WorldWideScience

Sample records for ophthalmoscopes

  1. Single pixel camera ophthalmoscope

    NARCIS (Netherlands)

    Lochocki, Benjamin; Gambín, Adrian; Manzanera, Silvestre; Irles, Esther; Tajahuerce, Enrique; Lancis, Jesus; Artal, Pablo

    2016-01-01

    Ophthalmoscopes to image the retina are widely used diagnostic tools in ophthalmology and are vital for the early detection of many eye diseases. Although there are various effective optical implementations of ophthalmoscopes, new, robust systems may have a future practical importance in cases where

  2. 150 years since Babbage's ophthalmoscope.

    Science.gov (United States)

    Keeler, C R

    1997-11-01

    The discovery of the ophthalmoscope in 1851 is rightly attributed to Hermann von Helmholtz. However, 4 years earlier, in 1847, Charles Babbage nearly invented the instrument that was to revolutionize ophthalmological examination so dramatically.

  3. 21 CFR 886.1570 - Ophthalmoscope.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmoscope. 886.1570 Section 886.1570 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES... the media (cornea, aqueous, lens, and vitreous) and the retina of the eye. (b) Classification. Class...

  4. Scanning laser ophthalmoscope design with adaptive optics

    OpenAIRE

    Laut, SP; Jones, SM; Olivier, SS; Werner, JS

    2005-01-01

    A design for a high-resolution scanning instrument is presented for in vivo imaging of the human eye at the cellular scale. This system combines adaptive optics technology with a scanning laser ophthalmoscope (SLO) to image structures with high lateral (∼2 μm) resolution. In this system, the ocular wavefront aberrations that reduce the resolution of conventional SLOs are detected by a Hartmann-Shack wavefront sensor, and compensated with two deformable mirrors in a closed-loop for dynamic cor...

  5. Reflective afocal broadband adaptive optics scanning ophthalmoscope

    Science.gov (United States)

    Dubra, Alfredo; Sulai, Yusufu

    2011-01-01

    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

  6. Modifying a Rodenstock scanning laser ophthalmoscope for imaging densitometry.

    Science.gov (United States)

    Tornow, R P; Beuel, S; Zrenner, E

    1997-08-01

    The necessary modifications and technical requirements are described for using a commercially available scanning laser ophthalmoscope (Rodenstock Model 101 SLO) as an imaging densitometer to assess human photopigment distribution. The main requirements are a linear detector amplifier, fast shutters for the laser beams, and a trigger unit. Images must be compensated for varying laser intensity. Both rod and cone photopigments are measured with the 514-nm argon laser of the SLO. Discrimination is possible owing to the different spatial distribution. The cone pigment density peaks in the foveal center (D = 0.40) with a steep decrease with increasing eccentricity E (full width at half-maximum, 2.5 degrees ). Rod photopigment increases with increasing eccentricity (D = 0.23 for E = 11 degrees ). These values are in agreement with previous reported results obtained with scanning laser ophthalmoscopes specially designed for retinal densitometry and high stability.

  7. Registration of retinal sequences from new video-ophthalmoscopic camera.

    Science.gov (United States)

    Kolar, Radim; Tornow, Ralf P; Odstrcilik, Jan; Liberdova, Ivana

    2016-05-20

    Analysis of fast temporal changes on retinas has become an important part of diagnostic video-ophthalmology. It enables investigation of the hemodynamic processes in retinal tissue, e.g. blood-vessel diameter changes as a result of blood-pressure variation, spontaneous venous pulsation influenced by intracranial-intraocular pressure difference, blood-volume changes as a result of changes in light reflection from retinal tissue, and blood flow using laser speckle contrast imaging. For such applications, image registration of the recorded sequence must be performed. Here we use a new non-mydriatic video-ophthalmoscope for simple and fast acquisition of low SNR retinal sequences. We introduce a novel, two-step approach for fast image registration. The phase correlation in the first stage removes large eye movements. Lucas-Kanade tracking in the second stage removes small eye movements. We propose robust adaptive selection of the tracking points, which is the most important part of tracking-based approaches. We also describe a method for quantitative evaluation of the registration results, based on vascular tree intensity profiles. The achieved registration error evaluated on 23 sequences (5840 frames) is 0.78 ± 0.67 pixels inside the optic disc and 1.39 ± 0.63 pixels outside the optic disc. We compared the results with the commonly used approaches based on Lucas-Kanade tracking and scale-invariant feature transform, which achieved worse results. The proposed method can efficiently correct particular frames of retinal sequences for shift and rotation. The registration results for each frame (shift in X and Y direction and eye rotation) can also be used for eye-movement evaluation during single-spot fixation tasks.

  8. Retinal Oximetry with Scanning Laser Ophthalmoscope in Infants.

    Directory of Open Access Journals (Sweden)

    Wouter B Vehmeijer

    Full Text Available Dual wavelength retinal oximetry has been developed for adults, but is not available for infants. Retinal oximetry may provide insight into the pathophysiology of oxygen-mediated diseases like retinopathy of prematurity. More insight in the oxygen metabolism of the retina in infants may provide valuable clues for better understanding and subsequent prevention or treatment of the disease. The measurements of oxygen saturation are obtained with two fundus images simultaneously captured in two different wavelengths of light. The comparison in light absorption of oxygenated and deoxygenated hemoglobin can be used to estimate the oxygen saturation within the retinal vessels by means of a software algorithm. This study aims to make retinal oximetry available for neonates. The first step towards estimating retinal oxygen saturation is determining the optical density ratio. Therefore, the purpose of this study is to image healthy newborn infants with a scanning laser ophthalmoscope and determine the optical density ratio for retinal oximetry analysis.Images of the retina of full-term healthy infants were obtained with an SLO, Optomap 200Tx (Optos, with two laser wavelengths (532nm and 633nm. The infant lay face down on the lower arm of the parent, while the parent supported the chest and chin with one hand, and stabilized the back with the other hand. No mydriatics or eyelid specula were used during this study. The images were analyzed with modified Oxymap Analyzer software for calculation of the Optical Density Ratio (ODR and vessel width. The ODR is inversely and approximately linearly related to the oxygen saturation. Measurements were included from the superotemporal vessel pair. A paired t-test was used for statistical analysis.Fifty-nine infants, (58% female, were included with mean gestational age of 40 ± 1.3 weeks (mean ± SD and mean post-natal age of 16 ± 4.8 days. A total of 28 images were selected for retinal oximetry analysis. The ODR was

  9. Binocular video ophthalmoscope for simultaneous recording of sequences of the human retina to compare dynamic parameters

    Science.gov (United States)

    Tornow, Ralf P.; Milczarek, Aleksandra; Odstrcilik, Jan; Kolar, Radim

    2017-07-01

    A parallel video ophthalmoscope was developed to acquire short video sequences (25 fps, 250 frames) of both eyes simultaneously with exact synchronization. Video sequences were registered off-line to compensate for eye movements. From registered video sequences dynamic parameters like cardiac cycle induced reflection changes and eye movements can be calculated and compared between eyes.

  10. Scanning Laser Ophthalmoscope Measurement of Local Fundus Reflectance and Autofluorescence Changes Arising from Rhodopsin Bleaching and Regeneration

    OpenAIRE

    Morgan, Jessica I. W.; Pugh, Edward N.

    2013-01-01

    Rhodopsin was measured locally in the retina with a widely available, dual wavelength scanning laser ophthalmoscope that does not require pupil dilation. Increased autofluorescence attendant bleaching arises largely from transient removal of rhodopsin's screening of autofluorescent fluorochromes.

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

    Directory of Open Access Journals (Sweden)

    Mihir Kothari

    2015-01-01

    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.

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

    Science.gov (United States)

    Kothari, Mihir; Kothari, Kedar; Kadam, Sanjay; Mota, Poonam; Chipade, Snehal

    2015-01-01

    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. 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. The cost of conversion to wireless-LED was 815/- rupees. Twenty-nine subjects, mean age 34.3 [formula in text] 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. Converting to wireless-LED IO is easy, cost-effective and preferred over a wired-halogen indirect ophthalmoscope.

  13. Mobile Laser Indirect Ophthalmoscope: For the Induction of Choroidal Neovascularization in a Mouse Model.

    Science.gov (United States)

    Weinberger, Dov; Bor-Shavit, Elite; Barliya, Tilda; Dahbash, Mor; Kinrot, Opher; Gaton, Dan D; Nisgav, Yael; Livnat, Tami

    2017-11-01

    This study aims to evaluate and standardize the reliability of a mobile laser indirect ophthalmoscope in the induction of choroidal neovascularization (CNV) in a mouse model. A diode laser indirect ophthalmoscope was used to induce CNV in pigmented male C57BL/6J mice. Standardization of spot size and laser intensity was determined using different aspheric lenses with increasing laser intensities applied around the optic disc. Development of CNV was evaluated 1, 5, and 14 days post laser application using fluorescein angiography (FA), histology, and choroidal flat mounts stained for the endothelial marker CD31 and FITC-dextran. Correlation between the number of laser hits to the number and size of developed CNV lesions was determined using flat mount choroid staining. The ability of intravitreally injected anti-human and anti-mouse VEGF antibodies to inhibit CNV induced by the mobile laser was evaluated. Laser parameters were standardized on 350 mW for 100 msec, using the 90 diopter lens to accomplish the highest incidence of Bruch's membrane rupture. CNV lesions' formation was validated on days 5 and 14 post laser injury, though FA showed leakage on as early as day 1. The number of laser hits was significantly correlated with the CNV area. CNV growth was successfully inhibited by both anti-human and mouse VEGF antibodies. The mobile laser indirect ophthalmoscope can serve as a feasible and a reliable alternative method for the CNV induction in a mouse model.

  14. High-resolution adaptive optics scanning laser ophthalmoscope with multiple deformable mirrors

    Science.gov (United States)

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

    2010-02-23

    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.

  15. Non-common path aberration correction in an adaptive optics scanning ophthalmoscope.

    Science.gov (United States)

    Sulai, Yusufu N; Dubra, Alfredo

    2014-09-01

    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.

  16. [Topographic mapping of retinal function with a scanning laser ophthalmoscope and multifocal electroretinography using short M-sequences].

    Science.gov (United States)

    Rudolph, G; Bechmann, M; Berninger, T; Kutschbach, E; Held, U; Tornow, R P; Kalpadakis, P; Zol'nikova, I V; Shamshinova, A M

    2001-01-01

    A new method of multifocal electroretinography making use of scanning laser ophthalmoscope with a wavelength of 630 nm (SLO-m-ERG), evoking short spatial visual stimuli on the retina, is proposed. Algorithm of presenting the visual stimuli and analysis of distribution of local electroretinograms on the surface of the retina is based on short m-sequences. Mathematical cross correlation analysis shows a three-dimensional distribution of bioelectrical activity of the retina in the central visual field. In normal subjects the cone bioelectrical activity is the maximum in the macular area (corresponding to the density of cone distribution) and absent in the blind spot. The method detects the slightest pathological changes in the retina under control of the site of stimulation and ophthalmoscopic picture of the fundus oculi. The site of the pathological process correlates with the topography of changes in bioelectrical activity of the examined retinal area in diseases of the macular area and pigmented retinitis detectable by ophthalmoscopy.

  17. Infrared scanning laser ophthalmoscope imaging of the macula and its correlation with functional loss and structural changes in patients with stargardt disease.

    Science.gov (United States)

    Anastasakis, Anastasios; Fishman, Gerald A; Lindeman, Martin; Genead, Mohamed A; Zhou, Wensheng

    2011-05-01

    To correlate the degree of functional loss with structural changes in patients with Stargardt disease. Eighteen eyes of 10 patients with Stargardt disease were studied. Scanning laser ophthalmoscope infrared images were compared with corresponding spectral-domain optical coherence tomography scans. Additionally, scanning laser ophthalmoscope microperimetry was performed, and results were superimposed on scanning laser ophthalmoscope infrared images and in selected cases on fundus autofluorescence images. Seventeen of 18 eyes showed a distinct hyporeflective foveal and/or perifoveal area with distinct borders on scanning laser ophthalmoscope infrared images, which was less evident on funduscopy and incompletely depicted in fundus autofluorescence images. This hyporeflective zone corresponded to areas of significantly elevated psychophysical thresholds on microperimetry testing, in addition to thinning of the retinal pigment epithelium and disorganization or loss of the photoreceptor cell inner segment-outer segment junction and external-limiting membrane on spectral-domain optical coherence tomography. Scanning laser ophthalmoscope infrared fundus images are useful for depicting retinal structural changes in patients with Stargardt disease. A spectral-domain optical coherence tomography/scanning laser ophthalmoscope microperimetry device allows for a direct correlation of structural abnormalities with functional defects that will likely be applicable for the determination of retinal areas for potential improvement of retinal function in these patients during future clinical trials and for the monitoring of the diseases' natural history.

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

    Science.gov (United States)

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

    2016-01-01

    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. Noninvasive imaging of the human rod photoreceptor mosaic using a confocal adaptive optics scanning ophthalmoscope

    Science.gov (United States)

    Dubra, Alfredo; Sulai, Yusufu; Norris, Jennifer L.; Cooper, Robert F.; Dubis, Adam M.; Williams, David R.; Carroll, Joseph

    2011-01-01

    The rod photoreceptors are implicated in a number of devastating retinal diseases. However, routine imaging of these cells has remained elusive, even with the advent of adaptive optics imaging. Here, we present the first in vivo images of the contiguous rod photoreceptor mosaic in nine healthy human subjects. The images were collected with three different confocal adaptive optics scanning ophthalmoscopes at two different institutions, using 680 and 775 nm superluminescent diodes for illumination. Estimates of photoreceptor density and rod:cone ratios in the 5°–15° retinal eccentricity range are consistent with histological findings, confirming our ability to resolve the rod mosaic by averaging multiple registered images, without the need for additional image processing. In one subject, we were able to identify the emergence of the first rods at approximately 190 μm from the foveal center, in agreement with previous histological studies. The rod and cone photoreceptor mosaics appear in focus at different retinal depths, with the rod mosaic best focus (i.e., brightest and sharpest) being at least 10 μm shallower than the cones at retinal eccentricities larger than 8°. This study represents an important step in bringing high-resolution imaging to bear on the study of rod disorders. PMID:21750765

  20. Functional and ophthalmoscopic observations in human laser accident cases using scanning-laser ophthalmoscopy

    Science.gov (United States)

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

    1994-06-01

    A scanning laser ophthalmoscope (SLO) equipped with an acousto- optical modulator (ACM) was used to make focal acuity and contrast sensitivity measurements in individuals with macular damage. The depth of modulation achieved by the ACM was determined by imaging the SLO raster pattern onto a Pulnix TM 745 video camera and evaluating the intensity distribution with a Big Sky BVA10 beam view analyzer. Contrast levels remained approximately constant over the entire range of SLO input raster power settings. A delta Technologies image processing system produced Landolt ring test stimuli at the center of the raster pattern. Contrast thresholds were determined at various retinal locations by having subjects fixate a specific location on a fixed grid imaged on the raster pattern. This procedure insured that the test stimuli were always imaged in the center of the raster pattern thereby avoiding peripheral variations in the raster pattern intensity distribution. Measurements of contrast sensitivity where focal test targets fell within the macular damage area demonstrated elevated contrast thresholds relative to retinal locations where focal test targets evaluated the border regions between normal and pathological retina.

  1. Image quality characteristics of a novel colour scanning digital ophthalmoscope (SDO) compared with fundus photography.

    Science.gov (United States)

    Strauss, Rupert W; Krieglstein, Tina R; Priglinger, Siegfried G; Reis, Werner; Ulbig, Michael W; Kampik, Anselm; Neubauer, Aljoscha S

    2007-11-01

    To establish a set of quality parameters for grading image quality and apply those to evaluate the fundus image quality obtained by a new scanning digital ophthalmoscope (SDO) compared with standard slide photography. On visual analogue scales a total of eight image characteristics were defined: overall quality, contrast, colour brilliance, focus (sharpness), resolution and details, noise, artefacts and validity of clinical assessment. Grading was repeated after 4 months to assess repeatability. Fundus images of 23 patients imaged digitally by SDO and by Zeiss 450FF fundus camera using Kodak film were graded side-by-side by three graders. Lens opacity was quantified with the Interzeag Lens Opacity Meter 701. For all of the eight scales of image quality, good repeatability within the graders (mean Kendall's W 0.69) was obtained after 4 months. Inter-grader agreement ranged between 0.31 and 0.66. Despite the SDO's limited nominal image resolution of 720 x 576 pixels, the Zeiss FF 450 camera performed better in only two of the subscales - noise (p = 0.001) and artefacts (p = 0.01). Lens opacities significantly influenced only the two subscales 'resolution' and 'details', which deteriorated with increasing media opacities for both imaging systems. Distinct scales to grade image characteristics of different origin were developed and validated. Overall SDO digital imaging was found to provide fundus pictures of a similarly high level of quality as expert photography on slides.

  2. Non-mydriatic video ophthalmoscope to measure fast temporal changes of the human retina

    Science.gov (United States)

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

    2015-07-01

    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.

  3. Retinal Oximetry and Vessel Diameter Measurements With a Commercially Available Scanning Laser Ophthalmoscope in Diabetic Retinopathy.

    Science.gov (United States)

    Blair, Norman P; Wanek, Justin; Felder, Anthony E; Joslin, Charlotte E; Kresovich, Jacob K; Lim, Jennifer I; Chau, Felix Y; Leiderman, Yannek; Shahidi, Mahnaz

    2017-10-01

    To test the hypothesis that retinal vascular diameter and hemoglobin oxygen saturation alterations, according to stages of diabetic retinopathy (DR), are discernible with a commercially available scanning laser ophthalmoscope (SLO). One hundred eighty-one subjects with no diabetes (No DM), diabetes with no DR (No DR), nonproliferative DR (NPDR), or proliferative DR (PDR, all had photocoagulation) underwent imaging with an SLO with dual lasers (532 nm and 633 nm). Customized image analysis software determined the diameters of retinal arteries and veins (DA and DV) and central retinal artery and vein equivalents (CRAE and CRVE). Oxygen saturations of hemoglobin in arteries and veins (SO2A and SO2V) were estimated from optical densities of vessels on images at the two wavelengths. Statistical models were generated by adjusting for effects of sex, race, age, eye, and fundus pigmentation. DA, CRAE, and CRVE were reduced in PDR compared to No DM (P ≤ 0.03). DV and CRVE were similar between No DM and No DR, but they were higher in NPDR than No DR (P ≤ 0.01). Effect of stage of disease on SO2A differed by race, being increased relative to No DM in NPDR and PDR in Hispanic participants only (P ≤ 0.02). Relative to No DM, SO2V was increased in NPDR and PDR (P ≤ 0.05). Alterations in retinal vascular diameters and SO2 by diabetic retinopathy stage can be detected with a widely available SLO, and covariates such as race can influence the results.

  4. Differentiation between primary and secondary Raynaud's phenomenon: a prospective study comparing nailfold capillaroscopy using an ophthalmoscope or stereomicroscope

    Science.gov (United States)

    Anders, H; Sigl, T; Schattenkirchner, M

    2001-01-01

    BACKGROUND—Nailfold capillary microscopy is a routine procedure in the investigation of patients with Raynaud's phenomenon (RP). As a standard method, nailfold capillary morphology is inspected with a stereomicroscope to look for capillary abnormalities such as giant loops, avascular areas, and bushy capillaries, which have all been found to be associated with certain connective tissue diseases.
AIM—To investigate prospectively whether nailfold capillary inspection using an ophthalmoscope is of equivalent diagnostic value to standard nailfold capillary microscopy.
METHOD—All the fingers of 26 patients with RP were examined in a blinded fashion and compared with the final diagnosis one month later.
RESULTS—All giant loops, large avascular areas, and bushy capillaries were identified by both methods. The correlation for moderate avascular areas and crossed capillaries was 0.93 and 0.955 respectively. The correlation for minor abnormalities that do not contribute to the differentiation between primary and secondary RP was 0.837 and 0.861 respectively. All patients were classified identically by the two methods.
CONCLUSION—For the evaluation of patients with RP, nailfold capillary morphology can reliably be assessed with an ophthalmoscope.

 PMID:11247874

  5. Quantitative analysis of fluorescence lifetime measurements of the macula using the fluorescence lifetime imaging ophthalmoscope in healthy subjects.

    Science.gov (United States)

    Dysli, Chantal; Quellec, Gwénolé; Abegg, Mathias; Menke, Marcel N; Wolf-Schnurrbusch, Ute; Kowal, Jens; Blatz, Johannes; La Schiazza, Olivier; Leichtle, Alexander B; Wolf, Sebastian; Zinkernagel, Martin S

    2014-04-03

    Fundus autofluorescence (FAF) cannot only be characterized by the intensity or the emission spectrum, but also by its lifetime. As the lifetime of a fluorescent molecule is sensitive to its local microenvironment, this technique may provide more information than fundus autofluorescence imaging. We report here the characteristics and repeatability of FAF lifetime measurements of the human macula using a new fluorescence lifetime imaging ophthalmoscope (FLIO). A total of 31 healthy phakic subjects were included in this study with an age range from 22 to 61 years. For image acquisition, a fluorescence lifetime ophthalmoscope based on a Heidelberg Engineering Spectralis system was used. Fluorescence lifetime maps of the retina were recorded in a short- (498-560 nm) and a long- (560-720 nm) spectral channel. For quantification of fluorescence lifetimes a standard ETDRS grid was used. Mean fluorescence lifetimes were shortest in the fovea, with 208 picoseconds for the short-spectral channel and 239 picoseconds for the long-spectral channel, respectively. Fluorescence lifetimes increased from the central area to the outer ring of the ETDRS grid. The test-retest reliability of FLIO was very high for all ETDRS areas (Spearman's ρ = 0.80 for the short- and 0.97 for the long-spectral channel, P macula in healthy subjects. By using a custom-built software, we were able to quantify fluorescence lifetimes within the ETDRS grid. Establishing a clinically accessible standard against which to measure FAF lifetimes within the retina is a prerequisite for future studies in retinal disease.

  6. Adaptive optics scanning laser ophthalmoscope using liquid crystal on silicon spatial light modulator: Performance study with involuntary eye movement

    Science.gov (United States)

    Huang, Hongxin; Toyoda, Haruyoshi; Inoue, Takashi

    2017-09-01

    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.

  7. In vivo retinal imaging for fixational eye motion detection using a high-speed digital micromirror device (DMD)-based ophthalmoscope.

    Science.gov (United States)

    Vienola, Kari V; Damodaran, Mathi; Braaf, Boy; Vermeer, Koenraad A; de Boer, Johannes F

    2018-02-01

    Retinal motion detection with an accuracy of 0.77 arcmin corresponding to 3.7 µm on the retina is demonstrated with a novel digital micromirror device based ophthalmoscope. By generating a confocal image as a reference, eye motion could be measured from consecutively measured subsampled frames. The subsampled frames provide 7.7 millisecond snapshots of the retina without motion artifacts between the image points of the subsampled frame, distributed over the full field of view. An ophthalmoscope pattern projection speed of 130 Hz enabled a motion detection bandwidth of 65 Hz. A model eye with a scanning mirror was built to test the performance of the motion detection algorithm. Furthermore, an in vivo motion trace was obtained from a healthy volunteer. The obtained eye motion trace clearly shows the three main types of fixational eye movements. Lastly, the obtained eye motion trace was used to correct for the eye motion in consecutively obtained subsampled frames to produce an averaged confocal image correct for motion artefacts.

  8. Cine recording ophthalmoscope

    Science.gov (United States)

    Fitzgerald, J. W.

    1972-01-01

    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.

  9. [From otoscope to ophthalmoscope and back. The interwoven history of their invention and introduction into medical practice. Pictures from the history of otorhinolaryngology, illustrated by instruments from the collection of the Ingolstadt German Medical History Museum].

    Science.gov (United States)

    Feldmann, H

    1995-11-01

    Friedrich Hofmann, medical officer in Burgsteinfurt, Westphalia, Germany, in 1841 described a concave mirror with a central aperture in it as the ideal instrument that allowed reflecting and focussing light into the external auditory canal and simultaneously inspecting the tympanic membrane without obstructing either the light or the view. He recommended his device also for the inspection of other concealed regions of the body. His invention was referred to by Martell Frank in his textbook of otology in 1845, but otherwise attracted no attention. Hermann Helmholtz, physiologist in Königsberg, East Prussia, devised his ophthalmoscope in 1850-51 in order to study the phenomenon of glowing eyes. With this instrument he was the first to see the retina of a living human. As means of illumination he used small panes of glass similar to cover-glasses which were introduced into the common visual axis of the observer and the subject at such an angle that light from a lamp was reflected into the subject's eye while the observer inspected the subject's retina through the glass and an appropriate lens. He recommended this type of illumination also for otoscopy. His invention was at once acclaimed throughout the world and opened completely new opportunities in ophthalmology. The slanting panes of glass, however, were not the ideal solution for illumination. It was only one year later that Ruete in Göttingen replaced them with a concave mirror with a central aperture, and there is every indication that Frank's report on Hofmann's mirror had suggested this technique to him. During the following two years quite a number of other modifications of the ophthalmoscope were constructed, all of them using the concave mirror with a central aperture, which soon became synonymous with the ophthalmoscope as such. Von Tröltsch, otologist and ophthalmologist in Würzburg, presented a concave mirror with a central aperture for otoscopy in Paris in 1855-56. His instrument was obviously

  10. 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

    2016-01-01

    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.

  11. 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

    2009-04-01

    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.

  12. Community Application from Mydriatic Ophthalmoscope Screening Analysis of 890 Cases of Diabetic Eyeground%社区应用免散瞳眼底镜筛查890例糖尿病患者眼底分析

    Institute of Scientific and Technical Information of China (English)

    夏娣; 刘春艳; 王丽萍; 赵得南

    2016-01-01

    目的:探讨应用免散瞳眼底镜检查在社区糖尿病患者眼底筛查和糖尿病视网膜病变诊断分期及指导治疗中的应用价值。方法对890例糖尿病患者(1780只眼)进行常规眼底检查并将结果进行整理分期。结果890例糖尿病患者检出糖尿病视网膜病变者共196(362只眼)例,根据I~II期药物治疗,III~IV期全视网膜激光光凝治疗,V~VI期进行玻璃体切割术治疗的原则进行指导治疗,前往专业眼科机构进行治疗,治疗后社区进行随访。结论免散瞳眼底镜检查是社区早期诊断糖尿病视网膜病变的有效工具,对社区糖尿病视网膜病变的筛查的重要手段。%Objective To study the application of free mydriatic fundus ophthalmoscope examination in the community dia-betes patients and diabetic retinopathy diagnosis in installment application value and guiding treatment. Methods 890 cases of diabetic patients (1 780 eyes) of routine fundus examination and finishing stages will result. Detection. Results 890 cases of diabetic patients with diabetic retinopathy is a total of 196 cases (362 eyes), according to the I-II drug therapy, III - IV whole retinal laser photocoagulation therapy, V- VI phases for the treatment of vitreous cut principle for guiding treatment, to professional eye treatment, community follow-up after treatment. Conclusion Free mydriatic funduscopic examination for early diagnosis of diabetic retinopathy is a community of effective tools, to the community an important means of screening of diabetic retinopathy.

  13. An Ophthalmoscope for under USD$10?

    African Journals Online (AJOL)

    tulyasys

    a traditional model, but appear of suffi cient quality for most diagnostic purposes. Of course, other questions remain as to how durable it will be, but given the huge difference in cost, size, and weight, it is worth keeping an eye open on progress. It is essential to highlight that although this product may improve access to ...

  14. Adaptive optics scanning laser ophthalmoscope imaging: technology update

    Directory of Open Access Journals (Sweden)

    Merino D

    2016-04-01

    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

  15. En-face Flying Spot OCT/Ophthalmoscope

    Science.gov (United States)

    Rosen, Richard B.; Garcia, Patricia; Podoleanu, Adrian Gh.; Cucu, Radu; Dobre, George; Trifanov, Irina; van Velthoven, Mirjam E. J.; de Smet, Marc D.; Rogers, John A.; Hathaway, Mark; Pedro, Justin; Weitz, Rishard

    This is a review of a technique for high-resolution imaging of the eye that allows multiple sample sectioning perspectives with different axial resolutions. The technique involves the flying spot approach employed in confocal scanning laser ophthalmoscopy which is extended to OCT imaging via time domain en face fast lateral scanning. The ability of imaging with multiple axial resolutions stimulated the development of the dual en face OCT-confocal imaging technology. Dual imaging also allows various other imaging combinations, such as OCT with confocal microscopy for imaging the eye anterior segment and OCT with fluorescence angiography imaging.

  16. A confocal scanning laser ophthalmoscope for retinal vessel oximetry

    Science.gov (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.

  17. De-warping of images and improved eye tracking for the scanning laser ophthalmoscope.

    Directory of Open Access Journals (Sweden)

    Phillip Bedggood

    Full Text Available 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.

  18. Retro-mode imaging and fundus autofluorescence with scanning laser ophthalmoscope of retinal dystrophies

    Directory of Open Access Journals (Sweden)

    Maurizio Battaglia

    2012-05-01

    Full Text Available Abstract Background Retinal dystrophies display a considerably wide range of phenotypic variability, which can make diagnosis and clinical staging difficult. The aim of the study is to analyze the contribution of retro-mode imaging (RMI and fundus autofluorescence (FAF to the characterization of retinal dystrophies. Methods Eighteen consecutive patients affected by retinal dystrophies underwent a complete ophthalmological examination, including best corrected visual acuity with ETDRS charts, blue-light fundus autofluorescence, (BL-FAF, near-infrared fundus autofluorescence (NIR-FAF, and RMI. The primary outcome was the identification of abnormal patterns on RMI. The secondary outcome was the correlation with the findings on BL-FAF and NIR-FAF. Results Overall, the main feature of RMI is represented by a pseudo-3D pattern of all the lesions at the posterior pole. More specifically, any accumulation of material within the retina appears as an area of elevation of different shape and size, displaying irregular and darker borders. No precise correlations between RMI, BL-AF, and NIR-AF imaging was found. Conclusions RMI and FAF appear to be useful tools for characterizing retinal dystrophies. Non-invasive diagnostic tools may yield additional information on the clinical setting and the monitoring of the patients.

  19. Central serous chorioretinopathy fundus autofluorescence comparison with two different confocal scanning laser ophthalmoscopes.

    Science.gov (United States)

    Nam, Ki Tae; Yun, Cheol Min; Kim, Jee Taek; Yang, Kyung-Sook; Kim, Hyun Joo; Kim, Seong-Woo; Oh, Jaeryung; Huh, Kuhl

    2015-12-01

    To compare the lesion characteristics of two different types of confocal scanning laser ophthalmoscopy (cSLO) autofluorescence (AF) images in central serous chorioretinopathy (CSC). The study included 63 eyes of 61 patients; 63 pairs of fundus autofluorescence (FAF) images were compared before CSC resolution in 63 eyes, FAF images of 31 eyes were also compared after CSC resolution. The lesion characteristics (brightness and composite pattern) were compared between Heidelberg Retina Angiograph 2 (HRA2; Heidelberg Engineering, Germany) and Optomap Tx (Optomap; Optos, Scotland) FAF images. The lesion composite pattern was categorized as diffuse or granular. Diffuse AF was defined as homogenously increased or decreased AF, and granular AF was defined as dot-like, coarse changes in AF. The mean disease duration and subretinal fluid (SRF) height in the spectral domain optical coherence tomography were compared according to the FAF image characteristics. Lesion brightness before CSC resolution was hypo-AF in 48 eyes (76.2 %), hyper-AF in three (4.8 %), and mixed-AF in 12 (19.0 %) in HRA2 FAF images. In comparison, nine (14.3 %) images were hypo-AF, 44 (69.8 %) were hyper-AF, and 10 (15.9 %) were mixed-AF in Optomap FAF images (P < 0.0001). There was no significant difference in lesion composite pattern between the two FAF image wavelengths. Patients with lesions that were hyper-AF in Optomap FAF and hypo-AF in HRA2 FAF had a shorter disease duration and greater SRF height (1 month, 281 um) than those who were hyper-AF in both Optomap and HRA2 images (26 months, 153 um; P = 0.004, 0.001). The two types of FAF images of CSC showed different lesion brightness before and after CSC resolution but demonstrated similar lesion composite patterns.

  20. Low-cost, high-resolution scanning laser ophthalmoscope for the clinical environment

    Science.gov (United States)

    Soliz, P.; Larichev, A.; Zamora, G.; Murillo, S.; Barriga, E. S.

    2010-02-01

    Researchers have sought to gain greater insight into the mechanisms of the retina and the optic disc at high spatial resolutions that would enable the visualization of small structures such as photoreceptors and nerve fiber bundles. The sources of retinal image quality degradation are aberrations within the human eye, which limit the achievable resolution and the contrast of small image details. To overcome these fundamental limitations, researchers have been applying adaptive optics (AO) techniques to correct for the aberrations. Today, deformable mirror based adaptive optics devices have been developed to overcome the limitations of standard fundus cameras, but at prices that are typically unaffordable for most clinics. In this paper we demonstrate a clinically viable fundus camera with auto-focus and astigmatism correction that is easy to use and has improved resolution. We have shown that removal of low-order aberrations results in significantly better resolution and quality images. Additionally, through the application of image restoration and super-resolution techniques, the images present considerably improved quality. The improvements lead to enhanced visualization of retinal structures associated with pathology.

  1. Ocular abnormalities in congenital Zika syndrome: are the ophthalmoscopic findings "the top of the iceberg"?

    Science.gov (United States)

    de Oliveira Dias, João Rafael; Ventura, Camila V; de Paula Freitas, Bruno; Prazeres, Juliana; Ventura, Liana O; Bravo-Filho, Vasco; Aleman, Tomas; Ko, Albert Icksang; Zin, Andréa; Belfort, Rubens; Maia, Mauricio

    2018-04-23

    Zika virus (ZIKV) is an arbovirus mainly transmitted to humans by mosquitoes from Aedes genus. Other ways of transmission include the perinatal and sexual routes, blood transfusion, and laboratory exposure. Although the first human cases were registered in 1952 in African countries, outbreaks were only reported since 2007, when entire Pacific islands were affected. In March 2015, the first cases of ZIKV acute infection were notified in Brazil and, to date, 48 countries and territories in the Americas have confirmed local mosquito-borne transmission of ZIKV. Until 2015, ZIKV infection was thought to only cause asymptomatic or mild exanthematous febrile infections. However, after explosive ZIKV outbreaks in Polynesia and Latin American countries, it was confirmed that ZIKV could also lead to Guillain-Barré syndrome and congenital birth abnormalities. These abnormalities, which can include neurologic, ophthalmologic, audiologic, and skeletal findings, are now considered congenital Zika syndrome (CZS). Brain abnormalities in CZS include cerebral calcifications, malformations of cortical development, ventriculomegaly, lissencephaly, hypoplasia of the cerebellum and brainstem. The ocular findings, which are present in up to 70% of infants with CZS, include iris coloboma, lens subluxation, cataract, congenital glaucoma, and especially posterior segment findings. Loss of retinal pigment epithelium, the presence of a thin choroid, a perivascular choroidal inflammatory infiltrate, and atrophic changes within the optic nerve were seen in histologic analyses of eyes from deceased fetuses. To date, there is no ZIKV licensed vaccines or antiviral therapies are available for treatment. Preventive measures include individual protection from mosquito bites, control of mosquito populations and the use of barriers measures such as condoms during sexual intercourse or sexual abstinence for couples either at risk or after confirmed infection. A literature review based on studies that analyzed ocular findings in mothers and infants with CZS, with or without microcephaly, was conducted and a theoretical pathophysiologic explanation for ZIKV-ocular abnormalities was formulated. Copyright © 2018. Published by Elsevier Ltd.

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

    Directory of Open Access Journals (Sweden)

    Serek Tekin

    2016-01-01

    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

  3. Scanning laser ophthalmoscope measurement of local fundus reflectance and autofluorescence changes arising from rhodopsin bleaching and regeneration.

    Science.gov (United States)

    Morgan, Jessica I W; Pugh, Edward N

    2013-03-01

    We measured the bleaching and regeneration kinetics of rhodopsin in the living human eye with two-wavelength, wide-field scanning laser ophthalmoscopy (SLO), and investigated the effect of rhodopsin bleaching on autofluorescence intensity. The retina was imaged with an Optos P200C SLO by its reflectance of 532 and 633 nm light, and its autofluorescence excited by 532 nm light, before and after exposure to lights calibrated to bleach rhodopsin substantially. Bleaching was confined to circular retinal regions of 4.8° visual angle located approximately 16° superotemporal and superonasal to fixation. Images were captured as 12-bit tiff files and postprocessed to extract changes in reflectance and autofluorescence. At the locus of bleaching transient increases in reflectance of the 532 nm, but not the 633 nm beam were observed readily and quantified. A transient increase in autofluorescence also occurred. The action spectrum, absolute sensitivity, and recovery of the 532 nm reflectance increase were consistent with previous measurements of human rhodopsin's spectral sensitivity, photosensitivity, and regeneration kinetics. The autofluorescence changes closely tracked the changes in rhodopsin density. The bleaching and regeneration kinetics of rhodopsin can be measured locally in the human retina with a widely available SLO. The increased autofluorescence excited by 532 nm light upon bleaching appears primarily due to transient elimination of rhodopsin's screening of autofluorescent fluorochromes in the RPE. The spatially localized measurement with a widely available SLO of rhodopsin, the most abundant protein in the retina, could be a valuable adjunct to retinal health assessment.

  4. Structure-Function Correlation Using Confocal Laser Ophthalmoscope in Primary Open-Angle Glaucoma and Pseudoexfoliative Glaucoma.

    Science.gov (United States)

    Pappas, Theofanis; Founti, Panayiota; Yin, Xiang Jun; Koskosas, Archimidis; Anastasopoulos, Eleftherios; Salonikiou, Angeliki; Kilintzis, Vasilios; Antoniadis, Antonios; Ziakas, Nikolaos; Topouzis, Fotis

    2016-04-01

    To compare Heidelberg Retina Tomograph (HRT) optic disc parameters and structure-function correlation between primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PEXG). Prospective, observation case series. A total of 54 POAG and 33 PEXG cases, consecutively recruited from a University Glaucoma Service, underwent a comprehensive ophthalmic examination, including HRT optic disc imaging. Glaucoma definition required the presence of both structural and functional damage. One eye per subject was included in the analysis. T test, Mann-Whitney U test, and analysis of covariance were used to compare HRT parameters between POAG and PEXG, adjusting for age, mean deviation (MD) in the visual field, intraocular pressure, and disc area. The correlation between HRT and MD was assessed in each group. Cup area (P=0.048), height variation contour (P=0.016), and cup/disc area ratio (P=0.023) were higher in POAG, whereas the mean retinal nerve fiber layer thickness (P=0.048), retinal nerve fiber layer cross-section area (P=0.044), and rim area (P=0.048) were lower in POAG, compared with PEXG. The correlation of HRT parameters with MD was significant only in the POAG group. At a similar level of functional damage, POAG subjects presented with more pronounced structural damage than PEXG subjects. The correlation between HRT and visual field parameters was more evident in POAG, compared with PEXG.

  5. Volumetric imaging of rod and cone photoreceptor structure with a combined adaptive optics-optical coherence tomography-scanning laser ophthalmoscope

    Science.gov (United States)

    Wells-Gray, Elaine M.; Choi, Stacey S.; Zawadzki, Robert J.; Finn, Susanna C.; Greiner, Cherry; Werner, John S.; Doble, Nathan

    2018-03-01

    We have designed and implemented a dual-mode adaptive optics (AO) imaging system that combines spectral domain optical coherence tomography (OCT) and scanning laser ophthalmoscopy (SLO) for in vivo imaging of the human retina. The system simultaneously acquires SLO frames and OCT B-scans at 60 Hz with an OCT volume acquisition time of 4.2 s. Transverse eye motion measured from the SLO is used to register the OCT B-scans to generate three-dimensional (3-D) volumes. Key optical design considerations include: minimizing system aberrations through the use of off-axis relay telescopes, conjugate pupil plane requirements, and the use of dichroic beam splitters to separate and recombine the OCT and SLO beams around the nonshared horizontal scanning mirrors. To demonstrate system performance, AO-OCT-SLO images and measurements are taken from three normal human subjects ranging in retinal eccentricity from the fovea out to 15-deg temporal and 20-deg superior. Also presented are en face OCT projections generated from the registered 3-D volumes. The ability to acquire high-resolution 3-D images of the human retina in the midperiphery and beyond has clinical importance in diseases, such as retinitis pigmentosa and cone-rod dystrophy.

  6. Evaluation of Chronic Stress Induced Neurodegeneration and Treatment Using and In-Vivo Retinal Model

    National Research Council Canada - National Science Library

    Rentmeiater-Bryant, Heike

    2002-01-01

    ...) has been long suspected. This study will determine the effectiveness of the snake eye/Scanning Laser Ophthalmoscope model, an in vivo, non- invasive imaging technique, for use as a longitudinal model in the study of neural...

  7. Photoreceptor atrophy in acute zonal occult outer retinopathy

    DEFF Research Database (Denmark)

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

    2006-01-01

    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...

  8. Childhood Eye Diseases in Bayelsa State, Nigeria: A Tertiary Eye ...

    African Journals Online (AJOL)

    -Streit) and a posterior segement examination using a direct and indirect ophthalmoscopes (KeelerR) as necessary. Those requiring refraction was sent to the optometrist. Objective refraction was done using a Carl Zeiss 599 autorefractometer ...

  9. Meeting the challenges in the diagnosis of inflammatory myopathies

    African Journals Online (AJOL)

    be costly, as delays in initiating treatment may ... Atypical features suggesting an alternative diagnosis are acute onset, severe ... an ophthalmoscope to identify vascular .... distinguish between active inflammation and muscle necrosis, but its.

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

    Science.gov (United States)

    Kampik, A; Rapp, J

    1979-02-01

    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.

  11. Prevalence and determinants of corneal blindness in a Semi-Urban ...

    African Journals Online (AJOL)

    Ocular examinations of the anterior and posterior segments of the participants were performed using pen touch, magnifying loupe, slit lamp and direct ophthalmoscope. The data collected were analyzed using the Statistical Package for Social Sciences software version 22. Summary statistics was presented using frequency ...

  12. [Difficulties of diagnosis in a case of optic nerve drusen].

    Science.gov (United States)

    Munteanu, M; Munteanu, G

    2000-01-01

    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.

  13. The Pediatric Cataract Register (PECARE)

    DEFF Research Database (Denmark)

    Haargaard, Birgitte; Nyström, Alf; Rosensvärd, Annika

    2015-01-01

    examination with a pencil light at age 5 weeks, whereas newborn red reflex examination using a handheld ophthalmoscope is routine protocol in Swedish maternity wards. Data regarding age of referral were derived from the Pediatric Cataract Register (PECARE). All children operated on before 1 year of age...

  14. [Sex-linked juvenile retinoschisis].

    Science.gov (United States)

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

    1976-02-01

    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.

  15. Tear ferning in normal dogs and dogs with keratoconjunctivitis sicca ...

    African Journals Online (AJOL)

    This study evaluates tear ferning as an ancillary technique for the evaluation of the canine tear film in normal eyes and eyes affected by keratoconjunctivitis sicca (KCS). Thirty dogs with KCS and 50 control dogs with normal tear film were evaluated with a full ophthalmoscopic examination and a Schirmer tear test type 1 ...

  16. Fundus reflectance : historical and present ideas

    NARCIS (Netherlands)

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

    2003-01-01

    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

  17. Prevalence of Cataract Blindness in Rural Ethiopia | Woldeyes ...

    African Journals Online (AJOL)

    ... examinations were performed using torch light, 2.5 X magnifying glasses and an ophthalmoscope. Cataract was defined as lens opacity identified as the cause of blindness and low vision after ruling out other causes. Unfortunately, there was no access to a refraction set and slit lamp to conduct thorough examinations.

  18. Impact of a sight-saver clinic on the prevalence of blindness in ...

    African Journals Online (AJOL)

    solely to age-related cataract was 0,39% (95% Cl ... The prevalence of blindness due solely to age- related ... National Council for the Blind, to provide preventive and ... of the optic disc and macula with a direct ophthalmoscope. ... whose cataracts had been treated by surgery were included .... Blindness and eye disease in.

