CLARUS Ultra-widefield Fundus Imaging

Multi-modal retinal analysis (true color, FAF-blue and FAF green) of a 67-year-old male diagnosed with Retinitis pigmentosa 30 years ago. ​

The widefield, True color fundus image allows the identification of peripheral retinal pigmentary changes such as areas of hypopigmentation and bone-spicule pigments, disuse arteriolar atrophy and waxy disc pallor. ​

Fundus autofluorescence (both green and blue) are helpful in determining the extension and pattern of RPE atrophy as well as the increased ring of hyper-autofluorescence at the macula. ​

However, FAF-green excitation wavelength is less absorbed by luteal pigments and provides more details regarding the RPE function at the macular area. Notice that, even presenting posterior capsule opacities in the left eye, the image quality does not compromise the analysis." ​

Image courtesy of Ricardo Luz Leitão Guerra, MD, Clínica de Olhos Leitão Guerra, Brazil

Multi-modal retinal analysis (true color, FAF green and Fluorescein angiography) of a 71-year-old male diagnosed with branch retinal artery occlusion. ​

FIGURE 1) True color fundus image allow the identification of a yellowish cholesterol emboli (Hollenhorst plaque) obstructing the inferno-temporal artery branch and the retinal whitening of the affected area. ​

FIGURE 2) Fundus autofluorescence presented a marked hyperautfluorescence of the cholesterol emboli. ​

FIGURE 3, 4 and 5) Fluorescein angiography is extremely helpful determining the extension of the ischemia, as well as the presence of retrograde filling, which is a sign of a better prognosis.   

Image courtesy of Ricardo Luz Leitão Guerra, MD, Clínica de Olhos Leitão Guerra, Brazil

True color image of a 83-year-old male diagnosed with primary open angle glaucoma. Optic disc analysis shows several signs of glaucoma, such as cup-to-disc ratio, Susanna Streaks (striate pattern of lamina cribrosa openings), nasal displacement of central retinal vessels, notch of the neuroretinal rim and Hoyt sign (localized RNFL loss).

Image courtesy of Ricardo Luz Leitão Guerra, MD, Clínica de Olhos Leitão Guerra, Brazil

Fundus imaging of a 61-year-old female diagnosed with arterial hypertension with irregular control. True color image allow the identification of hypertensive retinopathy signs, such as:​

• engorged venules
  
• coper-wire arterioles and ​
• AV nicking

Image courtesy of Ricardo Luz Leitão Guerra, MD, Clínica de Olhos Leitão Guerra, Brazil

Multi-modal retinal analysis (true color, FAF-blue and FAF green) of a ​23-year-old male referred for a retina specialist evaluation due to an optic disc abnormality. ​

In this case, fundus autofluorescence both green and blue were able to identify the presence of an optic disc drusen.

Image courtesy of Ricardo Luz Leitão Guerra, MD, Clínica de Olhos Leitão Guerra, Brazil

Multi-modal retinal analysis (true color and FAF green) of a 51-year-old female diagnosed with Stargadt disease (genetic test positive for ABCA4). ​

True color images shows areas of RPE atrophy at the macula and multiple flecks at the posterior pole and mid periphery. ​

Fundus autofluorescence is an extremely helpful tool in this case, enhancing the identification of the RPE atrophy and flecks. ​

An interesting thing about FAF in Stargardt disease is the preserved RPE area surrounding the optic disc.

Image courtesy of Ricardo Luz Leitão Guerra, MD, Clínica de Olhos Leitão Guerra, Brazil

Multi-modal retinal analysis (true color and fluorescein angiography) ​of a 49-year-old male diagnosed with Proliferative diabetic retinopathy. ​

True color image shows several microvascular abnormalities, exudates and neovascularization. ​

Fluorescein angiography enhance the identification of the microvascular abnormalities, such as microaneurysms, IRMA’s, ischemic areas and several neovascularizations. ​

Treatment was performed by panretinal photocoagulation (PRP) in one session using Visulas Green VITE (multi spot laser).

Image courtesy of Ricardo Luz Leitão Guerra, MD, Clínica de Olhos Leitão Guerra, Brazil

Ultra wide field (UWF) image (acquired by a montage of six wide field images) presenting a retinal tear partially blocked by laser scars. ​

This UWF high resolution image allows the identification of the untreated area and is a useful tool for treatment planning and follow up.

Image courtesy of Ricardo Luz Leitão Guerra, MD, Clínica de Olhos Leitão Guerra, Brazil