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Asia-Pacific Journal of Ophthalmology... 2020With the advent of smartphone-based fundus imaging (SBFI), a low-cost alternative to conventional digital fundus photography has become available. SBFI allows for a... (Review)
Review
With the advent of smartphone-based fundus imaging (SBFI), a low-cost alternative to conventional digital fundus photography has become available. SBFI allows for a mobile fundus examination, is applicable both with and without pupil dilation, comes with built-in connectivity and post-processing capabilities, and is relatively easy to master. Furthermore, it is delegable to paramedical staff/technicians and, hence, suitable for telemedicine. Against this background a variety of SBFI applications have become available including screening for diabetic retinopathy, glaucoma, and retinopathy of prematurity and its applications in emergency medicine and pediatrics. In addition, SBFI is convenient for teaching purposes and might serve as a surrogate for direct ophthalmoscopy. First wide-field montage techniques are available and the combination of SBFI with machine learning algorithms for image analyses is promising. In conclusion, SBFI has the potential to make fundus examinations and screenings for patients particularly in low- and middle-income settings more accessible and, therefore, aid tackling the burden of diabetic retinopathy, glaucoma, and retinopathy of prematurity screening. However, image quality for SBFI varies substantially and a reference standard for grading appears prudent. In addition, there is a strong need for comparison of different SBFI approaches in terms of applicability to disease screening and cost-effectiveness.
Topics: Diagnostic Imaging; Diagnostic Techniques, Ophthalmological; Eye Diseases; Fundus Oculi; Humans; Ophthalmoscopy; Photography; Smartphone; Telemedicine
PubMed: 32694345
DOI: 10.1097/APO.0000000000000303 -
Klinische Monatsblatter Fur... Dec 2014
Topics: Biotechnology; Diagnostic Techniques, Ophthalmological; Germany; Ophthalmoscopy
PubMed: 25519501
DOI: 10.1055/s-0034-1383368 -
Progress in Retinal and Eye Research Sep 2017Imaging techniques based on retinal autofluorescence have found broad applications in ophthalmology because they are extremely sensitive and noninvasive. Conventional... (Review)
Review
Imaging techniques based on retinal autofluorescence have found broad applications in ophthalmology because they are extremely sensitive and noninvasive. Conventional fundus autofluorescence imaging measures fluorescence intensity of endogenous retinal fluorophores. It mainly derives its signal from lipofuscin at the level of the retinal pigment epithelium. Fundus autofluorescence, however, can not only be characterized by the spatial distribution of the fluorescence intensity or emission spectrum, but also by a characteristic fluorescence lifetime function. The fluorescence lifetime is the average amount of time a fluorophore remains in the excited state following excitation. Fluorescence lifetime imaging ophthalmoscopy (FLIO) is an emerging imaging modality for in vivo measurement of lifetimes of endogenous retinal fluorophores. Recent reports in this field have contributed to our understanding of the pathophysiology of various macular and retinal diseases. Within this review, the basic concept of fluorescence lifetime imaging is provided. It includes technical background information and correlation with in vitro measurements of individual retinal metabolites. In a second part, clinical applications of fluorescence lifetime imaging and fluorescence lifetime features of selected retinal diseases such as Stargardt disease, age-related macular degeneration, choroideremia, central serous chorioretinopathy, macular holes, diabetic retinopathy, and retinal artery occlusion are discussed. Potential areas of use for fluorescence lifetime imaging ophthalmoscopy will be outlined at the end of this review.
Topics: Fluorescein Angiography; Humans; Ophthalmoscopy; Retina; Retinal Diseases
PubMed: 28673870
DOI: 10.1016/j.preteyeres.2017.06.005 -
Harefuah Jul 2020
Topics: Fundus Oculi; Humans; Ophthalmoscopy
PubMed: 33249799
DOI: No ID Found -
Ophthalmology Mar 2019
Topics: Humans; Infant, Newborn; Ophthalmoscopy; Retinopathy of Prematurity
PubMed: 30803525
DOI: 10.1016/j.ophtha.2018.10.025 -
Current Opinion in Neurology Feb 2019The funduscopic examination can be a technically difficult, and often omitted, portion of the neurologic examination, despite its great potential to influence patient... (Review)
Review
PURPOSE OF REVIEW
The funduscopic examination can be a technically difficult, and often omitted, portion of the neurologic examination, despite its great potential to influence patient care.
