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Mouse fundus photography and angiography: a catalogue of normal and mutant phenotypes.

PURPOSE: Mice are an increasingly important tool in ophthalmic research. As a result of studying spontaneous and induced mutations, many new ocular diseases have been described in mice in recent years, including several degenerative retinal diseases that demonstrate progression with age. Clearly, documentation of progressive changes in clinical phenotype is an important facet of characterizing new mutations and for comparing them with human diseases. Despite these facts, there are few published photographs of mouse fundi. The small size of the mouse eye and the steep curvature of its structures have made it difficult to obtain high quality fundus photographs. The purpose of this work was to develop procedures for mouse fundus photography and angiography and to use these techniques to examine several new mouse strains with ocular abnormalities. METHODS: We have used a small animal fundus camera and condensing lens to develop a reliable technique for producing high quality fundus images of conscious albino and pigmented mice. The fundus camera also was utilized to develop a method for fluorescein angiography, which demonstrated the normal retinal vascular bed as well as abnormal vascular leakage. In addition, several mouse strains with previously unreported ocular abnormalities (including two with inherited optic nerve colobomas) and a catalogue of previously unpublished clinical images for various mutant mice are presented. RESULTS: Altogether, we provide clinical images for C57BL/6J, BALB/cByJ, retinal degeneration 1 (rd1), Rd2, rd3, rd7, achondroplasia, nervous, motor neuron degeneration, Purkinje cell degeneration, kidney and retinal defects, optic nerve coloboma 1, and two apparently multigenic optic nerve colobomas in a strain of mixed derivation (ONC) and the inbred CALB/Rk strain. CONCLUSIONS: Our photography procedure reliably produces high quality images of the mouse fundus. This permitted us to record progressive retinal changes over time in the same animal, allowed us to compare the phenotypes of newly discovered retinal mutants to existing mutants at other institutions and to potentially similar human conditions, and finally, permitted us to produce a catalogue of previously unpublished clinical phenotypes for various mutant mice.

Animals↗

Inexpensive digital photography in clinical dermatology and dermatologic surgery.

Digital photography can be used to follow clinical improvement in a variety of dermatoses, document pre and postoperative results, and document histologic findings from skin biopsies. Images may be printed as part of text documents and can be filed in conventional medical charts. Images can be transmitted via electronic mail rapidly and to any location. We have found digital photography to be relatively inexpensive and a powerful tool to enhance dermatologic practice.

Dermatologic Surgical Procedures↗

Understanding fluorescein contact lens photography: equipment and technique.

A basic consideration of the utilization of close-up photography in the ophthalmic health care field is discussed. These principles can be applied to fluorescein contact lens photography using a hand-held camera. The discussion is divided into two areas: basic theory and equipment is reviewed, and a description of the clinical technique is described.

Contact Lenses↗

[Medical photography and cinematography before 1914: privileged rapport with the neurosciences].

Arthur Van Gehuchten (1861-1914), Belgian anatomist and neurologist, professor at the Université catholique de Louvain, was an enthusiastic user of photography and a pioneer of medical cinematography. He used these techniques widely in order to illustrate his lectures, papers and his neurological textbook. His films and photographic plates are at the present time being studied and restored. The nitrate films are the oldest belgian films surviving. Neuroscientists have played a major role in the development of medical photography and cinematography and in the use of these techniques for clinical, research or didactic purposes.

Belgium↗

The use of digital photography to support a medical mission to Honduras.

The South Texas Physicians Outreach (STPO) organization makes at least one annual mission to Santa Rosa de Copan, Honduras to provide much needed medical and surgical care to the residents of western Honduras. The author was named the team photographer for both a trip in 1998 and a subsequent visit in 1999. In preparing for the 1999 trip, a plan to reduce the expenditure by STPO for photography support was put into motion. It was decided that digital photography would eliminate most of the cost for documentation of the team's activities in clinics, surgery, and human interest activities. This article provides a short history of the organization, a brief overview of the 1998 trip, and a discussion of the photographic aspects of the 1999 trip.

Documentation↗

Dental photography in support of patient documentation and communication.

Intraoral conditions, which in the course of dental treatment are subject to change, can be recorded in detail by means of photography. Pictures provide an improved documentation and the option of monitoring particular situations over longer periods of time. We propose a standardized preoperative 35-mm photographic series. For intraoral photography, special intraoral mirrors and lip-and-cheek retractors are modified as needed. Macro 35-mm cameras with macro flash are by now well-established. Such equipment combined with the technique outlined in this report make standardized photographic documentation possible without mouth-angle retractors and mirror rims obstructing the view.

Communication↗

[Digital photography and blurred image processing of retinal nerve fiber layer in glaucoma].

