about 750 mg neohesperidin dihydrochalcone per kg body weight per day, was the no-effect level.

  7. Toxicologic evaluation of DHA-rich algal oil: Genotoxicity, acute and subchronic toxicity in rats. (United States)

    Schmitt, D; Tran, N; Peach, J; Bauter, M; Marone, P


    DHA-rich algal oil ONC-T18, tested in a battery of in vitro and in vivo genotoxicity tests, did not show mutagenic or genotoxic potential. The acute oral LD50 in rats has been estimated to be greater than 5000 mg/kg of body weight. In a 90-day subchronic dietary study, administration of DHA-rich algal oil at concentrations of 0, 10,000, 25,000, and 50,000 ppm in the diet for 13 weeks did not produce any significant toxicologic manifestations. The algal oil test article was well tolerated as evidenced by the absence of major treatment-related changes in the general condition and appearance of the rats, neurobehavioral endpoints, growth, feed and water intake, ophthalmoscopic examinations, routine hematology and clinical chemistry parameters, urinalysis, or necropsy findings. The no observed adverse effect level (NOAEL) was the highest level fed of 50,000 ppm which is equivalent to 3,305 and 3,679 mg/kg bw/day, for male and female rats, respectively. The studies were conducted as part of an investigation to examine the safety of DHA-rich algal oil. The results confirm that it possesses a toxicity profile similar to other currently marketed algal oils and support the safety of DHA-rich algal oil for its proposed use in food.

  8. Quantitative Analysis of Fundus-Image Sequences Reveals Phase of Spontaneous Venous Pulsations (United States)

    Moret, Fabrice; Reiff, Charlotte M.; Lagrèze, Wolf A.; Bach, Michael


    Purpose Spontaneous venous pulsation correlates negatively with elevated intracranial pressure and papilledema, and it relates to glaucoma. Yet, its etiology remains unclear. A key element to elucidate its underlying mechanism is the time at which collapse occurs with respect to the heart cycle, but previous reports are contradictory. We assessed this question in healthy subjects using quantitative measurements of both vein diameters and artery lateral displacements; the latter being used as the marker of the ocular systole time. Methods We recorded 5-second fundus sequences with a near-infrared scanning laser ophthalmoscope in 12 young healthy subjects. The image sequences were coregistered, cleaned from microsaccades, and filtered via a principal component analysis to remove nonpulsatile dynamic features. Time courses of arterial lateral displacement and of diameter at sites of spontaneous venous pulsation or proximal to the disk were retrieved from those image sequences and compared. Results Four subjects displayed both arterial and venous pulsatile waveforms. On those, we observed venous diameter waveforms differing markedly among the subjects, ranging from a waveform matching the typical intraocular pressure waveform to a close replica of the arterial waveform. Conclusions The heterogeneity in waveforms and arteriovenous phases suggests that the mechanism governing the venous outflow resistance differs among healthy subjects. Translational relevance Further characterizations are necessary to understand the heterogeneous mechanisms governing the venous outflow resistance as this resistance is altered in glaucoma and is instrumental when monitoring intracranial hypertension based on fundus observations. PMID:26396929

  9. A fully automatic framework for cell segmentation on non-confocal adaptive optics images (United States)

    Liu, Jianfei; Dubra, Alfredo; Tam, Johnny


    By the time most retinal diseases are diagnosed, macroscopic irreversible cellular loss has already occurred. Earlier detection of subtle structural changes at the single photoreceptor level is now possible, using the adaptive optics scanning light ophthalmoscope (AOSLO). This work aims to develop a fully automatic segmentation framework to extract cell boundaries from non-confocal split-detection AOSLO images of the cone photoreceptor mosaic in the living human eye. Significant challenges include anisotropy, heterogeneous cell regions arising from shading effects, and low contrast between cells and background. To overcome these challenges, we propose the use of: 1) multi-scale Hessian response to detect heterogeneous cell regions, 2) convex hulls to create boundary templates, and 3) circularlyconstrained geodesic active contours to refine cell boundaries. We acquired images from three healthy subjects at eccentric retinal regions and manually contoured cells to generate ground-truth for evaluating segmentation accuracy. Dice coefficient, relative absolute area difference, and average contour distance were 82±2%, 11±6%, and 2.0±0.2 pixels (Mean±SD), respectively. We find that strong shading effects from vessels are a main factor that causes cell oversegmentation and false segmentation of non-cell regions. Our segmentation algorithm can automatically and accurately segment photoreceptor cells on non-confocal AOSLO images, which is the first step in longitudinal tracking of cellular changes in the individual eye over the time course of disease progression.

  10. Transpupillary thermotherapy in subfoveal choroidal neovascular membrane secondary to age-related macular degeneration

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    Verma Lalit


    Full Text Available Purpose: To report our initial experience in the treatment of subfoveal choroidal neovascular membrane, secondary to age-related macular degeneration (AMD by transpupillary thermotherapy (TTT. Methods: Fifty consecutive patients with subfoveal choroidal neovascularisation (CNV secondary to AMD, were included in the study. The parameters assessed before the TTT were visual acuity by ETDRS chart, scotoma score by Amsler grid chart, reading speed, fundus examination by direct and indirect ophthalmoscope as well as +90 Diopter lens followed by digital fundus photography and fluorescein angiography (FA. Results: The letter visual acuity improved or stabilized in 72% cases up to 12 weeks after TTT. Mean scotoma score decreased from a mean of 47.56, to 43.56 at 6 weeks and to 37 at 12 weeks. Mean reading speed increased from 27.04 words/minute at pretreatment to 34.52 words/minute at 6 weeks and 37.33 words/minute 12 weeks after TTT. Conclusion: TTT is not only a cheaper alternative to photodynamic therapy (PDT, but also is an efficacious tool in stabilisation or improvement of visual acuity in the management of subfoveal choroidal neovascular membrane due to AMD.

  11. Integration of spectral domain optical coherence tomography with microperimetry generates unique datasets for the simultaneous identification of visual function and retinal structure in ophthalmological applications (United States)

    Koulen, Peter; Gallimore, Gary; Vincent, Ryan D.; Sabates, Nelson R.; Sabates, Felix N.


    Conventional perimeters are used routinely in various eye disease states to evaluate the central visual field and to quantitatively map sensitivity. However, standard automated perimetry proves difficult for retina and specifically macular disease due to the need for central and steady fixation. Advances in instrumentation have led to microperimetry, which incorporates eye tracking for placement of macular sensitivity values onto an image of the macular fundus thus enabling a precise functional and anatomical mapping of the central visual field. Functional sensitivity of the retina can be compared with the observed structural parameters that are acquired with high-resolution spectral domain optical coherence tomography and by integration of scanning laser ophthalmoscope-driven imaging. Findings of the present study generate a basis for age-matched comparison of sensitivity values in patients with macular pathology. Microperimetry registered with detailed structural data performed before and after intervention treatments provides valuable information about macular function, disease progression and treatment success. This approach also allows for the detection of disease or treatment related changes in retinal sensitivity when visual acuity is not affected and can drive the decision making process in choosing different treatment regimens and guiding visual rehabilitation. This has immediate relevance for applications in central retinal vein occlusion, central serous choroidopathy, age-related macular degeneration, familial macular dystrophy and several other forms of retina related visual disability.

  12. Optical coherence tomography angiography of retinal vascular occlusions produced by imaging-guided laser photocoagulation (United States)

    Soetikno, Brian T.; Shu, Xiao; Liu, Qi; Liu, Wenzhong; Chen, Siyu; Beckmann, Lisa; Fawzi, Amani A.; Zhang, Hao F.


    Retinal vascular occlusive diseases represent a major form of vision loss worldwide. Rodent models of these diseases have traditionally relied upon a slit-lamp biomicroscope to help visualize the fundus and subsequently aid delivery of high-power laser shots to a target vessel. Here we describe a multimodal imaging system that can produce, image, and monitor retinal vascular occlusions in rodents. The system combines a spectral-domain optical coherence tomography system for cross-sectional structural imaging and three-dimensional angiography, and a fluorescence scanning laser ophthalmoscope for Rose Bengal monitoring and high-power laser delivery to a target vessel. This multimodal system facilitates the precise production of occlusions in the branched retinal veins, central retinal vein, and branched retinal arteries. Additionally, changes in the retinal morphology and retinal vasculature can be longitudinally documented. With our device, retinal vascular occlusions can be easily and consistently created, which paves the way for futures studies on their pathophysiology and therapeutic targets. PMID:28856036

  13. Progressive retinal nonperfusion in ischemic central retinal vein occlusion. (United States)

    Wykoff, Charles C; Brown, David M; Croft, Daniel E; Major, James C; Wong, Tien P


    Serial wide-field fluorescein angiography was performed on eyes with preproliferative (ischemic) central retinal vein occlusion to evaluate retinal perfusion. Serial wide-field fluorescein angiography was performed on 12 preproliferative central retinal vein occlusion eyes in the 3-year Rubeosis Anti-VEGF (RAVE) trial using the Staurenghi lens (Ocular Staurenghi 230SLO Retina Lens) with a scanning laser ophthalmoscope (Heidelberg HRA Spectralis). "Disk area" was defined anatomically for each eye. Mean total field of gradable retina was 290 disk areas (range, 178-452). All eyes demonstrated extensive areas of retinal nonperfusion; at baseline, mean area of retinal perfusion was 106 disk areas (range, 37-129), correlating with a mean of 46.5% perfused retinal area (range, 19.1-56.4%). The area of retinal nonperfusion increased in all eyes with a mean loss of approximately 8.1% of perfused retinal area per year (range, 4.3-12.4%), which corresponded to a mean 15-disk areas (range, 12-35) of retina evolving from perfused to nonperfused annually. The extent of baseline and final nonperfusion was not significantly different between eyes that developed neovascularization and eyes that did not. In this population of severe central retinal vein occlusion eyes, profound retinal nonperfusion was observed with wide-field fluorescein angiography at baseline and the extent of nonperfusion progressed while undergoing anti-vascular endothelial growth factor therapy.

  14. Perfil oftalmológico dos alunos do programa alfabetização solidária em quatro municípios do Ceará Ophthalmological profile of adult students belonging to a literacy program in four cities of Ceará

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    Islane Castro Verçosa


    Full Text Available OBJETIVO: Avaliar o perfil oftalmológico de estudantes da Alfabetização Solidária no Estado do Ceará, identificar as principais causas de baixa acuidade visual, descrever a experiência e os principais resultados obtidos. MÉTODOS: Foram utilizados para o exame oftalmológico de mil e sete (1007 alunos do Programa Alfabetização Solidária dois refratores automatizados, dois refratores tipo Greens, duas colunas pantográficas, duas cadeiras, quatro oftalmoscópios, uma lâmpada de fenda portátil, dois tonômetros de aplanação, um oftalmoscópio indireto. Participantes: alfabetizadores treinados para medida da acuidade visual, oftalmologistas, residentes de oftalmologia, auxiliares e secretárias. RESULTADOS: Observamos que cerca da metade dos alunos (46% tinha baixa de acuidade visual (acuidade visual menor que 0,8 em ambos os olhos, 66,33% da população estudada necessitou correção óptica, destes, 37,00% eram présbitas. Predominou a população na faixa de 41 a 50 anos. A maioria da população examinada era do sexo feminino (56%. Trinta e nove por cento da po- pulação estudada apresentou alguma doença oftalmológica. Encontramos o pterígio e a catarata como doenças mais freqüentes. CONCLUSÃO: O programa deve ter no início do seu funcionamento prévio exame oftalmológico dos alunos de cada comunidade, para melhor aproveitamento do conteúdo ensinado, diminuindo desta forma a grande evasão escolar.PURPOSE: To evaluate the ophthalmologic profile of "Alfabetização Solidária" - a program that teaches illiterate adults how to read and write; to identify the main causes of low visual acuity; to show our experience and the main results of promoting visual health in the community. METHODS: Ophthalmologic equipment (two automatic refractors, two Green refractors, two supports, two chairs, four ophthalmoscopes, one portable slit lamp, two applanation tonometers, one indirect ophthalmoscope. PARTICIPANTS: Teachers trained to

  15. Prevention and Control Mode and Practice of Diabetic Fundus Lesions Based on the Mobile Internet Fundus Imaging%基于移动互联网眼底成像的 糖尿病眼底病变防控模式与实践研究

    Institute of Scientific and Technical Information of China (English)

    梁志伟; 周丽文; 张晓阳; 徐宁; 梁倩蓉; 赖小平; 袁野; 周毅


    Objective:To provide technical support to the screening of fundus lesions of diabetics in the jurisdiction carried out by grassroots communities, remote specialized agencies and teams, and improve the prevention and control capacity of major chronic non-communicable diseases. Methods:A flow chart which can be used in the prevention and control of a single major chronic non-communicable disease and has business-information-financial flow and value co-win; 20 test objects are selected, the ophthalmoscope is carried a hand to take photos for their fundus, and then through the collaborative service platform images collected are delivered to a specialized agency and a team in a another place for study; residents are asked on site, or the follow-up is completed one week after the activity for further screening and analysis. Results:Among 20 test objects selected, 17 people accept and participate in the trial test, of which fundus lesions are found in 8 people. One has fundus bleeding with high blindness risk characterization. Conclusion:Through the collaborative healthcare service of the hand-held ophthalmoscope and the interconnected and mobile operating platform, the screening of diabetic fundus lesions of residents is carried out for the regional prevention and control. The regional healthcare collaborative win-win service mode can be build, so as to help to improve the prevention and control capacity of major chronic non-communicable diseases.%目的:为基层社区、远程专科机构和团队共同对辖区糖尿病患者眼底病变开展筛查提供技术支持,提升重大慢性非传染性疾病防控能力.方法:设计一个可用于防控某单种重大慢性非传染性疾病、具有业务-信息-金融互流,以及价值共赢的流程图;选出20名拟预试对象,采用手持眼底镜对其眼底部进行拍照,再通过协同服务平台将所采集图片远程传送到异地的专科机构和团队进行研读;对居民现场询问或活动结束一

  16. Arteriovenous Passage Times and Visual Field Progression in Normal Tension Glaucoma

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    Eva Charlotte Koch


    Full Text Available Purpose. Fluorescein angiographic studies revealed prolonged arteriovenous passage (AVP times and increased fluorescein filling defects in normal tension glaucoma (NTG compared to healthy controls. The purpose of this study was to correlate baseline AVP and fluorescein filling defects with visual field progression in patients with NTG. Patients and Methods. Patients with a follow-up period of at least 3 years and at least 4 visual field examinations were included in this retrospective study. Fluorescein angiography was performed at baseline using a confocal scanning laser ophthalmoscope (SLO, Rodenstock Instr.; fluorescein filling defects and AVP were measured by digital image analysis and dye dilution curves (25 Hz. Visual field progression was evaluated using regression analysis of the MD (Humphrey-Zeiss, SITA-24-2, MD progression per year (dB/year. 72 patients with NTG were included, 44 patients in study 1 (fluorescein filling defects and 28 patients in study 2 (AVP. Results. In study 1 (mean follow-up years, visual field tests, MD progression per year ( dB/year was significantly correlated to the age (, but not to fluorescein filling defects, IOP, or MD at baseline. In study 2 (mean follow-up years, visual field tests, MD progression per year ( dB/year was significantly correlated to AVP (, but not to age, IOP, or MD at baseline. Conclusion. Longer AVP times at baseline are correlated to visual field progression in NTG. Impaired retinal blood flow seems to be an important factor for glaucoma progression.


    Directory of Open Access Journals (Sweden)

    V. S. Zadionchenko


    Full Text Available Aim. To evaluate antihypertensive efficiency of benasepril therapy (Lotensin, Novartis and its effects on microcirculation, endothelium function, system of cytoprotection, ophthalmoscopic and functional characteristics of eye retina in patients with arterial hypertension (AH. Material and methods. 40 patients with AH of 1-3 degree (AH1, AH2, and AH3 were studied. After wash-out period all patients were prescribed benasepril 5-10 mg daily. If necessary, hydrochlorothiazide 12,5 mg daily was added. Treatment lasted during 6 months. Patients were examined at the beginning and at the end of the study. Ambulatory blood pressure (BP monitoring was carried out. Microcirculation was assessed by method of laser Doppler flowmetry. Stable plasma metabolites of nitric oxide (NO were determined by spectral photometry. Cytoprotection was assessed by content of heat shock proteins (HSP70 in leucocytes of peripheral blood. Ophthalmoscopy, color and contrast static campimetry with evaluation of sensory-motor reaction (SMR time in different fields of vision were carried out. Results. Therapy with benasepril allowed to improve daily profile of BP and to reach its target level in all AH patients. Number of patients with spastic type of microcirculation decreased. Functional condition of endothelium improved which revealed in normalization of endothelial production of NO. Therapy with benasepril resulted in intracellular HSP70 level decrease which testified restriction of cellular destruction. The cytoprotective effect of benasepril was stronger in patient with severe AH. Therapy with benasepril resulted in SMR time decrease which signifies its positive influence on retinal blood flow. Evaluation of contrast and color sensitiveness of retina allowed to reveal and quantitatively assess earlier dysfunctions of retinal tissue perfusion, compared to ophthalmoscopy. Conclusion. Benasepril is an efficient antihypertensive drug which improves microcirculation, endothelium

  18. Diffuse infiltrating retinoblastoma invading subarachnoid space

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    Kase S


    Full Text Available Satoru Kase1, Kazuhiko Yoshida1, Shigenobu Suzuki2, Koh-ichi Ohshima3, Shigeaki Ohno4, Susumu Ishida11Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo; 2Department of Ophthalmic Oncology, National Cancer Center Hospital, Tokyo; 3Section of Ophthalmology, Okayama Medical Center, Okayama; 4Department of Ocular Inflammation and Immunology, Hokkaido University Graduate School of Medicine, Sapporo, JapanAbstract: We report herein an unusual case of diffuse infiltrating retinoblastoma involving the brain, which caused a patient’s death 27 months after enucleation. An eight-year-old boy complained of blurred vision in his right eye (OD in October 2006. Funduscopic examination showed optic disc swelling, dense whitish vitreous opacity, and an orange-colored subretinal elevated lesion adjacent to the optic disc. Fluorescein angiography revealed hyperfluorescence in the peripapillary region at an early-phase OD. Because the size of the subretinal lesion and vitreous opacity gradually increased, he was referred to us. His visual acuity was 20/1000 OD on June 20, 2007. Slit-lamp biomicroscopy showed a dense anterior vitreous opacity. Ophthalmoscopically, the subretinal orange-colored area spread out until reaching the mid peripheral region. A B-mode sonogram and computed tomography showed a thick homogeneous lesion without calcification. Gadolinium-enhanced magnetic resonance imaging showed a markedly enhanced appearance of the underlying posterior retina. Enucleation of the right eye was performed nine months after the initial presentation. Histopathology demonstrated retinal detachment and a huge choroidal mass invading the optic nerve head. The tumor was consistent with diffuse infiltrating retinoblastoma. The patient died due to brain involvement 27 months after enucleation. Ophthalmologists should be aware that diffuse infiltrating retinoblastoma may show an unfavorable course if its diagnosis is delayed

  19. In vivo and in vitro investigations of retinal fluorophores in age-related macular degeneration by fluorescence lifetime imaging (United States)

    Hammer, M.; Quick, S.; Klemm, M.; Schenke, S.; Mata, N.; Eitner, A.; Schweitzer, D.


    Ocular fundus autofluorescence imaging has been introduced into clinical diagnostics recently for the observation of the age pigment lipofuscin, a precursor of age-related macular degeneration (AMD). However, a deeper understanding of the generation of single compounds contributing to the lipofuscin as well as of the role of other fluorophores such as FAD, glycated proteins, and collagen needs their discrimination by fluorescence lifetime imaging (FLIM). FLIM at the ocular fundus is performed using a scanning laser ophthalmoscope equipped with a picosecond laser source (448nm or 468nm respectively, 100ps, 80 MHz repetition rate) and dual wavelength (490-560nm and 560-7600nm) time-correlated single photon counting. A three-exponential fit of the fluorescence decay revealed associations of decay times to anatomical structures. Disease-related features are identified from alterations in decay times and-amplitudes. The in-vivo investigations in patients were paralleled by experiments in an organ culture of the porcine ocular fundus. Photo-oxidative stress was induced by exposure to blue light (467nm, 0.41 mW/mm2). Subsequent analysis (fluorescence microscopy, HPLC, LC-MS) indicated the accumulation of the pyridinium bis-retinoid A2E and its oxidation products as well as oxidized phospholipids. These compounds contribute to the tissue auto-fluorescence and may play a key role in the pathogenesis of AMD. Thus, FLIM observation at the ocular fundus in vivo enhances our knowledge on the etiology of AMD and may become a diagnostic tool.

  20. Eye safety analysis for non-uniform retinal scanning laser trajectories (United States)

    Schelinski, Uwe; Dallmann, Hans-Georg; Grüger, Heinrich; Knobbe, Jens; Pügner, Tino; Reinig, Peter; Woittennek, Franziska


    Scanning the retinae of the human eyes with a laser beam is an approved diagnosis method in ophthalmology; moreover the retinal blood vessels form a biometric modality for identifying persons. Medical applied Scanning Laser Ophthalmoscopes (SLOs) usually contain galvanometric mirror systems to move the laser spot with a defined speed across the retina. Hence, the load of laser radiation is uniformly distributed and eye safety requirements can be easily complied. Micro machined mirrors also known as Micro Electro Mechanical Systems (MEMS) are interesting alternatives for designing retina scanning systems. In particular double-resonant MEMS are well suited for mass fabrication at low cost. However, their Lissajous-shaped scanning figure requires a particular analysis and specific measures to meet the requirements for a Class 1 laser device, i.e. eye-safe operation. The scanning laser spot causes a non-uniform pulsing radiation load hitting the retinal elements within the field of view (FoV). The relevant laser safety standards define a smallest considerable element for eye-related impacts to be a point source that is visible with an angle of maximum 1.5 mrad. For non-uniform pulsing expositions onto retinal elements the standard requires to consider all particular impacts, i.e. single pulses, pulse sequences in certain time intervals and cumulated laser radiation loads. As it may be expected, a Lissajous scanning figure causes the most critical radiation loads at its edges and borders. Depending on the applied power the laser has to be switched off here to avoid any retinal injury.

  1. Retinal changes in pregnancy-induced hypertension

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    Akash Pankaj Shah


    Full Text Available Aims: The aim was to determine the prevalence of retinal changes in pregnancy-induced hypertension (PIH and any association between the retinal changes and age, parity, blood pressure, proteinuria, and severity of the disease. Settings and Design: Hospital-based cross-sectional study. Materials and Methods: All the patients admitted with a diagnosis of PIH were included in this study. Age, gravida, gestation period, blood pressure, and proteinuria were noted from the case records. Fundus examination was done with a direct ophthalmoscope. The findings were noted and were analyzed using SPSS program. Results: A total of 150 patients of PIH were examined. The mean age of patients was 25.1 years. The gestation period ranged from 27 weeks to 42 weeks; 76 (50.67% were the primi gravida. 92 (61.33% patients had gestational hypertension, 49 (32.67% patients had preeclampsia, and 9 (6% had eclampsia. Retinal changes (hypertensive retinopathy were noted in 18 (12% patients - Grade 1 in 12 (8% and Grade 2 in 6 (4%. Hemorrhages or exudates or retinal detachment were not seen in any patient. There was statistically significant positive association of retinal changes and blood pressure (P = 0.037, proteinuria (P = 0.0005, and severity of the PIH (P = 0.004. Conclusions: Retinal changes were seen in 12% of patients with PIH. Occurrence of hypertensive retinopathy in PIH cases has been decreased due to better antenatal care and early detection and treatment of PIH cases. There is a greater chance of developing retinopathy with increase in blood pressure, severity of PIH, and proteinuria in cases of PIH.

  2. Effect of retinal photocoagulation on intraretinal lipid exudates in diabetic macular edema documented by optical coherence tomography. (United States)

    Deák, Gábor Gy; Bolz, Matthias; Kriechbaum, Katharina; Prager, Sonja; Mylonas, Georgios; Scholda, Christoph; Schmidt-Erfurth, Ursula


    To study the changes in the distribution and morphologic features of intraretinal microexudates after macular photocoagulation. Prospective cohort study. Thirteen treatment-naïve patients with clinically significant macular edema in type 2 diabetes. Patients were treated with focal macular photocoagulation. Changes in the localization of hyperreflective foci were analyzed by spectral domain (SD) optical coherence tomography (OCT) during follow-up at day 1, week 1, and months 1, 2, 3, and 4 in defined areas. Further, fundus photography and infrared imaging were performed at all visits and findings were correlated to OCT results. Changes in retinal morphologic features detected in OCT. A dynamic change in the distribution pattern of hyperreflective foci was observed over 4 months after the photocoagulation. With the decrease of retinal thickness, the dots either resolved completely or became confluent at the apical border of the outer nuclear layer, and finally formed ophthalmoscopically detectable hard exudates during extended follow-up. In the event of retinal thickening despite laser treatment, the hyperreflective dots maintained their previous distribution throughout all retinal layers. As a fourth response, dissemination of plaques of hard exudates into multiple, separate, hyperreflective foci were detected. Hyperreflective foci in the retina seem to represent precursors or components of hard exudates. Their specific localization depends greatly on the presence of microvascular extravasation and intraretinal fluid accumulation. Retinal photocoagulation has a major impact on retinal edema and subsequently on the distribution of intraretinal lipid deposits. The author(s) have no proprietary or commercial interest in any materials discussed in this article. Copyright 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  3. Optograms and criminology: science, news reporting, and fanciful novels. (United States)

    Lanska, Douglas J


    A persistent nineteenth-century urban legend was the notion that photograph-like images of the last-seen object or person would be preserved in the eyes of the dead. This popular notion followed technological developments (the daguerreotype and ophthalmoscope) that antedated by decades a basic understanding of retinal physiology. From 1876 to 1877, Boll described photochemical bleaching of the retina and produced a crude retinal image that remained briefly visible after death in an experimental animal. From 1877 to 1881, Kühne elaborated the processes involved in photochemical transduction, and created more complex retinal images, or "optograms," that were visible after the death of experimental animals under special laboratory circumstances. In 1880, Kühne reported the first human "optogram" when he examined the eyes following the state execution of a convicted murderer. Although the work of these physiologists increased public interest in "optography" as a potential tool in forensic investigations, Kühne and his student, Ayres, concluded after an extensive series of investigations that optography would never be useful for this purpose. Nevertheless, because of the prior tantalizing results, optography became a frequent consideration in speculative news reports of sensational unsolved murders, and as a plot device in works of fiction, some quite fantastical. Fictional portrayals included works by Rudyard Kipling and Jules Verne. Despite denouncement of optography for forensic investigations by Kühne, and by numerous physicians, the general public and mass media continued to press for examination of the retinae of murder victims well into the twentieth century, particularly in high-profile unsolved cases. © 2013 Elsevier B.V. All rights reserved.

  4. Multimodal adaptive optics for depth-enhanced high-resolution ophthalmic imaging (United States)

    Hammer, Daniel X.; Mujat, Mircea; Iftimia, Nicusor V.; Lue, Niyom; Ferguson, R. Daniel


    We developed a multimodal adaptive optics (AO) retinal imager for diagnosis of retinal diseases, including glaucoma, diabetic retinopathy (DR), age-related macular degeneration (AMD), and retinitis pigmentosa (RP). The development represents the first ever high performance AO system constructed that combines AO-corrected scanning laser ophthalmoscopy (SLO) and swept source Fourier domain optical coherence tomography (SSOCT) imaging modes in a single compact clinical prototype platform. The SSOCT channel operates at a wavelength of 1 μm for increased penetration and visualization of the choriocapillaris and choroid, sites of major disease activity for DR and wet AMD. The system is designed to operate on a broad clinical population with a dual deformable mirror (DM) configuration that allows simultaneous low- and high-order aberration correction. The system also includes a wide field line scanning ophthalmoscope (LSO) for initial screening, target identification, and global orientation; an integrated retinal tracker (RT) to stabilize the SLO, OCT, and LSO imaging fields in the presence of rotational eye motion; and a high-resolution LCD-based fixation target for presentation to the subject of stimuli and other visual cues. The system was tested in a limited number of human subjects without retinal disease for performance optimization and validation. The system was able to resolve and quantify cone photoreceptors across the macula to within ~0.5 deg (~100-150 μm) of the fovea, image and delineate ten retinal layers, and penetrate to resolve targets deep into the choroid. In addition to instrument hardware development, analysis algorithms were developed for efficient information extraction from clinical imaging sessions, with functionality including automated image registration, photoreceptor counting, strip and montage stitching, and segmentation. The system provides clinicians and researchers with high-resolution, high performance adaptive optics imaging to help

  5. Cobalt60 plaques in recurrent retinoblastoma

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    Fass, D.; McCormick, B.; Abramson, D.; Ellsworth, R. (Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, NY, NY (USA))


    Cobalt60 plaque irradiation is one treatment option for patients with recurrent retinoblastoma following conventional external beam irradiation (ERT). Tumorocidal doses can be delivered without excessive risk of normal tissue injury. In patients not considered candidates for xenon arc or cryotherapy, 60Co is an alternative to enucleation. Between 1968 and 1987, 85 patients were treated with 60Co plaques, 72 of whom had failed prior ERT. Age at diagnosis ranged from 1 week to 4 years. There are 37 males and 35 females. Seventy-one patients had bilateral disease and one had unilateral. Three patients had both eyes plaqued. Prior ERT ranged from 30 to 70 Gy (mean 4200 Gy). Time from initial therapy to failure ranged from 13 to 60 months. Cobalt plaques of 10 mm, 15 mm, or 10 {times} 15 mm were used depending on tumor size and location. Dose prescribed to the apex of the tumor ranged from 30 to 50 Gy (median 40 Gy) given over 3 to 8 days. Twelve patients had two plaque applications; three patients had three plaque applications. All patients were followed with routine ophthalmoscopic examinations. Follow-up ranged from 2 to 22 years (mean 8.7). Seven patients died of metastatic disease; 10 patients developed non-ocular second tumors. Thirty patients required enucleation. Twenty-two patients had clear tumor progression, two patients had radiation complications, and six patients had a combination of tumor growth and complications. Cobalt60 can salvage eyes in retinoblastoma patients failing ERT. Currently, the authors are using I125 in an attempt to spare normal ocular tissue and reduce subsequent complications.

  6. Protection by an oral disubstituted hydroxylamine derivative against loss of retinal ganglion cell differentiation following optic nerve crush.

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    James D Lindsey

    Full Text Available Thy-1 is a cell surface protein that is expressed during the differentiation of retinal ganglion cells (RGCs. Optic nerve injury induces progressive loss in the number of RGCs expressing Thy-1. The rate of this loss is fastest during the first week after optic nerve injury and slower in subsequent weeks. This study was undertaken to determine whether oral treatment with a water-soluble N-hydroxy-2,2,6,6-tetramethylpiperidine derivative (OT-440 protects against loss of Thy-1 promoter activation following optic nerve crush and whether this effect targets the earlier quick phase or the later slow phase. The retina of mice expressing cyan fluorescent protein under control of the Thy-1 promoter (Thy1-CFP mice was imaged using a blue-light confocal scanning laser ophthalmoscope (bCSLO. These mice then received oral OT-440 prepared in cream cheese or dissolved in water, or plain vehicle, for two weeks and were imaged again prior to unilateral optic nerve crush. Treatments and weekly imaging continued for four more weeks. Fluorescent neurons were counted in the same defined retinal areas imaged at each time point in a masked fashion. When the counts at each time point were directly compared, the numbers of fluorescent cells at each time point were greater in the animals that received OT-440 in cream cheese by 8%, 27%, 52% and 60% than in corresponding control animals at 1, 2, 3 and 4 weeks after optic nerve crush. Similar results were obtained when the vehicle was water. Rate analysis indicated the protective effect of OT-440 was greatest during the first two weeks and was maintained in the second two weeks after crush for both the cream cheese vehicle study and water vehicle study. Because most of the fluorescent cells detected by bCSLO are RGCs, these findings suggest that oral OT-440 can either protect against or delay early degenerative responses occurring in RGCs following optic nerve injury.

  7. [Optical coherence tomography follow-up of a case of solar maculopathy]. (United States)

    Macarez, R; Vanimschoot, M; Ocamica, P; Kovalski, J-L


    Solar maculopathy is caused by sun-gazing without protection and in most cases appears to be reversible. Retinal damage may be caused by photochemical changes combined with a rise in temperature at the time of sun observation. We report a case of bilateral solar retinopathy following direct sun gazing after observation of the partial eclipse on 3 October 2005. A 25-year-old Caucasian man presented 24 h after watching the eclipse with symptoms of blurred vision and a bright positive central scotoma. Total direct viewing time was approximately 5 min. While observing the eclipse, the patient kept both eyes open. On presentation, his visual acuity was 20/25 in his right eye and 20/32 in his left eye. Ophthalmoscopic examination revealed a bilateral yellowish-white spot in the center of the foveal region. Static visual field examination did not disclose any absolute scotoma but a decrease in the foveal threshold was noted in both eyes. Optical coherence tomography (OCT) examination revealed a bilateral increased reflectivity of the inner foveal retina that was greater in the left eye. This finding was associated with a hyporeflective area of the underlying retinal pigment epithelium: choriocapillaris complex and an increase in retinal thickness. Eight days later, visual acuity was 20/20 in each eye. Funduscopy showed the yellow lesion had vanished. Four months after exposure, funduscopy was normal and OCT scan showed normal reflectivity of all retinal layers in the fovea. However, static visual field examination disclosed a decreased foveal threshold on the left eye. We compare the OCT findings in this patient with the data reported in the literature. Indeed, various OCT findings have been reported depending on the intensity and frequency of sun exposure. This observation demonstrates that OCT appears to be potentially useful in the evolutive follow-up of solar maculopathy, and emphasizes the importance of eye safety during solar eclipse observation.

