Simultaneous stereophotogrammetric and angiographic fundus camera

We developed an apparatus for serial, simultaneous stereophotogrammetric fundus angiography by modifying a fundus camera. The paired stereoangiograms obtained by this system provided satisfactory stereoscopy and fair depth of field. With this system, mounting and filing of slides were easy. Accurate photogrammetric analysis of the fundus can be performed. Clinical results were impressive in both young and old subjects with fully dilated pupils.     

The optics of fundus examination

It has been 140 years since the invention of the ophthalmoscope in 1851 by Herman von Helmholtz. Since then, a considerable amount of time and effort has been devoted to improving the clinician's view of the fundus both for diagnostic and therapeutic reasons. Recently, there have been some notable advances in this respect, such as the 90 diopter lens, the “2.2 pan retinal” lens, and numerous “wide angle” fundus-viewing contact lenses to which the Volk Quadraspheric fundus lens has been the most recent addition. This paper is a review of the optical principles underlying the methods of fundus examination currently available.     

Simultaneous stereograms of the fundus oculi

Stereophotograms and stereoangiograms of the fundus in selected pathological conditions are presented. The simultaneous performance of fundus stereograms are devoid of drawbacks and faults encountered in stereoscopic pictures registered in double time. A major consistency of the half-pictures results from an identical utilization of the focal depth and an uniform illumination in one exposure. In the fluorographic examination this method is a method of choice in the registration of a spatial picture throughout the examination.     

早产儿视网膜病变眼底检查方法及眼底图像特征研究进展

早产儿视网膜病变(ROP)是可预防的儿童期失明主要原因,具有筛查难、诊断难及客观评估难等特点。ROP筛查有多种方式,包括各种接触或非接触成像设备、基于智能手机的眼底照相、基于人工智能的眼底图像分析等。ROP诊断是基于对ROP整个视网膜眼底的可视化和记录,也是后续筛查、治疗评估的基础。眼底筛查对早期识别非常关键,有助于早期发现和及时转诊。通过分析总结ROP眼底图像特征,可能发现其潜在的特征规律,及时有针对性地预防和治疗。人工智能可促进ROP筛查的自动化、可量化和客观诊断。本文综述目前临床上常用的ROP眼底检查方法及眼底图像特征规律,总结人工智能用于ROP自动诊断的最新研究进展。     

有晶状体眼人工晶状体植入术前眼底检查结果分析

目的：研究有晶状体眼人工晶状体植入手术前患者术眼三面镜检查的结果,分析其眼底的病理改变,探讨术前眼底检查对早期诊断和处理视网膜病变的临床意义。
　　方法：回顾我院2011-04/2012-04行有晶状体眼人工晶状体植入术患者64例127眼,术前的三面镜下眼底检查结果,对患者年龄、屈光度数、三面镜检查的发现及视网膜光凝的情况进行分析及归纳。
　　结果：患者64例127眼中共34眼(26.8%)发现周边部视网膜病变,其中视网膜裂孔8眼(6.3%),视网膜格子样变性区15眼(11.8%),视网膜霜样变性区5眼(3.9%),视网铺路石样变性区3眼(2.4%),玻璃体视网膜粘连牵引2眼(1.6%),视网膜出血1眼(0.8%)。共25眼术前接受了视网膜光凝。3 mo后接受ICL植入手术,术后随访1a无视网膜脱离发生。
　　结论：有晶状体眼人工晶状体植入术前进行三面镜下眼底检查有助于发现患者周边部视网膜的病变及异常,并于术前做出适当的处理,有助于提高手术的安全性,能够指导术后对患者眼底情况的随访。     

前置镜检查在白内障术前检查中的应用

目的:观察裂隙灯显微镜下前置镜检查在白内障术前眼底检查及预测术后最佳矫正视力(BCVA)中的应用价值。方法:观察671例874眼白内障超声乳化手术患者,根据白内障混浊(C,N,P)级别相加分为三组,A组:3级及以下;B组:4级;C组:5级。术前分别采用直接检眼镜及前置镜(+90D)检查眼底,结合晶状体混浊程度与术前BCVA匹配性分析预测术后BCVA,术后2wk再次检查眼底、BCVA。比较直接检眼镜检查和前置镜检查的眼底病变术前检出率及术后BCVA预测符合率,采用Pearson卡方检验(非校正法)。结果:直接检眼镜检查方法眼底病变术前检出率分别为A组:96.8%(30/31);B组:69.5%(66/95);C组:35.3%(18/51),术后BCVA预测符合率分别为A组:94.8%(163/172);B组:87.4%(416/476);C组:60.6%(137/226)。前置镜检查方法眼底病变术前检出率分别为A组:100%(31/31);B组:93.7%(89/95);C组:84.3%(43/51),术后BCVA预测符合率分别为A组:95.9%(165/172);B组:92.0%(438/476);C组:76.1%(172/226)。B组及C组前置镜检查眼底病变术前检出率、术后BCVA预测符合率明显优于直接检眼镜检查,差异有显著性(P<0.01)。前置镜组总体眼底病变术前检出率92.1%,术后BCVA预测符合率88.7%。结论:裂隙灯显微镜下前置镜检查在白内障术前检查中眼底病变检出率明显优于直接检眼镜,结合晶状体混浊程度与术前BCVA匹配性分析可以粗略预测非成熟期白内障患者术后BCVA。     

Do-it-yourself adapter for fundus examination with 90D and 78D lens

The COVID-19 pandemic has brought a radical change in safety measures in outpatient clinics. The use of face masks by patients and healthcare workers has become a mandatory norm. Exhaled air with a face mask often follows an upward route. The warm exhaled air leads to fogging of 90/78D lens during fundus examination, hampering visualization. This can be prevented by the use of a simple yet innovative DIY adapter for a 90/78D lens, which can be made using simple household items such as PVC pipes or water hose pipes.     

