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At least 73 records · Page 4Linked to original sources
PubMed2005

Baseline topographic optic disc measurements are associated with the development of primary open-angle glaucoma: the Confocal Scanning Laser Ophthalmoscopy Ancillary Study to the Ocular Hypertension Treatment Study.

OBJECTIVE: To determine whether baseline confocal scanning laser ophthalmoscopy (CSLO) optic disc topographic measurements are associated with the development of primary open-angle glaucoma (POAG) in individuals with ocular hypertension. METHODS: Eight hundred sixty-five eyes from 438 participants in the CSLO Ancillary Study to the Ocular Hypertension Treatment Study with good-quality baseline CSLO images were included in this study. Each baseline CSLO parameter was assessed in univariate and multivariate proportional hazards models to determine its association with the development of POAG. RESULTS: Forty-one eyes from 36 CSLO Ancillary Study participants developed POAG. Several baseline topographic optic disc measurements were significantly associated with the development of POAG in both univariate and multivariate analyses, including larger cup-disc area ratio, mean cup depth, mean height contour, cup volume, reference plane height, and smaller rim area, rim area to disc area, and rim volume. In addition, classification as "outside normal limits" by the Heidelberg Retina Tomograph classification and the Moorfields Regression Analysis classifications (overall, global, temporal inferior, nasal inferior, and superior temporal regions) was significantly associated with the development of POAG. Within the follow-up period of this analysis, the positive predictive value of CSLO indexes ranged from 14% (Heidelberg Retina Tomograph classification and Moorfields Regression Analysis overall classification) to 40% for Moorfields Regression Analysis temporal superior classification. CONCLUSIONS: Several baseline topographic optic disc measurements alone or when combined with baseline clinical and demographic factors were significantly associated with the development of POAG among Ocular Hypertension Treatment Study participants. Longer follow-up is required to evaluate the true predictive accuracy of CSLO measures.

False Positive Reactions↗
PubMed1977

Noninvasive copper measurement in chalcosis: comparison with electroretinography and ophthalmoscopy.

The developement of chalcosis bulbi in rabbits' eyes is investigated by ophthalmoscopy, electroretinography, and diagnostic x-ray spectrometry (DXS), a new method for in vivo analysis and quantitation of metals. The DXS is shown to provide an effective method for the early detection of intraocular foreign bodies (IOFB) dissolution. The ophthalmoscopic changes observed in chalcosis are discussed in relation to dissolution of IOFB and electroretinographic findings.

Animals↗
PubMed1980

Mydriatic solution for outpatient indirect ophthalmoscopy.

A mydriatic used for outpatient indirect ophthalmoscopy should produce prompt, maximal, transient mydrasis after a single instillation. Cycloplegia or systemic side effects should be minimal. A solution of tropicamide with phenylephrine hydrochloride seems to achieve this most effectively. In a general retina clinic population, the percentage of pupils dilated, the degree of dilation, and the resistence of the dilation to intense illumination were used to evaluate various concentrations of the drugs. Eight-tenths percent tropicamide with 5% phenylephrine adequately dilated 98.8% of the eyes, among which 25% had dark irides and 9% were receiving miotic therapy. Reduction of the concentration of either component produced less adequate mydriasis; an increase of the tropicamide concentration resulted in a saturated solution with drug precipitate forming on storage and a less adequate dilation. With the optimal combination, 1 drop adequately dilates the general population; 2 drops appear on more effective than 1.

Administration, Topical↗
PubMed1992

Fundus measurements with indirect ophthalmoscopy. An experimental approach.

We examined the factors influencing the accuracy of indirect ophthalmoscopic estimates of choroidal tumor size by studying indirect ophthalmoscope photographs of solid black domes implanted in the suprachoroidal space of postmortem human eyes. Measurements of the indirect ophthalmoscope photographs showed clinically significant differences in the absolute diameter of the visualized fundus, which varied with differences in condensing lens power and width, anteroposterior location of viewed fundus, and axial length of the experimental eye. Linear regression analysis demonstrated that the field of view of each condensing lens varied similarly with axial length and that the majority of variation in field size for each condensing lens was attributable to axial length variation. Equatorial fields of view averaged 11% smaller than posterior fields of view. The accuracy of estimated absolute intraocular dimensions using indirect ophthalmoscopy potentially approaches +/- 5%.

