WorldWideScience

Sample records for ophthalmoscopy

  1. Direct ophthalmoscopy on YouTube

    DEFF Research Database (Denmark)

    Borgersen, Nanna Jo; Henriksen, Mikael Johannes Vuokko; Konge, Lars

    2016-01-01

    BACKGROUND: Direct ophthalmoscopy is well-suited for video-based instruction, particularly if the videos enable the student to see what the examiner sees when performing direct ophthalmoscopy. We evaluated the pedagogical effectiveness of instructional YouTube videos on direct ophthalmoscopy...... in general. We then systematically searched YouTube. Two authors reviewed eligible videos to assess eligibility and extract data on video statistics, content, and approach to visualization. Correlations between video statistics and contents were investigated using two-tailed Spearman's correlation. RESULTS...... the patient and how to examine the fundus. Time spent on fundus examination correlated with the number of views per week (Spearman's ρ=0.53; P=0.029). CONCLUSION: Videos may help overcome the pedagogical issues in teaching direct ophthalmoscopy; however, the few available videos on YouTube fail to address...

  2. In vivo integrated photoacoustic ophthalmoscopy, optical coherence tomography, and scanning laser ophthalmoscopy for retinal imaging

    Science.gov (United States)

    Song, Wei; Zhang, Rui; Zhang, Hao F.; Wei, Qing; Cao, Wenwu

    2012-12-01

    The physiological and pathological properties of retina are closely associated with various optical contrasts. Hence, integrating different ophthalmic imaging technologies is more beneficial in both fundamental investigation and clinical diagnosis of several blinding diseases. Recently, photoacoustic ophthalmoscopy (PAOM) was developed for in vivo retinal imaging in small animals, which demonstrated the capability of imaging retinal vascular networks and retinal pigment epithelium (RPE) at high sensitivity. We combined PAOM with traditional imaging modalities, such as fluorescein angiography (FA), spectral-domain optical coherence tomography (SD-OCT), and auto-fluorescence scanning laser ophthalmoscopy (AF-SLO), for imaging rats and mice. The multimodal imaging system provided more comprehensive evaluation of the retina based on the complementary imaging contrast mechanisms. The high-quality retinal images show that the integrated ophthalmic imaging system has great potential in the investigation of blinding disorders.

  3. 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.

  4. Human milk for neonatal pain relief during ophthalmoscopy

    Directory of Open Access Journals (Sweden)

    Laiane Medeiros Ribeiro

    2013-10-01

    Full Text Available Ophthalmoscopy performed for the early diagnosis of retinopathy of prematurity (ROP is painful for preterm infants, thus necessitating interventions for minimizing pain. The present study aimed to establish the effectiveness of human milk, compared with sucrose, for pain relief in premature infants subjected to ophthalmoscopy for the early diagnosis of ROP. This investigation was a pilot, quasi-experimental study conducted with 14 premature infants admitted to the neonatal intensive care unit (NICU of a university hospital. Comparison between the groups did not yield a statistically significant difference relative to the crying time, salivary cortisol, or heart rate (HR. Human milk appears to be as effective as sucrose in relieving acute pain associated with ophthalmoscopy. The study’s limitations included its small sample size and lack of randomization. Experimental investigations with greater sample power should be performed to reinforce the evidence found in the present study.

  5. Ophthalmoscopy versus non-mydriatic fundus photography in the ...

    African Journals Online (AJOL)

    The contribution of non-mydriatic fundus photography in the detection of diabetic retinopathy before and after dilatation of the pupils in black diabetics was investigated and compared with direct ophthalmoscopy. Eighty-six patients were examined and good-quality photographs were obtained for 54,7% of eyes before and ...

  6. Photography or Ophthalmoscopy for Detection of Diabetic Retinopathy?

    NARCIS (Netherlands)

    Leiden, Hendrik A. van; Moll, Annette C.; Dekker, Jacqueline M.; Abramoff, M.D.; Polak, Bettine C.P.

    2003-01-01

    The U.K. National Screening Committee recommended digital fundus photography as the screening method of choice for diabetic retinopathy (DR). However, concerns have been expressed about replacing ophthalmoscopy with slit-lamp biomicroscopy by digital photography. These concerns included the

  7. Smartphone Image Acquisition During Postmortem Monocular Indirect Ophthalmoscopy.

    Science.gov (United States)

    Lantz, Patrick E; Schoppe, Candace H; Thibault, Kirk L; Porter, William T

    2016-01-01

    The medical usefulness of smartphones continues to evolve as third-party applications exploit and expand on the smartphones' interface and capabilities. This technical report describes smartphone still-image capture techniques and video-sequence recording capabilities during postmortem monocular indirect ophthalmoscopy. Using these devices and techniques, practitioners can create photographic documentation of fundal findings, clinically and at autopsy, without the expense of a retinal camera. Smartphone image acquisition of fundal abnormalities can promote ophthalmological telemedicine--especially in regions or countries with limited resources--and facilitate prompt, accurate, and unbiased documentation of retinal hemorrhages in infants and young children. © 2015 American Academy of Forensic Sciences.

  8. Adaptive optics scanning laser ophthalmoscopy in fundus imaging, a review and update

    OpenAIRE

    Zhang, Bing; Li, Ni; Kang, Jie; He, Yi; Chen, Xiao-Ming

    2017-01-01

    Adaptive optics scanning laser ophthalmoscopy (AO-SLO) has been a promising technique in funds imaging with growing popularity. This review firstly gives a brief history of adaptive optics (AO) and AO-SLO. Then it compares AO-SLO with conventional imaging methods (fundus fluorescein angiography, fundus autofluorescence, indocyanine green angiography and optical coherence tomography) and other AO techniques (adaptive optics flood-illumination ophthalmoscopy and adaptive optics optical coherenc...

  9. 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.

  10. Ophthalmoscopy simulation: advances in training and practice for medical students and young ophthalmologists

    Directory of Open Access Journals (Sweden)

    Ricci LH

    2017-06-01

    Full Text Available Lucas Holderegger Ricci,1 Caroline Amaral Ferraz2 1Department of Ophthalmology, School of Medicine, Laureate International Universities, São Paulo (SP, Brazil; 2Department of Ophthalmology, Federal University of São Paulo (UNIFESP, São Paulo (SP, Brazil Objective: To describe and appraise the latest simulation models for direct and indirect ophthalmoscopy as a learning tool in the medical field. Methods: The present review was conducted using four national and international databases – PubMed, Scielo, Medline and Cochrane. Initial set of articles was screened based on title and abstracts, followed by full text analysis. It comprises of articles that were published in the past fifteen years (2002–2017.Results: Eighty-three articles concerning simulation models for medical education were found in national and international databases, with only a few describing important aspects of ophthalmoscopy training and current application of simulation in medical education. After secondary analysis, 38 articles were included.Conclusion: Different ophthalmoscopy simulation models have been described, but only very few studies appraise the effectiveness of each individual model. Comparison studies are still required to determine best approaches for medical education and skill enhancement through simulation models, applied to both medical students as well as young ophthalmologists in training. Keywords: direct ophthalmoscopy, indirect ophthalmoscopy, skills, simulator, simulation models

  11. Cone and Rod Loss in Stargardt Disease Revealed by Adaptive Optics Scanning Light Ophthalmoscopy

    Science.gov (United States)

    Song, Hongxin; Rossi, Ethan A.; Latchney, Lisa; Bessette, Angela; Stone, Edwin; Hunter, Jennifer J.; Williams, David R.; Chung, Mina

    2015-01-01

    Importance Stargardt disease (STGD1) is characterized by macular atrophy and flecks in the retinal pigment epithelium. The causative ABCA4 gene encodes a protein localizing to photoreceptor outer segments. The pathologic steps by which ABCA4 mutations lead to clinically detectable retinal pigment epithelium changes remain unclear. We investigated early STGD1 using adaptive optics scanning light ophthalmoscopy. Observations Adaptive optics scanning light ophthalmoscopy imaging of 2 brothers with early STGD1 and their unaffected parents was compared with conventional imaging. Cone and rod spacing were increased in both patients (P optics scanning light ophthalmoscopy reveals increased cone and rod spacing in areas that appear normal in conventional images, suggesting that photoreceptor loss precedes clinically detectable retinal pigment epithelial disease in STGD1. PMID:26247787

  12. Simulation models applied to practical learning and skill enhancement in direct and indirect ophthalmoscopy: a review

    Directory of Open Access Journals (Sweden)

    Lucas Holderegger Ricci

    2014-10-01

    Full Text Available The purpose of this review was to analyze and describe simulation methods for practical learning and training of the ophthalmoscopy exam and to organize them into specific topics relative to each principle of operation, while evaluating their preliminary results. A critical review of articles that described and evaluated simulated models for ophthalmoscopy published in the last ten years (2004-2014 was performed. One hundred articles about ophthalmology and simulation were found in national and international periodicals, but only a few discussed the examination of the posterior pole of the eye. For this study, 25 articles were considered; those articles described simulation methods, general concepts, and its actual use in ophthalmoscopy. There were many different simulation methods described, but only few articles proved their efficacy or performed a comparison between models. Review of this topic may give information for the critical analysis of the simulation devices and ideas for the development of new ones.

  13. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    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.)

  15. Imaging of the optic disk in caring for patients with glaucoma: ophthalmoscopy and photography remain the gold standard.

    Science.gov (United States)

    Spaeth, George L; Reddy, Swathi C

    2014-01-01

    Optic disk imaging is integral to the diagnosis and treatment of patients with glaucoma. We discuss the various forms of imaging the optic nerve, including ophthalmoscopy, photography, and newer imaging modalities, including optical coherence tomography (OCT), confocal scanning laser ophthalmoscopy (HRT), and scanning laser polarimetry (GDx), specifically highlighting their benefits and disadvantages. We argue that ophthalmoscopy and photography remain the gold standard of imaging due to portability, ease of interpretation, and the presence of a large database of images for comparison. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Adaptive optics scanning laser ophthalmoscopy in fundus imaging, a review and update

    Directory of Open Access Journals (Sweden)

    Bing Zhang

    2017-11-01

    Full Text Available Adaptive optics scanning laser ophthalmoscopy (AO-SLO has been a promising technique in funds imaging with growing popularity. This review firstly gives a brief history of adaptive optics (AO and AO-SLO. Then it compares AO-SLO with conventional imaging methods (fundus fluorescein angiography, fundus autofluorescence, indocyanine green angiography and optical coherence tomography and other AO techniques (adaptive optics flood-illumination ophthalmoscopy and adaptive optics optical coherence tomography. Furthermore, an update of current research situation in AO-SLO is made based on different fundus structures as photoreceptors (cones and rods, fundus vessels, retinal pigment epithelium layer, retinal nerve fiber layer, ganglion cell layer and lamina cribrosa. Finally, this review indicates possible research directions of AO-SLO in future.

  17. Diagnostic accuracy of direct ophthalmoscopy for detection of diabetic retinopathy using fundus photographs as a reference standard.

    Science.gov (United States)

    Ahsan, Shahid; Basit, Abdul; Ahmed, Kazi Rumana; Ali, Liaquat; Shaheen, Fariha; Ulhaque, Muhammad Saif; Fawwad, Asher

    2014-01-01

    To determine the diagnostic accuracy of direct ophthalmoscopy for the presence and severity of diabetic retinopathy (DR) using fundus photographs as a reference standard. Patients with type 2 diabetes attending the outpatient department (OPD) of a tertiary care diabetes center, from October 2009 to March 2010 were recruited in the study after obtaining signed informed consent. Patients with type 1 diabetes and gestational diabetes or having eye problems were excluded. After checking visual acuity, direct ophthalmoscopy of each eye was done by diabetologist, followed by photography of two fields of retina by fundus camera. DR was graded by a retinal specialist, according to International Diabetic Retinopathy Disease Severity Scale. According to severity, patients with DR were grouped into non-sight threatening diabetic retinopathy (NSTDR) and sight threatening diabetic retinopathy (STDR). Sensitivity and specificity of direct ophthalmoscopy for detection of any retinopathy, NSTDR and STDR was calculated. A total of 728 eyes were examined by direct ophthalmoscopy as well as fundus photography. Sensitivity (95% CI) of direct ophthalmoscopy for any retinopathy, NSTDR and STDR was found to be 55.67% (50.58-60.78), 37.63% (32.67-42.59) and 68.25% (63.48-73.02) respectively. Whereas, specificity of direct ophthalmoscopy was found to be 76.78% (72.45-81.11), 71.27% (CI: 66.63-75.91) and 90.0% (86.93-93.07) for any retinopathy, NSTDR and STDR respectively. The sensitivity and specificity of direct ophthalmoscopy performed by the diabetologist for the presence and severity of DR was lower compared to the recommended level of sensitivity and specificity of a screening test of DR. Copyright © 2014 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  18. 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. 

  19. Simultaneous in vivo imaging of melanin and lipofuscin in the retina with multimodal photoacoustic ophthalmoscopy

    Science.gov (United States)

    Zhang, Xiangyang; Zhang, Hao F.; Zhou, Lixiang; Jiao, Shuliang

    2012-02-01

    We combined photoacoustic ophthalmoscopy (PAOM) with autofluorescence imaging for simultaneous in vivo imaging of dual molecular contrasts in the retina using a single light source. The dual molecular contrasts come from melanin and lipofuscin in the retinal pigment epithelium (RPE). Melanin and lipofuscin are two types of pigments and are believed to play opposite roles (protective vs. exacerbate) in the RPE in the aging process. We successfully imaged the retina of pigmented and albino rats at different ages. The experimental results showed that multimodal PAOM system can be a potentially powerful tool in the study of age-related degenerative retinal diseases.

  20. ASSOCIATIONS BETWEEN MACULAR EDEMA AND CIRCULATORY STATUS IN EYES WITH RETINAL VEIN OCCLUSION: An Adaptive Optics Scanning Laser Ophthalmoscopy Study.

    Science.gov (United States)

    Iida, Yuto; Muraoka, Yuki; Uji, Akihito; Ooto, Sotaro; Murakami, Tomoaki; Suzuma, Kiyoshi; Tsujikawa, Akitaka; Arichika, Shigeta; Takahashi, Ayako; Miwa, Yuko; Yoshimura, Nagahisa

    2017-10-01

    To investigate associations between parafoveal microcirculatory status and foveal pathomorphology in eyes with macular edema (ME) secondary to retinal vein occlusion (RVO). Ten consecutive patients (10 eyes) with acute retinal vein occlusion were enrolled, 9 eyes of which received intravitreal ranibizumab (IVR) injections. Foveal morphologic changes were examined via optical coherence tomography (OCT), and parafoveal circulatory status was assessed via adaptive optics scanning laser ophthalmoscopy (AO-SLO). The mean parafoveal aggregated erythrocyte velocity (AEV) measured by adaptive optics scanning laser ophthalmoscopy in eyes with retinal vein occlusion was 0.99 ± 0.43 mm/second at baseline, which was significantly lower than that of age-matched healthy subjects (1.41 ± 0.28 mm/second, P = 0.042). The longitudinal adaptive optics scanning laser ophthalmoscopy examinations of each patient showed that parafoveal AEV was strongly inversely correlated with optical coherence tomography-measured central foveal thickness (CFT) over the entire observation period. Using parafoveal AEV and central foveal thickness measurements obtained at the first and second examinations, we investigated associations between differences in parafoveal AEV and central foveal thickness, which were significantly and highly correlated (r = -0.84, P = 0.002). Using adaptive optics scanning laser ophthalmoscopy in eyes with retinal vein occlusion macular edema, we could quantitatively evaluate the parafoveal AEV. A reduction or an increase in parafoveal AEV may be a clinical marker for the resolution or development/progression of macular edema respectively.

  1. Cone structure imaged with adaptive optics scanning laser ophthalmoscopy in eyes with nonneovascular age-related macular degeneration.

    Science.gov (United States)

    Zayit-Soudry, Shiri; Duncan, Jacque L; Syed, Reema; Menghini, Moreno; Roorda, Austin J

    2013-11-15

    To evaluate cone spacing using adaptive optics scanning laser ophthalmoscopy (AOSLO) in eyes with nonneovascular AMD, and to correlate progression of AOSLO-derived cone measures with standard measures of macular structure. Adaptive optics scanning laser ophthalmoscopy images were obtained over 12 to 21 months from seven patients with AMD including four eyes with geographic atrophy (GA) and four eyes with drusen. Adaptive optics scanning laser ophthalmoscopy images were overlaid with color, infrared, and autofluorescence fundus photographs and spectral domain optical coherence tomography (SD-OCT) images to allow direct correlation of cone parameters with macular structure. Cone spacing was measured for each visit in selected regions including areas over drusen (n = 29), at GA margins (n = 14), and regions without drusen or GA (n = 13) and compared with normal, age-similar values. Adaptive optics scanning laser ophthalmoscopy imaging revealed continuous cone mosaics up to the GA edge and overlying drusen, although reduced cone reflectivity often resulted in hyporeflective AOSLO signals at these locations. Baseline cone spacing measures were normal in 13/13 unaffected regions, 26/28 drusen regions, and 12/14 GA margin regions. Although standard clinical measures showed progression of GA in all study eyes, cone spacing remained within normal ranges in most drusen regions and all GA margin regions. Adaptive optics scanning laser ophthalmoscopy provides adequate resolution for quantitative measurement of cone spacing at the margin of GA and over drusen in eyes with AMD. Although cone spacing was often normal at baseline and remained normal over time, these regions showed focal areas of decreased cone reflectivity. These findings may provide insight into the pathophysiology of AMD progression. (ClinicalTrials.gov number, NCT00254605).

  2. Direct ophthalmoscopy on YouTube: analysis of instructional YouTube videos' content and approach to visualization.

    Science.gov (United States)

    Borgersen, Nanna Jo; Henriksen, Mikael Johannes Vuokko; Konge, Lars; Sørensen, Torben Lykke; Thomsen, Ann Sofia Skou; Subhi, Yousif

    2016-01-01

    Direct ophthalmoscopy is well-suited for video-based instruction, particularly if the videos enable the student to see what the examiner sees when performing direct ophthalmoscopy. We evaluated the pedagogical effectiveness of instructional YouTube videos on direct ophthalmoscopy by evaluating their content and approach to visualization. In order to synthesize main themes and points for direct ophthalmoscopy, we formed a broad panel consisting of a medical student, junior and senior physicians, and took into consideration book chapters targeting medical students and physicians in general. We then systematically searched YouTube. Two authors reviewed eligible videos to assess eligibility and extract data on video statistics, content, and approach to visualization. Correlations between video statistics and contents were investigated using two-tailed Spearman's correlation. We screened 7,640 videos, of which 27 were found eligible for this study. Overall, a median of 12 out of 18 points (interquartile range: 8-14 key points) were covered; no videos covered all of the 18 points assessed. We found the most difficulties in the approach to visualization of how to approach the patient and how to examine the fundus. Time spent on fundus examination correlated with the number of views per week (Spearman's ρ=0.53; P=0.029). Videos may help overcome the pedagogical issues in teaching direct ophthalmoscopy; however, the few available videos on YouTube fail to address this particular issue adequately. There is a need for high-quality videos that include relevant points, provide realistic visualization of the examiner's view, and give particular emphasis on fundus examination.

  3. Matching fundus photographs of classmates. An informal competition to promote learning and practice of direct ophthalmoscopy among medical students.

    Science.gov (United States)

    Krohn, Jørgen; Kjersem, Bård; Høvding, Gunnar

    2014-05-01

    To present a new approach for teaching direct ophthalmoscopy to medical students. At the University of Bergen, four consecutive classes of fourth-year medical students complete a required 9-week ophthalmology course every year. In the present project, one fundus photograph was taken of each student. The photographs were randomly numbered, printed on A4 glossy photo paper, and displayed on the classroom wall. Each student was given a form to fill in the fellow students' names matching the number of the fundus photographs. They were encouraged to practise direct ophthalmoscopy on their classmates outside formal teaching hours. At the end of the course, they returned the filled-in forms, and those with the highest number of correct matches between the fundus photographs and fellow students received a reward. Between 2011 and 2013, 239 students completed their ophthalmology course. Of these, 220 students (92%) voluntarily participated in the project. The mean score was 70% correct matches between fundus photographs and fellow students (range 7 - 100%). The students' course evaluations were overall positive. We recommend the use of peer fundus photographs in the context of a learning competition as a simple, inexpensive, and effective way to improve teaching of direct ophthalmoscopy.

  4. Use of focus measure operators for characterization of flood illumination adaptive optics ophthalmoscopy image quality.

    Science.gov (United States)

    Alonso-Caneiro, David; Sampson, Danuta M; Chew, Avenell L; Collins, Michael J; Chen, Fred K

    2018-02-01

    Adaptive optics flood illumination ophthalmoscopy (AO-FIO) allows imaging of the cone photoreceptor in the living human retina. However, clinical interpretation of the AO-FIO image remains challenging due to suboptimal quality arising from residual uncorrected wavefront aberrations and rapid eye motion. An objective method of assessing image quality is necessary to determine whether an AO-FIO image is suitable for grading and diagnostic purpose. In this work, we explore the use of focus measure operators as a surrogate measure of AO-FIO image quality. A set of operators are tested on data sets acquired at different focal depths and different retinal locations from healthy volunteers. Our results demonstrate differences in focus measure operator performance in quantifying AO-FIO image quality. Further, we discuss the potential application of the selected focus operators in (i) selection of the best quality AO-FIO image from a series of images collected at the same retinal location and (ii) assessment of longitudinal changes in the diseased retina. Focus function could be incorporated into real-time AO-FIO image processing and provide an initial automated quality assessment during image acquisition or reading center grading.

  5. Towards simultaneous Talbot bands based optical coherence tomography and scanning laser ophthalmoscopy imaging.

    Science.gov (United States)

    Marques, Manuel J; Bradu, Adrian; Podoleanu, Adrian Gh

    2014-05-01

    We report a Talbot bands-based optical coherence tomography (OCT) system capable of producing longitudinal B-scan OCT images and en-face scanning laser ophthalmoscopy (SLO) images of the human retina in-vivo. The OCT channel employs a broadband optical source and a spectrometer. A gap is created between the sample and reference beams while on their way towards the spectrometer's dispersive element to create Talbot bands. The spatial separation of the two beams facilitates collection by an SLO channel of optical power originating exclusively from the retina, deprived from any contribution from the reference beam. Three different modes of operation are presented, constrained by the minimum integration time of the camera used in the spectrometer and by the galvo-scanners' scanning rate: (i) a simultaneous acquisition mode over the two channels, useful for small size imaging, that conserves the pixel-to-pixel correspondence between them; (ii) a hybrid sequential mode, where the system switches itself between the two regimes and (iii) a sequential "on-demand" mode, where the system can be used in either OCT or SLO regimes for as long as required. The two sequential modes present varying degrees of trade-off between pixel-to-pixel correspondence and independent full control of parameters within each channel. Images of the optic nerve and fovea regions obtained in the simultaneous (i) and in the hybrid sequential mode (ii) are presented.

  6. 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.

  7. Comparison of digital imaging screening and indirect ophthalmoscopy for retinopathy of prematurity.

    Science.gov (United States)

    Ezz El Din, Zahraa Mohamed; El Sada, Mohamed Ahmed; Ali, Aliaa Adel; Al Husseiny, Khalid; Yousef, Aly Abdel Rahman

    2015-01-01

    The aims of this study were to determine the incidence and severity of retinopathy of prematurity (ROP) using digital imaging screening, confirm findings by indirect opthalmoscopy, and document risk factors of ROP in the neonatal intensive care unit (NICU) of a large tertiary hospital in a developing country. This prospective cohort study included infants with gestational age (GA) ≤ 32 wk, birth weight (BW) ≤ 1,500 g, or older and heavier neonates who were critically ill. Two hundred twenty two eyes (111 infants) were screened with digital imaging (Ret-Cam) and indirect ophthalmoscopy until retinal vascularization was complete or the disease regressed. Perinatal risk factors for ROP were analyzed. The overall incidence of ROP was 18.9 %. The incidence of ROP requiring treatment was 5.4 % (12/222) of the total eyes screened. Lower GA and blood transfusion were independent risk factors associated with ROP by multivariate analysis (p = 0.001, OR = 0.562, 95 % CI = 0.395-0.802, and p = 0.027, OR = 6.11, 95 % CI = 1.22-30.44, respectively). Digital imaging facilitated timely screening and detection of ROP, and enabled transfer of images, allowing early intervention for patients who required treatment.

  8. Dynamic distance direct ophthalmoscopy, a novel technique to assess accommodation in children

    Directory of Open Access Journals (Sweden)

    Mihir Kothari

    2012-01-01

    Full Text Available Aim: To describe and compare dynamic distance direct ophthalmoscopy (DDDO with dynamic retinoscopy (DR in assessment of accommodation in children. Materials and Methods: This prospective observational study had four components. Component 1: to understand the characteristic digital images of DDDO. Component 2: to compare DDDO with DR for detection of accommodative defects in children (1-16 years. Component 3: to compare DDDO with DR for the detection of completeness of pharmacologically induced cycloplegia in children (5-16 years and Component 4: to assess which one of the two techniques was more sensitive to detect onset of cycloplegia after instillation of 1% cyclopentolate eye drops. Results: Component 1: image analysis of DDDO on two subjects (7 years and 35 years demonstrated superior pupillary crescent that progressively disappeared with increasing accommodation. Concurrently an inferior crescent appeared that became bigger in size with increasing accommodation. Component 2: the prevalence of defects in accommodation was 3.3% (33/1000 children. Three had unilateral accommodation failure. Sensitivity of DDDO was 94%, specificity 100%, positive predictive value 100%, negative predictive value 99%, and clinical agreement (kappa 0.97. Component 3: in the detection of completeness of pharmacologically induced cycloplegia (n=30, the sensitivity of DDDO was 94%, specificity 96%, positive predictive value 97%, negative predictive value 93% and kappa 0.9. DR had two false positives. DDDO had one false negative. Component 4: DDDO detected onset of pharmacologically induced cycloplegia 5 min earlier than DR (n=5. Conclusion: DDDO is a novel, simple, clinical and reliable method to assess accommodation in young children. This test can assess the accommodative response of both eyes simultaneously.

  9. 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.

  10. Multimodal ophthalmic imaging using spectrally encoded scanning laser ophthalmoscopy and optical coherence tomography

    Science.gov (United States)

    El-Haddad, Mohamed T.; Malone, Joseph D.; Li, Jianwei D.; Bozic, Ivan; Arquitola, Amber M.; Joos, Karen M.; Patel, Shriji N.; Tao, Yuankai K.

    2017-08-01

    Ophthalmic surgery involves manipulation of delicate, layered tissue structures on milli- to micrometer scales. Traditional surgical microscopes provide an inherently two-dimensional view of the surgical field with limited depth perception which precludes accurate depth-resolved visualization of these tissue layers, and limits the development of novel surgical techniques. We demonstrate multimodal swept-source spectrally encoded scanning laser ophthalmoscopy and optical coherence tomography (SS-SESLO-OCT) to address current limitations of image-guided ophthalmic microsurgery. SS-SESLO-OCT provides inherently co-registered en face and cross-sectional field-of-views (FOVs) at a line rate of 400 kHz and >2 GPix/s throughput. We show in vivo imaging of the anterior segment and retinal fundus of a healthy volunteer, and preliminary results of multi-volumetric mosaicking for ultrawide-field retinal imaging with 90° FOV. Additionally, a scan-head was rapid-prototyped with a modular architecture which enabled integration of SS-SESLO-OCT with traditional surgical microscope and slit-lamp imaging optics. Ex vivo surgical maneuvers were simulated in cadaveric porcine eyes. The system throughput enabled volumetric acquisition at 10 volumes-per-second (vps) and allowed visualization of surgical dynamics in corneal sweeps, compressions, and dissections, and retinal sweeps, compressions, and elevations. SESLO en face images enabled simple real-time co-registration with the surgical microscope FOV, and OCT cross-sections provided depth-resolved visualization of instrument-tissue interactions. Finally, we demonstrate novel augmented-reality integration with the surgical view using segmentation overlays to aid surgical guidance. SS-SESLO-OCT may benefit clinical diagnostics by enabling aiming, registration, and mosaicking; and intraoperative imaging by allowing for real-time surgical feedback, instrument tracking, and overlays of computationally extracted biomarkers of disease.

  11. The fundus photo has met its match: optical coherence tomography and adaptive optics ophthalmoscopy are here to stay.

    Science.gov (United States)

    Morgan, Jessica I W

    2016-05-01

    Over the past 25 years, optical coherence tomography (OCT) and adaptive optics (AO) ophthalmoscopy have revolutionised our ability to non-invasively observe the living retina. The purpose of this review is to highlight the techniques and human clinical applications of recent advances in OCT and adaptive optics scanning laser/light ophthalmoscopy (AOSLO) ophthalmic imaging. Optical coherence tomography retinal and optic nerve head (ONH) imaging technology allows high resolution in the axial direction resulting in cross-sectional visualisation of retinal and ONH lamination. Complementary AO ophthalmoscopy gives high resolution in the transverse direction resulting in en face visualisation of retinal cell mosaics. Innovative detection schemes applied to OCT and AOSLO technologies (such as spectral domain OCT, OCT angiography, confocal and non-confocal AOSLO, fluorescence, and AO-OCT) have enabled high contrast between retinal and ONH structures in three dimensions and have allowed in vivo retinal imaging to approach that of histological quality. In addition, both OCT and AOSLO have shown the capability to detect retinal reflectance changes in response to visual stimuli, paving the way for future studies to investigate objective biomarkers of visual function at the cellular level. Increasingly, these imaging techniques are being applied to clinical studies of the normal and diseased visual system. Optical coherence tomography and AOSLO technologies are capable of elucidating the structure and function of the retina and ONH noninvasively with unprecedented resolution and contrast. The techniques have proven their worth in both basic science and clinical applications and each will continue to be utilised in future studies for many years to come. © 2016 The Authors Ophthalmic & Physiological Optics © 2016 The College of Optometrists.

  12. Simultaneous in vivo imaging of melanin and lipofuscin in the retina with photoacoustic ophthalmoscopy and autofluorescence imaging

    Science.gov (United States)

    Zhang, Xiangyang; Zhang, Hao F.; Puliafito, Carmen A.; Jiao, Shuliang

    2011-08-01

    We combined photoacoustic ophthalmoscopy (PAOM) with autofluorescence imaging for simultaneous in vivo imaging of dual molecular contrasts in the retina using a single light source. The dual molecular contrasts come from melanin and lipofuscin in the retinal pigment epithelium (RPE). Melanin and lipofuscin are two types of pigments and are believed to play opposite roles (protective versus exacerbate) in the RPE in the aging process. We have successfully imaged the retina of pigmented and albino rats at different ages. The experimental results showed that multimodal PAOM system can be a potentially powerful tool in the study of age-related degenerative retinal diseases.

  13. Optical coherence tomography, scanning laser polarimetry and confocal scanning laser ophthalmoscopy in retinal nerve fiber layer measurements of glaucoma patients.

    Science.gov (United States)

    Fanihagh, Farsad; Kremmer, Stephan; Anastassiou, Gerasimos; Schallenberg, Maurice

    2015-01-01

    To determine the correlations and strength of association between different imaging systems in analyzing the retinal nerve fiber layer (RNFL) of glaucoma patients: optical coherence tomography (OCT), scanning laser polarimetry (SLP) and confocal scanning laser ophthalmoscopy (CSLO). 114 eyes of patients with moderate open angle glaucoma underwent spectral domain OCT (Topcon SD-OCT 2000 and Zeiss Cirrus HD-OCT), SLP (GDx VCC and GDx Pro) and CSLO (Heidelberg Retina Tomograph, HRT 3). Correlation coefficients were calculated between the structural parameters yielded by these examinations. The quantitative relationship between the measured RNFL thickness globally and for the four regions (superior, inferior, nasal, temporal) were evaluated with different regression models for all used imaging systems. The strongest correlation of RNFL measurements was found between devices using the same technology like GDx VCC and GDx Pro as well as Topcon OCT and Cirrus OCT. In glaucoma patients, the strongest associations (R²) were found between RNFL measurements of the two optical coherence tomography devices Topcon OCT and Cirrus OCT (R² = 0.513) and between GDx VCC and GDx Pro (R² = 0.451). The results of the OCTs and GDX Pro also had a strong quantitative relationship (Topcon OCT R² = 0.339 and Cirrus OCT R² = 0.347). GDx VCC and the OCTs showed a mild to moderate association (Topcon OCT R² = 0.207 and Cirrus OCT R² = 0.258). The confocal scanning laser ophthalmoscopy (HRT 3) had the lowest association to all other devices (Topcon OCT R² = 0.254, Cirrus OCT R² = 0.158, GDx Pro R² = 0.086 and GDx VCC R² = 0.1). The measurements of the RNFL in glaucoma patients reveal a high correlation of OCT and GDx devices because OCTs can measure all major retinal layers and SLP can detect nerve fibers allowing a comparison between the results of this devices. However, CSLO by means of HRT topography can only measure height values of the retinal surface but it cannot distinguish

  14. [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

    Objective: To evaluate the efficacy of large spot indirect ophthalmoscopy laser alone or combined with systemic chemotherapy in the treatment of early and middle stage retinoblastoma. Methods: Retrospective series case study. Clinical data of 21 patients (22 eyes) who were diagnosed as retinoblastoma (RB) in Peking University People's Hospital from March 2009 to August 2014 were collected. Medical and family history, ocular ultrasound, orbital and cranial MRI or CT examination of RB Children were detailed recorded. Ocular examination and laser treatment were performed under general anesthesia, once every 3-4 weeks until the tumor was under control. The observation period was at least 3 months after the last treatment. The ocular examination included intraocular pressure measurement, anterior segment and fundus examination and the fundus photography with Retcam. Laser therapeutic instrument was large spot indirect ophthalmoscopy laser of 810nm wavelength. Results: Of the 21 children, 16 were male and 5 were female. The range of age was 3 to 82 months averaged 17.3 months. Among 22 eyes, four with small tumor, eight with medium tumor, and ten with large tumor. Two eyes underwent laser treatment only and 20 eyes underwent laser treatment combined with systemic chemotherapy. During the average observation period of 33.9 months, 15 tumors were treated successfully, but 7 failed. The total success rate was 68.2%. The number and success rate of small, medium and large tumor eyes were 4 (100%), 5 (62.5%) and 5 (50%), respectively. There was one case of tumor brain metastases, and the classification of contralateral eye of the child was E phase. Iris burns happened in one eye, obvious vitreous proliferation in one eye and mild vitreous hemorrhage occurred in two eyes, which did not affect the treatment of laser. However, obvious tumor hemorrhage happened in two eyes and affected laser therapy. There was no complicated cataract, iatrogenic retinal hole and tumor intravitreal

  15. Image-guided intraocular injection using multimodality optical coherence tomography and fluorescence confocal scanning laser ophthalmoscopy in rodent ophthalmological models

    Science.gov (United States)

    Terrones, Benjamin D.; Benavides, Oscar R.; Leeburg, Kelsey C.; Mehanathan, Sankarathi B.; Levine, Edward M.; Tao, Yuankai K.

    2018-02-01

    Intraocular injections are routinely performed for delivery of anti-VEGF and anti-inflammatory therapies in humans. While these injections are also performed in mice to develop novel models of ophthalmic diseases and screen novel therapeutics, the injection location and volume are not well-controlled and reproducible. We overcome limitations of conventional injections methods by developing a multimodality, long working distance, non-contact optical coherence tomography (OCT) and fluorescence confocal scanning laser ophthalmoscopy (cSLO) system for retinal imaging before and after injections. Our OCT+cSLO system combines a custom-built spectraldomain OCT engine (875+/-85 nm) with 125 kHz line-rate with a modified commercial cSLO with a maximum frame-rate of 30 fps (512 x 512 pix.). The system was designed for an overlapping OCT+cSLO field-of-view of 1.1 mm with a 7.76 mm working distance to the pupil. cSLO excitation light sources and filters were optimized for simultaneous GFP and tdTomato imaging. Lateral resolution was 3.02 µm for OCT and 2.74 μm for cSLO. Intravitreal injections of 5%, 10%, and 20% intralipid with Alex Fluor 488 were manually injected intraocularly in C57BL/6 mice. Post-injection imaging showed structural changes associated with retinal puncture, including the injection track, a retinal elevation, and detachment of the posterior hyaloid. OCT enables quantitative analysis of injection location and volumes whereas complementary cSLO improves specificity for identifying fluorescently labeled injected compounds and transgenic cells. The long working distance of our non-contact OCT+cSLO system is uniquely-suited for concurrent imaging with intraocular injections and may be applied for imaging of ophthalmic surgical dynamics and real-time image-guided injections.

  16. High-resolution imaging of the retinal nerve fiber layer in normal eyes using adaptive optics scanning laser ophthalmoscopy.

    Science.gov (United States)

    Takayama, Kohei; Ooto, Sotaro; Hangai, Masanori; Arakawa, Naoko; Oshima, Susumu; Shibata, Naohisa; Hanebuchi, Masaaki; Inoue, Takashi; Yoshimura, Nagahisa

    2012-01-01

    To conduct high-resolution imaging of the retinal nerve fiber layer (RNFL) in normal eyes using adaptive optics scanning laser ophthalmoscopy (AO-SLO). AO-SLO images were obtained in 20 normal eyes at multiple locations in the posterior polar area and a circular path with a 3-4-mm diameter around the optic disc. For each eye, images focused on the RNFL were recorded and a montage of AO-SLO images was created. AO-SLO images for all eyes showed many hyperreflective bundles in the RNFL. Hyperreflective bundles above or below the fovea were seen in an arch from the temporal periphery on either side of a horizontal dividing line to the optic disc. The dark lines among the hyperreflective bundles were narrower around the optic disc compared with those in the temporal raphe. The hyperreflective bundles corresponded with the direction of the striations on SLO red-free images. The resolution and contrast of the bundles were much higher in AO-SLO images than in red-free fundus photography or SLO red-free images. The mean hyperreflective bundle width around the optic disc had a double-humped shape; the bundles at the temporal and nasal sides of the optic disc were narrower than those above and below the optic disc (Poptical coherence tomography correlated with the hyperreflective bundle widths on AO-SLO (Pfiber bundles and Müller cell septa. The widths of the nerve fiber bundles appear to be proportional to the RNFL thickness at equivalent distances from the optic disc.

  17. High-resolution imaging of retinal nerve fiber bundles in glaucoma using adaptive optics scanning laser ophthalmoscopy.

    Science.gov (United States)

    Takayama, Kohei; Ooto, Sotaro; Hangai, Masanori; Ueda-Arakawa, Naoko; Yoshida, Sachiko; Akagi, Tadamichi; Ikeda, Hanako Ohashi; Nonaka, Atsushi; Hanebuchi, Masaaki; Inoue, Takashi; Yoshimura, Nagahisa

    2013-05-01

    To detect pathologic changes in retinal nerve fiber bundles in glaucomatous eyes seen on images obtained by adaptive optics (AO) scanning laser ophthalmoscopy (AO SLO). Prospective cross-sectional study. Twenty-eight eyes of 28 patients with open-angle glaucoma and 21 normal eyes of 21 volunteer subjects underwent a full ophthalmologic examination, visual field testing using a Humphrey Field Analyzer, fundus photography, red-free SLO imaging, spectral-domain optical coherence tomography, and imaging with an original prototype AO SLO system. The AO SLO images showed many hyperreflective bundles suggesting nerve fiber bundles. In glaucomatous eyes, the nerve fiber bundles were narrower than in normal eyes, and the nerve fiber layer thickness was correlated with the nerve fiber bundle widths on AO SLO (P fiber layer defect area on fundus photography, the nerve fiber bundles on AO SLO were narrower compared with those in normal eyes (P optic disc, the nerve fiber bundle width was significantly lower, even in areas without nerve fiber layer defect, in eyes with glaucomatous eyes compared with normal eyes (P = .026). The mean deviations of each cluster in visual field testing were correlated with the corresponding nerve fiber bundle widths (P = .017). AO SLO images showed reduced nerve fiber bundle widths both in clinically normal and abnormal areas of glaucomatous eyes, and these abnormalities were associated with visual field defects, suggesting that AO SLO may be useful for detecting early nerve fiber bundle abnormalities associated with loss of visual function. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Multimodality optical coherence tomography and fluorescence confocal scanning laser ophthalmoscopy in a zebrafish model of retinal vascular occlusion and remodeling

    Science.gov (United States)

    Li, Xiaoyue; Spitz, Kathleen; Bozic, Ivan; Tao, Yuankai K.

    2018-02-01

    Neovascularization in diabetic retinopathy (DR) and age-related macular degeneration (AMD) result in severe vision-loss and are two of the leading causes of blindness. The structural, metabolic, and vascular changes underlying retinal neovascularization are unknown and, thus, there is an unmet need to identify mechanisms of pathogenesis and novel anti-angiogenic therapies. Zebrafish is a robust ophthalmological model because its retina has comparable structure to the human retina and its fecundity and life-cycle enable development of mutant phenotypes of human pathologies. Here, we perform multimodal imaging with OCT and fluorescence confocal scanning laser ophthalmoscopy (cSLO) to identify changes in retinal structure and function in a zebrafish model of vascular leakage. Transgenic zebrafish with EGFP tagged plasma protein were imaged longitudinally at six time points over two weeks to visualize vascular perfusion changes from diethylaminobenzaldehyde (DEAB) treatment. Complementary contrast from OCT-A perfusion maps and cSLO imaging of plasma protein EGFP shows vascular occlusions posttreatment. cSLO images confirm presence of vessels despite loss of OCT-A signal. Plasma protein EGFP contrast also shows significant changes in vessel structure as compared to baseline images. OCT structural volumes show empty vessel cross-sections confirming non-perfusion. In addition, we present algorithms for automated biometric identification of OCT datasets using OCT-A vascular patterns in the presence of significant vascular perfusion changes. These results establish a framework for large-scale in vivo assays to identify novel anti-angiogenic compounds and understand the mechanisms ofneovascularization associated with retinal ocular pathologies.

  19. Assessment of β-zone peripapillary atrophy by optical coherence tomography and scanning laser ophthalmoscopy imaging in glaucoma patients

    Directory of Open Access Journals (Sweden)

    Seidensticker F

    2014-06-01

    Full Text Available Florian Seidensticker,1,* Lukas Reznicek,2,* Thomas Mann,2 Irene Hübert,2 Anselm Kampik,2 Michael Ulbig,2 Christoph Hirneiss,2 Aljoscha S Neubauer,2 Marcus Kernt2 1Department of Ophthalmology, Hannover Medical School, Hannover, Germany; 2Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany  *These authors have contributed equally to this work Purpose: To assess β-zone peripapillary atrophy (β-PPA using spectral domain optical coherence tomography (SD-OCT, scanning laser ophthalmoscopy (SLO, and fundus autofluorescence (FAF imaging in patients with primary open-angle glaucoma with advanced glaucomatous visual field defects. Methods: A consecutive, prospective series of 82 study eyes with primary open-angle glaucoma were included in this study. All study participants underwent a full ophthalmic examination followed by SD-OCT, wide-field SLO, and FAF imaging of the optic nerve head and the peripapillary region. Results: Eighty-four glaucomatous eyes were included in our prospective study. Correlation analyses for horizontally and vertically obtained β-PPA for all three imaging modalities (color SLO, FAF, and SD-OCT revealed highest correlations between FAF and color SLO (Pearson correlation coefficient: 0.904 [P<0.001] for horizontal β-PPA and 0.786 [P<0.001] for vertical β-PPA. Bland–Altman plotting revealed highest agreements between color SLO and FAF, with −2.1 pixels ±1.96 standard deviation (SD for horizontal β-PPA, SD: 10.5 pixels and 2.4 pixels ±1.96 SD for vertical β-PPA. Conclusion: β-PPA can be assessed using en-face SLO and cross-sectional SD-OCT imaging. Correlation analyses revealed highest correlations between color SLO and FAF imaging, while correlations between SLO and SD-OCT were weak. A more precise structural definition of β-PPA is needed. Keywords: fundus autofluorescence, FAF, OCT, SD-OCT, SLO, glaucomatous optic neuropathy

  20. Adaptive optics ophthalmoscopy.

    Science.gov (United States)

    Roorda, Austin; Duncan, Jacque L

    2015-11-01

    This review starts with a brief history and description of adaptive optics (AO) technology, followed by a showcase of the latest capabilities of AO systems for imaging the human retina and an extensive review of the literature on where AO is being used clinically. The review concludes with a discussion on future directions and guidance on usage and interpretation of images from AO systems for the eye.

  1. Adaptive optics ophthalmoscopy

    OpenAIRE

    Roorda, Austin; Duncan, Jacque L.

    2015-01-01

    This review starts with a brief history and description of adaptive optics (AO) technology, followed by a showcase of the latest capabilities of AO systems for imaging the human retina and an extensive review of the literature on where AO is being used clinically. The review concludes with a discussion on future directions and guidance on usage and interpretation of images from AO systems for the eye.

  2. Inability to perform posterior segment monitoring by scanning laser ophthalmoscopy or optical coherence tomography with some occlusive intraocular lenses in clinical use.

    Science.gov (United States)

    Yusuf, Imran H; Peirson, Stuart N; Patel, Chetan K

    2012-03-01

    To evaluate whether occlusive intraocular lenses (IOLs) produced by several manufacturers for clinical use equivalently transmit near-infrared (IR) light for scanning laser ophthalmoscopy (SLO) or optical coherence tomography (OCT) imaging. Nuffield Laboratory of Ophthalmology, Oxford University, United Kingdom. Evaluation of diagnostic test or technology. The study evaluated 6 black IOLs of 2 designs: 3 poly(methyl methacrylate) (PMMA) and 3 iris-claw anterior chamber IOLs. Each IOL was placed between a broad-spectrum white light source and a spectroradiometer to generate transmission spectra. Transmission in the near-IR range was examined using an 850 nm light-emitting diode. Scanning laser ophthalmoscopy or OCT imaging using Spectralis spectral-domain SLO or OCT was attempted through occlusive IOLs in a model eye. Artisan iris-claw and MS 612 PMMA occlusive IOLs totally occluded all wavelengths of light, including in the near IR range in which SLO and OCT imaging systems operate. It was not possible to capture SLO or OCT images through the iris-claw and PMMA occlusive IOLs in a model eye. Results suggest the property of near-IR transmission that permits SLO or OCT imaging through occlusive IOLs is restricted to the Morcher range of occlusive IOLs. Patients with non-near IR transmitting IOLs will not be able to receive detailed posterior segment monitoring with SLO or OCT. This finding may have a significant impact on preoperative occlusive IOL selection and the management of current patients with occlusive IOLs. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  3. Scanning laser ophthalmoscopy and optical coherence tomography imaging of spectacular ecdysis in the corn snake (Pantherophis guttatus) and the California king snake (Lampropeltis getulus californiae).

    Science.gov (United States)

    Cazalot, Guillaume; Rival, Franck; Linsart, Adeline; Isard, Pierre-François; Tissier, Marion; Peiffer, Robert Louis; Dulaurent, Thomas

    2015-01-01

    One of the singularities of the eyes of snakes is the presence of the spectacle, a transparent and vascularized integument covering the cornea. The spectacle is completely renewed during ecdysis. Combined scanning laser ophthalmoscopy (SLO), optical coherence tomography (OCT), and conventional macrophotography were used to image this phenomenon. A spectral OCT/SLO examination and macrophotography were performed in four healthy adult corn snakes (Pantherophis guttatus) and one healthy adult California king snake (Lampropeltis getulus californiae) the day before the start of ecdysis and then daily during ecdysis. In all animals, ecdysis lasted 5 days. The spectacle was hardly visible at baseline, but became obvious at day one, while the subspectacular space became larger and the superficial cornea presented a hyperechoic band. At day two, eye surface became translucent, and at the same time, vascularization of the spectacle was visible using SLO. At day 3, the vascularization was no longer visible, while the subspectacular space increased and the eye surface remained translucent. At day 4, the eye surface was transparent and the superficial hyperechoic band started to become less bright. At day 5, the old spectacle was shed and all the parameters returned to baseline. We hypothesize that the echogenicity modifications of the anterior cornea correspond to major metabolic activity associated with new spectacle formation. This increased metabolic activity may contribute to the neovascularization and play an important role in the accumulation of fluid in the subspectacular space, facilitating the shedding of the old spectacle. © 2014 American College of Veterinary Ophthalmologists.

  4. Volumetric fluorescence retinal imaging in vivo over a 30-degree field of view by oblique scanning laser ophthalmoscopy (oSLO).

    Science.gov (United States)

    Zhang, Lei; Song, Weiye; Shao, Di; Zhang, Sui; Desai, Manishi; Ness, Steven; Roy, Sayon; Yi, Ji

    2018-01-01

    While fluorescent contrast is widely used in ophthalmology, three-dimensional (3D) fluorescence retinal imaging over a large field of view (FOV) has been challenging. In this paper, we describe a novel oblique scanning laser ophthalmoscopy (oSLO) technique that provides 3D volumetric fluorescence retinal imaging with only one raster scan. The technique utilizes scanned oblique illumination and angled detection to obtain fluorescent cross-sectional images, analogous to optical coherence tomography (OCT) line scans (or B-scans). By breaking the coaxial optical alignment used in conventional retinal imaging modalities, depth resolution is drastically improved. To demonstrate the capability of oSLO, we have performed in vivo volumetric fluorescein angiography (FA) of the rat retina with ~25μm depth resolution and over a 30° FOV. Using depth segmentation, oSLO can obtain high contrast images of the microvasculature down to single capillaries in 3D. The multi-modal nature of oSLO also allows for seamless combination with simultaneous OCT angiography.

  5. Accuracy of deep learning, a machine-learning technology, using ultra-wide-field fundus ophthalmoscopy for detecting rhegmatogenous retinal detachment.

    Science.gov (United States)

    Ohsugi, Hideharu; Tabuchi, Hitoshi; Enno, Hiroki; Ishitobi, Naofumi

    2017-08-25

    Rhegmatogenous retinal detachment (RRD) is a serious condition that can lead to blindness; however, it is highly treatable with timely and appropriate treatment. Thus, early diagnosis and treatment of RRD is crucial. In this study, we applied deep learning, a machine-learning technology, to detect RRD using ultra-wide-field fundus images and investigated its performance. In total, 411 images (329 for training and 82 for grading) from 407 RRD patients and 420 images (336 for training and 84 for grading) from 238 non-RRD patients were used in this study. The deep learning model demonstrated a high sensitivity of 97.6% [95% confidence interval (CI), 94.2-100%] and a high specificity of 96.5% (95% CI, 90.2-100%), and the area under the curve was 0.988 (95% CI, 0.981-0.995). This model can improve medical care in remote areas where eye clinics are not available by using ultra-wide-field fundus ophthalmoscopy for the accurate diagnosis of RRD. Early diagnosis of RRD can prevent blindness.

  6. Multimodality optical coherence tomography and fluorescence confocal scanning laser ophthalmoscopy for image-guided feedback of intraocular injections in mouse models

    Science.gov (United States)

    Benavides, Oscar R.; Terrones, Benjamin D.; Leeburg, Kelsey C.; Mehanathan, Sankarathi B.; Levine, Edward M.; Tao, Yuankai K.

    2018-02-01

    Rodent models are robust tools for understanding human retinal disease and function because of their similarities with human physiology and anatomy and availability of genetic mutants. Optical coherence tomography (OCT) has been well-established for ophthalmic imaging in rodents and enables depth-resolved visualization of structures and image-based surrogate biomarkers of disease. Similarly, fluorescence confocal scanning laser ophthalmoscopy (cSLO) has demonstrated utility for imaging endogenous and exogenous fluorescence and scattering contrast in the mouse retina. Complementary volumetric scattering and en face fluorescence contrast from OCT and cSLO, respectively, enables cellular-resolution longitudinal imaging of changes in ophthalmic structure and function. We present a non-contact multimodal OCT+cSLO small animal imaging system with extended working distance to the pupil, which enables imaging during and after intraocular injection. While injections are routinely performed in mice to develop novel models of ophthalmic diseases and screen novel therapeutics, the location and volume delivered is not precisely controlled and difficult to reproduce. Animals were imaged using a custom-built OCT engine and scan-head combined with a modified commercial cSLO scan-head. Post-injection imaging showed structural changes associated with retinal puncture, including the injection track, a retinal elevation, and detachment of the posterior hyaloid. When combined with imagesegmentation, we believe OCT can be used to precisely identify injection locations and quantify injection volumes. Fluorescence cSLO can provide complementary contrast for either fluorescently labeled compounds or transgenic cells for improved specificity. Our non-contact OCT+cSLO system is uniquely-suited for concurrent imaging with intraocular injections, which may be used for real-time image-guided injections.

  7. The Photosensitivity of Rhodopsin Bleaching and Light-Induced Increases of Fundus Reflectance in Mice Measured In Vivo With Scanning Laser Ophthalmoscopy

    Science.gov (United States)

    Zhang, Pengfei; Goswami, Mayank; Zawadzki, Robert J.; Pugh, Edward N.

    2016-01-01

    Purpose To quantify bleaching-induced changes in fundus reflectance in the mouse retina. Methods Light reflected from the fundus of albino (Balb/c) and pigmented (C57Bl/6J) mice was measured with a multichannel scanning laser ophthalmoscopy optical coherence tomography (SLO-OCT) optical system. Serial scanning of small retinal regions was used for bleaching rhodopsin and measuring reflectance changes. Results Serial scanning generated a saturating reflectance increase centered at 501 nm with a photosensitivity of 1.4 × 10−8 per molecule μm2 in both strains, 2-fold higher than expected were irradiance at the rod outer segment base equal to that at the retinal surface. The action spectrum of the reflectance increase corresponds to the absorption spectrum of mouse rhodopsin in situ. Spectra obtained before and after bleaching were fitted with a model of fundus reflectance, quantifying contributions from loss of rhodopsin absorption with bleaching, absorption by oxygenated hemoglobin (HbO2) in the choroid (Balb/c), and absorption by melanin (C57Bl/6J). Both mouse strains exhibited light-induced broadband reflectance changes explained as bleaching-induced reflectivity increases at photoreceptor inner segment/outer segment (IS/OS) junctions and OS tips. Conclusions The elevated photosensitivity of rhodopsin bleaching in vivo is explained by waveguide condensing of light in propagation from rod inner segment (RIS) to rod outer segment (ROS). The similar photosensitivity of rhodopsin in the two strains reveals that little light backscattered from the sclera can enter the ROS. The bleaching-induced increases in reflectance at the IS/OS junctions and OS tips resemble results previously reported in human cones, but are ascribed to rods due to their 30/1 predominance over cones in mice and to the relatively minor amount of cone M-opsin in the regions scanned. PMID:27403994

  8. Evaluation of baseline structural factors for predicting glaucomatous visual-field progression using optical coherence tomography, scanning laser polarimetry and confocal scanning laser ophthalmoscopy.

    Science.gov (United States)

    Sehi, M; Bhardwaj, N; Chung, Y S; Greenfield, D S

    2012-12-01

    The objective of this study is to assess whether baseline optic nerve head (ONH) topography and retinal nerve fiber layer thickness (RNFLT) are predictive of glaucomatous visual-field progression in glaucoma suspect (GS) and glaucomatous eyes, and to calculate the level of risk associated with each of these parameters. Participants with ≥28 months of follow-up were recruited from the longitudinal Advanced Imaging for Glaucoma Study. All eyes underwent standard automated perimetry (SAP), confocal scanning laser ophthalmoscopy (CSLO), time-domain optical coherence tomography (TDOCT), and scanning laser polarimetry using enhanced corneal compensation (SLPECC) every 6 months. Visual-field progression was assessed using pointwise linear-regression analysis of SAP sensitivity values (progressor) and defined as significant sensitivity loss of >1 dB/year at ≥2 adjacent test locations in the same hemifield at P<0.01. Cox proportional hazard ratios (HR) were calculated to determine the predictive ability of baseline ONH and RNFL parameters for SAP progression using univariate and multivariate models. Seventy-three eyes of 73 patients (43 GS and 30 glaucoma, mean age 63.2±9.5 years) were enrolled (mean follow-up 51.5±11.3 months). Four of 43 GS (9.3%) and 6 of 30 (20%) glaucomatous eyes demonstrated progression. Mean time to progression was 50.8±11.4 months. Using multivariate models, abnormal CSLO temporal-inferior Moorfields classification (HR=3.76, 95% confidence interval (CI): 1.02-6.80, P=0.04), SLPECC inferior RNFLT (per -1 μm, HR=1.38, 95% CI: 1.02-2.2, P=0.02), and TDOCT inferior RNFLT (per -1 μm, HR=1.11, 95% CI: 1.04-1.2, P=0.001) had significant HRs for SAP progression. Abnormal baseline ONH topography and reduced inferior RNFL are predictive of SAP progression in GS and glaucomatous eyes.

  9. 间接镜氪激光光凝结合改进宽环扎治疗视网膜脱离%Krypton laser photocoagulation using indirect ophthalmoscopy combined with improved encircling scleral buckles in the treatment of retinal detachment

    Institute of Scientific and Technical Information of China (English)

    郑穗联; 陈如; 王若洁; 蔡剑秋; 施明光

    2011-01-01

    Objective To assess the clinical result of the krypton laser photocoagulation using indirect ophthalmoscopy combined with improved encircling scleral buckles.Methods Forty-one eyes of 41 patients were treated with encircling scleral buckles and drainage, some combined with intravitreal injection of gas or balanced salt solution (BSS).All of the retinal breaks were treated with krypton laser photocoagulation using indirect ophthalmoscopy after surgery.Results The visual acuity improved (P<0.05).The reattachment of the retina: 36 eyes were successfully repaired, 5 eyes became recurrent retinal detachment (the reattachment rate was 88.37%).Among the 5 cases, 4 patients were successfully treated with vitrectomy except one patient of traumatic retinal detachment was given up.Conclusions The treatment of retinal detachment should follow the principles of simple surgical methods and fewer complications.The krypton laser photocoagulation using indirect ophthalmoscopy combined with improved encircling scleral buckles in the treatment of retinal detachment in proper cases is a safe, simple and convenient, easy operated and effective method.%目的 讨论采用间接镜氪激光光凝结合改进宽环扎治疗视网膜脱离的临床疗效.方法 对41例41只眼PVRB级或以下的孔源性视网膜脱离病人行宽环扎、放液,部分病人联合玻璃体腔注气或平衡液,术后间接镜氪激光治疗视网膜裂孔.结果 视力提高:术后视力为3.87±0.74,术前视力为3.40±0.86,P<0.05.视网膜复位情况:41只眼中手术成功36只眼,5只眼复发性,成功率88.37%.5只眼复发性视网膜脱离,除1例外伤性视网膜脱离放弃手术外,其余患者均行玻璃体手术后复位.结论 对视网膜脱离术我们建议遵循手术方式简单、并发症少的原则.选择适当病例,间接镜氪激光光凝结合改进宽环扎治疗视网膜脱离是一种安全、简便、易操作、效果良好的方法.

  10. 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

  11. Ophthalmoscopy versus non-mydriatic fundus photography in the ...

    African Journals Online (AJOL)

    1990-09-01

    Sep 1, 1990 ... non-mydriatic fundus camera in the detection of diabetic retinopathy .... the external and the internal fixation lamps of the non- mydriatic ... .Rosen ES, Raines M, Hancock R. Use of non-mydriatic cameras to screen diabetic ...

  12. Roth spots seen on ophthalmoscopy: diseases with which they may be associated.

    Science.gov (United States)

    Falcone, P M; Larrison, W I

    1995-05-01

    Roth spots seen on fundoscopic examination (white-centered hemorrhages) were classically described as septic emboli in patients with subacute bacterial endocarditis (SBE). Many physicians have considered them pathognomonic for this entity. More recent evidence suggests, however, that they are nonspecific and may be found in other disease states. A review of the pathogenesis of these white-centered hemorrhages will be provided, along with some diseases other than SBE in which they may occur.

  13. 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.

  14. 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.

  15. 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

  16. Fluorescence lifetime imaging ophthalmoscopy in type 2 diabetic patients who have no signs of diabetic retinopathy

    Science.gov (United States)

    Schweitzer, Dietrich; Deutsch, Lydia; Klemm, Matthias; Jentsch, Susanne; Hammer, Martin; Peters, Sven; Haueisen, Jens; Müller, Ulrich A.; Dawczynski, Jens

    2015-06-01

    The time-resolved autofluorescence of the eye is used for the detection of metabolic alteration in diabetic patients who have no signs of diabetic retinopathy. One eye from 37 phakic and 11 pseudophakic patients with type 2 diabetes, and one eye from 25 phakic and 23 pseudophakic healthy subjects were included in the study. After a three-exponential fit of the decay of autofluorescence, histograms of lifetimes τi, amplitudes αi, and relative contributions Qi were statistically compared between corresponding groups in two spectral channels (490diabetic patients and age-matched controls (p450 ps, and the shift of τ3 from ˜3000 to 3700 ps in ch1 of diabetic patients when compared with healthy subjects indicate an increased production of free flavin adenine dinucleotide, accumulation of advanced glycation end products (AGE), and, probably, a change from free to protein-bound reduced nicotinamide adenine dinucleotide at the fundus. AGE also accumulated in the crystalline lens.

  17. 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 greatly reduces eye motion artifacts in the recorded volume scans. The capability of the AO-SLO/OCT system was tested with measurements in healthy volunteers: the instrument allowed the visualization of the 3D architecture of foveal cones and rods with virtually no motion artifacts. The first chapter of this thesis provides a short overview on the state of the art in optical imaging methods. In the next two chapters, the two publications that arose during this thesis are presented. The first publication describes the AO-SLO system and presents corresponding imaging results. The second publication contains the realization of the combined AO-SLO/OCT instrument together with first images obtained with the instrument. The thesis concludes with a discussion of the advantages and features as well as possible improvements of the instrument together with recommendations for further investigations. (author) [de

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. The effect of compression on clinical diagnosis of glaucoma based on non-analyzed confocal scanning laser ophthalmoscopy images

    NARCIS (Netherlands)

    Abramoff, M.D.

    2006-01-01

    Knowledge of the effect of compression of ophthalmic images on diagnostic reading is essential for effective tele-ophthalmology applications. It was therefore with great anticipation that I read the article “The Effect of Compression on Clinical Diagnosis of Glaucoma Based on Non-analyzed Confocal

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

    Directory of Open Access Journals (Sweden)

    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.

  4. 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.

  5. 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.

  6. Quantitative evaluation of experimental choroidal neovascularization by confocal scanning laser ophthalmoscopy: fluorescein angiogram parallels heparan sulfate proteoglycan expression

    Directory of Open Access Journals (Sweden)

    C.V. Regatieri

    2010-07-01

    Full Text Available The objective of the present study was to develop a quantitative method to evaluate laser-induced choroidal neovascularization (CNV in a rat model using Heidelberg Retina Angiograph 2 (HRA2 imaging. The expression of two heparan sulfate proteoglycans (HSPG related to inflammation and angiogenesis was also investigated. CNV lesions were induced with argon laser in 21 heterozygous Zucker rats and after three weeks a fluorescein angiogram and autofluorescence exams were performed using HRA2. The area and greatest linear dimension were measured by two observers not aware of the protocol. Bland-Altman plots showed agreement between the observers, suggesting that the technique was reproducible. After fluorescein angiogram, HSPG (perlecan and syndecan-4 were analyzed by real-time RT-PCR and immunohistochemistry. There was a significant increase in the expression of perlecan and syndecan-4 (P < 0.0001 in retinas bearing CNV lesions compared to control retinas. The expression of these two HSPG increased with increasing CNV area. Immunohistochemistry demonstrated that the rat retina damaged with laser shots presented increased expression of perlecan and syndecan-4. Moreover, we observed that the overexpression occurred in the outer layer of the retina, which is related to choroidal damage. It was possible to develop a standardized quantitative method to evaluate CNV in a rat model using HRA2. In addition, we presented data indicating that the expression of HSPG parallels the area of CNV lesion. The understanding of these events offers opportunities for studies of new therapeutic interventions targeting these HSPG.

  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. 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.

  9. 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.

  10. Comparison between Early Treatment Diabetic Retinopathy Study 7-field retinal photos and non-mydriatic, mydriatic and mydriatic steered widefield scanning laser ophthalmoscopy for assessment of diabetic retinopathy

    DEFF Research Database (Denmark)

    Rasmussen, Malin L; Broe, Rebecca; Frydkjaer-Olsen, Ulrik

    2015-01-01

    AIMS: To compare non-mydriatic, mydriatic and steered mydriatic widefield retinal images with mydriatic 7-field Early Treatment Diabetic Retinopathy Study (ETDRS)-standards in grading diabetic retinopathy (DR). METHODS: We examined 95 patients (190 eyes) with type 1 diabetes. A non...

  11. Accuracy of ultra-wide-field fundus ophthalmoscopy-assisted deep learning, a machine-learning technology, for detecting age-related macular degeneration.

    Science.gov (United States)

    Matsuba, Shinji; Tabuchi, Hitoshi; Ohsugi, Hideharu; Enno, Hiroki; Ishitobi, Naofumi; Masumoto, Hiroki; Kiuchi, Yoshiaki

    2018-05-09

    To predict exudative age-related macular degeneration (AMD), we combined a deep convolutional neural network (DCNN), a machine-learning algorithm, with Optos, an ultra-wide-field fundus imaging system. First, to evaluate the diagnostic accuracy of DCNN, 364 photographic images (AMD: 137) were amplified and the area under the curve (AUC), sensitivity and specificity were examined. Furthermore, in order to compare the diagnostic abilities between DCNN and six ophthalmologists, we prepared yield 84 sheets comprising 50% of normal and wet-AMD data each, and calculated the correct answer rate, specificity, sensitivity, and response times. DCNN exhibited 100% sensitivity and 97.31% specificity for wet-AMD images, with an average AUC of 99.76%. Moreover, comparing the diagnostic abilities of DCNN versus six ophthalmologists, the average accuracy of the DCNN was 100%. On the other hand, the accuracy of ophthalmologists, determined only by Optos images without a fundus examination, was 81.9%. A combination of DCNN with Optos images is not better than a medical examination; however, it can identify exudative AMD with a high level of accuracy. Our system is considered useful for screening and telemedicine.

  12. Grading diabetic retinopathy (DR using the Scottish grading protocol

    Directory of Open Access Journals (Sweden)

    Sonia Zachariah

    2016-04-01

    Full Text Available Although traditionally the features of DR have been identified through direct ophthalmoscopy or slit lamp biomicroscopy, digital photography is more sensitive than direct ophthalmoscopy and is comparable to slit lamp examination by a trained observer.

  13. A Case Study on Idiopathic Orbital Pseudotumor: Surgery and ...

    African Journals Online (AJOL)

    This is a case study of five isolated orbital nerve inflammatory pseudotumor cases ... Optic disk edema was observed by ophthalmoscopy. ... The patients on clinical examination were found to have protrusion, reduced visual acuity of the right ...

