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 Photography
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
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
Paper
Schwartz DM, et al. Ophthalmology (2014)
Reinventing the Eye Exam
Reinventing the Eye Exam
Reinventing the Eye Exam
Conclusion
Multicolour
Angiography
Ultrawidefield
Autofluorescence
OCT
Reinventing the Eye Exam!
Team Eye.. No “I” in team
Medical records
Bad old days…2019
Exciting horizons and a bright future..