Scanning Laser Ophthalmoscopy and Angiography With a Wide-Field Contact Lens System

Abstract

To perform fluorescein and indocyanine green angiography for large or peripheral chorioretinal structures using a contact lens system that provides a 5-fold increase in the field of view of a confocal scanning laser ophthalmoscope (SLO).Methods: Separate handheld contact and noncontact ophthalmoscopic lenses were manually aligned with the optical axis of a confocal SLO to demonstrate the feasibility of wide-field SLO angiography. An integrated, widefield contact lens system was then designed and constructed to increase the SLO's 10°, 20°, and 30°imaging fields to 50°, 100°, and 150°, respectively.Results: Simultaneous fluorescein and indocyanine green angiography was performed with the integrated, widefield contact lens system for more than 50 patients with disorders that affect their peripheral retina and choroid. Retinal and choroidal abnormalities, including neovas-cularization and capillary nonperfusion, are easily detected and documented well beyond the range of conventional fundus cameras and SLOs. Peripheral retinal and choroidal hemodynamics can be readily observed and recorded.Conclusions: A confocal SLO has adequate resolution for clinically useful reflectance and angiographic imaging even when its field size is increased 5-fold by a widefield contact lens system. Dynamic and static wide-field angiography can be performed without the limitations of manual or computer-automated photomontages. Peripheral retinal conditions can be studied and recorded to confirm observations from indirect ophthalmoscopy and to facilitate retinal photocoagulation and vitreoretinal surgery.

Ultra-Widefield Retina Imaging: Principles of Technology and Clinical Applications

“…The first panoramic fundus pictures were made from a montage of 19 photographs using a movable fixation light to enable the acquisition of 96° fundus images [4]. Contact lens-based systems, including Pomerantzeff camera [5], Panoret-1000 [6], RetCam [7], and Staurenghi lens [8], provide up to 160° panoramic photographs. However, these methods require exact patient alignment, good pupillary dilation, and a skilled photographer, thus their use is impractical in clinical practice.…”

Imaging Before, During, and After Steroid Therapy

“…Today, multimodal imaging combined with spectral domain OCT and wide-fi eld imaging [ 9 ] could allow a better understanding and management of retinal and choroidal disorders.…”

Advances in Imaging in Age-Related Macular Degeneration

“…However, even in optimal circumstances, this does not allow for complete coverage of the retina and is often technically challenging. Fundus contact lens have also been employed to afford wider fields of view (e.g., the Staurenghi lens), however, the need to apply the lens directly to the eye is a limiting factor in the widespread utilization of such approaches [44,45]. Other contact widefield imaging devices include RetCam (Clarity Medical Systems, United States) and Panoret-1000 (Medibell Medical Vision Technologies, Israel) [46].…”