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Journal of Visualized Experiments : JoVE Jul 2017Smartphone fundus photography is a simple technique to obtain ocular fundus pictures using a smartphone camera and a conventional handheld indirect ophthalmoscopy lens....
Smartphone fundus photography is a simple technique to obtain ocular fundus pictures using a smartphone camera and a conventional handheld indirect ophthalmoscopy lens. This technique is indispensable when picture documentation of optic nerve, retina, and retinal vessels is necessary but a fundus camera is not available. The main advantage of this technique is the widespread availability of smartphones that allows documentation of macula and optic nerve changes in many settings that was not previously possible. Following the well-defined steps detailed here, such as proper alignment of the phone camera, handheld lens, and the patient's pupil, is the key for obtaining a clear retina picture with no interfering light reflections and aberrations. In this paper, the optical principles of indirect ophthalmoscopy and fundus photography will be reviewed first. Then, the step-by-step method to record a good quality retinal image using a smartphone will be explained.
Topics: Fundus Oculi; Humans; Ophthalmoscopy; Photography; Smartphone
PubMed: 28715396
DOI: 10.3791/55958 -
Advances in Experimental Medicine and... 2019Retinal imaging has advanced to enable noninvasive in vivo visualization of macular photoreceptors with cellular resolution. Images of retinal structure are best... (Review)
Review
Retinal imaging has advanced to enable noninvasive in vivo visualization of macular photoreceptors with cellular resolution. Images of retinal structure are best interpreted in the context of visual function, but clinical measures of visual function lack resolution on the scale of individual cells. Combined with cross-sectional measures of retinal structure acquired with optical coherence tomography (OCT), macular photoreceptor function can be evaluated using visual acuity and fundus-guided microperimetry, but the resolution of these measures is limited to relatively large retinal areas. By incorporating adaptive optics correction of aberrations in light entering and exiting the pupil, individual photoreceptors can be visualized and stimulated to assess structure and function. Discrepancy between structural images and visual function can shed light on the origin of visible features and their relation to visual function. Dysflective cones, cones with abnormal waveguiding properties on confocal adaptive optics scanning laser ophthalmoscopy (AOSLO) images and measurable function, provide insight into the visual significance of features in retinal images and may facilitate identification of patients who could benefit from therapies.
Topics: Fundus Oculi; Humans; Ophthalmoscopy; Retina; Retinal Cone Photoreceptor Cells; Tomography, Optical Coherence
PubMed: 31884601
DOI: 10.1007/978-3-030-27378-1_22 -
La Tunisie Medicale Jul 2023Pterygium surgery is a closed globe surface surgery. Although it is perfectly standard and followed by excellent results, it is not exempt from the general rule that...
INTRODUCTION
Pterygium surgery is a closed globe surface surgery. Although it is perfectly standard and followed by excellent results, it is not exempt from the general rule that there is no surgery without risk. It therefore seems important to integrate simulation as a pedagogical tool for training ophthalmology residents in pterygium surgery.
AIM
To evaluate the effectiveness of procedural simulation as a training tool for pterygium surgery.
RESULTS
During the study period, eight residents participated in the three workshops. The global assessment of residents' knowledge showed a mean score of 3/5 [1.5/5-4/5] and 4.1/5 [3.25/5-5/5] before and after the training respectively. There was a significant negative correlation between the initial score on the pre-test and the improvement of this score on the post-test, with an r'=-0.87 and a p=0.005. We noted a significant improvement in the global performance score (p<0.001) and even a significant improvement in the specific performance score (p=0.02) between the 3 workshops. The average training satisfaction score was 13.87/16 [10/16-16/16]. We noted a significant positive correlation with r=0.838 and p=0.009 between knowledge improvement and learner satisfaction.
CONCLUSION
The training of fundus examination using an ophthalmoscopic simulator can improve the skills and knowledge of ophthalmic learners. This type of training can be an innovative addition to traditional learning methods.
