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Tunde Peto - One of the best experts on this subject based on the ideXlab platform.

  • The clinical relevance of visualising the Peripheral Retina.
    Progress in retinal and eye research, 2018
    Co-Authors: Nicola Quinn, Lajos Csincsik, Erin Flynn, Christine A. Curcio, Szilard Kiss, Srinivas R. Sadda, Ruth E. Hogg, Tunde Peto, Imre Lengyel
    Abstract:

    Abstract Recent developments in imaging technologies now allow the documentation, qualitative and quantitative evaluation of Peripheral Retinal lesions. As wide field Retinal imaging, capturing both the central and Peripheral Retina up to 200° eccentricity, is becoming readily available the question is: what is it that we gain by imaging the periphery? Based on accumulating evidence it is clear that findings in the periphery do not always associate to those observed in the posterior pole. However, the newly acquired information may provide useful clues to previously unrecognised disease features and may facilitate more accurate disease prognostication. In this review, we explore the anatomy and physiology of the Peripheral Retina, focusing on how it differs from the posterior pole, recount the history of Peripheral Retinal imaging, describe various Peripheral Retinal lesions and evaluate the overall relevance of Peripheral Retinal findings to different diseases.

  • a population based ultra widefield digital image grading study for age related macular degeneration like lesions at the Peripheral Retina
    Ophthalmology, 2015
    Co-Authors: Imre Lengyel, Adrienne Csutak, Daniela Florea, Irene Leung, Alan C Bird, Fridbert Jonasson, Tunde Peto
    Abstract:

    Purpose Our understanding of the relevance of Peripheral Retinal abnormalities to disease in general and in age-related macular degeneration (AMD) in particular is limited by the lack of detailed Peripheral imaging studies. The purpose of this study was to develop image grading protocols suited to ultra-widefield imaging (UWFI) in an aged population. Design A cross-sectional study of a random population sample in which UWFI was introduced at the 12-year review of the Reykjavik Eye Study in Iceland. Participants Five hundred seventy-six subjects 62 years of age or older. Methods Ultra-widefield (up to 200°) color and autofluorescence images were obtained using the Optos P200CAF laser scanning ophthalmoscope (Optos plc, Dunfermline, Scotland). The images were graded at Moorfields Eye Hospital Reading Centre primarily based on the International Classification for AMD. Macular and Peripheral changes were graded using a standardized grid developed for this imaging method. Main Outcome Measures Presence or absence of hard, crystalline, and soft drusen; Retinal pigment epithelial changes; choroidal neovascularization (CNV); atrophy; and hypoautofluorescence and hyperautofluorescence were graded in the Peripheral Retina. Results Of the eyes examined, 81.1% had AMD-like changes in the macula alone (13.6%), periphery alone (10.1%), and both periphery and macula (57.4%). There was no AMD-like CNV or pigment epithelial detachment in the periphery except in those cases in which these clearly originated from the macula. Seven patients had AMD-like atrophy in the periphery without end-stage disease in the macula. One patient with end-stage disease in the macula had normal periphery results on the color images. While analyzing the eyes, we detected pathologic appearances that were very reliably identified by graders. Conclusions Phenotyping the Retinal periphery using the categories defined by the International Classification confirmed the presence of wide-ranging AMD-like pathologic changes even in those without central sight-threatening macular disease. Based on our observations, we propose here new, reliably identifiable grading categories that may be more suited for population-based UWFI.

