Imaging a Child's Fundus Without Dilation Using a Handheld Confocal Scanning Laser Ophthalmoscope

Kelly, John P.

doi:10.1001/archopht.121.3.391

Cited by 15 publications

(7 citation statements)

References 21 publications

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“…13 Advantages of the handheld nonmydriatic SLO device included high tolerability, feasibility in children with poor fixation, and portability; however, there were several disadvantages, including inability to produce color images and long acquisition times (up to 15 minutes). The SLO device used was also only a prototype device that is not commercially available.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and quality of nonmydriatic fundus photography in children

Toffoli

Lamirel

Henderson

et al. 2011

Journal of American Association for Pediatric Ophthalmology and

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Purpose Ocular funduscopic examination is difficult in young children and is rarely attempted by nonophthalmologists. Our objective was to determine the feasibility of reliably obtaining high-quality nonmydriatic fundus photographs in children. Methods Nonmydriatic fundus photographs were obtained in both eyes of children seen in a pediatric ophthalmology clinic. Ease of fundus photography was recorded on a 10-point Likert scale (10 = very easy). Quality was graded from 1 to 5 (1, inadequate for any diagnostic purpose; 2, unable to exclude all emergent findings; 3, only able to exclude emergent findings; 4, not ideal, but still able to exclude subtle findings; and 5, ideal quality). The primary outcome measure was image quality by age. Results A total of 878 photographs of 212 children (median age, 6 years; range,1-18 years) were included. Photographs of at least one eye were obtained in 190 children (89.6%) and in both eyes in 181 (85.3%). Median rating for ease of photography was 7. Photographs of some clinical value (grade ≥2) were obtained in 33% of children <3 years and 95% >3 years. High-quality photographs (grade 4 or 5) were obtained in both eyes in 7% of children <3 years, 57% of children ≥3 to <7 years, 85% of children ≥7 to <9 years, and 65% of children ≥9 years. The youngest patient with high-quality photographs in both eyes was 22 months. Conclusions Nonmydriatic fundus photographs of adequate quality can be obtained in children over age 3 and in some children as young as 22 months.

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Section: Discussionmentioning

confidence: 99%

Feasibility and quality of nonmydriatic fundus photography in children

Toffoli

Lamirel

Henderson

et al. 2011

Journal of American Association for Pediatric Ophthalmology and

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“…The widely used SLO produced by Rodenstock, Germany is no longer commercially available. However, SLO models with comparable capabilities are described by Kelly et al (2003) and Sharp et al (2004).…”

Section: Characteristics Of Central Scotomamentioning

confidence: 99%

Functional and cortical adaptations to central vision loss

2005

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Age-related macular degeneration (AMD), affecting the retina, afflicts one out of ten people aged 80 years or older in the United States. AMD often results in vision loss to the central 15-20 deg of the visual field (i.e. central scotoma), and frequently afflicts both eyes. In most cases, when the central scotoma includes the fovea, patients will adopt an eccentric preferred retinal locus (PRL) for fixation. The onset of a central scotoma results in the absence of retinal inputs to corresponding regions of retinotopically mapped visual cortex. Animal studies have shown evidence for reorganization in adult mammals for such cortical areas following experimentally induced central scotomata. However, it is still unknown whether reorganization occurs in primary visual cortex (V1) of AMD patients. Nor is it known whether the adoption of a PRL corresponds to changes to the retinotopic mapping of V1. Two recent advances hold out the promise for addressing these issues and for contributing to the rehabilitation of AMD patients: improved methods for assessing visual function across the fields of AMD patients using the scanning laser ophthalmoscope, and the advent of brain-imaging methods for studying retinotopic mapping in humans. For the most part, specialists in these two areas come from different disciplines and communities, with few opportunities to interact. The purpose of this review is to summarize key findings on both the clinical and neuroscience issues related to questions about visual adaptation in AMD patients.

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“…Unfortunately, integrating wavefront sensing and correcting AO components into SLO results in systems too large and heavy for handheld use. As a compromise, handheld SLO (without AO) was first demonstrated by Kelly et al [17] and was found to be helpful in imaging children with nystagmus, photophobia, eccentric fixation, cone dystrophy, and mild papilledema. However, due to low resolution, this system was unable to visualize individual photoreceptors.…”

Section: Introductionmentioning

confidence: 99%

Handheld adaptive optics scanning laser ophthalmoscope

DuBose

Nankivil

Larocca

et al. 2018

Optica

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Adaptive optics scanning laser ophthalmoscopy (AOSLO) has enabled in vivo visualization and enhanced understanding of retinal structure and function. Current generation AOSLOs have a large footprint and are mainly limited to imaging cooperative adult subjects. To extend the application of AOSLO to new patient populations, we have designed the first portable handheld AOSLO (HAOSLO) system. By incorporating a novel computational wavefront sensorless AO algorithm and custom optics, we have miniaturized our HAOSLO to weigh less than 200 grams. HAOSLO imaged the cones closest to the fovea with a handheld probe in adults and captured the first AO-enhanced image of cones in infants.

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Imaging a Child's Fundus Without Dilation Using a Handheld Confocal Scanning Laser Ophthalmoscope

Cited by 15 publications

References 21 publications

Feasibility and quality of nonmydriatic fundus photography in children

Feasibility and quality of nonmydriatic fundus photography in children

Functional and cortical adaptations to central vision loss

Handheld adaptive optics scanning laser ophthalmoscope

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