Intraoperative fundus inspection during surgery

2020 ◽  
Vol 30 (5) ◽  
pp. 1168-1171
Author(s):  
John Wong ◽  
Sara Sella ◽  
Ehud I Assia
Keyword(s):  
Anterior Chamber ◽  
Anterior Segment ◽  
Posterior Pole ◽  
Air Bubble ◽  
Light Reflex ◽  
Supplementary Video ◽  
Anterior Segment Surgery ◽  
Corneal Incisions

Introduction: We describe a technique of intraoperative fundus visualization during anterior segment surgery using an anterior chamber air bubble. Methods: An air bubble that occupies one-half to two-thirds of the anterior chamber is injected via existing corneal incisions at any time during surgery. By focusing downwards and looking through the air bubble, an upright image of the posterior pole of the fundus is seen. The technique is demonstrated in a series of cases in the form of photos and supplementary video files. Results: Visualization of the fundus can be safely and effectively performed regardless of the lens status (phakic/pseudophakic/aphakic) of the eye. This technique allows the posterior pole and up to mid-peripheral fundus to be quickly inspected at any stage of surgery. Conclusion: This technique may help surgeons to briefly inspect the fundus in cases of unusual light reflex or following complicated surgery without any additional instrumentation.

scholarly journals Effect of Hemodialysis on Anterior Chamber Angle Measured by Anterior Segment Optical Coherence Tomography

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Yong Un Shin ◽  
Ji Hong Kim ◽  
Heeyoon Cho ◽  
Dae Sung Kim ◽  
Joo-Hark Yi ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Chamber ◽  
Anterior Segment ◽  
Posterior Pole ◽  
Wide Field ◽  
Inner Plexiform Layer ◽  
Optical Coherence ◽  
Anterior Chamber Angle ◽  
Fiber Layer ◽  
Chamber Angle

Purpose. To investigate the effect of hemodialysis (HD) on the anterior chamber angle by anterior segment optical coherence tomography (ASOCT) and other ophthalmologic parameters in patients with end-stage kidney disease (ESKD). Methods. A prospective observational study was performed on 20 patients who underwent HD for ESKD. Anterior chamber angle images were obtained by 16 mm line scan of ASOCT. The angle opening distance (AOD) and the trabecular-iris space area (TISA) were determined using the ImageJ program. Additional 12 mm horizontal and 9 mm vertical wide-field scans centered on the posterior pole were performed for the measurement of peripapillary retinal nerve fiber layer (pRNFL) thickness and macular ganglion cell-inner plexiform layer (mGCIPL) thickness. Changes in intraocular pressure (IOP), AOD, TISA, pRNFL thickness, and mGCIPL thickness before and after HD were statistically analyzed. Results. The IOP decreased significantly from 17.5 ± 3.4 before HD to 16.2 ± 2.3 after HD (P=0.017). There was a statistically significant decrease in AOD 750 and TISA 750 (P=0.005 and P=0.007, respectively). AOD 500 and TISA 500 also decreased, which was almost statistically significant (P=0.061 and P=0.081, respectively). Mean pRNFL thickness and mGCIPL thickness did not show significant change after HD. Conclusion. We observed a significant decrease in IOP and anterior chamber angle measurements after HD. Our study suggests that HD can influence the anterior segment structure of eyes.

Pediatric Free-floating Anterior Chamber Cyst of the Iris Pigment Epithelium

2018 ◽  
Vol 1 ◽  
pp. 3
Author(s):  
Joshua S Agranat ◽  
Yoshihiro Yonekawa
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Chamber ◽  
Incidental Finding ◽  
Pigment Epithelium ◽  
Anterior Segment ◽  
Ultrasound Biomicroscopy ◽  
Optical Coherence ◽  
Visual Axis ◽  
Associated Malignancy ◽  
Anatomic Locations

Iris pigment epithelial (IPE) cysts are a subset of iris cysts that arise from the IPE. They are spontaneously erupting epithelial-lined cavities that are found in various anatomic locations of the iris, including the iris pupillary margin, midzone, periphery, and free floating in the vitreous or anterior chamber. We report the case of an asymptomatic 13-year-old boy with an incidental finding of a dislodged anterior chamber cyst diagnosed on routine examination. Modern multimodal image analysis of the cyst including anterior segment optical coherence tomography and ultrasound biomicroscopy (UBM) was utilized to characterize the microstructural anatomy of the lesion. The patient was managed conservatively without complications. Cysts of the IPE typically do not affect vision or ocular health and can be monitored and observed after ascertaining no associated malignancy. Initial diagnostic investigation can include UBM and anterior segment optical coherence tomography. Intervention should be reserved only for cases where the cyst growth leads to obstruction of the visual axis and/or other secondary complications.

scholarly journals Posterior Uveal Effusion after Cataract Surgery

2021 ◽  
pp. 62-67
Author(s):  
Annegret Abaza ◽  
Özlem Dikmetas ◽  
Irmingard Neuhann ◽  
Faik Gelisken
Keyword(s):  
Cataract Surgery ◽  
Corticosteroid Therapy ◽  
Anterior Segment ◽  
Subretinal Fluid ◽  
Posterior Pole ◽  
Functional Improvement ◽  
Long Term Observation ◽  
The Right ◽  
Uveal Effusion