Topics: Humans; Pterygium; Fundus Oculi; Knowledge; Ophthalmology; Ophthalmoscopy
PubMed: 38445419
DOI: No ID Found -
Asia-Pacific Journal of Ophthalmology... 2018With the increasing survival of preterm babies in the Asia-Pacific region, there has been an increase in the incidence of retinopathy of prematurity (ROP). There is also... (Review)
Review
With the increasing survival of preterm babies in the Asia-Pacific region, there has been an increase in the incidence of retinopathy of prematurity (ROP). There is also a lack of trained ophthalmologists to screen for this disease. New strategies for screening of ROP are required, wherein the load on the ophthalmologist can be reduced. Telemedicine is an excellent tool to address this need. This paper reviews the initial studies comparing digital imaging with indirect ophthalmoscopy, the current active ROP telescreening programs in the world, and ends with studies dealing with automated diagnosis of ROP.
Topics: Humans; Infant, Newborn; Mass Screening; Ophthalmoscopy; Retinopathy of Prematurity; Telemedicine
PubMed: 29405045
DOI: 10.22608/APO.2017478 -
Asia-Pacific Journal of Ophthalmology... 2019Retinopathy of prematurity (ROP) is a leading cause of preventable childhood blindness worldwide. Barriers to ROP screening and difficulties with subsequent evaluation... (Review)
Review
Retinopathy of prematurity (ROP) is a leading cause of preventable childhood blindness worldwide. Barriers to ROP screening and difficulties with subsequent evaluation and management include poor access to care, lack of physicians trained in ROP, and issues with objective documentation. Digital retinal imaging can help address these barriers and improve our knowledge of the pathophysiology of the disease. Advancements in technology have led to new, non-mydriatic and mydriatic cameras with wider fields of view as well as devices that can simultaneously incorporate fluorescein angiography, optical coherence tomography (OCT), and OCT angiography. Image analysis in ROP is also being employed through smartphones and computer-based software. Telemedicine programs in the United States and worldwide have utilized imaging to extend ROP screening to infants in remote areas and have shown that digital retinal imaging can be reliable, accurate, and cost-effective. In addition, tele-education programs are also using digital retinal images to increase the number of healthcare providers trained in ROP. Although indirect ophthalmoscopy is still an important skill for screening, digital retinal imaging holds promise for more widespread screening and management of ROP.
Topics: Health Services Accessibility; Humans; Image Processing, Computer-Assisted; Infant, Newborn; Neonatal Screening; Ophthalmoscopy; Reproducibility of Results; Retinopathy of Prematurity; Telemedicine; Tomography, Optical Coherence
PubMed: 31037876
DOI: 10.22608/APO.201963 -
Telemedicine Journal and E-health : the... Apr 2020(Review)
Review
Topics: Humans; Infant, Newborn; Ophthalmoscopy; Photography; Physical Examination; Reproducibility of Results; Retinopathy of Prematurity; Telemedicine
PubMed: 32209016
DOI: 10.1089/tmj.2020.0010 -
Indian Journal of Ophthalmology Oct 2019
Topics: Humans; Male; Middle Aged; Ophthalmoscopy; Retina; Retinoschisis; Visual Acuity
PubMed: 31546543
DOI: 10.4103/ijo.IJO_193_19 -
Asia-Pacific Journal of Ophthalmology... 2018Throughout ophthalmic history it has been shown that progress has gone hand in hand with technological breakthroughs. In the past, fluorescein angiography and fundus... (Review)
Review
Throughout ophthalmic history it has been shown that progress has gone hand in hand with technological breakthroughs. In the past, fluorescein angiography and fundus photographs were the most commonly used imaging modalities in the management of diabetic macular edema (DME). Today, despite the moderate correlation between macular thickness and functional outcomes, spectral domain optical coherence tomography (SD-OCT) has become the DME workhorse in clinical practice. Several SD-OCT biomarkers have been looked at including presence of epiretinal membrane, vitreomacular adhesion, disorganization of the inner retinal layers, central macular thickness, integrity of the ellipsoid layer, and subretinal fluid, among others. Emerging imaging modalities include fundus autofluorescence, macular pigment optical density, fluorescence lifetime imaging ophthalmoscopy, OCT angiography, and adaptive optics. Technological advances in imaging of the posterior segment of the eye have enabled ophthalmologists to develop hypotheses about pathological mechanisms of disease, monitor disease progression, and assess response to treatment. Spectral domain OCT is the most commonly performed imaging modality in the management of DME. However, reliable biomarkers have yet to be identified. Machine learning may provide treatment algorithms based on multimodal imaging.