  19. Wavefront sensorless adaptive optics ophthalmoscopy in the human eye

    Science.gov (United States)

    Hofer, Heidi; Sredar, Nripun; Queener, Hope; Li, Chaohong; Porter, Jason

    2011-01-01

    Wavefront sensor noise and fidelity place a fundamental limit on achievable image quality in current adaptive optics ophthalmoscopes. Additionally, the wavefront sensor ‘beacon’ can interfere with visual experiments. We demonstrate real-time (25 Hz), wavefront sensorless adaptive optics imaging in the living human eye with image quality rivaling that of wavefront sensor based control in the same system. A stochastic parallel gradient descent algorithm directly optimized the mean intensity in retinal image frames acquired with a confocal adaptive optics scanning laser ophthalmoscope (AOSLO). When imaging through natural, undilated pupils, both control methods resulted in comparable mean image intensities. However, when imaging through dilated pupils, image intensity was generally higher following wavefront sensor-based control. Despite the typically reduced intensity, image contrast was higher, on average, with sensorless control. Wavefront sensorless control is a viable option for imaging the living human eye and future refinements of this technique may result in even greater optical gains. PMID:21934779

  20. Improving high resolution retinal image quality using speckle illumination HiLo imaging.

    Science.gov (United States)

    Zhou, Xiaolin; Bedggood, Phillip; Metha, Andrew

    2014-08-01

    Retinal image quality from flood illumination adaptive optics (AO) ophthalmoscopes is adversely affected by out-of-focus light scatter due to the lack of confocality. This effect is more pronounced in small eyes, such as that of rodents, because the requisite high optical power confers a large dioptric thickness to the retina. A recently-developed structured illumination microscopy (SIM) technique called HiLo imaging has been shown to reduce the effect of out-of-focus light scatter in flood illumination microscopes and produce pseudo-confocal images with significantly improved image quality. In this work, we adopted the HiLo technique to a flood AO ophthalmoscope and performed AO imaging in both (physical) model and live rat eyes. The improvement in image quality from HiLo imaging is shown both qualitatively and quantitatively by using spatial spectral analysis.

  1. Differential diagnosis of retinal vasculitis.

    Science.gov (United States)

    Abu El-Asrar, Ahmed M; Herbort, Carl P; Tabbara, Khalid F

    2009-10-01

    Retinal vaculitis is a sight-threatening inflammatory eye condition that involves the retinal vessels. Detection of retinal vasculitis is made clinically, and confirmed with the help of fundus fluorescein angiography. Active vascular disease is characterized by exudates around retinal vessels resulting in white sheathing or cuffing of the affected vessels. In this review, a practical approach to the diagnosis of retinal vasculitis is discussed based on ophthalmoscopic and fundus fluorescein angiographic findings.

  2. A clinical approach to the diagnosis of retinal vasculitis.

    Science.gov (United States)

    El-Asrar, Ahmed M Abu; Herbort, Carl P; Tabbara, Khalid F

    2010-04-01

    Retinal vasculitis is a sight-threatening inflammatory eye condition that involves the retinal vessels. Detection of retinal vasculitis is made clinically, and is confirmed with the help of fundus fluorescein angiography. Active vascular disease is characterized by exudates around retinal vessels resulting in white sheathing or cuffing of the affected vessels. In this review, a practical approach to the diagnosis of retinal vasculitis is discussed based on ophthalmoscopic and fundus fluorescein angiographic findings.

  3. Heidelberg Retina Tomograph for the Detection of Glaucoma

    Directory of Open Access Journals (Sweden)

    Barbara Cvenkel

    2012-06-01

    Full Text Available Heidelberg Retina Tomograph (HRT is a confocal scanning laser ophthalmoscope which acquires and analyzes 3-dimensional images of the optic nerve head. The latest instrument HRT3 includes software with larger ethinic-specific normative database. This review summarizes relevant published literature on HRT in diagnosing glaucoma, detecting glaucoma progression, the diagnostic accuracy of HRT among other imaging devices and its role in clinical practice.

  4. Fluorescence Lifetime Imaging in Stargardt Disease: Potential Marker for Disease Progression

    OpenAIRE

    Dysli Chantal; Wolf Sebastian; Hatz Katja; Zinkernagel Martin

    2016-01-01

    PURPOSE The purpose of this study was to describe autofluorescence lifetime characteristics in Stargardt disease (STGD) using fluorescence lifetime imaging ophthalmoscopy (FLIO) and to investigate potential prognostic markers for disease activity and progression. METHODS Fluorescence lifetime data of 16 patients with STGD (mean age, 40 years; range, 22-56 years) and 15 age-matched controls were acquired using a fluorescence lifetime imaging ophthalmoscope based on a Heidelberg Eng...

  5. ADAPTIVE OPTICS IMAGING OF FOVEAL SPARING IN GEOGRAPHIC ATROPHY SECONDARY TO AGE-RELATED MACULAR DEGENERATION.

    Science.gov (United States)

    Querques, Giuseppe; Kamami-Levy, Cynthia; Georges, Anouk; Pedinielli, Alexandre; Capuano, Vittorio; Blanco-Garavito, Rocio; Poulon, Fanny; Souied, Eric H

    2016-02-01

    To describe adaptive optics (AO) imaging of foveal sparing in geographic atrophy (GA) secondary to age-related macular degeneration. Flood-illumination AO infrared (IR) fundus images were obtained in four consecutive patients with GA using an AO retinal camera (rtx1; Imagine Eyes). Adaptive optics IR images were overlaid with confocal scanning laser ophthalmoscope near-IR autofluorescence images to allow direct correlation of en face AO features with areas of foveal sparing. Adaptive optics appearance of GA and foveal sparing, preservation of functional photoreceptors, and cone densities in areas of foveal sparing were investigated. In 5 eyes of 4 patients (all female; mean age 74.2 ± 11.9 years), a total of 5 images, sized 4° × 4°, of foveal sparing visualized on confocal scanning laser ophthalmoscope near-IR autofluorescence were investigated by AO imaging. En face AO images revealed GA as regions of inhomogeneous hyperreflectivity with irregularly dispersed hyporeflective clumps. By direct comparison with adjacent regions of GA, foveal sparing appeared as well-demarcated areas of reduced reflectivity with less hyporeflective clumps (mean 14.2 vs. 3.2; P = 0.03). Of note, in these areas, en face AO IR images revealed cone photoreceptors as hyperreflective dots over the background reflectivity (mean cone density 3,271 ± 1,109 cones per square millimeter). Microperimetry demonstrated residual function in areas of foveal sparing detected by confocal scanning laser ophthalmoscope near-IR autofluorescence. Adaptive optics allows the appreciation of differences in reflectivity between regions of GA and foveal sparing. Preservation of functional cone photoreceptors was demonstrated on en face AO IR images in areas of foveal sparing detected by confocal scanning laser ophthalmoscope near-IR autofluorescence.

  6. A Novel Approach for Sub-Threshold Detection and Prevention of Laser Injury in Ocular Tissue

    Science.gov (United States)

    2009-05-31

    which laser-induced changes in the autofluorescence features of retina were observed in vivo following laser treatment. 10 Use or disclosure of...wavelength scanning laser ophthalmoscope (SLO) for multi spectral in vivo fluorescence imaging of animal retina following laser exposure. The imaging...system was optimized for retinal imaging in aged Brown Norway rats. In order to induce laser lesions in the retina in vivo, we integrated the surgical

  7. Non-invasive retinal imaging in mice with fluorescent Scanning Laser Ophthalmoscopy and Fourier Domain Optical Coherence Tomography

    OpenAIRE

    Hossein-Javaheri, Nima

    2010-01-01

    Visualization of the internal structures of the retina is critical for clinical diagnosis and monitoring of pathology as well as for medical research investigating the root causes of retinal degeneration. The aim of this thesis is to develop multi-modal non-invasive imaging technology for studying retinal degeneration and gene therapy in mice. We have constructed a FD-OCT prototype and combined it with a Scanning Laser Ophthalmoscope (SLO) to permit real time alignment of the retinal field of...

  8. Orphan disease: Cherubism, optic atrophy, and short stature

    OpenAIRE

    Balaji Jeevanandham; Rajoo Ramachandran; Vignesh Dhanapal; Ilanchezhian Subramanian; Venkata Sai

    2018-01-01

    A 12-year-old female presented with complaints of progressive visual impairment in both her eyes. On clinical examination, she was short for her age and her ophthalmoscopic examination revealed bilateral optic atrophy. Computed tomography of the patient revealed multiple expansile lytic lesions of mandible suggesting cherubism. The optic atrophy was confirmed on magnetic resonance imaging, which additionally revealed bilateral retrocerebellar arachnoid cysts. This association of cherubism wit...

  9. Interactive segmentation for geographic atrophy in retinal fundus images

    OpenAIRE

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

    2008-01-01

    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...

  10. X-linked ocular albinism in Blacks. Ocular albinism cum pigmento.

    Science.gov (United States)

    O'Donnell, F E; Green, W R; Fleischman, J A; Hambrick, G W

    1978-07-01

    X-linked ocular albinism can be an unsuspected cause of congenital nystagmus in blacks. In this study, eight of ten black ocular albinos from two kindreds had nonalbinotic, moderately pigmented fundi and no transillumination of the iris. We refer to this paradoxical condition as "ocular albinism cum pigmento." The only constant ophthalmoscopic feature was a foveal hypoplasia. Biopsy of clinically normal skin to demonstrate giant pigment granules is the most accurate means of diagnosis.

  11. Ocular Onchocerciasis in the Yanomami Communities from Brazilian Amazon: Effects on Intraocular Pressure

    OpenAIRE

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

    2014-01-01

    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 ...

  12. USAFSAM Review and Analysis of Radiofrequency Radiation Bioeffects Literature.

    Science.gov (United States)

    1981-11-01

    less than 0.2 mW/cm . Clinical tests included ophthalmoscopic examination and a neurologic check-up supplemented by psychologic tests and EEG...34). These 12 studies are assessed individually and collectively below, followed by the analyses of each per se. Collective Summary In Lilienfeld et al...hours/workday). Electrocardiograms, heart and lung X-rays, eryth- rocyte sedimentation rates, urinalyses, and liver function tests were conducted as well

  13. COMPARISON OF RETINAL PATHOLOGY VISUALIZATION IN MULTISPECTRAL SCANNING LASER IMAGING.

    Science.gov (United States)

    Meshi, Amit; Lin, Tiezhu; Dans, Kunny; Chen, Kevin C; Amador, Manuel; Hasenstab, Kyle; Muftuoglu, Ilkay Kilic; Nudleman, Eric; Chao, Daniel; Bartsch, Dirk-Uwe; Freeman, William R

    2018-03-16

    To compare retinal pathology visualization in multispectral scanning laser ophthalmoscope imaging between the Spectralis and Optos devices. This retrospective cross-sectional study included 42 eyes from 30 patients with age-related macular degeneration (19 eyes), diabetic retinopathy (10 eyes), and epiretinal membrane (13 eyes). All patients underwent retinal imaging with a color fundus camera (broad-spectrum white light), the Spectralis HRA-2 system (3-color monochromatic lasers), and the Optos P200 system (2-color monochromatic lasers). The Optos image was cropped to a similar size as the Spectralis image. Seven masked graders marked retinal pathologies in each image within a 5 × 5 grid that included the macula. The average area with detected retinal pathology in all eyes was larger in the Spectralis images compared with Optos images (32.4% larger, P < 0.0001), mainly because of better visualization of epiretinal membrane and retinal hemorrhage. The average detection rate of age-related macular degeneration and diabetic retinopathy pathologies was similar across the three modalities, whereas epiretinal membrane detection rate was significantly higher in the Spectralis images. Spectralis tricolor multispectral scanning laser ophthalmoscope imaging had higher rate of pathology detection primarily because of better epiretinal membrane and retinal hemorrhage visualization compared with Optos bicolor multispectral scanning laser ophthalmoscope imaging.

  14. Spectral domain optical coherence tomography as an effective screening test for hydroxychloroquine retinopathy (the “flying saucer” sign

    Directory of Open Access Journals (Sweden)

    Eric Chen

    2010-10-01

    Full Text Available Eric Chen, David M Brown, Matthew S Benz, Richard H Fish, Tien P Wong, Rosa Y Kim, James C MajorRetina Consultants of Houston, The Methodist Hospital, Houston, Texas, USAPurpose: While the long-term incidence of hydroxychloroquine (HCQ retinopathy is low, there remains no definitive clinical screening test to recognize HCQ toxicity before ophthalmoscopic fundus changes or visual symptoms. Patients receiving HCQ were evaluated with spectral domain optical coherence tomography (SD OCT to assess the feasibility of identifying HCQ retinopathy at an early stage.Methods: Twenty-five patients referred for the evaluation of hydroxychloroquine toxicity underwent a comprehensive ocular examination, Humphrey visual field (HVF perimetry, time domain OCT, and SD OCT. Some patients with screening abnormalities also underwent further diagnostic testing at the discretion of the treating providers.Results: Five patients were found to have SD OCT findings corresponding to HCQ toxicity and retinal damage as seen by clinical exam and/or HVF perimetry. Two patients with advanced toxicity were found to have significant outer retina disruption in the macula on SD OCT. Three patients with early HCQ toxicity and HVF 10-2 perifoveal defects were found to have loss of the perifoveal photoreceptor inner segment/outer segment (IS/OS junction with intact outer retina directly under the fovea, creating the “flying saucer” sign. While two of these three patients had early ophthalmoscopic fundus changes, one had none.Conclusion: Outer retinal abnormalities including perifoveal photoreceptor IS/OS junction disruption can be identified by SD OCT in early HCQ toxicity, sometimes even before ophthalmoscopic fundus changes are apparent. SD OCT may have a potential complementary role in screening for HCQ retinopathy due to its quick acquisition and because it is more objective than automated perimetry.Keywords: drug toxicity, hydroxychloroquine, photoreceptors, screening test

  15. Spectral domain optical coherence tomography as an effective screening test for hydroxychloroquine retinopathy (the "flying saucer" sign).

    Science.gov (United States)

    Chen, Eric; Brown, David M; Benz, Matthew S; Fish, Richard H; Wong, Tien P; Kim, Rosa Y; Major, James C

    2010-10-21

    While the long-term incidence of hydroxychloroquine (HCQ) retinopathy is low, there remains no definitive clinical screening test to recognize HCQ toxicity before ophthalmoscopic fundus changes or visual symptoms. Patients receiving HCQ were evaluated with spectral domain optical coherence tomography (SD OCT) to assess the feasibility of identifying HCQ retinopathy at an early stage. Twenty-five patients referred for the evaluation of hydroxychloroquine toxicity underwent a comprehensive ocular examination, Humphrey visual field (HVF) perimetry, time domain OCT, and SD OCT. Some patients with screening abnormalities also underwent further diagnostic testing at the discretion of the treating providers. Five patients were found to have SD OCT findings corresponding to HCQ toxicity and retinal damage as seen by clinical exam and/or HVF perimetry. Two patients with advanced toxicity were found to have significant outer retina disruption in the macula on SD OCT. Three patients with early HCQ toxicity and HVF 10-2 perifoveal defects were found to have loss of the perifoveal photoreceptor inner segment/outer segment (IS/OS) junction with intact outer retina directly under the fovea, creating the "flying saucer" sign. While two of these three patients had early ophthalmoscopic fundus changes, one had none. Outer retinal abnormalities including perifoveal photoreceptor IS/OS junction disruption can be identified by SD OCT in early HCQ toxicity, sometimes even before ophthalmoscopic fundus changes are apparent. SD OCT may have a potential complementary role in screening for HCQ retinopathy due to its quick acquisition and because it is more objective than automated perimetry.

  16. SOME ASPECTS OF SCANNING LASER OPHTHALMOSCOPY IN THE DIAGNOSTICS OF OPHTHALMOPATHOLOGY

    Directory of Open Access Journals (Sweden)

    S. A. Kochergin

    2017-01-01

    Full Text Available The exact diagnosis of the fundus pathology requires the most modern equipment use. This is mandatory for the selection of the most complete therapy and monitoring of ongoing treatment. At present, the method of scanning laser ophthalmoscopy is widely spread. However, for the earliest detection of the smallest pathological changes, data of the normal ocular fundus state using a scanning laser ophthalmoscope is necessary. Thus, the purpose of our research becomes relevant. Purpose: to give a characteristic of the fundus in patients without concomitant pathology with using various modes of a scanning laser ophthalmoscope. Patients and methods. 116 people (232 eyes at the age from 17 to 71 years (mean age 32.5±12 years were examined. The patients were divided into two groups. Group I: 81 patients (162 eyes with different ophthalmopathology. Group II: 35 people (70 eyes — practically healthy and did not have an anamnesis of consulting an ophthalmologist. Diagnosis of the patients’ fundus was performed using a scanning laser ophthalmoscopy with retro-mode imaging and autofluorescence registration. Results. After the conducted research features and regularities of the reflectivity distribution of laser beams from the fundus structures are revealed. Also a characteristic of various anatomical formations and zones of the fundus in the normal conditions is given when examined by a scanning laser ophthalmoscope. An algorithm for examining patients and analyzing the images was developed. Conclusion. The use of scanning laser ophthalmoscopy made possible to take a fresh look at the algorithms of diagnosing patients with fundus pathology. Understanding the normal conditions ofundus allowed an earlier detection of the smallest pathological changes in the retina. 

  17. In vivo two-photon imaging of retina in rabbits and rats.

    Science.gov (United States)

    Jayabalan, Gopal Swamy; Wu, Yi-Kai; Bille, Josef F; Kim, Samuel; Mao, Xiao Wen; Gimbel, Howard V; Rauser, Michael E; Fan, Joseph T

    2018-01-01

    The purpose of this study was to evaluate the retina using near-infrared (NIR) two-photon scanning laser ophthalmoscopy. New Zealand white rabbits, albino rats, and brown Norway rats were used in this study. An autofluorescence image of the retina, including the retinal cells and its associated vasculatures was obtained by a real-time scan using the ophthalmoscope. Furthermore, the retinal vessels, nerve fiber layers and the non-pigmented retina were recorded with two-photon fluorescein angiography (FA); and the choroidal vasculatures were recorded using two-photon indocyanine green angiography (ICGA). Two-photon ICGA was achieved by exciting a second singlet state at ∼398 nm. Simultaneous two-photon FA and two-photon ICGA were performed to characterize the retinal and choroidal vessels with a single injection. The minimum laser power threshold required to elicit two-photon fluorescence was determined. The two-photon ophthalmoscope could serve as a promising tool to detect and monitor the disease progression in animal models. Moreover, these high-resolution images of retinal and choroidal vessels can be acquired in a real-time scan with a single light source, requiring no additional filters for FA or ICGA. The combination of FA and ICGA using the two-photon ophthalmoscope will help researchers to characterize the retinal diseases in animal models, and also to classify the types (classic, occult or mixed) of choroidal neovascularization (CNV) in macular degeneration. Furthermore, the prototype can be adapted to image the retina of rodents and rabbits. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Clinical Examination Component of Telemedicine, Telehealth, mHealth, and Connected Health Medical Practices.

    Science.gov (United States)

    Weinstein, Ronald S; Krupinski, Elizabeth A; Doarn, Charles R

    2018-05-01

    Telemedicine and telehealth are the practices of medicine at a distance. Performing the equivalent of a complete clinical examination by telemedicine would be unusual. However, components of a more traditional clinical examination are part of the telemedicine workup for specific conditions. Telemedicine clinical examinations are facilitated, and enhanced, through the integration of a class of medical devices referred to as telemedicine peripherals (eg, electronic stethoscopes, tele-ophthalmoscopes, video-otoscopes, and so forth). Direct-to-consumer telehealth is a rapidly expanding segment of the health care service industry. Copyright © 2018 Elsevier Inc. All rights reserved.

  19. Magnetic resonance imaging of optic nerve

    International Nuclear Information System (INIS)

    Gala, Foram

    2015-01-01

    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

  20. The opportunistic screening of refractive errors in school-going children by pediatrician using enhanced Br?ckner test

    OpenAIRE

    Jain, Piyush; Kothari, Mihir T; Gode, Vaibhav

    2016-01-01

    Aim: The aim of this study was to compare the results of enhanced Brückner test (EBT) performed by a pediatrician and an experienced pediatric ophthalmologist. Subjects and Methods: In this prospective double-masked cohort study, a pediatrician and a pediatric ophthalmologist performed the EBT in a classroom of a school in semi-dark lighting condition using a direct ophthalmoscope. The results of the test were compared using 2 × 2 Bayesian table and kappa statistics. The findings of the pedia...

  1. A Case of oculocutaneous albinism in a Maltese.

    Science.gov (United States)

    Park, Shin Ae; Yi, Na Young; Kim, Min Su; Lim, Ji Hey; Jeong, Man Bok; Nam, Tchi Chou; Seo, Kang Moon

    2005-12-01

    A 4-month-old female maltese dog was admitted to Veterinary Medical Teaching Hospital of Seoul National University for evaluation of abnormal color of bilateral irises. This patient had the photophobia in the light and exhibited the complete absence of pigment resulting in white hair, pink muzzle, eyelids and foot-pads. Central zone of the irises were yellow in color influenced by tapetal reflex, and peripheral zone were pale blue. The iridal capillaries were transparented on the irises. Ophthalmoscopic examination revealed a yellow tapetal fundus but no pigment in the nontapetal fundus.

  2. Bilateral choroidal osteomas associated with fatal systemic illness.

    Science.gov (United States)

    Kline, L B; Skalka, H W; Davidson, J D; Wilmes, F J

    1982-02-01

    An 11-year-old black boy complained of intermittent occipital headaches with nausea and projectile vomiting. Previous skin and lung biopsy specimens were interpreted as histiocytosis X. Cranial computed tomographic scanning disclosed a mass lesion in the region of the choroid plexus of the left lateral ventricle. This was surgically removed but proved nondiagnostic despite extensive histologic examination. An ophthalmologic evaluation showed discrete, elevated, yellow-white choroidal tumors in both maculas. The ophthalmoscopic appearance, as well as ultrasonography and computed tomography, led to the diagnosis of choroidal osteomas.

  3. Orphan disease: Cherubism, optic atrophy, and short stature

    Directory of Open Access Journals (Sweden)

    Balaji Jeevanandham

    2018-01-01

    Full Text Available A 12-year-old female presented with complaints of progressive visual impairment in both her eyes. On clinical examination, she was short for her age and her ophthalmoscopic examination revealed bilateral optic atrophy. Computed tomography of the patient revealed multiple expansile lytic lesions of mandible suggesting cherubism. The optic atrophy was confirmed on magnetic resonance imaging, which additionally revealed bilateral retrocerebellar arachnoid cysts. This association of cherubism with optic atrophy and short stature was grouped as orphan disease by National Institutes of Health and only one case was reported in the literature so far.

  4. Orphan disease: Cherubism, optic atrophy, and short stature.

    Science.gov (United States)

    Jeevanandham, Balaji; Ramachandran, Rajoo; Dhanapal, Vignesh; Subramanian, Ilanchezhian; Sai, Venkata

    2018-01-01

    A 12-year-old female presented with complaints of progressive visual impairment in both her eyes. On clinical examination, she was short for her age and her ophthalmoscopic examination revealed bilateral optic atrophy. Computed tomography of the patient revealed multiple expansile lytic lesions of mandible suggesting cherubism. The optic atrophy was confirmed on magnetic resonance imaging, which additionally revealed bilateral retrocerebellar arachnoid cysts. This association of cherubism with optic atrophy and short stature was grouped as orphan disease by National Institutes of Health and only one case was reported in the literature so far.

  5. Cortical heterotopia in Aicardi's syndrome - CT findings

    International Nuclear Information System (INIS)

    Besenski, N.; Bosnjak, V.; Ligutic, I.; Marusic-Della Marina, B.

    1988-01-01

    The case of 5-month-old female infant with Aicardi's syndrome is presented. The main clinical features were severe developmental retardation and intractable epileptic seizures. Ophthalmoscopic examination revealed pathognomonic choriorethinopathy. Ultrasonic examination of the brain detected agenesis of the corpus callosum, whereas CT showed a coexisting malformation of the brain, i.e. cortical heterotopia of the gray matter. Agenesis of the corpus callosum is an entity well-recognized by sonography. However, ultrasonography is an insufficient modality for the visualization of cortical heterotopia which is common to all cases of Aicardi's syndrome. Therefore, in cases of suspected Aicardi's syndrome CT is recommended, as it enables the diagnosis of cortical heterotopia. (orig.)

  6. In vivo observation of transient photoreceptor movement correlated with oblique light stimulation

    Science.gov (United States)

    Lu, Yiming; Liu, Changgeng; Yao, Xincheng

    2018-02-01

    Rod-dominated transient retinal phototropism (TRP) has been observed in freshly isolated retinas, promising a noninvasive biomarker for high resolution assessment of retinal physiology. However, in vivo mapping of TRP is challenging due to its fast time course and sub-cellular signal magnitude. By developing a line-scanning and virtually structured detection based super-resolution ophthalmoscope, we report here in vivo observation of TRP in frog retina. In vivo characterization of TRP time course and magnitude were implemented by using variable light stimulus intensities.

  7. The Preliminary Development of a Robotic Laser System Used for Ophthalmic Surgery

    Science.gov (United States)

    1988-01-01

    the fundus took hold with the invention of the ophthalmoscope in 1851 by Helmholtz [2-5] and the first fundus photograph by Jackman and Webb in 1886...2-25. W. T. Jackman and J. D. Webster, "On Photographing the Retina of the Living Eye", Phil. Photographer, Vol. 23, pg. 275, 1886. 2-26. J. A. M...Mainster, G. T. Timberlake, R. H. Webb and G. W. Hughes , "Scanning Laser Ophthalmoscopy", Ophthalmology, Vol. 89, No. 7, pp. 852-857, July 1982. 7-39. D

  8. Ocular onchocerciasis in the Yanomami communities from Brazilian Amazon: effects on intraocular pressure.

    Science.gov (United States)

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

    2014-01-01

    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.

  9. In Vivo Imaging of Microglia Turnover in the Mouse Retina After Ionizing Radiation and Dexamethasone Treatment

    DEFF Research Database (Denmark)

    Alt, C.; Runnels, J. M.; Mortensen, L. J.

    2014-01-01

    irradiation with a confocal scanning laser ophthalmoscope that we custom-built specifically for multicolor imaging of the murine retina. RESULTS. Ionizing radiation resulted in loss of 75% of the resident retinal microglia population after 70 days. Recruitment of BMDCs was delayed with respect...... dexamethasone preserves resident microglia and minimizes recruitment of BMDCs after ionizing radiation exposure and BMT.......PURPOSE. Gamma irradiation and bone marrow transplantation (BMT) are established clinical procedures for the treatment of hematologic malignancies. The radiation targets cells in the bone marrow, but injury to other tissues, including the central nervous system (CNS), have been reported. Here, we...

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    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......-artifact-free, ultrahigh resolution and high contrast retinal and choroidal imaging. The two wavelengths of the device provide the complementary information needed for diagnosis of subtle retinal changes, while also increasing visibility of deeper-lying layers to image pathologies that include opaque media in the anterior...... eye segment or eyes with increased choroidal thickness....

  11. Papilledema secondary to a superior sagittal sinus thrombosis. Mantle cell lymphoma paraneoplastic syndrome.

    Science.gov (United States)

    Platas-Moreno, I; Antón-Benito, A; Pérez-Cid-Rebolleda, M T; Rosado Sierra, M B

    2016-01-01

    A 46 year old patient presented with visual loss in the left eye during the previous months. Ophthalmoscopic examination and magnetic resonance angiography found the presence of papilledema due to thrombosis in superior sagittal sinus. The examination findings revealed a mantle cell lymphoma. Cerebral venous thrombosis is an unusual cause of papilledema. This type of thrombosis may be secondary to hyper-viscosity within a context of a paraneoplastic syndrome. Copyright © 2015 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  12. Foveal cone spacing and cone photopigment density difference: objective measurements in the same subjects.

    Science.gov (United States)

    Marcos, S; Tornow, R P; Elsner, A E; Navarro, R

    1997-07-01

    Foveal cone spacing was measured in vivo using an objective technique: ocular speckle interferometry. Cone packing density was computed from cone spacing data. Foveal cone photopigment density difference was measured in the same subjects using retinal densitometry with a scanning laser ophthalmoscope. Both the cone packing density and cone photopigment density difference decreased sharply with increasing retinal eccentricity. From the comparison of both sets of measurements, the computed amounts of photopigment per cone increased slightly with increasing retinal eccentricity. Consistent with previous results, decreases in cone outer segment length are over-compensated by an increase in the outer segment area, at least in retinal eccentricities up to 1 deg.

  13. Inherited retinal dysplasia and persistent hyperplastic primary vitreous in Miniature Schnauzer dogs.

    Science.gov (United States)

    Grahn, Bruce H; Storey, Eric S; McMillan, Catherine

    2004-01-01

    The objectives of this study were to define the clinical syndrome of retinal dysplasia and persistent primary vitreous in Miniature Schnauzer dogs and determine the etiology. We examined 106 Miniature Schnauzers using a biomicroscope and indirect ophthalmoscope. The anterior and posterior segments of affected dogs were photographed. Four enucleated eyes were examined using routine light microscopy and scanning electron microscopy. A pedigree was constructed and related dogs were test-bred to define the mode of inheritance of this syndrome. Congenital retinal dysplasia was confirmed in 24 of 106 related Miniature Schnauzer dogs. Physical and postmortem examinations revealed that congenital abnormalities were limited to the eyes. Biomicroscopic, indirect ophthalmoscopic, and neuro-ophthalmic examinations confirmed that some of these dogs were blind secondary to bilateral retinal dysplasia and detachment (nonattachment) (n = 13), and the remainder had generalized retinal dysplasia (n = 11). Fifteen of these dogs were also diagnosed with unilateral (n = 9) or bilateral (n = 6) persistent hyperplastic primary vitreous. Nutritional, infectious, or toxic etiologies were not evident on physical, postmortem, light microscopic, or transmitting and scanning electron microscopic examination of four affected Miniature Schnauzers. We examined the pedigree and determined that an autosomal recessive mode of inheritance was most likely. Three test-bred litters including those from affected parents, carrier and affected parents, and carrier parents confirmed this mode of inheritance. This study confirms that retinal dysplasia and persistent hyperplastic primary vitreous is a congenital abnormality that is inherited as an autosomal recessive condition in Miniature Schnauzers.

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

    Science.gov (United States)

    Kulikov, Alexei N; Maltsev, Dmitrii S; Boiko, Ernest V

    2016-01-01

    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.

  15. Sub-Airy Confocal Adaptive Optics Scanning Ophthalmoscopy.

    Science.gov (United States)

    Sredar, Nripun; Fagbemi, Oladipo E; Dubra, Alfredo

    2018-04-01

    To demonstrate the viability of improving transverse image resolution in reflectance scanning adaptive optics ophthalmoscopy using sub-Airy disk confocal detection. The foveal cone mosaic was imaged in five human subjects free of known eye disease using two custom adaptive optics scanning light ophthalmoscopes (AOSLOs) in reflectance with 7.75 and 4.30 mm pupil diameters. Confocal pinholes of 0.5, 0.6, 0.8, and 1.0 Airy disk diameters (ADDs) were used in a retinal conjugate plane before the light detector. Average cone photoreceptor intensity profile width and power spectrum were calculated for the resulting images. Detected energy using a model eye was recorded for each pinhole size. The cone photoreceptor mosaic is better resolved with decreasing confocal pinhole size, with the high spatial frequency content of the images enhanced in both the large- and small-pupil AOSLOs. The average cone intensity profile width was reduced by ∼15% with the use of a 0.5 ADD pinhole when compared to a 1.0 ADD, with an accompanying reduction in signal greater than a factor of four. The use of sub-Airy disk confocal pinhole detection without increasing retinal light exposure results in a substantial improvement in image resolution at the cost of larger than predicted signal reduction. Improvement in transverse resolution using sub-Airy disk confocal detection is a practical and low-cost approach that is applicable to all point- and line-scanning ophthalmoscopes, including optical coherence tomographers.

  16. Near-infrared reflectance bull’s eye maculopathy as an early indication of hydroxychloroquine toxicity

    Directory of Open Access Journals (Sweden)

    Wong KL

    2015-03-01

    Full Text Available Keye L Wong,1 Scott E Pautler,2 David J Browning31Retina Associates of Sarasota, Sarasota, FL, USA; 2Retina Vitreous Associates of Florida, Tampa, FL, USA; 3Charlotte Eye Ear Nose and Throat Associates, Charlotte, NC, USAImportance: In some patients, hydroxychloroquine ocular toxicity may progress even following cessation of therapy. Any leverage the clinician may use to allow earlier detection may avert significant vision loss.Observation: We report three cases suggesting that bull’s eye maculopathy seen on near-infrared reflectance with a confocal scanning laser ophthalmoscope could be an early, objective manifestation of hydroxychloroquine ocular toxicity, and with progression of the disease this near-infrared “bull’s eye” change may disappear.Conclusion and relevance: Alerting clinicians to this observation may allow a larger case series to corroborate the hypothesis that bull’s eye maculopathy detected by near-infrared reflectance may represent an early sign of hydroxychloroquine toxicity.Keywords: confocal, scanning laser ophthalmoscope, multifocal ERG

  17. A study of fundus status in myopia

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    Christina Samuel, Sundararajan D

    2014-07-01

    Full Text Available Background: The most important sensory organ for a human is the eye. Any damage to the retina can cause diminution or loss of vision. One of the most important refractive errors of the eye is Myopia apart from hypermetropia and astigmatism. It is one of the commonest conditions seen in everyday practice. Myopic degeneration is one of the common causes of decreased visual acuity. Aim: The aim of this clinical study is to observe the fundus changes associated with Myopia. Methods: A prospective study of 100 cases of myopia were included in this study. Detailed anterior segment and good posterior segment examination after achieving mydriasis was done with a direct ophthalmoscope and indirect ophthalmoscope with 20D lens. Result: In our study, we found that males were more commonly affected than females with myopia (54%. 50% of the cases affected belonged to the student community. 53.68% had positive changes in the retina suggestive of degenerative changes in the fundus. Conclusion: Degenerative changes of fundus are most commonly seen in myopic patients of which Tessellated fundus was about 90.20%. Vitreous degenerative changes for 70.59%. Crescent formation was 87.25%. Dull foveal reflex in 82.35% and lattice degeneration accounted for 40%.

  18. Variation in sensitivity, absorption and density of the central rod distribution with eccentricity.

    Science.gov (United States)

    Tornow, R P; Stilling, R

    1998-01-01

    To assess the human rod photopigment distribution and sensitivity with high spatial resolution within the central +/-15 degrees and to compare the results of pigment absorption, sensitivity and rod density distribution (number of rods per square degree). Rod photopigment density distribution was measured with imaging densitometry using a modified Rodenstock scanning laser ophthalmoscope. Dark-adapted sensitivity profiles were measured with green stimuli (17' arc diameter, 1 degrees spacing) using a T ubingen manual perimeter. Sensitivity profiles were plotted on a linear scale and rod photopigment optical density distribution profiles were converted to absorption profiles of the rod photopigment layer. Both the absorption profile of the rod photopigment and the linear sensitivity profile for green stimuli show a minimum at the foveal center and increase steeply with eccentricity. The variation with eccentricity corresponds to the rod density distribution. Rod photopigment absorption profiles, retinal sensitivity profiles, and the rod density distribution are linearly related within the central +/-15 degrees. This is in agreement with theoretical considerations. Both methods, imaging retinal densitometry using a scanning laser ophthalmoscope and dark-adapted perimetry with small green stimuli, are useful for assessing the central rod distribution and sensitivity. However, at present, both methods have limitations. Suggestions for improving the reliability of both methods are given.

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

    Directory of Open Access Journals (Sweden)

    Sílvia Regina Ramos

    1999-12-01

    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

  20. Normative data set identifying properties of the macula across age groups: integration of visual function and retinal structure with microperimetry and spectral-domain optical coherence tomography.

    Science.gov (United States)

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

    2011-01-01

    A normative database of functional and structural parameters of the macula from normal subjects was established to identify reference points for the diagnosis of patients with macular disease using microperimetry and scanning laser ophthalmoscope/spectral-domain optical coherence tomography (SD-OCT). This was a community-based, prospective, cross-sectional study of 169 eyes from subjects aged 21 years to 85 years with best-corrected visual acuity of 20/25 or better and without any ocular disease. Full-threshold macular microperimetry combined with the acquisition of structural parameters of the macula with scanning laser ophthalmoscope/SD-OCT was recorded (SD-OCT/scanning laser ophthalmoscope with add-on Microperimetry module; OPKO). Fixation, central, subfield, and mean retinal thickness were acquired together with macular sensitivity function. Thickness and sensitivity as primary outcome measures were mapped and superimposed correlating topographically differentiated macular thickness with sensitivity. Statistical evaluation was performed with age, gender, and ethnicity as covariates. Subfield and mean retinal thickness and sensitivity were measured with macular microperimetry combined with SD-OCT and differentiated by macular topography and subjects' age, gender, and ethnicity. Mean retinal sensitivity and thickness were calculated for 169 healthy eyes (mean age, 48 ± 17 years). A statistically significant decrease in sensitivity was found only in the age group of participants ≥ 70 years and in peripheral portions of the macula in individuals aged ≥60 years and was more pronounced in the area surrounding the fovea than in the center of the macula, while retinal thickness did not change with age. No statistically significant differences in the primary outcome measures or their correlations were found when using gender or ethnicity as a covariate. A database for normal macular thickness and sensitivity was generated with a combined microperimetry SD

  1. ROLE OF HIGH RESOLUTION ULTRASONOGRAPHY IN THE EVALUATION OF POSTERIOR SEGMENT LESIONS OF THE EYE

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    Rashmi Nagaraju

    2015-01-01

    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

  2. Eyeground photography in cardiovascular disease study

    Energy Technology Data Exchange (ETDEWEB)

    Kunishige, H; Kato, H

    1972-01-01

    Color slides and black/white prints were made of the fundus of both eyes of 458 males age > 39 y, and the results related to age, blood pressure, duration of hypertension, and arteriole-venule (A-V) ratio. Evaluation of changes from color slides was similar to ophthalmoscopic findings. Frequency of abnormal findings increases with age, blood pressure, and hypertension; people with fundus abnormalities had a higher frequency of cardiomegaly, aortic calcification and tortuosity, and ECG abnormalities. Generalized narrowness of arterioles and changes in venule caliber at A-V crossing were the most frequently observed abnormalities. The A-V ratio can be related to generalized narrowness but not to either age, blood pressure, or hypertension. No correlation was observed between frequency of abnormal findings and estimated radiation dose among A-bomb survivors (5 tables, 4 figures). (DLC)

  3. A study on relations between the levels of GMP-140 and microangiopathy in NIDDM

    International Nuclear Information System (INIS)

    Du Tongxin; Wang Zizheng; Shi Hongzhen

    1995-01-01

    The relations between the level of GMP-140 and microangiopathy in NIDDM for earlier diagnosis or better treatment are investigated, the level of GMP-140 in both platelet and plasma was measured. The level of GMP-140 in both platelet and plasma in 104 cases with NIDDM (55 with and 49 without microagiopathy) and 38 controls were assayed by RIA and also simultaneously with direct platelet count. The level of GMP-140 in both platelet and plasma in NIDDM was remarkably higher than that in controls (P 1 = 0.69, r 2 = 0.75). No differences existed in platelet count between NIDDM and controls. The level of GMP-140 and ophthalmoscopic study had no change after decreasing the concentration of blood glucose (<7.8 mmol/L) and administrating aspirin for 6 months. Microangiopathy in NIDDM had close relation with platelet function and the level of GMP-140

  4. Diagnostics of anterior eye segment in cats and dogs

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    Hadži-Milić Milan

    2006-01-01

    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.

  5. Contrast-based sensorless adaptive optics for retinal imaging.

    Science.gov (United States)

    Zhou, Xiaolin; Bedggood, Phillip; Bui, Bang; Nguyen, Christine T O; He, Zheng; Metha, Andrew

    2015-09-01

    Conventional adaptive optics ophthalmoscopes use wavefront sensing methods to characterize ocular aberrations for real-time correction. However, there are important situations in which the wavefront sensing step is susceptible to difficulties that affect the accuracy of the correction. To circumvent these, wavefront sensorless adaptive optics (or non-wavefront sensing AO; NS-AO) imaging has recently been developed and has been applied to point-scanning based retinal imaging modalities. In this study we show, for the first time, contrast-based NS-AO ophthalmoscopy for full-frame in vivo imaging of human and animal eyes. We suggest a robust image quality metric that could be used for any imaging modality, and test its performance against other metrics using (physical) model eyes.

  6. Images of photoreceptors in living primate eyes using adaptive optics two-photon ophthalmoscopy

    Science.gov (United States)

    Hunter, Jennifer J.; Masella, Benjamin; Dubra, Alfredo; Sharma, Robin; Yin, Lu; Merigan, William H.; Palczewska, Grazyna; Palczewski, Krzysztof; Williams, David R.

    2011-01-01

    In vivo two-photon imaging through the pupil of the primate eye has the potential to become a useful tool for functional imaging of the retina. Two-photon excited fluorescence images of the macaque cone mosaic were obtained using a fluorescence adaptive optics scanning laser ophthalmoscope, overcoming the challenges of a low numerical aperture, imperfect optics of the eye, high required light levels, and eye motion. Although the specific fluorophores are as yet unknown, strong in vivo intrinsic fluorescence allowed images of the cone mosaic. Imaging intact ex vivo retina revealed that the strongest two-photon excited fluorescence signal comes from the cone inner segments. The fluorescence response increased following light stimulation, which could provide a functional measure of the effects of light on photoreceptors. PMID:21326644

  7. The opportunistic screening of refractive errors in school-going children by pediatrician using enhanced Brückner test.

    Science.gov (United States)

    Jain, Piyush; Kothari, Mihir T; Gode, Vaibhav

    2016-10-01

    The aim of this study was to compare the results of enhanced Brückner test (EBT) performed by a pediatrician and an experienced pediatric ophthalmologist. In this prospective double-masked cohort study, a pediatrician and a pediatric ophthalmologist performed the EBT in a classroom of a school in semi-dark lighting condition using a direct ophthalmoscope. The results of the test were compared using 2 × 2 Bayesian table and kappa statistics. The findings of the pediatric ophthalmologists were considered gold standard. Two hundred and thirty-six eyes of 118 subjects, mean age 6.8 ± 0.5 years (range, 5.4-7.8 years), were examined. The time taken to complete this test was ametropia in children.

  8. Transscleral diode photocoagulation of large retinal and choroidal vascular lesions.

    Directory of Open Access Journals (Sweden)

    Yun Feng

    Full Text Available BACKGROUND: Transscleral retinal photocoagulation with a diode laser is used in glaucoma refractory to medical and surgical treatment. Our main research question was how the technique performed in large vascular lesions associated with hemangiomas of the retina and choroid. METHODOLOGY/CLINICAL FINDINGS: Patient charts were retrieved from the hospital files for patients who underwent the procedure and were followed for at least 24 months. Five patients (6 eyes fit the criteria. Cases included Von Hippel's disease (2 eyes, Coats' disease (1 eye and choroidal hemangioma (3 cases. Transscleral diode laser treatment was performed under retrobulbar and topical anesthesia with a retinopexy probe (IRIS DioPexy, IRIS Medical Instruments, Mountain View, CA applied transsclerally under indirect ophthalmoscope visualization. We found an improvement in best-corrected visual acuity at 24 months postoperatively. CONCLUSIONS/SIGNIFICANCE: Transscleral photocoagulation may have a clinical application in these diseases as an alternate to the high cost of photodynamic therapy with photosensitizing agents.

  9. Eye disorders in newborn infants (excluding retinopathy of prematurity).

    Science.gov (United States)

    Wan, Michael J; VanderVeen, Deborah K

    2015-05-01

    A screening eye examination is an essential part of the newborn assessment. The detection of many ocular disorders in newborn infants can be achieved through careful observation of the infant's visual behaviour and the use of a direct ophthalmoscope to assess the ocular structures and check the red reflex. Early diagnosis and subspecialty referral can have a critical impact on the prognosis for many ocular conditions, including potentially blinding but treatable conditions such as congenital cataracts, life-threatening malignancies such as retinoblastoma and harbingers of disease elsewhere such as sporadic aniridia and its association with the development of Wilms tumour. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Wide-field optical coherence tomography based microangiography for retinal imaging

    Science.gov (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.

