Advantages of Retinal Imaging in an Eye Exam

Technology in optometry is constantly advancing, both on the optical side and on the eye health side. Today, I want to discuss more on the new technology used to help optometrists perform eye examinations. Recent studies have shown that the most effective way to examine the retina during an eye exam is a thorough dilated retinal examination done by the optometrist, coupled with retinal imaging.1

At Advance Eye Care Center, we have recently expanded our imaging capabilities with this in mind. As previously discussed, we perform dilated retinal examinations as part of all adult routine examinations. In addition, we have had high resolution central retinal photography since 2008. In November, 2012 we introduced the Optos Daytona wide-field retinal imaging system to our office. This instrument takes up to a 200 degree image of the retina, and in ideal conditions can image about 80 per cent of the retina — the same as previous Optomap imaging systems. This expands our ability to photo-document and assess the retina via this imaging on top of our dilated examinations.

The second feature of the Optos Daytona is its capability to perform wide-field fundus auto-fluorescence imaging. Fundus auto-fluorescence gives us the ability to assess the retina in a new perspective. Conventional retinal examination allows us to view the retina from the interior side and assess it as a single functional unit. And while the retina is a functional unit, 10 distinct cell layers make up the total structure of the retina.

The deepest 2 layers of the retina (the furthest from where we view) are the retinal pigmented epithelium (RPE) and the photoreceptors. The RPE helps control nutrition and eliminate waste from the retina, while the photoreceptors are the specialized cells that capture light and turn it into our vision. A conventional retinal exam cannot directly assess any one individual layer of the the retina. However, fundus auto-fluorescence takes advantage of a unique pigment found in the RPE layer to give us a scan to assess the health of these two layers in more detail. Healthy RPE cells contain a pigment called lipofuscein and when scanned, give a flat grey appearance. Cells that are damaged or sick will begin to leak this pigment into surrounding areas, giving a very bright appearance to the image. Finally, dead cells do not have this pigment and appear dark on the scan.

Fundus autofluorescence, in conjunction with conventional assessment, is valuable in helping detect and monitor progression of retinal diseases of these cells layers such as macular degeneration (AMD), retinitis pigmentosa, Best’s Disease, Stargardt’s Retinal dystrophy and many others. With many different therapeutic options being studied for these diseases, early detection and accurate monitoring will be more and more important in the future.

Fundus autofluorescence is now a part of all adult routine examinations at Advance Eye Care Center. New patients are welcome. To arrange an appointment call 306.586.7036, or use our online appointment request form at www.advanceeyecarecenter.com.   FLR

  1. Brown K, Sewell JM, Trempe C, Peto T, Travison TG. Comparison of image-assisted versus traditional fundus examination. Eye

and Brain Feb 2013