Topics: Diabetic Retinopathy; Diagnostic Techniques, Ophthalmological; Fluorescein Angiography; Humans; Macular Edema; Multimodal Imaging; Ophthalmoscopy; Optical Imaging; Optics and Photonics; Tomography, Optical Coherence
PubMed: 29376234
DOI: 10.22608/APO.2017504 -
Asia-Pacific Journal of Ophthalmology... 2020The diagnosis and treatment of medical retinal disease is now inseparable from retinal imaging in all its multimodal incarnations. The purpose of this article is to... (Review)
Review
The diagnosis and treatment of medical retinal disease is now inseparable from retinal imaging in all its multimodal incarnations. The purpose of this article is to present a selection of very different retinal imaging techniques that are truly translational, in the sense that they are not only new, but can guide us to new understandings of disease processes or interventions that are not accessible by present methods. Quantitative autofluorescence imaging, now available for clinical investigation, has already fundamentally changed our understanding of the role of lipofuscin in age-related macular degeneration. Hyperspectral autofluorescence imaging is bench science poised not only to unravel the molecular basis of retinal pigment epithelium fluorescence, but also to be translated into a clinical camera for earliest detection of age-related macular degeneration. The ophthalmic endoscope for vitreous surgery is a radically new retinal imaging system that enables surgical approaches heretofore impossible while it captures subretinal images of living tissue. Remote retinal imaging coupled with deep learning artificial intelligence will transform the very fabric of future medical care.
Topics: Artificial Intelligence; Fluorescein Angiography; Fundus Oculi; Humans; Macular Degeneration; Ophthalmoscopy; Retinal Pigment Epithelium; Tomography, Optical Coherence
PubMed: 32487917
DOI: 10.1097/APO.0000000000000292 -
Progress in Retinal and Eye Research Jan 2020Quantitative fundus autofluorescence (qAF) is an approach that is built on a confocal scanning laser platform and used to measure the intensity of the inherent... (Review)
Review
Quantitative fundus autofluorescence (qAF) is an approach that is built on a confocal scanning laser platform and used to measure the intensity of the inherent autofluorescence of retina elicited by short-wavelength (488 nm) excitation. Being non-invasive, qAF does not interrupt tissue architecture, thus allowing for structural correlations. The spectral features, cellular origin and topographic distribution of the natural autofluorescence of the fundus indicate that it is emitted from retinaldehyde-adducts that form in photoreceptor cells and accumulate, under most conditions, in retinal pigment epithelial cells. The distributions and intensities of fundus autofluorescence deviate from normal in many retinal disorders and it is widely recognized that these changing patterns can aid in the diagnosis and monitoring of retinal disease. The standardized protocol employed by qAF involves the normalization of fundus grey levels to a fluorescent reference installed in the imaging instrument. Together with corrections for magnification and anterior media absorption, this approach facilitates comparisons with serial images and images acquired within groups of patients. Here we provide a comprehensive summary of the principles and practice of qAF and we highlight recent efforts to elucidate retinal disease processes by combining qAF with multi-modal imaging.
Topics: Fluorescein Angiography; Fundus Oculi; Humans; Macular Degeneration; Ophthalmoscopy; Retinal Pigment Epithelium; Tomography, Optical Coherence
PubMed: 31472235
DOI: 10.1016/j.preteyeres.2019.100774