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At least 109 records · Page 6Linked to original sources
PubMed2005

Evaluation of the influence of tilt of optic disc on the measurement of optic disc variables obtained by optical coherence tomography and confocal scanning laser ophthalmoscopy.

PURPOSE: To evaluate the relationship between optic disc variables measured by confocal scanning laser ophthalmoscopy (CSLO) and optical coherence tomography (OCT). METHODS: Fifty-one eyes in 27 non-glaucomatous patients were scanned using a CSLO-TopSStrade mark and an OCT-OCT 3000trade mark. The relationship between the following four optic disc variables-disc area (DA), cup area (CA), neuroretinal rim area (NRRA), and cup-disc area ratio (CDAR)-measured by CSLO and OCT were evaluated, and the relationship between these measurements and optic disc tilt was assessed. Horizontal (HD) and vertical diameters (VD) of the optic disc were measured from disc photographs, and by CSLO and OCT, and ratios (HD/VD) were then compared. RESULTS: There was a good correlation in DA, CA, and CDAR except NRRA between OCT and CSLO measurements. In eyes with a tilt >/=4 degrees, DA and NRRA were measured larger, and CDAR and CA were measured smaller by OCT than by CSLO. However, in the eyes with a tilt of <4 degrees, no significant differences in measurement of disc variables were observed for the two measurement systems. HD/VD measured from disc photographs was well correlated with those determined by CSLO (r = 0.741, P < 0.0001), however, it correlated poorly with those measured by OCT in whole study eyes (r = 0.410, P = 0.008) and in eyes tilted by >/=4 degrees, respectively (P = 0.280). CONCLUSIONS: Although CSLO and OCT measurements of the optic disc are highly correlated, discrepancy becomes prominent in eyes with a disc tilted >/=4 degrees. Therefore, analysis of the optic nerve head by OCT must be cautiously interpreted in eyes with a highly tilted disc.

Adolescent↗
PubMed1998

Use of scanning laser ophthalmoscopy to monitor papilloedema in idiopathic intracranial hypertension.

AIMS: To determine the sensitivity of confocal scanning laser ophthalmoscopy (SLO) in detecting clinically significant changes in papilloedema secondary to idiopathic intracranial hypertension (IIH) and the correlation with visual field loss. METHODS: Eight patients--three new, two recurrent, and three chronic cases of IIH--were examined over a 9 month period with SLO (Heidelberg retina tomograph) of optic nerve head and 30-2 Humphrey visual fields (six cases). Optic disc swelling (volume) was assessed in each eye using a circular contour line placed around the swollen optic nerve head on the mean image of three topographic images. Nine volume measurements from single images in each eye of every patient were performed on one occasion to assess repeatability. RESULTS: In the five acute cases optic disc volumes (range 1-16 mm3) decreased with treatment to stable, normal levels. Three of these had mild, reproducible, field defects which resolved. Two chronic cases had stable or fluctuating disc volume with no detectable change in grade of papilloedema and mild field loss. In one case which underwent theco-peritoneal shunting both disc volume and field worsened, indicating therapeutic failure. Both improved postoperatively. CONCLUSIONS: SLO has a high sensitivity for detecting small changes in disc volumes and correlates closely with visual field change in the short term. It can confirm therapeutic failure by detecting stable or increasing disc volume. Decreasing volume may indicate resolution of papilloedema or secondary optic atrophy, so accompanying funduscopy and visual fields remain essential.

Adult↗
PubMed2005

Relationships between standard automated perimetry, HRT confocal scanning laser ophthalmoscopy, and GDx VCC scanning laser polarimetry.

