Novel observations and potential applications using digital infrared iris imaging

Abstract

Digital infrared iris photography using a modified digital camera system was performed on approximately 300 subjects seen during routine clinical care and research at one facility. Because this image database offered an opportunity to gain new insight into the potential utility of infrared iris imaging, it was surveyed for unique image patterns. Then, a selection of photographs was compiled that would illustrate the spectrum of this imaging experience. Potentially informative image patterns were observed in subjects with cataracts, diabetic retinopathy, Posner-Schlossman syndrome, iridociliary cysts, long anterior lens zonules, nevi, oculocutaneous albinism, pigment dispersion syndrome, pseudophakia, suspected vascular anomaly, and trauma. Image patterns were often unanticipated regardless of preexisting information and suggest that infrared iris imaging may have numerous potential clinical and research applications, some of which may still not be recognized. These observations suggest further development and study of this technology.

Fig 1

Arc-shaped IR blocking lesion (arrows) in left eye of a 33-year-old Hispanic male who had vision loss of six-months duration, mild dyscoria, an angle recession and a retinal detachment.

Fig 2

Dyscoria and IR-blocking regions (arrows) along the axes of pupil peaking in a 52-year-old African-American male who had diabetic retinopathy and a history of panretinal photocoagulation (Top). UBM of the irides in the lesion meridians (Bottom).

Fig 3

28-year-old white female with focal iris elevation at 8 o’clock (arrow) (Top left) had an irregular IR transmittance in the limbal region (arrows) (Top right). UBM showed the lesion to be a large iridociliary cyst (Middle left). A 50-year-old white female (Middle right) and a 24-year-old white female (Bottom left) with multiple iridociliary cysts. IR imaging highlights cortical lens opacities in a 65-year-old who has light transmission changes (arrows) that may also represent an iridociliary cyst (Bottom right).

Fig 4

Imaging of the right eye of an otherwise normal 31-year-old male disclosed an IR-blocking pattern suggestive of branching blood vessels within the iris (arrows).

Fig 5

IR images of subjects with PDS. A 51-year-old white male (Top left) exhibits classic spoke-like defects. 52-year-old white male (Top right) with Krukenberg’s spindles, heavy trabecular pigment, and Scheie lines showed an indistinct ITD pattern. 64-year-old African-American female (2^nd row left) with Krukenberg’s spindles, heavy trabecular pigment, and Scheie lines showed a coalescent, 360 degree ring of mid-peripheral ITDs (arrow) not detectable without IR imaging. The highlighted club-shaped region in the pupil zone is heavy pigment on the posterior lens surface (long arrow). 67-year-old African-American male (2^rd row right) had patchy ITDs only visible with IR except for faint suggestion of the ITD at 6 o’clock. 43-year-old Hispanic male (3^rd row left) with PDS signs had poorly defined, somewhat “wispy” and ring-like, ITDs that did not conform to the classic mid-peripheral spoke-like pattern. He also had a posterior subcapsular cataract (arrow) highlighted with the imaging. Long anterior lens zonules (LAZ) (arrows) in a subject (3^rd row right). An ITD adjacent to the pupil (arrow) at 2 o’clock in a 58-year-old white male LAZ subject (Bottom left). A different perspective on his parapupillary iris transillumination (arrow) is gained when IR imaging is repeated after pupil dilation (Bottom right).

Fig 6

A “speckled” IR pattern (Middle) in left eye of a 50-year-old black male with a Posner-Scholssman-like syndrome in that eye and PDS in both eyes. The right eye did not show a similar speckled pattern (Top). Both eyes showed subtle ITDs (arrows) mainly in the 6 o’clock region, presumably from PDS. 73-year-old African-American male with Posner-Schlossman syndrome and sectoral ITDs in the involved eye (Bottom).

Fig 7

Sectoral ITDs are highlighted with IR imaging of an 83-year-old pseudophake. Laser capsulotomy-induced IOL pits appear as brighter spots (arrows) within the right pupil (Top). The outline of the IOL is visible with the IR image in the left eye (arrows) (Middle). IR imaging highlights ITDs in a 54-year-old white male who had piggyback IOL implantation and developed pigmentary glaucoma and severe glare (Bottom).

Fig 8

Extreme iris translucency in a 19-year-old African-American male with oculocutaneous albinism (Top). In contrast, a 7-year-old white male with ocular albinism and dark-brown irides had only a few ITD patches in the right eye, one which was captured (arrow) with IR imaging (Middle). The IR imaging provided a sensitive means to evaluate the iris of the child despite eye movement and nystagmus. Clear images of diffuse iris translucency in a 49-year-old African-American male who had oculocutaneous albinism and pronounced nystagmus.

Fig 9

Densely pigmented nevus that blocks light transmission in a 26-year-old white male.

Fig 10

Densely pigmented nevus that blocks light transmission in a 26-year-old white man. Standard color photograph is shown on the left and an infrared image of the nevus (arrow) is shown on the right.