
Ryan's Retina
- 7th Edition - April 13, 2022
- Imprint: Elsevier
- Editors: SriniVas R. Sadda, Andrew P. Schachat, Charles P. Wilkinson, David R. Hinton, Peter Wiedemann, K. Bailey Freund, David Sarraf
- Language: English
- Hardback ISBN:9 7 8 - 0 - 3 2 3 - 7 2 2 1 3 - 1
- eBook ISBN:9 7 8 - 0 - 3 2 3 - 7 2 2 1 4 - 8
Through six outstanding and award-winning editions, Ryan’s Retina has offered unsurpassed coverage of this complex subspecialty—everything from basic science through the latest… Read more

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Request a sales quoteFeatures sweeping content updates, including new insights into the fundamental pathogenic mechanisms of age-related macular degeneration, advances in imaging including OCT angiography and intraoperative OCT, new therapeutics for retinal vascular disease and AMD, novel immune-based therapies for uveitis, and the latest in instrumentation and techniques for vitreo-retinal surgery.
Includes five new chapters covering Artificial Intelligence and Advanced Imaging Analysis, Pachychoroid Disease and Its Association with Polypoidal Choroidal Vasculopathy, Retinal Manifestations of Neurodegeneration, Microbiome and Retinal Disease, and OCT-Angiography.
Includes more than 50 video clips (35 new to this edition) highlighting the latest surgical techniques, imaging guidance, and coverage of complications of vitreoretinal surgery. New videos cover Scleral Inlay for Recurrent Optic Nerve Pit Masculopathy, Trauma with Contact Lens, Recurrent Retinal Detachment due to PVR, Asteroid Hyalosis, and many more.
Contains more than 2,000 high-quality images (700 new to this edition) including anatomical illustrations, clinical and surgical photographs, diagnostic imaging, decision trees, and graphs.
Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.
- Cover image
- Title page
- Table of Contents
- Copyright
- Video table of contents
- Contributors
- Video contributors
- Dedication
- Preface
- List of Illustrations
- List of Tables
- VOLUME 1
- Part 1. Retinal Imaging and Diagnostics
- 1. Fluorescein angiography: Basic principles and interpretation
- Introduction
- Basic principles
- Equipment
- Technique
- Interpretation
- Normal fluorescein angiogram
- Abnormal fluorescein angiogram
- Acknowledgments
- References
- 2. Clinical applications of diagnostic indocyanine green angiography
- Introduction
- History
- Chemical and pharmacokinetics
- Toxicity
- Instrument comparison
- Injection technique
- Indocyanine green angiography interpretation
- References
- 3. Optical coherence tomography
- Physical principles of optical coherence tomography
- Quantitative analysis of optical coherence tomography data sets
- Optical coherence tomography angiography
- Normal macular anatomy
- Spectral domain-based optical coherence tomography in retinal disorders
- Future directions
- Disclosures
- Acknowledgments
- References
- 4. Optical coherence tomography angiography (OCTA)
- Overview
- Principles of octa
- OCTA algorithms
- Image visualization
- Quantitative metrics
- Artifacts
- Commercially available devices
- Advantages and limitations of OCTA
- Normal retinal and choroidal vascular anatomy and circulation
- Understanding and interpreting OCTA
- Retinal vascular disease
- Degeneration
- Macular neovascularization secondary to other disorders
- Inflammatory disease
- References
- 5. Autofluorescence imaging
- Basic principles
- Techniques of fundus autofluorescence imaging
- Interpretation of fundus autofluorescence images
- Recent developments in fundus autofluorescence imaging
- Spectrally resolved FAF
- Fluorescence lifetime imaging ophthalmoscopy (FLIO)
- Clinical applications
- References
- 6. Widefield imaging
- Introduction
- Historical perspective and nomenclature
- Historical widefield imaging systems
- Modern widefield imaging systems
- Overview of imaging capabilities and optical principles
- Clinical utility of widefield imaging
- Limitations
- Future directions
- Conclusions
- References
- 7. Advanced imaging technologies
- Introduction: Retinal imaging to date
- Adaptive optics: Imaging of single cells in the retina
- Measuring visual function with adaptive optics
