Elsevier

Ophthalmology

Volume 106, Issue 12, 1 December 1999, Pages 2296-2300
Ophthalmology

Automated scanning laser ophthalmoscope image montages of retinal diseases

Presented in part as a poster at the American Academy of Ophthalmology annual meeting, New Orleans, Louisiana, November 1999.
https://doi.org/10.1016/S0161-6420(99)90529-8Get rights and content

Abstract

Purpose

To generate wide-field automated seamless retinal montage images.

Design

Prospective, observational, case series study.

Participants

Eighteen eyes of 14 patients were studied.

Intervention

A digital scanning laser ophthalmoscope (SLO), the Heidelberg Retina Angiograph (HRA), was used to obtain overlapping images of the fundus during fluorescein angiograms, indocyanine green angiograms, or monochromatic retinal imaging using infrared or green light. Software was used to generate seamless montages.

Main outcome measures

Ability to electronically synthesize retinal montages. Four laser wavelengths were used. The wide-field degrees, vertical and horizontal number of pixels, and diameter of the individual images were measured.

Results

High-resolution (pixel size, 10 μm), wide-field, typically 100° to 140°, digital montages of the postequatorial retina can be generated from HRA images.

Conclusions

The software automatically and rapidly aligned the retinal blood vessels and synthesized a montage of the entire fundus that could then be overlaid on images taken at different times to illustrate change. These montages will allow improved ability to understand and follow retinal diseases.

Section snippets

Confocal scanning laser ophthalmoscopy

The confocal laser scanning ophthalmoscope images the retina in three dimensions and has been described previously by our group.3, 4 A small pinhole aperture located in a plane conjugate to the focus plane allows imaging of “optical slices” of the retina; this technique is called confocal imaging or imaging in a tightly confocal mode.5 We have previously described the use of this technology for examination of the macula, optic nerve head, and angiography.6 The confocal SLO largely discriminates

Results

The results of this study are summarized in Table 1. Twelve eyes of 8 patients were imaged using fluorescein angiography, 488-nm illumination, and filter cutoff at 500 nm Figure 2, Figure 3. Eight eyes of five patients were imaged using infrared light, 840 nm Figure 4, Figure 5, Figure 6. Two eyes of two patients were imaged using ICG angiography, 795-nm wavelength that provided illumination to excite the ICG dye, which fluoresces at 835 nm (Fig 7), and eight eyes of six patients using red-free

Discussion

Automated fundus montage synthesis provides an accurate way to evaluate the entire fundus with high resolution as well as to localize an area of interest. Zooming increases the magnification, providing details of the entire fundus without loss of resolution, a fact that cannot be achieved with a fundus camera. In this way, we can obtain global information about the image and local information about a single feature. The depth of focus of fundus cameras is great enough to encompass the entire

References (10)

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Supported by National Eye Institute EY07366, Bethesda, Maryland; Research to Prevent Blindness Inc., New York, New York; and the Whitaker Foundation, Rosslyn, Virginia, Biomedical Engineering Research Grant. Dr. William R. Freeman is the recipient of the RPB Lew Wasserman Award.

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