OBJECTIVE: Red-free photographs are effective in detecting retinal nerve fiber layer (RNFL). The reasons why it is not used by most clinics are difficulty in laborious developing and blurred image evaluating. To account for getting real-time image and blurred image evaluating, the digital photography and computerized image processing are used. METHODS: RNFL photographs were taken by Nikon Fundus Camera connected with a high resolution digital camera (Kodak) and a green filter. As usual it is necessary to see the texture of RNFL in evaluating its image, but blurred images due to media opacities greatly lose their resolution. The way we used no focus on seeing the texture of RNFL, but on evaluating the distribution pattern of RNFL. RNFL images have more white reflex in temporal superior, temporal inferior, nasal superior and nasal inferior sections around optic disc according to the thickness of RNFL. Threshold segmentation was used, we shift a threshold bar to the position until the nasal or temporal section around optic disc is black with the software Photoshop. RESULTS: In the normal RNFL image, the white reflex was of butterfly pattern, i.e., the temporal superior and temporal inferior sections around optic disc were white. In cases with glaucoma, the characteristic of early damage of optic nerve was the loss of RNFL at the temporal superior and temporal inferior part of the retina, thus the normal butterfly pattern was changed, the temporal superior or/and temporal inferior sections were black. With this method it is more effective to evaluate RNFL. However, in cases with retinal pigment epithelium faint in color and in cases with choroidal defect, it is still difficult to evaluate the distribution of RNFL. CONCLUSIONS: It is an easy and effective way to detect glaucomatous damage with the digital photography and RNFL pattern evaluation.

Glaucoma↗

[Diagnosis of tumor-like fundus changes by means of a combination of echography, infrared photography and fluorescein angiography (author's transl)].

Using a combination of echography, infrared photography and fluorescein angiography in tumor simulating changes of the fundus an optimum combination of these diagnostic methods was achieved. The echography allows exact measurements of the prominence and in lesions exceeding 1.1 to 1.5 mm also a tissue differentiation. By infrared photography melanin could be differentiated from the bloodpigments and lipofuscin and the extension of pigmented tissues could be revealed. Fluoresceinangiography visualizes the vascular pattern and the permeability of the vessels of tumors or pseudotumors. Up to now 100 cases with tumorlike fundus lesions were subjected to this combined examination method and many of these cases preserved from enucleation.

Choroid Neoplasms↗

[The application of digital photography with retroillumination for lens in cataract study].

OBJECTIVE: To evaluate the reliability of digital photography with retroillumination for lens as a tool to assess the degree of lens opacity, and to study the morphological features of some lens diseases using the digital images. METHODS: The cataract screener (Neitz CT-S) was connected to a computer capable of acquiring digital images of lens. The digital lens retroillumination and slit lamp images were collected in 64 eyes. Three independent separate examiners took three sets of different CT-S digital photographs in four cataract subjects. The area of lens opacification in the images was measured and analyzed using threshold adjustment in PhotoShop software and a customized program in Matlab software. RESULTS: The distinct digital images of lens cortical opacity, posterior subcapsular opacity and other lens diseases were obtained with CT-S computer digital photography, which images were much better than slit lamp sectional digital images. The sensitivity and specificity of measuring lens opacification with CT-S digital images were 90% and 94% respectively. However, the digital lens retroillumination images were not as sensitive as the slit lamp images for nuclear cataracts. The variation coefficients of lens opacity area in the three sets of CT-S digital images in the same subject, which were taken by the independent examiners, were from 2.23% to 10.86%. The cortical opacification in CT-S digital images was linear, cuniform or clustered aggregate shadow configuration. The posterior subcapsular opacification was discal vacuolar or granular appearance. CONCLUSIONS: The reproducibility of the CT-S digital images taken by the independent examiners is excellent. This technique can objectively show cortical or posterior subcapsular opacities, but nuclear cataracts.

Adult↗

Gross photography of ophthalmic pathology specimens.

Removal of the entire eyeball or a portion of it is required in many ophthalmic conditions. The gross features of such specimens provide valuable information. Gross photography of an intraocular tumour, ruptured eyeball or other pathological specimens including lid lesions, orbital tumors, intraocular lens implants, intraocular and extraocular parasites, retinal pathology such as haemorrhages and peripheral degenerations, establishes a permanent documentation. We herein describe the technique of gross photography of such valuable specimens, using a dissecting microscope with a special arrangement. This technique is currently used by us with gratifying results.

Computers↗

Comparison of a digital retinal imaging system and seven-field stereo color fundus photography to detect diabetic retinopathy in the primary care environment.