RECENT FINDINGS
Medical practitioners are often first taught to examine the ocular fundus using a direct ophthalmoscope, however, this skill requires frequent practice. Nonmydriatic tabletop and portable fundus photography and even smartphone-based photography offer alternative and practical means for approaching examination of the ocular fundus. These alternative tools have been shown to be practical in a variety of settings including ambulatory clinics and emergency departments. Decreased retinal microvascular density detected with fundus photography has been linked to accelerated rates of cognitive decline. Research has also found optic disc pallor and retinopathy detected via fundus photography to be more prevalent in patients with recent stroke or transient ischemic attack.
SUMMARY
Alternative methods of funduscopic examination based on fundus photography have the potential to improve the ease of use, portability, and availability of funduscopy. Recognition of changes in retinal microvasculature has the potential to noninvasively identify patients at the highest risk for cognitive impairment and cerebrovascular disease. However, further research is needed to determine the specific utility of measurements of retinal microvascular changes in clinical care. Innovative funduscopy techniques offer neurologists new approaches to this essential facet of the neurological examination.
Topics: Eye Diseases; Fundus Oculi; Humans; Neurologic Examination; Ophthalmoscopy; Photography
PubMed: 30516640
DOI: 10.1097/WCO.0000000000000637 -
Indian Journal of Ophthalmology Jul 2015The methods of fundus examination include direct and indirect ophthalmoscopy and imaging with a fundus camera are an essential part of ophthalmic practice. The usage of... (Review)
Review
The methods of fundus examination include direct and indirect ophthalmoscopy and imaging with a fundus camera are an essential part of ophthalmic practice. The usage of unconventional equipment such as a hand-held video camera, smartphone, and a nasal endoscope allows one to image the fundus with advantages and some disadvantages. The advantages of these instruments are the cost-effectiveness, ultra portability and ability to obtain images in a remote setting and share the same electronically. These instruments, however, are unlikely to replace the fundus camera but then would always be an additional arsenal in an ophthalmologist's armamentarium.
Topics: Fluorescein Angiography; Fundus Oculi; Humans; Ophthalmoscopy; Retinal Diseases; Smartphone
PubMed: 26458475
DOI: 10.4103/0301-4738.167123 -
Eye (London, England) Jan 2021This is a comprehensive review of the principles and applications of adaptive optics (AO) in ophthalmology. It has been combined with flood illumination ophthalmoscopy,... (Review)
Review
This is a comprehensive review of the principles and applications of adaptive optics (AO) in ophthalmology. It has been combined with flood illumination ophthalmoscopy, scanning laser ophthalmoscopy, as well as optical coherence tomography to image photoreceptors, retinal pigment epithelium (RPE), retinal ganglion cells, lamina cribrosa and the retinal vasculature. In this review, we highlight the clinical studies that have utilised AO to understand disease mechanisms. However, there are some limitations to using AO in a clinical setting including the cost of running an AO imaging service, the time needed to scan patients, the lack of normative databases and the very small size of area imaged. However, it is undoubtedly an exceptional research tool that enables visualisation of the retina at a cellular level.
Topics: Humans; Ophthalmology; Ophthalmoscopy; Optics and Photonics; Retina; Tomography, Optical Coherence
PubMed: 33257798
DOI: 10.1038/s41433-020-01286-z -
BioMed Research International 2015
Topics: Animals; Cross-Linking Reagents; Humans; Keratoconus; Ophthalmoscopy; Photochemotherapy; Riboflavin; Tomography, Optical Coherence; Treatment Outcome; Ultraviolet Therapy
PubMed: 25949993
DOI: 10.1155/2015/306439 -
British Journal of Hospital Medicine... Feb 2017
Review
Topics: Diagnosis, Differential; Eye Diseases; Humans; Ophthalmoscopy
PubMed: 28165780
DOI: 10.12968/hmed.2017.78.2.C28