Choroid Neoplasms↗
PubMed1987

In vivo capillary microscopy findings and ophthalmoscopy findings in scleroderma.

We used in vivo capillary microscopy to examine the nailfold capillaries of 19 patients with scleroderma (18 women and 1 man; average age 56.6), and compared these findings with those obtained using an ophthalmoscope. The ophthalmoscope revealed hemorrhages in 68% of the patients, a reduction in the number of capillaries in 79%, avascular areas in 79%, and dilated capillaries in 84%. The findings from ophthalmoscopy showed a correlation of approximately 80% with those from capillary microscopy. Since the diagnosis of scleroderma can be confirmed with this instrument, we suggest that it be used when microscopy equipment is not available.

Adult↗
PubMed1995

Ophthalmoscopy for congenital hypertrophy of the retinal pigment epithelium (CHRPE) in patients with sporadic colorectal carcinoma.

In order to investigate the frequency of congenital hypertrophy of the retinal pigment epithelium (CHRPE) in sporadic colorectal cancer, ophthalmoscopy was carried out in 34 patients with colorectal carcinoma without known familial disposition. CHRPE is one of the most frequent extracolonic manifestations in familial adenomatous polyposis. None of the patients showed any sign of CHRPE. It is concluded that although genetic factors are presumably of importance in the development of sporadic colorectal cancer, CHRPE cannot be used as a marker for future risk of colorectal carcinoma except in polyposis families.

Adult↗
PubMed2002

Analysis of digital scanning laser ophthalmoscopy fundus autofluorescence images of geographic atrophy in advanced age-related macular degeneration.

BACKGROUND: Fundus autofluorescence (AF) imaging using confocal scanning laser ophthalmoscopy (cSLO) has been shown to be superior to fundus photography or angiography for delineating areas of geographic atrophy (GA) in retinal pigment epithelium (RPE) and for recording variation over time. We have evaluated a method for automated computerized detection and quantitation of RPE atrophy. METHODS: AF images in vivo were recorded with a confocal scanning laser ophthalmoscope (exc. 488 nm, em. >500 nm; Heidelberg Retina Angiograph). The intensity of AF in atrophic areas was markedly decreased. Two independent readers analysed these areas in 24 right eyes manually by outlining GA areas using a mouse-driven arrow (method A) and automatically by image analysis software (Global Lab Image/2) after subjective adjustment of thresholding (method B). Agreement between observers and between methods A and B was assessed by the Bland-Altman design for method-comparison studies. RESULTS: Larger areas were measured using method A than B by both readers (agreement A/B: reader 1 mean difference 1.04 mm, 95% CI [0.66,1.42]; reader 2 mean difference 0.62 mm, 95% CI [0.43,0.81]). The agreement between the readers was mean difference 0.39 mm (95% CI [0.02,0.76]) for A and mean difference -0.03 mm (95% CI [-0.23,0.18]) for B. Features making the delineation of borders of GA difficult included large choroidal vessels with autofluorescent properties in the GA area and media opacities. CONCLUSIONS: Fundus AF cSLO imaging provides a reliable means to delineate areas of GA. The automated image analysis allows more accurate detection and quantitative documentation of atrophic areas than manual outlining. This method will be useful in longitudinal natural history studies and for monitoring effects of future therapeutic interventions to slow down GA progression in patients with advanced atrophic ARMD and other retinal diseases associated with outer retinal atrophy.

Atrophy↗
PubMed2005

Comparison of confocal scanning laser ophthalmoscopy, scanning laser polarimetry and optical coherence tomography to discriminate ocular hypertension and glaucoma at an early stage.

