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PubMed1992

Examination of macular vitreoretinal interface disorders with monochromatic photography.

Monochromatic light accentuates details of different retinal layers because of its variable absorption and reflectance by structures both within and above these layers. Monochromatic photography was used to examine macular vitreoretinal interface abnormalities in 19 patients. Short wavelength photographs (490 nm) provided the best detail of inner retinal abnormalities, including epiretinal membranes, vitreoretinal traction, and the internal surface of confluent macular edema (pseudocyst). Although 540-nm red-free photography provided acceptable photographs, it did not provide optimal detail of inner or deep retinal abnormalities. Longer wavelengths, 585 and 610 nm, best disclosed the extent of deep retinal abnormalities, including the extent of confluent macular edema (pseudocysts) and retinal detachment that surrounded macular holes. The addition of short- and long-wave-length photography to traditional red-free photography may provide better localization, understanding, and documentation of the three-dimensional relationships in macular vitreoretinal interface disorders.

Eye Diseases↗
PubMed1993

The diagnosis of diabetic retinopathy. Ophthalmoscopy versus fundus photography.

PURPOSE: To compare fundus photography with ophthalmoscopy in the detection of diabetic retinopathy. METHODS: Ophthalmoscopy and fundus photographs with a nonmydriatic camera, both performed through dilated pupils, were compared to diagnose retinopathy in a cohort of 410 Oklahoma Indians with noninsulin-dependent diabetes mellitus. A total of 795 eyes were examined using both methods. The mean age of participants was 60.3 years, with a mean duration of diabetes of 17.3 years. RESULTS: An overall agreement of 86.3% with a kappa statistic kappa of 0.74 was found between ophthalmoscopy and fundus photography with a nonmydriatic camera. For the diagnosis of proliferative diabetic retinopathy, kappa = 0.84 with an agreement of 98.1%. With a total of 61 cases of proliferative retinopathy diagnosed by either method in our study, ophthalmoscopy alone detected 88.5% and fundus photography, 78.7%. When compared on a lesion-by-lesion basis, agreement between the two diagnostic methods was highest for nonproliferative retinopathy, as well as fibrous proliferation. CONCLUSION: The fundus photography with a nonmydriatic camera, performed with mydriasis, is comparable to ophthalmoscopy for the detection of retinopathy. It may prove to be a suitable, cost-effective method for routine screening in diabetes clinics, provided ophthalmologic referral is ensured for those with a diagnosis of any form of retinopathy, questionable retinopathy, nondiabetic retinopathy, those with poor quality photographs, as well as those with acute changes in visual acuity.

Diabetes Mellitus, Type 2↗
PubMed1999

Digital fluorescence photography can assess the suppressive effect of benzoyl peroxide on Propionibacterium acnes.

BACKGROUND: Porphyrins produced by Propionibacterium acnes exhibit an orange-red fluorescence under UVA light. The amount of fluorescence can be estimated by digital fluorescence photography. OBJECTIVE: We thought that digital fluorescence photography would be a quicker and simpler method than bacteriologic culture to demonstrate depopulation of P acnes in sebaceous follicles. We used benzoyl peroxide to bring about rapid suppression of P acnes. METHODS: Benzoyl peroxide 10% was applied twice daily for 7 days to the faces of 9 subjects. Five subjects were untreated controls. Digital fluorescence photographs of cheek and nose, and scrub samples for quantitative recovery of P acnes from the cheek were taken at baseline, day 3, day 7 (end of treatment), and day 16 (regression phase). RESULTS: The effect of benzoyl peroxide against P acnes was clearly demonstrated both by culture and by fluorescence photography after only 3 days. Image analysis of porphyrin fluorescence correlated well with the decrease in P acnes density from scrub cultures. No further decrease was observed at day 7 (end of therapy). Ten days later there was a return to baseline values, although in some subjects these remained lower. CONCLUSION: Digital fluorescence photography is a reliable, fast, and easy screening technique to demonstrate the suppressive effect of topical antibacterial agents on P acnes.

Adolescent↗
PubMed2004

Comparison of optometry vs digital photography screening for diabetic retinopathy in a single district.

