A simple method for panretinal imaging with the slit lamp

Abstract

Slit lamp biomicroscopy of the retina with a convex lens is a key procedure in clinical practice. The methods presented enable ophthalmologists to adequately image large and peripheral parts of the fundus using a video-slit lamp and freely available stitching software. A routine examination of the fundus with a slit lamp and a +90 D lens is recorded on a video film. Later, sufficiently sharp still images are identified on the video sequence. These still images are imported into a freely available image-processing program (Hugin, for stitching mosaics together digitally) and corresponding points are marked on adjacent still images with some overlap. Using the digital stitching program Hugin panoramic overviews of the retina can be built which can extend to the equator. This allows to image diseases involving the whole retina or its periphery by performing a structured fundus examination with a video-slit lamp. Similar images with a video-slit lamp based on a fundus examination through a hand-held non-contact lens have not been demonstrated before. The methods presented enable those ophthalmologists without high-end imaging equipment to monitor pathological fundus findings. The suggested procedure might even be interesting for retinological departments if peripheral findings are to be documented which might be difficult with fundus cameras.