Clinical Case Library

Retinitis pigmentosa

Retinitis Pigmentosa

A patient with a diagnosis of retinitis pigmentosa was referred for visual field examination due to suspicion of glaucoma. The iCare COMPASS examination showed a tubular visual field with preserved sensitivity within the macular area. The overlapping of functional and structural data revealed that loci with the lowest sensitivity corresponded to areas with atrophy of the retinal pigment epithelium-photoreceptor complex. The normal retinal sensitivity outside the atrophic areas, combined with optic nerve head abnormalities typical of diseases like retinitis pigmentosa, made the diagnosis of glaucoma unlikely. The numeric sensitivity threshold map is displayed upside-down in the iCare COMPASS report, to match each grid location with the corresponding retinal locus while maintaining the correct fundus image orientation. Images and diagnoses courtesy of Prof. Luca ROSSETTI MD and Dario ROMANO MD.

Diabetic retinopathy (DR)

Proliferative Diabetic Retinopathy

iCare EIDON’s high-resolution image highlights retinal vascular abnormalities associated with proliferative diabetic retinopathy. Laser photocoagulation has been used to control neovascularization (panretinal photocoagulation). Images and diagnoses courtesy of Flore DE BATS MD and Pierre-Loïc CORNUT MD.

Best disease

Thanks to its natural-looking colors, iCare EIDON’s TrueColor image provides a clear visualization of the yellow yolk-like lesion in the macula, typical of bestrophinopathy. The blue FAF image highlights the presence of hyper-fluorescent sedimented material in the area corresponding to the lesion. Images and diagnoses courtesy of Flore DE BATS MD and Pierre-Loïc CORNUT MD.

Retinal vein occlusion (RVO)

Branch Retinal Vein Occlusion (BRVO)

The image clearly shows the effects of the superotemporal Branch Retinal Vein Occlusion. It shows the extent of the haemorrhaging, including two cotton wool spots. iCare EIDON’s clear and high-resolution imaging allows the identification of the likely occlusion site, being just after the 3rd bifurcation of the vein. Images and diagnoses courtesy of Simon DELLA VEDOVA, Optometrist.

Borrelia chorioretinitis

Borrelia Chorioretinitis

iCare EIDON’s 200° TrueColor mosaic shows a patchy pattern of sharply demarcated confluent defects in the retina and choroid. The 90° FAF image highlights areas of hypo-fluorescence, that can indicate damage to the retina, and hyper-fluorescence, which could indicate inflammation of the retina and underlying choroid. Images and diagnoses courtesy of Adam WYLĘGAŁA MD.

Retinal Vein Occlusion (RVO)

Central Retinal Vein Occlusion (CRVO) with disc edema

This two-field TrueColor mosaic acquired with iCare EIDON demonstrates tortuosity and engorgement of all branches of the central retinal vein, extensive deep blot and flame-shaped hemorrhages involving the peripheral retina and posterior pole, and disc edema. In the inferior area, we can observe a dexamethasone implant. Images and diagnoses courtesy of Flore DE BATS MD and Pierre-Loïc CORNUT MD.

Choroidal Neovascular Membrane (CNVM)

Choroidal Neovascular Membrane

The two iCare EIDON images present a case of choroidal neovascular membrane. The vasculature is intact, with no hemorrhages. The macula shows a grey tinge of color with a lighter area stretching temporally and inferiorly (typical of a raised area). The FAF image shows the central macula uniformly dark (normal appearance) with a hyper-fluorescent crescent area temporally, indicating abnormal RPE function. Images and diagnoses courtesy of Simon DELLA VEDOVA, Optometrist.

Nevus

Choroidal nevus & macular drusen

The fundus of the patient is characterized by a pigmented plane choroidal nevus associated with macular drusen, clearly visualized thanks to iCare EIDON’s natural-looking colors. Images and diagnoses courtesy of Flore DE BATS MD and Pierre-Loïc CORNUT MD.