PURPOSE: To compare (a). the clinical effectiveness and (b). cost effectiveness of the two models in screening for diabetic retinopathy. METHODS: (a). Retrospective analysis of referral diagnoses of each screening model in their first respective years of operation and an audit of screen positive patients and a sample of screen negatives referred to the hospital eye service from both screening programmes. (b). Cost effectiveness study. PARTICIPANTS: (1). A total of 1643 patients screened in the community and in digital photography clinics; (2). 109 consecutive patients referred to the Diabetic Eye Clinic through the two existing models of diabetic retinopathy screening; (3). 55 screen negative patients from the optometry model; (4). 68 screen negative patients audited from the digital photography model. RESULTS: The compliance rate was 45% for optometry (O) vs 50% for the digital imaging system (I). Background retinopathy was recorded at screening in 22% (O) vs 17% (I) (P=0.03) and maculopathy in 3.8% (O) vs 1.7% (I) (P=0.02). Hospital referral rates were 3.8% (O) vs 4.2% (I) Sensitivity (75% for optometry, 80% for digital photography) and specificity (98% for optometry and digital photography) were similar in both models. The cost of screening each patient was pound 23.99 (O) vs pound 29.29 (I). The cost effectiveness was pound 832 (O) vs pound 853(I) in the first year. CONCLUSION: The imaging system was not always able to detect early retinopathy and maculopathy; it was equally specific in identifying sight-threatening disease. Cost effectiveness was poor in both models, in their first operational year largely as a result of poor compliance rates in the newly introduced screening programme. Cost effectiveness of the imaging model should further improve with falling costs of imaging systems. Until then, it is essential to continue any existing well-coordinated optometry model.

Adult↗
PubMed1986

[Can the use of infrared photography give evidence of the prognosis of hereditary macular degeneration?].

The question as to whether infrared photography can help determine the prognosis of hereditary macular degeneration cannot be answered simply in the affirmative or negative. Changes in the retinal surface layers are not detected by infrared photography. Therefore, no statement can be made regarding the prognosis of these types of macular degeneration. As far as macular degenerations of the deeper layers of the fundus are concerned, it cannot be stated as a general rule that severe changes in the infrared photograph imply a worse prognosis. Rather, one has to differentiate on the basis of the form and limitations of the defects. Infrared photography furnishes prognostic information by facilitating differential diagnosis between the prognostically favorable central areolar choroidal atrophy and the unfavorable progressive diffuse atrophy of the choroid. Further pointers to the prognosis can be obtained by differentiation between Stargardt's macular degeneration and diseases with favorable prognoses, which appear similar at the fundus, namely central areolar choroidal atrophy and dominant macular degeneration, which has a relatively benign course. In Stargardt's macular degeneration infrared photography seems to provide the following prognostic information: whether the degeneration is limited to the macula; whether flavimaculatus spots appear, or whether diffuse chorioatrophic degeneration will occur.

Atrophy↗
PubMed2002

From photography to cinematography: recording movement and gait in a neurological context.

The major challenge of photography has been freezing movement, to transform it into a fixed image or series of images. Very soon, photographers became interested in movement itself and tried to use photography as a tool to analyze movement. At the early stages, physicians interested in movement, perhaps surprisingly, made important technical contributions. Mécanisme de la physionomie humaine, by Duchenne, the first book with physiological experiments illustrated by photographs, is a landmark in this historical development. At the Salpêtrière, thanks to Charcot, photography officially entered clinical neurology. Medical journals with photographs were actively developed by Bourneville. Londe established a clinical photographic laboratory and published the first book on medical photography. The study of animal and human movement by Muybridge and Marey in the 1880s led to chronophotography and later cinematography. Clinicians such as Dercum and Richer took advantage of these new techniques to study pathological movement and gait in neurological diseases.

Animals↗
PubMed2001

Standardizing digital photography: it's not all in the eye of the beholder.

