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1.
Br J Ophthalmol ; 102(12): 1607-1610, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30206157

RESUMO

AIMS: To determine if early dilated fundus examination for cytomegalovirus (CMV) retinitis leads to better visual outcomes in areas with limited HIV care, where patients may have long-standing retinitis before they are diagnosed with HIV. METHODS: Twenty-four eyes of 17 patients with CMV retinitis who were seen at an urban HIV clinic in Chiang Mai, Thailand, were included in this retrospective cohort study. Participants were divided into two groups based on the amount of time from the first documented CD4 count below 100 cells/mm3 to the first eye examination for CMV retinitis. Average visual acuity in each group was calculated at the time CMV retinitis was first detected, and then at 3, 6 and 12 months after diagnosis. RESULTS: The group of patients who received an eye examination within approximately 4 months of the initial low CD4 count measurement had better baseline visual acuity (median 20/30,IQR 20/20 to 20/60) compared with patients who presented later (median 20/80, 20/60 to hand motion); p=0.03). Visual acuity did not change significantly during the 12-month study period in either the early group (p=0.69) or late group (p=0.17). CONCLUSION: In this study, patients who were examined sooner after a low CD4 count had better vision than patients who were examined later. Routine early screening of patients with CD4 counts under below 100 cells/mm3 may detect earlier disease and prevent vision loss.


Assuntos
Retinite por Citomegalovirus/diagnóstico , Diagnóstico Tardio , Diagnóstico Precoce , Oftalmoscopia/estatística & dados numéricos , Adulto , Retinite por Citomegalovirus/fisiopatologia , Diagnóstico Tardio/efeitos adversos , Diagnóstico Tardio/estatística & dados numéricos , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Encaminhamento e Consulta/estatística & dados numéricos , Estudos Retrospectivos , Tailândia , Acuidade Visual
2.
Ophthalmic Epidemiol ; 25(5-6): 345-350, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30015527

RESUMO

PURPOSE: To study optic nerve head (ONH) characteristics using scanning laser ophthalmoscopy, Heidelberg retina tomograph (HRT), in an elderly population. METHODS: A population-based, cross-sectional study included 1460 eyes of 1460 consecutive, subjects >60 years, in North India. All subjects underwent a detailed ophthalmic evaluation and imaged on HRT. Stereometric parameters, Moorfields regression analysis (MRA) and discriminant function analysis were analyzed. Correlation between ONH parameters and disc area, age, sex, and intraocular pressure was analyzed. RESULTS: Disc size had a normal Gaussian distribution (2.22 ± 0.48 mm2), but all other stereometric parameters showed a wide variation. MRA found 1320 (90.4%) eyes within normal limits, 71 (4.86%), borderline limits, and 69 (4.73%) outside normal limits. Comparison of eyes meeting International Society of Geographical and Epidemiological Ophthalmology criteria for a glaucoma suspect, C:D > 0.7, with those that did not show a statistically significant difference in the cup area, rim area, rim disc ratio, and cup volume (p = 0.02, 0.02, 0.02, 0.03, respectively). An Intraocular pressure (IOP) ≥21 mmHg was seen in 3.01%, and only 12 eyes out of 1460, 0.82%, had an IOP ≥21 mmHg and a cup:disc ratio of more than 0.7. A van Herick estimation of < Grade 3 was seen in 19.4% Conclusions: Stereometric parameter data, MRA, and clinical examination in this population at high risk for glaucoma found that about 10% of individuals over 60 years of age could be classified as glaucoma suspects and would need further evaluation.