  14. The anterior chamber angle width in adults in a tertiary eye hospital ...

    African Journals Online (AJOL)

    2011-03-25

    Mar 25, 2011 ... had visual acuity assessment, visual field analysis, ophthalmoscopy, intraocular pressure measurement, ... Peripheral anterior synechiae were observed in three eyes. ..... The high incidence of narrow angles with the near.

  15. Early diagnosis of retinopathy in juvenile diabetes by fluorescence angiography

    International Nuclear Information System (INIS)

    Krzywicki, S.; Slankiewicz, A.; Jablonska-Budaj, U.

    1980-01-01

    The authors defined the usefulness of the fluorescein angiography of the retina and choroid in the early stage diagnosis of diabetic retinopathy in children comparing its results to the traditional ophthalmoscopy. Examination involved 50 children from 4 to 18 (30 boys and 20 girls) on insulin treatment. The duration of the disease was 1 to 14 years (average 7.36 years). Ophthalmoscopy showed pathological changes in 24% of the children. The fluorescein angiography visualized more microaneurysms compared to ophthalmoscopy and showed them sometimes in the eyes where they had not been found in eye fundus studies. By means of angiography the early and advanced stages of vascular complications were found in 64% of patients. Comparing to ophthalmoscopy a 40% increase was noted. Fluorescein angiography can lead to the decrease in the number of patients with markedly impaired visual acuity and cases of blindness in the diabetic population. (author)

  16. Early diagnosis of retinopathy in juvenile diabetes by fluorescence angiography

    Energy Technology Data Exchange (ETDEWEB)

    Krzywicki, S; Slankiewicz, A; Jablonska-Budaj, U [Szpital-Pomnik Centrum Zdrowia Dziecka, Warsaw (Poland). Zespol Problemowy Okulistiky

    1980-09-01

    The authors defined the usefulness of the fluorescein angiography of the retina and choroid in the early stage diagnosis of diabetic retinopathy in children comparing its results to the traditional ophthalmoscopy. Examination involved 50 children from 4 to 18 (30 boys and 20 girls) on insulin treatment. The duration of the disease was 1 to 14 years (average 7.36 years). Ophthalmoscopy showed pathological changes in 24% of the children. The fluorescein angiography visualized more microaneurysms compared to ophthalmoscopy and showed them sometimes in the eyes where they had not been found in eye fundus studies. By means of angiography the early and advanced stages of vascular complications were found in 64% of patients. Comparing to ophthalmoscopy a 40% increase was noted. Fluorescein angiography can lead to the decrease in the number of patients with markedly impaired visual acuity and cases of blindness in the diabetic population.

  17. The sensitivity and specificity of one field non-mydriatic digital fundus photography for DR screening

    Directory of Open Access Journals (Sweden)

    Bin-Bin Li

    2013-07-01

    Full Text Available AIM:To evaluate the sensitivity and specificity of one-field non-mydriatic digital fundus photography and direct ophthalmoscopy for diabetic retinopathy(DRscreening, compared with fundus fluorescein angiography( FFA .METHODS:All 93 patients of type 1 or 2 diabetic who have underwent one-field non-mydriatic digital fundus photography, and direct ophthalmoscopy with dilation of their pupils, and FFA by ophthalmologists. The sensitivity and specificity of one-field non-mydriatic digital fundus photography and direct ophthalmoscopy were calculated respectively, compared with FFA.RESULTS: The sensitivity and specificity of one-field non-mydriatic digital fundus photography for detection of any DR were 80.4% and 94.7%; The sensitivity and specificity of direct ophthalmoscopy for detection of any DR were 64.2% and 84.2%; After the standard for referable DR being lowered down to the moderate non-proliferative diabetic retinopathy(M-NPDR, the sensitivity and specificity of non-mydriatic digital fundus photography for detection were 88.9% and 98.4%, the sensitivity and specificity of direct ophthalmoscopy for detection were 71.5% and 96.7%.CONCLUSION: One-field non-mydriatic digital fundus photography is an effective method for DR screening.

  18. Adaptive optics imaging of inherited retinal diseases.

    Science.gov (United States)

    Georgiou, Michalis; Kalitzeos, Angelos; Patterson, Emily J; Dubra, Alfredo; Carroll, Joseph; Michaelides, Michel

    2017-11-15

    Adaptive optics (AO) ophthalmoscopy allows for non-invasive retinal phenotyping on a microscopic scale, thereby helping to improve our understanding of retinal diseases. An increasing number of natural history studies and ongoing/planned interventional clinical trials exploit AO ophthalmoscopy both for participant selection, stratification and monitoring treatment safety and efficacy. In this review, we briefly discuss the evolution of AO ophthalmoscopy, recent developments and its application to a broad range of inherited retinal diseases, including Stargardt disease, retinitis pigmentosa and achromatopsia. Finally, we describe the impact of this in vivo microscopic imaging on our understanding of disease pathogenesis, clinical trial design and outcome metrics, while recognising the limitation of the small cohorts reported to date. © 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.

  19. The effect of subretinal viscoelastics on the porcine retinal function

    DEFF Research Database (Denmark)

    Sørensen, Nina Fischer; Ejstrup, Rasmus; Svahn, Thøger Frøsig

    2012-01-01

    pharmaceutical therapy is needed, and can only be tested in a suitable animal model. The porcine model is promising and the mfERG is well validated in this model. RD was induced in 18 pigs by vitrectomy and healon injection of various concentrations. Preoperatively and 6 weeks postoperatively eight animals were...... examined by mfERG. The major component P1 was analyzed statistically. Indirect ophthalmoscopy and bilateral color fundus photography (FP) were performed. Selected animals underwent high-resolution optical coherence tomography (OCT). Examination by ophthalmoscopy and FP showed that the RDs remained detached...

  20. Visual damage following direct sighting of solar eclipse in Ghana ...

    African Journals Online (AJOL)

    kemrilib

    and Technology, KUMASI, GHANA, WEST AFRICA. *Author for Correspondence. E-mail: ... such as scanning laser Ophthalmoscopy and the multifocal electroretinography (ERG) offer the possibility of detailed examination of small retina ..... with lasers and other Optical sources. New. York, Plenum Publishing 1980. 1064 p.

  1. DYNAMISM OF DOT SUBRETINAL DRUSENOID DEPOSITS IN AGE-RELATED MACULAR DEGENERATION DEMONSTRATED WITH ADAPTIVE OPTICS IMAGING.

    Science.gov (United States)

    Zhang, Yuhua; Wang, Xiaolin; Godara, Pooja; Zhang, Tianjiao; Clark, Mark E; Witherspoon, C Douglas; Spaide, Richard F; Owsley, Cynthia; Curcio, Christine A

    2018-01-01

    To investigate the natural history of dot subretinal drusenoid deposits (SDD) in age-related macular degeneration, using high-resolution adaptive optics scanning laser ophthalmoscopy. Six eyes of four patients with intermediate age-related macular degeneration were studied at baseline and 1 year later. Individual dot SDD within the central 30° retina were examined with adaptive optics scanning laser ophthalmoscopy and optical coherence tomography. A total of 269 solitary SDD were identified at baseline. Over 12.25 ± 1.18 months, all 35 Stage 1 SDD progressed to advanced stages. Eighteen (60%) Stage 2 lesions progressed to Stage 3 and 12 (40%) remained at Stage 2. Of 204 Stage 3 SDD, 12 (6.4%) disappeared and the rest remained. Twelve new SDD were identified, including 6 (50%) at Stage 1, 2 (16.7%) at Stage 2, and 4 (33.3%) at Stage 3. The mean percentage of the retina affected by dot SDD, measured by the adaptive optics scanning laser ophthalmoscopy, increased in 5/6 eyes (from 2.31% to 5.08% in the most changed eye) and decreased slightly in 1/6 eye (from 10.67% to 10.54%). Dynamism, the absolute value of the areas affected by new and regressed lesions, ranged from 0.7% to 9.3%. Adaptive optics scanning laser ophthalmoscopy reveals that dot SDD, like drusen, are dynamic.

  2. 21 CFR 886.1380 - Diagnostic condensing lens.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Diagnostic condensing lens. 886.1380 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1380 Diagnostic condensing lens. (a) Identification. A diagnostic condensing lens is a device used in binocular indirect ophthalmoscopy (a procedure...

  3. Visual damage following direct sighting of solar eclipse in Ghana ...

    African Journals Online (AJOL)

    education concerning the damaging effects of the solar eclipse. Advanced techniques, such as scanning laser Ophthalmoscopy and the multifocal electroretinography (ERG) offer the possibility of detailed examination of small retina lesions in Ghana after an eclipse of the sun. African Journal of Health Sciences Vol. 14 (3-4) ...

  4. Babbage, Charles (1792-1871)

    Science.gov (United States)

    Murdin, P.

    2000-11-01

    Polymath, eleventh Lucasian Professor at Cambridge. Known not only for work on astronomy but also in cryptanalysis, probability, geophysics, altimetry, ophthalmoscopy, statistical linguistics, meteorology, actuarial science, lighthouse technology, the use of tree rings as historic climatic records, magnetism, biology, geology, religion, submarines, politics, economics and mathematics. Most import...

  5. 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

  6. African Journal of Neurological Sciences - 2009 Vol. 28 No 1

    African Journals Online (AJOL)

    with slit-ventricles develop shunt-induced craniostenosis, which causes ... the inability of the skull to expand and accommodate brain growth because of functional fusion of cranial ... She had mild right esotropia and her upgaze was normal; ophthalmoscopy was not performed. ... The shunt was left in situ and not altered.

  7. Impaired vascular function during short-term poor glycaemic control in Type 1 diabetic patients

    DEFF Research Database (Denmark)

    Sørensen, V.R.; Mathiassen, E.R.; Clausen, P.

    2005-01-01

    AIM: To study the effects of short-term poor glycaemic control on vascular function in Type 1 diabetic patients. METHODS: Ten Type 1 diabetic patients, with diabetes duration of less than 10 years and normal urinary albumin excretion and ophthalmoscopy, were studied. All patients were examined af...

  8. Nigerian Journal of Ophthalmology - Vol 22, No 2 (2014)

    African Journals Online (AJOL)

    Evaluation of Competence of Medical Students in Performing Direct Ophthalmoscopy · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Emmanuel Olu Megbelayin, Edet Uduak Asana, George Dennis Nkanga, Roseline Ekanem Duke, Affiong Andem Ibanga, ...

  9. Retinopathy in severe malaria in Ghanaian children - overlap between fundus changes in cerebral and non-cerebral malaria

    DEFF Research Database (Denmark)

    Essuman, Vera A; Ntim-Amponsah, Christine T; Astrup, Birgitte S

    2010-01-01

    diagnostic tool. This study was designed to determine the diagnostic usefulness of retinopathy on ophthalmoscopy in severe malaria syndromes: Cerebral malaria (CM) and non-cerebral severe malaria (non-CM), i.e. malaria with respiratory distress (RD) and malaria with severe anaemia (SA), in Ghanaian children...

  10. Diabetes Care and Treatment Project: A Diabetes Institute of the Walter Reed Health Care System and Joslin (and University of Hawaii) Telemedicine Initiative

    Science.gov (United States)

    2010-04-01

    digital teleophthalmology system as used by three federal healthcare agencies for detecting proliferative diabetic retinopathy . Telemedicine and e...Research Group. Detection of diabetic macular edema: ophthalmoscopy versus photography—Early Treatment Diabetic Retinopathy Study report number 5...project are the establishment of a telemedicine system for comprehensive diabetes management and the assessment of diabetic retinopathy that

  11. Retinitis-pigmentosa-like tapetoretinal degeneration in a rabbit breed.

    Science.gov (United States)

    Reichenbach, A; Baar, U

    1985-08-15

    By chance, we found a rabbit strain with retinal dystrophy. The eyes of these rabbits were examined by ophthalmoscopy, electroretinography, histology, and cytology--the latter after retina dissociation with papaine. The results suggest this rabbit strain to be a possible animal model for human retinitis pigmentosa.

  12. Fundus fluorescence Angiography in diagnosing diabetic retinopathy.

    Science.gov (United States)

    Wang, Shuhui; Zuo, Yuqin; Wang, Ning; Tong, Bin

    2017-01-01

    To investigate the manifestation characteristics of fundus fluorescence angiography (FFA) and its values in diagnosing diabetic retinopathy through comparing direct ophthalmoscopy. Two hundred fifty patients (500 eyes) who were suspected as diabetic retinopathy and admitted to the hospital between February 2015 and December 2016 were selected. They underwent direct ophthalmoscopy and FFA. The manifestation characteristics of FFA in the diagnosis of diabetic retinopathy were summarized. The two examination methods were compared. In the diagnosis with direct ophthalmoscopy, 375 eyes out of 500 eyes were diagnosed as diabetic retinopathy (75%); there were 74 eyes at stage I, 88 eyes at stage II, 92 eyes at stage III, 83 eyes of stage IV, 28 eyes of stage V and 10 eyes of stage VI. In the diagnosis with FFA, 465 eyes out of 500 eyes were diagnosed as diabetic retinopathy (93%); there were 94 eyes at stage I, 110 eyes at stage II, 112 at stage III, 92 eyes at stage IV, 41 eyes at stage V and 16 eyes at stage VI. The detection rate of diabetic retinopathy using FFA was significantly higher than that using direct ophthalmoscopy (Pretinopathy (67.96%), 75 eyes had pre-proliferative lesions (16.13%), 149 eyes had proliferative lesions (32.04%), 135 eyes had diabetic maculopathy (29.03%) and 31 eyes had diabetic optic disc lesions (6.67%). The detection rate of diabetic retinopathy using FFA is higher than that using direct ophthalmoscopy. FFA could accurately determine clinical stage. Therefore, it is an important approach in treatment efficacy evaluation and treatment guidance, suggesting a significant application value.

  13. Evaluation of a simulation tool in ophthalmology: application in teaching funduscopy

    Directory of Open Access Journals (Sweden)

    Joice Elise Androwiki

    2015-02-01

    Full Text Available Purpose: The aim of this study was to evaluate the Eye Retinopathy Trainer® as a teaching tool for direct ophthalmoscopy examination by comparing it with the traditional method using volunteers. Methods: Fourth year medical students received training in direct ophthalmoscopy using a simulation tool and human volunteers. Ninety students were randomized into a Simulation Group or a Control Group by the inclusion or absence of the simulation model in classroom practice. Differences between the groups were analyzed using unpaired Student’s t-test. Results: The Simulation Group was superior to the Control Group, with 51.06% successful in performing fundus examination in both the anatomical model simulation and the human model in comparison with 21.15% in the Control Group. Conclusion: The Eye Retinopathy Trainer® appears to be an effective teaching tool for practice and improvement of ophthalmologic examination among fourth year medical students.

  14. Smartphone Fundus Photography.

    Science.gov (United States)

    Nazari Khanamiri, Hossein; Nakatsuka, Austin; El-Annan, Jaafar

    2017-07-06

    Smartphone fundus photography is a simple technique to obtain ocular fundus pictures using a smartphone camera and a conventional handheld indirect ophthalmoscopy lens. This technique is indispensable when picture documentation of optic nerve, retina, and retinal vessels is necessary but a fundus camera is not available. The main advantage of this technique is the widespread availability of smartphones that allows documentation of macula and optic nerve changes in many settings that was not previously possible. Following the well-defined steps detailed here, such as proper alignment of the phone camera, handheld lens, and the patient's pupil, is the key for obtaining a clear retina picture with no interfering light reflections and aberrations. In this paper, the optical principles of indirect ophthalmoscopy and fundus photography will be reviewed first. Then, the step-by-step method to record a good quality retinal image using a smartphone will be explained.

  15. Ocular Fundus Photography as an Educational Tool.

    Science.gov (United States)

    Mackay, Devin D; Garza, Philip S

    2015-10-01

    The proficiency of nonophthalmologists with direct ophthalmoscopy is poor, which has prompted a search for alternative technologies to examine the ocular fundus. Although ocular fundus photography has existed for decades, its use has been traditionally restricted to ophthalmology clinical care settings and textbooks. Recent research has shown a role for nonmydriatic fundus photography in nonophthalmic settings, encouraging more widespread adoption of fundus photography technology. Recent studies have also affirmed the role of fundus photography as an adjunct or alternative to direct ophthalmoscopy in undergraduate medical education. In this review, the authors examine the use of ocular fundus photography as an educational tool and suggest future applications for this important technology. Novel applications of fundus photography as an educational tool have the potential to resurrect the dying art of funduscopy. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  16. Radon inhalations applied in the treatment of eye fundus diseases

    International Nuclear Information System (INIS)

    Ogielska, E.; Tuszewska, R.

    1981-01-01

    The results of treatment with radon inhalations of 101 patients with various diseases of the visual system affecting the posterior segment of the eyeball are reported. In most cases clinical improvement was obtained. This was due to a favourable effect of radon on tissue blood flow and its mobilizing action on the reticuloendothelial system. Ophthalmoscopy demonstrated in the treated patients arterial vasodilation in the retina, resorption of haemorrhages and exudates. (author)

  17. 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...

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

    OpenAIRE

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

    2016-01-01

    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 d...

  19. MRI and intraocular tamponade media

    International Nuclear Information System (INIS)

    Manfre, I.; Fabbri, G.; Avitabile, T.; Biondi, P.; Reibaldi, A.; Pero, G.

    1993-01-01

    Thirteen patients who underwent surgery for retinal detachment and injection of intraocular tamponade media (silicone oil, flurosilicone oil, or perfluoro-carbon liquid) underwent magnetic resonance imaging (MRI), using spin-echo T1- and T2-weighted images. The ophthalmic tamponade media showed different signal intensity, according to their chemical structure. Unlike ophthalmoscopy or ultrasonography, MRI showed no oil-related artefact, making possible recognition of recurrent retinal detachment. (orig.)

  20. MRI and intraocular tamponade media

    Energy Technology Data Exchange (ETDEWEB)

    Manfre, I. (Dept. of Neuroradiology, Inst. of Neurosurgery, Univ. of Catania (Italy)); Fabbri, G. (Dept. of Neuroradiology, Inst. of Neurosurgery, Univ. of Catania (Italy)); Avitabile, T. (Inst. of Ophthalmology, Univ. of Catania (Italy)); Biondi, P. (Inst. of Ophthalmology, Univ. of Catania (Italy)); Reibaldi, A. (Inst. of Ophthalmology, Univ. of Catania (Italy)); Pero, G. (Dept. of Neuroradiology, Inst. of Neurosurgery, Univ. of Catania (Italy))

    1993-05-01

    Thirteen patients who underwent surgery for retinal detachment and injection of intraocular tamponade media (silicone oil, flurosilicone oil, or perfluoro-carbon liquid) underwent magnetic resonance imaging (MRI), using spin-echo T1- and T2-weighted images. The ophthalmic tamponade media showed different signal intensity, according to their chemical structure. Unlike ophthalmoscopy or ultrasonography, MRI showed no oil-related artefact, making possible recognition of recurrent retinal detachment. (orig.)

  1. Visual function and retinal vessel diameters during hyperthermia in man

    DEFF Research Database (Denmark)

    Jensen, Bettina Hagström; Bram, Thue; Kappelgaard, Per

    2017-01-01

    .01), a 10.6-mmHg mean reduction in diastolic blood pressure (p vein...... laser ophthalmoscopy was used to measure retinal trunk vessel diameters. Assessment was made at baseline, during hyperthermia and after cooling. RESULTS: The induction of a mean increase in core body temperature of 1.02°C was associated with a 7.15-mmHg mean reduction in systolic blood pressure (p

  2. Canine and feline fundus photography and videography using a nonpatented 3D printed lens adapter for a smartphone.

    Science.gov (United States)

    Espinheira Gomes, Filipe; Ledbetter, Eric

    2018-05-11

    To describe an indirect funduscopy imaging technique for dogs and cats using low cost and widely available equipment: a smartphone, a three-dimensional (3D) printed indirect lens adapter, and a 40 diopters (D) indirect ophthalmoscopy lens. Fundus videography was performed in dogs and cats using a 40D indirect ophthalmoscopy lens and a smartphone fitted with a 3D printed indirect lens adapter. All animals were pharmacologically dilated with topical tropicamide 1% solution. Eyelid opening and video recording were performed using standard binocular indirect ophthalmoscopy technique. All videos were uploaded to a computer, and still images were selected and acquired for archiving purposes. Fundic images were manipulated to represent the true anatomy of the fundus. It was possible to promptly obtain good quality images from normal and diseased retinas using the nonpatented 3D printed, lens adapter for a smartphone. Fundic imaging using a smartphone can be performed with minimal investment. This simple imaging modality can be used by veterinary ophthalmologists and general practitioners to acquire, archive, and share images of the retina. The quality of images obtained will likely improve with developments in smartphone camera software and hardware. © 2018 American College of Veterinary Ophthalmologists.

  3. The use of retinal photography in nonophthalmic settings and its potential for neurology.

    Science.gov (United States)

    Pérez, Mario A; Bruce, Beau B; Newman, Nancy J; Biousse, Valérie

    2012-11-01

    Ocular fundus examination is an important element of the neurological examination. However, direct ophthalmoscopy is difficult to perform without pupillary dilation and requires extensive practice to accurately recognize optic nerve and retinal abnormalities. Recent studies have suggested that digital retinal photography can replace direct ophthalmoscopy in many settings. Ocular fundus imaging is routinely used to document and monitor disease progression in ophthalmology. Advances in optical technology have made it easier to obtain high-quality retinal imaging, even without pupillary dilation. Retinal photography has a high sensitivity, specificity, and interexamination/intraexamination agreement compared with in-person ophthalmologist examination, suggesting that photographs can be used in lieu of ophthalmoscopy in many clinical situations. Nonmydriatic retinal photography has recently gained relevance as a helpful tool for diagnosing neuro-ophthalmologic disorders in the emergency department. In addition, several population-based studies have used retinal imaging to relate ophthalmic abnormalities to the risk of hypertension, renal dysfunction, cardiovascular mortality, subclinical and clinical stroke, and cognitive impairment. The possibility of telemedical consultation offered by digital retinal photography has already increased access to timely and accurate subspecialty care, particularly for underserved areas. Retinal photography (even without pupillary dilation) has become increasingly available to medical fields outside of ophthalmology, allowing for faster and more accurate diagnosis of various ocular, neurological, and systemic disorders. The potential for telemedicine may provide the additional benefits of improving access to appropriate urgent consultation in both clinical and research settings.

  4. The use of retinal photography in non-ophthalmic settings and its potential for neurology

    Science.gov (United States)

    Pérez, Mario A.; Bruce, Beau B.; Newman, Nancy J.; Biousse, Valérie

    2012-01-01

    Background Ocular fundus examination is an important element of the neurological examination. However, direct ophthalmoscopy is difficult to perform without pupillary dilation and requires extensive practice to accurately recognize optic nerve and retinal abnormalities. Recent studies have suggested that digital retinal photography can replace direct ophthalmoscopy in many settings. Review Summary Ocular fundus imaging is routinely used to document and monitor disease progression in ophthalmology. Advances in optical technology have made it easier to obtain high-quality retinal imaging, even without pupillary dilation. Retinal photography has a high sensitivity, specificity, and inter-/intra-examination agreement compared to in-person ophthalmologist examination, suggesting that photographs can be used in lieu of ophthalmoscopy in many clinical situations. Non-mydriatic retinal photography has recently gained relevance as a helpful tool for diagnosing neuro-ophthalmologic disorders in the emergency department. Additionally, several population-based studies have used retinal imaging to relate ophthalmic abnormalities to the risk of hypertension, renal dysfunction, cardiovascular mortality, subclinical and clinical stroke, and cognitive impairment. The possibility of telemedical consultation offered by digital retinal photography has already increased access to timely and accurate subspecialty care, particularly for underserved areas. Conclusion Retinal photography (even without pupillary dilation) has become increasingly available to medical fields outside of ophthalmology, allowing for faster and more accurate diagnosis of various ocular, neurologic and systemic disorders. The potential for telemedicine may provide the additional benefits of improving access to appropriate urgent consultation in both clinical and research settings. PMID:23114666

  5. Adenocarcinoma of the lung presenting as retinal detachment

    Directory of Open Access Journals (Sweden)

    Kaushik Saha

    2014-01-01

    Full Text Available Retinal detachment is a rare presentation of lung cancer. A young female presented with blurring of vision in her right eye for the last 10 days without any history of trauma. On indirect ophthalmoscopy, there was a presence of right sided retinal detachment which was treated with oral prednisolone (60 mg/day. After 1 month of continuous treatment, she came back with dry cough left sided chest pain and deterioration of her eye symptoms. Chest X-ray showed left lung mass. Computed tomography guided fine needle aspiration cytology and with immunohistochemistry confirmed adenocarcinoma of the lung. She was treated with 6 cycles of chemotherapy with paclitaxel and gemcitabine.

  6. 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.

  7. Homonymous Central Quadrantanopia Caused by an Extrastriate (V2/V3 Infarction: A Case Report

    Directory of Open Access Journals (Sweden)

    Shu-Fang Lin

    2008-08-01

    Full Text Available A 66-year-old Taiwanese aboriginal male had complained of right-side blurred vision for 2 months, especially when reading. He had a 10-year history of hypertension and cardiovascular disease. His best-corrected visual acuity was 20/25 in each eye. Ophthalmoscopy revealed asymmetrical cupping, but a normal disc. Humphrey perimetry showed an upper homonymous para-central quadrantanopic defect. Brain magnetic resonance imaging showed an infarction in the left lower calcarine area over the extrastriate (V2/V3 cortical area and a narrowing of the left middle and posterior cerebral arteries due to severe arteriosclerosis.

  8. Central serous choroidopathy in the Hallermann-Streiff Syndrome.

    Science.gov (United States)

    Blair, N P; Brockhurst, R J; Lee, W

    1981-08-01

    Central serous choroidopathy was observed in a young patient with the Hallermann-Streiff syndrome. Typical features of this syndrome include microphthalmos, proportionate dwarfism, dyscephaly with birdlike facies, dental abnormalities, and hypotrichosis. Exceptional aspects of this case include age of onset (11 years), high hyperopic refractive error (+ 13.00 sphere), and multiple recurrences caused by six separate documented leaks from the choroid. Fundus changes previously reported in the Hallermann-Streiff syndrome, interpreted as chorioretinal pigmentary changes, may have been secondary to previous undiagnosed central serous choroidopathy. Periodic ophthalmoscopy should be performed and may detect unrecognized episodes of central serous choroidopathy for which photocoagulation would be beneficial.

  9. Imaging of the peripheral retina

    Directory of Open Access Journals (Sweden)

    Marcus Kernt

    2013-01-01

    Full Text Available The technical progress of the recent years has revolutionized imaging in ophthalmology. Scanning laser ophthalmoscopy (SLO, digital angiography, optical coherence tomography (OCT, and detection of fundus autofluorescence (FAF have fundamentally changed our understanding of numerous retinal and choroidal diseases. Besides the tremendous advances in macular diagnostics, there is more and more evidence that central pathologies are often directly linked to changes in the peripheral retina. This review provides a brief overview on current posterior segment imaging techniques with a special focus on the peripheral retina.

  10. 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

  11. Quantitatively Measured Anatomic Location and Volume of Optic Disc Drusen: An Enhanced Depth Imaging Optical Coherence Tomography Study

    DEFF Research Database (Denmark)

    Malmqvist, Lasse; Lindberg, Anne-Sofie Wessel; Dahl, Vedrana Andersen

    2017-01-01

    function using automated perimetric mean deviation (MD) and multifocal visual evoked potentials. Increased age (P = 0.015); larger ODD volume (P = 0.002); and more superficial anatomic ODD location (P = 0.007) were found in patients with ODD visible by ophthalmoscopy compared to patients with buried ODD.......025) and had a higher effect on MD when compared to retinal nerve fiber layer thickness. Large ODD volume is associated with optic nerve dysfunction. The worse visual field defects associated with visible ODD should only be ascribed to larger ODD volume and not to a more superficial anatomic ODD location....

  12. MR imaging findings of retinal hemorrhage in a case of nonaccidental trauma

    International Nuclear Information System (INIS)

    Altinok, Deniz; Saleem, Sheena; Smith, Wilbur; Zhang, Zaixiang; Markman, Lisa

    2009-01-01

    Retinal hemorrhage is a well-recognized manifestation of child abuse found in many babies with shaken baby syndrome. The presence of retinal hemorrhage is generally associated with more severe neurological damage and a worse clinical outcome. MR imaging findings of retinal hemorrhages are not well described in the pediatric literature. We present a 6-month-old boy with new-onset seizures, subdural hemorrhage and bilateral retinal hemorrhages that were detected by MRI and confirmed by indirect ophthalmoscopy. This case demonstrates the MR imaging findings of retinal hemorrhages and the importance of radiologists being able to recognize these specific imaging features. (orig.)

  13. MR imaging findings of retinal hemorrhage in a case of nonaccidental trauma

    Energy Technology Data Exchange (ETDEWEB)

    Altinok, Deniz; Saleem, Sheena; Smith, Wilbur [Children' s Hospital of Michigan, Department of Pediatric Imaging, Detroit, MI (United States); Zhang, Zaixiang [Wayne State University School of Medicine, Department of Radiology, Detroit, MI (United States); Markman, Lisa [Children' s Hospital of Michigan, Child Protection Team, Detroit, MI (United States)

    2009-03-15

    Retinal hemorrhage is a well-recognized manifestation of child abuse found in many babies with shaken baby syndrome. The presence of retinal hemorrhage is generally associated with more severe neurological damage and a worse clinical outcome. MR imaging findings of retinal hemorrhages are not well described in the pediatric literature. We present a 6-month-old boy with new-onset seizures, subdural hemorrhage and bilateral retinal hemorrhages that were detected by MRI and confirmed by indirect ophthalmoscopy. This case demonstrates the MR imaging findings of retinal hemorrhages and the importance of radiologists being able to recognize these specific imaging features. (orig.)

  14. Headache and pregnancy

    DEFF Research Database (Denmark)

    Negro, A; Delaruelle, Z; Ivanova, T A

    2017-01-01

    , brain MRI and MR angiography with contrast ophthalmoscopy and lumbar puncture. During pregnancy and breastfeeding the preferred therapeutic strategy for the treatment of primary headaches should always be a non-pharmacological one. Treatment should not be postponed as an undermanaged headache can lead...... to stress, sleep deprivation, depression and poor nutritional intake that in turn can have negative consequences for both mother and baby. Therefore, if non-pharmacological interventions seem inadequate, a well-considered choice should be made concerning the use of medication, taking into account all...

  15. Comparative study of the retinal nerve fibre layer thickness performed with optical coherence tomography and GDx scanning laser polarimetry in patients with primary open-angle glaucoma.

    Science.gov (United States)

    Wasyluk, Jaromir T; Jankowska-Lech, Irmina; Terelak-Borys, Barbara; Grabska-Liberek, Iwona

    2012-03-01

    We compared the parameters of retinal nerve fibre layer in patients with advanced glaucoma with the use of different OCT (Optical Coherence Tomograph) devices in relation to analogical measurements performed with GDx VCC (Nerve Fiber Analyzer with Variable Corneal Compensation) scanning laser polarimetry. Study subjects had advanced primary open-angle glaucoma, previously treated conservatively, diagnosed and confirmed by additional examinations (visual field, ophthalmoscopy of optic nerve, gonioscopy), A total of 10 patients were enrolled (9 women and 1 man), aged 18-70 years of age. Nineteen eyes with advanced glaucomatous neuropathy were examined. 1) Performing a threshold perimetry Octopus, G2 strategy and ophthalmoscopy of optic nerve to confirm the presence of advanced primary open-angle glaucoma; 2) performing a GDx VCC scanning laser polarimetry of retinal nerve fibre layer; 3) measuring the retinal nerve fibre layer thickness with 3 different optical coherence tomographs. The parameters of the retinal nerve fibre layer thickness are highly correlated between the GDx and OCT Stratus and 3D OCT-1000 devices in mean retinal nerve fibre layer thickness, retinal nerve fibre layer thickness in the upper sector, and correlation of NFI (GDx) with mean retinal nerve fibre layer thickness in OCT examinations. Absolute values of the retinal nerve fibre layer thickness (measured in µm) differ significantly between GDx and all OCT devices. Examination with OCT devices is a sensitive diagnostic method of glaucoma, with good correlation with the results of GDx scanning laser polarimetry of the patients.

  16. Opinion and Special Articles: Amateur fundus photography with various new devices: Our experience as neurology residents.

    Science.gov (United States)

    Zafar, Saman; Cardenas, Ylec Mariana; Leishangthem, Lakshmi; Yaddanapudi, Sridhara

    2018-05-08

    Times are changing in the way we secure and share patient fundus photographs to enhance our diagnostic skills in neurology. At the recent American Academy of Neurology meeting, the use of a fundus camera and smartphones to secure good-quality fundus photographs of patients presenting with headache to the emergency department (ED) was presented. We were enthusiastic to replicate the success of the Fundus Photography vs Ophthalmoscopy Trial Outcomes in the Emergency Department (FOTO-ED) study in our neurology department, but encountered problems in terms of cost, setup, feasibility, and portability of the device. As neurology residents, we came up with 3 easier options. We present these 3 options as our personal experience, and hope to reignite enthusiasm among neurology trainees to find their own means of performing ophthalmoscopy routinely in the hospital, as it appears that the Internet market is now thriving with many other devices to make this examination easier and more rewarding. Of the options explored above, the Handheld Fundus Camera was a clear favorite among the residents, and we have placed one in our call room for routine use. It travels to the clinic, floor, intensive care unit, and ED when needed. It has enhanced the way we approach the fundus examination and been a fun skill to acquire. We look forward to further advances that will make it possible to carry such a device in a physician's pocket. © 2018 American Academy of Neurology.

  17. Ocular findings associated with a Cys39Arg mutation in the Norrie disease gene.

    Science.gov (United States)

    Joos, K M; Kimura, A E; Vandenburgh, K; Bartley, J A; Stone, E M

    1994-12-01

    To diagnose the carriers and noncarriers in a family affected with Norrie disease based on molecular analysis. Family members from three generations, including one affected patient, two obligate carriers, one carrier identified with linkage analysis, one noncarrier identified with linkage analysis, and one female family member with indeterminate carrier status, were examined clinically and electrophysiologically. Linkage analysis had previously failed to determine the carrier status of one female family member in the third generation. Blood samples were screened for mutations in the Norrie disease gene with single-strand conformation polymorphism analysis. The mutation was characterized by dideoxy-termination sequencing. Ophthalmoscopy and electroretinographic examination failed to detect the carrier state. The affected individuals and carriers in this family were found to have a transition from thymidine to cytosine in the first nucleotide of codon 39 of the Norrie disease gene, causing a cysteine-to-arginine mutation. Single-strand conformation polymorphism analysis identified a patient of indeterminate status (by linkage) to be a noncarrier of Norrie disease. Ophthalmoscopy and electroretinography could not identify carriers of this Norrie disease mutation. Single-strand conformation polymorphism analysis was more sensitive and specific than linkage analysis in identifying carriers in this family.

  18. A Patient with Keratoconus, Nanophthalmos, Lipodermoids, and Pigmentary Retinopathy.

    Science.gov (United States)

    Sammouh, Fady K; Baban, Tania A; Warrak, Elias L

    2016-06-01

    A 44-year-old male with no pertinent history other than poor vision for more than 25 years was examined. Best corrected visual acuity was 20/80 OD [MR: +14.25 +1.00 × 15°] and 20/200 OS [MR: +15.00 +1.50 × 175°]. Significant limitation in ocular movements and the presence of an orbital lipodermoid in the infero-temporal aspect of each eye were noted. Forced duction test was positive for the same directions of limitation indicating possible extraocular muscle fibrosis. Ophthalmoscopy was remarkable for the presence of peripheral bony spicules. Corneal topography was compatible with keratoconus (Kmax = 55.04D OD and 52.87D OS). A-scan revealed axial lengths of 16.96 mm OD and 16.32 mm OS, compatible with a diagnosis of nanophthalmos. OCT revealed diffuse macular thickening for both eyes with foveal thickness of 350 µm OD and 353 µm OS. Over the next 12 years the patient had stable visual acuity, manifest refractions and anterior segment examination. Ophthalmoscopy revealed only minimal progression of pigmentary changes. We report the first case of these simultaneous multiple findings which may refer to a possible syndromic association of congenital or early childhood onset.

  19. 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

  20. Long-term effects of short-term retinal bleb detachments in rabbits.

    Science.gov (United States)

    Ivert, Lena; Kjeldbye, Hild; Gouras, Peter

    2002-03-01

    To examine the effects of saline-induced bleb detachments in rabbit retina. Retinal bleb detachments were produced by the injection of 50 microl of balanced salt solution (BSS) into the subretinal space of one eye of each of six rabbits using a glass pipette with a flat tip, 50 microm in diameter. The retina was examined by biomicroscopy, scanning laser ophthalmoscopy (SLO), auto-fluorescence and simultaneous fluorescein and indocyanine green (ICG) angiography. Histological examination was carried out at 1, 2, 3 and 4 months after surgery. All rabbits showed leakage of fluorescein for at least a day after detachment, but within 1 month the leakage ceased. ICG staining developed gradually at the level of the RPE or Bruch's membrane near sites of previous staining. Lipofuscin fluorescence also developed gradually around areas of staining. Histology revealed the source of the excessive lipofuscin to be in the RPE layer, especially in cells migrating away from Bruch's membrane. Short-term bleb detachments cause a transient breakdown in the blood-retinal barrier, long-term ICG staining at or deep to the RPE layer, hyperlipofuscinosis and migration of the RPE. The abnormal lipofuscin accumulation is apparent on fluorescence ophthalmoscopy and can be confused with markers such as green fluorescent protein.

  1. PERIPHERAL AVASCULAR RETINA WITH DISK ANOMALY AND HIGH MYOPIA: A Novel Association in a Hereditary Isolated Ocular Disorder.

    Science.gov (United States)

    Habib, Ahmed M; Elkitkat, Rania S; Saleh, Mohamed I; Abd El-Salam, Mohammed M

    2016-02-01

    To describe a family pedigree with a previously undescribed association of autosomal dominantly inherited ocular abnormalities. Case series study performed on 15 family members. Examination included history taking, visual acuity, intraocular pressure, slit-lamp, gonioscopy, indirect ophthalmoscopy (10 members), fluorescein angiography (5 members), general examination and renal ultrasound (4 members), and hemoglobin electrophoresis for the proband and another member. Family pedigree revealed autosomal-dominant inheritance. Visual acuity ranged from 6/36 to no light perception. Examination revealed rubeosis in 7 eyes and atrophia bulbi in 11 eyes. Indirect ophthalmoscopy for 11 eyes revealed evidence of an ocular triad of peripheral avascular retina, disk anomaly (cavitary optic disk anomaly or disk dysplasia), and tessellated fundus of high myopia. The authors also observed new vessels elsewhere with or without extensive subretinal exudations in 6 eyes. All patients with any residual vision (up to perception of light) had nystagmus. Four affected members underwent general examination, renal ultrasound, and serum creatinine level (to exclude papillorenal syndrome), and all were normal. Hemoglobin electrophoresis (to exclude sickle cell retinopathy) revealed within normal values. To the authors' knowledge, the aforementioned ocular triad has not been previously described, in association, with an autosomal-dominant pattern of inheritance.

  2. Bilateral vision loss in a captive cheetah (Acinonyx jubatus).

    Science.gov (United States)

    Walser-Reinhardt, Ladina; Wernick, Morena B; Hatt, Jean-Michel; Spiess, Bernhard M

    2010-09-01

    The following case report describes a 1-year-old female cheetah (Acinonyx jubatus) with bilateral blindness and unresponsive pupils. For comparison, a second healthy 2.5-year-old male cheetah without visual deficits was also examined. Clinical examination of both animals included biomicroscopy, indirect ophthalmoscopy, tonometry, and electroretinography. The young female cheetah showed no menace response, no direct or indirect pupillary light reflex, and no dazzle reflex in either eye. Fundus lesions, as detected by indirect ophthalmoscopy, are described for the female animal. In both eyes, the fundus color was green/turquoise/yellow with multiple hyperpigmented linear lesions in the tapetal area around the optic nerve. The optic nerve head was dark gray and about half the normal size suggesting bilateral optic nerve hypoplasia and retinal dysplasia or differentially optic nerve atrophy and chorioretinal scarring. The ERG had low amplitudes in the right eye but appeared normal in the left eye compared with the male cheetah. Blood levels did not suggest current taurine deficiency. This is addressed to some degree in the discussion. Bilateral optic nerve hypoplasia or optic nerve atrophy is a rare anomaly in cats and has not yet been described in a cheetah.

  3. Treatment of early complications on eye fundus in patients with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Iva Akmadža

    2016-09-01

    Full Text Available Early ocular complications in patients with diabetes mellitus (DM mostly refer to non-proliferative diabetic retinopathy (NPDR. Generally speaking, diabetic retinopathy (DR is one of the most common causes of blindness and the most common cause of blindness between the age of 20 and 65. DM is a disease characterized by metabolic disorders of carbohydrates, lipids and proteins. The main characteristic is hyperglycemia, which affects all organs by different pathogenetic pathways. The presence of DR is associated with the duration of DM, glycemic control and blood pressure. DR is a microangiopathy and is diagnosed by simple indirect ophthalmoscopy. It is very important to perform regular eye examinations in patients with DM, whereas DR is usually asymptomatic in the early stage of the disease. Optical coherence tomography (OCT has the great importance in diagnostics of DR. Besides indirect ophthalmoscopy and OCT, fluorescein angiography and ultrasound are also widely used to diagnose DR. The prevention of the disease is most important, which is in domain of internal medicine specialist, diabetologist and general practitioner. Intravitreal anti-vascular endothelial growth factor therapy is the gold standard in treatment of NPDR associated with diabetic macular edema (DME and impaired vision. Intravitreal injections of corticosteroids and laser photocoagulation are also used. The current and future treatment modalities are presented in the text that follows.

  4. Nonmydriatic Ocular Fundus Photography in the Emergency Department: How It Can Benefit Neurologists.

    Science.gov (United States)

    Bruce, Beau B

    2015-10-01

    Examination of the ocular fundus is a critical aspect of the neurologic examination. For example, in patients with headache the ocular fundus examination is needed to uncover "red flags" suggestive of secondary etiologies. However, ocular fundus examination is infrequently and poorly performed in clinical practice. Nonmydriatic ocular fundus photography provides an alternative to direct ophthalmoscopy that has been studied as part of the Fundus Photography versus Ophthalmoscopy Trial Outcomes in the Emergency Department (FOTO-ED) Study. Herein, the results of the FOTO-ED study are reviewed with a particular focus on the study's implications for the acute care of patients presenting with headache and focal neurologic deficits. In headache patients, not only optic disc edema and optic disc pallor were observed as would be expected, but also a large number of abnormalities associated with hypertension. Based upon subjects with focal neurologic deficits, the FOTO-ED study suggests that the ocular fundus examination may assist with the triage of patients presenting with suspected transient ischemic attack. Continued advances in the ease and portability of nonmydriatic fundus photography will hopefully help to restore ocular fundus examination as a routinely performed component of all neurologic examinations. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  5. Non-mydriatic ocular fundus photography in the emergency department: how it can benefit neurologists

    Science.gov (United States)

    Bruce, Beau B.

    2016-01-01

    Examination of the ocular fundus is a critical aspect of the neurological examination. For example, in patients with headache the ocular fundus examination is needed to uncover “red flags” suggestive of secondary etiologies. However, ocular fundus examination is infrequently and poorly performed in clinical practice. Non-mydriatic ocular fundus photography provides an alternative to direct ophthalmoscopy that has been studied as part of the Fundus photography vs. Ophthalmoscopy Trial Outcomes in the Emergency Department (FOTO-ED) study. Herein, we review the results of the FOTO-ED study with a particular focus on the study's implications for the acute care of patients presenting with headache and focal neurologic deficits. In headache patients, we not only observed optic disc edema and optic disc pallor as would be expected, but also a large number of abnormalities associated with hypertension. Based upon subjects with focal neurological deficits, the FOTO-ED study suggests that the ocular fundus examination may assist with the triage of patients presenting with suspected transient ischemic attack. Continued advances in the ease and portability of non-mydriatic fundus photography will hopefully help to restore ocular fundus examination as a routinely performed component of all neurological examinations. PMID:26444394

  6. Computer-Aided Video Differential Planimetry

    Science.gov (United States)

    Tobin, Michael; Djoleto, Ben D.

    1984-08-01

    THE VIDEO DIFFERENTIAL PLANIMETER (VDP)1 is a re-mote sensing instrument that can measure minute changes in the area of any object seen by an optical scanning system. The composite video waveforms obtained by scanning the object against a contrasting back-ground are amplified and shaped to yield a sequence of constant amplitude pulses whose polarity distinguishes the studied area from its background and whose varying widths reflect the dynamics of the viewed object. These pulses are passed through a relatively long time-constant capacitor-resistor circuit and are then fed into an integrator. The net integration voltage resulting from the most recent sequence of object-background time pulses is recorded and the integrator is returned to zero at the end of each video frame. If the object's area remains constant throughout the following frame, the integrator's summation will also remain constant. However, if the object's area varies, the positive and negative time pulses entering the integrator will change, and the integrator's summation will vary proportionately. The addition of a computer interface and a video recorder enhances the versatility and the resolving power of the VDP by permitting the repeated study and analysis of selected portions of the recorded data, thereby uncovering the major sources of the object's dynamics. Among the medical and biological procedures for which COMPUTER-AIDED VIDEO DIFFERENTIAL PLANIMETRY is suitable are Ophthalmoscopy, Endoscopy, Microscopy, Plethysmography, etc. A recent research study in Ophthalmoscopy2 will be cited to suggest a useful application of Video Differential Planimetry.

  7. Role of imaging in glaucoma diagnosis and follow-up

    Directory of Open Access Journals (Sweden)

    Vizzeri Gianmarco

    2011-12-01

    Full Text Available The purpose of the review is to provide an update on the role of imaging devices in the diagnosis and follow-up of glaucoma with an emphasis on techniques for detecting glaucomatous progression and the newer spectral domain optical coherence tomography instruments. Imaging instruments provide objective quantitative measures of the optic disc and the retinal nerve fiber layer and are increasingly utilized in clinical practice. This review will summarize the recent enhancements in confocal scanning laser ophthalmoscopy, scanning laser polarimetry, and optical coherence tomography with an emphasis on how to utilize these techniques to manage glaucoma patients and highlight the strengths and limitations of each technology. In addition, this review will briefly describe the sophisticated data analysis strategies that are now available to detect glaucomatous change overtime.

  8. Dengue retinochoroiditis.

    Science.gov (United States)

    Tabbara, Khalid

    2012-01-01

    Dengue is a mosquito-borne infection caused by a flavivirus. I describe the ocular findings observed in two patients infected with dengue virus who presented with acute onset of loss of vision preceded by febrile illness, malaise, generalized fatigue headache, and maculopapular rash. Ophthalmologic evaluation in each patient revealed a normal anterior segment. Vitreous cells were noted in one patient. Ophthalmoscopy revealed multiple foci of retinochoroiditis, vasculitis, cotton-wool spots, and retinal hemorrhages. The healing of the lesion showed discrete atrophic and pigmented retinochoroiditic scars. Fluorescein angiography displayed early hypofluorescence and late hyperfluorescence suggestive of leakage. The healed scars showed late staining. The serologic testing showed elevated IgG antibodies, and one had high IgM antibodies to dengue virus. Ocular findings of dengue fever consist of multifocal areas of retinochoroiditis and may lead to loss of vision. In Saudi Arabia, dengue fever should be considered in the differential diagnosis of multifocal chorioretinal lesions and retinal vasculitis.

  9. Chaetomium retinitis.

    Science.gov (United States)

    Tabbara, Khalid F; Wedin, Keith; Al Haddab, Saad

    2010-01-01

    To report a case of Chaetomium atrobrunneum retinitis in a patient with Hodgkin lymphoma. We studied the ocular manifestations of an 11-year-old boy with retinitis. Biomicroscopy, ophthalmoscopy, and fundus photography were done. Magnetic resonance imaging of the brain was performed. A vitreous biopsy was subjected to viral, bacterial, and fungal cultures. Vitreous culture grew C. atrobrunneum. Magnetic resonance imaging showed multiple cerebral lesions consistent with an infectious process. The patient was given intravenous voriconazole and showed improvement of the ocular and central nervous system lesions. We report a case of central nervous system and ocular lesions by C. atrobrunneum. The retinitis was initially misdiagnosed as cytomegaloviral retinitis. Vitreous biopsy helped in the early diagnosis and prompt treatment of a life- and vision-threatening infection.

  10. Validity and cost-effectiveness of methods for screening of primary open angle glaucoma

    Directory of Open Access Journals (Sweden)

    Fröschl, Barbara

    2007-02-01

    Full Text Available Health political background: About 950,000 people are affected by glaucoma in Germany, about 50% of which are undiagnosed. The German Ophthalmological Society and the German Association of Ophthalmologists recommend a screening for glaucoma according to their guidelines. The Federal Joint Committee disapproved a glaucoma-screening program on expense of the compulsory health insurance in 2004. Scientific background: Primary open angle glaucoma is diagnosed by evaluation of the optic disc, the retinal fibre layer and the visual field. The main examinations are ophthalmoscopy, scanning laser polarimetry, confocal scanning laser ophthalmoscopy, retinal thickness analysis and optical coherence tomography. Scotomas are diagnosed by perimetry (standard automated perimetry, short wavelength automated perimetry and frequency doubling perimetry. The intraocular pressure is the most important treatable risk factor and is measured by (contact or non-contact tonometry. Research questions: The aim of this HTA-report is to investigate the diagnostic validity and cost effectiveness of diagnostic techniques or combinations of these methods with respect to the use in a screening setting in Germany. Methods: A systematic literature research was performed in 35 international databases and yielded 2602 articles. Overall 57 publications were included for assessment, according to predefined selection criteria. Results: The 55 medical articles deal mainly with frequency doubling perimetry, confocal scanning laser ophthalmoscopy and scanning laser polarimetry. Few articles cover short wavelength automated perimetry, tonometry and ophalmocopic evaluations by ophthalmologists. The quality of the papers is generally low, as far as the evidence in respect of screening is concerned. No single method exists with both, high sensitivity and high specificity for screening purpose. Data are also not sufficient to recommend combinations of methods. Only two economic models on cost

  11. Sudden acquired retinal degeneration syndrome in western Canada: 93 cases.

    Science.gov (United States)

    Leis, Marina L; Lucyshyn, Danica; Bauer, Bianca S; Grahn, Bruce H; Sandmeyer, Lynne S

    2017-11-01

    This study reviewed clinical data from dogs diagnosed with sudden acquired retinal degeneration syndrome (SARDS) in western Canada. Medical records from the Western College of Veterinary Medicine from 2002 to 2016 showed that 93 cases of SARDS were diagnosed based on presentation for sudden blindness and a bilaterally extinguished electroretinogram. The most common pure breeds were the miniature schnauzer, dachshund, and pug. The mean age at diagnosis was 8.1 years and males and females were equally affected. Most of the dogs were presented with normal non-chromatic, but abnormal chromatic pupillary light reflexes. The incidence of retinal degeneration as detected via ophthalmoscopy increased over time after SARDS diagnosis. Polyuria, polydipsia, polyphagia, weight gain, elevated liver enzyme values, isosthenuria, and proteinuria were common clinical and laboratory findings. Chromatic pupillary light reflex testing may be more valuable than non-chromatic pupillary light testing in detecting pupil response abnormalities in dogs with SARDS, although electroretinography remains the definitive diagnostic test.

  12. Intravitreal flomoxef sodium in rabbits.

    Science.gov (United States)

    Mochizuki, K; Torisaki, M; Yamashita, Y; Komatsu, M; Tanahashi, T

    1993-01-01

    We studied the intraocular concentration of flomoxef sodium in nonvitrectomized and vitrectomized eyes of albino rabbits after intravenous administration of 100 mg/kg flomoxef sodium. The concentration of flomoxef sodium in the vitreous body was undetectable (flomoxef sodium was investigated with ophthalmoscopy, electroretinography (ERG) and light microscopy after intravitreal injection of 200, 500, 1,000 and 2,000 micrograms flomoxef sodium in albino and pigmented rabbits. No ERG changes were induced with 200 micrograms. Other higher doses caused transient ERG changes. After the 200-micrograms injection, the intravitreal concentration decreased exponentially, the half-life being 4.4 h. The antibacterial activity, broad coverage and low intravitreal toxicity of flomoxef sodium suggest that this compound may be used to treat bacterial endophthalmitis.

  13. Combining morphometric features and convolutional networks fusion for glaucoma diagnosis

    Science.gov (United States)

    Perdomo, Oscar; Arevalo, John; González, Fabio A.

    2017-11-01

    Glaucoma is an eye condition that leads to loss of vision and blindness. Ophthalmoscopy exam evaluates the shape, color and proportion between the optic disc and physiologic cup, but the lack of agreement among experts is still the main diagnosis problem. The application of deep convolutional neural networks combined with automatic extraction of features such as: the cup-to-disc distance in the four quadrants, the perimeter, area, eccentricity, the major radio, the minor radio in optic disc and cup, in addition to all the ratios among the previous parameters may help with a better automatic grading of glaucoma. This paper presents a strategy to merge morphological features and deep convolutional neural networks as a novel methodology to support the glaucoma diagnosis in eye fundus images.

  14. Retinitis due to opportunistic infections in Iranian HIV infected patients.

    Directory of Open Access Journals (Sweden)

    Ali Abdollahi

    2013-10-01

    Full Text Available We tried to evaluate prevalence and characteristics of Iranian HIV infected patients with retinitis due to opportunistic infections. In this cross sectional study, we evaluated 106 HIV infected patients via indirect ophthalmoscopy and slit lamp examination by 90 lens to find retinitis cases. General information and results of ophthalmologic examination were analyzed. Prevalence of retinitis due to opportunistic infections was 6.6%: cytomegalovirus (CMV retinitis 1.88%, toxoplasmosis retinochoroiditis 1.88% and tuberculosis chorioretinitis 2.83%. CD4 count was higher than 50 cell/µlit in both cases with CMV retinitis. Along with increasing survival in the HIV infected patients, the prevalence of complications such as ocular manifestation due to opportunistic infections are increasing and must be more considered.

  15. The assessment of visually impaired persons working capacities using electrophysiological and ophthalmic ergonomics methods

    Directory of Open Access Journals (Sweden)

    M. I. Razumovsky

    2014-07-01

    Full Text Available Aim was to analyze working capacities of visually impaired persons by means of complex electrophysiological and ophthalmic ergonomics eye examination.Materials and methods. Standard clinical ophthalmologic examination (visual acuity measurement, refractometry, biomicroscopy, ophthalmoscopy as well as electrophysiological (electrooculography, electrical sensitivity of the eye, critical flicker fusion frequency and ophthalmic ergonomics tests (accommodation measurement, professional testing using automated system «Proftest-1» were performed.Results. Complex electrophysiological and ophthalmic ergonomics tests were performed in 20 visually impaired persons. Their results revealed direct correlation between electrophysiological and ophthalmic ergonomics indices.Conclusion. Working capacities of visually impaired persons can be assessed reliably using complex electrophysiological and ophthalmic ergonomics eye examination only.

  16. The assessment of visually impaired persons working capacities using electrophysiological and ophthalmic ergonomics methods

    Directory of Open Access Journals (Sweden)

    M. I. Razumovsky

    2014-01-01

    Full Text Available Aim was to analyze working capacities of visually impaired persons by means of complex electrophysiological and ophthalmic ergonomics eye examination.Materials and methods. Standard clinical ophthalmologic examination (visual acuity measurement, refractometry, biomicroscopy, ophthalmoscopy as well as electrophysiological (electrooculography, electrical sensitivity of the eye, critical flicker fusion frequency and ophthalmic ergonomics tests (accommodation measurement, professional testing using automated system «Proftest-1» were performed.Results. Complex electrophysiological and ophthalmic ergonomics tests were performed in 20 visually impaired persons. Their results revealed direct correlation between electrophysiological and ophthalmic ergonomics indices.Conclusion. Working capacities of visually impaired persons can be assessed reliably using complex electrophysiological and ophthalmic ergonomics eye examination only.

  17. 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.

  18. Analysis of the ABCR (ABCA4) gene in 4-aminoquinoline retinopathy: is retinal toxicity by chloroquine and hydroxychloroquine related to Stargardt disease?

    Science.gov (United States)

    Shroyer, N F; Lewis, R A; Lupski, J R

    2001-06-01

    To determine if mutations in ABCR (ABCA4) are associated with chloroquine/hydroxychloroquine retinopathy. DNA from eight patients with chloroquine or hydroxychloroquine retinopathy was studied. Controls were 80 individuals over age 65 years with normal retinal examinations. Ophthalmoscopy, color vision testing, visual fields, retinal photography, and fluorescein angiography were performed on the eight patients. Direct DNA sequencing of the exons and flanking intronic regions of the ABCR gene was completed for all patients. Clinical evaluation confirmed the diagnosis of chloroquine/hydroxychloroquine retinopathy and excluded Stargardt disease in each patient. Two patients had heterozygous ABCR missense mutations previously associated with Stargardt disease. None of the controls had these missense mutations. Three other patients had other missense polymorphisms. Some individuals who have ABCR mutations may be predisposed to develop retinal toxicity when exposed to chloroquine/hydroxychloroquine. We urge further study of a larger cohort of patients with chloroquine/hydroxychloroquine retinopathy.

  19. Microperimetry and optical coherent tomography in patients operated on y the conventional retinal detachment surgery

    International Nuclear Information System (INIS)

    Guerra Garcia, Roberto Alejandro; Rodriguez Rodriguez, Beatriz N; Eguia Martinez, Frank

    2008-01-01

    A descriptive study was made to determine the visual acuity, microperimetry and optical coherence tomography in patients operated on by the conventional rhegmatogenous retinal detachment at 'Ramon Pando Ferrer' Cuban Ophthalmologic Institute from October 2006 to March 2007. Twenty six patients, who had gone to the hospital with normal values in ophthalmoscopy and biomicroscopy and three-six months of disease development. Better corrected visual acuity, fixation, average sensitivity, morphology and macular thickness were obtained after surgery. Average visual acuity was 0,41 and fixation was stable in most of patients; average retinal sensitivity was 11 decibels. The most frequent finding was serum detachment. Average macular thickness was 246,3 micras. There was no statistical relation between preoperative time of disease development and the macular characteristics of detachment in these tests. (Author)

  20. Central Retinal Artery Occlusion in a Patient with Metabolic Syndrome X

    Directory of Open Access Journals (Sweden)

    Sonja Predrag Cekić

    2010-01-01

    Full Text Available Purpose: To report a case of central retinal artery occlusion (CRAO in a patient with metabolic syndrome X. Case Report: A 64 year-old-man presented with abrupt, painless, and severe loss of vision in his left eye. Indirect ophthalmoscopy disclosed signs compatible with CRAO and laboratory investigations revealed erythrocyte sedimentation rate of 74 mm/h, C-reactive protein (CRP level of 21 mg/l, hyperglycemia, hyperuricemia, hypertriglyceridemia and hypercholesterolemia. Fluorescein angiography and immunological studies excluded other systemic disorders. The patient met the full criteria of the National Cholesterol Education Program for metabolic syndrome X. Conclusion: In addition to different vascular complications such as stroke, and cardiovascular disease, metabolic syndrome X may be associated with retinal vascular occlusions.

  1. Validity of dual X-ray absorptiometry scanning for determination of body composition in IDDM patients

    DEFF Research Database (Denmark)

    Rosenfalck, A M; Almdal, T; Gotfredsen, A

    1995-01-01

    Data on body composition in patients with insulin-dependent diabetes mellitus (IDDM) are scarce. Dual X-ray absorptiometry (DXA) scanning has proved useful for this purpose in other groups of patients. We tested the validity of the DXA scanner for the determination of fat-free mass (FFM) and fat......, 5 males and 8 females, aged 34.2 years +/- SD 10.4, and 11 IDDM patients, 5 males, 6 females, aged 28.1 years +/- 7.3, diabetes duration 4.2 +/- 2.9 (1.0-9.9), were examined. The patients had no long-term diabetic complications and they had normal ophthalmoscopy and urine albumin excretion...

  2. Radiotherapy of choroidal metastases

    Energy Technology Data Exchange (ETDEWEB)

    Hoogenhout, J; Gasteren, J J.M. van; Brink, H M.A.; Verbeek, A M; Beex, L V.A.M.

    1989-05-01

    With binocular indirect ophthalmoscopy, fluorescin angiography and ultrasonography 68 choroidal metastases in 52 eyes of 39 patients were diagnosed. The primary tumors were mainly breast cancer (81%) and lung cancer (10%). After radiation treatment the visual acuity improved in 17 eyes (38%), stabilized in 15 eyes (33%), whereas in 13 eyes (29%) deterioration could not be prevented (seven eyes unknown). Regression of the lesions or its accompanying secondary retinal detachment was seen in 78% of the eyes treated. Acute transient side effects of radiation therapy were keratoconjunctivitis (nine patients) and acute glaucoma in one patient. No cataractous changes of the lens were observed in the post radiation period (one to 42 months). Irradiation of choroidal metastases can contribute to improvement of the quality of life with a treatment scheme of 30 Gy in ten daily fractions.

  3. Genetic heterogeneity in familial exudative vitreoretinopathy; exclusion of the EVR1 locus on chromosome 11q in a large autosomal dominant pedigree.

    Science.gov (United States)

    Bamashmus, M A; Downey, L M; Inglehearn, C F; Gupta, S R; Mansfield, D C

    2000-04-01

    Familial exudative vitreoretinopathy (FEVR) is associated with mutations in the Norrie disease gene in X linked pedigrees and with linkage to the EVR1 locus at 11q13 in autosomal dominant cases. A large autosomal dominant FEVR family was studied, both clinically and by linkage analysis, to determine whether it differed from the known forms of FEVR. Affected members and obligate gene carriers from this family were examined by slit lamp biomicroscopy, indirect ophthalmoscopy, and in some cases fluorescein angiography. Patient DNAs were genotyped for markers at the EVR1 locus on chromosome 11q13. The clinical evaluation in this family is consistent with previous descriptions of FEVR pedigrees, but linkage analysis proves that it has a form of FEVR genetically distinct from the EVR1 locus on 11q. This proves that there are at least three different loci associated with comparable FEVR phenotypes, a situation similar to that existing for many forms of retinal degeneration.

  4. Evaluation of state-of-the-art imaging systems for in vivo monitoring of retinal structure in mice: current capabilities and limitations

    Science.gov (United States)

    Zhang, Pengfei; Zam, Azhar; Pugh, Edward N.; Zawadzki, Robert J.

    2014-02-01

    Animal models of human diseases play an important role in studying and advancing our understanding of these conditions, allowing molecular level studies of pathogenesis as well as testing of new therapies. Recently several non-invasive imaging modalities including Fundus Camera, Scanning Laser Ophthalmoscopy (SLO) and Optical Coherence Tomography (OCT) have been successfully applied to monitor changes in the retinas of the living animals in experiments in which a single animal is followed over a portion of its lifespan. Here we evaluate the capabilities and limitations of these three imaging modalities for visualization of specific structures in the mouse eye. Example images acquired from different types of mice are presented. Future directions of development for these instruments and potential advantages of multi-modal imaging systems are discussed as well.

  5. [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.

  6. Sudden acquired retinal degeneration syndrome in western Canada: 93 cases

    Science.gov (United States)

    Leis, Marina L.; Lucyshyn, Danica; Bauer, Bianca S.; Grahn, Bruce H.; Sandmeyer, Lynne S.

    2017-01-01

    This study reviewed clinical data from dogs diagnosed with sudden acquired retinal degeneration syndrome (SARDS) in western Canada. Medical records from the Western College of Veterinary Medicine from 2002 to 2016 showed that 93 cases of SARDS were diagnosed based on presentation for sudden blindness and a bilaterally extinguished electroretinogram. The most common pure breeds were the miniature schnauzer, dachshund, and pug. The mean age at diagnosis was 8.1 years and males and females were equally affected. Most of the dogs were presented with normal non-chromatic, but abnormal chromatic pupillary light reflexes. The incidence of retinal degeneration as detected via ophthalmoscopy increased over time after SARDS diagnosis. Polyuria, polydipsia, polyphagia, weight gain, elevated liver enzyme values, isosthenuria, and proteinuria were common clinical and laboratory findings. Chromatic pupillary light reflex testing may be more valuable than non-chromatic pupillary light testing in detecting pupil response abnormalities in dogs with SARDS, although electroretinography remains the definitive diagnostic test. PMID:29089658

  7. Suppression of experimental tractional retinal detachment by low-dose radiation therapy

    International Nuclear Information System (INIS)

    Meredith, T.A.; Ficker, L.; Stevens, R.; Olkowski, Z.; Anderson, M.; Hartmann, J.; Crocker, I.

    1988-01-01

    We used a standardized model of traction retinal detachment (TRD) created by cellular membranes in the rabbit to test the effects of low-dose radiation therapy in suppressing TRD. The vitreous and lens were removed from pigmented rabbits, and homologous conjunctival fibroblasts were grown in cell culture. After resolution of postoperative inflammation, 50,000 fibroblasts in 0.1 mL of culture fluid were injected into the vitreous cavity. Ten eyes were maintained as controls. Nineteen eyes received 6 Gy (600 rad) of x-ray irradiation one to three hours after cellular injection. Eyes were monitored weekly for three weeks with indirect ophthalmoscopy. Seven (70%) of ten control eyes developed TRD at one week; no additional TRDs were noted at weeks 2 and 3. Significantly smaller numbers of irradiated eyes developed TRD: at week 1, two (11%) of 19; at week 2, five (28%) of 18; and at week 3, five (29%) of 17

  8. Proliferative retinopathy predicts nephropathy

    DEFF Research Database (Denmark)

    Karlberg, Charlotte; Falk, Christine; Green, Anders

    2012-01-01

    We wanted to examine proliferative retinopathy as a marker of incident nephropathy in a 25-year follow-up study of a population-based cohort of Danish type 1 diabetic patients and to examine cross-sectional associations between nephropathy and retinopathy in long-term surviving patients of the same...... cohort. All type 1 diabetic patients from Fyn County, Denmark, were identified as of 1 July 1973. One hundred and eighty four patients were examined in 1981-1982 (baseline) and in 2007-2008 (follow-up). The level of retinopathy was graded by ophthalmoscopy at baseline and nine-field digital colour fundus...... and proliferative retinopathy, respectively. In conclusion, proliferative retinopathy is an independent marker of long-term nephropathy in type 1 diabetes. Upcoming studies should examine whether these microvascular complications are also causally linked in type 1 diabetes....

  9. Digital tool for detecting diabetic retinopathy in retinography image using gabor transform

    Science.gov (United States)

    Morales, Y.; Nuñez, R.; Suarez, J.; Torres, C.

