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.

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

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.

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!!!