Assuntos
Glaucoma/diagnóstico , Oftalmoscopia/estatística & dados numéricos , Disco Óptico/diagnóstico por imagem , Doenças do Nervo Óptico/diagnóstico , Vigilância da População , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Glaucoma/complicações , Glaucoma/epidemiologia , Humanos , Incidência , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Doenças do Nervo Óptico/epidemiologia , Doenças do Nervo Óptico/etiologia
4.
PLoS One ; 12(10): e0183485, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29065121

RESUMO

The purpose of this study was to determine among patients with candidemia the real rate of ophthalmoscopy and the impact of performing ocular assessment on the outcome of the disease. We performed a post hoc analysis of a prospective, multicenter, population-based candidemia surveillance program implemented in Spain during 2010-2011 (CANDIPOP). Ophthalmoscopy was performed in only 168 of the 365 patients with candidemia (46%). Ocular lesions related to candidemia were found in only 13/168 patients (7.7%), of whom 1 reported ocular symptoms (incidence of symptomatic disease in the whole population, 0.27% [1/365]). Ophthalmological findings led to a change in antifungal therapy in only 5.9% of cases (10/168), and performance of the test was not related to a better outcome. Ocular candidiasis was not associated with a worse outcome and progressed favorably in all but 1 evaluable patient, who did not experience vision loss. The low frequency of ophthalmoscopy and ocular involvement and the asymptomatic nature of ocular candidiasis, with a favorable outcome in almost all cases, lead us to reconsider the need for systematic ophthalmoscopy in all candidemic patients.


Assuntos
Candidemia/diagnóstico por imagem , Oftalmoscopia/estatística & dados numéricos , Idoso , Antifúngicos/uso terapêutico , Candidemia/tratamento farmacológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Espanha
6.
Ophthalmologe ; 113(9): 735-45, 2016 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-27541733

RESUMO

Age-related macular degeneration (AMD) is the main cause of blindness in industrialized societies. Population-based epidemiological investigations generate important data on prevalence, incidence, risk factors, and future trends. This review summarizes the most important epidemiological studies on AMD with a focus on their transferability to Germany including existing evidence for the main risk factors for AMD development and progression. Future tasks, such as the standardization of grading systems and the use of recent retinal imaging technology in epidemiological studies are discussed. In Germany, epidemiological data on AMD are scarce. However, the need for epidemiological research in ophthalmology is currently being addressed by several recently started population-based studies.


Assuntos
Cegueira/diagnóstico , Cegueira/epidemiologia , Degeneração Macular/diagnóstico , Degeneração Macular/epidemiologia , Oftalmoscopia/estatística & dados numéricos , Cegueira/terapia , Causalidade , Comorbidade , Progressão da Doença , Medicina Baseada em Evidências , Alemanha/epidemiologia , Humanos , Degeneração Macular/terapia , Prevalência , Fatores de Risco
7.
Ophthalmologe ; 113(9): 746-51, 2016 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-27448218

RESUMO

Glaucoma is the second leading cause of blindness worldwide. The purpose of this paper is to give a review on the epidemiology of the disease, on the importance and the consequences of glaucoma for people regarding their daily life, their ability to work, and quality of life.


Assuntos
Cegueira/diagnóstico , Cegueira/epidemiologia , Glaucoma/diagnóstico , Glaucoma/epidemiologia , Oftalmoscopia/estatística & dados numéricos , Seleção Visual , Cegueira/terapia , Causalidade , Comorbidade , Progressão da Doença , Medicina Baseada em Evidências , Alemanha/epidemiologia , Glaucoma/terapia , Humanos , Prevalência , Fatores de Risco
8.
PLoS One ; 10(6): e0131154, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26110792

