Ординатура / Офтальмология / Учебные материалы / Color Atlas of Ophthalmology The Quick-Reference Manual for Diagnosis and Treatment
.pdfPreface
Every day you m ay m ake progress. Every step m ay be fruitful. Yet there w ill stretch out before you an ever-lengthening, everascending, ever-im proving path. You k now you w ill never get to the end of the journey. But this, so far from discouraging, only adds to the joy and glory of the clim b.
Win ston Ch u rch ill (1874–1965)
W h at is an oph th alm ologist? On e w h o h as gradu ated from m edical sch ool an d is in terested in th e eye. On e w h o h as com pleted th ree years of sp ecialized oph th al- m ic t rain ing. On e w h o h as sp en t a fur th er t w o years in sub-specializat ion . On e w h o h as m en tored th e n ext gen erat ion of oph th alm ologists. On e w h o h as in n o- vated an d ch anged preferred pract ice p at tern s in oph th alm ology. All th ese classes of oph th alm ologists n eed solid kn ow ledge com bin ed w ith pat ien t em pathy to best ser ve p at ien t s.
Th e purpose of th is fu lly revised secon d edit ion of th e su ccessful Color Atlas of Ophthalm ology: The Quick-Reference Manual for Diagnosis and Treatm ent is to give you th e kn ow ledge n eeded to face w ith con fiden ce th e fu ll range of pat ien ts’ op h - th alm ic disorders. In ou r field, w h ere w e n ecessarily learn , diagn ose, an d teach visu ally, top -fligh t clin ical p h otograph s, like th e h u n dreds in th is book (all n ew to th is edit ion ), are essen t ial. Th e n in eteen ch apters, w rit ten by expert con t ribu tors from North Am erica, Eu rope, an d In dia, are w ell-organ ized an d con cise, an d th e form at of “Presen tat ion -Differen t ial Diagn osis-Man agem en t” is design ed for easy an d speedy referen ce, so you don’t h ave to w ade th rough ext ran eou s m aterial to fin d w h at you n eed . Th is pocket atlas is in ten ded for th e residen t on rou n ds or st udying for an exam , th e pract icing oph th alm ologist w h o n eeds con firm at ion of an un usual fin ding, or th e prim ar y physician w h o requ ires a reliable guide to eye disorders.
We are gratefu l to th e people at Th iem e Pu blish ers, especially to J. Ow en Zurh ellen an d Dom in ik Pu cek. We an d Th iem e h ope an d expect th at ou r pocket atlas aids you in p roviding pat ien t s w ith th e best care possible.
Am ar Agarw al, MS, FRCS, FRCOphth
Soosan Jacob, MS, FRCS, DNB, MNAMS
Ch en n ai, In dia
xi
About the Editors
Amar Agarw al, MS, FRCS, FRCOphth
Dr. Agar w al’s Grou p of Eye Hospitals an d Eye Research Cen t re
Ch en n ai, In dia
Prof. Am ar Agar w al is th e p ion eer of ph akon it , w h ich is ph ako w ith n eedle in cision tech n ology. Th is tech n ique becam e
popularized as bim an u al ph aco, m icroin - cision cataract surger y (MICS), or m icroph aco. He is th e first to rem ove cat aracts th rough a 0.7 m m t ip w ith th e tech n ique called m icroph akon it . He is also th e first to h ave discovered an d developed cataract su rger y w ith out an esth esia. An - oth er of h is in n ovat ion s is FAVIT (fallen vit reous), a n ew tech n ique for rem oving dropped n uclei. Th e air pu m p, based on th e sim ple idea of using an aqu ariu m pum p to in crease th e flu id in fusion in to th e eye in bim an u al ph aco an d coaxial ph aco, h as h elped preven t u n st able an - terior ch am ber an d su rge du ring cata-
ract su rger y. Th is provided th e basis for variou s tech n iqu es of forced in fu sion for sm all in cision cat aract surger y. Dr. Agar w al w as also th e first to use t r ypan blu e for stain ing ep iret in al m em bran es an d p ublish ed th e det ails in h is four-volu m e textbook of op h th alm ology. He h as also discovered a n ew refract ive error called aberropia. He h as been th e first to do a com bin ed su rger y of m icroph akon it (700 µm cataract surger y) w ith a 25-gauge vit rectom y in th e sam e pat ien t , th u s u sing th e sm allest in cision s possible for cat aract an d vit rectom y. An d h e is th e first surgeon to im plan t a n ew m irror telescopic in t raocu lar len s (IOL) Lipsh it z Macu lar Im plan t (LMI) for pat ien ts suffering from age-related m acular degen erat ion . Th e Malyugin ring for sm all pu pil cat aract surger y w as also m odified by h im an d is kn ow n as th e Agar w al m odificat ion of th e Malyugin ring for m iot ic pu pil cat aract surgeries w ith posterior capsular defect s. He h as been th e w orld’s first to im plan t a glu ed IOL. In th is procedure a posterior ch am ber (PC) IOL is fixed in th e eye w ith ou t any capsules, using fibrin glu e.
