Sandor,
Good question. I believe that they were evaluating Bruch’s terminus. The
inflection point is an important diagnostic feature. As far as the RNFL goes,
I’ll ask the investigator that was involved in the study. I’ll have to get back
to you.
Brice Critser, CRA
Director of Diagnostic Imaging
University of Iowa Hospitals & Clinics, Department of Ophthalmology
On Oct 10, 2018, at 5:36 PM, sandor ferenczy
<sandorferenczy@xxxxxxxxx<mailto:sandorferenczy@xxxxxxxxx>> wrote:
Brice,
Good paper - we use similar methods to monitor for papilledema in our orbital
tumor patients.
One question - why wasn’t the 5 line raster measured perpendicular to the RPE?
-sandor
On Oct 10, 2018, at 16:52, Critser, Douglas B
<douglas-critser@xxxxxxxxx<mailto:douglas-critser@xxxxxxxxx>> wrote:
We were involved with a really nice study on the topic. A little light reading
for you. The discussion section ended with…
Currently available SD-OCT methods of imaging the ONH
and macula appear to produce reliable data, which can be used
to investigate the effects of papilledema on the ONH and
retina. It is clinically important to carefully evaluate algorithm
performance in SD-OCT scans, since failures may lead to false
interpretations of data and may adversely influence clinical
decisions. Three-dimensional segmentation–based applications
appear to be superior to commercially available 2D algorithms
for calculating thickness of RNFL, TRT, and GCL. Analysis of
these measures, correlation with acetazolamide use, weight
loss, and change in lumbar puncture–determined opening
pressure will be reported after the primary outcome of the
IIHTT are analyzed and reported.
Brice Critser, CRA
Director of Diagnostic Imaging
University of Iowa Hospitals and Clinics
Department of Ophthalmology
From: optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx>
[mailto:optimal-bounce@xxxxxxxxxxxxx] On Behalf Of Sandor Ferenczy
Sent: Wednesday, October 10, 2018 3:42 PM
To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>
Subject: [External] [optimal] Re: FA for ONH Drusen?
With IIH (the dx formerly knows as pseudotumor cerebri) intraocular findings
would be limited to VF defects & papilledema from the increase intracranial
pressure. Extraocular, the eyes may turn inward.
Spinal tap & CSF pressure test need to be done.
-sandor
On Wed, Oct 10, 2018 at 4:11 PM Stuart Alfred
<stuart.alfred@xxxxxxxxx<mailto:stuart.alfred@xxxxxxxxx>> wrote:
Denice,
I am unaware of the IIH testing, more than drusen. Prior to communication
with the physician, I want the Ateam's advice.
Understood re. either modality of FA being unnecessary for drusen, but is it
useful for IIH detection?
Thanks.
Stuart Alfred / 317-517-9455 /
stuart.alfred@xxxxxxxxx<mailto:stuart.alfred@xxxxxxxxx>
Board of Education - OPS {Equipment Chair} -
www.opsweb.org<http://www.opsweb.org>
On Wed, Oct 10, 2018 at 2:10 PM CPMC Ophthalmic Diagnostic Center
<cpmceyelab@xxxxxxxxxxxxxxxx<mailto:cpmceyelab@xxxxxxxxxxxxxxxx>> wrote:
Why are we doing FA on ON Drusen
The definitive pathognomonic testing would be FAF and US in that combo
Often, there are not enough fluorophores for FAF to smoke them out
Sometimes, with US, they are not large enough for the 150 micron resolution
Combo of both works wonders
( reference my OPS talk “Imaging for ONH Drusen, and Histopathology of the
Human Eye; Hogan )
Here, unless there is something about the history I am missing, we would NOT do
an FA
Denice
Denice Barsness, CRA, COMT, CDOS, FOPS
CPMC Dept of Ophthalmology/ The Eye Institute
Ophthalmic Diagnostic Services
711 Van Ness Avenue Suite 250
San Francisco CA 94109
415-600-5781
FAX 415-558-7011
From: Barsness, Denice
Sent: Wednesday, October 10, 2018 7:04 AM
To: CPMC Ophthalmic Diagnostic Center
<cpmceyelab@xxxxxxxxxxxxxxxx<mailto:cpmceyelab@xxxxxxxxxxxxxxxx>>
Subject: FW: [**External**] [optimal] More pediatric angiography questions
________________________________
From: optimal-bounce@freelists.orgOn<mailto:optimal-bounce@freelists.orgOn>
Behalf OfStuart Alfred
Sent: Wednesday, October 10, 2018 7:02:08 AM (UTC-08:00) Pacific Time (US &
Canada)
To: OPTIMAL
Subject: [**External**] [optimal] More pediatric angiography questions
WARNING: This email originated outside of the Sutter Health email system!
DO NOT CLICK links if the sender is unknown and never provide your User ID or
Password.
My satellite office is being sought out by the Riley Hospital ophthalmology
team for help with pt. testing. This is a personal accomplishment for me.
Really proud, and humbled.
Two upcoming visits:
14 year old. Weight: 100lb Working diagnosis: IIH, ON drusen
13 year old. Weight: 100lb Working Dx: ON drusen
My prescription of testing OU [stricly Spectralis FA &/ or Cirrus 5000] would
involve:
Fasting 2 hours prior
Spectralis OCT ON - ONH button [73 sec., 60ym] art at 9
ON photos - IR 30degree, RF//BR 30 deg., FAF 30 & 20 degrees
FA oral, using 10% AK-FLUOR
convert weight for admin. using referenced calculations. i.e. 2 vials 10%
5mL, into 3.5 oz. apple juice.
start timer upon pat. consuming. At 2 minutes start FA using 30 degree lens,
laser at 95% sensitivity. Acquire images every 3 minutes until 15 min. So OU
at 2, 5, 8, 11, 14mins.
Any advice OPTIMAL? Please!
I don't see any reason to choose IV over oral.?
Thanks,
Stuart Alfred / 317-517-9455 /
stuart.alfred@xxxxxxxxx<mailto:stuart.alfred@xxxxxxxxx>
Board of Education - OPS {Equipment Chair} -
www.opsweb.org<https://na01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.opsweb.org&data=02%7C01%7Cbarsned%40sutterhealth.org%7Cd9997b94b7324df013fc08d62eb91acb%7Caef453eadaa243e0be62818066e9ff63%7C0%7C0%7C636747769916528108&sdata=U%2BqtXR8J%2BaDuYNEpZ4kAmO6Rwi7fK34kBinOL2CvNOs%3D&reserved=0>
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