RESUMO

PURPOSE: To address the problem of unequal scales for the measurement of two-dimensional structures in OCT images, and demonstrate the use of intra¬ocular objects of known dimensions in the murine eye for the equal calibration of axes. METHODS: The first part of this work describes the mathematical foundation of major distortion effects introduced by X-Y scaling differences. Illustrations were generated with CorelGraph X3 software. The second part bases on image data obtained with a HRA2 Spectralis (Heidelberg Engineering) in SV129 wild-type mice. Subretinally and intravitreally implanted microbeads, alginate capsules with a diameter of 154±5 µm containing GFP-marked mesenchymal stem cells (CellBeads), were used as intraocular objects for calibration. RESULTS: The problems encountered with two-dimensional measurements in cases of unequal scales are demonstrated and an estimation of the resulting errors is provided. Commonly, the Y axis is reliably calibrated using outside standards like histology or manufacturer data. We show here that intraocular objects like dimensionally stable spherical alginate capsules allow for a two-dimensional calibration of the acquired OCT raw images by establishing a relation between X and Y axis data. For our setup, a correction factor of about 3.3 was determined using both epiretinally and subretinally positioned beads (3.350 ± 0.104 and 3.324 ± 0.083, respectively). CONCLUSIONS: In this work, we highlight the distortion-related problems in OCT image analysis induced by unequal X and Y scales. As an exemplary case, we provide data for a two-dimensional in vivo OCT image calibration in mice using intraocular alginate capsules. Our results demonstrate the need for a proper two-dimensional calibration of OCT data, and we believe that equal scaling will certainly improve the efficiency of OCT image analysis.


Assuntos
Tomografia de Coerência Óptica/estatística & dados numéricos , Animais , Olho/anatomia & histologia , Proteínas de Fluorescência Verde , Processamento de Imagem Assistida por Computador/estatística & dados numéricos , Camundongos , Camundongos da Linhagem 129 , Oftalmoscopia/estatística & dados numéricos , Retina/anatomia & histologia , Vasos Retinianos/anatomia & histologia
9.
Ophthalmologe ; 111(5): 443-7, 2014 May.
Artigo em Alemão | MEDLINE | ID: mdl-24838865

RESUMO

BACKGROUND: Epidemiological studies continue to receive growing attention in health services research. OBJECTIVES: How can ophthalmological health services research benefit from the Study of Health in Pomerania (SHIP)? METHODS: The SHIP is a population-based, epidemiological project conducted in the northeast of Germany. In 1997 a random sample of 6,265 eligible subjects was enrolled for the first SHIP cohort. Between 1997 and 2001 baseline examinations were performed, followed by 5-year follow-up from 2002 to 2006, from 2008 to 2012 and from 2014. A second independent sample of 8,016 eligible subjects was enrolled in 2008. Baseline examinations of this new cohort (SHIP-Trend) were conducted between 2008 and 2012 and the first follow-up is scheduled for 2015. Included in SHIP are a large variety of different assessments including eye examinations. All participants are subjected to non-mydriatic funduscopy and static vessel analysis (SVA). RESULTS: A total number of 4,420 subjects participated in the interdisciplinary baseline examinations of SHIP-Trend. Standardized fundus photography was performed with a non-mydriatic camera in 3,934 subjects. CONCLUSION: Estimations of the prevalence of major eye diseases may provide valid indicators for healthcare provision within healthcare research. New concepts of prevention with a strengthened integration of ophthalmological diagnostics can be identified from the widespread spectrum of different healthcare examinations. Regional differences in the efficiency of healthcare provision can be evaluated with comparative studies between different German populations.


Assuntos
Oftalmopatias/diagnóstico , Oftalmopatias/epidemiologia , Pesquisa sobre Serviços de Saúde/organização & administração , Nível de Saúde , Oftalmologia/organização & administração , Oftalmoscopia/estatística & dados numéricos , Vigilância da População/métodos , Adolescente , Adulto , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto Jovem
10.
JAMA Ophthalmol ; 132(3): 304-9, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24384560

