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Algorafi Retinal Course(OnLine)
Recognized by the vitreo retinal study group
Course Description:-
Authors
Ibrahim Algorafi,MD(Chairman)
Walid ALgorafi,MD
Yahia al-Dhabbi,MD
Summary
Miscellaneous fundus
photography presented according to the cause, and described in the way
of spot diagnosis, critical signs ,all
photographs
belong to algorafi eye clinic .
Objectives
Upon completion of
this online course, the ophthalmologist should be able to
-review Knowledge.
-Differentiate
between the diabetic retinopathy and hypertensive retinopathy.
-Differentiate
between the CSCR and the Cystoid macular edema.
-suspecting an
artifact.
Audience
MD,MBBS,MBCHB with 3 years
experience in ophthalmology are eligible to enter the test.
Price
This course is offered free of
charge, free test and free certificate shipment.
Introduction :
Fluorescein angiography is frequently an essential part of retinal
investigation. However, with an understanding of Fluorescein
angiography, it is frequently unnecessary to perform angiography
following an examination because of the knowledge of the expected
pattern. Thus once the Fluorescein appearance of the lesion, or
lesions, is recognized, then angiography is no longer required. For
instance , a cotton-wool spot will always show an area of arteriolar
occlusion associated with capillary closure and knowing this , it is
not essential to carry out angiography. However in many complex retinal
patterns, angiography proves itself to be very useful in both diagnosis
and the management of an individual retinal disorder. Fluorescein
angiography is also vital in identifying areas which require treatment,
such as in disciform macular degeneration , and also is essential in
evaluating the response to the treatment and the necessity of
retreatment .
Phases of the normal angiogram:
1 -Prearterial phase.
2 -Arterial phase.
3 -Arteriovenous ( capillary ) phase.
4 -Venous phase.
Abnormal features on fluorescein angiography:
Masking: any structure that lies in front of the retina or
choriodal circulation will result in masking . May be produced by
(hemorrhage, pigment, exudate or fluid)
 
Masking by
hemorrhage.
Masking by Retinal Ischemia (Capillary non perfusion )
Transmission defect: Any defect in the pigment epithelium ,
which results in its thinning will show the choroidal circulation more
readily and therefore , there will be a hyper fluorescent area on the
fluorescein angiogram. May be produced by (choroiditis, Laser, choroidal
rupture, macular hole,high myopia,pale eyes )
Transmission
defect in full thickness macular hole.
Filling defect: A filling defect may be present in
either the retinal of choroidal circulation. May be produced by ( emboli
gives filling defect ,Takayasu's disease gives delay in the filling)
Filling defect and retinal Ischemia in Coats
Retinal telangictasis.
Staining: Staining is the accumulation of dye within a
structure which persist after the transit of the dye ,clearly indicating
some damage to the tight junction of the retinal pigment epithelium.
May be produced by ( Drusen)
The
drusen in this picture stained by the dye with more staining in late
pictures.
Leakage: Progressive leakage of Fluorescein dye , out
of the retinal circulation or optic disc, persists long after transit of
the dye, may produced by (diabetic retinopathy,macroanurysm, CSCR)
Leakage
in the proliferative diabetic retinopathy.
 
Leakage
in the CSCR.(Central Serous Chorioretinopahty)
Pooling: Pooling of dye is the consequence of the
leakage and is most characteristic of lesions, (such as central serous
retinopathy and pigment epithelial detachment, where large fluid-filled
spaces gradually fill with Fluorescein during and following the
angiogram )
Pooling
in the RPE detachment in patient having ARMD( age related macular
degeneration ).
*All photographs belong
to Algorafi eye clinic, all right reserved 2001-2004
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