By Carl D. Regillo MD
Experiences the fundamental anatomy of the retina and diagnostic ways to retinal ailment. contains wide examinations of problems of the retina and vitreous, together with disorder, irritation, hereditary dystrophies, abnormalities and trauma. Discusses laser remedy and vitreoretinal surgical procedure. final significant revision 2008-2009.
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Additional resources for 2011-2012 Basic and Clinical Science Course, Section 12: Retina and Vitreous (Basic & Clinical Science Course)
This allows enhanced imaging in occult CNV and pigment epithelial detachments. Choroidal neovascularization appears on ICG angiography as a plaque, a focal hot spot, or a combination of both. Plaques are us ually formed by late-staining vessels and usually correspond to occult CNY. Focal hot spots are well-delineated fluorescent spots less than I disc diameter in size that typically indicate retinal angiomatous proliferations (RA P) and polypoidal vasculopathy, wh ich are va riants of CNY. However, ICG used in eyes with these features has not consistently produced images of well-defined CNV that look like traditional CNV on FA.
Lower doses of fluorescein should be used in patients with renal comprom ise. Berkow JW, Flower R\·V, Orth DH, Kelley JS. Fluorescein and Indocyanine Green Angiography: Technique and Interpretation . 2nd ed. Ophthal mology Monograph s. San Francisco: Ameri can Academy of Ophthalmology; 1997. Kwiterovich KA, Maguire MG, Murphy RP, et a1. Frequency of adverse systemiC reactions after fluorescein angiography: results of a prospeclive study. Ophthalmology . 1 991;98:1139~ 1142. Indocyan ine Green Angi ography lndocyanine green (leG) is a wate r-soluble, tricarbocyanine dye with a molecular weight of 775 daltons that is almost completely protein-bound (98%) after intravenous injection .
Electroretinogram Recording and Interpreting the Response The clinica l electroretin ogram is a mass response evoked from the enti re retina by a brief flash of light. Five different respo nses are bas ic to most clinical evalu ations and are stan- dardized intern ationally so that ERG results can be interpreted easily at d ifferent medical centers (Fig 3- 1): 1. "rod res ponse" (dark-adapted) 2. maximal combined resp~nse (dark-adapted) 33 34 • Retina and Vitreous DARK-ADAPTED LIGHT-ADAPTED "Rod response" Single-flash "cone response" Maximal combined response Approximate Calibrations y I I I Ib I I I I Oscillatory potentials L rod/cone responses osci llatory potentials 100 20 30 10 ~v ms 30-Hz flicker responses Figure 3-1 Diagram of the 5 basic ERG responses defined by the Internati onal Standard for Electroretinography.