RESUMO

IMPORTANCE: We present a method to reintroduce ophthalmic training into the medical school curriculum. OBJECTIVES: To evaluate knowledge and skills acquired when participating in a service project, the Community Vision Project, and to develop a quantitative method for testing skills with the direct ophthalmoscope in patients. DESIGN: Second-year medical students participated in the study. After 1 month, their knowledge was compared with that of peers and graduates (internal medicine residents). Also at 1 month, their direct ophthalmoscope skills were compared with those of upperclassmen who had completed all core clerkships. One year later, after the participants had completed their core clerkships, long-term ophthalmoscope skills retention was tested, and their performance was compared with that of their classmates. SETTING AND PARTICIPANTS: Training occurred in mobile eye clinics. Knowledge and skills assessments were performed in the hospital eye clinic among students and residents at The University of New Mexico School of Medicine. Patients were recruited from the hospital eye clinic. Participants attended a 3-hour training session held by an attending physician in the hospital eye clinic and took part in at least 1 mobile eye clinic. MAIN OUTCOMES AND MEASURES: A knowledge assessment quiz was administered to participants (n = 12), their classmates (n = 18), and internal medicine residents (n = 33). Skills assessment with the direct ophthalmoscope was performed at 1 month and at 1 year in 5 participants and 5 nonparticipants. Tonometer skills were assessed by comparing participants' readings with those of an ophthalmologist's obtained in patients at the mobile eye clinics. RESULTS Participants' median knowledge assessment scores were 48% higher than those of their classmates and 37% higher than those of internal medicine residents (P < .001 for both). Short-term (1 month) direct ophthalmoscopy median scores were 60% (quartile 1 to quartile 3 range, 40%-80%) for participants and 40% (quartile 1 to quartile 3 range, 20%-60%) for nonparticipating upperclassmen (P = .24). Long-term direct ophthalmoscopy median scores were 100% (quartile 1 to quartile 3 range, 75%-100%) for participants and 0% (quartile 1 to quartile 3 range, 0%-25%) for nonparticipating classmates (P = .11). Participants' tonometer readings were similar to those of the ophthalmologist's; their median reading was 2 mm Hg (quartile 1 to quartile 3 range, 0-4 mm Hg) higher than that of the ophthalmologist's (P = .05, sign test). CONCLUSIONS AND RELEVANCE: Service-based learning offered an efficient model for incorporating ophthalmic training into the medical school curriculum. A viable tool for quantitatively testing ophthalmoscope skills is presented.


Assuntos
Competência Clínica/estatística & dados numéricos , Assistência à Saúde , Educação Médica/estatística & dados numéricos , Avaliação Educacional , Área Carente de Assistência Médica , Oftalmologia/educação , Estudantes de Medicina , Serviços de Saúde Comunitária , Currículo , Feminino , Humanos , Masculino , Oftalmoscopia/estatística & dados numéricos , Projetos Piloto , Tonometria Ocular/estatística & dados numéricos
11.
Cont Lens Anterior Eye ; 37(3): 153-6, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24169502

RESUMO

PURPOSE: To evaluate the risk factors in the development of pterygium in the Marmara region of Turkey as well as the efficacy of vertical interpalpebral distance, protrusion level and tear function in the development of pterygium. MATERIALS AND METHODS: The cases were grouped in two as the research group consisted of patients with pterygium and the control group consisted of healthy people. A total of 294 patients with pterygium (108 bilateral, 186 unilateral) and 200 controls were included in the study. All patients and control group underwent a thorough ophthalmic examination, including tear function analysis using tear film breakup time measurement, protrusion level and vertical interpalpebral distance. RESULTS: No statistically significant difference was found between the bilateral pterygium subgroup and control group in terms of vertical interpalpebral distance and protrusion value (p=0.733, p=0.625). When the pterygium eyes and the control group were compared in the unilateral pterygium subgroup, no significant difference was found in terms of vertical interpalpebral distance and protrusion value (p=0.533, p=0.209). CONCLUSIONS: While UV efficiency in pterygium was obvious, protrusion value and vertical interpalpebral distance were not found to be a risk factor in the formation of pterygium.


