[optimal] Re: Conjunctival FA

  • From: "Egnatz, Thomas James" <tegnatz@xxxxxxxxx>
  • To: optimal@xxxxxxxxxxxxx
  • Date: Wed, 29 May 2013 15:04:02 -0400

Katherine,
If you are doing a dark iris, no iris vessels will be visible with FA, unless there is something obvious, like rubeosis. For conjunctival FA, turn power way down and watch the exposure on the monitor. The first JOPS had an article by Csaba Martonyi about a conjunctival FA done with a Zeiss slit lamp.
Fluorescein Angio-Photography of the Conjunctiva, Martonyi CL. 10/1978 Vol 1:1 p.14 PDF (96k) (should be accessible on the OPS website).
The Topcon retinal camera gives good anterior segment sharpness (better that the Zeiss FF-3, don't know about the current Zeiss cameras). I use either 35 or 20 degrees depending. Like Sandor, focus by moving the base. If the knob is focused all the way anterior, more mag and sometimes more distortion and less resolution. All the way posterior, less mag, less distortion and more resolution. The lower magnification can be compensated for zooming on the monitor. 

Tom

Quoting Sandor Ferenczy <sandorferenczy@xxxxxxxxx>:


Katherine,

it is pretty simple - i usually focus as anteriorly as i can, set mag to 35
degrees and focus by moving the camera away from/towards the patient
(similar to a slit lamp)

exposure will need to be set way down, as the white conj will blowout very
quickly. our exposure for a darker iris isnt usually much different than
the retina, but it can be almost impossible to get proper exposure for both
the conj and iris, so be ready to adjust flash level on the fly as you
switch between conj and iris.


-sandor


Sandor Ferenczy, CRA, OCTc

Director of Ophthalmic Photography

Ocular Oncology Service
Wills Eye Institute
840 Walnut Street, 14th Floor
Philadelphia, Pa 19107

www.fighteyecancer.com



On Wed, May 29, 2013 at 11:25 AM, Lee, Katherine K. <leek@xxxxxxxx> wrote:


 We may be asked to do an FA on a patient with recurring sub-conj.
hemorrhages.  Our retina doc says he wants a "conjunctival FA"   We have
a zeiss camera with OIS software, lots of fundus FA experience but really
no iris FA experience.   Any insight you could share would be appreciated

Katherine K Lee COT
Storm Eye Institute
843-792-2764
fax   792-8865
pager  17576

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*From:* optimal-bounce@xxxxxxxxxxxxx [optimal-bounce@xxxxxxxxxxxxx] On
Behalf Of Breit, Peter [BreitP@xxxxxxxx]
*Sent:* Wednesday, May 29, 2013 9:54 AM
*To:* optimal@xxxxxxxxxxxxx
*Subject:* [optimal] FW: IVFA Fluorescein approved versions



Just for your info in case a patient or doc asked for clarification , I
believe that was sent by one of you a short while ago.




http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/EnforcementActivitiesbyFDA/SelectedEnforcementActionsonUnapprovedDrugs/ucm280534.htm





*Thank you*

*Peter*



Peter L. Breit, CRA.

Director Ophthalmic Services

The Lankenau Hospital & Bryn Mawr Hospital

484-476-3338

484-476-8206 fax

484-437-3262 mobile

page 3707

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