Fluorescence Angiography in Ophthalmology (eBook)

Preface 5
Foreword 7
Table of Contents 9
The physical and chemical fundamentals of fluorescence angiography 11
Fluorescence 12
Fluorescein 12
Indocyanine Green 13
The Technical Fundamentals of Fluorescence Angiography 15
The basic design of a scanning laser ophthalmoscope 16
Light Sources 17
Lasers for Fluorescein Angiography 17
Lasers for red- free fundus imaging 18
Lasers for Indocyanine green ( ICG) angiography 19
Lasers for reflective infrared imaging 19
The Fundamentals of Optical Imaging The confocal principle 19
Resolution in depth 20
Resolution in breadth 20
The Heidelberg Retina Angiograph 2 20
HRA2- Parameters for basic imaging modes 21
Simultaneous mode 21
Composite mode 22
Fixation assistance 22
Wide angle objective 22
ART module 22
Examination of the anterior segment 22
Stereoscopic imaging 22
Components of the analytical software 23
Normal Fluorescence Angiography and General Pathological Fluorescence Phenomena 25
Normal Fluorescence Angiography and general pathological fluorescence phenomena 26
Choroid 26
Cilioretinal vessels 26
Optic disc 26
Retinal vessels 26
Macula 26
Sclera 27
Iris 27
Normal ICG- Angiography 27
Pathological fluorescence phenomena 27
Hyperfluorescence 27
Hypofluorescence 28
Fundus Autofluorescence 41
Introduction 42
Scanning laser ophthalmoscopy and modified fundus photography 42
Methods Fundamentals 42
The operational sequence of a fundus examination with the cSLO 42
Lipofuscin in the retinal pigment epithelium 43
Normal fundus autofluorescence 43
Fundus autofluorescence – typical findings 43
Lipofuscin Melanin 45
Macular Disorders 65
Age- Related Macular Degeneration ( AMD) 66
Drusen 66
Irregular Pigmentation of the Retinal Pigment Epithelium ( RPE) 72
Geographic atrophy of the RPE 72
Choroidal Neovascularization ( CNV) 74
Classic Choroidal Neovascularization 74
Occult Choroidal Neovascularization 79
Mixed Forms 84
Localization of Choroidal Neovascularization 84
Serous Detachment of the Retinal Pigment Epithelium 86
Breaks in the Retinal Pigment Epithelium ( RPE) 92
Idiopathic Polypoid Choroidal Vasculopathy 94
Retinal Angiomatous Proliferation ( RAP) 96
Disciform Scarring 98
Fluorescein Angiographic Phenomena Following Therapy 100
Laser Coagulation 100
Photodynamic Therapy ( PDT) 100
Anti VEGF Therapy 100
Cystoid Macular Edema 112
Hereditary Macular Disorders Stargardt’s Disease 114
Fundus Flavimaculatus 114
Best’s Disease ( Vitelliform Macular dystrophy) 116
Pattern Dystrophies of the Retinal Pigment Epithelium ( RPE) 118
Congenital X- Chromosome Retinoschisis 120
Adult Vitelliform Macular Degeneration ( AVMD) 122
The Macular Degeneration of Myopia 124
Angioid Streaks 126
Central Serous Chorioretinopathy ( CSC) 128
Chronic Idiopathic Central Serous Chorioretinopathy ( CICSC) 130
Idiopathic Juxtafoveal Teleangiectasias 132
Epiretinal Gliosis 134
Macular Holes 136
Chloroquine Maculopathy 138
Retinal Vascular Disease 141
Diabetic Retinopathy Nonproliferative Diabetic Retinopathy 142
Proliferative Diabetic Retinopathy 144
Hypertensive Retinopathy 146
Retinal Arterial Occlusions Occlusion of the Central Retinal Artery 148
Branch Retinal Artery Occlusion 148
Retinal Vein Occlusions 150
Central Retinal Vein Occlusion ( CRVO) 150
Tributary Retinal Vein Occlusion 154
Retinal Macroaneurysms 156
Coats‘ Disease 158
Retinal Capillary Hemangioma 160
Cavernous Hemangioma of the Retina 162
Vascular Tortuosity 164
Inflammatory Retinal/Choroidal Disease 167
Toxoplasmic Retinochoroiditis 168
Multifocal Choroiditis 170
Acute Posterior Multifocal Placoid Pigment Epitheliopathy ( APMPPE) 172
Punctate inner Choroidopathy ( PIC) 176
Presumed Ocular Histoplasmosis Syndrome ( POHS) 178
Birdshot Chorioretinopathy 180
Perivasculitis 183
Occlusive Retinal Vasculitis 183
Inflammatory Macular Edema 188
Serpiginous Choroiditis 190
Diseases of the Optic Nerve Head 193
Congenital Anomalies of the Optic Disc Oblique Insertion of the Optic Nerve 194
Myelinated Nerve Fibers 194
Drusen of the Optic Disc 196
Coloboma of the Optic Disc 200
Optic Pit 200
Capillary Hemangioma of the Juxtapapillary Retina 204
Endophytic Growth 204
Sessile Growth 204
Exophytic Growth 208
Pigmented Optic Disc Anomalies 210
Anterior Ischemic Optic Neuropathy 212
Papillitis 214
Papilledema 216
Parapapillary Choroidal Neovascularization 218
Intraocular Tumors 221
Choroidal Melanoma 222
Choroidal Metastases 224
Choroidal Hemangioma 228
Subject Index 231