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PubMed1991

Measurement of optic disc and neuroretinal rim areas in normal and glaucomatous eyes. A new clinical method.

A technique based on indirect ophthalmoscopy has been devised to enable measurement of structures in the posterior pole of the eye. It has been used to measure clinically the maximal and minimal diameters of both the optic disc and cup of 130 normal eyes from 66 patients and 33 optic discs from 20 patients with glaucomatous visual field loss. The disc area and neuroretinal rim area were derived mathematically for each eye. In the normal group the neuroretinal rim area was strongly correlated with the disc area (r = 0.89, P less than 0.0001). Only 9.1% of the glaucomatous group fell within the 95% prediction interval for the normal group, indicating a high degree of sensitivity and specificity for predicting the presence of visual field loss. Discs associated with mild field loss could be discriminated from those associated with moderate or severe field loss on the basis of disc and rim area measurements.

Aged↗

PubMed1993

Ocular fundus findings in Malawian children with cerebral malaria.

BACKGROUND: Cerebral malaria is a major cause of mortality and morbidity in children in tropical regions. The pathogenesis of this important complication of Plasmodium falciparum infection is not well understood. A number of observers have commented on the presence of retinal pathology in various types of malaria. Previous reports have not demonstrated that fundus findings are significantly associated with outcome. METHODS: The authors examined the ocular fundi, by direct and indirect ophthalmoscopy, of 56 children admitted consecutively with cerebral malaria. RESULTS: Every child with a normal fundus on admission recovered fully, but two conditions were found to be associated with a poor outcome. Patients with papilledema had a relative risk of poor outcome 5.2 times greater than those without this finding (P < 0.01). Patients with retinal edema outside the posterior vascular arcades had a relative risk of poor outcome 3.9 times greater than those without this finding (P < 0.01). These two fundus findings were independently predictive of a poor outcome. CONCLUSION: Fundus findings are useful as predictors of outcome in children with cerebral malaria. The authors' findings suggest that there may be two distinct mechanisms associated with poor outcome in these children.

Antimalarials↗

PubMed1998

Diagnostic yield of the routine dilated fundus examination.

OBJECTIVE: This study aimed to estimate the risk of errors of omission inherent in the elimination of the routine dilated fundus examination in asymptomatic patients presenting for routine eye checkups, or in patients with purely refractive complaints. DESIGN: The study design was a retrospective chart review. PARTICIPANTS: The authors reviewed the records of initial visits of more than 3800 patients drawn from the practices of 3 board-certified ophthalmologists with substantial general ophthalmology components. Patients with best-corrected visual acuity in either eye of poorer than 20/25, myopia greater than -3.00 diopters, or other risk factors for disease of the fundus or optic nerve (such as ocular hypertension, glaucoma, previous ocular surgery, diabetes mellitus, and history of retinal detachment) were excluded. The authors identified 1094 such records that documented the findings of dilated fundus examination, including indirect ophthalmoscopy. MAIN OUTCOME MEASURES: The authors recorded the prevalence of all fundus abnormalities, of those deemed clinically significant, and those beyond the view of routine examination with the direct ophthalmoscope. Findings were stratified by patient age. RESULTS: Of the 1094 eligible records, 53 (4.84%) had recorded fundus abnormalities. Of these, 23 were of no adverse ophthalmologic consequences and were considered clinically insignificant. Of the 30 (2.74%) potentially significant findings, only 3 were located beyond the view of routine examination with the direct ophthalmoscope (0.274%; 95% confidence limits: 0.56%-0.80%). The prevalence of fundus findings increased strongly with increasing patient age, from 2.4% younger than age 20 to 14.8% older than age 60. Clinically significant findings increased from 0.8% younger than age 20 to 8.9% older than age 60. CONCLUSIONS: The authors estimate the rate of detection through routine dilated fundus examination of clinically significant fundus lesions in asymptomatic patients at 2.73% (95% confidence limits, 1.86%-3.80%). One tenth of these are beyond the view of the direct ophthalmoscope. The prevalence of fundus abnormalities increases tenfold with increasing patient age.