PURPOSE: This study was designed to determine and compare the relationships between visual function measured with standard automated perimetry (SAP) and structure, either as neuroretinal rim area measured with confocal scanning laser ophthalmoscopy (CSLO), or as retinal nerve fiber layer thickness determined by scanning laser polarimetry with variable corneal compensation (SLP-VCC). METHODS: Forty-six healthy subjects and 76 glaucoma patients were examined with SAP, with CSLO by means of the commercially available Heidelberg Retina Tomograph I (HRT), and with SLP-VCC by means of the commercially available GDx VCC. The relationships between SAP, expressed either in the typically used decibel scale or as number of abnormal points in the total deviation probability plot, and CSLO and between SAP and SLP-VCC were described with linear and logarithmic regression analysis for global data and six individual sectors. The relationship between measurements with CSLO and SLP-VCC was fit with linear regression analysis. RESULTS: The relationships between SAP and CSLO and between SAP and SLP-VCC appeared curvilinear for all sectors except the temporal one between SAP and SLP-VCC. For CSLO, a logarithmic fit was significantly better than a linear one for the global data and in the superotemporal and inferonasal sectors. For SLP-VCC, a curvilinear fit was better for the global data and in the superotemporal, superonasal, and inferonasal sectors. CSLO data correlated linearly with SLP-VCC data in all sectors, except temporally. CONCLUSIONS: CSLO and SLP-VCC showed a very similar curvilinear relationship with SAP. The observed curvilinear relationships confirm earlier reports that these imaging devices appear to detect glaucomatous loss earlier than SAP.

Birefringence↗
PubMed2006

In vivo imaging and quantitative evaluation of the rat retinal nerve fiber layer using scanning laser ophthalmoscopy.

PURPOSE: To determine whether scanning laser ophthalmoscopy (SLO) is useful for in vivo imaging and quantitative evaluation of rat retinal nerve fiber layer (RNFL) using an optic nerve crush model. METHODS: The optic nerve of the right eye was crushed intraorbitally with a clip. The left eye served as the untreated control. Fundus images of both eyes were recorded by SLO using an argon blue laser before and 1, 2, and 4 weeks after optic nerve crush. The focused plane was sequentially moved by changing the refractive values in the SLO setting. The range of refractive values (DeltaF) in which the RNFL reflex was clearly observed was determined. The RNFL thickness in retinal sections was measured and compared to the DeltaF value from SLO images taken before histologic preparation. RESULTS: Striations of RNFL radiating from the optic disc were clearly visible by SLO. No obvious changes in the RNFL reflex were observed 1 week after optic nerve crush. However, striations of RNFL became uniformly darker and thinner 2 weeks after the crush and were barely visible 4 weeks after the crush. The DeltaF value was unchanged 1 week after the crush, but then decreased significantly and progressively after the second week. DeltaF was unchanged in the control eyes during the experimental period. The DeltaF value correlated significantly with the histologically determined RNFL thickness. CONCLUSIONS: SLO is a useful and valuable tool for in vivo imaging and quantitative evaluation of rat RNFL.

Animals↗
PubMed2007

The effects of study design and spectrum bias on the evaluation of diagnostic accuracy of confocal scanning laser ophthalmoscopy in glaucoma.

PURPOSE: To assess the effects of study design and spectrum bias on the evaluation of diagnostic accuracy of confocal scanning laser ophthalmoscopy (CSLO) in glaucoma. METHODS: Analysis 1 included 67 eyes with glaucomatous visual field loss and 56 eyes of normal volunteers. Estimates of diagnostic accuracy in this analysis were compared to those obtained from analysis 2, which included a cohort of patients with suspected glaucoma, but without visual field loss at the time of CSLO imaging. For analysis 2, 40 eyes with progressive glaucomatous optic disc change were included in the glaucoma group and 43 eyes without any evidence of progressive damage to the optic nerve that were observed untreated for an average time of 9.01 +/- 3.09 years were included in the normal group. Areas under the receiver operating characteristic (ROC) curves (AUC) were used to evaluate diagnostic accuracy of CSLO parameters. RESULTS: There was a statistically significant difference between the performance of the parameter with largest AUC, discriminant function Bathija, in analysis 1 (AUC = 0.91) compared with its performance in analysis 2 (AUC = 0.71; P = 0.002). For the contour-line-independent parameter glaucoma probability score, a statistically significant difference was also observed in the performance obtained in analysis 1 (AUC = 0.89) compared with analysis 2 (AUC = 0.65; P < 0.001). CONCLUSIONS: Estimates of diagnostic accuracy of CSLO in glaucoma can be largely different depending on the population studied and the reference standard used to define disease. Diagnostic accuracy estimates obtained from case-control studies including well-defined groups of subjects with or without disease may not be applicable to the clinically relevant population.

Adult↗
PubMed2005

Automated analysis of digital fundus autofluorescence images of geographic atrophy in advanced age-related macular degeneration using confocal scanning laser ophthalmoscopy (cSLO).

