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Continuum (Minneapolis, Minn.) Aug 2014Papilledema is one of the most concerning physical examination findings in neurology: it has a broad differential diagnosis of intracranial (and occasionally spinal)... (Review)
Review
PURPOSE OF REVIEW
Papilledema is one of the most concerning physical examination findings in neurology: it has a broad differential diagnosis of intracranial (and occasionally spinal) pathology associated with increased intracranial pressure. Papilledema impairs axoplasmic flow within the optic nerves and compresses the optic nerves externally; it may lead to profound visual loss. Thus, detection of papilledema and assessment of visual function are essential to patient management. This article reviews the treatment of papilledema-related visual loss in pseudotumor cerebri syndrome, one of the most common causes of papilledema encountered by neurologists.
RECENT FINDINGS
Results from the Idiopathic Intracranial Hypertension Trial (IIHTT), the first randomized, double-masked, placebo-controlled trial for the treatment of patients with mild visual loss from idiopathic intracranial hypertension, were published in April 2014. The IIHTT provides the first evidence-based treatment recommendations, showing the benefit of acetazolamide and weight loss for improving visual status in patients with mild visual field loss from idiopathic intracranial hypertension.
SUMMARY
A detailed ophthalmic examination, including perimetry, is critical to the evaluation, treatment, and assessment of treatment response in patients with papilledema.
Topics: Adult; Diagnosis, Differential; Double-Blind Method; Female; Humans; Intracranial Hypertension; Ophthalmoscopes; Optic Disk; Papilledema; Randomized Controlled Trials as Topic
PubMed: 25099098
DOI: 10.1212/01.CON.0000453314.75261.66 -
Journal of Biomedical Optics 2004In the past two decades, optical coherence tomography (OCT) has been established as an adjunct diagnostic technique for noninvasive, high-resolution, cross-sectional... (Review)
Review
In the past two decades, optical coherence tomography (OCT) has been established as an adjunct diagnostic technique for noninvasive, high-resolution, cross-sectional imaging in a variety of medical fields. The rapid development of ultrabroad bandwidth light sources has recently enabled a significant improvement in OCT imaging resolution, demonstrating the potential of OCT to accomplish its original goal of performing noninvasive optical biopsies, i.e., the in vivo visualization of microstructural morphology in situ, which had previously only been possible with histopathology. In addition, these novel light sources might also enable the use of spectroscopic OCT, an extension of ultrahigh-resolution OCT, for enhancing image contrast as well as detecting spatially resolved functional, biochemical tissue information. State-of-the-art-light sources that now permit ultrahigh-resolution OCT covering the whole wavelength region from 500 to 1600 nm are reviewed and fundamental limitations of OCT image resolution are discussed. Ex vivo ultrahigh-resolution OCT tomograms are compared with histological results; first clinical in vivo ultrahigh-resolution OCT and preliminary spectroscopic OCT results are presented and their impact for future clinical and research applications is discussed.
Topics: Equipment Design; Eye; Eye Diseases; Humans; Imaging, Three-Dimensional; Lasers; Ophthalmoscopes; Ophthalmoscopy; Tomography, Optical Coherence
PubMed: 14715057
DOI: 10.1117/1.1629679 -
Journal of Biomedical Optics 2004Imaging the vitreous is an attempt to view what is by design invisible. The inability to adequately image vitreous hinders a more complete understanding of its normal... (Review)
Review
Imaging the vitreous is an attempt to view what is by design invisible. The inability to adequately image vitreous hinders a more complete understanding of its normal structure and function and how these change in aging and disease. The combined use of more than one technique could provide better imaging for investigational and clinical purposes. Past and present imaging methodologies are summarized and research and clinical techniques that are currently in development for future applications, are discussed. Dark-field slit microscopy has been used to characterize vitreous anatomy, both within the vitreous body as well as at the vitreo-retinal interface. In addition to this methodology, slit-lamp biomicroscopy; direct, indirect, and scanning laser ophthalmoscopies; ultrasonography; optical coherence tomography; magnetic resonance and Raman spectroscopies; and dynamic light-scattering methodologies for noninvasive evaluation are presented. Dark-field slit microscopy enables in vitro imaging without dehydration or tissue fixatives. Optical coherence tomography enables better in vivo visualization of the vitreo-retinal interface than scanning laser ophthalmoscopy and ultrasonography, but does not image the vitreous body. Dynamic light scattering can determine the average sizes of vitreous macromolecules within the vitreous body as well as possibly image the posterior vitreous cortex once detached, while Raman spectroscopy can detect altered vitreous molecules, such as glycated collagen and other proteins in diabetic vitreopathy.
Topics: Eye Diseases; Humans; Ophthalmoscopes; Ophthalmoscopy; Photometry; Scattering, Radiation; Spectrum Analysis; Tomography, Optical Coherence; Ultrasonography; Vitreous Body
PubMed: 14715056
DOI: 10.1117/1.1627339 -
CMAJ : Canadian Medical Association... Jul 2008
Topics: Diagnostic Imaging; Humans; Ophthalmoscopes; Papilledema; Sensitivity and Specificity
PubMed: 18625992
DOI: 10.1503/cmaj.1080071 -
International Journal of Pharmaceutics Sep 2021To address the need for noninvasive monitoring of injectable preformed drug delivery implants in the eye, we developed noninvasive methods to monitor such implants in...