  • A Population-Based Ultra-Widefield Digital Image Grading Study for Age-Related Macular Degeneration–Like Lesions at the Peripheral Retina
    Ophthalmology, 2015
    Co-Authors: Imre Lengyel, Adrienne Csutak, Daniela Florea, Irene Leung, Alan C Bird, Fridbert Jonasson, Tunde Peto
    Abstract:

    Purpose Our understanding of the relevance of Peripheral Retinal abnormalities to disease in general and in age-related macular degeneration (AMD) in particular is limited by the lack of detailed Peripheral imaging studies. The purpose of this study was to develop image grading protocols suited to ultra-widefield imaging (UWFI) in an aged population. Design A cross-sectional study of a random population sample in which UWFI was introduced at the 12-year review of the Reykjavik Eye Study in Iceland. Participants Five hundred seventy-six subjects 62 years of age or older. Methods Ultra-widefield (up to 200°) color and autofluorescence images were obtained using the Optos P200CAF laser scanning ophthalmoscope (Optos plc, Dunfermline, Scotland). The images were graded at Moorfields Eye Hospital Reading Centre primarily based on the International Classification for AMD. Macular and Peripheral changes were graded using a standardized grid developed for this imaging method. Main Outcome Measures Presence or absence of hard, crystalline, and soft drusen; Retinal pigment epithelial changes; choroidal neovascularization (CNV); atrophy; and hypoautofluorescence and hyperautofluorescence were graded in the Peripheral Retina. Results Of the eyes examined, 81.1% had AMD-like changes in the macula alone (13.6%), periphery alone (10.1%), and both periphery and macula (57.4%). There was no AMD-like CNV or pigment epithelial detachment in the periphery except in those cases in which these clearly originated from the macula. Seven patients had AMD-like atrophy in the periphery without end-stage disease in the macula. One patient with end-stage disease in the macula had normal periphery results on the color images. While analyzing the eyes, we detected pathologic appearances that were very reliably identified by graders. Conclusions Phenotyping the Retinal periphery using the categories defined by the International Classification confirmed the presence of wide-ranging AMD-like pathologic changes even in those without central sight-threatening macular disease. Based on our observations, we propose here new, reliably identifiable grading categories that may be more suited for population-based UWFI.

  • Comparison of image-assisted versus traditional fundus examination.
    Eye and brain, 2013
    Co-Authors: Kristen Brown, Tunde Peto, Jeanette M Sewell, Clement Trempe, Thomas G. Travison
    Abstract:

    BACKGROUND The purpose of this study was to evaluate the ability of image-assisted fundus examination to detect Retinal lesions compared with traditional fundus examination. METHODS Subjects were imaged using a nonmydriatic ultrawide field scanning laser ophthalmoscope. After imaging, subjects underwent both a traditional and an image-assisted fundus examination, in random order. During the image-assisted method, ultrawide field scanning laser ophthalmoscopic images were reviewed in conjunction with a dilated fundus examination. Lesions detected by each method were assigned to one of three regions, ie, optic disc, posterior pole/macula, or mid-to-Peripheral Retina. Discrepancies between the image-assisted and the traditional examination methods were adjudicated by a Retinal ophthalmologist. RESULTS In total, 170 subjects (339 eyes) were recruited. Agreement between image-assisted and traditional fundus examination varied by lesion type and was excellent for staphyloma (kappa 0.76), fair for suspicious cupping (kappa 0.66), drusen in the posterior pole/macula and mid-to-Peripheral Retina (0.45, 0.41), Retinal pigment epithelial changes in the posterior pole/macula (0.54), Peripheral Retinal degeneration (0.50), cobblestone (0.69), vitreoRetinal interface abnormalities (0.40), and vitreous lesions (0.53). Agreement was poor for hemorrhage in the mid-to-Peripheral Retina (kappa 0.33), and nevi in the mid-to-Peripheral Retina (0.34). When the methods disagreed, the results indicated a statistically significant advantage for the image-assisted examination in detecting suspicious cupping (P = 0.04), drusen in the posterior pole/macula and mid-to-Peripheral Retina (P = 0.004, P < 0.001), Retinal pigment epithelial changes in the posterior pole/macula (P = 0.04), nevi in the posterior pole/macula and mid-to-Peripheral Retina (P = 0.01, P = 0.007), Peripheral Retinal degeneration (P < 0.001), hemorrhage in the mid-to-Peripheral Retina (P = 0.01), and vitreous lesions (P < 0.001). CONCLUSION Image-assisted fundus examination may enhance detection of Retinal lesions compared with traditional fundus examination alone.