- Imaging retinal function (optophysiology)
- Vascular imaging and retinal blood flow
- Imaging retinal melanin
- Conclusions and future directions
- Disclosures
- References
- 8. Artificial intelligence and advanced imaging analysis
- History of AI
- Machine learning
- Computer vision and advanced image analysis
- Recent advances in computer vision: Deep learning
- Components of deep learning model architecture
- Deep learning model architectures
- Training deep learning models
- Beyond traditional deep learning models
- The evaluation of AI models
- Deep learning using fundus photography
- Deep learning using OCT imaging
- Deep learning using other retinal imaging
- Regulatory
- Gaps in technology
- Immediate challenges with deployment of AI systems into retina clinics
- Ethical questions on the impact of AI
- Conclusions
- Acknowledgments
- References
- 9. Clinical electrophysiology
- Introduction
- The techniques and principles of interpretation
- Inherited photoreceptor diseases
- Inherited inner retinal disorders
- Acquired retinal diseases
- Inflammatory and autoimmune disorders
- The role of electrophysiology in an era of precision medicine
- Summary
- Acknowledgments
- References
- 10. Diagnostic ophthalmic ultrasound
- Introduction
- History of pulse echo phenomenon
- Ophthalmic ultrasound: Physics and basic engineering
- Clinical examination: B-scan of the posterior segment
- Cross section B-scans of ocular pathology: Posterior segment ultrasonography
- Pattern recognition from the inside-out: Vitreous, ocular wall, optic nerve, and orbit
- Cross section B-scans of ocular pathology: Anterior segment ultrasonography
- Anterior UHF ultrasonography: Pattern recognition examples
- Pre- and postoperative ophthalmic ultrasound
- Current and future development
- References
- 11. Color vision and night vision
- Overview
- Rod and cone functions
- Visual pathways for rod and cone functions
- Dark adaptation functions: Assessment of the shift from day vision to night vision
- Color vision
- Variations in human color vision
- Clinical evaluation of color vision
- New developments in color vision research
- Adaptive optics (AO) retinal imaging system
- References
- 12. Visual acuity and contrast sensitivity
- Visual acuity tests
- Contrast sensitivity tests
- References
- 13. Visual fields in retinal disease
- Introduction
- Principles of perimetry
- Methods of visual field testing
- Perimetry in specific retinal diseases
- Other modalities of perimetry in retinal disease
- Conclusions
- References
- Part 2. Basic Science and Translation to Therapy
- Section 1. Anatomy and Physiology
- 14. The development of the retina
- Embryology of the eye
- Specifying the eye field
- Patterning the retinal, RPE, and anterior domains of the optic cup
- Histogenesis of the retinal cell types
- Inner retinal development
- Photoreceptor development
- Ganglion cell death
- Retinal maturation
- Conclusions
- References
- 15. Function and anatomy of the mammalian retina
- Visual illusions and multiple channels
- Neuronal communication: Chemical and electrical
- Gross retinal morphology
- Classification of retinal cells
- Gene therapy to cure color blindness
- New tools to identify ganglion cell types
- Clinical relevance of functional anatomy
- Conclusions
- Acknowledgments
- References
- 16. Structure and function of rod and cone photoreceptors
- Introduction
- Photoreceptor fundamentals
- Photoreceptor outer-segment structure
- Phototransduction
- Inner segment and connecting cilia
- Photoreceptor synaptic terminal
- Establishing synapses between photoreceptors and bipolar cells
- Photoreceptor dysfunction and disease
- Influences of photoreceptor degeneration on the retinal circuitry
- References
- 17. Cell biology of the retinal pigment epithelium
- Embryology
- Anatomy and histology
- The retinal pigment epithelium transcriptome and proteome
- Specialized functions of the retinal pigment epithelium
- References
- 18. Glial cells of the fovea
- Introduction
- Microglia
- Astroglia
- Müller glia
- Foveal glia
- Foveal development
- References
- 19. Retinal and choroidal vasculature: Retinal oxygenation
- Introduction
- History of retinal ischemia
- Normoxia
