Nitin S Shetty
Tarun Sharma
Mahesh P Shanmugam
Muna P Bhende
Lekha Gopal
Preetam Samant
Lingam Gopal
All authors are Consultants of Sri Bhagwan Mahavir Vitreoretinal Service, Sankara Nethralaya,
Chennai
Foreword
Preface
Acknowledgements
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
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Atlas of Fundus Fluorescein Angiography
© 2004, Authors
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the authors and the publisher.
First Edition : 2004
9788180611964
Typeset at JPBMP typesetting unit
Printed at Gopsons Papers Ltd., A-14, Sector 60, Noida
5
For more than three decades, retinal specialists and ophthalmologists have enhanced their diagnostic and therapeutic skills through the diagnostic adjunct, fluorescein angiography. Numerous texts and atlases have been written on the interpretation of this procedure in English, French, Italian, German, and Japanese. The authors of this text have taken full advantage of their regional experience and encyclopedic knowledge of chorioretinal diseases by focusing on seven distinct divisions of retinal and macular disease in categorizing a myriad of abnormalities.
Thanks to them, there is for the first time an atlas on the subject of fluorescein angiography with a preferential emphasis on disorders prevalent in India. Arrays of excellent photographs have been used to fulfill this purpose, preceded by a section on technique and methodology to provide physicians-in-training and ophthalmic technicians, with the fundamentals needed to incorporate this discipline in their overall ophthalmic evaluations. The text is not meant for to describe new disease or new clinical manifestations and pathogenetic mechanisms in old disease. Nor does it provide an extensive bibliography to expand the potential for research of a given subject. The principal purposes are to introduce images for pattern recognition by clinicians to use in their practice, to enable a more accurate diagnosis, and in turn, to offer patients a more appropriate and effective treatment. Yet, the authors have in their preparation introduced new insight into pathophysiological mechanism of disease in the ocular fundus and offered unusual and challenging images which enhances our appreciation of these peculiar diseases.
In short, this volume represents a high level of industry, initiative, intuition, and intelligence by a group of skilled ophthalmologists and clinical scientists. Their efforts will be reciprocally rewarded by the gratitude of the ophthalmologists and retinal specialists who read this text and by the incalculable pleasure their photographs will bring, even to the casual and discerning reader.
Lawrence A Yannuzzi md
Vice-Chairman
Department of Ophthalmology and Director of Retinal Services
Manhattan Eye, Ear and Throat Hospital
Professor of Clinical Ophthalmology
College of Physicians and Surgeons
7
Fundus fluorescein angiography has played a crucial role in our understanding of different disease processes affecting the eye. A good knowledge of the changes occurring in the fluorescein angiogram is important for correct diagnosis and management of eye disorders. With this in mind, we decided to compile the cases seen at Sankara Nethralaya and publish it in the form of an Atlas. The aim of bringing out this Atlas is to have a comprehensive book on the fluorescein angiographic findings in different disorders, so as to help the reader in understanding the disorder and in managing these types of cases.
The Vitreoretinal services at Sankara Nethralaya examines about 300 patients and undertakes 25 to 30 fluorescein angiography procedures everyday. These images are stored in the digital archival system, an excellent source for selecting cases for this Atlas. The meticulous manner in which records are maintained has greatly helped in making of this Atlas. All the cases, without exception, have been seen at Sankara Nethralaya, Chennai.
The book is not intended to be a textbook on fluorescein angiography; the script has been kept to the minimum. On the other hand, a color fundus photograph, a red free photograph and pictures of different phases of the angiogram are included for almost all cases. A detailed legend is given for all photographs.
The book has been divided into seven major sections with separate color coding for each. This was done to make the book as user-friendly as possible. Every attempt has been made to include as many representative cases as possible in each section.
9
Dr SS Badrinath has been the driving force in bringing out this Atlas. His constant emphasis on maintaining good clinical records proved extremely useful in making of this Atlas. Without his encouragement, this book would not have come into existence. We are deeply indebted to his active support of our efforts.
This Atlas is a testimony of the excellent teamwork involving all the Consultants and the Vitreoretinal fellows at Sankara Nethralaya. Cases published in this Atlas were contributed by the Consultants. The vitreoretinal fellows helped in collecting and compiling the cases. Our sincere thanks and gratitude to all the following:
Consultants
- Dr Pramod Bhende
- Dr Dhanashree Ratra
- Dr Candaee D' Souza
- Dr Pratik Ranjan Sen
- Dr Parveen Sen
- Dr Sourav Sinha
- Dr Ajeet Wagle
- Dr Ashok
- Dr Rajeev Raman
- Dr Madhav Rao
- Dr Niren Dongre
Vitreoretinal fellows
- Dr Kasinathan
- Dr Pratima Kathil
- Dr Krishna R Murthy
- Dr Pooja Sinha
- Dr Vikas Khetan
- Dr Debajit Deka
- Dr N SriBhargava
- Dr Rajeev Kumar Reddy
- Dr Manisha Agarwal
- Dr Sumitha Sharma
- Dr Girish A Gadre
- Dr Sachin B Kabra
- Dr Amit Nagpal
- Dr MR Sriram Gopal
- Dr Pradeep S
- Dr V Vasudeva Chakravarthy
- Dr Parag C Apte
- Dr Chetan Rao
- Dr Anuj Gogi
- Dr Nishank Mittal
- Dr Ramesh N Patel
- Dr Maneesh Bapayee
- Dr Rupak Kanti Biswas
- Dr Aarti Rupauliha Pankaj
- Dr Unnikrishnan Nair
- Dr Pukhraj Rishi
- Dr Debraj Shome
- Dr PJ Ramana Kumar
- Dr G Sunil
Special thanks go to our photography department headed by Chief photographer, Mr SP Govindarajan and ably supported by Mr Jayaraman (photographer), Mr Anand (photographer) and Mrs Lakshmi (Nursing staff). The entire credit for the quality of photographs goes to the photography team.
Mr Murali, Mr Sridhar, Mr Mohan, Mr Elango and Mr Chidambaram of the multimedia department helped in scanning and organization of the images.
Our sincere thanks to the publishers Jaypee Brothers Medical Publishers, for their technical assistance and for printing and publishing the Atlas on time.
Last but by no means the least, we offer our humble gratitude to all our patients for trusting us and letting us participate in the management of their eye problems.