Adolescent↗

PubMed1998

What happens to untreated asymptomatic retinal breaks, and are they affected by posterior vitreous detachment?

OBJECTIVE: The purpose of the study was to ascertain the natural consequences of asymptomatic retinal breaks and to learn what effects, if any, the occurrence of posterior vitreous detachment (PVD) has on such breaks. DESIGN: This was a cohort study of consecutive asymptomatic phakic patients, all of whom had asymptomatic retinal breaks, observed without treatment over periods of 1 to 33 years (average, 11 years). PARTICIPANTS: There were 196 patients with 235 involved eyes. INTERVENTION: Periodic clinical examinations, including binocular indirect ophthalmoscopy with scleral indentation on all eyes and posterior vitreous examination on 50 eyes, were performed. RESULTS: In the total study period, one small peripheral retinal detachment developed, without symptoms, from a previous subclinical detachment over a period of 14 years. Nineteen eyes (8%) originally had or developed 22 areas of subclinical detachment, 2 of which were treated because of moderate extension, even though remaining subclinical and without symptoms. Ten eyes encountered acute PVDs, which caused symptomatic retinal tears in three eyes, one of which also had a clinical retinal detachment. Of the 50 asymptomatic eyes examined with Goldmann lens and slit lamp, 12 (24%) were found to have an existing PVD, which had not led to any complication of the previous retinal breaks in any eye. CONCLUSIONS: Asymptomatic retinal breaks discovered in phakic primary eyes do not show any significant tendency toward clinical retinal detachment, with the exception of a few of those cases that progress to subclinical retinal detachment. It is only some of these, comprising 1% to 2% of the total group, that may justify treatment. Posterior vitreous detachment coexists safely with asymptomatic retinal breaks in phakic primary eyes and shows no tendency to provoke complications to pre-existing breaks at the time of its occurrence.

Adolescent↗

PubMed1999

Angiographic and histologic effects of fundus photodynamic therapy with a hydrophilic sensitizer (mono-L-aspartyl chlorin e6).

PURPOSE: To demonstrate the efficacy of the photosensitizer mono-L-aspartyl chlorin e6 (NPe6) in closing choroidal vessels at low energy levels, that tissue uptake and clearance are rapid, and that low concentrations of drug are needed to achieve clinical effects. DESIGN: Experimental animal study. ANIMALS: Pigmented rabbits and Japanese monkeys were used in this study. METHODS: Using a modified 664-nm diode laser, the fundi of pigmented rabbits and Japanese monkeys were irradiated after intravenous administration of NPe6 (2-100 mg/kg). Time from injection to irradiation varied from 5 to 15 minutes, and duration of exposure varied from 1 to 10 seconds. Power output at the corneal surface was either 3.6 or 5.9 mW. Animals were examined by indirect ophthalmoscopy and fluorescein angiography at 2 hours and 7 days after treatment. After enucleation 7 days after treatment, specimens were prepared for light and electron microscopy. MAIN OUTCOME MEASURES: Angiographic evidence of occlusion and histopathologic evidence of retinal damage. RESULTS: Both clinical and histopathologic examination demonstrated effects on the choroidal vasculature and the retinal pigment epithelium, including necrosis of endothelial cells and occlusion in choroidal vessels, particularly within the choriocapillaris, at low energy levels. Overlying neurosensory retina was minimally affected. Fluorescein angiography of lesions treated with 2 mg/kg and laser fluence of 2.3 to 7.5 J/cm2 showed a normal appearance 2 hours after treatment, which changed to early hypofluorescent and later hyperfluorescent lesions 7 days after treatment. In contrast, those animals receiving the 10-mg/kg dose and laser fluence of 0.46 to 0.75 J/cm2 showed marked hypofluorescence of choroidal lesions and occlusion of retinal vessels 7 days after treatment. CONCLUSIONS: Effective occlusion of normal choroidal vessels was achieved at 2 mg/kg using 2.3 to 7.5 J/cm2 or at 10 mg/kg using 0.46 to 0.75 J/cm2 with minimal injury to overlying neurosensory retina.