- Hyperoxia
- Hypoxia
- Adult retinal hypoxia and etiology
- Adult choroidal ischemia
- Conclusions
- References
- 20. Mechanisms of normal retinal adhesion
- Introduction
- Models for measuring retinal adhesion
- Adhesive force and environmental factors
- Mechanical forces inside the subretinal space
- Metabolic factors
- Subretinal fluid transport and subretinal protein
- Pharmacologic modification of adhesion
- Implications for vitreoretinal surgery
- Pathophysiology of serous detachment
- Conclusions and general implications
- References
- 21. Structure, function, and pathology of Bruch’s membrane
- Introduction, history, embryology
- Structure of Bruch’s membrane in young adults
- Bruch’s membrane in aging
- Function of Bruch’s membrane
- Pathology of Bruch’s membrane
- Summary
- References
- 22. Vitreous and vitreoretinal interface
- Biochemistry
- Anatomy and histology
- Physiology
- Pathology
- Acknowledgments
- References
- Section 2. Basic Mechanisms of Injury in the Retina
- 23. Mechanisms of oxidative stress in retinal injury
- Introduction
- Overview of oxidative stress in the retina
- Retinal diseases related to oxidative stress
- Oxidative injury to the retina
- Retinal therapies targeting oxidative stress
- Conclusions
- References
- 24. Mechanisms of endoplasmic reticulum stress in retinal disease
- Introduction
- The endoplasmic reticulum
- Endoplasmic reticulum stress and UPR signaling
- Retinal diseases associated with ER stress
- Summary
- References
- 25. Cell death, apoptosis, and autophagy in retinal injury
- Introduction
- Modes of cell death
- Autophagy and cell maintenance
- Age-related retinal cell loss
- Retinal damage: Death and repair
- Therapeutic options
- Conclusions
- References
- 26. Inflammation and immune responses in retinal health and disease
- Introduction
- Innate defenses in the maintainance of retinal health
- Autoinflammation and autoimmunity
- Inflammation, vascular regulation, and pathologic angiogenesis (neovascularization)
- Inflammation and age-related macular degeneration
- Targeting inflammation through molecular stratification: Genetics and beyond
- Conclusions
- Acknowledgments
- References
- 27. Basic mechanisms of pathologic retinal and choroidal angiogenesis
- Introduction
- Mechanisms of choroidal angiogenesis
- Angiogenic and antiangiogenic factors in neovascularization
- Conclusions
- References
- 28. Blood–retinal barrier, immune privilege, and autoimmunity
- Introduction
- Blood–ocular barriers
- Ocular autoimmunity and uveitis
- Autoimmunity in human uveitis
- Role of infection in autoimmunity
- Conclusions
- Acknowledgments
- References
- 29. Mechanisms of diabetic macular edema and therapeutic approaches
- Introduction: The global impact of diabetes and diabetic retinopathy
- Overview of diabetic retinopathy, the blood retinal barrier, and edema
- Characterization of diabetic macular edema and diagnostic imaging technologies
- Histopathology of diabetic macular edema
- Molecular and cellular mechanisms underpinning diabetic macular edema
- Current treatments for diabetic macular edema
- Summary
- References
- 30. Cellular effects of detachment and reattachment on the neural retina and the retinal pigment epithelium
- Introduction
- Use and limitations of animal models in the study of retinal detachment
- Cellular changes in response to retinal detachment
- Chronic retinal detachment and proliferative vitreoretinopathy
- Retinal reattachment
- References
- 31. Retinal manifestations of neurodegeneration: A focus on Alzheimer disease
- Introduction
- Clinical and histopathologic evidence of optic nerve involvement in alzheimer disease
- In vivo diagnostic imaging studies corroborate optic nerve atrophy
- Histopathologic hallmarks of neurodegeneration in the retina
- Histopathologic hallmarks of aβ and tau pathology in the retina
- Retinal amyloid and hyperspectral imaging of the retina
- The melanopsin retinal ganglion cells in alzheimer disease and circadian rhythms
- Pupillary function in alzheimer disease
- Retinal vascular involvement in alzheimer disease
- The retinal choroid
- Future directions: Can novel ocular biomarkers be used to monitor or manage alzheimer disease?