Diabetic retinopathy (DR)

Diabetic Retinopathy

iCare EIDON provides high image quality and resolution from the posterior pole to the periphery, allowing to detect the most subtle signs of DR. Images and diagnoses courtesy of John WARREN OD.

Glaucoma; nevus

Choroidal nevus and glaucoma

A large choroidal nevus in the macular region of the left eye is well evident in the Infrared image. iCare COMPASS allows to study the retinal function in this anatomical area and to accurately correlate it with the visual field function. The numeric sensitivity threshold map is displayed upside-down in the iCare COMPASS report, to match each grid location with the corresponding retinal locus while maintaining the correct fundus image orientation. Images and diagnoses courtesy of Francesco ODDONE MD.

Diabetic retinopathy (DR)

Diabetic Retinopathy

iCare EIDON’s FA image shows extensive peripheral microvascular dropout with ischemia and leakage from multiple foci of neovascularization. Images and diagnoses courtesy of Sharam DANESH MD.

Age-related macular degeneration (AMD)

Dry age-related macular degeneration

iCare EIDON’s FAF image shows the drusen as areas of hyper-fluorescence and the geographic atrophy as dark areas. The clear borders of the GA show the foveal sparing, which explains why acuity remained at 6/7.5 even in this advanced case of AMD. Images and diagnoses courtesy of Simon DELLA VEDOVA, Optometrist.

Epiretinal Membrane (ERM); retinal tear

Epiretinal Membrane & retinal tear

This two-field TrueColor mosaic acquired with iCare EIDON provides a sharp view of the epiretinal membrane, which appears like cellophane and causes traction and puckering of the retina. A retinal tear is visible in the temporal area. Images and diagnoses courtesy of Flore DE BATS MD and Pierre-Loïc CORNUT MD.

Familiar Exudative Vitreoretinopathy (FEVR)

Familiar Exudative Vitreoretinopathy with peripheral ischemia

iCare EIDON’s 200° TrueColor mosaic provides a sharp visualization of peripheral retinal defects. In this example, the fundus of the patient is characterized by stretched retinal vessels and a peripheral ischemic area, treated with photocoagulation. Images and diagnoses courtesy of Flore DE BATS MD and Pierre-Loïc CORNUT MD.

Glaucoma

The red-free photo shows a temporal defect of the nerve fiber bundle, starting from the disc hemorrhage located in the inferotemporal sector of the optic nerve head. Thanks to the structure-function correlation provided by iCare COMPASS, it is easy to note that locations with reduced sensitivity are localized along the RNFL defect. The numeric sensitivity threshold map is displayed upside-down in the iCare COMPASS report, to match each grid location with the corresponding retinal locus while maintaining the correct fundus image orientation. Images and diagnoses courtesy of Prof. Luca ROSSETTI MD and Dario ROMANO MD.

Horseshoe tear

A horseshoe tear was incidentally discovered in a follow-up visit of a patient with a history of hypertensive retinopathy and BRVO. iCare EIDON’s high-resolution images allowed to easily detect the horseshoe tear in the superior-temporal quadrant of the retina and to clearly visualize the signs of hypertensive retinopathy. Images and diagnoses courtesy of John WARREN OD.

Hypertensive choroidopathy

This is an example of iCare EIDON’s 200° TrueColor mosaic, showing signs of hypertensive choroidopathy. Fibrinoid necrosis of choroidal arterioles led to segmental infarction of choriocapillaris, which caused Elschnig spots and Siegrist streaks. Images and diagnoses courtesy of Flore DE BATS MD and Pierre-Loïc CORNUT MD.

Hypertensive choroidopathy

The image shows signs of hypertensive choroidopathy. iCare EIDON’s TrueColor Confocal technology provides a sharp visualization of peripheral retinal defects through cataract. Images and diagnoses courtesy of Flore DE BATS MD and Pierre-Loïc CORNUT MD.

Juvenile X-linked retinoschisis

The image shows the foveal schisis as a spoke wheel pattern radiating from the fovea and a domelike elevation of a thin layer of retina. With the condition presenting often in the first decade of life, the ease of use and patient comfort that the iCare EIDON brings is an important benefit to capture such clear images of young patients. Images and diagnoses courtesy of Simon DELLA VEDOVA, Optometrist.

