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Investigative Ophthalmology & Visual... Feb 2022To characterize the association between foveal shape and cone and retinal pigment epithelium (RPE) cell topographies in healthy humans.
PURPOSE
To characterize the association between foveal shape and cone and retinal pigment epithelium (RPE) cell topographies in healthy humans.
METHODS
Multimodal adaptive scanning light ophthalmoscopy and optical coherence tomography (OCT) were used to acquire images of foveal cones, RPE cells, and retinal layers in eyes of 23 healthy participants with normal foveas. Distributions of cone and RPE cell densities were fitted with nonlinear mixed-effects models. A linear mixed-effects model was used to examine the relationship between cone and RPE inter-cell distances and foveal shape as obtained from the OCT scans of retinal thickness.
RESULTS
The best-fit model to the cone densities was a power function with a nasal-temporal asymmetry. There was a significant linear relationship among cone and RPE cell spacing, foveal shape, and foveal cell topography. The model predictions of the central 10° show that the contributions of both the cones and RPE cells are necessary to account for foveal shape.
CONCLUSIONS
The results indicate that there is a strong relationship between cone and RPE cell spacing and the shape of the human adolescent and adult fovea. This finding adds to the existing evidence of the critical role that the RPE serves in fetal foveal development and through adolescence, possibly via the imposition of constraints on the number and distribution of foveal cones.
Topics: Adolescent; Adult; Aged; Female; Fovea Centralis; Healthy Volunteers; Humans; Male; Middle Aged; Ophthalmoscopy; Retinal Cone Photoreceptor Cells; Tomography, Optical Coherence; Visual Acuity; Young Adult
PubMed: 35113142
DOI: 10.1167/iovs.63.2.8 -
Medical Science Monitor : International... Dec 2023Visualization of the retinal structure is crucial for understanding the pathophysiology of ophthalmic diseases, as well as for monitoring their course and treatment... (Review)
Review
Visualization of the retinal structure is crucial for understanding the pathophysiology of ophthalmic diseases, as well as for monitoring their course and treatment effects. Until recently, evaluation of the retina at the cellular level was only possible using histological methods, because the available retinal imaging technology had insufficient resolution due to aberrations caused by the optics of the eye. Adaptive optics (AO) technology improved the resolution of optical systems to 2 µm by correcting optical wave-front aberrations, thereby revolutionizing methods for studying eye structures in vivo. Within 25 years of its first application in ophthalmology, AO has been integrated into almost all existing retinal imaging devices, such as the fundus camera (FC), scanning laser ophthalmoscopy (SLO), and optical coherence tomography (OCT). Numerous studies have evaluated individual retinal structures, such as photoreceptors, blood vessels, nerve fibers, ganglion cells, lamina cribrosa, and trabeculum. AO technology has been applied in imaging structures in healthy eyes and in various ocular diseases. This article aims to review the roles of AO imaging in the diagnosis, management, and monitoring of age-related macular degeneration (AMD), diabetic retinopathy (DR), glaucoma, hypertensive retinopathy (HR), central serous chorioretinopathy (CSCR), and inherited retinal diseases (IRDs).
Topics: Humans; Retina; Ophthalmoscopy; Tomography, Optical Coherence; Diabetic Retinopathy; Central Serous Chorioretinopathy
PubMed: 38044597
DOI: 10.12659/MSM.941926 -
Arquivos de Neuro-psiquiatria May 2023The observation of the human retina began in 1851 after the invention of the first ophthalmoscope by the German physicist Hermann von Helmholtz. In the following...
The observation of the human retina began in 1851 after the invention of the first ophthalmoscope by the German physicist Hermann von Helmholtz. In the following decades, direct and indirect ophthalmoscopy, with the use of ophthalmoscopes and condensing lenses, respectively, became part of the clinical examination, especially in ophthalmology and neurology. Today, over 170 years later, many ophthalmoscopes and condensing lenses exist on the market. Nevertheless, ophthalmoscopy is still not widely adopted as part of the physical exam of general practitioners, and the teaching of ophthalmoscopy in medical school remains challenging. Studies have shown that students prefer using newer ophthalmoscope models or condensing lenses during training, but most do not feel confident in performing ophthalmoscopy afterwards, regardless of the models used. Also, few students acquire ophthalmoscopes for their future practice, and clinical trials have not clearly demonstrated superiority of newer ophthalmoscope models over the conventional ones in diagnostic accuracy. The technological improvement of smartphone cameras in recent years has made it feasible to photograph the fundus of the eye using ophthalmoscopes or condensing lenses, reducing the need for retinographs and similar equipment. Smartphone assisted indirect fundoscopy is becoming increasingly popular. This approach allows adequate identification of the structures of the fundus, is cost-efficient, easy to implement, and permits easy recording and sharing of the images obtained, which is useful for case discussions and medical teaching. However, controlled clinical trials validating this method in the evaluation of optic nerve pathologies are needed.
