Ophthalmic Photography and Diagnostic Imaging

Hi, I’m Gene. I’m a photographer here at Vitreous Retina Macula Consultants of New York. Our imaging department is an
integral part of the diagnostic procedure to evaluate retinal conditions
and follow the response to treatment. Our department is equipped with the most
advanced retinal imaging technology available, putting us at the forefront of
ophthalmic imaging and allowing us to offer unmatched imaging quality to our
patients. An interesting fact: ophthalmic imaging or photography of the eye is the
only place in the entire body that we can visualize actual living tissue. Our
equipment can image at such a microscopic level that we are able to
capture individual blood cells moving throughout the vessels of the retina.
Let’s take a look at the diagnostic technology offered here at VRM. Angiography is a procedure we use to view circulation and abnormal blood vessels
in the retina, which commonly occur in diseases such as diabetic
retinopathy, vascular occlusions, age-related macular degeneration, central
serious chorioretinopathy and hypertensive retinopathy. Fluorescein angiography which uses a bright yellow contrast dye shows the circulation of the
retinal vessels. While indocyanine green angiography uses a green colored dye that highlights the choroid, a layer deeper than the retina. The dye is injected into the arm and a rapid sequence of pictures are taken to view the dye as it flows into the eye. The test only takes a few minutes and provides vital information for
the physicians to decide the best course of treatment. Optical coherence tomography or OCT
is a non-invasive imaging technique that captures a cross-sectional view, allowing us to visualize the individual layers of retinal tissue. Many people are familiar with computerized
tomography performed in hospitals, but unlike most hospital scans, these images do not expose the patient to any radiation. A safe beam of light is used to look at these structures
within the retinal tissue, which are not accessible for viewing by normal examination. Seeing the retina from this cross-sectional viewpoint provides us with a powerful way to detect, diagnose, and treat retinal disease. Pathological changes associated with age-related macular degeneration, diabetic macular edema,
central serous chorioretinopathy, and retinal edema associated with retinal vein
occlusions can be easily detected and monitored with this form of imaging. OCT imaging can also be crucial in diagnosing and following glaucoma with scans designed to calculate changes to the optic nerve and surrounding nerve fiber layer, an area primarily affected by glaucoma. OCT is also imperative in measuring choroidal thickness to detect early changes of certain systemic diseases. Because of our recognized status, many manufacturers utilize our
department to test new research equipment before it is available on the open market.
We pride ourselves on having access to a wide variety of advanced prototype
imaging technology not generally available to the public. Technology called adaptive optics, widely
used in astronomy, but relatively new to retinal imaging, allows us to visualize
individual cells of the photoreceptor layer and the retina. This ability to see
retinal disease on a cell by cell basis allows us to more precisely study the
progression of disease or response to treatment. Swept source optical coherence tomography is a type
of research OCT using a light wave that more effectively penetrates the retinal tissue,
providing us with a more detailed cross-sectional view of the eye. Structures that are unable to be seen on conventional OCT now be viewed and
evaluated and a quick, non-invasive way. OCT angiography is a scan that detects
the motion of flowing blood cells and creates an image similar to intravenous
angiography, but without the injection of contrast dye,
making this a non-invasive alternative to the traditional procedure. Fundus photography is a term we use to describe taking a picture of the back of the eye, an area more specifically called the retina. This allows us to
document its current appearance and record it for later reference. Even if you don’t have any retinal problems, it’s good to have a baseline image for any future changes that may happen. We use filters on the fundus camera to utilize specific wavelengths of light to highlight different areas of the retina. One of these techniques is called fundus autofluorescence, which uses a very specific wavelength to capture the accumulation of a
substance called lipofuscin. While this substance can sometimes naturally occur with age, it can also accumulate when cells aren’t functioning normally, a red flag that retinal disease may be present. If these retinal changes extend beyond what we can visualize with our normal cameras, we may choose to utilize an ultra widefield camera. This camera, otherwise known as Optos Imaging System, can document up to 4x the area that a standard camera is capable of photographing. In conclusion, the photography department serves as the foundation of the diagnostic procedure for our patients at VRM. All of these highly specialized cameras are available on site so that our patients may
access the most state-of-the-art medical imaging available and receive the most
cutting-edge retinal care, allowing us to diagnose and treat, if necessary, the same day. Thank you.

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