    2016-02-01

    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. Modeling Photo-Bleaching Kinetics to Create High Resolution Maps of Rod Rhodopsin in the Human Retina.

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    Martin Ehler

    Full Text Available We introduce and describe a novel non-invasive in-vivo method for mapping local rod rhodopsin distribution in the human retina over a 30-degree field. Our approach is based on analyzing the brightening of detected lipofuscin autofluorescence within small pixel clusters in registered imaging sequences taken with a commercial 488nm confocal scanning laser ophthalmoscope (cSLO over a 1 minute period. We modeled the kinetics of rhodopsin bleaching by applying variational optimization techniques from applied mathematics. The physical model and the numerical analysis with its implementation are outlined in detail. This new technique enables the creation of spatial maps of the retinal rhodopsin and retinal pigment epithelium (RPE bisretinoid distribution with an ≈ 50μm resolution.

  12. Modeling Photo-Bleaching Kinetics to Create High Resolution Maps of Rod Rhodopsin in the Human Retina

    Science.gov (United States)

    Ehler, Martin; Dobrosotskaya, Julia; Cunningham, Denise; Wong, Wai T.; Chew, Emily Y.; Czaja, Wojtek; Bonner, Robert F.

    2015-01-01

    We introduce and describe a novel non-invasive in-vivo method for mapping local rod rhodopsin distribution in the human retina over a 30-degree field. Our approach is based on analyzing the brightening of detected lipofuscin autofluorescence within small pixel clusters in registered imaging sequences taken with a commercial 488nm confocal scanning laser ophthalmoscope (cSLO) over a 1 minute period. We modeled the kinetics of rhodopsin bleaching by applying variational optimization techniques from applied mathematics. The physical model and the numerical analysis with its implementation are outlined in detail. This new technique enables the creation of spatial maps of the retinal rhodopsin and retinal pigment epithelium (RPE) bisretinoid distribution with an ≈ 50μm resolution. PMID:26196397

  13. Two-photon excited autofluorescence imaging of human retinal pigment epithelial cells

    Science.gov (United States)

    Han, Meng; Blindewald-Wittich, Almut; Holz, Frank G.; Giese, Günter; Niemz, Markolf H.; Snyder, Sarah; Sun, Hui; Yu, Jiayi; Agopov, Michael; La Schiazza, Olivier; Bille, Josef F.

    2006-01-01

    Degeneration of retinal pigment epithelial (RPE) cells severely impairs the visual function of retina photoreceptors. However, little is known about the events that trigger the death of RPE cells at the subcellular level. Two-photon excited autofluorescence (TPEF) imaging of RPE cells proves to be well suited to investigate both the morphological and the spectral characteristics of the human RPE cells. The dominant fluorophores of autofluorescence derive from lipofuscin (LF) granules that accumulate in the cytoplasm of the RPE cells with increasing age. Spectral TPEF imaging reveals the existence of abnormal LF granules with blue shifted autofluorescence in RPE cells of aging patients and brings new insights into the complicated composition of the LF granules. Based on a proposed two-photon laser scanning ophthalmoscope, TPEF imaging of the living retina may be valuable for diagnostic and pathological studies of age related eye diseases.

  14. Head injury management guidelines for general practitioners

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    Jeremy C Ganz

    2011-01-01

    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

  15. Cortical heterotopia in Aicardi's syndrome - CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Besenski, N.; Bosnjak, V.; Ligutic, I.; Marusic-Della Marina, B.

    1988-07-01

    The case of 5-month-old female infant with Aicardi's syndrome is presented. The main clinical features were severe developmental retardation and intractable epileptic seizures. Ophthalmoscopic examination revealed pathognomonic choriorethinopathy. Ultrasonic examination of the brain detected agenesis of the corpus callosum, whereas CT showed a coexisting malformation of the brain, i.e. cortical heterotopia of the gray matter. Agenesis of the corpus callosum is an entity well-recognized by sonography. However, ultrasonography is an insufficient modality for the visualization of cortical heterotopia which is common to all cases of Aicardi's syndrome. Therefore, in cases of suspected Aicardi's syndrome CT is recommended, as it enables the diagnosis of cortical heterotopia.

  16. Clinical results of fluorescence lifetime imaging in ophthalmology

    Science.gov (United States)

    Schweitzer, D.; Quick, S.; Klemm, M.; Hammer, M.; Jentsch, S.; Dawczynski, J.; Becker, W.

    2009-07-01

    A laser scanner ophthalmoscope was developed for in vivo fluorescence lifetime measurements at the human retina. Measurements were performed in 30 degree fundus images. The fundus was excited by pulses of 75 ps (FWHM). The dynamic fluorescence was detected in two spectral channels K1(490-560nm), K2(560-700 nm) by time-correlated single photon counting. The decay of fluorescence was three-exponentially. Local and global alterations in lifetimes were found between healthy subjects and patients suffering from age-related macular degeneration, diabetic retinopathy, and vessel occlusion. The lifetimes T1, T2, and T3 in both channels are changed to longer values in AMD and diabetic retinopathy in comparison with healthy subjects. The lifetime T2 in K1 is most sensitive to metabolic alterations in branch arterial vessel occlusion.

  17. STAGE 5 RETINOPATHY OF PREMATURITY IN ONE EYE – CASE REPORT

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    Gordana Stanković-Babić

    2012-03-01

    Full Text Available Retinopathy of prematurity (ROP is a leading cause of blindness in children and one of the most important reasons of blindness in the perinatal period. The aim of the paper was to present a nine-month-old baby boy with esotropia, microphtalmos and completely detached retina in one eye, as the end stage of the disease, who had not been checked for ROP. The boy was born in the 32nd gestational week, with 1670 g birth weight. Indirect ophthalmoscope examination and ultrasonography of the left eye showed stage 5 retinopathy of prematurity. On the right eye, the finding was valid. Retinopathy of prematurity today needs recognition, understanding and awareness among ophthalmologists, pediatricians, neonatologists. Early diagnosis of damage is important in the treatment of ROP.

  18. Anterior ischemic optic neuropathy in a patient with Churg-Strauss syndrome.

    Science.gov (United States)

    Lee, Ji Eun; Lee, Seung Uk; Kim, Soo Young; Jang, Tae Won; Lee, Sang Joon

    2012-12-01

    We describe a patient with Churg-Strauss syndrome who developed unilateral anterior ischemic optic neuropathy. A 54-year-old man with a history of bronchial asthma, allergic rhinitis, and sinusitis presented with sudden decreased visual acuity in his right eye that had begun 2 weeks previously. The visual acuity of his right eye was 20 / 50. Ophthalmoscopic examination revealed a diffusely swollen right optic disc and splinter hemorrhages at its margin. Goldmann perimetry showed central scotomas in the right eye and fluorescein angiography showed remarkable hyperfluorescence of the right optic nerve head. Marked peripheral eosinphilia, extravascular eosinophils in a bronchial biopsy specimen, and an increased sedimentation rate supported the diagnosis of Churg-Strauss syndrome. Therapy with methylprednisolone corrected the laboratory abnormalities, improved clinical features, and preserved vision, except for the right central visual field defect. Early recognition of this systemic disease by ophthalmologists may help in preventing severe ocular complications.

  19. [A case of MEWDS. "The multiple evanescent white-dot syndrome"].

    Science.gov (United States)

    Lefrançois, A; Hamard, H; Corbe, C; Schmitt, A; Badelon, I; Vidal, A

    1989-01-01

    A young white man developed acute bilateral visual loss with no previous general illness. Ophthalmoscopic examination showed multiple small yellow-white lesions scattered throughout the posterior poles and mild periphery fundus. There was also fine granularity of two foveal areas and one optic disc margin was blurred. Fluorescein angiography showed early hyperfluorescence of the lesions and late staining of the retinal pigment epithelium. Electrophysiologic abnormalities were transient, asymmetric, more marked in photopic than in scotopic. The origin could be in retinal bipolar cells. These lesions regressed, with return of normal visual function within several weeks. These clinical findings are different from others acute inflammatory diseases primarily involving retinal pigment epithelium and photoreceptors. This aspect is usually described as "multiple evanescent white dot syndrome". The etiology of this syndrome remains unknown with no evidence of systemic disease. A history of flulike illness is rare.

  20. [Follow-up on MEWDS by fundus perimetry and multifocal ERG with the SLO].

    Science.gov (United States)

    Bültmann, S; Martin, M; Rohrschneider, K

    2002-09-01

    Most conventional techniques for examination such as perimetry or ERG may not be sensitive enough to detect functional alterations due to MEWDS precisely. We report on a follow-up performed by fundus perimetry and the new technique of multifocal ERG using the scanning laser ophthalmoscope. A 24-year-old female patient (VA 0.2/0.8) was followed up for 7 weeks with these techniques as well as Octopus perimetry, fluorescence angiography, Ganzfeld ERG and biomicroscopy. Multifocal ERG stimulation (mfERG, Retiscan) was performed with the SLO. Visual acuity improved from 0.2 to 0.8 and the central relative scotoma disappeared while a relevant increase of P1-wave amplitudes in mfERG could be observed. Combining objective measurements from the fundus controlled SLO-mfERG and results from fundus perimetry enable good correlation of morphology and results, even for minor alterations of the macula only accessible by few established clinical examinations.

  1. [Choroidal neovascularization followed in a patient with "Multiple Evanescent White Dot Syndrome" (MEWDS) -- a case report].

    Science.gov (United States)

    Löw, U; Palmowski, A M; Weich, C-M; Ruprecht, K W

    2004-12-01

    Since the description of the "multiple evanescent white dot syndrome" (MEWDS) by Jampol et al, choroiditis has been in the focus of interest. But the classical type of MEWDS was an exceptional case in clinical routine. A 48-year-old female presented to our hospital with a sudden unilateral visual acuity decrease and an extension of the blind spot. Ophthalmoscopy and fluorescein angiography revealed typical multiple grey-white chorioretinal patches of the same stage with lesion areas of about 100 - 200 microm compatible with the diagnose of MEWDS. Although visual acuity increased continuously the patient developed a classical choroidal neovascularization within 4 weeks. She was treated with PDT and visual acuity as well as the ophthalmoscopic diagnosis remained stable. In spite of visual improvement in MEWDS, regular control is recommended. In addition we propose to consider the diagnosis of MEWDS if an enlargement of the blind spot and CNV without lesions of the retinal pigment epithelium are diagnosed.

  2. Systemic aspirin and systemic vitamin E in senile cataracts : cataract V

    Directory of Open Access Journals (Sweden)

    Sharma Y

    1989-01-01

    Full Text Available We undertook a prospective study in senile cataract patients using systemic aspirin and systemic vitamin E. Vitamin E treated eyes did show less progression of PSC opacities extent and less new nuclear opacities during the follow-up, but overall vitamin E treated eyes did no better than the control group eyes. More eyes in systemic aspirin treated group maintained the initial vision and loss of vision in the aspirin group was also less marked. Aspirin also caused a significant less mean increase in cortical opacity extent, nuclear/opacity and density and PSC opacity extent and density as well as in ophthalmoscopically graded opacity extent and density. We suggest that aspirin is a potential drug which should be further evaluated in large double blind photodocumentated studies. The present data does not justify the recommendation that aspirin be prescribed for slowing down cataract progression. This must await large studies and confirmation.

  3. Incidence, risk factors, and morphology in operating microscope light retinopathy

    International Nuclear Information System (INIS)

    Khwarg, S.G.; Linstone, F.A.; Daniels, S.A.; Isenberg, S.J.; Hanscom, T.A.; Geoghegan, M.; Straatsma, B.R.

    1987-01-01

    A review of 135 consecutive cataract operations identified ten cases (7.4%) of operating microscope light retinopathy. Ophthalmoscopically, these light retinopathy lesions appeared as a focal pigment epithelial change with varying degrees of pigment clumping in the center. Fluorescein angiography accentuated the lesion by demonstrating a sharply demarcated transmission defect, occasionally with multiple satellite lesions. The shape of the lesion matched the shape of the illuminating source of the particular operating microscope used during the surgery. The most significant risk factor associated with the production of these light retinopathy lesions was prolonged operating time. Mean total operating time for the ten patients with light retinopathy was 51 minutes longer than for those without (P less than .0001). Other significant associated factors were the presence of diabetes mellitus (P less than .03), younger age (P less than .05), and the use of hydrochlorothiazide (P less than .04)

  4. Detection of early metabolic alterations in the ocular fundus of diabetic patients by time-resolved autofluorescence of endogenous fluorophores

    Science.gov (United States)

    Schweitzer, D.; Klemm, M.; Quick, S.; Deutsch, L.; Jentsch, S.; Hammer, M.; Dawczynski, J.; Kloos, C. H.; Mueller, U. A.

    2011-07-01

    Measurements of time-resolved autofluorescence (FLIM) at the human ocular fundus of diabetic patients permit the detection of early pathologic alterations before signs of diabetic retinopathy are visible. The measurements were performed by the Jena Fluorescence Lifetime Laser Scanner Ophthalmoscope applying time-correlated single photon counting (TCSPC) in two spectral channels (K1: 490-560 nm, K2:560-700ps). The fluorescence was excited by 70 ps pulses (FWHM) at 448 nm. The decay of fluorescence intensity was triple-exponentially approximated. The frequency of amplitudes, lifetimes, and relative contributions was compared in fields of the same size and position in healthy subjects and in diabetic patients. The most sensitive parameter was the lifetime T2 in the short-wavelength channel, which corresponds to the neuronal retina. The changes in lifetime point to a loss of free NADH and an increased contribution of protein-bound NADH in the pre-stage of diabetic retinopathy.

  5. An Algorithm to Detect the Retinal Region of Interest

    Science.gov (United States)

    Şehirli, E.; Turan, M. K.; Demiral, E.

    2017-11-01

    Retina is one of the important layers of the eyes, which includes sensitive cells to colour and light and nerve fibers. Retina can be displayed by using some medical devices such as fundus camera, ophthalmoscope. Hence, some lesions like microaneurysm, haemorrhage, exudate with many diseases of the eye can be detected by looking at the images taken by devices. In computer vision and biomedical areas, studies to detect lesions of the eyes automatically have been done for a long time. In order to make automated detections, the concept of ROI may be utilized. ROI which stands for region of interest generally serves the purpose of focusing on particular targets. The main concentration of this paper is the algorithm to automatically detect retinal region of interest belonging to different retinal images on a software application. The algorithm consists of three stages such as pre-processing stage, detecting ROI on processed images and overlapping between input image and obtained ROI of the image.

  6. Selective retina therapy (SRT)

    International Nuclear Information System (INIS)

    Brinkmann, R.; Birngruber, R.

    2007-01-01

    Selective Retina Therapy (SRT) is a new and very gentle laser method developed at the Medical Laser Center Luebeck. It is currently investigated clinically in order to treat retinal disorders associated with a decreased function of the retinal pigment epithelium (RPE). SRT is designed to selectively effect the RPE while sparing the neural retina and the photoreceptors as well as the choroid. Aim of the therapy is the rejuvenation of the RPE in the treated areas, which should ideally lead to a long term metabolic increase at the chorio-retinal junction. In contrast to conventional laser photocoagulation, which is associated with a complete thermal necrosis of the treated site, SRT completely retains full vision. This paper reviews the methods and mechanisms behind selective RPE effects and reports the first clinical results. An online dosimetry technique to visualize the ophthalmoscopically invisible effects is introduced. (orig.)

  7. Quantitative, simultaneous, and collinear eye-tracked, high dynamic range optical coherence tomography at 850 and 1060 nm

    Science.gov (United States)

    Mooser, Matthias; Burri, Christian; Stoller, Markus; Luggen, David; Peyer, Michael; Arnold, Patrik; Meier, Christoph; Považay, Boris

    2017-07-01

    Ocular optical coherence tomography at the wavelengths ranges of 850 and 1060 nm have been integrated with a confocal scanning laser ophthalmoscope eye-tracker as a clinical commercial-class system. Collinear optics enables an exact overlap of the different channels to produce precisely overlapping depth-scans for evaluating the similarities and differences between the wavelengths to extract additional physiologic information. A reliable segmentation algorithm utilizing Graphcuts has been implemented and applied to automatically extract retinal and choroidal shape in cross-sections and volumes. The device has been tested in normals and pathologies including a cross-sectional and longitudinal study of myopia progress and control with a duplicate instrument in Asian children.

  8. Fixational eye movement: a negligible source of dynamic aberration.

    Science.gov (United States)

    Mecê, Pedro; Jarosz, Jessica; Conan, Jean-Marc; Petit, Cyril; Grieve, Kate; Paques, Michel; Meimon, Serge

    2018-02-01

    To evaluate the contribution of fixational eye movements to dynamic aberration, 50 healthy eyes were examined with an original custom-built Shack-Hartmann aberrometer, running at a temporal frequency of 236Hz, with 22 lenslets across a 5mm pupil, synchronized with a 236Hz pupil tracker. A comparison of the dynamic behavior of the first 21 Zernike modes (starting from defocus) with and without digital pupil stabilization, on a 3.4s sequence between blinks, showed that the contribution of fixational eye movements to dynamic aberration is negligible. Therefore we highlighted the fact that a pupil tracker coupled to an Adaptive Optics Ophthalmoscope is not essential to achieve diffraction-limited resolution.

  9. A Graph Cut Approach to Artery/Vein Classification in Ultra-Widefield Scanning Laser Ophthalmoscopy.

    Science.gov (United States)

    Pellegrini, Enrico; Robertson, Gavin; MacGillivray, Tom; van Hemert, Jano; Houston, Graeme; Trucco, Emanuele

    2018-02-01

    The classification of blood vessels into arterioles and venules is a fundamental step in the automatic investigation of retinal biomarkers for systemic diseases. In this paper, we present a novel technique for vessel classification on ultra-wide-field-of-view images of the retinal fundus acquired with a scanning laser ophthalmoscope. To the best of our knowledge, this is the first time that a fully automated artery/vein classification technique for this type of retinal imaging with no manual intervention has been presented. The proposed method exploits hand-crafted features based on local vessel intensity and vascular morphology to formulate a graph representation from which a globally optimal separation between the arterial and venular networks is computed by graph cut approach. The technique was tested on three different data sets (one publicly available and two local) and achieved an average classification accuracy of 0.883 in the largest data set.

  10. Selective retina therapy (SRT); Selektive Retina-Therapie (SRT)

    Energy Technology Data Exchange (ETDEWEB)

    Brinkmann, R.; Birngruber, R. [Luebeck Univ. (Germany). Inst. fuer Biomedizinische Optik; Medizinisches Laserzentrum Luebeck GmbH, Luebeck (Germany)

    2007-07-01

    Selective Retina Therapy (SRT) is a new and very gentle laser method developed at the Medical Laser Center Luebeck. It is currently investigated clinically in order to treat retinal disorders associated with a decreased function of the retinal pigment epithelium (RPE). SRT is designed to selectively effect the RPE while sparing the neural retina and the photoreceptors as well as the choroid. Aim of the therapy is the rejuvenation of the RPE in the treated areas, which should ideally lead to a long term metabolic increase at the chorio-retinal junction. In contrast to conventional laser photocoagulation, which is associated with a complete thermal necrosis of the treated site, SRT completely retains full vision. This paper reviews the methods and mechanisms behind selective RPE effects and reports the first clinical results. An online dosimetry technique to visualize the ophthalmoscopically invisible effects is introduced. (orig.)

  11. 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

    2010-01-01

    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......BACKGROUND: Acute optic neuritis occurs with and without papillitis. The presence of papillitis has previously been thought to imply an anterior location of the neuritis, but imaging studies seeking to test this hypothesis have been inconclusive. METHODS: This prospective observational cohort study...

  12. Scleral Buckling Using a Non-contact Wide-Angle Viewing System with a 25-Gauge Chandelier Endoilluminator.

    Science.gov (United States)

    Jo, Jaehyuck; Moon, Byung Gil; Lee, Joo Yong

    2017-12-01

    To report the outcome of scleral buckling using a non-contact wide-angle viewing system with a 25-gauge chandelier endoilluminator. Retrospective analyses of medical records were performed for 17 eyes of 16 patients with primary rhegmatogenous retinal detachment (RRD) without proliferative vitreoretinopathy who had undergone conventional scleral buckling with cryoretinopexy using the combination of a non-contact wide-angle viewing system and chandelier endoillumination. The patients were eight males and five females with a mean age of 26.8 ± 10.2 (range, 11 to 47) years. The mean follow-up period was 7.3 ± 3.1 months. Baseline best-corrected visual acuity was 0.23 ± 0.28 logarithm of the minimum angle of resolution units. Best-corrected visual acuity at the final visit showed improvement (0.20 ± 0.25 logarithm of the minimum angle of resolution units), but the improvement was not statistically significant (p = 0.722). As a surgery-related complication, there was vitreous loss at the end of surgery in one eye. As a postoperative complication, increased intraocular pressure (four cases) and herpes simplex epithelial keratitis (one case) were controlled postoperatively with eye drops. One case of persistent RRD after primary surgery needed additional vitrectomy, and the retina was postoperatively attached. Scleral buckling with chandelier illumination as a surgical technique for RRD has the advantages of relieving the surgeon's neck pain from prolonged use of the indirect ophthalmoscope and sharing the surgical procedure with another surgical team member. In addition, fine retinal breaks that are hard to identify using an indirect ophthalmoscope can be easily found under the microscope by direct endoillumination. © 2017 The Korean Ophthalmological Society

  13. Prevalence of disc cupping in non-glaucomatous eyes

    Directory of Open Access Journals (Sweden)

    José Pablo Chiappe

    2015-02-01

    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.

  14. Preliminary results of a prospective study of inter- and intra-user variability of the Royal Veterinary College corneal clarity score (RVC-CCS) for use in veterinary practice.

    Science.gov (United States)

    Sanchez, Rick F; Dawson, Charlotte; Matas Riera, Màrian; Escanilla, Natàlia

    2016-07-01

    To introduce a new corneal clarity score for use in small animals and describe its inter- and intra-user variability. Twelve dogs and two cats with corneal abnormalities and five dogs with healthy corneas. Four examiners scored every patient twice and never consecutively, focusing on the central cornea. The peripheral cornea was scored separately. The following scoring system was used to describe corneal clarity: G0: no fundus reflection is visible on retroillumination (RI) using a head-mounted indirect ophthalmoscope. G1: a fundus reflection is visible with RI. G2: a 0.1-mm diameter light beam is visible on the anterior surface of the iris and/or lens. G3: gross fundic features are visible when viewed with indirect ophthalmoscopy (IO) using a head-mounted indirect ophthalmoscope and a hand-held 30D lens, although fine details are not clear. G4: fine details of the fundic features are clearly visible with IO. The minimum grades given were analyzed for inter- and intra-user variability with kappa analysis. Intra- and interuser variability of the central corneal clarity ranged from 0.78 to 0.96, showing substantial to almost perfect reproducibility, and from 0.66 to 0.91, showing substantial to almost perfect reliability, respectively. Intra- and interuser variability of the peripheral cornea ranged from 0.83 to 0.95, showing almost perfect agreement, and from 0.53 to 0.91, showing moderate to almost perfect agreement. The RVC-CCS is well suited to assess and monitor central corneal clarity in small animals and to compare outcomes between studies and different surgeons. © 2015 American College of Veterinary Ophthalmologists.

  15. Comparative study between fundus autofluorescence and red reflectance imaging of choroidal nevi using ultra-wide-field scanning laser ophthalmoscopy.

    Science.gov (United States)

    Zapata, Miguel Angel; Leila, Mahmoud; Teixidor, Teresa; Garcia-Arumi, Jose

    2015-06-01

    To explore the utility of fundus autofluorescence (FAF) and red reflectance (RR) imaging using ultra-wide-field scanning laser ophthalmoscope in choroidal nevi. Retrospective observational case study reviewing clinical data, color, FAF, and RR images of patients with choroidal nevi and comparing the findings. The ultra-wide-field scanning laser ophthalmoscope uses green laser 532 nm and red laser 633 nm that enabled FAF and RR imaging, respectively in separate channels. Superimposition of both images yielded a composite color image. The study included 46 eyes of 45 patients. Nevi were unilateral in 44 patients (98%). Forty-one nevi (89.1%) were located temporally between the macula and the equator. All nevi (100%) were deeply pigmented. The most frequent surface changes were lipofuscin pigments, zones of retinal pigment epithelium atrophy, and retinal pigment epithelium pigment clumps in 31 (67.3%), 18 (39.1%), and 8 eyes (17.3%), respectively. Color photographs were superior to FAF in detecting nevus boundaries and surface changes. Red reflectance correlated strongly with color images, although the nevus boundaries and surface changes were better delineated in RR mode. Red reflectance was superior to FAF in delineating the boundaries and surface changes of the nevus; clear visibility (3+) for RR versus no or poor visibility (0/1+) for FAF. Nevertheless, the areas of retinal pigment epithelium atrophy were better delineated in FAF mode; clear visibility (3+) for FAF versus poor visibility (1+) for FAF. Red reflectance imaging is more sensitive than conventional photography for follow-up of choroidal nevi. Fundus autofluorescence should be considered only as a complementary tool to RR imaging.

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

    Directory of Open Access Journals (Sweden)

    Moral-Pumarega M

    2012-08-01

    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.

  17. Scanning laser densitometry and color perimetry demonstrate reduced photopigment density and sensitivity in two patients with retinal degeneration.

    Science.gov (United States)

    Tornow, R P; Stilling, R; Zrenner, E

    1999-10-01

    To test the feasibility of scanning laser densitometry with a modified Rodenstock scanning laser ophthalmoscope (SLO) to measure the rod and cone photopigment distribution in patients with retinal diseases. Scanning laser densitometry was performed using a modified Rodenstock scanning laser ophthalmoscope. The distribution of the photopigments was calculated from dark adapted and bleached images taken with the 514 nm laser of the SLO. This wavelength is absorbed by rod and cone photopigments. Discrimination is possible due to their different spatial distribution. Additionally, to measure retinal sensitivity profiles, dark adapted two color static perimetry with a Tübinger manual perimeter was performed along the horizontal meridian with 1 degree spacing. A patient with retinitis pigmentosa had slightly reduced photopigment density within the central +/- 5 degrees but no detectable photopigment for eccentricities beyond 5 degrees. A patient with cone dystrophy had nearly normal pigment density beyond +/- 5 degrees, but considerably reduced photopigment density within the central +/- 5 degrees. Within the central +/- 5 degrees, the patient with retinitis pigmentosa had normal sensitivity for the red stimulus and reduced sensitivity for the green stimulus. There was no measurable function beyond 7 degrees. The patient with cone dystrophy had normal sensitivity for the green stimulus outside the foveal center and reduced sensitivity for the red stimulus at the foveal center. The results of color perimetry for this patient with a central scotoma were probably influenced by eccentric fixation. Scanning laser densitometry with a modified Rodenstock SLO is a useful method to assess the human photopigment distribution. Densitometry results were confirmed by dark adapted two color static perimetry. Photopigment distribution and retinal sensitivity profiles can be measured with high spatial resolution. This may help to measure exactly the temporal development of retinal

  18. CORRELATION OF FUNDUS CHANGES IN RELATION TO REFRACTIVE ERROR IN PATIENTS WITH MYOPIA- A CLINICAL PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Balasubramanian M. Manickavelu

    2018-01-01

    Full Text Available BACKGROUND Retina is unique among the complex element of the central nervous system and the special senses. It may be readily viewed during life and it is sufficiently transparent, so that alterations within and adjacent to it may be observed in vivo. The peripheral retina owing to its thinness comparing to that of the central part, poorly-developed retinal cells, absence of large blood vessels, relatively insensitive to light, less resistance to traction, forms a seat for various lesions, which are potentially dangerous for the vision. It is in myopia that we meet the most frequent and the most obvious anomalies in the fundus changes, which bear some relation to the degree of myopia and appeal to be concerned with it either as a cause or effect or perhaps both. The aim of our study is to correlate fundus changes in relation to refractive error in patients with myopia. MATERIALS AND METHODS In our study, 100 cases of myopic (-6D:50 cases patients were selected. Detailed evaluation done. History of refractive error includes duration, age at which spectacles were worn for the first time. Time of last change of spectacles, family history of myopia, history of other symptoms like progressive loss of vision, defective vision related to day or night, sudden loss of vision, flashes and floaters. Anterior segment was examined followed by the recording of initial visual acuity and the best corrected visual acuity was noted. IOP was measured for all the cases using Schiotz tonometry. Axial length was measured in all the cases. Fundus examined with direct ophthalmoscope, indirect ophthalmoscope, 3 mirror and 90D lens. Bscan was done in few cases. The media, disc, vessels, macula and the surrounding retina were examined. The periphery was examined with indentation method. The various fundus features and pathological lesions in different degrees of myopia were noted. RESULTS Females were comparatively more affected. Highest incidence was seen in the younger

  19. 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

    2009-01-01

    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

  20. Monitoring macular pigment changes in macular holes using fluorescence lifetime imaging ophthalmoscopy.

    Science.gov (United States)

    Sauer, Lydia; Peters, Sven; Schmidt, Johanna; Schweitzer, Dietrich; Klemm, Matthias; Ramm, Lisa; Augsten, Regine; Hammer, Martin

    2017-08-01

    To investigate the impact of macular pigment (MP) on fundus autofluorescence (FAF) lifetimes in vivo by characterizing full-thickness idiopathic macular holes (MH) and macular pseudo-holes (MPH). A total of 37 patients with MH and 52 with MPH were included. Using the fluorescence lifetime imaging ophthalmoscope (FLIO), based on a Heidelberg Engineering Spectralis system, a 30° retinal field was investigated. FAF decays were detected in a short (498-560 nm; ch1) and long (560-720 nm; ch2) wavelength channel. τ m , the mean fluorescence lifetime, was calculated from a three-exponential approximation of the FAF decays. Macular coherence tomography scans were recorded, and macular pigment's optical density (MPOD) was measured (one-wavelength reflectometry). Two MH subgroups were analysed according to the presence or absence of an operculum above the MH. A total of 17 healthy fellow eyes were included. A longitudinal FAF decay examination was conducted in nine patients, which were followed up after surgery and showed a closed MH. In MH without opercula, significant τ m differences (p hole area (MHa) and surrounding areas (MHb) (ch1: MHa 238 ± 64 ps, MHb 181 ± 78 ps; ch2: MHa 275 ± 49 ps, MHb 223 ± 48 ps), as well as between MHa and healthy eyes or closed MH. Shorter τ m , adjacent to the hole, can be assigned to areas with equivalently higher MPOD. Opercula containing MP also show short τ m . In MPH, the intactness of the Hele fibre layer is associated with shortest τ m . Shortest τ m originates from MP-containing retinal layers, especially from the Henle fibre layer. Fluorescence lifetime imaging ophthalmoscope (FLIO) provides information on the MP distribution, the pathogenesis and topology of MH. Macular pigment (MP) fluorescence may provide a biomarker for monitoring pathological changes in retinal diseases. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  1. Avaliação ocular multimodal em doenças heredodistróficas e degenerativas da retina Multimodal fundus imaging in heredodystrophic and degenerative diseases of the retina

    Directory of Open Access Journals (Sweden)

    Daniela Cavalcanti Ferrara

    2009-10-01

    Full Text Available A tomografia de coerência óptica incorporou-se gradativamente ao contemporâneo arsenal diagnóstico em Oftalmologia, passando a exercer papel fundamental na investigação e condução de doenças oculares, particularmente na especialidade de Retina e Vítreo. A disponibilização comercial da nova geração de aparelhos, chamada de tomografia de coerência óptica "espectral", baseada em conceito físico distinto que permite a aquisição de imagens em alta velocidade, marcou o início de uma nova era desta tecnologia de investigação auxiliar. Adicionalmente, sua recente combinação com o oftalmoscópio de varredura a laser confocal (confocal scanning laser ophthalmoscope vem propiciando a aquisição de imagens tomográficas guiadas em tempo real pelos diferentes modos de imagem (autofluorescência de fundo, reflectância com luz "infravermelha" e angiografia com fluoresceína ou indocianina verde. A avaliação ocular multimodal (multimodal fundus imaging permite a correlação real e minuciosa de achados da morfologia retiniana e do epitélio pigmentar com dados de estudos angiográficos e de autofluorescência ou reflectância, propiciando assim inferências valiosas sobre a fisiologia do tecido. Neste artigo, discutimos brevemente as possíveis implicações da avaliação ocular multimodal na prática da especialidade de Retina e Vítreo.Optical coherence tomography was progressively incorporated to the contemporary diagnostic arsenal in Ophthalmology, playing a crucial role in the diagnosis and management of eye diseases, particularly in the specialty of retina and vitreous. The commercial availability of the new generation of devices, coined "spectral" optical coherence tomography, which is based in a distinct physical concept that permits high-speed image acquisition, launched a new era for this investigative ancillary tool. In addition, the recent combination of this new technology with a confocal scanning laser ophthalmoscope

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

    Science.gov (United States)

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

    2017-06-01

    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 time and 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. IDOCS: intelligent distributed ontology consensus system--the use of machine learning in retinal drusen phenotyping.

    Science.gov (United States)

    Thomas, George; Grassi, Michael A; Lee, John R; Edwards, Albert O; Gorin, Michael B; Klein, Ronald; Casavant, Thomas L; Scheetz, Todd E; Stone, Edwin M; Williams, Andrew B

    2007-05-01

    To use the power of knowledge acquisition and machine learning in the development of a collaborative computer classification system based on the features of age-related macular degeneration (AMD). A vocabulary was acquired from four AMD experts who examined 100 ophthalmoscopic images. The vocabulary was analyzed, hierarchically structured, and incorporated into a collaborative computer classification system called IDOCS. Using this system, three of the experts examined images from a second set of digital images compiled from more than 1000 patients with AMD. Images were annotated, and features were identified and defined. Decision trees, a machine learning method, were trained on the data collected and used to extract patterns. Interrelationships between the data from the different clinicians were investigated. Six drusen classes in the structured vocabulary were largely sufficient to describe all the identified features. The decision trees classified the data with 76.86% to 88.5% accuracy and distilled patterns in the form of hierarchical trees composed of 5 to 15 nodes. Experts were largely consistent in their characterization of soft, and to a lesser extent, hard drusen, but diverge in definition of other drusen. Size and crystalline morphology were the main determinants of drusen type across all experts. Machine learning is a powerful tool for the characterization of disease phenotypes. The creation of a defined feature set for AMD will facilitate the development of an IDOCS-based classification system.

  4. The effect of the menstrual cycle on optic nerve head analysis in healthy women.

    Science.gov (United States)

    Akar, Munire Erman; Taskin, Omur; Yucel, Iclal; Akar, Yusuf

    2004-12-01

    To determine the effect of the menstrual cycle on optic nerve head topographic analysis in normally menstruating, healthy women. The study included single eyes selected randomly from each of 52 healthy women with regular menstrual cycles. All subjects underwent a complete ocular examination. Optic nerve head topographic analyses were performed using a confocal scanning laser ophthalmoscope, the Heidelberg Retinal Tomograph II (HRT II, software version 1.6). The analyses were repeated three times during the menstrual cycle: in the follicular phase (days 7-10 of the cycle), at ovulation, and in the late luteal phase (days 1-3 before menstrual bleeding). Serum oestradiol, progesterone and luteinizing hormone levels were measured at each menstrual phase. Fourteen subjects were excluded from the study. The mean age of the subjects (n = 38) was 25.6 +/- 3.7 years (range 21-34 years). Blood oestradiol levels were significantly lower in the late luteal phase (35.8 pg/ml) (p cup : disc ratio, cup : disc area ratio and the cup area were significantly higher during the luteal phase (p menstrual cycle in healthy women significantly alter neuroretinal rim area and cup variables of the optic nerve head. These findings should be taken into consideration in the clinical follow-up of young women with glaucoma.

  5. The effect of the menstrual cycle on the optic nerve head analysis of migrainous women.

    Science.gov (United States)

    Yucel, Iclal; Akar, Munire; Durukan, A; Akar, Yusuf; Taskin, Omur; Dora, Babur; Yilmaz, Nurgul

    2005-03-01

    To determine the effect of the menstrual cycle on the optic nerve head topographic analysis of normally menstruating migrainous women. Randomly selected one eye of 44 migrainous and 49 healthy control women with regular menstrual cycles were included in the study. All subjects underwent complete ocular examination. Optic nervehead topographic analysis were performed using a confocal scanning laser ophthalmoscope, HRT II (Heidelberg Retinal Tomograph II, software version 1.6;Heidelberg Engineering, Heidelberg, Germany). They were repeated for two times during the menstrual cycle: in follicular phase (7th to 10th day of the cycle) and in the luteal phase (days 3 to 4 before the menstrual bleeding). Serum estradiol, progesterone, and luteinizing hormone measurements were repeated at each menstrual phase. The mean age of migrainous and control subjects were 31.5 + 5.1 years and 33.4 +/- 3.7 years, respectively (P > 0.05). Their mean disc areas were 2.26 +/- 0.46 mm(2) and 1.95 +/- 0.39 mm(2), respectively(P 0.05). The parameter rim volume decreased, while the parameters cup volume and cup shape measure increased significantly in the luteal phase of the migrainous women (all P values cup parameters during the menstrual cycle of the migrainous women. Further clinical trials on ocular blood flow changes during the menstrual cycle of the migrainous women may highlight the role of sex steroids in the optic nerve head of the migrainous women.

  6. Blepharitis due to in a cat from northern Portugal

    Directory of Open Access Journals (Sweden)

    Paulo Pimenta

    2015-07-01

    Full Text Available Case summary We report a clinical case of blepharitis due to Cryptococcus neoformans yeasts in a 2-year-old stray cat from northern Portugal (Vila Real without concurrent naso-ocular signs. Ophthalmological examination revealed mucopurulent discharge from an open wound in the right upper and lower lids. Slit-lamp biomicroscopy showed a normal anterior segment, and intraocular pressure was within the normal reference interval. No fundoscopic alterations were detected in either eye by direct and indirect ophthalmoscopic examination. Cytological examination of an appositional smear showed numerous polymorphic neutrophils and macrophages, together with spherical yeast cells compatible with Cryptococcus species. Molecular analysis by means of PCR and restriction fragment length polymorphism identified C neoformans genotype VNI. The cat was treated with itraconazole, and amoxicillin and clavulanic acid, combined with a commercial ear ointment and an imidacloprid/moxidectin spot-on application for bilateral parasitic otitis caused by Otodectes cynotis . One month after treatment, the clinical signs were completely resolved. Localised cutaneous lesions, as in the present case, probably result from contamination of cat-scratch injuries with viable encapsulated yeasts. Relevance and novel information This is, to the best of our knowledge, the first clinical report of feline blepharitis due to C neoformans without concurrent naso-ocular signs. The current findings, together with those from recent reports of the infection in domestic animals, should alert the veterinary community both in Portugal and in Europe to this underdiagnosed disease.

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

    Science.gov (United States)

    Mabaso, Raymond G; Oduntan, Olalekan A

    2014-11-21

    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. To assess risk factors for VI and blindness amongst a black diabetic South African population aged ≥ 40 years. The study was conducted in seven Government healthcare facilities (two hospitals, four clinics and one health centre) in Mopani District, Limpopo province, South Africa. 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. 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. Findings suggest that lifestyle intervention and appropriate eyecare programmes may reduce VI and blindness in this population.

  8. Complex differential variance angiography with noise-bias correction for optical coherence tomography of the retina.

    Science.gov (United States)

    Braaf, Boy; Donner, Sabine; Nam, Ahhyun S; Bouma, Brett E; Vakoc, Benjamin J

    2018-02-01

    Complex differential variance (CDV) provides phase-sensitive angiographic imaging for optical coherence tomography (OCT) with immunity to phase-instabilities of the imaging system and small-scale axial bulk motion. However, like all angiographic methods, measurement noise can result in erroneous indications of blood flow that confuse the interpretation of angiographic images. In this paper, a modified CDV algorithm that corrects for this noise-bias is presented. This is achieved by normalizing the CDV signal by analytically derived upper and lower limits. The noise-bias corrected CDV algorithm was implemented into an experimental 1 μm wavelength OCT system for retinal imaging that used an eye tracking scanner laser ophthalmoscope at 815 nm for compensation of lateral eye motions. The noise-bias correction improved the CDV imaging of the blood flow in tissue layers with a low signal-to-noise ratio and suppressed false indications of blood flow outside the tissue. In addition, the CDV signal normalization suppressed noise induced by galvanometer scanning errors and small-scale lateral motion. High quality cross-section and motion-corrected en face angiograms of the retina and choroid are presented.

  9. Clinical and electroretinographic findings of progressive retinal atrophy in miniature schnauzer dogs of South Korea.

    Science.gov (United States)

    Jeong, Man Bok; Park, Shin Ae; Kim, Se Eun; Park, Young Woo; Narfström, Kristina; Seo, Kangmoon

    2013-10-01

    The purpose of the study was to describe the clinical and electroretinographic features of clinical cases of progressive retinal atrophy (PRA) in miniature schnauzer (MS) of South Korea. Sixty-six MS (14 normal and 52 affected) were included. All animals underwent routine ocular examinations. Electroretinogram (ERG) was recorded in the 14 normal and 15 affected dogs. For normal dogs, the mean age ± SD was 4.1 ± 2.4 years (1 to 9 years), and there were no ocular abnormalities on the basis of ocular examinations and ERG results. For the PRA-affected dogs, it was shown that the mean age ± SD was 4.3 ± 1.1 years (2 to 7 years), and 44 dogs (84.6%) were 3 to 5 years old. Most of the PRA-affected dogs had abnormal menace responses (98.1%) and pupillary light reflexes (PLRs, 88.5%); some dogs showed normal menace response (1.9%) and PLRs (11.5%). Ophthalmoscopic abnormalities in the affected group included one or more of the following changes: hyperreflectivity and discoloration of the tapetal area, attenuation of retinal vessels, depigmentation in non-tapetal area and optic disc atrophy. ERG in the affected dogs showed non-recordable responses in all cases tested with clinical signs of PRA. The present study showed that PRA in MS was mainly observed between the age of 3 to 5 years. ERG revealed abnormal rod and cone responses in affected dogs at the ages studied.

  10. What was Glaucoma Called Before the 20th Century?

    Science.gov (United States)

    Leffler, Christopher T.; Schwartz, Stephen G.; Giliberti, Francesca M.; Young, Matthew T.; Bermudez, Dennis

    2015-01-01

    Glaucoma involves a characteristic optic neuropathy, often with elevated intraocular pressure. Before 1850, poor vision with a normal eye appearance, as occurs in primary open-angle glaucoma, was termed amaurosis, gutta serena, or black cataract. Few observers noted palpable hardness of the eye in amaurosis. On the other hand, angle-closure glaucoma can produce a green or gray pupil, and therefore was called, variously, glaucoma (derived from the Greek for glaucous, a nonspecific term connoting blue, green, or light gray) and viriditate oculi. Angle closure, with palpable hardness of the eye, mydriasis, and anterior prominence of the lens, was described in greater detail in the 18th and 19th centuries. The introduction of the ophthalmoscope in 1850 permitted the visualization of the excavated optic neuropathy in eyes with a normal or with a dilated greenish-gray pupil. Physicians developed a better appreciation of the role of intraocular pressure in both conditions, which became subsumed under the rubric “glaucoma”. PMID:26483611

  11. Identification of an early damage of the retina by laser radiation

    International Nuclear Information System (INIS)

    Walther, G.; Hochgesand, P.; Stockhausen, M.; Valeske, W.