- Acknowledgments
- References
- Section 3. Genetics
- 32. Genetic mechanisms of retinal disease
- Introduction
- Basic concepts in human genetics
- The human genome
- Genetic testing for inherited retinal diseases
- Genetic testing methods
- Conclusions
- Acknowledgments
- References
- 33. Mitochondrial genetics of retinal disease
- Mitochondrial origins
- Mitochondrial structure
- Mitochondrial DNA
- Mitochondrial function
- Electron leakage and reactive oxygen species formation
- Localization of mitochondria within the retina and optic nerve
- Influences of mtDNA on cell function
- References
- 34. Epigenetic mechanisms of retinal disease
- Introduction
- Major factors of epigenetic regulation
- Interplay between genetic and epigenetic factors
- Epigenetic mechanisms in retinal development
- Epigenetic mechanisms in retinal diseases
- Perspectives and challenges of epigenetics
- References
- 35. Microbiome and retinal disease
- Introduction
- Dietary patterns are related to the risk for and progression of age-related macular degeneration
- Summary
- References
- Section 4. Translational Basic Science
- 36. Gene therapy for retinal disease
- Background: Preclinical gene therapy studies
- History of retinal gene therapy
- Current status of retinal gene therapy trials: Retinal diseases evaluated in human clinical trials
- Promises and challenges of bringing retinal gene transfer from bench to bedside
- Conclusions
- References
- 37. Stem cells and cellular therapy for retinal degenerative diseases
- Stem cells as therapeutics to treat retinal degenerative diseases
- Definitions
- Müller glial cells
- Stem cell–derived photoreceptors
- Stem cell–derived RPE cells
- Human clinical trials using stem cells for the treatment of retinal diseases
- Discerning the legitimacy of a human stem cell treatment
- Concluding remarks
- Acknowledgments
- References
- 38. Nanomedicine in ophthalmology
- Introduction
- General principles of nanotechnology and nanomedicine
- Applications to ophthalmology
- Obstacles to incorporation of nanotechnology into ophthalmology
- Conclusions
- References
- 39. Neuroprotection
- History and definitions
- Neuroprotection through the serotonin pathway
- Neurotrophic factors for retinitis pigmentosa
- CNTF protein and historical selection
- CNTF phase I trial for human photoreceptor degeneration
- New technology for endpoints for photoreceptor degenerations
- Delivery of neurotrophins
- Antioxidants
- Neuroprotection with small molecules
- Modulation of retinal milieu and neurotrophic factors through environmental components
- References
- 40. Drug delivery
- Introduction
- A brief history of the field of drug delivery
- Drug delivery
- Gene delivery
- Cellular delivery for sustained drug delivery
- Routes of delivery to the retina
- Pharmacokinetics in the eye
- References
- 41. Retinal laser therapy: Biophysical basis and applications
- Introduction
- Basics of lasers
- Interactions of light with tissue
- Monitoring the retinal temperature
- References
- VOLUME 2
- Medical Retina
- Section 1. Retinal Degenerations and Dystrophies
- 42. Macular dystrophies
- Introduction
- The initial approach to a patient with macular dystrophy
- Best macular dystrophy
- Stargardt disease
- Stargardt-like dominant macular dystrophy (SLDMD)
- PROM1-associated macular dystrophy
- Pattern dystrophy
- Sorsby fundus dystrophy
- Occult macular dystrophy
- Autosomal dominant radial drusen (doyne honeycomb retinal dystrophy, malattia leventinese)
- North carolina macular dystrophy
- Spotted cystic dystrophy
- Dominant cystoid macular dystrophy
- Fenestrated sheen macular dystrophy (FSMD)
- Drusen in immune complex–mediated and complement-mediated membranoproliferative glomerulonephritis
- Maternally inherited diabetes and deafness
- Acknowledgments
- References
- 43. Retinitis pigmentosa and allied disorders
- Early history
- Typical retinitis pigmentosa
- Syndromic retinitis pigmentosa
- Differential diagnosis-phenocopies of retinitis pigmentosa
- Differential diagnosis: Pseudoretinitis pigmentosa
- Basic science
- Genetic consultation
- Treatment
- Purported “cures” for RP
- Future management
- Acknowledgments
- References
- 44. Abnormalities of rod and cone function
- Introduction
- Stationary diseases associated with night blindness
- Stationary diseases of the cone system
- Progressive cone dystrophies
