Purpose. We describe in detail a relatively simple technique of fundus photography in human and rabbit eyes using a smartphone, an inexpensive app for the smartphone, and instruments that are readily available in an ophthalmic practice.Methods. Fundus images were captured with a smartphone and a 20D lens with or without a Koeppe lens. By using the coaxial light source of the phone, this system works as an indirect ophthalmoscope that creates a digital image of the fundus. The application whose software allows for independent control of focus, exposure, and light intensity during video filming was used. With this app, we recorded high-definition videos of the fundus and subsequently extracted high-quality, still images from the video clip.Results. The described technique of smartphone fundus photography was able to capture excellent high-quality fundus images in both children under anesthesia and in awake adults. Excellent images were acquired with the 20D lens alone in the clinic, and the addition of the Koeppe lens in the operating room resulted in the best quality images. Successful photodocumentation of rabbit fundus was achieved in control and experimental eyes.Conclusion. The currently described system was able to take consistently high-quality fundus photographs in patients and in animals using readily available instruments that are portable with simple power sources. It is relatively simple to master, is relatively inexpensive, and can take advantage of the expanding mobile-telephone networks for telemedicine.
This manuscript reports a rare association of the development of acute macular neuroretinopathy (AMN) after administration of an influenza vaccination. A 42-year-old white female presented with a 2-week history of black spots and a paracentral scotoma in the right eye after receiving a seasonal influenza vaccination. Findings on multimodal imaging were classic for AMN, and these findings improved but did not fully resolve 4 weeks after initial presentation with observation alone. Although a febrile illness or the use of oral contraceptives is most commonly associated with the development of AMN, it is important for clinicians to also consider influenza vaccination as a possible etiology.
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Ophthalmic Surg Lasers Imaging Retina
. 2018;49:e165–e168.]
The use of medications directed against vascular endothelial growth factor (VEGF) signaling has revolutionized the treatment of age-related macular degeneration (AMD) and many other retinal diseases in the last decade. However, the rapidly increasing use of these agents has led to a rise in treatment-associated complications. One of the most feared by patients and ophthalmologists is post-injection endophthalmitis, which can result in severe vision loss and, in rare cases, loss of the eye. The aim of this article is to review the incidence, clinical findings, risk factors, management, and visual outcomes in cases of endophthalmitis following intravitreal injections of anti-VEGF medications.
Traumatic retinal detachments are a significant cause of morbidity. There are currently no evidence-based guidelines on the appropriate time to perform vitreoretinal surgery to repair a traumatic retinal detachment. Early intervention, within seven days of the inciting trauma, may decrease proliferative vitreoretinopathy and postoperative endophthalmitis. Later intervention may yield a reduced risk of inflammation and hemorrhage, particularly in cases of concomitant open globe injuries. This article reviews the literature on the management of retinal detachments associated with ocular trauma from the years 2006 to 2016. Particular focus was placed on the timing of surgery, concomitant open globe injury, anatomical success rates, visual acuity, and complication rates. In this review, anatomical success was not significantly related to timing of intervention when compared between early and delayed intervention in eyes with and without concomitant open globe injuries. Visual acuities postoperatively varied widely despite timing of intervention due to the large variation in mechanism and extent of ocular injuries. Proliferative vitreoretinopathy was a common complication. Preliminary data indicate that endophthalmitis rates may be lower when early vitreoretinal surgery is performed. There is insufficient data to conclude whether early or delayed surgery leads to improved outcomes, highlighting the need for further research in this domain.