Noninvasive monitoring of suprachoroidal, subretinal, and intravitreal implants using confocal scanning laser ophthalmoscope (cSLO) and optical coherence tomography (OCT).
To address the need for noninvasive monitoring of injectable preformed drug delivery implants in the eye, we developed noninvasive methods to monitor such implants in different locations within the eye. Cylindrical polymeric poly(lactide-co-glycolide) or metal implants were injected into isolated bovine eyes at suprachoroidal, subretinal, and intravitreal locations and imaged noninvasively using the cSLO and OCT modes of a Heidelberg Spectralis HRA + OCT instrument after adjusting for the corneal curvature. Length and diameter of implants were obtained using cSLO images for all three locations, and the volume was calculated. Additionally, implant volume for suprachoroidal and subretinal location was estimated by integrating the cross-sectional bleb area over the implant length in multiple OCT images or using the maximum thickness of the implant based on thickness map along with length in cSLO image. Simultaneous cSLO and OCT imaging identified implants in different regions of the eye. Image-based measurements of implant dimensions mostly correlated well with the values prior to injection using blade micrometer. The accuracy (82-112%) and precision (1-19%) for noninvasive measurement of length was better than the diameter (accuracy 69-130%; precision 3-38%) using cSLO image for both types of implants. The accuracy for the measurement of volume of both types of implants from all three intraocular locations was better with cSLO imaging (42-152%) compared to those obtained using OCT cross-sectional bleb area integration (117-556%) or cSLO and thickness map (32-279%) methods. Suprachoroidal, subretinal, and intravitreal implants can be monitored for length, diameter, and volume using cSLO and OCT imaging. Such measurements may be useful in noninvasively monitoring implant degradation and drug release in the eye.
Topics: Animals; Cattle; Cross-Sectional Studies; Lasers; Ophthalmoscopes; Tomography, Optical Coherence
PubMed: 34271155
DOI: 10.1016/j.ijpharm.2021.120887 -
The British Journal of Ophthalmology May 1976An instrument is described that provides a stable magnified image for ophthalmoscopy and a low power operating microscope combined to allow greatly improved fundal...
An instrument is described that provides a stable magnified image for ophthalmoscopy and a low power operating microscope combined to allow greatly improved fundal inspection and to eliminate the need to change instruments during detachment surgery.
Topics: Humans; Microscopy; Ophthalmoscopes; Retina; Retinal Degeneration
PubMed: 952811
DOI: 10.1136/bjo.60.5.390 -
Optics Express Jun 2020Poor access to eye care is a major global challenge that could be ameliorated by low-cost, portable, and easy-to-use diagnostic technologies. Diffuser-based imaging has...
Poor access to eye care is a major global challenge that could be ameliorated by low-cost, portable, and easy-to-use diagnostic technologies. Diffuser-based imaging has the potential to enable inexpensive, compact optical systems that can reconstruct a focused image of an object over a range of defocus errors. Here, we present a diffuser-based computational funduscope that reconstructs important clinical features of a model eye. Compared to existing diffuser-imager architectures, our system features an infinite-conjugate design by relaying the ocular lens onto the diffuser. This offers shift-invariance across a wide field-of-view (FOV) and an invariant magnification across an extended depth range. Experimentally, we demonstrate fundus image reconstruction over a 33 FOV and robustness to ±4D refractive error using a constant point-spread-function. Combined with diffuser-based wavefront sensing, this technology could enable combined ocular aberrometry and funduscopic screening through a single diffuser sensor.
Topics: Diagnostic Imaging; Equipment Design; Humans; Image Processing, Computer-Assisted; Light; Models, Theoretical; Ophthalmoscopes; Retina
PubMed: 32672237
DOI: 10.1364/OE.395112 -
Optometry and Vision Science : Official... Apr 2010Adaptive optics (AO) describes a set of tools to correct or control aberrations in any optical system. In the eye, AO allows for precise control of the ocular... (Review)
Review
Adaptive optics (AO) describes a set of tools to correct or control aberrations in any optical system. In the eye, AO allows for precise control of the ocular aberrations. If used to correct aberrations over a large pupil, for example, cellular level resolution in retinal images can be achieved. AO systems have been demonstrated for advanced ophthalmoscopy as well as for testing and/or improving vision. In fact, AO can be integrated to any ophthalmic instrument where the optics of the eye is involved, with a scope of applications ranging from phoropters to optical coherence tomography systems. In this article, I discuss the applications and advantages of using AO in a specific system, the AO scanning laser ophthalmoscope. Since the Borish award was, in part, awarded to me because of this effort, I felt it appropriate to select this as the topic for this article. Furthermore, users of AO scanning laser ophthalmoscope continue to appreciate the benefits of the technology, some of which were not anticipated at the time of development, and so it is time to revisit this topic and summarize them in a single article.
Topics: Equipment Design; Humans; Lenses; Ophthalmoscopes; Ophthalmoscopy
PubMed: 20160657
DOI: 10.1097/OPX.0b013e3181d39479 -
The British Journal of Ophthalmology Apr 1948
Topics: Microscopy; Physical Examination; Slit Lamp
PubMed: 18170442
DOI: 10.1136/bjo.32.4.232 -
Transactions of the American... 1965
Topics: Ophthalmoscopes; Ophthalmoscopy
PubMed: 5859789
DOI: No ID Found