Atlas of Laser Scanning Ophthalmoscopy by Alexander Friedrich Scheuerle, Eckart Schmidt, H.E. Völcker,

By Alexander Friedrich Scheuerle, Eckart Schmidt, H.E. Völcker, L.E. Pillunat, F.E. Kruse

Glaucoma is still one of many best factors of blindness. Laser scanning tomography has received an vital position within the ophthalmologic analysis, specially within the long term follow-up of glaucoma. Confocal laser scanning ophthalmoscopy presents key insights into the three-d anatomy of the optic disc in vivo. This special atlas comprises incredible photos of all clinically proper illnesses clinically determined by way of present types of the Heidelberg Retina Tomograph. It correlates classical diagnostic instruments like perimetry, tonometry and fundus images with cutting-edge experiences together with electronic retinal angiography, optical coherence tomography and laser scanning tomography. particular gains comprise the illustrated insurance of illnesses of the optic nerve head; differing kinds and levels of glaucoma, non-glaucomatous neuropathy and papilledema; computerized category systems for the detection of glaucoma; ideas for the translation of follow-up leads to optic disc tracking and macular illnesses. The presently published Macular Edema Module expands the diagnostic spectrum of laser scanning ophthalmoscopy considerably, including measuring and tracking of diabetic and cystoid macular edema. This atlas is the main accomplished updated reference of laser scanning ophthalmoscopy to be had, perfect for citizens and normal ophthalmologists who are looking to improve their diagnostic skills.

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001 finear cup/disc ratio ( ) maximum ContOUl elevation (rom) maximum ContOUI depre ssion [roml elM tempollll·supeliol [roml elM tempO! 4 T . 8 . 431 mm Topography Std Dev. a 30°-visual field, OD lb Topography image, OD , Intensitiy image, OD d Stereometric parameters Plate 19 Comments • Very thin neuroretinal rim in the temporal/temporal superior sector (1) • Pathologically decreased global "rim area" and "rim volume" • Pathologically increased "cup/disc area ratio" and "linear cup/disc ratio" • Vertically pronounced cup shape • Pathologically decreased "height variation contour" value • Pathologic "cup shape measure" value • Moorfields analysis rates only two superior sectors as "out of normal limits" • Both discriminat functions rate optic disc as "glaucomatous" Note the similar development of glaucomatous damage in the right (upper plate) and left optic disc of this patient.

F·· .... ·.. ·····r· .......... ·r·········· .... : ot··· II II • ·· . •••••••• •••• • • • •• • 0 .. 0 , - 0 ••• ' " • • , r·r ............. • .. 0 . n .. . ------ . . N ~- r1 n . , . 555 cmm Cup/Disk Area Ratio 0. 487 mm Cup Shape Measure Height Variation Contour Mean RNFL Thickness -0. 356 mm Topography Std Dev. 0 TO .. • T'"" - ' ____ .. 286 mm' Cup Volume 0. 333mm RNFL Cross Sectional Area 2. 555 mm Topography Std Dev. F. SCHEUERLE, E. 1 Automated Classification Procedures Laser scanning ophthalmoscopy provides a topographic height map of the optic disc and the peripapillary retina.

Nevertheless, this methocljs purely a statistical description of whether a disc " lies within the defined normal limits. In a recent study, HRT-based classification of "glaucoma" or "normal" was moderately sensitive but not very specific when compared with clinical impression with standard binocular ophthalmoscopy (Kesen et al. 2002). It is also to be noted that all published studies concerning the validity and reliability of discriminant functions or regression analysis are based on relatively small study populations that certainly do not include the natural variety of optic disc samples.

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