Topics: Humans; Smartphone; Ophthalmoscopy; Ophthalmoscopes; Fundus Oculi; Neurology
PubMed: 37257471
DOI: 10.1055/s-0043-1763489 -
JAMA Ophthalmology May 2018
Topics: Humans; Infant, Low Birth Weight; Infant, Newborn; Ophthalmoscopy; Retinopathy of Prematurity; Telemedicine
PubMed: 29621373
DOI: 10.1001/jamaophthalmol.2018.0656 -
Der Nervenarzt Aug 2016
Topics: Fundus Oculi; Humans; Image Interpretation, Computer-Assisted; Mobile Applications; Ophthalmoscopes; Ophthalmoscopy; Optic Nerve Diseases; Smartphone
PubMed: 27402574
DOI: 10.1007/s00115-016-0160-7 -
Current Opinion in Ophthalmology May 2024In this review, we explore the investigational applications of optical coherence tomography (OCT) in retinopathy of prematurity (ROP), the insights they have delivered... (Review)
Review
PURPOSE OF REVIEW
In this review, we explore the investigational applications of optical coherence tomography (OCT) in retinopathy of prematurity (ROP), the insights they have delivered thus far, and key milestones for its integration into the standard of care.
RECENT FINDINGS
While OCT has been widely integrated into clinical management of common retinal diseases, its use in pediatric contexts has been undermined by limitations in ergonomics, image acquisition time, and field of view. Recently, investigational handheld OCT devices have been reported with advancements including ultra-widefield view, noncontact use, and high-speed image capture permitting real-time en face visualization. These developments are compelling for OCT as a more objective alternative with reduced neonatal stress compared to indirect ophthalmoscopy and/or fundus photography as a means of classifying and monitoring ROP.
SUMMARY
OCT may become a viable modality in management of ROP. Ongoing innovation surrounding handheld devices should aim to optimize patient comfort and image resolution in the retinal periphery. Future clinical investigations may seek to objectively characterize features of peripheral stage and explore novel biomarkers of disease activity.
Topics: Infant, Newborn; Humans; Child; Retinopathy of Prematurity; Tomography, Optical Coherence; Retina; Ophthalmoscopy; Diagnostic Techniques, Ophthalmological
PubMed: 38205941
DOI: 10.1097/ICU.0000000000001030 -
Ophthalmic Surgery, Lasers & Imaging... Jun 2020
Topics: Humans; Ophthalmoscopy; Retinal Diseases; Tomography, Optical Coherence; Vitreous Body
PubMed: 32579689
DOI: 10.3928/23258160-20200603-01 -
JAMA Ophthalmology May 2018Examinations for retinopathy of prematurity (ROP) are typically performed using binocular indirect ophthalmoscopy. Telemedicine studies have traditionally assessed the... (Comparative Study)
Comparative Study
IMPORTANCE
Examinations for retinopathy of prematurity (ROP) are typically performed using binocular indirect ophthalmoscopy. Telemedicine studies have traditionally assessed the accuracy of telemedicine compared with ophthalmoscopy as a criterion standard. However, it is not known whether ophthalmoscopy is truly more accurate than telemedicine.
OBJECTIVE
To directly compare the accuracy and sensitivity of ophthalmoscopy vs telemedicine in diagnosing ROP using a consensus reference standard.
DESIGN, SETTING, AND PARTICIPANTS
This multicenter prospective study conducted between July 1, 2011, and November 30, 2014, at 7 neonatal intensive care units and academic ophthalmology departments in the United States and Mexico included 281 premature infants who met the screening criteria for ROP.
EXPOSURES
Each examination consisted of 1 eye undergoing binocular indirect ophthalmoscopy by an experienced clinician followed by remote image review of wide-angle fundus photographs by 3 independent telemedicine graders.
MAIN OUTCOMES AND MEASURES
Results of both examination methods were combined into a consensus reference standard diagnosis. The agreement of both ophthalmoscopy and telemedicine was compared with this standard, using percentage agreement and weighted κ statistics.