BACKGROUND: The aim was to compare the ability of confocal scanning laser ophthalmoscopy (CSLO), scanning laser polarimetry (SLP), and optical coherence tomography (OCT) to discriminate eyes with ocular hypertension (OHT), glaucoma-suspect eyes (GS) or early glaucomatous eyes (EG) from normal eyes. METHODS: Ocular hypertension, GS, and EG were defined as normal disc with intraocular pressure >21 mmHg, glaucomatous disc without visual field loss, and glaucomatous disc accompanying the early glaucomatous visual filed loss respectively. Ninety-three normal eyes, 26 OHT, 55 GS, and 67 EG were enrolled. Optic disc configuration was analyzed by CSLO (version 3.04), whereas retinal nerve fiber layer thickness was analyzed by SLP (GDx-VCC; version 5.3.2) and OCT-1 (version A6X1) in each individual. The measurements were compared in the four groups of patients. Receiver operating characteristic curve (ROC) and area under the curve (AUC) discriminating OHT, GS or EG from normal eyes were compared for the three instruments. RESULTS: Most parameters in GS and EG eyes showed significant differences compared with normal eyes. However, there were few significant differences between normal and OHT eyes. No significant differences were observed in AUCs between SLP and OCT. In EG eyes, the greatest AUC parameter in OCT (inferior--120; 0.932) had a higher AUC than that in CSLO (vertical cup/disc ratio; 0.845; P=0.017). In GS, the greatest AUC parameter in OCT (average retinal nerve fiber layer [RNFL] thickness; 0.869; P=0.002) and SLP (nerve fiber indicator [NFI]; 0.875; P=0.002) had higher AUC than that in CSLO (vertical cup/disc ratio; 0.720). CONCLUSIONS: Three instruments were useful in identifying GS and EG eyes. For glaucomatous eyes with or without early visual field defects, SLP and OCT performed similarly or had better discriminating abilities compared with CSLO.

Area Under Curve↗
PubMed1979

Learning scleral depression with binocular indirect ophthalmoscopy.

Scleral depression with binocular indirect ophthalmoscopy will be easier to learn if the examiner observes the patient's pupillary reflex through the ophthalmoscope without looking through the hand-held condensing lens. When the tip of the scleral depressor is properly positioned the pupillary reflex will darken slightly. If the condensing lens is then moved into position the actual scleral depression will be visible.

Humans↗
PubMed1979

The effect of prolonged indirect ophthalmoscopy on the human eye.

In an experiment designed to simulate an excessively prolonged clinical examination, seven human eyes were exposed to light focused through a 20-diopter, aspheric condensing lens for 30 to 45 minutes. Three eyes contained primary malignant tumors of the choroid and were enucleated 1 1/2 to 4 1/2 days after light exposure. Follow-up data on four blind eyes with clear media were evaluated 15 to 36 months after light exposure. Concentrated prolonged light exposure used in this experiment caused grossly visible progressive corneal edema, along with significant discomfort to the patient. Even with light exposures sufficient to cause these complications of the anterior segment, retinal injury was recognizable only with electron microscopy and was characterized by irregular bending and twisting of the outer segments of the photoreceptors, changes that are considered reversible in nonhuman primate studies. Intermediate to long-term follow-up of 15 to 36 months after light exposure to blind eyes failed to reveal lens changes or delayed light-induced degenerative changes in the retina recognizable by ophthalmoscopy, fundus biomicroscopy, or color and fluorescein fundus photography.

Adult↗
PubMed1991

Global tracking of the ocular fundus pattern imaged by scanning laser ophthalmoscopy.

This paper presents an algorithm for the automatic global tracking of ocular fundus landmarks in video image sequences generated by scanning laser ophthalmoscopy (SLO). The tracking algorithm is based on the computation of the discrete unnormalized cross-correlation of an interactively preselected small template and respective images in time sequences of fundus patterns. The correlation is executed with binary images derived from an automatical threshold limitation of the grey-value images. Due to the [+1/-1] representation of the binary images the unnormalized correlation functions directly relate to the Hamming distance of the template and the objects in the images. Experiments show that even templates with features distorted by noise are accurately recognized at any position. The accuracy of position detection is better than 0.4%. Possible hardware implementations of the algorithm which would reduce computation time are briefly mentioned.

Algorithms↗
PubMed1994

Physiological perturbation of ocular and cerebral blood flow as measured by scanning laser ophthalmoscopy and color Doppler imaging.