BACKGROUND AND OBJECTIVE: Because patients with diabetes mellitus may visit their primary care physician regularly but not their ophthalmologist, a retinal risk assessment in the primary care setting could improve the screening rate for diabetic retinopathy. An imaging system for use in the primary care setting to identify diabetic retinopathy requiring referral to an ophthalmologist was evaluated. PATIENTS AND METHODS: In a masked prospective study, images were obtained from 11 patients with diabetes mellitus using both the digital retinal imaging system and seven-field stereo color fundus photography. The ability to obtain gradable images and to identify diabetic retinal lesions was compared. RESULTS: Of all images, 85% of digital retinal imaging system images and 88% of seven-field images were gradable. Agreement based on "no retinopathy" versus "any retinopathy" was excellent (Kappa = 0.96). Agreement based on "microaneurysms or less retinopathy" versus "retinal hemorrhages or worse retinopathy" was very good (Kappa = 0.83). CONCLUSIONS: The agreement between the digital retinal imaging system and seven-field photography indicates that the digital retinal imaging system may be useful to screen for diabetic retinopathy.

Adolescent↗

[Intra-oral digital photography with the non professional camera--simplicity and effectiveness at a low price].

Over the last five years digital photography has become ubiquitous. For the family photo album, a 4 or 5 megapixel camera costing about 2000 NIS will produce satisfactory results for most people. However, for intra-oral photography the common wisdom holds that only professional photographic equipment is up to the task. Such equipment typically costs around 12,000 NIS and includes the camera body, an attachable macro lens and a ringflash. The following article challenges this conception. Although professional equipment does produce the most exemplary results, a highly effective database of clinical pictures can be compiled even with a "non-professional" digital camera. Since the year 2002, my clinical work has been routinely documented with digital cameras of the Nikon CoolPix series. The advantages are that these digicams are economical both in price and in size and allow easy transport and operation when compared to their expensive and bulky professional counterparts. The details of how to use a non-professional digicam to produce and maintain an effective clinical picture database, for documentation, monitoring, demonstration and professional fulfillment, are described below.

Humans↗

Oral photography.

Oral photography is an important tool in veterinary dentistry. For years it has been used in the education process. Case documentation by photography has become more valuable. It is important that these photographs be of good quality. This article reviews the hardware such as cameras and the software such as film and exposure.

Animals↗

External eye photography using 35 mm camera systems.

1. For any close-up photography, a single lens reflex type of camera should be used. 2. Magnification of an image can be increased either by lengthening the distance between the lens and the film or by adding supplementary lenses. 3. Photography of the eye presents special lighting problems, requiring the pretesting of exposures, and careful exposure control.

Eye↗

A Polaroid SX-70 camera system for external ocular photography.

An inexpensive Polaroid SX-70 camera system for external eye photography can be assembled from easily obtainable parts. The advantages of this system include a "what-you-see-is-what-you-get" capability, instantly available prints (which permit repeat photography while the patient is still present), and convenient storage of acceptable prints.

Eye↗

Ophthalmoscopy versus non-mydriatic fundus photography in the detection of diabetic retinopathy in black patients.

The contribution of non-mydriatic fundus photography in the detection of diabetic retinopathy before and after dilatation of the pupils in black diabetics was investigated and compared with direct ophthalmoscopy. Eighty-six patients were examined and good-quality photographs were obtained for 54.7% of eyes before and 86.6% of eyes after dilatation. Photographically documented retinopathy was detected by ophthalmoscopy in only 64.7% of eyes. The two methods were concordant for the presence of retinopathy in 62.2% of eyes before and 56.9% of eyes after dilatation. Photography through dilated pupils also improved the rate of detection of diabetic retinopathy from 24% to 30%. The 45 degrees non-mydriatic fundus camera was found to be a valuable adjunct in the detection of diabetic retinopathy in a busy diabetic clinic.

Adolescent↗

Screening for diabetic retinopathy--comparison of a nurse and a doctor with retinal photography.

The efficacy of diabetic retinal screening by a nurse trained in ophthalmoscopy and of a diabetologist was assessed by comparison with fundal photography. The study was performed in 282 subjects, 59 with known diabetes and 223 participating in a screening survey, of whom 13 had diabetes and 43 impaired glucose tolerance. The prevalence of retinopathy in the diabetic subjects was 36.8% and serious retinopathy 9.5% while in the screened subjects it was 3.5% and 0.9% respectively. The characteristics of nurse examination as a test to detect retinopathy was: sensitivity 50.0% +/- CL16.8%, specificity 99.2% +/- CL0.9%, which compared with 51.3% +/- CL15.7% and 98.7% +/- CL1.2% for the doctor. The nurse failed to detect serious retinopathy as accurately as the doctor, although new vessels were missed in 5 of 6 cases by the doctor. Screening for retinopathy requires either ophthalmoscopy by an observer trained to a higher level than is common in doctors, or non-mydriatic retinal photography.

Adult↗

Tympanic membrane photography: historical perspective.

When viewed in a broad perspective, photographic documentation of the tympanic membrane, both in the normal and pathologic state, has enabled otologists to better understand many disease processes in the ear. Furthermore, good reproductions have served as invaluable aids in teaching both physicians and students as well as permitting better understanding of pathologic conditions for which patients may need therapeutic intervention. This review traces the development over the last century of tympanic membrane photography, reflecting advances made in both the art and science of otologic photography.

History, 19th Century↗