HI - RES
WELL, HIGHER RESOLUTION, ANYWAY. WE RECENTLY UPGRADED FROM A 3 MP
DIGITAL CAPTURE SYSTEM TO A 6 MP CAPTURE SYSTEM. THE RESULTS HAVE
BEEN MORE DETAIL, BETTER TONAL RANGE, AND OBVIOUSLY LARGER IMAGES.

LEFT EYE OPTIC NERVE AND MACULA

B. R. A. O.
A BRANCH RETINAL ARTERY OCCLUSION IS A CONDITION (AS ITS NAME IMPLIES) WHERE
A SPECIFIC BRANCH ARTERY IN THE RETINA IS BLOCKED OR OCCLUDED . AS ONE MIGHT EXPECT,
ISCHEMIA, ATROPHY AND ULTIMATELY LOSS OF SIGHT ARE THE RESULTS OF THE BRAO.

IN THIS FUNDUS PHOTO, YOU CAN SEE THE WHAT MIGHT BE PLAQUE CAUSING THE OCCLUSION
IN THE OPTIC NERVE. AT THAT POINT, THE ARTERIES ACTUALLY LOOK PINCHED. THE CLOUDY
AREA THAT RADIATES OUT FROM THE OPTIC NERVE AROUND THOSE ARTERIES IS THE ISCHEMIA
OR BLOOD STARVED TISSUE RESULTING FROM THE BRAO.

P H O T O . M O N T A G E . III
HERE IS ANOTHER PHOTO MONTAGE OF A PATIENT
PRESENTING WITH HONEY-COMB-LIKE DRUSEN IN THE
SUPERIOR, NASAL, AND INFERIOR ASPECTS OF THE RIGHT EYE.

I AM FINALLY BACK, POSTING 2-3 WEEK OLD WORK AFTER MY COMPUTER CRASHED IN MID-JULY.

I'M SORRY; WE ARE CURRENTLY EXPERIENCING
TECHNICAL DIFFICULTIES

NEW WORK HAS BEEN SUSPENDED DUE TO ZAPPED COMPUTER
WE'LL BE BACK WITH MORE EYELIGHT SOON!

PHOTO MONTAGE III: NPDR
HERE IS YET ANOTHER PATIENT WITH DIABETIC RETINOPATHY - NON PROLIFERATIVE DIABETIC RETINOPATHY (NPDR) TO BE EXACT. NOTE THE 'DOT AND BLOT' HEMORHAGES IN BOTH EYES AS WELL AS 'GHOST CAPILLARIES' IN BOTH MACULAS. (click to enlarge)BELOW ARE LATE PHASE ANGIOGRAPHIC MONTAGES OF EACH EYE.

RIGHT.......................&.........................LEFT

IT IS TYPICALLY A PRETTY GOOD IDEA TO 'LOOK AROUND' DURING THE ANGIOGRAPHY OF THE DIABETIC PATIENT TO CHECK FOR N.V.E. (NEO-VASCULARIZATION ELSEWHERE). THESE NEW BLOOD VESSELS ARE UNSTABLE AND TEND TO 'LEAK' IN THE EYE. IN SPITE OF THIS PATIENT'S MASSIVE CAPILLARY DROP-OUT (DARK, FLAT-LOOKING AREAS OF THE ANGIOGRAM), THERE DOESN'T SEEM TO BE ANY N.V.E. PRESENT

EXTERNAL PHOTOS I: ECTROPION
WE TYPICALLY TAKE EXTERNAL PHOTOS WITH A DIGITAL SLR TO DOCUMENT
CONDITIONS TO BE TREATED WITH COSMETIC SURGICAL PROCEDURES. THIS
PHOTO OF AN ECTROPION LEFT LOWER LID WAS CAPTURED WITH A
NIKON D50, 105MM LENS, AND SB-600 SPEEDLIGHT

AN ECTROPION IS A SAGGING EYE LID THAT LEAVES THE EYE EXPOSED AND DRY.
MOST COMMON IN PATIENTS OVER 60, THE ECTROPION IS THE RESULT OF A LACK
OF TONE N THE MUSCLES THAT KEEP THE LID TAUGHT AGAINST THE EYE.
EXCESSIVE TEARING AND IRRITATION ARE PRIMARY SYMPTOMS,
HOWEVER CONSTANT WIPING OF THE EYE CAN MAKE THE CONDITION WORSE.
THIS PATIENT WILL UNDERGO A blepharoplasty ectropion repair TO TIGHTEN THE LID BACK UP.