Animals↗

PubMed1999

Microalbuminuria and retinopathy in a diabetic population of Cameroon.

Microalbuminuria and retinopathy was studied in a non-proteinuric diabetic population of Cameroon. Patients were enrolled on a consecutive basis in two referral hospitals in Yaoundé. Retinopathy was evaluated by direct ophthalmoscopy and biomicroscopy, and controlled by mydriatic fundus photography. Detection of microalbuminuria was carried out on an overnight urine sample using Micral II test (Boehringer Mannheim). Anthropometric and blood pressure measurements were done using validated methods. In 64 non-proteinuric diabetic patients (9 IDDM and 55 NIDDM) aged 19-70 years with known duration of diabetes of 1-23 years, the prevalence of retinopathy was 37.5%. Microalbuminuria was detected in 53.1% of patients. Microalbuminuria correlated with duration of diabetes, and blood pressure, retinopathy was positively correlated with age, and blood pressure. Retinopathy was not significantly associated with the known duration of diabetes. Retinopathy was found to be independently associated with microalbuminuria (P < 0.001) and microalbuminuria appeared to be a sensitive marker of retinopathy. The prevalence of retinopathy and microalbuminuria in this population was high. Microalbuminuria and non-proliferative retinopathy are independently associated, and are both associated with increased blood pressure levels in the study population. As shown in previous studies microalbuminuria may also be a sensitive marker of early diabetic retinopathy in African diabetic patients.

Adult↗

PubMed2004

[Phase 2 clinical study of 123I-N-(2-diethylaminoethyl)-2-iodobenzamide in the diagnostic of primary and metastatic ocular melanoma].

PURPOSE: Iodobenzamides are reported to possess an affinity for melanoma. A first selected compound, BZA, was studied in a phase 2 clinical trial on 159 patients as an imaging agent for the detection of primary melanoma and metastases with good results. We report the results of a second phase 2 clinical trial on 40 patients with a new radiopharmaceutical BZA2 (an orthoiodinated BZA analog), which was expected to provide quality images sooner after injection and with better imaging contrast. PATIENTS AND METHODS: Performance was evaluated in 40 patients classified with primary ocular lesions (12), suspicion of metastases of ocular or cutaneous origin (15), or with no known secondary lesion (13), and results were compared with conventional investigation techniques (ophthalmoscopy, ultrasonography, and angiography for ocular melanoma, whole-body CT scan and ultrasonography for metastases). RESULTS: No adverse events were recorded. The overall results on a per patient basis showed a sensitivity of 78% and a specificity of 95%. The four false negatives observed were ocular lesions (three with a thickness<3mm and one achromic), but all the proven secondary lesions were imaged. Moreover, negative BZA2 scintigraphy in cases of suspicious lesions led to the correction of two diagnoses: the prostatic origin of bone metastases and the endocrine tumor origin (APUD system) of an ocular lesion. DISCUSSION: BZA2 scintigraphy is an easy test with good tolerance. In the diagnosis of ocular primary melanoma, the sensitivity of the test is 64%, although limited by the thickness (3mm) and the pigmentation of the lesion. However, the BZA2 scintigraphy is a very useful test for the detection of melanoma metastases, with a sensitivity of 100% and a specificity of 95%. CONCLUSION: BZA2 scintigraphy showed good tolerance in patients and it appears promising for differential diagnosis, staging, and restaging of melanoma.

Benzamides↗

PubMed2001

Postmortem endoscopy of the ocular fundus. A valuable tool in forensic postmortem practice.