    2017-01-01

    Diabetic retinopathy is a chronic disease and is the leading cause of blindness in the population. The fundamental problem is that diabetic retinopathy is usually asymptomatic in its early stage and, in advanced stages, it becomes incurable, hence the importance of early detection. To detect diabetic retinopathy, the ophthalmologist examines the fundus by ophthalmoscopy, after sends the patient to get a Retinography. Sometimes, these retinography are not of good quality. This paper show the implementation of a digital tool that facilitates to ophthalmologist provide better patient diagnosis suffering from diabetic retinopathy, informing them that type of retinopathy has and to what degree of severity is find . This tool develops an algorithm in Matlab based on Gabor transform and in the application of digital filters to provide better and higher quality of retinography. The performance of algorithm has been compared with conventional methods obtaining resulting filtered images with better contrast and higher.

  10. Advances in Retinal Optical Imaging

    Directory of Open Access Journals (Sweden)

    Yanxiu Li

    2018-04-01

    Full Text Available Retinal imaging has undergone a revolution in the past 50 years to allow for better understanding of the eye in health and disease. Significant improvements have occurred both in hardware such as lasers and optics in addition to software image analysis. Optical imaging modalities include optical coherence tomography (OCT, OCT angiography (OCTA, photoacoustic microscopy (PAM, scanning laser ophthalmoscopy (SLO, adaptive optics (AO, fundus autofluorescence (FAF, and molecular imaging (MI. These imaging modalities have enabled improved visualization of retinal pathophysiology and have had a substantial impact on basic and translational medical research. These improvements in technology have translated into early disease detection, more accurate diagnosis, and improved management of numerous chorioretinal diseases. This article summarizes recent advances and applications of retinal optical imaging techniques, discusses current clinical challenges, and predicts future directions in retinal optical imaging.

  11. Large intradural craniospinal arachnoid cyst: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Souvagya Panigrahi

    2012-01-01

    Full Text Available Presence of an arachnoid cyst at craniospinal junction is not very common. This is a very rare anatomic site, with only seven other cases reported in the literature. We report a case of large intradural craniospinal arachnoid cyst presenting with obstructive hydrocephalus and cranial nerve palsy. A 39-year-old male presented with 8-month history of neck pain, headache, vomiting, visual disturbances, diminished taste sensation, and numbness of face. He had bilateral papilledema on ophthalmoscopy. Magnetic resonance imaging (MRI revealed a posterior fossa arachnoid cyst extending down to the lower border of C5 vertebra. Posterior decompression was done through C5 laminectomy. He made a full recovery and was asymptomatic at 6-month follow-up examination. The clinical features, diagnosis, and management of these rare craniospinal arachnoid cysts are discussed.

  12. [Type 2 diabetes mellitus and chronic kidney disease].

    Science.gov (United States)

    Ponťuch, Peter

    The number of type 2 diabetic patients is increasing world-wide and a prediction of prevalence of chronic kidney disease up to 2025 in European diabetic population is alarming. Albuminuria and estimated glomerular filtration rate are cardinal biochemical parameters in diagnostics of diabetic nephropathy. Following diagnostic methods are also used: renal ultrasonography, ophthalmoscopy and in not clarified cases renal biopsy. Long-term optimal glycemic control, efficient antihypertensive treatment by angiotensin converting enzyme inhibitor, or angiotensin receptor blocker and recommended protein intake is a cornerstone of therapy. The research is presently focused on new pathophysiological mechanisms, as analysis of genome, microRNA, kidney injury biomarkers and proteomes.Key words: chronic kidney disease - type 2 diabetes mellitus.

  13. Complementary angiographic and autofluorescence findings in pseudoxanthoma elasticum.

    Science.gov (United States)

    Lee, Thomas K M; Forooghian, Farzin; Cukras, Catherine; Wong, Wai T; Chew, Emily Y; Meyerle, Catherine B

    2010-02-01

    Pseudoxanthoma elasticum (PXE) is a systemic disease with characteristic findings on fundus examination. The fundus findings may be difficult to detect with ophthalmoscopy. A case report is described as follows. A PXE patient had subtle retinal findings on fundoscopy that were more prominently seen using a combination of both fundus autofluorescence (FAF) imaging and indocyanine green (ICG) angiography. The fundus features visualized using each of these two modalities appeared different from each other. FAF imaging and ICG angiography may be able to more prominently detect pathology at the level of the retinal pigment epithelium and Bruch's membrane, respectively. The use of these imaging modalities together may be complementary and useful in the evaluation of patients with PXE.

  14. Radiation retinopathy caused by low dose irradiation and antithyroid drug-induced systemic vasculitis

    International Nuclear Information System (INIS)

    Sonoda, Koh-hei; Ishibashi, Tatsuro

    2005-01-01

    We report on a patient with Graves' disease with radiation retinopathy caused by low-dose irradiation and antithyroid drug-induced antineutrophil cytoplasmic antibody (ANCA)-positive vasculitis. A 38-year-old woman with Graves' disease presented with bilateral blurred vision, micro-aneurysms, telangiectasia, and macular edema. The patient was examined by ophthalmoscopy and fluorescein angiography, and radiation retinopathy was diagnosed. The patient had been treated with low-dose irradiation for her Graves' ophthalmopathy a few years earlier. She also had ANCA-positive vasculitis induced by the antithyroid drug (propylthiouracil, PTU) that had been prescribed for her at that time. Because of multiple avascular areas on both retinas, she was treated by intensive retinal photocoagulation to control progressive retinopathy. The radiation doses used to treat Graves' disease ophthalmopathy are low. Nevertheless, there is still a risk of radiation retinopathy developing in patients with PTU-induced ANCA-positive vasculitis. (author)

  15. Relation of anthropometric measurements to ocular biometric changes and refractive error in children with thalassemia.

    Science.gov (United States)

    Elkitkat, Rania S; El-Shazly, Amany A; Ebeid, Weam M; Deghedy, Marwa R

    2018-03-01

    To evaluate and correlate anthropometric, biometric, and refractive error changes in thalassemia major (TM). One hundred children with TM and another hundred healthy controls were recruited. Height, weight, body mass index (BMI), and occipitofrontal circumference (OFC) were the anthropometric parameters recorded. Full ophthalmologic examination was performed, including best-corrected visual acuity, cycloplegic refraction, slit-lamp examination, Goldmann applanation tonometry, indirect ophthalmoscopy, keratometry (K readings), and ocular biometry. Compared to controls, children with TM were shorter and lighter, with a smaller BMI (pbiometric data, patients with thalassemia had steeper mean K readings (p = 0.03), shorter axial length (AXL) (p = 0.005), shorter vitreous chamber depth (pbiometric changes (steeper corneas and thicker lenses) to reach emmetropization, with an exaggerated response and subsequent myopic shift. However, growth retardation is not directly related to ocular growth changes, myopic shift, or variations in biometric parameters.

  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. Syphilitic posterior placoid chorioretinitis as initial presentation of early neurosyphilis.

    Science.gov (United States)

    Molina-Sócola, F E; López-Herrero, F; Medina-Tapia, A; Rueda-Rueda, T; Contreras-Díaz, M; Sánchez-Vicente, J L

    2017-10-01

    A 36 year-old male with a recent HIV diagnosis, presented with loss of vision of his left eye. Ophthalmoscopy revealed a unilateral yellowish placoid lesion in the macula. After fluorescein angiography, optical coherence tomography, optical coherence tomography angiography, syphilis serology, and cerebrospinal fluid results, he was diagnosed with neurosyphilis and syphilitic posterior placoid chorioretinitis. Acute syphilitic posterior placoid chorioretinitis is a rare ocular manifestation of syphilis. All patients with characteristic clinical and angiographic findings of acute syphilitic posterior placoid chorioretinitis should be tested for a neurosyphilis and human immunodeficiency virus co-infection. Early treatment with intravenous penicillin is usually effective with good visual results. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Modern technologies for retinal scanning and imaging: an introduction for the biomedical engineer

    Science.gov (United States)

    2014-01-01

    This review article is meant to help biomedical engineers and nonphysical scientists better understand the principles of, and the main trends in modern scanning and imaging modalities used in ophthalmology. It is intended to ease the communication between physicists, medical doctors and engineers, and hopefully encourage “classical” biomedical engineers to generate new ideas and to initiate projects in an area which has traditionally been dominated by optical physics. Most of the methods involved are applicable to other areas of biomedical optics and optoelectronics, such as microscopic imaging, spectroscopy, spectral imaging, opto-acoustic tomography, fluorescence imaging etc., all of which are with potential biomedical application. Although all described methods are novel and important, the emphasis of this review has been placed on three technologies introduced in the 1990’s and still undergoing vigorous development: Confocal Scanning Laser Ophthalmoscopy, Optical Coherence Tomography, and polarization-sensitive retinal scanning. PMID:24779618

  19. 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

  20. Proliferative diabetic retinopathy is associated with microalbuminuria in patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    M.C. Boelter

    2006-08-01

    Full Text Available Diabetic retinopathy is one of the leading causes of blindness in working-age individuals. Diabetic patients with proteinuria or those on dialysis usually present severe forms of diabetic retinopathy, but the association of diabetic retinopathy with early stages of diabetic nephropathy has not been entirely established. A cross-sectional study was conducted on 1214 type 2 diabetic patients to determine whether microalbuminuria is associated with proliferative diabetic retinopathy in these patients. Patients were evaluated by direct and indirect ophthalmoscopy and grouped according to the presence or absence of proliferative diabetic retinopathy. The agreement of diabetic retinopathy classification performed by ophthalmoscopy and by stereoscopic color fundus photographs was 95.1% (kappa = 0.735; P < 0.001. Demographic information, smoking history, anthropometric and blood pressure measurements, glycemic and lipid profile, and urinary albumin were evaluated. On multiple regression analysis, diabetic nephropathy (OR = 5.18, 95% CI = 2.91-9.22, P < 0.001, insulin use (OR = 2.52, 95% CI = 1.47-4.31, P = 0.001 and diabetes duration (OR = 1.04, 95% CI = 1.01-1.07, P = 0.011 were positively associated with proliferative diabetic retinopathy, and body mass index (OR = 0.90, 95% CI = 0.86-0.96, P < 0.001 was negatively associated with it. When patients with macroalbuminuria and on dialysis were excluded, microalbuminuria (OR = 3.3, 95% CI = 1.56-6.98, P = 0.002 remained associated with proliferative diabetic retinopathy. Therefore, type 2 diabetic patients with proliferative diabetic retinopathy more often presented renal involvement, including urinary albumin excretion within the microalbuminuria range. Therefore, all patients with proliferative diabetic retinopathy should undergo an evaluation of renal function including urinary albumin measurements.

  1. Slit lamps and lenses: a potential source of nosocomial infections?

    Science.gov (United States)

    Sobolewska, Bianka; Buhl, Michael; Liese, Jan; Ziemssen, Focke

    2018-01-30

    The aim of the study was to evaluate the bacterial contamination level of contact surfaces on slit lamps and the grip areas of lenses. Within unannounced audits, two regions of the slit lamps (headrest and joystick), indirect ophthalmoscopy devices, and ultrasound probes were obtained with rayon-tipped swab. Non-contact lenses used for indirect fundoscopy were pressed on RODAC (Replicate Organism Detection and Counting) plates. One hundred and eighty-one surfaces were sampled. The total number of colony-forming units was assessed and bacterial species were identified. Spa-typing and antimicrobial susceptibility testing were performed from Staphylococcus aureus isolates. Among the total bacterial isolates from ophthalmological equipment (lenses: 51 of 78, slit lamps: 43 of 88, ophthalmoscopy helmets: 3 of 8, ultrasound probes: 2 of 7), coagulase-negative staphylococci (CNS) was most frequently found, followed by Micrococcus spp. (lenses vs. slit lamps: P lenses (76%) was significantly higher than that of slit lamps (54%) (P lenses from residents vs. from consultants (78% vs. 35%, P = 0.01). A total of seven different spa-types of S. aureus were isolated. No correlation was found between S. aureus contamination of different ophthalmological equipments (Spearman's rank correlation coefficient, ρ = 0.04, P = 0.75). Methicillin-resistant S. aureus was not detected. Bacterial species of the normal skin flora were isolated from the ophthalmological equipment. The bacterial contamination of the portable devices was significantly higher than that of slit lamps. Therefore, proper hygiene of the mobile instruments should be monitored in order to prevent transmission of bacteria in residents and consultants.

  2. Clinical Abservation of Krypton Laser Photocoagulation Preventing Retinal Detachment after LASIK on High Myopia%眼底激光预防中高度近视LASIK术后视网膜脱离的临床观察

    Institute of Scientific and Technical Information of China (English)

    周建平; 胡莉群; 胡长青

    2014-01-01

    目的观察LASIK术前对中高度近视患者行预防性眼底激光光凝的疗效。方法准备接受LASIK手术的中高度近视患者作详细眼底检查,直接眼底镜、间接眼底镜和三面镜检查明确有视网膜变性或(和)干性裂孔的患者共61例(112眼)行氪激光光凝治疗。结果61例(112眼)患者氪激光光凝术后变性区及裂孔封闭良好,未发生视网膜脱离。结论对明确有视网膜变性和裂孔的中高度近视患者LASIK术前行氪激光光凝是预防LASIK术后发生孔源性视网膜脱离的一种安全有效的方法。%Objective To observe the effect of krypton laser photocoagulation before LASIK on high myopia. Methods Full fundus examination on high myopic patients was performed with direct ophthalmoscopy, indirect ophthalmoscopy and three mirror contact lens. 112 eyes of 61 patients with peripheral retinal degeneration or retinal hole were treated by krypton laser photocoagulation before LASIK. Results 112 eyes of 61 patients with peripheral retinal degeneration or retinal hole were stable after krypton laser photocoagulation.No retinal detachment was occurred. Conclusion The krypton laser photocoagulation is a safe and ef ective method to preventing retinal detachment for the patients with peripheral retinal degeneration or retinal hole.

  3. 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

  4. Safety of iPhone retinal photography.

    Science.gov (United States)

    Hong, Sheng Chiong; Wynn-Williams, Giles; Wilson, Graham

    2017-04-01

    With the advancement in mobile technology, smartphone retinal photography is becoming a popular practice. However, there is limited information about the safety of the latest smartphones used for retinal photography. This study aims to determine the photobiological risk of iPhone 6 and iPhone 6 plus when used in conjunction with a 20Diopter condensing lens for retinal photography. iPhone 6 and iPhone 6 plus (Apple, Cupertino, CA) were used in this study. The geometrical setup of the study was similar to the indirect ophthalmoscopy technique. The phone was set up at one end of the bench with its flash turned on at maximal brightness; a 20 Dioptre lens was placed 15 cm away from the phone. The light that passes through the lens was measured with a spectroradiometer and an illuminance probe at the other end to determine the spectral profile, spatial irradiance, radiant power emitted by the phone's flash. Trigonometric and lens formula were applied to determine the field of view and retinal surface in order to determine the weighted retinal irradiance and weighted retinal radiant exposure. Taking ocular transmission and the distribution of the beam's spatial irradiance into account, the weighted retinal irradiance is 1.40 mW/cm 2 and the weighted retinal radiant exposure is 56.25 mJ/cm 2 . The peak weighted foveal irradiance is 1.61 mW/cm 2 . Our study concluded that the photobiological risk posed by iPhone 6 indirect ophthalmoscopy was at least 1 order of magnitude below the safety limits set by the ISO15004-2.2.

  5. Retinoschisislike alterations in the mouse eye caused by gene targeting of the Norrie disease gene.

    Science.gov (United States)

    Ruether, K; van de Pol, D; Jaissle, G; Berger, W; Tornow, R P; Zrenner, E

    1997-03-01

    To investigate the retinal function and morphology of mice carrying a replacement mutation in exon 2 of the Norrie disease gene. Recently, Norrie disease mutant mice have been generated using gene targeting technology. The mutation removes the 56 N-terminal amino acids of the Norrie gene product. Ganzfeld electroretinograms (ERGs) were obtained in five animals hemizygous or homozygous for the mutant gene and in three female animals heterozygous for the mutant gene. As controls, three males carrying the wild-type gene were examined. Electroretinogram testing included rod a- and b-wave V-log I functions, oscillatory potentials, and cone responses. The fundus morphology has been visualized by scanning laser ophthalmoscopy. Rod and cone ERG responses and fundus morphology were not significantly different among female heterozygotes and wild-type mice. In contrast, the hemizygous mice displayed a severe loss of ERG b-wave, leading to a negatively shaped scotopic ERG and a marked reduction of oscillatory potentials. The a-wave was normal at low intensities, and only with brighter flashes was there a moderate amplitude loss. Cone amplitudes were barely recordable in the gene-targeted males. Ophthalmoscopy revealed snowflakelike vitreal changes, retinoschisis, and pigment epithelium irregularities in hemizygotes and homozygotes, but no changes in female heterozygotes. The negatively shaped scotopic ERG in male mice with a Norrie disease gene mutation probably was caused by retinoschisis. Pigment epithelial changes and degenerations of the outer retina are relatively mild. These findings may be a clue to the embryonal retinoschisislike pathogenesis of Norrie disease in humans or it may indicate a different expression of the Norrie disease gene defect in mice compared to that in humans.

  6. Could Visual Impairment in the Pediatric Age Group Be Reduced?

    Directory of Open Access Journals (Sweden)

    Doğan Ceyhan

    2013-06-01

    Full Text Available Pediatric age is the most important period for preventive eye care services and research. Vision loss in this period could cause a long life without sight and also significant financial and moral losses, in terms of people and society. Rational screening programs may reduce vision loss in childhood and this issue increases the value of the subject. Retinopathy of prematurity, congenital/infantile cataracts and glaucoma, optic nerve and retinal pathologies, refractive errors, amblyopia, and strabismus are the major clinical pictures causing visual loss in childhood. Using the epidemiological data, it could be estimated that every year approximately two to three thousand children suffer an ophthalmologic disease that causes significant visual loss. Regarding the refractive errors and amblyopia, it could be estimated that hundreds of thousands of children need ophthalmological follow-up in the country. For the timely treatment of these pathologies, a couple of short eye examination programs seem more realistic. Childhood vision loss in the country could be reduced, by informing pediatricians and family physicians and by proper guiding of the public opinion. Effective eye screening could be achieved with the implementation of simple methods like red reflex/Brückner test with ophthalmoscopy, or simultaneous (binocular retinoscopy and ophthalmoscopy of both eyes. Screening programs could be spread throughout the country by appropriate training of the physicians in the health institutions of the country. Screening programs will contribute to reduce the rate of visual disability by disseminating ophthalmologic practices throughout the country. (Turk J Ophthalmol 2013; 43: 195-201

  7. Alterações retinianas em jovens portadores de anemia falciforme (hemoglobinopatias em hospital universitário no nordeste do Brasil Retinal impairment in young individuals with sickle cell anemia (hemoglobin SS disease in university hospital in Northeastern of Brazil

    Directory of Open Access Journals (Sweden)

    Allisson Mário dos Santos

    2012-10-01

    Full Text Available OBJETIVOS: Descrever e classificar alterações retinianas encontradas em portadores de anemia falciforme com genótipo SS, bem com comparar métodos diagnósticos (mapeamento de retina e angiofluoresceinografia. MÉTODOS: Neste estudo transversal foram avaliados pacientes portadores de anemia falciforme com idade igual ou superior a sete anos. Esses pacientes foram submetidos a mapeamento de retina e angiofluoresceinografia. Os achados do mapeamento de retina foram agrupados em três classes: sem alterações; alterações não proliferativas e alterações proliferativas. Os resultados à angiofluoresceinografia foram classificados de acordo com os estágios de Goldberg, variando de I a V e expressando gradiente crescente de gravidade. RESULTADOS: Foram avaliados 61olhos de 31pacientes. A retinopatia falciforme foi encontrada em 38/61 (62,3% dos olhos examinados. A média de idade do grupo de portadores de retinopatia foi menor que dos pacientes sem retinopatia (14,4 versus 17,4 anos, p=0,04. Observou-se elevada freqüência de retinopatia não proliferativa, especialmente as tortuosidades vasculares (27,9%, seguidas por anastomoses arteriovenosas na periferia da retina (24,6% e oclusões arteriolares (8,2%. Em um olho foi observado neovascularização. Em 16,4% dos olhos obteve-se resultado normal no mapeamento de retina e alterado à angiofluoresceinografia. CONCLUSÕES: As alterações retinianas do tipo não proliferativa são frequentes e precoces nos portadores de anemia falciforme do tipo SS, sendo a angiofluoresceinografia mais sensível no diagnóstico quando comparada ao mapeamento de retina.PURPOSES: To describe and categorize retinal vascular changes in patients with sickle cell anemia, as well as to compare diagnostic methods (indirect ophthalmoscopy and fluorescein angiography. METHODS: Patients with sickle cell anemia over the age of seven were examined. Complete ophthalmologic examination with indirect ophthalmoscopy and

  8. Acute Solar Retinopathy Imaged With Adaptive Optics, Optical Coherence Tomography Angiography, and En Face Optical Coherence Tomography.

    Science.gov (United States)

    Wu, Chris Y; Jansen, Michael E; Andrade, Jorge; Chui, Toco Y P; Do, Anna T; Rosen, Richard B; Deobhakta, Avnish

    2018-01-01

    Solar retinopathy is a rare form of retinal injury that occurs after direct sungazing. To enhance understanding of the structural changes that occur in solar retinopathy by obtaining high-resolution in vivo en face images. Case report of a young adult woman who presented to the New York Eye and Ear Infirmary with symptoms of acute solar retinopathy after viewing the solar eclipse on August 21, 2017. Results of comprehensive ophthalmic examination and images obtained by fundus photography, microperimetry, spectral-domain optical coherence tomography (OCT), adaptive optics scanning light ophthalmoscopy, OCT angiography, and en face OCT. The patient was examined after viewing the solar eclipse. Visual acuity was 20/20 OD and 20/25 OS. The patient was left-eye dominant. Spectral-domain OCT images were consistent with mild and severe acute solar retinopathy in the right and left eye, respectively. Microperimetry was normal in the right eye but showed paracentral decreased retinal sensitivity in the left eye with a central absolute scotoma. Adaptive optics images of the right eye showed a small region of nonwaveguiding photoreceptors, while images of the left eye showed a large area of abnormal and nonwaveguiding photoreceptors. Optical coherence tomography angiography images were normal in both eyes. En face OCT images of the right eye showed a small circular hyperreflective area, with central hyporeflectivity in the outer retina of the right eye. The left eye showed a hyperreflective lesion that intensified in area from inner to middle retina and became mostly hyporeflective in the outer retina. The shape of the lesion on adaptive optics and en face OCT images of the left eye corresponded to the shape of the scotoma drawn by the patient on Amsler grid. Acute solar retinopathy can present with foveal cone photoreceptor mosaic disturbances on adaptive optics scanning light ophthalmoscopy imaging. Corresponding reflectivity changes can be seen on en face OCT, especially

  9. Development and experimental basis of local subretinal technique of xenogenic’s injection stem cells labelled by magnetic perticles

    Directory of Open Access Journals (Sweden)

    Yu. A. Belyy

    2014-10-01

    Full Text Available Purpose: is to develop a technique for local subretinal injection of xenogeneic stem cells labeled with magnetic particles and to prove experimentally its effectiveness.Material and methods: We used a line of stem cells HEK-293 GFP,labeled with magnetic particles. The study was made on 84 eyes of 42 chinchilla rabbits 6 months of age, the weight were from 2.5 to 3.5 kg. All right eyes were experimental (42 eyes and all left eyes (42 eyes were the control group. In the experimental group we used original complex of polymer elastic magnetic implant (PEMI with laser probe and fixed it to the sclera, then we made a median vitrectomy and injected HEK-293 GFP under the retina using a specially designed dispenser. In the control group PEMI was not fixed. We examined animals using biomicroscopy, ophthalmoscopy, ultrasound scanning, optical coherence tomography  OCT, computer tomography (CT, morphological study (cryohistological sections in 1, 3, 5, 7, 14 day and 1 month after surgery.Results: According the results of biomicroscopy in observation periods up to 3 days the vascular injection was visualized in the area operation. According the results of ophthalmoscopy and ultrasound scanning in 1 day the local retinal detachment was visualized in the area of local injection of the stem cells, which was not visualized in terms of further observations. CT helped us to confirm the local place of PEMI fixation. The morphological study results showed that cells were located in the subretinal space up to 14 days in the experimental group, and only up 3 days in the control group.Conclusion: The suggested surgical technique enables to control the injection of cells into the subretinal space, reduces the risk of tissue damage and exit cells in the vitreous space. The suggested methodology allows the fixing of the cellular material in the local place of the injection and enables to predict cells`s movement.

  10. FFA STUDY OF MACULAR LESIONS

    Directory of Open Access Journals (Sweden)

    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. [Survey on avoidable blindness and visual impairment in Panama].

    Science.gov (United States)

    López, Maritza; Brea, Ileana; Yee, Rita; Yi, Rodolfo; Carles, Víctor; Broce, Alberto; Limburg, Hans; Silva, Juan Carlos

    2014-12-01

    Determine prevalence of blindness and visual impairment in adults aged ≥ 50 years in Panama, identify their main causes, and characterize eye health services. Cross-sectional population study using standard Rapid Assessment of Avoidable Blindness methodology. Fifty people aged ≥ 50 years were selected from each of 84 clusters chosen through representative random sampling of the entire country. Visual acuity was assessed using a Snellen chart; lens and posterior pole status were assessed by direct ophthalmoscopy. Cataract surgery coverage was calculated and its quality assessed, along with causes of visual acuity blindness was 3.0% (95% CI: 2.3-3.6). The main cause of blindness was cataract (66.4%), followed by glaucoma (10.2%). Cataract (69.2%) was the main cause of severe visual impairment and uncorrected refractive errors were the main cause of moderate visual impairment (60.7%). Surgical cataract coverage in individuals was 76.3%. Of all eyes operated for cataract, 58.0% achieved visual acuity ≤ 20/60 with available correction. Prevalence of blindness in Panama is in line with average prevalence found in other countries of the Region. This problem can be reduced, since 76.2% of cases of blindness and 85.0% of cases of severe visual impairment result from avoidable causes.

  12. [National survey of blindness and avoidable visual impairment in Argentina, 2013].

    Science.gov (United States)

    Barrenechea, Rosario; de la Fuente, Inés; Plaza, Roberto Gustavo; Flores, Nadia; Segovia, Lía; Villagómez, Zaida; Camarero, Esteban Elián; Zepeda-Romero, Luz Consuelo; Lansingh, Van C; Limburg, Hans; Silva, Juan Carlos

    2015-01-01

    Determine the prevalence of blindness and avoidable visual impairment in Argentina, its causes, the coverage of cataract surgery, and the barriers that hinder access to these services. Cross-sectional population study conducted between May and November 2013 using the standard methodology for rapid assessment of avoidable blindness (RAAB), with a random cluster sampling of 50 people aged 50 years or more, -representative of the entire country. Participants' visual acuity (VA) was measured and the lens and posterior pole were examined by direct ophthalmoscopy. An assessment was made of the causes of having VA blindness was 0.7% (confidence interval of 95%: 0.4-1.0%). Unoperated cataract was the main cause of blindness and severe visual impairment (44.0% and 71.1%, respectively), while the main cause of moderate visual impairment was uncorrected refractive errors (77.8%). Coverage of cataract surgery was of 97.1%, and 82.0% of operated eyes achieved VA ≥ 20/60. The main barriers to receiving this treatment were fear of the surgical procedure or of a poor result (34.9%), the cost (30.2%), and not having access to the treatment (16.3%). There is a low prevalence of blindness in the studied population and cataract is the main cause of blindness and severe visual impairment. Efforts should continue to extend coverage of cataract surgery, enhance preoperative evaluation, improve calculations of the intraocular lenses that patients need, and correct post-operative refractive errors with greater precision.

  13. Prevalence and causes of corneal blindness.

    Science.gov (United States)

    Wang, Haijing; Zhang, Yaoguang; Li, Zhijian; Wang, Tiebin; Liu, Ping

    2014-04-01

    The study aimed to assess the prevalence and causes of corneal blindness in a rural northern Chinese population. Cross-sectional study. The cluster random sampling method was used to select the sample. This population-based study included 11 787 participants of all ages in rural Heilongjiang Province, China. These participants underwent a detailed interview and eye examination that included the measurement of visual acuity, slit-lamp biomicroscopy and direct ophthalmoscopy. An eye was considered to have corneal blindness if the visual acuity was blindness and low vision. Among the 10 384 people enrolled in the study, the prevalence of corneal blindness is 0.3% (95% confidence interval 0.2-0.4%). The leading cause was keratitis in childhood (40.0%), followed by ocular trauma (33.3%) and keratitis in adulthood (20.0%). Age and illiteracy were found to be associated with an increased prevalence of corneal blindness. Blindness because of corneal diseases in rural areas of Northern China is a significant public health problem that needs to be given more attention. © 2013 Royal Australian and New Zealand College of Ophthalmologists.

  14. Is Smoking a Risk Factor for Proliferative Diabetic Retinopathy in Type 1 Diabetes?

    DEFF Research Database (Denmark)

    Gaedt Thorlund, Mie; Borg Madsen, Mette; Green, Anders

    2013-01-01

    were asked about their smoking habits. The level of retinopathy was evaluated by ophthalmoscopy at baseline and by nine 45-degree colour field fundus photos at the follow-up. Results: In multivariate analyses there was a trend that current smokers at baseline were more likely to develop PDR......Aim: The aim was to evaluate if smoking was a risk factor for proliferative retinopathy (PDR) in a 25-year follow-up study. Methods: 201 persons from a population-based cohort of Danish type 1 diabetic patients were examined at baseline and again 25 years later. At both examinations the patients...... at the follow-up (odds ratio 1.90, 95% confidence interval 0.88-4.11, p = 0.10). Neither smoking status at the follow-up nor pack-years of smoking were associated with PDR. Conclusions: We found neither a beneficial nor a harmful effect of smoking on long-term incidence. Selective mortality among smokers...

  15. Role of Q-switched ND:YAG laser in nevus of Ota: A study of 25 cases

    Directory of Open Access Journals (Sweden)

    Shivangi Sharma

    2011-01-01

    Full Text Available Background: Nevus of Ota is common condition in Indian patients. The condition is more common in females, with a male-female ratio of 1:4.8. Aim : To evaluate long-term efficacy safety and stability of Q-switched ND:YAG laser in treatment of Nevus of Ota. Design: 6 month follow-up of patients of Nevus of Ota, treated with Q-switched ND:YAG laser Materials and Methods : Twenty-five patients of Nevus of Ota were treated with Q-switched ND:YAG laser for a period of 1 year and 9 months; patient had fitzpatricks skin type 4 and 5; detailed history, clinical examination, ophthalmoscopy, and otoscopy was done in all cases; clinical photographs were taken before and after the completion of treatments. Six-month follow-up was done after the last session. Response to treatment was graded based on physician′s global assessment. Result : More than 70% improvement was seen in 15 patients (60%. Eight patients (32% had moderate and two patients (8% showed mild improvement.

  16. PREVALENCE OF DIABETIC RETINOPATHY IN PATIENTS WITH NEWLY DIAGNOSED TYPE II DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    A. Bostak

    2006-11-01

    Full Text Available Diabetic retinopathy is a common complication of type II diabetes mellitus and carries with it the threat of blindness. Accurate information regarding the incidence of diabetic retinopathy and associated risk factors is important in the prevention of its development and of the visual impairment caused by this complication. This study was designed to determine the prevalence of diabetic retinopathy in newly diagnosed patients with type II diabetes mellitus. We have also evaluated the association of diabetic retinopathy with clinical and biochemical variables. In a cross-sectional study, 152 consecutive patients with newly diagnosed type II diabetes mellitus were referred from two outpatient clinics in Tehran for ophthalmologic exam to detect retinopathy. Indirect ophthalmoscopy was performed and data regarding risk factors were extracted from routine medical records. Chi square and Mann Whitney U tests were used to analyze the data. The overall prevalence of diabetic retinopathy was 13.8 %( 21 cases: three cases with microaneurysm only, 10 with mild, 5 with moderate and 2 with severe non proliferative diabetic retinopathy. Only one patient had advanced proliferative retinopathy. The prevalence of diabetic retinopathy was positively associated with age, duration of disease, fasting plasma glucose, HbA1c, and systolic blood pressure. Diabetic retinopathy is common in newly diagnosed type II diabetes mellitus patients. Ophthalmologic consultation is essential at the time of diagnosis for all patients.

  17. Discovery of a Cynomolgus Monkey Family With Retinitis Pigmentosa.

    Science.gov (United States)

    Ikeda, Yasuhiro; Nishiguchi, Koji M; Miya, Fuyuki; Shimozawa, Nobuhiro; Funatsu, Jun; Nakatake, Shunji; Fujiwara, Kohta; Tachibana, Takashi; Murakami, Yusuke; Hisatomi, Toshio; Yoshida, Shigeo; Yasutomi, Yasuhiro; Tsunoda, Tatsuhiko; Nakazawa, Toru; Ishibashi, Tatsuro; Sonoda, Koh-Hei

    2018-02-01

    To accelerate the development of new therapies, an inherited retinal degeneration model in a nonhuman primate would be useful to confirm the efficacy in preclinical studies. In this study, we describe the discovery of retinitis pigmentosa in a cynomolgus monkey (Macaca fascicularis) pedigree. First, screening with fundus photography was performed on 1443 monkeys at the Tsukuba Primate Research Center. Ophthalmic examinations, such as indirect ophthalmoscopy, ERGs using RETeval, and optic coherent tomography (OCT) measurement, were then performed to confirm diagnosis. Retinal degeneration with cystoid macular edema was observed in both eyes of one 14-year-old female monkey. In her examinations, the full-field ERGs were nonrecordable and the outer layer of the retina in the parafoveal area was not visible on OCT imaging. Moreover, less frequent pigmentary retinal anomalies also were observed in her 3-year-old nephew. His full-field ERGs were almost nonrecordable and the outer layer was not visible in the peripheral retina. His father was her cousin (the son of her mother's older brother) and his mother was her younger half-sibling sister with a different father. The hereditary nature is highly probable (autosomal recessive inheritance suspected). However, whole-exome analysis performed identified no pathogenic mutations in these monkeys.

  18. A novel IMPDH1 mutation (Arg231Pro) in a family with a severe form of autosomal dominant retinitis pigmentosa.

    Science.gov (United States)

    Grover, Sandeep; Fishman, Gerald A; Stone, Edwin M

    2004-10-01

    To define ophthalmic findings in a family with autosomal dominant retinitis pigmentosa and a novel IMPDH1 gene mutation. Genetic and observational family study. Sixteen affected members of a family with autosomal dominant retinitis pigmentosa. Ophthalmic examination, including best-corrected visual acuity (VA), slit-lamp biomicroscopy, direct and indirect ophthalmoscopy, Goldmann kinetic perimetry, and electroretinography were performed. Deoxyribonucleic acid single-strand conformation polymorphism (SSCP) analysis was done. Abnormal polymerase chain reaction products identified by SSCP analysis were sequenced bidirectionally. All affected patients had the onset of night blindness within the first decade of life. Ocular findings were characterized by diffuse retinal pigmentary degenerative changes, marked restriction of peripheral visual fields, severe loss of VA, nondetectable electroretinography amplitudes, and a high frequency of posterior subcapsular lens opacities. Affected members were observed to harbor a novel IMPDH1 gene mutation. A novel IMPDH1 gene mutation (Arg231Pro) was associated with a severe form of autosomal dominant retinitis pigmentosa. Families affected with a severe form of this genetic subtype should be investigated for a mutation in the IMPDH1 gene.

  19. Cluster endophthalmitis following multiple intravitreal bevacizumab injections from a single use vial

    Directory of Open Access Journals (Sweden)

    Perwez Khan

    2016-01-01

    Full Text Available The risk of endophthalmitis is always a concern when an intraocular procedure is performed. Intravitreal injection is a frequently used method for therapeutic management of many diseases, affecting the posterior segment of the eye. Hence, it is important to assess the risk of complications, especially endophthalmitis. Most studies conducted concentrate on risk assessment from single use from single drug vial. The present article reports the occurrence of cluster endophthalmitis following multiple intravitreal bevacizumab injections from a single vial. Intravitreal injection of bevacizumab was administered to eight eyes of eight patients. Administered dose was prepared from single 4-ml vial of bevacizumab and was injected in the eye, after patient preparation and under aseptic conditions. The procedure was repeated for the remaining patients, thereby imparting multiple pricks in the same vial. Four of the eight patients reported to the hospital on the 3rd day after injection with complaints of pain, watering, and diminution of vision. Two patients reported the following day with similar complaints. Two patients who did not report by the 4th day were contacted and recalled for an examination. All the patients were thoroughly examined using slit lamp biomicroscopy and indirect ophthalmoscopy. Six out of eight were clinically diagnosed to have endophthalmitis and were administered intravitreal antibiotics. The present report highlights possibility of microbial contamination of the drug vial or during compounding process. However, from the present incident, we are encouraged to stay vigilant and wary of contamination

  20. Necrotic enlargement of cone photoreceptor cells and the release of high-mobility group box-1 in retinitis pigmentosa

    Science.gov (United States)

    Murakami, Y; Ikeda, Y; Nakatake, S; Tachibana, T; Fujiwara, K; Yoshida, N; Notomi, S; Nakao, S; Hisatomi, T; Miller, J W; Vavvas, DG; Sonoda, KH; Ishibashi, T

    2015-01-01

    Retinitis pigmentosa (RP) refers to a group of inherited retinal degenerations resulting form rod and cone photoreceptor cell death. The rod cell death due to deleterious genetic mutations has been shown to occur mainly through apoptosis, whereas the mechanisms and features of the secondary cone cell death have not been fully elucidated. Our previous study showed that the cone cell death in rd10 mice, an animal model of RP, involves necrotic features and is partly mediated by the receptor interacting protein kinase. However, the relevancy of necrotic cone cell death in human RP patients remains unknown. In the present study, we showed that dying cone cells in rd10 mice exhibited cellular enlargement, along with necrotic changes such as cellular swelling and mitochondrial rupture. In human eyes, live imaging of cone cells by adaptive optics scanning laser ophthalmoscopy revealed significantly increased percentages of enlarged cone cells in the RP patients compared with the control subjects. The vitreous of the RP patients contained significantly higher levels of high-mobility group box-1, which is released extracellularly associated with necrotic cell death. These findings suggest that necrotic enlargement of cone cells is involved in the process of cone degeneration, and that necrosis may be a novel target to prevent or delay the loss of cone-mediated central vision in RP. PMID:27551484

  1. Webcams as a tool for teaching in Optometry training

    Science.gov (United States)

    Gargallo, A.; Arines, J.

    2015-04-01

    Clinical Optometry lab training is devoted to develop the students skills needed in eye healthcare professional practice. Nevertheless, students always find difficulties in the management of some optometric instruments and in the understanding of the evaluation techniques. Moreover, teachers also have problems in explaining the eye evaluation tests or making demonstrations of instruments handling. In order to facilitate the learning process, webcams adapted to the optometric devices represent a helpful and useful tool. In this work we present the use of webcams in some of the most common clinical test in Optometry as ocular refraction, colour vision test, eye health evaluation with slip-lamp, retinoscopy, ophthalmoscopy and contact lens fitting. Our experience shows that with this simple approach we can do things easier: show the instrument handling to all the students at the same time; take pictures or videos of different eye health conditions or exploratory routines for posterior visualization with all the students; recreate visual experience of the patient during optometric exam; simulate colour vision pathologies; increase the interactions between students allowing them to help and correct each other; and also record the final routine exam in order to make possible its revision with the students.

  2. Progression of pectinate ligament dysplasia over time in two populations of Flat-Coated Retrievers.

    Science.gov (United States)

    Pearl, Rose; Gould, David; Spiess, Bernhard

    2015-01-01

    Two of the authors (DG, BS) independently observed that a number of Flat-Coated Retrievers (FCRs) previously unaffected by pectinate ligament dysplasia (PLD) appeared to develop the condition later in life. This study was instigated to investigate progression of PLD within individual dogs over time. Flat-Coated Retrievers that had previously undergone gonioscopy under the UK/ECVO hereditary eye schemes were included in the study. A second gonioscopic examination was performed 1.92-12.58 years later (mean 6, median 5.75 years) and the results compared. 39 FCR (17 males, 22 females) in the UK and 57 FCR (27 males, 30 females) in Switzerland were included. Slit-lamp biomicroscopy, indirect ophthalmoscopy, and gonioscopy were performed in all dogs. Gonioscopy allowed classification as either unaffected or affected; percentage of the iridocorneal drainage angle (ICA) affected by PLD was determined, before calculating progression observed as mild, moderate, or severe. 39 of 96 (40.6%) dogs demonstrated progression of PLD (P 90% ICA affected, consistent with a high risk of glaucoma. To the authors' knowledge, this is the first report describing progression of PLD in individual dogs over time, in a breed affected by primary, angle closure glaucoma. © 2013 American College of Veterinary Ophthalmologists.

  3. [Gonioscopy - How, Why, What for?

    Science.gov (United States)

    Unterlauft, J D

    2017-08-01

    Aim Gonioscopy is used to exam the anterior chamber angle and the neighbouring structures. Gonioscopy can be performed using a contact lens, with the patient sitting at the slit lamp or in a supine position. Due to the total inner reflection of the cornea, the anterior chamber angle would otherwise be invisible in a healthy eye. During normal daily clinical routine, gonioscopy is often omitted, due to lack of time, although additional information could be gained. Materials and Methods The aim is to give a summary of the diagnostic possibilities using gonioscopy and to emphasise the importance of this relatively easy clinical method. Results The development of gonioscopy, the appropriate tools, proper procedure at the slit lamp and the most popular grading systems are described. In addition, an overview of detectable pathological changes in the anterior chamber angle is given and future prospects about developments in gonioscopy. Conclusion Gonioscopy can provide additional information otherwise missed by slit lamp examination or ophthalmoscopy alone. Up to now, no (semi-)automatic devices have been developed which could completely replace gonioscopy. Therefore gonioscopy remains an important part of a complete ophthalmological examination and should be learned, mastered and performed regularly by every ophthalmologist. Georg Thieme Verlag KG Stuttgart · New York.

  4. Occurrence and features of uveitis in patients with rheumatic diseases: current peculiarities of clinical examination and patient management.

    Directory of Open Access Journals (Sweden)

    Dzhalavyan Y.V.

    2017-06-01

    Full Text Available The objectives of the study are to establish the occurrence of uveitis in patients with rheumatic diseases, to assess the features of the uveitis in rheumatic disease in children and adults, and to analyze the effectiveness of theirtreatment. Materials and Methods. The study included 670 people with RH (stage I and 35 patients who had uveitis and / or rheumatic fever who agreed to undergo additional ophthalmologic bleeding (stage II, including a standard ophthalmological examination including visiometry, biomicroscopy of the anterior segment, ophthalmoscopy of the posterior segment of the eye, refractometry, optical coherence tomography in angiomode(tomograph-angiograph CIRRUS HD-OCT MODEL 5000 (Carl Zeiss, Germany, dopplerography of the vessels of the eye. Results. The prevalence of uveitis in rheumatic diseases was established in 21%, which is higher than that in the general population. Uveitis in rheumatic diseases is recurrent and well-treated condition with frequent and complete improvement of visual acuity, and angiographycal features of uveitis, p <0,05 for all parameters. Conclusions. The high incidence of uveitis and relapsing their course in rheumatic diseases lead to necessity of an ophthalmologist's examination every 6 months. It is desirable to perform a comprehensive angiographic examination of uvea for the timely detection of erased and subclinical forms of uveitis.

  5. Refractive Errors in State Junior High School Students in Bandung

    Directory of Open Access Journals (Sweden)

    Sabila Tasyakur Nikmah

    2016-12-01

    Full Text Available Background: Uncorrected refractive error is one of the avoidable causes of vision impairment in children and adults. Vision problem in children has been shown to affect their psychological and academic performance. This study aims at identifying and gaining more insights on the characteristic of the refractive errors in state junior high school students in Bandung to avoid uncorrected refractive errors. Methods: A cross-sectional study was conducted in September–November 2015 in state junior high schools in Bandung, West Java, Indonesia. Sample was selected using multistage random sampling technique. Children were examined using tumbling E examination; then students with visual acuity worse than 6/12 underwent Snellen Chart test, refractometry without pupil dilatation, correction with trial lens, then was followed by direct ophthalmoscopy. Results: From a total of 435 children who completed all the examination, 80 children (18.39% had refractive errors; consisted of 151 eyes (94.38% with myopia and 9 eyes (5.62% with astigmatism. Refractive errors were found to be more common in female children (73.7% than male children (26.3%. Among those with refractive errors, 45 children (56.3% did not use any corrective glasses before the examination. Conclusions: Routine refractive error test in vision screening examination is needed for students. It is equally important to raise more awareness toward eye disease in community.

  6. LONG-TERM OUTCOMES OF RETINAL DEGENERATIVE DISORDER TREATMENT WITH PEPTIDE BIOREGULATORS

    Directory of Open Access Journals (Sweden)

    M. I. Razumovskiy

    2015-01-01

    Full Text Available Aim. To analyze long-term outcomes and efficacy of retinal degeneration treatment with Retinalamin.Patients and methods. Group I included 20 patients (40 eyes with pigmentary retinal dystrophy (15 patients, 30 eyes and retinal abiotrophy (5 patients, 10 eyes who received treatment with Retinalamin for 5‑7 years. Group II included 11 patients (22 eyes with pigmentary retinal dystrophy (9 patients, 18 eyes and retinal abiotrophy (2 patients, 4 eyes who received treatment with Retinalamin for 23‑25 years. Group III (controls included 15 patients (30 eyes with pigmentary retinal dystrophy (11 patients, 22 eyes and retinal abiotrophy (4 patients, 8 eyes who received traditional treatment (vasodilators, angioprotectors, antisclerotic agents, vitamins for 25 years. Standard ophthalmological examination, i.e., visual acuity measurement, visual field test, refractometry, biomicroscopy, ophthalmoscopy, was performed.Results. First course of treatment with Retinalamin improved vision in 58.1 % of retinal degeneration patients. Visual fields improved in 64.5 % of cases. Repeated treatment courses (1‑2 times a year for 23‑25 years preserved residual vision in 55.6 % of patients and object vision in 11.1 % of cases. In retinal abiotrophy patients, residual vision preserved in 100 % of cases.Conclusions. In retinal degenerations, Retinalamin improves vision and visual fields and decreases total area of absolute scotomas even after the first treatment course as well as preserves vision in prolonged use. 

  7. Gamma Knife Perfexion® radiosurgery and endo diode laser thermotherapy for choroidal melanoma with technical analysis: A case report.

    Science.gov (United States)

    Tsai, Yi-Chieh; Kuo, Chun-Yuan; Lin, Jia-Wei; Yang, Shun-Tai; Lai, Shih-Chung; Tsai, Jo-Ting

    2018-01-01

    Radiosurgery serves an important function in the treatment of patients with intraocular tumors and preserves visual function via organ conservation. Therefore, it is important to ensure the safety and precision of GK-SRS as a primary treatment for intraocular tumors. The present case study described a 57-year-old female with uveal melanoma treated with GK-SRS. Retrobulbar anesthesia following fixation of the treated eye, via the suture of two of the extraocular muscles to the stereotactic frame, was performed to immobilize the eye during treatment. Computed tomography (CT) scans were performed following eye fixation, immediately prior to and following GK-SRS, to validate the accuracy of the tumor localization. The eye movement analysis revealed that the gravity center point deviations of the tumor and lens during treatment were <0.110 mm. At least 95% of the tumor volume was covered by the prescription dose according to three sets of CT images. The patient underwent a trans pars plana vitrectomy owing to a right eye vitreous hemorrhage. A 37-month follow-up assessment revealed tumor shrinkage, and the disappearance of the serous retinal detachments was noted on the basis of ophthalmoscopy and orbital magnetic resonance imaging. No major complications developed during the follow-up period. Using our treatment protocol, GK-SRS is a non-invasive procedure which is used as a brief single fraction treatment for intraocular tumor. The eye fixation method used in the present study has high accuracy.

  8. IDIOPATHIC INTRACRANIAL HYPERTENSION IN A WOMAN WITH SCHIZOPHRENIA

    Directory of Open Access Journals (Sweden)

    Ivan N. Dimitrov

    2012-02-01

    Full Text Available Idiopathic intracranial hypertension (IIH or benign intracranial hypertension is a neurological syndrome characterized by elevated intracranial pressure. This uncommon disorder occurs primarily in obese women aged 10 to 50 years, sometimes in association with endocrine and metabolic dysfunction, with systemic diseases or when treated with multiple medications. We describe a case of IIH in a 43-year-old woman with schizophrenia treated with risperidone, demonstrating a typical clinical picture of benign intracranial hypertension. For the 5 years of treatment with risperidone she put on 35 kg in total (BMI> 35; for the last 2-3 months she began to complain of visual obscurations, nausea with vomiting. Ophthalmoscopy revealed bilateral asymmetric papilledema (OD>OS. Magnetic resonance imaging was normal, intracranial pressure was elevated IIH was diagnosed. Risperidone was discontinued and replaced with Seroquel 200 mg daily. Treatment with furosemide and mannitol 10 % was initiated. Papilledema resolved completely over the next 2 months. The patient was followed-up for four years after risperidone withdrawal. Weight loss of 28 kg was noted for four years. There were no relapses of headache, nausea, visual obscuration. Ophthalmologic examination revealed no papilledema.We suggest that prolonged use of antipsychotics, such as risperidone, should require proper surveillance for possible development of IIH and routine ophthalmologic examinations should be performed.

  9. All-optical recording and stimulation of retinal neurons in vivo in retinal degeneration mice

    Science.gov (United States)

    Strazzeri, Jennifer M.; Williams, David R.; Merigan, William H.

    2018-01-01

    Here we demonstrate the application of a method that could accelerate the development of novel therapies by allowing direct and repeatable visualization of cellular function in the living eye, to study loss of vision in animal models of retinal disease, as well as evaluate the time course of retinal function following therapeutic intervention. We use high-resolution adaptive optics scanning light ophthalmoscopy to image fluorescence from the calcium sensor GCaMP6s. In mice with photoreceptor degeneration (rd10), we measured restored visual responses in ganglion cell layer neurons expressing the red-shifted channelrhodopsin ChrimsonR over a six-week period following significant loss of visual responses. Combining a fluorescent calcium sensor, a channelrhodopsin, and adaptive optics enables all-optical stimulation and recording of retinal neurons in the living eye. Because the retina is an accessible portal to the central nervous system, our method also provides a novel non-invasive method of dissecting neuronal processing in the brain. PMID:29596518

  10. Meaning of visualizing retinal cone mosaic on adaptive optics images.

    Science.gov (United States)

    Jacob, Julie; Paques, Michel; Krivosic, Valérie; Dupas, Bénédicte; Couturier, Aude; Kulcsar, Caroline; Tadayoni, Ramin; Massin, Pascale; Gaudric, Alain

    2015-01-01

    To explore the anatomic correlation of the retinal cone mosaic on adaptive optics images. Retrospective nonconsecutive observational case series. A retrospective review of the multimodal imaging charts of 6 patients with focal alteration of the cone mosaic on adaptive optics was performed. Retinal diseases included acute posterior multifocal placoid pigment epitheliopathy (n = 1), hydroxychloroquine retinopathy (n = 1), and macular telangiectasia type 2 (n = 4). High-resolution retinal images were obtained using a flood-illumination adaptive optics camera. Images were recorded using standard imaging modalities: color and red-free fundus camera photography; infrared reflectance scanning laser ophthalmoscopy, fluorescein angiography, indocyanine green angiography, and spectral-domain optical coherence tomography (OCT) images. On OCT, in the marginal zone of the lesions, a disappearance of the interdigitation zone was observed, while the ellipsoid zone was preserved. Image recording demonstrated that such attenuation of the interdigitation zone co-localized with the disappearance of the cone mosaic on adaptive optics images. In 1 case, the restoration of the interdigitation zone paralleled that of the cone mosaic after a 2-month follow-up. Our results suggest that the interdigitation zone could contribute substantially to the reflectance of the cone photoreceptor mosaic. The absence of cones on adaptive optics images does not necessarily mean photoreceptor cell death. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Ophthalmic parameters in adult lowland paca (Cuniculus paca) raised in captivity.

    Science.gov (United States)

    Balthazar da Silveira, Camila P; Lima, Tiago B; Crivelaro, Roberta M; de Lacerda, Luciana C C; Pádua, Ivan R M; Renzo, Roberta; de Barros Sobrinho, Alexandre A F; Oliveira, Fabrício S; Aldrovani, Marcela; Laus, José L

    2018-01-01

    To investigate the ophthalmic parameters of lowland pacas, including the anatomic features, tear production, intraocular pressure, central corneal thickness, and morphology of the corneal endothelium. Thirteen adult, anesthetized Cuniculus paca. Eyes were evaluated using slit-lamp biomicroscopy, the Schirmer tear test I, digital applanation tonometry, binocular indirect ophthalmoscopy, and noncontact specular microscopy. The biomicroscopy findings showed blue/brown pigmented bulbar conjunctivae, well-developed cilia (only in the upper eyelid margin), superior and inferior lacrimal puncta, brown irides, round pupils, and vestiges of the nictitating membrane. The results of the Schirmer tear test I revealed (mean ± SD) a lacrimation rate of 4.10 ± 0.44 mm/min. The intraocular pressure was 6.34 ± 0.43 mmHg. Central corneal thickness measured by specular microscopy was 0.35 ± 0.01 mm. The mean values of density, hexagonality, and the area of the endothelial cells were 2083.15 ± 42.47 cells/mm 2 , 67.07 ± 3.30%, and 486.30 ± 9.56 μm 2 , respectively. The ocular parameters defined in this study may be used for reference in future studies and might also contribute to therapeutic approaches appropriate to this species. © 2017 American College of Veterinary Ophthalmologists.

  12. Two Cases of Endogenous Endophthalmitis Caused by Gram-Positive Bacteria with Good Visual Outcome

    Directory of Open Access Journals (Sweden)

    Machiko Itoh

    2010-09-01

    Full Text Available Background: Endogenous endophthalmitis is a rare disease and its visual prognosis is poor. Case Reports: We present two patients, a 60-year-old man and a 53-year-old man, who developed endogenous endophthalmitis caused byGram-positive organismsbut recovered good vision after antibiotics and vitrectomy. Results: The first patient complained of ocular pain and visual decrease in his right eye. Ophthalmoscopy showed inflammation in the anterior chamber and vitreous opacities. Antibiotic was administrated systemically, and blood culture detected Streptococcus anginosus. He underwent successful heart surgery for endocarditis and total dental extraction for severe gingivitis. Vitrectomy was performed 36 days after the onset and vision improved from 0.02 to 0.7. The second patient was referred for acute visual decrease in his left eye. Severe iritis and vitreous opacities were observed, and systemic examination showed acute pyelitis and prostatic abscesses. Blood cultures detected Staphylococcus sp., and systemic antibiotics were given. Vitrectomy was performed 12 days after the onset, and vision improved from 0.06 to 1.2. Conclusions: We conclude that the rapid treatment with systemic antibiotics for the organisms at the primary site, and the vitrectomy, even though delayed, can lead to a good recovery of vision.

  13. Mobile phones for retinopathy of prematurity screening in Lagos, Nigeria, sub-Saharan Africa.

    Science.gov (United States)

    Oluleye, Tunji S; Rotimi-Samuel, Adekunle; Adenekan, Adetunji

    2016-01-01

    Retinopathy of prematurity (ROP), thought to be rare in Nigeria, sub-Saharan Africa, has been reported in recent studies. Developing cost-effective screening is crucial for detecting retinal changes amenable to treatment. This study describes the use of an iPhone combined with a 20-D lens in screening for ROP in Lagos, Nigeria. The ROP screening program was approved by the Lagos University Teaching Hospital Ethical Committee. Preterm infants with birthweight of less than 1.5 kg or gestational age of less than 32 weeks were screened. In conjunction with the neonatologist, topical tropicamide (0.5%) and phenylephrine (2.5%) was used to dilate the pupils. A pediatric lid speculum was used. Indirect ophthalmoscopy was used to examine the fundus to ensure there were no missed diagnoses. An iPhone 5 with 20-D lens was used to examine the fundus. The App Filmic Pro was launched in the video mode. The camera flash served as the source of illumination. Its intensity was controlled by the app. The 20-D lens was used to capture the image of the retina, which was picked up by the camera system of the mobile phone. Another app, Aviary, was used to edit the picture. The images captured by the system were satisfactory for staging and determining the need for treatment. An iPhone combined with a 20-D lens appear to be useful in screening for ROP in resource-poor settings. More studies are needed in this area.

  14. Efficacy of intravitreal Ranibizumab injection for choroidal neovascularization secondary to pathologic myopia

    Directory of Open Access Journals (Sweden)

    Li-Hong Cui

    2016-03-01

    Full Text Available AIM:To observe the efficacy and safety of intravitreal Ranibizumab injection in patiens with choroidal neovascularization(CNVsecondary to pathologic myopia.METHODS:In this retrospective and comparative study,24 patients(25 eyeswith CNV secondary to pathologic myopia were enrolled. All patients were assessed by examinations of ETDRS visual acuity chart, preplaced-mirror ophthalmoscopy, fundus fluorescein angiography(FFA, indocyanine green angiography(ICGAand optical coherence tomography(OCT. Patiens received intravitreally injected ranibizumab 0.5mg(0.05mL. Treatments were repeated if the follow-up indicated that it was necessary. The follow-up periods were 4~10mo. Best corrected visual acuity(BCVA, central macular thickness(CMTand leakage of CNV before and after the treatment were compared. RESULTS:No local or systemic complications occurred in any patients during the treatment or follow-up. The average time of injection was 1.52. The mean BCVA was 23.93±12.46 letters before the therapy. In the last follow-up, the mean BCVA was 40.63±7.25 letters, improved by 14.27±9.36 letters and the difference was statically significant(t=5.74, Pt=3.96, PCONCLUSION:Intravitreal ranibizumab injection for CNV secondary to pathologic myopia is safe and effective, and this treatment can improve visual acuity, reduce retina edema and leakage of CNV.

  15. [Contact glass tonometer].

    Science.gov (United States)

    Dekker, P W; Kanngiesser, H; Robert, Y C

    1996-05-01

    This paper presents a tonometer built into a contactlens, which allows to measure the eye-pressure and to perform ophthalmoscopy at the same time. Artificially induced changes of the eye-pressure and their influence on the visible fundus can now be checked simultaneously. The contactlens-tonometer (CGT) also is able to record continuously the pulse-curve, which can indicate any circulatory problem. So, the device is expected to give us additional diagnostic criteria of early glaucoma. Each ophthalmologyst in the field will be able to perform with this device a oculodynamometry in an easy way. By this it is possible to estimate the pressure-tolerance of the optic disk from glaucoma-patients. There have been taken some measurements on enucleated human eyes, comparing our device with a Statham-transducer in the vitreous. We found a good correlation. In a second step, we made measurements (65) on healthy volunteers, comparing the device with Perkins-Tonometry. We found a correlation (R = 0.58). The error of the measurements was about +/- 3 mm Hg. Considering both, the deviation of the Perkins-Tonometer with which our results were compared, and the fact of a good correlation (R = 0.999) in the study with the enucleated human eyes, we found that the contact-lens-tonometer measures the intraocular pressure exactly. In future studies, we want to analyze the dynamic component of the measurements.

  16. Bilateral optic nerve head drusen with chorioretinal coloboma in the right eye

    Directory of Open Access Journals (Sweden)

    Ali Reza Dehghani

    2016-01-01

    Full Text Available Chorioretinal coloboma is a congenital defect of the eye caused by improper closure of the embryonic fissure. Optic nerve head drusen (ONHD are white calcareous deposits that are generally asymptomatic. We report a very rare association of both in a healthy patient with no any systemic syndrome. A 16-year-old man was referred to our clinic from suffering blurred vision. Best corrected visual acuity of the right eye was 6/10 and 10/10 in the left one. External ocular and slit lamp examination were normal. Dilated ophthalmoscopy showed marked swelling in both optic nerves and chorioretinal coloboma in the right eye inferiorly. Ultrasonography showed an echodense structure with acoustic shadowing in both eyes consistent with buried ONHD. Visual field testing showed normal field in the left eye and moderate superior field depression in the right eye corresponding to inferior coloboma in funduscopy. Results of general medical and neurologic, cardiologic, and other examinations were normal. To the best our knowledge combination of bilateral ONHD and unilateral chorioretinal coloboma in a healthy patient with no any systemic syndrome has not been published in the literature. We reported this very rare association and recommended examine eyes and other body organs. In such cases that coloboma is associated with ONHD, we should keep in mind Noonan syndrome. The diagnosis of Noonan syndrome is clinical and confirm by the consultant pediatricians and clinical geneticists.

  17. Causes of childhood blindness in a school for the visually impaired in Hong Kong.

    Science.gov (United States)

    Fan, D S P; Lai, T Y Y; Cheung, E Y Y; Lam, D S C

    2005-04-01

    To identify the causes of blindness in children attending a school for the blind in Hong Kong. Cross-sectional observational study. School for blind children in Hong Kong. Eighty-two blind students at the Ebenezer School and Home for the Visually Impaired were examined between December 1998 and August 1999. Demographic data were obtained from students and a questionnaire assessment made of their medical and ocular history. Visual acuity was assessed and visual loss classified according to the World Health Organization classification of visual impairment. Complete ophthalmic assessments were performed in all students including slit-lamp examination and dilated binocular indirect ophthalmoscopy. The mean age of the students was 12.2 years. Ten (12.2%) had a family history of eye disease. Major past medical illnesses were reported in 50% with prematurity and diseases of the central nervous system found in 26.8% and 11.0% of students, respectively. The most common anatomical site for visual impairment was the retina (47.6%), followed by diseases of the optic nerve (14.6%), and diseases of the anterior segment and the lens (14.6%). The pattern of childhood blindness in Hong Kong is similar to that seen in other developed countries. Preventable causes of childhood blindness, such as prematurity and birth asphyxia, were responsible for a large proportion of cases. Early diagnosis and treatment of such conditions may reduce the incidence of childhood blindness in Hong Kong.

  18. Fundus autofluorescence findings in a mouse model of retinal detachment.

    Science.gov (United States)

    Secondi, Roberta; Kong, Jian; Blonska, Anna M; Staurenghi, Giovanni; Sparrow, Janet R

    2012-08-07

    Fundus autofluorescence (fundus AF) changes were monitored in a mouse model of retinal detachment (RD). RD was induced by transscleral injection of hyaluronic acid (Healon) or sterile balanced salt solution (BSS) into the subretinal space of 4-5-day-old albino Abca4 null mutant and Abca4 wild-type mice. Images acquired by confocal scanning laser ophthalmoscopy (Spectralis HRA) were correlated with spectral domain optical coherence tomography (SD-OCT), infrared reflectance (IR), fluorescence spectroscopy, and histologic analysis. Results. In the area of detached retina, multiple hyperreflective spots in IR images corresponded to punctate areas of intense autofluorescence visible in fundus AF mode. The puncta exhibited changes in fluorescence intensity with time. SD-OCT disclosed undulations of the neural retina and hyperreflectivity of the photoreceptor layer that likely corresponded to histologically visible photoreceptor cell rosettes. Fluorescence emission spectra generated using flat-mounted retina, and 488 and 561 nm excitation, were similar to that of RPE lipofuscin. With increased excitation wavelength, the emission maximum shifted towards longer wavelengths, a characteristic typical of fundus autofluorescence. In detached retinas, hyper-autofluorescent spots appeared to originate from photoreceptor outer segments that were arranged within retinal folds and rosettes. Consistent with this interpretation is the finding that the autofluorescence was spectroscopically similar to the bisretinoids that constitute RPE lipofuscin. Under the conditions of a RD, abnormal autofluorescence may arise from excessive production of bisretinoid by impaired photoreceptor cells.

  19. FLIMX: A Software Package to Determine and Analyze the Fluorescence Lifetime in Time-Resolved Fluorescence Data from the Human Eye.

    Directory of Open Access Journals (Sweden)

    Matthias Klemm

    Full Text Available Fluorescence lifetime imaging ophthalmoscopy (FLIO is a new technique for measuring the in vivo autofluorescence intensity decays generated by endogenous fluorophores in the ocular fundus. Here, we present a software package called FLIM eXplorer (FLIMX for analyzing FLIO data. Specifically, we introduce a new adaptive binning approach as an optimal tradeoff between the spatial resolution and the number of photons required per pixel. We also expand existing decay models (multi-exponential, stretched exponential, spectral global analysis, incomplete decay to account for the layered structure of the eye and present a method to correct for the influence of the crystalline lens fluorescence on the retina fluorescence. Subsequently, the Holm-Bonferroni method is applied to FLIO measurements to allow for group comparisons between patients and controls on the basis of fluorescence lifetime parameters. The performance of the new approaches was evaluated in five experiments. Specifically, we evaluated static and adaptive binning in a diabetes mellitus patient, we compared the different decay models in a healthy volunteer and performed a group comparison between diabetes patients and controls. An overview of the visualization capabilities and a comparison of static and adaptive binning is shown for a patient with macular hole. FLIMX's applicability to fluorescence lifetime imaging microscopy is shown in the ganglion cell layer of a porcine retina sample, obtained by a laser scanning microscope using two-photon excitation.

  20. Enhanced Visualization of Subtle Outer Retinal Pathology by En Face Optical Coherence Tomography and Correlation with Multi-Modal Imaging.

    Directory of Open Access Journals (Sweden)

    Danuta M Sampson

    Full Text Available To present en face optical coherence tomography (OCT images generated by graph-search theory algorithm-based custom software and examine correlation with other imaging modalities.En face OCT images derived from high density OCT volumetric scans of 3 healthy subjects and 4 patients using a custom algorithm (graph-search theory and commercial software (Heidelberg Eye Explorer software (Heidelberg Engineering were compared and correlated with near infrared reflectance, fundus autofluorescence, adaptive optics flood-illumination ophthalmoscopy (AO-FIO and microperimetry.Commercial software was unable to generate accurate en face OCT images in eyes with retinal pigment epithelium (RPE pathology due to segmentation error at the level of Bruch's membrane (BM. Accurate segmentation of the basal RPE and BM was achieved using custom software. The en face OCT images from eyes with isolated interdigitation or ellipsoid zone pathology were of similar quality between custom software and Heidelberg Eye Explorer software in the absence of any other significant outer retinal pathology. En face OCT images demonstrated angioid streaks, lesions of acute macular neuroretinopathy, hydroxychloroquine toxicity and Bietti crystalline deposits that correlated with other imaging modalities.Graph-search theory algorithm helps to overcome the limitations of outer retinal segmentation inaccuracies in commercial software. En face OCT images can provide detailed topography of the reflectivity within a specific layer of the retina which correlates with other forms of fundus imaging. Our results highlight the need for standardization of image reflectivity to facilitate quantification of en face OCT images and longitudinal analysis.