I T S . T I M E . T O . P L A Y
NAME THAT PATHOLOGY

HOW WOULD YOU CLASSIFY THE FIERY LOOKING REGION
(SUPERIOR TEMPORAL TO THE OPTIC DISC) IN THE RETINA ABOVE?
(a) A NEVUS
(b) A BENIGN NEOPLASM
(c) A MELANOMA
(d) A CARCINOMA

THE ANGIOGRAPHY SHOWS ONLY A TRANSMISSIONAL FLUORESCENCE OF THAT AREA OF
THE RETINA WHICH IS INDICATIVE OF A
(b) BENIGN (CHOROIDAL) NEOPLASM.

OPHTHALMIC BLOOPERS I: THE G. F. A.
HERE IS AN ANGIOGRAM I DID LAST WEEK AT OUR FAYETTEVILLE CLINIC. THE COLOR PHOTO
WENT SMOOTHLY ENOUGH, BUT THE ACTUAL F.A. DIDN'T FAIR SO COOLLY. I CHANGED THE LIGHT
SOURCE TO THE GREEN-BLUE LIGHT (490 NM), BUT DIDN'T CHANGE THE DIGITAL CAPTURE SETTINGS
TO BLACK AND WHITE.THE RESULT IS THE GREEN FLUORESCEIN ANGIOGRAM (G.F.A.)

YOU CAN SEE THAT I REALIZED MY MISTAKE BETWEEN SHOTS 26 AND 27, AND IT ISN'T FOR
3 SECONDS THAT I GET MY FIRST VALID ANGIOGRAM. I DID A CRUDE 'AUTO LEVELS'
ADJUSTMENT IN PHOTOSHOP AND THESE ARE THE WACK'D COLORS I GOT.

THE WEEK IN ROCK
I HAD A PRETTY DECENT WEEK, LAST WEEK, REGARDING THE ANGIOGRAPHY I AM
LEARNING AT CAROLINA EYE. HERE IS A SAMPLING OF THE WORK I DID LAST WEEK.

PIGMENT EPITHELIAL DETACHMENT WITH A PROBABLE OCCULT SUBRETINAL NEOVASCULAR MEMBRANE

PATHOLOGIC MYOPIA WITH PERIPAPILLARY ATROPHYDRY AGE RELATED MACULAR DEGENERATION WITH FINE DRUSENI MUST THANK BILL AND MELANY (THE HEART & SOUL OF CAROLINA EYE'S PHOTOGRAPHY DEPT.)

FOR ALL OF THEIR COACHING, ENCOURAGEMENT, AND PATIENCE UP TO THIS POINT.
THEIR MENTORING HAS BEEN THE KEY TO MY DEVELOPMENT AND SUCCESS.

SLITLAMP PHOTOGRAPHY III: A.C.I.O.L.
HERE IS A SLITLAMP PHOTO OF AN ANTERIOR CHAMBER INTER-OCULAR LENS.

THE AC IOL IS A LENS REPLACEMENT AND RESTS IN THE ANTERIOR CHAMBER OF THE EYE,
IN FRONT OF THE IRIS. AS YOU CAN SEE, THE LENS IS HELD INTO PLACE BY TWO PLASTIC
'BRACKETS' (SHOWN IN THE PHOTO AT THE TOP AND BOTTOM OF THE LENS ITSELF.) THIS
TYPE OF LEN REPLACEMENT IS NO LONGER AS COMMON AS POSTERIOR CHAMBER INTER
OCULAR LENS (PC IOL), BUT IS (OBVIOUSLY) STILL USED IN SOME CASES.