Assuntos
Exoftalmia/diagnóstico , Exoftalmia/epidemiologia , Pálpebras/patologia , Oftalmoscopia/estatística & dados numéricos , Pterígio/diagnóstico , Pterígio/epidemiologia , Lágrimas/citologia , Causalidade , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Reprodutibilidade dos Testes , Fatores de Risco , Sensibilidade e Especificidade , Lágrimas/química , Turquia/epidemiologia
12.
Klin Oczna ; 115(1): 25-8, 2013.
Artigo em Polonês | MEDLINE | ID: mdl-23882735

RESUMO

PURPOSE: The aim of this study was to evaluate an incidence of the vitreomacular adhesion in patients with age-related macular degeneration. MATERIAL AND METHODS: We examined 472 eyes in 241 patients (136 W/ 105 M) in age of 54-92 years (mean 62.6 years +/- 8.5) with dry or wet age-related macular degeneration using Cirrus HD-OCT (Zeiss) macular cube 512x128 program or 5-line pro-gram. RESULTS: Vitreomacular adhesion was observed in 139 eyes with dry age-related macular degeneration (29.4%, p=0.000*), in 101 eyes with drusen (21.4%, p=0.000*), in 38 eyes with retinal pigment epithelium alterations (8%, p=0.202), in 278 eyes with wet age-related macular degeneration (58.9%, p=0.001*), in 21 eyes with pigment epithelial detachment (4.4%, p=0.303), in 161 eyes with choroidal neovascularzation (34. 1%, p=0.031*/ and in 96 eyes with scar (20.4%, p=0.040*). CONCLUSIONS: Probably, vitreomacular adhesion alone is not able to induce age-related macular degeneration, but it may be associated with choroidal neovascularization development, it can contribute to exudate formation and choroidal neovascularization, it may induces or sustains a chronic low-grade inflammation in the macula region.


Assuntos
Neovascularização de Coroide/epidemiologia , Neovascularização de Coroide/patologia , Macula Lutea/patologia , Degeneração Macular/epidemiologia , Degeneração Macular/patologia , Corpo Vítreo/patologia , Idoso , Idoso de 80 Anos ou mais , Causalidade , Comorbidade , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Oftalmoscopia/estatística & dados numéricos , Medição de Risco , Sensibilidade e Especificidade , Aderências Teciduais/epidemiologia , Aderências Teciduais/patologia , Tomografia de Coerência Óptica/estatística & dados numéricos
13.
Comput Methods Programs Biomed ; 111(1): 104-14, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23535181

RESUMO

Recent research suggests that retinal vessel caliber (or cross-sectional width) measured from retinal photographs is an important feature for predicting cardiovascular diseases (CVDs). One of the most utilized measures is to quantify retinal arteriolar and venular caliber as the Central Retinal Artery Equivalent (CRAE) and Central Retinal Vein Equivalent (CRVE). However, current computer tools utilize manual or semi-automatic grading methods to estimate CRAE and CRVE. These methods involve a significant amount of grader's time and can add a significant level of inaccuracy due to repetitive nature of grading and intragrader distances. An automatic and time efficient grading of the vessel caliber with highly repeatable measurement is essential, but is technically challenging due to a substantial variation of the retinal blood vessels' properties. In this paper, we propose a new technique to measure the retinal vessel caliber, which is an "edge-based" vessel tracking method. We measured CRAE and CRVE from each of the vessel types. We achieve very high accuracy (average 96.23%) for each of the cross-sectional width measurement compared to manually graded width. For overall vessel caliber measurement accuracy of CRAE and CRVE, we compared the results with an existing semi-automatic method which showed high correlation of 0.85 and 0.92, respectively. The intra-grader reproducibility of our method was high, with the correlation coefficient of 0.881 for CRAE and 0.875 for CRVE.


