Gonioscopic Angle Imaging: Difference between revisions

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Gonioscopy is a very important part of glaucoma evaluation, but is often underrated. In addition to differentiating between open and closed angle glaucoma, other clues in the angle also may help in diagnosis. Documenting the gonioscopic photographs would help in objective assessment. This article covers the latest techniques in gonioscopic imaging.
Gonioscopy is a very important part of glaucoma evaluation, but is often underrated. In addition to differentiating between open and closed angle glaucoma, other clues in the angle also may help in diagnosis. Documenting the gonioscopic photographs would help in objective assessment. This article covers the latest techniques in gonioscopic imaging.


In addition to the conventional single-mirror, two-mirror, three-mirror and four-mirror gonioprisms, there is also a six-mirror Gonio Lens named Volk G-6 goniolens (Volk Optical, Inc., Mentor, OH) which helps to do a more complete angle examination without rotating the goniolens. Angle photography can be done with slitlamp cameras using a goniolens, but is difficult to get correct focus and exposure. Smartphone cameras can also be used with a slitlamp adapter to take gonioscopic photographs and videos.(Figure 4)
In addition to the conventional single-mirror, two-mirror, three-mirror and four-mirror gonioprisms, there is also a six-mirror Gonio Lens named Volk G-6 goniolens (Volk Optical, Inc., Mentor, OH) which helps to do a more complete angle examination without rotating the goniolens. Angle photography can be done with slitlamp cameras using a goniolens, but is difficult to get correct focus and exposure. Smartphone cameras can also be used with a slitlamp adapter to take gonioscopic photographs and videos.


EyeCam (Clarity Medical Systems, Pleasanton, CA, USA), designed for widefield pediatric fundus imaging, can also be used for Angle Photography by addition of a 130 degree wide-field lens.15
EyeCam (Clarity Medical Systems, Pleasanton, CA, USA), designed for widefield pediatric fundus imaging, can also be used for Angle Photography by addition of a 130 degree wide-field lens.<ref>Quek DTL, Nongpiur ME, Perera SA, Aung T. Angle imaging: Advances and challenges. ''Indian J Ophthalmol''. 2011;59(Suppl1):S69-S75. doi:10.4103/0301-4738.73699</ref>
A team from Singapore is working on GonioPen16(Figure 5), a handheld angle photography device, which provides high resolution iridocorneal angle photographs. It is a small, compact device that can be used by a technician with minimal training.17


The new GS-1 Gonioscope (Nidek, Aichi, Japan) released in September 201818, is a table-top, contact-based, angle photography device that takes gonioscopic photographs and stitiches them together in 360 degrees. It captures using a 16 mirror goniolens and takes images at multiple focal points so that focus can be adjusted on to different angle structures later.19
A team from Singapore is working on GonioPen,<ref>Shinoj VK, Murukeshan VM, Baskaran M, Aung T. Integrated flexible handheld probe for imaging and evaluation of iridocorneal angle. ''J Biomed Opt''. 2015;20(1):016014. doi:10.1117/1.JBO.20.1.016014</ref> a handheld angle photography device, which provides high resolution iridocorneal angle photographs. It is a small, compact device that can be used by a technician with minimal training.<ref>Hong XJJ, Shinoj VK, Murukeshan VM, Baskaran M, Aung T. Preclinical imaging of iridocorneal angle and fundus using a modified integrated flexible handheld probe. ''J Med Imaging (Bellingham)''. 2017;4(2):026001. doi:10.1117/1.JMI.4.2.026001</ref>


Direct Smartphone Imaging of Goniscopy can be done without a slitlamp as shown by Dr Nilesh Kumar et al.
The new GS-1 Gonioscope (Nidek, Aichi, Japan) released in September 2018,<ref>NIDEK launches the GS-1 Gonioscope | News | NIDEK CO.,LTD. Accessed May 3, 2020. <nowiki>https://www.nidek-intl.com/news-event/news/entry-3367.html</nowiki></ref> is a table-top, contact-based, angle photography device that takes gonioscopic photographs and stitiches them together in 360 degrees. It captures using a 16 mirror goniolens and takes images at multiple focal points so that focus can be adjusted on to different angle structures later.<ref>Gonioscope GS-1 | Retina & Glaucoma | NIDEK CO.,LTD. Accessed May 3, 2020. <nowiki>https://www.nidek-intl.com/product/ophthaloptom/diagnostic/dia_retina/gs-1.html</nowiki></ref>
 