  1. 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.

  2. FUNDUS AUTOFLUORESCENCE LIFETIMES AND CENTRAL SEROUS CHORIORETINOPATHY.

    Science.gov (United States)

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

    2017-11-01

    To quantify retinal fluorescence lifetimes in patients with central serous chorioretinopathy (CSC) and to identify disease specific lifetime characteristics over the course of disease. Forty-seven participants were included in this study. Patients with central serous chorioretinopathy were imaged with fundus photography, fundus autofluorescence, optical coherence tomography, and fluorescence lifetime imaging ophthalmoscopy (FLIO) and compared with age-matched controls. Retinal autofluorescence was excited using a 473-nm blue laser light and emitted fluorescence light was detected in 2 distinct wavelengths channels (498-560 nm and 560-720 nm). Clinical features, mean retinal autofluorescence lifetimes, autofluorescence intensity, and corresponding optical coherence tomography (OCT) images were further analyzed. Thirty-five central serous chorioretinopathy patients with a mean visual acuity of 78 ETDRS letters (range, 50-90; mean Snellen equivalent: 20/32) and 12 age-matched controls were included. In the acute stage of central serous chorioretinopathy, retinal fluorescence lifetimes were shortened by 15% and 17% in the respective wavelength channels. Multiple linear regression analysis showed that fluorescence lifetimes were significantly influenced by the disease duration (P autofluorescence lifetimes, particularly in eyes with retinal pigment epithelial atrophy, were associated with poor visual acuity. This study establishes that autofluorescence lifetime changes occurring in central serous chorioretinopathy exhibit explicit patterns which can be used to estimate perturbations of the outer retinal layers with a high degree of statistical significance.

  3. Correlation of Optical Coherence Tomography and Autofluorescence in the Outer Retina and Choroid of Patients With Choroideremia.

    Science.gov (United States)

    Xue, Kanmin; Oldani, Marta; Jolly, Jasleen K; Edwards, Thomas L; Groppe, Markus; Downes, Susan M; MacLaren, Robert E

    2016-07-01

    To evaluate the relationships between RPE, photoreceptor, and choroidal degeneration in choroideremia. Enhanced-depth imaging optical coherence tomography (EDI-OCT), scanning laser ophthalmoscopy (SLO), and autofluorescence (AF) were performed on 39 patients (78 eyes) with choroideremia. The edges of surviving outer retina on OCT and residual AF were aligned. The distribution of outer retinal tubulations was mapped over a range of ages (16-71 years), and comparison made between pre- and postsubretinal gene therapy. Subfoveal choroidal thickness (SFCT) was compared between 23 choroideremia patients (42 eyes) and 20 age- and refraction-matched male controls (40 eyes). The edges of RPE AF aligned with a reduction in outer nuclear layer thickness (Spearman's rho = 0.9992). Correlation was also found between the quality of AF and integrity of ellipsoid zone within islands of surviving retina. Tubulations existed in 71 of 78 (91%) eyes with choroideremia and remained stable following gene therapy. Subfoveal choroidal thickness was reduced at baseline in choroideremia (179.7 ± 17.2 μm) compared with controls (302.0 ± 4.8 μm; P retina and hence being potentially light responsive (ClinicalTrials.gov, NCT01461213).

  4. 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

  5. Small-Gauge Pars Plana Vitrectomy for the Management of Symptomatic Posterior Vitreous Detachment after Phacoemulsification and Multifocal Intraocular Lens Implantation: A Pilot Study from the Pan-American Collaborative Retina Study Group

    Science.gov (United States)

    Navarro, Rodrigo M.; Machado, Leonardo M.; Maia, Ossires; Wu, Lihteh; Farah, Michel E.; Magalhaes, Octaviano; Arevalo, J. Fernando; Maia, Mauricio

    2015-01-01

    Purpose. To determine the efficacy of 23-gauge pars plana vitrectomy (PPV) for symptomatic posterior vitreous detachment (PVD) on visual acuity (VA) and quality after multifocal intraocular lenses (IOLs). Methods. In this prospective case series, patients who developed symptomatic PVD and were not satisfied with visual quality due to floaters and halos after multifocal IOL implantation underwent PPV. Examinations included LogMAR uncorrected visual acuity (UCVA), intraocular pressure, biomicroscopy, and indirect ophthalmoscopy at baseline and 1, 7, 30, and 180 days postoperatively. Ultrasonography and aberrometry were performed. The Visual Functioning Questionnaire 25 (VFQ-25) was administered preoperatively and at 30 days postoperatively. Both the postoperative UCVA and questionnaire results were compared to preoperative findings using the Wilcoxon test. Results. Sixteen eyes of 8 patients were included. VA significantly improved from 0.17 to 0.09 postoperatively (P = 0.017). All patients reported improvement of halos, glare, and floaters. VFQ-25 scores significantly improved in general vision (P = 0.023), near activities (P = 0.043), distance activities (P = 0.041), mental health (P = 0.011), role difficulties (P = 0.042), and driving (P = 0.016). Conclusion. PPV may increase UCVA and quality of vision in patients with bilateral multifocal IOLs and symptomatic PVD. Larger studies are advised. PMID:26504590

  6. 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.

  7. Optic nerve size evaluated by magnetic resonance imaging in children with optic nerve hypoplasia, multiple pituitary hormone deficiency, isolated growth hormone deficiency, and idiopathic short stature.

    Science.gov (United States)

    Birkebaek, Niels Holtum; Patel, Leena; Wright, Neville Bryce; Grigg, John Russell; Sinha, Smeeta; Hall, Catherine Margaret; Price, David Anthony; Lloyd, Ian Christopher; Clayton, Peter Ellis

    2004-10-01

    To objectively define criteria for intracranial optic nerve (ON) size in ON hypoplasia (ONH) on magnetic resonance imaging (MRI) scans. Intracranial ON sizes from MRI were compared between 46 children with ONH diagnosed by ophthalmoscopy (group 1, isolated ONH, 8 children; and group 2, ONH associated with abnormalities of the hypothalamic-pituitary axis and septum pellucidum, 38 children) and children with multiple pituitary hormone deficiency (group 3, multiple pituitary hormone deficiency, 14 children), isolated growth hormone deficiency (group 4, isolated growth hormone deficiency, 15 children), and idiopathic short stature (group 5, idiopathic short stature, 10 children). Intracranial ON size was determined by the cross-sectional area, calculated as [pi x (1/2) height x (1/2) width]. Groups 1 and 2 had lower intracranial ON size than did groups 3, 4, and 5 (P imaging of the ONs with cross-sectional area short child more than 12 months of age, with or without hypothalamic-pituitary axis abnormalities, confirms the clinical diagnosis of ONH.

  8. THE EYE — MIRROR OF CARDIOVASCULAR DISORDER. RELATIONSHIP OF THE RETINA FUNCTIONAL STATE AND THE HYPERTENSION SEVERITY

    Directory of Open Access Journals (Sweden)

    V. S. Zadionchenko

    2011-01-01

    Full Text Available Aim. To study the retina state by functional methods in patients with arterial hypertension (HT of various degrees. Material and methods. Patients with uncomplicated HT of 1-3 degrees (n=81 and healthy subjects (n=20 of control group were examined. Routine (direct ophthalmoscopy and functional (evaluation of contrast and color sensitivity of the retina, electroretinography methods were used. Results. Functional retinal changes (reduction in color and contrast sensitivity progressed with increasing HT degree. These changes were located in the area of central retinal artery (paramacular area and area of choroidal blood flow (macular region. Retinal bioelectrical activity disturbance was also found by the electroretinography. Conclusion. The identified functional disorders suggest the retina involvement in the pathological process even in the early HT and may be associated with its severity. It confirms a relationship of HT with disorders of eye as a target organ in HT. Published data and results of our studies can refute the point of view about impossibility of changes assessment on the eye fundus in patients with uncomplicated HT, and indicates that it was premature exclusion of the eye from the list of target organs in HT.

  9. Combination of Intravitreal Ranibizumab and Laser Photocoagulation for Aggressive Posterior Retinopathy of Prematurity

    Directory of Open Access Journals (Sweden)

    Ágata Mota

    2012-04-01

    Full Text Available Purpose: To report on 2 cases of aggressive posterior retinopathy of prematurity (ROP treated with intravitreal ranibizumab (Lucentis® and laser photocoagulation. Methods: Two premature females, born at 25 and 26 weeks’ gestation with a birth weight of 530 and 550 g, respectively, with aggressive posterior ROP received combined treatment with laser photocoagulation and intravitreal ranibizumab (0.3 mg [30 µl] to each eye. Structural outcomes were evaluated by indirect ophthalmoscopy and documented by retinography. Results: An intravitreal injection was made at 34 weeks of postmenstrual age in the first case, followed by laser photocoagulation 1 week later. There was a partial regression of ROP with treatment. Five weeks later, neovascularization regrowth with bleeding in both eyes (intraretinal and subhyaloid occurred and retreatment with combined therapy was performed. In the second case, single therapy with laser photocoagulation was made at 34 weeks of postmenstrual age. In spite of the confluent photocoagulation in the avascular area, progression to 4A ROP stage occurred 1 week later. Both eyes were retreated 1 week later with intravitreal ranibizumab and laser photocoagulation. Treatment resulted in ROP regression in both cases. There were no signs of systemic or ocular adverse side effects. Conclusion: The cases presented show that combination therapy of indirect laser photocoagulation and intravitreal ranibizumab can be effective in the management of aggressive posterior ROP. Further investigation on anti-VEGF safety in premature infants is necessary . Additional studies are needed to define the role of anti-VEGF in ROP treatment.

  10. Two cases of radiation retinopathy

    International Nuclear Information System (INIS)

    Shoda, Miho; Yuzawa, Mitsuko; Matsui, Mizuo; Kaneko, Akihiro.

    1992-01-01

    Radiation retinopathy is characterized by retinal micovascular abnormalities after radiation therapy of the eye and its surrounding structures. The authors performed focal laser photocoagulation in two cases of radiation retinopathy. Case 1 was a 16 year old woman with radiation retinopathy who had been treated for retioblastoma in her right eye using cobalt 60-applicator 16 years prior to the first visit. Her corrected visual acuity of the right eye was 0.4. Ophthalmoscopy revealed large macular deposits, soft exudates, and retinal hemorrhage. Fluorescein angiography showed hyperpermeability of capillaries in the vicinity of the lower temporal retinal vessels. The visual acuity improved to 1.2 after the photocoagulation. Case 2 was a 16 year old man who had received 50 gray of external beam for a primary rhabdo-myosarcoma in the temporal region. Retinal avascular areas in the posterior pole of his both eyes were observed and the area showed increased retinal vessel permeability in the right eye was photocoagulated. The visual acuity in his right eye increased from 0.08 to 1.0 following the treatment. (author)

  11. Vision development over an extended follow-up period in babies after successful vitrectomy for stage 4b retinopathy of prematurity.

    Science.gov (United States)

    Gadkari, Salil; Kamdar, Rushita; Kulkarni, Sucheta; Deshpande, Madan; Taras, Sudhir

    2015-05-01

    To demonstrate improvement in the vision of babies after successful vitrectomy for stage 4b retinopathy of prematurity (ROP) over an extended period of time. This was an observational prospective case series. Eight babies who had undergone successful vitrectomy in either their only seeing eye (or both eyes) with stage 4b ROP were followed up post-operatively for a period of 80 weeks or more. Vision with Teller acuity chart, refraction, binocular indirect ophthalmoscopy, and documentation with RetCam was done at each visit. Vision of the (only/better) seeing operated eye with corrective glasses was graded for the purpose of statistical evaluation. Paired t test was performed to compare the vision prior to 30 weeks and at or after 80 weeks. Statistically significant improvement in vision was noted at or after 80 weeks as compared to the vision recorded before 30 weeks (p = 0.0062). Unlike in adult intraocular surgeries where stable visual acuity is reached well before 30 weeks, continuing improvement at 80 weeks and beyond is noted. Gradual restoration of the retinal architecture and plasticity of the infant's developing brain are thought to be responsible.

  12. Differences of optic disc appearance between normal tension and high tension glaucoma patients

    Directory of Open Access Journals (Sweden)

    Stojčić Milan

    2011-01-01

    Full Text Available Introduction. The term glaucoma is used to cover a wide range of diseases, whose main feature is optic neuropathy. According to the level of intraocular pressure (IOP, the open angle glaucoma is arbitrarily divided into high tension glaucoma (HTG and normal tension glaucoma (NTG. Objective. The aim of this study was to investigate the differences of optic disc cup appearance between patients with NTG and HTG. Methods. Prospective study included 30 patients (60 eyes with NTG and 30 patients (60 eyes with HTG. IOP was measured by Goldmann applanation tonometry. Examination of optic disc head was performed by indirect ophthalmoscopy with Volk 90 D superfield lens through a dilated pupil to observe qualitative and quantitative parameters. Visual fields were examined in all patients with the Octopus program G1, full threshold strategy (Octopus 500 EZ, Interzeag, Switzerland. Results. Vertical form of optic disc cup was present in 11 eyes with NTG (18.3% and three eyes with HTG (5% (p<0.05. A disc with localized tissue loss (polar notching on the inferior pole was observed in eight eyes with NTG (13.3% and in one eye with HTG (1.7% (p<0.01. Uniformly enlarged, round cup was more frequent in patients with HTG than NTG: 93.3% and 68.3% respectively (p<0.05. Conclusion. The perceived differences indicate a complex multifactorial nature of glaucoma disease and a possible existence of two pathophysiological ways of optic disc changes within the same basic disease.

  13. Retrospective cohort study shows that the risks for retinopathy of prematurity included birth age and weight, medical conditions and treatment.

    Science.gov (United States)

    Ali, Aliaa A; Gomaa, Nancy A S; Awadein, Ahmed R; Al-Hayouti, Huda H; Hegazy, Ahmed I

    2017-12-01

    This study described the characteristics and risk factors of neonates who developed retinopathy of prematurity (ROP) and severe treatable ROP in two Egyptian neonatal intensive care units (NICUs). This retrospective cohort study comprised 108 preterm neonates who were screened for ROP after being admitted to the two NICUs run by Cairo University Hospital from June 2014 to May 2015. Patients were examined using digital fundus photography and indirect ophthalmoscopy was performed if ROP was detected. Retinopathy of prematurity occurred in 75 patients. Late-onset sepsis, ventilation and hypercapnia were independently associated with ROP. Patients who developed severe treatable ROP had a younger gestational age (GA) than patients who did not develop ROP or developed mild or moderate ROP (29 weeks, range 27-33 weeks versus 32 weeks, range 28-36 weeks, p = 0.002) and a lower birthweight (1200 g, range 980-1590 g versus 1460 g, range 770-2475 g, p = 0.029). The risk factors associated with severe treatable ROP included the duration of admission, the duration of incubator oxygen, late-onset sepsis, intraventricular haemorrhage, total parenteral nutrition and the duration of caffeine citrate therapy. This study showed that the risks for ROP were wide-ranging and included GA and weight, medical conditions and treatment. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  14. Services for the Detection and Treatment of Retinopathy of Prematurity in Major Indian Cities: The 11-City 9-State Study.

    Science.gov (United States)

    Gilbert, Clare; Shukla, Rajan; Kumar, Rakesh; Khera, Ajay; Murthy, G Vs

    2016-11-07

    Control of visual loss from retinopathy of prematurity requires high quality neonatal care, and timely screening and treatment of sight-threatening disease. We assessed services for retinopathy of prematurity provided by ophthalmic training institutions in major Indian cities. Eleven cities were purposefully selected and eye-care facilities were evaluated using predefined criteria. Field teams visited these facilities to collect data by interview and observation using structured questionnaires. 30 training institutions were visited (18 public; 12 not-for-profit); 24 (24/30, 80%) provided a service for retinopathy of prematurity in 58 neonatal units (30 public, 28 private). 15/24 (63%) screened in one unit; six (25%) in 2-3 units and three (12%) in >3 units. Not-for-profit facilities (n=9) screened in more units than public facilities (n=15)(mean (range) 4.5 [1-12] vs 1.1 [1-2] units). Indirect ophthalmoscopy by ophthalmologists was the commonest screening modality but only half of these visited the units weekly. Laser was the commonest treatment, but only half treated babies in the neonatal unit. Annual treatments ranged from 1-200 (mean 39). Eye-care services for retinopathy of prematurity need to expand, particularly in the government sector.

  15. Topical use of chitosan in ophthalmology: tolerance assessment and evaluation of precorneal retention.

    Science.gov (United States)

    Felt, O; Furrer, P; Mayer, J M; Plazonnet, B; Buri, P; Gurny, R

    1999-04-15

    The mucoadhesive polysaccharide chitosan was evaluated as a potential component in ophthalmic gels for enabling increased precorneal drug residence times. This cationic vehicle was expected to slow down drug elimination by the lacrymal flow both by increasing solution viscosity and by interacting with the negative charges of the mucus. The molecular weight (Mw) and concentration of polysaccharide were studied in four types of chitosan as parameters that might influence ocular tolerability and precorneal residence time of formulations containing tobramycin as therapeutic agent. An ocular irritation test, using confocal laser scanning ophthalmoscopy (CLSO) combined with corneal fluorescein staining, clearly demonstrated the excellent tolerance of chitosan after topical administration onto the corneal surface. Gamma scintigraphic data showed that the clearance of the formulations labelled with 99mTc-DTPA was significantly delayed in the presence of chitosan with respect to the commercial collyrium (Tobrex(R)), regardless of the concentration and of the molecular weight of chitosan in solution. At least a 3-fold increase of the corneal residence time was achieved in the presence of chitosan when compared to Tobrex(R). Copyright.

  16. Efficacy observation on multiple wave length laser for diabetic retinopathy and central retinal vein occlusion

    Directory of Open Access Journals (Sweden)

    Tao Tian

    2014-07-01

    Full Text Available AIM:To observe the efficacy of the multiple wave length laser in treating diabetic retinopathy combined with central retinal vein occlusion. METHODS:Totally 95 cases(100 eyeswith diabetic retinopathy combined with central retinal vein occlusion were treated by multiple wave length laser. Krypton yellow laser was used for macular edema in focal photocoagulation and diffuse photocoagulation. For peripheral retina, krypton green or krypton red laser were used. Visual acuity, slit-lamp biomicroscopy, ophthalmoscopy and fundus fluorescein angiography were performed preoperatively and postoperatively. The patients were followed up for 12 to 48wk. In this study, change in visual acuity and macular edema were observed in both groups, and statistical analysis was performed. RESULTS:The effective rate was 61.2% in diffuse macular edema group and 86.3% in focal macular edema group. The general effective rate of later was higher than the former, while the treatment effect had significant statistical difference(PCONCLUSION: Multiple wave length laser is an effective and safe way to treat diabetic macular edema of diabetic retinopathy combined with central retinal vein occlusion,which is worth widely applying in clinical practice.

  17. [National survey on the prevalence and causes of blindness in Peru].

    Science.gov (United States)

    Campos, Betty; Cerrate, Amelia; Montjoy, Enrique; Dulanto Gomero, Víctor; Gonzales, César; Tecse, Aldo; Pariamachi, Andrés; Lansingh, Van C; Dulanto Reinoso, Víctor; Minaya Barba, Jean; Silva, Juan Carlos; Limburg, Hans

    2014-11-01

    To estimate the prevalence of blindness and visual impairment among adults in Peru and to determine their causes, to evaluate the coverage and quality of the cataract surgical services and to investigate the barriers that inhibit access to these services. A cross-sectional population study with two-stage random cluster sampling of individuals of ≥ 50 years old, representative of the entire country, using the standard methodology of the Rapid Assessment of Avoidable Blindness. Visual acuity was assessed and the condition of the lens and posterior pole examined by direct ophthalmoscopy. Cataract surgical coverage was calculated. Its quality, as well as the causes of visual acuity glaucoma (13.7%) and age-related macular degeneration (11.5%). Uncorrected refraction errors were the principal cause of moderate visual impairment (67.2%). Cataract surgical coverage was 66.9%. 60.5% of the eyes operated for cataracts achieved a visual acuity ≥ 20/60 with available correction. The main barriers to cataract surgery were the high cost (25.9%) and people being unaware that treatment was possible (23.8%). The prevalence of blindness and visual impairment in Peru is similar to that of other Latin American countries. Given the low cataract surgical coverage and the aging of the population, access to the services could be improved by increasing the population education on eye health and the response capacity of the ophthalmological and cataract surgical services, and by reducing the costs of the latter.

  18. Correlation analysis of electronic products with myopia in preschool and school aged children

    Directory of Open Access Journals (Sweden)

    Li-Li Sun

    2016-02-01

    Full Text Available AIM: To explore the influence of electronic products on myopia in preschool and school aged children, and the development regularities of myopia, to formulate reasonable guidelines for using eyes healthily, and lay a solid foundation for the prevention and control work. METHODS: This retrospective analysis enrolled 900 3~12 years old children from outpatients department, and all of them were established individualized archives, recording: uncorrected visual acuity, optometry, slit lamp, ophthalmoscopy, strabismus inspection results; recording eye usage condition on TVs, computers, mobile phones, iPad, homework, extra-curricular books. Statistical analyze the refractive status of each age group, the use of electronic products of different age groups and their correlation with refractive status. RESULTS: The number of preschool children with normal uncorrected visual acuity was more than that of early school-age children, and the difference was statistically significant(PP>0.05; the number of children aged 7~12(early school aged childrenwith myopia was more than that of children aged 3~6(preschool childrenand the difference was statistically significant(PCONCLUSION: For preschool children, it is necessary to conduct early screening, health guidance, the establishment of personalized medical records and one-to-one personalized guidance; it is also needed to avoid the arduous learning task with the stacking usage of eyes, to fight for myopia and to control the development of myopia. Therefore, to reduce the use of electronic products has become a topic worthy of further study.

  19. Applying photoacoustics to quantification of melanin concentration in retinal pigment epithelium (Conference Presentation)

    Science.gov (United States)

    Shu, Xiao; Zhang, Hao F.; Liu, Wenzhong

    2016-03-01

    The melanin in the retinal pigment epithelium (RPE) protects retina and other ocular tissues by photo-screening and acting as antioxidant and free radical scavenger. It helps maintain normal visual functions since human eye is subjected to lifelong high oxygen stress and photon exposure. Loss of the RPE melanin weakens the protection mechanism and jeopardizes ocular health. Local decrease in the RPE melanin concentration is believed to be both a cause and a sign of early-stage age-related macular degeneration (AMD), the leading blinding disease in developed world. Current technology cannot quantitatively measure the RPE melanin concentration which might be a promising marker in early AMD screening. Photoacoustic ophthalmoscopy (PAOM), as an emerging optical absorption-based imaging technology, can potentially be applied to measure the RPE melanin concentration if the dependence of the detectable photoacoustic (PA) signal amplitudes on the RPE melanin concentrations is verified. In this study, we tested the feasibility of using PA signal ratio from RPE melanin and the nearby retinal blood vessels as an indicator of the RPE melanin variation. A novel whole eye optical model was designed and Monte Carlo modeling of light (MCML) was employed. We examined the influences on quantification from PAOM axial resolution, the depth and diameter of the retinal blood vessel, and the RPE thickness. The results show that the scheme is robust to individual histological and illumination variations. This study suggests that PAOM is capable of quantitatively measuring the RPE melanin concentration in vivo.

  20. Optic atrophy, necrotizing anterior scleritis and keratitis presenting in association with Streptococcal Toxic Shock Syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Papageorgiou Konstantinos I

    2008-02-01

    Full Text Available Abstract Introduction We report a case of optic atrophy, necrotizing anterior scleritis and keratitis presenting in a patient with Streptococcal Toxic Shock Syndrome. Case presentation A 43-year-old woman developed streptococcal toxic shock syndrome secondary to septic arthritis of her right ankle. Streptococcus pyogenes (b-haemolyticus Group A was isolated from blood cultures and joint aspirate. She was referred for ophthalmology review as her right eye became injected and the pupil had become unresponsive to light whilst she was in the Intensive Therapy Unit (ITU. The iris appeared atrophic and was mid-dilated with no direct or consensual response to light. Three zones of sub-epithelial opacification where noted in the cornea. There where extensive posterior synechiae. Indirect ophthalmoscopy showed a pale right disc. The vision was reduced to hand movements (HM. A diagnosis of optic atrophy was made secondary to post-streptococcal uveitis. She subsequently developed a necrotizing anterior scleritis. Conclusion This case illustrates a previously unreported association of optic atrophy, necrotizing anterior scleritis and keratitis in a patient with post-streptococcal uveitis. This patient had developed Streptococcal Toxic Shock Syndrome secondary to septic arthritis. We recommend increased awareness of the potential risks of these patients developing severe ocular involvement.

  1. Eye injury treatment in intensive care unit patients

    Directory of Open Access Journals (Sweden)

    L. K. Moshetova

    2015-01-01

    Full Text Available Aim. To describe eye injuries in intensive care unit (ICU patients with multitrauma, to study conjunctival microflora in these patients, and to develop etiologically and pathogenically targeted treatment and prevention of wound complications.Materials and methods. Study group included 50 patients (54 eyes with combined mechanical cerebral and eye injury. All patients underwent possible ophthalmological examination (biomicroscopy, ophthalmoscopy and ocular fundus photographing with portative fundus camera, tonometry, cranial CT and MRT, and bacteriological study of conjunctival smears. Results. Modern methods of ophthalmological examination of ICU patients provided correct diagnosis and prediction of wound healing. Eye injury treatment schedule provided maximum possible results in all ICU patients. Hospitalacquired infection results in asymptomatic dissemination of pathogenic microbes on ocular surface. Conclusions. 14-day topical treatment with antimicrobials, steroids, and NSAIDs reduces posttraumatic inflammation caused by mechanical eye injuries in ICU patients. Bacteriological studies of conjunctival smears demonstrate the presence of pathogenic flora in ICU patients. In these patients, the most effective antibacterial agents are third-generation fluoroquinolones. 

  2. A Protective Eye Shield for Prevention of Media Opacities during Small Animal Ocular Imaging

    Science.gov (United States)

    Bell, Brent A.; Kaul, Charles; Hollyfield, Joe G.

    2014-01-01

    Optical coherence tomography (OCT), scanning laser ophthalmoscopy (SLO) and other non-invasive imaging techniques are increasingly used in eye research to document disease-related changes in rodent eyes. Corneal dehydration is a major contributor to the formation of ocular opacities that can limit the repeated application of these techniques to individual animals. General anesthesia is usually required for imaging, which is accompanied by the loss of the blink reflex. As a consequence, the tear film cannot be maintained, drying occurs and the cornea becomes dehydrated. Without supplemental hydration, structural damage to the cornea quickly follows. Soon thereafter, anterior lens opacities can also develop. Collectively these changes ultimately compromise image quality, especially for studies involving repeated use of the same animal over several weeks or months. To minimize these changes, a protective shield was designed for mice and rats that prevent ocular dehydration during anesthesia. The eye shield, along with a semi-viscous ophthalmic solution, is placed over the corneas as soon as the anesthesia immobilizes the animal. Eye shields are removed for only the brief periods required for imaging and then reapplied before the fellow eye is examined. As a result, the corneal surface of each eye is exposed only for the time required for imaging. The device and detailed methods described here minimize the corneal and lens changes associated with ocular surface desiccation. When these methods are used consistently, high quality images can be obtained repeatedly from individual animals. PMID:25245081

  3. 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.

  4. Usher's syndrome--case report.

    Science.gov (United States)

    Kwiecień, Sława; Sulak, Robert; Szaflik, Jerzy

    2008-01-01

    The aim of this study is to present a case of coincidence of sensorineural hearing loss with chronic recurrent bilateral cystoid macular oedema in a 32-year-old woman, who was admitted to the clinic for deterioration of visual acuity of four months' duration. The patient gave a history of hearing loss for 29 years. Visual field examination disclosed peripheral ring scotoma. Electrophysiological examination was performed: pattern visual evoked response was within normal limits and electroretinogram displayed diminished both photopic and scotopic response. As ophthalmoscopy demonstrated no pigment in the fundus of the eye, the findings were consisted with diagnosis of retinitis pigmentosis sine pigmento. The presence of loss of hearing indicated the necessity of performing the genetic examination for Usher's syndrome. In order to establish a final diagnosis of Usher's syndrome genetic examination must be performed, but family history is relevant. Early investigation for Usher's syndrome in children with sensorineural hearing impairment is of a great significance. The patient may develop symptoms of retinitis pigmentosa in second or even third decade of his life. The necessity of thorough investigation for detecting other systemic abnormalities should be emphasized. There is no effective treatment of this syndrome. A child with Usher's syndrome requires a comprehensive care of different medical specialties. Psychological, educational and sociological attitude is also of a great importance in the child development.

  5. Retinal Imaging Techniques for Diabetic Retinopathy Screening

    Science.gov (United States)

    Goh, James Kang Hao; Cheung, Carol Y.; Sim, Shaun Sebastian; Tan, Pok Chien; Tan, Gavin Siew Wei; Wong, Tien Yin

    2016-01-01

    Due to the increasing prevalence of diabetes mellitus, demand for diabetic retinopathy (DR) screening platforms is steeply increasing. Early detection and treatment of DR are key public health interventions that can greatly reduce the likelihood of vision loss. Current DR screening programs typically employ retinal fundus photography, which relies on skilled readers for manual DR assessment. However, this is labor-intensive and suffers from inconsistency across sites. Hence, there has been a recent proliferation of automated retinal image analysis software that may potentially alleviate this burden cost-effectively. Furthermore, current screening programs based on 2-dimensional fundus photography do not effectively screen for diabetic macular edema (DME). Optical coherence tomography is becoming increasingly recognized as the reference standard for DME assessment and can potentially provide a cost-effective solution for improving DME detection in large-scale DR screening programs. Current screening techniques are also unable to image the peripheral retina and require pharmacological pupil dilation; ultra-widefield imaging and confocal scanning laser ophthalmoscopy, which address these drawbacks, possess great potential. In this review, we summarize the current DR screening methods using various retinal imaging techniques, and also outline future possibilities. Advances in retinal imaging techniques can potentially transform the management of patients with diabetes, providing savings in health care costs and resources. PMID:26830491

  6. Improved photoacoustic dosimetry for retinal laser surgery

    Science.gov (United States)

    Dufour, Suzie; Brown, Robert B.; Gallant, Pascal; Mermut, Ozzy

    2018-02-01

    Lasers are employed for numerous medical interventions by exploiting ablative, disruptive or thermal effects. In ocular procedures, lasers have been used for decades to treat diseases such as diabetic retinopathy, macular edema and aged related macular degeneration via photocoagulation of retinal tissues. Although laser photocoagulation is well established in today's practice, efforts to improve clinical outcomes by reducing the collateral damage from thermal diffusion is leading to novel treatments using shorter (μs) laser pulses (e.g. selective retinal therapy) which result in physical rather than thermal damage. However, for these new techniques to be widely utilized, a method is required to ensure safe but sufficient dosage has been applied, since no visible effects can be seen by ophthalmoscopy directly post treatment. Photoacoustic feedback presents an attractive solution, as the signal is dependent directly on absorbed dosage. Here, we present a method that takes advantage of temporal pulse formatting technology to minimize variation in absorbed dose in ophthalmic laser treatment and provide intelligent dosimetry feedback based on photoacoustic (PA) response. This method tailors the pulse to match the frequency response of the sample and/or detection chain. Depending on the system, this may include the absorbing particle size, the laser beam diameter, the laser pulse duration, tissue acoustic properties and the acoustic detector frequency response. A significant improvement (<7x) of photoacoustic signal-to-noise ratio over equivalent traditional pulse formats have been achieved, while spectral analysis of the detected signal provides indications of cavitation events and other sample properties.

  7. Early diagnosis of diabetic retinopathy in primary care.

    Science.gov (United States)

    Jimenez-Baez, Maria Valeria; Marquez-Gonzalez, Horacio; Barcenas-Contreras, Rodolfo; Morales Montoya, Carlos; Espinosa-Garcia, Laura Fatima

    2015-01-01

    To evaluate the impact of a strategy for early detection of diabetic retinopathy in patients with type 2 diabetes mellitus (DMT2) in Quintana Roo, México. Study transversal, observational, prospective, analytical, eight primary care units from Mexican Social Security Institute in the northern delegation of the State of Quintana Roo, Mexico were included. A program for early detection of diabetic retinopathy (DR) in adult 376,169 was designed. Were diagnosed 683 cases of type 2 diabetes, in 105 patients randomized was conducted to direct ophthalmoscopy were subjected to a secondary hospital were assigned. Will determine the degree of diabetic retinopathy and macular edema was performed. In population were 55.2% female, mean age 48+11.1 years, 23.8 % had some degree of DR, 28.0% with mild non- proliferative diabetic retinopathy 48.0 % moderate 16.0% and severe and 8.0% showed proliferative diabetic retinopathy. Those over age 30 are 2.8 times more risk of developing DR, OR= 2.8; 95%CI: 0.42-18.0, and OR= 1.7; 95%CI: 1.02-2.95 women. The implementation of programs aimed at the early detection of debilitating conditions such as diabetic retinopathy health impact beneficiaries, effective links between primary care systems and provide second level positive health outcomes for patient diseases.

  8. Magnetic resonance imaging in ophthalmic diagnosis. Results of examinations using a small field-of-view surface coil

    International Nuclear Information System (INIS)

    Kato, Yuji; Yoshida, Akitoshi; Kanno, Harumi; Ogasawara, Hironobu; Murakami, Noboru; Cheng, Hong-Ming.

    1997-01-01

    We obtained T 1 -and T 2 -weighted magnetic resonance (MR) images in 3 patients with vitreoretinal disorders using a recently developed surface coil that was inductively coupled and had a small field of view. On both T 1 -and T 2 -weighted images, tractional retinal detachment was clearly detected in the first patient, who had proliferative diabetic retinopathy. T 1 - and T 2 -weighted images of the second patient, who had total retinal detachment with proliferative vitreous retinopathy, revealed a funnel-shaped thickened retina. The third patient had postoperative rhegmatogenous retinal detachment with opacity due to postoperative cataract and intravitreous injection of gas; on this patient's MR images we could clearly differentiate the reattached retina, silicone used for scleral buckling, and intravitreous gas, even though these differentiations were not possible with ophthalmoscopy or B-scan ultrasonography. High resolution MR imaging with our technique can be performed in a short time and regardless of the eye's condition. Our findings strongly indicate that MRI with a small field-of-view surface coil is a useful tool for diagnosing various vitreoretinal disorders and observing pathological changes. (author)

  9. Study of retrobulbar hemodynamics in diabetes via color doppler ultrasound

    Directory of Open Access Journals (Sweden)

    Wei Chen

    2014-09-01

    Full Text Available AIM: To explore the changes of retrobulbar hemodynamics in diabetes via color doppler ultrasound. METHODS: Totally 80 patients(160 eyeswith eye diseases in type 2 diabetes from June 2010 to May 2013 in our hospital were enrolled as research group. By fundus photography and direct ophthalmoscopy, patients were assigned to diabetes without retinopathy group(DNR subgroup, non-proliferative diabetic retinopathy group(NPDR subgroupand proliferative diabetic retinopathy group(PDR subgroup. Of 60 healthy patients(120 eyesover the same period were chosen as control group. The doppler parameters of central retinal artery(CRA, posterior ciliary artery(PCAand ophthalmic artery(OAwere measured.RESULTS: There were significant differences on circulatory parameters of CRA, PCA and OA between both groups(PPPCONCLUSION: The monitoring of retinal blood flow and analysis of blood spectrum morphology via color doppler ultrasound can effectively evaluate the degree of diabetic retinopathy lesions, especially before DR vascular disease. Early detection can reveal the hemodynamic change pattern of DR, facilitating the prevention of diabetic eye complications and improvement of the quality of life.

  10. Evidence of macular pigment in the central macula in albinism.

    Science.gov (United States)

    Wolfson, Yulia; Fletcher, Emily; Strauss, Rupert W; Scholl, Hendrik P N

    2016-04-01

    Albinism represents a spectrum of disorders with diminished to absent amounts of melanin pigmentation including the posterior segment of the eye. Macular pigment (MP) consists of two main carotenoids, lutein and zeaxanthin, concentrated in the macula. MP serves as blue light absorbent, antioxidant, and may reduce chromatic aberration and glare. It remains unclear if albinos have detectable MP. The purpose was to investigate the distribution of MP in albino patients with psychophysical and imaging techniques. MP was measured at the eccentricity of 0.5° by heterochromatic flicker perimetry (QuantifEye(®); Tinsley Precision Instruments Ltd.) or by scanning laser ophthalmoscopy (MPOD module, MultiColor Spectralis(®), Heidelberg Engineering, Heidelberg, Germany) in four albino patients, who were also investigated with multimodal ophthalmic imaging. Visual acuity ranged from 20/32 to 20/125, nystagmus was present in three patients, and all patients showed typical foveal hypoplasia on fundus exam and optical coherence tomography. Fundus autofluorescence (FAF) demonstrated various degrees of central FAF signal attenuation. Genetic testing was available in three patients and confirmed the diagnosis. Measurable amounts of MP were detected in all four patients and ranged from 0.05 to 0.24, which is below the normal range. We conclude that MP can be demonstrated and measured in albinos. Further studies are needed to investigate MP accumulation following carotenoid supplementation and its impact on visual performance. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Assessment of Color Vision Among School Children: A Comparative Study Between The Ishihara Test and The Farnsworth D-15 Test

    Directory of Open Access Journals (Sweden)

    Rajesh Kishor Shrestha

    2016-10-01

    Full Text Available Introduction: Color vision is one of the important attribute of visual perception. The study was conducted at different schools of Kathmandu to compare the  ndings of the Ishihara Pseudoisochromatic test and the Farnsworth D-15 test.  Method: A cross-sectional study was conducted among 2120 students of four schools of Kathmandu. Assessment included visual acuity measurement, slit lamp examination of anterior segment and fundus examination with direct ophthalmoscopy. Each student was assessed with the Ishihara pseudoisochromatic test and the Farnsworth D-15 test. The Chi-square test was performed to analyse color vision defect detected by the Ishihara test and the Farnsworth D-15 test. Results: A total of 2120 students comprising of 1114 males (52.5% and 1006 females (47.5% were recruited in the study with mean age of 12.2 years (SD 2.3 years. The prevalence of color vision defect as indicated by the Ishihara was 2.6 and as indicated by the D-15 test was 2.15 in males.  Conclusion: For school color vision screening, the Ishihara color test and the Farnsworth D-15 test have equal capacity to detect congenital color vision defect and they complement each other.  Keywords: color vision; children; defect; Farnsworth D-15; Ishihara.

  12. Ocular disease in the guinea pig (Cavia porcellus): a survey of 1000 animals.

    Science.gov (United States)

    Williams, David; Sullivan, Ann

    2010-09-01

    Anecdotal evidence has suggested that guinea pigs have a high prevalence of ocular lesions. Here we undertook a survey of 1000 guinea pigs from populations of animals kept as laboratory animals, breeding show cavies, animals kept as pets and those from rescue and rehoming centers. Each animal was examined to assess for ocular abnormalities. A full ophthalmic examination was performed on each animal with direct and indirect ophthalmoscopy and with slit lamp biomicroscopy. Measurement of tear production using the Schirmer tear test 1 and intraocular pressure using the Tonopen applanation tonometer after topical anesthesia was undertaken in selected animals. Forty-five percent of animals examined had some ocular abnormality. The majority were lens lesions including 17% with cataract and 21% with subclinical lens abnormalities such as nuclear sclerosis. Other abnormalities included conjunctivitis in 4.7% and keratitis in 3.6%. Lipid deposition in conjunctiva was observed in 2.3% of guinea pigs and ciliary body heterotopic bone formation in 0.8% of animals. This study shows a high proportion of eyes with some degree of abnormality in animals otherwise considered healthy. Information on diseases of the guinea pig eye is important given the use of the species as a laboratory rodent and also the number kept as pets and show animals.

  13. [National survey of blindness and avoidable visual impairment in Honduras].

    Science.gov (United States)

    Alvarado, Doris; Rivera, Belinda; Lagos, Luis; Ochoa, Mayra; Starkman, Ivette; Castillo, Mariela; Flores, Eduardo; Lansingh, Van C; Limburg, Hans; Silva, Juan Carlos

    2014-11-01

    To determine the prevalence of blindness and visual impairment in Honduras, its causes and the response by the health services to growing demand. A cross-sectional population study was conducted between June and December 2013 using the standard methodology of the Rapid Assessment of Avoidable Blindness. A random sample survey was done in 63 clusters of 50 individuals aged ≥ 50, representative of the country as a whole. Visual acuity (VA) was assessed using a Snellen eye chart, and the condition of the lens and posterior pole was examined by direct ophthalmoscopy. Cataract surgical coverage was calculated and an assessment made of its quality, the causes of VA 20/60 with available correction. The main barriers against cataract surgery were cost (27.7%) and the lack of availability or difficulty of geographical access to the treatment (24.6%). The prevalence of blindness and visual impairment in Honduras is similar to that of other Latin American countries. 67% of cases of blindness could be resolved by improving the response capacity of the ophthalmological services, especially of cataract surgery, improving optician services and incorporating eye care in primary health care.

  14. Outcomes of macular hole surgery in patients treated intraoperatively for retinal breaks and/or lattice degeneration.

    Science.gov (United States)

    Hwang, John; Escariao, Paulo; Iranmanesh, Reza; Tosi, Gian Marco; Chang, Stanley

    2007-01-01

    To assess the outcome of macular hole surgery in patients treated intraoperatively for retinal breaks and/or lattice degeneration. Retrospective review of patients who underwent macular hole surgery from September 1998 to August 2005. Outcomes in eyes that received intraoperative endolaser photocoagulation for retinal breaks and/or lattice degeneration were compared to outcomes in a case-matched control group without retinal breaks or lattice degeneration. A total of 235 consecutive macular hole surgery cases were reviewed. Twenty-four eyes from 24 patients received intraoperative endolaser photocoagulation for retinal breaks and/or lattice degeneration. Macular hole closure occurred in all case and control eyes without any incidence of postoperative retinal detachment. Best-corrected visual acuity improvement of at least three Snellen lines occurred in 100% of case eyes and 92% of control eyes. Outcomes of macular hole surgery in patients with retinal breaks and/or lattice degeneration are similar to outcomes in the overall population when these conditions are treated with intraoperative endolaser photocoagulation. Postoperative retinal detachment does not appear to be correlated with treated retinal tears and greater attention should focus on detecting and managing intraoperative breaks. In our hands, routine use panoramic viewing has replaced indirect ophthalmoscopy, by saving time, and reducing the risk of contamination.

  15. Early rhegmatogenous retinal detachment following laser in situ keratomileusis for high myopia.

    Science.gov (United States)

    Farah, M E; Höfling-Lima, A L; Nascimento, E

    2000-01-01

    Four eyes had early rhegmatogenous retinal detachment within 3 months of laser in situ keratomileusis (LASIK) for correction of high myopia using the microkeratome, Clear Corneal Molder. In two eyes, retinal detachment resulted from horseshoe tears, one occurring in an otherwise normal region of the retina and the other at the margin of an area of lattice degeneration detected during preoperative examination. The first eye was treated with retinopexy using a 287 encircling scleral exoplant, drainage of subretinal fluid, and laser photocoagulation by indirect ophthalmoscopy. The other eye was treated with pneumatic retinopexy and cryotherapy. In the other eyes, retinal detachment was the result of giant tears with no evidence of prior retinal degeneration. These eyes were treated with pars plana vitrectomy, fluid-gas exchange with 15% perfluoropropane (C3F8), endolaser photocoagulation, and a 42 encircling scleral exoplant. After treatment, the first two eyes achieved spectacle-corrected visual acuity of 20/40. In the last two eyes, final spectacle-corrected visual acuity was 20/400 in one eye and light perception in the other. Although no cause-effect relationship between LASIK and retinal detachment can be stated, these cases suggest that LASIK may be associated with retinal detachment, particularly in highly myopic eyes. Further studies are necessary to determine high-risk patient characteristics.

  16. Subretinal drusenoid deposits with increased autofluorescence in eyes with reticular pseudodrusen.

    Science.gov (United States)

    Lee, Mee Yon; Ham, Don-Il

    2014-01-01

    To characterize a variant type of drusenoid deposit with different imaging features in comparison to reticular pseudodrusen. Retrospective observational consecutive case series. Eyes showing atypical drusenoid lesions were sorted out from 257 eyes of 133 patients previously diagnosed as reticular pseudodrusen. Eyes were evaluated using color fundus photography, confocal scanning laser ophthalmoscopy, and spectral domain optical coherence tomography. A variant type of drusenoid deposits showing different imaging features from reticular pseudodrusen was found in 17 eyes of 12 patients (6.6%). The mean age of patients was 62.7 ± 11.6 years, and all patients were women. These deposits were observed as yellowish white, round to oval lesions on color photographs, located under the sensory retina and above the retinal pigment epithelium on spectral domain optical coherence tomography similar to reticular pseudodrusen. However, they were present in a smaller number as discrete lesions and showed increased autofluorescence. None of them were accompanied by late age-related macular degeneration. Subretinal drusenoid deposits are not homogeneous and can be classified into two types according to the fundus autofluorescence. Multimodal imaging tests are needed for the differential diagnosis of subretinal drusenoid deposits.

  17. Clinical features of the head injury caused by child abuse in infants

    International Nuclear Information System (INIS)

    Nishimoto, Hiroshi; Kurihara, Jun

    2007-01-01

    The diagnosis and managements of the head injury in battered children are greatly complicated by medical history and the mechanisms of injury. In the present study, we evaluated the clinical features of the head injury in battered children. Clinical signs and symptoms, the mechanisms of injury, intracranial pathology, and prognosis of 25 battered children with head injury treated between 1984 and 2003 were retrospectively analyzed. The age of 25 children was between 1 month and 2 years old. The average of the ages was 7 months old. In 68% of 25 patients, the age was 6 months or less. The medical history of head injury was unclear in 16 children. The chief complains were disturbance of consciousness, convulsion, vomiting and hypothermia. Retinal hemorrhages were recognized in 88% of the patients and these were bilateral in 68%. Acute subdural hematomas (19 cases) and chronic subdural hematomas (6 cases) were shown on CTs or MRIs. In four cases, cerebral contusions were complicated as intracranial pathology. In 44% of the patients, the hypoxic-ischemic injury was confirmed on CTs or MRIs. Fractures of limbs and ribs were recognized on skeletal survey in 40% of the patients. 71% of 17 survival cases had moderate or severe psychomotor disabilities at the end of follow-up periods. In children under 2 years of age with subdural hematomas, clinical investigations other than CT and MRI, included ophthalmoscopy by ophthalmologist and skeletal survey, are crucial and mandatory for early diagnosis of the child abuse. (author)

  18. Posterior vitreous detachment induced by nattokinase (subtilisin NAT): a novel enzyme for pharmacologic vitreolysis.

    Science.gov (United States)

    Takano, Akiomi; Hirata, Akira; Ogasawara, Kazuya; Sagara, Nina; Inomata, Yasuya; Kawaji, Takahiro; Tanihara, Hidenobu

    2006-05-01

    To investigate the effects of intravitreal injection of nattokinase (subtilisin NAT), a serine protease that is produced by Bacillus subtilis (natto), for induction of posterior vitreous detachment (PVD). Different doses of nattokinase (1, 0.1, or 0.01 fibrin-degradation units [FU]) or physiologic saline as a control were injected into the vitreous cavity of rabbit eyes. Scanning electron microscopy was used to observe the retinal surfaces of four rabbit eyes per concentration. Histologic alterations were assessed by light microscopy, using four eyes from each group. Electroretinography (ERG) was performed to observe retinal function, ranging from 1 hour to 1 week after the nattokinase (1 or 0.1 FU) or saline solution administration, using four eyes from each group at each time point. Also, findings in all rabbits were monitored by slit lamp examination and by indirect ophthalmoscopy with a 20-D lens. Scanning electron microscopy showed smooth retinal surfaces, indicating the occurrence of PVD at 30 minutes after intervention in all the experimental eyes injected with 0.1 or 1.0 FU nattokinase, but none of the control eyes. Light microscopy and ERG analysis showed no critical change even after the use of 0.1 FU nattokinase, an amount sufficient to induce PVD. However, toxicity in the forms of preretinal hemorrhage and ERG changes was noted with the higher dose (1 FU) of nattokinase. The results suggested that nattokinase is a useful enzyme for pharmacologic vitreolysis because of its efficacy in inducing PVD.

  19. Toxicity profiles of subretinal indocyanine green, Brilliant Blue G, and triamcinolone acetonide: a comparative study

    DEFF Research Database (Denmark)

    Ejstrup, Rasmus; Dornonville de la Cour, Morten; Heegaard, Steffen

    2012-01-01

    BACKGROUND: This study introduces a novel porcine model to examine the histopathological and electrophysiological consequences of retinotoxicity exerted by dyes commonly used for internal limiting membrane (ILM) staining. METHODS: Indocyanine green (ICG) 0.5 mg/ml, Brilliant Blue G (BBG) 0.25 mg....../ml and triamcinolone acetonide (TA) 13 mg/ml was injected subretinally in 12 vitrectomized pig eyes. At 6 weeks, retinas were examined by multifocal electroretinography (mfERG), ophthalmoscopy, fluorescein angiograpy, histopathology, and apoptosis assay. RESULTS: mfERG responses were significantly lower in ICG......-injected eyes than in healthy fellow eyes (p¿=¿0.039). The ratio between injected eyes and healthy fellow eyes was lower in the ICG group than in the BBG (p¿=¿0.009) and TA group (p¿=¿0.025). No difference between BBG and TA existed. All retinas were reattached, and fluorescein angiographies showed a window...

  20. Presumed choroidal metastasis of Merkel cell carcinoma

    International Nuclear Information System (INIS)

    Small, K.W.; Rosenwasser, G.O.; Alexander, E. III; Rossitch, G.; Dutton, J.J.

    1990-01-01

    Merkel cell carcinoma is a rare skin tumor of neural crest origin and is part of the amine precursor uptake and decarboxylase system. It typically occurs on the face of elderly people. Distant metastasis is almost uniformly fatal. Choroidal metastasis, to our knowledge, has not been described. We report a patient with Merkel cell carcinoma who had a synchronous solid choroidal tumor and a biopsy-proven brain metastasis. Our 56-year-old patient presented with a rapidly growing, violaceous preauricular skin tumor. Computed tomography of the head disclosed incidental brain and choroidal tumors. Light and electron microscopy of biopsy specimens of both the skin and the brain lesions showed Merkel cell carcinoma. Ophthalmoscopy, fluorescein angiography, and A and B echography revealed a solid choroidal mass. The brain and skin tumors responded well to irradiation. A radioactive episcleral plaque was applied subsequently to the choroidal tumor. All tumors regressed, and the patient was doing well 28 months later. To our knowledge this is the first case of presumed choroidal metastasis of Merkel cell carcinoma

  1. Assessment of intraocular pressure in chinchillas of different age groups using rebound tonometry

    Directory of Open Access Journals (Sweden)

    Flor Diana Yokoay Claros Chacaltana

    2016-01-01

    Full Text Available ABSTRACT: The aim of this research was to measure the intraocular pressure (IOP of normal chinchilla eyes using the rebound tonometer. A further aim was to assess whether there were differences in the values of intraocular pressure in relation to animals age, gender and time of day. Thirty-six chinchillas were divided into three groups of 12 chinchillas each, by age: Group I (2-6-month-old, Group II (20 and 34 months and Group III (37 and 135 months. Ophthalmic examination was performed previously by Schirmer tear test, slit lamp biomicroscopy, indirect ophthalmoscopy and fluorescein test in all chinchillas. Three measurements of intraocular pressure were assessed on the same day (7, 12 and 19h. Tonometry was performed on both eyes using the rebound tonometer after calibration in "p" mode. Statistical analysis was performed with SigmaPlot for Windows. The mean IOP for groups I, II and III were 2.47±0.581mmHg, 2.47±0.581mmHg and 2.51±0.531mmHg, respectively. No significant differences were reported between age and IOP and no significant differences were reported between the time of day and IOP. The IOP in chinchillas did not differ significantly between genders or ages of the animals, and did not change with time of day.

  2. Antioxidant status of dog aqueous humor after extracapsular lens extraction

    Directory of Open Access Journals (Sweden)

    Barros P.S.M.

    2003-01-01

    Full Text Available We determined the antioxidant status of the aqueous humor after extracapsular lens extraction in 14 mongrel dogs weighing about 10 kg. The animals were examined by slit lamp biomicroscopy, applanation tonometry and indirect ophthalmoscopy. One eye was submitted to conventional extracapsular lens extraction and the other was used as control. Samples of aqueous humor were obtained by anterior chamber paracentesis before and at days 1, 2, 3, 7 and 15 after surgery. Total antioxidant status was determined as the capacity of aqueous humor to inhibit free radical generation by 2,2-azobis(2-amidopropane chlorine. Ascorbic acid concentration was measured by HPLC with UV detection. Protein content was determined with the biuret reagent. Statistical analysis was performed by ANOVA followed by the Tukey-Kramer test. Protein concentration increased from 0.61 to 22 mg/ml 24 h after surgery. These levels were maintained and returned to normal at day 7. Total antioxidant capacity was reduced from 50 to about 30 min until day 3 and at day 7 it was equal to control. Ascorbic acid levels were reduced from 252 to about 110 µM and then returned to control values at day 15. Considering the importance of ascorbic acid concentration in aqueous humor for the maintenance of the antioxidant status of the anterior segment of the eye, the decrease of antioxidant defenses suggests that the surgical procedures promote an oxidative stress condition in the eye.

  3. Intravitreal properties of porous silicon photonic crystals

    Science.gov (United States)

    Cheng, L; Anglin, E; Cunin, F; Kim, D; Sailor, M J; Falkenstein, I; Tammewar, A; Freeman, W R

    2009-01-01

    Aim To determine the suitability of porous silicon photonic crystals for intraocular drug-delivery. Methods A rugate structure was electrochemically etched into a highly doped p-type silicon substrate to create a porous silicon film that was subsequently removed and ultrasonically fractured into particles. To stabilise the particles in aqueous media, the silicon particles were modified by surface alkylation (using thermal hydrosilylation) or by thermal oxidation. Unmodified particles, hydrosilylated particles and oxidised particles were injected into rabbit vitreous. The stability and toxicity of each type of particle were studied by indirect ophthalmoscopy, biomicroscopy, tonometry, electroretinography (ERG) and histology. Results No toxicity was observed with any type of the particles during a period of >4 months. Surface alkylation led to dramatically increased intravitreal stability and slow degradation. The estimated vitreous half-life increased from 1 week (fresh particles) to 5 weeks (oxidised particles) and to 16 weeks (hydrosilylated particles). Conclusion The porous silicon photonic crystals showed good biocompatibility and may be used as an intraocular drug-delivery system. The intravitreal injectable porous silicon photonic crystals may be engineered to host a variety of therapeutics and achieve controlled drug release over long periods of time to treat chronic vitreoretinal diseases. PMID:18441177

  4. Fluorescein angiography and retinal vascular development in premature infants.

    Science.gov (United States)

    Purcaro, Velia; Velia, Purcaro; Baldascino, Antonio; Antonio, Baldascino; Papacci, Patrizia; Patrizia, Papacci; Giannantonio, Carmen; Carmen, Giannantonio; Molisso, Anna; Anna, Molisso; Molle, Fernando; Fernando, Molle; Lepore, Domenico; Domenico, Lepore; Romagnoli, Costantino; Costantino, Romagnoli

    2012-10-01

    To investigate the role of fluorescein angiography (FA) in the management of retinopathy of prematurity (ROP) in preterm newborns. An observational case series of 13 extremely low birth weight infants. From September 2009 to March 2010, 13 newborn infants with a gestational age <29 weeks end/or birth weight <1000 g underwent serial fluorescein angiography with RetCam (Clarity, Pleasanton, CA) every 2 weeks. The fluorescein angiograms were examined to optimize the timing of diagnosis of ROP and to investigate development of retinal and choroidal vascularization. There were no side effects related to FA. Variable features of retinal and choroidal circulation in preterm infants with a high risk of developing ROP were noted. FA allows vessels branching at the junction between vascular and avascular retina (V-Av junction) to be viewed easily and shows the ROP findings that sometimes cannot be seen by indirect ophthalmoscopy. Dye leakage is the most significant sign of progression to severe ROP or the need for surgery in newborn babies with ROP. RetCam-assisted intravenous FA is safe and allows a more objective assessment of the ROP stage and zone.

  5. FLIMX: A Software Package to Determine and Analyze the Fluorescence Lifetime in Time-Resolved Fluorescence Data from the Human Eye.

    Science.gov (United States)

    Klemm, Matthias; Schweitzer, Dietrich; Peters, Sven; Sauer, Lydia; Hammer, Martin; Haueisen, Jens

    2015-01-01

    Fluorescence lifetime imaging ophthalmoscopy (FLIO) is a new technique for measuring the in vivo autofluorescence intensity decays generated by endogenous fluorophores in the ocular fundus. Here, we present a software package called FLIM eXplorer (FLIMX) for analyzing FLIO data. Specifically, we introduce a new adaptive binning approach as an optimal tradeoff between the spatial resolution and the number of photons required per pixel. We also expand existing decay models (multi-exponential, stretched exponential, spectral global analysis, incomplete decay) to account for the layered structure of the eye and present a method to correct for the influence of the crystalline lens fluorescence on the retina fluorescence. Subsequently, the Holm-Bonferroni method is applied to FLIO measurements to allow for group comparisons between patients and controls on the basis of fluorescence lifetime parameters. The performance of the new approaches was evaluated in five experiments. Specifically, we evaluated static and adaptive binning in a diabetes mellitus patient, we compared the different decay models in a healthy volunteer and performed a group comparison between diabetes patients and controls. An overview of the visualization capabilities and a comparison of static and adaptive binning is shown for a patient with macular hole. FLIMX's applicability to fluorescence lifetime imaging microscopy is shown in the ganglion cell layer of a porcine retina sample, obtained by a laser scanning microscope using two-photon excitation.

  6. The impact of ocular tuberculosis on vision after two months of intensive therapy.

    Science.gov (United States)

    Oliveira, Suzana Batista Vereza de; Passos, Ângelo Ferreira; Hadad, David Jamil; Zbyszynski, Lorena; Júnior, Pedro Sousa de Almeida; Castellani, Luiz Guilherme Schmidt; Dietze, Reynaldo; Palaci, Moisés

    2018-04-18

    Tuberculosis (TB) is an infectious disease of global importance with major economic and social burden accounting for 25% of all avoidable deaths in developing countries. Extrapulmonary involvement may occur either in association with clinically apparent pulmonary tuberculosis or in isolation. This cross-sectional descriptive study aimed to evaluate the impact of ocular tuberculosis in visual acuity at baseline and after two months of intensive anti-tuberculous therapy. A sample of 133 pulmonary TB patients, seven disseminated TB, and three pleural TB patients was evaluated. All patients underwent routine ophthalmic evaluation, including assessment of visual acuity, biomicroscopy, applanation tonometry, indirect ophthalmoscopy, and fluorescent angiography as appropriate. None of the patients had impaired visual acuity due to TB. A rate of 4.2% (6/143) of ocular involvement was found. None of the patients with ocular involvement were HIV-infected. Of the six patients with ocular involvement, five met the diagnostic criteria for probable and one for possible ocular lesions. As for the type of ocular lesions, two patients had bilateral findings: one had sclerouveitis and the second had choroidal nodules. The other four patients presented with unilateral lesions: peripheral retinal artery occlusion in the right eye (one case), choroidal nodules in the left eye (one case), and choroidal nodules in the right eye (two cases). Patients progressed favorably after two month of intensive therapy, with no significant reduction in vision. Copyright © 2018 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda. All rights reserved.

  7. Baseline data from a multicenter, 5-year, prospective cohort study of Japanese age-related macular degeneration: an AMD2000 report.

    Science.gov (United States)

    Tsujikawa, Akitaka; Akagi-Kurashige, Yumiko; Yuzawa, Mitsuko; Ishibashi, Tatsuro; Nakanishi, Hideo; Nakatani, Eiji; Teramukai, Satoshi; Fukushima, Masanori; Yoshimura, Nagahisa

    2018-03-01

    To report research participants' baseline characteristics in the AMD2000 study, a prospective, multicenter, 5-year, observational cohort study of Japanese age-related macular degeneration (AMD). The characteristics were determined using multimodal imaging. Patients with AMD were recruited at 18 clinical sites in Japan between April 2006 and March 2009. Each patient underwent a complete ophthalmic examination, including measurement of best-corrected visual acuity (Landolt chart), indirect ophthalmoscopy, slit-lamp biomicroscopy with a contact lens, optical coherence tomography imaging, fundus photography, and fluorescein and indocyanine green angiography. Four hundred sixty participants (326 men [70.9%]) were included in the study. At enrollment, 131 eyes (28.5%) had hard drusen and 125 eyes (27.2%) had soft drusen in the macular area. A total of 455 eyes (98.9%) were diagnosed as having wet AMD, and 5 eyes (1.1%), as having dry AMD. Of the 455 eyes with wet AMD, 209 eyes (45.4%) had typical AMD, 228 eyes (49.6%) had polypoidal choroidal vasculopathy (PCV), and 18 eyes (3.9%) had retinal angiomatous proliferation. The size of choroidal neovascularization (CNV) was significantly smaller with indocyanine green angiography than with fluorescein angiography (P macular edema, older age, scar, extrafoveal macular edema, subfoveal CNV, large branching vascular network, and hard exudates. Japanese patients with AMD are predominantly male, lack drusen, and have a high rate of PCV.

  8. Decreased retinal sensitivity after internal limiting membrane peeling for macular hole surgery.

    Science.gov (United States)

    Tadayoni, Ramin; Svorenova, Ivana; Erginay, Ali; Gaudric, Alain; Massin, Pascale

    2012-12-01

    To compare the retinal sensitivity and frequency of microscotomas found by spectral domain optical coherence tomography (SD-OCT) combined with scanning laser ophthalmoscopy (SLO) microperimetry after idiopathic macular hole closure, in eyes that underwent internal limiting membrane (ILM) peeling and eyes that did not. This was a retrospective, non-randomised, comparative study. Combined SD-OCT and SLO microperimetry was performed in 16 consecutive eyes after closure of an idiopathic macular hole. A customised microperimetry pattern with 29 measurement points was used. The ILM was peeled in 8/16 eyes. The main outcome measure was mean retinal sensitivity. Mean retinal sensitivity (in dB) was lower after peeling: 9.80 ± 2.35 dB with peeling versus 13.19 ± 2.92 without (p=0.0209). Postoperative microscotomas were significantly more frequent after ILM peeling: 11.3 ± 6.6 points with retinal sensitivity below 10 dB in eyes that underwent peeling versus 2.9 ± 4.6 in those that did not (p=0.0093). These results suggest that ILM peeling may reduce retinal sensitivity, and significantly increase the incidence of microscotomas. Until a prospective trial confirming or not these results, it seems justified to avoid peeling the ILM when its potential benefit seems minor or unproved, and when peeling is carried out, to limit the surface peeled to the bare minimum.

  9. Foveal hemorrhage in an eye with foveal hypoplasia associated with albinism.

    Science.gov (United States)

    Masuda, Naonori; Hasegawa, Taiji; Yamashita, Mariko; Ogata, Nahoko

    2014-01-01

    Oculocutaneous albinism is a group of congenital disorders caused by alterations of melanin biosynthesis. We report our findings in a patient with oculocutaneous albinism who presented with foveal hypoplasia and a foveal hemorrhage. A 48-year-old man noted a dark spot in the middle of the visual field of his right eye. He had depigmented skin, white hair, white eyebrows, and white cilia. He also had horizontal nystagmus and depigmented irides. His best-corrected visual acuity was 2/100 with -14.0 diopters in the right eye and 3/100 with -5.0 diopters in the left eye. Ophthalmoscopy showed diffuse depigmentation in both eyes and a foveal hemorrhage in the right eye. Optical coherence tomography showed the absence of a foveal pit in both eyes and a subretinal hyperreflective lesion corresponding to the foveal hemorrhage in the right eye. Fluorescein angiography showed that the retinal and choroidal vessels were relatively hypofluorescent because of the lack of a blocking effect of the pigments in the retinal pigment epithelium. Fluorescein angiography and indocyanine green angiography did not show any evidence of choroidal neovascularization in either eye. The foveal hemorrhage in the right eye spontaneously regressed and finally resolved at 3 months after onset. At the final examination, the patient reported that his vision had recovered. A foveal hemorrhage is a rare condition in an eye with foveal hypoplasia associated with albinism. The hemorrhage may be related to high myopia and also to the hypoplasia of the fovea associated with albinism.

  10. Retinal Nerve Fiber Layer Converges More Convexly on Normal Smaller Optic Nerve Head.

    Science.gov (United States)

    Jung, Kyoung In; Shin, Jeong Ah; Park, Hae-Young Lopilly; Park, Chan Kee

    2015-08-01

    To investigate retinal nerve fiber layer (RNFL) configuration in the optic nerve head (ONH) and peripapillary area according to disc size and to determine whether it explains cup discrepancy among eyes with different disc sizes. Horizontal and vertical RNFL curvature and mean thickness were measured using confocal scanning laser ophthalmoscopy (Heidelberg Retina Tomograph) in 63 normal subjects grouped by disc size. Average and quadrant RNFL thickness, disc size, average cup-to-disc ratio (CDR), and convergence angle at the optic disc were also measured using Cirrus HD-optical coherence tomography. The relationships between disc size and RNFL curvature, thickness, angle at optic disc, and CDR were evaluated. RNFL curvature and convergence angle reflects convexity "on" and "into" the optic disc, respectively. CDR was smaller for small discs and was positively correlated with disc size (Poptic disc were positively correlated with disc size (POptic disc area was negatively correlated with mean RNFL thickness at the optic disc margin measured by HRT (P=0.002), but not in the peripapillary area by optical coherence tomography. Using imaging techniques, we demonstrated that the shape of the RNFLs converging "on" and entering "into" the optic disc was more convex for small optic discs compared with large discs. A low CDR for small discs could be mediated by these RNFL profiles at the ONH, which may guide the clinical evaluation of glaucomatous ONH damage.

  11. Evidence-based guideline summary: Evaluation, diagnosis, and management of facioscapulohumeral muscular dystrophy: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the Practice Issues Review Panel of the American Association of Neuromuscular & Electrodiagnostic Medicine.