BACKGROUND: Fundus autofluorescence (AF) imaging using confocal scanning laser ophthalmoscopy (cSLO) provides an accurate delineation of areas of geographic atrophy (GA). Automated computer-assisted methods for detecting and removing interfering vessels are needed to support the GA quantification process in longitudinal studies and in reading centres. METHODS: A test tool was implemented that uses region-growing techniques to segment GA areas. An algorithm for illuminating shadows can be used to process low-quality images. Agreement between observers and between three different methods was evaluated by two independent readers in a pilot study. Agreement and objectivity were assessed using the Bland-Altman approach. RESULTS: The new method (C) identifies vascular structures that interfere with the delineation of GA. Results are comparable to those of two commonly used procedures (A, B), with a mean difference between C and A of -0.67 mm2 (95% CI [-0.99, -0.36]), between B and A of -0.81 mm2, (95% CI [-1.08, -0.53]), and between C and B of 0.15 mm2 (95% CI [-0.12, 0.41]). Objectivity of a method is quantified by the mean difference between observers: A 0.30 mm2 (95% CI [0.02, 0.57]), B -0.11 mm2 (95% CI [-0.28, 0.10]), and C 0.12 mm2 (95% CI [0.02, 0.22]). CONCLUSION: The novel procedure is comparable with regard to objectivity and inter-reader agreement to established methods of quantifying GA. It considerably speeds up the lengthy measurement process in AF with well defined GA zones.

Algorithms↗
PubMed2006

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

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

Aged↗
PubMed1999

Analysis of the retinal edema of full-thickness macular holes by scanning laser ophthalmoscopy and optical coherence tomography.

The purpose of this study was to investigate the relationship between the dark area illuminated by scanning laser ophthalmoscopy (SLO) and cystic spaces around macular holes as shown by optical coherence tomography (OCT). SLO allows for two dimensional retinal examination, using short wave length (514 nm, argon) which is useful for the vitreoretinal surface and inner retina; red helium-neon laser (633 nm), which is capable of imaging deeper tissues; and infrared diode laser (780 nm), for choroidal examination. OCT is analogous to ultrasound except that optical rather than acoustic reflectivity is measured. OCT can produce the cross-sectional view of retina. Using SLO (helium-neon laser) and OCT, we examined 8 eyes with full-thickness macular holes. Eight normal eyes served as controls. Cystic spaces were in proportion to dark areas with statistical significance as shown by correlation analysis. Evaluation of the full-thickness macular holes by using both SLO and OCT is highly useful.

Aged↗
PubMed2000

Time course of the size of the dark area in macular holes by scanning laser ophthalmoscopy.

To investigate the time course of idiopathic macular hole development by scanning laser ophthalmoscopy (SLO), we examined 28 eyes of 25 patients with macular holes. Cases included four eyes with stage 1-B disease (foveal detachment), 3 with stage 2 (break at the fovea), 13 with stage 3 (full-thickness macular hole), and 8 with stage 4 (hole with pseudo-operculum, posterior vitreous detachment), according to Gass's classification. The diameter of the dark area around the macular holes was recorded by SLO using a helium-neon laser. We compared the percent difference of dark area recorded between initial findings and these after three months. The size of the dark area increased after three months in eyes with stages 1, 2, and 3 disease. The size of the dark area in stage 4 disease decreased after 3 months. In the stage before posterior vitreous detachment (PVD), the dark areas increased. Once PVD occurred, these areas decreased. These findings suggested that the time course of the dark area may be related to the development of PVD.

Aged↗
PubMedDate not supplied

Adaptive optics ophthalmoscopy.

Retinal images in the human eye are normally degraded because we are forced to use the optical system of the human eye--which is fraught with aberrations--as the objective lens. The recent application of adaptive optics technology to measure and compensate for these aberrations has produced retinal images in human eyes with unprecedented resolution. The adaptive optics ophthalmoscope is used to take pictures of photoreceptors and capillaries and to study spectral and angular tuning properties of individual photoreceptors. Application of adaptive optics technology for ophthalmoscopy promises continued progress toward understanding the basic properties of the living human retina and also for clinical applications.

Humans↗
PubMedDate not supplied

Ophthalmoscopy and vitreoretinal surgery in patients with an ARRAY refractive multifocal intraocular lens implant.