    1973-01-01

    The purpose of this investigation has been to find out the retinal threshold energy for a Q-switched Ruby-Laser with an impulse duration of 50 ns. A commercial Laser-Type (Fa. Eltrughs, Heidelberg, West Germany, Type CE 602) was used. For the test rabbits were used general anesthesia: the threshold energy was first determined ophthalmoscopically-enzyme-histochemically. In the first series the coagulation energy accounted between 7 x 10 -4 J and 9 x 10 -7 J, in the second between 10 -6 J and 1.5 x 10 -5 J. Clinically the threshold energy was found at a level of 3 - 5 x 10 -6 J, clinical-enzyme-histochemically at 1 - 2 x 10 -6 J. A theoretical and physical calculation leaded to 0.3 - 3 x 10 -6 J. Since the energy measurement varies and due to the different resorption qualities of the human and the rabbit's retina the threshold energy accounts 10 -7 J. Labour safety protection should prescribe a threshold energy less than 10 -8 J for a Q-switched Ruby-Laser of an impulse duration of 50 ns. (orig.) [de

  12. Retinal fundus imaging with a plenoptic sensor

    Science.gov (United States)

    Thurin, Brice; Bloch, Edward; Nousias, Sotiris; Ourselin, Sebastien; Keane, Pearse; Bergeles, Christos

    2018-02-01

    Vitreoretinal surgery is moving towards 3D visualization of the surgical field. This require acquisition system capable of recording such 3D information. We propose a proof of concept imaging system based on a light-field camera where an array of micro-lenses is placed in front of a conventional sensor. With a single snapshot, a stack of images focused at different depth are produced on the fly, which provides enhanced depth perception for the surgeon. Difficulty in depth localization of features and frequent focus-change during surgery are making current vitreoretinal heads-up surgical imaging systems cumbersome to use. To improve the depth perception and eliminate the need to manually refocus on the instruments during the surgery, we designed and implemented a proof-of-concept ophthalmoscope equipped with a commercial light-field camera. The sensor of our camera is composed of an array of micro-lenses which are projecting an array of overlapped micro-images. We show that with a single light-field snapshot we can digitally refocus between the retina and a tool located in front of the retina or display an extended depth-of-field image where everything is in focus. The design and system performances of the plenoptic fundus camera are detailed. We will conclude by showing in vivo data recorded with our device.

  13. Prevalence of Diabetic retinopathy in Kashmir, India - A hospital based study

    Directory of Open Access Journals (Sweden)

    Tariq Qureshi

    2013-03-01

    Full Text Available Objective To assess the prevalence of diabetic retinopathy among Kashmiri population. Material and Method In a cross-sectional hospital based study, 500 patients with established diabetes who attended eye OPD at Govt Medical College Srinagar were evaluated for the presence or absence of retinopathy. Relevant clinical examination was done and the findings were recorded at one point of time. No follow-up findings of the patients were included in this study. Direct Ophthalmoscope (Heinzand slit lamp bio-microscope (Zeiss were used for examination. Statistical package for Social Sciences (SPSS was used for statistical analysis. p60 yrs of age and 49 patients (36.2% were between 40-68 yrs of age. 33 (24.5% were males and 102 (75.5% were females. 30 patients (12.8% with diabetes of = 15 yr. Mild DR was present in 67 (37.4% patients, moderate to severe DR in 46 (9.2% patients, proliferative DR in 5(1% patients and diabetic maculopathy in 17(3.4%patients. Patients who were managed with insulin, either alone or with oral hypoglycemic drugs, had more prevalence of DR. Conclusion The present study concluded that DR is highly prevalent in this part

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

    Directory of Open Access Journals (Sweden)

    Mohsen Akhgary

    2014-01-01

    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.

  15. Laser beams hazards. Experimental determination of a laser ocular lesion threshold

    International Nuclear Information System (INIS)

    Courant, D.; Court, L.; Gueneau, G.; Bagot, J.D.; Abadie, B.; Brouillet, B.; Laborde, G.; Duchene, A.

    1984-10-01

    The risks due to the use of laser have called for the definition of exposure limits. The determination of these values requires the knowledge of the physical parameters of exposure and both the anatomical and the physiological properties of the skin and the eye. The parameters of the mechanisms involved in the biological effects of laser beams, the concept of damage criteria and the experimental results found in the literature are first discussed. The main parameter of the beam determining the injury: wavelength, time and the size of the image are then analysed. Some examples of experimental determinations of laser ocular lesion thresholds, carried out on the retinae of the rabbit and the monkey, emphasize, the difficulties met in the determination of the exposure limits. These experiments involve the effect of laser beam in the visible spectrum. Several techniques are compared: a direct ophthalmoscopic observation, a method with fluorescein angiography, a histologic study with light microscopy and an electrophysiological study. The results show that the determination of exposure limits is chiefly a function of the experimental techniques used, the delay of the observation after exposure and the probability of risk selected. The experimental results demonstrate the importance of these parameters and bring into light the uncertainties of the present guidelines [fr

  16. Effect of intravitreal triamcinolone acetonide on healing of retinal photocoagulation lesions.

    Science.gov (United States)

    Nomoto, Hiroyuki; Lavinsky, Daniel; Paulus, Yannis M; Leung, Loh-Shan; Dalal, Roopa; Blumenkranz, Mark S; Palanker, Daniel

    2013-01-01

    To evaluate the effect of intravitreal triamcinolone acetonide (TA) on healing of retinal photocoagulation lesions using drug and laser dosing typically employed in clinical practice. Laser burns with a 267-μm retinal beam size at 532-nm wavelength were applied to 40 eyes of Dutch belted rabbits. Barely visible to intense lesions were produced with pulses of 5, 10, 20, and 50 milliseconds and power of 175 mW. Eyes received intravitreal injections of either 2 mg TA/50 μL or balanced salt solution administered either 1 week before or immediately after laser treatment. Lesion grades were assessed acutely ophthalmoscopically and by a masked observer histologically at 1, 3, 7, 30, and 60 days. Both TA groups demonstrated significant reduction in retinal thickness throughout follow-up compared with balanced salt solution groups (P salt solution groups contracted much more than in the TA groups, especially the more intense burns, and this difference persisted to 2 months. The healing rate of the barely visible burns was not significantly affected by TA compared with the balanced salt solution control eyes. Triamcinolone acetonide injection previously or concurrently with photocoagulation significantly decreases laser-induced edema but interferes with lesions healing, thereby leaving wider residual scarring, especially persistent in more intense burns.

  17. [Long-term outcome of vitrectomy combined with internal limiting membrane peeling for idiopathic macular holes].

    Science.gov (United States)

    Yamamoto, Kaori; Hori, Sadao

    2011-01-01

    To elucidate the long-term outcome of internal limiting membrane (ILM) peeling on visual function during vitrectomy for idiopathic macular holes using scanning laser ophthalmoscope (SLO) microperimetry. Prospective uncontrolled study. We studied 31 eyes (29 patients) with idiopathic macular holes. All patients underwent vitrectomy with ILM peeling. The SLO microperimetry was performed preoperatively, and once a year for 3 years postoperatively to detect scotomas in and around the macular holes, and both within and in close vicinity to the areas of ILM peeling. Closure of macular holes after one surgery was confirmed in all cases except for 2 with second surgery. The visual acuity by logarithmic minimum angle of resolution (logMAR) averaged 0.71 +/- 0.36 before surgery, 0.23 +/- 0.31 one year, 0.14 +/- 0.27 two years and 0.12 +/- 0.26 three years after surgery. There was significant improvement up to 2 years after the surgery. All scotomas detected before surgery in the holes, and 77.4% of those detected around the holes decreased gradually. No scotomas were detected in or around the area of ILM peeling either before or after surgery. ILM peeling in vitrectomy for idiopathic macular holes successfully improved visual acuity and did not influence retinal sensitivity in and around the area of ILM peeling. The scotomas detected in and around the holes before surgery gradually reduced or disappeared.

  18. SLO-infrared imaging of the macula and its correlation with functional loss and structural changes in patients with Stargardt disease

    Science.gov (United States)

    Anastasakis, Anastasios; Fishman, Gerald A; Lindeman, Martin; Genead, Mohamed A; Zhou, Wensheng

    2010-01-01

    Purpose To correlate the degree of functional loss with structural changes in patients with Stargardt disease. Methods Eighteen eyes of 10 Stargardt patients were studied. Scanning laser ophthalmoscope (SLO) infrared images were compared to corresponding spectral domain optical coherence tomography (SD-OCT) scans. Additionally, SLO microperimetry was performed and results were superimposed on SLO infrared images and in selected cases on fundus autofluorescence (FAF) images. Results Seventeen of 18 eyes showed a distinct hypo-reflective foveal and/or perifoveal area with distinct borders on SLO-infrared images which was less evident on funduscopy and incompletely depicted in FAF images. This hypo-reflective zone corresponded to areas of significantly elevated psychophysical thresholds on microperimetry testing, in addition to thinning of the retinal pigment epithelium (RPE), disorganization or loss of the photoreceptor cell inner-outer segment (IS-OS) junction and external limiting membrane (ELM) on SD-OCT. Conclusion SLO-infrared fundus images are useful for depicting retinal structural changes in Stargardt patients. An SD-OCT/SLO microperimetry device allows for a direct correlation of structural abnormalities with functional defects that will likely be applicable for the determination of retinal areas for potential improvement of retinal function in these patients during future clinical trials and for the monitoring of the diseases' natural history. PMID:21293320

  19. Microarray-based mutation analysis of the ABCA4 (ABCR) gene in autosomal recessive cone-rod dystrophy and retinitis pigmentosa.

    Science.gov (United States)

    Klevering, B Jeroen; Yzer, Suzanne; Rohrschneider, Klaus; Zonneveld, Marijke; Allikmets, Rando; van den Born, L Ingeborgh; Maugeri, Alessandra; Hoyng, Carel B; Cremers, Frans P M

    2004-12-01

    Mutations in the ABCA4 gene have been associated with autosomal recessive Stargardt disease (STGD1), cone-rod dystrophy (CRD), and retinitis pigmentosa (RP). We employed a recently developed genotyping microarray, the ABCR400-chip, to search for known ABCA4 mutations in patients with isolated or autosomal recessive CRD (54 cases) or RP (90 cases). We performed detailed ophthalmologic examinations and identified at least one ABCA4 mutation in 18 patients (33%) with CRD and in five patients (5.6%) with RP. Single-strand conformation polymorphism (SSCP) analysis and subsequent DNA sequencing revealed four novel missense mutations (R24C, E161K, P597S, G618E) and a novel 1-bp deletion (5888delG). Ophthalmoscopic abnormalities in CRD patients ranged from minor granular pigmentary changes in the posterior pole to widespread atrophy. In 12 patients with recordable electroretinogram (ERG) tracings, a cone-rod pattern was detected. Three patients demonstrated progression from a retinal dystrophy resembling STGD1 to a more widespread degeneration, and were subsequently diagnosed as CRD. In addition to a variable degree of atrophy, all RP patients displayed ophthalmologic characteristics of classic RP. When detectable, ERG recordings in these patients demonstrated rod-cone patterns of photoreceptor degeneration. In conclusion, in this study, we show that the ABCA4 mutation chip is an efficient first screening tool for arCRD.

  20. Psychophysical function in age-related maculopathy.

    LENUS (Irish Health Repository)

    Neelam, Kumari

    2012-02-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Ribhi Hazin

    2014-01-01

    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.

  2. Non-vitrectomizing vitreous surgery and adjuvant intravitreal tissue plasminogen activator for non-recent massive premacular hemorrhage

    Directory of Open Access Journals (Sweden)

    Tsung-Tien Wu

    2011-12-01

    Full Text Available Massive premacular hemorrhage can cause sudden visual loss. We sought to evaluate the efficacy, safety and visual outcome of nonvitrectomizing vitreous surgery with intravitreal tissue plasminogen activator (t-pa for long-lasting thick premacular hemorrhage. This retrospective, interventional study examined three consecutive eyes of three patients who received nonvitrectomizing vitreous surgery with intravitreal t-pa for the treatment of non-recent massive premacular hemorrhage. Detailed ophthalmoscopic examinations were performed pre- and postoperatively to evaluate the visual outcome, the resolution of premacular hemorrhage and the changes in lenticular opacity.In all three eyes, the premacular hemorrhage cleared after the procedure. Final best-corrected visual acuities improved from 6/30 to 6/10 in patient 1, 2/60 to 6/4 in patient 2, and 3/60 to 6/6 in patient 3. Operated and fellow eyes did not differ in terms of nuclear sclerosis. No complications from the procedure were noted.In these selected cases, nonvitrectomizing vitreous surgery with intravitreal t-pa was an effective and safe alternative treatment for non-recent massive premacular hemorrhage.

  3. Eye structure and amphibious foraging in albatrosses

    Science.gov (United States)

    Martin, G. R.

    1998-01-01

    Anterior eye structure and retinal visual fields were determined in grey-headed and black-browed albatrosses, Diomedea melanophris and D. chrysostoma (Procellariiformes, Diomedeidae), using keratometry and an ophthalmoscopic reflex technique. Results for the two species were very similar and indicate that the eyes are of an amphibious optical design suggesting that albatross vision is well suited to the visual pursuit of active prey both on and below the ocean surface. The corneas are relatively flat (radius ca. 14.5 mm) and hence of low absolute refractive power (ca. 23 dioptres). In air the binocular fields are relatively long (vertical extent ca. 70 degrees) and narrow (maximum width in the plane of the optic axes 26–32 degrees), a topography found in a range of bird species that employ visual guidance of bill position when foraging. The cyclopean fields measure approximately 270 degrees in the horizontal plane, but there is a 60 degrees blind sector above the head owing to the positioning of the eyes below the protruding supraorbital ridges. Upon immersion the monocular fields decrease in width such that the binocular fields are abolished. Anterior eye structure, and visual field topography in both air and water, show marked similarity with those of the Humboldt penguin.

  4. Uses of the word "macula" in written English, 1400-present.

    Science.gov (United States)

    Schwartz, Stephen G; Leffler, Christopher T

    2014-01-01

    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. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. 3D modeling to characterize lamina cribrosa surface and pore geometries using in vivo images from normal and glaucomatous eyes

    Science.gov (United States)

    Sredar, Nripun; Ivers, Kevin M.; Queener, Hope M.; Zouridakis, George; Porter, Jason

    2013-01-01

    En face adaptive optics scanning laser ophthalmoscope (AOSLO) images of the anterior lamina cribrosa surface (ALCS) represent a 2D projected view of a 3D laminar surface. Using spectral domain optical coherence tomography images acquired in living monkey eyes, a thin plate spline was used to model the ALCS in 3D. The 2D AOSLO images were registered and projected onto the 3D surface that was then tessellated into a triangular mesh to characterize differences in pore geometry between 2D and 3D images. Following 3D transformation of the anterior laminar surface in 11 normal eyes, mean pore area increased by 5.1 ± 2.0% with a minimal change in pore elongation (mean change = 0.0 ± 0.2%). These small changes were due to the relatively flat laminar surfaces inherent in normal eyes (mean radius of curvature = 3.0 ± 0.5 mm). The mean increase in pore area was larger following 3D transformation in 4 glaucomatous eyes (16.2 ± 6.0%) due to their more steeply curved laminar surfaces (mean radius of curvature = 1.3 ± 0.1 mm), while the change in pore elongation was comparable to that in normal eyes (−0.2 ± 2.0%). This 3D transformation and tessellation method can be used to better characterize and track 3D changes in laminar pore and surface geometries in glaucoma. PMID:23847739

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

    Directory of Open Access Journals (Sweden)

    Tarannum Mansoori

    2011-01-01

    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.

  7. Analysis on complications after intravitreal injection of bevacizumab

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    Cui-Wei Zhang

    2013-08-01

    Full Text Available AIM: To observe and analyze on the incidence rate and causes of complications after anintravitreal injection of bevacizumab. METHODS: Totally, 207 cases(207 eyeswith wet age-related macular degeneration were selected randomly. All cases were treated with intravitreal injections of bevacizumab(1.5mg/0.06mLand asked for chief complaints at 1 day, 1 week, 4, 12 weeks after operation, and also examined for routine visual acuity(best corrected visual acuity, BCVA, non-contact tonometer, slit lamp microscope and indirect ophthalmoscope etc.RESULTS: Among 207 cases(207 eyes, visual acuity improved efficiency was 90.8% 12 weeks after treatment, foreign body sensation was found in 7 cases(3.4%, eyelid skin pruritus in 1 case(0.5%, conjunctival congestion in 6 cases(2.9%, subconjunctival hemorrhage in 1 case(0.5%, post-operative intraocular pressure elevation in 2 cases(1.0%. CONCLUSION: The intravitreal injection of bevacizumab is effective with fewer complications. We propose to carry out a further randomized multicenter and larger-sample clinical research and further draw up the clinical application criterion of bevacizumab.

  8. Clinical analysis of intravitreal injection of Conbercept combined with 532-laser treating Coats disease in adulthood

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    Li Jiang

    2017-07-01

    Full Text Available AIM: To analyze clinical observation and the efficiency of intravitreal conbercept combined with 532-laser on Coats disease in adulthood. METHODS: This was an retrospective analysis. Six eyes from 6 patients(5 males and 1 femalewith coats disease diagnosed by fundus fluorescein angiography(FFAand optical coherence tomography(OCTwere enrolled. Before the injection, best-corrected visual acuity(BCVAof early treatment of diabetic retinopathy study(ETDRS, non-contact tonometer, ophthalmoscope, fundus photography, FFA, and OCT were examined. The initial average visual acuity(ETDRS letterswere 51.17±15.15. The initial average central retina thickness(CRTwas 303.30±107.87μm. All affected eyes were treated with intravitreal conbercept 0.05mL(10mg/mLcombined with 532-laser. Patients were followed up for 6 to 12mo, with a mean duration of 7.33±1.26mo. Post-treatment BCVA were compared with baseline using repeat analysis. RESULTS: The mean BCVA showed significant improvement during 1 wk, 1, 3mo post-treatment and the latest follow up(PCONCLUSION: Coats disease in adulthood more likely to have lower symptom and have a better response on treatment. Intravitreal conbercept combined with 532-laser significantly improve visual acuity and absorb the subretina fluid.

  9. Role of optical coherence tomography angiography in myopic choroidal neovascularization after intravitreal injections of Ranibizumab

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    Meng Cai

    2017-10-01

    Full Text Available AIM: To investigate the change of myopic choroidal neovascularization treated by ranibizumab and evaluate their value in monitoring the effect of anti- vascular endothelial growth factor(VEGFtherapy.METHODS: The study enrolled 30 patients(30 eyesdiagnosed with myopic choroidal neovascularization. All affected eyes were treated with intravitreal ranibizumab 0.05mL(10mg/mL. Best corrected visual acuity(BCVA, non-contact tonometer, ophthalmoscope, fundus fluorescein angiograph(FFAand OCTA were evaluated monthly until 6mo. The changes of BCVA and central macular thickness(CMTwere compared at 1, 3 and 6mo after treatment.RESULTS: All patients received an average of 1.70±0.65 injections. BCVA was 0.96±0.17(LogMARbefore therapy, and BCVA 1, 3 and 6mo after treatment respectively improved by 0.23±0.09, 0.34±0.07, 0.38±0.11. The differences were significant(t=5.461, 8.191, 8.894; Pt=12.007, 13.360, 9.531; PCONCLUSION: Intravitreal ranibizumab for CNV secondary to pathologic myopia is effective and safe; OCTA is a noninvasive and time-saving new technology, and it also is a promising tool for clinicians to make preliminary diagnosis and assess treatment efficacy in the follow-up visits.

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

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    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)

    2013-05-15

    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.)

  11. Simultaneous Confocal Scanning Laser Ophthalmoscopy Combined with High-Resolution Spectral-Domain Optical Coherence Tomography: A Review

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    Verônica Castro Lima

    2011-01-01

    Full Text Available We aimed to evaluate technical aspects and the clinical relevance of a simultaneous confocal scanning laser ophthalmoscope and a high-speed, high-resolution, spectral-domain optical coherence tomography (SDOCT device for retinal imaging. The principle of confocal scanning laser imaging provides a high resolution of retinal and choroidal vasculature with low light exposure. Enhanced contrast, details, and image sharpness are generated using confocality. The real-time SDOCT provides a new level of accuracy for assessment of the angiographic and morphological correlation. The combined system allows for simultaneous recordings of topographic and tomographic images with accurate correlation between them. Also it can provide simultaneous multimodal imaging of retinal pathologies, such as fluorescein and indocyanine green angiographies, infrared and blue reflectance (red-free images, fundus autofluorescence images, and OCT scans (Spectralis HRA + OCT; Heidelberg Engineering, Heidelberg, Germany. The combination of various macular diagnostic tools can lead to a better understanding and improved knowledge of macular diseases.

  12. Spectral autofluorescence imaging of the retina for drusen detection

    Science.gov (United States)

    Foubister, James J.; Gorman, Alistair; Harvey, Andy; Hemert, Jano van

    2018-02-01

    The presence and characteristics of drusen in retinal images, namely their size, location, and distribution, can be used to aid in the diagnosis and monitoring of Age Related Macular Degeneration (AMD); one of the leading causes for blindness in the elderly population. Current imaging techniques are effective at determining the presence and number of drusen, but fail when it comes to classifying their size and form. These distinctions are important for correctly characterising the disease, especially in the early stages where the development of just one larger drusen can indicate progression. Another challenge for automated detection is in distinguishing them from other retinal features, such as cotton wool spots. We describe the development of a multi-spectral scanning-laser ophthalmoscope that records images of retinal autofluorescence (AF) in four spectral bands. This will offer the potential to detect drusen with improved contrast based on spectral discrimination for automated classification. The resulting improved specificity and sensitivity for their detection offers more reliable characterisation of AMD. We present proof of principle images prior to further system optimisation and clinical trials for assessment of enhanced detection of drusen.

  13. Laser injury and in vivo multimodal imaging using a mouse model

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    Pocock, Ginger M.; Boretsky, Adam; Gupta, Praveena; Oliver, Jeff W.; Motamedi, Massoud

    2011-03-01

    Balb/c wild type mice were used to perform in vivo experiments of laser-induced thermal damage to the retina. A Heidelberg Spectralis HRA confocal scanning laser ophthalmoscope with a spectral domain optical coherence tomographer was used to obtain fundus and cross-sectional images of laser induced injury in the retina. Sub-threshold, threshold, and supra-threshold lesions were observed using optical coherence tomography (OCT), infrared reflectance, red-free reflectance, fluorescence angiography, and autofluorescence imaging modalities at different time points post-exposure. Lesions observed using all imaging modalities, except autofluorescence, were not visible immediately after exposure but did resolve within an hour and grew in size over a 24 hour period. There was a decrease in fundus autofluorescence at exposure sites immediately following exposure that developed into hyper-fluorescence 24-48 hours later. OCT images revealed threshold damage that was localized to the RPE but extended into the neural retina over a 24 hour period. Volumetric representations of the mouse retina were created to visualize the extent of damage within the retina over a 24 hour period. Multimodal imaging provides complementary information regarding damage mechanisms that may be used to quantify the extent of the damage as well as the effectiveness of treatments without need for histology.

  14. LONG-TERM SD-OCT/SLO IMAGING OF NEURORETINA AND RETINAL PIGMENT EPITHELIUM AFTER SUB-THRESHOLD INFRARED LASER TREATMENT OF DRUSEN

    Science.gov (United States)

    MOJANA, FRANCESCA; BRAR, MANPREET; CHENG, LINGYUN; BARTSCH, DIRK-UWE G.; FREEMAN, WILLIAM R.

    2012-01-01

    PURPOSE To determine the long-term effect of sub-threshold diode laser treatment for drusen in patients with non-exudative age-related macular degeneration (AMD) with spectral domain optical coherence tomography combined with simultaneous scanning laser ophthalmoscope (SD-OCT/SLO). METHODS 8 eyes of 4 consecutive AMD patients with bilateral drusen previously treated with sub-threshold diode laser were imaged with SD-OCT/SLO. Abnormalities in the outer retina layers reflectivity as seen with SD-OCT/SLO were retrospectively analyzed and compared with color fundus pictures and autofluorescence images (AF) acquired immediately before and after the laser treatment. RESULTS A focal discrete disruptions in the reflectivity of the outer retinal layers was noted in 29% of the laser lesions. The junction in between the inner and outer segment of the photoreceptor was more frequently affected, with associated focal damage of the outer nuclear layer. Defects of the RPE were occasionally detected. These changes did not correspond to threshold burns on color fundus photography, but corresponded to focal areas of increased AF in the majority of the cases. CONCLUSIONS Sub-threshold diode laser treatment causes long-term disruption of the retinal photoreceptor layer as analyzed by SD-OCT/SLO. The concept that sub-threshold laser treatment can achieve a selected RPE effect without damage to rods and cones may be flawed. PMID:21157398

  15. Wide-field fundus autofluorescence corresponds to visual fields in chorioretinitis patients

    Directory of Open Access Journals (Sweden)

    Seidensticker F

    2011-11-01

    Full Text Available Florian Seidensticker1, Aljoscha S Neubauer1, Tamer Wasfy1,2, Carmen Stumpf1, Stephan R Thurau1,*, Anselm Kampik1, Marcus Kernt1,*1Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany; 2Department of Ophthalmology, Tanta University, Tanta, Egypt *Both authors contributed equally to this workBackground and objectives: Detection of peripheral fundus autofluorescence (FAF using conventional scanning laser ophthalmoscopes (SLOs is difficult and requires pupil dilation. Here we evaluated the diagnostic properties of wide-field FAF detected by a two-laser wavelength wide-field SLO in uveitis patients.Study design/materials and methods: Observational case series of four patients suffering from different types of posterior uveitis/chorioretinitis. Wide-field FAF images were compared to visual fields. Panretinal FAF was detected by a newly developed SLO, which allows FAF imaging of up to 200° of the retina in one scan without the need for pupil dilation. Visual fields were obtained by Goldmann manual perimetry.Results: Findings from wide-field FAF imaging showed correspondence to visual field defects in all cases.Conclusion: Wide-field FAF allowed the detection of visual field defect-related alterations of the retinal pigment epithelium in all four uveitis cases.Keywords: fundus autofluorescence (FAF, Optomap, wide-field scanning laser ophthalmoscopy, imaging, uveitis, visual field

  16. The reduction of retinal autofluorescence caused by light exposure.

    Science.gov (United States)

    Morgan, Jessica I W; Hunter, Jennifer J; Merigan, William H; Williams, David R

    2009-12-01

    A prior study showed that long exposure to 568-nm light at levels below the maximum permissible exposure safety limit produces retinal damage preceded by a transient reduction in the autofluorescence of retinal pigment epithelial (RPE) cells in vivo. The present study shows how the effects of exposure power and duration combine to produce this autofluorescence reduction and find the minimum exposure causing a detectable autofluorescence reduction. Macaque retinas were imaged using a fluorescence adaptive optics scanning laser ophthalmoscope to resolve individual RPE cells in vivo. The retina was exposed to 568-nm light over a square subtending 0.5 degrees with energies ranging from 1 to 788 J/cm(2), where power and duration were independently varied. In vivo exposures of 5 J/cm(2) and higher caused an immediate decrease in autofluorescence followed by either full autofluorescence recovery (exposures or= 247 J/cm(2)). No significant autofluorescence reduction was observed for exposures of 2 J/cm(2) and lower. Reciprocity of exposure power and duration held for the exposures tested, implying that the total energy delivered to the retina, rather than its distribution in time, determines the amount of autofluorescence reduction. That reciprocity held is consistent with a photochemical origin, which may or may not cause retinal degeneration. The implementation of safe methods for delivering light to the retina requires a better understanding of the mechanism causing autofluorescence reduction. Finally, RPE imaging was demonstrated using light levels that do not cause a detectable reduction in autofluorescence.

  17. Two-photon excited fluorescence microscopy application for ex vivo investigation of ocular fundus samples

    Science.gov (United States)

    Peters, Sven; Hammer, Martin; Schweitzer, Dietrich

    2011-07-01

    Two-photon excited fluorescence (TPEF) imaging of ocular tissue has recently become a promising tool in ophthalmology for diagnostic and research purposes. The feasibility and the advantages of TPEF imaging, namely deeper tissue penetration and improved high-resolution imaging of microstructures, have been demonstrated lately using human ocular samples. The autofluorescence properties of endogenous fluorophores in ocular fundus tissue are well known from spectrophotometric analysis. But fluorophores, especially when it comes to fluorescence lifetime, typically display a dependence of their fluorescence properties on local environmental parameters. Hence, a more detailed investigation of ocular fundus autofluorescence ideally in vivo is of utmost interest. The aim of this study is to determine space-resolved the stationary and time-resolved fluorescence properties of endogenous fluorophores in ex vivo porcine ocular fundus samples by means of two-photon excited fluorescence spectrum and lifetime imaging microscopy (FSIM/FLIM). By our first results, we characterized the autofluorescence of individual anatomical structures of porcine retina samples excited at 760 nm. The fluorescence properties of almost all investigated retinal layers are relatively homogenous. But as previously unknown, ganglion cell bodies show a significantly shorter fluorescence lifetime compared to the adjacent mueller cells. Since all retinal layers exhibit bi-exponential autofluorescence decays, we were able to achieve a more precise characterization of fluorescence properties of endogenous fluorophores compared to a present in vivo FLIM approach by confocal scanning laser ophthalmoscope (cSLO).

  18. Two-Photon Autofluorescence Imaging Reveals Cellular Structures Throughout the Retina of the Living Primate Eye.

    Science.gov (United States)

    Sharma, Robin; Williams, David R; Palczewska, Grazyna; Palczewski, Krzysztof; Hunter, Jennifer J

    2016-02-01

    Although extrinsic fluorophores can be introduced to label specific cell types in the retina, endogenous fluorophores, such as NAD(P)H, FAD, collagen, and others, are present in all retinal layers. These molecules are a potential source of optical contrast and can enable noninvasive visualization of all cellular layers. We used a two-photon fluorescence adaptive optics scanning light ophthalmoscope (TPF-AOSLO) to explore the native autofluorescence of various cell classes spanning several layers in the unlabeled retina of a living primate eye. Three macaques were imaged on separate occasions using a custom TPF-AOSLO. Two-photon fluorescence was evoked by pulsed light at 730 and 920 nm excitation wavelengths, while fluorescence emission was collected in the visible range from several retinal layers and different locations. Backscattered light was recorded simultaneously in confocal modality and images were postprocessed to remove eye motion. All retinal layers yielded two-photon signals and the heterogeneous distribution of fluorophores provided optical contrast. Several structural features were observed, such as autofluorescence from vessel walls, Müller cell processes in the nerve fibers, mosaics of cells in the ganglion cell and other nuclear layers of the inner retina, as well as photoreceptor and RPE layers in the outer retina. This in vivo survey of two-photon autofluorescence throughout the primate retina demonstrates a wider variety of structural detail in the living eye than is available through conventional imaging methods, and broadens the use of two-photon imaging of normal and diseased eyes.

  19. Issues in quantifying atrophic macular disease using retinal autofluorescence.

    Science.gov (United States)

    Sunness, Janet S; Ziegler, Matthias D; Applegate, Carol A

    2006-01-01

    To demonstrate the potential and limits of autofluorescence imaging in identifying and delineating areas of atrophy. Fundus photographs and infrared scanning laser ophthalmoscope (SLO) imaging, SLO macular perimetry, and SLO autofluorescence imaging results were compared for two patients with geographic atrophy (GA) from age-related macular degeneration, one patient with pigmentary alteration of the retina, and two patients with Stargardt disease. The main outcome measure in this case series was the presence of reduced autofluorescence. Drusen may become undetectable during autofluorescence imaging for some patients, allowing simple identification of areas of GA with areas of reduced autofluorescence. In other patients, drusen themselves have decreased autofluorescence, despite having intact retinal function in the retina overlying them. Some patients may have areas of reduced autofluorescence that persist for many years, without evidence of the development of atrophy. In Stargardt disease, decreased autofluorescence can easily detect and delineate areas of scotoma. Areas with mottled autofluorescence may have overlying function, but the function may not be adequate to support a fixation locus in that area. Using decreased autofluorescence to delineate areas of atrophy may be helpful in atrophic macular disorders. For GA, correlation with fundus photographs or macular perimetry findings may be necessary to differentiate between drusen and atrophy. For Stargardt disease, the nature of areas of decreased autofluorescence may help explain visual function of those areas.

  20. Multifocal electroretinogram and central visual field testing in central areolar choroidal dystrophy.

    Science.gov (United States)

    Gundogan, Fatih Cakir; Dinç, Umut Asli; Erdem, Uzeyir; Ozge, Gokhan; Sobaci, Gungor

    2010-01-01

    To study multifocal electroretinogram (mfERG) and its relation to retinal sensitivity assessed by Humphrey visual field (HVF) analysis in central areolar choroidal dystrophy (CACD). Seven eyes of 4 patients with CACD and 15 normal control subjects were examined. mfERG and central 30/2 HVF were tested for each participant. Ring analysis in mfERG was evaluated. HVF results were evaluated in 5 concentric rings in order to compare the results to concentric ring analysis in mfERG. The differences between control subjects and patients were evaluated by Mann-Whitney U test and the correlations were assessed by Spearman test. Mean Snellen acuity was 0.49+/-0.10 in patients. HVF revealed central scotoma in 6 of 7 eyes (85.7%), whereas a paracentral scotoma extending to fixation point was detected in 1 eye. The retinal sensitivities in 5 concentric rings in HVF were significantly lower (p<0.001 for ring 1 to ring 4, and p=0.017 in ring 5) in CACD patients. Similarly, CACD patients had lower P1/N1 amplitudes (p<0.05) and delayed P1/N1 implicit times (p<0.05). In CACD, in the areas of scotoma detected by HVF, mfERG values were depressed. However, both mfERG and HVF abnormalities were found outside the areas of ophthalmoscopically normal retinal areas.

  1. Performance of OCT segmentation procedures to assess morphology and extension in geographic atrophy.

    Science.gov (United States)

    Schütze, Christopher; Ahlers, Christian; Sacu, Stefan; Mylonas, Georgios; Sayegh, Ramzi; Golbaz, Isabelle; Matt, Gerlinde; Stock, Géraldine; Schmidt-Erfurth, Ursula

    2011-05-01

    Investigating segmentation procedures and morphological findings in time domain (TD) and current spectral domain (SD) optical coherence tomography (OCT) devices in patients with geographic atrophy (GA). Fifty eyes of 46 patients with GA secondary to AMD and 15 control eyes were examined in this prospective noninterventional comparative case series. All patients underwent Stratus (model 3000), Cirrus (Carl Zeiss Meditec), Spectralis (Spectralis HRA+OCT; Heidelberg Engineering) and 3D-OCT-1000 (Topcon). Automated segmentation analyses were compared. An overlay of scanning laser ophthalmoscope (SLO) and three-dimensional retinal thickness (RT) maps were used to investigate whether areas of retinal thinning correspond to areas of retinal pigment epithelium (RPE) atrophy. Geographic atrophy areas identified in SLO scans were significantly larger than areas of retinal thinning in RT maps. No convincing topographic correlation could be found between areas of retinal thinning and actual GA size as identified in SLO and fundus photography. Spectralis OCT showed significantly more mild and severe segmentation errors than 3D and Cirrus OCT. This study showed substantial limitations in identifying zones of GA reliably when using automatic segmentation procedures in current SD-OCT devices. This limitation should be addressed to visualize and document RPE loss realistically in a frequent disease like GA. © 2010 The Authors. Journal compilation © 2010 Acta Ophthalmol.

  2. REDUCED GANGLION CELL VOLUME ON OPTICAL COHERENCE TOMOGRAPHY IN PATIENTS WITH GEOGRAPHIC ATROPHY.

    Science.gov (United States)

    Ramkumar, Hema L; Nguyen, Brian; Bartsch, Dirk-Uwe; Saunders, Luke J; Muftuoglu, Ilkay Kilic; You, Qisheng; Freeman, William R

    2017-11-07

    Geographic atrophy (GA) is the sequelae of macular degeneration. Automated inner retinal analysis using optical coherence tomography is flawed because segmentation software is calibrated for normal eyes. The purpose of this study is to determine whether ganglion cell layer (GCL) volume is reduced in GA using manual analysis. Nineteen eyes with subfoveal GA and 22 controls were selected for morphometric analyses. Heidelberg scanning laser ophthalmoscope optical coherence tomography images of the optic nerve and macula were obtained, and the Viewing Module was used to manually calibrate retinal layer segmentation. Retinal layer volumes in the central 3-mm and surrounding 6-mm diameter were measured. Linear mixed models were used for statistics. The GCL volume in the central 3 mm of the macula is less (P = 0.003), and the retinal nerve fiber layer volume is more (P = 0.02) in patients with GA when compared with controls. Ganglion cell layer volume positively correlated with outer nuclear layer volume (P = 0.020). The patients with geographic atrophy have a small significant loss of the GCL. Ganglion cell death may precede axonal loss, and increased macular retinal nerve fiber layer volumes are not indicative of GCL volume. Residual ganglion cell stimulation by interneurons may enable vision in patients with GA.

  3. Interactive segmentation for geographic atrophy in retinal fundus images.

    Science.gov (United States)

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

    2008-10-01

    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.

  4. Persistent hyperplastic primary vitreous: imaging evaluation

    International Nuclear Information System (INIS)

    Jacob, Beatriz Mahmud; Teixeira, Kim-Ir-Sen Santos; Figueiredo, Sizenildo da Silva; Nobrega, Bruno Barcelos da

    2003-01-01

    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)

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

    Energy Technology Data Exchange (ETDEWEB)

    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: biamjacob@hotmail.com

    2003-06-01

    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)

  6. Optical design considerations when imaging the fundus with an adaptive optics correction

    Science.gov (United States)

    Wang, Weiwei; Campbell, Melanie C. W.; Kisilak, Marsha L.; Boyd, Shelley R.

    2008-06-01

    Adaptive Optics (AO) technology has been used in confocal scanning laser ophthalmoscopes (CSLO) which are analogous to confocal scanning laser microscopes (CSLM) with advantages of real-time imaging, increased image contrast, a resistance to image degradation by scattered light, and improved optical sectioning. With AO, the instrumenteye system can have low enough aberrations for the optical quality to be limited primarily by diffraction. Diffraction-limited, high resolution imaging would be beneficial in the understanding and early detection of eye diseases such as diabetic retinopathy. However, to maintain diffraction-limited imaging, sufficient pixel sampling over the field of view is required, resulting in the need for increased data acquisition rates for larger fields. Imaging over smaller fields may be a disadvantage with clinical subjects because of fixation instability and the need to examine larger areas of the retina. Reduction in field size also reduces the amount of light sampled per pixel, increasing photon noise. For these reasons, we considered an instrument design with a larger field of view. When choosing scanners to be used in an AOCSLO, the ideal frame rate should be above the flicker fusion rate for the human observer and would also allow user control of targets projected onto the retina. In our AOCSLO design, we have studied the tradeoffs between field size, frame rate and factors affecting resolution. We will outline optical approaches to overcome some of these tradeoffs and still allow detection of the earliest changes in the fundus in diabetic retinopathy.

  7. Dynamic indocyanine green angiography measurements

    Science.gov (United States)

    Holmes, Timothy; Invernizzi, Alessandro; Larkin, Sean; Staurenghi, Giovanni

    2012-11-01

    Dynamic indocyanine green imaging uses a scanning laser ophthalmoscope and a fluorescent dye to produce movies of the dye-filling pattern in the retina and choroid of the eye. It is used for evaluating choroidal neovascularization. Movies are examined to identify the anatomy of the pathology for planning treatment and to evaluate progression or response to treatment. The popularity of this approach is affected by the complexity and difficulty in interpreting the movies. Software algorithms were developed to produce images from the movies that are easy to interpret. A mathematical model is formulated of the flow dynamics, and a fitting algorithm is designed that solves for the flow parameters. The images provide information about flow and perfusion, including regions of change between examinations. Imaged measures include the dye fill-time, temporal dispersion, and magnitude of the dye dilution temporal curves associated with image pixels. Cases show how the software can help to identify clinically relevant anatomy such as feeder vessels, drain vessels, capillary networks, and normal choroidal draining vessels. As a potential tool for research into the character of neovascular conditions and treatments, it reveals the flow dynamics and character of the lesion. Future varieties of this methodology may be used for evaluating the success of engineered tissue transplants, surgical flaps, reconstructive surgery, breast surgery, and many other surgical applications where flow, perfusion, and vascularity of tissue are important.

  8. Nerve fiber layer (NFL) degeneration associated with acute q-switched laser exposure in the nonhuman primate

    Science.gov (United States)

    Zwick, Harry; Zuclich, Joseph A.; Stuck, Bruce E.; Gagliano, Donald A.; Lund, David J.; Glickman, Randolph D.

    1995-01-01

    We have evaluated acute laser retinal exposure in non-human primates using a Rodenstock scanning laser ophthalmoscope (SLO) equipped with spectral imaging laser sources at 488, 514, 633, and 780 nm. Confocal spectral imaging at each laser wavelength allowed evaluation of the image plane from deep within the retinal vascular layer to the more superficial nerve fiber layer in the presence and absence of the short wavelength absorption of the macular pigment. SLO angiography included both fluorescein and indocyanine green procedures to assess the extent of damage to the sensory retina, the retinal pigment epithelium (RPE), and the choroidal vasculature. All laser exposures in this experiment were from a Q-switched Neodymium laser source at an exposure level sufficient to produce vitreous hemorrhage. Confocal imaging of the nerve fiber layer revealed discrete optic nerve sector defects between the lesion site and the macula (retrograde degeneration) as well as between the lesion site and the optic disk (Wallerian degeneration). In multiple hemorrhagic exposures, lesions placed progressively distant from the macula or overlapping the macula formed bridging scars visible at deep retinal levels. Angiography revealed blood flow disturbance at the retina as well as at the choroidal vascular level. These data suggest that acute parafoveal laser retinal injury can involve both direct full thickness damage to the sensory and non-sensory retina and remote nerve fiber degeneration. Such injury has serious functional implications for both central and peripheral visual function.

  9. Agreement between image grading of conventional (45°) and ultra wide-angle (200°) digital images in the macula in the Reykjavik eye study.

    Science.gov (United States)

    Csutak, A; Lengyel, I; Jonasson, F; Leung, I; Geirsdottir, A; Xing, W; Peto, T

    2010-10-01

    To establish the agreement between image grading of conventional (45°) and ultra wide-angle (200°) digital images in the macula. In 2008, the 12-year follow-up was conducted on 573 participants of the Reykjavik Eye Study. This study included the use of the Optos P200C AF ultra wide-angle laser scanning ophthalmoscope alongside Zeiss FF 450 conventional digital fundus camera on 121 eyes with or without age-related macular degeneration using the International Classification System. Of these eyes, detailed grading was carried out on five cases each with hard drusen, geographic atrophy and chorioretinal neovascularisation, and six cases of soft drusen. Exact agreement and κ-statistics were calculated. Comparison of the conventional and ultra wide-angle images in the macula showed an overall 96.43% agreement (κ=0.93) with no disagreement at end-stage disease; although in one eye chorioretinal neovascularisation was graded as drusenoid pigment epithelial detachment. Of patients with drusen only, the exact agreement was 96.1%. The detailed grading showed no clinically significant disagreement between the conventional 45° and 200° images. On the basis of our results, there is a good agreement between grading conventional and ultra wide-angle images in the macula.

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

    Directory of Open Access Journals (Sweden)

    Paulo de Tarso P. Pierre Filho

    2004-08-01

    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.

  11. Prevalence of ocular morbidity in rural population of eastern Uttar Pradesh, India

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    Anupama Kumar

    2016-09-01

    Full Text Available Background: Ocular morbidity is a significant problem in rural areas of India as it remains undiagnosed and neglected. Aims & Objectives:  To determine the prevalence of ocular morbidity in the rural population of Barabanki, Uttar Pradesh. Material & Methods: A community based cross-sectional study was conducted in the villages around RHTC Satrikh of HIMS Barabanki. Ocular examination and vision testing was done among 812 people using ophthalmoscopic instruments. Information was collected using pre-tested questionnaire. Analysis was done using SPSS and appropriate Statistical tests. Results: Of the total 812 individuals interviewed, the prevalence of ocular morbidity was 41.3% (335 subjects had one or more ocular morbidity; with 88.8% elderly affected (age >65 years.   Myopia was the most common ocular morbidity 14.8%, followed by cataract (14.3% and hypermetropia (12.8%.  Allergic and infective conjunctivitis affected 5.8% and 3.9%, respectively.  The prevalence of Vitamin A deficiency disorder (including night blindness and bitot spots was 1.3%.  Higher ocular morbidity was present in houses with higher SES. Environmental conditions had no significant relation to ocular morbidity.  Conclusion: The prevalence of ocular diseases among the elderly was highest and requires prompt attention.  Myopia was the most common ocular morbidity having a prevalence of 14.8%, followed by cataract (14.3% and hypermetropia (12.8%.

  12. [Tay-Sachs disease in non-Jewish infant in Israel].

    Science.gov (United States)

    Nadim, Nasser

    2012-01-01

    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.