Advances in digital photography have made it an efficient and economically appealing alternative to conventional photography. Nevertheless, as objective observers and clinical photographers, we must realize that all digital cameras are not created equal. Different digital cameras frequently used in plastic surgery practices (Olympus 600DL, Olympus 2500, Sony DSC-D700, Nikon Coolpix 950, and Nikon D1) were evaluated, using a subject photographed with each camera in the identical lighting conditions, to determine inherent differences in quality, color, and contrast of the resultant photographs. Three different lighting conditions were examined: single soft-box lighting, dual studio flash boxes, and operating room lighting with on-camera flash. The same digital settings (program mode, ISO camera default setting, high quality setting with JPEG compression) were used. Each camera was digitally color balanced using an 18 percent gray card. Raw and color-balanced images were viewed side-by-side. The macro-image capabilities of each camera were also examined. Conventional 35-mm photographs using a 105 macro-lens on Kodachrome and Ektachrome slide film were obtained for comparison. All of the digital cameras performed with noticeable differences, but they maintained consistency in the three different lighting conditions. Digital photographs differed most greatly with respect to quality and contrast, which was especially obvious once color balancing was performed. Marked differences in quality and ability were observed with respect to macro-image capabilities. Inherent differences in features among digital cameras produce dramatically different photographic results with regard to color, contrast, focus, and overall quality. With the increasing use of digital photography in plastic surgery journals and presentations, it must be recognized that digital cameras do not all display photographs of similar quality, especially when used to evaluate skin appearance. To standardize digital photography, the surgeon must realize that switching digital cameras is akin to switching film types. Standardization of digital photographs should include image resolution between 1.5 and 2.7 million pixels, ISO default setting, color balancing with an 18 percent gray card and software, consistency in focal distance, JPEG compression of medium-to-high quality, and backgrounds of medium blue or 18 percent gray.

Female↗
PubMed2003

Digital infrared photography assists in the detection of iris and ciliary body cysts.

PURPOSE: To report a case that illustrates the utility of digital infrared photography in the detection of iris and ciliary body cysts in an asymptomatic patient. MATERIALS AND METHODS: Digital infrared photography of the iris was performed in both eyes of a 50-year-old white woman who presented with bilateral endothelial pigment dusting and subtle iris transillumination defects. RESULTS: Infrared photography revealed a pronounced, rounded patch of transillumination in the periphery of the left iris. Also observed were focal, rounded regions of reduced transmittance in the peripheral iris of both eyes. These findings suggested the presence of bilateral iris and ciliary body cysts. High-resolution ultrasound biomicroscopic images were consistent with this suspicion. CONCLUSIONS: Digital infrared photography of the iris may be useful in the detection and evaluation of iris and ciliary body cysts.

Ciliary Body↗
PubMed2004

Melanomas detected with the aid of total cutaneous photography.

BACKGROUND: Early detection of melanoma results in excision of thinner melanomas, which are associated with better prognosis. Total cutaneous photography provides a temporal comparison of lesions, which allows clinicians and patients to recognize new and subtly changing lesions. OBJECTIVES: We examined the utility of total cutaneous photography in detecting melanoma, identified the reason for biopsy of suspicious lesions and determined who detected new melanomas, the physician on follow-up examination or the patient on self-examination. PATIENTS/METHODS: The charts of the 576 patients in the total cutaneous photography database were reviewed. Twelve patients were identified who had melanoma diagnosed with photographic assistance. Baseline and prebiopsy photographs, dermatology clinic notes (115 patient visits) and pathology reports for each biopsied lesion were reviewed. Histological diagnosis, cause for biopsy, and whether the lesion was detected by the patient or physician, was recorded for each of the biopsied lesions. Also noted were all the lesions that concerned patients, the cause for concern, and whether these lesions were biopsied. RESULTS: A total of 93 lesions were biopsied in these patients. Twenty-seven (35%) of 77 melanocytic lesions were histologically diagnosed as melanoma. The thickest melanoma found measured 1.1 mm, indicating a favourable prognosis in our patients. Seventy-four per cent of the melanomas were biopsied due to changes from baseline and 19% were biopsied because they were new lesions. The changes noted were subtle and the lesions that proved to be melanoma did not satisfy the classical clinical criteria for melanoma. Eight (30%) of the melanomas were identified by patients on skin self-examination. Twenty-six per cent of the lesions that concerned patients were not biopsied after evaluation by a physician. CONCLUSIONS: We found that photographically assisted follow-up helped detect new and subtly changing melanomas, which did not satisfy the classical clinical features of melanoma. In addition, photographically assisted follow-up helped detect nonmelanoma skin cancers. Patient skin self-examination proved to be valuable, in that it complemented physician follow-up examination in detecting melanomas. Photographic follow-up was also valuable in avoiding unnecessary biopsy in suspicious, but stable lesions. Total cutaneous photography therefore may be an effective way to increase the sensitivity and specificity for detecting melanoma.

Adult↗
PubMed2006

Ethical considerations for clinical photography in the global South.

Clinical photography is an important tool for teaching practitioners and field workers about the clinical manifestations of famine and undernutrition, particularly with respect to the Global South. Current international guidelines for clinical photography are not consistently applied or enforced, which has led to violations of privacy and rights, particularly for patients and victims of disaster in the Global South. Combining existing clinical photography guidelines from the North with ongoing clinical ethics debates in the South, this paper explores approaches to establishing photography guidelines throughout the world that will be sensitive to the privacy and dignities of all patients and victims of emergencies.