  8. Analysis of the RPE sheet in the rd10 retinal degeneration model

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    Jiang, Yi [Los Alamos National Laboratory


    The normal RPE sheet in the C57Bl/6J mouse is subclassified into two major tiling patterns: A regular generally hexagonal array covering most of the surface and a 'soft network' near the ciliary body made of irregularly shaped cells. Physics models predict these two patterns based on contractility and elasticity of the RPE cell, and strength of cellular adhesion between cells. We hypothesized and identified major changes in RPE regular hexagonal tiling pattern in rdl0 compared to C57BL/6J mice. RPE sheet damage was extensive but occurred in rd10 later than expected, after most retinal degeneration. RPE sheet changes occur in zones with a bullseye pattern. In the posterior zone around the optic nerve RPE cells take on larger irregular and varied shapes to form an intact monolayer. In mid periphery, there is a higher than normal density of cells that progress into involuted layers of RPE under the retina. The periphery remains mostly normal until late stages of degeneration. The number of neighboring cells varies widely depending on zone and progression. RPE morphology continues to deteriorate long after the photoreceptors have degenerated. The RPE cells are bystanders to the rd10 degeneration within photo receptors, and the collateral damage to the RPE sheet resembles stimulation of migration or chemotaxis. Quantitative measures of the tiling patterns and histopathology detected here, scripted in a pipeline written in Perl and Cell Profiler (an open source Matlab plugin), are directly applicable to RPE sheet images from noninvasive fundus autofluorescence (FAF), adaptive optics confocal scanning laser ophthalmoscope (AO-cSLO), and spectral domain optical coherence tomography (SD-OCT) of patients with early stage AMD or RP.

  9. Screening Preschool Children for Visual Disorders: A Pilot Study

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    Suman Adhikari, BOptom


    Full Text Available Purpose: Ocular and/or vision defects are one of the most common reasons for the referral of young children to the hospital. Vision disorders are the fourth most common disability of children and the leading cause of handicapping conditions in childhood. In preschool-age children, amblyopia and amblyogenic risk factors, such as strabismus and significant refractive errors, are the most prevalent and important visual disorders. The purpose of this pilot study was to determine the prevalence of visual disorders in preschool children in Kathmandu Valley, Nepal.Methods: Four hundred and eighty-four children attending eight preschools in Kathmandu Valley underwent detailed optometric examination. Visual acuity was assessed with either Sheridan Gardiner or Kay Picture chart monocularly. Binocularity was assessed with cover test and prism bar neutralisation. Refraction was carried out in all children. In most instances this was done without the use of a cycloplegic agent. Stereopsis was assessed with the Lang stereo test. Anterior and posterior segment abnormalities were assessed by using a pen light, hand-held slit lamp, and direct ophthalmoscope.Results: Refractive error was the most common visual disorder. Considering our criteria of refractive error for myopia ≥ 0.50 D, hyperopia ≥ 1.50 D, astigmatism ≥ 1.00 D, and anisometropia ≥ 1.00 D, the overall prevalence of refractive error in our study was 31.82%. The overall prevalence of myopia, hyperopia, and astigmatism was 24.17%, 2.48%, and 5.17%, respectively. Anisometropia was present in 1.65% of the participants, and 2%, 1.4%, and 0.2% had strabismus, amblyopia, and nystagmus, respectively.Conclusion: The relatively high prevalence of refractive error in our studied population needs more attention. The results suggest that there is a need for a large-scale community-based preschool screening program in Nepal so that affected children can be identified early and appropriate treatment can be

  10. In vivo analysis of the time and spatial activation pattern of microglia in the retina following laser-induced choroidal neovascularization. (United States)

    Crespo-Garcia, Sergio; Reichhart, Nadine; Hernandez-Matas, Carlos; Zabulis, Xenophon; Kociok, Norbert; Brockmann, Claudia; Joussen, Antonia M; Strauss, Olaf


    Microglia play a major role in retinal neovascularization and degeneration and are thus potential targets for therapeutic intervention. In vivo assessment of microglia behavior in disease models can provide important information to understand patho-mechanisms and develop therapeutic strategies. Although scanning laser ophthalmoscope (SLO) permits the monitoring of microglia in transgenic mice with microglia-specific GFP expression, there are fundamental limitations in reliable identification and quantification of activated cells. Therefore, we aimed to improve the SLO-based analysis of microglia using enhanced image processing with subsequent testing in laser-induced neovascularization (CNV). CNV was induced by argon laser in MacGreen mice. Microglia was visualized in vivo by SLO in the fundus auto-fluorescence (FAF) mode and verified ex vivo using retinal preparations. Three image processing algorithms based on different analysis of sequences of images were tested. The amount of recorded frames was limiting the effectiveness of the different algorithms. Best results from short recordings were obtained with a pixel averaging algorithm, further used to quantify spatial and temporal distribution of activated microglia in CNV. Morphologically, different microglia populations were detected in the inner and outer retinal layers. In CNV, the peak of microglia activation occurred in the inner layer at day 4 after laser, lacking an acute reaction. Besides, the spatial distribution of the activation changed by the time over the inner retina. No significant time and spatial changes were observed in the outer layer. An increase in laser power did not increase number of activated microglia. The SLO, in conjunction with enhanced image processing, is suitable for in vivo quantification of microglia activation. This surprisingly revealed that laser damage at the outer retina led to more reactive microglia in the inner retina, shedding light upon a new perspective to approach

  11. Array comparative genomic hybridization in retinoma and retinoblastoma tissues. (United States)

    Sampieri, Katia; Amenduni, Mariangela; Papa, Filomena Tiziana; Katzaki, Eleni; Mencarelli, Maria Antonietta; Marozza, Annabella; Epistolato, Maria Carmela; Toti, Paolo; Lazzi, Stefano; Bruttini, Mirella; De Filippis, Roberta; De Francesco, Sonia; Longo, Ilaria; Meloni, Ilaria; Mari, Francesca; Acquaviva, Antonio; Hadjistilianou, Theodora; Renieri, Alessandra; Ariani, Francesca


    In retinoblastoma, two RB1 mutations are necessary for tumor development. Recurrent genomic rearrangements may represent subsequent events required for retinoblastoma progression. Array-comparative genomic hybridization was carried out in 18 eye samples, 10 from bilateral and eight from unilateral retinoblastoma patients. Two unilateral cases also showed areas of retinoma. The most frequent imbalance in retinoblastomas was 6p gain (40%), followed by gains at 1q12-q25.3, 2p24.3-p24.2, 9q22.2, and 9q33.1 and losses at 11q24.3, 13q13.2-q22.3, and 16q12.1-q21. Bilateral cases showed a lower number of imbalances than unilateral cases (P = 0.002). Unilateral cases were divided into low-level ( or = 7) chromosomal instability groups. The first group presented with younger age at diagnosis (mean 511 days) compared with the second group (mean 1606 days). In one retinoma case ophthalmoscopically diagnosed as a benign lesion no rearrangements were detected, whereas the adjacent retinoblastoma displayed seven aberrations. The other retinoma case identified by retrospective histopathological examination shared three rearrangements with the adjacent retinoblastoma. Two other gene-free rearrangements were retinoma specific. One rearrangement, dup5p, was retinoblastoma specific and included the SKP2 gene. Genomic profiling indicated that the first retinoma was a pretumoral lesion, whereas the other represents a subclone of cells bearing 'benign' rearrangements overwhelmed by another subclone presenting aberrations with higher 'oncogenic' potential. In summary, the present study shows that bilateral and unilateral retinoblastoma have different chromosomal instability that correlates with the age of tumor onset in unilateral cases. This is the first report of genomic profiling in retinoma tissue, shedding light on the different nature of lesions named 'retinoma'.

  12. Quantification of optic disc edema during exposure to high altitude shows no correlation to acute mountain sickness.

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    Gabriel Willmann

    Full Text Available BACKGROUND: The study aimed to quantify changes of the optic nerve head (ONH during exposure to high altitude and to assess a correlation with acute mountain sickness (AMS. This work is related to the Tuebingen High Altitude Ophthalmology (THAO study. METHODOLOGY/PRINCIPAL FINDINGS: A confocal scanning laser ophthalmoscope (cSLO, Heidelberg Retina Tomograph, HRT3® was used to quantify changes at the ONH in 18 healthy participants before, during and after rapid ascent to high altitude (4559 m. Slitlamp biomicroscopy was used for clinical optic disc evaluation; AMS was assessed with Lake Louise (LL and AMS-cerebral (AMS-c scores; oxygen saturation (SpO₂ and heart rate (HR were monitored. These parameters were used to correlate with changes at the ONH. After the first night spent at high altitude, incidence of AMS was 55% and presence of clinical optic disc edema (ODE 79%. Key stereometric parameters of the HRT3® used to describe ODE (mean retinal nerve fiber layer [RNFL] thickness, RNFL cross sectional area, optic disc rim volume and maximum contour elevation changed significantly at high altitude compared to baseline (p<0.05 and were consistent with clinically described ODE. All changes were reversible in all participants after descent. There was no significant correlation between parameters of ODE and AMS, SpO₂ or HR. CONCLUSIONS/SIGNIFICANCE: Exposure to high altitude leads to reversible ODE in the majority of healthy subjects. However, these changes did not correlate with AMS or basic physiologic parameters such as SpO₂ and HR. For the first time, a quantitative approach has been used to assess these changes during acute, non-acclimatized high altitude exposure. In conclusion, ODE presents a reaction of the body to high altitude exposure unrelated to AMS.

  13. Quantification of Optic Disc Edema during Exposure to High Altitude Shows No Correlation to Acute Mountain Sickness (United States)

    Willmann, Gabriel; Fischer, M. Dominik; Schatz, Andreas; Schommer, Kai; Messias, Andre; Zrenner, Eberhart; Bartz-Schmidt, Karl U.; Gekeler, Florian


    Background The study aimed to quantify changes of the optic nerve head (ONH) during exposure to high altitude and to assess a correlation with acute mountain sickness (AMS). This work is related to the Tuebingen High Altitude Ophthalmology (THAO) study. Methodology/Principal Findings A confocal scanning laser ophthalmoscope (cSLO, Heidelberg Retina Tomograph, HRT3®) was used to quantify changes at the ONH in 18 healthy participants before, during and after rapid ascent to high altitude (4559 m). Slitlamp biomicroscopy was used for clinical optic disc evaluation; AMS was assessed with Lake Louise (LL) and AMS-cerebral (AMS-c) scores; oxygen saturation (SpO2) and heart rate (HR) were monitored. These parameters were used to correlate with changes at the ONH. After the first night spent at high altitude, incidence of AMS was 55% and presence of clinical optic disc edema (ODE) 79%. Key stereometric parameters of the HRT3® used to describe ODE (mean retinal nerve fiber layer [RNFL] thickness, RNFL cross sectional area, optic disc rim volume and maximum contour elevation) changed significantly at high altitude compared to baseline (p<0.05) and were consistent with clinically described ODE. All changes were reversible in all participants after descent. There was no significant correlation between parameters of ODE and AMS, SpO2 or HR. Conclusions/Significance Exposure to high altitude leads to reversible ODE in the majority of healthy subjects. However, these changes did not correlate with AMS or basic physiologic parameters such as SpO2 and HR. For the first time, a quantitative approach has been used to assess these changes during acute, non-acclimatized high altitude exposure. In conclusion, ODE presents a reaction of the body to high altitude exposure unrelated to AMS. PMID:22069483

  14. SD-OCT and Adaptive Optics Imaging of Outer Retinal Tubulation (United States)

    King, Brett J.; Sapoznik, Kaitlyn A.; Elsner, Ann E.; Gast, Thomas J.; Papay, Joel A.; Clark, Christopher A.; Burns, Stephen A.


    ABSTRACT Purpose To investigate outer retinal tubulation (ORT) using spectral domain optical coherence tomography (SD-OCT) and an adaptive optics scanning laser ophthalmoscope (AOSLO). To document the frequency of ORT in atrophic retinal conditions and quantify ORT dimensions versus adjacent retinal layers. Methods SD-OCT images were reviewed for the presence of retinal atrophy, scarring, and/or exudation. The greatest width of each ORT was quantified. Inner and outer retinal thicknesses adjacent to and within the area of ORT were measured for 18 patients. AOSLO imaged ORTs in five subjects with direct and scattered light imaging. Results ORT was identified in 47 of 76 subjects (61.8%) and in 65 eyes via SD-OCT in a wide range of conditions and ages, and in peripapillary atrophy. ORTs appeared as finger-like projections in atrophy, seen in the en face images. AOSLO showed some ORTs with bright cones that guide light within atrophic areas. Multiply scattered light mode AOSLO visualized variegated lines (18–35 μm) radiating from ORTs. The ORTs’ width on OCT b-scan images varied from 70 to 509 μm. The inner retina at the ORT was significantly thinner than the adjacent retina, 135 vs.170 μm (P = .004), whereas the outer retina was significantly thicker, 115 vs. 80 μm (P = .03). Conclusions ORTs are quite common in eyes with retinal atrophy in various disorders. ORTs demonstrate surviving photoreceptors in tubular structures found within otherwise nonsupportive atrophic areas that lack retinal pigment epithelium and choriocapillaris. PMID:27984506

  15. Comparing the fixational and functional preferred retinal location in a pointing task. (United States)

    Sullivan, Brian; Walker, Laura


    Patients with central vision loss (CVL) typically adopt eccentric viewing strategies using a preferred retinal locus (PRL) in peripheral retina. Clinically, the PRL is defined monocularly as the area of peripheral retina used to fixate small stimuli. It is not clear if this fixational PRL describes the same portion of peripheral retina used during dynamic binocular eye-hand coordination tasks. We studied this question with four participants each with a unique CVL history. Using a scanning laser ophthalmoscope, we measured participants' monocular visual fields and the location and stability of their fixational PRLs. Participants' monocular and binocular visual fields were also evaluated using a computer monitor and eye tracker. Lastly, eye-hand coordination was tested over several trials where participants pointed to and touched a small target on a touchscreen monitor. Trials were blocked and carried out monocularly and binocularly, with a target appearing at 5° or 15° from screen center, in one of 8 locations. During pointing, our participants often exhibited long movement durations, an increased number of eye movements and impaired accuracy, especially in monocular conditions. However, these compensatory changes in behavior did not consistently worsen when loci beyond the fixational PRL were used. While fixational PRL size, location and fixation stability provide a necessary description of behavior, they are not sufficient to capture the pointing PRL used in this task. Generally, patients use a larger portion of peripheral retina than one might expect from measures of the fixational PRL alone, when pointing to a salient target without time constraints. While the fixational and pointing PRLs often overlap, the fixational PRL does not predict the large area of peripheral retina that can be used.

  16. In Vivo Changes in Lamina Cribrosa Microarchitecture and Optic Nerve Head Structure in Early Experimental Glaucoma.

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    Kevin M Ivers

    Full Text Available The lamina cribrosa likely plays an important role in retinal ganglion cell axon injury in glaucoma. We sought to (1 better understand optic nerve head (ONH structure and anterior lamina cribrosa surface (ALCS microarchitecture between fellow eyes of living, normal non-human primates and (2 characterize the time-course of in vivo structural changes in the ONH, ALCS microarchitecture, and retinal nerve fiber layer thickness (RNFLT in non-human primate eyes with early experimental glaucoma (EG. Spectral domain optical coherence tomography (SDOCT images of the ONH were acquired cross-sectionally in six bilaterally normal rhesus monkeys, and before and approximately every two weeks after inducing unilateral EG in seven rhesus monkeys. ONH parameters and RNFLT were quantified from segmented SDOCT images. Mean ALCS pore area, elongation and nearest neighbor distance (NND were quantified globally, in sectors and regionally from adaptive optics scanning laser ophthalmoscope images. In bilaterally normal monkeys, ONH parameters were similar between fellow eyes with few inter-eye differences in ALCS pore parameters. In EG monkeys, an increase in mean ALCS Depth (ALCSD was the first structural change measured in 6 of 7 EG eyes. A decrease in mean minimum rim width (MRW simultaneously accompanied this early change in 4 of 6 EG eyes and was the first structural change in the 7th EG eye. Mean ALCS pore parameters were among the first or second changes measured in 4 EG eyes. Mean ALCS pore area and NND increased in superotemporal and temporal sectors and in central and peripheral regions at the first time-point of change in ALCS pore geometry. RNFLT and/or mean ALCS radius of curvature were typically the last parameters to initially change. Survival analyses found mean ALCSD was the only parameter to significantly show an initial change prior to the first measured loss in RNFLT across EG eyes.

  17. The Minnesota Grading System Using Fundus Autofluorescence of Eye Bank Eyes: A Correlation To Age-Related Macular Degeneration (An AOS Thesis) (United States)

    Olsen, Timothy W.


    Purpose To establish a grading system of eye bank eyes using fundus autofluorescence (FAF) and identify a methodology that correlates FAF to age-related macular degeneration (AMD) with clinical correlation to the Age-Related Eye Disease Study (AREDS). Methods Two hundred sixty-two eye bank eyes were evaluated using a standardized analysis of FAF. Measurements were taken with the confocal scanning laser ophthalmoscope (cSLO). First, high-resolution, digital, stereoscopic, color images were obtained and graded according to AREDS criteria. With the neurosensory retina removed, mean FAF values were obtained from cSLO images using software analysis that excludes areas of atrophy and other artifact, generating an FAF value from a grading template. Age and AMD grade were compared to FAF values. An internal fluorescence reference standard was tested. Results Standardization of the cSLO machine demonstrated that reliable data could be acquired after a 1-hour warm-up. Images obtained prior to 1 hour had falsely elevated levels of FAF. In this initial analysis, there was no statistical correlation of age to mean FAF. There was a statistically significant decrease in FAF from AREDS grade 1, 2 to 3, 4 (P < .0001). An internal fluorescent standard may serve as a quantitative reference. Conclusions The Minnesota Grading System (MGS) of FAF (MGS-FAF) establishes a standardized methodology for grading eye bank tissue to quantify FAF compounds in the retinal pigment epithelium and correlate these findings to the AREDS. Future studies could then correlate specific FAF to the aging process, histopathology AMD phenotypes, and other maculopathies, as well as to analyze the biochemistry of autofluorescent fluorophores. PMID:19277247

  18. Ocular morbidity among refugees in Southwest Ethiopia. (United States)

    Gelaw, Yeshigeta; Abateneh, Aemero


    Low vision and blindness are recognized as one of the major public health problems worldwide, especially in developing countries. The prevalence and cause of blindness and low vision vary from region to region, among different age and population groups in a country or geographical region. The objective of this study is thus to determine the causes of blindness and ocular morbidity among refugees in Southwest Ethiopia. A cross-sectional clinic based study was conducted on 1,054 refugees in Southwest Ethiopia. A basic anterior and posterior segment examination was done by ophthalmologists with Magnifying Loupe 2.5X and Direct Ophthalmoscope. Data were analyzed using SPSS version 16.0. The most common causes of ocular morbidity identified were trachoma 547(21.2%), cataract 501(19.4%), refractive error 353(13.7%), conjunctivitis 240(9.3%), glaucoma 130(5.1%) and climatic droplet keratopathy 112(4.4%). The overall prevalence of blindness was 26.2% and the prevalence of childhood blindness was 0.7%. The prevalence was higher among females (16.9%) than males (9.3%) and age groups 60 years and above (15.9%) than other age groups (10.3%) (Pcauses of blindness were cataract 112(40.6%), trachomatous corneal opacity 58(21.0%) and glaucoma 49(17.8%). The commonest cause of low vision was cataract 102(37.6%) followed by trachomatous corneal opacity 49(18.1%) and refractive error 35(12.9%). There is a very high burden of blinding eye diseases among refugees. Integrated multidisciplinary intervention strategies for the prevention and control of blindness and low vision in the study settings should be initiated.

  19. Hawk eyes I: diurnal raptors differ in visual fields and degree of eye movement.

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    Colleen T O'Rourke

    Full Text Available BACKGROUND: Different strategies to search and detect prey may place specific demands on sensory modalities. We studied visual field configuration, degree of eye movement, and orbit orientation in three diurnal raptors belonging to the Accipitridae and Falconidae families. METHODOLOGY/PRINCIPAL FINDINGS: We used an ophthalmoscopic reflex technique and an integrated 3D digitizer system. We found inter-specific variation in visual field configuration and degree of eye movement, but not in orbit orientation. Red-tailed Hawks have relatively small binocular areas (∼33° and wide blind areas (∼82°, but intermediate degree of eye movement (∼5°, which underscores the importance of lateral vision rather than binocular vision to scan for distant prey in open areas. Cooper's Hawks' have relatively wide binocular fields (∼36°, small blind areas (∼60°, and high degree of eye movement (∼8°, which may increase visual coverage and enhance prey detection in closed habitats. Additionally, we found that Cooper's Hawks can visually inspect the items held in the tip of the bill, which may facilitate food handling. American Kestrels have intermediate-sized binocular and lateral areas that may be used in prey detection at different distances through stereopsis and motion parallax; whereas the low degree eye movement (∼1° may help stabilize the image when hovering above prey before an attack. CONCLUSIONS: We conclude that: (a there are between-species differences in visual field configuration in these diurnal raptors; (b these differences are consistent with prey searching strategies and degree of visual obstruction in the environment (e.g., open and closed habitats; (c variations in the degree of eye movement between species appear associated with foraging strategies; and (d the size of the binocular and blind areas in hawks can vary substantially due to eye movements. Inter-specific variation in visual fields and eye movements can influence

  20. Effects of short term changes in the blood glucose level on the autofluorescence lifetime of the human retina in healthy volunteers (United States)

    Klemm, Matthias; Nagel, Edgar; Schweitzer, Dietrich; Schramm, Stefan; Haueisen, Jens


    Purpose: Fluorescence lifetime imaging ophthalmoscopy (FLIO) provides in vivo metabolic mapping of the ocular fundus. Changes in FLIO have been found in e.g. diabetes patients. The influence of short term metabolic changes caused by blood glucose level changes on is unknown. Aim of this work is the detection of short-term changes in fundus autofluorescence lifetime during an oral glucose tolerance test. Methods: FLIO was performed in 10 healthy volunteers (29+/-4 years, fasting for 12h) using a scanning laser ophthalmoscope (30° fundus, 34μm resolution, excitation with 473nm diode laser with 70 ps pulses at 80 MHz repetition rate, detection in two spectral channels 500-560nm (ch1) and 560-720nm (ch2) using the timecorrelated single photon counting method). The blood glucose level (BGL) was measured by an Accu-Chek® Aviva self-monitoring device. Before and after a glucose drink (300ml solution, containing 75g of glucose (Accu-Chek® Dextrose O.G.T.), BGL and FLIO were measured every 15min. The FLIMX software package was applied to compute the average fluorescence lifetime τ on the inner ring of the ETDRS grid using a modified 3-exponential approach. Results: The results are given as mean +/- standard deviation over all volunteers in ch1. Baseline measurement: BGL: 5.3+/-0.4 mmol/l, τ1: 49+/-6ps. A significant reduction (α=5% Wilcoxon rank-sum test) in τ1 is detected after 15min (BGL: 8.4+/-1.1 mmol/l, τ1: 44+/-5ps) and after 90min (BGL: 6.3+/-1.4 mmol/l, τ1: 41+/-5ps). Results of ch2 show smaller reductions in the fluorescence lifetimes over time.

  1. The role of serum apelin in retinopathy of prematurity

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    Ali YF


    Full Text Available Yasser F Ali,1 Salah El-Morshedy,1 Abdulbasit Abdulhalim Imam,2 Nasser Ismai A Abdelrahman,1 Riad M Elsayed,3 Usama M Alkholy,1 Nermin Abdalmonem,1 Mohammed M Shehab1 1Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, 2Department of Pediatrics, Al-Azhar Faculty of Medicine-Girls, Cairo, 3Pediatric Neurology Unit, Pediatric Department, Mansoura University, Mansoura, Egypt Objective: To evaluate the role of serum apelin as a diagnostic tool in retinopathy of prematurity (ROP disease.Patients and methods: Thirty-eight preterm infants (60% male with gestational age ranging from 30 to 36 weeks admitted to the neonatal intensive care unit, KJO Hospital, Saudi Arabia with proven diagnosis of ROP were included in the study. In addition, 27 preterm infants without ROP served as controls. All newborn infants in the study were subjected to adequate history taking, full clinical examination, and fundus examination by indirect ophthalmoscope (at 4–6 weeks as well as determination of serum apelin at birth and at 4–6 weeks of age.Results: The study revealed that oxygen therapy longer than 7 days’ duration, cesarean section (as a mode of delivery, sepsis, mechanical ventilation, blood transfusion, premature rupture of membranes, pneumothorax, perinatal asphyxia, cardiac problems, and neonatal jaundice were considered as risk factors related to development of ROP. Serum apelin levels were significantly lower in patients than controls (P<0.001 at time of diagnosis of the disease (4–6 weeks while no significant differences were observed in levels at birth.Conclusion: Serum apelin was found to be of significant diagnostic value in the occurrence of ROP. Keywords: retinopathy of prematurity, preterm infants, serum apelin

  2. Progress in measurement of ocular blood flow and relevance to our understanding of glaucoma and age-related macular degeneration. (United States)

    Harris, A; Chung, H S; Ciulla, T A; Kagemann, L


    New technologies have facilitated the study of the ocular circulation. These modalities and analysis techniques facilitate very precise and comprehensive study of retinal, choroidal, and retrobulbar circulations. These techniques include: 1. Vessel caliber assessment; 2. Scanning laser ophthalmoscopic fluorescein angiography and indocyanine green angiography to image and evaluate the retinal circulation and choroidal circulation respectively; 3. Laser Doppler flowmetry and confocal scanning laser Doppler flowmetry to measure blood flow in the optic nerve head and retinal capillary beds; 4. Ocular pulse measurement; and 5. color Doppler imaging to measure blood flow velocities in the central retinal artery, the ciliary arteries and the ophthalmic artery. These technique have greatly enhanced the ability to quantify ocular perfusion defects in many disorders, including glaucoma and age-related macular degeneration, two of the most prevalent causes of blindness in the industrialized world. Recently it has become clear, in animal models of glaucoma, that retinal ganglion cells die via apoptosis. The factors that initiate apoptosis in these cells remain obscure, but ischemia may play a central role. Patients with either primary open-angle glaucoma or normal-tension glaucoma experience various ocular blood flow deficits. With regard to age-related macular degeneration, the etiology remains unknown although some theories include primary retinal pigment epithelial senescence, genetic defects such as those found in the ABCR gene which is also defective in Stargardt's disease and ocular perfusion abnormalities. As the choriocapillaris supplies the metabolic needs of the retinal pigment epithelium and the outer retina, perfusion defect in the choriocapillaris could account for some of the physiologic and pathologic changes in AMD. Vascular defects have been identified in both nonexudative and exudative AMD patients using new technologies. This paper is a comprehensive update

  3. Single-cell resolution imaging of retinal ganglion cell apoptosis in vivo using a cell-penetrating caspase-activatable peptide probe.

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    Xudong Qiu

    Full Text Available Peptide probes for imaging retinal ganglion cell (RGC apoptosis consist of a cell-penetrating peptide targeting moiety and a fluorophore-quencher pair flanking an effector caspase consensus sequence. Using ex vivo fluorescence imaging, we previously validated the capacity of these probes to identify apoptotic RGCs in cell culture and in an in vivo rat model of N-methyl- D-aspartate (NMDA-induced neurotoxicity. Herein, using TcapQ488, a new probe designed and synthesized for compatibility with clinically-relevant imaging instruments, and real time imaging of a live rat RGC degeneration model, we fully characterized time- and dose-dependent probe activation, signal-to-noise ratios, and probe safety profiles in vivo. Adult rats received intravitreal injections of four NMDA concentrations followed by varying TcapQ488 doses. Fluorescence fundus imaging was performed sequentially in vivo using a confocal scanning laser ophthalmoscope and individual RGCs displaying activated probe were counted and analyzed. Rats also underwent electroretinography following intravitreal injection of probe. In vivo fluorescence fundus imaging revealed distinct single-cell probe activation as an indicator of RGC apoptosis induced by intravitreal NMDA injection that corresponded to the identical cells observed in retinal flat mounts of the same eye. Peak activation of probe in vivo was detected 12 hours post probe injection. Detectable fluorescent RGCs increased with increasing NMDA concentration; sensitivity of detection generally increased with increasing TcapQ488 dose until saturating at 0.387 nmol. Electroretinography following intravitreal injections of TcapQ488 showed no significant difference compared with control injections. We optimized the signal-to-noise ratio of a caspase-activatable cell penetrating peptide probe for quantitative non-invasive detection of RGC apoptosis in vivo. Full characterization of probe performance in this setting creates an important in

  4. Diffusion MR Imaging of Postoperative Bilateral Acute Ischemic Optic Neuropathy

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    Kannan, Anusha; Srinivasan, Sivasubramanian [Khoo Teck Puat Hospital, Singapore (Singapore)


    We read with great interest, the case report on ischemic optic neuropathy (1). We would like to add a few points concerning the blood supply of the optic nerve and the correlation with the development of post-operative ischemic neuropathy. Actually, the perioperative or post-operative vision loss (postoperative ischemic neuropathy) is most likely due to ischemic optic neuropathy. Ischemic optic neuropathy (2) is classified as an anterior ischemic optic neuropathy (AION) and posterior ischemic optic neuropathy (PION). This classification is based on the fact that blood supply (2) to the anterior segment of the optic nerve (part of the optic nerve in the scleral canal and the optic disc) is supplied by short posterior ciliary vessels or anastamotic ring branches around the optic nerve. The posterior part of the optic canal is relatively less perfused, and is supplied by ophthalmic artery and central fibres are perfused by a central retinal artery. So, in the post-operative period, the posterior part of the optic nerve is more vulnerable for ischemia, especially, after major surgeries (3), one of the theories being hypotension or anaemia (2) and resultant decreased perfusion. The onset of PION is slower than the anterior ischemic optic neuropathy. AION on the other hand, is usually spontaneous (idiopathic) or due to arteritis, and is usually sudden in its onset. The reported case is most likely a case of PION. The role of imaging, especially the diffusion weighted magnetic resonance imaging, is very important because the ophthalmoscopic findings in early stages of PION is normal, and it may delay the diagnosis. On the other hand, edema of the disc is usually seen in the early stages of AION.

  5. Lupeol, a pentacyclic triterpenoid isolated from Vernonia cinerea attenuate selenite induced cataract formation in Sprague Dawley rat pups. (United States)

    Asha, Radha; Gayathri Devi, V; Abraham, Annie


    This study investigated the inhibitory effects of active component isolated from flavonoid fraction of Vernonia cinerea (FVC), lupeol on selenite induced cataract formation. Previous reports suggest that phytochemicals or natural plant products retard the process of cataractogenesis by scavenging free oxygen radicals. Hence, the present study sought to assess the potential of lupeol on in vivo selenite induced cataract models. Lupeol, a pentacyclic triterpenoid, was isolated from the ethyl acetate fraction of methanolic extract of Vernonia cinerea, follows standard chromatographic techniques. Structural elucidation of the compound was carried out using (1)H NMR, (13)C NMR, Mass spectrometry together with other complementary techniques (UV and IR). From these, the isolated compound was identified as Lupeol (3'-hydroxylup-20(29)-ene). The antioxidant activity was comparatively studied using DPPH radical scavenging and FRAP assay. Lupeol exhibited higher DPPH radical scavenging activity as well as reducing power assay. In this study, cataract was induced by a single subcutaneous injection of sodium selenite (4 μg/g body weight) on rat pups. Lupeol was administered orally from 8th day upto 21st day at a concentration 25 μg/g body weight. Cataract was visualized on 16th day with the help of an ophthalmoscope and later on with the naked eye. On the 30th day, rats were euthanized by sodium pentothal injection, lenses were excised and the biochemical parameters such as activity of superoxide dismutase (SOD), catalase (CAT), Glutathione peroxidase (GPx), Glutathione reductase (GR), Glutathione-S-transferase (GST), Ca(2+) ATPase, glutathione content (GSH), reactive oxygen species (ROS), lipid peroxidation products (malondialdehyde) were estimated and found effective in the treatment of cataract by lupeol.