Retinal blood flow regulation in health remains poorly described. We hypothesized that retinal perfusion is controlled to provide constant O2 delivery to that tissue, and that changes in retinal blood flow in response to chemical stimuli parallel changes in carotid and retrobulbar perfusion. Accordingly, in 11 young adults with normal eye examinations, we measured retinal blood flow indices (via scanning laser ophthalmoscopy [SLO] during fluorescein angiography) and carotid, ophthalmic, and central retinal arterial blood flow indices (via Doppler imaging [CDI]) under control, hypoxic (alveolar PO2 = 55 +/- 3 mmHg) and hyperoxic (alveolar PO2 = 655 +/- 18 mmHg) conditions. The three conditions were counterbalanced in order and isocapnia was maintained in each. Retinal arterial mean dye velocity and arteriovenous passage time, as measured by SLO, were slowed by hyperoxia and accelerated by hypoxia, in rough proportion to the changes in arterial O2 content (+/- 10%; p < 0.05). In the seven subjects in which relative measurements of retinal arterial diameters were obtained, neither hypoxia nor hyperoxia significantly altered vessel diameter. At the same time, mean retinal capillary transit velocity was independent of PO2, suggesting that, in health, retinal capillaries may be recruited as PO2 falls. O2-induced changes in carotid, ophthalmic, or central retinal arterial blood flow velocities (via CDI) were not found, though a wide coefficient of variation (30% for CDI vs. 14% for SLO) may have contributed to this failure. We conclude that, under isocapnic conditions, retinal perfusion may be regulated to provide constant O2 delivery.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Measurement of retinal hemodynamics with scanning laser ophthalmoscopy: reference values and variation.

High resolution video fluorescein angiography using scanning laser ophthalmoscopy allows the assessment of retinal macro- and microcirculation. Data on the retinal macrocirculation were obtained from 221 healthy subjects. The data were derived from estimations of the arm-retina time, the arteriovenous passage time and mean arterial dye velocity, characterizing the passage of fluorescein to the eye, the mean arterial plasma velocity, and the arteriovenous passage through the entire vascular bed of one segment. Additionally, the transit of hypofluorescent segments in the capillary macular network were measured in 90 healthy subjects. These parameters provide a wide range of information for understanding the physiology of healthy and diseased eyes. Fundamental for all interpretations is the knowledge of the physiological variations. In the present study the inter- and intraindividual variability of retinal hemodynamics in healthy volunteers were assessed. The interindividual variation was 23.8% for the arm-retina time, 20.7% for the arteriovenous passage time, 23.7% for the mean arterial dye velocity, and 14.2% for the capillary flow velocity; the coefficient for variation, characterizing the intraindividual variation, was 26.6%, 15.6%, 16.7%, and 7.9%, respectively. The knowledge of the inter- and intraindividual variation of retinal blood flow indices allows for a priori power estimations for pathophysiologic and pharmacological studies.

Adult↗
PubMed2004

The confocal scanning laser ophthalmoscopy ancillary study to the ocular hypertension treatment study: study design and baseline factors.