准分子激光手术前眼底检查结果分析

目的:观察并统计准分子手术前眼底检查出视网膜变性的比率,探讨手术前检查对术后并发症防治的临床意义。方法:对2007-01/2008-01术前扩瞳检查1128例1128眼眼底情况进行分析,对比低、中、高度近视发生视网膜变性的几率,进行激光治疗及手术情况,平均随访1～15mo。结果:所选1128眼发现视网膜变性需激光治疗者48眼,视网膜干性裂孔20眼。结论:视网膜变性是近视眼最为常见的一种并发症,如果不及时处理,可以导致视网膜脱离等一系列严重损害视功能的后遗症,因此手术前的筛查对预防并发症的发生有极其重要的意义。     

A self-retaining contact lens for slit-lamp examination of the fundus and for photocoagulation treatment.

A self-retaining contact lens for slit-lamp examination and photocoagulation treatment of the posterior fundus afforded a wide-angle view of the retina and allowed freedom of both hands of the examiner.     

Diagnostic value of fundus examination in familial adenomatous polyposis

BACKGROUND—Multiple, bilateral lesions of congenital hypertrophy of the retinal pigment epithelium (CHRPE) have been described in patients suffering from familial adenomatous polyposis (FAP) since 1980. This study aimed to determine a reliable diagnostic criterion, based on the size and number of retinal CHRPE lesions, allowing the screening of patient carriers of the gene responsible for FAP.
METHODS—32 control subjects and 144 patients belonging to 85 FAP families were studied, divided into 124 carriers of the genetic alteration and 20 non-carriers.
RESULTS—In carriers of the deleted gene, multiple, bilateral retinal lesions were consistently observed. Lesion situation, size, shape, and degree of pigmentation were variable however. A positive criterion for FAP was defined as the presence of at least four lesions whatever their size, or at least two lesions one of which is large. This criterion showed a high sensitivity (0.68) and a maximal specificity (1). Within each family, the retinal phenotypic expression was homogeneous. CHRPE lesions were observed in two thirds of the FAP families and absent from the remaining third.
CONCLUSION—By using this new positive diagnostic criterion, fundus examination allows early detection of those children carrying the gene responsible for FAP in families positive at ocular examination.

     

OCT在小鼠眼底检查中的研究进展

OCT是应用测量光回波时间延迟的原理而获得被测组织的分层,该成像技术提供的视网膜断层截面图与组织形态学有很好的相关性。该技术目前也广泛应用于动物实验研究,特别是在小鼠的视网膜疾病研究中可以获取高分辨率的活体组织图像。现对小鼠视网膜OCT图像的成像装置、成像质量、图像分析、血流成像、疾病模型研究等方面的进展进行综述。     

孤立性脉络膜血管瘤的荧光素钠吲哚青绿同步眼底血管造影

目的探讨孤立性脉络膜血管瘤荧光素钠及吲哚青绿同步眼底血管造影的影像学特征及其临床意义,为诊断及治疗监测提供依据。方法应用海德堡HRA2共焦激光扫描眼底血管造影系统对9例9眼孤立性脉络膜血管瘤进行荧光素眼底血管造影(Fundus fluorescein angiography,FFA)和吲哚青绿血管造影(Indocyanine green angiography,ICGA)同步检查,分析比较2种检查影像学特征。结果FFA检查主要影像学表现为动脉前期或动脉早期瘤体部位血管丛状或斑状高荧光;静脉期高荧光灶渗漏融合;晚期瘤体呈弥漫性强荧光。其中3例瘤体表面夹杂不规则的点片状低荧光;6例瘤体表面及周围视网膜毛细血管扩张;5例可见与瘤体周围RPE带状萎缩相应的透见荧光。ICG早期可见瘤体由不规则血管网状高荧光组成;中期瘤体呈强荧光团;晚期所有病例均有特征性的"冲洗现象"。ICGA比FFA更清晰显示瘤体范围。结论孤立性脉络膜血管瘤ICGA影像比FFA影像更具特征性,能够更清晰地显示肿瘤边界;FFA则能显示视网膜血管及RPE的继发性损伤。FFA和ICGA同步检查对孤立性脉络膜血管瘤临床诊断、治疗及疗效监测有重要的指导意义。     

Simultaneous fundus imaging and optical coherence tomography of the mouse retina

PURPOSE: To develop a retinal imaging system suitable for routine examination or screening of mouse models and to demonstrate the feasibility of simultaneously acquiring fundus and optical coherence tomography (OCT) images. METHODS: The imaging system is composed of a photographic slit lamp for biomicroscopic examination of the fundus, an OCT interferometer, an OCT beam delivery system designed for the mouse eye, and a mouse positioning stage. Image acquisition was controlled with software that displays the fundus and OCT images in real time, and allows the user to control the position of the OCT beam spot on the fundus image display. The anesthetized mouse was placed in a cylindrical holder on the positioning stage, and a single operator adjusted the position of mouse. RESULTS: Fundus images and OCT scans were successfully acquired in both eyes of 8 C57BL/6 mice. Once the animal is anesthetized and placed in the holder, a typical imaging experiment takes less than 2 minutes. The retinal vasculature, pigmentation, nerve fiber arrangement, and optic nerve head were clearly visible on the fundus images. The quality of the OCT images was sufficient to allow measurement of the total, inner, and outer retinal thicknesses and to visualize the optic nerve head excavation. CONCLUSIONS: The study demonstrates the feasibility of acquiring simultaneous fundus and OCT images of the mouse retina, by a single operator, in a manner suitable for routine evaluation of mouse models of retinal disease.