Pathological changes of the ocular fundus in acute severe head or extracranial injury are difficult to document. In vivo examination usually has to be carried out under intensive care conditions. Postmortem ophthalmoscopy is usually impeded by rapid blurring of the cornea. Therefore, endoscopic fundal photography has been applied by using a pars plana approach during forensic postmortem procedures. This technique provides fundoscopic pictures of high quality as a valuable supplement for subsequent macro- and histopathological preparations and sections. Different patterns of fundoscopic findings seem to correspond to different types of injuries such as craniocerebral trauma, traumatic asphyxia and decompression sickness, and may allow some insight into the respective pathogenetic mechanism.

Adult↗

PubMed2003

Pseudophakic retinal detachment after uneventful phacoemulsification and subsequent neodymium: YAG capsulotomy for capsule opacification.

PURPOSE: To determine the incidence of retinal detachment (RD) after neodymium:YAG (Nd:YAG) laser capsulotomy for posterior capsule opacification (PCO) and define the characteristics of this type of RD. SETTING: A private practice, with statistical evaluation at a university department. METHODS: Five hundred twenty-six consecutive eyes that had Nd:YAG capsulotomy because of visually disturbing PCO were followed prospectively for up to 52 months (median 21 months) to determine the incidence of RD. The median age of the 142 men and 320 women was 76 years and the median axial length, 23.3 mm (range 20.5 to 31.3 mm). Before the capsulotomy, all eyes had uneventful phacoemulsification with implantation of a posterior chamber intraocular lens (PC IOL). Eyes with additional surgical procedures or with panretinal laser photocoagulation were excluded. Eyes in which a retinal hole had been treated before Nd:YAG (n = 4) were included. The fundus was examined by binocular indirect ophthalmoscopy with a 2.2 diopter Volk lens in full mydriasis. If necessary, an examination with a 3-mirror lens was done. RESULTS: The incidence of RD was 0% (0/483; 95% confidence interval [CI], 0.0%-0.8%) at 6 months, 0% (0/407; 95% CI, 0.0%-0.9%) at 12 months, and 0.5% (1/213; 95% CI, 0.0%-2.6%) at 24 months. Twenty-one months after Nd:YAG capsulotomy, 1 eye developed an RD that occurred as the result of a horseshoe tear that reopened. The tear, which formed 7 months after phacoemulsification and PC IOL implantation and 6 years before Nd:YAG capsulotomy, had been immediately treated with argon laser photocoagulation. Excluding the 4 eyes with preexisting tears, presumably sealed retinal holes, the incidence at 24 months was 0% (0/212; 95% CI, 0.0%-1.7%). No other eye developed RD over the follow-up. CONCLUSIONS: Retinal detachment after Nd:YAG capsulotomy for PCO was rare in eyes that had previous uneventful phacoemulsification and PC IOL implantation. The exact relationship between the 2 events remains to be established.

Aged↗

PubMedDate not supplied

Pregnancy does not induce or worsen retinal and peripheral nerve dysfunction in insulin-dependent diabetic women.

In order to verify whether pregnancy induces or worsens diabetic retinopathy or somatic and autonomic neuropathy, 16 insulin-dependent diabetic (IDDM) pregnant women, 14 age-matched nondiabetic pregnant women, and 12 IDDM nonpregnant women matched for age and disease duration were studied. Plasma glucose, HbA1c, and fructosamine were repeatedly assayed during pregnancy. Retinopathic and neuropathic endpoints were evaluated through ophthalmoscopy, electrophysiology of left peroneal and sural nerves (motor and sensory conduction velocities), and cardiovascular autonomic tests (deep breathing, cough test, lying-to-standing). In the IDDM pregnant women, evaluations were performed three times during pregnancy and 6 months after delivery. Good metabolic control was achieved during pregnancy. At baseline, nine IDDM pregnant women did not show signs of retinopathy, and seven had nonproliferative retinopathy. Only one patient showed worsening during pregnancy, but she improved after delivery. Motor conduction velocity, significantly lower in IDDM pregnant women, progressively improved, and, in the third trimester, was not significantly different from that of nondiabetic pregnant women. At baseline, none of the IDDM pregnant women had abnormal responses to cardiovascular autonomic tests. During pregnancy, the response to deep breathing appeared temporarily reduced in all pregnant women, possibly due to lowered ventilatory excursion at the end of pregnancy. In IDDM women with minimal or no retinopathy, and subclinical or no peripheral neuropathy, pregnancy does not appear to induce or worsen these complications.