- Retinal dystrophies with pathognomonic ERG phenotypes
- Genetics of cone–rod dystrophies
- Conclusions
- References
- 45. Hereditary vitreoretinal degenerations
- Introduction
- Snowflake vitreoretinal degeneration
- VCAN-related vitreoretinopathies
- Autosomal dominant vitreoretinopathies
- Autosomal recessive vitreoretinopathies
- Chondrodysplasias associated with vitreoretinal degeneration
- X-linked retinoschisis
- Retinal nuclear receptor (NR2E3)-related diseases
- Other vitreoretinal degenerations and vitreoretinopathies
- References
- 46. Hereditary choroidal dystrophies
- Introduction
- Choroidal atrophy phenotypes
- Gyrate atrophy of the choroid and retina
- Choroideremia
- Clinical phenotypes resembling hereditary choroidal dystrophies
- Conclusions
- References
- Section 2. Retinal Vascular Disease
- 47. Diabetic retinopathy: Etiologic mechanisms and genetics
- Introduction
- Anatomic lesions
- Biochemical mechanisms in the pathogenesis of diabetic retinopathy
- Genetic factors in the pathogenesis of diabetic retinopathy
- Other ocular factors
- Retinopathy in different forms of diabetes
- Animal models in the study of diabetic retinopathy
- Cell culture studies
- Conclusions
- References
- 48. Diabetes mellitus
- Introduction
- Prevalence of retinopathy
- Glycemic control and retinopathy
- Goals of treatment
- Glycemic control: Pharmacologic treatment
- Initiation and titration of therapy
- References
- 49. Nonproliferative diabetic retinopathy and diabetic macular edema
- Natural course of nonproliferative diabetic retinopathy
- Clinical evaluation of nonproliferative diabetic retinopathy
- Clinical evaluation of diabetic macular edema
- Management of nonproliferative diabetic retinopathy and diabetic macular edema
- Conclusions
- References
- 50. Proliferative diabetic retinopathy
- Pathogenesis of proliferative diabetic retinopathy
- Natural course of proliferative diabetic retinopathy
- Imaging of proliferative diabetic retinopathy
- Origin and early recognition of preretinal new vessels
- Relationship of proliferative diabetic retinopathy to type and duration of diabetes
- Absence of proliferative diabetic retinopathy in individuals with diabetes of extreme duration
- Proliferative diabetic retinopathy and blood glucose control
- Early worsening of retinopathy with improved glycemic control
- Systemic medications and proliferative diabetic retinopathy
- Other risk factors for proliferative diabetic retinopathy
- Management of proliferative diabetic retinopathy
- Current techniques of panretinal photocoagulation
- Regression of new vessels after initial photocoagulation and indications for retreatment
- Complications of PRP
- Antiangiogenic therapies for proliferative diabetic retinopathy
- Indications for vitrectomy
- Conclusions
- References
- 51. Telescreening for diabetic retinopathy
- Introduction
- Guidelines for telescreening program
- Steps of telescreening
- Technical considerations
- Operational considerations
- Quality assurance
- Evaluating telescreening programs
- Advances in telescreening
- Conclusions
- References
- 52. Hypertension
- Introduction
- Hypertensive retinopathy
- Hypertensive choroidopathy
- Hypertensive optic neuropathy
- Emerging imaging technology to evaluate hypertensive retinopathy
- Future directions
- Conclusions
- References
- 53. Retinal artery and capillary occlusions
- Central retinal artery occlusion
- Branch retinal artery occlusion
- Cilioretinal artery occlusion
- Combined retinal artery and vein occlusion
- Cotton-wool spots
- Paracentral acute middle maculopathy
- References
- 54. Acquired retinal macroaneurysms
- Clinical description
- Diagnosis of retinal macroaneurysm
- Natural course and treatment of retinal arterial macroaneurysms
- References
- 55. Branch retinal vein occlusion
- Introduction
- Risk factors
- Pathogenesis
- Clinical features
- Natural history
- Clinical evaluation
- Treatment options
- Follow-up
- Conclusions
- References
- 56. Central retinal vein occlusion
- Clinical features
- Perfusion status
- Pathogenesis
- Risk factors and associations
- Clinical evaluation
- Follow-up
- Conclusions
- References
- 57. Macular telangiectasia type 2
- Introduction
- Classification of macular telangiectasia
- Epidemiology
- Clinical presentation
- Retinal imaging
- Staging and prognostic factors
- Genetics
- Serine/glycine metabolism