  6. Malignant hypertensive retinopathy as a presenting sign of an occult dead fetus

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    Araújo J


    Full Text Available Joana Araújo,1 João Tavares-Ferreira,1 Susana Penas,1,2 Luís Figueira,1,3 Flávio Prézia Paiva,1 Fernando Falcão-Reis1,2 1Ophthalmology Department, São João Hospital, 2Department of Sense Organs, 3Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Porto, Portugal Abstract: We report one case of malignant hypertensive retinopathy as a presenting sign of fetal death in utero. Ophthalmic examination (including intravenous fluorescein angiography and optical coherence tomography and obstetric and systemic evaluation were performed, providing a multidisciplinary approach. A 33-year-old overweight woman (body mass index 47 kg/m2 with no systemic or ocular known disease was admitted to our emergency department with a one-week history of bilateral vision loss and no systemic complaints. On examination, best corrected visual acuity was 1/10 in the right eye and 1/10 in the left eye. Anterior segment examination of both eyes was unremarkable. Ophthalmoscopic fundus findings included bilateral optic disc edema, diffuse cotton wool spots, intraretinal exudates, retinal hemorrhages, and multiple serous retinal detachments involving both maculae. Physical examination revealed a blood pressure of 220/ 110 mmHg. Further systemic workup revealed a previously unknown 35-week pregnancy with a dead fetus. An emergency cesarean section was performed. Pre-eclampsia is a life-threatening disorder for both mother and fetus. This case highlights the need to rule out pre-eclampsia in all women of childbearing age presenting with ocular signs of malignant hypertension, even without external signs of pregnancy. Keywords: hypertensive retinopathy, pre-eclampsia, vision loss  

  7. [Eye injuries caused by lasers in military and industrial environment. Apropos of 13 cases]. (United States)

    Pariselle, J; Sastourne, J C; Bidaux, F; May, F; Renard, J P; Maurin, J F


    The aim of this study was to analyse the nature of wavelengths used by military forces, evaluate their clinical consequences in terms of ocular risk, and determine the therapeutic implications and specific preventative measures which should be implemented both in peace- and war-time-settings. We analyzed retrospectively 13 cases of laser injury (12 patients) treated in our unit over the past 10 years. We recorded the characteristics of the responsible lasers, effects on visual acuity and visual filed, initial ophthalmoscopic and angiographic aspects, treatment undertaken and patient follow-up. Wavelengths were know in only 10 cases. In 9 cases a NdYag laser operating at 1063 nm was involved. The tenth case was an Argon Coirorint laser accident. In three cases the wavelength could not be ascertained because it was confidential information or had been emitted by the enemy and had not been identified. Ocular injury was bilateral in 1 case and unilateral in 12. Retinal lesions were foveolar in 8 cases with an initial visual acuity varying from 1/10 to 10/10. Visual loss depended on the extent of the burn and did not tend to improve despite vasoprotector and corticosteroid treatments. In 2 cases the injury progressed without formation of an epimacular membrane. Retinal lesions were extra-foveolar in 5 cases and in 1 case vitreous hemorrhage required vitrectomy. With the widespread use of Yag lasers and the soon to be employed tuneable lasers, there in major risk of serious ocular injury resulting from foveolar burns or peripheral retina trauma with vitreous hemorrhage. In a war situation, a large number of laser casualties producing peripheral vitreous hemorrhage would create an important logistics problem for vitrectomy. The accent must therefore be focused on prevention. Personnel must be informed of the danger and instructed in wearing filter glasses adapted to the wavelengths being used, if known, or a universal photoactivated protective device, as yet a

  8. Early retinopathy in the Bernese Mountain Dog in France: preliminary observations. (United States)

    Chaudieu, G; Molon-Noblot, S


    The objective of the study was to describe a form of early retinopathy in the Bernese Mountain Dog in France. Sixty-two Bernese Mountain Dogs (38 males and 24 females), whose ages ranged from 2 months to 9 years, were examined over a period of 3 years. Visual behavior, pupillary light reflexes, menace responses and ocular fundi were evaluated in all animals. Electroretinography (ERG) was performed on six of the affected dogs after dark adaptation. Fluorescein angiography (FA) was performed on one affected dog. Whenever possible, the pedigrees of the affected dogs were evaluated. A histological examination of the retina was performed on one of the affected dogs. Eight dogs (seven males and one female) were diagnosed with retinopathy with an early onset of clinical signs. (Four dogs were aged between 3 months and 1 year, two dogs were aged 2 and 3.5 years, and one dog was 7 years old.) Night vision was impaired in most of the dogs. Retinopathy was characterized ophthalmoscopically by a bilateral, symmetrical horizontal zone of tapetal hyper-reflectivity adjacent to and above the optic disc, and sometimes by peri-papillary hyper-reflectivity. ERG changes included a reduction in b-wave amplitude varying from one case to another. Fluoroscein angiography demonstrated an ischemic-type alteration with epitheliopathy opposite the hyper-reflective zone. Pedigree examinations suggested a familial predisposition. The histological examination indicated photoreceptor degeneration that was more pronounced in the central tapetal zone. In France, retinopathy in the Bernese Mountain Dog involves an early retinal degeneration that produces specific manifestations of the ocular fundus, night visual impairment or blindness, and has familial transmission.

  9. Characteristics of fundus autofluorescence in cystoid macular edema

    Institute of Scientific and Technical Information of China (English)

    PENG Xi-jia; SU Lan-ping


    Background Fundus autofluorescence (FAF) imaging is a fast and noninvasive technique developed over the last decade.The authors utilized fluorescent properties of lipofuscin to study the health and viability of the retinal pigment epithelium (RPE)-photoreceptor complex.Observing the intensity and distribution of FAF of various retinal diseases is helpful for ascertaining diagnosis and evaluating prognosis.In this study,we described the FAF characteristics of cystoid macular edema (CME).Methods Sixty-two patients (70 eyes) with CME were subjected to FAF and fundus fluorescein angiography (FFA) by a confocal scanning laser ophthalmoscope (Heidelberg Retina Angiograph 2 (HRA2)).Characteristics of FAF images were compared with FFA images.Results FAF intensity in normal subjects was highest at the posterior pole and dipped at the fovea.All cases of CME showed fluorescein dye accumulated into honeycomb-like spaces in macular and formated a typical petaloid pattern or atypical petaloid pattern in the late phases of the angiography.Sixty-one eyes with CME on FAF images showed mild or moderate hyperautofluorescence petaloid pattern in fovea,the FAF patterns of these CME was perfectly corresponding with shape in their FFA images;nine eyes with CME secondary to exudative age related macular degeneration (AMD) showed expansion of the hypoautofluorescence without petaloid pattern in macula.Conclusion FAF imaging can be used as a new rapid,non-invasive and ancillary technique in the diagnosis of the majority of CME,except for AMD and small part of other fundus diseases.

  10. A cross-sectional survey of optometrists and optometric practices in Ghana. (United States)

    Boadi-Kusi, Samuel Bert; Ntodie, Michael; Mashige, Khathutshelo Percy; Owusu-Ansah, Andrew; Antwi Osei, Kwaku


    The study was conducted to profile optometrists and optometric practices in Ghana. An online survey was conducted among 146 optometrists, who were registered with the Ghana Optometric Association (GOA). It included questions on their demographics, equipment, ophthalmic procedures routinely conducted and the barriers to providing a full scope of optometric services. Ninety registered optometrists (62 per cent) responded, their mean age being 28.97 ± 3.36 years. There were more males (68.9 per cent) than females and most had the Doctor of Optometry (OD) degree, the profession's highest degree in Ghana. There were more practitioners in urban centres (71.1 per cent) and most practices had basic optometric instruments, such as direct ophthalmoscopes, slitlamp biomicroscopes and retinoscopes. Many optometrists routinely conducted direct ophthalmoscopy (100 per cent), slitlamp biomicroscopy (87.5 per cent) and contact tonometry (55.7 per cent); however, few provided contact lens (10.2 per cent) and low vision (9.1 per cent) assessments, with 76 per cent stating that it was due to the unavailability of low vision devices, poor sources of contact lenses (27 per cent) and perceived insufficient training (11.2 per cent). Many practitioners (97 per cent) reported the use of diagnostic pharmaceutical agents and therapeutic pharmaceutical agents (96.6 per cent). Most practitioners (52.9 per cent) preferred conferences for the delivery of continuous professional development over publications (26.4 per cent) and internet resources (12.6 per cent). The data elicited in this study provide a basis for addressing the country's unmet eye-care needs and can be used to determine training and support guidelines for the profession. © 2015 The Authors. Clinical and Experimental Optometry © 2015 Optometry Australia.

  11. Prevalence of diabetic retinopathy in Tehran province: a population-based study

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    Yaseri Mehdi


    Full Text Available Abstract Background To determine the prevalence and characteristics of diabetic retinopathy (DR among Iranian patients with diabetes. Methods Design: population-based cross-sectional study. Participants: patients with diabetes aged 25 to 64 years in Tehran province, Iran. This survey was conducted from April to October 2007. The study sample was derived from the first national survey of risk factors for non-communicable disease. Diabetes mellitus was defined as a fasting plasma glucose of ≥ 7.0 mmol/l (126 mg/dl or more, use of diabetic medications, or a physician's diagnosis of diabetes. All patients known to have diabetes underwent an eye examination by bio-microscope and indirect ophthalmoscope to check for any signs of DR through dilated pupils by + 78 lens. Participants were also interviewed and examined to determine their demographic characteristics, medical conditions and the regularity of their eye visits. Results Among 7989 screened patients, 759 (9.5% had diabetes. Of them, 639 patients (84.2% underwent eye examination. Five patients (0.7% with media opacity were excluded. Of 634 examined patients with diabetes, 240 had some degree of diabetic retinopathy, and the overall standardized prevalence of any retinopathy was 37.0% (95% CI: 33.2-40.8, including 27.3% (95% CI: 23.7-30.8 (n = 175 with non-proliferative and 9.6% (95% CI: 7.3-11.9 (n = 65 with proliferative diabetic retinopathy. Clinically significant macular edema and vision-threatening retinopathy were detected in 5.8% (95% CI: 4.0-7.7 (n = 38 and 14.0% (95% CI: 11.3-16.7 (n = 95 of patients, respectively. Only 143 patients (22.6% with diabetes had a history of regular eye examination. Conclusion This study demonstrated a high prevalence and poor control of DR in Tehran province. This suggests the need for adequate prevention and treatment in patients with diabetes.

  12. Image processing for improved eye-tracking accuracy (United States)

    Mulligan, J. B.; Watson, A. B. (Principal Investigator)


    Video cameras provide a simple, noninvasive method for monitoring a subject's eye movements. An important concept is that of the resolution of the system, which is the smallest eye movement that can be reliably detected. While hardware systems are available that estimate direction of gaze in real-time from a video image of the pupil, such systems must limit image processing to attain real-time performance and are limited to a resolution of about 10 arc minutes. Two ways to improve resolution are discussed. The first is to improve the image processing algorithms that are used to derive an estimate. Off-line analysis of the data can improve resolution by at least one order of magnitude for images of the pupil. A second avenue by which to improve resolution is to increase the optical gain of the imaging setup (i.e., the amount of image motion produced by a given eye rotation). Ophthalmoscopic imaging of retinal blood vessels provides increased optical gain and improved immunity to small head movements but requires a highly sensitive camera. The large number of images involved in a typical experiment imposes great demands on the storage, handling, and processing of data. A major bottleneck had been the real-time digitization and storage of large amounts of video imagery, but recent developments in video compression hardware have made this problem tractable at a reasonable cost. Images of both the retina and the pupil can be analyzed successfully using a basic toolbox of image-processing routines (filtering, correlation, thresholding, etc.), which are, for the most part, well suited to implementation on vectorizing supercomputers.

  13. Retinopatia de Purtscher e Purtscher-like Purtscher's and Purtscher-like retinopathies

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    Hilton Arcoverde Gonçalves de Medeiros


    Full Text Available A retinopatia de Purtscher é uma condição caracterizada pela baixa súbita de acuidade visual precedida por traumatismo, principalmente torácico, podendo aparecer em outros tipos de traumatismos. Uma entidade com o mesmo quadro clínico descrita como retinopatia "Purtscher-like" apresenta características semelhantes, no entanto na inexistência de um trauma direto. Neste caso pode vir associada a fenômenos tromboembólicos, secundária a pancreatite aguda, pós-manobra de Valsalva, pós-anestesia retrobulbar, e outros. O achado oftalmológico comum é a presença de manchas esbranquiçadas no polo posterior com hemorragias peripapilares, associadas à papiledema e áreas de não perfusão capilar. Neste artigo, revisamos os critérios diagnósticos, os padrões nos exames complementares e tratamentos utilizados em cada caso.Purtscher's retinopathy is a condition characterized by loss of vision within hours after an injury, especially thoracic. The term "Purtscher-like retinopathy" is used to describe a similar retinal appearance in a variety of conditions other than trauma. This condition have been reported in acute pancreatitis, lymphoproliferative disorders, chest compression, fat embolization, Valsalva maneuver, after retrobulbar anesthesia, and others. Fundus abnormalities include cotton-wool spots, retinal hemorrhage, non-capillary perfusion areas, and optic disk swelling. In this article we revise the ophthalmoscopic findings, the pattern of complimentary examinations and treatment indicated in each case.

  14. Real-time imaging of RGC death with a cell-impermeable nucleic acid dyeing compound after optic nerve crush in a murine model. (United States)

    Tsuda, Satoru; Tanaka, Yuji; Kunikata, Hiroshi; Yokoyama, Yu; Yasuda, Masayuki; Ito, Azusa; Nakazawa, Toru


    The retinal ganglion cells (RGCs) are the main source of therapeutic targets for neuroprotective glaucoma treatment, and evaluating RGCs is key for effective glaucoma care. Thus, we developed a minimally invasive, quick, real-time method to evaluate RGC death in mice. In this article we describe the details of our method, report new results obtained from C57BL/6J mice, and report that our method was usable in wild type (WT) and knockout (KO) mice lacking an RGC-death-suppressing gene. It used a non-invasive confocal scanning laser ophthalmoscope (cSLO) and a low molecular weight, photo-switching, cell-impermeant, fluorescent nucleic acid dyeing compound, SYTOX orange (SO). The RGCs were retrogradely labeled with Fluorogold (FG), the optic nerve was crushed (ONC), and SO was injected into the vitreous. After ten minutes, RGC death was visualized with cSLO in vivo. The retinas were then extracted and flat mounted for histological observation. SO-labeled RGCs were counted in vivo and FG-labeled RGCs were counted in retinal flat mounts. The time course of RGC death was examined in Calpastatin KO mice and wild type (WT) mice. Our in vivo imaging method revealed that SO-positive dead RGCs were mainly present from 4 to 6 days after ONC, and the peak of RGC death was after 5 days. Moreover, the number of SO-positive dead RGCs after 5 days differed significantly in the Calpastatin KO mice and the WT mice. Counting FG-labeled RGCs in isolated retinas confirmed these results. Thus, real-time imaging with SO was able to quickly quantify ONC-induced RGC death. This technique may aid research into RGC death and the development of new neuroprotective therapies for glaucoma. Copyright © 2016 Elsevier Ltd. All rights reserved.


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    Chakravarthy K


    Full Text Available BACKGROUND Diabetic Retinopathy (DR is the most common microvascular complication of Diabetes Mellitus (DM and is the leading cause of blindness in working age adults of patients with type 1 and 2 DM. Large observational and randomised studies shown that optimal blood glucose and blood pressure control halt or regress the disease and limit the risk of progression to the proliferative stage and visual loss. Recently, evidence has also emerged that Renin-Angiotensin System (RAS inhibitors may electively prevent or delay progression of retinopathy by acting on local RAS. Thus, metabolic and blood pressure control by RAS inhibition is to prevent or limit the onset of retinopathy and its progression towards visual-threatening stages. The aim of the study is to categorise and analyse grading of DR who are on currently ACE and ARBs unchanged for at least 2 years. MATERIALS AND METHODS 178 patients with type 1 and 2 DM of both genders on ARBs and ACEI unchanged for at least 2 years are divided into two groups as follows- 1. ARB group, which includesa 28 patients on losartan (50 mg. b 32 patients on losartan (50 mg + hydrochlorothiazide (12.5 mg. c 28 patients on telmisartan (40 mg. d 32 patients on telmisartan (40 mg + hydrochlorothiazide (12.5 mg. 2. ACE inhibitor group includesa 30 patients on enalapril (5 mg. b 28 patients on ramipril (2.5 mg + hydrochlorothiazide (12.5 mg. Retinopathy grading assessed by indirect ophthalmoscope and comparison of retinopathy grading between ARBs and ACEI groups have done. Two-tailed Chi-square test, GraphPad Prism Software used for statistical calculations. RESULTS Losartan and telmisartan (ARB group showed significant protection from diabetic retinopathy than enalapril and ramipril (ACEI group (p<0.05. CONCLUSION ARBs help in preventing the progression of DR and vision loss in those belonging to mild and moderate nonproliferative diabetic retinopathy patients.


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    Rama Bharathi


    Full Text Available PURPOSE: To estimate the prevalence of fundus changes in Pregnancy Induced Hypertension (PIH and to find the correlation of the findings with the levels of hypertension and with the severity of the disease. METHODS: This was a hospital based cross section al study conducted over a period of one year from July 2012 to June 2013. 150 patients with diagnosed PIH and admission into wards at King George Hospital, Visakhapatnam, with 36 weeks period of gestation and above, were included in the study. Those with p re - existing hypertension, coexisting diabetes mellitus, severe anaemia, renal disease and ocular diseases like cataract or corneal opacities were excluded from the study. After taking consent and ocular history, anterior segment was evaluated. Pupils were dilated with 0.5% tropicamide eye drops and fundus examination was done with direct ophthalmoscope. Information like age, para, BP etc., was noted down from case sheets. RESULTS: Total number of patients studied was 150.Mean age was 23.06+ 3.03years. 105 ( 70% were primigravidae and 45(30% were multigravidae. Fundus findings were seen in 35 cases (23.33%. 26 (17.33% had Grade I changes, 1 (0.66% had grade II changes, 6 (3.9% had grade III changes 2 (1.3% had serous retinal detachment/grade - IV. The de gree of retinopathy was correlating with the severity of the disease and levels of hypertension. CONCLUSION: The prevalence of fundus changes in PIH is 23.33%. Most of the fundus changes in PIH are underdiagnosed. Timely ophthalmoscopy should be called for in all cases of PIH as it would affect the decision of induction of delivery, thereby preventing other complications.

  17. Adaptive optics retinal imaging in the living mouse eye. (United States)

    Geng, Ying; Dubra, Alfredo; Yin, Lu; Merigan, William H; Sharma, Robin; Libby, Richard T; Williams, David R


    Correction of the eye's monochromatic aberrations using adaptive optics (AO) can improve the resolution of in vivo mouse retinal images [Biss et al., Opt. Lett. 32(6), 659 (2007) and Alt et al., Proc. SPIE 7550, 755019 (2010)], but previous attempts have been limited by poor spot quality in the Shack-Hartmann wavefront sensor (SHWS). Recent advances in mouse eye wavefront sensing using an adjustable focus beacon with an annular beam profile have improved the wavefront sensor spot quality [Geng et al., Biomed. Opt. Express 2(4), 717 (2011)], and we have incorporated them into a fluorescence adaptive optics scanning laser ophthalmoscope (AOSLO). The performance of the instrument was tested on the living mouse eye, and images of multiple retinal structures, including the photoreceptor mosaic, nerve fiber bundles, fine capillaries and fluorescently labeled ganglion cells were obtained. The in vivo transverse and axial resolutions of the fluorescence channel of the AOSLO were estimated from the full width half maximum (FWHM) of the line and point spread functions (LSF and PSF), and were found to be better than 0.79 μm ± 0.03 μm (STD)(45% wider than the diffraction limit) and 10.8 μm ± 0.7 μm (STD)(two times the diffraction limit), respectively. The axial positional accuracy was estimated to be 0.36 μm. This resolution and positional accuracy has allowed us to classify many ganglion cell types, such as bistratified ganglion cells, in vivo.

  18. Risk factors for visual impairment and blindness amongst black adult diabetis receiving treatment at Government healthcare facilitis in Mopani District, Limpopo province, South Africa

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    Raymond G. Mabaso


    Full Text Available Background: Diabetes mellitus (DM is a common systemic disease amongst Black South Africans. It may lead to diabetic retinopathy (DR, a common cause of visual impairment (VI and blindness. DR may signifiantly increase the prevalence of VI and blindness.Aim: To assess risk factors for VI and blindness amongst a black diabetic South African population aged ≥ 40 years.Setting: The study was conducted in seven Government healthcare facilities (two hospitals, four clinics and one health centre in Mopani District, Limpopo province, South Africa.Methods: This was a cross-sectional health facility-based quantitative study. Structured interviews were used to obtain information, which included sociodemographic profie, knowledge about DM and its ocular complications, presence of hypertension and accessibility to health facilities. Subsequently participants were examined for VI and blindness using an autorefractor, pinhole disc, ophthalmoscope and logMAR visual acuity chart. Anthropometric measurements (height, weight and waist were also taken. Associations between 31 risk factors and VI as well as blindness were statistically examined.Results: Participants (N = 225 included 161 women and 64 men aged 40–90 years (mean 61.5 ± 10.49 years; 41.3% of them had VI and 3.6% were blind. Cataracts (76.8% and DR (7.1% were the common causes of compensated VI and blindness. Risk factors that were associated with VI and blindness were age, monthly income, compliance with losing weight and physical activity.Conclusion: Findings suggest that lifestyle intervention and appropriate eyecare programmes may reduce VI and blindness in this population.

  19. [Retinal photocoagulation with a pulsed, frequency-doubled Nd:YAG laser (532 nm)]. (United States)

    Roider, J; Schiller, M; el Hifnawi, E S; Birngruber, R


    The small difference in wavelength between an argon laser (514 nm) and a frequency-doubled Nd:YAG laser (532 nm), together with the advantage of the solid-state technology, makes the Nd:YAG laser likely to play a major role in retinal photocoagulation in the near future. For technical reasons all frequency-doubled Nd:YAG lasers work in a quasi-continuous mode, emitting a burst of highly repetitive short laser pulses during the exposure time desired. We investigated the side effects due to high peak irradiances of those short laser pulse trains (Crystal Focus Nd:YAG laser, Emerald; pulse duration 1-10 microseconds, repetition rate 13 KHz) in rabbits in comparison with a standard argon laser system (Zeiss, Visulas, Argon II). The energy necessary for blanching the retina was similar in both cases. As opposed to the argon laser system, subretinal bubbles were regularly visible ophthalmoscopically with the Nd:YAG system, when average powers as high as 200 mW were used. The ED50 power for bubble formation is about 2-3 times above the ED50 power for blanching. Thermal calculations show that this bubble formation effect is likely to be related to the peak power of the short pulses. The hemorrhage threshold is similar in both systems. However, light microscopically there is no difference between the two laser systems. Panretinal photocoagulation (300-500 microns, 100-200 ms) in patients with proliferative diabetic retinopathy produced such bubbles about once per 1000 lesions.

  20. A degenerative retinal process in HIV-associated non-infectious retinopathy.

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    Igor Kozak

    Full Text Available HIV retinopathy is the most common non-infectious complication in the eyes of HIV-positive individuals. Oncotic lesions in the retinal nerve fiber layer, referred to as cotton wool spots (CWS, and intraretinal (IR hemorrhages are frequently observed but are not unique to this pathology. HIV-positive patients have impaired color vision and contrast sensitivity, which worsens with age. Evidence of inner-retinal lesions and damage have been documented ophthalmoscopically, however their long term structural effect has not been investigated. It has been hypothesized that they may be partially responsible for loss of visual function and visual field. In this study we utilized clinical data, retinal imaging and transcriptomics approaches to comprehensively interrogate non-infectious HIV retinopathy. The methods employed encompassed clinical examinations, fundus photography, indirect ophthalmoscopy, Farmsworth-Munsell 100 hue discrimination testing and Illumina BeadChip analyses. Here we show that changes in the outer retina, specifically in the retinal pigment epithelium (RPE and photoreceptor outer segments (POS contribute to vision changes in non-infectious HIV retinopathy. We find that in HIV-positive retinae there is an induction of rhodopsin and other transcripts (including PDE6A, PDE6B, PDE6G, CNGA1, CNGB1, CRX, NRL involved in visual transduction, as well as structural components of the rod photoreceptors (ABCA4 and ROM1. This is consistent with an increased rate of renewal of rod outer segments induced via increased phagocytosis by HIV-infected RPE previously reported in culture. Cone-specific transcripts (OPN1SW, OPN1LW, PDE6C, PDE6H and GRK7 are uniformly downregulated in HIV positive retina, likely due to a partial loss of cone photoreceptors. Active cotton wool spots and intraretinal hemorrhages (IRH may not affect photoreceptors directly and the interaction of photoreceptors with the aging RPE may be the key to the progressive vision

  1. Assessment of a Tele-education System to Enhance Retinopathy of Prematurity Training by International Ophthalmologists-in-Training in Mexico. (United States)

    Patel, Samir N; Martinez-Castellanos, Maria Ana; Berrones-Medina, David; Swan, Ryan; Ryan, Michael C; Jonas, Karyn E; Ostmo, Susan; Campbell, J Peter; Chiang, Michael F; Chan, R V Paul


    To evaluate a tele-education system developed to improve diagnostic competency in retinopathy of prematurity (ROP) by ophthalmologists-in-training in Mexico. Prospective, randomized cohort study. Fifty-eight ophthalmology residents and fellows from a training program in Mexico consented to participate. Twenty-nine of 58 trainees (50%) were randomized to the educational intervention (pretest, ROP tutorial, ROP educational chapters, and posttest), and 29 of 58 trainees (50%) were randomized to a control group (pretest and posttest only). A secure web-based educational system was created using clinical cases (20 pretest, 20 posttest, and 25 training chapter-based) developed from a repository of over 2500 unique image sets of ROP. For each image set used, a reference standard ROP diagnosis was established by combining the clinical diagnosis by indirect ophthalmoscope examination and image-based diagnosis by multiple experts. Trainees were presented with image-based clinical cases of ROP during a pretest, posttest, and training chapters. The accuracy of ROP diagnosis (e.g., plus disease, zone, stage, category) was determined using sensitivity and specificity calculations from the pretest and posttest results of the educational intervention group versus control group. The unweighted kappa statistic was used to analyze the intragrader agreement for ROP diagnosis by the ophthalmologists-in-training during the pretest and posttest for both groups. Trainees completing the tele-education system had statistically significant improvements (P Mexico. This system has the potential to increase competency in ROP diagnosis and management for ophthalmologists-in-training from middle-income nations. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  2. Terson syndrome and leukemia: a case report

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    Lorenzi U


    Full Text Available Umberto Lorenzi, Elisa Buschini, Antonio Fea, Federica Machetta, Federico Maria GrignoloOphthalmic Section, Department of Clinical Pathophysiology, University of Turin, Turin, Italy Abstarct: Terson syndrome is defined as intraocular hemorrhage associated with intracranial bleeding. This syndrome can occur in the event of intracranial hemorrhage or elevated intracranial pressure. To our knowledge, it has never been associated with chronic myeloid leukemia. A 45-year-old woman suffering from chronic myeloid leukemia was referred to our clinic with Terson syndrome after intracranial bleeding. We followed this patient for a year, performing visual acuity assessment, fundus examination, color retinography, and A-scan and B-scan ultrasonography. At presentation, her best-corrected visual acuity on the right was 20/63 and on the left was 20/320. In the right eye, retinoscopy showed blurring of the optic margins surrounded by retinal and preretinal hemorrhages, preretinal fibrosis of the optic disc along the vascular arcades, and perivascular retinal infiltrates. In the left eye, the optic disc was surrounded by retinal and preretinal hemorrhages, and massive fibrosis with hard exudates and severe preretinal hemorrhage were observed at the posterior pole. Roth spots and many circular hemorrhages were noted at the periphery of the retina. A-scan and B-scan ultrasonography did not show intraocular leukemic infiltration. The clinical picture remained stable over the following 12 months. In this patient, we observed the ophthalmoscopic features of chronic myeloid leukemia, but also coexistence of features typical of Terson syndrome. To our knowledge, no similar cases have been reported previously.Keywords: retinal disease, chronic myeloid leukemia, eye hemorrhage, intracranial hemorrhage

  3. Assessment of diabetic retinopathy using nonmydriatic ultra-widefield scanning laser ophthalmoscopy (Optomap) compared with ETDRS 7-field stereo photography. (United States)

    Kernt, Marcus; Hadi, Indrawati; Pinter, Florian; Seidensticker, Florian; Hirneiss, Christoph; Haritoglou, Christos; Kampik, Anselm; Ulbig, Michael W; Neubauer, Aljoscha S


    To compare the diagnostic properties of a nonmydriatic 200° ultra-widefield scanning laser ophthalmoscope (SLO) versus mydriatic Early Treatment of Diabetic Retinopathy Study (ETDRS) 7-field photography for diabetic retinopathy (DR) screening. A consecutive series of 212 eyes of 141 patients with different levels of DR were examined. Grading of DR and clinically significant macular edema (CSME) from mydriatic ETDRS 7-field stereo photography was compared with grading obtained by Optomap Panoramic 200 SLO images. All SLO scans were performed through an undilated pupil, and no additional clinical information was used for evaluation of all images by the two independent, masked, expert graders. Twenty-two eyes from ETDRS 7-field photography and 12 eyes from Optomap were not gradable by at least one grader because of poor image quality. A total of 144 eyes were analyzed regarding DR level and 155 eyes regarding CSME. For ETDRS 7-field photography, 22 eyes (18 for grader 2) had no or mild DR (ETDRS levels ≤ 20) and 117 eyes (111 for grader 2) had no CSME. A highly substantial agreement between both Optomap DR and CSME grading and ETDRS 7-field photography existed with κ = 0.79 for DR and 0.73 for CSME for grader 1, and κ = 0.77 (DR) and 0.77 (CSME) for grader 2. Determination of CSME and grading of DR level from Optomap Panoramic 200 nonmydriatic images show a positive correlation with mydriatic ETDRS 7-field stereo photography. Both techniques are of sufficient quality to assess DR and CSME. Optomap Panoramic 200 images cover a larger retinal area and therefore may offer additional diagnostic properties.

  4. Theoretical and practical aspects relating to the photothermal therapy of tumors of the retina and choroid: A review. (United States)

    Niederer, P; Fankhauser, F


    Photothermal treatment of tumors of the retina and choroid such as retinoblastomas, malignant melanomas, benign tumors as well as of vascular malformations can be performed by using laser radiation. A number of basic physical laws have to be taken into account in this procedure. Of particular importance thereby are: Arrhenius' law to approximate the kinetics of protein denaturation and photocoagulation, furthermore the electromagnetic radiation field, the distribution of both radiant and thermal energy induced in tumors and vascular structures, the influence of the wavelength and laser pulse duration (exposure time), as well as of the optical properties of the tissue. Strict confinement of the extent of the photothermal damage is critical since such pathological entities are frequently located close to the macula or optic nerve head.The conditions for tumor destruction are best fulfilled when using radiation in the near-infrared range of the electromagnetic spectrum such as that emitted from the diode (810 nm) and the Nd: YAG (1064 nm) laser, because of the good optical penetration properties of these radiations in tissue. Short wavelength sources of radiation, such as the argon ion (488, 514 nm) or the freqeuency-doubled Nd: YAG (532 nm) laser are less well suited for the irradiation of large vascular structures due to their poor penetration depths. However, for vascular formations with a small thickness (1 mm or less), short wavelength sources appear to be the most appropriate choice. Optical coupling of radiant energy to the eye by means of indirect ophthalmoscopic systems or positive contact lenses is furthermore of importance. Strong positive lenses may lead to severe constrictions of the laser beam within the anterior segment, that leads to high irradiance increasing the probability for structures to be damaged; with negative contact lenses, such as the -64 D Goldmann type lens, this danger is largely absent.

  5. Nevus of Ota: clinical-ophthalmological findings

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    Sebastião Cronemberger


    Full Text Available OBJECTIVE: To analyze the clinical and ophthalmological findings of patients with nevus of Ota. METHODS: Retrospective analysis of patients' charts with nevus of Ota. We registered the demographic data, location of the nevus and date of appearance, family history of similar spots, biomicroscopic, gonioscopic, tonometric, ophthalmoscopic and perimetric findings. RESULTS: We included 14 patients, six (43.0% men and eight (57.0% women, with a mean age of 21.7±17.5 years. Ten (71% were mulatto, three (21.4% white and one (7.1% black. Twelve (85.7% patients presented the spots at birth and two in puberty. Nine patients presented conjunctival and episcleral pigmentation in the right eye and five in the left eye. According to Tanino's classification, five (35.7% nevi were class 1, eight (57.1% class 2 and one (7.1% class 3. Heterochromia iridis was found in eight (57.1% patients. Anisocoria was present in three (21.4% patients. Five (35.7% patients presented a suspected glaucomatous cup disc ratio (≥0.7; six (42.9% presented a cup disc ratio ≤ 0.5 and three (21.4%, no cup disc. We found two curious and remarkable findings: a nevus of Ota on the palate of one patient and other on the optic disc associated with a pigmentary mottling of the fundus in another patient. The pigmentary mottling of the fundus was also seen in four more eyes. CONCLUSIONS: The nevus of Ota was frequently present at birth, in mulattos, and classified as Tanino's class 1 and 2. Heterochromia iridis was a common finding. Anisocoria was present in a small percentage of eyes. No patient developed glaucoma or malignancy.

  6. Retinal amyloid pathology and proof-of-concept imaging trial in Alzheimer's disease. (United States)

    Koronyo, Yosef; Biggs, David; Barron, Ernesto; Boyer, David S; Pearlman, Joel A; Au, William J; Kile, Shawn J; Blanco, Austin; Fuchs, Dieu-Trang; Ashfaq, Adeel; Frautschy, Sally; Cole, Gregory M; Miller, Carol A; Hinton, David R; Verdooner, Steven R; Black, Keith L; Koronyo-Hamaoui, Maya


    Noninvasive detection of Alzheimer's disease (AD) with high specificity and sensitivity can greatly facilitate identification of at-risk populations for earlier, more effective intervention. AD patients exhibit a myriad of retinal pathologies, including hallmark amyloid β-protein (Aβ) deposits. Burden, distribution, cellular layer, and structure of retinal Aβ plaques were analyzed in flat mounts and cross sections of definite AD patients and controls (n = 37). In a proof-of-concept retinal imaging trial (n = 16), amyloid probe curcumin formulation was determined and protocol was established for retinal amyloid imaging in live patients. Histological examination uncovered classical and neuritic-like Aβ deposits with increased retinal Aβ42 plaques (4.7-fold; P = 0.0063) and neuronal loss (P = 0.0023) in AD patients versus matched controls. Retinal Aβ plaque mirrored brain pathology, especially in the primary visual cortex (P = 0.0097 to P = 0.0018; Pearson's r = 0.84-0.91). Retinal deposits often associated with blood vessels and occurred in hot spot peripheral regions of the superior quadrant and innermost retinal layers. Transmission electron microscopy revealed retinal Aβ assembled into protofibrils and fibrils. Moreover, the ability to image retinal amyloid deposits with solid-lipid curcumin and a modified scanning laser ophthalmoscope was demonstrated in live patients. A fully automated calculation of the retinal amyloid index (RAI), a quantitative measure of increased curcumin fluorescence, was constructed. Analysis of RAI scores showed a 2.1-fold increase in AD patients versus controls (P = 0.0031). The geometric distribution and increased burden of retinal amyloid pathology in AD, together with the feasibility to noninvasively detect discrete retinal amyloid deposits in living patients, may lead to a practical approach for large-scale AD diagnosis and monitoring. National Institute on Aging award (AG044897) and The Saban and The Marciano Family

  7. Screening for retinopathy of prematurity-a comparison between binocular indirect ophthalmoscopy and RetCam 120

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    Shah Parag


    Full Text Available Aim: To compare the photographic screening for retinopathy of prematurity (ROP using RetCam 120 with binocular indirect ophthalmoscope (BIO, which is the current gold standard. Setting and Design: Prospective, comparative study. Materials and Methods: A total of 87 RetCam examinations were performed on 27 premature babies. They were stored in a separate file after deleting the identifying information. At the same visit using the BIO with scleral depression, an experienced vitreoretinal surgeon evaluated the fundus in detail. A masked examiner then evaluated the RetCam photographs for presence or absence of ROP, the stage and zone of the disease, and the presence or absence of plus disease. These data were then compared with the BIO findings to determine the sensitivity, specificity, and the positive and negative predictive values of the method. Results: ROP was detected in 63 of 87 examinations by BIO and in 56 of 87 RetCam examinations. Nine RetCam examinations were false-negative and two were false-positive. Sensitivity of RetCam was 85.71% (54/63 and specificity was 91.66% (22/24. The positive and negative predictive values were 96.43% and 70.97% respectively. Conclusion: Nine cases having ROP were missed by the RetCam. All these cases were either in zone 3 or the outer part of zone 2, which later regressed. These were missed mostly because of the restricted mobility of the camera head caused by its size and the barrier caused by the lid speculum arms. No case of threshold ROP was missed. RetCam may replace BIO for screening of ROP.