  13. AN ALGORITHM TO DETECT THE RETINAL REGION OF INTEREST

    Directory of Open Access Journals (Sweden)

    E. Şehirli

    2017-11-01

    Full Text Available Retina is one of the important layers of the eyes, which includes sensitive cells to colour and light and nerve fibers. Retina can be displayed by using some medical devices such as fundus camera, ophthalmoscope. Hence, some lesions like microaneurysm, haemorrhage, exudate with many diseases of the eye can be detected by looking at the images taken by devices. In computer vision and biomedical areas, studies to detect lesions of the eyes automatically have been done for a long time. In order to make automated detections, the concept of ROI may be utilized. ROI which stands for region of interest generally serves the purpose of focusing on particular targets. The main concentration of this paper is the algorithm to automatically detect retinal region of interest belonging to different retinal images on a software application. The algorithm consists of three stages such as pre-processing stage, detecting ROI on processed images and overlapping between input image and obtained ROI of the image.

  14. Red reflex screening in New Zealand: a large survey of practices and attitudes in the Auckland region.

    Science.gov (United States)

    Raoof, Naz; Dai, Shuan

    2016-07-15

    Red reflex testing forms an essential part of newborn (within the first week of life) and infant (6 weeks of age) screening in New Zealand, as outlined in the Well Child/Tamariki Ora handbook. This survey of practitioners undertaking red reflex screening aimed to determine current practices and attitudes of screeners, as well as any barriers to screening. A short, multiple-choice, on-line questionnaire was sent to approximately 1,500 health care professionals undertaking red reflex screening, over a 4-week period. Four hundred and eighty-three survey responses were received from 267 GPs (55.4%), 153 midwives (31.7%), and 50 paediatricians (10.4%). Thirty-six respondents (7.8%) performed red reflex screening only when they had time to do so, 13 (2.8%) only undertook this when there were concerns raised by the parents. Most respondents (97.3%) used an ophthalmoscope to perform screening. Seventynine respondents (16.6%) felt they were "not sure/underconfident" at performing this test. Only 83 of 479 respondents (17.3%) had received any formal training. The development of an online resource or practical 'refresher' sessions would be well received and likely to improve current practices.

  15. Combination of confocal principle and aperture stop separation improves suppression of crystalline lens fluorescence in an eye model.

    Science.gov (United States)

    Klemm, Matthias; Blum, Johannes; Link, Dietmar; Hammer, Martin; Haueisen, Jens; Schweitzer, Dietrich

    2016-09-01

    Fluorescence lifetime imaging ophthalmoscopy (FLIO) is a new technique to detect changes in the human retina. The autofluorescence decay over time, generated by endogenous fluorophores, is measured in vivo. The strong autofluorescence of the crystalline lens, however, superimposes the intensity decay of the retina fluorescence, as the confocal principle is not able to suppress it sufficiently. Thus, the crystalline lens autofluorescence causes artifacts in the retinal fluorescence lifetimes determined from the intensity decays. Here, we present a new technique to suppress the autofluorescence of the crystalline lens by introducing an annular stop into the detection light path, which we call Schweitzer's principle. The efficacy of annular stops with an outer diameter of 7 mm and inner diameters of 1 to 5 mm are analyzed in an experimental setup using a model eye based on fluorescent dyes. Compared to the confocal principle, Schweitzer's principle with an inner diameter of 3 mm is able to reduce the simulated crystalline lens fluorescence to 4%, while 42% of the simulated retina fluorescence is preserved. Thus, we recommend the implementation of Schweitzer's principle in scanning laser ophthalmoscopes used for fundus autofluorescence measurements, especially the FLIO device, for improved image quality.

  16. Apparent X-linked primary ciliary dyskinesia associated with retinitis pigmentosa and a hearing loss.

    Science.gov (United States)

    Krawczyński, Maciej R; Dmeńska, Hanna; Witt, Michał

    2004-01-01

    Three brothers, one 10-year-old and a pair of 14-year-old dizygotic twins--expressed the classical, early-onset retinitis pigmentosa (RP) with typical ophthalmoscopic findings, night blindness, visual field constricted to 10 degrees and flat ERG response. All three brothers were also diagnosed with primary ciliary dyskinesia (PCD) and had recurrent respiratory infections, chronic sinusitis and bronchiectasis. In all of them, resection of the middle lobe of the right lung was performed. A similar clinical picture of coexisting RP and PCD was noted in the brother of the probands' mother. All probands displayed situs solitus. Consistent with the X-linked mode of RP inheritance, there were also three obligatory female carriers of the disorder in this family: the mother of the affected boys, her mother and a daughter of her brother. In all of them, retinitis pigmentosa "sine pigmento" was found with milder but clinically significant symptoms (mild night blindness, visual field constricted to 30 degrees, and scotopic and photopic ERG responses reduced to 30-60%). No extraocular symptoms were detected in any of the heterozygous female carriers. This family presents an example of two rare phenomena: X-linked dominant retinitis pigmentosa (with milder expression in females) and a rare combination of RP with recurrent respiratory infections due to PCD.

  17. Study of serum soluble vascular cell adhesion molecule-1 levels in type 2 diabetic patients with diabetic retinopathy

    International Nuclear Information System (INIS)

    Li Fangdu; Chu Qiaomei

    2002-01-01

    To study the change and the correlation of serum soluble vascular cell adhesion molecule-1 (sV-CAM-1) levels with diabetic retinopathy in type 2 diabetic patients, serum sVCAM-1 levels were measured in duplicate by ELISA in 85 type 2 diabetic patients; fundus examination was performed by an ophthalmologist using ophthalmoscope or fundus fluorescein angiography, and the findings were graded as: no signs of diabetic retinopathy (NDR), background diabetic retinopathy (BDR) and proliferative diabetic retinopathy (PDR). Serum sVCAM-1 levels were significantly higher in the PDR and BDR groups than those in the control and NDR groups respectively (P<0.01). NDR group showed significantly increased serum sVCAM-levels compared with control group (P<0.01). In contrast, serum sVCAM-1 levels were not related to the presence of blood glucose, serum insulin levels or known diabetic duration. Authors' results suggest that serum sVCAM-1 might be implicated in the development of the diabetic retinopathy, and could assess the severity of diabetic retinopathy. The measurement of serum sVCAM-1 levels in 2 type diabetic patients may be clinically useful for early diagnosis or treatment of diabetic retinopathy

  18. Radiation retinopathy as an experimental model for ischemic proliferative retinopathy and rubeosis iridis

    International Nuclear Information System (INIS)

    Irvine, A.R.; Wood, I.S.

    1987-01-01

    We produced radiation retinopathy in capuchin monkeys and studied them with fluorescein angiography and light and electron microscopy. The animals were followed up from ten days to 3 1/2 years after radiation in order to determine whether this could provide an experimental model for other chronic ischemic-proliferative retinopathies, such as diabetes. The first change detected after radiation was the focal loss of capillary endothelial cells and pericytes. As the areas of acellular capillaries became confluent, cotton-wool spots became visible ophthalmoscopically. These increased in number and then faded away, leaving large areas of retinal capillary perfusion. Histologic studies showed occlusion first of the deeper, smaller retinal vessels and then gradually of the larger vessels. Intraretinal neovascularization as well as apparent recanalization then developed, but no new vessels extended through the internal limiting lamina into the vitreous. Rubeosis iridis with neovascular glaucoma developed 2 1/2 to 3 1/2 years postirradiation, and vitreous aspirate demonstrated a high level of angiogenic factor

  19. Prevalence of Diabetic retinopathy in Kashmir, India -A hospital based study

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    Tariq Qureshi

    2013-01-01

    Full Text Available Objective To assess the prevalence of diabetic retinopathy among Kashmiri population. MaterialandMethod Inacross-sectionalhospitalbasedstudy,500patientswith established diabetes who attended eye OPD at Govt Medical College Srinagar were evaluated for the presence or absence of retinopathy. Relevant clinical examination was done and the findings were recorded at one point of time. No follow-up findings of the patients were included in this study. Direct Ophthalmoscope (Heinzand slit lamp bio-microscope (Zeiss were used for examination. Statistical package for Social Sciences (SPSS was used for statistical analysis. p60 yrs of age and 49 patients (36.2% were between 40-68 yrs of age. 33 (24.5% were males and 102 (75.5% were females. 30 patients (12.8% with diabetes of = 15 yr. Mild DR was present in 67 (37.4% patients, moderate to severe DR in 46 (9.2% patients, proliferative DR in 5(1% patients and diabetic maculopathy in 17(3.4%patients. Patients who were managed with insulin, either alone or with oral hypoglycemic drugs, had more prevalence of DR. Conclusion The present study concluded that DR is highly prevalent in this part of the world and needs early detection and appropriate treatment to prevent blindness due to this condition.

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

    Science.gov (United States)

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

    2013-06-01

    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.

  1. Spectral imaging technique for retinal perfusion detection using confocal scanning laser ophthalmoscopy

    Science.gov (United States)

    Rasta, Seyed Hossein; Manivannan, Ayyakkannu; Sharp, Peter F.

    2012-11-01

    To evaluate retinal perfusion in the human eye, a dual-wavelength confocal scanning laser ophthalmoscope (cSLO) was developed that provides spectral imaging of the fundus using a combination of red (670 nm) and near-infrared (810 nm) wavelengths. The image of the ocular fundus was analyzed to find out if quantitative measurements of the reflectivity of tissue permit assessment of the oxygen perfusion of tissue. We explored problems that affect the reproducibility of patient measurements such as non-uniformity errors on the image. For the first time, an image processing technique was designed and used to minimize the errors of oxygen saturation measurements by illumination correction in retina wide field by increasing SNR. Retinal images were taken from healthy and diabetic retinopathy eyes using the cSLO with a confocal aperture of 100 μm. The ratio image (RI) of red/IR, as oxygen saturation (SO2) index, was calculated for normal eyes. The image correction technique improved the reproducibility of the measurements. Average RI intensity variation of healthy retina tissue was determined within a range of about 5.5%. The capability of the new technique to discriminate oxygenation levels of retinal artery and vein was successfully demonstrated and showed good promise in the diagnosis of the perfused retina.

  2. Ocular toxoplasmosis in immunosuppressed nonhuman primates

    Energy Technology Data Exchange (ETDEWEB)

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

    1988-06-01

    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.

  3. Histopathology of the effects of tuneable dye laser on monkey retina

    Energy Technology Data Exchange (ETDEWEB)

    Smiddy, W.E.; Patz, A.; Quigley, H.A.; Dunkelberger, G.R.

    1988-07-01

    The tuneable dye laser was used to simulate treatment of choroidal neovascularization and panretinal photocoagulation (PRP) in monkey retina. The histopathologic effects of wavelengths from 560 to 630 nm in juxtafoveal, papillomacular bundle, and nonfoveal areas were investigated. An unexpected observation using high-intensity burns in juxtafoveal and, to a lesser extent, in papillomacular bundle areas was inner retinal damage with 600-nm light. At moderate energy levels, the effect of 600 nm were more comparable with those with other wavelengths and included much less damage to the inner retinal layers. At mild energy levels, the effects were comparable with other wavelengths. During and after the application of the burns, the energy levels and ophthalmoscopic appearances were comparable for each wavelength for the high-, moderate-, and mild-intensity burns. The histopathologic effects of 630-nm light (tuneable dye red) were comparable with those of the standard krypton red (647 nm) laser. Nonmacular and PRP effects were similar with all wavelengths. These results indicate that power levels may need to be reduced when placing 600-nm (orange) laser burns in the macula.

  4. Uses of the Word “Macula” in Written English, 1400-Present

    Science.gov (United States)

    Schwartz, Stephen G.; Leffler, Christopher T.

    2014-01-01

    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. PMID:24913329

  5. Ocular toxoplasmosis in immunosuppressed nonhuman primates

    International Nuclear Information System (INIS)

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

    1988-01-01

    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

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

    Directory of Open Access Journals (Sweden)

    O. El-Tookhy

    2013-01-01

    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.

  7. Retinal vessels caliber assessment in patients with arterial hypertension

    Directory of Open Access Journals (Sweden)

    N. S. Semenova

    2014-07-01

    Full Text Available Purpose: to evaluate the diagnostic capability of automated retinal vessels (RV caliber estimation for hypertensive angiopathy.Methods: this study included 146 patients (292 eyes with arterial hypertension. All the subjects underwent fundus photography and RV caliber estimation. the latter was performed using newly developed computer-based method for automated vessel detection and central retinal arteriolar and venular equivalents determination (CRAE & CRVE. Sensitivity, specificity, and reproducibility of the method were estimated.Results: the method of RV caliber assessment showed good reproducibility. the overall specificity and sensitivity were 74% and 80.77%, respectively. Computer-based method of retinal vascular caliber assessment revealed higher predictive value comparing with ophthalmoscopic assessment (AUC = 0.903 and 0.85, respectively. Retinal arteriolar and venular caliber and AVR tend to decrease with age. Higher blood pressure is associated with narrower retinal arterioles.Conclusion: Novel method of RV caliber estimation demonstrated high information value. these findings are in good agreementwith data from major population-based studies.

  8. Retinal vessels caliber assessment in patients with arterial hypertension

    Directory of Open Access Journals (Sweden)

    N. S. Semenova

    2012-01-01

    Full Text Available Purpose: to evaluate the diagnostic capability of automated retinal vessels (RV caliber estimation for hypertensive angiopathy.Methods: this study included 146 patients (292 eyes with arterial hypertension. All the subjects underwent fundus photography and RV caliber estimation. the latter was performed using newly developed computer-based method for automated vessel detection and central retinal arteriolar and venular equivalents determination (CRAE & CRVE. Sensitivity, specificity, and reproducibility of the method were estimated.Results: the method of RV caliber assessment showed good reproducibility. the overall specificity and sensitivity were 74% and 80.77%, respectively. Computer-based method of retinal vascular caliber assessment revealed higher predictive value comparing with ophthalmoscopic assessment (AUC = 0.903 and 0.85, respectively. Retinal arteriolar and venular caliber and AVR tend to decrease with age. Higher blood pressure is associated with narrower retinal arterioles.Conclusion: Novel method of RV caliber estimation demonstrated high information value. these findings are in good agreementwith data from major population-based studies.

  9. [The Telehealth Network of the Americas and its role in primary health care].

    Science.gov (United States)

    Bill, Guillermo; Crisci, Carlos D; Canet, Tomislav

    2014-01-01

    The need to guarantee equitable access to health regardless of geographic, economic, or technological barriers motivated the Member States of the Organization of American States to create the Telehealth Network of the Americas, coordinated by the Inter-American Telecommunication Committee. The Network focuses on the use of new information and communications technology applied to health, based on the values of respect, equity, and solidarity and mandated by the philosophy of primary health. Its members include government agencies, nongovernmental organizations, university forums, hospital federations, and telecommunications companies, and it has already extended its reach to other continents and to different fields in which telemedicine is being used. Among its first achievements, it has implemented an innovative tool to be used in cases of disaster or limited geographic access. This mobile telemedicine station is housed in a portable case that includes a computer, various digital devices (otoscope, ophthalmoscope, microscope, dermatoscope), a high-resolution digital camera, an X-ray film viewer, and a satellite antenna. With this tool, it is possible to provide specialized support for rural physicians and primary health care workers located far from large urban centers.

  10. [Prevention of retinal detachment and treatment of retinoschisis].

    Science.gov (United States)

    Messmer, E P

    1990-01-01

    The necessity for prophylactic treatment for degenerative disease in the peripheral retina cannot be evaluated merely on the basis of the ophthalmoscopic findings. Factors such as the patient's history, refraction, the status of the vitreous, and prospective future cataract extraction all have a major impact on the risk of developing retinal detachment. The latter condition can be classified in to three groups: (1) low risk (patients with no history of retinal detachment, intraocular surgery or posterior vitreous detachment, myopia less than three diopters): treatment of atrophic holes and lattice degeneration is not justified, treatment of flap tears according to the circumstances; (2) medium risk (patients with no history of retinal or posterior vitreous detachment; however, myopia of more than three diopters and/or aphakia): the treatment of lattice degeneration is not justified; treatment of breaks according to the circumstances; (3) high risk: (patients with symptoms of posterior vitreous detachment): the treatment of lattice degeneration and atrophic holes is not justified: treatment of tears is necessary; fellow eyes: the treatment of retinal breaks is necessary; treatment of lattice degeneration seems advisable in cases with bilateral symmetric findings or prior to cataract extraction. Treatment of senile retinoschisis is only justified in cases with large and centrally located holes in the outer wall or in the presence of symptomatic schisis detachment.

  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

    Science.gov (United States)

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

    2011-06-01

    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. Multimodal scanning laser ophthalmoscopy for image guided treatment of age-related macular degeneration

    Science.gov (United States)

    Hammer, Daniel X.; Ferguson, R. D.; Patel, Ankit H.; Iftimia, Nicusor V.; Mujat, Mircea; Husain, Deeba

    2009-02-01

    Subretinal neovascular membranes (SRNM) are a deleterious complication of laser eye injury and retinal diseases such as age-related macular degeneration (AMD), choroiditis, and myopic retinopathy. Photodynamic therapy (PDT) and anti-vascular endothelial growth factor (VEGF) drugs are approved treatment methods. PDT acts by selective dye accumulation, activation by laser light, and disruption and clotting of the new leaky vessels. However, PDT surgery is currently not image-guided, nor does it proceed in an efficient or automated manner. This may contribute to the high rate of re-treatment. We have developed a multimodal scanning laser ophthalmoscope (SLO) for automated diagnosis and image-guided treatment of SRNMs associated with AMD. The system combines line scanning laser ophthalmoscopy (LSLO), fluorescein angiography (FA), indocyanine green angiography (ICGA), PDT laser delivery, and retinal tracking in a compact, efficient platform. This paper describes the system hardware and software design, performance characterization, and automated patient imaging and treatment session procedures and algorithms. Also, we present initial imaging and tracking measurements on normal subjects and automated lesion demarcation and sizing analysis of previously acquired angiograms. Future pre-clinical testing includes line scanning angiography and PDT treatment of AMD subjects. The automated acquisition procedure, enhanced and expedited data post-processing, and innovative image visualization and interpretation tools provided by the multimodal retinal imager may eventually aid in the diagnosis, treatment, and prognosis of AMD and other retinal diseases.

  13. Comparison of anterior segment optical coherence tomography angiography and fluorescein angiography for iris vasculature analysis.

    Science.gov (United States)

    Zett, Claudio; Stina, Deborah M Rosa; Kato, Renata Tiemi; Novais, Eduardo Amorim; Allemann, Norma

    2018-04-01

    The aim of this study is to perform imaging of irises of different colors using spectral domain anterior segment optical coherence tomography angiography (AS-OCTA) and iris fluorescein angiography (IFA) and compare their effectiveness in examining iris vasculature. This is a cross-sectional observational clinical study. Patients with no vascular iris alterations and different pigmentation levels were recruited. Participants were imaged using OCTA adapted with an anterior segment lens and IFA with a confocal scanning laser ophthalmoscope (cSLO) adapted with an anterior segment lens. AS-OCTA and IFA images were then compared. Two blinded readers classified iris pigmentation and compared the percentage of visible vessels between OCTA and IFA images. Twenty eyes of 10 patients with different degrees of iris pigmentation were imaged using AS-OCTA and IFA. Significantly more visible iris vessels were observed using OCTA than using FA (W = 5.22; p Iris pigmentation was negatively correlated to the percentage of visible vessels in both imaging methods (OCTA, rho = - 0.73, p iris vasculature. In both AS-OCTA and IFA, iris pigmentation caused vasculature imaging blockage, but AS-OCTA provided more detailed iris vasculature images than IFA. Additional studies including different iris pathologies are needed to determine the most optimal scanning parameters in OCTA of the anterior segment.

  14. Telemedicine in Majuro Hospital, Marshall Islands.

    Science.gov (United States)

    Gunawardane, K J

    2000-09-01

    Since March 1998 up to June 2000, telemedicine activities in Marshall Islands have mainly been for Referrals to Tripler Army Medical Center (TAMC) in Hawaii. The activities are based on a computer which has the Internet connection and accessories including a digital camera, flatbed scanner with a transparency adapter, color printer, a video printer, ophthalmoscope, otoscope and a video Lens, all of which were donated by Project Akamai in Hawaii. Two sessions of training were conducted by representatives from Akamai Project and from PBMA at the very beginning of the establishment of the unit, to all levels of Health Care Providers in Ministry of Health in Majuro. The computer and Internet facility is available 24 hours. Since March 1998 to June 2000, there had been 144 telemedicine consultations to TAMC. Out of a total of 326 off-island referrals for the same period, approximately 80 patients have been sent to TAMC using the PIHCP/Telemedicine program. This accounts for approximately 25% of total off-island referrals. This represents a significant reduction in cost. In addition to cost reduction the telemedicine unit most important impact is on the health providers, especially the physicians working at Majuro Hospital. Availability of medical information through internet has helped them to feel less isolated from the constantly changing field of medical science.

  15. Article Commentary: What was Glaucoma Called before the 20th Century?

    Directory of Open Access Journals (Sweden)

    Christopher T. Leffler

    2015-01-01

    Full Text Available Glaucoma involves a characteristic optic neuropathy, often with elevated intraocular pressure. Before 1850, poor vision with a normal eye appearance, as occurs in primary open-angle glaucoma, was termed amaurosis, gutta serena , or black cataract. Few observers noted palpable hardness of the eye in amaurosis. On the other hand, angle-closure glaucoma can produce a green or gray pupil, and therefore was called, variously, glaucoma (derived from the Greek for glaucous, a nonspecific term connoting blue, green, or light gray and viriditate oculi. Angle closure, with palpable hardness of the eye, mydriasis, and anterior prominence of the lens, was described in greater detail in the 18th and 19th centuries. The introduction of the ophthalmoscope in 1850 permitted the visualization of the excavated optic neuropathy in eyes with a normal or with a dilated greenish-gray pupil. Physicians developed a better appreciation of the role of intraocular pressure in both conditions, which became subsumed under the rubric “glaucoma”.

  16. Detection of eyeshine by flashlight fishes of the family Anomalopidae.

    Science.gov (United States)

    Howland, H C; Murphy, C J; McCosker, J E

    1992-04-01

    Flashlight fishes of the family Anomalopidae live in clear tropical waters and are nocturnally active. They have luminescent organs located just below the pupils of their eyes. The relation of the luminescent organ to the pupil of the anomalopid eye is similar to that of the illumination and pupil system of the ophthalmoscope and identical to that of some photoretinoscopes. Indeed, one species of flashlight fish, Anomalops katoptron, actually moves its luminous organ away from its pupils in the process of occluding its light organ, making a retinoscopic-like movement. By photographing the eyeshine of a number of fishes with a photoretinoscope and by analyzing the optics of light organs of fish of the family Anomalopidae as well as the optics of reflecting eyes, we show under what light conditions and ranges flashlight fishes may reasonably be able to detect eyeshine from other fishes in the environment. Further, we suggest that flashlight fishes may be able to communicate with each other by altering the accommodation of their eyes. In such a communication system, the sender radiates no energy and communicates only with the interrogating receiver of the information. To our knowledge, this utilization of eyeshine, both for detection and for communication, is unique in the animal kingdom.

  17. Clinical and molecular genetic analysis of a new mutation in children with Wolfram syndrome: a case report.

    Science.gov (United States)

    Xu, Qianqian; Qu, Huaiyu; Wei, Shihui

    2013-03-01

    A 12‑year‑old Chinese girl presented with gradual vision loss and insulin‑dependent diabetes mellitus and was suspected to suffer from Wolfram syndrome (WFS). A series of clinical examinations were performed, as well as direct DNA sequencing to screen the entire coding region of the WFS1 gene in the patient's family, including her parents and a brother. Ophthalmological examination revealed counting fingers/10 cm in the right eye and hand motions/10 cm in the left eye. Ophthalmoscopical examination identified bilateral optic atrophy without any signs of diabetic retinopathy. A hearing test was performed and revealed that the hearing ability for high frequency sounds was decreased. Urinary output in 24 h was >5,000 ml. In addition, a base substitution at c.2411T>C (Leu804Pro) in exon 8 was identified which was homozygous with the patient and heterozygous with the healthy parents and the brother. In the present case, a neuroophthalmology consult performed in the early stages of the disease was crucial for early diagnosis. In addition, this case study highlights the importance of performing a hearing test as well as collecting and analyzing 24‑h urine output in patients presenting with juvenile diabetes mellitus patients and optic atrophy without any signs of diabetic retinopathy.

  18. Intravitreal triamcinolone acetonide injections in the treatment of retinal vein occlusions.

    Science.gov (United States)

    Roth, Daniel B; Cukras, Catherine; Radhakrishnan, Ravi; Feuer, William J; Yarian, David L; Green, Stuart N; Wheatley, Harold M; Prenner, Jonathan

    2008-01-01

    To report the visual acuity response after intravitreal triamcinolone injection in patients with macular edema due to retinal vein occlusions. Retrospective nonrandomized interventional series of 172 consecutive patients with macular edema due to retinal vein occlusions who were treated with intravitreal triamcinolone acetonide injection. Patients underwent Snellen visual acuity testing and ophthalmoscopic examination at baseline and 1, 3, 6, and 12 months after intravitreal triamcinolone acetonide injection. All subtypes of retinal vein occlusions showed significant improvements in mean visual acuity 1 month after injection. This improvement in visual acuity was maintained over the 12-month period for all but the central retinal vein occlusion group. Seventy-one (41.3%) of the 172 patients received more than one intravitreal triamcinolone injection for unresolved or recurrent macular edema. This study demonstrates a benefit associated with intravitreal triamcinolone acetonide injection for retinal vein occlusions that was maintained by patients with branch retinal vein occlusions and hemiretinal vein occlusions over a 12-month period. Visual acuity improvement was not maintained in patients with central retinal vein occlusions with this course of treatment.

  19. Study on the aqueous humor contents of IL-1β and IL-6 in rabbits after extracapsular extraction of lens

    International Nuclear Information System (INIS)

    Zhao Jun

    2007-01-01

    Objective: To explore the relationship between the development of posterior capsular opacification and the aqueous humor contents of IL-1β and IL-6 after extracapsular extraction of lens in rabbits. Methods: Extracapsular extraction of lens was performed in 30 New Zealand rabbits. Aqueous humor contents of IL-1β and IL-6 were repeatedly determined with RIA and ophthal-moscopic as well as slit-lamp examination were repeatedly performed to detect any posterior capsular opacification developed on dl, d3, 1w, 2w, 1 month, 3 month posteperatively. Results: The aqueous humor contents of IL-1β and IL-6 increased gradually after operation, reached the peak on d7-d14, then gradually returned to within normal range by 2nd or 3rd month. Beginning from one month post-operatively, posterior capsular opacification was observed in some rabbits. By the end of 3rd month, Grade I opacification was developed in 5 rabbits, Grade H in 9 rabbits with Grade III (fundus view obliterated) in 14 rabbits. Peak IL-1β and IL- 6 content values were positively correlated with grading of future opacification. Conclusion: IL-1β and IL-6 might play important roles in the development of posterior capsular opacification after lens extraction in rabbits. (authors)

  20. Automated circumferential construction of first-order aqueous humor outflow pathways using spectral-domain optical coherence tomography

    Science.gov (United States)

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

    2017-06-01

    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.

  1. Ophthalmological and angiographic findings in workers exposed to carbon disulfide (author's transl)

    Energy Technology Data Exchange (ETDEWEB)

    Savic, S.

    1982-01-01

    Microaneurysms are important in the diagnosis of vascular changes caused by carbon disulfide. They can be diagnosed by ophtholmoscopy, angiography or angioscopy. In our opinion even a careful ophthalmoscopic investigation is sufficient for diagnosis, so that angiography is not absolutely necessary for any mass survey. The incidence of microaneurysms correlates with the duration (both daily and total) as well as with the intensity of exposure to carbon disulfide. The quantity correlates closely with the intensity of exposure. The incidence of microaneurysms is not correlated to age; however it was found to be highest in 40-50-year-old men working with staple fibers, whereas in the spinning department it occurred in 50-55-old men. Microaneurysms are found equally frequently in active workers and invalids. There was no difference between the two groups with regard to degenerative changes of the macula. However, the changes found in the eyes of men from the staple fiber department were more pronounced than in those from the spinning department.

  2. Retinal haemorrhage in infants with pertussis.

    Science.gov (United States)

    Raoof, Naz; Pereira, Susana; Dai, Shuan; Neutze, Jocelyn; Grant, Cameron Charles; Kelly, Patrick

    2017-12-01

    It has been hypothesised that paroxysmal coughing in infantile pertussis (whooping cough) could produce retinal haemorrhages identical to those seen in abusive head trauma. We aimed to test this hypothesis. This is a prospective study of infants hospitalised with pertussis in Auckland, New Zealand, from 2009 to 2014. The clinical severity of pertussis was categorised. All infants recruited had retinal examination through dilated pupils by the paediatric ophthalmology service using an indirect ophthalmoscope. Forty-eight infants with pertussis, aged 3 weeks to 7 months, were examined after a mean of 18 days of coughing. Thirty-nine had severe pertussis and nine had mild pertussis. All had paroxysmal cough, and all were still coughing at the time of examination. No retinal haemorrhages were seen. We found no evidence to support the hypothesis that pertussis may cause the pattern of retinal haemorrhages seen in abusive head trauma in infants. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. Type 1 Retinopathy of Prematurity and Its Laser Treatment of Large Preterm Infants in East China.

    Science.gov (United States)

    Shan, Haidong; Ni, Yinqing; Xue, Kang; Yu, Jia; Huang, Xin

    2015-01-01

    To describe Type 1 retinopathy of prematurity (ROP) and its laser treatment outcomes in premature infants with birth weight > 1250 g in Eastern China. A retrospective review of 3175 ROP records was conducted at Shanghai Eye & ENT Hospital of Fudan University. The records were collected at the ROP clinic from 2006 to 2014, including their demographic and medical information such as gestational age, birth weight, supplemental oxygen therapy, systemic complications, ROP stage, location, presence of plus disease. All infants were examined by RetCam fundus camera. Those with Type 1 ROP were also examined by indirect ophthalmoscope before undergoing transpupillary laser treatment. A total of 12 infants (24 eyes) with Type 1 ROP and birth weight > 1250 g were enrolled. All infants enrolled had plus disease and ROP in zone II retina. Specifically, 16 eyes (67%) had stage 2 ROP. 8 eyes (33%) had stage 3 ROP. ROP regressed in 23 eyes (96%) following laser treatment. Partial retinal detachment developed in one eye (4%). No severe involution sequelaes or laser-related complications were recorded. Mean follow-up was 30±6 weeks. Type 1 ROP may occur in large premature infants who have undergone supplemental oxygen therapy. This Type 1 ROP is mainly located in zone II retina. Laser treatment is a safe and effective intervention for these infants.

  4. [Potential of melatonin for prevention of age-related macular degeneration: experimental study].

    Science.gov (United States)

    Stefanova, N A; Zhdankina, A A; Fursova, A Zh; Kolosova, N G

    2013-01-01

    Decline with age of the content of melatonin is considered as one of the leading mechanisms of aging and development of associated diseases, including age-related macular degeneration (AMD)--the disease, which becomes the most common cause of blindness and acuity of vision deterioration in elderly. The prospects of the use of melatonin in the prevention of AMD is being actively discussed, but as a rule on the basis of the results of the experiments on cells in retinal pigment epithelium (RPE). We showed previously that the senescence-accelerated OXYS rat is an adequate animal model of AMD, already used for identifying the relevant therapeutic targets. Here we have investigated the effect of Melatonin (Melaksen, 0,004 mg per kg--a dose equivalent to the recommended one for people) on the development of retinopathy similar to AMD in OXYS rats. Ophthalmoscopic examinations show that Melatonin supplementation decreased the incidence and severity of retinopathy and improved some (but not all) histological abnormalities associated with retinopathy. Thus, melatonin prevented the structural and functional changes in RPE cells, reduced the severity of microcirculatory disorders. Importantly, Melatonin prevented destruction of neurosensory cells, associative and gangliolar neurons in the retina. Taken together, our data suggest the therapeutic potential of Melatonin for treatment and prevention of AMD.

  5. ALGORITHM OF DIAGNOSTICS AND TREATMENT OF AN AGE-RELATED MACULAR DEGENERATION AT PATIENTS WITH CHRONIC PERIPHERAL UVEITIS

    Directory of Open Access Journals (Sweden)

    Yu. I. Khoroshikh

    2014-01-01

    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.

  6. Collie Eye Anomaly in Switzerland.

    Science.gov (United States)

    Walser-Reinhardt, L; Hässig, M; Spiess, B

    2009-12-01

    In this retrospective study, the results of 3'527 eye examinations in 6 different breeds affected with Collie Eye Anomaly (CEA) over a period of 8 years (1999 - 2007) are described. CEA was divided into three main ophthalmoscopic features, a) choroidal hypoplasia (CRH), b) CRH and coloboma and c) coloboma alone. Of the 101 Smooth Collies 8.9 % showed signs of CRH, whereas 36.9 % of Rough Collies were affected with CRH, 2.8 % with CRH and coloboma and 0.38 % with coloboma alone. Choroidal hypoplasia was present in 13.1 %, CRH and coloboma in 1.8 % and coloboma alone in 0.2 % of the Shetland Sheepdogs. Only one Australian Shepherd dog had CRH, while 0.7 % of the Border Collies were affected with CRH. None of the Nova Scotia Duck Tolling Retrievers were affected with CEA. There were no statistically significant differences in the occurrence of CEA between males and females, nor was there any relation between coat colors. Significant differences could be shown between dogs younger or older than 8 weeks at first examination. CEA was more often diagnosed in dogs younger than 8 weeks within the Rough Collie and Shetland Sheepdog.

  7. Fundus fluorescein angiography in the early diagnosis of diabetic retinopathy significance%眼底荧光血管造影对早期诊断糖尿病性视网膜病变的意义

    Institute of Scientific and Technical Information of China (English)

    王霞; 裴承华; 丁爱东

    2014-01-01

    ObjectiveTo explore the Fundus fluorescein angiography in the early diagnosis of diabetic retinopathy significance.Methods300 cases (273 eyes) diabetic patients clinical data were collectes from 2010 December to 2012 December,and all patients were checked with ophthalmoscope and fundus fluorescein angiography two checking methods.Results153 cases were checked by the ophthalmoscopic lesions number,lesions was 56.05%;251 cases were detected by FFA lesions,which followed by fundus fluorescein angiography,lesions was 91.94%.The diagnosis of fundus fluorescein angiography of the correct rate had a higher Correct rate,the difference was statistically significant between the two groups (P<0.05).Non proliferative diabetic retinopathy had 55 cases by FFA lesions,accounting for 21.91% disease variables;preproliferative diabetic retinopathy had 73 cases,accounting for 29.08%;proliferative diabetic retinopathy had 65 cases,accounting for 25.91%;diabetic macularlesions had 35 cases,accounting for 13.94%;diabetic papillopathy had 23 cases,accounting for 9.16%.Conclusion Early diabetic retinopathy fluorescein angiography can be found on thelens cannot make diagnosis.%目的:探讨眼底荧光血管造影对早期诊断糖尿病性视网膜病变的意义。方法选取2010年12月~2012年12月300例(273只眼)糖尿病患者的临床资料,所有患者皆用检眼镜和荧光素眼底血管造影两种检查方法。结果采用检眼镜检出病变数153例,病变率为56.05%;后经荧光素眼底血管造影检查,发现FFA检出病变数251例,病变率为91.94%,荧光素眼底血管造影的诊断正确率较高,两组比较,差异具有统计学意义(P<0.05)。FFA检查病变种类主要包括非增生性糖尿病性视网膜病变55例,占病变数的21.91%;增生前糖尿病性视网膜病变73例,占29.08%;增生型糖尿病性视网膜病变;65例,占25.91%;糖尿病性黄斑病变35例,占13.94%;糖

  8. 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

    Directory of Open Access Journals (Sweden)

    Islane Castro Verçosa

    2003-01-01

    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

  9. Effect of the menstrual cycle on the optic nerve head in diabetes: analysis by confocal scanning laser ophthalmoscopy.

    Science.gov (United States)

    Akar, Munire Erman; Yucel, Iclal; Erdem, Uzeyir; Taskin, Omur; Ozel, Alper; Akar, Yusuf

    2005-04-01

    The purpose of this study was to examine and compare menstrual-cycle-dependent topographic changes in the optic nerve head of normally menstruating women with different grades of type 2 diabetes mellitus. We studied the right eyes of 123 normally menstruating women (36 with severe nonproliferative diabetic retinopathy [NPDR], 42 with mild NPDR and 45 healthy subjects). All subjects underwent a complete ocular examination at baseline. At 4 hormonally distinct phases of the menstrual cycle (early follicular, late follicular, mid-luteal and late luteal), we analysed the topography of the optic nerve head, using a confocal scanning laser ophthalmoscope, and measured the serum levels of estradiol, progesterone and luteinizing hormone. We excluded from analysis the data for 8 patients with severe NPDR, 10 patients with mild NPDR and 15 control subjects who were lost to follow-up examinations during the menstrual cycle. The mean age and optic disc area did not differ significantly among the 3 groups. The duration of diabetes was significantly longer in the patients with severe NPDR than in those with mild NPDR (p cup-shape measure, linear cup/disc ratio, cup/disc area ratio and cup area in the late luteal phase compared with the other phases of the menstrual cycle (p menstrual cycle. Severe NPDR is associated with significant topographic changes in the rim and cup of the optic nerve head during the menstrual cycle. This must be considered in the evaluation of women with both diabetes and glaucoma. The normal fluctuations in serum sex hormone levels during the menstrual cycle of diabetic women seem to affect the optic nerve head more when the disease is advanced.

  10. Prevalence and causes of blindness, visual impairment among different ethnical minority groups in Xinjiang Uygur autonomous region, China.

    Science.gov (United States)

    Li, Yanping; Huang, Wenyong; Qiqige, Aoyun; Zhang, Hongwei; Jin, Ling; Ti, Pula; Yip, Jennifer; Xiao, Baixiang

    2018-02-13

    The aim of this cross-sectional study is to ascertain the prevalence and causes of blindness, visual impairment, uptake of cataract surgery among different ethnic groups in Xinjiang Uygur Autonomous Region, China. Four thousand one hundred fifty people at 50 years and above from different minority ethnic groups were randomly selected for an eye examination. The four trained eye teams collected data using tumbling E visual chart, torch, portable slit lamp and direct ophthalmoscope in 2015. The World Health Organization's definition of blindness and visual impairment (VI) was used to classify patients in each ethnic group. Data were analyzed by different minority groups and were compared with Han Chinese. 3977 (95.8%) out of 4150 people were examined. The prevalence of blindness from the study population was 1.7% (95% confidence interval: 1.3-2.2%).There was no significant difference in prevalence of blindness between Han Chinese and people of Khazak and other minority ethnic groups, nor, between male and female. Cataract was the leading course (65.5%) of blindness and uncorrected refractive error was the most common cause of VI (36.3%) followed by myopic retinopathy. The most common barrier to cataract surgery was lack of awareness of service availability. This study documented a low blindness prevalence among people aged 50 years and over comparing to prevalence identified through studies of other regions in China. It still indicates blindness and un-operated cataract as the significant public health issue, with no evidence of eye health inequalities, but some inequities in accessing to cataract surgery amongst ethnic minority groups in Xinjiang.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Sector retinitis pigmentosa.

    Science.gov (United States)

    Van Woerkom, Craig; Ferrucci, Steven

    2005-05-01

    Retinitis pigmentosa (RP) is one of the most common hereditary retinal dystrophies and causes of visual impairment affecting all age groups. The reported incidence varies, but is considered to be between 1 in 3,000 to 1 in 7,000. Sector retinitis pigmentosa is an atypical form of RP that is characterized by regionalized areas of bone spicule pigmentation, usually in the inferior quadrants of the retina. A 57-year-old Hispanic man with a history of previously diagnosed retinitis pigmentosa came to the clinic with a longstanding symptom of decreased vision at night. Bone spicule pigmentation was found in the nasal and inferior quadrants in each eye. He demonstrated superior and temporal visual-field loss corresponding to the areas of the affected retina. Clinical measurements of visual-field loss, best-corrected visual acuity, and ophthalmoscopic appearance have remained stable during the five years the patient has been followed. Sector retinitis pigmentosa is an atypical form of RP that is characterized by bilateral pigmentary retinopathy, usually isolated to the inferior quadrants. The remainder of the retina appears clinically normal, although studies have found functional abnormalities in these areas as well. Sector RP is generally considered a stationary to slowly progressive disease, with subnormal electro-retinogram findings and visual-field defects corresponding to the involved retinal sectors. Management of RP is very difficult because there are no proven methods of treatment. Studies have shown 15,000 IU of vitamin A palmitate per day may slow the progression, though this result is controversial. Low vision rehabilitation, long wavelength pass filters, and pedigree counseling remain the mainstay of management.

  14. TO STUDY THE EFFECT OF ANGIOTENSIN RECEPTOR BLOCKERS ON DIABETIC RETINOPATHY

    Directory of Open Access Journals (Sweden)

    Chakravarthy K

    2017-05-01

    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.

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

    Science.gov (United States)

    Lindsey, James D; Duong-Polk, Karen X; Dai, Yi; Nguyen, Duy H; Leung, Christopher K; Weinreb, Robert N

    2013-01-01

    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.

  16. Macular autofluorescence in eyes with cystoid macula edema, detected with 488 nm-excitation but not with 580 nm-excitation.

    Science.gov (United States)

    Bessho, Kenichiro; Gomi, Fumi; Harino, Seiyo; Sawa, Miki; Sayanagi, Kaori; Tsujikawa, Motokazu; Tano, Yasuo

    2009-06-01

    Fundus autofluorescence (AF) derives from lipofuscin in the retinal pigment epithelium (RPE). Because lipofuscin is a by-product of phagocytosis of photoreceptors by RPE, AF imaging is expected to describe some functional aspect of the retina. In this study we report distribution of AF in patients showing macular edema. Three eyes with diabetic macular edema (DME) and 11 with retinal vein occlusion (RVO), associated with macular edema (ME) were examined. ME was determined by standard fundus examination, fluorescein angiography (FA) and optical coherence tomography (OCT). AF was recorded using a Heidelberg confocal scanning laser ophthalmoscope (cSLO) with 488 nm laser exciter (488 nm-AF), and a conventional Topcon fundus camera with halogen lamp exciter and 580 nm band-pass filter (580 nm-AF). Color fundus picture, FA image and these two AF images were analyzed by superimposing all images. All subjects presented cystoid macular edema (CME) with petaloid pattern hyperfluorescence in FA. In 488 nm-AF, all eyes (100%) showed macular autofluorescence of a similar shape to that of the CME in FA. In contrast, in 580 nm-AF only one eye (7%) presented this corresponding petaloid-shaped autofluorescence. In all cases, peripheral retinal edemas did not show autofluorescence corresponding to the leakage in FA. In eyes with CME, analogous hyperautofluorescence to the CME was always observed in 488 nm-AF, while it was rarely observed in 580 nm-AF. Moreover, this CME hyperautofluorescence was only seen in the macular area. We hypothesize that autofluorescence from CME may be considered as a "pseudo" or "relative" autofluorescence, due to macular stretching following CME that may result in lateral displacement of macular pigments (MPs) and subsequent reduction of MPs density, as MPs block 488 nm-AF more intensely than 580 nm-AF. Although this phenomenon may not directly indicate change of RPE function, it may be used as a method to assess or track CME non-invasively.

  17. "Eye-T": information technology adoption and use in Canada's optometry practices.

    Science.gov (United States)

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

    2011-03-01

    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

  18. Prevalence of diabetic retinopathy among self-reported adult diabetics in districts of Eastern Nepal in a community based study.

