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.