Clinical Trials as Topic↗
PubMedDate not supplied

Screening for diabetic retinopathy by one-field, non-mydriatic, 45 degrees digital photography is inadequate.

PURPOSE: To evaluate the sensitivity and specificity of one-field, non-mydriatic, 45 degrees digital photography for screening for diabetic retinopathy compared to indirect ophthalmoscopy using a slit-lamp, the reference standard. METHODS: A total of 100 consecutive diabetic patients (200 eyes) who underwent digital fundus photography and ocular examinations from June 2002 to November 2002 were included in this retrospective study. The patients, recruited from a hospital-based, retina referral practice, underwent 45 degrees, non-mydriatic, digital fundus photography using a non-mydriatic fundus camera. One image was obtained focusing the mid fundus between the optic disc and the macula. The fundus images were printed and graded by endocrinologists and a retinal specialist separately. The patients also underwent complete standard ocular examinations as the reference method for determining diabetic retinopathy, including dilation of their pupils and slit-lamp biomicroscopy done by ophthalmologists. The sensitivity and specificity of the digital photographic method were calculated by comparison to the reference method. RESULTS: The sensitivity and specificity of the retinal specialist's diabetic retinopathy grades were 53.8 and 89.0%, respectively. The sensitivity and specificity of the endocrinologists' grades were 45 and 75.3%, respectively. The false negative rates were 22 and 21.5% for endocrinologists and the retinal specialist, respectively. CONCLUSIONS: Screening for diabetic retinopathy using one-field, non-mydriatic, 45 degrees digital photography is inadequate.

Adult↗
PubMed1995

The use of Scheimpflug photography in the documentation of clinical states and in the biometry of the anterior eye segment.

From the start of our collaboration with the Institut für Experimentelle Ophthalmologie in the early 1980s, the scientist Otto Hockwin has always taken the greatest interest in the clinical use of Scheimpflug photography. I became a student of Hockwin's through my work on the effects of Verapramil. The straightforwardness and purposeful approach with which Hockwin persued any subject, once he had taken it up, served me as example and thereby helped me repeatedly to regain courage and patience in my own work. The Scheimpflug apparatus developed by Hockwin's team has proven its superiority over the conventional slit lamp photography through its excellent depth of focus. Further to the clinical applications of the Scheimpflug photography worked out by us and summed up once again in this paper, it also presents a widening of the scope hence available within ophthalmological teaching methods, which we can hardly do without these days. The students benefit from the far superior spatial image conveyed by the optical section through the anterior eye segment, compared to that obtained by the conventional slit lamp photography alone. The precision of the reproducible image of the anterior segment furthermore represents a vital supplementary aid in the solution of pre- and postoperative, as well as specialist diagnostic problems.

Adult↗
PubMed1984

The evolution of modern endoscopic photography.

Most of the problems of endoscopic photography through rigid and flexible instruments have been overcome. Within the not-too-distant future, it should be possible to take good endoscopic photographs through a standard 4-mm telescope using 200-ASA film, light being provided by a high-powered external flash unit transmitting light to the telescope through a liquid-filled light guide. It may, however, be better to suggest a compromise in which operative procedures and urethral photography can be carried out through the 30 degrees, 4-mm diameter telescope, but bladder inspection and photography performed through a 5.5- or 6-mm telescope. The standard set would then become a 0 degrees and 30 degrees, 4-mm diameter telescope, and a 70 degrees larger instrument for bladder photography and inspection.

Color↗
PubMedDate not supplied

Photography: an aesthetic technique for nursing inquiry.

Photographs visually capture experiences within life that are often not captured by language alone. Photography is a powerful tool for understanding human experience and a useful healing strategy. When photographs are used as an entree for interviewing participants, stories are elicited and a new view of their lives is revealed. As a person relates the story behind a photograph, new insights emerge about his or her human experience. With photography, other dimensions of observation and knowledge surrounding human experience emerge. This article discusses the use of photography as an aesthetic technique for nursing inquiry. A discussion of the uses of photography within nursing inquiry and suggestions for its use within method are presented.

Child↗
PubMed1994

Detection of retinopathy by non-mydriatic fundus photography in diabetics treated with oral hypoglycaemic agents or diet.

