Ophthalmic fundus imaging: today and beyond.
OBJECTIVE
To review and update techniques of posterior segment ophthalmic fundus imaging.


METHODS
Literature review and collective experience of the authors.


METHODS
This perspective includes sections on digital imaging, fundus autofluorescence, ultrasonography, angiography, and optical coherence tomography (OCT) -ophthalmoscopy written by leading clinicians and researchers in these areas.


RESULTS
Digital angiography has become the new standard in the ophthalmic community based upon improved technology which has enhanced resolution, processing time, and ease of image duplication, manipulation, and transmission. A relatively new imaging technique, fundus autofluorescence, highlights lipofuscin deposits and improves our understanding of the metabolic status of the retinal pigment epithelium. Diagnostic ultrasonography continues to be a major adjunct to ocular evaluation where advances now allow for exceptional versatility and portability. High speed angiographic techniques provide detailed visualization of choroidal perfusion which improves our understanding of both normal and pathologic vascular phenomenon. Advances in high-resolution OCT currently under development promise an even more detailed fundus representation. The integration of the scanning laser ophthalmoscope and OCT has produced a dynamic new instrument, the OCT ophthalmoscope, which simultaneously images the fundus in numerous ways with point to point correlation.


CONCLUSIONS
Ophthalmic imaging technology has revolutionized fundus examination. Currently available systems have contributed significantly to our understanding of the pathophysiology and treatment of various retinal diseases. Future advances promise near histologic resolution of retinal structures as well as real-time image manipulation and instantaneous transmission world-wide.
Yannuzzi
Lawrence A
LA
LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, New York 10021, USA. vrmny@aol.com
Ober
Michael D
MD
Slakter
Jason S
JS
Spaide
Richard F
RF
Fisher
Yale L
YL
Flower
Robert W
RW
Rosen
Richard
R
D015862:Choroid Diseases / Q000175:diagnosis*; D003952:Diagnostic Imaging / Q000379:methods*; D003941:Diagnostic Techniques, Ophthalmological; D005451:Fluorescein Angiography; D005453:Fluorescence; D005654:Fundus Oculi; D006801:Humans; D009887:Ophthalmoscopy; D012164:Retinal Diseases / Q000175:diagnosis*; D041623:Tomography, Optical Coherence; D014463:Ultrasonography