An terior segm en t opt ical coh eren ce tom ography w as u sed for th e first t im e in Dr. Agar w al’s eye h ospital to qu an t ify ch anges in an terior ch am ber (AC) m orp h ology in in flam m at ion , assessing all th e param eters. Th e hyperreflect ive spots detected in th e AC w ere cou n ted m an u ally an d w ith an au tom ated com pu ter algorith m . Also for th e first t im e, pseudoph akic bu llou s keratopathy w as m an aged by a com bin at ion of In t raLase (Abbot t Medical Opt ics, San t a An a, CA) keratoplast y, explan t at ion of th e AC IOL, vit rectom y, an d im plan t at ion of a glu ed PC IOL. A n ew su rgical tech n ique, Jacob-Agar w al sling surger y, w as devised for acquired an d con - gen it al ptosis w ith poor levator fu n ct ion in w h ich th e Seiff silicon e su spen sion set is u sed in a fron t alis sling procedu re. Th e en t ire length of th e silicon e set is gu ided in th e m uscle plan e th rough a single st ab in cision .
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xiv About the Editors
Prof. Agar w al h as received m any aw ards for h is w ork in oph th alm ology, th e m ost sign ifican t being th e Barraquer Aw ard an d th e Kelm an Aw ard . His videos h ave w on m any aw ards at film fest ivals of th e Am erican Societ y of Cat aract an d Refract ive Surger y, Am erican Academ y of Oph th alm ology, an d Eu ropean Societ y of Cataract an d Refract ive Su rger y. He h as also w rit ten m ore th an 40 books, w h ich h ave been p ublish ed in variou s langu ages, in cluding English , Span ish , an d Polish . He t rain s doctors from all over th e w orld in h is cen ter on ph aco, bim an ual ph aco, LASIK, an d vitreo-ret in al su rger y. He is a professor of oph th alm ology at Ram ach an dra Medical College in Ch en n ai, In dia, an d can be con t acted th rough th e h ospital’s Web site at h t tp://w w w .dragar w al.com .
Soosan Jacob, MS, FRCS, DNB, MNAMS
Dr. Soosan Jacob is a sen ior con su lt an t oph th alm ologist in Dr. Agar w al’s Group of Eye Hospit als an d Eye Research Cen t re, Ch en n ai, In dia. Sh e is a gold m edalist in oph th alm ology. Sh e h as w on m any in ter-
n at ion al aw ards at p rest igiou s in tern at ion - al con feren ces in th e Un ited St ates. Sh e is a n oted speaker an d h as con ducted cou rses
an d delivered lect ures |
in n u m erous n a- |
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t ion al an d in tern at ion al con feren ces. Sh e |
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h as a sp ecial in terest in cu t t ing-edge su rgi- |
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cal tech n iqu es for cataract , corn ea, glauco- |
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m a, an d refract ive su rger y, in cluding deep |
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lam ellar en doth elial keratoplast y, ocu lar |
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su rface recon st ruct ion , n ew refract ive so- |
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lut ion s, an d so on . |
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Dr. Jacob w as th e first to bring out th e |
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con cept of an terior segm en t t ran splan t a- |
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t ion . In th is, th e corn ea, sclera, an d an ar- |
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t ificial iris, pup il, an d IOL are t ran splan ted |
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en bloc in |
pat ien t s w ith |
an terior st aphy- |
lom a. Sh e |
also devised |
a n ew tech n iqu e |
for ptosis, w h erein th e |
sling su rger y can |
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be don e prim arily w ith a on e st ab in cision rath er th an th ree, th us im proving th e postoperat ive cosm et ic appearan ce of th e pat ien t , w h ile st ill ret ain ing excellen t fun ct ion al outcom e.
Sh e h as auth ored m any ar t icles an d n um erou s ch apters in 27 textbooks by in ter- n at ion al an d n at ion al pu blish ers an d is also th e editor for th ree textbooks in oph - th alm ology. Sh e is am ong th e sen ior facu lt y for th e Diplom ate of Nat ion al Board (DNB) postgradu ate t rain ing p rogram an d ph acoem ulsificat ion an d th e LASIK t rain ing p rogram for overseas doctors.