Assuntos
Fundo de Olho , Artéria Retiniana/anatomia & histologia , Veia Retiniana/anatomia & histologia , Algoritmos , Doenças Cardiovasculares/diagnóstico , Cor , Humanos , Interpretação de Imagem Assistida por Computador/métodos , Oftalmoscopia/estatística & dados numéricos , Fotografação
14.
Int J Infect Dis ; 17(3): e146-8, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23369606

RESUMO

Intraocular candidiasis is a potentially sight-threatening complication of candidemia. While the incidence of candidemia in North America has increased, the prevalence of intraocular candidiasis appears to be decreasing. In the USA and Europe, an ophthalmic examination is recommended for all candidemic patients to rule out intraocular involvement. However, improvements in management, clarification of the diagnosis, and trends in the epidemiology of intraocular candidiasis suggest that some candidemia patients might be safely managed without the recommended dilated ophthalmic examination.


Assuntos
Candidemia/complicações , Candidemia/diagnóstico , Técnicas de Diagnóstico Oftalmológico/estatística & dados numéricos , Infecções Oculares Fúngicas/diagnóstico , Oftalmoscopia/estatística & dados numéricos , Candida/isolamento & purificação , Candidemia/epidemiologia , Candidemia/microbiologia , Técnicas de Diagnóstico Oftalmológico/economia , Infecções Oculares Fúngicas/epidemiologia , Infecções Oculares Fúngicas/microbiologia , Humanos , Incidência , Oftalmoscopia/economia , Prevalência , Fatores de Risco , Estados Unidos
15.
J R Coll Physicians Edinb ; 42(4): 306-10, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23240115

RESUMO

BACKGROUND: We believe that there is a need to increase awareness, particularly among foundation year doctors, of the importance of performing a full neurological examination, including ophthalmoscopy, in medical inpatients. Following a serious unexpected incident (missed papilloedema), we implemented a multifaceted intervention, including ensuring greater availability of equipment for neurological/ ophthalmological assessment, education and curriculum redesign in two large teaching hospitals in the UK. METHODS: Following the results of our initial intervention, we introduced a patient assessment scoring system to evaluate patient recollection of the completeness of neurological examination by medical staff in the two Trusts over a four-month period. RESULTS: Of the 93 patients referred to neurology during this period, 33% could not recollect being examined with a tendon hammer and 48% said they had not been examined with an ophthalmoscope. In contrast, the majority (95.7%) remembered the use of a stethoscope in their examination. The data were fed back to medical staff which resulted in greater awareness of the importance of a complete neurological examination. No further adverse incidents of missed papilloedema were reported in the following 12 months, although it would be premature to state that this situation has been resolved. CONCLUSIONS: A patient assessment score can be used by medical staff to raise awareness of the importance of a complete neurological examination from referring physicians.


Assuntos
Competência Clínica/normas , Diagnóstico Tardio/prevenção & controle , Determinação de Necessidades de Cuidados de Saúde , Doenças do Nervo Óptico/diagnóstico , Participação do Paciente , Exame Físico/normas , Melhoria de Qualidade , Adulto , Conscientização , Feminino , Pesquisas sobre Serviços de Saúde , Hospitais de Ensino , Humanos , Masculino , Rememoração Mental , Neurologia , Oftalmologia , Oftalmoscopia/métodos , Oftalmoscopia/estatística & dados numéricos , Pacientes , Exame Físico/métodos , Médicos , Reino Unido , Adulto Jovem
16.
J Biomed Opt ; 17(11): 116005, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23117800

RESUMO

To evaluate retinal perfusion in the human eye, a dual-wavelength confocal scanning laser ophthalmoscope (cSLO) was developed that provides spectral imaging of the fundus using a combination of red (670 nm) and near-infrared (810 nm) wavelengths. The image of the ocular fundus was analyzed to find out if quantitative measurements of the reflectivity of tissue permit assessment of the oxygen perfusion of tissue. We explored problems that affect the reproducibility of patient measurements such as non-uniformity errors on the image. For the first time, an image processing technique was designed and used to minimize the errors of oxygen saturation measurements by illumination correction in retina wide field by increasing SNR. Retinal images were taken from healthy and diabetic retinopathy eyes using the cSLO with a confocal aperture of 100 µm. The ratio image (RI) of red/IR, as oxygen saturation (SO2) index, was calculated for normal eyes. The image correction technique improved the reproducibility of the measurements. Average RI intensity variation of healthy retina tissue was determined within a range of about 5.5%. The capability of the new technique to discriminate oxygenation levels of retinal artery and vein was successfully demonstrated and showed good promise in the diagnosis of the perfused retina.