  8. Prevention effect of travoprost on high intraocular pressure within 24 hours after diabetic retinopathy vitrectomy

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    Xue Li


    Full Text Available AIM: To observe the clinical significance of travoprost for prevention of high intraocular pressure(IOPwithin 24 hours after diabetic retinopathy(DRvitrectomy.METHODS: A total of 102 patients(102 eyeswith DR who underwent vitrectomy and related literatures were analyzed and compared. All patients were randomly assigned to group A(vitrectomy combined with intravitreal silicone oil, C3F8 or balanced salt solution tamponade group, 51 patients 51 eyesor group B(surgical therapy is the same as the group A, while instilling one drop of 0.04g/L travoprost eyedrops in the inferior cul-de-sac about 60 minutes before the surgery, 51 patients 51 eyes. The changes of IOP, best-corrected visual acuity(BCVAand ophthalmoscope observations within 24 hours respectively before and after the surgery were counted and analyzed.RESULTS: The mean IOP of each group within 24 hours after the surgery was higher than the contralateral eyes(t=2.17 and 2.09, Pt=2.41 and 2.28, Pχ2=4.86 and 3.99,Pt=1.43, P>0.05.CONCLUSION: The preliminary result in our scrutiny showed that the preoperative treatment of 0.04g/L travoprost eyedrops was well tolerated with the significant reduction in the incidence of high IOP and decrease in BCVA within 24 hours after DR vitrectomy. It has clinical significance about the prevention of visual impairment owing to high IOP within 24 hours after DR vitrectomy.

  9. Image processing for improved eye-tracking accuracy (United States)

    Mulligan, J. B.; Watson, A. B. (Principal Investigator)


    Video cameras provide a simple, noninvasive method for monitoring a subject's eye movements. An important concept is that of the resolution of the system, which is the smallest eye movement that can be reliably detected. While hardware systems are available that estimate direction of gaze in real-time from a video image of the pupil, such systems must limit image processing to attain real-time performance and are limited to a resolution of about 10 arc minutes. Two ways to improve resolution are discussed. The first is to improve the image processing algorithms that are used to derive an estimate. Off-line analysis of the data can improve resolution by at least one order of magnitude for images of the pupil. A second avenue by which to improve resolution is to increase the optical gain of the imaging setup (i.e., the amount of image motion produced by a given eye rotation). Ophthalmoscopic imaging of retinal blood vessels provides increased optical gain and improved immunity to small head movements but requires a highly sensitive camera. The large number of images involved in a typical experiment imposes great demands on the storage, handling, and processing of data. A major bottleneck had been the real-time digitization and storage of large amounts of video imagery, but recent developments in video compression hardware have made this problem tractable at a reasonable cost. Images of both the retina and the pupil can be analyzed successfully using a basic toolbox of image-processing routines (filtering, correlation, thresholding, etc.), which are, for the most part, well suited to implementation on vectorizing supercomputers.


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    Sivaraman M


    Full Text Available BACKGROUND The epidemiological study of diabetic maculopathy in Indian population for the period of three years duration and study the treatment outcome following laser photocoagulation for various type of diabetic maculopathy. MATERIALS AND METHODS The study was conducted from July 2000 to November 2002 in 96 eyes of 50 patients. Diabetic patients either referred or detected at GOH are taken into study. History regarding onset, duration, family history, drug schedule and dietary habits. Associated systemic factors HT, IHD, renal diseases are recorded. Patients are tested for BCVA using Snellen’s chart, IOP using Goldmann applanation tonometer, slit lamp examination, fundus examination using direct and indirect ophthalmoscope and 90D biomicroscopy. Fundus photography taken using fundus camera. FFA done in all cases. RESULTS 32 patients were above 50 years of age and 18 patients are below 50 years of age. The ratio of male-to-female is 2.85:1 and 92% of patients have bilateral involvement. 28% of patients with maculopathy had diabetes mellitus of 6-10 years duration and 24% of patients had 11-15 years duration. 18.7% cases had clinically significant macular oedema. In FFA study showed 44.8% had focal lesions, 34.4% had diffuse lesions and 28.8% had ischaemic lesions. 76.9% of focal lesions improved with focal photocoagulation and 50% of diffuse lesions improved with grid photocoagulation. CONCLUSION Diabetic maculopathy is the commonest cause of visual loss in patient with diabetic retinopathy. Periodic follow up and examination are necessary to detect the involvement of macula at an earlier stage. Early treatment with photocoagulation can stabilise the visual acuity and prevent visual loss.

  11. Correlation Factor Analysis of Retinal Microvascular Changes in Patients With Essential Hypertension

    Institute of Scientific and Technical Information of China (English)

    Huang Duru; Huang Zhongning


    Objectives To investigate correlation between retinal microvascular signs and essential hypertension classification. Methods The retinal microvascular signs in patients with essential hypertension were assessed with the indirect biomicroscopy lens, the direct and the indirect ophthalmoscopes were used to determine the hypertensive retinopathy grades and retinal arteriosclerosis grades.The rank correlation analysis was used to analysis the correlation these grades with the risk factors concerned with hypertension. Results Of 72 cases with essential hypertension, 28 cases complicated with coronary disease, 20 cases diabetes, 41 cases stroke,17 cases renal malfunction. Varying extent retinal arterioscleroses were found in 71 cases, 1 case with retinal hemorrhage, 2 cases with retina edema, 4 cases with retinal hard exudation, 5 cases with retinal hemorrhage complicated by hard exudation, 2 cases with retinal hemorrhage complicated by hard exudation and cotton wool spot, 1 case with retinal hemorrhage complicated by hard exudation and microaneurysms,1 case with retinal edema and hard exudation, 1 case with retinal microaneurysms, 1 case with branch retinal vein occlusion. The rank correlation analysis showed that either hypertensive retinopathy grades or retinal arteriosclerosis grades were correlated with risk factor lamination of hypertension (r=0.25 or 0.31, P<0.05), other correlation factors included age and blood high density lipoprotein concerned about hypertensive retinopathy grades or retinal arteriosclerosis grades, but other parameters, namely systolic or diastolic pressure, total cholesterol, triglyceride, low density lipoprotein cholesterol, fasting blood glucose,blood urea nitrogen and blood creatinine were not confirmed in this correlation analysis (P > 0.05).Conclusions Either hypertensive retinopathy grade or retinal arteriosclerosis grade is close with the hypertension risk factor lamination, suggesting that the fundus examination of patients with

  12. Relationship of spontaneous retinal vein pulsation with ocular circulatory cycle.

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    Mijin Kim

    Full Text Available PURPOSE: To determine the timing of spontaneous venous pulsation (SVP relative to the ocular circulatory cycle by using the movie tool of confocal scanning laser ophthalmoloscope. METHODS: A video recording of the fundus was obtained using a confocal scanning laser ophthalmoscope (Spectralis HRA, Heidelberg Engineering, Heidelberg, Germany at 8 frames/s in 47 eyes (15 glaucoma patients and 32 glaucoma suspects with visible pulsation of both the central retinal artery (CRA and vein (CRV. The timing of the maximum and minimum diameters of the CRA (CRA(max and CRAmin, respectively and CRV (CRV(max and CRV(min, respectively was identified during four pulse cycles. The interval between CRV(min and CRA(min, and between CRV(max and CRA(max was expressed as the number of frames and as a percentage of the ocular circulatory cycle. RESULTS: The ocular circulatory cycle (from one CRA(max to the next lasted 7.7 ± 1.0 frames (958.8 ± 127.2 ms, mean ± SD, with a mean pulse rate of 62.6 beats/min. The diameter of the CRA was increased for 2.4 ± 0.5 frames (301.9 ± 58.8 ms and decreased for 5.3 ± 0.9 frames (656.9 ± 113.5 ms. CRV(max occurred 1.0 ± 0.2 frames after CRA(max (equivalent to 13.0% of the ocular circulatory cycle, while CRV(min occurred 1.1 ± 0.4 frames after CRA(min (equivalent to 14.6% of the ocular circulatory cycle. CONCLUSIONS: During SVP, the diameter of the CRV began to decrease at early diastole, and the reduction persisted until early systole. This finding supports that CRV collapse occurs during ocular diastole.

  13. "Eye-T": information technology adoption and use in Canada's optometry practices. (United States)

    Stolee, Paul; McKillop, Ian; McMurray, Josephine; Strong, J Graham; Jones, Deborah A; Hildebrand, Jenna M


    While information technology (IT) is playing an increasing role in the delivery of optometric services, little specific information is available about how IT is changing the practice of optometry in Canada or whether optometry schools are adequately preparing their students to use this technology when they graduate. Quantitative data on how IT is being used, as well as related barriers and potential benefits, were obtained in a survey of Canadian optometrists (N = 474). Three site visits were made to geographically dispersed Canadian optometry practices identified as exemplars of IT adoption. More than 96% of Canadian optometrists use computers in their practices, but fewer have integrated computers into their examination rooms. Optometrists are regularly using computers to manage their practices and medical record keeping. The automated perimeter is the clinical assessment technology most used (88.4%), followed by the autorefractor (83.9%) and the autokeratometer (72.2%). The anterior segment camera is the technology most likely to be acquired within the next 5 years (36.9%), followed by the scanning laser ophthalmoscope (26.8%). Major benefits of IT for optometrists include being better able to provide patients with images and information to explain results and to inspire greater patient confidence that the practice is state of the art. Perceived barriers include the need for frequent updates, lack of resources for training, and cost. There is support for increased exposure to IT as part of training in optometry. Use of IT in optometry practices is widespread and likely to continue to increase in the years ahead. IT may be a key element in the future success of optometry practices in an increasingly competitive marketplace. Perceptions of high investment and training costs are barriers to further adoption. Optometrists may benefit from increased exposure to IT as part of their training. Copyright © 2010 American Optometric Association. Published by Elsevier Inc

  14. Clinical characteristics and treatment of neurofibroma of the choroid

    Institute of Scientific and Technical Information of China (English)

    WEI Wen-bin; JIE Ying; MO Jing; LI Bin


    Background Neurofibroma is a kind of benign neoplasm that derives from nervous tissues.Though this tumor is the most common types in the peripheral nervous system,it is rarely seen in the choroid and easy to be misdiagnosed of choroidal melanoma.The aim of this study was to review the clinical features of neurofibroma of the choroid in the Chinese race.Methods A retrospective case series design was used.Two male and one female patients diagnosed with choroidal neurofibroma in Beijing Tongren Eye Center were included in this study.The clinical histories were abstracted from the patients' medical records.Routine eye examinations including visual acuity,intraocular pressure,slit lamp and ophthalmoscope were performed.Auxiliary examinations included fluorescein fundus angiography (FFA),AB-ultrasound scan,color doppler imaging (CDI),and magnetic resonance imaging (MRI).Local resection of the tumors was performed and the specimens underwent pathological examinations.Results The tumors were of yellow-pink color with pigmentation on the surface.CDI showed arterial blood signals in the tumor and MRI showed high-intensity in the T1-weighted image and a slightly increased intensity in the T2-weighted image.FFA and indocyaninegreen angiography demonstrated the tumors were of hypofluorescence at early stage and hyperfluorescence with prominent leakage at late stage.The pathological examination confirmed the tumors were choroidal neurofibroma.After 5-10-year follow-up,there were no recurrences of the tumors and the retinas were well attached.Conclusions Choroidal neurofibroma is difficult to be diagnosed clinically and pathological confirmation is important.These tumors can be managed conservatively by local resection.

  15. Confocal scanning laser tomography of the optic nerve head on the patients with Alzheimer's disease compared to glaucoma and control. (United States)

    Kurna, Sevda Aydin; Akar, Gokcen; Altun, Ahmet; Agirman, Yasemin; Gozke, Eren; Sengor, Tomris


    The purpose of this study was to evaluate optic nerve head (ONH) differences of the patients with Alzheimer's disease (AD) measured by confocal scanning laser tomography [Heidelberg Retina Tomograph (HRT) III] and compare with glaucoma and control subjects. Eighty-four patients were enrolled into the study: 44 eyes of 24 patients with mild to moderate AD (Group 1), 68 eyes of 35 patients with glaucoma (Group 2), and 49 eyes of 25 heathy volunteers as a control (Group 3). A complete ophthalmologic examination as well as a confocal scanning laser ophthalmoscopic assessment with HRT III were performed on all patients. Mean values of the ONH topographic parameters such as rim area (RA), rim volume (RV), height variation contour, linear cup/disc ratio, cup shape measure, and retinal nerve fiber layer (RNFL) were recorded. Mean values of RNFL thickness was 0.23 ± 0.07 in AD, 0.22 ± 0.09 in glaucoma and 0.24 ± 0.07 in the control group (p = 0.323). RA and RV were significantly lower, and linear C/D ratio was significantly higher in the glaucoma group when compared to AD and control (p 0.05). We observed a negative correlation of the age with RNFL in all of the groups (p < 0.005). Age was the most important parameter affecting RNFL. Our results suggest that HRT does not demonstrate ONH differences between AD and control group, while it successfully differentiates glaucoma from AD and control cases of older age.

  16. [Apropos of preventive ophthalmologic interventions in the child population of compulsory school age. Authors' experience]. (United States)

    Cruciani, F; Mastromarino, A; Latini, M; Paganelli, G; Rocca, M; Fiore, F; Melino, G


    The results are reported of work carried out during the last five years by the Center of Social Ophthalmology, director Prof. G. Scuderi, which is part of the II Division of the Ophthalmologic Clinic of Rome University "La Sapienza" with the object of trying out together with territorial units a model of preventive intervention acting as a filter for specialized university facilities. In other words, already existing facilities and medical personnel were to be used and trained for specific methods and techniques. From 1985 through 1990, 787 children selected by ophthalmologic screening by school doctors among the compulsory school population of the RM 3 and 5 districts were seen and submitted to periodic checks. This cohort included children aged 5 to 14 without significant differences in sex distribution and with prevalence of the 8 to 10 year olds. Each subject was submitted to complete eye examination including refractometry and orthoptics, color vision, biomicroscopic and ophthalmoscopic examination. The principal findings show that about 36% of subjects examined have a natural vision of 11/10 while the high percentage of ametropia observed was mainly represented by astigmatism and hypermetropy, albeit of minor intensity. Strabismus was found in 2.79% and implied marked visual deficit that was often refractory to any type of treatment. In addition, the prevalence was determined of other abnormalities concerning eye motility, color vision and pathologies involving anterior segment and eyeground. In their conclusion, the authors stress the rarity of organic ocular pathology in children (mostly represented by inflammatory changes of the adnexes and conjunctiva) whereas amblyopia was one of the main causes of visual deficit in children. They stress the importance of early therapeutic intervention in order to allow complete visual rehabilitation. The results of the clinical model for prevention were excellent so that it can even be proposed for large scale

  17. The macular photostress test in diabetes, glaucoma, and cataract (United States)

    Baptista, António M. G.; Sousa, Raul A. R. C.; Rocha, Filomena A. S. Q.; Fernandes, Paula Sepúlveda; Macedo, António F.


    Purpose. The photostress recovery time test (PSRT) has been widely reported as a helpful screening clinical tool. However, the poor standardization of its measurement technique remains to be a limitation among clinicians. The purpose of this study is to apply a recommended clinical technique to measure the PSRT in some of the most commons eye diseases to ascertain whether these diseases affect the PSRT values. Methods. One hundred and one controls and 105 patients, with diagnosed diabetes (without visible signs of diabetic retinopathy), primary open angle glaucoma (POAG) or cataracts underwent photostress testing. The test was performed with a direct ophthalmoscope for illuminating the macula for 30 seconds. Participants belonged to three age classes: A, B and C; and were divided into four groups: control, diabetic, POAG and cataract. The age range for A, B and C classes were respectively 43-54, 55-64 and 65-74 years. The groups were also further compared within each age class. In addition, the influence of age on PSRT was evaluated using the control group. Results. Results demonstrate that PSRT changes with age (p<0.02). In class A, diabetic group had a faster PSRT than control group, (mean +/- standard deviation) 20.22+/-7.51 and 26.14+/-8.34 seconds. The difference between these groups was statistical significant (t-test, p=0.012). Cataract and POAG groups did not affect the PSRT significantly. Conclusions. The technique used for the Photostress showed that diabetics, younger than 54 years, may have faster PSRT and that, aging delays PSRT.

  18. Peripheral areas of nonperfusion in treated central retinal vein occlusion as imaged by wide-field fluorescein angiography. (United States)

    Spaide, Richard F


    To develop a method of imaging the retina using wide-field fluorescein angiography and use this method to investigate the areas of perfusion abnormalities in patients treated with ranibizumab for central retinal vein occlusion. Cross-sectional analysis of patients recruited to a prospective study. Patients in a prospective study of ranibizumab for central retinal vein occlusion were imaged with wide-field angiography. Fluorescein angiograms taken with the Optos P200 Scanning Laser Ophthalmoscope were obtained of the posterior portion of the eye and of the periphery through ocular steering. Resultant images of the periphery were registered to the posterior image using thin-plate spline warping. A transformation was used to measure the retinal surface area. Perfusion characteristics were compared with injection frequencies and protocol refraction visual acuity measurements. Of 22 patients imaged, 7 would be classified as nonperfused by the Central Retinal Vein Occlusion Study (CVOS) angiographic criteria. However, all patients showed confluent areas of nonperfusion in the retinal periphery ranging in size from 16 disk areas to 242 disk areas. The areas of peripheral nonperfusion were not significantly different in the Central Retinal Vein Occlusion Study-perfused group versus nonperfused group. The area of peripheral nonperfusion was not correlated with the number of injections (r = -0.13, P = 0.58), but was inversely correlated with visual acuity (r = -0.52, P = 0.013). Blood vessels at the border of the peripheral nonperfusion did not show signs of neovascular growth or profuse leakage. Angiographic mapping of the retina is possible using image-processing techniques with wide-field images. Eyes with central retinal vein occlusion develop widespread peripheral vascular obliteration in regions that are difficult to image with conventional fundus cameras. These nonperfused areas may have important implications for visual function.

  19. Therapeutic action of the mitochondria-targeted antioxidant SkQ1 on retinopathy in OXYS rats linked with improvement of VEGF and PEDF gene expression.

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    Anton M Markovets

    Full Text Available UNLABELLED: The incidence of age-related macular degeneration (AMD, the main cause of blindness in older patients in the developed countries, is increasing with the ageing population. At present there is no effective treatment for the prevailing geographic atrophy, dry AMD, whereas antiangiogenic therapies successful used in managing the wet form of AMD. Recently we showed that mitochondria-targeted antioxidant plastoquinonyl-decyl-triphenylphosphonium (SkQ1 is able to prevent the development and moreover caused regression of pre-existing signs of the retinopathy in OXYS rats, an animal model of AMD. Here we examine the effects of SkQ1 on expression of key regulators of angiogenesis vascular endothelial growth factor A (VEGF and its antagonist pigment epithelium-derived factor (PEDF genes in the retina of OXYS rats as evidenced by real-time PCR and an ELISA test for VEGF using Wistar rats as control. Ophthalmoscopic examinations confirmed that SkQ1 supplementation (from 1.5 to 3 months of age, 250 nmol/kg prevented development while eye drops SkQ1 (250 nM, from 9 to 12 months caused some reduction of retinopathy signs in OXYS rats and did not reveal any negative effects on the control Wistar rat's retina. Prevention of premature retinopathy by SkQ1 was connected with an increase of VEGF mRNA and protein in OXYS rat's retina up to the levels corresponding to the Wistar rats, and did not involve changes in PEDF expression. In contrast the treatment with SkQ1 drops caused a decrease of VEGF mRNA and protein levels and an increase in the PEDF mRNA level in the middle-aged OXYS rats, but in Wistar rats the changes of gene expression were the opposite. CONCLUSIONS: The beneficial effects of SkQ1 on retinopathy connected with normalization of expression of VEGF and PEDF in the retina of OXYS rats and depended on age of the animals and the stage of retinopathy.

  20. Morphometric evaluation of changes with time in optic disc structure and thickness of retinal nerve fibre layer in chronic ocular hypertensive monkeys. (United States)

    Shimazawa, Masamitsu; Tomita, Goji; Taniguchi, Takazumi; Sasaoka, Masaaki; Hara, Hideaki; Kitazawa, Yoshiaki; Araie, Makoto


    We examined the time course of changes in optic disc structure by means of a scanning laser ophthalmoscope (Heidelberg Retina Tomograph, HRT) in ocular hypertensive (experimental glaucoma) monkeys, and clarified the relationships between the histological RNFL thickness and HRT parameters. Further, the time course of changes in retinal nerve fiber layer (RNFL) thickness in individual eyes was measured using a scanning laser polarimeter with fixed corneal polarization compensator (GDx FCC). In the present study, two separate experiments were carried out. A chronic intraocular pressure (IOP) elevation was induced by laser trabeculoplasty in the left eye in 11 cynomolgus monkeys. In Experiment 1, the HRT and GDx parameters were measured 12 weeks after the laser treatment in 10 eyes in five monkeys. In Experiment 2, the time course of changes in the HRT and GDx parameters was examined before and 1, 3, 4, 5, 6, 8, 10, 12, 14, and 16 weeks after the laser treatment in 12 eyes in six monkeys. The retardation values (thickness parameters) obtained from the GDx were used to derive thickness and ratio parameters in the superior, inferior, nasal and temporal quadrants. Ratio parameters were expressed as a ratio of superior and inferior quadrant to nasal quadrant. After the last measurements, each eye was enucleated, and retinal cross sections were prepared for histological analysis. In the left (hypertensive) eyes, IOP was persistently elevated throughout the observation periods in both Experiments 1 and 2. In the HRT measurements in Experiment 1, seven out of eight global topographic parameters (exception, disc area) were statistically different between the hypertensive and control eyes 12 weeks after the laser treatment. In Experiment 2, the HRT parameters changed in a time-dependent manner, but each of them almost plateaued at about 4 weeks after the laser treatment. Significant correlations were seen between the histological mean RNFL thickness at 1.5 disc diameters from

  1. Direct ophthalmoscopy on YouTube: analysis of instructional YouTube videos’ content and approach to visualization

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    Borgersen NJ


    Tube fail to address this particular issue adequately. There is a need for high-quality videos that include relevant points, provide realistic visualization of the examiner’s view, and give particular emphasis on fundus examination. Keywords: direct ophthalmoscopy, ophthalmoscope, ophthalmology education, instructional videos, YouTube

  2. Alterações oftálmicas associadas à intoxicação experimental por closantel em caprinos Ophthalmic changes associated with the experimental poisoning by closantel in caprine

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    R. Ecco


    Full Text Available Alterações oftálmicas foram experimentalmente induzidas em caprinos após superdosagem com o anti-helmíntico closantel. Foram usados cinco caprinos com sete a oito meses de idade, produtos do cruzamento da raça Saanen com a Pardo Alpino. Os animais mostraram sinais de intoxicação entre quatro e cinco dias após a administração do closantel. Os sinais clínicos caracterizaram-se principalmente por distúrbios neurológicos centrais e cegueira. Ao exame clínico, observaram-se midríase bilateral, perda do reflexo pupilar à luz e cegueira bilateral. À oftalmoscopia indireta, foram observadas degeneração aguda de retina e papiledema. As alterações crônicas mostravam disco óptico acinzentado, atrofia de vasos e da retina. Nos fundos tapetal e não-tapetal notavam-se áreas de despigmentação e lesões irregulares castanho-amareladas. As alterações histológicas consistiam em perda dos neurônios da camada ganglionar e das células da camada nuclear interna e externa da retina. As alterações agudas no nervo óptico e na substância branca do encéfalo foram de degeneração espongiforme. As alterações crônicas do nervo óptico caracterizavam-se por extensa necrose e infiltração de células Gitter.Ophthalmic alterations were experimentally induced after overdose with the anthelmintic closantel. Five seven to eight- months-old, Saanen x Alpine caprine were used. The animals showed clinical signs of toxicosis four to five days after the administration of closantel. Clinical signs were primarily characterized by central nervous disturbances and blindness. Clinically, bilateral mydriasis, loss of pupillary light reflex, and blindness were observed. At indirect ophthalmoscopic examination, there was acute retinal degeneration and papilledema. Chronic ocular changes consisted of paleness of the optic disc, vascular atrophy, and retinal atrophy. Areas of pigment loss and irregular yellowish-brown foci were present in the tapetal

  3. Effect of the pyridoindole antioxidant stobadine on development of experimental diabetic cataract and on lens protein oxidation in rats: comparison with vitamin E and BHT. (United States)

    Kyselova, Zuzana; Gajdosik, Andrej; Gajdosikova, Alena; Ulicna, Olga; Mihalova, Danica; Karasu, Cimen; Stefek, Milan


    The aim of this study was to investigate the effect of dietary supplementation with the pyridoindole antioxidant stobadine on the development of diabetic cataract in rats. The findings were compared with the effect of the natural antioxidant vitamin E and the well known phenolic synthetic antioxidant butylated hydroxytoluene. Streptozotocin induced diabetic male Wistars rats were fed for 18 weeks a standard diet or a diet supplemented with stobadine (0.05% w/w), vitamin E (0.1% w/w), butylated hydroxytoluene (BHT, 0.4% w/w), or a mixture of stobadine (0.05% w/w) and vitamin E (0.1% w/w). The progress of cataract was monitored biweekly by ophthalmoscopic inspection. Plasma glucose and body weight were recorded regularly. At the end of the experiment, the content of free sulfhydryl and carbonyl was determined in total lens proteins and in the stobadine group plasma levels of malondialdehyde were also measured. Long term treatment of diabetic animals with stobadine (STB), vitamin E, or BHT led to a marked delay in the development of advanced stages of cataract. At the end of the experiment, the visual cataract score was significantly decreased in the diabetic groups treated with stobadine or BHT, while vitamin E had no significant effect. Unexpectedly, combined treatment with STB+vitamin E advanced the progression of the higher stages of cataract, though without affecting the overall visual cataract score. Neither of the antioxidants exerted an effect on the glycemic state or body weight of the animals. Biochemical analyses of eye lens proteins showed significant diminution of sulfhydryl groups and elevation of carbonyl groups in diabetic animals in comparison to healthy controls. Dietary supplementation with any of the antioxidants studied did not influence the levels of these biomarkers significantly. Nevertheless, in diabetic animals, stobadine supplementation significantly attenuated plasma levels of malondialdehyde, an index of systemic oxidative damage. The

  4. the first experience of phakoemulsification with vacuum trabeculoplasty ab interno for combined cataract and glaucoma

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    V. N. Trubilin


    Full Text Available Purpose: to describe of a new effective method of combined treatment of patients with primary open- angle glaucoma with mod- erately elevated intraocular pressure and cataract.Methods: Studies have been conducted among 30 patients (30 eyes from 46 to 85 years with a combination of cataract of varying degrees of maturity and open-angle glaucoma of different stages. In addition to the standard techniques there were used special clini- cal and functional methods of research: optical cogerent tomography of the anterior segment of the eye Visante OCt (Carl Zeiss, Ger- many, glaucomatous cupping and thickness of nerve fibers study using confocal scanning laser ophthalmoscope HRt II (Heidelberg Engineering, Germany. In accordance with the target patients were divided into 2 groups: the basic group consisted of 15 patients (15 eyes aged 63 to 76 years with primary open angle glaucoma of 1-2 stages and cataracts of varying degrees of maturity. In both groups there was performed the ultrasonic phakoemulsification of the lens on the phakoemulsificator Infinity (Alcon, US.Results: the analysis of intraocular pressure measurements showed that among patients from I and II group eye pressure had a downward trend in the early postoperative period, however, the average dynamics of reduction of the intraocular pressure in the group of patients where phakoemulsification and vacuum trabeculoplasty ab interno performed was higher than in the control group. In the gonioscopy of the corner of the anterior chamber the clinical presentation remained stable throughout the period of observation. In the postoperative period among patients in the main observation group according to OCt it was noted changing the depth of the anterior chamber of eye towards its increase by an average of 1.39 mm, as well as increasing the angle of the anterior chamber at an average of 9.98.Conclusion: Phakoemulsification with IOL implantation combined with vacuum trabeculoplasty ab interno is

  5. the first experience of phakoemulsification with vacuum trabeculoplasty ab interno for combined cataract and glaucoma

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    V. N. Trubilin


    Full Text Available Purpose: to describe of a new effective method of combined treatment of patients with primary open- angle glaucoma with mod- erately elevated intraocular pressure and cataract.Methods: Studies have been conducted among 30 patients (30 eyes from 46 to 85 years with a combination of cataract of varying degrees of maturity and open-angle glaucoma of different stages. In addition to the standard techniques there were used special clini- cal and functional methods of research: optical cogerent tomography of the anterior segment of the eye Visante OCt (Carl Zeiss, Ger- many, glaucomatous cupping and thickness of nerve fibers study using confocal scanning laser ophthalmoscope HRt II (Heidelberg Engineering, Germany. In accordance with the target patients were divided into 2 groups: the basic group consisted of 15 patients (15 eyes aged 63 to 76 years with primary open angle glaucoma of 1-2 stages and cataracts of varying degrees of maturity. In both groups there was performed the ultrasonic phakoemulsification of the lens on the phakoemulsificator Infinity (Alcon, US.Results: the analysis of intraocular pressure measurements showed that among patients from I and II group eye pressure had a downward trend in the early postoperative period, however, the average dynamics of reduction of the intraocular pressure in the group of patients where phakoemulsification and vacuum trabeculoplasty ab interno performed was higher than in the control group. In the gonioscopy of the corner of the anterior chamber the clinical presentation remained stable throughout the period of observation. In the postoperative period among patients in the main observation group according to OCt it was noted changing the depth of the anterior chamber of eye towards its increase by an average of 1.39 mm, as well as increasing the angle of the anterior chamber at an average of 9.98.Conclusion: Phakoemulsification with IOL implantation combined with vacuum trabeculoplasty ab interno is


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    Full Text Available BACKGROUND: It is estimated that there are 1.4 million irreversibly blind children in the world out of which 1 million are in Asia alone. India has the highest number of blind children than any other country. Nearly 70% of the childhood blindness is avoidable. There i s paucity of data available on the causes of childhood blindness. This study focuses on the posterior segment causes of blindness among children attending blind schools in 3 adjacent districts of Andhra Pradesh. MATERIAL & METHODS: This is a cross sectiona l study conducted among 204 blind children aged 6 - 16 years age. Detailed eye examination was done by the same investigator to avoid bias. Posterior segment examination was done using a direct and/or indirect ophthalmoscope after dilating pupil wherever nec essary. The standard WHO/PBL for blindness and low vision examination protocol was used to categorize the causes of blindness. A major anatomical site and underlying cause was selected for each child. The study was carried out during July 2014 to June 2015 . The results were analyzed using MS excel software and Epi - info 7 software version statistical software. RESULTS: Majority of the children was found to be aged 13 - 16 years (45.1% and males (63.7%. Family history of blindness was noted in 26.0% and consa nguinity was reported in 29.9% cases. A majority of them were belonged to fulfill WHO grade of blindness (73.0% and in majority of the cases, the onset of blindness was since birth (83.7%. The etiology of blindness was unknown in majority of cases (57.4% while hereditary causes constituted 25.4% cases. Posterior segment causes were responsible in 33.3% cases with retina being the most commonly involved anatomical site (19.1% followed by optic nerve (14.2%. CONCLUSIONS: There is a need for mandatory oph thalmic evaluation, refraction and assessment of low vision prior to admission into blind schools with periodic evaluation every 2 - 3 years

  7. Survey of 2 768 venerable aged patients with visual disorder%高龄老人视力障碍2768例调查

    Institute of Scientific and Technical Information of China (English)

    王兆艳; 崔霞; 李星星; 王玮


    目的通过对 2 768例 80岁以上老年人行眼部检查,探讨影响高龄老年人视力的主要致病因素.方法 1999- 01/2002- 04对眼科会诊的 2 768例( 5 536眼) 80岁以上老年人行眼科常规查体,对矫正视力低于 1.0者行视野、眼底荧光血管造影( fundus fluorescein angiography,FFA)、吲哚青绿脉络膜血管造影( indocyanine green angiography ,ICGA)、光学相干断层扫描( optical coherence tomography ,OCT)等检查,找出病因.结果患白内障者为 5 536眼( 100.00%),患老年性黄斑变性( aged-related macular degeneration,AMD)者为 1 982眼 (35.72% ),剥脱综合征 (pseudoexfoliation syndrome,PXS)为 1 550眼( 28.03%),青光眼 177眼( 3.22%),单纯性视神经萎缩 133眼( 2.43%).影响视力的主要原因依次是白内障、老年性黄斑变性、青光眼、视神经萎缩.结论高龄老年人眼部疾病明显增多,白内障和老年性黄斑变性是影响视力的主要病因.%Aim To investigate the main diseases affecting visual acuity in venerable aged patients.Methods 2 768 patients ( 5 536 eyes) over 80 years old were performed ocular examinations, and patients whose vision less than 1.0 were carried out slit-lamp,direct or indirect ophthalmoscope, fundus fluorescein angiography(FFA),indocyanine green angiography (ICGA) or optical coherence tomography(OCT) examinations to find out the causes.Results 5 536 eyes (100% ) had caught cataract,1 982 eyes (35.72% ) had caught aged-related macular degeneration (AMD),1 550 eyes (28.03% ) caught pseudoexfoliation syndrome (PXS),177 eyes (3.22% ) glaucoma,133 eyes (2.43% )simple optic atrophy.The main diseases that affect vision were cataract,aged-related macular degeneration, glaucoma and optic atrophy.Conclusion Ocular diseases in venerable aged patients have great increase,while cataract and aged-related macular degeneration are the main disease affecting vision.