    Science.gov (United States)

    Tawil, Rabi; Kissel, John T; Heatwole, Chad; Pandya, Shree; Gronseth, Gary; Benatar, Michael

    2015-07-28

    To develop recommendations for the evaluation, diagnosis, prognostication, and treatment of facioscapulohumeral muscular dystrophy (FSHD) from a systematic review and analysis of the evidence. Relevant articles were analyzed in accordance with the American Academy of Neurology classification of evidence schemes for diagnostic, prognostic, and treatment studies. Recommendations were linked to the strength of the evidence and other factors. Available genetic testing for FSHD type 1 is highly sensitive and specific. Although respiratory insufficiency occurs rarely in FSHD, patients with severe FSHD should have routine pulmonary function testing. Routine cardiac screening is not necessary in patients with FSHD without cardiac symptoms. Symptomatic retinal vascular disease is very rare in FSHD. Exudative retinopathy, however, is potentially preventable, and patients with large deletions should be screened through dilated indirect ophthalmoscopy. The prevalence of clinically relevant hearing loss is not clear. In clinical practice, patients with childhood-onset FSHD may have significant hearing loss. Because undetected hearing loss may impair language development, screening through audiometry is recommended for such patients. Musculoskeletal pain is common in FSHD and treating physicians should routinely inquire about pain. There is at present no effective pharmacologic intervention in FSHD. Available studies suggest that scapular fixation is safe and effective. Surgical scapular fixation might be cautiously offered to selected patients. Aerobic exercise in FSHD appears to be safe and potentially beneficial. On the basis of the evidence, patients with FSHD might be encouraged to engage in low-intensity aerobic exercises. © 2015 American Academy of Neurology.

  12. Epidemiology of ametropia of U.S. Army recruits.

    Science.gov (United States)

    McAlister, W H; Wingert, T A

    1995-02-01

    All people attempting to enlist in the U.S. Army must undergo a physical examination that requires a rudimentary vision screening. Those who pass the physical, upon reporting to basic training, are again evaluated and any treatment necessary to allow the recruits to function during their initial indoctrination is provided. Those who fail to see 20/20 O.D. and O.S. with their current spectacles fail the screening and are evaluated by an optometrist. If their condition is not disqualifying, appropriate correction is prescribed. We reviewed the records of all the recruits in a 1-month period who either required spectacles to see 20/20 or failed the screening at the 43rd AG BN (reception). Epidemiological evaluation revealed most to be either simple myopes or myopic astigmats. Hyperopia and hyperopic astigmatism accounted for the next most common diagnosis. Other conditions included anisometropia, antimetropia, amblyopia, keratoconus, and nystagmus. Examinations of these recruits were very limited, with dilated fundus evaluations being performed only when there was a high probability of a disqualifying condition. Therefore, it is unknown what retinal disease or degeneration may be present other than what would be visible with direct ophthalmoscopy.

  13. A Portable, Inexpensive, Nonmydriatic Fundus Camera Based on the Raspberry Pi® Computer

    Directory of Open Access Journals (Sweden)

    Bailey Y. Shen

    2017-01-01

    Full Text Available Purpose. Nonmydriatic fundus cameras allow retinal photography without pharmacologic dilation of the pupil. However, currently available nonmydriatic fundus cameras are bulky, not portable, and expensive. Taking advantage of recent advances in mobile technology, we sought to create a nonmydriatic fundus camera that was affordable and could be carried in a white coat pocket. Methods. We built a point-and-shoot prototype camera using a Raspberry Pi computer, an infrared-sensitive camera board, a dual infrared and white light light-emitting diode, a battery, a 5-inch touchscreen liquid crystal display, and a disposable 20-diopter condensing lens. Our prototype camera was based on indirect ophthalmoscopy with both infrared and white lights. Results. The prototype camera measured 133mm×91mm×45mm and weighed 386 grams. The total cost of the components, including the disposable lens, was $185.20. The camera was able to obtain good-quality fundus images without pharmacologic dilation of the pupils. Conclusion. A fully functional, inexpensive, handheld, nonmydriatic fundus camera can be easily assembled from a relatively small number of components. With modest improvements, such a camera could be useful for a variety of healthcare professionals, particularly those who work in settings where a traditional table-mounted nonmydriatic fundus camera would be inconvenient.

  14. Efficacy and tolerability of bilateral sustained-release dexamethasone intravitreal implants for the treatment of noninfectious posterior uveitis and macular edema secondary to retinal vein occlusion

    Directory of Open Access Journals (Sweden)

    Ryder SJ

    2015-06-01

    Full Text Available Steven J Ryder,1 Danilo Iannetta,1 Swetangi D Bhaleeya,2 Szilárd Kiss1 1Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA; 2Department of Ophthalmology, University of South Florida, Tampa, FL, USA Purpose: To report our experience with bilateral placement of dexamethasone 0.7 mg (DEX sustained-release intravitreal implant in the management of noninfectious posterior uveitis or macular edema secondary to retinal vein occlusion.Methods: A retrospective chart review of patients with bilateral noninfectious posterior uveitis and macular edema secondary to retinal vein occlusion who were treated with DEX intravitreal implant was performed. Ocular side effects such as intraocular pressure (IOP, cataract, and tolerability of bilateral injections was reviewed.Results: Twenty-two eyes of eleven patients treated with a total of 32 DEX implants were included. Ten of eleven patients received bilateral implants due to active noninfectious uveitis while the other demonstrated macular edema in both eyes following separate central retinal vein occlusions. Among the patients with bilateral uveitis, the mean interval between DEX implant in the initial eye and the subsequent DEX in the fellow eye was 15.6 days (range 2–71 days. Seven of the ten patients received the second implant in the fellow eye within 8 days of the initial implantation. None of the patients had bilateral implantations on the same day. Seven eyes required reimplantation for recurrence of inflammation (mean interval between first and repeat implantation was 6.00±2.39 months. Following single or, in the case of the aforementioned seven eyes, repeat DEX implantation, all 20 uveitic eyes demonstrated clinical and/or angiographic evidence of decreased inflammation in the form of reduction in vitreous cells on slit lamp ophthalmoscopy, macular edema on ophthalmoscopy, or optical coherence tomography and/or disc and vascular leakage on fluorescein angiography. The mean

  15. Síndrome de Usher: características clínicas Usher's syndrome: clinical characteristics

    Directory of Open Access Journals (Sweden)

    Josilene de Carvalho Soares Liarth

    2002-08-01

    Full Text Available Objetivos: Descrever e analisar as manifestações clínicas da síndrome de Usher bem como, estudar o padrão hereditário da doença nos pacientes examinados. Métodos: Foram estudados quatro pacientes, com diagnóstico de síndrome de Usher, na clínica oftalmológica de um hospital geral universitário, no período de dezembro de 1997 a março de 1999. Os pacientes foram submetidos a exames de acuidade visual, refração, biomicroscopia, oftalmoscopias direta e indireta, tonometria, retinografia, campo visual com perímetro de Goldman e audiometria. Foi desenhado o heredograma da família e realizado anamnese e oftalmoscopia binocular indireta de 63 familiares. Resultados: Dos quatro pacientes com síndrome de Usher, 1 foi do tipo I e 3 do tipo II. A acuidade visual dos pacientes variou de 20/100 a 20/400 e a disacusia de moderada a grave. Todos apresentaram retinose pigmentar típica e campo visual tubular. Não foram detectados outros casos de associação de retinose pigmentar e surdez dentre os familiares examinados. Conclusão: É importante enfatizar ao oftalmologista, o diagnóstico de síndrome de Usher, diante de um caso de retinose pigmentar, chamando atenção para o seu padrão de herança autossômica recessiva, assim como para a orientação ao paciente sobre as manifestações clínicas da doença e importância do acompanhamento oftalmo-otorrinolaringológico.Purpose: To describe and analyze the clinical manifestation of Usher's syndrome and to study their hereditary standard as well. Methods: Four patients with Usher's syndrome were studied at Ophthalmologic Clinic of the Getúlio Vargas Hospital, in Teresina-PI, between December, 1997 and March, 1999. The patients were scheduled for tests of visual acuity, refraction, biomicroscopy, direct and indirect ophthalmoscopy, tonometry, retinography, visual field with Goldman perimeter and audiometry. Family's pedigree was built and an anamnesis and indirect binocular

  16. Importância da perimetria de dupla freqüência na detecção do glaucoma: rastreamento em funcionários de hospital público numa área urbana de São Paulo The role of frequency doubling perimetry in the diagnosis of glaucoma: screening in employees of a public hospital in an urban area of São Paulo

    Directory of Open Access Journals (Sweden)

    Geraldo Vicente de Almeida

    2005-02-01

    Full Text Available OBJETIVO: Estudar a prevalência de glaucoma, em funcionários da Santa Casa de Misericórdia de São Paulo e analisar a validade da inclusão da perimetria de freqüência dupla junto à tonometria de não-contato e à oftalmoscopia direta, na triagem para glaucoma. MÉTODOS: Foram examinados 612 funcionários voluntários, 438 mulheres e 174 homens, com idade média de 45,05±7,7 anos. Eram 437 da raça branca, 104 mulatos, 43 da raça negra e 28 da raça amarela. Todos os funcionários tiveram ambos os olhos examinados por especialistas em glaucoma, que realizaram os seguintes exames: perimetria de freqüência dupla (FDT, oftalmoscopia direta (FO, tonometria de não-contato (TNC. RESULTADOS: Dos 612 indivíduos triados, 159 (25,98% apresentaram alguma anormalidade em pelo menos um dos exames: 5 (3,14% apresentaram pressão intra-ocular elevada (TNC+; 13 (8,17% apresentaram oftalmoscopia suspeita (FO+; 110 (69,18% apresentaram perimetria de freqüência dupla alterado (FDT+; 8 (5,03% TNC+ e FO+; 10 (6,28% TNC+ e FDT+; 9 (5,66% FO+ e FDT+; 4 (2,51% TNC+, FO+ e FDT+. Foram detectados 12 (1,96% indivíduos com glaucoma, quatro dos quais (0,65% com glaucoma de pressão normal. CONCLUSÕES: A perimetria de freqüência dupla mostrou-se útil para o rastreamento de glaucoma dentro da amostragem estudada. Do total de 12 indivíduos que tiveram o diagnóstico de glaucoma, 5 (41,6% não teriam sido detectados se não tivessem sido submetidos a perimetria de freqüência dupla.PURPOSE: To study the prevalence of glaucoma in employees of a public hospital in São Paulo and to analyze the role of frequency doubling perimetry along with non-contact tonometry and direct ophthalmoscopy, in the screening for glaucoma. METHODS: 612 employees of the Central Hospital of the "Santa Casa de São Paulo" were evaluated from October 15 to 20, 2000; 438 were women and 174 men, with mean age of 45.05±7.7 years (range, 35 to 81 years; 437 were white, 104 mulatto, 43

  17. Childhood blindness at a school for the blind in Riyadh, Saudi Arabia.

    Science.gov (United States)

    Kotb, Amgad A; Hammouda, Ehab F; Tabbara, Khalid F

    2006-02-01

    To determine the major causes of eye diseases leading to visual loss and blindness among children attending a school for the blind in Riyadh, Saudi Arabia. A total of 217 school children with visual disabilities attending a school for the blind in Riyadh were included. All children were brought to The Eye Center, Riyadh, and had complete ophthalmologic examinations including visual acuity testing, biomicroscopy, ophthalmoscopy, tonometry and laboratory investigations. In addition, some patients were subjected to electroretinography (ERG), electrooculography (EOG), measurement of visual evoked potentials (VEP), and laboratory work-up for congenital disorders. There were 117 male students with an age range of 6-19 years and a mean age of 16 years. In addition, there were 100 females with an age range of 6-18 years and a mean age of 12 years. Of the 217 children, 194 (89%) were blind from genetically determined diseases or congenital disorders and 23 (11%) were blind from acquired diseases. The major causes of bilateral blindness in children were retinal degeneration, congenital glaucoma, and optic atrophy. The most common acquired causes of childhood blindness were infections and trauma. The etiological pattern of childhood blindness in Saudi Arabia has changed from microbial keratitis to genetically determined diseases of the retina and optic nerve. Currently, the most common causes of childhood blindness are genetically determined causes. Consanguineous marriages may account for the autosomal recessive disorders. Public education programs should include information for the prevention of trauma and genetic counseling. Eye examinations for preschool and school children are mandatory for the prevention and cure of blinding disorders.

  18. Ocular findings after allogeneic hematopoietic stem cell transplantation.

    Science.gov (United States)

    Tabbara, Khalid F; Al-Ghamdi, Ahmad; Al-Mohareb, Fahad; Ayas, Mouhab; Chaudhri, Naeem; Al-Sharif, Fahad; Al-Zahrani, Hazzaa; Mohammed, Said Y; Nassar, Amr; Aljurf, Mahmoud

    2009-09-01

    To study the incidence, causes, and outcome of major ocular complications in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). Retrospective, noncomparative, observational clinical study. The study included a total of 620 patients who underwent allogeneic HSCT in the period from 1997 to 2007 at King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. Allogeneic HSCT. Patients with ocular complications were referred to the ophthalmology division for complete ophthalmologic examination, including visual acuity, tonometry, Schirmer test, biomicroscopy, and dilated ophthalmoscopy. Laboratory investigations were performed whenever indicated. The incidence and causes of major ocular complications after allogeneic HSCT were determined. Visual acuity at 1 year after allogeneic HSCT was recorded. Major ocular complications occurred in 80 (13%) of 620 patients who underwent allogeneic HSCT. There were 36 male patients (45%) and 44 female patients (55%) with a mean age of 29 years and an age range of 9 to 65 years. Prophylaxis for graft-versus-host disease (GVHD) consisted of cyclosporine and methotrexate in 69 patients, and cyclosporine, methotrexate and corticosteroids, or mycophenolate mofetil in 11 patients. The most frequently encountered ocular complications were chronic GVHD, dry eye syndrome without GVHD, corneal ulcers, cataract, glaucoma, cytomegalovirus retinitis, fungal endophthalmitis, and acquisition of allergic conjunctivitis from atopic donors. There was no correlation between the pattern of ocular complications and the transplanted stem cell source. Best-corrected visual acuity (BCVA) at 1 year after transplantation was less than 20/200 in 13 patients (16%), less than 20/50 in 17 patients (21%), and better than 20/50 in 50 patients (63%). Ocular complications are common in patients undergoing allogeneic HSCT. Early recognition and prompt treatment are important. The author(s) have no proprietary or commercial

  19. Regional differences in the prevalence of diabetic retinopathy: a multi center study in Brazil.

    Science.gov (United States)

    Drummond, Karla Rezende Guerra; Malerbi, Fernando Korn; Morales, Paulo Henrique; Mattos, Tessa Cerqueira Lemos; Pinheiro, André Araújo; Mallmann, Felipe; Perez, Ricardo Vessoni; Leal, Franz Schubert Lopes; de Melo, Laura Gomes Nunes; Gomes, Marília Brito

    2018-01-01

    Diabetic retinopathy has a significant impact in every healthcare system. Despite that fact, there are few accurate estimates in the prevalence of DR in Brazil's different geographic regions, particularly proliferative DR and diabetic macular edema. This study aims to determine the prevalence of diabetic retinopathy in Brazil's five continental regions and its determinant factors. This multi center, cross-sectional, observational study, conducted between August 2011 and December 2014, included patients with type 1 diabetes from the 5 Brazilian geographic regions (South, Southeast, North, Northeast and Midwest). During a clinical visit, a structured questionnaire was applied, blood sampling was collected and each patient underwent mydriatic binocular indirect ophthalmoscopy evaluation. Data was obtained from 1644 patients, aged 30.2 ± 12 years (56.1% female, 54.4% Caucasian), with a diabetes duration of 15.5 ± 9.3 years. The prevalence of diabetic retinopathy was 242 (36.1%) in the Southeast, 102 (42.9%) in the South, 183 (29.9%) in the North and Northeast and 54 (41.7%) in the Midwest. Multinomial regression showed no difference in the prevalence of non-proliferative diabetic retinopathy in each geographic region, although, prevalence of proliferative diabetic retinopathy (p = 0.022), and diabetic macular edema (p = 0.003) was higher in the Midwest. Stepwise analyses reviled duration of diabetes, level of HbA1c and hypertension as independent variables. The prevalence of non proliferative diabetic retinopathy in patients with type 1 diabetes was no different between each geographic region of Brazil. The Midwest presented higher prevalence of proliferative diabetic retinopathy and diabetic macular edema. Duration of DM and glycemic control is of central importance to all. Hypertension is another fundamental factor to every region, at special in the South and Southeast. Glycemic control and patients in social and economic vulnerability deserves

  20. Cone structure in patients with usher syndrome type III and mutations in the Clarin 1 gene.

    Science.gov (United States)

    Ratnam, Kavitha; Västinsalo, Hanna; Roorda, Austin; Sankila, Eeva-Marja K; Duncan, Jacque L

    2013-01-01

    To study macular structure and function in patients with Usher syndrome type III (USH3) caused by mutations in the Clarin 1 gene (CLRN1). High-resolution macular images were obtained by adaptive optics scanning laser ophthalmoscopy and spectral domain optical coherence tomography in 3 patients with USH3 and were compared with those of age-similar control subjects. Vision function measures included best-corrected visual acuity, kinetic and static perimetry, and full-field electroretinography. Coding regions of the CLRN1 gene were sequenced. CLRN1 mutations were present in all the patients; a 20-year-old man showed compound heterozygous mutations (p.N48K and p.S188X), and 2 unrelated women aged 25 and 32 years had homozygous mutations (p.N48K). Best-corrected visual acuity ranged from 20/16 to 20/40, with scotomas beginning at 3° eccentricity. The inner segment-outer segment junction or the inner segment ellipsoid band was disrupted within 1° to 4° of the fovea, and the foveal inner and outer segment layers were significantly thinner than normal. Cones near the fovea in patients 1 and 2 showed normal spacing, and the preserved region ended abruptly. Retinal pigment epithelial cells were visible in patient 3 where cones were lost. Cones were observed centrally but not in regions with scotomas, and retinal pigment epithelial cells were visible in regions without cones in patients with CLRN1 mutations. High-resolution measures of retinal structure demonstrate patterns of cone loss associated with CLRN1 mutations. These findings provide insight into the effect of CLRN1 mutations on macular cone structure, which has implications for the development of treatments for USH3. clinicaltrials.gov Identifier: NCT00254605.

  1. Attitudes towards and perceptions of visual loss and its causes among Hong Kong Chinese adults.

    Science.gov (United States)

    Lau, Joseph Tak Fai; Lee, Vincent; Fan, Dorothy; Lau, Mason; Michon, John

    2004-06-01

    As part of a study of visual function among Hong Kong Chinese adults, their attitudes and perceptions related to visual loss were examined. These included fear of visual loss, negative functional impacts of visual loss, the relationship between ageing and visual loss and help-seeking behaviours related to visual loss. Demographic factors associated with these variables were also studied. The study population were people aged 40 and above randomly selected from the Shatin district of Hong Kong. The participants underwent eye examinations that included visual acuity, intraocular pressure measurement, visual field, slit-lamp biomicroscopy and ophthalmoscopy. The primary cause of visual disability was recorded. The participants were also asked about their attitudes and perceptions regarding visual loss using a structured questionnaire. The prevalence of bilateral visual disability was 2.2% among adults aged 40 or above and 6.4% among adults aged 60 or above. Nearly 36% of the participants selected blindness as the most feared disabling medical condition, which was substantially higher than conditions such as dementia, loss of limbs, deafness or aphasia. Inability to take care of oneself (21.0%), inconvenience related to mobility (20.2%) and inability to work (14.8%) were the three most commonly mentioned 'worst impact' effects of visual loss. Fully 68% of the participants believed that loss of vision is related to ageing. A majority of participants would seek help and advice from family members in case of visual loss. Visual function is perceived to be very important by Hong Kong Chinese adults. The fear of visual loss is widespread and particularly affects self-care and functional abilities. Visual loss is commonly seen as related to ageing. Attitudes and perceptions in this population may be modified by educational and outreach efforts in order to take advantage of preventive measures.

  2. Causes of low vision and blindness in rural Indonesia

    Science.gov (United States)

    Saw, S-M; Husain, R; Gazzard, G M; Koh, D; Widjaja, D; Tan, D T H

    2003-01-01

    Aim: To determine the prevalence rates and major contributing causes of low vision and blindness in adults in a rural setting in Indonesia Methods: A population based prevalence survey of adults 21 years or older (n=989) was conducted in five rural villages and one provincial town in Sumatra, Indonesia. One stage household cluster sampling procedure was employed where 100 households were randomly selected from each village or town. Bilateral low vision was defined as habitual VA (measured using tumbling “E” logMAR charts) in the better eye worse than 6/18 and 3/60 or better, based on the WHO criteria. Bilateral blindness was defined as habitual VA worse than 3/60 in the better eye. The anterior segment and lens of subjects with low vision or blindness (both unilateral and bilateral) (n=66) were examined using a portable slit lamp and fundus examination was performed using indirect ophthalmoscopy. Results: The overall age adjusted (adjusted to the 1990 Indonesia census population) prevalence rate of bilateral low vision was 5.8% (95% confidence interval (CI) 4.2 to 7.4) and bilateral blindness was 2.2% (95% CI 1.1 to 3.2). The rates of low vision and blindness increased with age. The major contributing causes for bilateral low vision were cataract (61.3%), uncorrected refractive error (12.9%), and amblyopia (12.9%), and the major cause of bilateral blindness was cataract (62.5%). The major causes of unilateral low vision were cataract (48.0%) and uncorrected refractive error (12.0%), and major causes of unilateral blindness were amblyopia (50.0%) and trauma (50.0%). Conclusions: The rates of habitual low vision and blindness in provincial Sumatra, Indonesia, are similar to other developing rural countries in Asia. Blindness is largely preventable, as the major contributing causes (cataract and uncorrected refractive error) are amenable to treatment. PMID:12928268

  3. Prevalence of dry eye syndrome and diabetic retinopathy in type 2 diabetic patients

    Directory of Open Access Journals (Sweden)

    Afkhami-Ardekani Mohammad

    2008-06-01

    Full Text Available Abstract Background This study was performed to assess the prevalence of dry eye syndrome and diabetic retinopathy (DR in type 2 diabetic patients and their contributing factors. Methods 199 type 2 diabetic patients referred to Yazd Diabetes Research Center were consecutively selected. All Subjects were assessed by questionnaire about other diseases and drugs. Dry eye syndrome was assessed with Tear break up time tests and Schirmer. All the subjects underwent indirect ophthalmoscopy and retinal color photography. DR was graded according to early Treatment Diabetic Retinopathy (ETDRS criteria. Results Of 199 subjects, 108 patients (54.3% suffer from dry eye syndrome. Although dry eye syndrome was more common in older and female patients, this association was not significant. But there was significantly association between dry eye syndrome and duration of diabetes (P = 0.01. Dry eye syndrome was more frequent in diabetic patients with DR (P = 0.02. DR was found in 140 patients (70.35%, which included 34 patients (17.1% with mild non proliferative DR (NPDR, 34 patients (17.1% with moderate NPDR, 22 patients (11.1% with severe NPDR and 25 patients (25.1% with proliferative DR (PDR. There were significant relation between age, sex and duration of diabetes and DR. Conclusion In this study the prevalence of dry eye syndrome was 54.3%. Diabetes and dry eyes appear to have a common association. Further studies need to be undertaken to establish an etiologic relationship. However, examination for dry eye should be an integral part of the assessment of diabetic eye disease.

  4. Lacrimal system pathology in patients with malignant thyroid tumors after radioactive iodine therapy, and its correction methods

    Directory of Open Access Journals (Sweden)

    Natalya Yu. Beldovskaya

    2017-12-01

    Full Text Available Introduction. Radioactive iodine therapy after thyroidectomy is the standard of differentiated thyroid cancer treatment in the modern world. Main dose-dependent side effects described in the literature include: sialadenitis, xerostomia, taste and/or odor loss, swelling of surrounding tissues. Ophthalmic complications are rarely reported. Aim. To assess the lacrimal system condition in patients after radioactive iodine therapy for thyroid cancer. Material and methods. The study included 17 patients (34 eyes. There were female patients aged 19 to 43 years (mean age was 31 years who underwent a course of radioactive iodine therapy for thyroid cancer. All of them complained of periodic or constant tearing in the period from 2 months to 1 year after therapy course. In four patients, there was a permanent or periodic mucopurulent discharge when pressing on the lacrimal sac area. All patients underwent a standard ophthalmological examination, including visual acuity testing, anterior segment biomicroscopy, ophthalmoscopy, and tear production tests. Dye disappearance test, Jones I and II tests, lacrimal pathways irrigation, and, if necessary, cone-ray computer tomography with preliminary lacrimal pathways contrasting were performed to evaluate the tear outflow abnormalities. Results. Tear production disorders were detected in 20 eyes (58.8% (among them, moderate dry eye syndrome was diagnosed in 3 cases; tear outflow pathology was revealed in 14 eyes (41.2% (namely naso-lacrimal duct obstruction and stenosis, and chronic purulent dacryocystitis. For patients with tear production pathology artificial tears were prescribed, and endoscopic endonasal dacryocystorhinostomy was performed in cases of tear outflow disturbances. Conclusion. The use of radioactive iodine in doses exceeding 80 mCi leads to the development of lacrimal system pathology: dry eye syndrome of various severity, and tear outflow disorders. Lacrimal system pathology significantly worsens

  5. A 3-year prospective study on ocular injuries with tennis or cricket ball while playing cricket: A case series

    Directory of Open Access Journals (Sweden)

    Santosh Kumar Mahapatra

    2018-01-01

    Full Text Available Purpose: The purpose of this study is to study the clinical features, visual outcome, management, and ocular complications of ocular injury, following trauma with tennis or cricket ball. Methods: A prospective, noncomparative case study of patients having injury with tennis/cricket ball while playing cricket was conducted between January 2013 and April 2016. Seventy-six eyes of 76 patients were studied. Presenting vision, age, gender, time since injury, general and ocular examination, intraocular pressure, indirect ophthalmoscopy, B scan, and X-ray/computed tomography scan findings were noted. Patients were managed medically or surgically as per the need and followed up at least for 6 months. Results: Seventy-six eyes of 76 patients were studied. All cases were male, except two. Majority (80.2% were <25 years. Median presenting visual acuity (VA was 6/36 and median final VA was 6/18. Significant findings in the decreasing order of frequency were sphincter tear (26.3%, retinal detachment (23.6%, angle recession (18.4%, choroidal rupture (17.1%, and Berlin's edema (15.7%. Most of the cases (69.7% were managed medically. Only 30.2% cases needed surgical intervention. Final visual outcome in our study was depended on initial VA (P = 0.000. It was also correlating with presenting clinical feature (P = 0.010 and type of intervention (medical/surgical (P = 0.001. Conclusion: Cricket-related ocular injury generally has a poor prognosis with most cases being closed globe injury; retinal detachment is the most common vision-threatening presentation. In spite of being a common event, cricket-related injury is sparingly documented and hence needs further studies for proper documentation, prognostication, and formulation of definitive management plan.

  6. Clinical profile of uveitis in Hansen’s disease after completion of treatment – A study of 50 cases using Polymerase Chain Reaction (PCR on aqueous humour

    Directory of Open Access Journals (Sweden)

    Radha Annamalai

    2016-05-01

    Full Text Available Chronic low grade anterior uveitis is the commonest cause of blindness in leprosy. It is usually asymptomatic until the late stages and patients seek help only after irreversible visual loss. We analysed patients who had a recurrence of uveitis after completion of treatment with anti-leprosy drugs and had been proven as histopathologically negative. The presence of chronic uveitis, complications and the extent of ocular damage it may cause, can continue even after treatment, emphasising the importance of follow-up, early detection and treatment. This is a prospective cohort study. Ophthalmic evaluation was performed using slit lamp examination, biomicroscopy, indirect ophthalmoscopy, applanation tonometry, corneal sensation and Schirmer’s test. Split skin microscopy was done to confirm the activity of leprosy. In patients with recalcitrant iridocyclitis, anterior chamber paracentesis was performed. The sample was analysed both by smear and polymerase chain reaction. The sequences that were targeted using PCR included genes encoding the DNA of 36-kDa antigen, 18-kDa antigen, 65-kDa antigen and the repetitive sequences among other M. leprae genes. Aqueous aspirate showed copies of mycobacterium leprae DNA in five out of twelve patients with recalcitrant anterior uveitis. Direct smear and staining with Ziehl- Neelson staining for mycobacteria was positive showing both live and dead bacilli. Live bacilli can persist in the aqueous humour even after completion of treatment. In our study this was more frequently observed in tuberculoid leprosy. This is possibly due to an immune mediated response combined with inadequate treatment dose in these patients.

  7. Determination of Morphological, Biometric and Biochemical Susceptibilities in Healthy Eurasier Dogs with Suspected Inherited Glaucoma

    Science.gov (United States)

    Goulle, Frédéric; Thomas, Philippe; Isard, Pierre-François; Azoulay, Thierry; Lafarge-Beurlet, Stéphanie; Woods, Mike; Lavillegrand, Sylvie; Ivkovic, Ivana; Neveux, Nathalie; Sahel, José-Alain; Picaud, Serge; Froger, Nicolas

    2014-01-01

    In both humans and dogs, the primary risk factor for glaucoma is high intraocular pressure (IOP), which may be caused by iridocorneal angle (ICA) abnormalities. Oxidative stress has also been implicated in retinal ganglion cell damage associated with glaucoma. A suspected inherited form of glaucoma was recently identified in Eurasier dogs (EDs), a breed for which pedigrees are readily available. Because of difficulties in assessing ICA morphology in dogs with advanced glaucoma, we selected a cohort of apparently healthy dogsfor the investigation of ICA morphological status, IOP and plasma concentrations of oxidative stress biomarkers. We aimed to establish correlations between these factors, to identify predictive markers of glaucoma in this dog breed. A cohort of 28 subjects, volunteered for inclusion by their owners, was selected by veterinary surgeons. These dogs were assigned to four groups: young males, young females (1–3 years old), adult males and adult females (4–8 years old). Ocular examination included ophthalmoscopy, tonometry, gonioscopy, biometry and ultrasound biomicroscopy (UBM), and the evaluation of oxidative stress biomarkers consisting of measurements of plasma glutathione peroxidase (GP) activity and taurine and metabolic precursor (methionine and cysteine) concentrations in plasma. The prevalence of pectinate ligament abnormalities was significantly higher in adult EDs than in young dogs. Moreover, in adult females, high IOP was significantly correlated with a short axial globe length, and a particularly large distance between Schwalbe's line and the anterior lens capsule. GP activity levels were significantly lower in EDs than in a randomized control group of dogs, and plasma taurine concentrations were higher. Hence, ICA abnormalities were associated with weaker antioxidant defenses in EDs, potentially counteracted by higher plasma taurine concentrations. This study suggests that EDs may constitute an appropriate canine model for the

  8. Determination of morphological, biometric and biochemical susceptibilities in healthy Eurasier dogs with suspected inherited glaucoma.

    Directory of Open Access Journals (Sweden)

    Thomas Boillot

    Full Text Available In both humans and dogs, the primary risk factor for glaucoma is high intraocular pressure (IOP, which may be caused by iridocorneal angle (ICA abnormalities. Oxidative stress has also been implicated in retinal ganglion cell damage associated with glaucoma. A suspected inherited form of glaucoma was recently identified in Eurasier dogs (EDs, a breed for which pedigrees are readily available. Because of difficulties in assessing ICA morphology in dogs with advanced glaucoma, we selected a cohort of apparently healthy dogsfor the investigation of ICA morphological status, IOP and plasma concentrations of oxidative stress biomarkers. We aimed to establish correlations between these factors, to identify predictive markers of glaucoma in this dog breed. A cohort of 28 subjects, volunteered for inclusion by their owners, was selected by veterinary surgeons. These dogs were assigned to four groups: young males, young females (1-3 years old, adult males and adult females (4-8 years old. Ocular examination included ophthalmoscopy, tonometry, gonioscopy, biometry and ultrasound biomicroscopy (UBM, and the evaluation of oxidative stress biomarkers consisting of measurements of plasma glutathione peroxidase (GP activity and taurine and metabolic precursor (methionine and cysteine concentrations in plasma. The prevalence of pectinate ligament abnormalities was significantly higher in adult EDs than in young dogs. Moreover, in adult females, high IOP was significantly correlated with a short axial globe length, and a particularly large distance between Schwalbe's line and the anterior lens capsule. GP activity levels were significantly lower in EDs than in a randomized control group of dogs, and plasma taurine concentrations were higher. Hence, ICA abnormalities were associated with weaker antioxidant defenses in EDs, potentially counteracted by higher plasma taurine concentrations. This study suggests that EDs may constitute an appropriate canine model for

  9. Prothrombogenic thrombocytic phenotype in patients with nonproliferative diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    A.S. Gudz

    2018-03-01

    Full Text Available Background. Patients with type 2 diabetes mellitus (DM have increased reactivity of thrombocytes (Tc, the causes of which remain unclear. The hypothesis of the dependence of Tc receptors functional activity on the individual reactivity of the organism is tested. The purpose of the study was to establish whether the individual reactivity of Tc differs in patients with diabetic nonproliferative retinopathy (DNPR. Materials and methods. The study included 19 patients (19 eyes with type 2 DM, who, according to the results of the clinical and instrumental examination and according to the Early Treatment of Diabetic Retinopathy Study classification, had mild DNPR. Ophthalmological examination was performed before the beginning of treatment and included the collection of anamnesis, visual acuity study with optimal optical correction, tonometry, gonioscopy, biomicroscopy, ophthalmoscopy, optical coherence tomography (Stratus OCT apparatus. Thrombocytes were isolated by centrifugation from citrated peripheral blood of patients. To activate Tc, agonists were used: adenosine diphosphate (2.5 μM, adrenaline (2.5 μM, angiotensin II (1.0 μM, platelet activating factor (75.0 μM and collagen (1.0 mg/ml. The Tc aggregation was evaluated by a spectrophotometric method on the ChronoLog aggregometer (USA. Results. The revealed individual reactivity of Tc in patients with DNPR was manifested by the features of thrombogenesis induction. A hyperreactivity of Tc to three agonists was detected: adrenaline, collagen and angiotensin II, which was characteristic of prothrombogenic phenotype. Depending on the functional activity of the investigated receptors, two main clusters of Tc receptors were identified, which were equal by the activity of α2-adrenoreceptors and angiotensin type 1 receptors, but differed by the response of Tc to collagen. Conclusions. Determination of the prothrombogenic phenotype and clusters of functionally active Tc receptors opens the

  10. The frequency of secondary glaucoma in patients with iridocorneal endothelial syndrome in correlation to the presence of uveal ectropion

    Directory of Open Access Journals (Sweden)

    Marković Vujica

    2017-01-01

    Full Text Available Introduction/Objective. Iridocorneal endothelial (ICE syndrome incudes 3 clinical forms: progressive iris atrophy, Chandler’s syndrome, and Cogan–Reese syndrome. It is characterized by various degrees of iris atrophy, corneal endothelial changes, uveal ectropion, corectopia, peripheral anterior synechiae (PAS and secondary glaucoma. The aim of the study was to illustrate forms of ICE syndrome, determine frequency of secondary glaucoma with emphasis on cases with uveal ectropion, analyze response to medicament treatment and the need for surgical treatment in intraocular pressure (IOP control. Methods. Patients underwent slit lamp examination, applanation tonometry, gonioscopy, ophthalmoscopy, Humphrey visual field testing and Heidelberg retina tomography. Patients were divided into two groups: group I, without uveal ectropion (22 patients and group II, with uveal ectropion (14 patients. Results. A total of 36 patients were examined in a 10-year period. The average age was 38 years, male to female ratio 1:2. Secondary glaucoma was confirmed in 26 (72.2% patients, out of which 12 (54.5% in group I and 14 (100% in group II. PAS were more frequent in group II. In group I, mean initial IOP was 37 mmHg, and after medicament treatment 26 mmHg. Secondary glaucoma was controlled in 50% and remaining 50% underwent surgical treatment. In group II, mean initial IOP was 49 mmHg, and after medicament treatment 32 mmHg. All 14 patients (100% underwent surgical treatment in order to achieve IOP control. Conclusion. ICE syndrome is a rare, progressive disease, with high incidence of secondary glaucoma, which is more frequent in cases with uveal ectropion. In these cases, medicament treatment is not effective and trabeculectomy with antimetabolite application is necessary.

  11. A patient with acute macular neuroretinopathy and central retinal vein occlusion

    Directory of Open Access Journals (Sweden)

    Hirooka K

    2013-07-01

    Full Text Available Kiriko Hirooka,1 Wataru Saito,1,2 Kousuke Noda,1,2 Susumu Ishida1,21Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan; 2Department of Ocular Circulation and Metabolism, Hokkaido University Graduate School of Medicine, Sapporo, JapanPurpose: The precise mechanism causing acute macular neuroretinopathy (AMN is still unknown. A recent report suggested that choroidal circulation impairment correlates with its pathogenesis. We report a rare case with simultaneous onset of AMN and central retinal vein occlusion (CRVO, which is a retinal circulation disorder.Methods: Case report.Results: A 44-year-old woman complained of central visual loss of the left eye for the previous 2 weeks. The patient’s visual acuity was 0.5 in the left eye (OS. Fundoscopic examination revealed a wedge-shaped, dark reddish-brown lesion at the macula, and CRVO-like retinal hemorrhages OS. Fluorescein angiography revealed retinal vasculitis and hypofluorescence corresponding to the macular lesion. The patient’s scanning laser ophthalmoscopy infrared imaging result led to a diagnosis of AMN. Two weeks after corticosteroid pulse therapy, her visual acuity improved to 1.2 OS, with improvement of macular findings and Humphrey perimetry. When the dose of oral corticosteroid was decreased, the AMN lesion worsened, with recurrence of retinal hemorrhages. Visual functions improved again after an increased dose of corticosteroid.Conclusion: These results suggest that circulatory disorders almost simultaneously occurred in choroidal and retinal vessels, resulting in the onset of both AMN and CRVO.Keywords: choroidal circulation, optical coherence tomography, retinal circulation, systemic corticosteroid therapy

  12. The prevalence of visual impairment and blindness in underserved rural areas: a crucial issue for future.

    Science.gov (United States)

    Hashemi, H; Yekta, A; Jafarzadehpur, E; Doostdar, A; Ostadimoghaddam, H; Khabazkhoob, M

    2017-08-01

    PurposeTo determine the prevalence of visual impairment and blindness in underserved Iranian villages and to identify the most common cause of visual impairment and blindness.Patients and methodsMultistage cluster sampling was used to select the participants who were then invited to undergo complete examinations. Optometric examinations including visual acuity, and refraction were performed for all individuals. Ophthalmic examinations included slit-lamp biomicroscopy and ophthalmoscopy. Visual impairment was determined according to the definitions of the WHO and presenting vision.ResultsOf 3851 selected individuals, 3314 (86.5%) participated in the study. After using the exclusion criteria, the present report was prepared based on the data of 3095 participants. The mean age of the participants was 37.6±20.7 years (3-93 years). The prevalence of visual impairment and blindness was 6.43% (95% confidence interval (CI): 3.71-9.14) and 1.18% (95% CI: 0.56-1.79), respectively. The prevalence of visual impairment varied from 0.75% in participants aged less than 5 years to 38.36% in individuals above the age of 70 years. Uncorrected refractive errors and cataract were the first and second leading causes of visual impairment; moreover, cataract and refractive errors were responsible for 35.90 and 20.51% of the cases of blindness, respectively.ConclusionThe prevalence of visual impairment was markedly high in this study. Lack of access to health services was the main reason for the high prevalence of visual impairment in this study. Cataract and refractive errors are responsible for 80% of visual impairments which can be due to poverty in underserved villages.

  13. An adaptive optics imaging system designed for clinical use

    Science.gov (United States)

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

    2015-01-01

    Here we demonstrate a new imaging system that addresses several major problems limiting the clinical utility of conventional adaptive optics scanning light ophthalmoscopy (AOSLO), including its small field of view (FOV), reliance on patient fixation for targeting imaging, and substantial post-processing time. We previously showed an efficient image based eye tracking method for real-time optical stabilization and image registration in AOSLO. However, in patients with poor fixation, eye motion causes the FOV to drift substantially, causing this approach to fail. We solve that problem here by tracking eye motion at multiple spatial scales simultaneously by optically and electronically integrating a wide FOV SLO (WFSLO) with an AOSLO. This multi-scale approach, implemented with fast tip/tilt mirrors, has a large stabilization range of ± 5.6°. Our method consists of three stages implemented in parallel: 1) coarse optical stabilization driven by a WFSLO image, 2) fine optical stabilization driven by an AOSLO image, and 3) sub-pixel digital registration of the AOSLO image. We evaluated system performance in normal eyes and diseased eyes with poor fixation. Residual image motion with incremental compensation after each stage was: 1) ~2–3 arc minutes, (arcmin) 2) ~0.5–0.8 arcmin and, 3) ~0.05–0.07 arcmin, for normal eyes. Performance in eyes with poor fixation was: 1) ~3–5 arcmin, 2) ~0.7–1.1 arcmin and 3) ~0.07–0.14 arcmin. We demonstrate that this system is capable of reducing image motion by a factor of ~400, on average. This new optical design provides additional benefits for clinical imaging, including a steering subsystem for AOSLO that can be guided by the WFSLO to target specific regions of interest such as retinal pathology and real-time averaging of registered images to eliminate image post-processing. PMID:26114033

  14. Reliability and Repeatability of Cone Density Measurements in Patients With Stargardt Disease and RPGR-Associated Retinopathy.

    Science.gov (United States)

    Tanna, Preena; Kasilian, Melissa; Strauss, Rupert; Tee, James; Kalitzeos, Angelos; Tarima, Sergey; Visotcky, Alexis; Dubra, Alfredo; Carroll, Joseph; Michaelides, Michel

    2017-07-01

    To assess reliability and repeatability of cone density measurements by using confocal and (nonconfocal) split-detector adaptive optics scanning light ophthalmoscopy (AOSLO) imaging. It will be determined whether cone density values are significantly different between modalities in Stargardt disease (STGD) and retinitis pigmentosa GTPase regulator (RPGR)-associated retinopathy. Twelve patients with STGD (aged 9-52 years) and eight with RPGR-associated retinopathy (aged 11-31 years) were imaged using both confocal and split-detector AOSLO simultaneously. Four graders manually identified cone locations in each image that were used to calculate local densities. Each imaging modality was evaluated independently. The data set consisted of 1584 assessments of 99 STGD images (each image in two modalities and four graders who graded each image twice) and 928 RPGR assessments of 58 images (each image in two modalities and four graders who graded each image twice). For STGD assessments the reliability for confocal and split-detector AOSLO was 67.9% and 95.9%, respectively, and the repeatability was 71.2% and 97.3%, respectively. The differences in the measured cone density values between modalities were statistically significant for one grader. For RPGR assessments the reliability for confocal and split-detector AOSLO was 22.1% and 88.5%, respectively, and repeatability was 63.2% and 94.5%, respectively. The differences in cone density between modalities were statistically significant for all graders. Split-detector AOSLO greatly improved the reliability and repeatability of cone density measurements in both disorders and will be valuable for natural history studies and clinical trials using AOSLO. However, it appears that these indices may be disease dependent, implying the need for similar investigations in other conditions.

  15. INTRAOCULAR PRESSURE AND EXAMINATION FINDINGS IN THREE SPECIES OF CENTRAL AND SOUTH AMERICAN TREE FROGS (CRUZIOHYLA CRASPEDOPUS, CRUZIOHYLA CALCARIFER, AND ANOTHECA SPINOSA).

    Science.gov (United States)

    Lewin, Andrew C; Hausmann, Jennifer C; Miller, Paul E

    2017-09-01

    The purpose of this prospective study was to describe intraocular pressure (IOP) and examination findings in three tree frog species (Cruziohyla craspedopus [fringe leaf frog], Cruziohyla calcarifer [splendid leaf frog], and Anotheca spinosa [spiny-headed or coronated tree frog]). Thirty-one C. craspedopus, four C. calcarifer, and five A. spinosa were weighed, sexed based on phenotype where possible, and examined using slit-lamp biomicroscopy and indirect ophthalmoscopy. IOP was measured using the TonoVet and TonoLab rebound tonometers while the frogs were held two ways (unrestrained, then restrained). Statistical differences were determined using one-way analysis of variance (ANOVA) and t-tests. Mean ± SD IOP (TonoVet and TonoLab, respectively) was 15.1 ± 2.5 mmHg and 15.6 ± 4.1 mmHg in C. craspedopus; 14.8 ± 1.5 mmHg and 18.8 ± 3.1 mmHg in C. calcarifer; and 9.1 ± 2.1 mmHg and 10.8 ± 1.4 mmHg in A. spinosa. There was no significant difference in IOP in C. craspedopus by eye (Right vs Left), tonometer, or restraint method. IOP in female C. craspedopus was 1-3 mm Hg higher than in males with both devices (P Cruziohyla genus frogs and A. spinosa for the TonoVet (P < 0.05). There was no difference in IOP measurements between the TonoVet and TonoLab in C. craspedopus. IOP varied by gender in C. craspedopus and between species, but not by tonometer. Ocular abnormalities were minimal in this group of captive bred frogs.

  16. Optic disc drusen: understanding an old problem from a new perspective.

    Science.gov (United States)

    Hamann, Steffen; Malmqvist, Lasse; Costello, Fiona

    2018-04-16

    Optic disc drusen (ODD) are acellular deposits located in the optic nerve head of up to 2.4% of the population. They may develop as by-products of impaired axonal metabolism in genetically predisposed individuals, in whom a narrow scleral canal is hypothesized to play a role. Although ODD are often considered as benign innocent bystanders, recognized as part of a routine ophthalmological examination, the vast majority of patients with ODD have visual field defects. Optic disc drusen (ODD)-associated complications with severe visual loss, most often due to anterior ischaemic optic neuropathy, are also known to occur. There are no treatments available to prevent or ameliorate the vision loss caused by ODD. In children, the ODD are usually uncalcified and buried within the optic nerve head tissue. In these cases, the condition can be difficult to diagnose, as it often resembles a papilloedema with optic nerve head swelling caused by raised intracranial pressure. During the teenage years, the ODD progressively become more calcified and probably also larger, which allow them to be visible on ophthalmoscopy. With the advent and proper utilization of high-resolution modalities of optical coherence tomography (OCT), it has now become possible to detect even the smallest and most deeply located ODD. This allows for ODD detection at a much earlier developmental stage than has previously been possible and enhances the possibilities of research in underlying mechanisms. A review of the literature on ODD was conducted using the PUBMED database. The review focuses on the current knowledge regarding pathogenesis, diagnostics, clinical disease-tracking methodologies, structure-function relationships and treatment strategies of ODD. © 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  17. Adaptive-optics SLO imaging combined with widefield OCT and SLO enables precise 3D localization of fluorescent cells in the mouse retina.

    Science.gov (United States)

    Zawadzki, Robert J; Zhang, Pengfei; Zam, Azhar; Miller, Eric B; Goswami, Mayank; Wang, Xinlei; Jonnal, Ravi S; Lee, Sang-Hyuck; Kim, Dae Yu; Flannery, John G; Werner, John S; Burns, Marie E; Pugh, Edward N

    2015-06-01

    Adaptive optics scanning laser ophthalmoscopy (AO-SLO) has recently been used to achieve exquisite subcellular resolution imaging of the mouse retina. Wavefront sensing-based AO typically restricts the field of view to a few degrees of visual angle. As a consequence the relationship between AO-SLO data and larger scale retinal structures and cellular patterns can be difficult to assess. The retinal vasculature affords a large-scale 3D map on which cells and structures can be located during in vivo imaging. Phase-variance OCT (pv-OCT) can efficiently image the vasculature with near-infrared light in a label-free manner, allowing 3D vascular reconstruction with high precision. We combined widefield pv-OCT and SLO imaging with AO-SLO reflection and fluorescence imaging to localize two types of fluorescent cells within the retinal layers: GFP-expressing microglia, the resident macrophages of the retina, and GFP-expressing cone photoreceptor cells. We describe in detail a reflective afocal AO-SLO retinal imaging system designed for high resolution retinal imaging in mice. The optical performance of this instrument is compared to other state-of-the-art AO-based mouse retinal imaging systems. The spatial and temporal resolution of the new AO instrumentation was characterized with angiography of retinal capillaries, including blood-flow velocity analysis. Depth-resolved AO-SLO fluorescent images of microglia and cone photoreceptors are visualized in parallel with 469 nm and 663 nm reflectance images of the microvasculature and other structures. Additional applications of the new instrumentation are discussed.

  18. 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

  19. A nonrandomized, open-label study to evaluate the effect of nasal stimulation on tear production in subjects with dry eye disease.

    Science.gov (United States)

    Friedman, Neil J; Butron, Karla; Robledo, Nora; Loudin, James; Baba, Stephanie N; Chayet, Arturo

    2016-01-01

    Dry eye disease (DED), a chronic disorder affecting the tear film and lacrimal functional unit, is a widely prevalent condition associated with significant burden and unmet treatment needs. Since specific neural circuits play an important role in maintaining ocular surface health, microelectrical stimulation of these pathways could present a promising new approach to treating DED. This study evaluated the efficacy and safety of nasal electrical stimulation in patients with DED. This prospective, open-label, single-arm, nonrandomized pilot study included 40 patients with mild to severe DED. After undergoing two screening visits, enrolled subjects were provided with a nasal stimulation device and instructed to use it at home four times daily (or more often as needed). Follow-up assessments were conducted up to day 180. The primary efficacy endpoint was the difference between unstimulated and stimulated tear production quantified by Schirmer scores. Additional efficacy endpoints included change from baseline in corneal and conjunctival staining, symptoms evaluated on a Visual Analog Scale, and Ocular Surface Disease Index scores. Safety parameters included adverse event (AE) rates, visual acuity, intraocular pressure, slit-lamp biomicroscopy, indirect ophthalmoscopy, and endoscopic nasal examinations. Mean stimulated Schirmer scores were significantly higher than the unstimulated scores at all visits, and corneal and conjunctival staining and symptom scores from baseline to day 180 were significantly reduced. No serious device-related AEs and nine nonserious AEs (three device-related) were reported. Intraocular pressure remained stable and most subjects showed little or no change in visual acuity at days 30 and 180. No significant findings from other clinical examinations were noted. Neurostimulation of the nasolacrimal pathway is a safe and effective means of increasing tear production and reducing symptoms of dry eye in patients with DED.

  20. Relationship Between Optic Nerve Appearance and Retinal Nerve Fiber Layer Thickness as Explored with Spectral Domain Optical Coherence Tomography

    Science.gov (United States)

    Aleman, Tomas S.; Huang, Jiayan; Garrity, Sean T.; Carter, Stuart B.; Aleman, Wendy D.; Ying, Gui-shuang; Tamhankar, Madhura A.

    2014-01-01

    Purpose To study the relationship between the appearance of the optic nerve and the retinal nerve fiber layer (RNFL) thickness determined by spectral domain optical coherence tomography (OCT). Methods Records from patients with spectral domain-OCT imaging in a neuro-ophthalmology practice were reviewed. Eyes with glaucoma/glaucoma suspicion, macular/optic nerve edema, pseudophakia, and with refractive errors > 6D were excluded. Optic nerve appearance by slit lamp biomicroscopy was related to the RNFL thickness by spectral domain-OCT and to visual field results. Results Ninety-one patients (176 eyes; mean age: 49 ± 15 years) were included. Eighty-three eyes (47%) showed optic nerve pallor; 89 eyes (50.6%) showed RNFL thinning (sectoral or average peripapillary). Average peripapillary RNFL thickness in eyes with pallor (mean ± SD = 76 ± 17 μm) was thinner compared to eyes without pallor (91 ± 14 μm, P < 0.001). Optic nerve pallor predicted RNFL thinning with a sensitivity of 69% and a specificity of 75%. Optic nerve appearance predicted RNFL thinning (with a sensitivity and specificity of 81%) when RNFL had thinned by ∼ 40%. Most patients with pallor had RNFL thinning with (66%) or without (25%) visual field loss; the remainder had normal RNFL and fields (5%) or with visual field abnormalities (4%). Conclusions Optic nerve pallor as a predictor of RNFL thinning showed fair sensitivity and specificity, although it is optimally sensitive/specific only when substantial RNFL loss has occurred. Translational Relevance Finding an acceptable relationship between the optic nerve appearance by ophthalmoscopy and spectral domain-OCT RNFL measures will help the clinician's interpretation of the information provided by this technology, which is gaining momentum in neuro-ophthalmic research. PMID:25374773

  1. Relationship between foveal cone specialization and pit morphology in albinism.

    Science.gov (United States)

    Wilk, Melissa A; McAllister, John T; Cooper, Robert F; Dubis, Adam M; Patitucci, Teresa N; Summerfelt, Phyllis; Anderson, Jennifer L; Stepien, Kimberly E; Costakos, Deborah M; Connor, Thomas B; Wirostko, William J; Chiang, Pei-Wen; Dubra, Alfredo; Curcio, Christine A; Brilliant, Murray H; Summers, C Gail; Carroll, Joseph

    2014-05-20

    Albinism is associated with disrupted foveal development, though intersubject variability is becoming appreciated. We sought to quantify this variability, and examine the relationship between foveal cone specialization and pit morphology in patients with a clinical diagnosis of albinism. We recruited 32 subjects with a clinical diagnosis of albinism. DNA was obtained from 25 subjects, and known albinism genes were analyzed for mutations. Relative inner and outer segment (IS and OS) lengthening (fovea-to-perifovea ratio) was determined from manually segmented spectral domain-optical coherence tomography (SD-OCT) B-scans. Foveal pit morphology was quantified for eight subjects from macular SD-OCT volumes. Ten subjects underwent imaging with adaptive optics scanning light ophthalmoscopy (AOSLO), and cone density was measured. We found mutations in 22 of 25 subjects, including five novel mutations. All subjects lacked complete excavation of inner retinal layers at the fovea, though four subjects had foveal pits with normal diameter and/or volume. Peak cone density and OS lengthening were variable and overlapped with that observed in normal controls. A fifth hyper-reflective band was observed in the outer retina on SD-OCT in the majority of the subjects with albinism. Foveal cone specialization and pit morphology vary greatly in albinism. Normal cone packing was observed in the absence of a foveal pit, suggesting a pit is not required for packing to occur. The degree to which retinal anatomy correlates with genotype or visual function remains unclear, and future examination of larger patient groups will provide important insight on this issue. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  2. The Distribution of Macular Thickness and Its Determinants in a Healthy Population.

    Science.gov (United States)

    Hashemi, Hassan; Khabazkhoob, Mehdi; Yekta, AbbasAli; Emamian, Mohammad Hassan; Nabovati, Payam; Fotouhi, Akbar

    2017-10-01

    To determine the distribution of macular thickness in a healthy Iranian population aged 45-69 years and its association with certain determinants. All participants underwent optometric examinations including measurement of uncorrected and corrected visual acuity, objective refraction by retinoscopy, and subjective refraction. Subsequently, all participants underwent slit-lamp biomicroscopy followed by fundus examination through direct and indirect ophthalmoscopy, and optical coherence tomography (OCT) imaging under pupil dilation. Mean central macular thickness was 255.4 µm (95% confidence interval, CI, 254.5-256.3 µm), average inner macular thickness was 316.5 µm (95% CI 315.9-317.1 µm), average outer macular thickness was 275.3 µm (95% CI 274.8-275.8 µm), and overall average thickness was 278.6 µm (95% CI 278.1-279.1 µm). A linear multiple regression model showed that all indexes were significantly larger in male participants (p < 0.001). Central macular thickness increased with age (coef = 0.25, p < 0.001) while overall, inner and outer macular thickness decreased with age (coef = -0.18, -0.15, -0.19, respectively, all p < 0.001). Central and inner macular thickness had a positive correlation (coef = 3.8, 2.6, respectively, both p < 0.001) and outer macular thickness had a negative correlation (coef = -1.6, p < 0.001) with axial length. Age, sex, refractive error, axial length, and keratometry were found to be associated with macular thickness. These factors should be taken into account when interpreting macular thickness measurements with spectral-domain OCT.

  3. Comparative data on SD-OCT for the retinal nerve fiber layer and retinal macular thickness in a large cohort with Marfan syndrome.

    Science.gov (United States)

    Xu, WanWan; Kurup, Sudhi P; Fawzi, Amani A; Durbin, Mary K; Maumenee, Irene H; Mets, Marilyn B

    2017-01-01

    To report the distribution of macular and optic nerve topography in the eyes of individuals with Marfan syndrome aged 8-56 years using spectral domain optical coherence tomography (SD-OCT). Thirty-three patients with Marfan syndrome underwent a full eye examination including slit-lamp biomicroscopy, indirect ophthalmoscopy, and axial length measurement; and SD-OCT measurements of the retinal nerve fiber layer (RNFL) and macular thickness. For patients between the ages of 8 and 12 years, the average RNFL thickness is 98 ± 9 μm, the vertical cup to disc (C:D) ratio is 0.50 ± 0.10, the central subfield thickness (CST) is 274 ± 38 μm, and the macular volume is 10.3 ± 0.6 mm 3 . For patients between the ages of 13 and 17 years, the average RNFL is 86 ± 16 μm, the vertical C:D ratio is 0.35 ± 0.20, the CST is 259 ± 15 μm, and the macular volume is 10.1 ± 0.5 mm 3 . For patients 18 years or older, the average RNFL is 89 ± 12 μm, the vertical C:D ratio is 0.46 ± 0.18, the CST is 262 ± 20 μm, and the macular volume is 10.2 ± 0.4 mm 3 . When the average RNFL data are compared to a normative, age-adjusted database, 6 of 33 (18%) were thinner than the 5% limit. This study reports the distribution of SD-OCT data for patients with Marfan syndrome. Compared to a normative database, 18% of eyes with Marfan syndrome had RNFL thickness < 5% of the population.

  4. Extrafoveal Cone Packing in Eyes With a History of Retinopathy of Prematurity.

    Science.gov (United States)

    Ramamirtham, Ramkumar; Akula, James D; Soni, Garima; Swanson, Matthew J; Bush, Jennifer N; Moskowitz, Anne; Swanson, Emily A; Favazza, Tara L; Tavormina, Jena L; Mujat, Mircea; Ferguson, R Daniel; Hansen, Ronald M; Fulton, Anne B

    2016-02-01

    To study the density and packing geometry of the extrafoveal cone photoreceptors in eyes with a history of retinopathy of prematurity (ROP). We used a multimodal combination of adaptive optics (AO) scanning light ophthalmoscopy (SLO) and optical coherence tomography (OCT). Cones were identified in subjects (aged 14-26 years) with a history of ROP that was either severe and treated by laser ablation of avascular peripheral retina (TROP; n = 5) or mild and spontaneously resolved, untreated (UROP; n = 5), and in term-born controls (CT; n = 8). The AO-SLO images were obtained at temporal eccentricities 4.5°, 9°, 13.5°, and 18° using both confocal and offset apertures with simultaneous, colocal OCT images. Effects of group, eccentricity, and aperture were evaluated and the modalities compared. In the SLO images, cone density was lower and the packing pattern less regular in TROP, relative to CT and UROP retinae. Although SLO image quality appeared lower in TROP, root mean square (RMS) wavefront error did not differ among the groups. In TROP eyes, cone discrimination was easier in offset aperture images. There was no evidence of cone loss in the TROP OCT images. Low cone density in TROP confocal SLO images may have resulted from lower image quality. Since AO correction in these eyes was equivalent to that of the control group, and OCT imaging showed no significant cone loss, the optical properties of the inner retina or properties of the cones themselves are likely altered in a way that affects photoreceptor imaging.

  5. Comparison of the effectiveness of three retinal camera technologies for malarial retinopathy detection in Malawi

    Science.gov (United States)

    Soliz, Peter; Nemeth, Sheila C.; Barriga, E. Simon; Harding, Simon P.; Lewallen, Susan; Taylor, Terrie E.; MacCormick, Ian J.; Joshi, Vinayak S.

    2016-03-01

    The purpose of this study was to test the suitability of three available camera technologies (desktop, portable, and iphone based) for imaging comatose children who presented with clinical symptoms of malaria. Ultimately, the results of the project would form the basis for a design of a future camera to screen for malaria retinopathy (MR) in a resource challenged environment. The desktop, portable, and i-phone based cameras were represented by the Topcon, Pictor Plus, and Peek cameras, respectively. These cameras were tested on N=23 children presenting with symptoms of cerebral malaria (CM) at a malaria clinic, Queen Elizabeth Teaching Hospital in Malawi, Africa. Each patient was dilated for binocular indirect ophthalmoscopy (BIO) exam by an ophthalmologist followed by imaging with all three cameras. Each of the cases was graded according to an internationally established protocol and compared to the BIO as the clinical ground truth. The reader used three principal retinal lesions as markers for MR: hemorrhages, retinal whitening, and vessel discoloration. The study found that the mid-priced Pictor Plus hand-held camera performed considerably better than the lower price mobile phone-based camera, and slightly the higher priced table top camera. When comparing the readings of digital images against the clinical reference standard (BIO), the Pictor Plus camera had sensitivity and specificity for MR of 100% and 87%, respectively. This compares to a sensitivity and specificity of 87% and 75% for the i-phone based camera and 100% and 75% for the desktop camera. The drawback of all the cameras were their limited field of view which did not allow complete view of the periphery where vessel discoloration occurs most frequently. The consequence was that vessel discoloration was not addressed in this study. None of the cameras offered real-time image quality assessment to ensure high quality images to afford the best possible opportunity for reading by a remotely located

  6. 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.

  7. Reliability and Repeatability of Cone Density Measurements in Patients With Stargardt Disease and RPGR-Associated Retinopathy

    Science.gov (United States)

    Tanna, Preena; Kasilian, Melissa; Strauss, Rupert; Tee, James; Kalitzeos, Angelos; Tarima, Sergey; Visotcky, Alexis; Dubra, Alfredo; Carroll, Joseph; Michaelides, Michel

    2017-01-01

    Purpose To assess reliability and repeatability of cone density measurements by using confocal and (nonconfocal) split-detector adaptive optics scanning light ophthalmoscopy (AOSLO) imaging. It will be determined whether cone density values are significantly different between modalities in Stargardt disease (STGD) and retinitis pigmentosa GTPase regulator (RPGR)–associated retinopathy. Methods Twelve patients with STGD (aged 9–52 years) and eight with RPGR-associated retinopathy (aged 11–31 years) were imaged using both confocal and split-detector AOSLO simultaneously. Four graders manually identified cone locations in each image that were used to calculate local densities. Each imaging modality was evaluated independently. The data set consisted of 1584 assessments of 99 STGD images (each image in two modalities and four graders who graded each image twice) and 928 RPGR assessments of 58 images (each image in two modalities and four graders who graded each image twice). Results For STGD assessments the reliability for confocal and split-detector AOSLO was 67.9% and 95.9%, respectively, and the repeatability was 71.2% and 97.3%, respectively. The differences in the measured cone density values between modalities were statistically significant for one grader. For RPGR assessments the reliability for confocal and split-detector AOSLO was 22.1% and 88.5%, respectively, and repeatability was 63.2% and 94.5%, respectively. The differences in cone density between modalities were statistically significant for all graders. Conclusions Split-detector AOSLO greatly improved the reliability and repeatability of cone density measurements in both disorders and will be valuable for natural history studies and clinical trials using AOSLO. However, it appears that these indices may be disease dependent, implying the need for similar investigations in other conditions. PMID:28738413

  8. Diabetic retinopathy and its risk factors in patients with type 2 diabetes attending rural primary healthcare facilities in Tamil Nadu.

    Science.gov (United States)

    Fredrick, Tony; Kaur, Prabhdeep; Murhekar, Manoj V; Jayaraman, Yuvaraj; Kolandaswamy, K; Rao, Sudha Ramachandra; David, Joseph K

    2016-01-01

    India has a high burden of diabetic retinopathy ranging from 12.2% to 20.4% among patients with type 2 diabetes mellitus (T2DM). A T2DM management programme was initiated in the public sector in Tamil Nadu. We estimated the prevalence of diabetic retinopathy and its associated risk factors. We did a cross-sectional survey among patients with T2DM attending two primary health centres for treatment and follow-up in Kancheepuram, Tamil Nadu in January- March 2013. We did a questionnaire-based survey, and measured blood pressure and biochemical parameters (serum creatinine, plasma glucose, etc.) of the patients. We examined their eyes by direct and indirect ophthalmoscopy and defined diabetic retinopathy using a modified classification by Klein et al. We calculated the proportion and 95% CI for the prevalence and adjusted odds ratio (AOR) for risk factors associated with diabetic retinopathy. Among the 270 patients, the mean (SD) age was 54.5 (10) years. The median duration of T2DM was 48 months. The prevalence of diabetic retinopathy was 29.6%. Overall, 65.9% of patients had hypertension, 14.4% had nephropathy (eGFR 5 years (AOR 6.5, 95% CI 3.6-11.7), poor glycaemic control (AOR 2.4, 95% CI 1.4-4.4), and nephropathy (AOR 2.3, 95% CI 1.1-4.6). There was a high burden of undetected retinopathy and other comorbid conditions among patients with T2DM. Early detection of comorbid conditions and glycaemic control can be improved by training care-providers and educating patients.

  9. 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.

  10. Blockade of Tumor Necrosis Factor-Alpha: A Role for Adalimumab in Neovascular Age-Related Macular Degeneration Refractory to Anti-Angiogenesis Therapy

    Directory of Open Access Journals (Sweden)

    Beatriz Fernández-Vega

    2016-03-01

    Full Text Available Aims: To report a case of wet age-related macular degeneration (wet-AMD refractory to intravitreal anti-vascular endothelial growth factor (anti-VEGF therapy in a patient who showed visual and anatomical improvement and stabilization after starting a subcutaneous treatment course with adalimumab, an anti-tumor necrosis factor-alpha (TNF-α drug, for concomitant Crohn's disease. Methods: Observational case report of a female patient. Ophthalmological evaluation was performed by slit lamp and ophthalmoscopy (posterior pole and anterior segment. Best-corrected visual acuity (BCVA was determined, and imaging was performed by fluorescein angiography, indocyanine green angiography, and optical coherence tomography (OCT. Intravitreal therapies used and treatment with anti-TNF-α were recorded. Results: A 64-year-old woman with wet-AMD was treated with fourteen intravitreal injections of ranibizumab (0.5 mg for a period of 40 months with intervals of 1-6 months. She initially showed a good visual and anatomical response to periodic anti-VEGF treatment but during check visits, anatomical and functional responses deteriorated. At the 40-month follow-up, the patient had developed Crohn's disease, and her rheumatologist started treatment with adalimumab (40 mg subcutaneously every 2 weeks. During the 25 months of treatment with adalimumab, the patient did not require any additional intravitreal anti-VEGF treatments because her BCVA, clinical, and OCT findings improved and remained stable. Conclusions: We described a case of a patient with wet-AMD refractory to anti-VEGF therapy, which clinically benefited from subcutaneous adalimumab therapy. Treatment with subcutaneous anti-TNF-α in combination with anti-VEGF therapy avoids the high cost and risks related to multiple intravitreal anti-VEGF injections with good functional and anatomic outcomes.