Assuntos
Microscopia Confocal/métodos , Oftalmoscopia/métodos , Oxigênio/metabolismo , Retina/metabolismo , Humanos , Microscopia Confocal/instrumentação , Microscopia Confocal/estatística & dados numéricos , Oftalmoscópios , Oftalmoscopia/estatística & dados numéricos , Fenômenos Ópticos , Valores de Referência , Reprodutibilidade dos Testes , Retina/anatomia & histologia , Vasos Retinianos/metabolismo
17.
Klin Monbl Augenheilkd ; 229(10): 1030-5, 2012 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-23096146

RESUMO

PURPOSE: The aim of this study was to evaluate posterior vitreomacular adhesion as a risk factor for choroidal neovascularisation (CNV) in age-related macular degeneration (AMD). The vitreoretinal interface was examined using spectralis optical coherence tomography (Spectralis-OCT, Heidelberg Engineering). PATIENTS AND METHODS: In a retrospective observational case series 375 consecutive eyes of 375 patients (age 51-90 years) were examined with spectralis OCT and fluorescein angiography (Spectralis-HRA, Heidelberg Engineering). Vitreomacular adhesion was defined when a posterior hyaloid line attached to the inner retinal surface was seen in OCT. In 202 patients with exudative AMD the incidence of posterior vitreomacular adhesion was compared to 173 control eyes (72 with non-exudative AMD and 101 eyes without retinal alterations). RESULTS: We found posterior vitreomacular adhesions in 151 patients (40.27 %). In the control group 53 patients (30.6 %) showed vitreomacular adhesions compared to 98 patients (48.5 %) with exudative AMD. The difference was statistically significant (p = 0.001). The location of vitreomacular adhesion was observed over the area of the CNV in 87 patients (88 %) with exudative AMD. CONCLUSIONS: Spectralis OCT allows a detailed examination of the vitreomacular interface. The frequency of posterior vitreomacular adhesion is significantly increased in eyes with CNV in AMD. Chronic vitreomacular traction may be a risk factor for the development of exudative AMD.


Assuntos
Neovascularização de Coroide/epidemiologia , Neovascularização de Coroide/patologia , Degeneração Macular/epidemiologia , Degeneração Macular/patologia , Aderências Teciduais/epidemiologia , Aderências Teciduais/patologia , Tomografia de Coerência Óptica/estatística & dados numéricos , Comorbidade , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Oftalmoscopia/estatística & dados numéricos , Prevalência , Reprodutibilidade dos Testes , Medição de Risco , Sensibilidade e Especificidade , Corpo Vítreo/patologia
18.
Invest Ophthalmol Vis Sci ; 53(10): 6526-31, 2012 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-22871828