  8. A technique to train new oculomotor behavior in patients with central macular scotomas during reading related tasks using scanning laser ophthalmoscopy: immediate functional benefits and gains retention

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    Lorincz Erika N


    Full Text Available Abstract Background Reading with a central scotoma involves the use of preferred retinal loci (PRLs that enable both letter resolution and global viewing of word. Spontaneously developed PRLs however often privilege spatial resolution and, as a result, visual span is commonly limited by the position of the scotoma. In this study we designed and performed the pilot trial of a training procedure aimed at modifying oculomotor behavior in subjects with central field loss. We use an additional fixation point which, when combined with the initial PRL, allows the fulfillment of both letter resolution and global viewing of words. Methods The training procedure comprises ten training sessions conducted with the scanning laser ophthalmoscope (SLO. Subjects have to read single letters and isolated words varying in length, by combining the use of their initial PRL with the one of an examiner's selected trained retinal locus (TRL. We enrolled five subjects to test for the feasibility of the training technique. They showed stable maculopathy and persisting major reading difficulties despite previous orthoptic rehabilitation. We evaluated ETDRS visual acuity, threshold character size for single letters and isolated words, accuracy for paragraphed text reading and reading strategies before, immediately after SLO training, and three months later. Results Training the use of multiple PRLs in patients with central field loss is feasible and contributes to adapt oculomotor strategies during reading related tasks. Immediately after SLO training subjects used in combination with their initial PRL the examiner's selected TRL and other newly self-selected PRLs. Training gains were also reflected in ETDRS acuity, threshold character size for words of different lengths and in paragraphed text reading. Interestingly, subjects benefited variously from the training procedure and gains were retained differently as a function of word length. Conclusion We designed a new

  9. The management of diabetic retinopathy in the public sector of eThekwini district of KwaZulu-Natal

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    Zaheera Abdool


    Full Text Available Background: Estimates from the year 1990–2010 showed an increase in blindness and vision impairment (moderate or severe because of diabetic retinopathy (DR in Sub-Saharan Africa’s sub-regions (central, eastern, southern and western Africa.1 The rate of DR in South Africa is expected to increase because of the lack of screening protocols and policies for the management of diabetic eye disease in the district health system of South Africa. Aim: The purpose of this study was to determine the current role of healthcare practitioners (HCPs towards managing DR in the eThekwini district of KwaZulu-Natal.Method: A cross-sectional study was conducted, and questionnaires were distributed to a total of 104 HCPs in public health institutions situated in the northern eThekwini district of KwaZulu-Natal. Clinics and community health centres (CHCs were selected based on the assumption that primary healthcare nurses, medical officers (MOs and ophthalmic nurses and/or optometrists practice at these institutions. The hospitals selected were the referral institutions for the selected clinics and CHCs. The questionnaires distributed included questions relating to diabetic patient registers, referrals to and from other HCPs, management of ocular complications, ocular screening methods, fundus examinations and involvement in screening programmes.Results: Over a third of the ophthalmologists (35.3% indicated that DR was present at the initial examination in more than 50% of patients, though overall ophthalmologists reported loss of vision in at least one eye in fewer than 5% of patients on presentation. Less than half of the public sector general practitioners or MOs (40.6% conducted fundus examinations but 90.6% did not dilate pupils, although 71.9% had knowledge on the use of a direct ophthalmoscope. Only 40.6% of the MOs discussed the ocular complications of uncontrolled diabetes mellitus (DM with patients and 62.5% encouraged regular eye examinations. Less

  10. Subvisible retinal laser therapy: titration algorithm and tissue response. (United States)

    Lavinsky, Daniel; Sramek, Christopher; Wang, Jenny; Huie, Philip; Dalal, Roopa; Mandel, Yossi; Palanker, Daniel


    Laser therapy for diabetic macular edema and other retinal diseases has been used within a wide range of laser settings: from intense burns to nondamaging exposures. However, there has been no algorithm for laser dosimetry that could determine laser parameters yielding a predictable extent of tissue damage. This multimodal imaging and structural correlation study aimed to verify and calibrate a computational model-based titration algorithm for predictable laser dosimetry ranging from nondamaging to intense coagulative tissue effects. Endpoint Management, an algorithm based on a computational model of retinal photothermal damage, was used to set laser parameters for various levels of tissue effect. The algorithm adjusts both power and pulse duration to vary the expected level of thermal damage at different percentages of a reference titration energy dose. Experimental verification was conducted in Dutch Belted rabbits using a PASCAL Streamline 577 laser system. Titration was performed by adjusting laser power to produce a barely visible lesion at 20 ms pulse duration, which is defined as the nominal (100%) energy level. Tissue effects were then determined for energy levels of 170, 120, 100, 75, 50, and 30% of the nominal energy at 1 hour and 3, 7, 30, and 60 days after treatment. In vivo imaging included fundus autofluorescence, fluorescein angiography, and spectral-domain optical coherence tomography. Morphologic changes in tissue were analyzed using light microscopy, as well as scanning and transmission electron microscopy. One hundred and seventy percent and 120% levels corresponded to moderate and light burns, respectively, with damage to retinal pigment epithelium, photoreceptors, and at highest settings, to the inner retina. 50% to 75% lesions were typically subvisible ophthalmoscopically but detectable with fluorescein angiography and optical coherence tomography. Histology in these lesions demonstrated some selective damage to retinal pigment epithelium and

  11. Prevalence and associated factors of myopia among high school students in Gondar town, northwest Ethiopia, 2016

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    Belete GT


    Full Text Available Gizachew Tilahun Belete,1 Dereje Hayilu Anbesse,1 Adino Tesfahun Tsegaye,2 Mohammed Seid Hussen1 1Department of Optometry, 2Department of Biostatistics and Epidemiology, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia Introduction: Myopia is an important cause of correctable visual impairment and preventable blindness worldwide. Prevalence rates are approximately 20%–35% among the older teenage population globally. It has a medical burden of pathologic complications such as maculopathy and glaucomatous optic neuropathy. High school students experience high-performance and study pressures in the preparation for the final national examination. As a result they are exposed to excessive near work and indoor activities. They are also ignored for regular screening. Objective: To determine the prevalence and associated factors of myopia among high school students in Gondar town, Ethiopia. Methods: An institution-based cross-sectional study was conducted on 498 high school students with systematic random sampling method from April 18 to April 29, 2016, in three full-cycle high schools (9th–12th grades. A standardized structured questionnaire, Snellen acuity chart, pinhole, retinoscope, trial case lenses, pen torch, and direct ophthalmoscope were used to collect data. Results: A total of 495 study participants were included, and they had a mean age of 17.48±1.59 years. The prevalence of myopia was 11.9% (95% confidence interval [CI]: 10.2, 17.9. Family history of myopia (adjusted odds ratio [AOR]=8.08 [95% CI: 4.30, 15.16], school being private (AOR=2.88 [95% CI: 1.02, 8.11], longer time spent for near work (AOR=2.89 [95% CI: 1.12, 7.43], longer time spent partaking in indoor activities (AOR=4.32 [95% CI: 1.69, 10.99], shorter near working distance (AOR=3.06 [95% CI: 1.33, 7.06], lack of outdoor sport activities (AOR=2.27 [95% CI: 1.05, 4.90], use of visual display units (AOR=2.81 [95% CI

  12. Rapid assessment of avoidable blindness and diabetic retinopathy in Chiapas, Mexico. (United States)

    Polack, Sarah; Yorston, David; López-Ramos, Antonio; Lepe-Orta, Sergio; Baia, Rogerio Martins; Alves, Luciano; Grau-Alvidrez, Carlos; Gomez-Bastar, Pedro; Kuper, Hannah


    To estimate the prevalence and causes of blindness in Chiapas, Mexico, and to assess the feasibility of using the Rapid Assessment of Avoidable Blindness framework to estimate diabetic retinopathy (DR) prevalence. A cross-sectional population-based survey. Sixty-six clusters of 50 people 50 years of age or older were selected by probability proportionate to size sampling. Households within clusters were selected through compact segment sampling. Participants underwent visual acuity (VA) screening and diagnosis of cause of visual impairment by an ophthalmologist. Participants were classed as having diabetes if they had a previous diagnosis of diabetes, were receiving treatment for glucose control, or had a random blood glucose level of more than 200 mg/dl. Participants with diabetes were assessed for DR using dilated clinical examination (direct and indirect ophthalmoscope) and 1 dilated digital fundus photograph per eye (graded by an ophthalmologist during the survey and regraded by a retinal specialist-"reference standard") following the Scottish DR grading protocol. Prevalence of blindness (VA <20/400 in the best eye with available correction) and DR. Three thousand three hundred subjects were selected, of whom 2864 (87%) were examined. The estimated prevalence of bilateral blindness was 2.3% (95% confidence interval [CI], 1.7%-2.9%). Cataract was the leading cause of bilateral blindness (63%), followed by posterior segment diseases (24%), which included DR (8% of blindness). The prevalence of diabetes was 21% (19.5%-23.1%). Among participants with diabetes, the prevalence of DR (in at least 1 eye) was 38.9% (95% CI, 33.7%-44.1%). The prevalence of sight-threatening DR (STDR; defined as proliferative DR, referable maculopathy, or both) was 21.0% (95% CI, 16.7%-25.3%). Agreement with the reference standard was good for any retinopathy and STDR for the clinical examination (κ = 0.80 and 0.79, respectively) and the photograph graded during the survey (κ = 0.80 and

  13. Case of acute optic nerve compression caused by tuberculum sellae meningioma with optic canal involvement

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    Chai Y


    Full Text Available Yuzhu Chai1, Hiroko Yamazaki1, Akihide Kondo2, Toshiyuki Oshitari3, Shuichi Yamamoto31Department of Ophthalmology, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, 2Department of Neurosurgery, Juntendo University, School of Medicine, Tokyo, 3Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, JapanAbstract: We present detailed ophthalmic findings in a case of tuberculum sellae meningioma with acute visual symptoms due to optic canal involvement. A 62-year-old Japanese woman reported a 1-week history of headaches and blurred vision in her left eye. Her visual acuity was 0.3 in the left eye with no ophthalmoscopic abnormalities. A relative afferent pupillary defect and inferior temporal field defect were found in the left eye. Pattern visual evoked potentials were undetectable in the left eye. Enhanced magnetic resonance imaging showed a 9 mm intracranial lesion around the left optic nerve anterior to the chiasm. She was diagnosed with granulomatous inflammation because of the increased cell counts and protein concentration in the cerebrospinal fluid. She was treated with steroid pulse therapy, and her visual acuity and visual field defect improved to normal in 3 weeks. However, 16 months after the onset, she suffered from headaches again and had a complete loss of vision in her left eye. There was no response to steroid pulse therapy. Enhanced magnetic resonance imaging revealed that the lesion had extended into the left optic canal, and emergency tumor removal surgery was carried out. The histopathological diagnosis was meningioma. One month after the surgery, her left visual acuity improved to 1.2, and her visual field was almost normal. Pattern visual evoked potentials were present but had a prolonged P100 latency of 170 ms. A thinning of the ganglion cell complex was detected by optical coherence tomography. Ophthalmologists should be aware that a small tuberculum

  14. Influence of Fluorescein Angiography on the Diagnosis and Management of Retinopathy of Prematurity (United States)

    Klufas, Michael A.; Patel, Samir N.; Ryan, Michael C.; Gupta, Mrinali Patel; Jonas, Karyn E.; Ostmo, Susan; Martinez-Castellanos, Maria Ana; Berrocal, Audina M.; Chiang, Michael F.; Chan, R.V. Paul


    Purpose To examine the influence of fluorescein angiography (FA) on the diagnosis and management of retinopathy of prematurity (ROP). Design Prospective cohort study. Participants Nine recognized ROP experts (3 pediatric ophthalmologists; 6 retina specialists) interpreted 32 sets (16 color fundus photographs; 16 color fundus photographs paired with the corresponding FAs) of wide-angle retinal images from infants with ROP. Methods All experts independently reviewed the 32 image sets on a secure web site and provided a diagnosis and management plan for the case presented, first based on color fundus photographs alone, and then by color fundus photographs and corresponding FA. Main Outcome Measures Sensitivity and specificity of the ROP diagnosis (zone, stage, plus disease, and category – i.e. no ROP, mild ROP, type-2 ROP, and treatment-requiring ROP) was calculated using a consensus reference standard diagnosis, determined from the diagnosis of the color fundus photographs by three experienced readers in combination with the clinical diagnosis based on ophthalmoscopic examination. The kappa statistic was used to analyze the average intergrader agreement among experts for the diagnosis of zone, stage, plus disease, and category. Results Addition of FA to color fundus photographs resulted in a significant improvement in sensitivity for diagnosis of stage 3 or worse disease (39.8% vs. 74.1%, P = 0.008), type-2 or worse ROP (69.4% vs. 86.8%, P = 0.013), and pre-plus or worse disease (50.5 vs. 62.6%, P = 0.031). There was a nonsignificant trend towards improved sensitivity for diagnosis of treatment-requiring ROP (22.2% vs. 40.3%, P = 0.063). Using the kappa statistic, addition of FA to color fundus photographs significantly improved intergrader agreement for diagnosis of treatment-requiring ROP. Addition of FA to color fundus photographs did not significantly affect intergrader agreement for the diagnosis of stage, zone, or plus disease. Conclusions Compared to color

  15. Overlay of conventional angiographic and en-face OCT images enhances their interpretation

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    Pool Chris W


    Full Text Available Abstract Background Combining characteristic morphological and functional information in one image increases pathophysiologic understanding as well as diagnostic accuracy in most clinical settings. En-face optical coherence tomography (OCT provides a high resolution, transversal OCT image of the macular area combined with a confocal image of the same area (OCT C-scans. Creating an overlay image of a conventional angiographic image onto an OCT image, using the confocal part to facilitate transformation, combines structural and functional information of the retinal area of interest. This paper describes the construction of such overlay images and their aid in improving the interpretation of OCT C-scans. Methods In various patients, en-face OCT C-scans (made with a prototype OCT-Ophthalmoscope (OTI, Canada in use at the Department of Ophthalmology (Academic Medical Centre, Amsterdam, The Netherlands and conventional fluorescein angiography (FA were performed. ImagePro, with a custom made plug-in, was used to make an overlay-image. The confocal part of the OCT C-scan was used to spatially transform the FA image onto the OCT C-scan, using the vascular arcades as a reference. To facilitate visualization the transformed angiographic image and the OCT C-scan were combined in an RGB image. Results The confocal part of the OCT C-scan could easily be fused with angiographic images. Overlay showed a direct correspondence between retinal thickening and FA leakage in Birdshot retinochoroiditis, localized the subretinal neovascular membrane and correlated anatomic and vascular leakage features in myopia, and showed the extent of retinal and pigment epithelial detachment in retinal angiomatous proliferation as FA leakage was subject to blocked fluorescence. The overlay mode provided additional insight not readily available in either mode alone. Conclusion Combining conventional angiographic images and en-face OCT C-scans assists in the interpretation of both

  16. Present situation of retinopathy of prematurity management in mainland China: a survey based on 109 hospitals%国内109家医院早产儿视网膜病防治现状调查

    Institute of Scientific and Technical Information of China (English)



    (highest hospital rank in China) hospitals were capable of performing the retina screening test.In contrast,there was only 25.00% of the rest of the hospitals for which the screening tests were able to be conducted.A total of 63 hospitals provided detailed retina test protocols.Of them,34 hospitals adopted indirect ophthalmoscope,9 hospitals used Retcam camera system,20 hospitals still used direct ophthalmoscope.Fifty-nine hospitals (54.13% of all the hospitals in this study) were equipped with oxygen analysers.Nineteen hospitals reported the incidence of ROP in their premature infants(gestational age ≤34 weeks) in 2008,the mean rate was 3.87% with a range from O.17% to 16.31%.Nine hospitals offered ROP treatment.Four of which used laser photocoagulation,1 hospital performed cryotherapy,and the rest 4 hospitals used both of the modalities.There were 12 infants developed blindness in 109 hospitals between Jun.2004 and Jun.2009.During the same period,there were 22 cases of ROP related medical liability cases reported in 7 hospital,15 cases of the 22 cases occurred in 1 hospital.Conclusions According to the survey,the current management of ROP in level-Ⅲ A hospitals appears to be better than the other hospitals.However,the overall capability and actual conduction rate of ROP screening are low,the screening instruments and measures are not up to date,oxygen therapy in premature infants is not standard,subsequent treatment is not provided in most of the cases,there are a considerable number of blindness and medical liabilities related to ROP.

  17. Sustained release ability and safety of matrine polyactic acid microsphere intravitreal injection%苦参碱聚乳酸微球的缓释性和玻璃体腔注射的安全性研究

    Institute of Scientific and Technical Information of China (English)

    刘丹岩; 马景学; 曹德英; 王建欣; 刘建宗; 吕兰存


    Background The anti-proliferative effect of matrine has been demonstrated and its relevance to prevention and treatment of proliferative retinovitreopathy is concerned.Howeverthe intravitreous injection of free-matrine reiteratively may raise the risk of ocular infection.ObjectiveThe goal of the present study is to investigate the sustained releasing ability and safety of matrine polyactic acid microsphere(MAT-PLA-MS\tintravitreal injection.MethodsMAT-PLA-MS was prepared by Hebei Medical University and examined under the transmission electron microscope.The release of MAT-PLA-MS was monitored by ultraviolet spectrophotometry.Free-matrine with the dose of 1,2,4mg was intravitreally injected respectively in 12 eyes of New Zealand albino rabbits in free-matrine group and MAT-PLA-MS with matrine(2,4,6mg respectively was administered in 16 eyes separately in matrine microsphere group.The blank microsphere was injected in 6 right eyes as blank control group and normal saline solution was injected in 6 fellow eyes as control group.The retinal function change was evaluated by electroretinogram(ERG),and the morphological and histological change of retina following drug injection were assessed under the slit lamp biomicroscope,indirect ophthalmoscope,light microscope and transmission electron microscope.The decomposed process of MAT-PLA-MS in vitreous was recorded with ocular anterior segment and fundus color camera.Results MAT-PLA-MS containing matrine showed the spherical shape with the mean diameter of 2.28±47μm under the transmission electron microscope and the drug-loading rate 6.17% and drug-release rate 87.93% in vitro for 672 hours,presenting the controllable release characteristics.After implantation into the vitreous,the MAT-PLA-MS containing matrine decomposed gradually with the prolong of time.The b amplitudes of ERG maximum response were significantly declined in 4mg free-matrine injection group in comparison with before injection in various time points(P0

  18. Clinical observation of intravitreal ranibizumab for treatment of exudative aged-related macular degeneration%抗血管内皮生长因子单克隆抗体Ranibizumab治疗渗出性老年黄斑变性疗效观察

    Institute of Scientific and Technical Information of China (English)

    易佐慧子; 戚沆; 胡静; 翁铭; 曹思; 陈长征


    Objective To evaluate the clinical efficacy of intravitreal injections of anti-vascular endothelial growth factor monoclonal antibody ranibizumab in exudative aged-related macular degeneration.Methods A prospective,uncontrolled,open-label study.There were 20 eyes of 20 patients with exudative aged-related macular degeneration included in the study.All affected eye were treated with intravitreal ranibizumab 0.05ml (10mg/ml),once per month for 3 months.Further injection might be required if the monthly follow-up indicate.Before the injection,best-corrected visual acuity of early treatment of diabetic retinopathy study (ETDRS),non-contact tonometer,ophthalmoscope,fundus fluorescein angiograph (FFA) and (or) indocyanine green angiography (ICGA),optical coherence tomography (OCT) examination were necessary.The patients were followed for 3 to 12 months.Best-corrected visual acuity,OCT and ophthalmoscope examination were assessed monthly.If necessary,FFA and (or) ICGA were used.The ETDRS,central macular thickness (CMT) were compared before and after treatment.Results All eyes received an average of (3.65±0.99) injections,the end vision of follow-up increased (12.65±11.61) letters than before (t =4.87,P =0.00),foveal thickness decreased (127.37±108.48) m (t =5.12,P =0.00).There were no systemic or ocular serious adverse events during the time.Conclusions Intravitreal ranibizumab for exudative aged-related macular degeneration show visual acuity improvement,retinal thickness reduction and safety.%目的 观察玻璃体腔内注射抗血管内皮生长因子单克隆抗体Ranibizumab治疗渗出性老年黄斑变性的临床疗效.方法 前瞻、无对照、开放性研究.对2011年7月至2012年7月在武汉大学人民医院经眼科常规检查、荧光素钠眼底血管造影(FFA)和(或)吲哚青绿血管造影(ICGA)、光学相干断层扫描(OCT)确诊为渗出性老年黄斑变性20例患者20只眼纳入研究,所有患眼均接受10 mg/mL的Ra-nibizumab 0.05 m

  19. Perda auditiva neurossensorial súbita idiopática: evolução na presença de hipertensão arterial sistêmica, diabetes melito e dislipidemias Idiopathic sudden sensorineural hearing loss: evolution in the presence of hypertension, diabetes mellitus and dyslipidemias

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    Jayson Nagaoka


    tinnitus, dizziness and ear fullness sensation, presence of cerebral microangiopathy observed in magnetic resonance imaging, ophthalmoscopic findings, treatment onset, improvements in audiometric findings and at speech discrimination tests. Statistical analysis of data was performed. RESULTS: The associate disease group showed higher ages, cerebral microangiopathy observed in magnetic resonance imaging and later improvement in speech discrimination tests, being this difference statistically significant. CONCLUSION: Idiopathic sudden sensorineural hearing loss co-occurring with hypertension, diabetes mellitus or dyslipidemias, in older patients, is associated with a higher prevalence of cerebral microangiopathy, revealed by magnetic resonance imaging, and associated with a slower hearing recovering, showed by later improvements in speech discrimination tests.

  20. Eye Injuries Among Primary School Children in Enugu, Nigeria: Rural vs Urban. (United States)

    Okpala, Nonso Ejikeme; Umeh, Rich Enujioke; Onwasigwe, Ernest Nnemeka


    A cross-sectional survey of the prevalence of eye injuries among primary school children in two noncontiguous local government areas of Enugu State of Nigeria was undertaken. One of the local government areas was urban, while the other one was rural. Children who were schools in the urban area and three randomly selected schools in the rural area were interviewed and examined with Snellen chart, pen torch, head loupe, and direct ophthalmoscope. The findings were recorded using a semi-structured questionnaire and the World Health Organization Programme for Prevention of Blindness (WHO/PBL) eye examination form. Training on visual acuity measurement was done for each of the class teachers. A total of 1,236 children school (20.41%). The farm was next in frequency (7.14%), especially among boys in the rural area. The church and the road/street constituted the remainder. Regarding persons causing the injury, the child's playmate was the commonest (55.10%) followed by self (27.55%). Parents and guardians were the next (9.18%). These were injuries associated with corporal punishment. Corporal punishment-related eye injury, according to this study, appears to be common in the rural area and affects boys predominantly. Other human intermediary agents that cause an eye injury include passersby (2.04%), RTA (2.04%), siblings (2.04%), and others (1.02%). The primary agents that caused an eye injury were sticks/wood, 29 (29.60%); stone, 21 (21.43%); pieces of metal, 19 (19.39%); fall, 10 (10.20%); fight/fist blow, 9 (9.918%); plastic, 2 (2.04%); fingernails, 2 (2.04%); farm tools/fruits, 2 (2.04%); and RTA, glass, and headbutt, each 1.02%. Farm implements/fruits as well as fingernails appear to be fairly common primary agents that cause an eye injury in the rural Enugu, Nigeria. In terms of prevalence, there was no significant difference between the urban and rural areas. The findings from this study showed a high prevalence of eye injury among primary school children. In terms

  1. Transconjunctival retinopexy with active external drainage of subretinal fluid: a prospective pilot study of eight consecutive cases Retinopexia transconjuntival com drenagem externa do fluido sub-retiniano: um estudo piloto prospectivo de oito casos consecutivos

    Directory of Open Access Journals (Sweden)

    Rubens Camargo Siqueira


    Full Text Available PURPOSE: To describe an alternative surgical technique for the management of retinal detachment with no or minimal proliferative vitreoretinopathy (grade B using transconjunctival retinopexy with active external drainage of subretinal fluid. METHODS: In a prospective, interventional study, eight consecutive patients with retinal detachment with no or minimal proliferative vitreoretinopathy (grade B underwent transconjunctival retinopexy with active external drainage of subretinal fluid. Transconjunctival external drainage of subretinal fluid was achieved by using a 29 gauge needle placed in the subretinal space under indirect ophthalmoscopic monitoring. Active suction was performed (500 mmHg vacuum using a vitrectomy line coupled to the needle. After retinal reattachment, cryotherapy was applied to the scleral region corresponding to the area of the retinal break(s. RESULTS: In all cases there was retinal attachment at the end of surgery. Retinal redetachment occurred in four pseudophakic patients who then underwent pars plana vitrectomy. The four phakic patients maintained retinal attachment during follow-up (13-20 months. CONCLUSION: Transconjunctival retinopexy with active external drainage of subretinal fluid represents a useful, faster, and cheaper alternative to scleral buckling for retinal detachments with no or minimal proliferative retinopathy in phakic patients and, unlike scleral buckling, is not associated with induced myopia.OBJETIVO: Descrever uma técnica cirúrgica alternativa para o tratamento de descolamento da retina sem ou com mínima vitreorretinopatia proliferativa (grau B usando uma retinopexia transconjuntival com drenagem externa do fluido sub-retiniano. MÉTODOS: Prospectivo estudo intervencional, com oito pacientes consecutivos com descolamento da retina com nenhum ou mínima vitreorretinopatia proliferativa (grau B que foram submetidos a retinopexia transconjuntival com drenagem externa ativa do fluido sub

  2. Resultados preliminares de um sistema computadorizado e estereoscópico para pupilometria in vivo Preliminary results of a computerized and stereoscopic system for in vivo pupillometry

    Directory of Open Access Journals (Sweden)

    Luis Alberto Vieira de Carvalho


    ophthalmoscope helmet and a typical diving mask as support for a high-resolution and sensitivity CCD. Using an IBM compatible computer sequences of video in AVI format were digitized for several seconds at a mean rate of 30 Hz. Algorithms using principles of image processing were implemented for detection of the pupil edges. RESULTS: We present preliminary results of this system for a voluntary patient. Data for the horizontal (x and vertical (y central position and for the diameter of the pupil were then exported to files that could be read by typical spread sheet programs (Excel. CONCLUSIONS: In this manner, precise data can be obtained stereoscopically (for both pupils at the same time for any patient, given that the accommodation process is guaranteed by using a white LED virtual mire located 6 meters from the patient's eye. An electronic board precisely controls the level of illumination. We believe here developed instrument may be useful in certain ophthalmic practices where precise pupil geometric data are needed.

  3. Influence factor of the prognosis of traumatic subretinal hemorrhage after vitreo-retinal surgery%玻璃体视网膜手术治疗外伤性视网膜下出血的预后影响因素

    Institute of Scientific and Technical Information of China (English)

    高新晓; 姜燕荣


    Objective To evaluate the influence factor of the prognosis of traumatic subretinal hemorrhage after vitreo-retinal surgery. Methods The clinical data of 50 patients with traumatic subretinal hemorrhage who had undergone vitreo-retinal surgery were retrospectively analyzed. All patients had ocular traurnatie history and subretinal hemorrhage diagnosed by fundus and B-scan examination; the preoperative visual acuity was less than 0. 1. According to different conditions, the traumatic eyes were treated with vitreo-retinal surgery, combined with lensectomy, retinotomy or silicone oil tamponade, respectively. The period of follow-up after surgery was 2-53 months, and the average period was 7.27 months. The corrected visual acuity and retinal reattachment at the last follow-up were observed. The visual acuity ≥0. 1 was the standard of good prognosis; retina[ reattachment was observed by indirect ophthalmoscope and color fundus photography. The prognostic factors mainly included type of injury, open or closed injury, the disease course, preoperative visual acuity, retinal detachment, hemorrhagic choroidal detachment, vitreous hemorrhage, the sites of submacular hemorrhage, methods of surgery. The relationships between those prognostic factors and visual acuity outcome or retinal reattachment were analyzed by χ2 test and logistic regression analysis. Results About 46.0% patients had good prognosis of the visualacuity. In the eyes with preoperative visual acuity of no light perception to hand moving and finger counting to 0. 1, the rate of good visual aeuitywas 34. 2% and 83.3%, respectively; the difference between the two groups was significant(χ2=8. 860, P = 0.003). In the eyes with or without preoperative retinal detachment, the rate of good visual acuity was 37.5% and 80. 0%, respectively; the difference between the two groups was significant (χ2=4. 232,P=0. 040). In the eyes with subretinal hemorrhage involving the macular fovea or not, the rate of good visual

  4. Rel ati onshi p betw een Reti nopathy and Serum L ev el s of Calcium and Magnesium in PIHS%妊娠高血压性视网膜病变与血清钙、镁离子的关系

    Institute of Scientific and Technical Information of China (English)

    胡鹭萍; 徐国兴


    Objective To investigate the relations between the retinopathy and serum calcium and magnesium levels in patients with pregnancy induced hypertension syndrome (PIHS) . Methods In this retrospective study ,medical charts for 129 patients with PIHS and 130 healthy pregnant women as the control group were analyzed . We examined the retina with direct ophthalmoscope ,measured the concen‐tration of Ca2+ and Mg2+ in the serum ,and then performed statistical analysis . Results More than half of PIHS patients were diagnosed with retinopathy (52 .7% ) ,the severity of PIHS and the prevalence of retinopathy were positively correlated . Serum Ca2+ and Mg2+ levels were decreased in PIHS patients than those in the control group (P<0 .05) . With the aggravation of retinopathy ,serum Ca2+ and Mg2+ levels decreased . Conclusion Serum Ca2+ and Mg2+ levels can be a new indicator for PIHS . Fundus examina‐tion regularly and detection of serum Ca2+ and Mg2+ levels during pregnancy can contribute to the diagno‐sis and severity evaluation of retinopathy in PIHS patients .%目的:探讨妊娠高血压综合征(妊高症)患者视网膜病变与血清钙、镁离子的关系。方法回顾性分析129例妊高症患者的资料,并随机抽取同期住院的130例正常妊娠的孕妇作为对照组,分析其视网膜病变与妊高症病情程度的关系;将妊高症患者按视网膜病变分组,分析各组血清钙、镁离子水平与视网膜病变程度的关系,并与对照组进行比较。结果妊高症患者视网膜病变发生率52.7%,且随着病程加重患病率越高;妊高症各组血清钙、镁离子水平均低于对照组(P<0.05),随着视网膜病变加重,钙、镁离子水平降低越明显,各组间差别有统计学意义(P<0.05)。结论血清钙、镁离子水平可反应妊高症患者病程及视网膜病变的严重程度。孕期定期检查眼底和检测血清钙、镁离子有助于妊高症眼底

  5. Ophthalmic manifestations in acquired immune deficiency syndrome patients with cryptococcal meningitis%获得性免疫缺陷综合征合并隐球菌性脑膜炎的眼部病变特征分析

    Institute of Scientific and Technical Information of China (English)

    毛菲菲; 孙挥宇; 李丹


    Objective Analysis ophthalmic manifestations in acquired immune deficiency syndrome(AIDS) patients with cryptococcal meningitis.Methods Retrospective study.Forty AIDS patients (including 32 men and 8 women) with cryptococcal meningitis were studied.The age of the patients varied from 11 to 67 years,average on (38 ± 12) years (mean ± standard deviation).All the patients underwent detailed ocular examinations including corrected visual acuity,eye movement,intraocular pressure,slit lamp microscope,indirect ophthalmoscope and color fundus photography.The CD4+ T cell count was evaluated and Lumbar puncture was done to examine the cerebral spinal fluid(CSF).Eighteen patients were followed up for a period between 2weeks to 4years.Four patients died during hospitalization.The remaining 18 patients failed to be followed up due to moving away.Results Binocular diplopia were present in 3 patients.It showed Binocular or monocular abducens nerve palsy.Papilledema were found in 37 eyes of 19 cases.One person had unilateral papilledema.Among 19 cases,24 eyes of 12 cases were accompanied with peripapillary hemorrhages and 7 cases of 13 eyes without peripapillary hemorrhages.Optic atrophy occurs in 6 cases of 12 eyes and multifocal choroiditis in 2 cases of 4 eyes.Twenty-seven eyes of 14 patients had normal fundus or cytomegalovirus retinitis(CMVR) only.Conclusions AIDS patients with cryptococcal meningitis merger may be accompanied by a variety of eye complications.Papilledema are the most common manifestations.%目的 探讨获得性免疫缺陷综合征(AIDS)合并隐球菌性脑膜炎患者眼部表现.方法 回顾性研究.观察40例AIDS合并隐球菌性脑膜炎患者眼部病变特点,其中男性32例,女性8例,男女比例4∶1,年龄11~67岁,平均年龄(38±12)岁,对所有患者均行视力、眼球运动、眼压、裂隙灯显微镜、散瞳间接检眼镜眼底检查及眼底彩色照相.所有患者进行CD4+T淋巴细胞的检测,

  6. Phenotype of congenital cataract accompanied with iris dysplasia%先天性白内障合并先天性虹膜发育异常的临床表型

    Institute of Scientific and Technical Information of China (English)