D R U S E N
DRUSEN IS A BUILD-UP OF LIPID AND PROTEIN MATERIAL BETWEEN THE RETINAL
PIGMENT EPITHELIAL (RPE) AND THE CHORIOCAPILLARIS LAYERS OF THE RETINA.
THE PALE YELLOW/WHITE SPOTS IN THE COLOR AND RED-FREE PHOTOS BELOW ARE DRUSEN.

ALTHOUGH DRUSEN IS TYPICALLY ASSOCIATED WITH AGE RELATED MACULAR DEGENERATION, THE EXACT CAUSE
OF DRUSEN AND WHETHER IT IS A SYMPTOM OF OR A PRECURSOR TO ARMD IS NOT COMPLETELY CLEAR.

SLITLAMP PHOTOGRAPHY II
CONJUNCTIVAL PYOGENIC GRANULOMA

Pyogenic granuloma is a rather general term for a relatively common benign vascular lesion
of the skin and mucosa whose exact cause is unknown. However, the term, pyogenic granuloma,

is a bit of a misnomer since the lesion is neither pyogenic (pus-forming) nor a granulomatous

reaction (abnormal behavior related to immune specialized cells known as phagocytes).

THIS IS ACTUALLY A POST-OP PHOTO OF A ONCE, MUCH MORE SEVER CASE. THIS IS WHAT WAS LEFT.

PHOTO MONTAGE II:
S C I E N C E . A S . A R T ?
HERE ARE A COUPLE MORE OPHTHALMIC PHOTO MONTAGES WITH A TWIST;
IN BOTH, MERGED A COLOR, FUNDUS PHOTO WITH A RED-FREE, BLACK AND WHITE PHOTO AND A MID-VENOUS PHASE ANGIOGRAM. ALTHOUGH THERE IS PROBABLY NO CLINICAL APPLICATION FOR THESE HYBRID IMAGES,
IT IS SORT OF COOL LOOKING.
GLAUCOMA

DIABETIC RETINOPATHY

PHOTO MONTAGE I
DIGITAL CAPTURE IN FUNDUS PHOTOGRAPHY AND ANGIOGRAPHY
HAS ALLOWED FOR UNIQUE AND INTERESTING WAYS OF RETINAL
IMAGING. BELOW IS A COLOR PHOTO OF A PATIENT WHO
IS SUFFERING FROM DIABETIC RETINOPATHY AND IS PRESENTING
WITH A 'BOAT-SHAPED' PRE-RETINAL HEMORRHAGE.

HERE ARE SEVERAL DIFFERENT VIEWS OF THE SAME RETINA
TAKEN DURING THE ANGIOGRAM.THE SOFTWARE ASSOCIATED WITH OUR DIGITAL CAPTURE SYSTEM CAN 'STITCH' (OR MONTAGE) THESE IMAGES TOGETHER TO GIVE US A BETTER, OVERALL VIEW OF THE RETINA. NOW WE CAN VIEW THE HEMORRHAGE AS WELL AS THE AREA OF NVE (NEO-VASCULARIZATION ELSEWHERE) IN THE SUPERIOR TEMPORAL REGION OF THE RETINA THAT IS LIKELY RESPONSIBLE FOR THAT HEMORRHAGE. WE CAN ALSO SEE THE EXTENT OF PAN-RETINAL LASER TREATMENT THIS PATIENT HAS HAD IN THE PAST (THE SMALL DARK SPLOTCHY SPOTS).

S C A N S III - M A C U L A R H O L E
BELOW ARE TWO OCT SCANS OF A MACULAR HOLE.
A MACULAR HOLE IS TYPICALLY CAUSED BY A PATHOLOGICAL THINNING OR SHRINKING OF THE VITREOUS WITHIN THE EYE. VITREOUS IS THE JELLY-LIKE SUBSTANCE THAT FILLS THE EYE AND IS ATTACHED TO THE RETINA. AS THE VITREOUS 'SHRINKS' IT PULLS AT THE RETINA AND THE MACULA. THIS TRACTION CAUSES THE MACULAR HOLE AND THE OVERALL RESULT IS DISTORTION IN OR COMPLETE LOSS OF FINE DETAILED VISION.