Direct Smartphone Imaging of Goniscopy can be done without a slitlamp as shown by Dr Nilesh Kumar et al.<ref>Kumar N, Francesco B, Sharma A. Smartphone-based Gonio-Imaging: A Novel Addition to Glaucoma Screening Tools. ''J Glaucoma''. 2019;28(9):e149-e150. doi:10.1097/IJG.0000000000001306</ref>


= Indications =
= Indications =
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= References =
= References =
<references />

Revision as of 23:32, May 29, 2020

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Diagnostic Intervention

Gonioscopic Angle Imaging

Description/Overview

Gonioscopy is a very important part of glaucoma evaluation, but is often underrated. In addition to differentiating between open and closed angle glaucoma, other clues in the angle also may help in diagnosis. Documenting the gonioscopic photographs would help in objective assessment. This article covers the latest techniques in gonioscopic imaging.

In addition to the conventional single-mirror, two-mirror, three-mirror and four-mirror gonioprisms, there is also a six-mirror Gonio Lens named Volk G-6 goniolens (Volk Optical, Inc., Mentor, OH) which helps to do a more complete angle examination without rotating the goniolens. Angle photography can be done with slitlamp cameras using a goniolens, but is difficult to get correct focus and exposure. Smartphone cameras can also be used with a slitlamp adapter to take gonioscopic photographs and videos.

EyeCam (Clarity Medical Systems, Pleasanton, CA, USA), designed for widefield pediatric fundus imaging, can also be used for Angle Photography by addition of a 130 degree wide-field lens.[1]

A team from Singapore is working on GonioPen,[2] a handheld angle photography device, which provides high resolution iridocorneal angle photographs. It is a small, compact device that can be used by a technician with minimal training.[3]

The new GS-1 Gonioscope (Nidek, Aichi, Japan) released in September 2018,[4] is a table-top, contact-based, angle photography device that takes gonioscopic photographs and stitiches them together in 360 degrees. It captures using a 16 mirror goniolens and takes images at multiple focal points so that focus can be adjusted on to different angle structures later.[5]

Direct Smartphone Imaging of Goniscopy can be done without a slitlamp as shown by Dr Nilesh Kumar et al.[6]

Indications

All indications of gonioscopy are indications of gonioscopic imaging Objective documentation of gonioscopic findings is the indication

Limitations

Imaging resolution is limited based on the quality of the camera and the lighting. Nothing currently compares to the resolution of direct visualization of gonioscopy.

References

  1. Quek DTL, Nongpiur ME, Perera SA, Aung T. Angle imaging: Advances and challenges. Indian J Ophthalmol. 2011;59(Suppl1):S69-S75. doi:10.4103/0301-4738.73699
  2. Shinoj VK, Murukeshan VM, Baskaran M, Aung T. Integrated flexible handheld probe for imaging and evaluation of iridocorneal angle. J Biomed Opt. 2015;20(1):016014. doi:10.1117/1.JBO.20.1.016014
  3. Hong XJJ, Shinoj VK, Murukeshan VM, Baskaran M, Aung T. Preclinical imaging of iridocorneal angle and fundus using a modified integrated flexible handheld probe. J Med Imaging (Bellingham). 2017;4(2):026001. doi:10.1117/1.JMI.4.2.026001
  4. NIDEK launches the GS-1 Gonioscope | News | NIDEK CO.,LTD. Accessed May 3, 2020. https://www.nidek-intl.com/news-event/news/entry-3367.html
  5. Gonioscope GS-1 | Retina & Glaucoma | NIDEK CO.,LTD. Accessed May 3, 2020. https://www.nidek-intl.com/product/ophthaloptom/diagnostic/dia_retina/gs-1.html
  6. Kumar N, Francesco B, Sharma A. Smartphone-based Gonio-Imaging: A Novel Addition to Glaucoma Screening Tools. J Glaucoma. 2019;28(9):e149-e150. doi:10.1097/IJG.0000000000001306
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