Srinivas R. Sadda - One of the best experts on this subject based on the ideXlab platform.

  • The clinical relevance of visualising the Peripheral Retina.
    Progress in retinal and eye research, 2018
    Co-Authors: Nicola Quinn, Lajos Csincsik, Erin Flynn, Christine A. Curcio, Szilard Kiss, Srinivas R. Sadda, Ruth E. Hogg, Tunde Peto, Imre Lengyel
    Abstract:

    Abstract Recent developments in imaging technologies now allow the documentation, qualitative and quantitative evaluation of Peripheral Retinal lesions. As wide field Retinal imaging, capturing both the central and Peripheral Retina up to 200° eccentricity, is becoming readily available the question is: what is it that we gain by imaging the periphery? Based on accumulating evidence it is clear that findings in the periphery do not always associate to those observed in the posterior pole. However, the newly acquired information may provide useful clues to previously unrecognised disease features and may facilitate more accurate disease prognostication. In this review, we explore the anatomy and physiology of the Peripheral Retina, focusing on how it differs from the posterior pole, recount the history of Peripheral Retinal imaging, describe various Peripheral Retinal lesions and evaluate the overall relevance of Peripheral Retinal findings to different diseases.

  • appearance of far Peripheral Retina in normal eyes by ultra widefield fluorescein angiography
    American Journal of Ophthalmology, 2017
    Co-Authors: Guiying Mai, Yan Luo, Di Cao, Xiao Wang, Hong Yan, Srinivas R. Sadda
    Abstract:

    Purpose To characterize the appearance of the far Peripheral Retina of normal eyes using ultra-widefield fluorescein angiography (UWFA). Design Cross-sectional study. Methods This study enrolled 101 eyes with best-corrected visual acuity ≥20/20, with refractive error Results In the far Peripheral Retina, granular background fluorescence (GB) appeared in all eyes (100%), a mottled fluorescent band (MB) appeared in 44 eyes (43.6%), and Retinal vascular leakage (VL) appeared in 20 eyes (19.8%). According to Peripheral angiographic findings, the eyes were allocated into 3 groups: Group 1 (MB− and VL−), Group 2 (MB+ and VL−), and Group 3 (MB−/+ and VL+). Ultrasound biomicroscopy showed ciliary body edema and exudates in Group 3. The mean CBT1 (mm) and CBT2 (mm) of Group 3 were greater than those of Group 1 and Group 2 (0.315 ± 0.037 vs 0.240 ± 0.019 vs 0.251 ± 0.030; 0.571 ± 0.084 vs 0.375 ± 0.051 vs 0.410 ± 0.050, P P  = .575 for CBT1; P  = .150 for CBT2). Conclusions Normal Peripheral Retinas generally show granular background fluorescence, with or without a mottled fluorescent band.

Francesco Boscia - One of the best experts on this subject based on the ideXlab platform.

  • Intraoperative Visualization of Peripheral Retina with Wide-Angle Viewing Systems
    Investigative Ophthalmology & Visual Science, 2012
    Co-Authors: Homayoun Tabandeh, Francesco Boscia
    Abstract:

    BACKGROUND: Wide-angle viewing systems have significantly improved intraoperative visualization of Peripheral Retina. The static field of view for most systems is in the range 120 to 140 degrees. Intraoperative manipulations such as ocular rotation, lens tilting, and lens decenteration can further enhance Peripheral viewing. From a surgical perspective it is more relevant to know the distance of an area of interest from the Ora Serrata, than from the optic disc. The current study evaluated the distance of the Retina area that corresponded to A) the internal tip of the sclerotomy cannula and B) edge of the viewing field from the ora serrata. METHODS: Non-comparative, clinical case series. Participants: patients undergoing pars plana vitrectomy (PPV) and endolaser photocoagulation. Exclusion criteria included patients with pupil diameter

  • intraoperative visualization of Peripheral Retina with wide angle viewing systems
    Investigative Ophthalmology & Visual Science, 2012
    Co-Authors: Homayoun Tabandeh, Francesco Boscia
    Abstract:

    BACKGROUND: Wide-angle viewing systems have significantly improved intraoperative visualization of Peripheral Retina. The static field of view for most systems is in the range 120 to 140 degrees. Intraoperative manipulations such as ocular rotation, lens tilting, and lens decenteration can further enhance Peripheral viewing. From a surgical perspective it is more relevant to know the distance of an area of interest from the Ora Serrata, than from the optic disc. The current study evaluated the distance of the Retina area that corresponded to A) the internal tip of the sclerotomy cannula and B) edge of the viewing field from the ora serrata. METHODS: Non-comparative, clinical case series. Participants: patients undergoing pars plana vitrectomy (PPV) and endolaser photocoagulation. Exclusion criteria included patients with pupil diameter <5mm. During PPV, the Retina areas corresponding to the internal tip of the sclerotomy cannula and the edge of the viewing field were marked with endolaser photocoagulation. The ora serrata was visualized with scleral depression and the distance between the ora serrata and the laser marks were measured in “cannula diameter” units. The measurements were subsequently converted to millimeter units. RESULTS: 35 eyes of 35 patients were included in the study. Contact lens viewing system (OVI 130) was used in 23 eyes (group1) and a non-contact viewing system (BIOM) was used in 12 eyes (group2). The cannula tip was visualized in 22 (95%) eyes in group1, and in 10 (83%) eyes in group 2. The mean distance from the edge of the viewing field to ora serrata was 1.1 mm (range 0-2.9 mm) for group 1 and 1.2 mm (range 0.4-3.3 mm) for group 2. The mean distance from the cannula tip to ora serrata was 1.4 mm (range 0.3 to 2.9 mm) for the 32 subjects in which the tip of cannula could be visualized. The 3 eyes in which the cannula tip could not be visualized also had a longer field edge-ora distance. CONCLUSION: Internal tip of a sclerotomy cannula can serve as a useful landmark indicating proximity to the ora serrata. With the current wide-angle systems it is possible to visualize the Peripheral Retina to the vicinity of the vitreous base without the need for scleral depression in most cases. • Traditionally scleral depression is performed in order to visualize the vitreous base • Wide-angle viewing systems have significantly improved intraoperative visualization of Peripheral Retina • The static field of view for most systems is in the range 120 to 140 degrees • Intraoperative manipulations such as ocular rotation, lens tilting, and lens decenteration further enhance Peripheral viewing • From a surgical perspective it is more relevant to know the distance of an area of interest from the Ora Serrata, than from the optic disc • Findings of the current study indicate that it is possible to visualize the Peripheral Retina to within 1 -2 mm of the ora serrata (within the vicinity of the vitreous base without the need for scleral depression • There does not seem to be a major difference in the extent of visualization of the Peripheral Retina between the contact vs. noncontact viewing systems • Non-comparative, clinical case series • Participants: patients undergoing PPV and endolaser photocoagulation • Exclusion criteria : patients with pupil diameter <5mm • During PPV, the Retina areas corresponding to the internal tip of the sclerotomy cannula and the edge of the viewing field were marked with endolaser photocoagulation. The ora serrata was visualized with scleral depression and the distance between the ora serrata and the laser marks were measured in “cannula diameter” units. The measurements were subsequently converted to millimeter units. • Outcome measures: Distance of cannula tip from the ora serrata Distance of edge of the viewing field from the ora serrata CONCLUSION • 35 eyes of 35 patients. Contact lens viewing system (OVI 130) was used in 23 eyes (group1) and a non-contact viewing system (BIOM) was used in 12 eyes (group2). • Pupil diameter: Mean 7.2 mm, Range 5 – 9 mm • Lens status: Phakic 19, PCIOL 13, ACIOL 3 • Cannula tip was visualized in 22 (95%) eyes in group1, and in 10 (83%) eyes in group 2. The mean distance from the edge of the viewing field to ora serrata was 1.1 mm (range 0-2.9 mm) for group 1 and 1.2 mm (range 0.4-3.3 mm) for group 2. The mean distance from the cannula tip to ora serrata was 1.4 mm (range 0.3 to 2.9 mm) for the 32 subjects in which the tip of cannula could be visualized. The 3 eyes in which the cannula tip could not be visualized also had a longer field edge-ora distance. Cannula Tip Visualized Cannula Tip Distance from Ora Edge of Field Distance from Ora OVI 130 95% 1.3 mm (0.3 – 3.2) 1.1 mm (0 – 2.9) BIOM 83% 1.5 mm (0.5 – 3.6) 1.2 mm (0.4 – 3.3) “During pars plana vitrectomy the internal tip of a sclerotomy cannula can serve as a useful landmark indicating proximity to the ora serrata. With the current wide-angle systems it is possible to visualize the Peripheral Retina to the vicinity of the vitreous base without the need for scleral depression in most cases” DISCUSSION