Contributors
Marie D. Acierno, MD
Associate Professor
Depart m en t of Oph th alm ology
Director, Op h th alm ology Residen cy Program Ch ief of Oph th alm ology
Earl K. Long Medical Cen ter LSU Health Scien ces Cen ter New Orlean s, LA
Am ar Agarw al, MS, FRCS, FRCOphth
Professor of Oph th alm ology Ram ach an dra Medical College
Dr. Agar w al’s Grou p of Eye Hospitals & Eye Research Cen t re Ch en n ai, In dia
Athiya Agarw al, MD, FRSH, DO
Director
Dr. Agar w al’s Grou p of Eye Hospitals & Eye Research Cen t re Ch en n ai, In dia
Donald R. Bergsm a, MD
Herbert E. Kau fm an Professor an d Ch airm an
Depart m en t of Oph th alm ology
LSU Health Scien ces Cen ter
Director
LSU Eye Cen ter of Excellen ce
New Orlean s, LA
Blake A. Booth, MD
Residen t
Depart m en t of Oph th alm ology
Un iversit y of Alabam a at Birm ingh am
Birm ingh am , AL
Francesco Boscia, MD
Dirigen te Medico I Livello
Depart m en t of Oph th alm ology an d Otolar yngology Un iversit y Bari
Bari, It aly
Sam uel Boyd, MD
Ch ief
Vit reoret in al Depart m en t
Boyd Eye Cen ter
Pan am a Cit y, Republic of Pan am a
xv
xvi Contributors
Clem ent K. Chan, MD
Presiden t an d Medical Director
South ern Californ ia Desert Ret in a Con su ltan t s
Associate Clin ical Professor
Depart m en t of Oph th alm ology
Lom a Lin da Un iversit y
Lom a Lin da, CA
Kim berly P. Cockerham , MD, FACS
Adju n ct Clin ical Professor
Depart m en t of Oph th alm ology
St an ford Un iversit y Sch ool of Medicin e
Private Pract ice
Cockerh am Eye Con su lt an ts
Los Altos, CA
Kenneth M. Daniels, OD, FAAO
Adju n ct Assist an t Clin ical Professor
Cen ter for In tern at ion al St u dies
Pen n sylvan ia College of Optom et r y at Salus Un iversit y
Ph iladelph ia, PA
Private Pract ice
Hopew ell-Lam bert ville Eye Associates
Hopew ell, NJ
Lori Vidal Denham , MS
Research Assistan t
Depart m en t of Bioch em ical Engin eering
Tu lan e Un iversit y
New Orlean s, LA
Noa Ela-Dalm an, MD
Clin ical In st r uctor
Depart m en t of Oph th alm ology
Jules Stein Eye In st it u te
UCLA Sch ool of Medicin e
Los Angeles, CA
Duncan A. Friedm an, MD, MPH
Residen t Physician
Depart m en t of Oph th alm ology
Un iversit y of Alabam a at Birm ingh am
Birm ingh am , AL
Pablo Gili-Manzanaro
Depart m en t of Oph th alm ology
Fu n dación Hospital de Alcorcón
Barcelon a, Spain
Santosh Hanovar, MD
LV Prasad Eye In st it u te,
Hyderabad, In dia
Contributors xvii
David R. Hardten, MD, FACS
Adju n ct Associate Professor
Depart m en t of Oph th alm ology
Un iversit y of Min n esot a
Min n esot a Eye Con sult an t s
Min n eap olis, MN
Jam es M. Hill, PhD
Assistan t Professor
Depart m en t of Microbiology, Im m u n ology, an d Parasitology
LSU Health Scien ces Cen ter
New Orlean s, LA
Jeffery A. Hobden, PhD
Assistan t Professor
Depart m en t of Microbiology, Im m u n ology, an d Parasitology
LSU Health Scien ces Cen ter
New Orlean s, LA
Jean T. Jacob, PhD
Professor of Oph th alm ology an d Neu roscien ce
Depart m en t of Oph th alm ology
LSH Health Scien ces Cen ter
Director of Research
LSU Eye Cen ter
New Orlean s, LA
Soosan Jacob, MS, FRCS, DNB, MNAMS
Dr. Agar w al’s Grou p of Eye Hospitals & Eye Research Cen t re
Ch en n ai, In dia
Herbert E. Kaufm an, MD
Em erit us Boyd Professor of Oph th alm ology, Ph arm acology, an d Microbiology LSU Health Scien ces Cen ter
New Orlean s, LA
Natalia Kram arevsky, MD
Virgin ia Beach Eye Cen ter, P.C.