- Association of systemic diseases
- Differential diagnosis
- Clinicopathologic correlation
- Therapeutic options
- Summary and future research directions
- References
- 58. Coats disease
- Introduction
- History
- Histopathology, etiology, and pathogenesis
- Clinical presentation
- Diagnostic testing
- Differential diagnosis
- Treatment
- Outcomes
- References
- 59. Hemoglobinopathies
- Prevalence
- Genetic modifiers
- Pathophysiology
- Systemic manifestations
- Ophthalmic clinical features
- Nonproliferative sickle retinopathy
- Proliferative sickle retinopathy
- Ophthalmic treatments
- Imaging
- Health maintenance and retinopathy screening
- Potential therapeutic options for the future
- References
- 60. Radiation retinopathy
- Introduction
- Etiology, pathogenesis, and histopathology
- Natural history and clinical features
- Classification
- Risk factors
- Incidence and dosimetry
- Differential diagnosis and diagnostic evaluation
- Prevention and treatment
- Prognosis
- Conclusions
- References
- 61. Ocular ischemic syndrome
- Demographics and incidence
- Etiology
- Symptoms
- Ancillary studies
- Systemic associations
- Differential diagnosis
- Treatment
- References
- 62. Systemic coagulopathy syndromes
- Introduction
- General considerations
- Ophthalmic involvement
- Differential diagnosis of choroidal ischemia
- Conclusions
- References
- 63. Pediatric retinal vascular diseases
- Retinopathy of prematurity
- International classification
- Current concepts in management of retinopathy of prematurity
- Other pediatric retinal vascular diseases
- References
- Section 3. Choroidal Vascular/Bruch’s Membrane Disease
- 64. Epidemiology and risk factors for age-related macular degeneration
- Introduction
- Classification
- Prevalence and incidence
- Quality of life
- Sociodemographic factors
- Ocular risk factors
- Behavioral and lifestyle factors
- Cardiovascular-related factors
- Hormonal and reproductive factors
- Inflammatory factors
- Genetic factors
- Summary and conclusions
- References
- 65. Pathogenesis of age-related macular degeneration
- Introduction: Age-related macular degeneration, a vascular-initiated, deposit-driven disease
- Age-related macular degeneration by the layers
- Classification of advanced age-related macular degeneration organized by extracellular deposits
- Topography of photoreceptors, retinal pigment epithelium, and deposits
- The drusen lifecycle: Clinical and lifespan aspects
- Vision implicates soft drusen; choriocapillaris exonerates lipofuscin
- Learning about subretinal drusenoid deposit using drusen as a model
- Cell and molecular mechanisms of deposit formation; role of high-density lipoprotein genes
- Role of the complement gene pathway
- Conclusions
- References
- 66. Age-related macular degeneration: Non-neovascular early AMD, intermediate AMD, and geographic atrophy
- Introduction
- Normal aging of the macula
- Pathology of non-neovascular AMD
- Prognosis and management of non-neovascular AMD
- References
- 67. Neovascular age-related macular degeneration
- Introduction
- Histopathology
- Etiology and classification
- Diagnosis and characterization of macular neovascularization
- Complications
- Prevention and risk factors for development of neovascular exudative age-related macular degeneration
- Treatment
- Patient education and rehabilitation
- References
- 68. Pharmacotherapy of age-related macular degeneration
- Introduction
- Neovascular age-related macular degeneration
- Non-neovascular AMD
- Summary
- References
- 69. Pathologic myopia
- Epidemiology
- Pathogenesis
- Histopathology
- Animal models
- Optical coherence tomograhy-based classification of myopic maculopathy
- Conclusions
- References
- 70. Angioid streaks
- Introduction
- Histopathology
- Systemic associations
- Ocular manifestations and clinical course
- Ocular imaging and diagnosis
- Optical coherence tomography angiography
- Therapy
- Conclusions
- References
- 71. Ocular histoplasmosis
- Historical perspective
- Clinical features of ocular histoplasmosis
- Relationship of ocular disease to systemic infection
- Epidemiology of ocular histoplasmosis
- Pathogenesis
- Natural history of ocular histoplasmosis and public health implications
- Treatment
- References
- 72. Pachychoroid disease and its association with polypoidal choroidal vasculopathy
- Introduction and definition
- Evolving concept of pachychoroid as a potential pathogenic mechanism
