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Variable angle retinal nerve fibre layer photography: a review.

Optic disc and retinal nerve fibre layer (RNFL) photography have been an integral part of the routine screening of glaucoma patients, ocular hypertensives and glaucoma suspects in Perth since 1979. During this period 60 degrees, 40 degrees, 30 degrees and 8 degrees angles of view were examined for potential use in RNFL photography. The degree of dilation and media opacity is highly variable in glaucoma patients because of the age group involved and the miotic therapy. It was found that the 30 degree angle of view gave the most consistent results for routine RNFL photography. Ocular hypertensives tended to be of a lower mean age and 40 degrees wide angle photography was possible but required two different photographic techniques and was not continued. Both 60 degrees and high-magnification RNFL photography are currently used only with selected patients for teaching and demonstration. A modified Hasselblad 120 roll film camera was used for high-resolution RNFL photography. The Hasselblad adaptors, high-resolution results and comparisons with wide-angle RNFL photographs are illustrated in this paper.

Fundus Oculi

Examination of macular vitreoretinal interface disorders with monochromatic photography.

Monochromatic light accentuates details of different retinal layers because of its variable absorption and reflectance by structures both within and above these layers. Monochromatic photography was used to examine macular vitreoretinal interface abnormalities in 19 patients. Short wavelength photographs (490 nm) provided the best detail of inner retinal abnormalities, including epiretinal membranes, vitreoretinal traction, and the internal surface of confluent macular edema (pseudocyst). Although 540-nm red-free photography provided acceptable photographs, it did not provide optimal detail of inner or deep retinal abnormalities. Longer wavelengths, 585 and 610 nm, best disclosed the extent of deep retinal abnormalities, including the extent of confluent macular edema (pseudocysts) and retinal detachment that surrounded macular holes. The addition of short- and long-wave-length photography to traditional red-free photography may provide better localization, understanding, and documentation of the three-dimensional relationships in macular vitreoretinal interface disorders.

Eye Diseases

Photography of the nerve fiber layer in retinal disturbances.

The diagnostic value of nerve fiber layer photography is assessed. The series comprised 39 patients with various neuro-ophthalmological diseases. Photography of the nerve fibers in the retina is time consuming and requires skill on the part of the photographer. Differences in the papillomacular nerve fiber layer are difficult to distinguish using the present methods. The wasting of nerve fibers could be documented by photography in advanced cases with bitemporal hemianopia, but not in small relative scotomas. Cases with homonymous hemianopia are interesting because lesions in the optic tract can be differentiated from affections of the second neuron on the basis of retinal nerve fiber atrophy. In demyelinating diseases inspection of the retinal nerve fiber layer is of clinical importance and diagnostic changes appear,

Adolescent

Photography as a method of recording and improving skill in laparoscopy.

The techniques of photography in diagnostic laparoscopy are presented. It is suggested that photography, as well as being the best method of recording information, is of great use in improving and teaching laparoscopic skill, through comparison of case findings either at subsequent laparotomy on the same patient, or in similar conditions found at laparoscopy in different patients. Presumptive and hurried diagnoses cannot be made if a camera is used; the abnormality must be found to be photographed and recorded. A plea is made for the increased use of photography. Experience is presented with both polaroid and reflex 35 mm cameras.

Female

[Monitoring the progress of lens opacities in cases of senile cataract by retro-illumination photography (author's transl)].

A follow-up study of lens opacities, utilizing retro-illumination photography with the fundus camera is described. After giving technical details, results are discussed and possible errors pointed out. If evaluation by planimetry or other devices is not possible, a useful procedure is the evaluation of simultaneous projected slides by a group of ophthalmologists not directly involved in the trial. This is demonstrated by testing the effect of 1-hydroxy-pyrido-(3,2alpha)-5-phenoxazone-3-carboxylic acid on the progress of senile cataract in a total of 48 eyes. Together with slit image photography of Brown (2, 3) the method of retro-illumination photography of the lens presented in this paper is a definite improvement in demonstrating the temporal course of cataract development.

Aged

Laryngeal photography.

Various methods of still photography and videography of the larynx are described in this article, some simple, inexpensive, and recommended for residents and occasional laryngeal photographers, while others are more involved, costly, and recommended for serious laryngologists. The choice of a specific method depends upon the physician's need, the availability of the equipment, budget, and more importantly, photographic skill and imagination. Although still photography is a valuable method of laryngeal documentation today, videography increasingly is gaining favor. Because of its simplicity, reproducibility, time and cost effectiveness, and capacity to simultaneously record laryngeal images and voice, videography has distinct advantages and may someday replace still photography of the larynx.

Humans

[Comparative study of reproduction and Scheimpflug's photography of the crystalline lens].

Two types of lens photography are compared in the same patients: photography according to Schaimpflüger and reproduction biomicrophotography with subsequent densitometry of the negatives. The authors find Schaimpflüger's photography preferable, its advantages consisting in convenience of the procedure and possibility to make standard pictures. An experienced worker can make high-quality images of the lens optic section with a slit photographic lamp, this permitting an objective assessment of changes in the optic densities of different lenticular laminae.

Densitometry

[Further fields of application of the infrared false colour film in ophthalmological photography (author's transl)].