  11. Antivascular Endothelial Growth Factor Bevacizumab for Radiation Optic Neuropathy: Secondary to Plaque Radiotherapy

    International Nuclear Information System (INIS)

    Finger, Paul T.; Chin, Kimberly J.

    2012-01-01

    Purpose: To evaluate the intravitreal antivascular endothelial growth factor, bevacizumab, for treatment of radiation optic neuropathy (RON). Methods and Materials: A prospective interventional clinical case series was performed of 14 patients with RON related to plaque radiotherapy for choroidal melanoma. The RON was characterized by optic disc edema, hemorrhages, microangiopathy, and neovascularization. The entry criteria included a subjective or objective loss of vision, coupled with findings of RON. The study subjects received a minimum of two initial injections of intravitreal bevacizumab (1.25 mg in 0.05 mL) every 6–8 weeks. The primary objectives included safety and tolerability. The secondary objectives included the efficacy as measured using the Early Treatment Diabetic Retinopathy Study chart for visual acuity, fundus photography, angiography, and optical coherence tomography/scanning laser ophthalmoscopy. Results: Reductions in optic disc hemorrhage and edema were noted in all patients. The visual acuity was stable or improved in 9 (64%) of the 14 patients. Of the 5 patients who had lost vision, 2 had relatively large posterior tumors, 1 had had the vision decrease because of intraocular hemorrhage, and 1 had developed optic atrophy. The fifth patient who lost vision was noncompliant. No treatment-related ocular or systemic side effects were observed. Conclusions: Intravitreal antivascular endothelial growth factor bevacizumab was tolerated and generally associated with improved vision, reduced papillary hemorrhage, and resolution of optic disc edema. Persistent optic disc neovascularization and fluorescein angiographic leakage were invariably noted. The results of the present study support additional evaluation of antivascular endothelial growth factor medications as treatment of RON.

  12. In vivo optical imaging of amblyopia: Digital subtraction autofluorescence and split-spectrum amplitude-decorrelation angiography.

    Science.gov (United States)

    Guo, Lei; Tao, Jun; Xia, Fan; Yang, Zhi; Ma, Xiaoli; Hua, Rui

    2016-09-01

    Amblyopia is a visual impairment that is attributed to either abnormal binocular interactions or visual deprivation. The retina and choroids have been shown to be involved in the development of amblyopia. The purpose of this study was to investigate the retinal and choroidal microstructural abnormalities of amblyopia using digital subtraction autofluorescence and split-spectrum amplitude-decorrelation angiography (SSADA) approaches. This prospective study included 44 eyes of 22 patients with unilateral amblyopia. All patients who received indirect ophthalmoscopy, combined depth imaging spectral domain optical coherence tomography (OCT), SSADA-OCT, and macular blue light (BL-) and near-infrared (NIR-) autofluorescences underwent pupil dilation. The subfoveal choroidal thickness (SFCT) was measured. BL- and NIR-autofluorescences were determined for all patients and used to generate subtraction images with ImageJ software. The superficial, deep layers of the retina, and inner choroid layer were required for SSADA-OCT. For the normal eyes, a regularly increasing signal was observed in the central macula based on the subtraction images. In contrast, a decreased signal for the central patch or a reduced peak was detected in 16 of 22 amblyopic eyes (72.7%). The mean SFCT of the amblyopic eyes was greater than that of the fellow normal eyes (399.25 ± 4.944 µm vs. 280.58 ± 6.491 µm, respectively, P autofluorescence. The mechanistic relationship of a thicker choroid and choroidal capillary atrophy with amblyopia remains to be described. The digital subtraction image confirmed the changes in the microstructure of the amblyopic retina as a supplementary approach to detect the progression of amblyopia. Lasers Surg. Med. 48:660-667, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  13. 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.

  14. COMPARISON OF MANUAL AND SEMIAUTOMATED FUNDUS AUTOFLUORESCENCE ANALYSIS OF MACULAR ATROPHY IN STARGARDT DISEASE PHENOTYPE.

    Science.gov (United States)

    Kuehlewein, Laura; Hariri, Amir H; Ho, Alexander; Dustin, Laurie; Wolfson, Yulia; Strauss, Rupert W; Scholl, Hendrik P N; Sadda, SriniVas R

    2016-06-01

    To evaluate manual and semiautomated grading techniques for assessing decreased fundus autofluorescence (DAF) in patients with Stargardt disease phenotype. Certified reading center graders performed manual and semiautomated (region finder-based) grading of confocal scanning laser ophthalmoscopy (cSLO) fundus autofluorescence (FAF) images for 41 eyes of 22 patients. Lesion types were defined based on the black level and sharpness of the border: definite decreased autofluorescence (DDAF), well, and poorly demarcated questionably decreased autofluorescence (WDQDAF, PDQDAF). Agreement in grading between the two methods and inter- and intra-grader agreement was assessed by kappa coefficients (κ) and intraclass correlation coefficients (ICC). The mean ± standard deviation (SD) area was 3.07 ± 3.02 mm for DDAF (n = 31), 1.53 ± 1.52 mm for WDQDAF (n = 9), and 6.94 ± 10.06 mm for PDQDAF (n = 17). The mean ± SD absolute difference in area between manual and semiautomated grading was 0.26 ± 0.28 mm for DDAF, 0.20 ± 0.26 mm for WDQDAF, and 4.05 ± 8.32 mm for PDQDAF. The ICC (95% confidence interval) for method comparison was 0.992 (0.984-0.996) for DDAF, 0.976 (0.922-0.993) for WDQDAF, and 0.648 (0.306-0.842) for PDQDAF. Inter- and intra-grader agreement in manual and semiautomated quantitative grading was better for DDAF (0.981-0.996) and WDQDAF (0.995-0.999) than for PDQDAF (0.715-0.993). Manual and semiautomated grading methods showed similar levels of reproducibility for assessing areas of decreased autofluorescence in patients with Stargardt disease phenotype. Excellent agreement and reproducibility were observed for well demarcated lesions.

  15. 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.

  16. Time-resolved autofluorescence imaging of human donor retina tissue from donors with significant extramacular drusen.

    Science.gov (United States)

    Schweitzer, Dietrich; Gaillard, Elizabeth R; Dillon, James; Mullins, Robert F; Russell, Stephen; Hoffmann, Birgit; Peters, Sven; Hammer, Martin; Biskup, Christoph

    2012-06-08

    Time and spectrally resolved measurements of autofluorescence have the potential to monitor metabolism at the cellular level. Fluorophores that emit with the same fluorescence intensity can be discriminated from each other by decay time of fluorescence intensity after pulsed excitation. We performed time-resolved autofluorescence measurements on fundus samples from a donor with significant extramacular drusen. Tissue sections from two human donors were prepared and imaged with a laser scanning microscope. The sample was excited with a titanium-sapphire laser, which was tuned to 860 nm, and frequency doubled by a BBO crystal to 430 nm. The repetition rate was 76 MHz and the pulse width was 170 femtoseconds (fs). The time-resolved autofluorescence was recorded simultaneously in 16 spectral channels (445-605 nm) and bi-exponentially fitted. RPE can be discriminated clearly from Bruch's membrane, drusen, and choroidal connective tissue by fluorescence lifetime. In RPE, bright fluorescence of lipofuscin could be detected with a maximum at 510 nm and extending beyond 600 nm. The lifetime was 385 ps. Different types of drusen were found. Most of them did not contain lipofuscin and exhibited a weak fluorescence, with a maximum at 470 nm. The lifetime was 1785 picoseconds (ps). Also, brightly emitting lesions, presumably representing basal laminar deposits, with fluorescence lifetimes longer than those recorded in RPE could be detected. The demonstrated differentiation of fluorescent structures by their fluorescence decay time is important for interpretation of in vivo measurements by the new fluorescence lifetime imaging (FLIM) ophthalmoscopy on healthy subjects as well as on patients.

  17. 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.

  18. Multimodal ophthalmic imaging using handheld spectrally encoded coherence tomography and reflectometry (SECTR)

    Science.gov (United States)

    Leeburg, Kelsey C.; El-Haddad, Mohamed T.; Malone, Joseph D.; Terrones, Benjamin D.; Tao, Yuankai K.

    2018-02-01

    Scanning laser ophthalmoscopy (SLO) provides high-speed, noninvasive en face imaging of the retinal fundus. Optical coherence tomography (OCT) is the current "gold-standard" for ophthalmic diagnostic imaging and enables depth-resolved visualization of ophthalmic structures and image-based surrogate biomarkers of disease. We present a compact optical and mechanical design for handheld spectrally encoded coherence tomography and reflectometry (SECTR) for multimodality en face spectrally encoded reflectometry (SER) and cross-sectional OCT imaging. We custom-designed a double-pass telecentric scan lens, which halves the size of 4-f optical relays and allowed us to reduce the footprint of our SECTR scan-head by a factor of >2.7x (volume) over our previous design. The double-pass scan lens was optimized for diffraction-limited performance over a +/-10° scan field. SECTR optics and optomechanics were combined in a compact rapid-prototyped enclosure with dimensions 87 x 141.8 x 137 mm (w x h x d). SECTR was implemented using a custom-built 400 kHz 1050 nm swept-source. OCT and SER were simultaneously digitized on dual input channels of a 4 GS/s digitizer at 1.4 GS/s per channel. In vivo human en face SER and cross-sectional OCT images were acquired at 350 fps. OCT volumes of 1000 B-scans were acquired in 2.86 s. We believe clinical translation of our compact handheld design will benefit point-of-care ophthalmic diagnostics in patients who are unable to be imaged on conventional slit-lamp based systems, such as infants and the bedridden. When combined with multi-volumetric registration methods, handheld SECTR will have advantages in motion-artifact free imaging over existing handheld technologies.

  19. Bedside ROP screening and telemedicine interpretation integrated to a neonatal transport system: Economic aspects and return on investment analysis.

    Science.gov (United States)

    Kovács, Gábor; Somogyvári, Zsolt; Maka, Erika; Nagyjánosi, László

    Peter Cerny Ambulance Service - Premature Eye Rescue Program (PCA-PERP) uses digital retinal imaging (DRI) with remote interpretation in bedside ROP screening, which has advantages over binocular indirect ophthalmoscopy (BIO) in screening of premature newborns. We aimed to demonstrate that PCA-PERP provides good value for the money and to model the cost ramifications of a similar newly launched system. As DRI was demonstrated to have high diagnostic performance, only the costs of bedside DRI-based screening were compared to those of traditional transport and BIO-based screening (cost-minimization analysis). The total costs of investment and maintenance were analyzed with micro-costing method. A ten-year analysis time-horizon and service provider's perspective were applied. From the launch of PCA-PERP up to the end of 2014, 3722 bedside examinations were performed in the PCA covered central region of Hungary. From 2009 to 2014, PCA-PERP saved 92,248km and 3633 staff working hours, with an annual nominal cost-savings ranging from 17,435 to 35,140 Euro. The net present value was 127,847 Euro at the end of 2014, with a payback period of 4.1years and an internal rate of return of 20.8%. Our model presented the NPVs of different scenarios with different initial investments, annual number of transports and average transport distances. PCA-PERP as bedside screening with remote interpretation, when compared to a transport-based screening with BIO, produced better cost-savings from the perspective of the service provider and provided a return on initial investment within five years after the project initiation. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Predictors for the progression of geographic atrophy in patients with age-related macular degeneration: fundus autofluorescence study with modified fundus camera.

    Science.gov (United States)

    Jeong, Y J; Hong, I H; Chung, J K; Kim, K L; Kim, H K; Park, S P

    2014-02-01

    We examined the association between abnormal fundus autofluorescence (FAF) features on images obtained by a modified fundus camera (mFC) and geographic atrophy (GA) progression in patients with age-related macular degeneration (AMD). Serial FAF images of 131 eyes from 131 patients with GA were included in the study. All FAF images were obtained with an mFC (excitation, ∼ 500-610 nm; emission, ∼ 675-715 nm). The GA area was quantified at baseline and 1 year later using a customized segmentation program. The yearly GA enlargement rate was then calculated. Abnormal FAF patterns in the junctional zone of GA were classified as None or Minimal change, Focal, Patchy, Banded, or Diffuse according to previously published classification based on confocal scanning laser ophthalmoscopy (cSLO). The relationship between GA enlargement and abnormal FAF was evaluated. The mean rate of GA enlargement was the fastest in eyes with Diffuse pattern (1.74 mm(2) per year), followed by eyes with the Banded pattern (1.69 mm(2) per year). Binary logistic regression analysis revealed that eyes with the Banded and Diffuse pattern had significantly higher risk for GA enlargement compared with eyes with the other patterns. FAF image obtained by mFC appears to be acceptable for evaluating GA in accordance with an established cSLO-based classification. Eyes with the Banded or the Diffuse patterns of abnormal FAF at baseline indicate a high risk for GA progression. Identifying patients at high risk for GA progression using an mFC is broadly available method that can provide additional information to help predict disease course.

  1. INFORMATIVITY OF SPECTRAL OPTICAL COHERENT TOMOGRAPHY IN AGGRESSIVE POSTERIOR RETINOPATHY OF PREMATURITY

    Directory of Open Access Journals (Sweden)

    A. V. Tereshchenko

    2017-01-01

    Full Text Available The purpose: to evaluate the informativity of optical coherence tomography in patients with aggressive posterior retinopathy of prematurity. Patients and methods. spectral optical coherence tomography using portable device iVue-100 with a removable camera (Optovue, USA was held in 32 children (64 eyes with aggressive posterior retinopathy of prematurity with a gestational period 26–31 week. Results. Children with aggressive posterior retinopathy of prematurity at the stage of early clinical manifestations, in addition to the indication that the immaturity of the retina, according to the spectral optical coherence tomography revealed only a few areas of epiretinal proliferation, which are not visualized with a digital retinoscopy and binocular indirect ophthalmoscopy. When the process is more pronounced in children with retinopathy of prematurity aggressive rear stage manifestation already determined multiple zones epiretinal proliferation as a "mushroom" and "flake" conglomerates with rear zone hyaloid membrane had an uneven seal. Coarser structural disorders of the retina and the vitreoretinal interface have been identified in patients with advancedstage aggressive posterior retinopathy of prematurity. We determined the shaft extraretinal proliferation as a "comb", as well as portions of epiretinal proliferation on the border of vascularized and avascular retina, which tended to merge, and the formation of massive hyperreflection complexes, lifted back hyaloid membrane, which was not only uneven sealed, but in some places is stratified. Conclusion. Despite the complexity of the procedure and the complexity of its implementation, the data obtained are particularly valuable and informative because they allow to complement the clinical picture and objectify it. It helps to choose the optimal tactics and improvement of a differentiated approach to the treatment of aggressive posterior retinopathy of prematurity.

  2. Incidência e resultados do tratamento da retinopatia da prematuridade no Hospital de Clínicas de Porto Alegre, Brasil

    Directory of Open Access Journals (Sweden)

    João Borges Fortes Filho

    2007-06-01

    Full Text Available Introduction: Retinopathy of prematurity is a leading cause of blindness in children. This paper aims to evaluate the incidence, the rate of diode laser treatment and the six-month outcomes in all very low birth weight preterm infants from Hospital de Clínicas de Porto Alegre, Brazil, between October 2002 and October 2006, screened for the disease according to the Brazilian recommendations. Methods: A prospective cohort was conducted on 322 premature children with birth weight ≤1.500 grams or a gestational age at birth ≤32 weeks. All patients were examined by indirect binocular ophthalmoscopy with pupil’s dilation after the 6th week of life. The examination were repeated depending on the disease classification. Results: Retinopathy of prematurity occurred in 82 infants in an incidence rate of 25.47%. Threshold disease occurred in 18 of the patients (5.59%. All of them had the disease affecting posterior Zone II needing laser treatment under general anesthesia or sedation in the Neonatal Intensive Care Unity. Three of the treated children needed a second laser session. One patient of the re-treated group needed scleral buckling surgery with an equatorial silicon band after progression for stage 4 of ROP. One patient missed the opportunity for laser and the disease progressed to stage 5 of ROP and blindness. Conclusions: The incidence of retinopathy at our institution was similar to international results and also the percentage of threshold disease needing treatment. Laser photocoagulation was effective to stabilize the disease among 17 treated patients. One non-treated patient had evolution for blindness.

  3. 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.

  4. 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

  5. The correlation of albuminuria and glomerular filtration rate with diabetic retinopathy in type 2 diabetes%尿白蛋白、肾小球滤过率与2型糖尿病视网膜病变的相关性研究

    Institute of Scientific and Technical Information of China (English)

    蔡芸莹; 马中书; 邱明才

    2012-01-01

    目的 比较T2DM视网膜病变(DR)不同时期,尿蛋白、肾小球滤过率(GFR)变化,寻找早期筛查DR的指标. 方法 采用回顾性病历研究,根据散瞳眼底检查分组,同期测定各组24h尿白蛋白定量,以MDRD公式计算GFR. 结果 与正常眼底组相比,DR组患者的GFR明显减低(P<0.05),且尿白蛋白(UAlb)、GFR均与DR呈显著独立相关(P<0.05). 结论 UAlb、GFR均与DR密切相关,其联合筛查有利于DR早期检出.%Objective To compare changes of urinary albumin and eGFR between different stages of diabetic retinopathy(DR) to look for early screening diabetic retinopathy indicators. Methods The clinical data were analyzed retrospectively. Diabetic retinopathy was assessed by mydriatic ophthalmoscopy. While determinating the urinary albumin quantitative for 24 hours, the estimated glomerular filtration rate(GFR) was measured by MDRD formula Results The levels of GFR were significantly lower in two DR groups than in normal retina group(P< 0. 05). Both urinary albumin(Ualb) and GFR were independently risks for diabetic retinopathy. Conclusion Ualb and GFR are closely associated with diabetic retinopathy. Clinicians need to check both urinary albumin and eGFR to screen for early diabetic retinopathy.

  6. Modern aspects of diagnostics and monitoring of tape-toretinal degeneration

    Directory of Open Access Journals (Sweden)

    Nekhorosheva А.А.

    2017-06-01

    Full Text Available Objective: to evaluate the informativity of clinical and instrumental methods of examining patients with tapetoretinal abiotrophy (TRA. Material and Methods. 45 patients with a diagnosis ofTRA, divided into 3 groups: 1 8 people (under 18 years; 2 20 people (19-40 years; 3 17 people (over 41 years. Performed: standard ophthalmological examination, computer perimetry (kinetic, static perimetry in the "Macula threashold 24-2bs" mode, OCULUS Twinfield device, fundus shots (TOPCON device, EPS* (Neuro-MEP device. Results. The average total value of the visual fields of the first group patients amounted to 394±23°, the second group has 173±26° result and the third group has 86±15° result. Mean deviation of the bacillary component of electroretinogram in the first group has reached 53.8±10.4%, 70.2±4.3% in the second group and 84.7±7.3% in the third group. As for the rhythmic component, the indicators were following: 20.3±4.3%, 41.6±5.2%, 62.3±6.4% in the first, second and the third groups respectively. The data of static perimetry showed a decrease in the average photosensitivity in the central parts with respect to the population's age. According to the data of ophthalmoscopy the bony bodies' remoteness of the location from the center of the fundus corresponds to the degree of narrowing of the field of vision. Conclusion. There is a significant relationship between the total value of the peripheral boundaries of the visual field, electroretinogram data and perimetry.

  7. Comparison of clinical characteristics of rhegmatogenous retinal detachment in pseudophakic and phakic Eyes

    International Nuclear Information System (INIS)

    Mukhtar, M. A.; Ishaq, M.; Mehboob, M. A.; Islam, Q. U.

    2017-01-01

    Objective: To compare the clinical profile, systemic risk factors, and characteristics of rhegmatogenous retinal detachment (RRD) in pseudophakic and phakic eyes. Study Design: Cross-sectional comparative study. Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi from August 2013 to August 2015. Methodology: A total of 164 eyes (96 pseudophakic patients and 68 phakic patients) with RRD were analyzed. Demographic data and associated known risk factors of study population were acquired. Retinal examination was done by single experienced retinal surgeon using indirect ophthalmoscopy for type of retinal break, location and number of retinal breaks, status of macula, morphological extent of RRD and retinal degenerations. All the findings were endorsed on a pre-devised proforma. Results: Mean age of patients in pseudophakic and phakic groups was 61.18+-10.39 and 59.27+-9.57 years, respectively. Frequency of male patients in pseudophakic and phakic groups was 74% and 57.4%, respectively. Mean axial length in pseudophakic and phakic groups was 23.13+-2.18 mm and 21.9+-2.01 mm, respectively. Difference in axial length and gender distribution between two groups was statistically significant (p < 0.05). Difference in frequency of patients with history of hypertension and myopia between two groups was statistically significant (p < 0.05). Characteristics of RRD (type, location and number of retinal breaks, macula status, and extent of RRD) between groups were not statistically significant. Conclusion: RRD is more common in pseudophakic patients with male gender, increased axial length, myopia, and hypertension. (author)

  8. 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

  9. Comparison of normotensive and glaucoma simplex patients according to age and sex

    Directory of Open Access Journals (Sweden)

    Stojčić Milan

    2012-01-01

    Full Text Available Introduction. According to the level of intraocular pressure (IOP, open angle glaucoma is divided into high tension glaucoma (HTG and normal tension glaucoma (NTG. Objective. To determine if there are differences in the distribution of patients by age and sex between NTG and HTG. Methods. Our prospective study included 30 patients with NTG and 30 with HTG. A complete eye examination was performed. The examination included measuring of intraocular pressure by Goldmann applanation tonometry, examination of optic disc head by indirect ophthalmoscopy with Volk 90 D lens and visual field examination using the Octopus program. Results. The average damage of visual field in the group of patients with NTG was 8.14±4.43 dB, while in the group with HTG it was 7.40±2.84 dB (p>0.05. The average age of the group of patients with NTG was 66±11.58 years, while among those with HTG the average age was 59.7±11.63 years (p<0.01. Among the patients with NTG there were three times more women than men (χ2=9.124; p<0.01, while in the group of patients with HTG there were more men than women, but without statistically significant difference between the tested groups (χ2=1.851; p>0.05. Conclusion. Open angle glaucoma is a disease of elderly population. According to our results, risk factors for this disease can be age and sex. NTG is more frequently present than HTG among elderly population and females.

  10. Parafoveal retinal cone mosaic imaging in children with ultra-compact switchable SLO/OCT handheld probe (Conference Presentation)

    Science.gov (United States)

    LaRocca, Francesco; Nankivil, Derek; DuBose, Theodore B.; Toth, Cynthia A.; Farsiu, Sina; Izatt, Joseph A.

    2016-03-01

    In vivo photoreceptor imaging has enhanced the way vision scientists and ophthalmologists understand the retinal structure, function, and etiology of numerous retinal pathologies. However, the complexity and large footprint of current systems capable of resolving photoreceptors has limited imaging to patients who are able to sit in an upright position and fixate for several minutes. Unfortunately, this excludes an important fraction of patients including bedridden patients, small children, and infants. Here, we show that our dual-modality, high-resolution handheld probe with a weight of only 94 g is capable of visualizing photoreceptors in supine children. Our device utilizes a microelectromechanical systems (MEMS) scanner and a novel telescope design to achieve over an order of magnitude reduction in size compared to similar systems. The probe has a 7° field of view and a lateral resolution of 8 µm. The optical coherence tomography (OCT) system has an axial resolution of 7 µm and a sensitivity of 101 dB. High definition scanning laser ophthalmoscopy (SLO) and OCT images were acquired from children ranging from 14 months to 12 years of age with and without pathology during examination under anesthesia in the operating room. Parafoveal cone imaging was shown using the SLO arm of this device without adaptive optics using a 3° FOV for the first time in children under 4 years old. This work lays the foundation for pediatric research, which will improve understanding of retinal development, maldevelopment and early onset of diseases at the cellular level during the beginning stages of human growth.

  11. Retinal vascular speed prematurity requiring treatment.

    Science.gov (United States)

    Solans Pérez de Larraya, Ana M; Ortega Molina, José M; Fernández, José Uberos; Escudero Gómez, Júlia; Salgado Miranda, Andrés D; Chaves Samaniego, Maria J; García Serrano, José L

    2018-03-01

    To analyse the speed of temporal retinal vascularisation in preterm infants included in the screening programme for retinopathy of prematurity. A total of 185 premature infants were studied retrospectively between 2000 and 2017 in San Cecilio University Hospital of Granada, Spain. The method of binocular indirect ophthalmoscopy with indentation was used for the examination. The horizontal disc diameter was used as a unit of length. Speed of temporal retinal vascularisation (disc diameter/week) was calculated as the ratio between the extent of temporal retinal vascularisation (disc diameter) and the time in weeks. The weekly temporal retinal vascularisation (0-1.25 disc diameter/week, confidence interval) was significantly higher in no retinopathy of prematurity (0.73 ± 0.22 disc diameter/week) than in stage 1 retinopathy of prematurity (0.58 ± 0.22 disc diameter/week). It was also higher in stage 1 than in stages 2 (0.46 ± 0.14 disc diameter/week) and 3 of retinopathy of prematurity (0.36 ± 0.18 disc diameter/week). The rate of temporal retinal vascularisation (disc diameter/week) decreases when retinopathy of prematurity stage increases. The area under the receiver operating characteristic curve was 0.85 (95% confidence interval: 0.79-0.91) for retinopathy of prematurity requiring treatment versus not requiring treatment. The best discriminative cut-off point was a speed of retinal vascularisation prematurity may be required. However, before becoming a new standard of care for treatment, it requires careful documentation, with agreement between several ophthalmologists.

  12. Neurodegeneration severity can be predicted from early microglia alterations monitored in vivo in a mouse model of chronic glaucoma

    Directory of Open Access Journals (Sweden)

    Alejandra Bosco

    2015-05-01

    Full Text Available Microglia serve key homeostatic roles, and respond to neuronal perturbation and decline with a high spatiotemporal resolution. The course of all chronic CNS pathologies is thus paralleled by local microgliosis and microglia activation, which begin at early stages of the disease. However, the possibility of using live monitoring of microglia during early disease progression to predict the severity of neurodegeneration has not been explored. Because the retina allows live tracking of fluorescent microglia in their intact niche, here we investigated their early changes in relation to later optic nerve neurodegeneration. To achieve this, we used the DBA/2J mouse model of inherited glaucoma, which develops progressive retinal ganglion cell degeneration of variable severity during aging, and represents a useful model to study pathogenic mechanisms of retinal ganglion cell decline that are similar to those in human glaucoma. We imaged CX3CR1+/GFP microglial cells in vivo at ages ranging from 1 to 5 months by confocal scanning laser ophthalmoscopy (cSLO and quantified cell density and morphological activation. We detected early microgliosis at the optic nerve head (ONH, where axonopathy first manifests, and could track attenuation of this microgliosis induced by minocycline. We also observed heterogeneous and dynamic patterns of early microglia activation in the retina. When the same animals were aged and analyzed for the severity of optic nerve pathology at 10 months of age, we found a strong correlation with the levels of ONH microgliosis at 3 to 4 months. Our findings indicate that live imaging and monitoring the time course and levels of early retinal microgliosis and microglia activation in glaucoma could serve as indicators of future neurodegeneration severity.

  13. The Evonik-Mainz-Eye-Care-Study (EMECS: design and execution of the screening investigation.

    Directory of Open Access Journals (Sweden)

    Lorenz Barleon

    Full Text Available To determine if screening for major ophthalmological diseases is feasible within the frame of routine occupational medicine examinations in a large working population.13037 employees of Evonik Industries aged 40 to 65 years were invited to be screened for major ophthalmological diseases (glaucoma, age related macular degeneration and diabetic retinopathy between June 2007 and March 2008 within an extended setting of occupational medicine. Ophthalmological examinations consisted of visual acuity, objective refraction, pachymetry, tonometry, perimetry (frequency doubling technology, confocal scanning laser ophthalmoscopy and digital fundus photography. Participants responded to a questionnaire addressing history of ocular and general diseases and social history.4183 participants (961 female and 3222 male were examined at 13 different sites. Response rates for eligible persons at those sites ranged from 17.9 to 60.5% but were in part limited by availability of examination slots. Average age of participants was 48.4 ± 5.4 years (mean ± SD. 4147 out of 4183 subjects (99.1% had a visual acuity ≥ 0.5 in the better eye and 3665 out of 4183 (87.6% subjects had a visual acuity ≥ 0.8 in the better eye. 1629 participants (38.9% had previously not been seen by an ophthalmologist at all or not within the last three years.This article describes the study design and basic characteristics of study participants within a large occupational medicine based screening study for ophthalmological diseases. Response rates exceeded expectations and were limiting examination capacity. Meaningful data could be obtained for almost all participants. We reached participants who previously had not received ophthalmic care. Thus, ophthalmological screening appears to be feasible within the frame of routine occupational medicine examinations.

  14. 氪离子激光光凝治疗糖尿病视网膜病变疗效观察%Clinical research in the treatment of diabetic retinopathy with krypton lasers photocoagulation

    Institute of Scientific and Technical Information of China (English)

    李翠英

    2013-01-01

    目的 观察氪离子激光治疗糖尿病视网膜病变(DR)的效果.方法 荧光素眼底血管造影(FFA)确诊为Ⅲ~Ⅴ期DR96例(184只眼),术前查视力、裂隙灯、眼底和FFA,根据病变部位、性质、屈光介质情况选择不同波长激光进行全视网膜光凝(PRP),术后随访6~36个月.结果 治疗后184只眼视力提高60只眼,占32.61%;视力无变化90只眼,占48.91%;视力下降34只眼,占18.48%.结论 氪离子激光治疗可提高或保护DR患者的视功能.%Objective To observe the effects of krypton lasers on diabetic retinopathy. Methods 96 cases (184 eyes) of diabetic retinopathy in the stages of Ⅲ - Ⅴ were reviewed and identified by fundus fluorescein angiography (FFA). The visual acuity, slit-lamp, ophthalmoscopy and fundus fluorescein angiography were performed preoperatively. They were treated with krypton lasers paneretinal photocoagulation, according to the characteristics and the different manifestations of the affected eyes. The follow-up period was 6-36 months. Results Visual acuity improved in 60 eyes (32.61% ), remained with no changes in 90 eyes (48.91% ), and decreased in 34 eyes (18.48% ). Conclusion The krypton lasers is a safe and effective approach in treating diabetic retinopathy. It can improve or retain patients vision.

  15. A 28-Day Repeated Dose Toxicological Study of an Aqueous Extract of Morus Alba L.

    Science.gov (United States)

    Marx, Tennille K; Glávits, Róbert; Endres, John R; Palmer, Philip A; Clewell, Amy E; Murbach, Timothy S; Hirka, Gábor; Pasics, Ilona

    2016-11-01

    Morus alba L. (white mulberry) leaves are one of the oldest recognized traditional Chinese medicines. More recently, M alba leaves and their constituents, particularly iminosugars (or azasugars), have garnered attention for their ability to maintain normal blood glucose concentrations, an effect identified in both animal studies and human clinical trials. Reducose (Phynova Group Limited) is a commercial water-soluble extract of M alba leaves standardized to 5% 1-deoxynojirimycin (DNJ), an iminosugar with α-glucosidase inhibition properties. Although there is an extensive history of consumption of M alba leaves by humans and animals worldwide, suggesting that the leaves and their extracts have a relatively good safety profile, we are unaware of safety assessments on an extract containing a higher amount of DNJ than that occurs naturally. The current 28-day repeated dose oral toxicity study in rats, conducted according to Organisation for Economic Co-operation and Development guidelines, was carried out to assess the safety of Reducose. Male and female Hsd.Han Wistar rats (4 groups of 10 animals/sex) were administered Reducose via gavage at doses of 0, 1,000, 2,000 and 4,000 mg/kg body weight (bw)/d. No treatment-related mortality or adverse effects (per clinical observations, body weight/weight gain, food consumption, ophthalmoscopy, clinical pathology, gross pathology, organ weights, or histopathology) were observed, and no target organs were identified. The no observed adverse effect level was determined to be 4,000 mg/kg bw/d for both male and female rats, the highest dose tested. © The Author(s) 2016.

  16. The organization of flash electroretinography unit in Veterinary Medicine

    International Nuclear Information System (INIS)

    Santos HonshoI, Cristiane dos; Pontes Oriá, Arianne; Laus, José Luiz; Dorea Neto, Francisco; Veiga Monteiro Lazaro Júnior, Luiz Paulo da

    2004-01-01

    Electroretinography is the technique that allows the evaluation of changes in electrical potential that occur when the eye is stimulated by light. Such changes reflect the response of several retinal cells including photoreceptors (cones and rods). Thus it evaluates the retinal functionality and can diagnose abnormalities in retinas seem to be normal by ophthalmoscopy. Due to the constant evolution in veterinary ophthalmology, new centers of retinal electrophysiology have been introduced around the world either for early diagnosis of retinopathies or for preoperative evaluation of animals with cataracts and glaucoma, as well as for continuing research. The Ophthalmology Unit of the “Governador Laudo Natel” Veterinary Teaching Hospital, in the Faculty of Agronomic and Veterinary Sciences (FCAV) – Sao Paulo State University (UNESP) – Jaboticabal Campus, Brazil, supported by the Fundação de Amparo à Pesquisa do Estado de São Paulo – FAPESP (Sao Paulo State Foundation for Research), set up the Unit of Ocular Electrophysiology for animals in order to provide conditions for the diagnosis of retinopathies. As a pioneering venture in Brazil, the organization of the services faced many challenges till the moment it was set up: the organization and arrangement of appropriate rooms, independent electrical distribution for the installation of separate pieces of equipment, adaptation of containment tables, training and qualification of the staff, and the elaboration and standardization of anesthetic and stimulation protocols. The wealth of information generated by our experience gave us the inspiration to write this paper, which aims to contribute to the work of researchers and veterinary ophthalmologists in this new and opportune field of specialization

  17. Advanced diabetic nephropathy with “Clean” eyes: An extreme phenotype

    Directory of Open Access Journals (Sweden)

    Debmalya Sanyal

    2018-01-01

    Full Text Available Introduction: It is generally accepted that renal and eye changes in diabetes are concordant. There are however a fair number of patients with diabetes who have end-stage renal disease (ESRD without any of the typical eye changes. The present study highlights the discordance between retinopathy and nephropathy and describes a series of patients of long-standing diabetes undergoing renal transplant who had little or no evidence of retinopathy. Methods: All patients with ESRD undergoing renal transplants underwent comprehensive fundus evaluation including dilated indirect ophthalmoscopy, slit lamp biomicroscopy, and fundus photography. The patients' age, gender, physical parameters (body mass index and blood pressure, duration of diabetes, glycosylated hemoglobin (HbA1c, albumin creatinine ratio, and presence of diabetic peripheral neuropathy (DPN were determined. Renal histopathology was reviewed, if available. Results: Five patients with diabetic nephropathy (DN underwent renal transplant and had no evidence of diabetic retinopathy (DR or up to two microaneurysms per fundus. All the patients were between 50 and 65 (mean ± standard deviation – 58.6 ± 4.67 years of age. The mean duration of diabetes was 16 ± 2.91 years. All had poor glycemic control with a mean HbA1c of 9.2 ± 0.837%. All had hypertension, macroalbuminuria, and DPN. Conclusion: There is a well-recognized association between retinopathy and nephropathy, in which nephropathy without retinopathy is rare but retinopathy without nephropathy is common. We have identified a subset of patients with kidney disease of sufficient severity to warrant renal transplant but who are protected from retinopathy. It is possible that there is an extreme phenotype of DN patients with unaffected eyes who carry genes protecting against DR.

  18. Clinicopathological report of retinitis pigmentosa with vitamin E deficiency caused by mutation of the alpha-tocopherol transfer protein gene.

    Science.gov (United States)

    Pang, J; Kiyosawa, M; Seko, Y; Yokota, T; Harino, S; Suzuki, J

    2001-01-01

    To discuss the clinicopathological findings in a patient with retinitis pigmentosa (RP) accompanied by a vitamin E deficiency caused by an H101Q mutation in the alpha-tocopherol transfer protein (alpha-TTP) gene. The clinical course of this patient was followed by conventional ophthalmological examinations over a 3-year period. After the patient died from pancreatic cancer, the eyes were obtained, and examined by light and electron microscopy. The patient complained of night blindness subsequent to adult-onset ataxia, although the ataxia was very mild. His visual acuity was 0.6 OU, and ophthalmoscopy revealed RP sine pigmento. Ring scotomas were detected, and the electroretinography, electro-oculography, and dark-adaptation were altered. Fluorescein angiography showed granular hyperfluorescence around the macula. No progression of the visual and neurological symptoms was observed during the 10 years he was taking oral vitamin E. Histopathological examination revealed the loss of the outer and inner segments of the photoreceptors in the area corresponding to the ring scotoma, as well as a disorganization and shortening of the outer segments in the peripheral retina. We conclude that the clinical and pathological findings in the eyes of this patient having RP with vitamin E deficiency caused by an H101Q mutation are similar to those of common autosomal recessive RP. However, special attention is required in making a diagnosis of RP with vitamin E deficiency because RP with vitamin E deficiency is medically treatable. The mild Friedreich-type ataxia accompanying the RP may be helpful in identifying this disease.

  19. A SOLITARY FIBROUS ORBITAL TUMOR IN A PATIENT WITH NEUROFIBROMATOSIS AND AN UTERINE CARCINOMA

    Directory of Open Access Journals (Sweden)

    E. E. Grishina

    2016-01-01

    Full Text Available We present a rare combination of a solitary fibrous orbital tumor and uterine cancer in a  female patient with type I  neurofibromatosis. This 77-year old patient developed a  left painless exophthalmos within 2 years and decreased visual acuity of the left eye. At the age of 20  she was diagnosed with type I neurofibromatosis. Half a year ago she underwent hysteron-oophorectomy due to uterine adenocarcinoma. The visual acuity of her left eye was decreased to 0.3, with an increase of intraocular pressure to 30 mm Hg. She had a 13-mm left-sided exophthalmos with misplacement of the eye downwards and laterally at 40°. Reposition of the left eye was severely impaired, with limitation of the eye movements to all directions. Ophthalmoscopy showed optic disc discoloration and blunting of its inner border. The patient underwent trans-conjunctival orbitotomy, with removal of three encapsulated tumor nodules. Histological and immunochemical studies of the removed tissue identified solitary fibrous tumor of the left orbit with an undetermined malignant potential. In the post-operative period, visual acuity of the left eye was 0.2, with no exophthalmos and right position of the eye. There was a non-significant limitation of the left eye movement to the left and to the right. X-ray computed tomography confirmed radical tumor excision. Conclusion: Solitary fibrous tumor is a  rare orbital neoplasm. Nevertheless, it should be included into the differential diagnosis list of spin-cell orbital tumors. It is necessary to aim at tumor removal through the least traumatic orbital access. Relapsing course of the tumor is the rationale for a  long-term follow-up of patients after removal of solitary fibrous orbital tumor.

  20. Antivascular Endothelial Growth Factor Bevacizumab for Radiation Optic Neuropathy: Secondary to Plaque Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Finger, Paul T., E-mail: pfinger@eyecancer.com [New York Eye Cancer Center, New York, NY (United States); Chin, Kimberly J. [New York Eye Cancer Center, New York, NY (United States)

    2012-02-01

    Purpose: To evaluate the intravitreal antivascular endothelial growth factor, bevacizumab, for treatment of radiation optic neuropathy (RON). Methods and Materials: A prospective interventional clinical case series was performed of 14 patients with RON related to plaque radiotherapy for choroidal melanoma. The RON was characterized by optic disc edema, hemorrhages, microangiopathy, and neovascularization. The entry criteria included a subjective or objective loss of vision, coupled with findings of RON. The study subjects received a minimum of two initial injections of intravitreal bevacizumab (1.25 mg in 0.05 mL) every 6-8 weeks. The primary objectives included safety and tolerability. The secondary objectives included the efficacy as measured using the Early Treatment Diabetic Retinopathy Study chart for visual acuity, fundus photography, angiography, and optical coherence tomography/scanning laser ophthalmoscopy. Results: Reductions in optic disc hemorrhage and edema were noted in all patients. The visual acuity was stable or improved in 9 (64%) of the 14 patients. Of the 5 patients who had lost vision, 2 had relatively large posterior tumors, 1 had had the vision decrease because of intraocular hemorrhage, and 1 had developed optic atrophy. The fifth patient who lost vision was noncompliant. No treatment-related ocular or systemic side effects were observed. Conclusions: Intravitreal antivascular endothelial growth factor bevacizumab was tolerated and generally associated with improved vision, reduced papillary hemorrhage, and resolution of optic disc edema. Persistent optic disc neovascularization and fluorescein angiographic leakage were invariably noted. The results of the present study support additional evaluation of antivascular endothelial growth factor medications as treatment of RON.

  1. Plasma E-selectin levels can play a role in the development of diabetic retinopathy.

    Science.gov (United States)

    Kasza, Márta; Meleg, J; Vardai, J; Nagy, B; Szalai, E; Damjanovich, J; Csutak, A; Ujhelyi, B; Nagy, V

    2017-01-01

    Diabetic retinopathy is one of the leading causes of blindness. There are several risk factors, such as the duration of diabetes or glycemic control of the patient; however, several biochemical factors also alter the process. Our aim was to investigate the role of soluble E-selectin in the formation of diabetic retinopathy. Fifty-seven patients (37 female and 20 male, aged 61.71 ± 12.31 years) and 14 healthy control subjects (ten female and four male, aged 63.06 ± 10.46 years) were enrolled in the study. We measured the soluble E-selectin level in the plasma of patients by ELISA. All patients underwent careful ophthalmological examination, including ophthalmoscopy and color fundus photography, while diabetic retinopathy grading was performed in line with the 2012 classification of the American Academy of Ophthalmology (AAO). The soluble E-selectin level was significantly higher in patients with diabetes compared to controls (32.95 ng/ml vs. 26.55 ng/ml, p = 0.03). Dividing patients into groups by the presence of retinopathy, the E-selectin level was also significantly higher in the retinopathy group (p diabetic patients by the severity of retinopathy (groups A, B, and C, by the guidelines of the AAO), however, we did not find any significant difference in soluble E-selectin levels, although it tended to be higher in group B. An elevated E-selectin level can play a role in the development of diabetic retinopathy, but it does not seem to alter disease severity. However, glycemic control and the reduction of cardiovascular risk factors may also alter the level of E-selectin that might play a role in the prevention of diabetic retinopathy.

  2. Ocular abnormalities in atopic dermatitis in Indian patients

    Directory of Open Access Journals (Sweden)

    Kaujalgi Radhika

    2009-01-01

    Full Text Available Background and Aims: Atopic dermatitis (AD is a common skin disease. Long-standing, severe AD with repeated scratching and rubbing of the face, which requires continuous dermatologic care, predisposes the patient to various ocular complications. The knowledge of the frequency and significance of these ocular complications may allow their early diagnosis and treatment. The present study assesses the ocular complications in Indian children suffering from AD. Methods: In order to study the ocular complications in AD, 100 patients (61 male and 39 female between the ages of 1 and 14 years were recruited. All the patients had complete dilated fundus examination with indirect ophthalmoscopy. The lid, conjunctiva and cornea were examined. Also, any evidence of cataract formation and retinal disorders were recorded. Results: The mean age of the children was 5.4 years. Forty-three (43.0% AD patients showed ocular abnormalities in the form of lid and conjunctival changes. Of these, 18 (41.9% patients showed only lid involvement, 16 (37.2% only conjunctival involvement and both conjunctival and lid changes were seen in nine (20.9% patients. Conjunctival changes were mostly in the form of a cobblestone appearance of the papillae, with mild to moderate papillary reaction and papillary hypertrophy. Variables observed to have a significant impact on the development of ocular abnormalities were age more than 5 years, duration of illness> 12 months, positive family history of atopy, presence of palmar hyperlinearity and a combination of both xerosis and Dennie-Morgan fold. Conclusions: The present study is the first of its kind from India to document an association between AD in children and various ocular manifestations. The ocular manifestations observed in our cohort were not associated with significant ocular morbidity or visual impairment possibly because of a less-severe disease in Indians.

  3. Grade III or Grade IV Hypertensive Retinopathy with Severely Elevated Blood Pressure

    Directory of Open Access Journals (Sweden)

    Amanda D Henderson

    2012-12-01

    Full Text Available Introduction: Hypertensive retinopathy describes a spectrum of retinal changes in patients with elevated blood pressure (BP. It is unknown why some patients are more likely to develop acute ocular end-organ damage than others with similar BP. We examined risk factors for grade III/IV hypertensive retinopathy among patients with hypertensive urgency in the emergency department (ED and compared healthcare utilization and mortality between patients with and without grade III/IV hypertensive retinopathy.Methods: A preplanned subanalysis of patients who presented to a university hospital ED with diastolic BP > 120 mmHg and who enrolled in the Fundus Photography versus Ophthalmoscopy Trial Outcomes in the ED study was performed. Bilateral nonmydriatic ocular fundus photographs, vital signs, and demographics were obtained at presentation. Past medical history, laboratory values, healthcare utilization, and mortality were ascertained from medical record review at least 8 months after initial ED visit.Results: Twenty-one patients with diastolic BP > 120 mmHg, 7 of whom (33% had grade III/IV hypertensive retinopathy, were included. Patients with retinopathy were significantly younger than those without (median 33 vs 50 years, P = 0.02. Mean arterial pressure (165 vs 163 mmHg was essentially equal in the 2 groups. Patients with retinopathy had substantially increased but nonsignificant rates of ED revisit (57% vs 29%, P = 0.35 and hospital admission after ED discharge (43% vs 14%, P = 0.28. One of the patients with retinopathy died, but none without.Conclusion: Younger patients may be at higher risk for grade III/IV hypertensive retinopathy among patients with hypertensive urgency. Chronic compensatory mechanisms may have not yet developed in these younger patients. Alternatively, older patients with retinopathy may be underrepresented secondary to increased mortality among these patients at a younger age (survivorship bias. Further research is needed to

  4. Assessing Photoreceptor Structure in Retinitis Pigmentosa and Usher Syndrome.

    Science.gov (United States)

    Sun, Lynn W; Johnson, Ryan D; Langlo, Christopher S; Cooper, Robert F; Razeen, Moataz M; Russillo, Madia C; Dubra, Alfredo; Connor, Thomas B; Han, Dennis P; Pennesi, Mark E; Kay, Christine N; Weinberg, David V; Stepien, Kimberly E; Carroll, Joseph

    2016-05-01

    The purpose of this study was to examine cone photoreceptor structure in retinitis pigmentosa (RP) and Usher syndrome using confocal and nonconfocal split-detector adaptive optics scanning light ophthalmoscopy (AOSLO). Nineteen subjects (11 RP, 8 Usher syndrome) underwent ophthalmic and genetic testing, spectral-domain optical coherence tomography (SD-OCT), and AOSLO imaging. Split-detector images obtained in 11 subjects (7 RP, 4 Usher syndrome) were used to assess remnant cone structure in areas of altered cone reflectivity on confocal AOSLO. Despite normal interdigitation zone and ellipsoid zone appearance on OCT, foveal and parafoveal cone densities derived from confocal AOSLO images were significantly lower in Usher syndrome compared with RP. This was due in large part to an increased prevalence of non-waveguiding cones in the Usher syndrome retina. Although significantly correlated to best-corrected visual acuity and foveal sensitivity, cone density can decrease by nearly 38% before visual acuity becomes abnormal. Aberrantly waveguiding cones were noted within the transition zone of all eyes and corresponded to intact inner segment structures. These remnant cones decreased in density and increased in diameter across the transition zone and disappeared with external limiting membrane collapse. Foveal cone density can be decreased in RP and Usher syndrome before visible changes on OCT or a decline in visual function. Thus, AOSLO imaging may allow more sensitive monitoring of disease than current methods. However, confocal AOSLO is limited by dependence on cone waveguiding, whereas split-detector AOSLO offers unambiguous and quantifiable visualization of remnant cone inner segment structure. Confocal and split-detector thus offer complementary insights into retinal pathology.

  5. The KIDROP model of combining strategies for providing retinopathy of prematurity screening in underserved areas in India using wide-field imaging, tele-medicine, non-physician graders and smart phone reporting

    Directory of Open Access Journals (Sweden)

    Anand Vinekar

    2014-01-01

    Full Text Available Aim: To report the Karnataka Internet Assisted Diagnosis of Retinopathy of Prematurity (KIDROP program for retinopathy of prematurity (ROP screening in underserved rural areas using an indigenously developed tele-ROP model. Materials and Methods: KIDROP currently provides ROP screening and treatment services in three zones and 81 neonatal units in Karnataka, India. Technicians were trained to use a portable Retcam Shuttle (Clarity, USA and validated against ROP experts performing indirect ophthalmoscopy. An indigenously developed 20-point score (STAT score graded their ability (Level I to III to image and decide follow-up based on a three-way algorithm. Images were also uploaded on a secure tele-ROP platform and accessed and reported by remote experts on their smart phones (iPhone, Apple. Results: 6339 imaging sessions of 1601 infants were analyzed. A level III technician agreed with 94.3% of all expert decisions. The sensitivity, specificity, positive predictive value and negative predictive value for treatment grade disease were 95.7, 93.2, 81.5 and 98.6 respectively. The kappa for technicians to decide discharge of babies was 0.94 (P < 0.001. Only 0.4% of infants needing treatment were missed.The kappa agreement of experts reporting on the iPhone vs Retcam for treatment requiring and mild ROP were 0.96 and 0.94 (P < 0.001 respectively. Conclusions: This is the first and largest real-world program to employ accredited non-physicians to grade and report ROP. The KIDROP tele-ROP model demonstrates that ROP services can be delivered to the outreach despite lack of specialists and may be useful in other middle-income countries with similar demographics.

  6. Posterior vitreous detachment and retinal detachment after cataract surgery.

    Science.gov (United States)

    Ripandelli, Guido; Coppé, Andrea Maria; Parisi, Vincenzo; Olzi, Diego; Scassa, Cecilia; Chiaravalloti, Adele; Stirpe, Mario

    2007-04-01

    To evaluate possible changes of vitreous status in emmetropic eyes after uneventful phacoemulsification surgery, and possible related complications such as the onset of retinal detachment (RD). Retrospective case series. Four hundred fifty-three emmetropic eyes from 453 patients (mean age, 62.03+/-5.57 years) subjected to uneventful phacoemulsification with intraocular lens implantation in the capsular bag were considered in the study. They had a refractive error within +/-0.5 diopters (mean, -0.21+/-0.08). Eyes with peripheral retinal lattice degeneration were included only if asymptomatic and only if the degeneration involved one retinal quadrant. After cataract surgery, the 453 eyes were evaluated preoperatively at days 1, 15, and 30 and months 3, 6, 12, 18, 24, 36, 48, and 60. The whole period of follow-up was 5 years. Evaluation of vitreous status by biomicroscopic examination, indirect binocular ophthalmoscopy, and B-scan ultrasonography. Postoperative onset of posterior vitreous detachment (PVD) and RD. After cataract surgery, a PVD occurred in 107 of 141 (75.88%) eyes without preoperative PVD or lattice degeneration. Posterior vitreous detachment occurred in 41 of 47 eyes (87.23%) with preoperative lattice degeneration and no PVD. Eyes with preoperative lattice degeneration and postoperative PVD showed a higher incidence of RD after cataract surgery (21.27%) than eyes without preoperative PVD or lattice degeneration (0.70%). In all patients with lattice degeneration, RD originated from horseshoe retinal tears on lattice areas located on the superior quadrants. No correlation was observed between the development of RD and age. Our results suggest that the onset of postoperative PVD should be considered an important risk factor for the development of RD after cataract surgery, particularly in eyes with lattice areas.

  7. Characteristics and pattern of rhegmatogenous retinal detachment in pakistan.

    Science.gov (United States)

    Jamil, Muhammad Hannan; Farooq, Nesr; Khan, Muhammad Tariq; Jamil, Ahmed Zeeshan

    2012-08-01

    To determine the presenting characteristics of rhegmatogenous retinal detachment (RRD) in a consecutive series of Pakistani patients. Case series. Layton Rahmatullah Benevolent Trust (LRBT), Lahore, from June 2010 to October 2011. A total of 107 eyes underwent RRD surgery. Detailed diagrams were drawn pre-operatively for all. Other recorded details included, bio-data, age, gender, visual acuity, autorefractometery, predisposing risk factors, lens state and duration of symptoms. The data was analyzed with respect to age and gender distribution, frequency of various risk factors for RRD, duration of RRD and its various presenting characteristics. Mean age of the patients were 33.1 ± 1.5 years, 85% were males. Bilateral RRD was discovered in 2.8% patients. No identifiable risk factor for RRD was present in 28%, while in rest of the 72% eyes, the commonest risk factors were intraocular surgery, trauma and peripheral myopic degeneration in decreasing order of frequency. There were 70.1% phakic, 23.4% pseudophakic and 6.5% aphakic eyes. Majority (93.5%) presented with macula off detachment. There was an overall average time lapse of 97.24 ± 16.95 days between presenting and first occurrence of symptoms. In 31.8% of eyes no break could be found pre-operatively, while 38.3% had 1 and 29.9% eyes had ³ 2 breaks. Majority of the primary breaks were horse-shoe tears (42.1%). Total RRD was found in 35.5% eyes. Infero-temporal and supero-temporal were the most frequently involved quadrants (93.5% and 86.9% respectively). Intraocular surgery, trauma and lattice degeneration in myopia are established common risk factors for RRD. These patients deserve meticulous fundus examination with indentation indirect ophthalmoscopy by trained professionals.

  8. Retinal peripheral changes after laser in situ keratomileusis in patients with high myopia.

    Science.gov (United States)

    Suzuki, Cássia R; Farah, Michel E

    2004-02-01

    Retinal detachment has been reported after laser in situ keratomileusis (LASIK) in myopic eyes. This complication may be related to the risk from myopia before surgery or may be induced by LASIK surgery itself. We performed a study to evaluate retinal peripheral changes after LASIK in patients with high myopia and to correlate symptoms on presentation and vitreoretinal anatomic changes. The study was carried out at a university-affiliated hospital in São Paulo between November 1997 and February 1999. Patients scheduled to undergo LASIK were included if their spherical equivalent was greater than 6.00 dioptres. The exclusion criteria were previous retinal treatment and myopic macular degenerations. We performed binocular indirect ophthalmoscopy with scleral indentation and fundus biomicroscopy with Goldmann lens before LASIK and 1, 3 and 6 months after surgery. We examined 198 eyes preoperatively. Of the 198, 50 did not undergo LASIK surgery owing to refractive criteria, and 79 were lost to follow-up. We thus studied 69 eyes. The mean spherical equivalent preoperatively was -8.00 D (standard deviation 1.95 D). Twenty-four eyes had normal retinal periphery preoperatively; all 24 remained without alterations after LASIK. Forty-five eyes had peripheral alterations: 17 (24.6%) had cystic degeneration, 14 (20.3%) had lattice degeneration, 11 (15.9%) had white-without-pressure, 5 (7.2%) had cystic tufts, 3 (4.3%) had pavingstone degeneration, 2 (2.9%) had pigmentary alteration, 1 (1.4%) had holes with free operculum, and 1 (1.4%) had punctiform holes. The only alteration after surgery was almost punctiform holes around the previous cystic tuft 1 month after surgery in one patient. Retinal detachment did not develop in any of the eyes. In this group of patients it appears that LASIK did not lead to progressive peripheral retinal lesions in asymptomatic patients during the period studied.

  9. Cataract surgery in patients with ocular pseudoexpholiation.

    Science.gov (United States)

    Petrovic, Mirjana Janicijevic; Vulovic, Tatjana Sarenac; Vulovic, Dejan; Janicijevic, Katarina; Petrovic, Marko; Vujic, Dragan

    2013-01-01

    Retrospective 5-year study based on general and ophthalmic history records, and including 268 eyes (174 patients), aged 50 years and over. Ophthalmological examination involved visual acuity, measuring of intraocular pressure, slit lamp examination and indirect ophthalmoscopy. Type of surgical treatment was tailored for each patient (extra capsular cataract extraction, phaco-emulsiphication). Preoperative slit lamp examination showed phacodonesis in 17.91% (47), iridodonesis in 2.98% (8), pigment dispersion in 6.72% (18), lens subluxation in 4.85% (13) on the total. Extra capsular cataract extraction was performed in 36.94% (99) and phaco-emulsiphication in the others. Analysis of intra operative complications showed: posterior capsular rupture 17.91% (48), zonular dialysis or break 5.97% (16), lens subluxation 1.86% (5), intraocular bleeding 2.98% (8), vitreous loss 13.80% (37). Postoperative complications include: anterior chamber reaction 45.90% (123), intraocular lens tilt 15.67% (42), endothelial decompensation 21.64% (58), subluxation/luxation IOL 3.73% (10), secondary cataract 21.46% (58), pigment dispersion 37.68% (101), increased IOP 13.80% (37), residual lens matter 13.80% (37), hyphema 3.73% (10), posterior synechiae 6.72% (18), iris prolapsus 2.73% (8). Cataract surgery in PES will frequently encounter small pupils, shallow anterior chambers, posterior adhesions, weak zonular support, partial subluxation or complete dislocation of lens. Authors presented the best possible approach on PES and surgical methods for patients with cataract with special accent of possible surgical complications.

  10. Automated Photoreceptor Cell Identification on Nonconfocal Adaptive Optics Images Using Multiscale Circular Voting.

    Science.gov (United States)

    Liu, Jianfei; Jung, HaeWon; Dubra, Alfredo; Tam, Johnny

    2017-09-01

    Adaptive optics scanning light ophthalmoscopy (AOSLO) has enabled quantification of the photoreceptor mosaic in the living human eye using metrics such as cell density and average spacing. These rely on the identification of individual cells. Here, we demonstrate a novel approach for computer-aided identification of cone photoreceptors on nonconfocal split detection AOSLO images. Algorithms for identification of cone photoreceptors were developed, based on multiscale circular voting (MSCV) in combination with a priori knowledge that split detection images resemble Nomarski differential interference contrast images, in which dark and bright regions are present on the two sides of each cell. The proposed algorithm locates dark and bright region pairs, iteratively refining the identification across multiple scales. Identification accuracy was assessed in data from 10 subjects by comparing automated identifications with manual labeling, followed by computation of density and spacing metrics for comparison to histology and published data. There was good agreement between manual and automated cone identifications with overall recall, precision, and F1 score of 92.9%, 90.8%, and 91.8%, respectively. On average, computed density and spacing values using automated identification were within 10.7% and 11.2% of the expected histology values across eccentricities ranging from 0.5 to 6.2 mm. There was no statistically significant difference between MSCV-based and histology-based density measurements (P = 0.96, Kolmogorov-Smirnov 2-sample test). MSCV can accurately detect cone photoreceptors on split detection images across a range of eccentricities, enabling quick, objective estimation of photoreceptor mosaic metrics, which will be important for future clinical trials utilizing adaptive optics.

  11. Role of the Norrie disease pseudoglioma gene in sprouting angiogenesis during development of the retinal vasculature.

    Science.gov (United States)

    Luhmann, Ulrich F O; Lin, Jihong; Acar, Niyazi; Lammel, Stefanie; Feil, Silke; Grimm, Christian; Seeliger, Mathias W; Hammes, Hans-Peter; Berger, Wolfgang

    2005-09-01

    To characterize developmental defects and the time course of Norrie disease in retinal and hyaloid vasculature during retinal development and to identify underlying molecular angiogenic pathways that may be affected in Norrie disease, exudative vitreoretinopathy, retinopathy of prematurity, and Coats' disease. Norrie disease pseudoglioma homologue (Ndph)-knockout mice were studied during retinal development at early postnatal (p) stages (p5, p10, p15, and p21). Histologic techniques, quantitative RT-PCR, ELISA, and Western blot analyses provided molecular data, and scanning laser ophthalmoscopy (SLO) angiography and electroretinography (ERG) were used to obtain in vivo data. The data showed that regression of the hyaloid vasculature of Ndph-knockout mice occurred but was drastically delayed. The development of the superficial retinal vasculature was strongly delayed, whereas the deep retinal vasculature did not form because of the blockage of vessel outgrowth into the deep retinal layers. Subsequently, microaneurysm-like lesions formed. Several angiogenic factors were differentially transcribed during retinal development. Increased levels of hypoxia inducible factor-1alpha (HIF1alpha) and VEGFA, as well as a characteristic ERG pattern, confirmed hypoxic conditions in the inner retina of the Ndph-knockout mouse. These data provide evidence for a crucial role of Norrin in hyaloid vessel regression and in sprouting angiogenesis during retinal vascular development, especially in the development of the deep retinal capillary networks. They also suggest an early and a late phase of Norrie disease and may provide an explanation for similar phenotypic features of allelic retinal diseases in mice and patients as secondary consequences of pathologic hypoxia.

  12. 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.

  13. Headache and pregnancy: a systematic review.

    Science.gov (United States)

    Negro, A; Delaruelle, Z; Ivanova, T A; Khan, S; Ornello, R; Raffaelli, B; Terrin, A; Reuter, U; Mitsikostas, D D

    2017-10-19

    This systematic review summarizes the existing data on headache and pregnancy with a scope on clinical headache phenotypes, treatment of headaches in pregnancy and effects of headache medications on the child during pregnancy and breastfeeding, headache related complications, and diagnostics of headache in pregnancy. Headache during pregnancy can be both primary and secondary, and in the last case can be a symptom of a life-threatening condition. The most common secondary headaches are stroke, cerebral venous thrombosis, subarachnoid hemorrhage, pituitary tumor, choriocarcinoma, eclampsia, preeclampsia, idiopathic intracranial hypertension, and reversible cerebral vasoconstriction syndrome. Migraine is a risk factor for pregnancy complications, particularly vascular events. Data regarding other primary headache conditions are still scarce. Early diagnostics of the disease manifested by headache is important for mother and fetus life. It is especially important to identify "red flag symptoms" suggesting that headache is a symptom of a serious disease. In order to exclude a secondary headache additional studies can be necessary: electroencephalography, ultrasound of the vessels of the head and neck, brain MRI and MR angiography with contrast ophthalmoscopy and lumbar puncture. During pregnancy and breastfeeding the preferred therapeutic strategy for the treatment of primary headaches should always be a non-pharmacological one. Treatment should not be postponed as an undermanaged headache can lead to stress, sleep deprivation, depression and poor nutritional intake that in turn can have negative consequences for both mother and baby. Therefore, if non-pharmacological interventions seem inadequate, a well-considered choice should be made concerning the use of medication, taking into account all the benefits and possible risks.

  14. Case of Unilateral Peripheral Cone Dysfunction

    Directory of Open Access Journals (Sweden)

    Yujin Mochizuki

    2012-05-01

    Full Text Available Purpose: Peripheral cone dystrophy is a subgroup of cone dystrophy, and only 4 cases have been reported. We present a patient with unilateral peripheral cone dysfunction and report the functional changes determined by electrophysiological tests and ultrastructural changes determined by spectral domain optical coherence tomography (SD-OCT. Case: A 34-year-old woman complained of blurred vision in both eyes. Our examination showed that her visual acuity was 0.05 OD and 0.2 OS. A relative afferent pupillary defect was present in her right eye. The results of slit-lamp examination, ophthalmoscopy, and fluorescein angiography were normal except for pallor of the right optic disc. SD-OCT showed a diffuse thinning of the retina in the posterior pole of the right eye. A severe constriction of the visual fields was found in both eyes but more in the right eye. The photopic full-field electroretinograms (ERGs were reduced in the right eye but normal in the left eye. The multifocal ERGs were severely reduced throughout the visual field except in the central area of the right eye. The multifocal ERGs from the left eye were normal. The pattern visual evoked responses were within the normal range in both eyes. She had a 5-year history of sniffing paint thinner. Results: Although the visual dysfunction was initially suspected to be due to psychological problems from the results of subjective tests, objective tests indicated a peripheral cone dysfunction in the right eye. The pathophysiological mechanism and the relationship with thinner sniffing were not determined. Conclusions: Our findings indicate that peripheral cone dysfunction can occur unilaterally. Electrophysiology and SD-OCT are valuable tests to perform to determine the pathogenesis of unusual ocular findings objectively.

  15. The efficacy of intravitreal interferon alpha-2b for the treatment of experimental endotoxin-induced uveitis

    Directory of Open Access Journals (Sweden)

    Mehrdad Afarid

    2016-01-01

    Full Text Available Purpose: To study the efficacy of intravitreal interferon alpha-2b for endotoxin-induced uveitis. Materials and Methods: A total of 36 rabbits were randomly allocated to one of the three groups: (1 received interferon plus balanced-salt solution; (2 received lipopolysaccharide (LPS plus interferon; and (3 received LPS plus balanced-salt solution. Intraocular inflammation was evaluated by slit-lamp biomicroscopy (standardization of uveitis nomenclature grading, binocular indirect ophthalmoscopy (BIO score, and histopathology. Results: Group 2 showed significantly lower mean (±standard deviation anterior chamber reaction than Group 3 (3.1 ± 0.9 vs. 3.8 ± 0.4 on day 1 postinjection, lower vitreous cells on days 1 through 7 (day 1: 3.1 ± 0.9 vs. 3.8 ± 0.4; day 3: 2.1 ± 1.6 vs. 3.8 ± 0.4; day 7: 1.9 ± 1.3 vs. 3.6 ± 0.7, and lower BIO score on days 1-7 (day 1: 3.3 ± 1.2 vs. 4.4 ± 0.7; day 3: 3.0 ± 1.4 vs. 4.3 ± 0.9; day 7: 2.4 ± 1.4 vs. 3.7 ± 1.2. The protein content of anterior and vitreous aspirates was lower in Group 2 than 3 (1618.5 ± 411.4 vs. 2567.3 ± 330.8 and 2157.0 ± 283.3 vs. 3204.6 ± 259.5, respectively. Conclusion: Intravitreal interferon alpha-2b was effective in controlling endotoxin-induced uveitis.

