New beginnings..

St Mary’s Ophthalmology

Phillip Moradi

BSc, MBChB, FRCOphth, MD (res.)

Translational Research Fellow Ophthalmology, UCL Consultant Ophthalmologist, NHS

Ophthalmology

• New cataract surgery machine

• New retinal diagnostics, OCT

• Satellite Unit

• Full complement of doctors: 4-5 Substantive Consultants

• Excellent group of well trained middle grade doctors

• Joint glaucoma clinic with QA, Portsmouth

• National cataract database: complication rates 2% vs <1%

Fundus Cameras

Fundus Photography

J M OD

Scanning Laser Ophthalmoscopy (SLO)

Monochromatic (Multi-Colour) Imaging

Ocular Angiography

Fundus Fluorescein Angiography (FFA)

1. Retinal Vasculitis and Non-perfusion 2. Choroidal Neovascularization 3. Cystoid Macular Oedema 4. Retinitis/Choroiditis Papillitis/Scleritis

FFA in Uveitis

Fluorescein sodium

Retinal vessel

FA in inflammatory diseases gives mostly information on the superficial structures of the fundus

• Disc

• Retinal vasculitis

• Retina

• Cystoid macular edema

• Exudative retinal detachment (ERD)

Vogt-Koyanagi-Harada disease

Behçet’s uveitis

Birdshot chorioretinitis

VKH disease

Fundus Autofluorescence (FAF)

Fundus Autofluorescence (FAF)

FAF in Uveitis

1. Marker of RPE Damage 2. RPE Disease Activity???

Ultrawidefield (UWF) Imaging

Optos p200

UWF Imaging in Uveitis

1. Mapping of inflammatory lesions 2. Retinal Vasculitis 3. Peripheral Non-Perfusion 4. Degeneration of RPE

Wide Angle

Optical Coherence Tomography (OCT)

Current Uses in Uveitis?

1. Cystoid Macular Oedema

2. Choroidal Neovascularization

Current Uses in Uveitis?

3. Abnormalities of the Vitreoretinal Interface

Current Uses in Uveitis?

Current Uses in Uveitis?

Choroid

Haller’s Layer

Sattler’s Layer

Choroid

Choroid

???

Paper

Schwartz DM, et al. Ophthalmology (2014)

Results

Results

Results

Results

Results

Results

Results

Binocular OCT

Reinventing the Eye Exam

Reinventing the Eye Exam

Reinventing the Eye Exam

Conclusion

Multicolour

Angiography

Ultrawidefield

Autofluorescence

OCT

Reinventing the Eye Exam!

Satellite Unit

Satellite OCT

Team Eye.. No “I” in team

Medical records

Bad old days…2019

Medisight EPR

Exciting horizons and a bright future..