    韦春玲; 李娟娟; 胡竹林; 黎铧


    Background Certain relationship has been found between phenotype and genes mutation of congenital cataract.It is clear that different genetic mutations can cause the same complication in congenital cataract,meanwhile,different complications may be caused by the same gene mutation.However,their mechanism is still remained unclear.Objective This study was to observe the phenotype of congenital cataract accompanied with iris dysplasia.Methods Fifteen patients with congenital cataract accompanied with iris dysplasia were included in this study.The slit lamp,gonioscope and ophthalmoscope were used for the examination of the anterior ocular segment,the anterior chamber angle and fundus on all the patients.This study was approved by the Ethic Committee of Second People' s Hospital of Yunnan Province.Written informed consent was obtained from each patient or the custodian prior to any medical procedure.Results All the patients showed binocular involvement.Congenital nuclear cataract with whole coloboma of iris was seen in 7 cases,and 2 cases showed an entire cataract associated with incomplete coloboma of iris.Entire cataract with aniridia was diagnosed in 5 patients,and suture cataract complicated with aniridia was in 1 patient.Conclusions Some regular patterns can be implied between the morphological type of cataract and iris dysplasia,which may be helpful for further study of these diseases.%背景 先天性白内障临床类型与遗传基因位点存在一定的相关性,而不同致病基因的先天性白内障可伴发相同的眼部合并症,同时不同的眼部合并症可由同一致病基因引起,它们之间是否存在对应关系尚未明确.目的 观察先天性白内障合并先天性虹膜发育异常的表现类型,总结其发病规律.方法 对云南省第二人民医院眼科诊治的先天性白内障合并先天性虹膜发育异常患者15例进行眼科形态学观察,分析不同类型的先天性白内障伴发虹

  7. Effect of suramin on traumatic proliferative vitreoretinopathy in rabbit%苏拉明对外伤性增生性玻璃体视网膜病变抑制作用的实验研究

    Institute of Scientific and Technical Information of China (English)

    孙海燕; 闫爱民; 赵平


    Objective To provide experimental reason to prevent PVR with chitosan. Methods 40 New Zealand white rabbit were selected and divided into five groups in random. Normal group was not injected any medicine in vitreous celom, model group was injected physiology salt 0.1ml and 0.1ml Platelet rich Plasma, experiment 1,2, 3 group was injected different concentration chitosan(40 mg/ml, 60 mg/ml,80 mg/ml) 0. 1 ml and 0. 1 ml Platelet rich Plasma. Changes in vitreous body and retina were observed with silt lamp micoroscope, ophthalmoscope and BUS. The eyes were taken out to make samples to measure the content of TNF-α and EGF. Results Average level of experiment group 1,2,3 were lower than model group on 21st,28th day. Histological analysis revealed no significant functional changes. Compared with model group,the contents of TNF-α and EGF were decreased signihcantly change in the experiment groups(P<0. 01 ). The contents of TNF-α and EGF in the experiment group 2 and 3 was signincantly compared with experiment group 1 ( P < 0. 01 ). Conclusion Suramin can decrease the content of TNF-α and EGF in the vitreous body, and then prevented the proliferative vitreoretinopathy.%目的 探讨苏拉明(suramin)对兔外伤性增生性玻璃体视网膜病变的防治作用。方法 40只健康新西兰大白兔,随机分5组:空白组(玻璃体腔内不予注射),模型组(玻璃体腔内注入0.1ml生理盐水及0.1ml富含血小板的血浆),实验1组、2组、3组(玻璃体腔内分别注入40 mg/ml、60 mg/ml和80 mg/ml苏拉明0.1ml和0.1ml富含血小板的血浆)。观察并记录玻璃体视网膜的改变,术后28 d分别检测玻璃体中EGF和TNF-α的含量。结果 术后21 d、28 d实验1组、2组、3组的增生级别均低于模型组(P<0.05)。组织学检查,苏拉明实验三组均未发现明显的视网膜形态改变。实验1组、2组、3组玻璃体中TNF-α和EGF含量均低于模型组(P<0.01)。实验2组、3组间玻璃体中TNF-α和EGF含

  8. Cases analysis of diabetic retinopathy and diabetic macular edema%糖尿病视网膜病变与糖尿病性黄斑水肿相关性病例分析

    Institute of Scientific and Technical Information of China (English)

    王佳; 张晓峰


    Objective To investigate the relationship between the occurrence and severity of diabetic retinopathy (DR) and the occurrence and severity of diabetic macular edema (DME).Method Ten cases (10 eyes) of diabetic retinopathy complicated with macular edema that were diagnosed jointly by endocrinologists and ophthalmologists were enrolled in this study.Recruitment criteria included history of diabetes confirmed by endocrinologists,central visual acuity,intraocular pressure,and established diagnosis of diabetic retinopathy and macular edema with the Results of direct ophthalmoscope and slit lamp joint front mirror fundus examination,dilated fundus photography,optical coherence tomography technique (OCT),and sodium fluorescein angiography (FFA).A careful staging of DR and DME followed detailed history and ophthalmic examination for each patient.The relationship between diabetic retinopathy and diabetic macular edema were analyzed.Results We found that diabetic macular edema presented in all stages of the diabetic retinopathy,but the degree of macular edema was not related to the severity of DR.Conclusion Diabetic macular edema can occur in any stage of the diabetic retinopathy and its severity is not linked to the severity of DR.But the case number in this study is small and there were some limitations as well.Further studies are needed to reveal the real relationship between DR and DME.%目的 观察糖尿病性黄斑水肿(DME)的发生及严重程度与糖尿病视网膜病变(DR)的发生及严重程度之间的关系.方法 经内分泌科及眼科诊断为DR合并DME的患者中随机抽取10例(10只眼)纳入本次研究.纳入标准为:所有入选对象均经内分泌科确诊有数年糖尿病史的糖尿病患者,在眼科均行中心视力、眼压、直接检眼镜、裂隙灯联合前置镜眼底检查、散瞳眼底彩色照相、相干光断层成像术(OCT)、荧光素眼底血管造影(FFA),均符合DR和DME的临床诊断标准.并按照相关标准

  9. Analysis of clinical characteristics of 29 patients with ocular ischemic syndrome%眼缺血综合征患者29例临床特征分析

    Institute of Scientific and Technical Information of China (English)

    李雁; 张军军; 陆方


    Objective To investigate and analyze the characteristics of ocular ischemic syndrome (OIS). Methods Clinical data of 31 eyes in 29 OIS patients were retrospectively analyzed. For all patients, history inquiry, visual acuity, examination of slit lamp, binocular indirect ophthalmoscope, fundus photography, fundus fluorescein angiography and color Doppler imaging examination were recommended. Results OIS is more common in the elderly, In our group,patients mainly showed progressive vision loss, 19 eyes appeared scattered retinal hemorrhage in the mid-peripheral retina,7 eyes were observed retinal vein dilation and tortuous,and 3 eyes showed thinning artery stenosis. Outstanding manifestation in fundus fluorescein angiography were as follows, all patients showed prolonged arm-retinal circulation time with(22. 16 ±6.46) s and ar-teriovenous circulation time with( 14.02 ±7.26) s, retinal artery filling forward in 15 eyes and peripheral retinal flake avascular area in 12 eyes. Color Doppler imaging in 5 cases showed carotid atherosclerotic plaques and slight increase of internal carotid artery resistance index in 6 cases. Conclusions OIS is a multidisciplinary disease, and the patients always with poor prognosis. So we should strengthen awareness of the disease, ensure early diagnosis and treatment.%目的 分析眼缺血综合征(ocular ischemic syndrome,OIS)的临床特点.方法 收集29例(31眼)患者临床资料,进行回顾性分析.对所有患者进行病史采集、视力检查、裂隙灯显微镜、双目间接检眼镜、眼底照相、FFA及彩色超声多普勒成像检查.结果 OIS发病多见于中老年人,本组患者主要表现为渐进性视力下降.19眼出现了中周部视网膜散在出血,7眼见视网膜静脉扩张、迂曲,3眼表现为动脉狭窄变细.FFA突出表现为所有患者臂-视网膜循环时间延长[(22.16±6.46)s]和动静脉循环时间延长[(14.02±7.26)s],15眼观察到明显的动脉充盈前锋,12眼存在视网

  10. Characterization of the 10q26-orthologue in rhesus monkeys corroborates a functional connection between ARMS2 and HTRA1. (United States)

    Pahl, Lisa; Spangenberg, Astrid; Schubert, Stephanie; Schönmann, Uwe; Schmidtke, Jörg; Stuhrmann, Manfred


    Age-related macular degeneration, which is the leading cause of blindness in industrialized countries, is a multifactorial, degenerative disorder of the macula with strong heritability. For age-related macular degeneration in humans, the genes ARMS2 and HTRA1 in the region 10q26 are both promising candidates for being involved in pathogenesis. However, the associated variants are located in a region of strong linkage disequilibrium and so far, the identification of the causative gene in humans was not yet possible. This dilemma might be solved using an appropriate model organism. Rhesus monkeys suffer from drusen, a major hallmark of age-related macular degeneration, and the drusen-phenotype shares susceptibility factors with human macular degeneration. Thus, the rhesus monkey represents a natural animal model to uncover genetic factors leading to macular degeneration. Moreover, the existence of genetically homogenous cohorts offers an excellent opportunity to determine risk factors. However, the 10q26-orthologue genomic region in rhesus monkeys is not characterized in detail so far. Therefore, the aim of this study is to analyze the rhesus linkage disequilibrium structure and to investigate whether variants in ARMS2 or HTRA1 are associated with the drusen-phenotype as well. We sequenced parts of a 20 kb region around ARMS2 and HTRA1 in a genetically homogeneous cohort of 91 rhesus monkeys descending from the CPRC rhesus cohort on Cayo Santiago and currently housed in the German Primate Centre in Göttingen. Within this group, ophthalmoscopic examinations revealed a naturally high drusen prevalence of about 47% in monkeys >5 years. We detected 56 genetic variants within and around ARMS2 and HTRA1 and, as one deviates from Hardy-Weinberg-Equilibrium, 55 polymorphisms were used to generate a linkage disequilibrium-Plot and to perform association studies. We observed strong linkage disequilibrium between the markers and were able to define two haplotype blocks. One of

  11. 晶状体半脱位白内障术中两类折叠型 lOL做悬吊术的疗效比较%Observation of two types of foldable scleral - fixated posterior chamber intraocular lens to treat cataract dislocation

    Institute of Scientific and Technical Information of China (English)

    邓芳祝; 邝国平


    AlM:To observe the clinical efficacy of two types of scleral-fixated posterior chamber intraocular lens ( lOL ) combined intra-capsule lens extraction to treat cataract dislocation. METHODS: After intra - capsule lens extraction of dislocated cataract, two types of lOL were used as scleral-fixated posterior chamber lOL . First group was with four seal loops, the second group was with two open loops. All 21 patients (23 eyes) took the examination of the best corrected visual acuity, intraocular pressure, fundus, and lOL decentration using camera system attached to slit - lamp ophthalmoscope and lOL tilted using ultrasound biomicroscopy (UBM) at 6mo after surgery.RESULTS: After 6mo, all patients had improved eye sight. There was significant difference in the mean lOL decentration between the two groups ( 0. 57mm vs 0. 79mm, P CONCLUSlON: lOL with four loops are more appropriate as scleral-fixated posterior chamber lOL with less tiltness and dicentration.%目的:探讨囊内摘除联合两类人工晶状体( intraocular lens,IOL)做悬吊术治疗晶状体半脱位白内障的临床疗效。  方法:晶状体半脱位患者21例23眼,行晶状体囊内摘除前部玻璃体切割联合IOL悬吊术,依植入IOL类别分为四个闭合襻IOL组和两个C襻IOL组,术后观察视力、眼压、综合验光、眼底,6mo时裂隙灯眼前节摄像系统拍照确定 IOL 偏心值,超声生物显微镜( ultrasound biomicroscopy,UBM)检查确定IOL的倾斜度检查。  结果:所有患眼术后视力均有不同程度的提高。四襻组IOL平均偏心为0.57mm,两襻组平均偏心0.79mm;四襻组IOL平均倾斜度为6°,两襻组平均倾斜度11°,两组间差异均有统计学意义(P  结论:晶状体半脱位术中四个闭合襻IOL做悬吊术后居中性更好,IOL倾斜度更小。

  12. Effect of Qingjie Huoxue Decoction on histopathologic changes of retinal vasculitis induced by bovine serum albumin%清解活血汤对兔自身免疫性视网膜血管炎病理学变化的影响

    Institute of Scientific and Technical Information of China (English)

    宋柯; 张津京; 李庆生; 江伟; 张红; 镇华


    目的 探讨清解活血汤对牛血清白蛋白诱导的视网膜血管炎的治疗作用.方法 用牛血清白蛋白与弗试佐剂足底皮内注射及牛血清白蛋白玻璃体腔注射制作青紫蓝兔自身免疫性视网膜血管炎模型.模型动物分为阳性对照组、空白对照组、中药高剂量组、中药低剂量组;分别予地塞米松肌肉注射,生理盐水、高剂量中药及低剂量中药灌胃.观察各组实验兔的眼底表现和组织形态变化情况.结果 空白对照组的眼底改变主要有视网膜水肿、出血,静脉呈节段状粗大迂曲,视盘水肿,视网膜色素紊乱等.病理学检查见视网膜血管区域大量红细胞及炎性细胞,感光细胞层排列紊乱,RPE细胞色素增多、迁移或团簇,晚期神经纤维层局灶性坏死,感光细胞层缺失中断.其余各治疗组的眼底表现和病理切片结果好于空白对照组,中药高剂量组的视网膜损害最小.结论 牛血清白蛋白诱导兔自身免疫性视网膜血管炎可作为一种良好的模型供将来研究使用.清解活血汤能有效控制模型动物的视网膜出血及炎症反应,高剂量药物的效果最好.%OBJECTIVE To discuss the therapeutic effect of Qingjie Huoxue Decoction on retinal vasculitis induced by bovine serum albumin. METHODS Injected bovine serum albumin and complete Freund's adjuvant through hypodermic medication and intravenous injection of bovine serum albumin in order to build the model of autoimmune retinal vasculitis on pigmented rabbits. The experimental rabbits were divided into positive control group, normal control group, high-dose and low-dose Chinese herbal medicine group. RESULTS Ophthalmoscopic studies indicated that fundus changes were retinal hemorrhage, edema, thick and tortuous like segment veins, optic disc swelling and retinal pigment disorder on the rabbits in normal control group. A large number of red blood cells, inflammatory cells and the disorganized

  13. Investigação do reflexo vermelho em recém-nascidos e sua relação com fatores da história neonatal Investigación del reflejo rojo en recién nacidos y su relación con factores de la historia neonatal Investigation of the related factors between newborn history and red reflex

    Directory of Open Access Journals (Sweden)

    Ingrid Martins Leite Lúcio


    relationship between red reflex in premature newborns (PN and factors of the newborn history. It's a descriptive, exploratory, quantitative study conducted in a public maternity in Fortaleza, State of Ceará, with 114 PN between the months of April and May of 2004. For data registration was used a questionnaire, and for the ocular exam a direct ophthalmoscope. Data showed the following findings: 68% of PN had an Apgar under seven during the first minute; 112 were submitted to oxygen therapy; and 68 to phototherapy. As for the red reflex, 13 (11% showed alterations, with significant statistical association between red reflex and the Apgar during the first minute of life (p= 0.041. The results cause concern because 10 of the 13 PN with red reflex showed retinopathy of prematurity.

  14. 45岁以上黄斑区神经上皮脱离患者疾病类型分析%Types of macular neuroepithelial detachment in patients aged above 45 years

    Institute of Scientific and Technical Information of China (English)

    曹绪胜; 周海英; 张风; 周辉


    Objective To observe the of macular serous neuroepithelial detachment and the necessary auxiliary examination methods for the diagnosis.Methods The clinical data of 46 patients (49 eyes) aged above 45 years with macular serous neuroepithelial detachment who have been diagnosed by binocular indirect ophthalmoscope and optical coherence tomography (OCT) were retrospectively analyzed.All the patients had undergone fundus fluorescein angiography (FFA) and indocyanine angiography (ICGA),and the diagnosis was established based on the results of FFA,ICGA and OCT.Results In these 46 patients (49 eyes),central serous chorioretinopathy (CSC) was found in 31 (34 eyes,69.4%),age-related macular degeneration (AMD) was found in 12 (12 eyes,24.5%),and polypoidal choroidal vasculopathy (PCV) was found in 3 (3 eyes,6.9%).In the 34 eyes with CSC,12 eyes (35.3%) had typical CSC and 22 eyes (64.7%) had chronic CSC.If the 12 eyes with AMD,9 eyes (75%) had occult CNV,2 eyes (16.7%) had minimally classic CNV,and 1 eye had classic CNV.Conclusions The causes of serous macular neuroepithelial detachment in patients aged above 45 years are complex;ICGA may help to establish the definitive diagnosis of chronic CSC,occult CNVO and PCV should be considered.%目的 观察45岁以上患者发生黄斑区浆液性神经上皮脱离的疾病类型,探讨疾病诊断必要的辅助检查方法.方法 对年龄在45岁以上,双目间接检眼镜检查结合光相十断层扫描(OCT)确诊为黄斑区浆液性神经上皮脱离患者46例49只眼的临床资料进行同顾性分析.所有患者均接受荧光素眼底血管造影(FFA)、吲哚青绿血管造影(ICGA)检查.结合 FFA、ICGA和OCT检查做出诊断.结果 中心性浆液性脉络膜视网膜病变(CSC)31例34只眼,占所有患者的69.4%.其中,9例12只眼呈典型CSC表现,占CSC患者的35.3%;22例22只眼为慢性CSC,占CSC患者的64.7%.渗出型老年性黄斑变性(AMD)12例12只眼,占所有患者的24.5%.其中隐匿型9

  15. 贝伐单抗兔眼前房注射后在眼组织的分布及其不良反应的研究%Distribution of bevacizumab in ocular tissue and its toxic effect after injection of anterior chamber

    Institute of Scientific and Technical Information of China (English)

    刘琳; 马翔; 季艳丽; 冶卓


    消失.结论 前房注射贝伐单抗1.25 mg对正常兔眼组织无明显的毒性作用和不良反应,注射后药物能快速分布于注射眼的前房角、虹膜、睫状体、脉络膜和视网膜,主要堆积在血管样组织中.%Background Bevacizumab has been widely used in the treatment of new blood vessel disease in ophthalmology.The investigation of the pharmacokinetics and safety after intracameral injection of bevacizumab can offer the basis for the management of iris neovascularization and neovascular glaucoma.Objective The present study was to observe the distribution of bevacizumab(avastin)in eye tissue and toxic effects following the injection of anterior chamber.Methods Twenty-four New Zealand albino rabbits were divided into two groups randomly.0.05 ml (1.25mg)of Bevacizumab was intracamerally injected into the left eyes in the experimental group,and a balanced salt solution of 0.05 ml was injected in the same way into the left eyes of the control group.The anterior segment of eyes and ocular fundus were examined by slit-lamp microscope and direct ophthalmoscope after injection.Intraocular pressure was measured and corneal endothelial microscopy was performed before and after the injections.Five rabbits of the two groups were sacrificed on the first day,the fourth day,the seventh day,the fourteenth day,and the thirtieth day after injection,and the eyeballs were enucleated for histopathological examination.The ultrastructure of eye tissue was observed under the transmission electron microscope on the fourth day and the thirtieth day,and then immunofluorescence staining were performed to assess the distribution of bevacizumab in the eye tissues.This experiment complied with the Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission(Version 1988).Results No abnormality in the cornea,lens,vitreous and retina was observed after the injection of bevacizumab under the slit lamp microscope and direct

  16. Spectral domain-optical coherence tomography analysis of choroid osteoma%脉络膜骨瘤的频域光相干断层扫描观察

    Institute of Scientific and Technical Information of China (English)

    薛康; 钱江; 张勇进; 黄欣; 黎蕾


    -OCT),and to explore their relationship with visual acuity.Methods The records and SD-OCT images of 14 patients (18 eyes) diagnosed with choroidal osteoma at this hospital were reviewed retrospectively.All patients received examinations of best corrected visual acuity (BCVA),direct or indirect ophthalmoscope,slit lamp ophthalmoscope,fundus fluorescein angiography,B scan and/or computerized tomography.Subtle structure changes of the retina and choroidal osteoma were observed by four lines of the horizontal,the vertical scanning lines through the foveal and the tumor basal diameter under the model of five Line Raster.The correlation between the retinal and choroidal morphology and visual acuity was evaluated.Results The choroidal features of SD-OCT image of choroidal osteoma can be categorized into hyper-reflective in six eyes (33.3 %),isoreflective in five eyes (27.8%),hypo-reflective in three eyes (16.7%) and mixing-reflective in four eyes (22.2%).The foveal thickness ranged from 50.2 to 245.1 μm,and the average foveal thickness was (130.2±58.3) μm.The horizontal and vertical diameters of choroidal osteoma ranged from 5.6 to 15.8 mm and 4.6 to 12.8 mm respectively.The average horizontal and vertical diameters of choroidal osteoma were (7.8 ± 2.9) mm and (6.5 ±2.5) mm respectively.The statistical analysis revealed that BCVA was not related to the horizontal,vertical diameters of choroidal osteoma or the foveal thickness (r =0.262,0.229,0.137; P =0.284,0.294,0.362).BCVA was related to the involvement of fovea and the integrity of photoreceptor inner/ outer segment junction (IS/OS) (r=-3.838,-4.559; P=0.001 5,0.000 3),but not related to macular choroidal neovascularization (CNV) or serous retinal detachment (r=-0.144,0.411; P=0.684,0.687).Conclusions The main SD-OCT image characteristics of eyes with choroidal osteoma was hyper-reflective and isoreflective.BCVA was not related to the horizontal,the vertical diameters of choroidal osteoma,the foveal thickness


    Directory of Open Access Journals (Sweden)

    Nilo Sérgio Troncoso Chaves


    Full Text Available

    Ten mixed breed dogs, with a 10 kg average weight, were selected at Centro de Zoonoses de Goiânia. After being examined and considered healthy the dogs were enumerated from 11 to 20 on their collars. Each animal had swine cornea implanted into the left eye. The swine cornea was obtained at Casa de Banha Caçula, a slaughterhouse, and conserved in humid chamber for a maximum 6 hour period. Before surgery, each animal received 4 mg dissodic fosphate/acetate dexamethasone IM and was instilled one drop of betamethasone dissodic fosphate and one drop of gentamicin sulphate, maintaining the ocular medication 4 times/day and the intramuscular medication once a week, until euthanasia. After xenografts being realized, each cornea was examined every 7 days using direct ophthalmoscope to analyse transparency, vessels new formation, episcleral and conjunctival vessels reaction, cornea thickness, depth and presence or absence of deposits into the anterior chamber. On day 7 clinical evaluation, all cornea xenotransplant eyes (100% had lost transparency (++,+++, there was episcleral vessels reaction (P, anterior chamber depth was preserved (N, there wasn’t edema, as well as deposits (A on anterior chamber. On day 14, with the loss of two corneas by “self-trauma”, the other dogs had their implanted corneas (80% completely opaque (+++, with important ciliary reaction (P, edema (A; however, the anterior chamber integrity was preserved (N, without presence of deposits (A. With three more dogs euthanized between days 14 and 21, due to corticosteroids side-effects, the remaining dogs (50% preserved their implants with the day 14 alterations until the end of this experience.

    Foram utilizados 10 cães, sem ra

  18. Transpupillary thermotherapy for choroidal metastases%脉络膜转移癌的经瞳孔温热疗法观察

    Institute of Scientific and Technical Information of China (English)

    王明扬; 王光璐


    Objective To study the effect of Transpupillary thermotherapy (TTT) on choroidal metastases. Methods Nine cases were enrolled in the study, male 2 and female 7 cases. Bilateral eyes were affected in 3 cases. The age of cases was 37-60yrs with averaged at 44.6 yrs. The visual acuity was ≤0.05 in 1 eye,0.06-0.2 in 2 eyes, 0.3-1.0 in 9 eyes. The metastatic tumor showed as a yellow-white flat lesions with retinal detachment in different extent on their surfaces. The number of the lesions was single in 2 eyes, 2 in 3 eyes, ≥3 in 7 eyes. The location of the lesions was at the posterior pole in 4 eyes, at the macular and its surrounding in 6eyes, around the disc in 2 eyes. The primary tumor was located at the lung and bronchus in 5 cases, at the breast in 3 cases, at the large intestine in 1 case. Indirect ophthalmoscope, fundus fluorescein angiography (FFA), ultrasound (A, B) and optical coherence tomography (OCT) were used for exam. Treatment was delivered via slit lamp using an 810 nm diode laser (Iridex) with 250 to 1000 mw, with average 510 mw; the spot size was 2.0-3.0mm, duration ranged from 60 s to 120 s. The lesions just turned into pale-white appearance after treatment. The number of laser spot was 2-6 with average 3.7 spots. The session for management was 1-6 with average 2.9. The interval between 2 sessions was 1-3 months. The lesion just underlying the fovea was combined with photodynamic therapy (visudyne) in 1 case. Results The lesions turned into a flat scar with pigmentation and fluid absorption after treatment. The visual acuity was improved in 2 cases, unchanged in 4 cases, declined in 6 cases. The visual decline was caused by the lesion underneath the fovea and secondary macular lesions. The fellow-up was 1-32 months with average 9.6 months. Conclusions TTT is rational for choroidal metastatic lesions and has definite effect with low cost. It is worth doing in the future. Early discovering and managing the lesions helped to protect the visual

  19. [A challenge to primary open-angle glaucoma including normal-pressure. Clinical problems and their scientific solution]. (United States)

    Sugiyama, Kazuhisa


    response to glaucoma medication between fellow eyes. Latanoprost was applied to the first eye and then to both eyes of POAG or ocular hypertension patients. IOP measurements were performed twice on different days at baseline, during treatment of the first eye only and for both eyes. No significant correlations of ΔIOP 1 (IOP at baseline-IOP after treatment) between fellow eyes were found. ΔIOP 2 (ΔIOP 1-IOP fluctuation of the contralateral eye) was significantly correlated between the fellow eyes using two post-treatment IOP measurements. Using multiple IOP measurements may improve the prediction of a fellow eye's response to glaucoma medication in one-eye trials. We used a scanning laser ophthalmoscope (SLO) for in vivo imaging and counting of rat retinal ganglion cells (RGCs). RGC survival decreased gradually after crushing the optic nerve. RGC counts by SLO were comparable to those in retinal flat mounts. We developed OCT system for rat eyes. The mean retinal nerve fiber layer (RNFL) thicknesses in the circumpapillary OCT scans were unchanged 1 week after crushing the optic nerve, but then decreased significantly and progressively after the second week. RNFL thicknesses in OCT images correlated significantly with thicknesses determined histologically. SLO and OCT will be useful for evaluating the effects of neuroprotective drugs. We developed a new glaucoma filtration surgery system using a thin honeycomb-patterned biodegradable film in rabbits. The film had a honeycomb-patterned surface that faced the subconjunctival Tenon tissue, while the other side was smooth. Postoperative IOPs of the film-treated eyes were significantly lower than those of the control eyes, but were not significantly different from those of the MMC-treated eyes. The thin honeycomb-patterned film that was attached to the inner bleb wall worked as an adhesion barrier in glaucoma filtration surgery in rabbits.

  20. 眼轴长度与糖尿病视网膜病变程度的关系%Relationship between axial length and severity of diabetic retinopathy

    Institute of Scientific and Technical Information of China (English)

    屈超义; 王建洲; 王欣荣; 赵海梅; 宋虎平


    Objective To investigate the relationship between axial length and severity of diabetic retinopathy (DR) ,and explore its clinical significance. Methods Eighty-four type-2 diabetic patients (160 eyes) were divided into three groups according to axial length:shorter than 24 mm (87 eyes) .between 24 mm and 26 mm (48 eyes), longer than 26 mm (25 eyes). Visual acuity was examined in each group by international standard visual acuity chart, and the anterior segment was examined by slit lamp microscope. Fundus was examined by binocular indirect ophthalmoscope and Quorescein fun-dus angiography under dilated pupil. Axial length was measured by type-A ultrasound. The patients were divided into three groups according to the severity of DR: no DR, none proliferative DR (PDR) and PDR. The relationship between axial length and the severity of DR was analysis by Kendall test and Spearman' s rank-correlation coefficient test. The comparison of PDR morbidity in three groups was performed by chi-square test. Results With the axial length increased, the severity of DR reduced, which showed the negative ranked relation,there were statistical differences(Kendall test,/1 < 0.05, r = - 0. 34; Spearman' s rank-correlation coefficient test, P < 0. 01, r = - 0. 367), and there was statistical difference in the incidence of PDR between axial length longer than 26 mm group and other two groups^2 = 34.457 ,P <0.05). Conclusions When the axial length becomes longer, the severity of DR reduces. As a protective factor of PDR,long axial length is significant to predict DR development and guide the treatment of DR.%目的 研究眼轴长度与糖尿病视网膜病变( diabetic retinopathy,DR)程度的关系,并探讨其临床意义.方法 按照眼轴长度将84例(160眼)2型糖尿病患者分为3组:眼轴长度≤24 mm(87眼)、24~26 mm(48眼)、>26 mm(25眼).采用国际标准视力表检查视力;使用裂隙灯显微镜检查眼前节,托品酰胺眼液散瞳(排除高眼压后),双目

  1. 麻风病眼部病变-1 004例麻风病患者的研究%Ocular involvement in leprosy-A field study of 1 004 patients

    Institute of Scientific and Technical Information of China (English)

    S C Reddy; B D Raju


    AIM: To determine the prevalence of ocular involvement and pattern of ocular morbidity in leprosy patients.METHODS: Leprosy patients were examined in their respective treatment centres by the ophthalmologist over a period of three years. After recording visual acuity, anterior segment was examined with torch light and magnifying loupe.Intraocular pressure was measured with Schiotz tonometer.Fundus was examined, after dilating pupils with tropicamide eye drops, with direct ophthalmoscope.RESULTS: Out of 1 004 patients examined, 530 were suffering from lepromatous leprosy, 413 from tuberculoid leprosy, 61 from borderline leprosy. Ocular lesions related to leprosy were noted in 606 (60.3%) patients. Corneal changes (81.1%) were the most frequently observed lesions followed by eyelid changes (42.1%). Potentially sight threatening lesions such as lagophthalmos (17.3%), corneal anaesthesia (36.1%), and iridocyclitis (14.7%) were seen in these patients. None of the patients showed any fundus changes related to leprosy. Cataract, not related to systemic disease,was noted in 177 (17.6%) leprosy patients. Blindness related to leprosy was seen in 169 (16.8%) patients; chronic iridocyclitis with its complications was the most common cause of blindness in these patients.CONCLUSION: Ocular involvement was seen in 60.3% of leprosy patients; corneal lesions being the most common. One or more potentially sight threatening lesions were seen in two-thirds of these patients. Blindness related to leprosy was seen in 16.8% of patients. Early referral of patients with eye problems and treatment of potentially sight threatening lesions and cataract will reduce the prevalence of blindness in leprosy patients.%目的:探讨麻风病患者的眼部病变的流行病学和眼部疾病类型.方法:眼科医生历经3a就各自治疗中心的麻风病患者进行了检查,记录视力后,手电筒和放大镜观察眼前节,Schiotz眼压计测量眼内压,tropicamide眼水散大瞳孔后,直

  2. 230例极低出生体质量儿随访至纠正6月龄生存质量分析%Analysis of the quality of life of 230 very low birth weight infants followed up to 6 months of corrected age

    Institute of Scientific and Technical Information of China (English)

    蒋青莲; 包蕾


    , 40 infants (17.4%) were given up the treatment, 60 infants (26.1%) were improved at discharge, and 100 infants (43.4%) were cured at discharge. In the 30 cases of death, causes of death were mainly neonatal respiratory distress syndrome (18 cases), pulmonary hemorrhage (5 cases), and sepsis (3 cases). In the 200 survived infants at discharge, at 6 months of corrected age of follow-up, 13 infants (6.5%) were lost to follow-up, and 54 infants (27.0%) died, among whom 40 infants died because of giving up therapeutic intervention due to economic factor or discharges without permission. At 1, 3, 6 month of follow-up, the length and weight of VLBW infants were gradually approaching normal, and, however, at 6 months of corrected age, the length and weight of VLBW infants were still obviously below the children’s growth standard. The length of VLBW infants was more deeply below the growth standard than the weight. In 109 infants who had fundus ophthalmoscope, 21 cases had retinopathy of prematurity (ROP) I, and 7 cases had ROP II. In 98 infants who had the hearing screening test, 5 cases failed in one ear and 11 cases failed in both ears. In 95 infants who had the head magnetic resonance imaging (MRI) examination, 10 cases had intracranial hemorrhage and 9 cases had premature brain injury. In 49 infants who completed the neonatal behavioral neurological assessment (NBNA) at corrected age of 42 weeks, the scores were all lower than 35. In 36 infants who were assessed by Gesell developmental scale at the 3 months of corrected age, 11 cases had mild developmental delay and 2 cases had moderate developmental delay. In 24 infants who were assessed at the 6 months corrected age, only 2 cases had mild developmental delay. VLBW infants had a rapid progress in social contact, social behavior, and gross motor movement. Conclusions Economic, neonatal respiratory distress syndrome, pulmonary hemorrhage, and sepsis are pivotal factors for the survival and quality of life of VLBW

  3. Incidência e gravidade da retinopatia da prematuridade e sua associação com morbidade e tratamentos instituídos no Hospital Universitário Antonio Pedro, entre 2003 a 2005 Incidence and severity of retinopathy of prematurity and its association with morbidity and treatments instituted at Hospital Antonio Pedro from Universidade Federal Fluminense, between 2003 and 2005

    Directory of Open Access Journals (Sweden)