  16. The efficacy of intravitreal interferon alpha-2b for the treatment of experimental endotoxin-induced uveitis.

    Science.gov (United States)

    Afarid, Mehrdad; Lashkarizadeh, Hamid; Ashraf, Mohammad J; Nowroozzadeh, Mohammad Hossein; Shafiee, Sayed M

    2016-05-01

    To study the efficacy of intravitreal interferon alpha-2b for endotoxin-induced uveitis. A total of 36 rabbits were randomly allocated to one of the three groups: (1) received interferon plus balanced-salt solution; (2) received lipopolysaccharide (LPS) plus interferon; and (3) received LPS plus balanced-salt solution. Intraocular inflammation was evaluated by slit-lamp biomicroscopy (standardization of uveitis nomenclature grading), binocular indirect ophthalmoscopy (BIO) score, and histopathology. Group 2 showed significantly lower mean (±standard deviation) anterior chamber reaction than Group 3 (3.1 ± 0.9 vs. 3.8 ± 0.4) on day 1 postinjection, lower vitreous cells on days 1 through 7 (day 1: 3.1 ± 0.9 vs. 3.8 ± 0.4; day 3: 2.1 ± 1.6 vs. 3.8 ± 0.4; day 7: 1.9 ± 1.3 vs. 3.6 ± 0.7), and lower BIO score on days 1-7 (day 1: 3.3 ± 1.2 vs. 4.4 ± 0.7; day 3: 3.0 ± 1.4 vs. 4.3 ± 0.9; day 7: 2.4 ± 1.4 vs. 3.7 ± 1.2). The protein content of anterior and vitreous aspirates was lower in Group 2 than 3 (1618.5 ± 411.4 vs. 2567.3 ± 330.8 and 2157.0 ± 283.3 vs. 3204.6 ± 259.5, respectively). Intravitreal interferon alpha-2b was effective in controlling endotoxin-induced uveitis.

  17. Clinical findings and normative ocular data for free-living Anna's (Calypte anna) and Black-chinned (Archilochus alexandri) Hummingbirds.

    Science.gov (United States)

    Moore, Bret A; Maggs, David J; Kim, Soohyun; Motta, Monica J; Bandivadekar, Ruta; Tell, Lisa A; Murphy, Christopher J

    2018-02-20

    To estimate the prevalence of ocular disease and obtain normative ocular data for free-living hummingbirds. Two hundred and sixty-three free-living, adult Hummingbirds from coastal and inland central California were studied, including Anna's (Calypte anna, n = 186) and Black-chinned (Archilochus alexandri; n = 77) hummingbirds. Slit lamp biomicroscopy and indirect ophthalmoscopy were performed on all individuals. Rebound tonometry, measurement of horizontal palpebral fissure length, and streak retinoscopy were performed on select individuals. Five conscious Anna's Hummingbirds underwent ocular imaging including fundus photography, digital slit lamp photography, and anterior segment and retinal optical coherence tomography. The prevalence of ocular disease in this population was 2.28%. Ocular imaging revealed a thin cornea, shallow anterior chamber, large lens, and a single central, deep convexiclivate fovea. Mean ± SD intraocular pressure was 11.21 ± 2.23 mm Hg. Mean ± SD eyelid length was 2.59 ± 0.19 mm. All eyes were emmetropic or mildly hyperopic with a mean (range) ± SD refractive error of +0.32 (-0.25 to +1) ± 0.33 diopters. Consistent with previous reports, these data suggest that hummingbirds have visual characteristics found in predatory and prey species, as well as a low prevalence of spontaneous ocular disease. This work provides a set of reference values and clinical findings that can be used in the future research on hummingbird vision and ocular disease. It also provides representative diagnostic images of normal birds and demonstrates that advanced ocular imaging can be performed on manually restrained hummingbirds without pharmacologic dilation. © 2018 American College of Veterinary Ophthalmologists.

  18. Prevalence of correctable visual impairment in primary school children in Qassim Province, Saudi Arabia.

    Science.gov (United States)

    Aldebasi, Yousef H

    2014-01-01

    The worldwide prevalence of refractive errors (RE), which is a common cause of treatable visual impairment among children, varies widely. We assessed the prevalence of correctable visual impairment (uncorrected RE) in primary school children in Qassim, Saudi Arabia. A cross-sectional study was conducted in 21 primary schools. A total of 5176 children (mean age 9.5±1.8 years), 2573 boys (49.7%) and 2603 girls (50.3%), underwent a comprehensive eye examination. The examinations consisted of visual acuity, autorefraction, cover test, ocular motility, pupillary evaluation, anterior segment examination, cycloplegic auto-refraction and dilated fundus examination with direct ophthalmoscopy. The children were divided into groups based on their age and gender. The overall prevalence of RE in the better eye was 18.6% (n=963), and the prevalence of uncorrected RE 16.3% (n=846), with only 2.3% (n=127) of children wearing spectacles during examination. The prevalence of uncorrected myopia (5.8%) and myopic astigmatism (5.4%) was higher compared to that of hyperopic astigmatism (2.7%), mixed astigmatism (1.7%) and hyperopia (0.7%). The anisometropia prevalence was 3.6%. Risks for astigmatism, myopia and anisometropia were positively associated with age. In addition, myopia and anisometropia risks were also associated with female gender, while risk of astigmatism was correlated with male gender. Few children with vision reducing RE wore spectacles; an additional 16.3% of children could benefit from spectacle prescription. The prevalence of uncorrected RE in children is relatively high and represents an important public health problem in school-aged children in Qassim province. Performance of routine periodical vision screening throughout childhood may reverse this situation. Copyright © 2013 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  19. In-vivo imaging of retinal nerve fiber layer vasculature: imaging – histology comparison

    Directory of Open Access Journals (Sweden)

    Libby Richard T

    2009-08-01

    Full Text Available Abstract Background Although it has been suggested that alterations of nerve fiber layer vasculature may be involved in the etiology of eye diseases, including glaucoma, it has not been possible to examine this vasculature in-vivo. This report describes a novel imaging method, fluorescence adaptive optics (FAO scanning laser ophthalmoscopy (SLO, that makes possible for the first time in-vivo imaging of this vasculature in the living macaque, comparing in-vivo and ex-vivo imaging of this vascular bed. Methods We injected sodium fluorescein intravenously in two macaque monkeys while imaging the retina with an FAO-SLO. An argon laser provided the 488 nm excitation source for fluorescence imaging. Reflectance images, obtained simultaneously with near infrared light, permitted precise surface registration of individual frames of the fluorescence imaging. In-vivo imaging was then compared to ex-vivo confocal microscopy of the same tissue. Results Superficial focus (innermost retina at all depths within the NFL revealed a vasculature with extremely long capillaries, thin walls, little variation in caliber and parallel-linked structure oriented parallel to the NFL axons, typical of the radial peripapillary capillaries (RPCs. However, at a deeper focus beneath the NFL, (toward outer retina the polygonal pattern typical of the ganglion cell layer (inner and outer retinal vasculature was seen. These distinguishing patterns were also seen on histological examination of the same retinas. Furthermore, the thickness of the RPC beds and the caliber of individual RPCs determined by imaging closely matched that measured in histological sections. Conclusion This robust method demonstrates in-vivo, high-resolution, confocal imaging of the vasculature through the full thickness of the NFL in the living macaque, in precise agreement with histology. FAO provides a new tool to examine possible primary or secondary role of the nerve fiber layer vasculature in retinal

  20. Foveal hemorrhage in an eye with foveal hypoplasia associated with albinism

    Directory of Open Access Journals (Sweden)

    Masuda N

    2014-09-01

    Full Text Available Naonori Masuda, Taiji Hasegawa, Mariko Yamashita, Nahoko Ogata Department of Ophthalmology, Nara Medical University, Nara, Japan Abstract: Oculocutaneous albinism is a group of congenital disorders caused by alterations of melanin biosynthesis. We report our findings in a patient with oculocutaneous albinism who presented with foveal hypoplasia and a foveal hemorrhage. A 48-year-old man noted a dark spot in the middle of the visual field of his right eye. He had depigmented skin, white hair, white eyebrows, and white cilia. He also had horizontal nystagmus and depigmented irides. His best-corrected visual acuity was 2/100 with -14.0 diopters in the right eye and 3/100 with -5.0 diopters in the left eye. Ophthalmoscopy showed diffuse depigmentation in both eyes and a foveal hemorrhage in the right eye. Optical coherence tomography showed the absence of a foveal pit in both eyes and a subretinal hyperreflective lesion corresponding to the foveal hemorrhage in the right eye. Fluorescein angiography showed that the retinal and choroidal vessels were relatively hypofluorescent because of the lack of a blocking effect of the pigments in the retinal pigment epithelium. Fluorescein angiography and indocyanine green angiography did not show any evidence of choroidal neovascularization in either eye. The foveal hemorrhage in the right eye spontaneously regressed and finally resolved at 3 months after onset. At the final examination, the patient reported that his vision had recovered. A foveal hemorrhage is a rare condition in an eye with foveal hypoplasia associated with albinism. The hemorrhage may be related to high myopia and also to the hypoplasia of the fovea associated with albinism. Keywords: albinism, foveal hemorrhage, foveal hypoplasia, simple hemorrhage

  1. Evaluation of the patients with Grave's ophthalmopathy after the corticosteroids treatment.

    Science.gov (United States)

    Petrović, Mirjana Janićijević; Sarenac, Tatjana; Srećković, Suncica; Petrović, Marko; Vulović, Dejan; Janićijević, Katarina

    2012-03-01

    Graves' ophthalmopthy is one of the most common causes of exophthalmos as well as the most common manifestation of Graves' disease. The treatment of Graves' ophthalmopathy includes ophthalmological and endocrinological therapy. The aim of this study was to clinically evaluate the patients with Graves' ophthalmopathy treated with corticosteroids. Evaluation of 21 patients was performed in the Ophthalmology Clinic and Endocrinology Clinic, Clinical Centre Kragujevac, in the period from 2009 to 2010. They were treated with pulse doses of intravenous corticosteroids. They were referred to ophthalmologist by endocrinologist in euthyroid condition in the active phase of Graves' ophthalmopathy (ultrasonography of orbit findings and positive findings of antithyroid stimulating hormone receptor antibody--anti-TSH R Ab). The clinical activity score (CAS) and NO SPECS classification for evaluation of disease severity were used. Ophthalmological examination includes: best corrected visual acuity, slit-lamp exam, Hertels' test, direct ophthalmoscopy and ultrasonography of the orbit. According to our results 76.19% of the patients were female; mean age of the patients was 35.2 +/- 5.6 years. According to CAS classification after 6 months of the treatment recovery was shown in 23.81% of the patients, partial amelioration in 47.62% and no clinical amelioration in 28.57% of the patients. We achieved better results with male, young patients with high clinical activity score. Good results were observed after the first dose of corticosteroids, much better CAS after the third dose, which maintained until 6 months after the first treatment. Our results signify that intravenous pulse dose of corticosteroids treatment of the patients with Graves' ophthalmopthy is safe, comfortable, clinically justified and accessible for the clinicians and patients. Positive results are achieved after the first dose with increasing trend up to the third dose, which was maintained for the next three months.

  2. Cone Structure in Patients With Usher Syndrome Type III and Mutations in the Clarin 1 Gene

    Science.gov (United States)

    Ratnam, Kavitha; Västinsalo, Hanna; Roorda, Austin; Sankila, Eeva-Marja K.; Duncan, Jacque L.

    2015-01-01

    Objective To study macular structure and function in patients with Usher syndrome type III (USH3) caused by mutations in the Clarin 1 gene (CLRN1). Methods High-resolution macular images were obtained by adaptive optics scanning laser ophthalmoscopy and spectral domain optical coherence tomography in 3 patients with USH3 and were compared with those of age-similar control subjects. Vision function measures included best-corrected visual acuity, kinetic and static perimetry, and full-field electroretinography. Coding regions of the CLRN1 gene were sequenced. Results CLRN1 mutations were present in all the patients; a 20-year-old man showed compound heterozygous mutations (p.N48K and p.S188X), and 2 unrelated women aged 25 and 32 years had homozygous mutations (p.N48K). Best-corrected visual acuity ranged from 20/16 to 20/40, with scotomas beginning at 3° eccentricity. The inner segment-outer segment junction or the inner segment ellipsoid band was disrupted within 1° to 4° of the fovea, and the foveal inner and outer segment layers were significantly thinner than normal. Cones near the fovea in patients 1 and 2 showed normal spacing, and the preserved region ended abruptly. Retinal pigment epithelial cells were visible in patient 3 where cones were lost. Conclusions Cones were observed centrally but not in regions with scotomas, and retinal pigment epithelial cells were visible in regions without cones in patients with CLRN1 mutations. High-resolution measures of retinal structure demonstrate patterns of cone loss associated with CLRN1 mutations. Clinical Relevance These findings provide insight into the effect of CLRN1 mutations on macular cone structure, which has implications for the development of treatments for USH3. Trial Registration clinicaltrials.gov Identifier: NCT00254605 PMID:22964989

  3. Achados oculares em pacientes com mielomeningocele: 72 casos Ocular findings in 72 patients with meningomyelocele

    Directory of Open Access Journals (Sweden)

    Mônica Fialho Cronemberger

    2000-10-01

    Full Text Available Objetivo: Estudar as alterações oculares em pacientes com mielomeningocele. Material e Método: Realizado estudo retrospectivo em 72 pacientes com mielomeningocele, descrevendo as alterações oculares presentes nessa população, além de correlacionar com a presença ou não de hidrocefalia. Resultados: Dos 72 pacientes com mielomeningocele, com idade variando de 5 meses a 18 anos, 64 (88,9% pacientes tinham hidrocefalia. Destes 64 pacientes, 36 (56,3% tinham estrabismo, sendo que 21 (58,3% eram endotrópicos, 13 (36,1% exotrópicos, 1 (2,8% exofórico e 1 (2,8% com estrabismo discinético. Do total dos 72 pacientes estudados 38 (52,8% eram estrábicos. A anisotropia foi encontrada em 16 (22,2% pacientes, sendo que em 14 (87,5% em A e em 2 (12,5% em V. Todos os 16 pacientes com anisotropia apresentavam hidrocefalia. O erro refrativo mais freqüente foi a hipermetropia encontrada em 64 (44,4% olhos. Atrofia óptica foi encontrada em 9 (12,5% pacientes. Conclusão: A mielomeningocele, associada a hidrocefalia, apresenta uma porcentagem de estrabismo maior do que o encontrado na população normal.Purpose: To study ocular findings in patients with meningomyelocele. Methods: A retrospective study of 72 patients with myelomeningocele was performed to evaluate ocular motility disorders, refractive errors and indirect ophthalmoscopy findings. Results: In a group of 72 patients with myelomeningocele, aged 5 month -- 18 years, 64 (88.9% had hydrocephalus. Of this group of 64 patients, 36 (56.3% had strabismus, 21 (58.3% of whom were esotropic, and 13 (36.1% exotropic, 1 (2.8% exophoric and 1 (2.8% presented sometimes esotropia and sometimes exotropia. Of the total of 72 studied patients, 38 (52.8% had strabismus. Anisotropia was found in 16 (22.2% patients, 14 (87.5% with an A pattern and 2 (12.5% with a V pattern. The most frequent refractive error was hyperopia, found in 64 (44.4% eyes. All the 16 patients with anisotropia had hydrocephalus

  4. ACUTE CEREBROVASCULAR ACCIDENTS IN PREGNANCY, LABOR AND POSTPARTUM

    Directory of Open Access Journals (Sweden)

    R. R. Arustamyan

    2016-01-01

    Full Text Available Background: Acute cerebrovascular accidents are rare and serious complication of pregnancy, labor and puerperium, leading to an increase in maternal and perinatal morbidity and mortality. More than 12% of maternal mortality is related to stroke. Aim: To assess the impact of pregnancy on the incidence of stroke, as well as the impact of cerebrovascular disorders on pregnancy, labor and puerperium. Materials and methods: We retrospectively and prospectively analyzed the course of pregnancy, labor and puerperium in 136 female patients with strokes of various etiologies. The diagnosis of stroke and cerebrovascular disorders was verified with magnetic resonance imaging, angiography, conventional and multiaxial computerized tomography, ophthalmoscopy, electroencephalography, electrocardiography and echocardiography (trans-thoracic and trans-esophageal, 24-hour blood pressure monitoring and electrocardiogram monitoring, ultrasound assessment of extra and intracranial vasculature with duplex scanning, cerebral angiography and laboratory assessments. Results: The analysis of 92 strokes that occurred during pregnancy, labor and postpartum showed that 38% of the cases (n=35 were caused by various cerebrovascular abnormalities. In 18.5% of the cases (n=17, acute cerebrovascular accidents occurred in patients with preeclampsia/eclampsia. Most often (84.8%, or 78/97 of cases strokes or other cerebrovascular accidents developed in II and III trimesters. The most severe cases were patients with intracranial hemorrhages (n=31. In this group, there were 5  deaths of mothers, 1  antenatal and 1  neonatal fetal deaths. In 90% of these cases (28/31, intracranial hemorrhage in pregnancy was related to manifestation of intracerebral vascular abnormality (arteriovenous malformations, arterial aneurysms, cavernomas. We observed a 4-fold rate of arteriovenous malformation ruptures during pregnancy (21 cases vs. 5. The rates of arterial aneurysm and cavernoma ruptures

  5. Ocular manifestations of rheumatoid arthritis and their correlation with anti-cyclic citrullinated peptide antibodies

    Directory of Open Access Journals (Sweden)

    Vignesh AP

    2015-02-01

    Full Text Available Ammapati Paul Pandian Vignesh, Renuka Srinivasan Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India Purpose: To study the ocular manifestations of rheumatoid arthritis and to correlate the role of anti-cyclic citrullinated peptide antibody (anti-CCP antibody with the ocular manifestations.Methods: Three-hundred and ninety-two eyes of the 196 rheumatoid arthritis patients who attended the ophthalmology outpatient department underwent a detailed ocular examination using slit lamp biomicroscopy and ophthalmoscopy. The tear function of all the patients was assessed using Schirmer’s test, tear film break-up time and ocular surface staining. The anti-CCP antibody titers for all the rheumatoid arthritis patients were estimated using enzyme-linked immunosorbent assay tests.Results: Seventy-seven patients (135 eyes, 39% out of the 196 patients studied had ocular manifestations typical of rheumatoid arthritis. Dry eye was the most common manifestation (28%, 54 patients. Of the patients, 78% was females (60 patients. The mean duration of rheumatoid arthritis in patients with ocular manifestations was 5.4±2.7 years and without ocular manifestations was 2.1±1.6years. Three percent of the patients had episcleritis (six patients. Scleritis was present in 2% of the patients (four patients. Peripheral ulcerative keratitis and sclerosing keratitis was present in 1% of the population each (two patients each. Eighty-five percent (66 patients had bilateral manifestations 15% (eleven patients had unilateral manifestations. There was a strong association between the presence of anti-CCP antibodies and ocular manifestations of rheumatoid arthritis which was shown by the statistically significant P-value of <0.0001.Conclusion: Ocular manifestations are a significant part of the extra-articular manifestation of rheumatoid arthritis. Dry eye was the most common ocular manifestation. There was a

  6. TECHNIQUES OF EVALUATION OF HEMOGLOBIN OXYGEN SATURATION IN CLINICAL OPHTHALMOLOGY

    Directory of Open Access Journals (Sweden)

    S. Yu. Petrov

    2016-01-01

    Full Text Available Oxygen content in body fluids and tissues is an important indicator of life support functions. A number of ocular pathologies, e.g. glaucoma, are of presumable vascular origin which means altered blood supply and oxygen circulation. Most oxygen is transported in the blood in the association with hemoglobin. When passing through the capillaries, hemoglobin releases oxygen, converting from oxygenated form to deoxygenated form. This process is accompanied by the changes in spectral characteristics of hemoglobin which result in different colors of arterial and venous blood. Photometric technique for the measurement of oxygen saturation in blood is based on the differences in light absorption by different forms of hemoglobin. The measurement of saturation is called oximetry. Pulse oximetry with assessment of tissue oxygenation is the most commonly used method in medicine. The degree of hemoglobin oxygen saturation in the eye blood vessels is the most accessible for noninvasive studies during ophthalmoscopy and informative. Numerous studies showed the importance of this parameter for the diagnosis of retinopathy of various genesis, metabolic status analysis in hyperglycemia, diagnosis and control of treatment of glaucoma and other diseases involving alterations in eye blood supply. The specific method for evaluation of oxygen concentration is the measurement of pressure of oxygen dissolved in the blood, i.e. partial pressure of oxygen. In ophthalmological practice, this parameter is measured in anterior chamber fluid evaluating oxygen level for several ophthalmopathies including different forms of glaucoma, for instillations of hypotensive eye drops as well as in vitreous body near to the optic disc under various levels of intraocular pressure. Currently, monitoring of oxygen saturation in retinal blood vessels, i.e. retinal oximetry, is well developed. This technique is based on the assessment of light absorption by blood depending on

  7. Proliferative vitreo-retinal disorders: experimental models in vivo and in vitro.

    Science.gov (United States)

    Martini, B

    1992-01-01

    The aim of the present thesis was to develop, refine, and assess experimental models for the study of proliferative vitreo-retinal disorders. An intravitreal injection of a colloidal solution of microparticles was used in the primate eye to produce pathologic changes including intraocular cell invasion, cell proliferation, neovascularization, collagen synthesis, and tractional retinal detachment. In a separate primate model for laser-induced subretinal neovascularization, the origin and the occurrence of macrophages was evaluated. Examinations were performed using ophthalmoscopy, slit-lamp microscopy, light microscopy, and transmission electron microscopy. Cell cultures were employed to study the effects of vitreous humor and macrophages on the proliferation of cultured retinal pigment epithelial (RPE) cells and cultured fibroblasts using a Coulter counter. Morphologic changes were documented by phase micrography. A quantitative estimation of the extracellular matrix deposition of fibrous proteins by macrophage-modulated RPE cells as well as by vitreous-modulated RPE cells was done using enzymatic digestion and radioactive labeling techniques. A qualitative analysis of the types of collagen that was deposited in the extracellular matrices by vitreous modulated cultures was also made using indirect immunofluorescence. Using a newly developed RPE cell specific monoclonal antibody, the avidin-biotin-peroxidase labeling technique was finally employed to test the phenotypic epitope expression of macrophage-modulated and non-modulated RPE cells. A new experimental in vivo model for pathologic changes that characterize proliferative vitreo-retinal disorders was developed in the primate eye. In the model for laser-induced subretinal neovascularization, macrophages were shown to be principally recruited from the systemic circulation. Using cell cultures, it was found that both macrophage-conditioned medium and vitreous humor, separately or combined, exert mitogenic effects

  8. Population-based assessment of prevalence and causes of visual impairment in the state of Telangana, India: a cross-sectional study using the Rapid Assessment of Visual Impairment (RAVI) methodology.

    Science.gov (United States)

    Marmamula, Srinivas; Khanna, Rohit C; Kunkunu, Eswararao; Rao, Gullapalli N

    2016-12-15

    To assess the prevalence and causes of visual impairment (VI) among a rural population aged 40 years and older in the state of Telangana in India. Population-based cross-sectional study. Districts of Adilabad and Mahbubnagar in south Indian state of Telangana, India. A sample of 6150 people was selected using cluster random sampling methodology. A team comprising a trained vision technician and a field worker visited the households and conducted the eye examination. Presenting, pinhole and aided visual acuity were assessed. Anterior segment was examined using a torchlight. Lens was examined using distant direct ophthalmoscopy in a semidark room. In all, 5881 (95.6%) participants were examined from 123 study clusters. Among those examined, 2723 (46.3%) were men, 4824 (82%) had no education, 2974 (50.6%) were from Adilabad district and 1694 (28.8%) of them were using spectacles at the time of eye examination. VI was defined as presenting visual acuity <6/18 in the better eye and it included moderate VI (<6/18 to 6/60) and blindness (<6/60). The age-adjusted and gender-adjusted prevalence of VI was 15.0% (95% CI 14.1% to 15.9%). On applying binary logistic regression analysis, VI was associated with older age groups. The odds of having VI were higher among women (OR 1.2; 95% CI 1.0 to 1.4). Having any education (OR 0.4; 95% CI 0.3 to 0.6) and current use of glasses (OR 0.19; 95% CI 0.1 to 0.2) were protective. VI was also higher in Mahbubnagar (OR 1.0 to 1.5) district. Cataract (54.7%) was the leading cause of VI followed by uncorrected refractive errors (38.6%). VI continues to remain a challenge in rural Telangana. As over 90% of the VI is avoidable, massive eye care programmes are required to address the burden of VI in Telangana. 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/.

  9. "APOPTOSIS COLOR." SCREENING STRATEGY FOR DIAGNOSIS EARLY STAGES OF PRIMARY OPEN-ANGLE GLAUCOMA

    Directory of Open Access Journals (Sweden)

    M. A. Kovalevskaya

    2017-01-01

    Full Text Available Purpose: to develop a screening strategy for the early diagnosis of primary open-angle glaucoma.Patients and Methods: 1 group — 250 patients with suspected glaucoma (42–75 years, 2 — 250 with the 1st stage primary open-angle glaucoma (42–61, 3 — 3,000 healthy persons (35 to 50. Surveys: visometry, tonometry iCare, biomicroscopy, gonioscopy, pachymeria, ophthalmoscopy with a high dioptric lens of 60 D, standard automated perimetry of the SITA-Standard and SITA-SWAP program, assessing the color sensitivity according to the Famsworth-Munsell 100 HueTes method.Results: 1 group — SITA-SWAP: MD -2,55±0,7 dB, PSD 2,46±1,15 dB. Mansell test: TES = 58.6±18.7 (p<0.05, average level of color recognition; mild deficiency of color vision — 41–100 TES; by the RGB system: colors of the first order; tone in RGB (0–239: blue — 160; HCV: blue — 240; range of wavelengths: blue — 440–485 nm; frequency: blue — 620–680 THz. 2 group — on SITA-SWAP: MD — 5,13±1,3 dB, PSD 2,58±0,9 dB. Mansell test: TES = 86,9±21,8; average level of color recognition; mild deficiency of color vision; single deviations in the system of blue (azure, blue, blue; color I order (blue, III order (blue, azure; tone in RGB — (0–239: blue (azure, blue — 140, blue — 160; HCV — blue (azure, blue — 210, blue — 240; range of wavelengths: 450–500 nm (blue — 485–500, blue — 440–485; frequencies: 600–680 THz (blue — 600–620, blue — 620–680. Control group — SITA-SWAP within the norm, Mansell test: TES = 40,1±17,3 (p<0.05, medium level of color recognition, lack of color vision absent / mild, single deviations.Conclusion: in patients with glaucoma suspicion, the score of errors was higher than in the control group with Munsell test. In patients with glaucoma, the number of errors is greater than in patients with suspected glaucoma, and 2.2 times higher than in the control group.

  10. Residency evaluation and adherence design study: Young ophthalmologists' perception of their residency programs – Clinical and surgical skills

    Directory of Open Access Journals (Sweden)

    Parikshit Gogate

    2017-01-01

    Full Text Available Background: Residency training is the basis of good clinical and surgical practice. Purpose: The aim is to know the demographics, training experience, and perception of young ophthalmologists to improve the present residency programs in India. Setting: Young ophthalmologists trained in India. Methods: A survey was conducted by the Academic and Research Committee of the All India Ophthalmology Society, in 2014–2016 of young ophthalmologists (those trained between 2002 and 2012, with 2–10 years' postresidency experience to gauge teaching of clinical and surgical skills during the postgraduate residency program. Statistical Analysis: Statistical Package for Social Sciences version 16. Results: Of the 1005 respondents, 531 fulfilled inclusion criteria. Average age was 32.6 years (standard deviation [SD] 4. On a scale of 0–10, clinical skills teaching was graded as (mean, SD: Slit lamp examination (7.2, SD 2.8, indirect ophthalmoscopy (6.2, SD 3.3, gonioscopy (5.7, SD 3.4, perimetry (6.2, SD 3.2, optical coherence tomography (4.6, SD 4, and orthoptic evaluation (4.3, SD 3.1. The mean (SD and median of surgeries performed independently was intracapsular cataract extraction 3.0 (14.9, 0; extracapsular cataract extraction 39.9 (53.2, 18; small incision cataract surgery 75.3 (64.4, 55; phacoemulsification 30 (52.6, 1; pterygium excision 31.5 (43.5, 15; dacryocystectomy 20.3 (38.1, 4; dacryocystorhinostomy 11.7 (26.2, 2; chalazion 46.4 (48.3, 30; trabeculectomies 4 (14.9, 0; strabismus correction 1.4 (4.9, 0; laser-assisted in situ Keratomileusis 1.5 (12.2, 0; retinal detachment 1.5 (12.5, 0; vitrectomy 3.0 (17.0, 0; keratoplasty 5.2 (17.8, 0; eyelid surgery 8.6 (18.9, 2 and ocular emergencies 41.7 (52.4, 20. Observed and assisted surgeries were more common. However, the range of grading was 0–10 in all categories. Conclusion: Residency training in India varies considerably from program to program. Standardization is needed to assure all graduates

  11. Interconnection between several eye biomechanical and biometric parameters in children with axial and refractive mild myopia

    Directory of Open Access Journals (Sweden)

    T. Ye. Tsybulskaya

    2016-08-01

    Full Text Available Aim – to study the relationship of biometric and biomechanical indicators of corneoscleral capsule of the eye in children with axial and refractive mild myopia. Materials and methods. Axial myopia was diagnosed in 32 children (64 eyes, refractive myopia – 18 (36 eyes. The control group – 16 children without ophthalmic diseases (32 eyes. Eye examination: visometry, automated refractometry, biomicroscopy, ophthalmoscopy, determination of the axial length of the eyeball and corneal hysteresis. Results. Significant differences were determined in the indicators of dioptric power of the cornea: 42.2 dpt in patients with axial and 44.7 dpt with refractive myopia (p<0.05, and also difference between patients with refractive myopia and the control group, in which the diopter power of cornea was 42.6 (p<0.05. There are also significant differences in the indicators of the axial length of eyes between axial and refractive myopia – 24.5±0.64 mm and 23.1±0.43 mm (p<0.05. Significant difference with the control group in the axial length marked only in eyes with axial myopia 22.7±0.33 mm and 24.5±0.64 mm, respectively (p<0.05. Corneal hysteresis determined significantly reduced on eyes with both the axial and refractive myopia, which was significantly lower than in the indicators of emmetropic eyes of the control group 13.7 (p<0.05. Corneal hysteresis is inversely related to the axial length of the eyeball: in patients with axial myopia r -0.32, p<0.05; with refractive myopia r -0.36, p<0.05. Сorrelation between diopter power of cornea and axial length of the eyeball: r -0.53, р<0.05 in eyes with axial myopia and r -0.42, p<0.05 refractive myopia. Comparative analysis showed no significant differences between the corneal hysteresis, the axial length of the eye and the spherical component of myopia. Conclusions. In patients with axial and refractive mild myopia corneal hysteresis is reduced on average in 1.2 and 1.1 times, in comparison with

  12. Features of YAG-laser treatment of posterior capsule opacification in eyes with intraocular comorbidities ext

    Directory of Open Access Journals (Sweden)

    O. I. Borzunov

    2015-01-01

    Full Text Available Purpose: is to evaluate the effectiveness of YAG laser posterior lens capsule dissection in patients with secondary cataract with concurrent intraocular pathology. Patients and methods: retro- and prospective analysis of the results of the YAG — laser treatment of secondary cataract in the 196 eyes, including the intraocular concomitant pathology (myopia, glaucoma, age-related macular degeneration, diabetic retinopathy, retinitis pigmentosa operated retinal detachment, chronic uveitis in remission, peripheral chorioretinal degeneration. Effectiveness of treatment was evaluated by checking visual acuity and dynamics of complaints as aberration, glare, distortion in the central field of view without proper disease of the macula. Complex preoperative studies included: refractometry, visometry with correction, perimetry, tonometry, biomicroscopy, ophthalmoscopy, ultrasound examination of the eyeball (if necessary. The examination results should demonstrate convincing evidence that posterior capsular opacification is the main reason for the decrease of visual acuity. Results:, Visual acuity, at average increased from 0.4‑0.6 to 0.8‑1.0 in 50 cases after dissection, Visual acuity improved to 2‑3 lines in 66‑4–5, 24‑6‑7 lines in 74 cases. Visual acuity remains the same, but contrast sensitivity was increased in 6 cases. The IOL location after disruption was evaluated by β-scanning and biomicroscopy. In case of the initial correct IOL position in all 195 (100 % cases, there were no dislocation in the postoperative period. Complications that can be identified were single microcraters on the IOL surface in cases of its full contact with the posterior capsule. These injuries did not affect the visual functions.Conclusion: YAG -Laser dissection of secondary cataract is effective, less traumatic, and the optimal treatment of secondary cataract, including patients with concomitant intraocular pathology, and helps to avoid over

  13. The Prevalence of Amblyopia and Its Determinants in a Population-based Study.

    Science.gov (United States)

    Faghihi, Mohammad; Hashemi, Hassan; Nabovati, Payam; Saatchi, Mohammad; Yekta, Abbasali; Rafati, Shokoofeh; Ostadimoghaddam, Hadi; Khabazkhoob, Mehdi

    2017-12-01

    To determine the prevalence of amblyopia and its determinants in a population-based study in Mashhad County, Iran. This cross-sectional, population-based study was conducted on the population of Mashhad County aged >1 year using randomized stratified cluster sampling. Examinations were performed after selection of the participants and their free transportation to the sampling site. The examinations included the measurement of uncorrected and corrected visual acuity, cycloplegic and non-cycloplegic refraction, cover testing, slit-lamp biomicroscopy, and ophthalmoscopy. In this study, amblyopia was defined as best corrected visual acuity (BCVA) of 20/30 or less or 2-line interocular optotype acuity differences with no pathology. After considering the exclusion criteria, the data of 2739 individuals, 65.6% of whom were women, were analyzed. The mean age of the participants was 29.5±17.5 years. The prevalence of amblyopia was 4.6% (95% CI: 3.77%-5.43%) in the total population. The lowest prevalence was 2.24% in the age group 5-15 years (95% CI: 0.99%-3.48%) and the highest prevalence was 7.14% in the age group 55-65 years (95% CI: 2.64%-11.56%). Anisometropic amblyopia was observed in 45.24% of the amblyopic participants. Isometropic, mixed (strabismic/anisometropic), and strabismic amblyopia were other common causes of amblyopia, with a prevalence of 24.6%, 16.67%, and 13.49% in amblyopic patients, respectively. The odds ratio (OR) of having amblyopia for each 1-year increase in age was 1.02 (95% CI: 1.01-1.03). Amblyopia was less common in people with better socioeconomic status. This study showed the prevalence of amblyopia in all age groups in a population-based study for the first time. The findings of this study regarding the relatively high prevalence of amblyopia in the older population and its lower prevalence in young people indicate attention to amblyopia in recent years.

  14. A nonrandomized, open-label study to evaluate the effect of nasal stimulation on tear production in subjects with dry eye disease

    Directory of Open Access Journals (Sweden)

    Friedman NJ

    2016-05-01

    Full Text Available Neil J Friedman,1 Karla Butron,2 Nora Robledo,2 James Loudin,3 Stephanie N Baba,3 Arturo Chayet2 1Department of Ophthalmology, Stanford University, Mid-Peninsula Ophthalmology Medical Group, Palo Alto, CA, USA; 2Codet Vision Institute, Tijuana, Mexico; 3Oculeve, Inc., South San Francisco, CA, USA Background: Dry eye disease (DED, a chronic disorder affecting the tear film and lacrimal functional unit, is a widely prevalent condition associated with significant burden and unmet treatment needs. Since specific neural circuits play an important role in maintaining ocular surface health, microelectrical stimulation of these pathways could present a promising new approach to treating DED. This study evaluated the efficacy and safety of nasal electrical stimulation in patients with DED. Methods: This prospective, open-label, single-arm, nonrandomized pilot study included 40 patients with mild to severe DED. After undergoing two screening visits, enrolled subjects were provided with a nasal stimulation device and instructed to use it at home four times daily (or more often as needed. Follow-up assessments were conducted up to day 180. The primary efficacy endpoint was the difference between unstimulated and stimulated tear production quantified by Schirmer scores. Additional efficacy endpoints included change from baseline in corneal and conjunctival staining, symptoms evaluated on a Visual Analog Scale, and Ocular Surface Disease Index scores. Safety parameters included adverse event (AE rates, visual acuity, intraocular pressure, slit-lamp biomicroscopy, indirect ophthalmoscopy, and endoscopic nasal examinations. Results: Mean stimulated Schirmer scores were significantly higher than the unstimulated scores at all visits, and corneal and conjunctival staining and symptom scores from baseline to day 180 were significantly reduced. No serious device-related AEs and nine nonserious AEs (three device-related were reported. Intraocular pressure remained

  15. Safety and Efficacy of an Artificial Tear Containing 0.3% Hyaluronic Acid in the Management of Moderate-to-Severe Dry Eye Disease.

    Science.gov (United States)

    López-de la Rosa, Alberto; Pinto-Fraga, José; Blázquez Arauzo, Francisco; Urbano Rodríguez, Rubén; González-García, María J

    2017-11-01

    To evaluate the safety and efficacy of a new 0.3% hyaluronic acid artificial tear compared with 0.9% saline solution (0.9% NaCl) in moderate-to-severe dry eye patients after 1 month's use. A total of 16 patients with moderate-to-severe dry eye were included in this crossover study. After a 1-week washout period, patients used the experimental (Visaid 0.3%) or control solution (0.9% NaCl), selected randomly, applying three to eight drops daily for a month. After another washout period, patients used the other solution in the same way. Percentage of change (ΔY) was calculated and analyzed for (1) safety variables: visual acuity, intraocular pressure, and ophthalmoscopy evaluation; (2) efficacy variable: Ocular Surface Disease Index (OSDI) questionnaire; and (3) secondary variables: biomicroscopy findings, fluorescein corneal staining, lissamine green conjunctival staining, tear breakup time (TBUT), contrast sensitivity, Schirmer test, and subject satisfaction. There were no significant differences in the safety parameters for either solution. After using Visaid 0.3%, patients showed significant improvements in OSDI score (ΔY: -9.66%±10.90), tarsal hyperemia (ΔY: -16.67%±27.89), corneal staining extension (ΔY: -34.90%±42.41), TBUT (ΔY: 13.98%±26.19), and subjective satisfaction (ΔY: 38.06%±47.06). When using 0.9% NaCl, Schirmer test results were significantly worse (ΔY: -11.47%±19.27). A significant difference between the 2 solutions was found in TBUT (ΔY: 13.98%±26.19 vs. 10.15%±42.34, respectively; P=0.0214). Visaid 0.3% is a safe product with some benefits over 0.9% NaCl in reducing ocular symptoms and improving some ocular signs in patients with moderate-to-severe dry eye.

  16. [Comparison of Preferential Hyperacuity Perimeter (PHP) test and Amsler grid test in the diagnosis of different stages of age-related macular degeneration].

    Science.gov (United States)

    Kampmeier, J; Zorn, M M; Lang, G K; Botros, Y T; Lang, G E

    2006-09-01

    Age-related macular degeneration (ARMD) is the leading cause of blindness in people over 65 years of age. A rapid loss of vision occurs especially in cases with choroidal neovascularisation. Early detection of ARMD and timely treatment are mandatory. We have prospectively studied the results of two diagnostic self tests for the early detection of metamorphopsia and scotoma, the PHP test and the Amsler grid test, in different stages of ARMD. Patients with ARMD and best corrected visual acuity of 6/30 or better (Snellen charts) were examined with a standardised protocol, including supervised Amsler grid examination and PHP, a new device for metamorphopsia or scotoma measurement, based on the hyperacuity phenomenon in the central 14 degrees of the visual field. The stages of ARMD were independently graded in a masked fashion by stereoscopic ophthalmoscopy, stereoscopic fundus colour photographs, fluorescein angiography, and OCT. The patients were subdivided into 3 non-neovascular groups [early, late (RPE atrophy > 175 microm) and geographic atrophy], a neovascular group (classic and occult CNV) and an age-matched control group (healthy volunteers). 140 patients, with ages ranging from 50 to 90 years (median 68 years), were included in the study. Best corrected visual acuity ranged from 6/30 to 6/6 with a median of 6/12. 95 patients were diagnosed as non-neovascular ARMD. Thirty eyes had early ARMD (9 were tested positive by the PHP test and 9 by the Amsler grid test), and 50 late ARMD (positive: PHP test 23, Amsler grid test 26). The group with geographic atrophy consisted of 15 eyes (positive: PHP test 13, Amsler grid test 10). Forty-five patients presented with neovascular ARMD (positive: PHP test 38, Amsler grid test 36), 34 volunteers served as control group (positive: PHP test 1, Amsler grid test 5). The PHP and Amsler grid tests revealed comparable results detecting metamorphopsia and scotoma in early ARMD (30 vs. 30 %) and late ARMD (46 vs. 52 %). However, the

  17. Translimbal laser photocoagulation to the trabecular meshwork as a model of glaucoma in rats.

    Science.gov (United States)

    Levkovitch-Verbin, Hana; Quigley, Harry A; Martin, Keith R G; Valenta, Danielle; Baumrind, Lisa A; Pease, Mary Ellen

    2002-02-01

    To develop and characterize a model of pressure-induced optic neuropathy in rats. Experimental glaucoma was induced unilaterally in 174 Wistar rats, using a diode laser with wavelength of 532 nm aimed at the trabecular meshwork and episcleral veins (combination treatment group) or only at the trabecular meshwork (trabecular group) through the external limbus. Intraocular pressure (IOP) was measured by a tonometer in rats under ketamine-xylazine anesthesia. Possible retinal vascular compromise was evaluated by repeated fundus examinations and by histology. The degree of retinal ganglion cell (RGC) loss was assessed by a masked, semiautomated counting of optic nerve axons. Effects of laser treatment on anterior ocular structures and retina were judged by light microscopy. After the laser treatment, IOP was increased in all eyes to higher than the normal mean IOP of 19.4 +/- 2.1 mm Hg (270 eyes). Peak IOP was 49.0 +/- 6.1 mm Hg (n = 108) in the combination group that was treated by a laser setting of 0.7 seconds and 0.4 W and 34.0 +/- 5.7 mm Hg (n = 46) in the trabecular group. Mean IOP after 6 weeks was 25.5 +/- 2.9 mm Hg in glaucomatous eyes in the combination group compared with 22.0 +/- 1.8 mm Hg in the trabecular group. IOP in the glaucomatous eyes was typically higher than in the control eyes for at least 3 weeks. In the combination group, RGC loss was 16.1% +/- 14.4% at 1 week (n = 8, P = 0.01), 59.7% +/- 25.7% at 6 weeks (n = 88, P < 0.001), and 70.9% +/- 23.6% at 9 weeks (n = 12, P < 0.001). The trabecular group had mean axonal loss of 19.1% +/- 14.0% at 3 weeks (n = 9, P = 0.004) and 24.3% +/- 20.2% at 6 weeks (n = 25, P < 0.001), increasing to 48.4% +/- 32.8% at 9 weeks (n = 12, P < 0.001). Laser treatment led to closure of intertrabecular spaces and the major outflow channel. The retina and choroid were normal by ophthalmoscopy at all times after treatment. Light microscopic examination showed only loss of RGCs and their nerve fibers. Increased IOP caused

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

    Science.gov (United States)

    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

  19. A preliminary evaluation of dexamethasone palmitate emulsion: a novel intravitreal sustained delivery of corticosteroid for treatment of macular edema.

    Science.gov (United States)

    Daull, Philippe; Paterson, Christopher A; Kuppermann, Baruch D; Garrigue, Jean-Sébastien

    2013-03-01

    Dexamethasone palmitate (DXP) is a lipophilic prodrug of dexamethasone (DXM), a potent corticosteroid used to treat a variety of ophthalmic diseases. The aim of the study was to characterize the sustained release capacity (in rabbit), efficacy (in rat and rabbit), and safety (in rabbit, cat, and minipig) of intravitreal (IVT) DXP emulsions in preclinical models. Oil-in-water emulsions of DXP were administered by IVT injections in rats, rabbits, cats, or minipigs. Efficacy was assessed in rabbits by the inhibition of VEGF-induced vascular leakage and in rats by inhibition of laser-induced choroidal neovascularization. Concentrations of DXP and DXM in aqueous humor, vitreous, retina, choroid, and blood were determined to characterize the ocular and systemic pharmacokinetic (PK) profile. Complete ophthalmic examinations (indirect ophthalmoscopy, slit-lamp biomacroscopy, electroretinography, tonometry) were performed to assess the ocular safety of IVT DXP doses up to 2,600 μg in minipig, followed by histopathologic examinations. A validated feline model of DXM-induced elevated intraocular pressure (IOP) was used to assess the ocular hypertensive impact (i.e., the safety) of an IVT injection of DXP emulsion. Rat and rabbit efficacy data demonstrated that IVT injections of DXP emulsions were effective. Rabbit PK data demonstrated that following a single 1,280 μg IVT injection resulted in sustained DXM levels in the retina and choroid (1,179.6 and 577.7 ng/g with a half-life of 189 and 103 days, respectively) sufficient to inhibit VEGF-induced vascular hyper-permeability for up to 9 months. No adverse ocular findings were observed in the rabbit at the 1,280 μg DXP dose. Plasma levels of DXP and DXM were close to the lower limit of quantification (0.5 ng/mL). In minipigs, no systemic effects were observed at a dose up to 2,600 μg DXP. In steroid responsive cats, IVT DXP emulsions increased IOP to a lesser extent than triamcinolone acetonide with a more rapid return to

  20. REPRODUCIBILITY OF MACULAR PIGMENT OPTICAL DENSITY MEASUREMENT BY TWO-WAVELENGTH AUTOFLUORESCENCE IN A CLINICAL SETTING.

    Science.gov (United States)

    You, Qi Sheng; Bartsch, Dirk-Uwe G; Espina, Mark; Alam, Mostafa; Camacho, Natalia; Mendoza, Nadia; Freeman, William R

    2016-07-01

    Macular pigment, composed of lutein, zeaxanthin, and meso-zeaxanthin, is postulated to protect against age-related macular degeneration, likely because of filtering blue light and its antioxidant properties. Macular pigment optical density (MPOD) is reported to be associated with macular function evaluated by visual acuity and multifocal electroretinogram. Given the importance of macular pigment, reliable and accurate measurement methods are important. The main purpose of this study is to determine the reproducibility of MPOD measurement by two-wavelength autofluorescence method using scanning laser ophthalmoscopy. Sixty-eight eyes of 39 persons were enrolled in the study, including 11 normal eyes, 16 eyes with wet age-related macular degeneration, 16 eyes with dry age-related macular degeneration, 11 eyes with macular edema due to diabetic mellitus, branch retinal vein occlusion or macular telangiectasia, and 14 eyes with tractional maculopathy, including vitreomacular traction, epiretinal membrane, or macular hole. MPOD was measured with a two-wavelength (488 and 514 nm) autofluorescence method with the Spectralis HRA + OCT after pupil dilation. The measurement was repeated for each eye 10 minutes later. The analysis of variance and Bland-Altman plot were used to assess the reproducibility between the two measurements. The mean MPOD at eccentricities of 1° and 2° was 0.36 ± 0.17 (range: 0.04-0.69) and 0.15 ± 0.08 (range: -0.03 to 0.35) for the first measurement and 0.35 ± 0.17 (range: 0.02-0.68) and 0.15 ± 0.08 (range: -0.01 to 0.33) for the second measurement, respectively. The difference between the 2 measurements was not statistically significant, and the Bland-Altman plot showed 7.4% and 5.9% points outside the 95% limits of agreement, indicating an overall excellent reproducibility. Similarly, there is no significant difference between the first and second measurements of MPOD volume within eccentricities of 1°, 2°, and 6° radius, and the Bland

  1. NEAR-INFRARED AUTOFLUORESCENCE IN BILATERAL DIFFUSE UVEAL MELANOCYTIC PROLIFERATION ASSOCIATED WITH ESOPHAGEAL CARCINOMA AND CHOROIDAL METASTASIS.

    Science.gov (United States)

    Golshahi, Azadeh; Bornfeld, Norbert; Weinitz, Silke; Kellner, Ulrich

    2016-01-01

    To investigate the advantage of near-infrared autofluorescence (787 nm) for the detection of melanocytic lesions in a patient with bilateral diffuse uveal melanocytic proliferation in association with esophageal carcinoma complicated by most likely unilateral choroidal metastasis. In this retrospective case report, a 55-year-old woman referred for the evaluation of sudden visual loss underwent normal ophthalmological evaluation and, in addition, was examined with near-infrared reflectance, near-infrared autofluorescence, fundus autofluorescence (Heidelberg Retina Angiograph II [HRA2; Heidelberg Engineering]), spectral domain optical coherence tomography (Spectralis OCT; Heidelberg Engineering), and multifocal electroretinography (RetiScan; Roland Consult). The patient had been diagnosed with esophageal carcinoma 3 months before the onset of visual symptoms. The visual acuity was 20/40 in the right eye and 20/20 in the left eye. Bilateral patchy melanocytic proliferation was detected on ophthalmoscopy. The extent of lesions was best detected with near-infrared reflectance and near-infrared autofluorescence, whereas fundus autofluorescence and spectral domain optical coherence tomography did not reveal alterations of the outer retina or retinal pigment epithelium in this early stage of bilateral diffuse uveal melanocytic proliferation. The right eye showed in addition to the findings on the left eye choroidal folds in the fovea and an elevated lesion inferotemporal of the fovea suspicious of a choroidal metastasis. In the B-scan ultrasonography, a homogenous lesion was seen. Spectral domain optical coherence tomography demonstrated a mild accumulation of subretinal fluid adjacent to and over the choroidal metastasis. Transretinal biopsy of this elevated lesion revealed a low differentiated carcinoma of squamous epithelium, compatible with choroidal metastasis of the esophageal carcinoma. The choroidal metastasis increased within 3 months after the first visit. The

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

    Science.gov (United States)

    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

  3. Reproducibility of Macular Pigment Optical Density Measurement by Two-wave Length Auto-fluorescence in a Clinical Setting

    Science.gov (United States)

    You, Qi-Sheng; Bartsch, Dirk-Uwe G.; Espina, Mark; Alam, Mostafa; Camacho, Natalia; Mendoza, Nadia; Freeman, William

    2015-01-01

    Purpose Macular pigment, composed of lutein, zeaxanthin, and meso-zeaxanthin, is postulated to protect against age-related macular degeneration (AMD), likely due to filtering blue light and its antioxidant properties. Macular pigment optical density (MPOD) is reported to be associated with macular function evaluated by visual acuity and multifocal electroretinogram. Given the importance of macular pigment, reliable and accurate measurement methods are important. The main purpose of current study is to determine the reproducibility of MPOD measurement by two-wave length auto-fluorescence method using scanning laser ophthalmoscopy. Methods Sixty eight eyes of 39 persons were enrolled in the study, including 11 normal eyes, 16 eyes with wet AMD, 16 eyes with dry AMD, 11 eyes with macular edema due to diabetic mellitus, branch retinal vein occlusion or macular telangiectasia and 14 eyes with tractional maculopathy including vitreomacular traction, epiretinal membrane or macular hole. MPOD was measured with a two-wavelength (488 and 514 nm) auto-fluorescence method with the Spectralis HRA+OCT after pupil dilation. The measurement was repeated for each eye 10 minutes later. The Analysis of variance (ANOVA) and Bland-Altman plot were used to assess the reproducibility between the two measurements. Results The mean MPOD at eccentricities of 1° and 2° was 0.36±0.17 (range: 0.04–0.69) and 0.15±0.08(range: −0.03, 0.35) for the first measurement and 0.35±0.17 (range: 0.02, 0.68) and 0.15±0.08 (range: −0.01, 0.33) for the second measurement respectively. The difference between the two measurements was not statistically significant, and the Bland-Altman plot showed 7.4% and 5.9% points outside the 95% limits of agreement, indicating an overall excellent reproducibility. Similarly, there is no significant difference between the first and second measurements of MPOD volume within eccentricities of 1°, 2° and 6° radius, and the Bland-Altman plot showed 8.8%, 2.9% and

  4. Towards metabolic mapping of the human retina.

    Science.gov (United States)

    Schweitzer, D; Schenke, S; Hammer, M; Schweitzer, F; Jentsch, S; Birckner, E; Becker, W; Bergmann, A

    2007-05-01

    Functional alterations are first signs of a starting pathological process. A device that measures parameter for the characterization of the metabolism at the human eye-ground would be a helpful tool for early diagnostics in stages when alterations are yet reversible. Measurements of blood flow and of oxygen saturation are necessary but not sufficient. The new technique of auto-fluorescence lifetime measurement (FLIM) opens in combination with selected excitation and emission ranges the possibility for metabolic mapping. FLIM not only adds an additional discrimination parameter to distinguish different fluorophores but also resolves different quenching states of the same fluorophore. Because of its high sensitivity and high temporal resolution, its capability to resolve multi-exponential decay functions, and its easy combination with laser scanner ophthalmoscopy, multi-dimensional time-correlated single photon counting was used for fundus imaging. An optimized set up for in vivo lifetime measurements at the human eye-ground will be explained. In this, the fundus fluorescence is excited at 446 or 468 nm and the time-resolved autofluorescence is detected in two spectral ranges between 510 and 560 nm as well as between 560 and 700 nm simultaneously. Exciting the fundus at 446 nm, several fluorescence maxima of lifetime t1 were detected between 100 and 220 ps in lifetime histograms of 40 degrees fundus images. In contrast, excitation at 468 nm results in a single maximum of lifetime t1 = 190 +/- 16 ps. Several fundus layers contribute to the fluorescence intensity in the short-wave emission range 510-560 nm. In contrast, the fluorescence intensity in the long-wave emission range between 560 and 700 nm is dominated by the fluorescence of lipofuscin in the retinal pigment epithelium. Comparing the lateral distribution of parameters of a tri-exponential model function in lifetime images of the fundus with the layered anatomical fundus structure, the shortest component (t1

  5. Investigation of new dyes for chromovitrectomy: preclinical biocompatibility of trisodium, orangell and methyl violet.

    Science.gov (United States)

    Badaro, Emmerson; Souza-Lima, Rodrigo A; Novais, Eduardo A; Maia, Mauricio; Hirai, Flávio; Meyer, Carsten H; Farah, Michel Eid; Rodrigues, Eduardo B

    2015-01-01

    To investigate the retinal toxicity by electroretinography (ERG), clinical examination and histology after intravitreal injection of biological stains in two concentrations: Trisodium (0.50 g/L and 1.00 g/L), Orangell (0.25 g/L and 1.00 g/L) and Methyl Violet (0.50 g/L and 1.00 g/L). Eighteen New-Zealand albinos rabbits were assigned in six groups (n = 3 in each group). The animals in group 1 received Trisodium in the dose of 0.50 g/L and group 2 received 1.00 g/L; Group 3 received Orangell in the dose of 0.25 g/L and group 4 received 1.00 g/L; Group 5 received Methyl Violet in the dose of 1.00 g/L and group 6 received 0.50 g/L. A volume of 0.05 mL of dye was injected in the right eyes, whereas the left eyes received the same volume of balanced salt solution (BSS) as control. ERG recordings and clinical examination were performed at baseline and seven days after intravitreal injection. The ERG responses at one week after injection were compared with baseline levels. A decrease in the post-injection amplitude of more than 50% was considered remarkable. After the 7-day follow-up, rabbits were euthanized and eye enucleated for light microscopy (LM) histological evaluation. At clinical examination by indirect ophthalmoscopy seven days after dye injection, all eyes were negative for cataract, hemorrhage, retinal detachment, and intraocular opacities. Amplitude analysis of maximum scotopic b-wave showed no significant reduction in either dye injected or control eyes. Neither dye nor BSS caused significant retinal alteration on LM at doses tested. Trisodium, Orangell and Methyl Violet can be applied in future studies in order to prove the capacity to stain preretinal tissues and vitreous without toxicity. The three dyes did not induce significant ERG amplitude reduction or LM alterations in this preliminary experimental research. Trisodium, Orangell and Methyl Violet may be potentially useful vital dyes for ocular surgery, and deserve further

  6. Factors promoting development of renal tubulointerstitial lesions in patients with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Minara Shamkhalovna Shamkhalova

    2010-09-01

    Full Text Available Aim. To identify profibrogenic mediators, markers of endothelial dysfunction and hemostasis in patients with diabetes mellitus (DM and chronickidney disease (CKD. Materials and methods. The study included 120 patients with DM and 20 age-matched normotensive subjects without DM showing the glomerularfiltration rate (GFR > 60 ml/min/1.73 m3. Four groups of patients were distinguished: 1 - DM2 patients without renal pathology (n=33, 2 - DM2 patients with diabetic nephropathy (n=24, 3 - DM2 patients with ischemic nephropathy (IN (n=33 verified by contrast visualization techniques(multispiral CM of abdominal aorta and renal arteries, abdominal angiography of renal arteries or MR angiography of renal arteries and abdominal aorta, 4 - DM1 patients with DN (n=30. Clinical examination included assessment of complaints, analysis of medical history of the main diseaseand concomitant disorders, determination of the main clinical and biochemical characteristics of blood and urine, measurement of НbА1с and 24-hralbuminuria (AU by standard methods, estimation of GFR by the MDRD formula, ECG, echocardiography, 24-hr AP monitoring, counseling bycardiologist and ophthalmologist (fundal examination by ophthalmoscopy. Standard kits were used to detect profibrogenic mediators and markersof endothelial dysfunction including transforming growth factor-beta (TGF-b, angiotensin II (AT II, monocyte chemoattractant protein (MCP-1,regulated on activation normal T cell expressed and secreted (RANTES, adhesion factors (intracellular adhesion molecule (ICAM-1, vascular celladhesion molecule (VCAM-1 vascular endothelial growth factor (VEGF, interleukin-6 (IL-6, asymmetric dimethylargnine (ADMA, homocysteine(HCYST, metalloproteinases (MMP, von Willebrand factor (vWF, plasminogen activator inhibitor (PAI-I. Results. DM patients with CKD had elevated blood profibrogenic cytokine (MCP-1, TGF-1b, IL-6 and extracellular matrix degradation factor(MMP-9 levels compared with

  7. Lesion size detection in geographic atrophy by polarization-sensitive optical coherence tomography and correlation to conventional imaging techniques.

    Science.gov (United States)

    Schütze, Christopher; Bolz, Matthias; Sayegh, Ramzi; Baumann, Bernhard; Pircher, Michael; Götzinger, Erich; Hitzenberger, Christoph K; Schmidt-Erfurth, Ursula

    2013-01-28

    To investigate the reproducibility of automated lesion size detection in patients with geographic atrophy (GA) using polarization-sensitive spectral-domain optical coherence tomography (PS-OCT) and to compare findings with scanning laser ophthalmoscopy (SLO), fundus autofluorescence (FAF), and intensity-based spectral-domain OCT (SD-OCT). Twenty-nine eyes of 22 patients with GA were examined by PS-OCT, selectively identifying the retinal pigment epithelium (RPE). A novel segmentation algorithm was applied, automatically detecting and quantifying areas of RPE atrophy. The reproducibility of the algorithm was assessed, and lesion sizes were correlated with manually delineated SLO, FAF, and intensity-based SD-OCT images to validate the clinical applicability of PS-OCT in GA evaluation. Mean GA lesion size of all patients was 5.28 mm(2) (SD: 4.92) in PS-OCT. Mean variability of individual repeatability measurements was 0.83 mm(2) (minimum: 0.05; maximum: 3.65). Mean coefficient of variation was 0.07 (min: 0.01; max: 0.19). Mean GA area in SLO (Spectralis OCT) was 5.15 mm(2) (SD: 4.72) and 2.5% smaller than in PS-OCT (P = 0.9, Pearson correlation coefficient = 0.98, P < 0.01). Mean GA area in intensity-based SD-OCT pseudo-SLO images (Cirrus OCT) was 5.14 mm(2) (SD: 4.67) and 2.7% smaller than in PS-OCT (P = 0.9, Pearson correlation coefficient = 0.98, P < 0.01). Mean GA area of all eyes measured 5.41 mm(2) (SD: 4.75) in FAF, deviating by 2.4% from PS-OCT results (P = 0.89, Pearson correlation coefficient = 0.99, P < 0.01). PS-OCT demonstrated high reproducibility of GA lesion size determination. Results correlated well with SLO, FAF, and intensity-based SD-OCT fundus imaging. PS-OCT may therefore be a valuable and specific imaging modality for automated GA lesion size determination in scientific studies and clinical practice.

  8. Chemistry and biology of the initial steps in vision: the Friedenwald lecture.

    Science.gov (United States)

    Palczewski, Krzysztof

    2014-10-22

    Visual transduction is the process in the eye whereby absorption of light in the retina is translated into electrical signals that ultimately reach the brain. The first challenge presented by visual transduction is to understand its molecular basis. We know that maintenance of vision is a continuous process requiring the activation and subsequent restoration of a vitamin A-derived chromophore through a series of chemical reactions catalyzed by enzymes in the retina and retinal pigment epithelium (RPE). Diverse biochemical approaches that identified key proteins and reactions were essential to achieve a mechanistic understanding of these visual processes. The three-dimensional arrangements of these enzymes' polypeptide chains provide invaluable insights into their mechanisms of action. A wealth of information has already been obtained by solving high-resolution crystal structures of both rhodopsin and the retinoid isomerase from pigment RPE (RPE65). Rhodopsin, which is activated by photoisomerization of its 11-cis-retinylidene chromophore, is a prototypical member of a large family of membrane-bound proteins called G protein-coupled receptors (GPCRs). RPE65 is a retinoid isomerase critical for regeneration of the chromophore. Electron microscopy (EM) and atomic force microscopy have provided insights into how certain proteins are assembled to form much larger structures such as rod photoreceptor cell outer segment membranes. A second challenge of visual transduction is to use this knowledge to devise therapeutic approaches that can prevent or reverse conditions leading to blindness. Imaging modalities like optical coherence tomography (OCT) and scanning laser ophthalmoscopy (SLO) applied to appropriate animal models as well as human retinal imaging have been employed to characterize blinding diseases, monitor their progression, and evaluate the success of therapeutic agents. Lately two-photon (2-PO) imaging, together with biochemical assays, are revealing functional

  9. Bioactivation antioxidant and transglycating properties of N-acetylcarnosine autoinduction prodrug of a dipeptide L-carnosine in mucoadhesive drug delivery eye-drop formulation: powerful eye health application technique and therapeutic platform.

    Science.gov (United States)

    Babizhayev, Mark A

    2012-06-01

    A considerable interest in N-acetylcarnosine ocular drug design for eye health is based on clinical strategies to improve ocular drug delivery through metabolic enzymatic activation. Human biology aspects of ocular N-acetylcarnosine deacetylation during its pass through the cornea to the aqueous humor and dipeptide hydrolyzing enzymes are characterized. Novel approaches to ocular drug delivery increasing intraocular bioavailability of N-acetylcarnosine biologically activated metabolite carnosine become an integral development ensuring prolonged retention of the medication in the mucoadhesive precorneal area and facilitating transcorneal penetration of the natural dipeptide with the corneal promoters. A comprehensive list of techniques for peptide drug design, synthesis, purification, and biological analyses was considered: liquid chromatography (LC), high performance liquid chromatography (HPLC), (1) H and (13) C nuclear magnetic resonance (NMR), electrospray ionization (ESI) mass spectroscopy, and spectrophotometry. The antioxidant activity of therapeutics-targeted molecules was studied in aqueous solution and in a lipid membrane environment. A deglycation therapeutic system was developed involving removal, by transglycation of sugar or aldehyde moieties from Schiff bases by histidyl-hydrazide compounds or aldehyde scavenger L-carnosine. Clinical studies included ophthalmoscopy, visual acuity (VA), halometer disability glare tests, slit-image, and retro-illumination photography. N-acetylcarnosine 1% lubricant eye drops are considered as an auto-induction prodrug and natural ocular redox state balance therapies with implications in prevention and treatment of serious eye diseases that involve pathways of continuous oxidative damage to ocular tissues(cataracts, primary open-angle glaucoma, age-related macular degeneration) and sight-threatening glycosylation processes (diabetic retinopathy and consequent visual impairment) important for public health. The results of

  10. 眼底荧光造影检查对筛检糖尿病眼底病变的临床价值%Fundus Fluorescence Angiography Revealed the Clinical Value of Screening Diabetic Retinal Pathological Changes

    Institute of Scientific and Technical Information of China (English)

    王克

    2016-01-01

    Objective To explore the application value of fundus fluorescein angiography in screening of diabetic retinopa-thy. Methods Convenient selection who were admitted to our hospital in January 2013 to January 2016 By ophthalmoscopy and fundus fluorescence angiography 78 cases (156 eyes) in patients with diabetes mellitus retinopathy screening, according to Dr staging criteria for diagnosis of diabetic retinopathy staging, and thus as the foundation to give guidance of treatment. Results The detection rate of fundus fluorescein angiography in diabetic retinopathy (82.50%) was higher than that in the fundus examination (67.31%). The difference was statistically significant (P< 0.05). DR stage I period of 47 eyes (30.1%). II phase 29 eyes(18.6%), III phase 25 eyes(16%), IV phase 17 eyes(10.9%), V phase 7 eyes(4.5%), VI phase 3 eyes (1.9%). Conclusion The detection rate of fundus fluorescein angiography in diabetic retinopathy is high, which can be used as an important reference index to guide the treatment of ocular fundus diseases.%目的:探讨眼底荧光造影检查在糖尿病眼底病变筛查中的应用价值。方法方便选取2013年1月—2016年1月以眼底镜和眼底荧光造影检查该院收治的78例(156眼)糖尿病患者进行眼底病变筛查,依DR分期标准对筛查出的糖尿病视网膜病变进行分期,并以此为基础给予患者治疗指导。结果眼底荧光造影对糖尿病眼底病变的检出率显(82.50%)著高于眼底镜下检查(67.31%)。比较差异有统计学意义(P﹤0.05)。 DR分期I期47眼(30.1%)。 II期29眼(18.6%),III期25眼(16.0%),IV期17眼(10.9%),V期7眼(4.5%),VI期3眼(1.9%)。结论以眼底荧光造影筛查糖尿病眼底病变检出率高,可作为指导眼底病变治疗的重要参考指标在临床推广使用。

  11. 多波长激光治疗DR合并视网膜中央静脉阻塞%Efficacy observation on multiple wave length laser for diabetic retinopathy and central retinal vein occlusion

    Institute of Scientific and Technical Information of China (English)

    田涛; 刘茹; 彭婧利; 谢丽莲; 邝国平

    2014-01-01

    目的:观察多波长激光治疗糖尿病视网膜病变( diabetic retinopathy,DR)合并视网膜中央静脉阻塞( central retinal vein occlusion, CRVO)的疗效。  方法:选取DR合并CRVO患者95例100眼,采用多波长激光进行光凝治疗。其中黄斑区以氪黄激光治疗为主,包括局部光凝和格栅光凝,周边光凝以氪绿或氪红激光进行治疗。手术前后均进行视力、眼底、荧光素眼底血管造影检查。术后随访12~48 wk。观察比较两组光凝前后视力及黄斑水肿变化,并做统计学分析。  结果:在黄斑格栅光凝组,有效率为61.2%,在黄斑局部光凝组,有效率为86.3%,后者总有效率高于前者,有统计学差异(P  结论:多波长激光治疗DR合并CRVO患者的黄斑水肿安全、有效。%AlM:To observe the efficacy of the multiple wave length laser in treating diabetic retinopathy combined with central retinal vein occlusion. METHODS:Totally 95 cases ( 100 eyes ) with diabetic retinopathy combined with central retinal vein occlusion were treated by multiple wave length laser. Krypton yellow laser was used for macular edema in focal photocoagulation and diffuse photocoagulation. For peripheral retina, krypton green or krypton red laser were used. Visual acuity, slit - lamp biomicroscopy, ophthalmoscopy and fundus fluorescein angiography were performed preoperatively and postoperatively. The patients were followed up for 12 to 48wk. ln this study, change in visual acuity and macular edema were observed in both groups, and statistical analysis was performed. RESULTS: The effective rate was 61. 2% in diffuse macular edema group and 86. 3% in focal macular edema group. The general effective rate of later was higher than the former, while the treatment effect had significant statistical difference (P CONCLUSlON:Multiple wave length laser is an effective and safe way to treat diabetic macular edema of diabetic retinopathy combined with central retinal vein

  12. Rapid assessment of avoidable blindness in Uruguay: results of a nationwide survey

    Directory of Open Access Journals (Sweden)

    Marcelo Gallarreta

    2014-10-01

    Full Text Available OBJECTIVE: To investigate and describe the prevalence and causes of blindness and moderate and severe visual impairment in older adults living in Uruguay. METHODS: All individuals aged ≥ 50 years old living in randomly selected clusters were eligible to participate. In each census enumeration unit selected, 50 residents aged 50 years and older were chosen to participate in the study using compact segment sampling. The study participants underwent visual acuity (VA measurement and lens examination; those with presenting VA (PVA < 20/60 also underwent direct ophthalmoscopy. Moderate visual impairment (MVI was defined as PVA < 20/60-20/200, severe visual impairment (SVI was defined as PVA < 20/200-20/400, and blindness was defined as PVA < 20/400, all based on vision in the better eye with available correction. RESULTS: Out of 3 956 eligible individuals, 3 729 (94.3% were examined. The age- and sex-adjusted prevalence of blindness was 0.9% (95% confidence interval (CI: 0.5-1.3. Cataract (48.6% and glaucoma (14.3% were the main causes of blindness. Prevalence of SVI and MVI was 0.9% (95% CI: 0.5-1.3 and 7.9% (95% CI: 6.0-9.7 respectively. Cataract was the main cause of SVI (65.7%, followed by uncorrected refractive error (14.3%, which was the main cause of MVI (55.2%. Cataract surgical coverage was 76.8% (calculated by eye and 91.3% (calculated by individual. Of all eyes operated for cataract, 70.0% could see ≥ 20/60 and 15.3% could not see 20/200 post-surgery. CONCLUSIONS: Prevalence of blindness in Uruguay is low compared to other Latin American countries, but further reduction is feasible. Due to Uruguay's high cataract surgical coverage and growing proportion of people ≥ 50 years old, the impact of posterior pole diseases as a contributing factor to blindness might increase in future.