Myopic maculopathy

Myopic Maculopathy

Thanks to Active Retinal Tracking and fundus perimetry, iCare COMPASS was able to produce accurate results, despite the patient’s unstable fixation. In this way, it is clear how the lowest sensitivities mainly correspond to peripapillary and macular atrophic areas, and it is easy to assess the functional damage of the healthy retina. The numeric sensitivity threshold map is displayed upside-down in the iCare COMPASS report, to match each grid location with the corresponding retinal locus while maintaining the correct fundus image orientation. Images and diagnoses courtesy of Prof. Luca ROSSETTI MD and Dario ROMANO MD.

Myopic maculopathy

The fundus of the patient is characterized by papillary edema and typical signs of myopic maculopathy including patchy chorioretinal atrophy. Thanks to its TrueColor Confocal technology and its autofocus capacity, iCare EIDON allowed an easy and high-quality acquisition despite the patient’s high myopia. Images and diagnoses courtesy of Flore DE BATS MD and Pierre-Loïc CORNUT MD.

Myopic maculopathy

The fundus of the patient is characterized by papillary edema and typical signs of myopic maculopathy including patchy chorioretinal atrophy. Thanks to its TrueColor Confocal technology and its autofocus capacity, iCare EIDON allowed an easy and high-quality acquisition despite the patient’s high myopia. Images and diagnoses courtesy of Flore DE BATS MD and Pierre-Loïc CORNUT MD.

Neuroretinitis

iCare EIDON’s image highlights the swollen appearance of the optic disc and clearly shows the choroidal folds, confirming the presence of neuroretinitis. Images and diagnoses courtesy of Adam WYLĘGAŁA MD.

Retinal hole

Operculated retinal hole

Here you can see two examples of iCare EIDON’s 200° TrueColor mosaics. In the first image, an operculated hole is visible in the mid-peripheral inferior-temporal field of the retina. The second photograph demonstrates the laser scars surrounding the hole after laser retinopexy. Images and diagnoses courtesy of Jacob CHENG MD.

Retinal hole

Operculated retinal hole

This 200° TrueColor mosaic acquired with iCare EIDON shows the presence of a retinal hole in the temporal quadrant. The hole appears as a red circular area in the periphery of the image, surrounded by a lighter ring of edema and by circular laser burns. A shadow is also visible on the surface of the retina, which is caused by the operculum. Images and diagnoses courtesy of Adam WYLĘGAŁA MD.

Retinal hole; Epiretinal Membrane (ERM)

Operculated retinal hole & Epiretinal membrane

The first image shows a round area of discoloration in the temporal periphery. The white circle centrally is the hole, with the operculum a darker circle just inferiorly. The second image is a 3 month follow up acquisition, performed after laser retinopexy. It allows to see the barrier laser fully surrounding the area the hole was found and shows that the retinal hole went on to form a tear. The clarity of iCare EIDON’s TrueColor image also shows early formation of an Epiretinal Membrane at the macula. Images and diagnoses courtesy of Simon DELLA VEDOVA, Optometrist.

Optic disc drusen

In this iCare EIDON TrueColor image, drusen appear as round, white/yellow refractile bodies on the surface of the nerve. Superficial optic disc drusen demonstrate hyper-autofluorescence, as clearly shown in the FAF image. Images and diagnoses courtesy of Flore DE BATS MD and Pierre-Loïc CORNUT MD.

Glaucoma

Papillary hemorrhage and glaucoma

Optic disc hemorrhage is a risk factor for glaucoma progression, and patients with such risk factors should be followed closely to ensure that the treatment plan is sufficient. iCare COMPASS allows to detect and monitor the hemorrhage and the relative visual field. The hemorrhage is evident in the 24-2 printout. The numeric sensitivity threshold map is displayed upside-down in the iCare COMPASS report, to match each grid location with the corresponding retinal locus while maintaining the correct fundus image orientation. Images and diagnoses courtesy of Francesco ODDONE MD.

