Near-infrared reflectance imaging of neovascular age-related macular degeneration

Contains fulltext : 81007.pdf (publisher's version ) (Closed access)PURPOSE: To evaluate various types of neovascular age-related macular degeneration (AMD) by near-infrared fundus reflectance (NIR) as compared to fundus fluorescein angiography (FFA) and to test NIR for assessment of leakage due to choroidal neovascularization (CNV). PATIENTS AND METHODS: Thirty-three patients with neovascular AMD (cases) and 20 age-matched patients with non-exudative AMD and healthy subjects (controls) were examined with a confocal scanning laser ophthalmoscope (Heidelberg Retina Angiograph 2). NIR images of neovascular AMD were qualitatively compared to the corresponding FFA and to age-matched controls. CNV membranes and exudation areas were manually segmented on FFA and NIR and analyzed quantitatively. Results : Of all cases included, five eyes had classic CNV, six had minimal classic lesions, 15 occult CNV's and seven eyes had retinal angiomatous proliferation (RAP). A dark halo on NIR was found in all cases and showed high correspondence to leakage on FFA (r (2) = 0.93; p < 0,0005). In classic CNV and minimal classic CNV, the classic part of the lesion on FFA revealed strong correlation to a dark core surrounded by a bright reflecting ring on NIR (r (2) = 0.88; p < 0.0005). Occult parts on FFA of minimal classic CNV and occult CNV lesions appeared as poorly demarcated, jagged areas of increased NIR. RAP was characterized by speckled NIR located at the intraretinal neovascular complex. CONCLUSIONS: NIR imaging in neovascular AMD revealed characteristic alterations depending on the type of CNV. These changes may reflect histological differences of the lesions. Leakage caused local darkening of NIR, presumably originating from increased light-scattering and absorbance by fluid accumulation and sub-cellular structure alterations

Presentation d'un nouvel appareillage pour l'ophtalmoscopie et l'angioscopie. [A new apparatus for ophthalmoscopy and angioscopy (author's transl)]

New techniques with special filters for ophthalmoscopy and angioscopy are described and discussed. An apparatus with light source, light transmission by fiber optics and with a direct and an indirect ophthalmoscope is presented

Clinical trials with the Equator-Plus camera

The Equator-Plus camera can photograph a 148-degree view of the fundus, measured from the nodal point of the eye. We tested this instrument clinically more than 800 times on over 700 eyes. The large field, which is three to four times that of any conventional fundus camera, is achieved by using a special contact lens as the front element in the camera optics. Photographs taken with the Equator-Plus camera can resolve a lesion as small as one-eighth of a disk diameter, if the contrast is good. Protruding tumors, choroidal or retinal detachment, and extensive disease of the choroid and fundus show up well with this technique. We obtained good pictures in 87% of the clinical tests. We have not observed complications of any kind after photography with the Equator-Plus camera