Gellrich Marcus-Matthias
Ophthalmological practice, Ziegeleiweg 10, 25548 Kellinghusen, Germany.
Springerplus. 2015 Feb 3;4:56. doi: 10.1186/s40064-015-0838-5. eCollection 2015.
Fundus biomicroscopy with the slit lamp as it is practiced widely nowadays was not established until the 1980-es with the introduction of the Volk lenses +90 and +60D. Thereafter little progress has been made in retinal imaging with the slit lamp. It is the aim of this paper to fully exploit the potential of a video slit lamp for fundus documentation by using easily accessible additions. Suitable still images are easily retrieved from videorecordings of slit lamp examinations. The effects of changements in the slit lamp itself (slit beam and apertures) and its examination equipment (converging lenses from +40 to +90D) on quality and spectrum of fundus images are demonstrated. Imaging software is applied for reconstruction of larger fundus areas in a mosaic pattern (Hugin®) and to perform the flicker test in order to visualize changes in the same fundus area at different points of time (Power Point®). The three lenses +90/+60/+40D are a good choice for imaging the whole spectrum of retinal diseases. Displacement of the oblique slit light can be used to assess changes in the surface profile of the inner retina which occurs e.g. in macular holes or pigment epithelial detachment. The mosaic function in its easiest form (one strip macula adapted to one strip with the optic disc) provides an overview of the posterior pole comparable to a fundus camera's image. A reconstruction of larger fundus areas is feasible for imaging in vitreoretinal surgery or occlusive vessel disease. The flicker test is a fine tool for monitoring progressive glaucoma by changes in the optic disc, and it is also a valuable diagnostic tool in macular disease. Nearly all retinal diseases can be imaged with the slit lamp - irrespective whether they affect the posterior pole, mainly the optic nerve or the macula, the whole retina or only its periphery. Even a basic fundus controlled perimetry is possible. Therefore fundus videography with the slit lamp is a worthwhile approach especially for the many ophthalmologists without access to the most recent diagnostic equipment or a professional photographer at hand.
如今广泛应用的带裂隙灯的眼底生物显微镜检查直到20世纪80年代随着+90D和+60D的 Volk 透镜的引入才得以确立。此后，裂隙灯在视网膜成像方面进展甚微。本文的目的是通过使用易于获取的附加装置充分挖掘视频裂隙灯在眼底记录方面的潜力。从裂隙灯检查的视频记录中很容易获取合适的静态图像。展示了裂隙灯本身（裂隙光束和光圈）及其检查设备（+40D至+90D的会聚透镜）的变化对眼底图像质量和光谱的影响。成像软件用于以拼接模式（Hugin®）重建更大的眼底区域，并进行闪烁测试，以便在不同时间点可视化同一眼底区域的变化（Power Point®）。+90/+60/+40D这三个透镜是对整个视网膜疾病光谱进行成像的不错选择。倾斜裂隙光的移位可用于评估例如黄斑裂孔或色素上皮脱离时发生的视网膜内层表面轮廓的变化。最简单形式的拼接功能（一条黄斑带适配一条视盘带）可提供与眼底相机图像相当的后极概览。对于玻璃体视网膜手术或闭塞性血管疾病的成像，重建更大的眼底区域是可行的。闪烁测试是通过视盘变化监测进行性青光眼的良好工具，也是黄斑疾病中有价值的诊断工具。几乎所有视网膜疾病都可以用裂隙灯成像——无论它们影响后极、主要是视神经或黄斑、整个视网膜还是仅其周边。甚至基本的眼底控制视野检查也是可能的。因此，对于许多无法使用最新诊断设备或手头没有专业摄影师的眼科医生来说，带裂隙灯的眼底摄像术是一种值得采用的方法。