Sen tara Virgin ia Beach Gen eral Hosp ital
Virgin ia Beach , VA
Dhivya Ashok Kum ar, MD
Con su ltan t
Depart m en t of Oph th alm ology
Dr. Agar w al’s Grou p of Eye Hospitals & Eye Research Cen t re
Ch en n ai, In dia
Mandeep Lam ba, MBBS, DNB, FERC
Con su ltan t , Ret in a Fou n dat ion
Dr. Agar w al’s Grou p of Eye Hospitals & Eye Research Cen t re
Ch en n ai, In dia
xviii Contributors
Paolo Lanzetta, MD
Associate Professor
Depart m en t of Oph th alm ology
Un iversit y of Udin e
Udin e, Italy
W. Barry Lee, MD
Private Pract ice
Corn ea, Extern al Disease, an d Refract ive Surger y
Eye Con sult an ts of Atlan t a, Piedm on t Hospit al
Atlan ta, GA
Richard L. Lindstrom , MD
Adju n ct Professor Em erit u s
Depart m en t of Oph th alm ology
Un iversit y of Min n esot a
Fou n der an d At ten ding Surgeon
Min n esot a Eye Con sult an t s
Min n eapolis, MN
Andrea T. Murina, MD
Residen t
Depart m en t of In tern al Medicin e
LSU Health Scien ces Cen ter
New Orlean s, LA
Andrea Olm o s, BS
Depart m en t of Oph th alm ology
Un iversit y of Californ ia, San Fran cisco
San Fran cisco, CA
Louis E. Probst, MD
Nat ion al Medical Director
TLC Th e Laser Eye Cen ters
Ch icago, IL
Sw ati Ravani, MS
Associate Professor
BMJ Region al In st it ute of Oph th alm ology
Ah m edabad, In dia
Arthur L. Rosenbaum , MD
Brin dell an d Milton Got tlieb Professor of Oph th alm ology
Ch ief, Division of Pediat ric Oph th alm ology an d St rabism us
Vice Ch airm an
Depart m en t of Oph th alm ology
Jules Stein Eye In st it u te
UCLA Sch ool of Medicin e
Los Angeles, CA
Praveen Saluja, MS
Dr. Agar w al’s Grou p of Eye Hospitals & Eye Research Cen t re
Ch en n ai, In dia
Contributors xix
Carlo Sborgia, MD
Ch air, In st it u te of Oph th alm ology
Depart m en t of Oph th alm ology an d Otolar yngology
Un iversit y of Bari
Bari, It aly
Ivan R. Schw ab, MD, FACS
Professor
Depart m en t of Oph th alm ology
Un iversit y of Californ ia, Davis Health System Eye Cen ter
Sacram en to, CA
Cristina Sim ón-Castellví
Sim on Eye Clin ic
Barcelon a, Spain
Guillerm o Sim ón-Castellví
Ch ief, An terior Segm en t Su rgeon
Sim on Eye Clin ic
Depart m en t of Oph th alm ology
Un iversit y of Barcelon a
Barcelon a, Spain
José María Sim ón-Castellví
An terior Segm en t Con su lt an t
Em ergen cy Room
Sim on Eye Clin ic
Presiden t
World Federat ion of Cath olic Medical Associat ion s
Barcelon a, Spain
Sarabel Sim ón -Castellví
Ch ief, Posterior Segm en t Su rgeon
Sim on Eye Clin ic
Barcelon a, Spain
Jo sé María Sim ó n-Tor
Ch airm an
Glaucom a Sen ior Con su ltan t
Sim on Eye Clin ic
Barcelon a, Spain
Giuseppe Sm aldone, MD
Residen t
Depart m en t of Oph th alm ology an d Otolar yngology
Un iversit y of Bari
Bari, It aly
Dariusz G. Tarasew icz, MD, PhD
Ret in a Sect ion Ch ief
Depart m en t of Oph th alm ology
Kaiser Perm an en te
Sacram en to, CA
xx Contributors
Federico G. Velez, MD
Assistan t Clin ical Professor
Depart m en t of Oph th alm ology
Jules Stein Eye In st it u te
UCLA Sch ool of Medicin e
Los Angeles, CA
Director
Division of Pediat ric Op h th alm ology an d St rabism u s
Olive View -UCLA Medical Cen ter
Sylm ar, CA
Daniele Veritti, MD
Regist rar
Depart m en t of Oph th alm ology
Un iversit y of Udin e
Udin e, Italy
Christopher I. Zoum alan, MD
Clin ical In st r uctor
Depart m en t of Oph th alm ology
Division of Oph th alm ic Plast ic an d Recon st ruct ive Su rger y
New York Un iversit y
Langon e Medical Cen ter
Man h at tan Eye, Ear, an d Th roat Hospital
New York, NY