Retinal imaging has been around perhaps a lot longer than most people realize. The very first ophthalmoscope was invented in 1850 by a doctor named Hermann VonHelmholtz.
This was the first time in history doctors could actually view a living, human retina.
Soon to follow was the further development and eventual introduction of much more advanced versions of the ophthalmoscope. The sheer knowledge and understanding of our many eye conditions began to flourish. This event - lead us to the ushering in of what most in this field refer to as the “Golden Age of Ophthalmology.”
Only two short years after the invention of the first ophthalmoscope, we were introduced to the first indirect ophthalmoscope that was invented by a doctor named Ruete.
This scope allowed a stereoscopic – as well as a wider view of the fundus. And even though it was rather hazy – there was now a view of the retinal periphery accessible to the practicing ophthalmologist.
The Development of Fundus Photography
What was then known as “stereoscopic fundus photography” pioneered by Jackson and Weber in 1886 served as the prototype camera technology for the era. It was fixed to the patient’s head, and then a 2.5-minute exposure was used when developing the film.
Even though this technology only used a set-up that showed just the largest details - this primitive retinal anatomy and pathology was revolutionary. It allowed photographic documentation for all of the most significant retinal findings.
The Development of Fluorescein Angiography (FA)
The technique called “Fluorescein Angiography” was initially demonstrated in the human eye in 1961 by two medical students, Novotny and Alvis.
This discovery served to pave the way for many more contrast studies of ocular circulation. This has more recently become the gold-standard of imaging. Its primary function is to expose the ocular circulation for the diagnosis of vascular diseases.
Paving the Way for Indocyanine Green Dye (ICG)
It was during the 1990’s that we were introduced to high resolution digital imaging systems. These made it possible to allow the addition of contrast studies – which requires the use of indocyanine green dye.
Indocyanine green dye has been used for years in cardiac blood flow studies. It is used for the infrared fluorescence spectrum available within the dye which previously limited its practical use in the eye.
When confronted with the enhanced sensitivity of the digital camera – especially when it comes to infrared wavelengths that permit real-time observation and recording – this view is only made possible with the use of indocyanine green dye - as it transits through the ocular circulation.
Here you will find the infrared fluorescence of ICG highlights the circulation of the choroid. This actually provides enhanced views of deeper vascular structures. These images are all very complementary to those that are also produced by fluorescein.
The unique ability of ICG – is to highlight the neovascular component of a retinal pigment epithelial detachment. This is seen most often in patients with age-related macular degeneration.
Advances Continue Making Their Way into the Market
Significant advances have been made since the 1800s. Retinal imaging has more than flourished in the last century. It continues to do so well into our new millennium.
Keep an Eye on Ophthalmic Pictor Retinal Imaging
The Advanced Retinal Imaging Laboratory is located within the Retina Center of The New York Eye and Ear Infirmary of Mount Sinai. This is only one of many research centers that has been studying and advancing the use of retinal imagery in our markets.
Keep your eyes on the newest developments in ophthalmic Pictor retinal imaging today – there is most certainly much more to come. Stay tuned.