[optimal] Re: Conjunctival FA

  • From: CPMC Ophthalmic Diagnostic Center <cpmceyelab@xxxxxxxxxxxxxxxx>
  • To: "optimal@xxxxxxxxxxxxx" <optimal@xxxxxxxxxxxxx>
  • Date: Wed, 29 May 2013 13:35:36 -0700

Unless I have missed the obvious statement, patient should NOT be dilated for 
anterior segment angiography.

Denice Barsness, CRA, COMT, ROUB, CDOS, FOPS
Ophthalmic Diagnostic Center
CPMC Department of Ophthalmology
2100 Webster Street Suite 212
San Francisco CA 94115
(415) 600-3937   FAX (415) 600-6563

-----Original Message-----
From: optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx] On 
Behalf Of Egnatz, Thomas James
Sent: Wednesday, May 29, 2013 12:04 PM
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: Conjunctival FA

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/Enfo
>> rcementActivitiesbyFDA/SelectedEnforcementActionsonUnapprovedDrugs/uc
>> m280534.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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