Adult↗

PubMed1997

Asymptomatic uveitis in young people with inflammatory bowel disease.

PURPOSE: To ascertain the prevalence of uveitis in a population of pediatric patients with inflammatory bowel disease without ocular symptoms. METHODS: We prospectively evaluated all young people who came to the pediatric gastroenterology clinic with endoscopically proven inflammatory bowel disease between March 1994 and June 1995. All the patients were examined for evidence of ocular manifestations of inflammatory bowel disease. The examination consisted of slit-lamp examination, tonometry, and indirect ophthalmoscopy. None of the patients had visual or ocular symptoms. Eighteen patients had Crohn's disease and 14 had ulcerative colitis. RESULTS: Of the 32 patients evaluated, four (12.5%) had evidence of asymptomatic ocular inflammation, defined as anterior chamber cell and flare. All patients with ocular inflammation were male. Three of these four male patients had Crohn's disease; the other had ulcerative colitis. Five patients had posterior subcapsular cataract, one had esotropia and amblyopia, and one had unilateral high myopia. CONCLUSIONS: The prevalence of asymptomatic uveitis in our population of young people with inflammatory bowel disease was 12.5%. These findings suggest the need for a screening ophthalmologic examination to rule out occult eye disease in young people with inflammatory bowel disease.

Adolescent↗

PubMed2004

Glaucoma without cupping.

BACKGROUND: Although glaucoma can exist with normal intraocular pressures (IOPs), clinicians still rely on the presence of a large cup to "flag" suspects, regardless of IOP, whereas a small cup at the same pressure level is often ignored. High-tech instruments offer a new dimension of evaluation in the objective assessment of structure when subjective tests of function and/or ophthalmoscopic observations are equivocal. CASE REPORTS: Thirteen cases are presented and show evidence of glaucoma based on glaucomatous visual-field defects, often with steadily rising intraocular pressures and retinal nerve fiber layer loss. Surprisingly, these patients maintained small C/D ratios. Accordingly, ophthalmoscopy and/or disk topography classified these disks as normal. CONCLUSIONS: Although unrecognized in virtually the entire world's ophthalmic literature, normal cup glaucoma is a real clinical entity. At least half the normal cup glaucoma cases presented herein have disk drusen (obvious, subtle, or occult), while others are highly myopic and/or have documented IOP spikes. Several of the cases defy classification and explanation at the present time.

Adult↗

PubMed2004

Cost-effectiveness of digital photographic screening for retinopathy of prematurity in the United Kingdom.

OBJECTIVES: To compare the cost-effectiveness of alternative methods of screening for retinopathy of prematurity (ROP) in the United Kingdom, including the existing method of indirect ophthalmoscopy by ophthalmologists and digital photographic screening by nurses. METHODS: A decision tree model was used to compare five screening modalities for the UK population of preterm babies, using a health service perspective. Data were taken from published sources, observation at a neonatal intensive care unit (NICU), and expert judgment. RESULTS: We estimated that use of standard digital cameras by nurses in NICUs would cost more than current methods (pound 371 compared with pound 321 per baby screened). However, a specialist nurse visiting units with a portable camera would be cheaper (pound 172 per baby). These estimates rely on nurses capturing and interpreting the images, with suitable training and supervision. Alternatively, nurses could capture the images then transmit them to a central unit for interpretation by ophthalmologists, although we estimate that this would be rather more expensive (pound 390 and pound 201, respectively, for NICU and visiting nurses). Sensitivity analysis was used to examine the robustness of estimates. CONCLUSIONS: It is likely that there is an opportunity to improve the efficiency of the ROP screening program. We estimate that screening by specialist nurses trained in image capture and interpretation using portable digital cameras is a cost-effective alternative to the current program of direct visualization by ophthalmologists. This option would require the development of a suitable portable machine. Direct comparative research is strongly needed to establish the accuracy of the various screening options.