RESUMO

PURPOSE: To assess the prevalence of peripheral fundus autofluorescence (FAF) abnormalities in a variety of diseases seen at a tertiary retina clinic. METHODS: We conducted a retrospective review of cases seen at the Doheny Eye Institute between November 2009 and May 2011, who had ultra-widefield FAF and pseudocolor imaging performed on new models of scanning laser ophthalmoscopes. Patients with a history of previous therapies that could alter the FAF findings, including vitrectomy, cryotherapy, laser photocoagulation, or photodynamic therapy, were excluded from the analysis. Based on their primary diagnosis the eyes were grouped into nine disease categories: age-related macular degeneration, central serous retinopathy, dystrophy, inflammatory disorders, ocular tumor, retinal vascular disorders, other, normal, and unknown. All FAF and accompanying pseudocolor images were reviewed independently by two reading center-certified graders. RESULTS: A total of 470 eyes of 248 patients were included for analysis of which 461 eyes had images of sufficient quality for grading. The prevalence of peripheral findings was 65.5% (n = 302) for FAF images and 68.5% (n = 316) for the pseudocolor images (P < 0.001). The prevalence of peripheral abnormalities differed significantly between the disease categories ranging from 18.5% to 82.2% for FAF and 18.5% to 82.4% for pseudocolor images. CONCLUSIONS: Peripheral FAF abnormalities are frequent and readily revealed by FAF imaging. Interestingly, even cases with presumably macular disease demonstrated a high prevalence of peripheral findings. Further investigation in prospective studies is warranted.


Assuntos
Imagem Óptica/métodos , Retina/patologia , Doenças Retinianas/epidemiologia , Doenças Retinianas/patologia , Centros de Atenção Terciária , Campos Visuais/fisiologia , Adulto , Idoso , Feminino , Fundo de Olho , Humanos , Luz , Masculino , Pessoa de Meia-Idade , Oftalmoscopia/métodos , Oftalmoscopia/estatística & dados numéricos , Imagem Óptica/instrumentação , Imagem Óptica/estatística & dados numéricos , Prevalência , Retina/fisiopatologia , Doenças Retinianas/fisiopatologia , Estudos Retrospectivos
19.
Appl Opt ; 51(9): 1198-208, 2012 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-22441462

RESUMO

A Lagrange multiplier-based damped least-squares control algorithm for woofer-tweeter (W-T) dual deformable-mirror (DM) adaptive optics (AO) is tested with a breadboard system. We show that the algorithm can complementarily command the two DMs to correct wavefront aberrations within a single optimization process: the woofer DM correcting the high-stroke, low-order aberrations, and the tweeter DM correcting the low-stroke, high-order aberrations. The optimal damping factor for a DM is found to be the median of the eigenvalue spectrum of the influence matrix of that DM. Wavefront control accuracy is maximized with the optimized control parameters. For the breadboard system, the residual wavefront error can be controlled to the precision of 0.03 µm in root mean square. The W-T dual-DM AO has applications in both ophthalmology and astronomy.


Assuntos
Algoritmos , Fenômenos Astronômicos , Oftalmoscopia/estatística & dados numéricos , Dispositivos Ópticos/estatística & dados numéricos , Desenho de Equipamento , Humanos , Análise dos Mínimos Quadrados , Lentes/estatística & dados numéricos , Oftalmoscópios
20.
IEEE Trans Pattern Anal Mach Intell ; 33(11): 2245-58, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21464502

RESUMO

A robust multiscale stereo matching algorithm is proposed to find reliable correspondences between low contrast and weakly textured retinal image pairs with radiometric differences. Existing algorithms designed to deal with piecewise planar surfaces with distinct features and Lambertian reflectance do not apply in applications such as 3D reconstruction of medical images including stereo retinal images. In this paper, robust pixel feature vectors are formulated to extract discriminative features in the presence of noise in scale space, through which the response of low-frequency mechanisms alter and interact with the response of high-frequency mechanisms. The deep structures of the scene are represented with the evolution of disparity estimates in scale space, which distributes the matching ambiguity along the scale dimension to obtain globally coherent reconstructions. The performance is verified both qualitatively by face validity and quantitatively on our collection of stereo fundus image sets with ground truth, which have been made publicly available as an extension of standard test images for performance evaluation.


Assuntos
Fundo de Olho , Retina/anatomia & histologia , Algoritmos , Percepção de Profundidade , Humanos , Imageamento Tridimensional/estatística & dados numéricos , Modelos Biológicos , Oftalmoscopia/estatística & dados numéricos , Tomografia de Coerência Óptica/estatística & dados numéricos
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