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At least 217 records · Page 12Linked to original sources
PubMed2000

Identifying early glaucomatous changes. Comparison between expert clinical assessment of optic disc photographs and confocal scanning ophthalmoscopy.

OBJECTIVE: To compare the ability of expert clinicians, using qualitative assessment of stereoscopic optic disc photographs, and confocal scanning laser ophthalmoscope imaging to discriminate between healthy persons and patients with early glaucoma. DESIGN: Comparative instrument validation study. PARTICIPANTS: Seventy-two healthy persons and 51 patients with early glaucoma (average visual field mean deviation, -3.6 dB). Early glaucoma was defined as a history of ocular hypertension and a reproducible visual field defect scoring 5 or less in the Advanced Glaucoma Intervention Study classification, regardless of optic disc appearance. INTERVENTION: Stereoscopic optic nerve head (ONH) photography and Heidelberg Retina Tomograph (HRT) imaging, (Heidelberg Engineering GmbH, Dossenheim, Germany). MAIN OUTCOME MEASURES: Ability of clinical assessment of stereoscopic ONH photographs and analysis of HRT parameters, taking into account the optic disc size, to detect early glaucomatous optic disc changes. RESULTS: The specificity of the majority opinion of five observers to detect early glaucomatous optic disc changes was 94.4%, with a sensitivity of 70.6%. Using the HRT analysis, the specificity was 95.8% and the sensitivity was 84. 3%. CONCLUSIONS: Heidelberg Retina Tomograph image analysis that takes into account the optic disc size is more sensitive than clinical assessment of stereoscopic optic disc photographs in distinguishing between healthy persons and patients with early glaucoma.

Aged↗
PubMed1989

Detection of diabetic macular edema. Ophthalmoscopy versus photography--Early Treatment Diabetic Retinopathy Study Report Number 5. The ETDRS Research Group.

Clinical and photographic methods were used to assess retinopathy during the examinations of diabetic patients enrolled in the Early Treatment Diabetic Retinopathy Study (ETDRS). In analyzing available data from eyes randomly selected for deferral of treatment, the authors compare the clinical detection (including contact lens biomicroscopy) with photographic detection (30 degrees stereoscopic color fundus photographs) of diabetic macular edema. Based on clinical detection, 53% (1778 patients) had hard exudates within 1 disc diameter (DD) of the center of macula, 56% (1868 patients) had retinal thickening within this region, and 31% (1027 patients) had thickening at the center of macula. These analyses show agreements of 83, 78, and 83% between retinal specialists and photographic graders when assessing these three characteristics, respectively. Agreement was 81% in the detection of macular edema for which treatment is indicated (clinically significant macular edema). Each method has its advantages but in general there was close agreement between these methods, particularly for clinically significant macular edema, which supports the reliability of each method.

Diabetic Retinopathy↗
PubMed1993

Retinal hemodynamics using scanning laser ophthalmoscopy and hemorheology in chronic open-angle glaucoma.

PURPOSE: Recent studies suggest that elevated intraocular pressure is not the only causative factor for the development of visual field loss and optic nerve damage in glaucomatous eyes. The authors determine whether retinal hemodynamics or blood fluidity are alternated in eyes of patients with open-angle glaucoma compared with those of age- and sex-matched healthy subjects. METHOD: High-quality video fluorescein angiograms were obtained from single eyes of 51 patients with chronic open-angle glaucoma. From these angiograms, the arm-retina time, mean dye velocity, and arteriovenous passage time were quantified. The data from patients were compared with those of an age- and sex-matched group of healthy subjects. RESULTS: In patients with chronic open-angle glaucoma, an 11% reduction of the mean dye velocity (P < 0.05) and a 41% prolongation of the arteriovenous passage time (P < 0.01) was observed relative to the values obtained among the control subjects. Among hematocrit values, plasma viscosity, and erythrocyte aggregation, only plasma viscosity showed a significant increase (4%; P < 0.01) in patients with chronic open-angle glaucoma. CONCLUSION: These results indicate that a pronounced circulatory deficit exists within the retinal vasculature of glaucomatous eyes, which may coexist with, but cannot be fully attributed to, an increase in plasma viscosity.

Adult↗
PubMed1998

Functional assessment of macular hole surgery by scanning laser ophthalmoscopy.

OBJECTIVE: This study aimed to evaluate more precisely the benefit of macular hole surgery. DESIGN: The design was a prospective study of 40 eyes in 40 patients examined before and after surgery of full-thickness macular holes with a scanning laser ophthalmoscope (SLO). PARTICIPANTS: Forty patients with full-thickness macular holes participated. Three of the holes were stage 2, 23 were stage 3, and 14 were stage 4. INTERVENTION: The SLO examination consisted of macular imaging and assessment of macular function using tests produced by an acousto-optical modulator. MAIN OUTCOME MEASURES: Preferred retinal locus (PRL) was determined, visual acuity was measured, and scotoma was detected by microscotometry and by the line test (modified Watzke-Allen test). RESULTS: Anatomic success was achieved in 32 of 40 cases as assessed biomicroscopically. On SLO examination before surgery, macular holes were seen as a central bright round disc outlined by a thin dark edge surrounded by a dark ring and a less dark area with ill-defined limits. In all cases, the PRL was located on the upper edge of the hole, a scotoma was always detected inside the hole, and the line was seen as broken in 26 of 32 cases. After surgery, the hole closed completely in 25 of 32 eyes; it disappeared from 14 of these 25 eyes and was replaced by a dark or clear disc in 11. In the other seven successful cases, its size shrank and its edge flattened but remained faintly visible. The hole remained unchanged in eight cases. Eccentric PRL became central in 28 of 32 cases. The scotoma disappeared in 23 of 32 cases. The line was seen as continuous in 24 of 32 cases. Complete anatomic and functional successes were achieved in 19 of the 32 cases of macular hole closure. CONCLUSION: The SLO examination allows accurate assessment of the anatomic and functional results of macular hole surgery. Various degrees of functional success were recorded, depending on the test used.

