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Medical Forum / General / Vision / August 2007Fundus photo question.
In looking at a fundus photograph, how do the professionals here on the board, differ the arteries from the veins (arterioles from venules)? Don W. Veins are larger and darker, and arterioles have a more prominent light reflection along their center. Where they might be indistinguishable, you can usually trace a vessel back to a point where you can see a difference in color, or caliber, or an arterial light reflex. It's noteworthy that the vessel walls are transparent. What you see is the actual blood column. -MT > In looking at a fundus photograph, how do the professionals here on > the board, differ the arteries from the veins (arterioles from > venules)? > > Don W. > Veins are larger and darker, and arterioles have a more prominent light > reflection along their center. [quoted text clipped - 7 lines] > > -MT Thanks. I have read about the center line light reflex of the arterioles. Do the veins cross the arteries more often, or vice versa? That is, is there a layering effect of one type crossing over the other? Also, what is your (or anyone else's) view of judging the effects of hypertension (systemic) on the arteries. Can you see buildup? Don W. > I have read about the center line light reflex of the arterioles. > Do the veins cross the arteries more often, or vice versa? That is, > is there a layering effect of one type crossing over the other? Arteries usually cross over veins, but exceptions aren't rare. > Also, what is your (or anyone else's) view of judging the effects of > hypertension (systemic) on the arteries. Can you see buildup? If you meant "buildup" then you're probably talking about arteriosclerosis, rather than HT. They are often seen together. HT usually affects the hydraulics, such that arteries are distended and tortuous, and they can be seen pinching off the underlying veins ("A/V nicking.") Arteriosclerosis alters the color and uniformity of the blood column. The arterial light reflex becomes yellowish or silvery, and irregularities in caliber appear where there are arterial placques. -MT > Arteriosclerosis alters the color and uniformity of the blood column. The > arterial light reflex becomes yellowish or silvery, and irregularities in > caliber appear where there are arterial placques. Thanks. So one could get a handle on the sclerotic buildup in the rest of the body by looking at the retina. I presume. Wonder why this test is not used more frequently in assessing the condition of the systemic vascular system Don W. > > Arteriosclerosis alters the color and uniformity of the blood column. The > > arterial light reflex becomes yellowish or silvery, and irregularities in [quoted text clipped - 8 lines] > > Don W. Because it is too subjective? Use of the ophthalmoscope is not taught to residents? Hi, Please can you teach me how to use the ophthalmoscope; I have always wondered how you use the instrument. Where do you buy one, please? Is it hard to use, and how long will it take to learn it. I really really want one so that I can make tests of all my friends' eyes and see if their eyes are OK. > Hi, > [quoted text clipped - 3 lines] > want one so that I can make tests of all my friends' eyes and see if > their eyes are OK. Well, you could look at: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=27560 Don W. > Because it is too subjective? Use of the ophthalmoscope is not taught > to residents? With the advent of nonmydriactic fundus cameras (like Optomap (I am not a saleman), may make fundus viewing very much easier and minimize the need for an ophthalmoscope?? Don W. > With the advent of nonmydriactic fundus cameras (like Optomap (I am > not a saleman), may make fundus viewing very much easier and minimize > the need for an ophthalmoscope?? I have an Optomap, and I've had a retinal camera. Neither of them show as much detail as the little hand-held ophthalmoscope that _every_ medical student is taught to use. But the hand-held unit takes practice, and it's pretty difficult with small pupils. I've heard residents (non-ophth) confess that they couldn't make it work, but it's still one of the most valuable instruments. You can crank in the focus and examine the parts in front of the pupil, and it makes an excellent illumination source for testing pupil reactions. It's almost no good for peripheral retinal. That's where the imaging techniques excel. -MT |
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