THE TREATMENT FOR THIS CONDITION IS A SURGICAL PROCEDURE KNOWN AS A VITRECTOMY. BASICALLY, THE VITREOUS IS REMOVED FROM THE EYE AND REPLACED WTIH A SALINE SOLUTION. THEN A TINY BIT OF THE REMAINING MACULAR TISSUE IS 'PEELED' TO PROMPT HEALING IN THAT AREA. FINALLY, THE EYE IS FILLED WITH A GAS BUBBLE THAT HOLDS THE TISSUE IN PLACE UNTIL IT IS COMPLETELY HEALED. THE GAS BUBBLE EVENTUALLY DISSIPATES AND THE EYE REFILLS WITH ITS OWN FLUID ONCE MORE. POST OPERATION RECOVERY CAN BE VERY CHALLENGING, HOWEVER, AS THE PATIENT WILL NEED TO POSITION THEIR HEAD 'FACE-DOWN' CONTINUOUSLY FOR SEVERAL DAYS FOLLOWING THE SURGERY.

MORE ANGIOGRAPHY
HERE'S A BIT MORE ABOUT THE PROCESS OF OBTAINING A GOOD ANGIOGRAM.
WE WOULD START BY GETTING A SHARP, WELL EXPOSED COLOR IMAGE OF THE RETINA. BELOW IS A FUNDUS PHOTOGRAPH OF A DIABETIC PATIENT'S LEFT EYE.

THE FUNDUS PHOTO IS USED AS A 'BASE-LINE' IMAGE. IN SOME CASES , A RED-FREE PHOTOGRAPH
IS ALSO USED AS A 'BASE-LINE'. THE FIRST IMAGE IN THE ANGIOGRAM BELOW (TOP RIGHT NUMBERED '7')
IS A RED-FREE PHOTO. NEXT, APPROXIMATELY 5 CC OF SODIUM FLUORESCEIN ARE INJECTED
INTO THE PATIENT'S BLOODSTREAM. FLUORESCEIN IS A MINERAL DYE THAT FLUORESCES UNDER A BLUE
LIGHT (APPROXIMATELY 490 NM). IT TAKES ABOUT 10-20 SECONDS FOR THE DYE TO REACH THE RETINA.
AT THIS POINT, PHOTOS NEED TO BE TAKEN AT A RATE OF ABOUT 1 PER SECOND TO GIVE AN ACCURATE
ACCOUNT OF THE PATIENT'S RETINAL CIRCULATION. BELOW WE CAN TRACE THE DYE THROUGH
THE RETINAL ARTERIAL STAGE (TOP ROW IMAGES # '9','10', AND '11')
THE EARLY VENOUS STAGE (SECOND ROW IMAGES # '12', '13', '14', AND '15')
VENOUS AND LATE VENOUS STAGES (IMAGES # '17', '19', '22', '25', '27', '30', AND '31')
AND FINALLY
THE LATE STAINING OCCURRING ABOUT 5 MINUTES AFTER THE INJECTION (IMAGE #'39').
THE RETINAL IMAGES IN THE ANGIOGRAM 'READ' FROM RIGHT TO LEFT AND THEIR TIMES ARE DISPLAYED IN THE UPPER LEFT OF EACH IMAGE. THE TIMES REFER TO THE POINT THE IMAGE WAS CAPTURED FOLLOWING THE INJECTION.

SLITLAMP PHOTOGRAPHY I:

A SLITLAMP IS A HIGH INTENSITY LIGHT SOURCE CONCENTRATED INTO A NARROW

BEAM (OR SLIT) OF LIGHT USED IN CONCERT WITH A MICROSCOPE TO EXAMINE
THE ANTERIOR SEGMENT ( FRONT) OF THE EYE. INCORPORATE AN IMAGE

CAPTURING DEVICE AND NOW YOU HAVE A SLITLAMP CAMERA.
HERE IS ONE OF MY FIRST SLITLAMP PHOTOS.