Imre Lengyel - One of the best experts on this subject based on the ideXlab platform.

  • The clinical relevance of visualising the Peripheral Retina.
    Progress in retinal and eye research, 2018
    Co-Authors: Nicola Quinn, Lajos Csincsik, Erin Flynn, Christine A. Curcio, Szilard Kiss, Srinivas R. Sadda, Ruth E. Hogg, Tunde Peto, Imre Lengyel
    Abstract:

    Abstract Recent developments in imaging technologies now allow the documentation, qualitative and quantitative evaluation of Peripheral Retinal lesions. As wide field Retinal imaging, capturing both the central and Peripheral Retina up to 200° eccentricity, is becoming readily available the question is: what is it that we gain by imaging the periphery? Based on accumulating evidence it is clear that findings in the periphery do not always associate to those observed in the posterior pole. However, the newly acquired information may provide useful clues to previously unrecognised disease features and may facilitate more accurate disease prognostication. In this review, we explore the anatomy and physiology of the Peripheral Retina, focusing on how it differs from the posterior pole, recount the history of Peripheral Retinal imaging, describe various Peripheral Retinal lesions and evaluate the overall relevance of Peripheral Retinal findings to different diseases.

  • a population based ultra widefield digital image grading study for age related macular degeneration like lesions at the Peripheral Retina
    Ophthalmology, 2015
    Co-Authors: Imre Lengyel, Adrienne Csutak, Daniela Florea, Irene Leung, Alan C Bird, Fridbert Jonasson, Tunde Peto
    Abstract:

    Purpose Our understanding of the relevance of Peripheral Retinal abnormalities to disease in general and in age-related macular degeneration (AMD) in particular is limited by the lack of detailed Peripheral imaging studies. The purpose of this study was to develop image grading protocols suited to ultra-widefield imaging (UWFI) in an aged population. Design A cross-sectional study of a random population sample in which UWFI was introduced at the 12-year review of the Reykjavik Eye Study in Iceland. Participants Five hundred seventy-six subjects 62 years of age or older. Methods Ultra-widefield (up to 200°) color and autofluorescence images were obtained using the Optos P200CAF laser scanning ophthalmoscope (Optos plc, Dunfermline, Scotland). The images were graded at Moorfields Eye Hospital Reading Centre primarily based on the International Classification for AMD. Macular and Peripheral changes were graded using a standardized grid developed for this imaging method. Main Outcome Measures Presence or absence of hard, crystalline, and soft drusen; Retinal pigment epithelial changes; choroidal neovascularization (CNV); atrophy; and hypoautofluorescence and hyperautofluorescence were graded in the Peripheral Retina. Results Of the eyes examined, 81.1% had AMD-like changes in the macula alone (13.6%), periphery alone (10.1%), and both periphery and macula (57.4%). There was no AMD-like CNV or pigment epithelial detachment in the periphery except in those cases in which these clearly originated from the macula. Seven patients had AMD-like atrophy in the periphery without end-stage disease in the macula. One patient with end-stage disease in the macula had normal periphery results on the color images. While analyzing the eyes, we detected pathologic appearances that were very reliably identified by graders. Conclusions Phenotyping the Retinal periphery using the categories defined by the International Classification confirmed the presence of wide-ranging AMD-like pathologic changes even in those without central sight-threatening macular disease. Based on our observations, we propose here new, reliably identifiable grading categories that may be more suited for population-based UWFI.