Aside from the distinction between old hemorrhages and pigmented changes of the ocular fundus, the use of metaspectrophotography of the eye with the Kodak Ektrachrome Infrared Film IE 135-20 can be extended successfully to other fields of ophthalmological photography. By shifting the spectral range used for photography towards near infrared and cutting off the short wavelenght part by a yellow filter, spoiling scattering is avoided up to 98 percent. Thus clear goniophotography is rendered possible even with higher magnification. Better pictures are achieved in photography of the periphery of the ocular fundus, of the fundus of eyes with moderate opacity of the cristalline lens, of juvenile macular degeneration, and of pigmented areas of the iris suspected to be tumorous.

Eye Diseases

Ocular fundus photography.

This chapter is a review of fundus photography techniques, with particular emphasis on the important parameters of producing high quality fundus photographs. The role of fundus photography has extended beyond that of a documentary service to one with specific diagnostic value. Thus, ocular fundus photography relates directly to patient care and is an essential part of the sophisticated armamentarium of any clinical ophthalmological unit.

Fundus Oculi

[Diagnostic references in optic nerve diseases using retinal nerve fiber photography].

Two patients with optic nerve disease are reported. The first patient was 20 years old and had suffered a closed head injury 1 year earlier. She presented with an incongruous right hemianopsia; retinal nerve fiber layer photography disclosed an infragenicular lesion and descending atrophy of the medial postchiasmal parts of the optic tract. The second patients was 24 years old. He had had depressed visual acuity in his right eye for 7 h before presentation. Perimetry showed a quadrant anopsia of the lower nasal field. The diagnosis made on the basis of fluorescein-angiography was recurrent retinochorioiditis with acute occlusion of an arterial branch. Retinal nerve fiber layer photography in this early stage showed a more pronounced nerve fiber pattern in the area normally supplied by the occluded artery, most probably caused by axoplasmic edema; along the course nerve fibers showed ascending atrophy in this circumscribed area. In both cases papillometry had given no evidence of any alteration in the area of the neuroretinal rim. In contrast to glaucomatous optic atrophy, localized disturbances of perfusion apparently cannot be detected by examination of the area of the neuroretinal rim of the optic nerve. In nonglaucomatous optic nerve diseases retinal nerve fiber layer photography is more informative.

Adult

Nonmydriatic fundus photography in screening for treatable diabetic retinopathy.

Diabetic retinopathy is a complication of both insulin-dependent (type I) and non-insulin-dependent (type II) diabetes. The American Diabetes Association and others recommend screening for retinopathy, beginning 5 years after onset of symptoms for patients with type I diabetes and at the time of diagnosis for patients with type II diabetes. Ideally, diabetic patients are evaluated at recommended intervals by an ophthalmologist. Realistically, however, this is often not feasible, for reasons both of cost and availability. There is evidence that many diabetic patients are being referred too late for intervention, perhaps in part due to lax screening and detection, often the responsibility of internists and other primary care physicians. Data supports the need for a cheap, widely available, easy-to-use, effective screening tool for detecting treatable diabetic retinopathy. To this end, several studies have evaluated nonmydriatic fundus photography, and compared it with more-established methods of detecting diabetic retinal disease. The real question to be considered is whether nonmydriatic fundus photography will help to detect early treatable retinopathy better than the average physician using ophthalmoscopy. Several studies support its usefulness in this regard, and are discussed in this review. Questions remain, however, and further study is warranted in evaluating its potential role.

Diabetes Mellitus, Type 1

Fundus photography in optometric practice.

Fundus photography, an established facet of institutional clinic and hospital ocular care, is emerging as a valuable tool for the private practitioner. Ocular photography permits improved patient care with the additional benefit of providing a means for continuing education for the practitioner. The initial investment depends on the type of fundus camera selected and the number of accessories included in the purchase. The type of camera and accessories selected by a practitioner will vary with the mode and scrope of his/her practice. Numerous types of film are available, but Kodachrome 25 (ASA 25) is recommended. The experienced fundus photographer develops a routine of camera preparation and photographic techniques that provides a consistently successful photographic session.

Adolescent

Nature-based meaning-focused photography intervention enhances subjective well-being: A three-arm randomized controlled study.

Gaining meaning from nature contact can promote subjective well-being. However, few studies have validated the effectiveness of nature-based meaning interventions in enhancing subjective well-being. This study consisted of a 7-day online intervention to examine the effects of nature-based meaning-focused photography on well-being by comparing a photo-only group, a photo + writing group, and a waiting list control group and how meaning in life mediates the relationship between nature contact and well-being. A pre-registered three-arm randomized controlled trial (groups: photo + writing group vs. photo-only group vs. control group) * (time: pre-test vs. post-test vs. 1-month follow-up) was conducted with 219 college students. In the photo + writing group, participants captured nature scenes and wrote 100-word reflections. The photo-only group only took nature photos. The primary outcomes were meaning in life and well-being, and the secondary outcome was life satisfaction. A conservative Bayesian causal forest analysis based on machine learning was used to detect both treatment and heterogeneous intervention effects. Compared with the control group, the photo + writing group showed positive effects on meaning in life, subjective well-being, and life satisfaction, with average treatment effects of 0.36, 0.27, and 0.66 standard deviations (SD), respectively. The photo-only group also showed generally positive effects on these outcomes, with average treatment effects of 0.27, 0.24, and 0.54 SD, respectively. However, these effects were not sustained after 1 month. The intervention was especially beneficial for participants from lower subjective socioeconomic status, with limited prior nature exposure, or lower baseline psychological well-being. Importantly, enhanced meaning in life helped explain how the intervention improved well-being and life satisfaction. This study also demonstrated that combining nature-based photography and reflective writing can improve well-being.

Humans