    Science.gov (United States)

    Agarwal, Lalit T; Agarwal, Nisha

    2017-07-01

    Diabetic retinopathy (DR) is the leading cause of blindness among working age adults around the world. Each year more and more people live with this condition, which can result in life-changing complications. To determine the prevalence and risk factors of diabetic retinopathy (DR) in a large community based screening programme, in order to estimate the future burden of the disease. A cross sectional community based study was conducted between 1st January and 31st December 2014 in a purposive sample of adults with selfreported diabetes mellitus (DM) from Morang and Sunsari district of Nepal. A structured questionnaire was used to collect patient data. Ophthalmological evaluation was done and fundus was examined for grading DR using direct and indirect ophthalmoscope. Among the 698 diabetic patients, mean age was 55.02±11.8 years (ranging from 24 to 91 years). 12.3% of diabetic were not under any treatment. Only 69.3% of patients had visited eye specialist for diabetic retinopathy screening. Prevalence of DR was found to be 15.3%; 13.9% had non-proliferative DR and 1.4% had proliferative DR. Prevalence of diabetic macular edema was 2.1%. In Morang district prevalence of DR was 14.2% and in Sunsari district it was 16.2%. In the binary-logistic regression analysis, duration of diabetes was associated with significantly increased risk of DR (OR: 1.13; 95% confidence interval (CI), 1.09 to 1.17; p<0.001). History of absence of arterial hypertension decreased the risk of DR (OR: 0.56; 95% CI, 0.36 to 0.87; p=0.01). One sixth of the patients with diabetes in the Eastern region of Nepal have retinopathy. Diabetic retinopathy risk increased with duration of diabetes and decreased with history of no co-existing arterial hypertension. © NEPjOPH.

  19. Quantitative fundus autofluorescence in recessive Stargardt disease.

    Science.gov (United States)

    Burke, Tomas R; Duncker, Tobias; Woods, Russell L; Greenberg, Jonathan P; Zernant, Jana; Tsang, Stephen H; Smith, R Theodore; Allikmets, Rando; Sparrow, Janet R; Delori, François C

    2014-05-01

    To quantify fundus autofluorescence (qAF) in patients with recessive Stargardt disease (STGD1). A total of 42 STGD1 patients (ages: 7-52 years) with at least one confirmed disease-associated ABCA4 mutation were studied. Fundus AF images (488-nm excitation) were acquired with a confocal scanning laser ophthalmoscope equipped with an internal fluorescent reference to account for variable laser power and detector sensitivity. The gray levels (GLs) of each image were calibrated to the reference, zero GL, magnification, and normative optical media density to yield qAF. Texture factor (TF) was calculated to characterize inhomogeneities in the AF image and patients were assigned to the phenotypes of Fishman I through III. Quantified fundus autofluorescence in 36 of 42 patients and TF in 27 of 42 patients were above normal limits for age. Young patients exhibited the relatively highest qAF, with levels up to 8-fold higher than healthy eyes. Quantified fundus autofluorescence and TF were higher in Fishman II and III than Fishman I, who had higher qAF and TF than healthy eyes. Patients carrying the G1916E mutation had lower qAF and TF than most other patients, even in the presence of a second allele associated with severe disease. Quantified fundus autofluorescence is an indirect approach to measuring RPE lipofuscin in vivo. We report that ABCA4 mutations cause significantly elevated qAF, consistent with previous reports indicating that increased RPE lipofuscin is a hallmark of STGD1. Even when qualitative differences in fundus AF images are not evident, qAF can elucidate phenotypic variation. Quantified fundus autofluorescence will serve to establish genotype-phenotype correlations and as an outcome measure in clinical trials.

  20. The impact of normal saline on the incidence of exposure keratopathy in patients hospitalized in intensive care units

    Directory of Open Access Journals (Sweden)

    Zohreh Davoodabady

    2018-01-01

    Full Text Available Background: Patients in the intensive care unit (ICU have impaired ocular protective mechanisms that lead to an increased risk of ocular surface diseases including exposure keratopathy (EK. This study was designed to evaluate the effect of normal saline (NS on the incidence and severity of EK in critically ill patients. Materials and Methods: This single-blind randomized controlled trial was conducted on 50 patients admitted to ICUs. The participants were selected through purposive sampling. One eye of each patient, randomly was allocated to intervention group (standard care with NS and the other eye to control group (standard care. In each patient, one eye (control group randomly received standard care and the other eye (intervention group received NS every 6 h in addition to standard care. The presence and severity of keratopathy was assessed daily until day 7 of hospitalization using fluorescein and an ophthalmoscope with cobalt blue filter. Chi-square test was used for statistical analysis in SPSS software. Results: Before the study ( first day there were no statistically significant differences in the incidence and severity of EK between groups. Although, the incidence and severity of EK after the study (7th day was higher in the intervention group compared to the control group, their differences were not statistically significant. Although, the incidence and severity of EK, from the 1st day until the 7th, increased within both groups, this increase was statistically significant only in the intervention (NS group. Conclusions: The use of NS as eye care in patients hospitalized in ICUs can increase the incidence and severity of EK and is not recommended.

  1. Adaptive optics imaging of healthy and abnormal regions of retinal nerve fiber bundles of patients with glaucoma.

    Science.gov (United States)

    Chen, Monica F; Chui, Toco Y P; Alhadeff, Paula; Rosen, Richard B; Ritch, Robert; Dubra, Alfredo; Hood, Donald C

    2015-01-08

    To better understand the nature of glaucomatous damage of the macula, especially the structural changes seen between relatively healthy and clearly abnormal (AB) retinal regions, using an adaptive optics scanning light ophthalmoscope (AO-SLO). Adaptive optics SLO images and optical coherence tomography (OCT) vertical line scans were obtained on one eye of seven glaucoma patients, with relatively deep local arcuate defects on the 10-2 visual field test in one (six eyes) or both hemifields (one eye). Based on the OCT images, the retinal nerve fiber (RNF) layer was divided into two regions: (1) within normal limits (WNL), relative RNF layer thickness within mean control values ±2 SD; and (2) AB, relative thickness less than -2 SD value. As seen on AO-SLO, the pattern of AB RNF bundles near the border of the WNL and AB regions differed across eyes. There were normal-appearing bundles in the WNL region of all eyes and AB-appearing bundles near the border with the AB region. This region with AB bundles ranged in extent from a few bundles to the entire AB region in the case of one eye. All other eyes had a large AB region without bundles. However, in two of these eyes, a few bundles were seen within this region of otherwise missing bundles. The AO-SLO images revealed details of glaucomatous damage that are difficult, if not impossible, to see with current OCT technology. Adaptive optics SLO may prove useful in following progression in clinical trials, or in disease management, if AO-SLO becomes widely available and easy to use. Copyright 2015 The Association for Research in Vision and Ophthalmology, Inc.

  2. Increasing the field of view of adaptive optics scanning laser ophthalmoscopy.

    Science.gov (United States)

    Laslandes, Marie; Salas, Matthias; Hitzenberger, Christoph K; Pircher, Michael

    2017-11-01

    An adaptive optics scanning laser ophthalmoscope (AO-SLO) set-up with two deformable mirrors (DM) is presented. It allows high resolution imaging of the retina on a 4°×4° field of view (FoV), considering a 7 mm pupil diameter at the entrance of the eye. Imaging on such a FoV, which is larger compared to classical AO-SLO instruments, is allowed by the use of the two DMs. The first DM is located in a plane that is conjugated to the pupil of the eye and corrects for aberrations that are constant in the FoV. The second DM is conjugated to a plane that is located ∼0.7 mm anterior to the retina. This DM corrects for anisoplanatism effects within the FoV. The control of the DMs is performed by combining the classical AO technique, using a Shack-Hartmann wave-front sensor, and sensorless AO, which uses a criterion characterizing the image quality. The retinas of four healthy volunteers were imaged in-vivo with the developed instrument. In order to assess the performance of the set-up and to demonstrate the benefits of the 2 DM configuration, the acquired images were compared with images taken in conventional conditions, on a smaller FoV and with only one DM. Moreover, an image of a larger patch of the retina was obtained by stitching of 9 images acquired with a 4°×4° FoV, resulting in a total FoV of 10°×10°. Finally, different retinal layers were imaged by shifting the focal plane.

  3. Adaptive optics retinal imaging in the living mouse eye

    Science.gov (United States)

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

    2012-01-01

    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. PMID:22574260

  4. Phenotypic diversity in autosomal-dominant cone-rod dystrophy elucidated by adaptive optics retinal imaging.

    Science.gov (United States)

    Song, Hongxin; Rossi, Ethan A; Stone, Edwin; Latchney, Lisa; Williams, David; Dubra, Alfredo; Chung, Mina

    2018-01-01

    Several genes causing autosomal-dominant cone-rod dystrophy (AD-CRD) have been identified. However, the mechanisms by which genetic mutations lead to cellular loss in human disease remain poorly understood. Here we combine genotyping with high-resolution adaptive optics retinal imaging to elucidate the retinal phenotype at a cellular level in patients with AD-CRD harbouring a defect in the GUCA1A gene. Nine affected members of a four-generation AD-CRD pedigree and three unaffected first-degree relatives underwent clinical examinations including visual acuity, fundus examination, Goldmann perimetry, spectral domain optical coherence tomography and electroretinography. Genome-wide scan followed by bidirectional sequencing was performed on all affected participants. High-resolution imaging using a custom adaptive optics scanning light ophthalmoscope (AOSLO) was performed for selected participants. Clinical evaluations showed a range of disease severity from normal fundus appearance in teenaged patients to pronounced macular atrophy in older patients. Molecular genetic testing showed a mutation in in GUCA1A segregating with disease. AOSLO imaging revealed that of the two teenage patients with mild disease, one had severe disruption of the photoreceptor mosaic while the other had a normal cone mosaic. AOSLO imaging demonstrated variability in the pattern of cone and rod cell loss between two teenage cousins with early AD-CRD, who had similar clinical features and had the identical disease-causing mutation in GUCA1A . This finding suggests that a mutation in GUCA1A does not lead to the same degree of AD-CRD in all patients. Modifying factors may mitigate or augment disease severity, leading to different retinal cellular phenotypes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Morphology and Topography of Retinal Pericytes in the Living Mouse Retina Using In Vivo Adaptive Optics Imaging and Ex Vivo Characterization

    Science.gov (United States)

    Schallek, Jesse; Geng, Ying; Nguyen, HoanVu; Williams, David R.

    2013-01-01

    Purpose. To noninvasively image retinal pericytes in the living eye and characterize NG2-positive cell topography and morphology in the adult mouse retina. Methods. Transgenic mice expressing fluorescent pericytes (NG2, DsRed) were imaged using a two-channel, adaptive optics scanning laser ophthalmoscope (AOSLO). One channel imaged vascular perfusion with near infrared light. A second channel simultaneously imaged fluorescent retinal pericytes. Mice were also imaged using wide-field ophthalmoscopy. To confirm in vivo imaging, five eyes were enucleated and imaged in flat mount with conventional fluorescent microscopy. Cell topography was quantified relative to the optic disc. Results. We observed strong DsRed fluorescence from NG2-positive cells. AOSLO revealed fluorescent vascular mural cells enveloping all vessels in the living retina. Cells were stellate on larger venules, and showed banded morphology on arterioles. NG2-positive cells indicative of pericytes were found on the smallest capillaries of the retinal circulation. Wide-field SLO enabled quick assessment of NG2-positive distribution, but provided insufficient resolution for cell counts. Ex vivo microscopy showed relatively even topography of NG2-positive capillary pericytes at eccentricities more than 0.3 mm from the optic disc (515 ± 94 cells/mm2 of retinal area). Conclusions. We provide the first high-resolution images of retinal pericytes in the living animal. Subcellular resolution enabled morphological identification of NG2-positive cells on capillaries showing classic features and topography of retinal pericytes. This report provides foundational basis for future studies that will track and quantify pericyte topography, morphology, and function in the living retina over time, especially in the progression of microvascular disease. PMID:24150762

  6. Changes in ocular higher-order aberrations following botulinum toxin treatment in patients with blepharospasm : BTX improves dry eye in patients with BEB.

    Science.gov (United States)

    Isshiki, Yoshihiko; Ishikawa, Hiroto; Mimura, Osamu

    2016-11-01

    To evaluate the effects of botulinum toxin type A (BTX-A) treatment in patients with benign essential blepharospasm (BEB) by monitoring the ocular surface and ocular higher-order aberrations (HOAs) before and after treatment. The present study reports a prospective case series of 38 patients (76 eyes, 11 men and 27 women; mean age 66.8 ± 9.8 years) with BEB who underwent BTX-A treatment at Kokura Memorial Hospital between 2013 and 2014. Patients were evaluated for ophthalmoscopic findings, Schirmer I test, tear film break-up time (t-BUT), HOAs, fluctuation index (FI), stability index (SI) using a wavefront aberrometer, 15 subjective symptoms using the Dry Eye-Related Quality of Life Score (DEQS), and complications before and after the treatment. After BTX-A treatment, the Schirmer I test score improved significantly from 5.9 ± 5.4 to 8.7 ± 6.1 mm and t-BUT recovered from 5.2 ± 1.7 to 7.3 ± 1.7 s. HOAs were classified into four patterns: stable (60.5 %), small fluctuation (14.5 %), sawtooth (17.1 %), and reverse sawtooth (7.9 %), and they significantly reduced after the treatment. Only FI (not SI) showed a marked reduction, and the DEQS significantly improved from 44.7 ± 21.6 to 37.6 ± 21.0 after the treatment (p treatment with a high potential to improve ocular surface disorders induced by BEB.

  7. Clinical course over two to six years of age-related macular degeneration with or without radiation

    International Nuclear Information System (INIS)

    Kameda, Takanori; Noami, Sachiyo; Akita, Joe

    2002-01-01

    We previously reported about the long-term outcome as long as three years after radiation therapy for choroidal neovascularization secondary to age-related macular degeneration (AMD). Though MPS (Macular Photocoagulation Study) Group reported the long-term natural course of AMD, such reports have not been provided concerned about Japanese AMD patients. Furthermore, there is not report that revealed the course of AMD with radiation therapy more than three years. We evaluated the long-term natural course and long-term effect of low-dose radiation on AMD. The fundus ophthalmoscopic evaluation and visual outcome were compared retrospectively among control group and two treated groups; seven eyes received 10 Gy, and eight eyes 20 Gy. The control group consisted of 10 eyes without treatment. All patients were followed at least four years, and the average follow-up duration was 6.56 years. The course of median visual acuity without treatment showed the similar result to that of MPS Group's report. In control group, visual acuity (VA) after four years was better in no eyes, unchanged in two eyes, and worse in eight eyes; in treated group, better in four eyes, unchanged in one eye, and worse in ten eyes. After four years VA was kept 20/200 or higher in 2 eyes without treatment, 4 eyes with 10 Gy, and 4 eyes with 20 Gy of radiation. Then maximum VA was 20/125 with no treatment, and 20/50 with radiation therapy. The natural course of the AMD of Japanese patients showed similar results to US patients. All eyes of AMD withort treatment got worse in VA, and some showed better outcome with radiation therapy; but it was not statistically significant. (author)

  8. Evaluation of a follow-up protocol for patients on chloroquine and hydroxychloroquine treatment.

    Science.gov (United States)

    Sanabria, M R; Toledo-Lucho, S C

    2016-01-01

    To review the problems found after a new follow-up protocol for patients on chloroquine and hydroxychloroquine treatment. Retrospective study was conducted between May 2012 and January 2013 on the clinical files, retinographies, fundus auto-fluorescence (FAF) images, and central-10 degree visual fields (VF) of patients who were referred to the Ophthalmology Department as they had started treatment with hydroxychloroquine. One hundred twenty-six patients were included; 94.4% were referred from the Rheumatology Department and 5.6% from Dermatology. Mean age was 59.7 years, and 73.8% were women. All of them were on hydroxychloroquine treatment, and 300mg was the most frequent daily dose. Rheumatoid arthritis was the most common diagnosis (40.5%), followed by systemic lupus erythematosus (15.9%). The mean Snellen visual acuity was 0.76, and 26 patients had lens opacities. The VF were normal in 97 patients, 8 had mild to moderate defects with no definite pattern, and in 9 the results were unreliable. Of the 51 patients older than 65years, 16 (31.4%) had altered or unreliable VF. The FAF was normal in 104 patients (82.5%), and abnormal, but consistent with ophthalmoscopic features, in 12 patients (pathological myopia, age related changes, early, middle or late age-related macular degeneration). Visual fields as a reference test for the diagnosis of AP toxicity are not quite reliable for patients over 65. Therefore, the FAF is recommended as primary test, perhaps combined with another objective test, such as SD-OCT instead of VF. Copyright © 2015 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  9. Preparation and Evaluation of Biodegradable Scleral Plug Containing Curcumin in Rabbit Eye.

    Science.gov (United States)

    Zhang, Jun; Sun, Haiyan; Zhou, Nalei; Zhang, Bin; Ma, Jingxue

    2017-12-01

    To test whether biodegradable curcumin-loaded scleral plug is a promising choice for treating posterior ocular diseases, the study investigated the in vitro release profile of the scleral plug and its safety in vivo. Scleral plugs containing 0.5 mg, 1.0 mg and 1.5 mg curcumin were synthesized by a compression-sintering method. These scleral plugs were placed in tubes containing balanced salt solution (BSS) buffer, which was replaced by fresh buffer daily. The curcumin concentration in the removed aliquot was tested daily for 14 days using high-performance liquid chromatography (HPLC). In the study, 44 rabbits were randomly divided into four groups: control, 0.5 mg, 1.0 mg and 1.5 mg curcumin groups. The scleral plug was trans-scleral fixed in the right eye of the rabbits in the three curcumin-treated groups. The control rabbits only received sclerotomy. The treated rabbit eyes were examined by a slit-lamp biomicroscope, an indirect ophthalmoscope and electroretinogram (ERG), and subjected to histological analysis. The concentration of the 1.5 mg curcumin-loaded scleral plug was higher than 15 μg/ml for consecutive 14 days in vitro. The in vivo experiments revealed intraocular pressure, a-wave and b-wave amplitudes of ERG, and conjunctival reaction degree were not significantly different between the four groups. Retinal structure was normal in the curcumin-treated groups. The sclerotomy wound healed after the plug was completely degraded. Anterior chamber reaction or complications were not observed. The study suggests that curcumin-loaded scleral plug could sustain high concentration of curcumin in vitro and is safe in vivo. It might be a promising alternative choice for the treatment of posterior ocular diseases.

  10. The opportunistic screening of refractive errors in school-going children by pediatrician using enhanced Brückner test

    Directory of Open Access Journals (Sweden)

    Piyush Jain

    2016-01-01

    Full Text Available Aim: The aim of this study was to compare the results of enhanced Brückner test (EBT performed by a pediatrician and an experienced pediatric ophthalmologist. Subjects and Methods: In this prospective double-masked cohort study, a pediatrician and a pediatric ophthalmologist performed the EBT in a classroom of a school in semi-dark lighting condition using a direct ophthalmoscope. The results of the test were compared using 2 × 2 Bayesian table and kappa statistics. The findings of the pediatric ophthalmologists were considered gold standard. Results: Two hundred and thirty-six eyes of 118 subjects, mean age 6.8 ± 0.5 years (range, 5.4–7.8 years, were examined. The time taken to complete this test was <10 s per subject. The ophthalmologist identified 59 eyes as ametropic (12 hyperopic and 47 myopic eyes and 177 as emmetropic compared to 61 eyes as ametropic and 175 emmetropic by pediatrician. The prevalence of the test positive was 25.9%. The sensitivity of the pediatrician was 90.2%, specificity was 97.7%, predictive value of the positive test was 93.2%, and predictive value of the negative test was 96.6%. The clinical agreement (kappa between the pediatric ophthalmologist and the pediatrician was 0.9. Conclusion: The results of the EBT performed by pediatrician were comparable to that of an experienced pediatric ophthalmologist. Opportunistic screening of refractive errors using EBT by a pediatrician can be an important approach in the detection of ametropia in children.

  11. Alterations of the tunica vasculosa lentis in the rat model of retinopathy of prematurity.

    Science.gov (United States)

    Favazza, Tara L; Tanimoto, Naoyuki; Munro, Robert J; Beck, Susanne C; Garcia Garrido, Marina; Seide, Christina; Sothilingam, Vithiyanjali; Hansen, Ronald M; Fulton, Anne B; Seeliger, Mathias W; Akula, James D

    2013-08-01

    To study the relationship between retinal and tunica vasculosa lentis (TVL) disease in retinopathy of prematurity (ROP). Although the clinical hallmark of ROP is abnormal retinal blood vessels, the vessels of the anterior segment, including the TVL, are also altered. ROP was induced in Long-Evans pigmented and Sprague Dawley albino rats; room-air-reared (RAR) rats served as controls. Then, fluorescein angiographic images of the TVL and retinal vessels were serially obtained with a scanning laser ophthalmoscope near the height of retinal vascular disease, ~20 days of age, and again at 30 and 64 days of age. Additionally, electroretinograms (ERGs) were obtained prior to the first imaging session. The TVL images were analyzed for percent coverage of the posterior lens. The tortuosity of the retinal arterioles was determined using Retinal Image multiScale Analysis (Gelman et al. in Invest Ophthalmol Vis Sci 46:4734-4738, 2005). In the youngest ROP rats, the TVL was dense, while in RAR rats, it was relatively sparse. By 30 days, the TVL in RAR rats had almost fully regressed, while in ROP rats, it was still pronounced. By the final test age, the TVL had completely regressed in both ROP and RAR rats. In parallel, the tortuous retinal arterioles in ROP rats resolved with increasing age. ERG components indicating postreceptoral dysfunction, the b-wave, and oscillatory potentials were attenuated in ROP rats. These findings underscore the retinal vascular abnormalities and, for the first time, show abnormal anterior segment vasculature in the rat model of ROP. There is delayed regression of the TVL in the rat model of ROP. This demonstrates that ROP is a disease of the whole eye.

  12. Clinicopathologic correlation of chorioretinitis sclopetaria.

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    Dubovy, S R; Guyton, D L; Green, W R

    1997-01-01

    To report the clinicopathologic features in the eye of a patient who sustained a traumatic chorioretinal rupture from a gunshot wound to the orbit, chorioretinitis sclopetaria, with clinical follow up of more than 20 years. The patient was studied ophthalmoscopically and by fluorescein angiography after the trauma and was seen intermittently thereafter. The eyes were obtained postmortem; sections of the central portion of the right eye, including the macula and optic nerve head, and the inferior cap were examined by light microscopy. Histopathologic study of the right eye showed partial loss of the nerve fiber and ganglion cell layers in the macular area, temporal peripapillary and macular loss of the photoreceptors with hypertrophy and hyperplasia of the retinal pigment epithelium, an epiretinal membrane, and three defects in Bruch's membrane. Inferiorly, there was a 5-mm defect in choroid, Bruch's membrane, and retina. These structures were replaced by a loose and dense fibrous connective tissue. The sclera and a long posterior ciliary nerve remained intact. A thin fibrovascular tissue from the choroid extended into the subretinal space where it was covered by retinal pigment epithelium and thickened basement membrane in the posterior aspect of the inferior lesion. Marked hemiatrophy of the optic nerve was present. The clinicopathologic features of chorioretinitis sclopetaria include direct traumatic chorioretinal rupture followed by marked fibrovascular proliferation with variable replacement of choroid and retina with no retinal detachment. Posteriorly, indirect macular choroidal ruptures with hyperplasia and migration of the retinal pigment epithelium into the retina and choroid, epiretinal membrane formation, loss of photoreceptors, and marked hemiatrophy of the optic nerve were present.

  13. Confocal Adaptive Optics Imaging of Peripapillary Nerve Fiber Bundles: Implications for Glaucomatous Damage Seen on Circumpapillary OCT Scans.

    Science.gov (United States)

    Hood, Donald C; Chen, Monica F; Lee, Dongwon; Epstein, Benjamin; Alhadeff, Paula; Rosen, Richard B; Ritch, Robert; Dubra, Alfredo; Chui, Toco Y P

    2015-04-01

    To improve our understanding of glaucomatous damage as seen on circumpapillary disc scans obtained with frequency-domain optical coherence tomography (fdOCT), fdOCT scans were compared to images of the peripapillary retinal nerve fiber (RNF) bundles obtained with an adaptive optics-scanning light ophthalmoscope (AO-SLO). The AO-SLO images and fdOCT scans were obtained on 6 eyes of 6 patients with deep arcuate defects (5 points ≤-15 db) on 10-2 visual fields. The AO-SLO images were montaged and aligned with the fdOCT images to compare the RNF bundles seen with AO-SLO to the RNF layer thickness measured with fdOCT. All 6 eyes had an abnormally thin (1% confidence limit) RNF layer (RNFL) on fdOCT and abnormal (hyporeflective) regions of RNF bundles on AO-SLO in corresponding regions. However, regions of abnormal, but equal, RNFL thickness on fdOCT scans varied in appearance on AO-SLO images. These regions could be largely devoid of RNF bundles (5 eyes), have abnormal-appearing bundles of lower contrast (6 eyes), or have isolated areas with a few relatively normal-appearing bundles (2 eyes). There also were local variations in reflectivity of the fdOCT RNFL that corresponded to the variations in AO-SLO RNF bundle appearance. Relatively similar 10-2 defects with similar fdOCT RNFL thickness profiles can have very different degrees of RNF bundle damage as seen on fdOCT and AO-SLO. While the results point to limitations of fdOCT RNFL thickness as typically analyzed, they also illustrate the potential for improving fdOCT by attending to variations in local intensity.

  14. KATARAK PADA PETANI DAN KELUARGANYA DI KECAMATAN TELUK JAMBE BARAT

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    Lusianawaty Tana

    2012-10-01

    Full Text Available Cataract is a lens opacity that causes problem in eye acuity. Sixteen percents of cataract blindness in Indonesia were suffered by productive-age people. The objective of this study was to asses cataract prevalence in agriculture farmers and their families, and to determine the relation of cataract to some risk factors such as sociodemografic factor and one month expenditure rate. A cross sectional designed study was done in Teluk Jambe Barat Subdistrict in Karawang District, on 2005, with 1350 samples aged 30 years and up among agriculture farmers and their families in 4 villages, selected with purposive random sampling method. Data collection was done through interview, measurement, and examination. Cataract was diagnosed through ophthalmoscopic examination without midriatic by ophthalmologists. The study found that prevalence of cataract was 37.9% (n=1223, 90,54% of total sample, normal visus was 29.5%, eye impairment was 48.5%, Gangguan penglihatan berat was 16.6%, and blindness was 5.4%. Cataract proportion in peoples aged 33-44 years old was 4.66%, aged 45-54 years old was 30.31%, aged 55-64 years old was 76.89%, and aged 65 years old and up was 95.57%. The cataract had positive relation to the age and sex. The cataract among the people aged 55 years old and up was 26 times higher compared to people aged 30-54 years old. Cataract in female was 1.8 times higher than male. (p<0,05. Prevalence of cataract in this study was high enough, and need some efforts to prevent it.   Key word: cataract, farmers, age, sex, Karawang.

  15. Quantitative Fundus Autofluorescence in Recessive Stargardt Disease

    Science.gov (United States)

    Burke, Tomas R.; Duncker, Tobias; Woods, Russell L.; Greenberg, Jonathan P.; Zernant, Jana; Tsang, Stephen H.; Smith, R. Theodore; Allikmets, Rando; Sparrow, Janet R.; Delori, François C.

    2014-01-01

    Purpose. To quantify fundus autofluorescence (qAF) in patients with recessive Stargardt disease (STGD1). Methods. A total of 42 STGD1 patients (ages: 7–52 years) with at least one confirmed disease-associated ABCA4 mutation were studied. Fundus AF images (488-nm excitation) were acquired with a confocal scanning laser ophthalmoscope equipped with an internal fluorescent reference to account for variable laser power and detector sensitivity. The gray levels (GLs) of each image were calibrated to the reference, zero GL, magnification, and normative optical media density to yield qAF. Texture factor (TF) was calculated to characterize inhomogeneities in the AF image and patients were assigned to the phenotypes of Fishman I through III. Results. Quantified fundus autofluorescence in 36 of 42 patients and TF in 27 of 42 patients were above normal limits for age. Young patients exhibited the relatively highest qAF, with levels up to 8-fold higher than healthy eyes. Quantified fundus autofluorescence and TF were higher in Fishman II and III than Fishman I, who had higher qAF and TF than healthy eyes. Patients carrying the G1916E mutation had lower qAF and TF than most other patients, even in the presence of a second allele associated with severe disease. Conclusions. Quantified fundus autofluorescence is an indirect approach to measuring RPE lipofuscin in vivo. We report that ABCA4 mutations cause significantly elevated qAF, consistent with previous reports indicating that increased RPE lipofuscin is a hallmark of STGD1. Even when qualitative differences in fundus AF images are not evident, qAF can elucidate phenotypic variation. Quantified fundus autofluorescence will serve to establish genotype-phenotype correlations and as an outcome measure in clinical trials. PMID:24677105

  16. Clinical observation of intravitreal injection of Conbercept treating diabetic macularedema

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    Li Jiang

    2017-06-01

    Full Text Available AIM: To observe the clinical efficiency of intravitreal conbercept on diabetic macular edema(DME. METHODS: This was a single arm, open-babel prospective study. Twenty eyes from 20 patients(12 males and 8 femaleswith DME diagnosed by fundus fluorescein angiography(FFAand optical coherence tomography(OCTwere enrolled. Before the injection, best-corrected visual acuity(BCVAof early treatment of diabetic retinopathy study(ETDRS, non-contact tonometer, ophthalmoscope, fundus photography, fundus fluoresein angiograph(FFA, and OCT were examined. All affected eyes were treated with intravitreal conbercept 0.05mL(10mg/mL. Patients were followed up for 6 to 11mo, with a mean duration of 8.55±1.96mo. Post-treatment BCVA, CMT, leakage of macular edema and complications were compared with baseline using repeat analysis. RESULTS: The initial average visual acuity(ETDRS letterswere 43.35±17.45, range from 9 to 70. The initial average central macular thickness(CMTwas 576.30±167.92μm, range from 337 to 987μm. The mean BCVA showed significant improvement during 1, 3, 6mo post-treatment and the latest follow up, with a mean increase of 11.2±5.9, 13.8±7.9, 15.7±6.8 and 14.7±8.6, respectively(PPPPCONCLUSION: Intravitreal conbercept significantly improve visual acuity and macular edema exudation.

  17. Changes of subfoveal choroidal thickness after treated by Ranibizumab for choroidal neovascularization secondary to pathologic myopia

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    Jian-Shu Yuan

    2016-05-01

    Full Text Available AIM:To observe the change of subfoveal choroidal thickness(SFCTafter intravitreal injections of anti-vascular endothelial growth factor monoclonal antibody Ranibizumab in patients with choroidal neovascularization(CNVsecondary to pathologic myopia(PMand to research the relation between visual acuity and SFCT.METHODS:This was a prospective, contrast, open-label study.Fifty pathologic myopia patients with CNV(50 eyeswere recruited in this study. Before the injection,best-corrected visual acuity detected by visual chart from Early Treatment of Diabetic Retinopathy Study(ETDRS,non-contact tonometer,ophthalmoscope,fundus photography, fundus fluorescein angiograph(FFAand optical coherence tomography(OCTexamination were necessary. All affected eye were treated with intravitreal ranibizumab 0.05mL. Following up for 12mo, the changes of visual acuity and SFCT were compared before and after treatment, also the relation between them. RESULTS:All eyes received an average of 2.47±2.23 injections,the final vision of follow-up increased by 13.62±8.98 letters than that before(t=6.69,Pt=0.95, P>0.05.While after 6 and 12mo,the differences were significant(t=2.34, 2.61; PPP>0.05.There were no serious systemic or local side effects during the follow up.CONCLUSION:Intravitreal ranibizumab for CNV secondary to pathologic myopia is safe and can improve the visual acuity.Intravitreal injections of ranibizumab can induce SFCT reduction for CNV secondary to pathologic myopia.We hypothesized that increase of SFCT may be one of evaluation index for CNV activity.

  18. Prevalence of Diabetic Retinopathy and its Associated Factors in a Rural Area of Villupuram District of Tamil Nadu, India.

    Science.gov (United States)

    Nadarajan, Balasubramanian; Saya, Ganesh Kumar; Krishna, Ramesh Babu; Lakshminarayanan, Subitha

    2017-07-01

    There is limited information on prevalence of Diabetic Retinopathy (DR) among diabetic subjects and its associated factors in a rural setting in developing countries including India. The information will be useful for initiating early screening strategies for this group in the community. To assess the prevalence and certain associated factors of DR among diabetic subjects in a rural area of Tamil Nadu, India. This cross-sectional study was conducted among 105 Type 2 diabetic subjects in Pakkam and Mandagapattu sub-center area of Kondur Primary Health Center in Villupuram district of Tamil Nadu, India. Data on associated factors which include sociodemographic factors, duration of disease, family history, and frequency of blood test, treatment regularity, hypertension, visual acuity and cataract were collected. Detailed eye examination including visual acuity, direct ophthalmoscope and Non Mydriatic Fundus Camera was done. Data was analysed by univariate analysis and described in proportion or percentages. The mean age of the study population was 56.69 years. About 47 (44.8%) of the subjects were more than 60 years of age followed by 44 subjects (41.9%) in age group 45-59 years. Fundus examination in at least one eye was seen in 83 people (79.0%). Prevalence of DR in any eye and both the eye was 32.53% (27/83) and 31.58% (24/76) respectively. Severity of DR was moderate (51.9%) followed by mild (44.4%) and severe (3.7%). DR prevalence was more among >60 years age group (p=0.032) and lesser education level (p=0.057). There was no association of DR with duration of disease, family history of diabetes, treatment regularity, presence of hypertension, visual acuity and cataract (p>0.05). The prevalence of DR was inferred to be high and further larger follow up studies will explore the role of associated factors and its quantification in the causation of DR.

  19. Diffuse infiltrating retinoblastoma invading subarachnoid space

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    Kase S

    2011-06-01

    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

  20. Color Fundus Photography versus Fluorescein Angiography in Identification of the Macular Center and Zone in Retinopathy of Prematurity

    Science.gov (United States)

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

    2016-01-01

    Purpose To examine the utility of fluorescein angiography (FA) in identification of the macular center and the diagnosis of zone in patients with retinopathy of prematurity (ROP). Design Validity and reliability analysis of diagnostic tools Methods 32 sets (16 color fundus photographs; 16 color fundus photographs paired with the corresponding FA) of wide-angle retinal images obtained from 16 eyes of eight infants with ROP were compiled on a secure web site. 9 ROP experts (3 pediatric ophthalmologists; 6 vitreoretinal surgeons) participated in the study. For each image set, experts identified the macular center and provided a diagnosis of zone. Main Outcome Measures (1) Sensitivity and specificity of zone diagnosis (2) “Computer facilitated diagnosis of zone,” based on precise measurement of the macular center, optic disc center, and peripheral ROP. Results Computer facilitated diagnosis of zone agreed with the expert’s diagnosis of zone in 28/45 (62%) cases using color fundus photographs and in 31/45 (69%) cases using FA. Mean (95% CI) sensitivity for detection of zone I by experts as compared to a consensus reference standard diagnosis when interpreting the color fundus images alone versus interpreting the color fundus photographs and FA was 47% (35.3% – 59.3%) and 61.1% (48.9% – 72.4%), respectively, (t(9) ≥ (2.063), p = 0.073). Conclusions There is a marginally significant difference in zone diagnosis when using color fundus photographs compared to using color fundus photographs and the corresponding fluorescein angiograms. There is inconsistency between traditional zone diagnosis (based on ophthalmoscopic exam and image review) compared to a computer-facilitated diagnosis of zone. PMID:25637180

  1. Multimodal Imaging of Photoreceptor Structure in Choroideremia.

    Science.gov (United States)

    Sun, Lynn W; Johnson, Ryan D; Williams, Vesper; Summerfelt, Phyllis; Dubra, Alfredo; Weinberg, David V; Stepien, Kimberly E; Fishman, Gerald A; Carroll, Joseph

    2016-01-01

    Choroideremia is a progressive X-linked recessive dystrophy, characterized by degeneration of the retinal pigment epithelium (RPE), choroid, choriocapillaris, and photoreceptors. We examined photoreceptor structure in a series of subjects with choroideremia with particular attention to areas bordering atrophic lesions. Twelve males with clinically-diagnosed choroideremia and confirmed hemizygous mutations in the CHM gene were examined. High-resolution images of the retina were obtained using spectral domain optical coherence tomography (SD-OCT) and both confocal and non-confocal split-detector adaptive optics scanning light ophthalmoscope (AOSLO) techniques. Eleven CHM gene mutations (3 novel) were identified; three subjects had the same mutation and one subject had two mutations. SD-OCT findings included interdigitation zone (IZ) attenuation or loss in 10/12 subjects, often in areas with intact ellipsoid zones; RPE thinning in all subjects; interlaminar bridges in the imaged areas of 10/12 subjects; and outer retinal tubulations (ORTs) in 10/12 subjects. Only split-detector AOSLO could reliably resolve cones near lesion borders, and such cones were abnormally heterogeneous in morphology, diameter and density. On split-detector imaging, the cone mosaic terminated sharply at lesion borders in 5/5 cases examined. Split-detector imaging detected remnant cone inner segments within ORTs, which were generally contiguous with a central patch of preserved retina. Early IZ dropout and RPE thinning on SD-OCT are consistent with previously published results. Evidence of remnant cone inner segments within ORTs and the continuity of the ORTs with preserved retina suggests that these may represent an intermediate state of retinal degeneration prior to complete atrophy. Taken together, these results supports a model of choroideremia in which the RPE degenerates before photoreceptors.

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

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    Kannan, Anusha; Srinivasan, Sivasubramanian

    2012-01-01

    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.

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

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

    2012-09-15

    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.

  4. Iris autofluorescence in Fuchs' heterochromic uveitis.

    Science.gov (United States)

    Liu, Qian; Jia, Yading; Zhang, Suhua; Xie, Juan; Chang, Xin; Hou, Jia; Li, Gaiyun; Koch, Douglas D; Wang, Li

    2016-10-01

    To explore the characteristic autofluorescence patterns of iris depigmentation in eyes diagnosed with Fuchs' heterochromic uveitis (FHU). Near-infrared autofluorescence images and colour images of iris were taken in 21 eyes of 21 patients with FHU, 30 eyes of 15 normal subjects, 30 eyes of 15 normal age-related iris atrophy and 33 eyes of 20 patients with uveitis other than FHU. The confocal scanning laser ophthalmoscope (Heidelberg Retina Angiograph 2, HRA2) was used for melanin-related autofluorescence imaging. The indocyanine green angiography mode of HRA2 was applied for near-infrared laser imaging, and the wavelength of the excitation laser was 795 nm. Iris colour images were also taken with the slit lamp. In normal iris, moderately intense autofluorescence was noted for the pigment ruff at the pupillary border, the crests in the pupillary zone and the collarette; and there was mild autofluorescence in the ciliary zone. In eyes with age-related iris atrophy and uveitis, much less autofluorescence was seen than the healthy normal irides. In eyes with FHU, there was moderate but discontinuous autofluorescence in the pigment ruff, a petaloid pattern of autofluorescence in the pupillary zone, moderate autofluorescence in the collarette and reticular pattern of autofluorescence in the ciliary zone. Characteristic autofluorescence patterns appeared in eyes diagnosed with FHU. Near-infrared autofluorescence is a promising objective technique to document the iris changes in FHU. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. Long-term reduction in infrared autofluorescence caused by infrared light below the maximum permissible exposure.

    Science.gov (United States)

    Masella, Benjamin D; Williams, David R; Fischer, William S; Rossi, Ethan A; Hunter, Jennifer J

    2014-05-20

    Many retinal imaging instruments use infrared wavelengths to reduce the risk of light damage. However, we have discovered that exposure to infrared illumination causes a long-lasting reduction in infrared autofluorescence (IRAF). We have characterized the dependence of this effect on radiant exposure and investigated its origin. A scanning laser ophthalmoscope was used to obtain IRAF images from two macaques before and after exposure to 790-nm light (15-450 J/cm(2)). Exposures were performed with either raster-scanning or uniform illumination. Infrared autofluorescence images also were obtained in two humans exposed to 790-nm light in a separate study. Humans were assessed with direct ophthalmoscopy, Goldmann visual fields, multifocal ERG, and photopic microperimetry to determine whether these measures revealed any effects in the exposed locations. A significant decrease in IRAF after exposure to infrared light was seen in both monkeys and humans. In monkeys, the magnitude of this reduction increased with retinal radiant exposure. Partial recovery was seen at 1 month, with full recovery within 21 months. Consistent with a photochemical origin, IRAF decreases caused by either raster-scanning or uniform illumination were not significantly different. We were unable to detect any effect of the light exposure with any measure other than IRAF imaging. We cannot exclude the possibility that changes could be detected with more sensitive tests or longer follow-up. This long-lasting effect of infrared illumination in both humans and monkeys occurs at exposure levels four to five times below current safety limits. The photochemical basis for this phenomenon remains unknown. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  6. Immediate and long-term changes of fundus autofluorescence in continuous wave laser lesions of the retina.

    Science.gov (United States)

    Framme, Carsten; Roider, Johann

    2004-01-01

    To determine whether fundus autofluorescence imaging is able to show changes in retinal pigment epithelium (RPE) fluorescence after thermal laser photocoagulation. In vivo imaging of fundus autofluorescence was performed with a scanning laser ophthalmoscope. A laser with a wavelength of 488 nm was used for excitation of the tissue and autofluorescence was detected above 500 nm using a barrier filter. One hundred eight eyes of 87 patients who had had previous laser treatment were monitored. The appearance and size of the laser lesions were documented and correlated to the time of treatment. Immediate changes were observed prospectively in 13 eyes; long-term follow-up was studied retrospectively in 95 eyes. In all patients but one, autofluorescence was decreased in the area of laser lesions 1 hour after laser treatment. After 1 month, previously decreased autofluorescence in all lesions changed to significantly increased autofluorescence, which was stable up to 6 months after treatment. Mixed forms were present approximately 6 to 12 months after treatment, showing a central island of increased autofluorescence surrounded by a ring of decreased autofluorescence. After 1 to 2 years, lesions again changed to complete dark spots, enlarging later on. RPE destruction and subsequent proliferation after continuous wave laser photocoagulation can be visualized noninvasively by autofluorescence imaging. Immediate decreased autofluorescence may indicate acute damage of the RPE, subsequent increased autofluorescence seems to indicate proliferative behavior of the RPE, and final dark spots can indicate RPE atrophy secondary to a denaturation of neurosensory retinal tissue. Thus, autofluorescence can be used in the long-term monitoring of RPE changes after laser treatment. The enlargement of the laser atrophy zone demonstrates the potential risk of visual loss after central laser photocoagulation even years after treatment.

  7. Fundus Autofluorescence and Photoreceptor Cell Rosettes in Mouse Models

    Science.gov (United States)

    Flynn, Erin; Ueda, Keiko; Auran, Emily; Sullivan, Jack M.; Sparrow, Janet R.

    2014-01-01

    Purpose. This study was conducted to study correlations among fundus autofluorescence (AF), RPE lipofuscin accumulation, and photoreceptor cell degeneration and to investigate the structural basis of fundus AF spots. Methods. Fundus AF images (55° lens; 488-nm excitation) and spectral-domain optical coherence tomography (SD-OCT) scans were acquired in pigmented Rdh8−/−/Abca4−/− mice (ages 1–9 months) with a confocal scanning laser ophthalmoscope (cSLO). For quantitative fundus AF (qAF), gray levels (GLs) were calibrated to an internal fluorescence reference. Retinal bisretinoids were measured by quantitative HPLC. Histometric analysis of outer nuclear layer (ONL) thicknesses was performed, and cryostat sections of retina were examined by fluorescence microscopy. Results. Quantified A2E and qAF intensities increased until age 4 months in the Rdh8−/−/Abca4−/− mice. The A2E levels declined after 4 months of age, but qAF intensity values continued to rise. The decline in A2E levels in the Rdh8−/−/Abca4−/− mice paralleled reduced photoreceptor cell viability as reflected in ONL thinning. Hyperautofluorescent puncta in fundus AF images corresponded to photoreceptor cell rosettes in SD-OCT images and histological sections stained with hematoxylin and eosin. The inner segment/outer segment–containing core of the rosette emitted an autofluorescence detected by fluorescence microscopy. Conclusions. When neural retina is disordered, AF from photoreceptor cells can contribute to noninvasive fundus AF images. Hyperautofluorescent puncta in fundus AF images are attributable, in at least some cases, to photoreceptor cell rosettes. PMID:25015357

  8. Imaging retinal degeneration in mice by combining Fourier domain optical coherence tomography and fluorescent scanning laser ophthalmoscopy

    Science.gov (United States)

    Hossein-Javaheri, Nima; Molday, Laurie L.; Xu, Jing; Molday, Robert S.; Sarunic, Marinko V.