Cohort Studies↗

PubMed1990

Retinotopic representation of the bifoveate eye of the kestrel (Falco spraverius) on the optic tectum.

Like many diurnal raptors, the American kestrel or sparrow hawk, Falco sparverius, possesses two foveae in each eye. In this study, we used fundus photography and reversed ophthalmoscopy to plot the projection of these foveae onto the visual field, together with other retinal landmarks such as the pecten and ora terminali. From such data, it was determined that the central monocular fovea (CMF) and temporal binocular fovea (TBF) were separated by 36 deg and that the kestrel has 58 deg of binocular overlap when the eyes are appropriately converged. Single-cell and multi-unit recordings were used to systematically explore the tectal surface and map receptive fields (RF) onto a hemispheric screen. A retinotopic map of the tectal surface was produced from such data and revealed an expanded representation for each fovea on the tectum and a systematic increase in RF size from fovea to periphery. The functional significance of this organization is discussed.

Animals↗

PubMed1999

Reproducibility of volumetric macular measurements in diabetic patients with the Heidelberg Retina Tomograph.

AIMS: To quantify diabetic macular edema by confocal scanning laser ophthalmoscopy and assess its usefulness by determining the reproducibility of topographic measurements at the macula. METHODS: The volumes above reference plane bound by a 2 mm diameter circle centred on the fovea were measured by two observers. The reference plane was adjusted to the lowest point of the height variation of the contour line. The reproducibility of this technique was assessed in 20 eyes of 20 diabetic patients of which 8 eyes had macular edema. Three HRT scans of each eye were obtained. The measurements of volume above reference plane of each scan were repeated three times. RESULTS: For all diabetic eyes, the intra scan coefficients of variability measured 14.71% to 21.21%, the inter scan coefficient of variability was 30.46%. The average standard deviations were 0.053 mm3 for one examination per scan, 0.047 mm3 for two examinations per scan and 0.044 mm3 for three examinations per scan. Linear regression demonstrated an increase in standard deviation with greater volumetric measurements (p < 0.001). We found good correlation (r = 0.959, p < 0.001) and strong agreement between the two observer's findings for all 20 eyes. For the 8 eyes with macular edema, the coefficients of variability were similar to those calculated for all 20 eyes. The average SD for one examination per scan were 0.078 mm3, 0.069 mm3 for two examinations per scan and 0.062 mm3 for three examinations per scan. We found good correlation (r = 0.945, p < 0.001) and strong agreement between the two observer's findings in eyes with edema. CONCLUSION: The reproducibility of this technique has been demonstrated in diabetic eyes. This may have useful clinical applications for the quantification of diabetic macular edema and monitoring of laser therapy.

Adult↗

PubMed2001

Detection of ophthalmoscopically occult maculopathy by focal electroretinography.

We performed focal electroretinography (FERG) in 10 patients with reduced vision of unknown cause. No patient gave a family history of uncorrectably reduced vision, and none had taken any drug known to damage the retina. Visual acuity claims ranged from 20/40 to finger counting. Color discrimination was reduced in all but one patient. Visual field sensitivity was reduced nonspecifically in five of the six patients who could perform perimetry reliably. Ophthalmoscopy showed no pertinent abnormality in four of 10 patients, mildly reduced foveal reflex in two of 10, arteriolar narrowing in two of 10, foveal pigment disturbance in one of 10, and preretinal gliosis in one of 10. Flash visual evoked potential (VEP) testing showed no abnormality in seven of 7 patients. The pattern VEP was reduced or delayed in five of 5 patients, only one of whom showed the expected amplitude loss with decreasing check size. Five patients completed full-field electroretinography, six patients completed fluorescein angiography, and none showed pertinent abnormality on either test. FERG was performed in both eyes of seven patients and in one eye of three others. Signals were non-recordable from four eyes, abnormal in nine, equivocal in three, and normal in one. The severity of FERG abnormality did not correlate with the severity of acuity loss. FERG abnormalities were found in fourteen of 17 eyes of 10 patients with vision loss out of proportion to clinical findings. In these patients only one of 5 pattern VEP tests, none of 5 full-field ERGs, and none of 7 fluorescein angiograms suggested correspondingly severe maculopathy. The FERG results in these cases mitigated suspicions of nonorganic vision loss and permitted speedier referral to retinal disease and low vision specialists.