OBJECTIVE: To determine the prevalence of retinopathy by non-mydriatic fundus photography in diabetics treated with oral hypoglycaemic agents or diet. DESIGN: Cross-sectional survey of diabetes-induced fundal changes assessed by fundus photography. SETTING: Area of Health Centre of Oulu. Population 100,000. SUBJECTS: All 1,228 diabetic patients, aged 30 years or over and treated with oral hypoglycaemic agents or diet at the Health Centre of Oulu. MAIN OUTCOME MEASURES: Presence and severity of diabetic retinopathy in fundus photographs, need for laser photocoagulation, age, hypertension, body mass index (BMI), duration of diabetes, type of treatment of diabetes. RESULTS: Retinopathy was observed in 178 (18%) of those 1,015 diabetics examined at the health centre. Retinopathic changes requiring laser treatment were observed in 15 cases, and eight of them had not been diagnosed earlier. Sixty non-attenders photographed at the Central University Hospital were also included, and 12 of them had retinopathy. The presence of retinopathy was associated with long duration of diabetes, poor glycaemic control, and high systolic blood pressure. No association was detected with sex, age at onset of diabetes, BMI, medication for coronary artery disease, or hypertension. CONCLUSIONS: Non-mydriatic fundus photography detected a high prevalence of retinopathy in diabetic patients. Half of those with preproliferative changes were previously undiagnosed cases, and five were in need of immediate laser treatment. It is concluded that fundus photography is a useful tool for detecting retinopathy in a primary health care setting.

Adult↗
PubMed1993

A Master of Science course at the Cardiff School of Medical Photography.

Formal teaching and training in medical photography at Cardiff started in 1969 when a School of Medical Photography was established, as part of the Department of Medical Illustration, at the Cardiff Royal Infirmary. In the early 1970s the school was transferred with the Medical Illustration Department to the newly built University Hospital of Wales, and housed in planned accommodation at what is now the Institute of Health Care Studies. The school offered courses in medical photography at the level of the qualifying examinations of the Professional Institutes, to suitably qualified in-service students appointed to the Medical Illustration Department as Trainee Medical Photographers. In 1990, the University of Wales approved a Master of Science course in Medical Illustration (Photography and Video) offered by the school. The course is available both to in-service students of the school and to practising medical photographers as mature students on a distance learning programme. Details of the new course and its delivery are given.

Education, Graduate↗
PubMed1984

The color photography of gross specimens.

A method of color preservation and photography of gross specimens is presented in this article. The natural color and physical consistency of the preserved specimens assure "true to life" color photographs. The author explains how his institution's system of combining the Autopsy Review Conference with the photography of specimens saves much staff and employee time since the final gross descriptions and dissections are accomplished concurrently with the photography. A systematic method of photography is illustrated which eliminates most of the exposure determination functions that are time-consuming and subject to error.

Autopsy↗
PubMedDate not supplied

Feasibility study of imaging of intraductal papillary mucinous tumors of the pancreas based on integral photography.

BACKGROUND/AIMS: The principle of integral photography was first proposed by Lippman in 1908. Recently, the three-dimensional display system based on the principle of integral photography was developed. It projects three-dimensional objects using a lens array called a fly's eye lens and photographic film. Some groups have used it for surgical navigation in brain surgery. In this study, we tried to generate integral photographic images of intraductal papillary mucinous tumors of the pancreas, and evaluated the feasibility of this method. METHODOLOGY: Five patients with an intraductal papillary mucinous tumor of pancreas were studied. We used MRI data as three-dimensional data. MRI data were acquired with a 1.5-T clinical imager (Signal.5; GE Medical Systems, U.S.A). We used multi-slab single-shot fast spin-echo sequences. Section thickness was between 2 and 3mm in the coronal plane. From these data, integral photographic images were generated on a liquid crystal display by a three-dimensional rendering algorithm. RESULTS: Three-dimensional images using the principle of integral photography could be generated in all 5 cases. We could recognize these images as three-dimensional images by slightly moving the viewpoint to up, down, left, and right. From these images, we were able to grasp the three-dimensional relationship between the tumor, bile duct, and pancreatic duct. Using these three-dimensional images, a variety of minimally invasive surgical procedures were performed for intraductal papillary mucinous tumor of the pancreas, more safely and speedily than formerly. CONCLUSIONS: The images based on integral photography are suitable for medical imaging and are useful for surgical planning.

Adenocarcinoma, Mucinous↗