    2009-02-01

    Visualization of the internal structures of the retina is critical for clinical diagnosis and monitoring of pathology as well as for medical research investigating the root causes of retinal degeneration. Optical Coherence Tomography (OCT) is emerging as the preferred technique for non-contact sub-surface depth-resolved imaging of the retina. The high resolution cross sectional images acquired in vivo by OCT can be compared to histology to visually delineate the retinal layers. The recent demonstration of the significant sensitivity increase obtained through use of Fourier domain (FD) detection with OCT has been used to facilitate high speed scanning for volumetric reconstruction of the retina in software. The images acquired by OCT are purely structural, relying on refractive index differences in the tissue for contrast, and do not provide information on the molecular content of the sample. We have constructed a FDOCT prototype and combined it with a fluorescent Scanning Laser Ophthalmoscope (fSLO) to permit real time alignment of the field of view on the retina. The alignment of the FDOCT system to the specimen is crucial for the registration of measurements taken throughout longitudinal studies. In addition, fluorescence detection has been integrated with the SLO to enable the en face localization of a molecular contrast signal, which is important for retinal angiography, and also for detection of autofluorescence associated with some forms of retinal degeneration, for example autofluorescence lipofuscin accumulations are associated with Stargardt's Macular Dystrophy. The integrated FD OCT/fSLO system was investigated for imaging the retina of the mice in vivo.

  9. Autofluorescence Lifetimes in Geographic Atrophy in Patients With Age-Related Macular Degeneration.

    Science.gov (United States)

    Dysli, Chantal; Wolf, Sebastian; Zinkernagel, Martin S

    2016-05-01

    To investigate fluorescence lifetime characteristics in patients with geographic atrophy (GA) in eyes with age-related macular degeneration and to correlate the measurements with clinical data and optical coherence tomography (OCT) findings. Patients with GA were imaged with a fluorescence lifetime imaging ophthalmoscope. Retinal autofluorescence lifetimes were measured in a short and a long spectral channel (498-560 nm and 560-720 nm). Mean retinal fluorescence lifetimes were analyzed within GA and the surrounding retina, and data were correlated with best corrected visual acuity and OCT measurements. Fluorescence lifetime maps of 41 eyes of 41 patients (80 ± 7 years) with GA were analyzed. Mean lifetimes within areas of atrophy were prolonged by 624 ± 276 ps (+152%) in the short spectral channel and 418 ± 186 ps (+83%) in the long spectral channel compared to the surrounding tissue. Autofluorescence lifetime abnormalities in GA occurred with particular patterns, similar to those seen in fundus autofluorescence intensity images. Within the fovea short mean autofluorescence lifetimes were observed, presumably representing macular pigment. Short lifetimes were preserved even in the absence of foveal sparing but were decreased in patients with advanced retinal atrophy in OCT. Short lifetimes in the fovea correlated with better best corrected visual acuity in both spectral channels. This study established that autofluorescence lifetime changes in GA present with explicit patterns. We hypothesize that the short lifetimes seen within the atrophy may be used to estimate damage induced by atrophy and to monitor disease progression in the context of natural history or interventional therapeutic studies.

  10. Quantitative fundus autofluorescence in healthy eyes.

    Science.gov (United States)

    Greenberg, Jonathan P; Duncker, Tobias; Woods, Russell L; Smith, R Theodore; Sparrow, Janet R; Delori, François C

    2013-08-21

    Fundus autofluorescence was quantified (qAF) in subjects with healthy retinae using a standardized approach. The objective was to establish normative data and identify factors that influence the accumulation of RPE lipofuscin and/or modulate the observed AF signal in fundus images. AF images were acquired from 277 healthy subjects (age range: 5-60 years) by employing a Spectralis confocal scanning laser ophthalmoscope (cSLO; 488-nm excitation; 30°) equipped with an internal fluorescent reference. For each image, mean gray level was calculated as the average of eight preset regions, and was calibrated to the reference, zero-laser light, magnification, and optical media density from normative data on lens transmission spectra. Relationships between qAF and age, sex, race/ethnicity, eye color, refraction/axial length, and smoking status were evaluated as was measurement repeatability and the qAF spatial distribution. qAF levels exhibited a significant increase with age. qAF increased with increasing eccentricity up to 10° to 15° from the fovea and was highest superotemporally. qAF values were significantly greater in females, and, compared with Hispanics, qAF was significantly higher in whites and lower in blacks and Asians. No associations with axial length and smoking were observed. For two operators, between-session repeatability was ± 9% and ± 12%. Agreement between the operators was ± 13%. Normative qAF data are a reference tool essential to the interpretation of qAF measurements in ocular disease.

  11. Quantitative fundus autofluorescence in mice: correlation with HPLC quantitation of RPE lipofuscin and measurement of retina outer nuclear layer thickness.

    Science.gov (United States)

    Sparrow, Janet R; Blonska, Anna; Flynn, Erin; Duncker, Tobias; Greenberg, Jonathan P; Secondi, Roberta; Ueda, Keiko; Delori, François C

    2013-04-17

    Our study was conducted to establish procedures and protocols for quantitative autofluorescence (qAF) measurements in mice, and to report changes in qAF, A2E bisretinoid concentration, and outer nuclear layer (ONL) thickness in mice of different genotypes and age. Fundus autofluorescence (AF) images (55° lens, 488 nm excitation) were acquired in albino Abca4(-/-), Abca4(+/-), and Abca4(+/+) mice (ages 2-12 months) with a confocal scanning laser ophthalmoscope (cSLO). Gray levels (GLs) in each image were calibrated to an internal fluorescence reference. The bisretinoid A2E was measured by quantitative high performance liquid chromatography (HPLC). Histometric analysis of ONL thicknesses was performed. The Bland-Altman coefficient of repeatability (95% confidence interval) was ±18% for between-session qAF measurements. Mean qAF values increased with age (2-12 months) in all groups of mice. qAF was approximately 2-fold higher in Abca4(-/-) mice than in Abca4(+/+) mice and approximately 20% higher in heterozygous mice. HPLC measurements of the lipofuscin fluorophore A2E also revealed age-associated increases, and the fold difference between Abca4(-/-) and wild-type mice was more pronounced (approximately 3-4-fold) than measurable by qAF. Moreover, A2E levels declined after 8 months of age, a change not observed with qAF. The decline in A2E levels in the Abca4(-/-) mice corresponded to reduced photoreceptor cell viability as reflected in ONL thinning beginning at 8 months of age. The qAF method enables measurement of in vivo lipofuscin and the detection of genotype and age-associated differences. The use of this approach has the potential to aid in understanding retinal disease processes and will facilitate preclinical studies.

  12. Noninvasive Quantification of Retinal Microglia Using Widefield Autofluorescence Imaging.

    Science.gov (United States)

    Kokona, Despina; Schneider, Nadia; Giannakaki-Zimmermann, Helena; Jovanovic, Joel; Ebneter, Andreas; Zinkernagel, Martin

    2017-04-01

    To validate widefield autofluorescence (AF) in vivo imaging of the retina in mice expressing green fluorescent protein (gfp) in microglia, and to monitor retinal microglia reconstitution in vivo after lethal irradiation and bone marrow transplantation. Transgenic Cx3cr1gfp/gfp and wildtype Balb/c mice were used in this study. A confocal scanning laser ophthalmoscope was used for AF imaging with a 55° and a widefield 102° lens. Intrasession reproducibility was assessed for each lens. To investigate reconstitution in vivo, bone marrow from Cx3cr1gfp/gfp mice was used to rescue lethally irradiated wildtype mice. Data were compared to confocal microscopy of retinal flat mounts. Both the 55° and the 102° lens produced high resolution images of retinal microglia with similar microglia density. However, compared to the 55° lens, the widefield 102° lens captured approximately 3.6 times more microglia cells (1515 ± 123 cells versus 445 ± 76 cells [mean ± SD], for 102° and 55°, respectively, P < 0.001). No statistical difference in the number of gfp positive cells within corresponding areas was observed within the same imaging session. Imaging of microglia reconstitution showed a similar time course compared to flat mount preparations with an excellent correlation between microglia cell numbers in AF and gfp-stained flat mounts (R = 0.92, P < 0.0001). Widefield AF imaging of mice with gfp expressing microglia can be used to quantify retinal microglia. In vivo microglia counts corresponded very well with ex vivo counts on retinal flat mounts. As such, AF imaging can largely replace ex vivo quantification.

  13. Effects of short term changes in the blood glucose level on the autofluorescence lifetime of the human retina in healthy volunteers

    Science.gov (United States)

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

    2016-03-01

    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.

  14. In vivo analysis of the time and spatial activation pattern of microglia in the retina following laser-induced choroidal neovascularization.

    Science.gov (United States)

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

    2015-10-01

    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

  15. Performance of confocal scanning laser tomograph Topographic Change Analysis (TCA) for assessing glaucomatous progression.

    Science.gov (United States)

    Bowd, Christopher; Balasubramanian, Madhusudhanan; Weinreb, Robert N; Vizzeri, Gianmarco; Alencar, Luciana M; O'Leary, Neil; Sample, Pamela A; Zangwill, Linda M

    2009-02-01

    To determine the sensitivity and specificity of confocal scanning laser ophthalmoscope's Topographic Change Analysis (TCA; Heidelberg Retina Tomograph [HRT]; Heidelberg Engineering, Heidelberg, Germany) parameters for discriminating between progressing glaucomatous and stable healthy eyes. The 0.90, 0.95, and 0.99 specificity cutoffs for various (n=70) TCA parameters were developed by using 1000 permuted topographic series derived from HRT images of 18 healthy eyes from Moorfields Eye Hospital, imaged at least four times. The cutoffs were then applied to topographic series from 36 eyes with known glaucomatous progression (by optic disc stereophotograph assessment and/or standard automated perimetry guided progression analysis, [GPA]) and 21 healthy eyes from the University of California, San Diego (UCSD) Diagnostic Innovations in Glaucoma Study (DIGS), all imaged at least four times, to determine TCA sensitivity and specificity. Cutoffs also were applied to 210 DIGS patients' eyes imaged at least four times with no evidence of progression (nonprogressed) by stereophotography or GPA. The TCA parameter providing the best sensitivity/specificity tradeoff using the 0.90, 0.95, and 0.99 cutoffs was the largest clustered superpixel area within the optic disc margin (CAREA(disc) mm(2)). Sensitivities/specificities for classifying progressing (by stereophotography and/or GPA) and healthy eyes were 0.778/0.809, 0.639/0.857, and 0.611/1.00, respectively. In nonprogressing eyes, specificities were 0.464, 0.570, and 0.647 (i.e., lower than in the healthy eyes). In addition, TCA parameter measurements of nonprogressing eyes were similar to those of progressing eyes. TCA parameters can discriminate between progressing and longitudinally observed healthy eyes. Low specificity in apparently nonprogressing patients' eyes suggests early progression detection using TCA.

  16. Pursuit Latency for Chromatic Targets

    Science.gov (United States)

    Mulligan, Jeffrey B.; Ellis, Stephen R. (Technical Monitor)

    1998-01-01

    The temporal dynamics of eye movement response to a change in direction of stimulus motion has been used to compare the processing speeds of different types of stimuli (Mulligan, ARVO '97). In this study, the pursuit response to colored targets was measured to test the hypothesis that the slow response of the chromatic system (as measured using traditional temporal sensitivity measures such as contrast sensitivity) results in increased eye movement latencies. Subjects viewed a small (0.4 deg) Gaussian spot which moved downward at a speed of 6.6 deg/sec. At a variable time during the trajectory, the dot's direction of motion changed by 30 degrees, either to the right or left. Subjects were instructed to pursue the spot. Eye movements were measured using a video ophthalmoscope with an angular resolution of approximately 1 arc min and a temporal sampling rate of 60 Hz. Stimuli were modulated in chrominance for a variety of hue directions, combined with a range of small luminance increments and decrements, to insure that some of the stimuli fell in the subjects' equiluminance planes. The smooth portions of the resulting eye movement traces were fit by convolving the stimulus velocity with an exponential having variable onset latency, time constant and amplitude. Smooth eye movements with few saccades were observed for all stimuli. Pursuit responses to stimuli having a significant luminance component are well-fit by exponentials having latencies and time constants on the order of 100 msec. Increases in pursuit response latency on the order of 100-200 msec are observed in response to certain stimuli, which occur in pairs of complementary hues, corresponding to the intersection of the stimulus section with the subjects' equiluminant plane. Smooth eye movements can be made in response to purely chromatic stimuli, but are slower than responses to stimuli with a luminance component.

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

    Directory of Open Access Journals (Sweden)

    Shah Parag

    2006-01-01

    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.

  18. Fractal analysis reveals reduced complexity of retinal vessels in CADASIL.

    Directory of Open Access Journals (Sweden)

    Michele Cavallari

    2011-04-01

    Full Text Available The Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL affects mainly small cerebral arteries and leads to disability and dementia. The relationship between clinical expression of the disease and progression of the microvessel pathology is, however, uncertain as we lack tools for imaging brain vessels in vivo. Ophthalmoscopy is regarded as a window into the cerebral microcirculation. In this study we carried out an ophthalmoscopic examination in subjects with CADASIL. Specifically, we performed fractal analysis of digital retinal photographs. Data are expressed as mean fractal dimension (mean-D, a parameter that reflects complexity of the retinal vessel branching. Ten subjects with genetically confirmed diagnosis of CADASIL and 10 sex and age-matched control subjects were enrolled. Fractal analysis of retinal digital images was performed by means of a computer-based program, and the data expressed as mean-D. Brain MRI lesion volume in FLAIR and T1-weighted images was assessed using MIPAV software. Paired t-test was used to disclose differences in mean-D between CADASIL and control groups. Spearman rank analysis was performed to evaluate potential associations between mean-D values and both disease duration and disease severity, the latter expressed as brain MRI lesion volumes, in the subjects with CADASIL. The results showed that mean-D value of patients (1.42±0.05; mean±SD was lower than control (1.50±0.04; p = 0.002. Mean-D did not correlate with disease duration nor with MRI lesion volumes of the subjects with CADASIL. The findings suggest that fractal analysis is a sensitive tool to assess changes of retinal vessel branching, likely reflecting early brain microvessel alterations, in CADASIL patients.

  19. 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

    2006-01-01

    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

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

    Science.gov (United States)

    Kozak, Igor; Sasik, Roman; Freeman, William R; Sprague, L James; Gomez, Maria Laura; Cheng, Lingyun; El-Emam, Sharif; Mojana, Francesca; Bartsch, Dirk-Uwe; Bosten, Jenny; Ayyagari, Radha; Hardiman, Gary

    2013-01-01

    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 changes in HIV

  1. Study of hemodynamics of retroocular vascular by color Doppler ultrasound in diabetes%彩色多普勒超声对糖尿病眼球后血管血流动力学研究

    Institute of Scientific and Technical Information of China (English)

    雷震; 张梅; 李加平; 龙劲松

    2011-01-01

    目的:通过彩色多普勒超声观察糖尿病眼球后血管的血流动力学,研究其诊断价值.方法:共用彩色多普勒超声检查了正常人眼球、糖尿病视网膜病变(diabetic retinopathy,DR)及有糖尿病但无糖尿病视网膜病变(non-diabetic retinopathy,NDR)眼球的球后血管并与荧光素眼底血管造影及检眼镜对比.结果:随着DR的进展,糖尿病患者眼球后血管血流动力学改变的趋势是眼球后动脉的血流速度下降,阻力升高;球后静脉流速增高伴搏动性增强.结论:彩色多普勒超声技术为定量评价DR,判断其预后提供了重要的参考价值.%Objective: To observe the hemodynamic changes of retroocular and evaluate the diagnostic valuation of color Doppler ultraqound in diabetes. Methods: Retroocular hemodynamics were measured in normal and diabetic retinopathy (DR) and non-diabetic retinopathy (NDR) on color Doppler flow imagining and compared with fundus fluorescein angiography (FFA) and Ophthalmoscope. Results: In the progress of DR, the flow's decrease and the resistance's mcrease of retroocular artery were detected in this research, the increase of flow and pulsatility index of retroocular vein were observed too.Conclusion: Color Doppler ultrasound is of important reference value for not only prognosis but also quantitative analysis of diabetic retinopathy.

  2. Cobalt60 plaques in recurrent retinoblastoma

    Energy Technology Data Exchange (ETDEWEB)

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

    1991-08-01

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, Yi [Los Alamos National Laboratory

    2011-01-04

    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.

  4. Multimodal adaptive optics for depth-enhanced high-resolution ophthalmic imaging

    Science.gov (United States)

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

    2010-02-01

    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. The Thai DMS Diabetes Complications (DD.Comp.) project: prevalence and risk factors of diabetic retinopathy in Thai patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Jongsareejit, Amporn; Potisat, Somkiat; Krairittichai, Udom; Sattaputh, Charnvate; Arunratanachote, Woranut

    2013-11-01

    To determine the prevalence of diabetic retinopathy (DR) among patients with type 2 diabetes mellitus (T2DM) in Thailand and their associated risk factors. A cross-sectional, multi-sites, hospital-based study was carried out between June and December 2006. Diabetic patients from the outpatient department of seven public hospitals (3 tertiary, 2 secondary and 2 community hospital) in Thailand were performed by retinal specialist. One thousand seven of 1,120 diabetic patients received retinal examination using indirect ophthalmoscope. Patients were divided into two groups (absent and present DR). Most patients in both groups were female (72.7 and 68.0%). The prevalence of DR was 24.0% (n = 242), mild NPDR 9.4% (n = 95), moderate NPDR 10.5% (n = 106), severe NPDR 1.3% (n = 13), and proliferative (PDR) 2.8% (n = 28). Age at onset, duration of DM, systolic blood pressure, body mass index (BMI), fasting plasma glucose (FPG), HbA1c, Triglyceride (TG), alcohol consumption, foot ulcer, and proteinuria were recorded. Metformin and insulin taking were statistically, significantly different among these groups. There is more prevalent NPDR and PDR in insulin-taking than non-insulin-taking groups. The grading of diabetic retinopathy is associated with the duration of diabetes. In multivariate regression analysis, associated risk factors of DR patients were the duration of DM, HbA1c levels, and proteinuria. Diabetic retinopathy was present in about one fourth of type 2 diabetic patients in this study. Associated risk factors of DR were the duration of DM, HbA1c levels, and proteinuria. Regular screening for DR especially in T2DM with associated risk factor should be done for early treatment.

  6. Optograms and criminology: science, news reporting, and fanciful novels.

    Science.gov (United States)

    Lanska, Douglas J

    2013-01-01

    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.

  7. Frequency of diabetic retinopathy among dialysis patients and their awareness about the need for screening to prevent blindness

    International Nuclear Information System (INIS)

    Basit, I.; Hameed, A.; Akram, A.

    2014-01-01

    Objective: To observe frequency and spectrum of diabetic retinopathy among patients undergoing haemodialysis and to assess the awareness of importance of ophthalmic screening among these patients. Study Design: Observational descriptive study. Place and Duration of Study: The study was carried out at Combined Military Hospital Kharian, from August 2011 to January 2012. Patients and Methods: A total of 49 patients were included in the study who were under going maintenance hemodialysis during the observation period. All the patients were examined with ophthalmoscope after mydriasis. Patients who were not willing, irritable or in coma were not included in the study. Results: A total of 49 patients (n=49) were examined with 26 males and 13 females. Age of patients with diabetic retinopathy ranged from 45 years to 68 years, mean age of patients was 57.5 years. Nineteen patients (38.7%) were suffering from diabetes mellitus. Four had been operated for cataract out of which only one was advised regular follow up for effect of diabetes on vision. Only one patient who was UK national was aware of need and importance of regular eye examination to avoid preventable blindness and to monitor for end organ damage. Conclusion: These results indicate that hospital needs integrated diabetic clinics for patient awareness and management to prevent blindness due to diabetic retinopathy. In fact, Pakistan needs a national level retinopathy screening programme keeping in mind the increasing incidence of diabetes mellitus. National programme for retinopathy is doable as fundus cameras are widely available and can be operated by optometrists and integrated care protocols between different departments to avoid financial burden of care for diabetic gerartric patients. (author)

  8. Retinal micropseudocysts in diabetic retinopathy: prospective functional and anatomic evaluation.

    Science.gov (United States)

    Forte, Raimondo; Cennamo, Gilda; Finelli, Maria Luisa; Bonavolontà, Paola; Greco, Giovanni Maria; de Crecchio, Giuseppe

    2012-01-01

    To evaluate the prevalence, progression and functional predictive value of retinal micropseudocysts (MPCs) in diabetic patients. Prospective controlled observational study. From among all the type 2 diabetic patients evaluated during a period of 5 months between September 2009 and January 2010, we enrolled all patients with retinal MPCs at spectral-domain scanning laser ophthalmoscope/optical coherence tomography (SD-SLO/OCT) not previously treated for diabetic retinopathy. Forty diabetic patients without MPCs served as the control group. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), macular sensitivity and stability of fixation at SD-SLO/OCT microperimetry were measured monthly for 12 months. 22/156 patients with type 2 diabetes (14.1%, 32 eyes) met the inclusion criteria. The 95% confidence interval for the prevalence estimate of MPCs was 12.3-16.6%. Mean BCVA, CRT and central retinal sensitivity at baseline were 77.53 ± 2.2 Early Treatment Diabetic Retinopathy Study letters, 242.31 ± 31.0 µm and 15.95 ± 0.61 dB, respectively. Fixation was stable in all cases. Compared to the control group, eyes with MPCs had similar BCVA but greater CRT (p = 0.01) and reduced macular sensitivity (p = 0.001) at baseline and at each follow-up visit. Over time, CRT remained stable in eyes with MPCs, whereas macular sensitivity progressively decreased. MPCs in diabetic retinopathy are associated, temporally or causally, with a progressive reduction of macular sensitivity despite a stable BCVA, CRT and fixation. Copyright © 2011 S. Karger AG, Basel.

  9. Frequency of retinopathy in newly diagnosed patients of type 2 diabetes mellitus (dm)

    International Nuclear Information System (INIS)

    Khan, K.A.; Kamran, S.M.; Qureshi, M.N.

    2015-01-01

    This study was to determine the frequency of retinopathy in newly diagnosed type-II Diabetics. Study Design: Cross sectional descriptive study. Place and Duration of Study: It was conducted at Department of medicine, Military Hospital (MH), Rawalpindi from 1st Jan 2012 to 30 Jun 2012. Material and Methods: We included 200 patients of type-II DM from both genders diagnosed in last 03 months from both outdoor and indoor departments in the age range of 40 to 70 years by consecutive sampling. All patients having co morbidities affecting retina were excluded. Informed written consent was taken before enrollment. Formal approval of the study was taken from hospital ethical committee. Ocular Fundoscopy was performed with WelchAllyn Ophthalmoscope (REF 11470) as per standard protocols and both eyes were examined. The grade of DR (diabetic retinopathy) awarded as per highest changes in any of the two eyes. All tests were carried by a single person to avoid inter-observer variations. Findings of ocular fundoscopy were confirmed by ophthalmologist. All data was analyzed by using SPSS version 11. Results: Out of 200 subjects 63.5% were male and 36.5% were female. Age ranged from 40 to 70 years with mean age of 51.05+ 6.910 years. 29 (14.5%) subjects had Diabetic retinopathy. Out of 29 patients, 24 (82.8%) had preproliferative and 5 (17.2%) had proliferative diabetic retinopathy. Conclusion: A significant proportion of diabetic patients have retinopathy at the time of diagnosis of their disease which is more common in males and with increasing age. It is recommended to thoroughly screen the newly diagnosed diabetics for early detection of diabetic retinopathy and its management involving early referral to eye specialist. (author)

  10. ORGANOPROTECTIVE EFFECTS OF BENASEPRIL IN PATIENTS WITH ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    V. S. Zadionchenko

    2006-01-01

    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

  11. Blue light Exposure And Long-Term Deficits In Visual Function

    Science.gov (United States)

    Clarke, A. M.

    1980-10-01

    During the last 6 months of 1976, the fovea of two trained rhesus monkeys were exposed to a 10 nm bandwidth source, centered at 441 nm, at energy levels representing up to three times that required in the paramacula to cause minimal, ophthalmoscopically visible lesions to appear 48 hours postexposure (30 J/cm2 to 90 J/cm2, 1000 sec). After the acute period, a visual decrement lasting beyond 30 days postexposure occurred only for the 90 J/cm2, 1000 second fovea' exposure; the statistically significant criteria for recognition of the 20/20 (1.0 min of arc) Landolt ring target was not met, although the criteria for the 20/30 (1.5 min of arc) target was continuously met after 33 days of recovery. The animals are still regularly tested in the original protocol for visual acuity, and additionally have been examined for spectral sensitivity and changes in reaction time to the visual stimulus. During the last 6 months of 1979, only the eye originally exposed at the 90 J/cm2 level failed at any test session to meet the recognition criteria for 1.0 min targets, and all eyes met the criteria for 1.5 min targets at every session. This indicates no long-term changes in the visual acuity, ruling out physiologic repair mechanisms operating beyond the first 30 to 60 days postexposure, or long term degenerative changes accumulating after the initial recovery period. Additionally, the spectral sensitivity of the subject exposed to higher levels shows a mild red but no blue deficit for 20/50 (2.5 min) targets compared to the CIE photopic function. At 1.5 min however, the spectral sensitivity would seem to be better fit by a single photopigment curve, centered at 535 nm.

  12. Preferred retinal location induced by macular occlusion in a target recognition task

    Science.gov (United States)

    Ness, James W.; Zwick, Harry; Molchany, Jerome W.

    1996-04-01

    Laser-induced central retinal damage not only may diminish visual function, but also may diminish afferent input that provides the ocular motor system with the feedback necessary to move the target to the fovea. Local visual field stabilizations have been used to demonstrate that central artificial occlusions in the normal retina suppress visual function. The purpose of this paper is to evaluate the effect of local field stabilizations on the ocular motor system in a contrast sensitivity task. Five subjects who tested normal in a standard clinical eye exam viewed landolt rings at varying visual angles under three artificial scotoma conditions and a no scotoma condition. The scotoma conditions were a 2 degree(s) and 5 degree(s) stabilized central scotoma and a 2 degree(s) stabilized scotoma positioned 1 degree(s) nasal to the fovea. A Dual Purkinje Eye-Tracker (SRI, version 5) was used to provide eye-position data and to stabilize the artificial scotoma on the retina. The data showed a consistent preference for placing the target in the superior retina under the 2 degree(s) and 5 degree(s) conditions with a strong positive correlation between visual angle and deflection of the eye position into the superior retina. These data suggest that loss of visual function from laser-induced foveal damage may be due in part to a disruption in the ocular motor system. Thus, even if some function remains in the damage site ophthalmoscopically, the ocular motor system may organize around a nonfoveal retinal location, behaviorally suppressing foveal input.

  13. A 3D virtual reality ophthalmoscopy trainer.

    Science.gov (United States)

    Wilson, Andrew S; O'Connor, Jake; Taylor, Lewis; Carruthers, David

    2017-12-01

    Performing eye examinations is an important clinical skill that medical students often find difficult to become proficient in. This paper describes the development and evaluation of an innovative 3D virtual reality (VR) training application to support learning these skills. The VR ophthalmoscope was developed by a clinical team and technologist using the unity game engine, smartphone and virtual reality headset. It has a series of tasks that include performing systematic eye examinations, identifying common eye pathologies and a knowledge quiz. As part of their clinical training, 15 fourth-year medical students were surveyed for their views on this teaching approach. The Technology Acceptance Model was used to evaluate perceived usefulness and ease of use. Data were also collected on the usability of the app, together with the students' written comments about it. Users agreed that the teaching approach improved their understanding of ophthalmoscopy (n = 14), their ability to identify landmarks in the eye (n = 14) and their ability to recognise abnormalities (n = 15). They found the app easy to use (n = 15), the teaching approach informative (n = 13) and that it would increase students' confidence when performing these tasks in future (n = 15). Performing eye examinations is an important clinical skill DISCUSSION: The evaluation showed that a VR app can successfully simulate the processes involved in performing eye examinations. The app was highly rated for all elements of perceived usefulness, ease of use and usability. Medical students stated that they would like to be taught other medical skills in this way in future. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  14. Retinal changes in pregnancy-induced hypertension

    Directory of Open Access Journals (Sweden)

    Akash Pankaj Shah

    2015-01-01

    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.

  15. Association of age and macular pigment optical density using dual-wavelength autofluorescence imaging.

    Science.gov (United States)

    Lima, Verônica Castro; Rosen, Richard B; Prata, Tiago Santos; Dorairaj, Syril; Spielberg, Leigh; Maia, Mauricio; Sallum, Juliana M

    2013-01-01

    Several lines of evidence suggest that macular pigment may play a protective role against age-related macular degeneration, but the influence of age on macular pigment density levels remains unclear. This study was designed to investigate the relationship between age and the normal distribution of macular pigment optical density (MPOD) values surrounding the fovea. Consecutive healthy subjects with no evidence of ocular disease were enrolled in this study. After inclusion, MPOD values were measured at specific eccentricities (0.5, 1, and 2 degrees) from the foveal center using a dual-wavelength autofluorescence method employing a modified confocal scanning laser ophthalmoscope. Whenever both eyes were eligible, one was randomly selected for analysis. The correlation between age and MPOD values was investigated using regression analysis. Thirty subjects (30 eyes) were included (mean age 48.6 ± 16.4 [range 23-77] years). Significant differences were found between MPOD values measured at 0.5, 1, and 2 degrees from the center of the fovea (0.49 ± 0.12 density units, 0.37 ± 0.11 density units, and 0.13 ± 0.05 density units, respectively, P < 0.05). Significant correlations between age and MPOD values at 0.5 and 1 degree were found (P ≤ 0.02). Values measured at 2 degrees did not correlate significantly with age (P = 0.06). In healthy subjects, MPOD values were highest near the foveal center. These values appeared to increase during adulthood (peak at 45-50 years), followed by a gradual reduction after 60 years of age.

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

    Science.gov (United States)

    O'Rourke, Colleen T; Hall, Margaret I; Pitlik, Todd; Fernández-Juricic, Esteban

    2010-09-22

    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. 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. 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 behavioral strategies to visually search for and track prey while

  17. Visual abilities in two raptors with different ecology.

    Science.gov (United States)

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

    2016-09-01

    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. © 2016. Published by The Company of Biologists Ltd.

  18. Cobalt60 plaques in recurrent retinoblastoma

    International Nuclear Information System (INIS)

    Fass, D.; McCormick, B.; Abramson, D.; Ellsworth, R.

    1991-01-01

    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 x 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

  19. The role of serum apelin in retinopathy of prematurity

    Directory of Open Access Journals (Sweden)

    Ali YF

    2017-02-01

    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

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

    Science.gov (United States)

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

    2012-12-01

    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.

  1. Evaluation of an online peer fundus photograph matching program in teaching direct ophthalmoscopy to medical students.

    Science.gov (United States)

    Kwok, Jason; Liao, Walter; Baxter, Stephanie

    2017-10-01

    Direct ophthalmoscopy is an important clinical skill that is often poorly performed by medical professionals and students. This is attributable to a declining emphasis on ophthalmology in medical school. We present and evaluate a self-directed approach of teaching ophthalmoscopy to medical students that is suitable for the current medical curriculum. Prospective medical education trial. Ninety-five second-year medical students at Queen's University: 32 in the experimental group and 63 in the control group. The experimental group consisted of medical students who practised ophthalmoscopy with one another using an online peer fundus photograph matching exercise created by the Department of Ophthalmology at Queen's University. To use the program, students first examined a peer with an ophthalmoscope and then selected an online photograph of a fundus corresponding to that of the examinee. The program notifies students if a correct selection is made. To encourage use of the program, students participated in a 2-week ophthalmoscopy competition during their ophthalmology rotation. The control group consisted of students who did not participate in the learning exercise. On assessment at the end of the ophthalmology rotation, the experimental group (n = 32) was more accurate in matching fundus photographs compared with the control group (n = 63) (p = 0.02). Participants were faster at performing ophthalmoscopy at the end of the learning exercise (p peer fundus photographs in a self-directed manner appeared to increase the skill and confidence of medical students in ophthalmoscopy. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  2. Nutritional Manipulation of Primate Retinas, V: Effects of Lutein, Zeaxanthin, and n–3 Fatty Acids on Retinal Sensitivity to Blue-Light–Induced Damage

    Science.gov (United States)

    Barker, Felix M.; Snodderly, D. Max; Johnson, Elizabeth J.; Schalch, Wolfgang; Koepcke, Wolfgang; Gerss, Joachim

    2011-01-01

    Purpose. Blue-light photooxidative damage has been implicated in the etiology of age-related macular degeneration (AMD). The macular pigment xanthophylls lutein (L) and zeaxanthin (Z) and n–3 fatty acids may reduce this damage and lower the risk of AMD. This study investigated the effects of the lifelong absence of xanthophylls followed by L or Z supplementation, combined with the effects of n–3 fatty acid deficiency, on acute blue-light photochemical damage. Methods. Subjects included eight rhesus monkeys with no lifelong intake of xanthophylls and no detectable macular pigment. Of these, four had low n–3 fatty acid intake and four had adequate intakes. Control subjects had typical L, Z, and n–3 fatty acid intake. Retinas received 150-μm-diameter exposures of low-power 476-nm laser light at 0.5 mm (∼2°) eccentricity, which is adjacent to the macular pigment peak, and parafoveally at 1.5 mm (∼6°). Exposures of xanthophyll-free animals were repeated after supplementation with pure L or Z for 22 to 28 weeks. Ophthalmoscopically visible lesion areas were plotted as a function of exposure energy, with greater slopes of the regression lines indicating greater sensitivity to damage. Results. In control animals, the fovea was less sensitive to blue-light–induced damage than the parafovea. Foveal protection was absent in xanthophyll-free animals but was evident after supplementation. In the parafovea, animals low in n–3 fatty acids showed greater sensitivity to damage than animals with adequate levels. Conclusions. After long-term xanthophyll deficiency, L or Z supplementation protected the fovea from blue light–induced damage, whereas adequate n–3 fatty acid levels reduced the damage in the parafovea. PMID:21245404

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Non-damaging laser therapy of the macula: Titration algorithm and tissue response

    Science.gov (United States)

    Palanker, Daniel; Lavinsky, Daniel; Dalal, Roopa; Huie, Philip

    2014-02-01

    Retinal photocoagulation typically results in permanent scarring and scotomata, which limit its applicability to the macula, preclude treatments in the fovea, and restrict the retreatments. Non-damaging approaches to laser therapy have been tested in the past, but the lack of reliable titration and slow treatment paradigms limited their clinical use. We developed and tested a titration algorithm for sub-visible and non-damaging treatments of the retina with pulses sufficiently short to be used with pattern laser scanning. The algorithm based on Arrhenius model of tissue damage optimizes the power and duration for every energy level, relative to the threshold of lesion visibility established during titration (and defined as 100%). Experiments with pigmented rabbits established that lesions in the 50-75% energy range were invisible ophthalmoscopically, but detectable with Fluorescein Angiography and OCT, while at 30% energy there was only very minor damage to the RPE, which recovered within a few days. Patients with Diabetic Macular Edema (DME) and Central Serous Retinopathy (CSR) have been treated over the edematous areas at 30% energy, using 200μm spots with 0.25 diameter spacing. No signs of laser damage have been detected with any imaging modality. In CSR patients, subretinal fluid resolved within 45 days. In DME patients the edema decreased by approximately 150μm over 60 days. After 3-4 months some patients presented with recurrence of edema, and they responded well to retreatment with the same parameters, without any clinically visible damage. This pilot data indicates a possibility of effective and repeatable macular laser therapy below the tissue damage threshold.

  5. Computer-Based Image Analysis for Plus Disease Diagnosis in Retinopathy of Prematurity: Performance of the "i-ROP" System and Image Features Associated With Expert Diagnosis.

    Science.gov (United States)

    Ataer-Cansizoglu, Esra; Bolon-Canedo, Veronica; Campbell, J Peter; Bozkurt, Alican; Erdogmus, Deniz; Kalpathy-Cramer, Jayashree; Patel, Samir; Jonas, Karyn; Chan, R V Paul; Ostmo, Susan; Chiang, Michael F

    2015-11-01

    We developed and evaluated the performance of a novel computer-based image analysis system for grading plus disease in retinopathy of prematurity (ROP), and identified the image features, shapes, and sizes that best correlate with expert diagnosis. A dataset of 77 wide-angle retinal images from infants screened for ROP was collected. A reference standard diagnosis was determined for each image by combining image grading from 3 experts with the clinical diagnosis from ophthalmoscopic examination. Manually segmented images were cropped into a range of shapes and sizes, and a computer algorithm was developed to extract tortuosity and dilation features from arteries and veins. Each feature was fed into our system to identify the set of characteristics that yielded the highest-performing system compared to the reference standard, which we refer to as the "i-ROP" system. Among the tested crop shapes, sizes, and measured features, point-based measurements of arterial and venous tortuosity (combined), and a large circular cropped image (with radius 6 times the disc diameter), provided the highest diagnostic accuracy. The i-ROP system achieved 95% accuracy for classifying preplus and plus disease compared to the reference standard. This was comparable to the performance of the 3 individual experts (96%, 94%, 92%), and significantly higher than the mean performance of 31 nonexperts (81%). This comprehensive analysis of computer-based plus disease suggests that it may be feasible to develop a fully-automated system based on wide-angle retinal images that performs comparably to expert graders at three-level plus disease discrimination. Computer-based image analysis, using objective and quantitative retinal vascular features, has potential to complement clinical ROP diagnosis by ophthalmologists.

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

    Directory of Open Access Journals (Sweden)

    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

  7. Treatment of age-related subfoveal choroidal neovascularization by low-dose external radiation. A preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Harino, Seiyo; Oshima, Yusuke; Tsujikawa, Kaoru; Oh, Ami; Sugimoto, Kiyoshi [Yodogawa Christian Hospital, Osaka (Japan); Murayama, Shigeyuki; Inoue, Toshihiko

    1997-04-01

    We applied low dose external beam radiation (6MV) to 17 eyes of 17 patients (Mean age 70.9 years, range 58-85) who had subfoveal choroidal neovascularization associated with age-related macular degeneration. None of the cases were suitable for photocoagulation according to the Macular Photo-coagulation Study protocol, and no feeding vessels underlying choroidal neovascular membrane could be detected. Corrected visual acuity ranged from 0.02 to 0.6 before treatment. The patients were divided into two groups. One group of 11 eyes was treated with 10 Gy and the other group of 6 eyes with 21 Gy. Mean follow up period was 347{+-}89 (mean{+-}standard deviation) days in the 10 Gy group and 312{+-}100 days in the 21 Gy group. We evaluated the outcome as `effective` if no progression in neovascular membrane was found by ophthalmoscopic and angiographic examination. Only 3 eyes (21%) of patients in the 10 Gy group and 2 eyes (33%) in 21 Gy group showed any effect. Although the rate of progression in choroidal neovascular membrane was significantly smaller in the 10 and 21 Gy group than in the controls, the corrected visual acuity in the treated group was not improved over that of the controls. No serious complications were seen. Only one case showed a stabilized neovascular membrane in the control group of 7 patients. Although the present results seem to be worse than those in previous reports, the efficacy of this treatment still needs to be evaluated because no beneficial strategies in the treatment of subfoveal neovascularization have been established. (author)

  8. Clinical course over two to six years of age-related macular degeneration with or without radiation

    Energy Technology Data Exchange (ETDEWEB)

    Kameda, Takanori; Noami, Sachiyo; Akita, Joe [Kyoto Univ. (Japan). Graduate School of Medicine] (and others)

    2002-10-01

    We previously reported about the long-term outcome as long as three years after radiation therapy for choroidal neovascularization secondary to age-related macular degeneration (AMD). Though MPS (Macular Photocoagulation Study) Group reported the long-term natural course of AMD, such reports have not been provided concerned about Japanese AMD patients. Furthermore, there is not report that revealed the course of AMD with radiation therapy more than three years. We evaluated the long-term natural course and long-term effect of low-dose radiation on AMD. The fundus ophthalmoscopic evaluation and visual outcome were compared retrospectively among control group and two treated groups; seven eyes received 10 Gy, and eight eyes 20 Gy. The control group consisted of 10 eyes without treatment. All patients were followed at least four years, and the average follow-up duration was 6.56 years. The course of median visual acuity without treatment showed the similar result to that of MPS Group's report. In control group, visual acuity (VA) after four years was better in no eyes, unchanged in two eyes, and worse in eight eyes; in treated group, better in four eyes, unchanged in one eye, and worse in ten eyes. After four years VA was kept 20/200 or higher in 2 eyes without treatment, 4 eyes with 10 Gy, and 4 eyes with 20 Gy of radiation. Then maximum VA was 20/125 with no treatment, and 20/50 with radiation therapy. The natural course of the AMD of Japanese patients showed similar results to US patients. All eyes of AMD withort treatment got worse in VA, and some showed better outcome with radiation therapy; but it was not statistically significant. (author)

  9. Optical Coherence Tomography in Optic Nerve Hypoplasia: Correlation With Optic Disc Diameter, Nerve Fiber Layer Thickness, and Visual Function.

    Science.gov (United States)

    Kelly, John P; Baran, Francine; Phillips, James O; Weiss, Avery H

    2017-12-15

    The correlation between optic disc diameters (DDs) with average retinal nerve fiber layer thickness (RNFLT) and visual function in children with optic nerve hypoplasia (ONH) having nystagmus is unknown. Data were obtained from a retrospective review of 28 children (mean age: 9.4 years; ±5.1). Optic DD was defined as the maximal horizontal opening of Bruch membrane with spectral optical coherence tomography combined with a confocal laser ophthalmoscope. Average RNFLT was obtained from circumpapillary b-scans. RNFLT was also remeasured at eccentricities that were proportionate with DD to rule out potential sampling artifacts. Visual function was assessed by visual acuity at last follow-up and by visual evoked potentials (VEP) in 11 patients. The eye with the larger DD, which had better visual acuity, was analyzed to exclude potential effects of amblyopia. DD was correlated with average RNFLT (r = 0.61), visual acuity (r = 0.32), and VEPs (r = 0.66). The relationship between RNFLT and DD was as follows: average RNFLT (μm) = 0.074 * DD (μm) - 18.8. RNFLT also correlated with the ratio of horizontal optic DD to macula-disc-margin distance (DD:DM; r = 0.59). RNFLT measured at eccentricities proportionate with DD showed progressive decrease in thickness only for DDs <1,100 μm. All patients with DD <1,000 μm had subnormal visual acuity, whereas those with DD <1,200 μm had subnormal VEPs. DD correlates with average RNFLT and with visual function in children with ONH. Using OCT imaging, DD can be obtained in children with nystagmus and provides objective information.

  10. GMP-grade α-TEA lysine salt: a 28-Day oral toxicity and toxicokinetic study with a 28-Day recovery period in Beagle dogs

    International Nuclear Information System (INIS)

    Guerrouahen, Bella S.; Hahn, Tobias; Alderman, Zefora; Curti, Brendan; Urba, Walter; Akporiaye, Emmanuel T.

    2016-01-01

    Alpha-tocopheryloxyacetic acid (α-TEA) is a semi-synthetic derivative of naturally occurring vitamin E (alpha-tocopherol) that can be delivered via an oral route. Preclinical in vitro and in vivo data demonstrated that α-TEA is a potent anti-tumor agent with a safe toxicity profile in mice. We report a comprehensive study to evaluate the toxokinetics of good manufacturing practice (GMP)-grade α-TEA in dogs after daily oral administration for 28 days, followed by a 28-day recovery period. Male and female beagle dogs received capsules of α-TEA Lysine Salt at doses of 100, 300, 1500 mg/kg/day. α-TEA plasma levels were determined by high-performance liquid chromatography (HPLC) with mass spectrometric detection. During the treatment, animals were observe for clinical signs, food consumption, body weight, and subjected to ophthalmoscopic, and electrocardiographic assessments. At the end of the dosing period, blood was taken and toxicokinetic analyses and histopathology assessments were performed when animals were necropsied. Our findings showed that there was no α-TEA-related mortality or moribundity. At the highest dose, increases in white blood cells and fibrinogen levels were observed. These levels returned to normal at the end of the recovery period. Histopathological evaluation of major organs revealed no significant lesions related to α-TEA-treatment. We demonstrate that for designing clinical trials in patients, the highest non-severely toxic dose (HNSTD) of α-TEA is 1500 mg/kg/day in Beagle dogs and this data informed the design of dose-escalation studies of α-TEA in patients with advanced cancer

  11. [The efficacy of large spot indirect ophthalmoscopy laser alone or combined with systemic chemotherapy in retinoblastoma therapy].