PURPOSE: To describe the study design of the Confocal Scanning Laser Ophthalmoscopy (CSLO) Ancillary Study to the Ocular Hypertension Treatment Study (OHTS) and to examine the associations between optic disk topography, and baseline demographic, clinical, and ocular factors at study entry. DESIGN: A randomized clinical trial. METHODS: Participants in this ancillary study were recruited from seven of the 22 OHTS clinical centers. Each participant completed imaging annually using a CSLO, the Heidelberg Retina Tomograph (HRT). Associations between HRT topographic optic disk measurements and intraocular pressure (IOP), baseline photographic estimates of horizontal and vertical cup-to-disk diameter ratios by the OHTS Optic Disk Reading Center, baseline visual field indices, and demographic and clinical factors were assessed using linear mixed effects models. RESULTS: Four hundred thirty-nine participants had good quality images and were included in this baseline analysis. No associations between HRT topographic optic disk measurements and diabetes, systemic hypertension, cardiovascular disease, IOP, or visual function were found. The HRT topographic optic disk measurements were associated with baseline stereophotographic estimates of horizontal and vertical cup-to-disk diameter ratios. The strongest associations were found between stereophotographic assessment of horizontal and vertical cup-to-disk diameter ratios, and HRT cup-to-disk area ratio (r =.85 and.84, respectively), rim-to-disk area ratio (r = -.85 and -.84, respectively), mean cup depth (r =.84 and.83, respectively), and cup area (r =.83 and.80, respectively). After adjusting for optic disk area, all HRT topographic optic disk measurements remained associated with stereophotographic assessment of horizontal and vertical cup-to-disk diameter ratios. CONCLUSIONS: The CSLO ancillary study to the OHTS is the first multicenter clinical trial to use CSLO imaging to monitor changes in the optic disk. At study entry, HRT topographic measurements corresponded well with both horizontal and vertical stereophotographic-based estimates of cup-to-disk diameter ratio in ocular hypertensive participants.

Female↗
PubMed2006

Agreement and repeatability for standard automated perimetry and confocal scanning laser ophthalmoscopy in the diagnostic innovations in glaucoma study.

PURPOSE: To assess agreement between structural and functional testing in classifying eyes as normal or abnormal and their repeatability on two consecutive visits by means of standard automated perimetry (SAP) and confocal scanning laser ophthalmoscopy. DESIGN: Analysis of selected data obtained from a prospective longitudinal observational cohort study, the Diagnostic Innovations in Glaucoma Study. METHODS: One hundred fifty-one participants with a SAP and a Heidelberg Retina Tomograph (HRT) test within a three-month window at two visits within 15 months were included. Eyes were classified by SAP and HRT at each visit. Agreement and repeatability were assessed by kappa statistics. RESULTS: At visit 1, 33 (22%) of 151 eyes had only SAP defects, 11 (7%) eyes had only HRT defects, and 35 (23%) eyes had both SAP and HRT defects. Seventy-two eyes (48%) were classified as normal by both tests. Similar results were obtained for visit 2. The agreement between SAP and HRT in classifying eyes was 70% (kappa = 0.393) at visit one and 68% (kappa = 0.363) at visit 2. Repeatability of classification by SAP alone, HRT alone, and both SAP and HRT between visits 1 and 2 was 84% (kappa = 0.693), 89% (kappa = 0.752), and 90% (kappa = 0.723), respectively. CONCLUSIONS: Agreement between SAP and HRT was only fair at both visits. Repeatability across visits was substantial for SAP alone, HRT alone, and for the combination of SAP and HRT. These results suggest that detection of particular features of glaucomatous damage depends on the technique used. Structural and functional tests appear complementary, and both should be used for early detection of glaucoma.

Female↗
PubMed2005

Validity of screening for glaucomatous optic nerve damage using confocal scanning laser ophthalmoscopy (Heidelberg Retina Tomograph II) in high-risk populations: a pilot study.

