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Retinal Photography- Stereoscopic color retinal photography is frequently used to document the appearance of a retinal abnormality identified during the clinical examination. High quality images can be captured on color slide film and stored indefinitely by your doctor, to be used as a point of reference for future comparison in charting the course of a variety of retinal conditions. They are also often used in conjunction with retinal angiography (see below) to aid in the diagnosis and treatment of many medical retinal disorders such as diabetic retinopathy, age related macular degeneration, other retinal circulatory disturbances or ocular tumors.


Fluorescein Angiography- Intravenous injection of a fluorescent dye followed by a rapid, timed sequence of retinal photographs provides images of the retinal blood vessels at work. Dye passes first through the arteries, reaching the capillaries next and finally leaving the retinal circulation through the veins. Looking through the timed sequence of photos allows your doctor to draw many conclusions regarding the function of the retinal blood vessels. Of primary importance is the identification of dye leakage from previously normal blood vessels which are now diseased (such as in diabetic retinopathy) or from new abnormal blood vessels (such as in macular degeneration). Angiography serves not only a diagnostic purpose but also is a very important guide to the treatment of many retinal disorders. For example, by first pinpointing the source of leakage photographically, laser treatment can often be used effectively to cauterize the leaking blood vessels in an effort to reduce or eliminate the risk of visual loss posed by the leakage.

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ICG Angiography- Indocyanine green (ICG) is an intravenous dye which has been used for many years to study blood flow in the heart. In the past several years, techniques have been developed to use ICG to image ocular blood vessels, especially those under the retina in a vascular layer called the choroid. Leaky or abnormal blood vessels in the choroid are a common problem for people with macular degeneration, but traditional fluorescein angiography is sometimes unable to clearly identify these abnormal blood vessels under the retina. Because of its unique properties, ICG is able to delineate this process more clearly in as many as 40% of patients in whom fluorescein angiography is inconclusive.

Retina Vitreous Surgeons was first to bring all of these diagnostic technologies to Central New York and continues to provide the highest level of ophthalmic photographic services in the region.

 


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OCT Examination

The physicians of Retina Vitreous Surgeons are proud to announce the first Central New York availability and utilization of OCT technology. The OCT is a diagnostic imaging device that provides direct cross sectional images of the retina for objective measurement and subjective clinical evaluation in the detection of retinal diseases and glaucoma. The OCT images and analyzes macular thickness, the retinal nerve fiber layer and the optic disc using the latest technology for high resolution scans. The Optical Coherence Tomographer is a precision instrument that uses an optical measurement known as low-coherence interferometry. The principle is much like that of ultrasound, except that light is used instead of sound. This difference permits measurement of tissue and distance resolved to the scale of ≤ 10µm, versus the ≈ 200µm resolution with ultrasound. The instrument is crucial in the diagnosis of macular holes, macular edema and retinal traction.

 

Electrophysiology- The retina is an extension of the brain, containing many neurologic components. Minute electrical impulse are generated in the retina in response to light, color and movement. These impulses are first processed in certain layers of the retina and are then transmitted to higher centers in the brain by way of the optic nerve. These electrical impulses can be measured with small electrodes, much like an electrocardiogram can measure the electrical activity in the heart.

Electroretinogram (ERG) is a recording of the electrical activity in the retina. Detailed analysis of the ERG is vital in the diagnosis of many inherited retinal dystrophies such as Retinitis Pigmentosa. This test is also helpful in evaluating certain ocular circulatory problems, such as central retinal vein occlusion, to improve our understanding of the severity of the problem and to plan treatment strategies more effectively.

 

 

Electrooculogram (EOG)

The electrooculogram (EOG) is a measurement of the electrical activity in a layer of pigmented cells beneath the retina called the retinal pigment epithelium (RPE). The RPE is critical to the normal function of the retina but can fail in a number of disease states. Measurements of its ability to adapt to changing light intensity is often performed in conjunction with an ERG.

Taken together, these two tests can often permit a very specific diagnosis to be made in cases of possible retinal or RPE dystrophy, which can take many forms. A specific diagnosis aids in predicting the course of the disease as well as its pattern of inheritance, if any. Some of these conditions can be treated effectively if they are properly identified.

Retina Vitreous Surgeons provides the most comprehensive and technologically advanced electrodiagnostic services in Central New York, using sophisticated computer-aided testing protocols, recordings and waveform analysis.

 

 

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