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Fundus imaging in patients with cataract: role for a variable wavelength scanning laser ophthalmoscope.





An investigation was carried out to compare the image quality of the ocular fundus obtained clinically,

photographically, and with the scanning laser ophthalmoscope (SLO) at visible and infrared wavelengths

in patients with significant cataract.


Nineteen patients admitted for routine cataract extraction were examined clinically by two independent

observers to ascertain cataract type and clarity of fundus view with an indirect ophthalmoscope. Fundus

photography and both confocal and direct (non-confocal) SLO imaging at 590 nm, 670 nm, and 830 nm

were carried out after pupillary dilatation. Images obtained were graded independently using a recognised

grading system.


Quality of SLO images appeared to be superior to indirect ophthalmoscopy (p < 0.01) and fundus

photography (p < 0.001) when graded subjectively. Quantitative analysis of contrast of retinal vessels

demonstrated significantly higher contrast for the SLO compared with digitised fundus photographs at all

wavelengths tested (p < 0.001), with highest contrast at 590 nm. Use of a confocal aperture significantly

improved vessel contrast but may reduce overall image intensity.


Scanning laser ophthalmoscopy may offer a method to observe and record fine fundus detail in patients

who have marked cataract.




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