Hemorrhage; diabetic retinopathy (DR)

Pre-retinal hemorrhage and Diabetic Retinopathy

This iCare EIDON image shows a case of proliferative Diabetic Retinopathy with pre-retinal hemorrhage. Inferiorly there are the hemorrhages, with a “D” or boat shape. Temporal to the macula and nasal to the optic nerve head there are some feint vertical hemorrhages, which represent the movement of blood inferiorly due to gravity. Images and diagnoses courtesy of Simon DELLA VEDOVA, Optometrist.

Glaucoma

Primary Open Angle Glaucoma

These are two examples of 200° Mosaics acquired by iCare EIDON Family devices with the EIDON UWF Module, presenting a case of Primary Open Angle Glaucoma. The TrueColor image shows a healthy macula, and a blot hemorrhage nasal to the optic nerve head. The ONH shows a large vertical cup/disc ratio of 0.75, thin superior rim, peripapillary atrophy temporally and a small hemorrhage on the disc margin at 1 o’clock. The red-free image highlights a darker wedge defect projecting from the ONH at the 1-2 o’clock position. This wedge represents a localized loss of the RNFL, strongly associated with disc hemorrhage, confirming optic nerve damage. Images and diagnoses courtesy of Simon DELLA VEDOVA, Optometrist.

Diabetic retinopathy (DR)

Proliferative Diabetic Retinopathy

The natural colors of iCare EIDON’s image allow to easily discriminate among the different pathological signs typical of proliferative diabetic retinopathy. Images and diagnoses courtesy of John WARREN OD.

Diabetic retinopathy (DR)

Proliferative Diabetic Retinopathy (PDR)

Thanks to its natural-looking colors, this iCare EIDON image shows the full extent of Proliferative Diabetic Retinopathy in a single view: retinal hemorrhages scattered superiorly and temporally; exudates superior and around the macula; retinal fibrosis superior to the macula extending to the disc, causing traction at the macula with striations; new blood vessels forming near the traction and leaking; ghost vessels visible as white vessels (due to blood flow absence). Images and diagnoses courtesy of Simon DELLA VEDOVA, Optometrist.

Retinal detachment

Retinal Detachment

A 360° barrier circling the macula and ONH has been established in a series of successive treatments. iCare EIDON’s TrueColor mosaic shows the scarring and pigment of the original laser, along with some fresh laser burns appearing white in the superior nasal area where there is hemorrhaging. The image also highlights the detached retina inferiorly and nasally being contained by the laser retinopexy. Images and diagnoses courtesy of Simon DELLA VEDOVA, Optometrist.

Retinal tear

Retinal Tear

Here you can see two 200° TrueColor images showing a case of retinal tear, acquired with an iCare EIDON Family device before and after a successful procedure of Laser Retinopexy. The first image provides a clear and detailed visualization of a retinal tear in the temporal periphery, outlined by the whitish edge, with the typical horseshoe shape and some minor blot hemorrhages inferiorly. The second image, taken 3 days later, shows that the tear is fully enclosed by the Laser Retinopexy. Images and diagnoses courtesy of Simon DELLA VEDOVA, Optometrist.

Retinal detachment

Retinal detachment (repaired)

The two TrueColor images were acquired with iCare EIDON one day and one month after the pneumatic retinopexy. The first image demonstrates SF6 gas bubbles and an attached retina. The second image demonstrates resolution of SF6 gas and an attached retina. Images and diagnoses courtesy of Atul JAIN MD.

Retinal vein occlusion (RVO)

Retinal Vein Occlusion

iCare EIDON Family devices equipped with the UWF Module acquire 120° single-shot images, and automatic mosaics up to 200°. The first photograph demonstrates severe retinal vein occlusion, sparing only the nasal quadrant of the left eye. This is evident by the extensive retinal hemorrhages and tortuous veins. The second photo shows significant reduction of retinal hemorrhages, with residual ones only in the far periphery, after administration of multiple intra-vitreous agents over a year. Images and diagnoses courtesy of Jacob CHENG MD.

