The Sankara Nethralaya Atlas of Fundus Fluorescein Angiography

625 Pages·2013·79.239 MB·English

by  Pukhraj Rishi, Ekta Rishi, Tarun Sharma, Muna Bhende, Parveen Sen

The Sankara Nethralaya
Atlas of
Fundus Fluorescein Angiography

The Sankara Nethralaya
Atlas of
Fundus Fluorescein Angiography
Second Edition
Pukhraj Rishi MS DO
Ekta Rishi MS
Tarun Sharma MD FRCSEd MBA
Muna Bhende MS
Parveen Sen MS
Dhanashree Ratra MS DNB FRCSEd
Pradeep Susvar DO DNB MBA FRCS (Glas)
Suchitra Pradeep DO
Chetan Rao MS
Vikas Khetan DO DNB
Vinata Rajendran MS
Rajesh P DNB
Suganeswari G MS
Rupak Ray MS
Rajeev Raman MS DNB
Kasinathan N DO DNB FRCS (Glas)
Lingam Gopal MS DNB FRCSEd
All Authors are Consultants of Sri Bhagwan Mahavir
Vitreoretinal Service, Sankara Nethralaya, Chennai, Tamil Nadu,
India or have served as faculty in the past
Foreword
Lawrence A Yannuzzi
®
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The Sankara Nethralaya Atlas of Fundus Fluorescein Angiography
First Edition: 2004
Reprint: 2006
Second Edition: 2013
ISBN 978-93-5025-577-3
Printed at
Dedicated to
Our dear patients who indeed are the source for our knowledge and experience.

The Sankara Nethralaya Philosophy
“Let the word Sankara of Sankara Nethralaya ever remind me and my associates
His Holiness’ command that there be missionary spirit in the project.
Let the word Nethralaya constantly remind me and my colleagues that the place
of our work is an alaya (temple).
Work will be our worship which we shall do with sincerity,
dedication and utmost love.”

Foreword
For more than three decades, retinal specialists and ophthalmologists have enhanced their diagnostic and therapeutic
skills through the diagnostic adjunct, fluorescein angiography. Numerous texts and atlases have been written on
the interpretation of this procedure in English, French, Italian, German, and Japanese. The authors of this text have
taken full advantage of their regional experience and encyclopedic knowledge of chorioretinal diseases by focusing
on seven distinct divisions of retinal and macular disease in categorizing a myriad of abnormalities.
Thanks to them, there is for the first time an atlas on the subject of fluorescein angiography with a preferential
emphasis on disorders prevalent in India. Arrays of excellent photographs have been used to fulfill this purpose,
preceded by a section on technique and methodology to provide physicians-in-training and ophthalmic technicians,
with the fundamentals needed to incorporate this discipline in their overall ophthalmic evaluations. The text is not
meant for to describe new disease or new clinical manifestations and pathogenetic mechanisms in old disease. Nor
does it provide an extensive bibliography to expand the potential for research of a given subject. The principal
purposes are to introduce images for pattern recognition by clinicians to use in their practice, to enable a more
accurate diagnosis, and in turn, to offer patients a more appropriate and effective treatment. Yet, the authors have
in their preparation introduced new insight into pathophysiological mechanism of disease in the ocular fundus and
offered unusual and challenging images which enhances our appreciation of these peculiar diseases.
In short, this volume represents a high level of industry, initiative, intuition, and intelligence by a group of
skilled ophthalmologists and clinical scientists. Their efforts will be reciprocally rewarded by the gratitude of the
ophthalmologists and retinal specialists who read this text and by the incalculable pleasure their photographs will
bring, even to the casual and discerning reader.
Lawrence A Yannuzzi md
Vice-Chairman
Department of Ophthalmology
and Director of Retinal Services
Manhattan Eye, Ear and Throat Hospital
Professor of Clinical Ophthalmology
College of Physicians and Surgeons
Columbia University, USA

Preface to the
Second Edition
A lot has changed in the field of vitreous-retina since the first edition of The Sankara Nethralaya Atlas of Fundus
Fluorescein Angiography came out in 2004. Not only has our ability to investigate and diagnose clinical conditions
improved but also the rapidly evolving treatment options have had a major impact on disease modulation. This
has been possible due to the significant advances in multimodal retinal imaging, the advent of anti-VEGF era and
path-breaking changes in drug delivery systems. A good knowledge of the changes occurring in the fluorescein
angiogram is not only important for correct diagnosis and management of eye disorders, but also in determining
treatment end-points. Even though OCT is fast emerging as a non-invasive retinal imaging tool, the role of FFA in
diagnosis and treatment follow-up remains integral to the management of retinal conditions.
The aim of bringing out this Atlas is to have a comprehensive reference guide on the fluorescein angiographic
findings in different disorders, so as to help the reader in understanding and managing these types of cases. The
book is not intended to be a textbook on fluorescein angiography; the script has been kept to the minimum. This
book intends to be a ready-reckoner for the practicing vitreoretinal surgeon/medical retina specialist as much as a
reference guide for the vitreoretinal fellow. The same holds true for the Uvea specialists and fellows, respectively.
Comprehensive ophthalmologists will find this atlas extremely useful in arriving at the correct diagnosis and
appropriate management of their patients.
In this edition, we have added twenty-one new chapters and revised most of the previous ones. In doing so,
we have preserved the original format of the chapters and the layout of the sections. A ‘Self-test’ chapter has
been included in the end. Each section has been color coded which improves its user-friendliness while adding to
the esthetic appeal of the book. Approximately, 400 new images have been added. References have been revised
and updated.
Authors