    Raphael de Faria Schumann


    , its association with morbidity, and the treatments instituted at Antonio Pedro Hospital from the Universidade Federal Fluminense, between the years of 2003 and 2005. METHODS: Transversal and retrospective study performed with 73 PTI, with gestational age (GA of 32 weeks or less and/or birth weight (BW of less than 1,500 g. Ophthalmoscopic exam was accomplished between 4 and 6 weeks of chronologic age or within the 32nd to 36th week of postconceptional age. The following data were registered: prenatal check-up, mode of delivery, gestational and childbirth complications, gender, BW, GA, weight-gestational age classification, FiO2 maximum value, oxygen use, presence of patent ductus arteriosus, intracranial hemorrhage, sepsis, necrotizing enterocolitis, blood transfusion, and surfactant use. CRIB (Clinical Risk Index for Babies was used as severity score. RESULTS: Among the studied newborns, 34 did not present retinopathy of prematurity (46.6%. Out of the 53.4% that presented retinopathy of prematurity, 13 had retinopathy of prematurity 1 (17.8%, 20 had retinopathy of prematurity 2 (27.4% and 6 had retinopathy of prematurity 3 (8.2%. Male newborns corresponded to 45.2% of the sample. 83% of the mothers accomplished prenatal care, 64% presented complications in the gestation period and 38% during the delivery. Cesarean section was the most frequent delivery mode (69%. All preterm infant belonged to the same CRIB score. About half of the sample was small-for-date (49.3%. The lowest GA and BW (p<0.001 were associated to the occurrence and severity of retinopathy of prematurity. The more severe cases of retinopathy of prematurity were associated to higher FiO2 average values. Longer periods of oxygen therapy use were associated with more severe retinal disease (p<0.05. Apgar score at the 5th minute was not related to the occurrence of retinopathy of prematurity (p=0.743. Among the representative variables of treatment and morbidity, just blood transfusion was included in the

  4. 复杂眼外伤处理中玉期玻璃体手术联合睫状体离断复位观察%Clinical study of vitrectomy combined with cyclodialysis repair on primary stage of complicated ocular trauma

    Institute of Scientific and Technical Information of China (English)

    郭斌; 王莉; 范钦华; 张志强; 花雷; 余肖


    AIM: To evaluate the clinical effect of vitrectomy combined with cyclodialysis repair on primary stage for complicated ocular trauma with cyclodialysis. METHODS: The 13 consecutive cases ( 13 eyes ) of complicated ocular trauma with cyclodialysis from January 1, 2011 to October 31, 2014, were treated and studied, including 2 contusions, 7 penetrating injuries and 4 rupture injuries. The concomitant symptoms were corneal laceration, limbus laceration, scleral laceration, hyphema, iridodialysis, mydriasis, traumatic cataract or lens dislocation, vitreous hemorrhage, retinal contusion, retinal detachment, choroid contusion, suprachoroidal hemorrhage, intraocular foreign body, etc. The preoperative visual acuity ( VA ) ranged from light perception (LP) to hand movement (HM) or before eye ( BE) . The cyclodialysis was determined by ultrasound bio-microscopy ( UBM ) , three-mirror contact lens or was found in operation. The limits of cyclodialysis were about 2: 00 ~ 6 : 00 o'clock. Intraocular pressures ( IOP ) of contusion eyes before surgeries were 5. 4mmHg and 10.2mmHg. The operation opportunity was 6h ~3d after injuries and the main operation stages included closing wound in cornea and sclera, vitrectomy, lensectomy, and/or removal of intraocular blood, retinal reattachment, cyclodialysis repair by suturing. The external scleral puncture and draining were carried out in suprachoroidal hemorrhage. Inert gas or silicon oil was tamponaded. RESULTS: The ciliary body reattached in all cases determined by UBM and three-mirror contact lens. The BCVA was improved to HM/BE ~ 4. 7 and the IOP was 9. 8 ~24. 5mmHg at 1mo after surgeries, except that one eye was corneal edema after corneal laceration sutura. Retinal reattachment was determined by ultrasound or ophthalmoscope examination. CONCLUSION: For complicated ocular trauma with cyclodialysis, the vitrectomy with cyclodialysis repair on primary stage is effective to recover the anatomic structure and preserve the available

  5. The visual prognostic factors in vitreoretinal surgery for diabetic tractional retinal detachment%玻璃体视网膜手术治疗增生性糖尿病视网膜病变合并牵拉性视网膜脱离视力预后影响因素

    Institute of Scientific and Technical Information of China (English)

    孟丽珠; 陈松; 赵秉水; 李燕; 刘蓓; 关禹博


    Objective To evaluate the visual prognostic factors in vitreoretinal surgery for diabetic tractional retinal detachment (DTRD). Methods 102 eyes of 86 consecutive patients with DTRD underwent vitreoretinal surgery were analyzed retrospectively. All cases diagnosed via indirect ophthalmoscope and B ultrasonic scan after mydriasis. Follow-up duration varied from 12 to 56 months (mean: 23 months). Best corrected visual acuity (BCVA) and anatomic success were observed postoperatively. The patients were divided into visual acuity improved group and didn't improved group. T-test, Chi-square test and Multivariate Logistic regression analysis were performed to predict the prognosis of visual acuity. Results After primary vitreoretinal surgery, 87 eyes (85.3%) were anatomically reattached, 15 eyes (14.71%) needed reoperation because of the recurrence of retinal detachment (RD). Postoperative BCVA improved and better than 0. 05 in 49 eyes (48.04%), reduced or increased but less than 0. 05 in 53 eyes (51.96%). Comparing natural factors between these two groups, only combined cataract surgery and optic nerve atrophy were significant different (χ~2= 5.266, 9.274; P =0.022, 0.002). Among post-operative complications only the RD recurrence was significant different (χ~2= 12. 059, P = 0. 000). Multivariate Logistic regression revealed recurrence of RD and optic nerve atrophy were two independent risk factors in the final BCVA (P = 0. 003, 0. 041 ; OR = 33. 518,4. 079). Preoperative PRP was identified as the only protecting variable in the final BCVA(P=0. 034,OR=0. 270). Conclusion This study revealed recurrence of RD and optic nerve atrophy were two independent risk factors in final BCVA of DTRD patients.%目的 观察玻璃体视网膜手术治疗增生性糖尿病视网膜病变合并牵拉性视网膜脱离(DTRD)患者视力预后的影响因素.方法 回顾分析接受玻璃体视网膜手术治疗的86例DTRD患者102只眼的临床资料.所有患者均在散瞳后经间

  6. A pilot study investigating prismatic image relocation in subjects with bilateral central scotomas%使用棱镜重新定位双侧中心暗点患者视网膜物像的预试验

    Institute of Scientific and Technical Information of China (English)

    Matt Valdes; Stanley Woo; Joshua Pratt; George C. Woo


    Objective In this study we used a scanning laser ophthalmoscope (SLO) to evaluate the oculomotor response to ophthalmic prisms in patients with bilateral central scotomas.Methods Six low vision patients with bilateral central scotomas and six normally sighted subjects were recruited.Nidek MP-1 microperimetry was performed to confirm an absolute central scotoma and identify the subject's preferred retinal locus (PRL).A Rodenstock SLO captured real time images of the retina while projecting a target onto the previously identified PRL.A 6-8 prism diopter lens was then introduced while the subject was instructed to maintain fixation on the target.Retinal landmarks were used to measure the retinal image shift and subsequent refixation with the PRL.Average deviation and time (timestamp video) to refixate were calculated using ImageJ software.Results Refixation to the displaced target for the study group was within 3 pixels or 11.66 arc minutes (x axis:2.90±3.92;y axis:2.53±4.18).The control group refixated more accurately (x axis:0.33±1.15;y axis:0.89±2.50),but the amount was not statistically different from the AMD group (tx=1.32,Px>0.05 and ty=0.80,Py>0.05).Time to refixate demonstrated that the control group (0.98±0.19 s) was quicker than the AMD group (2.83±1.63 s) and the difference was statistically significant (t=5.03,P<0.01).One subject did not refixate.His data was excluded and analyzed individually.Conclusion With prismatic image relocation,patients with bilateral central scotomas refixate similar to normal subjects.However,time to refixate was significantly slower in the AMD group and one of the six subjects did not refixate.This data suggests patients with bilateral central scotomas are utilizing the same retinal location with and without the prism in place.Therefore,no benefit is achieved by image relocation.%目的 本研究使用激光扫描检眼镜(SLO)评价双侧中央暗点患者使用棱镜后的眼球运动反应.方法

  7. Effect of 7DH biotherapic of Toxoplasma gondii in mice infected with the protozoan

    Directory of Open Access Journals (Sweden)

    Denise Lessa Aleixo


    Full Text Available Introduction: Toxoplasmosis is a zoonosis caused by Toxoplasma gondii worldwide distributed [1]. In both, men and animals, the infection with T. gondii can lead to important pathologies [2]. The study of alternative treatments is important to set new therapeutic protocols, especially for the prevention of congenital toxoplasmosis. Aim: This study evaluated the effect of a biotherapic 7DH T. gondii in mice infected with T. gondii. Material and methods: The study was approved by the Ethics Committee for Animal Experimentation of the Universidade Estadual de Maringá – Protocol n° 036/2009. Fourteen mice were used – swiss male aged 57 days divided into two groups according to the treatment (or its diluent biotherapic: BIOT-200DH and Control (cereal alcohol-7%.The biotherapic was prepared with homogenized mouse brain (20 cysts of T.gondii/100μL-average 242 bradyzoites / cyst, according to the Brazilian Homeopathic Pharmacopoeia [3] in laminar flow. The experiment was performed as a blind randomized controlled trial. The animals were treated for 3 days immediately prior to infection. The oral treatment schedule was of 0.1mL/4x/ day, on the first day, followed by 2x/day. Animals aged 57 – 59 days were treated with biotherapic and were clinically evaluated. The animals were orally infected at the age of 60 days (20 cysts ME49-T. gondii. Within18-21 days of infection the clinical parameters were evaluated. On the 55th day of infection the eye fundus was examined (Ophthalmoscope Welch Allyn ® and the intraocular pressure was measured (Tonometer TONO-PEN ® XL. After 60 days of post-infection the animals were killed in a chamber saturated with halothane, the brains were homogenized and resuspended in 1 ml of saline solution. The cysts were counted according to a rate of 25 mL of suspension, covered with 24x24 mm glass, examined in its full length. Results and

  8. Analysis on clinical characteristics of choroidal folds%脉络膜皱褶的临床特征分析

    Institute of Scientific and Technical Information of China (English)

    陈长征; 周芸芸; 余运娴; 郑红梅; 陈静; 邢怡桥


    Objective To investigate the imaging characteristics of patients with choroidal folds,which including ocular fundus,fundus fluorescein angiography(FFA),indocyanine green angiography (ICGA)and optical coherence tomography(OCT). Methods The clinical data of 62 eyes of 34 patients with choroidal folds were analyzed retrospectively.The patients include 10 patients(20 eyes)of VogtKoyanagi-Harada syndrome,1 patients(2 eyes)of Beheet diseases,11 patients(21 eyes)of other uveitis,5 patients(9 eyes)of papolloedema,2 patients(2 eyes)of choroidal tumor,2 patients(4 eyes)of,hypotony with macular degeneration,1 patient(2 eyes)of,Graves diseases,1 patient(1 eye)of.blunt trauma and 1 patient(1 eye)of uveal effusion syndrome. All patients underwent the examination of direct ophthalmoscope,fundus color photography and FFA,meanwhile,9 patients(17 eyes)with ICGA examination,9 patients(18 eyes)with OCT examination. Results Choroidal folds were bright and dark stripes on the fundus,their numbers were variable.They can be arranged radially,horizontally,oblique or concentrically around the macular area,or radiating from optic disk but rarely over equator region.On FFA there were more folds which were subjected to coarse folds and wrinkles.They were obvious at early stage and no leakage at late stage.On ICGA choroidal folds showed normal or hyponuorescence at early stage,and hyperfluorescence or hyponuorescence at late stage.The hyperfluorescence or hypofluorescence bands were corresponding to the hyponuorescence of FFA but not obvious as FFA.On OCT choroidal folds involved choriod and retinal pigment epithelial layer(RPEL). Conclusion Choroidal fold is a bright and dark stripes that involved choriod and RPEL.The angiography showed hypofluorescence bands without leakage.Be familiar with the imaging features of choroidal folds can help to found the choroidal folds and the original diseases.%目的 观察脉络膜皱褶患者眼底、荧光素眼底血管造影(FFA)、吲哚青绿血管造

  9. 视觉对比敏感度和OCT在焊工体检中的应用%The application of visual contrast sensitivity and OCT in physical examination of welder

    Institute of Scientific and Technical Information of China (English)

    王文英; 冀向宁; 王志学; 王永森


    Objective To investigate the application of visual contrast sensitivity (CS) and optical coherence tomography (OCT) in physical examination of welder.Methods This is a cross-sectional study.Eighty-six welding workers who had medical checks in May 2014 in our hospital were the research objects (welder group),and 62 other type workers were the control group.Besides the general medical system examinations,eye examinations had been performed on the crowd including subjective symptoms,visual acuity,ophthalmoscopy,OCT and CS.The eye examination results in two groups were compared by chisquare analysis.The consistency in the results of readme symptoms with the results of visual acuity,ophthalmoscopy,OCT and CS were analysed by Kappa test,and the correlation between the results of OCT and CS were analysed by rank correlation test.Results In welder group,the abnormal rates of the examinations in readme symptoms,vision,ophthalmoscope,CS (6c/d) and OCT were 25.6%,5.8%,2.3%,30.2% and 22.1%.Compared with the results in control group,the differences in the results of symptoms,CS(6c/d) and OCT were statistically significant (x2 =7.412,P =0.007),(x2 =8.982,P =0.003),(x2 =10.533,P =0.001).In welder group,the results of OCT and CS (6c/d) were highly consistent with the results of subjective symptoms (Po =0.919,K =0.776),(Po =0.905,K =0.767).Positive correlation was found out between the results of OCT and the results of CS (6c/d) (C =0.753 、x2 =97.577,P =0.000).Conclusion Obvious retinal light damage exists in part welders.CS and OCT examination can accurately find out this damage respectively from the function and anatomy which are applied to eye examinations in welders.The damage of anatomy may be the cause for the change of the function.%目的 探讨在焊接工人体检中应用视觉对比敏感度(CS)和光学相干断层扫描(OCT)检查的意义.方法 横断面调查研究,以2014年5月在河北省沧州市中心医院体检的某工厂焊接工人86人为研

  10. The relationship between retinal hemorrhage in the newborn and obstetric%新生儿视网膜出血与产科临床的关系

    Institute of Scientific and Technical Information of China (English)



    Objective:To investigate the relationship between obstetric clinical and retinal hemorrhage in the newborn,if we take the retinal hemorrhage in the newborn as one of the markers of perinatal newborn health.Methods:300 newborns were selected from January 2011~January 2012.We focused on the fundus examination when made the thorough examination within 24 hours of birth.Before the fundus examination,using the 1% 10g/L compound tropicamide to pupil dilation in the eyes,after 30~45 minutes,we used the direct ophthalmoscope to examine the fundus,and reviewed by the experienced physician in the department of ophthalmology.Then we classified the datas according to the project.Results:The total bleeding rate of retinal hemorrhage in the newborn was 16.7%. The rate of retinal hemorrhage of severe preeclampsia is higher than lighter and moderate preeclampsia.The relationship between the newborn sex,weight and the retinal hemorrhage:134 cases were male,and 32 cases(23.9%) were retinal hemorrhage.166 cases were female,and 32 cases(19.6%) were retinal hemorrhage,P>0.05.The relationship between birth weight and retinal hemorrhage:the bleeding rate increased with the increase of body weight,but P>0.05,there was no significant. Fetal distress and labor had not significant influence on retina hemorrhage (P>0.05).The retinal hemorrhage rate of vaginal delivery (25.2%) was higher than cesarean section.The retinal hemorrhage of head attractor midwifery newborn was 38.9%.Conclusion:The relationship between retinal hemorrhage in the newborn and obstetrics is closely,so it is worthy of our attention in clinical.%目的:探讨新生儿视网膜出血与产科临床的关系,把新生儿视网膜出血作为观察围产期新生儿健康状况的指标之一。方法:2011年1月-2012年1月出生的新生儿中入选300例,在出生24小时内做全身检查的同时,着重进行眼底检查。检查眼底前,先用1%复方托品酰胺10g/L点眼散瞳,30~45分钟后,用

  11. Magnetic resonance imaging of congenital fibrosis of extraocular muscle associated with limb movement disorder in a family%伴有肢体运动障碍的先天性眼外肌纤维化综合征家系的影像学研究

    Institute of Scientific and Technical Information of China (English)

    周炼红; 李春义; 查云飞; 张俊涛; 刘甜


    Background Congenital fibrosis of extraocular muscles (CFEOM) affects patient' s appearance and quality of life,and no effective treatment for this disease is available.Imaging study is helpful for exploring the pathogenesis of CFEOM.Objective This study was to describe the characteristics of CFEOM associated with limb movement disorder using magnetic resonance imaging (MRI).Methods A family with CFEOM associated with limb movement disorder was investigated in Renmin Hospital of Wuhan University.Disease history was collected and the pedigree was investigated.Ophthalmologic examinations,including corrected visual acuity,refractive error,slitlamp examination,ophthalmoscopic examination,force of levator palpebrae superioris,ocular movement,eye position,forced duction test,and bell phenomenon examination,were performed.Ocular orbital and cranial MRI was performed in 4 CFEOM patients and 10 normal subjects to compare the structures of the extraocular muscles,motor nerve and cranium.Oral informed consent was obtained from each patient prior to any medical examination.Results A total of 1 1 members from 3 generations were investigated in this study,presenting with 4 cases of disease.The mode of inheritance of this family complied with the Mendelian autosomal dominant inheritance law.Clinical signs included disturbance of eye movement,deviation of eye position,ptosis,lack of Bell sign and positive reaction of passive pull test.In addition,unstable gait,improper body limb alignment,dysphasia and mental retardation were ohserved in 1 patient,which coincided with the diagnostic criteria of type 3 CFEOM.MRI results demonstrated that the levator palpebrae superioris,superior rectus and superior oblique muscle were clearly thinner,and the medial rectus,lateral rectus,inferior rectus muscle were thinning in the patients,showing significant differences in comparison with the normal controls(P<O.05).The oculomotor and abducens nerves became thinner and even absent in the patients

  12. Eye Injuries among Primary School Children in Enugu, Nigeria: Rural vs Urban

    Directory of Open Access Journals (Sweden)

    Nonso Ejikeme Okpala


    Full Text Available A cross-sectional survey of the prevalence of eye injuries among primary school children in two noncontiguous local government areas of Enugu State of Nigeria was undertaken. One of the local government areas was urban, while the other one was rural. Children who were <15 years in two randomly selected primary schools in the urban area and three randomly selected schools in the rural area were interviewed and examined with Snellen chart, pen torch, head loupe, and direct ophthalmoscope. The findings were recorded using a semi-structured questionnaire and the World Health Organization Programme for Prevention of Blindness (WHO/PBL eye examination form. Training on visual acuity measurement was done for each of the class teachers. A total of 1,236 children <15 years of age were studied and analyzed. Slightly more females, 652 (52.8%, than males, 584 (47.2%, constituted the sample population giving a female/male ratio of 1.1:1. A total of 98 (7.93% children had evidence of injury to the eye or its adnexa. Eyelid scar was the commonest (5.34% followed by eyebrow scar (2.10%. Canthal scar was the next (0.32%. Two girls had monocular blindness from eye trauma (0.16%. One had leucoma, while the other had a dislocated lens. All the monocular blind children of this study were from the urban area. The home was the commonest environment for an eye injury (69.39% followed by the school (20.41%. The farm was next in frequency (7.14%, especially among boys in the rural area. The church and the road/street constituted the remainder. Regarding persons causing the injury, the child's playmate was the commonest (55.10% followed by self (27.55%. Parents and guardians were the next (9.18%. These were injuries associated with corporal punishment. Corporal punishment-related eye injury, according to this study, appears to be common in the rural area and affects boys predominantly. Other human intermediary agents that cause an eye injury include passersby (2.04%, RTA

  13. 苦参碱聚乳酸微球防治增生性玻璃体视网膜病变的研究%Preventive effect of matrine polyactic acid microsphere on proliferative vitreoretinopathy

    Institute of Scientific and Technical Information of China (English)

    刘丹岩; 马景学; 安建斌; 王萌


    of cornea, aqueous humor, lens, vitreous and fundus were examined and recorded by slit lamp biomicroscope, indirect ophthalmoscope, fundus color camera and B ultrasonogram on the 1st, 3rd, 7th, 14th, 21st, 28th and 35th day following injection of drug. The inhibition effect of matrine on PVR was evaluated according to Ryan' s grading criteria of PVR. Results On the 14th days after implantation of MAT-PLA-MS, the rate of retinal detachment was 60%, 10%, 5% and 60% in normal saline group, free matrine group, MAT-PLA-MS group and blank-PLA-MS group respectively. Statistically significant difference was found among normal saline group, blank-PLA-MS group, MAT-PLA-MS group and free matrine group(P <0. 05). On the 21st day after injection of fibroblasts, the morbidity of retinal detachment was 80%, 30%, 10% and 80% in normal saline group, free matrine group, MAT-PLA-MS group and blank-PLA-MS group respectively, showing a significant difference among different groups. On the 28th day, the incidence rate of retinal detachment was 90%, 50%, 15% and 90% respectively, presenting statistical difference among various groups (P < 0. 05) as well as between free matrine group and MAT-PLA-MS group (P<0. 05). On the 35th day, considerably difference also was seen in the morbidity of retinal detachment among various groups (90%, 60%, 15% and 90% respectively) (P<0.05). Conclusion Implantation of MAT-PLA-M S into vitreous cavity can effectively inhibit the development of PVR induced by fibroblasts in rabbit model.

  14. The toxic effect observation of the retina after vitreous chamber injected with PDGFR-α ASODN%PDGFR-αASODN玻璃体内注射对视网膜的毒性作用

    Institute of Scientific and Technical Information of China (English)

    彭燕一; 李光辉; 秦程; 蒋姣姣


    目的:探讨PDGFR-αASODN对视网膜的毒性作用.方法:选择健康成年有色家兔24只,随机分为4组,每组6只;4组兔子3组右眼玻璃体分别注射0.1 mL不同浓度的PDGFR-αASODN/lipofectamineTM 2000溶液,另外1组注射0.1 mL平衡盐溶液作为对照组;4组兔子的左眼不注药. 于注药后第1、7、14及28天,对4组兔子的右眼行裂隙灯、间接检眼镜、视网膜电图(ERG)检查;第28天,取4组兔子的眼球,对视网膜组织进行光镜HE、免疫组化及透射电镜的观察. 结果:裂隙灯、间接检眼镜检查,各组在各个检查时间点均未发现异常.ERG b波振幅,实验组与对照组比较差异无显著性.注药后第28天,光镜下HE和免疫组化检查,各组视网膜组织均未发现任何病理变化.注药后第28天电镜检查,D组视网膜感光细胞:部分膜盘间隙扩张,部分膜盘融合,少数细胞核周围间隙略增大,其细胞核形态略不规则. 结论:玻璃体内注射0.1 mL PDGFR-αASODN/lip2000时,PDGFR-αASODN的浓度≤1.5 μmol/L是较为安全的.%Objective To explore the toxic effect of platelet-derived growth factor receptor (PDGFR)-αantisense oligonucleotide (αASODN) on the retina. Methods Twenty-four healthy adult colored rabbits were selected and randomly divided into four groups in six for each group. Intravitreous injections of 0.1ml different density diluents containing PDGFR-αASODN and liposome were performed in the right eyes in 3 groups. The other group was injected with 0.1 mL balanced salt solution (BSS) as the control group. The left eyes of all animals were not rejected. Slit lamp examination, indirect ophthalmoscopy and electroretinogram (ERG) examination were performed at 1, 7, 14 and 28 days after the injection. On the day 28, the right eyes were harvested, and HE、immunohistochemistry and transmission electron microscopy of retinal tissue were performed . Results The slit lamp, indirect ophthalmoscope examination of all groups were normal

  15. 纤溶酶和透明质酸酶诱导猪玻璃体后脱离的比较研究%A comparative study on the induction of posterior vitreous detachment by plasmin and/or hyaluronidase intravitreal injection into pig eyes

    Institute of Scientific and Technical Information of China (English)

    张志红; 陶海; 吴海洋


    目的:研究纤溶酶和透明质酸酶诱导猪玻璃体后脱离(PVD)的有效性和安全性,比较两种酶单独应用和联合应用的效果.方法:小型猪15只随机分为A,B,C三组,每组5只,随机选取1只眼为实验眼,对侧眼为对照眼.三组实验眼玻璃体腔分别注射50U(0.1 mL)透明质酸酶、0.5U(0.1mL)纤溶酶和0.5U(0.05mL)纤溶酶加50U(0.05mL)透明质酸酶,对照眼均注射平衡盐溶液(BSS)0.1ml.注药后进行裂隙灯、直、间接检眼镜、眼B超、视网膜电图(ERG)等检查,7d后摘除眼球进行光镜、透射电镜、扫描电镜检查.结果:B超检查显示A组有1只实验眼、B组有两只实验眼于注药后1d观察到部分性PVD,C组有1只实验眼于注药后1h观察到部分性PVD.B超、光镜和扫描电镜检查显示注药后7d A组和B组实验眼均见部分性PVD,C组实验眼均见完全性PVD,对照眼未见PVD.实验及对照眼注药前、后ERG a波、b波波幅均无显著性差异,光镜及透射电镜检查未见视网膜损害.结论:0.5U纤溶酶和50U透明质酸酶单独及联合应用均可快速、安全、有效地诱导猪眼玻璃体后脱离,且联合用药较单独用药诱导PVD更快速、更有效.%· AIM: To investigate the efficacy and safety of intravitreal injection of plasmin, hyaluronidase, or the combination of the two in inducing posterior vitreous detachment (PVD).· METHODS: 15 mini-type pigs were assigned to three groups (Group A, B and C), 5 in each group. One eye of each pig was intravitreally injected with the studying agent,and the fellow eye was used as control. Group A received a vitreous injection of hyaluronidase 50U (0.1mL); group B received plasmin 0.5U (0.1mL); group C received plasmin 0.5U (0.05mL) combined with hyaluronidase 50U (0.05mL). The fellow eyes in each group were injected with 0.1mL balanced salt solution (BSS). All the pigs were examined with slit-lamp biomicroscope, direct and indirect ophthalmoscope, B-scan and electroretinograph

  16. Photodynamic Therapy of Circumscribed Choroidal Haemangioma%光动力疗法治疗孤立型脉络膜血管瘤临床观察

    Institute of Scientific and Technical Information of China (English)

    谷威; 梁军


    dimensions.Periodic follow up with ophthalmoscope,visual acuity and angiographic studies were performed,Results All 9 patients showed evidences of regression with flatting of tumor,resolution of subretina fluid,and reduction of choroidal vasculature on angiograms.The visual acuity either improved.There were no photosensitive reactions or systematic adverse events occurred.Conclusions Verteporfin PDT is an effective treatment for the management of symptomatic circumscribed choroidal haemangioma.

  17. 两种波长自发荧光联合频域光学相干断层扫描对视网膜色素变性微结构与功能的再认识%Two-wavelength fundus autofluorescence combined with spectral-domain optical coherence tomography for recognition of retinitis pigmentosa in microstructure and function

    Institute of Scientific and Technical Information of China (English)

    华瑞; 胡悦东; 柳力敏; 张慧; 刘永珍; 陈蕾


    Objective To combine two-wavelength fundus autofluorescence (FAF) with multifocal electroretinography (mf-ERG) in retinitis pigmentosa (RP) and discuss the microstructural abnormalities as seen with spectral-domain optical conherence tomography (Spectralis OCT). Methods This was a noninterventional, observational study, based on the observation and analysis of a series of cases. Fifteen eyes of 8 patients with RP were evaluated with Spectralis OCT, blue light fundus autofluorescence (BL-FAF, excitation 488 nm, emission >500 nm) and near-infrared fundus autofluorescence (NIR-FAF, excitation 787 nm, emission >800 nm). BL-FAF and NIR-FAF imaging were performed with a confocal scanning laser ophthalmoscope (Heidelberg Retina Angiograph 2). Five of 8 patients received fundus fluorescein angiography (FFA) while 3 also had indocyanine green angiography (ICGA) simultaneously. Seven had fundus photography and mf-ERG was performed on 4 cases. The FAF distribution in RP was observed and the correlated changes of microstructural abnormalities were analyzed with Spectralis OCT and the response (Amp.P1) in mf-ERG. Results BL-FAF and NIR-FAF showed a hypoautofluorescent pattern in the atrophied area of the RPE and photoreceptor and bone spicule pigmentation, where mf-ERG showed that the peak in the fovea had disappeared and responses had markedly decreased throughout the macula. Spectralis OCT demonstrated that normal FAF demarcated the border within an area of preserved PR and RPE, while outer limiting membrane (OLM) showed disturbances. In several cases, the hyperautofluorescent pattern of NIR-FAF was less obvious than that of BL-FAF in these areas. In FFA images showing early stages, a window defect was seen at the posterior pole, suggesting RPE malfunction and in ICGA images of early stages, choroidal capillary atrophy was observed. Conclusion The two-wavelength FAF, Spectralis OCT and mf-ERG are useful noninvasive diagnostic tools to identify retinitis pigmentosa. The

  18. Diagnostic performance of laser retinal imaging in the epiretinal membrane%黄斑前膜患者激光视网膜成像特点分析

    Institute of Scientific and Technical Information of China (English)

    霍妍佼; 杨丽红; 魏文斌


    目的 探讨基于共聚焦激光扫描检眼镜(cSLO)的视网膜成像技术在黄斑前膜(ERM)患者中的诊断评估作用.方法 回顾性研究.对象为2015年6月至10月就诊于首都医科大学附属北京同仁医院眼底病门诊,确诊为ERM的患者共26例(32只眼).应用频域光学相干断层扫描(SD-OCT)进一步明确诊断.应用基于cSLO的海德堡炫彩视网膜成像技术和传统彩色眼底照相对患者进行视网膜成像的比较,根据SD-OCT扫描结果对每个ERM视网膜图像进行分析并评分.结果 基于cSLO的海德堡炫彩视网膜成像技术对ERM的评分中,蓝绿加强炫彩成像(3.44±0.80)、标准炫彩成像(2.84±0.85)、绿光反射(2.16±0.77)、蓝光反射(2.09±0.78)均明显高于传统彩色眼底照相(1.28±0.81)(P值均<0.001).而cSLO视网膜成像中的红外反射评分(1.13±0.71),与传统彩色眼底照相无明显差别(P=0.282).结论 基于cSLO的海德堡炫彩技术对于ERM患者所获得的视网膜图像的成像质量明显好于传统彩色眼底照相技术,结合SD-OCT断层扫描图像可以帮助医师更好地诊断并监测ERM.%Objective To determine the diagnostic performance of confocal scanning laser ophthalmoscope (cSLO)-based retinal imaging in the epiretinal membrane (ERM) patients.Methods Prospective case series study.Twenty-six patients (32 eyes) with ERM determined by spectral domain optical coherence tomography (SD-OCT) were recruited from June 2015 to October 2015 in the Beijing Tongren Eye Center.All subjects underwent retinal imaging using the cSLO-based Heidelberg MultiColor (Spectralis HRA-2;Heidelberg Engineering) technology and the traditional color fundus camera.A special grading score was used to analyze every retinal image according to the SD-OCT results.Results In the ERM patients,the largest average grading score in the cSLO-based retinal imaging was 3.44±0.80 with the blue and green enhanced MultiColor image,followed by the standard Multi

  19. Investigating Functional Extension of Optical Coherence Tomography for Spectroscopic Analysis of Blood Oxygen Saturation (United States)

    Chen, Siyu

    animals in situ. Thus, one question demanding immediate investigation is how the choice of illumination wavelength bands affect the performance of OCT oximetry. This is addressed using two approaches, (1) a numerical study using Monte Carlo methods, and (2) animal experiments involving the development of a vis- and NIR- dual band OCT imaging system. It is indicated that visible light is more suitable for OCT oximetry applications due to the higher absorption contrast between oxyhemoglobin and deoxyhemoglobin. The accuracy of OCT retinal oximetry is established to be around 5 percentage points (pp) regardless of physiological variation of blood sO2, vessel diameter, and is robust over a reasonable selection of sampling geometry. Despite the higher optical scattering experienced in the visible wavelength range, vis-OCT also demonstrated comparable or better imaging capability in terms of resolving anatomical features, imaging resolution, and retrieving other functional indicators such as blood flow. Besides retrieving blood sO2 from vessels directly visualized in structural OCT images, the possibility of using dynamic motion contrast to enhance otherwise non-resolvable micro vessels is investigated. Using this approach, it is subsequently proved that OCT angiography (OCTA) encodes blood absorption contrast and can be used to calculate sO2 within microvasculature. For the first time, measurements of relative sO2 change are reported in choroidal capillaries following inhalation oxygen challenge. This dissertation also represents a translational study that seeks to move technologies developed in the laboratory into real clinical applications. A vis-OCT imaging system with integrated scanning laser ophthalmoscope (SLO) is developed for human subjects. This prototype system can provide three-dimensional (3D) structural images and cross-sections of human fundus similar to that from commercial NIR-OCT systems. In addition, blood sO2 within retinal circulation is successfully

  20. Biotherapic 200 DH reduces of parasitism in mice infected with cerebral Toxoplasma gondii

    Directory of Open Access Journals (Sweden)