  • A Population-Based Ultra-Widefield Digital Image Grading Study for Age-Related Macular Degeneration–Like Lesions at the Peripheral Retina
    Ophthalmology, 2015
    Co-Authors: Imre Lengyel, Adrienne Csutak, Daniela Florea, Irene Leung, Alan C Bird, Fridbert Jonasson, Tunde Peto
    Abstract:

    Purpose Our understanding of the relevance of Peripheral Retinal abnormalities to disease in general and in age-related macular degeneration (AMD) in particular is limited by the lack of detailed Peripheral imaging studies. The purpose of this study was to develop image grading protocols suited to ultra-widefield imaging (UWFI) in an aged population. Design A cross-sectional study of a random population sample in which UWFI was introduced at the 12-year review of the Reykjavik Eye Study in Iceland. Participants Five hundred seventy-six subjects 62 years of age or older. Methods Ultra-widefield (up to 200°) color and autofluorescence images were obtained using the Optos P200CAF laser scanning ophthalmoscope (Optos plc, Dunfermline, Scotland). The images were graded at Moorfields Eye Hospital Reading Centre primarily based on the International Classification for AMD. Macular and Peripheral changes were graded using a standardized grid developed for this imaging method. Main Outcome Measures Presence or absence of hard, crystalline, and soft drusen; Retinal pigment epithelial changes; choroidal neovascularization (CNV); atrophy; and hypoautofluorescence and hyperautofluorescence were graded in the Peripheral Retina. Results Of the eyes examined, 81.1% had AMD-like changes in the macula alone (13.6%), periphery alone (10.1%), and both periphery and macula (57.4%). There was no AMD-like CNV or pigment epithelial detachment in the periphery except in those cases in which these clearly originated from the macula. Seven patients had AMD-like atrophy in the periphery without end-stage disease in the macula. One patient with end-stage disease in the macula had normal periphery results on the color images. While analyzing the eyes, we detected pathologic appearances that were very reliably identified by graders. Conclusions Phenotyping the Retinal periphery using the categories defined by the International Classification confirmed the presence of wide-ranging AMD-like pathologic changes even in those without central sight-threatening macular disease. Based on our observations, we propose here new, reliably identifiable grading categories that may be more suited for population-based UWFI.

Xincheng Yao - One of the best experts on this subject based on the ideXlab platform.

  • trans pars planar illumination enables a 200 ultra wide field pediatric fundus camera for easy examination of the Retina
    Biomedical Optics Express, 2020
    Co-Authors: Devrim Toslak, Felix Y Chau, Muhammet Kazim Erol, Changgeng Liu, R Paul V Chan, Taeyoon Son, Xincheng Yao
    Abstract:

    This study is to test the feasibility of using trans-pars-planar illumination for ultra-wide field pediatric fundus photography. Fundus examination of the Peripheral Retina is essential for clinical management of pediatric eye diseases. However, current pediatric fundus cameras with traditional trans-pupillary illumination provide a limited field of view (FOV), making it difficult to access the Peripheral Retina adequately for a comprehensive assessment of eye conditions. Here, we report the first demonstration of trans-pars-planar illumination in ultra-wide field pediatric fundus photography. For proof-of-concept validation, all off-the-shelf optical components were selected to construct a lab prototype pediatric camera (PedCam). By freeing the entire pupil for imaging purpose only, the trans-pars-planar illumination enables a 200° FOV PedCam, allowing easy visualization of both the central and Peripheral Retina up to the ora serrata. A low-cost, easy-to-use ultra-wide field PedCam provides a unique opportunity to foster affordable telemedicine in rural and underserved areas.