Retinal vein occlusion (RVO)

Retinal Vein Occlusion & Panretinal Photocoagulation

This is a case of RVO documented through a 200° TrueColor Mosaic, acquired by an iCare EIDON Family device with the EIDON UWF Module. Laser burns are clearly visible in the periphery: small, circular or oval shaped areas of lighter color compared to the surrounding tissue, often with pigmentary changes. Images and diagnoses courtesy of Adam WYLĘGAŁA MD.

Retinitis pigmentosa

Retinitis Pigmentosa

At fundus examination, the patient was found to have an inferior arcuate area of retinal atrophy starting from the optic nerve. iCare COMPASS showed a corresponding superior arcuate defect, with a suspicious sensitivity reduction on the inferior-nasal side, too. Thanks to fundus perimetry, with the overlapping of structural and functional data, it is easy to see how the suspicious inferior “nasal step” corresponds to an area of early retinal degeneration next to the atrophic inferior arcuate defect, which extends into the upper hemifield. The numeric sensitivity threshold map is displayed upside-down in the iCare COMPASS report, to match each grid location with the corresponding retinal locus while maintaining the correct fundus image orientation. Images and diagnoses courtesy of Prof. Luca ROSSETTI MD and Dario ROMANO MD.

Retinitis Pigmentosa

Thanks to iCare EIDON’s TrueColor Confocal technology, it is clearly visible that the fundus of the patient is characterized by the clumping of the disrupted retinal pigment epithelium distributed in bone-spicule formations, attenuated retinal vessels, and waxy pallor of the optic disc. Images and diagnoses courtesy of Flore DE BATS MD and Pierre-Loïc CORNUT MD.

Stargardt

Stargardt disease

Here you can see an example of a 120° Fundus Autofluorescence (FAF) image and a 120° TrueColor image acquired with iCare EIDON. The two images highlight some typical fundus manifestations of Stargardt disease, including pigment mottling, macular atrophy, a bull’s eye maculopathy and autofluorescent flecks. Images and diagnoses courtesy of Flore DE BATS MD and Pierre-Loïc CORNUT MD.

Choroidal Neovascular Membrane (CNVM)

Subfoveal Choroidal Neovascular Membrane

The image demonstrates multiple, small, yellowish punctate lesions at the level of the choroid. A subfoveal choroidal neovascular membrane with hyperpigmented borders is visible. iCare EIDON’s TrueColor Confocal technology provides a clear and sharp view of these typical signs of punctate inner choroidopathy. Images and diagnoses courtesy of Flore DE BATS MD and Pierre-Loïc CORNUT MD.

Submacular hemorrhage

The two TrueColor images were acquired with iCare EIDON before and after the pneumatic displacement of a submacular hemorrhage. Images and diagnoses courtesy of Flore DE BATS MD and Pierre-Loïc CORNUT MD.

Toxoplasmosis

The optic nerve head image shows increased excavation of the inferior pole, with an associated reduction of the peripapillary fiber reflection in the temporal-inferior sector. Taken individually, these findings could raise suspicion of glaucoma, but looking at the fundus perimetry it is easy to see how the area of sensitivity reduction is completely overlapped to the atrophic lesion, which could also explain the reduction of the corresponding fiber layer thinning. The numeric sensitivity threshold map is displayed upside-down in the iCare COMPASS report, to match each grid location with the corresponding retinal locus while maintaining the correct fundus image orientation. Images and diagnoses courtesy of Prof. Luca ROSSETTI MD and Dario ROMANO MD.

Vasculitis; Epiretinal Membrane (ERM)

Vasculitis & Retinal Atrophy

This image acquired with iCare EIDON shows a central sparing of the retina, with atrophy in the periphery. There is also evidence of an epiretinal membrane (ERM) in the macular region. Images and diagnoses courtesy of Adam WYLĘGAŁA MD.