    Denise Lessa Aleixo


    Full Text Available Introduction: Toxoplasmosis is a zoonosis that represents a serious public health problem, worldwide distributed. Pregnant women are part of the most risky group due to congenital sequels. The necessity of a preventive treatment for congenital infections is of great importance [1] Biotherapics, highly diluted medicines prepared with T. gondii according to the Brazilian Homeopathic Pharmacopoeia [2], is an important prevention strategy, ensuring a safe and cheap approach to protozoan infections [3]. However, little is known about the effects of different potencies and treatment schedules. Aim: To evaluate the effect of biotherapic 200DH in mice infected with Toxoplasma gondii. Material and methods: The study was approved by the Ethics Committee for Animal Experimentation of the Universidade Estadual de Maringá – Protocol n° 036/2009. Fourteen mice were used – swiss male aged 57 days divided into two groups according to the treatment (or its diluent biotherapic: BIOT-200DH and Control (cereal alcohol-7%. The biotherapic was prepared with homogenized mouse brain (20 cysts of T.gondii/100μL-average 242 bradyzoites / cyst, according to the Brazilian Homeopathic Pharmacopoeia in laminar flow. The experiment was performed as a blind randomized controlled trial. The animals were treated for 3 days immediately prior to infection. The treatment schedule was of 0.1mL/single dose/ day, by gavage. Animals aged 57 – 59 days were treated with biotherapic and were clinically evaluated. The animals were orally infected at the age of 60 days (20 cysts ME49-T. gondii. Within18-21 days of infection the clinical parameters were evaluated. On the 55th day of infection the eye fundus was Examined (Ophthalmoscope Welch Allyn ® and the intraocular pressure was measured (Tonometer TONO-PEN ® XL. After 60 days of post-infection the animals were killed in a chamber saturated with

  1. 地西泮、苯巴比妥联合表面麻醉对激光治疗早产儿视网膜病的镇痛效果%Efficacy of Diazepam and Phenobarbitone Combining with Surface Anesthesia in Preterm Infants with Retinopathy Undergoing Laser Therapy

    Institute of Scientific and Technical Information of China (English)

    冯冉冉; 连朝辉; 张国明; 董国庆; 杨传忠


    Objective To evaluate the safety and efficiency of Diazepam and Phenobarhitone combining with surface anesthesia for laser treatment of threshold retinopathy of prematurity ( ROP). Methods A cohort of 66 eyes of 33 neunates with threshold ROP were diagnosed threshold ROP by binocular indirect ophthalmoscope and fundus photography by Ret Cam Ⅱ ,and treated by diode laser peripheral retinal ablation. Phenobarbitone (10 mg · kg-1) were injected by vein 30 min before treatment, intravenous injection of diazepam (0.4 mg · kg-1) and 5 g · L-1 Proparacaine hydrochloride Eye Drops were given 5 min before treatment. Crying, requires O2 saturation, increased vital signs, expression, sleeples8ness(CRIES) pain measurement scores were recorded before the treatment,and every 15 min during and 15,30 min after the treatment,and the maximum score was used to assess the patients' tolerance to the treatment. Stress was assessed by the perioperatively mi-croscale blood glucose. Results The mean treatment duration was (34. 4 ± 10. I ) min (17 - 53 min). The mean laser counter was (1 228.7 ±542.7) points(290-2 350 points). The average value of maximum scores for the CRIES was (1.90 ±1.18) scores,which was significantly less than 4 scores. There were 29 neonates (87.9% ) whose scores was less than 4 and it was not necessary to add drug dosage. Four neonates whose maximum scores for the CRIES exceeded 4 scores were given added dosage. Postoperatively microscale blood glucose [(6.3 ±1.2) mmol · L-1] was significantly higher than the preoperative [(5.4 ±1.7) mmol · L-1 ](( = 3.987,P <0. 05);Perioperative complications: All the babies had conjunctival haemorrhage and comea chemosis.but the planned dose of laser was delivered. A short apnea was seen in 6 caseB,which recovered rapidly with the treatment of touching intervention,or oxygen therapy,or intravenous dripping of amino-phylline,or breathing apparatus assisted ventilation. Conclusions Diazepam and Phenobarbitone combining

  2. Treatment of honghua injection acupoint iontophoresis on traumatic vitreous hemorrhage%红花穴位离子导入治疗外伤性玻璃体积血实验研究

    Institute of Scientific and Technical Information of China (English)

    余海; 李慧丽; 李小丹; 刘晓熹; 贺翔鸽


    目的 探讨中药红花注射液眼部穴位离子导人的药代动力学作用以及对实验性外伤性玻璃体积血的治疗作用.方法 将兔实验性外伤性玻璃体积血模型18只(36只眼)随机分成2组,治疗组予红花注射液经睛明、承泣、攒竹、劳宫穴位离子导入;对照组不做任何治疗,观察玻璃体积血的自然转归.分不同时间点抽取兔房水和玻璃体,用高效液相色谱法测定房水和玻璃体中的药物质量浓度.用检眼镜观察眼底玻璃体积血吸收情况,并行眼底照相.结果 兔眼房水线性回归方程为Y=32.486X-5.154,(r=0.9989,P<0.01);玻璃体线性回归方程为Y=30.462X-5.024,(r=0.9951,P<0.01);兔房水和玻璃体内羟基红花黄色素A的质量浓度在0.5 h和2h差异均无统计学意义(P>0.05),5h时差异有统计学意义(P<0.01);治疗后治疗组眼底可见度明显优于对照组(P<0.01).结论 红花穴位离子导入可促进兔眼外伤性玻璃体积血的吸收,缩短病程,是一种简易有效的眼局部治疗方法.%Objective To investigate the effect and pharmcokinetic role of honghua injection acupoint iontophoresis on traumatic vitreous hemorrhage.Methods The traumatic vitreous hemorrhage model was induced by injecting into vitreous of 0.2 mL autohemorrhage in 36 eyes of 18 New Zealand white rabbits.2 ml of honghua solution was iontophorezed via acupoint iontophoresis in the Qingming,Chengqi,Cuanzhu,Laogong for 15 minutes per time and twice per day for 10 times in honghua-treated group (9 rabbits),and 9 model rabbits were as control group.Aqueous humor and vitreous were withdrawn at different time,and the drug concentration in aqueous humor and vitreous were detected with high-pressure liquid chromatography (HPLC).The absorption status of vitreous hemorrhage was clinically evaluated by ophthalmoscope.Results The aqueous humor regression equation of honghua peak area (Y) and honghua concentration (X) was Y=32.486 X-5

  3. [Noninvasive analysis of retinal microstructure and function: challenges and a promising future]. (United States)

    Yoshida, Akitoshi


    Challenges in the evaluation of the retinal microstructure. To facilitate evaluation of the retinal microstructure we participated in the development of a scanning laser ophthalmoscope (SLO) for 32 years. The 'retro-mode' is the latest developed lateral aperture SLO made in Japan. This instrument enables us to observe the cystoid spaces and retinal microfolds underlying the epiretinal membrane. We investigated the pathogenesis and the mechanism of early development of idiopathic macular holes (MHs) and the vitreomacular interface in idiopathic full-thickness MHs using spectral-domain optical coherence tomography (SD-OCT). We studied the anatomic morphology of stage 1-A impending MHs, characterized by a foveolar yellow spot, using SD-OCT in the fellow eyes of patients diagnosed with a full-thickness MH. SD-OCT showed the reflectivity of the perifoveal posterior vitreous detachment (PVD) with vitreofoveal adhesion in the eyes with a yellow spot; the foveal microstructure had a triangular foveolar detachment of the cone outer segment tip line. The foveolar detachment of the cone outer segment tip line might be responsible for the yellow spot seen in stage 1-A MHs. Using SD-OCT, we also analyzed the vitreomacular interface in idiopathic full-thickness MHs and identified four configurations of the vitreomacular interface in MHs without a complete PVD. The majority, i.e., 92%, of eyes with a MH without a complete PVD are likely due to the anteroposterior vitreofoveal traction exerted by a perifoveal PVD. About 55% of cases with an open roof in the eyes without a complete PVD might be at risk of progression to operculum formation (loss of retinal tissue). 2. Challenges in the evaluation of retinal function SLO microperimetry is used to evaluate the retinal function during observation of the retinal microstructure. We evaluated the retinal sensitivity and the focal visual acuity using our original microperimetry program and clarified the characteristics of the preferred

  4. Epidemiological characteristics and clinical phenotype of sporadic retinitis pigmentosa%散发性视网膜色素变性的流行病学及临床表型特征调查

    Institute of Scientific and Technical Information of China (English)

    张敏芳; 徐海伟; 孟晓红; 阴正勤


    Southwest Eye Hospital from July 2010 to November 2011.A total of 130 patients that matched the inclusion criteria were enrolled in this survey.Clinical ocular examinations and questionnaire surveys were given,including ophthalmoscopic examination,best corrective visual acuity( BCVA ),perimetry and Ganzfield electroretinogram (ERG)and color fundus photo.RP with different phenotypes were classified. Results A total of 130 sporadic RP patients were collected in this survey.Of them,66 were male and 64 were female with a mean age of (36.9±14.4) years.The average onset age of these subjects was (21.2±18.4) years.Seven (5.38%) patients had consanguineous marriage history,and 13 ( 10.00% )patients had systemic disease.Forty-four (33.85%) patients had outdoor jobs,and 86 (66.15% ) worked indoor.Eighty-nine patients had typical RP ( 68.5% ),and the number of patients that developed central RP and sine pigmento RP were 16 ( 12.3% ) and 16( 12.3% ),respectively.An absence of a- and b-waves in full-field ERG was detected in 99 (76.15% ) cases.The longest duration of night blindness was identified in typical RP patients and the lowest BCVA in central RP patients. Conclusions The age at first onset is early in sporadic RP.There are wide variations in different types of RP,but the ERG outcome is specific for all RP types.

  5. Avaliação oftalmológica em pacientes com AIDS e neurotoxoplasmose Ophthalmological evaluation of patients with AIDS and neurotoxoplasmosis

    Directory of Open Access Journals (Sweden)

    Jane Mary Alves


    -phase neurotoxoplasmosis. METHODS: A prospective study of case series type was developed, including 70 patients of both sexes and ages ranging from 20 to 63 years who were admitted to the wards of three public hospitals in the city of Recife, Pernambuco, Brazil, from January to October 2008, with diagnoses of AIDS and neurotoxoplasmosis determined according to the criteria of the Centers for Disease Control and Prevention (1992. The patients were characterized by a first episode of neurotoxoplasmosis (65; 92.9% or recurrence (5; 7.1%, unawareness of having AIDS (23; 32.9%, mean T CD4+ count of 139.8 ± 3.04 lymphocytes/mm³ and mean viral load of 137,080 ± 39,380 copies/ml. All patients underwent ophthalmological examination consisting of ocular inspection, gauging of visual acuity, investigation of ocular extrinsic muscle function and fundoscopy using a binocular indirect ophthalmoscope (model OHM 3.5 Eyetec® and external lens of 20 diopters (Volk®. RESULTS: The findings consisted of retinal cotton-wool spot exudates (8.6%, slight diffuse arteriolar constriction (8.6%, retinochoroiditis scars characteristic of ocular toxoplasmosis (5.7%, atrophy of retinal pigment epithelium (2.9%, retinal detachment (2.9%, increased papillary excavation (1.4%, retinal peripheral degeneration (1,4%, macroaneurysm (1.4%, bilateral papilledema (1.4% and vitreous-retinal traction (1.4%. CONCLUSIONS: Patients with AIDS and neurotoxoplasmosis may present fundoscopic abnormalities characteristic of ocular toxoplasmosis, either in active or in scar form, related to HIV or even to other opportunist or systemic diseases, which can be of great aid for integral treatment of patients by a multiprofessional team.

  6. Dynamic expression of inflammatory factors in experimental autoimmune uveitis in mice%实验性自身免疫性葡萄膜炎炎性因子表达的动态观察

    Institute of Scientific and Technical Information of China (English)

    王影; 李洋; 毕宏生; 滕达; 李姣; 崔彦


    /L,在注射后第5天达到(50.54±0.48)ng/L,于注射后第10天达到峰值,为(73.21±0.12) ng/L,然后逐渐降低.到第30天时,血清中IFN-γ的质量浓度为(5.15±0.18) ng/L,与免疫前相比差异仍有统计学意义(P=0.000).注射后模型鼠血清中TNF-α质量浓度升高迅速,免疫后第2天质量浓度较免疫前明显升高,第5天达到峰值,质量浓度为(134.25±0.59) ng/L,但至第15天降到最低.注射后第20天再次升高,达到(60.54±0.62)ng/L,之后又逐渐下降,第30天时和免疫前相比差异无统计学意义(P=0.660).IL-10在免疫后第5天可以被检测到,并且随着注射后时间的延长逐渐升高.到第15天时达到高峰,随后开始降低,第30天与免疫前相比差异有统计学意义(P=0.000).脾脏中IL-10、IL-17、TNF-α、IFN-γ 4种炎性因子mRNA表达变化趋势和血清中的变化一致. 结论 在B6小鼠的EAU中,Th1、Th2、Th17相关炎性因子IFN-γ、TNF-α、IL-10及IL-17具有特征性变化规律,IFN-γ可能与EAU的急性期病理过程相关;IL-17、TNF-α可能与葡萄膜炎的慢性化、复发性有关;IL-10可缓解EAU的病理过程.%Background C57BL/6(B6) is a kind of routine mouse specie used in experimental autoimmune uveitis (EAU) research.Previous studies showed that the pathogenesis of uveitis related to inflammatory cytokines secreted by different helper T(Th) cells.However,the interaction of different Th cells in EAU is unclear.Objective This study was to investigate the dynamic changes of inflammatory factors in the spleen and serum after immunization in EAU mice.Methods Forty-four SPF B6 mice were immunized by injection of interphotoreceptor retinoid-binding protein (IRBP) and complete Freund adjuvant (CFA) emulsion via caudal vein and footpad.Indirect ophthalmoscope was used to examine the eyes 3 times per week and the inflammatory response was scored based on Thurau's criteria.In the thirty day after injection,20 model eyes were extracted and the sections of eye tissue

  7. 青少年黄斑中心凹下脉络膜厚度与屈光度的关联性分析%Analysis of relationship between subfoveal choroidal thickness and refraction

    Institute of Scientific and Technical Information of China (English)

    徐洋涛; 刘泉; 杜嗣河; 秦嘉敏; 刘杏; 王丹阳; 刘曼丽


    understanding the mechanism of refractive error more clearly.Objective This study was to investigate the relationship between SFCT and refraction.Methods A retrospective serial cases analysis was performed.Forty anisometrope patients were recruited in Zhongshan Ophthalmic Center from June 2012 to August 2012.The subjects were divided into 6-13 years group and 14-21 years group.Vision acuity was tested by the EDTRS visual acuity chart and ocular anterior segment was examined under the slit lamp microscope,and the fundus examination was performed by direct ophthalmoscope.Subjective and objective optometry was performed after pupils were dilated.EDI OCT was used to illuminate choroidal image.Ocular axial length (AL) was obtained by Lenstar 900.The difference in SFCT between myopic eyes and hyperopic eyes was compared using Student t test,and the correlations between SFCT and refraction were analyzed by Pearson linear analysis and linear regression analysis.Results The average SFCT was (307.82±88.47) μm in all the tested eyes,and the SFCT of myopic eyes and hyperopic eyes was (270.60±70.57) μm and (376.95±76.59) μm,respectively,with a significant difference between them (P =0.000).In the 6-13 years group,positive correlations were found between SFCT and diopters with the regression coefficient 18.60 and regression equation Y =18.60X +310.79 (r=0.345,F=21.110,P=0.000) as well as between SFCT and AL with the regression coefficient -31.76 and regression equation Y =-31.76X+1 039.97 (r=0.262,F=17.320,P=0.000).In the 14-21 years group,SFCT showed positive correlation with diopters,with the regression coefficient 23.38 and regression equation Y=23.38X+353.17 (r =0.430,F =27.210,P =0.000) and negative correlation with AL,with the regression coefficient-35.82 and regression equation Y =-35.82X+1 132.75 (r=0.237,F=15.650,P=0.000).Conclusions SFCT seems to be positive correlated with diopter.When the diopter shifts toward positive value,SFCT value increases,and whenever diopter

  8. Clinical features of patients over 30 years old with Leber hereditary optic neuropathy%30岁以后发病的Leber遗传性视神经病变患者的临床特征

    Institute of Scientific and Technical Information of China (English)

    常永业; 解世朋; 王浩; 石慧君; 管敏鑫; 张铭连


    点基因突变为多见.%Objective To observe the clinical features of patients over 30 years old with Leber hereditary optic neuropathy (LHON).Methods Nine male LHON patients (18 eyes) were enrolled in this study.The patients aged from 34 to 56 years old,with an average age of (45.22±6.91) years.The course of the disease ranged from 7 days to 21 months,with a mean course of 5 months.Visual acuity,slit lamp microscope,chromoptometry,direct ophthalmoscope and fundus photography were measured for all patients,visual field examined for 6 patients (11 eyes).Mitochondrial DNA mutation was analyzed.The visual acuity was followed-up for 12 months.Results Seven of the 9 patients (77.78%) had family history.Five patients (55.56%) had both eyes involved simultaneously,and 4 patients (44.44%) had the eyes involved at different time.Three patients (33.33%) had sudden visual loss,and 6 patients (66.67%) had gradual visual loss.The visual acuity was light perception in 1 eye (5.55%),finger counting in 3 eyes (16.67%),0.01-0.1 in 7 eyes (38.89%),0.12-0.3 in 3 eyes (16.67%),equal or greater than 0.4 in 4 eyes (22.22%).Sixteen eyes (88.88%) had normal light reflex,1 eye (5.55%) had no light reflex,and 1 eye (5.55%) had relative afferent papillary defect.Eight eyes (44.44%) had normal optic disk,3 eyes (16.67%) had blurred optic disc border and disc telangiectasia,7 eyes (38.89%) had pale disc and clear boundary.Among 11 eyes underwent visual field examination,9 eyes (81.82%) had central or paracentral scotoma and 2 eyes (18.18%) had visual field narrowing.Among 9 patients,there were 7 patients (77.78%) with G11778A mutation,1 patient (11.11%) with G11696A mutation,and 1 patient (11.11%) with T14484C mutation.In the last follow-up,the visual acuity was light perception in 1 eye (5.55%),fingercounting in 4 eyes(22.22%),0.01-0.1 in 6 eyes(33.33%),0.12-0.3 in 3 eyes (16.67%),equal or greater than 0.4 in 4 eyes (22.22%).The visual acuity was improved in 9 eyes (50.00

  9. 16家三甲医院新生儿重症监护病房早产儿用氧及早产儿视网膜病变防治现状调查%Present situation of oxygen therapy and retinopathy of prematurity management in premature infants in NICUs : A survey based on 16 tertiary class-one hospitals in the mainland of China

    Institute of Scientific and Technical Information of China (English)



    therapy and ROP management in premature infants was carried out by experts in neonatal intensive care units (NICU) of 16 tertiary class-one hospitals in different areas of the mainland of China in Oct.2010,and data were collected and analyzed.Result In 16 tertiary firstclass hospitals,NICU had (113.0± 67.0) beds for newborn per unit,with hospital admission of (3596.6 ±1609.8) newborns in 2009,among them (1030.5 ± 580.2)cases were premature infants,and (397.8 ±237.1 ) cases had gestational age less than 34 weeks.Most hospitals obtained written informed consents before using oxygen for premature infants and 11 of them informed parents of all patients,while the lowest inform rate was only 22.06%.Indication for oxygen administration was abided strictly in all patients in 9 hospitals,but the lowest accordance rate to the indication was only 20%.All of the hospitals were equipped with central oxygen supply system,but only 8 hospitals were equipped with air-oxygen mixers,and 14 hospitals were equipped with oxygen concentration detectors. Incomplete records of oxygen therapy were found in 9 hospitals,and high oxygen saturation ( > 95% ) was found in more than 10% of infants who received oxygen therapy in 6hospitals.High PaO2 ( > 80 mm Hg,1 mm Hg =0.133 kPa) was found in more than 10% infants who received oxygen therapy in additional 3 hospitals.All of the NICUs had carried out ROP screening,but only 13 of them conducted it by themselves,and one still conducted it by direct ophthalmoscope.Of the 1023 medical records inspected randomly in 16 hospital,612(59.8% )had retinal examination records,and 69 were found to suffer from ROP,with the incidence rate of 11.27%,of them 7 threshold ROP cases were found with the incidence rate of 1.14%.Only 4 hospitals had carried out ROP treatment,of them 3 used laser therapy,and one used cryotherapy.The follow-up rates of ROP in premature infants after discharge were less than 50% in 8hospitals.Conclusion Since the first

  10. Risk factors for the diaplastic vitreous after scleral buckling in patients with rhegmatogenous retinal detachment%影响裂孔性视网膜脱离患者巩膜扣带术后复位的玻璃体相关危险因子

    Institute of Scientific and Technical Information of China (English)

    曾键; 刘瑶; 韩冰; 古洵清; 张国明


    体状态与玻璃体后界面变化是影响裂孔性视网膜脱离巩膜扣带术复位成功的危险因子,手术前了解其改变很重要.%BACKGROUND:Proliferative vitreoretinopathy (PVR) is the more significant risk factor for anatomic failure of rhegmatogenous retinal detachment (RRD) surgery.It has been known that several risk factors are connected with it,and PVR grade A or B can deteriorate it postoperatively.The predictive risk factor is still progressively evaluated between vitreous status or posterior vitreal cortex and retial interface.OBJECTIVE:To identify the clinical risk factors of dynamic change for anatomic failure in conventional RRD surgery in patients with PVR grade B in Chinese patients.DESIGN:A retrospective analysis.SETTINGS:Shenzhen Ophthalmic Center,Medical College of Jinan University; Department of Eye Fundus,Shenzhen Eye Hospital.PARTICIPANTS:This study was a retrospective review of a consecutive series of 449 eyes of 440 patients (318 males,122 females) admitted to the Department of Eye Fundus,Shenzhen Eye Hospital,who underwent conventional scleral buckling procedures for RRD with PVR grade B by this group doctors.All the surgery was performed by the same surgeon between January 1990 and December 1999.Informed consents were obtained from all the participants.METHODS:Preoperative and postoperative ophthalmic examination and surgery were performed by the same surgeon.Detailed drawings of findings in vitreous and fundus were routinely obtained with the use of both binocular indirect ophthalmoscope and three-mirror contact lens.The vitreous and PVD status were documented with B-scan ultrasonography.The vitreous status was categorized in five groups:normal vitreous,vitreous liquefaction,vitreous condensation,vitreous traction and combined vitreopathy group (combination of liquefaction,condensation and traction).The PVD status was categorized into three groups:absence of PVD,incomplete PVD and complete PVD.Retina anatomic reattachment

  11. Functional MRI for patients with visual pathway diseases%视路疾病患者脑功能性磁共振成像初步观察

    Institute of Scientific and Technical Information of China (English)

    沈旭中; 汤伟军; 叶纹


    Objective To observe the results of function MRI and perimetry in patients with visual pathway diseases. Methods Three patients (6 eyes) with pituitary adenoma and craniopharyngioma diagnosed via pathological examination and three healthy volunteers aged from 24 to 30 were collected. The best corrected visual acuity was non-light perception-1. 0 in the 6 sick eyes and 1. 0 in the healthy eyes;all the involved individuals had no other ocular diseases except myopia and without any contraindications of MRI. Common tests including the best visual acuity, fundus test by direct or indirect ophthalmoscope, center static visual field tested by Octopus 101 perimeter, program 32, tendency oriented perimetry were performed. The visual stimulation subtended a field of view of about 12 degrees,consisted of high contrast and drifting checkerboards. MRI parameters: GE signa VH/i 3. 0T scanner. Functional data: GRE-EPI sequence, 20 slices lying perpendicular to the calcarine sulcus. Anatomical data was obtained using 3DSPGR sequence to acquire high resolution. The cortical surface was unfolded and then cut and inflated. Functional data was presented to the inflated surface and subsequently analyzed by AFNI software. Results In six eyes, three had temporal defects, two had upper temporal visual field defects, and the other one did not finish the visual field test. The retinotopic representations of health adults were obtained by using the phase-encoded visual stimulation. The Eccentricity coordinate maps showed that foveal representations lay in the occipital poles and the representations appeared further anterior as eccentricity increased. The polar angle coordinate maps showed that early retinotopically organized areas had a representation of visual field. The visual cortex beneath the calcarine sulcus matched with the upper visual field of the opposite side and which upon the calcarine sulcus matched with the under visual field of the opposite side. Less or no visual cortex

  12. Clinical research of Terson's syndrome among spontaneous subarachnoid hemorrhage patients at emergency admission%急诊入院的自发性蛛网膜下腔出血患者中Terson综合征的临床研究

    Institute of Scientific and Technical Information of China (English)

    杨乾军; 毛剑波; 尹波; 佘相均; 曹婵媛; 沈丽君


    Objective To investigate the incidence,risk factors and relationship with intraocular hemorrhage of Terson's syndrome among patients with spontaneous subarachnoid hemorrhage (SSAH) after emergency admission.Methods Seventy-four consecutive patients with SSAH from June 2010 to September 2011 were prospectively examined.A direct ophthalmoscope examination was performed in all participants within three hours after emergency admission.If circumstances permit,fundus photos were taken.When initial fundus examination was conducted,the Hunt-Hess grade was classified by the brain surgeon.The fundus examination was taken on the 1st,3rd,and 7th day,2 weeks,1 month,and 3 months after emergency admission.The details were recorded,including sex,age,bleeding patterns,Hunt-Hess grade and death.The incidence of Terson's syndrome was analyzed and correlated with sex,age and Hunt-Hess grade.The relationship between intraocular hemorrhage and Hunt-Hess grade and mortality was analyzed.Results Among the 74 patients,19 were suffering from Terson's syndrome,31 eyes involved.The incidence of Terson's syndrome was 25.7%.Statistical analysis demonstrated that the sex of the patient was randomly distributed (x2=0.071,P=0.790),and the age components were also randomly distributed (Fisher's exact test,P=0.203).The Hunt-Hess grade components were non-randomly distributed (Fisher's exact test,P=0.000).Among the patients with preretinal hemorrhage and vitreous hemorrhage,HuntHess grade V was in 76.9% patients; among inter-retinal hemorrhage,Hunt-Hess grade was in 16..7% ofpatients.The distribution was non-random (Fisher's exact test,P=0.041).All intraocular hemorrhages were found at the time of first fundus examination.The mortality from Terson's syndrome was 68.4 % (13/19) according to the follow-up investigation.The mortality in patients with vitreous hemorrhage and preretinal hemorrhage was statistically different (Fisher's exact test,P=0.046) from patients with interretinal hemorrhage

  13. 以三级医院为依托的早产儿视网膜病防治管理模式可行性研究%Feasibility study of retinopathy of prematurity prevention mode based on lvevl-three hospitals

    Institute of Scientific and Technical Information of China (English)

    时先锋; 杨洋; 刘元铃; 江玮; 汪雅琴; 罗先琼


    hospitals.②there are 207 (72.8%)hospitals have neonatal department,and 1 55 (54.5%)hospitals have neonatal intensive care unit (NICU).There were significant differences among different area in NICU, whether Class 3 or Class 2 and below hospital(P <0.05).③there were 213 oculist who engaged in ROP screening,of which 1 74(81.7%)oculist in Class 3,others in Class 2 and below hospitals.④For Class 2 and below hospitals,there were significant differences among different area in O2 monitoring system,air/oxygen blender,blood gas analyzer,oxygen saturation monitor,ventilator support system,CPAP system, indirect ophthalmoscope(P < 0.05 ).⑤ A total of 21 7 (76.4%) hospitals evaluated the feasibility of spreading retinopathy of prematurity prevention mode based on Class 3 hospitals.Conclusions ROP prevention is a complicated systematic project, depending on the support from health administrative departments as well as all levels of the hospitals.As long as a regional prevention network based on Class 3 hospitals is established and cooperated by all the related departments,sharing resources and conveying practicable technology to lower level hospitals,which would the general level of ROP prevention improve effectively.

  14. 玻璃体手术治疗晚期早产儿视网膜病变的疗效及影响因素评估%Evaluation of effect and influence factors of vitrectomy for advanced retinopathy of prematurity

    Institute of Scientific and Technical Information of China (English)

    李家恺; 赵培泉


    Objective To observe the clinical effects of vitrectomy for advanced retinopathy of prematurity (ROP) and evaluate influence factors of anatomical recovery for stage 5 ROP.Methods Fiftyeight eyes of 40 infants with advanced ROP who underwent vitrectomy were retrospectively analyzed.There were 16 eyes of stage 4a,7 eyes of stage 4b,and 35 eyes of stage 5 ROP.Eighteen eyes received laser photocoagulation,2 eyes received cryotherapy,and 11 eyes received intravitreous injection of Bevacizumab (IVB) before surgery.The average follow-up time was 17.01 months.Anatomical outcome of retina after surgery was recorded by indirect ophthalmoscope and RetCam Ⅱ digital camera system.Visual outcome was measured by grating acuity test(lea gratingTM),and was converted to Snellen acuity values for analysis.For those who cannot cooperate to accomplish the test,we use hand move,light perception and non-light perception to record visual outcome. Results All 16 eyes of stage 4a were anatomically recovered (100.00%).5/7 eyes of stage 4b were anatomically recovered (71.43%) and 2/7 eyes were anatomically failed(28.57%).12/35 eyes of stage 5 were anatomically recovered (34.29%); 10/35 eyes were partial anatomically recovered (28.57%); 13 eyes were anatomically failed (37.14%). Anatomical outcome of stage 4a or 4b was better than stage 5 statistically(x2 =22.55,P<0.05).Of 16 eyes of stage 4a,3 eyes were absent for visual function test.In the rest 13 eyes of stage 4a,VA of 6 eyes (46.15%) was between 0.03 and 0.07; 5 eyes (38.46%) were hand move; 2 eyes (15.39%) were light perception.Of 7 eyes of stage 4b,2 eyes (28.57%) accomplished grating acuity test with VA of 0.008 and 0.017 respectively; 1 eye (14.29%) was hand move; 2 eyes (28.57%) were light perception; 2 eyes (28.57%) were non-light perception.Of 35 eyes of stage 5,5 eyes were absent for visual function test.In the rest 30 eyes of stage 5,VAof2 eyes (6.67%) was 0.004; 4 eyes (13.33%) were hand move

  15. 复发型视神经脊髓炎的临床特征与视功能分析%Clinical features and visual function of recurrent neuromyelitis optica

    Institute of Scientific and Technical Information of China (English)

    邓娟; 梁雪梅


    Objective To observe the clinical features and visual function of recurrent neuromyelitis optica (NMO).Methods Thirty-four patients with NMO were enrolled in this retrospective case series study.The patients included two males and 32 females.The average first onset age was (35.03± 14.56) years old and the average recurrent rate were (4.24±2.45) times.The recurrent rate of optic neuritis (ON) ranged from two to 12 times.The recurrent rate of ON was two times in 15 eyes of 10 patients,≥three times in 37 eyes of 24 patients.Vision acuity,direct ophthalmoscope,fundus pre-set lens examination,visual field and visual evoked potential (VEP) were evaluated.Clinical features were observed.The abnormal rate of optic nerve including optic edema and atrophy; abnormal rate of visual field including decreasing retinal sensitivity,central and paracentral scotoma,ring scotoma,half field defects,tunnel visual field,visual field centrality constriction; abnormal rate of VEP including Prolonged latent phase and/or decreasing amplitude of P100 wave from patients of first episode or recurrence was analyzed.Serum NMO-IgG was detected from 28 patients hy indirect immunofluorescence technique to observe its positive rate.Results All patients were characterized by repeated episodes of ON and myelitis.The main clinical feature of ON was visual loss,and the main clinical features of myelitis included sensory disability,dyskinesia and vesicorectal disorder.Blindness rate was 41.67% after the first attack of ON,33.33% after two relapses,and 64.86% after ≥ three relapses.The difference of blindness rate between first attack and two episodes was not significant (x2=0.270,P=0.603).However,the blindness rate in patients having ≥ three episodes was significantly higher than those having two episodes (x2=4.300,P=0.038).With recurrence rate increasing,the abnormal rate of the optic nerve (x2 =6.750,P =0.034) and VEP(x2 =6.990,P =0.030)increased.But the abnormal rate of visual field did

  16. 后巩膜炎10例临床特征分析%Clinical characteristics of 10 cases of posterior scleritis

    Institute of Scientific and Technical Information of China (English)

    万莉; 李世迎; 余涛; 刘勇; 黎海涛; 阴正勤


    肿胀等眼前节体征;结节型患者眼前节多正常.眼B型超声和MRI检查可见典型图像特征.全身和(或)眼局部糖皮质激素治疗可有效缓解患者症状.%Objectives To observe the clinical characteristics of patients with posterior scleritis.Methods Ten patients with 16 eyes diagnosed as posterior scleritis were enrolled in this study.Ten patients consisted of seven males and three females.Their age ranged from 18 to 75 years old,with a mean age of 42.0±14.7 years old.Except for two patients aged 18 and 75 years old,the other eight patients aged 33 to 55 years old.Routine eye examination was performed including visual acuity,slit lamp microscope,ophthalmoscope,B scan ultrasound,color fundus photography,fundus fluorescein angiography (FFA),orbit MRI and chest X-ray.According to the B scan ultrasonic examination,these ten posterior scleritis cases were divided into diffused and nodular types.Among them,the diffused type had 8 cases (14 eyes),the nodular type had 2 cases (2 eyes).The visual acuities of ten patients were from light perception to 0.4.The blood laboratory tests were negative in all cases.The diffused posterior scleritis patients received systemic and (or) local glucocorticoid therapy.The nodular posterior scleritis patients could not be ruled out choroidal melanoma in the initial evaluation,and they underwent enucleation operation in other hospitals.Results In the 14 eyes of diffused posterior scleritis,conjunctival congestion and edema were observed in 8eyes,eyelid edema in 2 eyes,normal eye surface in 4 eyes.In the two eyes of nodular posterior scleritis,there was no conjunctival congestion and edema or eyelids swelling.All 16 eyes performed FFA,11 eyes had fundus posterior pole early dot-like hyperfluorescence followed by leakage of fluorescence in the late stage,two eyes had hyperfluorescence mixed with hypofluorescence in the nearby retina of the lesion,and the rest three eyes had no abnormality in FFA.In 14 eyes of