Adolescent↗

PubMed2001

Retinal pigment epithelium translocation and central visual function in age related macular degeneration: preliminary results.

PURPOSE: To test the feasibility of a new surgical technique, and to assess visual function over the translocated retinal pigment epithelium (RPE) cells in patients operated upon for subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). MATERIALS AND METHODS: Six patients presenting previously untreated exudative AMD underwent surgical excision of the subfoveal CNV with RPE translocation and were followed from 1 to 10.5 months. The surgery consisted of a standard three port pars plana vitrectomy (TPPPV), excision of the CNV and RPE translocation. Pre and post-operative ocular examination included best-corrected visual acuity measurement, fundus color stereo photography and fundus fluorescein angiography. Optical coherence tomography (OCT) and confocal laser scanning ophthalmoscopy (cLSO) were performed post-operatively. A cross fixation target and a single-point flashing light were projected on different areas of the posterior pole using a cLSO. Photopic 10-2 perimetry, photopic fine matrix mapping, cLSO microperimetry were also performed pre and post-operatively in four patients. OCT cross-sectional scans and cLSO RPE autofluorescence were recorded to detect the presence of viable translocated RPE. Visual acuity, fixation, photopic 10-2 perimetry, photopic fine matrix mapping and cLSO microperimetry were tested for the presence of central visual function. RESULTS: RPE could be effectively translocated at the time of CNV removal from the edge of the RPE defect to a subfoveal location. OCT showed the translocated RPE as an area of increased optical reflectivity with optical shadowing external to it. cLSO showed autofluorescence of the translocated RPE. The cross fixation target was seen when projected on the translocated RPE. During eccentric fixation, the patients could see a flashing point-target projected on the translocated RPE. Photopic 10-2 perimetry, photopic fine matrix mapping and cLSO microperimetry showed presence of central visual function. CONCLUSIONS: The authors propose that translocation of RPE at the time of CNV removal, from the edge of the RPE defect to a subfoveal location, may have a role in the surgical management of AMD.

Aged↗

PubMed1998

Infrared imaging of central serous chorioretinopathy: a follow-up study.

BACKGROUND: Infrared (IR) imaging improved by using scanning laser ophthalmoscopy. The greater penetration of infrared light compared with visible wavelengths permits better visualization of subretinal structures such as drusen, hyperpigmentations and choroidal new vessels. Furthermore, using the indirect mode of the instrument to detect laterally scattered light, drusen and shallow detachments of the neuroretina can easily be visualized as prominent structures. In this study we investigated the potential use of non-invasive infrared imaging in follow-up examination of patients with central serous chorioretinopathy (CSCR). METHODS: All patients with an acute CSCR underwent fluorescein angiographic studies (488 nm) and infrared imaging (788 nm) in indirect mode using a scanning laser ophthalmoscope (SLO 101; Rodenstock) at baseline and follow-up after 3-5 weeks. RESULTS: The detachment of the neuroretina could easily be visualized by infrared imaging as prominent, oval-shaped structures. The height varied corresponding to the clinical course, whereas the extent showed no relation to the change in symptoms. CONCLUSION: IR-imaging is a quick, non-invasive tool which may efficiently be used in chorioretinal diseases. In CSCR patients it provides an adjunct in clinical follow-up by monitoring the course of the disease and the effect of treatment concepts.

Acute Disease↗