RESULTS
Among the 281 infants in the study (127 girls and 154 boys; mean [SD] gestational age, 27.1 [2.4] weeks), a total of 1553 eye examinations were classified using both ophthalmoscopy and telemedicine. Ophthalmoscopy and telemedicine each had similar sensitivity for zone I disease (78% [95% CI, 71%-84%] vs 78% [95% CI, 73%-83%]; P > .99 [n = 165]), plus disease (74% [95% CI, 61%-87%] vs 79% [95% CI, 72%-86%]; P = .41 [n = 50]), and type 2 ROP (stage 3, zone I, or plus disease: 86% [95% CI, 80%-92%] vs 79% [95% CI, 75%-83%]; P = .10 [n = 251]), but ophthalmoscopy was slightly more sensitive in identifying stage 3 disease (85% [95% CI, 79%-91%] vs 73% [95% CI, 67%-78%]; P = .004 [n = 136]).
CONCLUSIONS AND RELEVANCE
No difference was found in overall accuracy between ophthalmoscopy and telemedicine for the detection of clinically significant ROP, although, on average, ophthalmoscopy had slightly higher accuracy for the diagnosis of zone III and stage 3 ROP. With the caveat that there was variable accuracy between examiners using both modalities, these results support the use of telemedicine for the diagnosis of clinically significant ROP.
Topics: Female; Gestational Age; Humans; Infant; Infant, Newborn; Infant, Premature; Infant, Very Low Birth Weight; Intensive Care Units, Neonatal; Male; Observer Variation; Ophthalmoscopy; Photography; Physical Examination; Prospective Studies; Reproducibility of Results; Retinopathy of Prematurity; Sensitivity and Specificity; Telemedicine
PubMed: 29621387
DOI: 10.1001/jamaophthalmol.2018.0649 -
Der Ophthalmologe : Zeitschrift Der... Mar 2017Optical coherence tomography (OCT) imaging now plays an important role in the management of macular and retinal diseases. In addition to the many advantages of this... (Review)
Review
Optical coherence tomography (OCT) imaging now plays an important role in the management of macular and retinal diseases. In addition to the many advantages of this noninvasive imaging modality, limitations and pitfalls should be taken into consideration. The aim of this review is to discuss several possible sources of error in the conduct and interpretation of OCT imaging. Ultimately, this article should add to a meaningful and focused use in clinical practice.
Topics: Artifacts; Diagnosis, Differential; Diagnostic Errors; Humans; Neuroimaging; Ophthalmoscopy; Reproducibility of Results; Retinal Diseases; Sensitivity and Specificity; Tomography, Optical Coherence
PubMed: 28197710
DOI: 10.1007/s00347-017-0450-x -
Retina (Philadelphia, Pa.) Nov 2021To investigate and quantify the influence of imaging artifacts on retinal fluorescence lifetime (FLIO) values and to provide helpful hints and tricks to avoid imaging...
PURPOSE
To investigate and quantify the influence of imaging artifacts on retinal fluorescence lifetime (FLIO) values and to provide helpful hints and tricks to avoid imaging artifacts and to improve FLIO image acquisition quality.
METHODS
A systematic analysis of potential parameters influencing FLIO quality and/or fluorescence lifetime values was performed in a prospective systematic experimental imaging study in five eyes of five healthy subjects. For image acquisition, a fluorescence lifetime imaging ophthalmoscope (Heidelberg Engineering) was used. Quantitative analysis of FLIO lifetime changes due to imaging artifacts was performed.
RESULTS
Imaging artifacts with significant influence on fluorescence lifetimes included too short image acquisition time, insufficient illumination, ocular surface problems, and image defocus. Prior use of systemic or topical fluorescein makes analysis of retinal fluorescence lifetimes impossible.
CONCLUSION
Awareness of possible sources of imaging artifacts is important for FLIO image acquisition and analysis. Therefore, standardized imaging and analysis procedure in FLIO is crucial for high-quality image acquisition and the possibility for systematic quantitative fluorescence lifetime analysis.
Topics: Adult; Artifacts; Female; Fluorescein Angiography; Fundus Oculi; Humans; Male; Middle Aged; Ophthalmoscopy; Prospective Studies; Retina; Retinal Diseases; Tomography, Optical Coherence
PubMed: 34111887
DOI: 10.1097/IAE.0000000000003235