Fixation, Ocular↗
PubMed2001

Differential imaging in scanning laser ophthalmoscopy.

Differential imaging may be useful for understanding pathologies of the choroid. We use a prototype scanning laser ophthalmoscope capable of simultaneous multiple wavelength imaging to record fundus images. The advantages of simultaneous acquisition compared to serial acquisition are, reduced image capture times, and image registration is not required. The system is run under non-confocal conditions in using slit apertures with a width of up to 600 microm. The laser lines launched into the SLO were the 633 nm line of a HeNe- laser, and the 815 nm line from a tunable (740 nm to 840 nm) cw Ti:Sapphire-laser. The difference in absorption at these two wavelengths is used to produce a differential image. We compare conventional imaging with differential spectral imaging for viewing the choroidal vessels. Qualitative results show the contrast of choroidal vessels in differential imaging is improved compared with normal imaging in the region of the optic disk and for the level of pigmentation in the subjects examined.

Blood Vessels↗
PubMed2001

Glaucomatous optic nerve head changes with scanning laser ophthalmoscopy.

PURPOSE: To determine whether there are angiographic differences among normal, preperimetric and advanced glaucoma eyes using indocyanine green angiography with SLO. This method was chosen because of its sensibility to detect peripapillary capillary vessels. METHODS: Scanning laser opthalmoscopy was preformed on normal eyes, preperimetric glaucomas and advanced glaucomas. MATERIAL: The authors used a confocal SLO (Heidelberg Retina Angiograph-HRA) CONCLUSION: Several changes may be seen on peripapillary capillary vessels at the different glaucomatous stages. DISCUSSION: In normal subjects HRT shows preservation of the disc/cup area ratio; indocyanine green angiography shows normal prepapillary plexus pattern on the neuroretinal rim and cup. Subjects on glaucomatous preperimetric stage reveal a decrease in the disc/cup area ratio as a result of an increase of the cup area secondary to a reduction of the neuroretinal rim area. ICG at this hipertensive stage shows an increase in prepapillary plexus visualization, which may be a consequence of increased blood flow while autoregulation is still operative. Subjects with advanced glaucoma show prominent decrease in the disc/cup area ratio as well as marked capillary droupout in ICG angiography.

Coloring Agents↗
PubMed1994

Detection of diabetic retinopathy by scanning laser ophthalmoscopy.

A scanning laser ophthalmoscope (SLO) was used to examine the fundi of 54 diabetic patients through undilated pupils and the results compared by an experienced ophthalmologist with clinical examination through dilated pupils to assess the effectiveness of the SLO in detecting diabetic retinopathy. Whilst the SLO was not as good at detecting cotton wool spots and subtle intraretinal microvascular abnormalities, it did not miss any active new vessel formation and all eyes needing treatment would have been referred.

Diabetic Retinopathy↗
PubMedDate not supplied

[Value of ophthalmoscopy and histology for the prognosis of patients with retinoblastoma].

The predictive value of prognostic factors is of utmost importance for the treatment of patients with retinoblastoma. Functional results, that may be expected following sight saving therapy, can be deducted from ophthalmoscopic findings. Large tumors, tumors located centrally, the presence of extensive retinal detachment or diffuse vitreous seeding are poor prognostic signs. Histopathologic findings of the enucleated eye harbouring retinoblastoma correlate well with the incidence of metastatic disease. Patients in which the tumor has invaded the choroid, optic nerve or sclera have a high risk of developing metastases.

Child↗
PubMed1998

Scanning laser ophthalmoscopy of the optic disc at the level of the lamina cribrosa.

PURPOSE: To determine the suitability and reproducibility of optic disc morphometry performed on images focused at the level of the lamina cribrosa, obtained by means of the scanning laser ophthalmoscope (SLO). METHODS: Twenty-one eyes were imaged with argon blue and green, helium neon red and diode infrared laser sources of a scanning laser ophthalmoscope. Five images of the optic disc at the level of the lamina cribrosa were taken for each patient, digitized and traced by three trained observers, in order to identify the external contour of the optic disc and the inner edge of the neuroretinal rim. Dedicated software allowed the contours to be traced on the video and an estimate of the real sizes of optic disc parameters to be obtained according to Littman's equation. Standard deviation (SD) and coefficient of variation (CV) were used to determine the intra- and inter-observer reproducibility in measuring disc, dark annulus (DA), and reflective center (RC) areas, DA area/disc area (DA/D) and RC area/disc area (RC/D) ratios of each set of images taken with all laser wavelengths. RESULTS: A high contrast between the dark annulus of the lamina and the central highly reflective area was achieved at all laser wavelengths. The ranges of CVs for all of the observers, using all the laser wavelengths, were as follows: disc: 0.018-0.036; dark annulus: 0.015-0.039; reflective center: 0.014-0.031; DA/D: 0.005-0.01; RC/D: 0.007-0.018. No significant difference was observed between the measurements performed on the images acquired, using the different laser wavelengths. CONCLUSIONS: SLO imaging of the optic disc at the level of the lamina cribrosa proved to be suitable and highly reproducible at all laser wavelengths. The coefficients of variation of the measurements of optic disc parameters obtained using this technique are smaller than those obtained by means of conventional photographic methods.

Adult↗