  13. Correlation between risk factors during the neonatal period and appearance of retinopathy of prematurity in preterm infants in neonatal intensive care units in Alexandria, Egypt

    Directory of Open Access Journals (Sweden)

    Abdel Hadi AM

    2013-05-01

    Full Text Available Ahmed Mahmoud Abdel Hadi, Islam Shereen HamdyDepartment of Ophthalmology, Alexandria University Hospital, Alexandria, EgyptBackground: This study aimed to identify the main risk factors for development of retinopathy of prematurity (ROP in neonatal intensive care units in Alexandria, Egypt, from January 2010 to January 2012.Methods: A prospective cohort study was undertaken in infants weighing < 1250 g and maternal postmenstrual age < 32 weeks if there was concern about prolonged exposure to oxygen. The main clinical outcomes were occurrence of any stage of ROP and in particular severe ROP. Perinatal variables considered were: birth weight, gestational age, gender, method of ventilation (nasal continuous airway pressure or intermittent mechanical ventilation, packed red blood cell and/or plasma transfusion, occurrence of sepsis, neonatal indirect hyperbilirubinemia, intraventricular hemorrhage, and patent ductus arteriosus. After obtaining informed consent from the parents, infants at risk were examined for ROP using indirect ophthalmoscopy, ie, RetCam II fundus photography.Results: The study included 152 infants of mean gestational age 31.02 weeks and mean birth weight 1.229 kg. Seventy-two cases (47.5% were male and 80 cases (52.5% were female. Of the cases screened, 100 (65.6% had no ROP, 52 had ROP of any stage (34.4%, and 27 (18% had stage 1, five (3.3% had stage 2, 17 (11.5% had stage 3, and three (1.6% had stage 4 disease. No infants had stage 5 ROP. Of all our cases with ROP, 15 (28.6% had prethreshold disease type 1 that required treatment, comprising 9.8% of all cases screened for ROP. Using stepwise logistic regression analysis, all risk factors studied were found to be significantly associated with the development of ROP, except for neonatal indirect hyperbilirubinemia. Severity of ROP was inversely proportional to birth weight and gestational age.Conclusion: ROP occurred in 34.4% of all infants screened in the neonatal intensive

  14. Association of Bruch's membrane opening and optic disc morphology to axial length and visual field defects in eyes with primary open-angle glaucoma.

    Science.gov (United States)

    Nakanishi, Hideo; Suda, Kenji; Yoshikawa, Munemitsu; Akagi, Tadamichi; Kameda, Takanori; Ikeda, Hanako Ohashi; Yokota, Satoshi; Kurimoto, Yasuo; Tsujikawa, Akitaka

    2018-03-01

    To examine the morphology of Bruch's membrane opening (BMO), optic disc, and peripapillary atrophy (PPA) by scanning laser ophthalmoscopy (SLO) and spectral-domain optical coherence tomography (SD-OCT), and to determine their association with the axial length and visual field defects. This was a cross-sectional study of 94 eyes of 56 subjects; 77 eyes were diagnosed with primary open-angle glaucoma and 17 eyes as normal. The margins of the optic disc were determined in the SLO images, and that of the BMO in the SD-OCT images. The ovality and area of the BMO and the optic disc were measured. The beta and gamma-PPA areas were also measured. The association of each parameter with the axial length and the mean deviation (MD) of the visual field tests was determined by generalized estimating equations (GEEs). The optic disc ovality was associated with the axial length and the MD (β = -0.47, P = 7.6 × 10 -4 and β = 0.12, P = 0.040). The BMO ovality was not significantly associated with the axial length and the MD. The BMO area was associated with the axial length (β = 0.30, P = 0.029). A larger BMO area was associated with a thinner BMO-based neuroretinal rim width (BMO-MRW) after adjustments for the MD (β = -0.30, P = 2.1 × 10 -4 ). The beta- and gamma-PPA areas were associated with the axial length (β = 0.50, P = 7.4 × 10 -5 and β = 0.62, P = 4.2 × 10 -6 ). The optic disc ovality was associated with both the axial length and MD, whereas BMO ovality was not. Attention should be paid to the influence of the axial length-related enlargement of the BMO.

  15. Causes of blindness in rural Myanmar (Burma: Mount Popa Taung-Kalat Blindness Prevention Project

    Directory of Open Access Journals (Sweden)

    Arie Y Nemet

    2009-07-01

    Full Text Available Arie Y Nemet1, Pinhas Nemet2, Geoff Cohn3, Gina Sutton, Gerald Sutton4, Richard Rawson41Department of Ophthalmology, Sydney Hospital and Sydney Eye Hospital, Sydney, Australia; 2Sackler School of Medicine, Tel-Aviv University, Israel; 3Departments of Ophthalmology, University of New South Wales, Sydney, Australia; 4Department of Ophthalmology, University of Sydney, AustraliaPurpose: This study is a review of the major causes of visual impairment (VI and severe visual impairment/blindness (SVI/BL in Mount Popa Taung-Kalat, a rural region in Myanmar (Burma.Methods: A review of our clinical records of consecutive patients attending clinics was conducted. Participants of all ages (n = 650 of the population of Mount Popa Taung-Kalat and villages in its vicinity underwent ophthalmic interview and a detailed dilated ocular evaluation by trained Australian ophthalmologists and ophthalmic nurses. This evaluation included anterior segment examination with a slit lamp, intraocular pressure recording, and direct or indirect ophthalmoscopy. VI and SVI/BL were defined by the World Health Organization (WHO criteria. Results: Six hundred fifty subjects were screened, with a mean age of 49.0 ± 20.6 years (range, 1–99. One hundred five patients (16.2% were children (ages 1–18. Five hundred thirty-one eyes of the total 1,300 eyes (39.5% had VI/SVI/BL, and 40 eyes of the children (38.1% (average age 15.3 ± 13.3 had VI/SVI/BL. The leading causes of VI/SVI/BL were cataract with 288 cases (54.2%, glaucoma with 84 cases (15.8%, and corneal pathology with 78 cases (14.7%. Of all the VI/SVI/BL cases, 8.4% were preventable, 81.9% were treatable, and total of 90.5% were avoidable.Conclusions: In the current study, cataracts were the major cause of blindness and visual impairment, and most of the ophthalmic pathology causing blindness is avoidable. These results highlight the lack of basic ophthalmologist eye care and optician resources in rural regions in Myanmar

  16. Podoconiosis, trachomatous trichiasis and cataract in northern Ethiopia: A comparative cross sectional study.

    Directory of Open Access Journals (Sweden)

    Helen Burn

    2017-02-01

    Full Text Available Rural populations in low-income countries commonly suffer from the co-morbidity of neglected tropical diseases (NTDs. Podoconiosis, trachomatous trichiasis (both NTDs and cataract are common causes of morbidity among subsistence farmers in the highlands of northern Ethiopia. We explored whether podoconiosis was associated with cataract or trachomatous trichiasis (TT among this population.A comparative cross-sectional study was conducted in East Gojam region, Amhara, Ethiopia in May 2016. Data were collected from patients previously identified as having podoconiosis and from matched healthy neighbourhood controls. Information on socio-demographic factors, clinical factors and past medical history were collected by an interview-administered questionnaire. Clinical examination involved grading of podoconiosis by examination of both legs, measurement of visual acuity, direct ophthalmoscopy of dilated pupils to grade cataract, and eyelid and corneal examination to grade trachoma. Multiple logistic regression was conducted to estimate independent association and correlates of podoconiosis, TT and cataract.A total of 700 participants were included in this study; 350 podoconiosis patients and 350 healthy neighbourhood controls. The prevalence of TT was higher among podoconiosis patients than controls (65 (18.6% vs 43 (12.3% with an adjusted odds ratio OR 1.57 (95% CI 1.02-2.40, p = 0.04. There was no significant difference in prevalence of cataract between the two populations with an adjusted OR 0.83 (95% CI 0.55-1.25, p = 0.36. Mean best visual acuity was 0.59 (SD 0.06 in podoconiosis cases compared to 0.44 (SD 0.04 in controls, p<0.001. The proportion of patients classified as blind was higher in podoconiosis cases compared with healthy controls; 5.6% vs 2.0%; adjusted OR 2.63 (1.08-6.39, P = 0.03.Individuals with podoconiosis have a higher burden of TT and worse visual acuity than their matched healthy neighbourhood controls. Further research into

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

    Directory of Open Access Journals (Sweden)

    Rashmi Nagaraju

    2015-01-01

    of ophthalmoscopic diagnosis with significant difference (p - value < 0.0001. 2 I t is particularly well suited in cases of opaque conducting media when direct ophthalmoscopy is not possible. 3 HRUS is a highly sensitive modality and it can reliably differentiate various ocular detachments, vitreoretinal disorders and neoplastic lesion s with significant accuracy KEYWORDS:Eye; posterior segment; high resolution ultrasound; sonography

  18. Ultra-Widefield Steering-Based Spectral-Domain Optical Coherence Tomography Imaging of the Retinal Periphery.

    Science.gov (United States)

    Choudhry, Netan; Golding, John; Manry, Matthew W; Rao, Rajesh C

    2016-06-01

    To describe the spectral-domain optical coherence tomography (SD OCT) features of peripheral retinal findings using an ultra-widefield (UWF) steering technique to image the retinal periphery. Observational study. A total of 68 patients (68 eyes) with 19 peripheral retinal features. Spectral-domain OCT-based structural features. Nineteen peripheral retinal features, including vortex vein, congenital hypertrophy of the retinal pigment epithelium, pars plana, ora serrata pearl, typical cystoid degeneration (TCD), cystic retinal tuft, meridional fold, lattice and cobblestone degeneration, retinal hole, retinal tear, rhegmatogenous retinal detachment, typical degenerative senile retinoschisis, peripheral laser coagulation scars, ora tooth, cryopexy scars (retinal tear and treated retinoblastoma scar), bone spicules, white without pressure, and peripheral drusen, were identified by peripheral clinical examination. Near-infrared scanning laser ophthalmoscopy images and SD OCT of these entities were registered to UWF color photographs. Spectral-domain OCT resolved structural features of all peripheral findings. Dilated hyporeflective tubular structures within the choroid were observed in the vortex vein. Loss of retinal lamination, neural retinal attenuation, retinal pigment epithelium loss, or hypertrophy was seen in several entities, including congenital hypertrophy of the retinal pigment epithelium, ora serrata pearl, TCD, cystic retinal tuft, meridional fold, lattice, and cobblestone degenerations. Hyporeflective intraretinal spaces, indicating cystoid or schitic fluid, were seen in ora serrata pearl, ora tooth, TCD, cystic retinal tuft, meridional fold, retinal hole, and typical degenerative senile retinoschisis. The vitreoretinal interface, which often consisted of lamellae-like structures of the condensed cortical vitreous near or adherent to the neural retina, appeared clearly in most peripheral findings, confirming its association with many low-risk and vision

  19. [Incidence of vitreoretinal pathologic conditions in myopic eyes after laser in situ keratomileusis].

    Science.gov (United States)

    Lin, Jijian; Xie, Xin; Du, Xinhua; Yang, Yabo; Yao, Ke

    2002-09-01

    To determine the incidence of vitreoretinal pathologic conditions in myopic eyes after laser in situ keratomileusis. Vitreoretinal pathologic conditions of 1981 consecutive eyes (995 patients) having undergone laser-assisted in situ keratomileusis for the correction of myopia were studied. Preoperative and postoperative basic examinations included visual acuity, manifest and cycloplegic refraction, slit-lamp microscope examination, applanation tonometry and a fundus examination after pupil dilatation by indirect ophthalmoscopy and biomicroscopy with spherical lens of + 90 diopters. Before laser in situ keratomileusis, preventive treatment was carried out for predisposing lesion of retinal detachment in 8 eyes: 6 eyes for lattice degeneration and 2 eyes for atrophic holes. Postoperative examinations were conducted at 1, 3 and 12 months and once a year thereafter. All eyes were followed up for >/= 12 months. Eyes were followed for a mean of (18.40 +/- 4.50) months (range 12 - 28) after the surgery. Sixteen eyes of 13 patients (0.81%) developed vitreoretinopathy after LASIK, including 6 eyes with lattice degeneration (0.30%) in which one of them had previous laser treatment, 2 with posterior vitreous detachment (0.10%), 2 with macular hemorrhage (0.10%), 4 with rhegmatogenous retinal detachment (0.20%), and 2 with retinal tear without retinal detachment (0.10%) in which one of them had previous laser treatment for lattice degeneration. Five patients were males (5 eyes involved). Others were females. Mean age of the group with vitreoretinal pathologic conditions was 31.80 +/- 5.85 years (range 22 to 43). The interval between refractive surgery and development of vitreoretinal complication was (10.38 +/- 6.20) months (range 1 to 24). The eyes that developed vitreoretinopathy had myopia -4.75 to -15.00 diopters (mean -9.45 +/- 2.61 D) before LASIK. The comparison of incidences of vitreoretinopathy after LASIK between the group of >/= -6.00 D and lattice degeneration and

  20. Ultra-Widefield Steering-Based SD-OCT Imaging of the Retinal Periphery

    Science.gov (United States)

    Choudhry, Netan; Golding, John; Manry, Matthew W.; Rao, Rajesh C.

    2016-01-01

    Objective To describe the spectral-domain optical coherence tomography (SD-OCT) features of peripheral retinal findings using an ultra-widefield (UWF) steering technique to image the retinal periphery. Design Observational study. Participants 68 patients (68 eyes) with 19 peripheral retinal features. Main Outcome Measures SD-OCT-based structural features. Methods Nineteen peripheral retinal features including: vortex vein, congenital hypertrophy of the retinal pigment epithelium (CHRPE), pars plana, ora serrata pearl, typical cystoid degeneration (TCD), cystic retinal tuft, meridional fold, lattice and cobblestone degeneration, retinal hole, retinal tear, rhegmatogenous retinal detachment (RRD), typical degenerative senile retinoschisis, peripheral laser coagulation scars, ora tooth, cryopexy scars (retinal tear and treated retinoblastoma scar), bone spicules, white without pressure, and peripheral drusen were identified by peripheral clinical examination. Near infrared (NIR) scanning laser ophthalmoscopy (SLO) images and SD-OCT of these entities were registered to UWF color photographs. Results SD-OCT resolved structural features of all peripheral findings. Dilated hyporeflective tubular structures within the choroid were observed in the vortex vein. Loss of retinal lamination, neural retinal attenuation, RPE loss or hypertrophy were seen in several entities including CHRPE, ora serrata pearl, TCD, cystic retinal tuft, meridional fold, lattice and cobblestone degenerations. Hyporeflective intraretinal spaces, indicating cystoid or schitic fluid, were seen in ora serrata pearl, ora tooth, TCD, cystic retinal tuft, meridional fold, retinal hole, and typical degenerative senile retinoschisis. The vitreoretinal interface, which often consisted of lamellae-like structures of the condensed cortical vitreous near or adherent to the neural retina, appeared clearly in most peripheral findings, confirming its association with many low-risk and vision-threatening pathologies

  1. Lesiones traumáticas de los anexos y del segmento anterior del ojo en los boxeadores Traumatic lesions of the adnexa and of the anterior segment of the eye in fighters

    Directory of Open Access Journals (Sweden)

    Agustín Fernández Sánchez

    2003-06-01

    Full Text Available Se realizó un estudio retrospectivo con una muestra de 71 boxeadores a los cuales se les examinaron las estructuras de referencia mediante oftalmoscopia directa y biomicroscopia ocular, antes de las 6 horas posteriores al término de sus peleas; donde se obtuvo como resultado que los anexos afectados fueron los párpados con 5 hematomas, 4 edemas y 1 excoriación; y la conjuntiva con 4 hiperemias y 8 hemorragias. En el segmento anterior del ojo sólo se afectó la córnea con 13 lesiones en total, divididas en 10 excoriaciones superficiales y 3 profundas. Las lesiones traumáticas predominantes en los anexos del ojo son las de los párpados y las de la conjuntiva y las del segmento anterior del ojo, las de la córnea. El ojo más afectado fue el izquierdo y las lesiones más frecuentes fueron en las categorías de 13 y 14, 17 y 18 y 19 y 34 años las corneales, las conjuntivales y la de los párpados, respectivamente.A retrospective study was carried out with a sample of 71 fighters, whose reference structures were examined by direct ophthalmoscopy and ocular biomicroscopy within the 6 hours following their fights. As a result, it was observed that the affected adnexa were the eyelids with 5 hematomas, 4 edemas and 1 excoriation; and the conjunctiva with 4 hyperemias and 8 hemorrhages. In the anteriro segment, only the cornea was affected with 13 lesions in all, divided into 10 superficial and 3 deep excoriations.The traumatic lesions prevailing in the adnexa of the eye are those of the eyelids and the conjunctiva, whereas the predominating traumatic lesions of the anterior segment of the eye are those of the cornea. The left eye was the most affected and the most frequent lesions were in the categories 13 and 14, 17 and 18 and 19 and 34 years old in the cornea, the conjunctiva and the eyelids, respectively.

  2. Clinical characteristics of reticular pseudodrusen in Korean patients.

    Science.gov (United States)

    Lee, Mee Yon; Yoon, Jaemoon; Ham, Don-Il

    2012-03-01

    To clarify the clinical characteristics of reticular pseudodrusen in Korean patients. Retrospective, observational, consecutive case series. A total of 255 eyes of 130 patients diagnosed with reticular pseudodrusen were evaluated. Reticular pseudodrusen were diagnosed by characteristic fundus findings using ophthalmoscopy, color fundus photography with blue-channel examination, near-infrared photography, red-free photography, autofluorescence imaging, fluorescein angiography, indocyanine green angiography, and spectral-domain optical coherence tomography. Age-related macular degeneration (AMD) was determined by the International Classification and Grading System. The mean age was 72.6 ± 9.0 years (range, 43 to 92 years). Most reticular pseudodrusen patients had bilateral disease (97.7%), with a female preponderance (86.2%). All 3 patients who showed unilateral reticular pseudodrusen had neovascular AMD in the eye with no reticular pseudodrusen. AMD was found in 183 eyes (71.8 %), among which early AMD was found in 115 eyes (45.1%), geographic atrophy was found in 41 eyes (16.1%), and neovascular AMD was found in 27 eyes (10.6%). The mean age of patients with AMD and with no AMD was 73.7 ± 9.2 years (range, 58 to 92 years) and 69.9 ± 11.7 years (range, 43 to 90 years), respectively, and there was a statistical difference between these 2 groups (P < .05). Classic choroidal neovascularization was found in 13 eyes (48.1%), and occult choroidal neovascularization was found in 14 eyes (51.9%) in the neovascular AMD group. Reticular pseudodrusen occurs in Koreans, and clinical manifestations of reticular pseudodrusen in Koreans did not differ significantly from those described in white persons. However, our study demonstrated a higher rate of bilaterality compared with those previously reported, and geographic atrophy was found to be associated more commonly with reticular pseudodrusen than with neovascular AMD. Ethnical differences may be associated with these

  3. CORRELATION OF HBA1C WITH SIGHT-THREATENING DIABETIC RETINOPATHY (STDR IN TYPE 2 DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Ranjini Kotancher

    2017-09-01

    Full Text Available BACKGROUND Diabetic retinopathy is a major cause of blindness in the world with India being set to emerge as the diabetic capital of the world. Visual disability from diabetes is a significant health problem, but its morbidity is largely preventable and treatable. HbA1c (glycosylated haemoglobin is the best indicator of glycaemic control. It has long been known to predict the incidence and progression of diabetic retinopathy. Our aim is to evaluate the correlation of STDR in type 2 diabetes mellitus with HbA1c levels. MATERIALS AND METHODS A cross-sectional study was carried out in the Department of Ophthalmology, Government Medical College, Kozhikode, among 250 randomly selected type 2 Diabetes Mellitus patients and they were grouped into STDR, non-STDR and no diabetic retinopathy based on ophthalmoscopy. HbA1c level was estimated and its correlation was analysed using SPSS software version 17.0. Association of STDR with duration of diabetes and Body Mass Index (BMI were also studied. RESULTS Out of 250 patients studied, mean age was 58.98 with 126 males and 124 females and there was increased incidence of STDR in males. 104 patients with STDR had HbA1c value of more than 8, high incidence of STDR were noted with increasing levels of HbA1c and the correlation was statistically significant (p = 0.02. 74.1% of patients had STDR in the group with duration of diabetes 11 to 15 years, 90.90% in more than 21 years group compared to 43% in the 5 years group. Increase in duration of diabetes was found to be significantly associated with higher incidence of STDR (p = 0.01. Incidence of STDR were more in patients with normal BMI (p = 0.03. CONCLUSION Poor diabetic control as noted by high HbA1c level and longer duration of diabetes were significantly associated with sightthreatening diabetic retinopathy. Patients with STDR and high HbA1c levels have to be referred for appropriate evaluation and treatment at the earliest to prevent blindness.

  4. Idiopathic intracranial hypertension: case report

    Directory of Open Access Journals (Sweden)

    Iacob G.

    2015-12-01

    thoracic. The opening pression of lumbar puncture, done with the patient in the lateral decubitus position, was 60 cm H2O, the cytochemical CSF study were normal. The patient was operated: a lombo-peritoneal with a variable pressure valve was inserted. Two months after the patient general condition improved: he was without headache, abducens palsy and the visual field assessment, ocular motility examination, ophthalmoscopy were normal. Conclusion: IHH is rare, variable in evolution, and in many cases it disappears on its own within 6 months without affecting life expectancy. Weight loss, fluid or salt restriction, in conjunction with medical treatment, angioplasty and venous stenting across the sinus stenosis under general anesthesia and surgical treatment (shunting, optic nerve sheath decompression and fenestration, gastric by-pass surgery are treatment alternatives. Such disorder should be closed monitored because 10 to 25% of cases could be affected by recurrencies or by permanent vision loss to those patients with resistant papilledema despite treatment.

  5. Analysis of intravitreal using of anti vegf-medications for diseases of fundus accompanied by exudation and neovascularization

    Directory of Open Access Journals (Sweden)

    N. G. Zavgorodnya

    2013-08-01

    Full Text Available Nowadays, new methods of treatment of choroidal neovascularization are being actively developed and introduced in exudative form of age-related macular degeneration (AMD, complicated myopia, diabetic retinopathy and post-thrombotic retinopathy. Medications that block vascular endothelial growth factor (VEGF, which is the main link in the pathogenesis of retinal neovascularization and hyperfiltration, have become widespread. It is known that damage of endothelial cells of retinal vessels occurs in consequence of oxidative stress that leads to the death of pericytes, hyperfiltration of plasma from the vascular bed, hemorrhages and retinal hypoxia. The intracellular concentration of specific protein that regulates the transcription of genes (HIF-1 increases in response to hypoxic damage in the cells of the retina, which leads to increased transcription of the VEGF gene, which acts directly on the epithelium providing regeneration, stimulating the proliferation and neovascularization. Considering this, anti-VEGF medications have found their application in the treatment of choroidal neovascularization in clinical practice. Today, two preparations that block VEGF: selective (pegaptanib and non-selective (ranibizumab are used mostly common. The purpose of this investigation was to study the effectiveness of anti-VEGF medications in patients with choroidal neovascularization of different genesis. The analysis presents the results of 50 patients (50 eyes treatment with choroidal neovascularization on the background of various diseases of the retina. Pegaptanib ("Macugen" was used for the treatment of 35 patients (35 eyes, the rest (15 eyes - ranibizumab ("Lucentis". According to fluorescein angiography the subretinal neovascular membrane was in the stage of activity in all eyes. The effectiveness of the treatment was assessed by visometry, ophthalmoscopy, optical coherence tomography and fluorescein angiography. Application of intravitreal injection of

  6. Back pain in ophthalmology: National survey of Indian ophthalmologists

    Directory of Open Access Journals (Sweden)

    Ramesh Venkatesh

    2017-01-01

    Full Text Available Purpose: The aim is to assess the prevalence, severity, and associations of back pain among Indian ophthalmologists. Methods: A self-reporting questionnaire was sent to ophthalmologists with valid e-mail addresses registered with the All India Ophthalmological Society. The survey was open for responses for 2 months. Results: A total of 651 (5.96% responses were obtained; 394 (61% males and 257 (39% females. Half (50% of responses were obtained from doctors belonging to 31–40 years' age group. Two hundred and thirty (35% of the ophthalmologists had height ranging from 161 to 170 cm and 443 (68% had weight ranging from 51 to 75 kg. Four hundred and eighty-one (73.8% of the respondents had <15 years of ophthalmic experience. Cataract (346; 53.1% and general ophthalmology (342; 52.5% were commonly practised by the ophthalmologists. Time spent in the outpatient department (OPD was 39.37 ± 16.32 h/week and in the operating theater 13.64 ± 9.89 h/week, respectively. Self-reported prevalence of back pain was 70.5%. Fully 49% of respondents had low back pain, followed by neck pain (33% and upper extremity symptoms (16%. Age <50 years (odds ratio [OR] = 2.4485, female gender (OR = 2.0265, long working hours in OPD (OR = 1.6524, and performing retinal lasers and indirect ophthalmoscopy (OR = 3.3251 showed positive association with back pain. The intolerable back pain was noted in <7% of the respondents. Around 398 (61% respondents felt that their back pain was exacerbated while doing work and 86.6% felt that up to 5 h/week was lost due to persistent backache. Yoga and some form of exercise (74.3% was practised to alleviate back pain. Conclusion: Back pain symptoms appear to be common among ophthalmologists. Awkward posture and prolonged working hours are responsible for developing back pain among ophthalmologists. Performing yoga and regular exercises, modifications in instrumentation and creating a larger workforce of eye care practitioners are needed

  7. Absence of DJ-1 causes age-related retinal abnormalities in association with increased oxidative stress.

    Science.gov (United States)

    Bonilha, Vera L; Bell, Brent A; Rayborn, Mary E; Samuels, Ivy S; King, Anna; Hollyfield, Joe G; Xie, Chengsong; Cai, Huaibin

    2017-03-01

    Oxidative stress alters physiological function in most biological tissues and can lead to cell death. In the retina, oxidative stress initiates a cascade of events leading to focal loss of RPE and photoreceptors, which is thought to be a major contributing factor to geographic atrophy. Despite these implications, the molecular regulation of RPE oxidative stress under normal and pathological conditions remains largely unknown. A better understanding of the mechanisms involved in regulating RPE and photoreceptors oxidative stress response is greatly needed. To this end we evaluated photoreceptor and RPE changes in mice deficient in DJ-1, a protein that is thought to be important in protecting cells from oxidative stress. Young (3 months) and aged (18 months) DJ-1 knockout (DJ-1 KO) and age-matched wild-type mice were examined. In both group of aged mice, scanning laser ophthalmoscopy (SLO) showed the presence of a few autofluorescent foci. The 18 month-old DJ-1 KO retinas were also characterized by a noticeable increase in RPE fluorescence to wild-type. Optical coherence tomography (OCT) imaging demonstrated that all retinal layers were present in the eyes of both DJ-1 KO groups. ERG comparisons showed that older DJ-1 KO mice had reduced sensitivity under dark- and light-adapted conditions compared to age-matched control. Histologically, the RPE contained prominent vacuoles in young DJ-1 KO group with the appearance of enlarged irregularly shaped RPE cells in the older group. These were also evident in OCT and in whole mount RPE/choroid preparations labeled with phalloidin. Photoreceptors in the older DJ-1 KO mice displayed decreased immunoreactivity to rhodopsin and localized reduction in cone markers compared to the wild-type control group. Lower levels of activated Nrf2 were evident in retina/RPE lysates in both young and old DJ-1 KO mouse groups compared to wild-type control levels. Conversely, higher levels of protein carbonyl derivatives and i

  8. An evaluation of the public sector optometric service provided within the health districts in KwaZulu-Natal, South Africa

    Directory of Open Access Journals (Sweden)

    Moraka E. Maake

    2018-04-01

    Full Text Available Background: In South Africa, optometry has been traditionally positioned within the private sector. The situation has gradually changed over the past two decades, with optometry being introduced into the public sector in many parts of the country. Despite the growing numbers, optometrists are still new within the public health sector, motivating this study to evaluate the eye care services they provide. Methods: A cross-sectional, retrospective, descriptive study was undertaken. Stratified random selection was applied to select the study sites, and systematic sampling was used to select patients’ files. A saturated sample of public sector optometrists employed in the selected districts completed study questionnaires. Data were analysed using the Statistical Package for Social Sciences, Version 21. Results: A total of 2968 records were reviewed, and gender distribution was 67.6% female and 32.4% male. Refraction (86.73% was the most frequently conducted test, followed by ophthalmoscopy (74.73%, colour vision (0.07% and gonioscopy (0.03%. The response rate for the questionnaires was 64.7%. Optometric outreach services were conducted by 54.5% of optometrists, and the majority (83.3% reported that the farthest outreach facility was more than 50 km from their base hospital. The availability of equipment at outreach facilities was less as compared to base hospitals, while some reported not having the necessary equipment even at base hospitals. None of the optometrists did contact lens fitting at outreach facilities. A lack of equipment was cited as one of the reasons for not providing this service by 100% of optometrists. Most optometrists (63.6% believed that more than 30% of their referrals might have been avoided if they had prescribed therapeutic agents to manage ocular conditions. Conclusion: Introducing optometrists within the public sector improves access to services for rural communities. However, the minimum standard of optometric care

  9. Effects of the AMPA antagonist ZK 200775 on visual function: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Richard Bergholz

    Full Text Available BACKGROUND: ZK 200775 is an antagonist at the alpha-Amino-3-hydroxy-5-methyl-4-isoxazolepropionate (AMPA receptor and had earned attention as a possible neuroprotective agent in cerebral ischemia. Probands receiving the agent within phase I trials reported on an alteration of visual perception. In this trial, the effects of ZK 200775 on the visual system were analyzed in detail. METHODOLOGY: In a randomised controlled trial we examined eyes and vision before and after the intravenous administration of two different doses of ZK 200775 and placebo. There were 3 groups of 6 probands each: Group 1 recieved 0.03 mg/kg/h, group 2 0.75 mg/kg/h of ZK 200775, the control group received 0.9% sodium chloride solution. Probands were healthy males aged between 57 and 69 years. The following methods were applied: clinical examination, visual acuity, ophthalmoscopy, colour vision, rod absolute threshold, central visual field, pattern-reversal visual evoked potentials (pVEP, ON-OFF and full-field electroretinogram (ERG. PRINCIPAL FINDINGS: No effect of ZK 200775 was seen on eye position or motility, stereopsis, pupillary function or central visual field testing. Visual acuity and dark vision deteriorated significantly in both treated groups. Color vision was most remarkably impaired. The dark-adapted ERG revealed a reduction of oscillatory potentials (OP and partly of the a- and b-wave, furthermore an alteration of b-wave morphology and an insignificantly elevated b/a-ratio. Cone-ERG modalities showed decreased amplitudes and delayed implicit times. In the ON-OFF ERG the ON-answer amplitudes increased whereas the peak times of the OFF-answer were reduced. The pattern VEP exhibited lower amplitudes and prolonged peak times. CONCLUSIONS: The AMPA receptor blockade led to a strong impairment of typical OFF-pathway functions like color vision and the cone ERG. On the other hand the ON-pathway as measured by dark vision and the scotopic ERG was affected as well

  10. [History of the ear speculum. Images from the history of otorhinolaryngology, highlighted by instruments from the collection of the German Medical History Museum in Ingolstadt].

    Science.gov (United States)

    Feldmann, H

    1996-05-01

    Berlin in 1881. SUPPLEMENTARY INVENTIONS. An important supplementary invention was the pneumatic ear speculum by E. Siegle in Stuttgart (Germany) in 1864. It permitted not only inspecting the tympanic membrane but also examining its compliance and response to variations in air pressure in the ear canal. The importance of this instrument was recognized at once and has remained undisputed to this day. J. Bruton, an English military surgeon, presented his otoscope in 1862. It was the first device to incorporate interchangeable ear specula, illumination by a perforated mirror, and a magnifying lens into one handy instrument. It is the precursor of the modern diagnostic sets comprised of a battery-handle, various specula, and accessories for otoscopy, rhinoscopy, and ophthalmoscopy which started to come into use in the late twenties of this century. This historical development of the ear specula is described and illustrated in detail.

  11. Natural latex graft in lamellar and penetrating sclerectomies in rabbits Enxerto de látex natural na cicatrização de esclerectomias lamelar e penetrante em coelhos

    Directory of Open Access Journals (Sweden)

    Ivia Carmem Talieri

    2009-09-01

    Full Text Available The objective of study was to investigate the effects of natural latex with 0.1% of polylysine on lamellar and penetrating scleroctomies in rabbits. Two groups of twelve rabbits each (lamellar GI and penetrating GII were studied. Scleral square incisions near the limbus were performed on the left eye of each animal. The latex biomembrane was fixed to the recipient sclera and it covered with a conjunctival flap. The clinical evaluations were followed for 60 days. Aplannation tonometry, binocular indirect ophthalmoscopy and slit-lamp biomicroscopy were performed during evaluation. Bright field microscopy and polarization microscopy were employed. Blepharospasm, graft infection, mucoid ocular discharge and chemosis were not observed in either treatment group. The conjunctival hyperemia varied from moderate to hardly noticeable. The postoperative IOP was not statiscally significant, comparing to the preoperative IOP, for GI and GII. The histopathology by polarization microscopy showed that the neoformed tissue was primarily dependent on adjacent vascularized tissues and was constituted by collagen type III. Both groups presented optimum graft adhesion to the receiving sclera. The natural latex biomembrane with 0.1% polylysine constitutes a new alternative for scleral reconstruction. Furthermore, this is a durable material, easy to obtain and manipulate.Este trabalho teve como objetivo investigar os efeitos do látex natural com polilisina a 0,1% na cicatrização de esclerectomias lamelar e penetrante em coelhos. Foram estudados dois grupos de 12 coelhos (GI - lamelar e GII - penetrante. As esclerectomias foram realizadas no olho esquerdo de cada animal. A biomembrana de látex foi fixada à esclera receptora e foi recoberta com conjuntiva bulbar. As avaliações clínicas foram realizadas durante 60 dias. Para tal, empregaram-se a tonometria de aplanação, a oftalmoscopia indireta binocular e a biomicroscopia em lâmpada de fenda. Realizou-se an

  12. Frecuencia de maculopatía en pacientes con diabetes mellitus tipo 2: Reporte preliminar Frequency of maculopathy in patients with type 2 diabetes mellitus: A preliminary report

    Directory of Open Access Journals (Sweden)

    Harberth Fernández Leyva

    2002-08-01

    Full Text Available Se realizó un estudio transversal de 542 pacientes con diabetes mellitus tipo 2 (DM2 ICA- reclutados consecutivamente en el Centro de Atención al Diabético. Se les hizo historia clínica completa y examen oftalmológico: biomicroscopia y oftalmoscopia (directa e indirecta y examen con lente de 90 Dp. Se determinó glucemia en ayunas, 2 h después del desayuno y del almuerzo, hemoglobina glucosilada (HbA1 y excreción urinaria de albúmina (EUA. La maculopatía se clasificó en exudativa, edematosa e isquémica, y se relacionó con el sexo, hábito de fumar, tratamientos de la DM, edad actual, edad al comienzo de la enfermedad, presión arterial y las variables bioquímicas: glucemia en ayunas, posprandiales, HbA1 y EUA. Se excluyó la nefropatía clínica (EUA ³ 300 mg/L. Se consideró DM2 de reciente presentación cuando el diagnóstico clínico era menor de 6 meses. Padecían algún tipo de maculopatía 95 (17,5 % pacientes: 49 (9,0 %, formas exudativas; 29 (5,3 %, edematosas y 17 (3,2 %, isquémicas. No se hallaron diferencias significativas con el sexo, hábito de fumar o tratamientos utilizados, al dividirlos según la presencia o no de maculopatía. La duración de la DM fue de 12,4 ± 9,45 años para los pacientes con maculopatía, con diferencia estadísticamente significativa (p A cross-sectional study was conducted among 542 patients with ICA-type 2 diabetes mellitus consecutively recruited at the Diabetic Care Center. A complete medical history and an ophthalmological examination: biomicroscopy and ophthalmoscopy (direct and indirect and examination with lens of 90Dp were made. Fasting glycaemia, 2 hours after breakfast and lunch, glycosilated haemoglobin (HbA1 and urinary albumin excretion (UAE were determined. Maculopathy was classified as exudative, edematous and ischaemic and it was related to sex, smoking habit, treatments of DM, present age, age at the onset of the disease, arterial pressure and biochemical variables, such

  13. PATHOGENESIS OF OPTIC DISC EDEMA IN RAISED INTRACRANIAL PRESSURE

    Science.gov (United States)

    Hayreh, Sohan Singh

    2015-01-01

    Optic disc edema in raised intracranial pressure was first described in 1853. Ever since, there has been a plethora of controversial hypotheses to explain its pathogenesis. I have explored the subject comprehensively by doing basic, experimental and clinical studies. My objective was to investigate the fundamentals of the subject, to test the validity of the previous theories, and finally, based on all these studies, to find a logical explanation for the pathogenesis. My studies included the following issues pertinent to the pathogenesis of optic disc edema in raised intracranial pressure: the anatomy and blood supply of the optic nerve, the roles of the sheath of the optic nerve, of the centripetal flow of fluids along the optic nerve, of compression of the central retinal vein, and of acute intracranial hypertension and its associated effects. I found that, contrary to some previous claims, an acute rise of intracranial pressure was not quickly followed by production of optic disc edema. Then, in rhesus monkeys, I produced experimentally chronic intracranial hypertension by slowly increasing in size space-occupying lesions, in different parts of the brain. Those produced raised cerebrospinal fluid pressure (CSFP) and optic disc edema, identical to those seen in patients with elevated CSFP. Having achieved that, I investigated various aspects of optic disc edema by ophthalmoscopy, stereoscopic color fundus photography and fluorescein fundus angiography, and light microscopic, electron microscopic, horseradish peroxidase and axoplasmic transport studies, and evaluated the effect of opening the sheath of the optic nerve on the optic disc edema. This latter study showed that opening the sheath resulted in resolution of optic disc edema on the side of the sheath fenestration, in spite of high intracranial CSFP, proving that a rise of CSFP in the sheath was the essential pre-requisite for the development of optic disc edema. I also investigated optic disc edema with

  14. Estudo comparativo da flarefotometria em pacientes com melanoma maligno e nevo de coróide Comparative study of flare photometry in patients with choroidal malignant melanoma and choroidal nevus

    Directory of Open Access Journals (Sweden)

    Priscilla Luppi Ballalai

    2002-01-01

    Full Text Available Introdução: Os tumores malignos intra-oculares estão associados com um aumento do "flare" na câmara anterior, causado por uma quebra na barreira hemato-aquosa, que pode ocorrer por vários mecanismos. Estudos utilizando a flarefotometria confirmam o aumento do "flare" em olhos com tumores intra-oculares malignos e benignos. Objetivo: Avaliar a flarefotometria como auxiliar no diagnóstico diferencial de melanoma maligno e nevo de coróide, comparando-se com olhos contralaterais normais. Métodos: Foram avaliados olhos com melanoma maligno e olhos com nevo de coróide diagnosticados por meio de oftalmoscopia indireta e/ou ultra-sonografia. Os olhos normais contralaterais foram utilizados como controles. A flarefotometria foi realizada em todos os pacientes, sob midríase bilateral, utilizando equipamento Laser Flare Meter (FC 500, Kowa. Foram aplicados os testes de Wilcoxon, Mann-Whitney, e Spearman para análise estatística. Resultados: A média da flarefotometria nos olhos com melanoma maligno de coróide foi 17,1 ph/ms e nos olhos normais contralaterais foi 4,06 ph/ms. Nos olhos com nevo de coróide o valor da flarefotometria foi 6,12 ph/ms e nos olhos contralaterais normais foi 4,47 ph/ms. O valor da flarefotometria foi maior nos olhos com melanoma maligno e nevo quando comparado com os olhos contralaterais normais (pIntroduction: Malignant intraocular tumors are associated with an increase in the aqueous flare, caused by alterations of the blood-ocular barriers through various mechanisms. Several studies have demonstrated an ocular flare increase using flare photometry in eyes with benign and malignant tumors. Purpose: To evaluate flare photometry as an adjunct method in the differential diagnosis of choroidal malignant melanoma and choroidal nevus comparing to normal control eyes. Methods: Eyes with melanoma and nevus were diagnosed by indirect binocular ophthalmoscopy and/or ultrasound were evaluated. The fellow normal eyes were used

  15. CHARACTERISTICS OF LIPID METABOLISM IN PATIENTS WITH TYPE 1 DIABETES, DEPENDING ON THE AVAILABILITY OF DIABETIC MICROANGIOPATHY AND DIET

    Directory of Open Access Journals (Sweden)

    Yu. G. Samoilova

    2014-01-01

    Full Text Available Was investigated 67 children (36 boys and 31 girls in age from 6 to 18 years old, with type 1 diabetes patients who were treated at the Children's Hospital Endocrinology number 1 inTomsk, average age of the boys at the time of the survey amounted to (13.0 ± 0.4 years, girls – (13.5 ± 0.4 years. All children diagnosed with type 1 diabetes were under subcompensation. Clinical evaluation of patients included a medical history, physical examination, evaluation of physical development. A study of lipid profile (high-density lipoprotein (HDL cholesterol, low-density lipoprotein (LDL, cholesterol (TC, triglycerides (TG, atherogenic index. Screening for diabetic retinopathy was performed by examining the fundus by direct ophthalmoscopy after pupil dilation. Diagnosis of diabetic nephropathy, retinopathy performed according to the classification. Patients were divided into groups depending on the presence of complications, and the level of compensation lipid metabolism (children with satisfactory compensation of lipid metabolism (total cholesterol level less than 5.2 mmol / l, children with poor compensation lipid metabolism (total cholesterol above 5.2 mmol / l. Nature of the subjects studied nutrition using  a questionnaire drawn up on the basis of the standard dietary questionnaire program CINDI, allowing to evaluate the eating habits by examining the frequency of intake of various foods, food preferences and priorities. Products, according to the lipid-lowering diet on the recommendations of the European Society for atherosclerosis were combined and divided into groups according to frequency of use: commonly used products, and rarely use the products. Mathematical treatment of the results was performed using the software package Statistica 5.5 for Windows. In the first phase expected to total group performance statistics – the arithmetic mean value M and the error of the mean m, as well as visualization of the distribution of values

  16. PREVALENCE OF DEVASTATING OCULAR TRAUMA, IT’S EMERGENCY AND SECONDARY MANAGEMENT AND OUTCOME IN A TERTIARY CARE CENTRE

    Directory of Open Access Journals (Sweden)

    Jagadish Prasad Rou

    2017-10-01

    Full Text Available BACKGROUND Usually, young adults are the common victims of ocular trauma in their productive age. Severe ocular trauma most often leads to poor vision, at times total loss of vision, which is not only burden to their family, but also to the entire nation. Proper evaluation of severity of ocular trauma at the time of initial examination may help in planning for skillful management and help in prevention of severe visual morbidity. The aim of the study is to study the prevalence of ocular trauma and the visual outcome after one year of its emergency management and secondary management in selected cases in a tertiary care center. MATERIALS AND METHODS 89 cases of ocular trauma who presented to our tertiary care center of different age groups were studied prospectively from July 2016 to July 2017. Evaluation of all ocular trauma case was done primarily by slit-lamp examination, indirect ophthalmoscopy and 90D biomicroscopy, x-ray orbit, B-scan and CT scan orbit. All patients who required immediate admission and emergency management were included in the study and old cases of ocular trauma or underwent previous ocular surgical procedure and had ocular infections or any ocular pathology were excluded. All the subjects were managed either conservatively or surgically as and when required. Primary management like repair of lacerated lid injuries, corneal laceration and penetrating injury with or without iris prolapse, corneoscleral tear suturing, scleral tear suturing and removal of IOFB were done on emergency basis. Secondarily, patients were taken up for surgery for traumatic cataract extraction, posttraumatic glaucoma surgery, vitreoretinal surgery for vitreous haemorrhage, retinal haemorrhage and retinal detachment. RESULTS Out of 89 cases, 69 were males and 20 were females. Agricultural injury was the leading cause of ocular trauma in which injury from vegetative matter were the most common causative aetiology followed by objects like knife and

  17. Complicações oculares da terapêutica com a cloroquina e derivados Ocular complications of chloroquine and derivatives therapy

    Directory of Open Access Journals (Sweden)

    Augusto Cézar Lacava

    2010-08-01

    gastrointestinal, nervous and skeletal muscular systems and the skin. Ocular adverse reactions are: photophobia, cornea verticillata, poliosis, cataract, extraocular muscle palsy, anterior uveitis, toxic maculopathy and optical neuritis. PURPOSE: Bibliography review of complications due to the use of chloroquine and its derivatives. To analyze the current practice and propedeutics' evolution. To suggest practical managements for early toxicity signs. METHODS: Bibliographic review through research on MEDLINE, PUBMED, LILACS and SciELO database. DISCUSSION: All exams that can be used to screen ocular adverse reactions are described, such as: complete ophthalmologic exam, with emphasis on biomicroscopy and indirect binocular ophthalmoscopy, computerized visual field, Amsler grid testing and color vision testing, electrophysiological exams, polarimetry and optical coherence tomography. A description of maculopathy is presented, focusing on epidemiology, risk factors, histopathology and propedeutics. Chemical structure and the differences between 4-aminoquinolone derivatives are described. CONCLUSION: All patients using chloroquine and its derivatives must be followed-up and documented since the beginning of the therapy until they reach a cumulative dose above 100 grams. The higher the cumulative dose, the more we must be concerned with patient follow-up.

  18. Importância da avaliação oftalmológica em recém-natos Importance of the ophthalmological evaluation in newborns

    Directory of Open Access Journals (Sweden)

    Daniel Wasilewski

    2002-01-01

    deviation and direct ophthalmoscopy (red reflex in all patients. Results: Among all examined newborns, 3.75% showed some ocular disease. The most frequent problem was corneal opacity. The ocular diseases were not noticed by pediatricians, neonatologists and parents in fifty-six per cent of the cases presenting some problem. Conclusions: This study showed that many ocular disorders presented at birth are not noticed by pediatricians (56%, which highlights the importance of ophthalmological evaluation in all newborns as a routine examination in the first 48 hours of life.

  19. A and B mode ultrasonography in preoperative evaluation of lens and posterior segment of dogs eyes with cataract

    Directory of Open Access Journals (Sweden)

    Bianca C. Martins

    2010-02-01

    Full Text Available Ultrasonography of the lens and posterior segment is an indispensable step in the preoperative evaluation of dogs with cataracts, since ophthalmoscopy is not feasible when there is opacification of the lens. This study evaluated the echographic conditions of cataractous lens and fundus of the eye in dogs affected by cataracts. The study was conducted in 30 dogs (56 eyes, 10 males and 20 females, with different types of cataracts at different stages of development. Echography in A and B modes, simultaneously, was carried out for the examination of the lens and posterior segment. The examinations revealed anterior cortical, posterior cortical and nuclear cataract in 12 eyes (21.4%, anterior cortical, posterior cortical, nuclear and posterior capsular in 23 eyes (41%, anterior cortical, posterior cortical and posterior capsular cataract in one eye (1.7%, anterior cortical and nuclear cataract in one eye (1.7%, anterior cortical, nuclear and posterior capsular cataract in five eyes (8.9%, and anterior cortical cataract in seven eyes (12.5%. Abnormal ultrasonographic alterations were observed in the posterior segment in 26 eyes evaluated (46.4%. Vitreal degeneration was detected in 12 eyes (21.4%, images of vitreal exudate or hemorrhage in seven eyes (12.5%, persistence of hyaloid artery in four eyes (7.1% and lens subluxation in three eyes (5.3%. The results obtained reiterate the importance of ultrasonography in canine patients presented for cataract surgery given that alterations of the posterior segment are difficult to identify in a clinical examination when the lens is opacified.A ultrassonografia do segmento posterior do bulbo do olho é etapa indispensável na avaliação de cães com catarata que serão submetidos à facectomia, uma vez que a oftalmoscopia não é factível quando há opacificação da lente, notadamente nas cataratas maduras. Este estudo avaliou as condições ecográficas da lente cataratogênica e do fundo de olho de c

  20. Achados oculares em pacientes com mais de 99 anos Ocular findings in patients older than 99 years

    Directory of Open Access Journals (Sweden)

    Marcela Colussi Cypel

    2006-10-01

    desenvolvimento de política específica de saúde ocular. Esse estudo demonstrou idosos com maioria do sexo feminino (83,3%, boa saúde geral (35%, hipertensos (40%, com dificuldade para leitura (55% e com baixa visual em decorrência de degeneração macular relacionada à idade.PURPOSE: To determine vision conditions and ocular findings in patients older than 99 years. METHODS: Patients were recruited by media advertisement and examined at the Vision Institute of UNIFESP. The following examinations were performed: visual acuity, ectoscopy, refraction, biomicroscopy, tear film break-up time, Schirmer basal test, tonometry, direct and indirect ophthalmoscopy. Complementary examinations such as optical coherence tomography were performed when indicated. RESULTS: Thirty patients older than 99 years were identified. Mean age of 101.5±1.8, 25 females and 5 males. Most common systemic disease, according to history, was arterial hypertension. In 11 patients (55%, the best corrected far visual acuity was 20/100 or better. The best corrected near visual acuity was J4 or better also in 55% (11 patients and 63.0% (7 patients of these were the ones that had not been submitted to cataract surgery. The most frequent visual complaint was low vision for reading (55% and other 8 patients (40% reported no disturbance (satisfied with their vision. Lens opacity was present in 9 patients (60% and 8 patients (40% had previous cataract surgery (5 aphakic eyes, 9 pseudophakic eyes. Cataract was identified as important for impairment of vision in 5 patients but only 2 of them wanted to be submitted to surgery. The main cause of visual impairment was age-related macular degeneration, present in all patients, 95% with no exudative form. Vision improved with new refractive prescription in 4 patients. CONCLUSION: Once we understand the needs we can plan specific diagnostic and treatment strategies. This sample showed that most were female (83.3%, with good general health (35%, most with systemic arterial

  1. Incidência e fatores de risco da retinopatia diabética em pacientes do Hospital Universitário Onofre Lopes, Natal-RN Diabetic retinopathy incidence and risk factors in patients of the Onofre Lopes University Hospital, Natal-RN

    Directory of Open Access Journals (Sweden)

    Carlos Alexandre de Amorim Garcia

    2003-06-01

    and risk factors (length of illness and arterial hypertension for diabetic retinopathy in 1002 patients who were submitted to the diabetes program at the Onofre Lopes University Hospital from 1992 to 1995. METHODS: Retrospective study of patients diagnosed with diabetes mellitus referred by the university's diabetes Program to the Retina Department and were submitted to an ophthalmological examination, under the author's supervision, including: measurement of visual acuity, anterior and posterior biomicroscopy, Goldman applanation tonometry, and indirect ophthalmoscopy (tropicamide 1% + phenylephrine 10% and analysis of the patients' records regarding length of disease and clinical arterial hypertension diagnosis. RESULTS: Of 1002 diabetic patients (in 24 fundoscopy was impossible to perform 978 were divided into 4 groups: without diabetic retinopathy, 675 cases (69,01%; with non proliferative diabetic retinopathy, 207 cases (21,16%; with proliferative diabetic retinopathy, 70 cases (7,15%; and photocoagulated patients, 26 cases (2,65%. Of the total, 291 were males (29% and 711 females (71%. These 4 groups were analyzed regarding gender, age, visual acuity, duration of the disease, presence of cataract and systemic hypertension.Concerning the type of diabetes, 95 were type I (9,4%, 870 were type II (86,8%, and in 37 cases (3,7% the type of diabetes was not determined. CONCLUSION: It was shown that the longer patients had the disease, more likely they were to develop diabetic retinopathy and that hypertension systemic did not constitute a risk factor for the decrease of visual acuity in the hypertensive patients.

  2. Prevalência de metástases oculares em pacientes com doença metastática reconhecida: resultados preliminares Prevalence of ocular metastasis in patients with known metastatic disease: preliminary results

    Directory of Open Access Journals (Sweden)

    Zélia Maria da Silva Corrêa

    2005-04-01

    prospective fashion, the prevalence of intraocular metastasis: most frequent primary tumors and ocular tissue most frequently compromised by metastasis. METHODS: In-patients with malignant neoplasm and metastatic disease from a tertiary Oncology Hospital (HSR were consecutively evaluated between January 2001 and July 2002. All patients underwent complete ophthalmologic examination, including indirect ophthalmoscopy under pharmacological mydriasis using a 28 diopter-lens and, in cases suspicious of neoplasia, ultrasonography and fluorescein angiography were performed. Those cases of diagnostic uncertainty were submited to fine needle aspiration biopsy. The diagnosis of metastatic ocular tumor was established based on the clinical features and the results of the mentioned ancillary studies. RESULTS: The 100 studied patients presented ages between 17 and 87 years, 71 being females and 29 males. There was a predominance of Caucasian individuals (n=88 in this group. Twenty-one patients presented ocular lesions suggestive of metastasis. The primary malignancy originating ocular metastasis most frequently was breast cancer (28.6%. Evaluating the tumor type separately, lung cancer presented a highest prevalence of metastasis to the eye (71.5%. The choroid was involved in 57% of the cases and the main ocular complaint of these patients was blurring or decrease in vision. There was no difference in the frequency of involvement between the right and the left eye. CONCLUSION: The prevalence of ocular metastasis in patients with malignancy and metastatic disease seemed significant in the studied group. The neoplasms more frequently causing ocular metastasis were: breast and lung carcinoma, and the choroid was involved more frequently.

  3. O diagnóstico do carcinoma metastático de coróide pela biópsia aspirativa com agulha fina (BAAF: relato de caso The diagnosis of metastatic carcinoma of the choroid using fine-needle aspiration biopsy (FNAB: case report

    Directory of Open Access Journals (Sweden)

    Zélia Maria da Silva Corrêa

    2003-01-01

    male, while being treated for a solitary pulmonary condensation, reported sudden loss of vision, pain, discharge and red eye (right eye for 10 days. During the ophthalmic examination a nonregmatogenous retinal detachment as well as multiple choroidal tumors were confirmed by diagnostic ocular ultrasound. Fine-needle aspiration biopsy (FNAB was suggested to diagnose a possible metastatic disease. Fine-needle aspiration biopsy was performed under peribulbar anesthesia with sedation. A transvitreous route was chosen through a sclerotomy 4 mm from the limbus. The procedure was monitored via binocular indirect ophthalmoscopy. Two sample aspirates were obtained from different tumour foci. After fine-needle aspiration biopsy, the aspirates were sent for processing, fixation and stained with Papanicolaou and HE. RESULTS: Cytology confirmed the diagnosis of multiple metastatic tumors. Immunocytochemistry of ocular and lung aspirates revealed a common cell origin by a pankeratin (AE1/AE3 positive test. Regardless of systemic treatment with chemotherapy and improvement of the ocular status, the patient died 4 months after cytological diagnosis of metastatic carcinoma of the choroid. CONCLUSIONS: Fine-needle aspiration biopsy was efficient to diagnose and correlate ocular cytology with the primary tumor by imunohistochemical methods in this case. Fine-needle aspiration biopsy should still be used only in selected cases and further research will be necessary for it to become a standard diagnostic procedure in ophthalmology.

  4. Analysis on relative factors of the incidence and development diabetic retinopathy%糖尿病视网膜病变发生发展的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    张建文; 马丽; 马凤仙

    2013-01-01

    可作为DR发生发展的预示指标。%AIM:To investigate the relative factors of the incidence and development of diabetic retinopathy ( DR) . METHODS: The retinopathy of the 631 patients with type 2 diabetes mellitus ( T2DM ) was examined by ophthalmoscopy and fundus fluorescein angiography ( FFA) , and the relative factors which possibly associate with the incidence and development of DR were collected. RESULTS: There were 205 patients with DR, the morbidity rate of DR was 32.5% ( 95%CI:28.82%-36.15%) , the nonproliferative diabetic retinopathy ( NPDR ) and proliferative diabetic retinopathy ( PDR ) were 134 cases occupying 21.2% ( 95%CI: 18.04%-24.44%) and 71 cases occupying 11.3%(95%CI:8.78%-13.72%) of the patients with DR, respectively. Univariate analysis showed that income, living environment, whether treatment by insulin, combined with diabetic nephropathy ( DN) , combined with diabetic peripheral neuropathy ( DPN), hold on exercise, course of diabetes, fasting plasma glucose ( FPG ) , 2 hours'postprandial plasma glucose ( 2hPG ), glycosylated hemoglobin A1c ( HbA1c ), systolic blood pressure ( SBP) , total cholesterol ( TC) , urinary albumin excretion rate (UAER), serum creatinine (SCr), and blood urea nitrogen ( BUN ) were significant different among the patients without DR, the patients with NPDR and the patients with PDR ( P<0.05 or P<0.01 ).Multivariate ordinal Logistic regression analysis showed that the incidence and development of DR increased in patients with longer course of diabetes, high HbA1c, high UAER and without exercise, and decreased in patients without DN and DPN (P<0.05 or P<0.01). CONCLUSION:There was a high morbidity rate of DR in patients with patients with type 2 diabetes.The longer course of diabetes, high HbA1c, and without exercise were the independent development factors of DR, whether combined with DN, combined with DPN and UAER were indices for the incidence and development of DR.

  5. Analysis of microperimeter in diabetic patients without retinopathy%眼底未见改变的糖尿病患者微视野光敏度值分析

    Institute of Scientific and Technical Information of China (English)

    徐剑; 陈思明; 俞存

    2013-01-01

    -1 microperimeter in detecting the early retinal abnormalities in diabetic patients and to provide evidences and ways for the prevention and cure of diabetic retinopathy,using the microperimeter (MP-I) in diabetic patients without retinopathy.Methods 61 diabetic patients without retinopathy(total 105 eyes) were evaluated.MP-1 microperimeter was used to quantify the retinal sensitivity.We performed complete ophthalmic examinations,including best-corrected visual acuity,slit-lamp examination,indirect ophthalmoscopy,OCT,FFA,and microperimetry (central 20° of macula) on 105eyes of 61 participants.All statistical analysis including One-way ANOVA,correlation analysis and linear regession were calculate with SPSS 19.0.Results The mean age of participants was (mean ± SD) (54.51±7.96)years for participants with diabetes but no retinopathy.There was significant loss of retinal sensitivity in 2°retina and 4°retina in participants with diabetes but no retinopathy,P <0.05.(One-way ANOVA).The mean retinal sensitivity in 2°retina were positively correlated with the Best-corrected visual acuity.The correlation analysis showed a correlation coefficient of 0.817,P <0.01,R2=0.667,and regression formula coule been delivered as Y=0.04376X+ 4.5323(F =206.43,P =0.000).Conclusion The early changes of retinal function in patients with diabetes but no retinopathy can be detected and quantitatively by the MP-1 microperimeter even before the appearance of diabetic retinopathy.Using the MP-1 microperimeter,we can detect early loss of retinal sensitivity in patients with diabetes but no retinopathy.MP-1 is a sensitive method which can provide evidences and ways for the prevention and cure of diabetic retinopathy.

  6. Prevalência da retinopatia diabética em unidade do Programa de Saúde da Família Prevalence of the diabetic retinopathy in a Family's Health Program unity

    Directory of Open Access Journals (Sweden)

    Murielem Fernandes Guedes

    2009-04-01

    Program unity in Parque Prazeres - Campos dos Goytacazes, RJ, and the level of patient's knowledge about diabetes visual impairment. METHODS: Seventy two diabetic patients were selected, but only 46 attended the research. The patients were chosen based on Family's Health Program medical registers. They were submitted to visual acuity examination and afterward to a questionnaire in order to evaluate their knowledge level about visual impairment. Then, they were submitted to a direct fundoscopic examination. Statistical studies were done based on Microsoft Excel and Bioestat 5.0 RESULTS: Diabetic retinopathy prevalence was about 19,5% (CI 95% between 8,1 and 31%; 13% showed non proliferative diabetic retinopathy and 6,5% showed proliferative retinopathy. In accordance with World Health's Organization criteria: 8,5% were considered blind and 8,9% with low vision at the moment of ocular examination. Seventy two percent of patients had previous knowledge that diabetes could cause visual reduction, but 80% didn't know the necessary exams to diagnose it and 65% never were previously submitted to ophthalmoscopy. CONCLUSION: Blindness prevention programs by diabetic retinopathy in Family Health Programs are justified considering that the retinopathy diabetic prevalence in assisted communities could be high, as was in this study. The improvement of patient knowledge about the vision threatening risk and ophthalmological exams can allow a better retinopathy diabetic control.

  7. Tratamento conservador em retinoblastoma intra-ocular Conservative treatment for intraocular retinoblastoma

    Directory of Open Access Journals (Sweden)

    Clélia Maria Erwenne

    2003-12-01

    bilaterais foram conservados 48,9% dos olhos tratados. Entre os unilaterais, para os mesmos estádios obteve-se: I 0/0; II 2/2 (100,0%; III 1/3 (33,3%; IV 1/3 (33,3%; V 0/7 (0%. Considerando-se o total de unilaterais foram conservados 26,6% dos olhos. Não se observou nefro ou ototoxicidade às drogas neste grupo.PURPOSE: To report the results of conservation of the ocular globe after treatment with carboplatin and laser; with or without the use of other forms of local treatment or radiotherapy, if necessary. METHODS: All eyes, initially untreated, were evaluated using indirect ophthalmology under inhalation anesthesia in an outpatient clinic treatment setting. They were categorized according to the Reese-Ellsworth system; thereafter, the patients were evaluated clinically by a pediatric oncologist. The patients received the first cycle of chemotherapy consisting of intravenous carboplatin 200 mg/m², vincristine 1.5 mg/m² and etoposide 150 mg/m², for three days. This was followed by other cycles with intervals of between 21 and 28 days. From 7 to 15 days after the end of the chemotherapy cycle, another indirect ophthalmoscopy under inhalation anesthesia was performed, with documentation of the findings and laser hyperthermia application, using a Diode laser, 810 nm, continuous pulse with a large spot size. The procedure (chemotherapy and laser was repeated until complete cicatrization of all lesions was observed, or until the need for another treatment modality such as radiotherapy or enucleation became apparent. Follow-up examinations every two months during the first year and three months thereafter were done for review and for treatment of recurrent or new lesions. Pediatric oncology follow-up was also done throughout the entire initial assessment and follow-up period. RESULTS: We treated a total of 62 patients with retinoblastoma, of whom 32 were male and 30 female. Fifteen were unilateral and 47 were bilateral with a total of 107 eyes. The mean age was 16.9 months (2

  8. [Aiming for zero blindness].

    Science.gov (United States)

    Nakazawa, Toru

    2015-03-01

    chose CHOP as our primary target for drug development. Currently, we are in the process of screening a library of 1274 drugs, all of which are already used in human subjects, for CHOP inhibitors. The last topic of our discussion is future possibilities for glaucoma management. First, we discuss the development of next generation in vivo imaging modalities that allow detailed description of pathomechanisms of this multifactorial disease, glaucoma. The purpose of this research was to improve the efficacy of glaucoma diagnosis and to visualize its pathology at a cellular/molecular level and develop molecule-specific therapies. Currently available visual field tests are subjective, since they rely on a determination of the threshold of light perception, and are affected by poor reproducibility. The current dependence on visual field tests to ascertain the progression of glaucoma is thus a serious limitation on an important task of ophthalmologists. We, therefore, turned our focus to the establishment of an in vivo imaging method to detect dying retinal ganglion cells, which would highlight the pathologic state of glaucoma with high sensitivity. To this end, we used confocal scanning ophthalmoscopy to assess the usefulness of SYTOX Orange as a cell death probe. Our results showed that this probe could reveal dying retinal ganglion cells clearly, quickly and with high sensitivity. We, therefore, believe that the clinical application of probes that can sensitively detect dying retinal ganglion cells is a highly promising approach. This also applies to the use of molecular tools that can provide information on the molecular pathology of glaucoma. Finally, we would like to introduce our national collaborative work on the analysis of "big-data". The project aims to collect as wide a range of data as possible at an unprecedented scale. The data to be registered ranges from basic glaucoma data, such as IOP and visual field test results, to data from the most sophisticated