PURPOSE: To evaluate whether confocal scanning laser ophthalmoscopy (Heidelberg Retina Tomograph II [HRT II], Heidelberg Engineering, Heidelberg, Germany) is a valid tool for the detection of glaucomatous optic nerve damage. DESIGN: Observational, cross-sectional, nonconsecutive study in Montreal, Canada. PARTICIPANTS: Three hundred three nonconsecutive, high-risk persons were enrolled during a 6-month period. METHODS: Participants underwent HRT II testing and a standard ophthalmologic examination, including gonioscopy, intraocular pressure measurement, and optic disc grading. MAIN OUTCOME MEASURES: Positive likelihood ratio (PLR) and negative likelihood ratio (NLR), sensitivities and specificities, positive predictive value (PPV) and negative predictive value (NPV), and kappa coefficients of agreement of Moorfields regression analysis (MRA), cup shape measure (CSM), height variation contour (HVC), and mean retinal nerve fiber layer thickness (MRNFL). RESULTS: Three hundred three participants were enrolled, and 291 were examined clinically; 21 (7.2%) were found to have glaucoma. Heidelberg Retina Tomograph II testing was performed successfully and was of acceptable quality in 531 of 601 eyes (88%). When MRA was compared with the clinically based diagnosis, the weighted kappa coefficient was kappa = 0.567 (95% confidence interval [CI], 0.42-0.71) for the right eye and kappa = 0.516 (95% CI, 0.37-0.66) for the left eye. Best kappa coefficient of agreement was seen when normals were grouped with suspects in both clinical and MRA diagnosis (kappa = 0.604; 95% CI, 0.409-0.799 in the right eye). Depending on the gold standard and test-positive definitions for glaucoma, specificity ranged from 87% to 97%, sensitivity from 25% to 100%, PPV from 28% to 68%, NPV from 84% to 100%, PLR from 5.0 to 19.2, and NLR from 1.3 to 6.2. When CSM, HVC, and MRNFLT were compared with clinical diagnosis, all outcome measures were found to have lower ranges: specificity from 46.9% to 83.7%, sensitivity from 36.5% to 76.9%, PPV from 6% to 36%, NPV from 80% to 99%, PLR from 0.8 to 4.0, NLR from 0.9 to 3.0. CONCLUSIONS: The results of this study suggest that a glaucoma screening program may be effective in detecting glaucoma when targeting high-risk populations. Heidelberg Retina Tomograph II testing may prove to be a useful tool in detecting glaucomatous optic nerve damage and could be used as part of a complete glaucoma screening protocol.

Cross-Sectional Studies↗
PubMed2006

Comparison of the Moorfields classification using confocal scanning laser ophthalmoscopy and subjective optic disc classification in detecting glaucoma in blacks and whites.

OBJECTIVE: To compare the diagnostic accuracy of the Moorfields regression classification (MRC) and subjective optic disc evaluation in discriminating early to moderate glaucomatous from nonglaucomatous eyes. DESIGN: Cross-sectional observational study. PARTICIPANTS: Two hundred thirty-three patients with glaucoma and 216 normal subjects were included in the analysis. Racial groups were defined by self-description. METHODS: All subjects underwent confocal scanning laser ophthalmoscopy, stereophotography, and standard perimetry. Glaucoma was defined by visual field defect alone and confirmed with a second visual field test. Stereo photographs were graded as either normal or glaucomatous appearing in a masked fashion by 2 independent graders and adjudicated by a third grader in cases of disagreement. Mean disc area was compared between patients correctly and incorrectly diagnosed with either technique. MAIN OUTCOME MEASURES: Sensitivity and specificity of MRC and subjective evaluation of stereophotographs in the detection of glaucomatous visual field loss. RESULTS: With the MRC, the sensitivity and specificity were higher using the 95% cutoff than using the 99.9% cutoff. Classification based on subjective photo assessment had a greater agreement with the diagnosis of glaucoma than the MRC for blacks (MRC, sensitivity = 62.5%, specificity = 93.2%; Photo, sensitivity = 76.5%, specificity = 91.5%) and whites (MRC, sensitivity = 67.0%, specificity = 92.2%; photo, sensitivity = 78.4%, specificity = 91.9%). Disc area was significantly larger in patients incorrectly diagnosed with the MRC (P = 0.0289). CONCLUSIONS: Subjective optic disc grading by glaucoma specialists outperformed the MRC with the HRT II in both black and white subjects. Both subjective and objective diagnostic methods were associated with similar sensitivity and specificity between racial groups. The MRC was more likely to provide an incorrect diagnosis in subjects with larger optic discs.

Black or African American↗
PubMed2005

In vivo confocal imaging of the retina in animal models using scanning laser ophthalmoscopy.

Scanning-laser ophthalmoscopy is a technique for confocal imaging of the eye in vivo. The use of lasers of different wavelengths allows to obtain information about specific tissues and layers due to their reflection and transmission characteristics. In addition, fluorescent dyes excitable in the blue and infrared range offer a unique access to the vascular structures associated with each layer. In animal models, a further enhancement in specificity can be obtained by GFP expression under control of tissue-specific promotors. Important fields of application are studies in retinal degenerations and the follow-up of therapeutic intervention.

Animals↗