THIS PATIENT WAS REFERRED TO PHOTOGRAPHY TO GET IMAGES OF HIS pterygium.
HOWEVER, HE COULD ACTUALLY BE SUFFERING FROM A CORNEAL INTRAEPITHELIAL NEOPLASM

SRNVM REDUX: RETURN OF THE PANDA
THIS IS A FOLLOW-UP ANGIOGRAM OF ONE OF MY EARLIER PATIENTS. UNFORTUNATELY, WITH A SUBRETINAL NEOVASCULAR MEMBRANE THERE IS LITTLE CHANCE OF IMPROVING THE CONDITION. IN A CASE SUCH AS THIS, A RETINAL MD'S AIM IS TO PREVENT ANY PROGRESSION OF THE DISEASE.

AFTER TAKING THIS PICTURE, I TOLD THIS PATIENT THAT I THOUGHT HER CONDITION RESEMBLED A PANDA BEAR. INITIALLY, SHE SEEMED A BIT "PUT-OFF" BY MY COMMENT; BUT AFTER OUR SESSION, SHE WANTED A COPY OF THE ANGIOGRAM TO SHOW FAMILY AND FRIENDS. SHE IS really WONDERFUL TO WORK WITH.

SCANS - II
O P T I C A L . C O H E R E N C E . T O M O G R A P H Y
PROVIDES ANOTHER WAY OF "LOOKING" AT THE RETINA. THE STRATUS OCT SENDS BEAMS OF LIGHT INTO OUR PATIENTS' EYES AND THEN READS THE REFLECTIONS SENT BACK FROM THE DIFFERENT LAYERS OF THE RETINA. IT THEN INTERPRETS THOSE REFLECTIONS AND CREATES A VIRTUAL CROSS-SECTION OF THE RETINA. BELOW ARE TWO SCANS OF THE SAME EYE. THE FIRST IS A HORIZONTAL SCAN OF THE MACULA AND THE SECOND IS A VERTICAL SCAN. BOTH SCANS SHOW A 'PUCKERING' OF THE MACULA DUE TO CELLOPHANE RETINOPAHTY. WE WOULD NOT BE ABLE TO TELL THE TRUE EXTENT OF THIS CONDITION WITH A TYPICAL FUNDUS PHOTO.

HORTIZONAL

VERTICAL

WE TYPICALLY PERFORM SCANS OF EITHER THE MACULA OR THE NERVE FIBER LAYER AROUND THE OPTIC DISC. I HOPE TO SHOW OTHER PATHOLOGIES I AM SEEING WITH THE OCT SCANS IN FUTURE POSTS.

A. I. O. N.
ANTERIOR ISCHEMIC OPTIC NEUROPATHY
IS A CONDITION CAUSED BY THE INFARCTION OF BLOOD VESSELS THAT WOULD OTHERWISE SUPPLY THE ANTERIOR (OR FRONT) OF THE OPTIC NERVE. PATIENTS WITH AION WILL (INEVITABLY) PRESENT WITH A PALE, SWOLLEN OPTIC DISC AS WELL AS ASSOCIATED HEMORRAGING WHICH CAN BE NOTED IN THE COLOR FUNDUS PHOTO BELOW.

THE ANGIOGRAPHY ABOVE SHOWS THE VENOUS STAGE OCCURRING QUITE LATE IN THE ANGIOGRAM (ALMOST A MINUTE), WHICH IS TYPICAL IN AION PATIENTS AS THEIR CIRCULATION IS SUB-STANDARD.

C Y S T O I D . M A C U L A R . E D E M A
OR CME IS A PAINLESS DISORDER CHARACTERIZED BY CYST-LIKE SWELLING WITHIN
THE MACULAR REGION OF THE RETINA. SINCE THE MACULA IS COMPROMISED BY THE
SWELLING, CENTRAL VISION IS COMPROMISED & SYMPTOMS ARE TYPICALLY BLURRED AND
DECREASED CENTRAL VISION.