We developed a clinical strategy for dealing with situations in which ophthalmoscopic examination and vitreoretinal surgery are difficult in patients with an ARRAY refractive multifocal intraocular lens (IOL) implant. The ARRAY zonal-progressive IOL has a central 2.1-mm distance-vision zone for optically-unobstructed posterior pole observation. A concentric near-vision zone (+3.5-diopter add) surrounds this central zone. Optical ray-tracing is used to determine how a 2.1-mm pupil limitation restricts monocular and binocular retinal image size in head-mounted, slit-lamp, and operating microscope ophthalmoscopy. A 2.1-mm pupil decreases the retinal field of view of high magnification, narrow field lenses much more than that of wider-field, lower magnification lenses. This "worst-case" analysis suggests an ophthalmoscopic strategy, but is not strictly valid for the ARRAY lens because the near-vision zone surrounding its 2.1-mm central zone is not opaque. The near-vision zone contributes defocused information to the ophthalmoscopic image, diminishing its resolution and depth information. Wide-field, low magnification lenses are potentially less problematic than higher magnification lenses for examining and treating patients with an ARRAY IOL implant. This strategy is useful for panretinal photocoagulation or photodynamic therapy, but not for procedures requiring high magnification stereoscopic vision such as macular vitreoretinal surgery.

Eye Diseases↗
PubMed2004

[How I explore...significance of ophthalmoscopy in patients with arterial hypertension].

The ocular fundus is the only examination which allows a simple and non invasive visualisation of the terminal vascular system. Feature analysis of fundus examination supposes a similar vascular state in the other organs and permits direct diagnostic, prognostic and therapeutic choices. This article will emphasize the value of an ophthalmoscopy examination in patients with arterial hypertension.

Fundus Oculi↗
PubMed1992

A method of teaching indirect ophthalmoscopy to beginning residents.

The authors describe an effective tool for teaching indirect ophthalmoscopy that is easily constructed from a roll of tape. The materials are inexpensive and readily available. The hollow interior of the roll affords a large pupillary opening, and one does not risk scratching the condensing lens on the metal surface of a commercial model eye.

Education, Medical, Graduate↗
PubMed2005

Postmortem monocular indirect ophthalmoscopy.

Postmortem monocular indirect ophthalmoscopy permits examination of the posterior fundus and peripheral retina even if there is less than perfect anterior segment media such as postmortem corneal clouding. Light directed through the decedent's pupil from a bright focal light source illuminates the fundus and reflected light from the retina is then projected out of the eye. An aspheric condensing lens positioned in front of the eye focuses the retinal image at the focal plane of the lens. The real inverted, laterally reversed image comprises a wide field of view permitting evaluation of the decedent's fundus for retinal hemorrhages and other lesions.

Forensic Pathology↗
PubMed1990

A general numerical method evaluating three-dimensional eye rotations by scanning laser ophthalmoscopy.

A general computational method is described to specify completely the rotational state of the eye in three dimensions by scanning laser ophthalmoscopy (SLO). The method uses the simplex algorithm to fit the eye's rotational parameters to data given by n individually selected ocular fundus landmarks before and after the eye rotation. The rotational parameters are expressed as the rotation vector and three spherical Euler angles. The method, which was implemented in the C programming language, can be applied for various eye movement measurements in clinical and laboratory environments, including SLO.

Algorithms↗
PubMed1989

Use of a convex mirror in indirect ophthalmoscopy for patients in a prone position.

Fundus examination with the patient in a prone position sometimes requires the observer to assume an uncomfortable position. I describe using a convex rear-view mirror with an 800-mm radius of curvature in binocular indirect ophthalmoscopy to overcome this difficulty. This device is especially helpful in pneumatic retinopexy.

Fundus Oculi↗
PubMed1985

Minimizing risk of adverse reactions to mydriatic agents in binocular indirect ophthalmoscopy.

To minimize the risk of adverse side effects from mydriatics during binocular indirect ophthalmoscopy, a procedure was developed which intentionally starts with a dose significantly less than an ED99. Using a clinically effective diameter of greater than 7 mm as a criterion, I found that 1 drop of 0.5% tropicamide (T) constituted an ED74 (N = 46). When 1 drop of 2.5% phenylephrine (P) was added, this increased to an ED93 (N = 27). If present results can be generalized, then 1 drop of T, supplemented at 30 minutes with 1 drop of P, if necessary, should produce satisfactory dilatation in approximately 90% of the subjects.

Adult↗