    Science.gov (United States)

    Liang, J H; Cheng, Y; Deng, X; Yu, Y Y; Li, X X

    2016-10-11

    implant caused by laser blasting effect. Conclusions: Indirect ophthalmoscope laser in 810-nm diode laser with large-spot alone or combined with systemic chemotherapy may be effective treatment for retinoblastoma in earlier than stage C of international classification. It is suitable for large and multiple retinoblastoma. (Chin J Ophthalmol, 2016, 52: 745-748) .

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

    Directory of Open Access Journals (Sweden)

    Belete GT

    2016-12-01

    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

  13. The Role of the Trigemino Cervical Complex in Chronic Whiplash Associated Headache: A Cross Sectional Study.

    Science.gov (United States)

    Watson, Dean H; Drummond, Peter D

    2016-06-01

    To investigate signs of central sensitization in a cohort of patients with chronic whiplash associated headache (CWAH). Central sensitization is one of the mechanisms leading to chronicity of primary headache, and thus might contribute to CWAH. However, the pathophysiological mechanism of CWAH is poorly understood and whether it is simply an expression of the primary headache or has a distinct pathogenesis remains unclear. Thus, the factors involved in the genesis of CWAH require further investigation. Twenty-two patients with CWAH (20 females, 2 males; age 25-50 years, mean age 36.3 years) and 25 asymptomatic participants (13 females, 12 males; age 18-50 years, mean age 35.6 years) rated glare and light-induced discomfort in response to light from an ophthalmoscope. Hyperalgesia evoked by a pressure algometer was assessed bilaterally on the forehead, temples, occipital base, and the middle phalanx of the third finger. The number, latency, area under the curve, and recovery cycle of nociceptive blink reflexes elicited by a supraorbital electrical stimulus were also recorded. Eight and 6 CWAH patients had migrainous and tension-type headache (TTH) profiles, respectively; the remainder had features attributable to both migraine and TTH. Patients in the whiplash group reported significantly greater light-induced pain than controls (8.48 ± .35 vs 6.66 ± .43 on a 0-10 scale; P = .001). The CWAH patients reported significantly lower pressure pain thresholds at all sites. For stimuli delivered at 20 second intervals, whiplash patients were more responsive than controls (4.8 ± .6 blinks vs 3.0 ± .6 blinks in a block of 10 stimuli; P = .036). While R2 latencies and the area under the curve for the 20 second interval trials were comparable in both groups, there was a significant reduction of the area under the curve from the first to the second of the 2-second interval trials only in controls (99 ± 8% of baseline in whiplash patients vs 68

  14. Assessment of a Tele-education System to Enhance Retinopathy of Prematurity Training by International Ophthalmologists-in-Training in Mexico.

    Science.gov (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

    2017-07-01

    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 education system performed better on the posttest for accurately diagnosing plus disease (67% vs. 48%; P = 0.04) and the presence of ROP (96% vs. 91%; P education system compared with the control group. Intragrader agreement improved for identification of plus disease, zone, stage, and category of ROP after completion of the educational intervention. A tele-education system for ROP education was effective in improving the diagnostic

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

    Directory of Open Access Journals (Sweden)

    V. N. Trubilin

    2014-07-01

    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

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

    Directory of Open Access Journals (Sweden)

    V. N. Trubilin

    2012-01-01

    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

  17. The Hierarchy of Proinflammatory Cytokines in Ocular Inflammation.

    Science.gov (United States)

    Da Cunha, A P; Zhang, Q; Prentiss, M; Wu, X Q; Kainz, V; Xu, Y Y; Vrouvlianis, J; Li, H; Rangaswamy, N; Leehy, B; McGee, T L; Bell, C L; Bigelow, C E; Kansara, V; Medley, Q; Huang, Q; Wu, H Y

    2018-04-01

    The concept of tissue-dependent cytokine hierarchy has been demonstrated in a number of diseases, but it has not been investigated in ophthalmic diseases. Here, we evaluated the functional hierarchy of interleukin-1β (IL-1β), IL-6, IL-17A, and tumor necrosis factor (TNF) in the induction of ocular inflammation. We delivered adeno-associated virus (AAV) vectors expressing IL-1β, IL-6, IL-17A, or TNF intravitreally in naïve C57/BL6 mice and compared and contrasted the inflammatory effects in the eye 5 weeks after AAV-mediated gene transfer. We also used an in vitro human system to test the effect of cytokines on barrier function. We found that IL-1β had the highest ability to initiate ocular inflammation. The continuous overexpression of IL-1β resulted in a significant upregulation of additional proinflammatory mediators in the eye. Using scanning laser ophthalmoscope and optical coherence tomography imaging techniques, we showed that a low dose of AAVIL-1β was sufficient and was as pathogenic as a high dose of TNF in inducing vascular leakage, retinal degeneration, and cellular infiltration. Furthermore, only a marginal increase in IL-1β was enough to cause cellular infiltration, thus confirming the highly pathogenic nature of IL-1β in the eye. Contrary to our expectation, IL-6 or IL-17A had minimal or no effect in the eye. To examine the clinical relevance of our findings, we used an impedance assay to show that IL-1β alone or TNF alone was able to cause primary human retinal endothelial cell barrier dysfunction in vitro. Again, IL-6 alone or IL-17A alone had no effect on barrier function; however, in the presence of IL-1β or TNF, IL-17A but not IL-6 may provide additive proinflammatory effects. Our studies demonstrate the existence of a functional hierarchy of proinflammatory cytokines in the eye, and we show that IL-1β is the most pathogenic when it is continuously expressed in the eye.

  18. Macular function and morphologic features in juvenile stargardt disease: longitudinal study.

    Science.gov (United States)

    Testa, Francesco; Melillo, Paolo; Di Iorio, Valentina; Orrico, Ada; Attanasio, Marcella; Rossi, Settimio; Simonelli, Francesca

    2014-12-01

    To evaluate disease progression in a cohort of patients with a clinical and genetic diagnosis of Stargardt disease. Longitudinal cohort study. A total of 56 selected patients with a clinical and molecular diagnosis of Stargardt disease, an early age of onset, and a median follow-up length of 2 years. Patients underwent routine examination, including full-field electroretinography, microperimetry, and optical coherence tomography. Best-corrected visual acuity (BCVA), mean retinal sensitivity, fixation stability, preferred retinal locus, inner segment/outer segment (IS/OS) junction loss, and atrophic lesion area. A total of 56 patients with a mean age at disease onset of 15.3 years (range, 3-28 years), a mean disease duration of 12.1 years, and a mean age at baseline of 27.4 years were analyzed. The median BCVA was 20/200 in both eyes. Optical coherence tomography parameters (IS/OS alteration and retinal pigment epithelium lesion area) were obtained in only 49 patients because the signal quality was poor in the remaining 7 patients. Optical coherence tomography revealed a mean retinal pigment epithelium lesion area of 2.6 mm(2), preserved foveal IS/OS in 4.1% of patients, loss of foveal IS/OS in 59.2% of patients, and extensive loss of macular IS/OS in 36.7% of patients. Microperimetric findings showed a reduced macular sensitivity (mean, 10 decibels [dB]) and an unstable fixation in half of the patient cohort. The longitudinal analysis showed a significant progressive reduction of BCVA and macular sensitivity (at an estimated rate of 0.04 decimals and 1.19 dB/year, respectively) associated with a significant enlargement of retinal pigment epithelium lesion area (0.282 mm(2)/year). No significant changes in ophthalmoscopic findings and electroretinographic responses were detected. This study highlights the importance of microperimetry and optical coherence tomography in monitoring patients with Stargardt disease. Quantifying the decline of visual functionality and

  19. Macular function and morphological features in juvenile Stargardt disease: Longitudinal study

    Science.gov (United States)

    Testa, Francesco; Melillo, Paolo; Iorio, Valentina Di; Orrico, Ada; Attanasio, Marcella; Rossi, Settimio; Simonelli, Francesca

    2014-01-01

    Purpose to evaluate disease progression in a cohort of patients with clinical and genetic diagnosis of Stargardt disease. Design longitudinal cohort study. Subjects 56 selected patients with a clinical and molecular diagnosis of Stargardt disease, an early age of onset and a median follow-up length of two years. Methods patients underwent routine examination including full-field electroretinography, microperimetry and optical coherence tomography. Main Outcome Measures best corrected visual acuity, mean retinal sensitivity, fixation stability, preferred retinal locus, inner-outer segment (IS/OS) junction loss, atrophic lesion area. Results 56 patients with a mean age of disease onset of 15.3 years (range: 3 - 28 years), a mean disease length of 12.1 years and a mean age at baseline of 27.4 years were analyzed. The median best corrected visual acuity was 20/200 in both eyes. Optical coherence tomography parameters (IS/OS alteration and retinal pigment epithelium lesion area) were obtained in 49 patients because signal quality was poor in the remaining 7 patients. Optical coherence tomography revealed a mean retinal pigment epithelium lesion area of 2.6 mm2, preserved foveal IS/OS in 4.1% of patients, loss of foveal IS/OS in 59.2%, and extensive loss of macular IS/OS in 36.7%. Microperimetric findings showed a reduced macular sensitivity (mean 10 dB) and an unstable fixation in half of the patient cohort. The longitudinal analysis showed a significant progressive reduction of best corrected visual acuity and macular sensitivity (at an estimated rate of 0.04 decimals and 1.19 dB per year, respectively) associated with a significant enlargement of retinal pigment epithelium lesion area (0.282 mm2 per year). No significant changes in ophthalmoscopic findings and electroretinographic responses were detected. Conclusions this study highlights the importance of microperimetry and optical coherence tomography in monitoring Stargardt patients. In fact, quantifying the

  20. [Early therapeutic trials for retinitis pigmentosa].

    Science.gov (United States)

    Dufier, Jean-Louis

    2003-01-01

    Non syndromic forms of Retinitis Pigmentosa (RP) constitute a collection of clinically and genetically heterogeneous inherited retinal degenerative diseases. They are characterized by a bilateral progressive visual loss susceptible to cause blindness. These diseases are transmitted through pedigrees according to all known modes of inheritance. They are bilateral and usually start during infancy. However, very early clinical presentations exist, such as those observed in children affected by Leber Congenital Amaurosis, as well as late onset autosomal dominant forms of retinitis pigmentosa. The characteristic clinical aspect of the rod-cone RP dystrophies is marked by alterations of the peripheral retina associated with a night blindness and a progressive narrowing of the visual field. The ophthalmoscopic examination of RP patients commonly reveals thin retinal arteries and scattered pigmentary accumulations. In contrast, there are cone rod retinal dystrophies whose onset is marked by a decreased visual acuity before the appearance of any visual field alteration. Some forms of RPs display an ocular fundus devoid of any pigmentary alteration. Syndromic forms of RPs are not uncommon. The association of deafness with RP is detected in nearly 30% of the patients. Other associations with RP can include mental deficiency, facial dysmorphy, microcephaly, obesity, kidney deficiency, immune deficiencies, metabolic disorders. The existence of such syndromic forms of RP localizes RPs at the crossroad of several medical specialties. A long lasting collaboration between our department of ophthalmology and the department of medical genetics of the Necker-Sick Children Hospital has allowed us to establish numerous genotype-phenotype correlations, especially in LCA and Stargardt's disease. ABCR gene mutations cause Stargardt disease. ABCR mutations may also cause some types of Ages Related Macular Degenerations (AMD). Nowadays, there is no known efficient therapy available for

  1. Health information technology adoption in New Zealand optometric practices.

    Science.gov (United States)

    Heidarian, Ahmadali; Mason, David

    2013-11-01

    Health information technology (HIT) has the potential to fundamentally change the practice of optometry and the relationship between optometrists and patients and to improve clinical outcomes. This paper aims to provide data on how health information technology is currently being used in New Zealand optometric practices. Also this paper aims to explore the potential benefits and barriers to the future adoption of health information technology in New Zealand. One hundred and six New Zealand optometrists were surveyed about their current use of health information technology and about potential benefits and barriers. In addition, 12 semi-structured interviews were carried out with leaders of health information technology in New Zealand optometry. The areas of interest were the current and intended use of HIT, the potential benefits of and barriers to using HIT in optometric offices and the level of investment in health information technology. Nearly all optometrists (98.7 per cent) in New Zealand use computers in their practices and 93.4 per cent of them use a computer in their consulting room. The most commonly used clinical assessment technology in optometric practices in New Zealand was automated perimeter (97.1 per cent), followed by a digital fundus/retinal camera (82.6 per cent) and automated lensometer (62.9 per cent). The pachymeter is the technology that most respondents intended to purchase in the next one to five years (42.6 per cent), followed by a scanning laser ophthalmoscope (36.8 per cent) and corneal topographer (32.9 per cent). The main benefits of using health information technology in optometric practices were improving patient perceptions of ‘state of the art’ practice and providing patients with information and digital images to explain the results of assessment. Barriers to the adoption of HIT included the need for frequent technology upgrades, cost, lack of time for implementation, and training. New Zealand optometrists are using HIT

  2. Clinicopathologic correlation of argon laser photocoagulation of retinal angiomas in a patient with von Hippel-Lindau disease followed for more than 20 years.

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    Rosa, R H; Goldberg, M F; Green, W R

    1996-01-01

    The authors review the histopathologic findings in the eyes of a patient with multiple retinal angiomas and von Hippel-Lindau disease, who underwent treatment with argon laser photocoagulation with follow-up of more than 20 years. The patient was studied ophthalmoscopically and by fluorescein angiography before and after argon laser photocoagulation of retinal angiomas. The eyes were obtained postmortem, and the central portion of the right eye, including the macula and optic nerve head, was sectioned serially for light microscopy. The pupil-optic nerve segment of the left eye was step-sectioned serially for light microscopy. Histopathologic study of the right eye disclosed mild cystoid macular edema and focal areas of exudation in the midperiphery possibly secondary to irradiation of the head. A 1.5 x 0.3-mm area of residual angioma was present in the nasal peripapillary retina. Superotemporally, four chorioretinal scars were present in one photocoagulated area. These scars were composed of dense fibrous tissue with vascularization and variable retinal pigment epithelium hyperplasia. Large, nonangiomatous vessels within each of the scars were continuous with other retinal vessels. Inferotemporally, two chorioretinal scars were present in one photocoagulated area. Histopathologically, these scars were similar to the superotemporal scars, except that no patent retinal vessels traversed the inferotemporal scars. Neovascularization of the retina was associated with one superotemporal and one inferotemporal scar. No residual angiomatous tissue was present in the supero- or inferotemporal areas. Histopathologic examination of the left eye disclosed extensive vitreous organization and periretinal fibrovascular proliferation, extensive gliosis of the retina, and a 4.5 x 2-mm schisis cavity filled with fibrinous exudate. Three angiomas with variable fibrosis were present in the left eye. Despite a poor clinical course in one eye treated with xenon arc photocoagulation

  3. Correlation of visual acuity and central macular morphology in different types of diabetic macular edema

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    Qiu-Ju Wu

    2016-02-01

    Full Text Available AIM:To observe the correlation of visual acuity and central macular morphology in patients with different types of diabetic macular edema(DME. METHODS: Presented study was single-center, uncontrolled retrospective clinical study. Sixty-two patients(103 eyeswith DME were included. Best corrected visual acuity(BCVAwas evaluated using early treatment diabetic retinopathy study(ETDRSvision test chart. All patients were examined by non-contact tonometer, slit lamp, indirect ophthalmoscope, and fundus fluorescein angiography(FFA. Central subfield mean thickness(CSMTin the macular area of diameter 1mm was measured by optical coherence tomography(OCT.And in the same time the integrity of inner segments/ outer segments(IS/OSand external limiting membrane(ELMreflecting light strip of 350μm center horizontal scanning line was investigated by OCT. BCVA and CSMT in different types of DME patients were analyzed using Kruskal- Wallis test. BCVA and CSMT between the two-two groups in different types of DME patients were analyzed using Nemenyi test, and multiple regression analysis was used to analyze the relative factors of BCVA. RESULTS: In the 103 eyes, 47 eyes(45.6%were focal DME, 35 eyes(34.0%were diffuse DME, 6 eyes(5.8%were ischemic DME and 15 eyes(14.6%were proliferative DME. The difference of mean BCVA(H=69.167, PH=57.113, Pχ2=14.982,Pχ2=14.537,Pχ2=15.596,Pχ2=15.393,Pχ2=16.567,Pχ2=15.687,Pχ2=12.974、P=0.008; CSMT:χ2=13.999,Pr=-0.064,-0.207,-0.082 and -0.160, respectively, Pr=-0.885, -2.522, -1.504, and-0.595, respectively, P>0.05. CONCLUSION: There are statistically significant differences on macular morphology and vision function among different types of DME patients.

  4. Besifloxacin ophthalmic suspension 0.6% in patients with bacterial conjunctivitis: A multicenter, prospective, randomized, double-masked, vehicle-controlled, 5-day efficacy and safety study.

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    Karpecki, Paul; Depaolis, Michael; Hunter, Judy A; White, Eric M; Rigel, Lee; Brunner, Lynne S; Usner, Dale W; Paterno, Michael R; Comstock, Timothy L

    2009-03-01

    Besifloxacin ophthalmic suspension 0.6% is a new topical fluoroquinolone for the treatment of bacterial conjunctivitis. Besifloxacin has potent in vitro activity against a broad spectrum of ocular pathogens, including drug-resistant strains. The primary objective of this study was to compare the clinical and microbiologic efficacy of besifloxacin ophthalmic suspension 0.6% with that of vehicle (the formulation without besifloxacin) in the treatment of bacterial conjunctivitis. This was a multicenter, prospective, randomized, double-masked, vehicle-controlled, parallel-group study in patients with acute bacterial conjunctivitis. Patients received either topical besifloxacin ophthalmic suspension or vehicle administered 3 times daily for 5 days. At study entry and on days 4 and 8 (visits 2 and 3), a clinical assessment of ocular signs and symptoms was performed in both eyes, as well as pinhole visual acuity testing, biomicroscopy, and culture of the infected eye(s). An ophthalmoscopic examination was performed at study entry and on day 8. The primary efficacy outcome measures were clinical resolution and eradication of the baseline bacterial infection on day 8 in culture-confirmed patients. The safety evaluation included adverse events, changes in visual acuity, and biomicroscopy and ophthalmoscopy findings in all patients who received at least 1 dose of active treatment or vehicle. The safety population consisted of 269 patients (mean [SD] age, 34.2 [22.3] years; 60.2% female; 82.5% white) with acute bacterial conjunctivitis. The culture-confirmed intent-to-treat population consisted of 118 patients (60 besifloxacin ophthalmic suspension, 58 vehicle). Significantly more patients receiving besifloxacin ophthalmic suspension than vehicle had clinical resolution of the baseline infection at visit 3 (44/60 [73.3%] vs 25/58 [43.1%], respectively; P suspension compared with vehicle at visit 3 (53/60 [88.3%] vs35/58 [60.3%]; P suspension 0.6% given 3 times daily for 5 days

  5. Influence of Fluorescein Angiography on the Diagnosis and Management of Retinopathy of Prematurity

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    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

    2016-01-01

    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

  6. In vivo imaging of the retinal pigment epithelial cells

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    Morgan, Jessica Ijams Wolfing

    The retinal pigment epithelial (RPE) cells form an important layer of the retina because they are responsible for providing metabolic support to the photoreceptors. Techniques to image the RPE layer include autofluorescence imaging with a scanning laser ophthalmoscope (SLO). However, previous studies were unable to resolve single RPE cells in vivo. This thesis describes the technique of combining autofluorescence, SLO, adaptive optics (AO), and dual-wavelength simultaneous imaging and registration to visualize the individual cells in the RPE mosaic in human and primate retina for the first time in vivo. After imaging the RPE mosaic non-invasively, the cell layer's structure and regularity were characterized using quantitative metrics of cell density, spacing, and nearest neighbor distances. The RPE mosaic was compared to the cone mosaic, and RPE imaging methods were confirmed using histology. The ability to image the RPE mosaic led to the discovery of a novel retinal change following light exposure; 568 nm exposures caused an immediate reduction in autofluorescence followed by either full recovery or permanent damage in the RPE layer. A safety study was conducted to determine the range of exposure irradiances that caused permanent damage or transient autofluorescence reductions. Additionally, the threshold exposure causing autofluorescence reduction was determined and reciprocity of radiant exposure was confirmed. Light exposures delivered by the AOSLO were not significantly different than those delivered by a uniform source. As all exposures tested were near or below the permissible light levels of safety standards, this thesis provides evidence that the current light safety standards need to be revised. Finally, with the retinal damage and autofluorescence reduction thresholds identified, the methods of RPE imaging were modified to allow successful imaging of the individual cells in the RPE mosaic while still ensuring retinal safety. This thesis has provided a

  7. Effect of pharmacologically induced retinal degeneration on retinal autofluorescence lifetimes in mice.

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    Dysli, Chantal; Dysli, Muriel; Zinkernagel, Martin S; Enzmann, Volker

    2016-12-01

    Fluorescence lifetime imaging ophthalmoscopy (FLIO) was used to investigate retinal autofluorescence lifetimes in mouse models of pharmacologically induced retinal degeneration over time. Sodium iodate (NaIO 3 , 35 mg/kg intravenously) was used to induce retinal pigment epithelium (RPE) degeneration with subsequent loss of photoreceptors (PR) whereas N-methyl-N-nitrosourea (MNU, 45 mg/kg intraperitoneally) was employed for degeneration of the photoreceptor cell layer alone. All mice were measured at day 3, 7, 14, and 28 after the respective injection of NaIO 3 , MNU or NaCl (control). Fluorescence lifetime imaging was performed using a fluorescence lifetime imaging ophthalmoscope (Heidelberg Engineering, Heidelberg, Germany). Fluorescence was excited at 473 nm and fluorescence lifetimes were measured in a short and a long spectral channel (498-560 nm and 560-720 nm). Corresponding optical coherence tomography (OCT) images were consecutively acquired and histology was performed at the end of the experiments. Segmentation of OCT images and histology verified the cell type-specific degeneration process over time. Retinal autofluorescence lifetimes increased from day 3 to day 28 in mice after NaIO 3 treatment. Finally, at day 28, fluorescence lifetimes were prolonged by 8% in the short and 61% in the long spectral channel compared to control animals (p = 0.21 and p = 0.004, respectively). In mice after MNU treatment, the mean retinal autofluorescence lifetimes were already decreased at day 3 and retinal lifetimes were finally shortened by 27% in the short and 51% in the long spectral channel at day 28 (p = 0.0028). In conclusion, degeneration of the RPE with subsequent photoreceptor degeneration by NaIO 3 lead to longer mean fluorescence lifetimes of the retina compared to control mice, whereas during specific degeneration of the photoreceptor layer induced by MNU shorter lifetimes were measured. Therefore, short retinal fluorescence lifetimes may originate

  8. Association of age and macular pigment optical density using dual-wavelength autofluorescence imaging

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    Lima VC

    2013-04-01

    Full Text Available Verônica Castro Lima,1,2 Richard B Rosen,1,3 Tiago Santos Prata,2 Syril Dorairaj,4 Leigh Spielberg,1 Mauricio Maia,2 Juliana M Sallum21Retina Service, Department of Ophthalmology, The New York Eye and Ear Infirmary, New York, NY, 2Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil; 3New York Medical College, New York, NY, 4Department of Ophthalmology, Mayo Clinic, Jacksonville, FL, USABackground: Several lines of evidence suggest that macular pigment may play a protective role against age-related macular degeneration, but the influence of age on macular pigment density levels remains unclear. This study was designed to investigate the relationship between age and the normal distribution of macular pigment optical density (MPOD values surrounding the fovea.Methods: Consecutive healthy subjects with no evidence of ocular disease were enrolled in this study. After inclusion, MPOD values were measured at specific eccentricities (0.5, 1, and 2 degrees from the foveal center using a dual-wavelength autofluorescence method employing a modified confocal scanning laser ophthalmoscope. Whenever both eyes were eligible, one was randomly selected for analysis. The correlation between age and MPOD values was investigated using regression analysis.Results: Thirty subjects (30 eyes were included (mean age 48.6 ± 16.4 [range 23–77] years. Significant differences were found between MPOD values measured at 0.5, 1, and 2 degrees from the center of the fovea (0.49 ± 0.12 density units, 0.37 ± 0.11 density units, and 0.13 ± 0.05 density units, respectively, P < 0.05. Significant correlations between age and MPOD values at 0.5 and 1 degree were found (P ≤ 0.02. Values measured at 2 degrees did not correlate significantly with age (P = 0.06.Conclusion: In healthy subjects, MPOD values were highest near the foveal center. These values appeared to increase during adulthood (peak at 45–50 years, followed by a gradual reduction

  9. SOME OF THE RISK FACTORS FOR RETINOPATHY OF PREMATURITY

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    Gordana Stanković – Babić

    2014-09-01

    Full Text Available Retinopathy of prematurity (ROP remains the main cause of visual impairment in preterm infants. The study was aimed to assess the impact of some of the risk factors (gestational age, body weight of children at birth, associated diseases in children, maternal age at delivery, maternal smoking during pregnancy, multiple pregnancies on the occurrence of ROP in the sample of premature infants. We statistically processed the results (Student’s t test and the χ2 test of 93 preterm infants of both sexes: 39 boys and 54 girls, examined by indirect ophthalmoscope (Haine 500, Germany in mydriasis. The examination included all premature neonates with birth weight ≤ 2000g and/or gestational age ≤37 weeks, as well as neonates >37 weeks which have associated risk factors (oxygen, ventilation, sepsis, etc. Among 93 premature infants, with normal findings on the retina there were 72 children (77.42%, while in 21 (22.58% children we found ROP. Ophthalmological findings: the first stage of ROP was found in 15.05%, the second stage of ROP in 2.15% and third stage of ROP in 5.38% of the examined children. There were no patients with an aggressive form of ROP. Children with ROP were statistically of lower gestational age - 32.10 ± 2.70 compared to children without ROP - 35.37 ± 1.72 (p<0.001. Children with ROP had at birth significant lower body weight of 1741g ± 579.19 than children without ROP - 2168.75 ± 528.58 (p<0.01. Mothers of the children with ROP were, at the time of giving birth, over 29 ± 6.09 years old compared to mothers of children without ROP who were 26.42 ± 5.75 years old (p=0.0773. The presence of other diseases was significantly more prevalent in children with ROP 52.38% vs. 2.78% (p<0.001. The number of mothers of children with ROP who smoked during their pregnacy was considerable - 57.14 % vs. 37.50% (percent of non-smoking mothers, though the difference was not statistically significant. Knowing the risk factors and their

  10. FFA STUDY OF MACULAR LESIONS

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    K. Vinayagamurthy

    2017-08-01

    Full Text Available BACKGROUND Macula is an important portion of retina that occupies the posterior pole of retina. Any disease that affects macula results in significant loss of central vision, form vision and colour vision to an extent. Macular lesions can be hereditary as well as acquired. Macular lesions occur in both younger and older individuals. Anatomically, a macular lesions can vary from a simple lesion like an RPF defect to a vision-threatening lesions like choroidal neovascular membrane. Many screening tests that are sensitive and specific are available to assess the functioning of macula called as ‘macular function test’. But, the greater understanding of the retinal vascular led to the usage of fluorescein angiogram in the detection and screening of macular, retinovascular and optic disc lesions. Through fundus fluorescein angiogram is a thirty-year-old procedure; it is still in vogue in almost all parts of the world. It has its own merits. The aim of the study is to study the role of fluorescein angiography in the evaluation of macular lesions. MATERIALS AND METHODS A hospital-based prospective randomised study was done, which included 50 patients. Detailed patient history was taken and thorough ocular and systemic examination was done. All patients were examined by ophthalmoscopy (direct and indirect and slit-lamp examination with 90D followed by fluorescein angiography. Ophthalmoscopic and fluorescein angiography findings were analysed and categorised. Patients were advised proper ocular and systemic treatment and follow up. RESULTS 50 cases with macular lesions were analysed and categorised into conditions like ARMD, CSR, macular oedema, CME, degenerations and dystrophies and miscellaneous conditions. FFA altered the diagnosis in 8% cases and categorised the cases in all cases. 16% patients developed adverse reactions like allergy, vomiting and nausea. On statistical analysis, FFA proved to be cheap and superior diagnostic tool in confirming

  11. Blantyre Malaria Project Epilepsy Study (BMPES) of neurological outcomes in retinopathy-positive paediatric cerebral malaria survivors: a prospective cohort study.

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    Birbeck, Gretchen L; Molyneux, Malcolm E; Kaplan, Peter W; Seydel, Karl B; Chimalizeni, Yamikani F; Kawaza, Kondwani; Taylor, Terrie E

    2010-12-01

    Cerebral malaria, a disorder characterised by coma, parasitaemia, and no other evident cause of coma, is challenging to diagnose definitively in endemic regions that have high rates of asymptomatic parasitaemia and limited neurodiagnostic facilities. A recently described malaria retinopathy improves diagnostic specificity. We aimed to establish whether retinopathy-positive cerebral malaria is a risk factor for epilepsy or other neurodisabilities. Between 2005 and 2007, we did a prospective cohort study of survivors of cerebral malaria with malaria retinopathy in Blantyre, Malawi. Children with cerebral malaria were identified at the time of their index admission and age-matched to concurrently admitted children without coma or nervous system infection. Initially matching of cases to controls was 1:1 but, in 2006, enrolment criteria for cerebral malaria survivors were revised to limit inclusion to children with cerebral malaria and retinopathy on the basis of indirect ophthalmoscopic examination; matching was then changed to 1:2 and the revised inclusion criteria were applied retrospectively for children enrolled previously. Clinical assessments at discharge and standardised nurse-led follow-up every 3 months thereafter were done to identify children with new seizure disorders or other neurodisabilities. A Kaplan-Meier survival analysis was done for incident epilepsy. 132 children with retinopathy-positive cerebral malaria and 264 age-matched, non-comatose controls were followed up for a median of 495 days (IQR 195-819). 12 of 132 cerebral malaria survivors developed epilepsy versus none of 264 controls (odds ratio [OR] undefined; pepilepsy in children with cerebral malaria were a higher maximum temperature (39·4°C [SD 1·2] vs 38·5°C [1·1]; p=0·01) and acute seizures (11/12 vs 76/120; OR 6·37, 95% CI 1·02-141·2), and male sex was a risk factor for new neurodisabilities (20/28 vs 38/93; OR 3·62, 1·44-9·06). Almost a third of retinopathy-positive cerebral

  12. Ultrasound monitoring of vitreous in pre and postLasik patients

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    Amanda Alvarado, MD

    2003-12-01

    Full Text Available Title: Echografic Vitreoretinal Findings afterLaser In Situ Keratomileusis.Objective: To report the echographic changesobserved in the vitreous of patients followingLasik. Design: Prospective, observational,descriptive study. Method: We performed anultrasound of the vitreous of patients elegiblefor refractive surgery. Vitreous Changes weremeasured by video B scan ultrasonographybefore and at the first and third month after Lasikat Fundación Oftalmológica Nacional betweenJune 2002 and March 2003. Results: A total of16 patients, 67% women, 33% men, mean ageof 31.6 years (range between 22 and 40 years.A total of 29 eyes were studied, 16 right and 13left for a total of 87 echographies. The refractiveerrors in a range of -10.50 and +3.50 of sphericalequivalent. There were 24 myopic and 5hypermetropic eyes. The vitreous changes correspondedto a posterior vitreous detachment(PVD and the presence of opacities in thevitreous. At the beginning of the study 18 eyes(62% had evidenced PVD and all of the 29 eyes(100% had opacities; At the end of the controls changes were evidenced in 22 eyes (81%, thevitreous opacities increased in 14 eyes (48.27%,while they remained without changes in 15 eyes(51.7%. The presence of newly developed PVDwas documented in 10 eyes (30 %, there was anincrease of PVD in 8 eyes (27.5%, and in onecase we observed the presence of a traction areaat the vitreoretinal interfase that correspondedto 3.4% of the eyes studied; it was an hypermetropicpatient in whom ophthalmoscopically,after the echographic findings, we evidenced twooperculated like retinal holes that requiredtreatment with laser. Conclusions: We demostratedthat true changes are evidenced at thevitreous post Lasik. Posterior vitreous detachmentis the most significant discovery and itcould be implied in the genesis of tears anddetachment of the retina, but its incidence is evensmaller than in the general population and thisallows refractive surgery to remain as a

  13. 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

    2008-02-01

    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

  14. Impairments in Dark Adaptation Are Associated with Age-Related Macular Degeneration Severity and Reticular Pseudodrusen.

    Science.gov (United States)

    Flamendorf, Jason; Agrón, Elvira; Wong, Wai T; Thompson, Darby; Wiley, Henry E; Doss, E Lauren; Al-Holou, Shaza; Ferris, Frederick L; Chew, Emily Y; Cukras, Catherine

    2015-10-01

    We investigate whether ocular and person-based characteristics were associated with dark adaptation (DA). Cross-sectional, single-center, observational study. One hundred sixteen participants older than 50 years of age with a range of age-related macular degeneration (AMD) severity. Participants underwent best-corrected visual acuity (BCVA) testing, ophthalmoscopic examination, and multimodal imaging. Presence of reticular pseudodrusen (RPD) was assessed by masked grading of fundus images and was confirmed with optical coherence tomography. Eyes also were graded for AMD features (drusen, pigmentary changes, late AMD) to generate person-based AMD severity groups. One eye was designated the study eye for DA testing. Nonparametric statistical testing was performed on all comparisons. The primary outcome of this study was the rod intercept time (RIT), which is defined as the time for a participant's visual sensitivity to recover to a stimulus intensity of 5×10(-3) cd/m(2) (a decrease of 3 log units), or until a maximum test duration of 40 minutes was reached. A total of 116 study eyes from 116 participants (mean age, 75.4±9.4 years; 58% female) were analyzed. Increased RIT was associated significantly with increasing AMD severity, increasing age (r = 0.34; P = 0.0002), decreasing BCVA (r = -0.54; P < 0.0001), pseudophakia (P = 0.03), and decreasing subfoveal choroidal thickness (r = -0.27; P = 0.003). Study eyes with RPD (15/116 [13%]) had a significantly greater mean RIT compared with eyes without RPD in any AMD severity group (P < 0.02 for all comparisons), with 80% reaching the DA test ceiling. Impairments in DA increased with age, worse visual acuity, presence of RPD, AMD severity, and decreased subfoveal choroidal thickness. Analysis of covariance found the multivariate model that best fit the data included age, AMD group, and presence of RPD (R(2) = 0.56), with the presence of RPD conferring the largest parameter estimate. Copyright © 2015 American Academy of

  15. POSTERIOR SEGMENT CAUSES OF BLINDNESS AMONG CHILDREN IN BLIND SCHOOLS

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    Sandhya

    2015-09-01

    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

  16. 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.

  17. Retinocoroidite toxoplásmica em pacientes com AIDS e neurotoxoplasmose Toxoplasmic retinochoroiditis in patients with AIDS and neurotoxoplasmosis

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    Jane Mary Alves

    2010-04-01

    this study was to investigate the occurrence of typical or probable toxoplasmic retinochoroiditis in patients with AIDS and neurotoxoplasmosis. METHODS: A prospective case series was performed, including 70 patients of both genders, aged from 20 to 63 years, hospitalized in three public hospitals in Recife, Pernambuco, with such diagnosis according to the CDC criteria (1992, from January to October, 2008. RESULTS: Patients were characterized by first neurotoxoplasmosis episode (65, 92.9% or relapse (5, 7.1%, ignorance of AIDS diagnosis (23, 32.9%, mean CD4 T lymphocytes count of 139.8 ± 3.04 cells/mm³ and mean viral load of 137,080 ± 39,380 copies/mL. All patients underwent ophthalmologic examination, consisting of ocular inspection, visual acuity measurement, investigation of ocular extrinsic muscle function and fundoscopy, using binocular indirect ophthalmoscope (model OHN 3.5 (Eyetec® and 20 diopters external lens (Volk®. Four (5.7% patients presented retinochoroiditis scar lesions, characteristic of ocular toxoplasmosis, typical in 3 (75% of them and bilateral in one. There was no case of typical or probable active retinochoroiditis. Active ocular lesions were rare compared to scarring, which are associated with the presence of retinal cysts. CONCLUSION: Scarring lesions should be valued in patients with AIDS.

  18. [The evaluation of color vision and its diagnostic value in predicting the risk of diabetic retinopathy in patients with glucose metabolism disorders].

    Science.gov (United States)

    Jończyk-Skórka, Katarzyna; Kowalski, Jan

    2017-07-21

    TES was an independent risk factor that increased the risk of prediabetes almost six times (OR 5,924, 95% CI [1,169- 30,036], p = 0,032). In DM group sTES was an independent risk factor, which increased the risk of diabetes more than thirteen times (OR 13,408, 95% CI [2,324-77,345], p = 0,004). Higher values of sTES occurred in patients with retinopathy (NPDR) (p retinopathy over twenty times (OR 21,380, 95% CI [1,101 -89,241], p diabetes more than thirteen times. sTES ≥1,04 is an independent risk factor for diabetic retinopathy. sTES ≥1,04 increases the risk of diabetic retinopathy over twenty times. The color vision 100 Hue test can be useful in detecting glucose metabolism disorders even before the ophthalmoscopic manifestation of retinopathy. Early detection rises the possibility to prevent or delay the development of diabetes through lifestyle changes and implementation of healthy behaviors.

  19. Adaptive optics scanning laser ophthalmoscopy in combination with en-face optical coherence tomography

    International Nuclear Information System (INIS)

    Felberer, F.

    2014-01-01

    The human retina is a most important tissue and plays a fundamental role for the vision. Diseases of the eye affect the normal retinal function which, if untreated, may lead to vision loss or ultimately to blindness. Thus, in vivo diagnostic tools that provide detailed information on the retinal status are required in order to improve diagnosis and treatment. In recent years, several new optical imaging methods of the human retina have been developed and now represent the key part in a standard ophthalmic examination process. One of these technologies is optical coherence tomography (OCT), which provides images of the retina noninvasively and with a high axial resolution. However, imperfections of the eye's optics cause aberrations of the wavefront of the imaging light, thus limiting the transverse resolution of such systems. Improvements in the resolution of retinal images are necessary to resolve individual cells (e.g. photoreceptors) which may provide new opportunities in retinal diagnostics and therapy control. Adaptive optics (AO), a technology known from astronomy, may be used to increase image resolution. Aberrations of the imaging light are measured and corrected, resulting in an increase of lateral resolution up to the diffraction limit. Within this thesis, AO was combined with a scanning laser ophthalmoscope (SLO) that enables high resolution imaging of the retina. Measurements on healthy subjects demonstrated the ability of the system to resolve foveal cones (the smallest cone photoreceptors within the retina) and even rod photoreceptors. However, the depth resolution of the system remained limited compared to OCT instruments. Thus, in a second step, the instrument was extended to a combined AO-SLO/OCT system. The OCT system is based on transversal scanning (TS)-OCT which records en-face images of the retina and incorporates a high-speed axial eye tracking device. Together with transverse motion correction based on the AO-SLO images, the system

  20. 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

    Directory of Open Access Journals (Sweden)

    Jayson Nagaoka

    2010-06-01

    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.

  1. 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

    2008-12-01

    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.

  2. Radiation therapy for ocular choroidal neovascularization (phase I/II study)

    International Nuclear Information System (INIS)

    Sasai, Keisuke; Murata, Rumi; Mandai, Michiko; Takahashi, Masayo; Hiraoka, Masahiro

    1996-01-01

    Purpose/Objective: Choroidal neovascularization (CNV) is a major cause of severe loss of visual acuity in some ocular diseases such as age-related macular degeneration (ARMD) and angio-streaks. Laser photocoagulation has been used to treat patients with subfoveal neovascular lesions with well demarcated boundaries. However, the treatment method is usually associated with a large decrease in visual acuity. Therefore, indications for this treatment are very limited. Recently, some investigators reported the effect of low dose irradiation on the subretinal neovascular membranes in CNV. We conducted a phase I/II study to determine the toxicity and efficacy of external photon beam radiotherapy in patients with CNV. Materials and Methods: Between April 1994 and July 1995, 36 patients with choroidal neovascularization (34 with ARMD; 2 with angiostreaks) were treated with radiation therapy. Eligibility criteria for this study were as follows: the eyes had subretinal neovascular membranes in the avascular area of the fovea; the neovascular membranes had grown in size in the last 6 months; the best pretreatment corrected visual acuity was worse than (20(25)); there were no large subretinal hemorrhages causing decrease in visual acuity; patients were 50 years or older and had not received laser photocoagulation nor other treatment for this condition. Written informed consent was obtained from all patients. The patients underwent fluorescein angiographic evaluation and documentation of their neovascular disease prior to irradiation. Fluorescein angiography, measurement of the best corrected visual acuity, ophthalmoscopic and biomicroscopic examinations were performed at 1, 3, 6, and 12 months after treatment. Treatment planning was performed using a CT simulator which enables real-time treatment planning from multiple CT slices. The clinical target volume included the macula and optic disc, which received a dose of 10 Gy/5 fractions/1 week (first 18 eyes) or 20 Gy/10 fractions

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

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    Nonso Ejikeme Okpala

    2015-01-01

    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

  4. Investigating Functional Extension of Optical Coherence Tomography for Spectroscopic Analysis of Blood Oxygen Saturation

    Science.gov (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

  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

    2010-02-01

    -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. Establishing an experimental model of photodynamic induced anterior ischemic optic neuropathy

    Institute of Scientific and Technical Information of China (English)

    Runsheng Wang; Xiaodi Wang; Peilin Lü; Jianwei Bai; Jianzhou Wang; Xiaoqin Lei; Xiaoliang Zhou; Hongfen Sun; Aizhu Pan

    2006-01-01

    BACKGROUND: Scholars have supposed to establish animal models of optic neuropathy by pressing and partially amputating optic nerve, increasing intraocular pressure and injecting vasoconstrictor, etc., but the models are greatly different from anterior ischemia optic neuropathy. Therefore, a more ideal method is needed to establish animal model of anterior ischemic optic neuropathy (AION).OBJECTIVE: To establish AION models in rats, observe the functional changes of fundus, fundus fluorescein angiography (FFA), optical coherence tomography (OCT), flash visual evoked potential (F-VEP), and histopathologically confirm its reliability.DESIGN: A randomized control trial.SETTINGS: Department of Ophthalmology, Xi'an Fourth Hospital; Xi'an Institute of Ocular Fundus Diseases.MATERIALS: The experiments were carried out in the research room of Xi'an Institute of Ocular Fundus Diseases from February 2005 to May 2006. Thirty healthy male SD rats of 4-5 weeks old, weighing 140-160 g,were provided by the animal experimental center of the Fourth Military Medical University of Chinese PLA [SCXK (Military)2002-005], and those without eye disease examined by slit lamp and direct ophthalmoscope after mydriasis were enrolled. The conditions for feeding mice without special pathogen were strictly followed.The rats were randomly divided into blank control group (n =5), laser group (n =5), hematoporphyrin derivative (HPD) group and AION group (n =15), each group was numbered randomly. For each rat, the right eye was taken as the experimental eye, and the left one as the control one.METHODS: In the AION group, the rats were injected with HPD (10 mg/kg) via caudal vein, and then the optic discs were exposed to krypton red (647 nm, 80 mV) for 120 s, and the rats were in avoidance of light for 2 weeks postoperatively. Rats in the laser group were only exposed to krypton red (647 nm, 80 mV) for 120 s, and in avoidance of light for 2 weeks postoperatively; Those in the HPD group were only

  7. 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

    2010-02-01

    , 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

  8. EYE CLINICAL STUDY IN SWINE CORNEA IMPLANT DOGS TREATED WITH 2-1 BETAMETHASONE DISSODIC FOSPHATE AND DISSODIC FOSPHATED/ACETATE DEXAMETHASONE ESTUDO CLÍNICO NOS OLHOS DOS CÃES, TRATADOS COM 2-1 FOSFATO DISSÓDICO DE BETAMETASONA E FOSFATO DISSÓDICO/ACETATO DE DEXAMETASONA, QUE RECEBERAM IMPLANTES COM CÓRNEAS DE SUÍNOS

    Directory of Open Access Journals (Sweden)

    Nilo Sérgio Troncoso Chaves

    2007-09-01

    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.

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