THIS IS A FUNDUS PHOTO AND A LATE PHASE ANGIOGRAM (6 MINUTES 31 SECONDS) OF A RETINA
EXHIBITING CME. THERE APPEARS TO BE EVIDENCE OF AN OLD OCCLUSION AND THE CME
MAY BE SECONDARY TO THAT. ENJOY THIS HAIKU REGARDING THE ANGIOGRAM.

NOTE PETAL PATTERNS
IN THE MACULA DUE TO
HYPER FLUORESCENCE
06/01/07
TODAY, IT WAS BROUGHT TO MY ATTENTION THAT THE HYPER-FLUORESCENT PETAL PATTERN IN MY ANGIOGRAM (TYPICAL IN CME PATIENTS) IS, IN FACT, SECONDARY TO THE MACULAR SWELLING AND THAT MY HAIKU IS NOT TECHNICALLY ACURATE. ALLOW ME TO REPHRASE:
HYPER FLUORESCENCE
IN THE MACULA IS DUE
TO THE EDEMA

SCANS - I
E Y E S Y S
IN RECENT WEEKS, I HAVE BEEN TRAINING WITH THE CAROLINA EYE
SCANS DEPT TO OPERATE SEVERAL DIAGNOSTIC IMAGING MACHINES.
ITS NOT PHOTOGRAPHY - PER SE, BUT IT IS IMAGING; AND I'M DIGGING IT!
THE EYESYS MEASURES THE TOPOGRAPHY OF THE CORNEA. BELOW ARE SOME
VIEWS OF THIS MACHINE AND HOW OUR PATIENTS WOULD INTERFACE WITH IT.
THE PATIENT LOOKS INTO A SERIES OF RINGS OF LIGHT WITH A TINY
VIDEO CAMERA IN THE VERY CENTER. (ONE EYE AT A TIME) THE EYESYS
CAPTURES IMAGES OF ITS OWN RINGS REFLECTED IN THE SURFACES
OF THE PATIENT'S CORNEAS. (AS SHOWN BELOW)THEN IT CONVERTS THESE IMAGES INTO GRAPHICAL REPRESENTATIONS OF
THE TOPOGRAPHICAL DATA. HERE ARE THE TOPOGRAPHY SCANS OF EACH EYE

THIS PATIENT HAS K E R A T O C O N U S

ENOUGH PATHOLOGY, TIME FOR SOME:

A N A T O M YTHE OPTIC DISC IS THE POINT WHERE THE OPTIC NERVE ENTERS THE RETINA
THE MACULA IS THE PIGMENTED AREA OF THE RETINA THAT IS RICH IN CONES
AND IS RESPONSIBLE FOR CLEAR DETAILED VISION
THE FOVEA IS A SMALL RODLESS AREA OF THE MACULA THAT PROVIDES ACUTE VISION

M E L A N O M A

THIS PATIENT HAS A CHOROIDAL MELANOMA IN THE SUPERIOR TEMPORAL

REGION OF THE RETINA (IDENTIFIED BY THE ARROW BELOW).

HERE IS THE
A N G I O G R A P H Y THIS VIEW OF THE RETINA IS COMMONLY REFERRED TO AS "FIELD 4" IN OPTHALMIC PHOTOGRAPHY

CENTRAL SEROUS RETINOPATHY
IS A IDIOPATHIC CONDITION (SOMETIMES TEMPORARY) THAT IS
CHARACTERIZED BY A LEAKAGE OF FLUID IN THE CENTRAL MACULAR
REGION OF THE RETINA RESULTING IN BLURRED OR DISTORTED VISION.

IN THIS ANGIOGRAM I PERFORMED, YOU CAN FIRST SPOT THE LEAKAGE IN THE MACULA
IN THE THIRD FRAME OF THE ANGIOGRAM AND TRACK HOW IT GROWS THRU FRAME NINE.
(THE ORDER OF FRAMES GOES RIGHT TO LEFT FOR WHATEVER REASON.)