We report a case of posterior uveal effusion (UE) with a long-term follow-up that has occurred following cataract surgery. A 64-year-old woman presented with diminished vision of the right eye (RE) 3 weeks after an uneventful phacoemulsification and intraocular lens implantation. Complete ophthalmic examination including fluorescein angiography (FA), indocyanine green angiography (ICGA), echography and optical coherence tomography (OCT) were performed. Best corrected visual acuity (BCVA) of the RE was 20/50. Anterior segment and intraocular pressure were unremarkable. OCT revealed prominent folds of the choroid and retina, subretinal fluid and darkening of the choroid with reduced visibility of the choroidal vessels and the scleral border. The left eye (LE) was unremarkable. BCVA of the LE was: 20/20. After topical anti-inflammatory and systemic corticosteroid therapy for 5 months, no morphological change of the macula was seen. The patient was observed without any treatment. Forty-three months after the cataract surgery and 38 months after cessation of the corticosteroid therapy, OCT revealed a normal macular morphology and the BCVA improved to 20/25. Even though rare, UE at the posterior pole may occur after modern cataract surgery. OCT examination is a reliable tool in monitoring the macular morphology. Since morphological and functional improvement can be seen in long-term, observation may be considered for some cases of posterior UE with resistance to the therapy.

scholarly journals Changes in anterior segment optical coherence tomography following pars plana vitrectomy without tamponade

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Alireza Khodabande ◽  
Massood Mohammadi ◽  
Hamid Riazi-Esfahani ◽  
Shahab Karami ◽  
Massood Mirghorbani ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Chamber ◽  
Pars Plana Vitrectomy ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Optical Coherence ◽  
Mean Values ◽  
Iop Measurement ◽  
Pars Plana ◽  
The Mean

Abstract Background To evaluate changes in anterior segment morphology on anterior segment optical coherence tomography (AS-OCT) following pars plana vitrectomy (PPV) without tamponade. Methods Patients who underwent PPV without tamponade for epiretinal membrane were evaluated. Eligible patients underwent intraocular pressure (IOP) measurement and AS-OCT preoperatively as well as 1 month and 6 months post-operatively. Anterior chamber width (ACW), anterior chamber depth (ACD), trabecular iris angle (TIA), angle opening distance at 500 and 750 µm (AOD), and trabecular iris space area at 500 and 750 µm (TISA) at four quadrants were recorded and analyzed. Additionally, the mean values of TIA (MTIA), AOD (MAOD), and TISA (MTISA) for each eye (mean of four quadrants) were analyzed. Results 23 patients completed the study. The mean age of participants was 56.4 ± 3.6 years of age and 13/23 (56%) were female. Mean IOP of patients was 18.1 ± 1.1, 18.3 ± 1.1, and 18.1 ± 1.2 preoperatively,1 month post-operatively, and 6 months post-operatively, respectively. (p = 0.83). No difference was detected post-operatively in measurements of ACW, ACD, MTIA, MAOD500, MAOD750, MTISA500, and MTISA750. Conclusion Pars plana vitrectomy without tamponade was not associated with changes in anterior chamber morphology.

scholarly journals Five-year changes in anterior segment parameters in an older population in urban southern China: the Liwan Eye Study

2019 ◽  
Vol 104 (4) ◽  
pp. 582-587 ◽  
Author(s):  
Yu Jiang ◽  
Decai Wang ◽  
Wei Wang ◽  
Feng Chen ◽  
Lanhua Wang ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Pupil Diameter ◽  
Southern China ◽  
Anterior Segment ◽  
Population Based ◽  
Light Conditions ◽  
Anterior Chamber Angle ◽  
The Mean ◽  
Angle Width

PurposeTo investigate the 5-year changes in static and dynamic anterior segment optical coherence tomography (AS-OCT) parameters and their predictors.MethodsThis was a prospective, population-based cohort study of people aged 50 years and older residing in the Liwan District, Guangzhou, China. Standardised AS-OCT scans were performed in November 2008 and November 2013 under dark and light conditions. Customised software was used to analyse horizontal AS-OCT images. Parameters in dark and measurements of light-to-dark changes were used for analyses.ResultsA total of 186 (71.8%) subjects underwent AS-OCT twice, 5 years apart and were included for analyses. The mean age in 2008 was 64.7±7.0 years, and 60.2% were women. The anterior chamber width (ACW) decreased from 11.74±0.44 mm in 2008 to 11.60±0.37 mm in 2013 (p=0.001). There was a trend towards a decrease in dynamic capacity (light-to-dark changes) in the anterior segment, with decreased iris thickness at 750 µm (ΔIT750), ΔACW, Δ anterior chamber area (ACA) and Δ pupil diameter at 5 years (all p<0.05). After adjusting for age and sex, the following baseline parameters were associated with a greater decrease rate in trabecular iris space area at 500 µm (TISA500) at 5 years: TISA500, IT750 and ACA in dark (p<0.001 for all).ConclusionsAnterior chamber angle width decreased and the amount of light-to-dark changes declined during 5-year follow-up. Subjects with greater height, wider angle width and thicker iris at baseline have greater angle narrowing at follow-up.

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