C O T T O N W O O L S P O T SCOTTON WOOL SPOTS ARE INFARCTS IN THE NERVE FIBER LAYER OF THE RETINA
CAUSED BY POOR BLOOD FLOW IN OR AN OBSTRUCTION OF SMALL CAPILLARIES (ISCHEMIA).
ALTHOUGH THEY CAN DISAPPEAR WITHOUT TREATMENT, THEIR PRESENCE TYPICALLY
INDICATES A MORE SERIOUS SYSTEMIC PROBLEM SUCH AS DIABETES OR H.I.V.
THEY OBVIOUSLY GOT THEIR NAME DUE TO THEIR RESEMBLANCE TO COTTON-WOOL ...WHATEVER THAT IS.

RIGHT EYE__________________________________________________ LEFT EYE

FUNDUS PHOTO

THIS IS A DIABETIC PATIENT WHO IS SUFFERING A NON-ISCHEMIC CENTRAL RETINAL VIEN OCCLUSION WITH MODERATE RETINAL EDEMA IN THE RIGHT EYE AND SHOWING EARLY BACK GROUND DIABETIC CHANGES IN THE LEFT.

RIGHT EYE__________________________________________________ LEFT EYE

RED FREE
A RED FREE PHOTOGRAPH IS A BLACK AND WHITE IMAGE TAKEN WITHOUT DYE USING A GREEN FILTER. THIS HELPS TO DISTINGUISH BLOOD VESSELS FROM THE RETINA. NOTE THE FLAME SHAPED RETINAL HEMORRAGING IN THE RIGHT EYE.

RIGHT EYE__________________________________________________ LEFT EYE

FLUORESCEIN ANGIOGRAM
HERE IS A 'LATE PHASE' ANGIOGRAM OF THE SAME PAIR OF EYES.

I don't know if anyone is actually monitoring my progress here, but I TOOK THESE PICTURES!!!

M O R E F L U O R E S C E I N HERE IS A BIT OF
A N G I O G R A P H Y
I WAS ABLE TO DO
WITH A FAIRLY
"EASY" PATIENT.
THESE SHOTS
WERE TAKEN
20 SECONDS,
23 SECONDS,
1 MINUTE
7 SECONDS,
AND
6 MINUTES
10 SECONDS
AFTER NaFl INJECTION.
THIS PATIENT HAS
IDIOPATHIC SUB RETINAL
NEOVASCULARIZATION,
AND IS A COOL GUY.

MORE ON FLUORESCEIN ANGIOGRAPHY

FLUORESCEIN ANGIOGRAPHY
IS A TECHNIQUE FOR EXAMINING THE CIRCULATION OF
THE RETINA USING A DYE TRACING METHOD. AFTER AN
INJECTION OF SODIUM FLUORESCEIN INTO CIRCULATORY
SYSTEM, AN ANGIOGRAM IS OBTAINED BY PHOTOGRAPHING
THE FLUORESCENCE EMITTED BY THE RETINA WHILE
EXPOSING WITH A BLUE LIGHT (490 NANOMETERS)
Click to Enlarge

SOME MIGHT SAY THIS ANGIOGRAM INDICATES THE PATIENT HAS A SUB RETINAL NEOVASCULAR MEMBRANE WITH A DISCIFORM SCAR AND A SMALL SUB MACULAR HEMORRHAGE.....
BUT PERSONALLY, I THINK IT LOOKS LIKE A PANDA BEAR IN A COAT WALKING TOWARD A TESLA COIL.

P R E S E N T I N G
MY FIRST SHOTS AT FUNDUS PHOTOGRAPHY

RIGHT

I CAPTURED THESE RETINAL IMAGES WITH A SPECIALIZED CAMERA CALLED A FUNDUS CAMERA. I AM CURRENTLY LEARNING THE CAMERA BASICS AND TRYING TO FIND MY
MOJO
LEFT

THE FUNDUS CAMERA SHOOTS FILM AND DIGITAL
THESE IMAGES WERE CAPTURED DIGITALLY