- Pachychoroid disease spectrum
- Pachychoroid pigment epitheliopathy
- Pachychoroid neovasculopathy
- Polypoidal choroidal vasculopathy/aneurysmal pachychoroid neovasculopathy
- Peripapillary pachychoroid syndrome
- Management considerations
- Pachychoroid phenotypes and age-related macular degeneration
- Future research and conclusions
- Financial disclosures
- References
- 73. Central serous chorioretinopathy
- Introduction
- Definition, pathogenesis, risk factors, epidemiology, and demographics
- Clinical features
- Differential diagnosis
- Multimodal imaging
- Natural history
- Treatment
- Conclusions
- References
- 74. Uveal effusion syndrome and hypotony maculopathy
- Uveal effusion syndrome
- Hypotony maculopathy
- References
- Section 4. Inflammatory Disease/Uveitis
- Inflammation
- 75. Sympathetic ophthalmia
- Introduction
- Epidemiology
- Pathogenesis
- Immunopathology
- Clinical findings
- Diagnosis
- Differential diagnosis
- Course and complications
- Therapy
- Prevention
- Prognosis
- References
- 76. Vogt–Koyanagi–Harada disease
- Introduction and historical aspects
- Epidemiology
- Clinical description
- Pathology and pathogenesis
- Investigations
- Differential diagnosis
- Treatment
- Complications and management
- Prognosis
- Conclusions
- References
- 77. White spot syndromes and related diseases
- Introduction
- Birdshot chorioretinopathy
- Placoid diseases
- Multifocal choroiditis/punctate inner choroidopathy
- Multiple evanescent white dot syndrome
- Acute zonal occult outer retinopathy
- Acute macular neuroretinopathy
- Acknowledgments
- References
- 78. Autoimmune retinopathies
- Introduction
- Clinical features and investigations
- Phenotypes potentially related to autoimmune retinopathy
- Treatment and prognosis
- Conclusions
- References
- 79. Sarcoidosis
- General considerations
- Course and prognosis
- Ocular manifestations
- Posterior segment disease
- Diagnosis
- Fundus imaging
- Course and prognosis
- Therapy
- Conclusions
- References
- 80. Intermediate uveitis
- Introduction
- Epidemiology and demographics
- Presentation and clinical findings
- Imaging
- Differential diagnosis and workup
- Histopathology and pathophysiology
- Treatment
- Clinical course and complications
- References
- 81. Rheumatic disease
- Introduction
- Disease-specific section
- Ocular complications of rheumatologic therapies
- References
- Infections
- 82. HIV-associated infections
- Introduction
- Epidemiology of HIV infection and AIDS
- Occupational exposure to HIV
- HIV virology and pathogenesis
- Therapy of HIV infections
- Clinical spectrum of HIV
- Infection control related to HIV
- Ocular findings in AIDS: An overview
- Noninfectious retinopathy
- Infectious retinopathy
- Fungal diseases
- Bacterial retinitis
- Invasive diagnostic techniques for retinal disease
- Antiretroviral therapy
- References
- 83. Mycobacterial infections
- Introduction
- Pulmonary and extrapulmonary tuberculosis
- Ocular tuberculosis
- Adnexal tuberculosis
- Laboratory evaluation
- Treatment
- References
- 84. Eales disease
- Introduction
- Clinical features and natural history
- Pathology and pathogenesis
- Differential diagnosis
- Diagnostic workup for eales disease
- Epidemiologic spectrum of retinal vasculitis
- Management
- Summary
- References
- 85. Spirochetal infections
- Introduction
- Syphilitic uveitis
- Uveitis associated with lyme disease
- Ocular leptospirosis
- References
- 86. Ocular toxoplasmosis
- Introduction
- Pathogenesis
- Ocular disease
- Laboratory
- Outcomes and complications
- Treatment and prevention
- References
- 87. Helminthic disease
- Introduction
- Ocular toxocariasis
- Diffuse unilateral subacute neuroretinitis
- Onchocerciasis
- Cysticercosis
- References
- 88. Endogenous endophthalmitis: Bacterial and fungal
- Epidemiology and risk factors
- Clinical assessment of the patient
- Medical evaluation of the patient
- Endogenous bacterial endophthalmitis
- Endogenous fungal endophthalmitis
- Treatment strategies
- Suggested management
- References
- 89. Acute retinal necrosis syndrome
- Introduction
- Symptoms and clinical course
- Patient population
- Etiology
- Pathologic features
- Differential diagnosis
- Treatment and prognosis
- References
- 90. Drug toxicity of the posterior segment
- Disruption of the retina and retinal pigment epithelium
- Vascular damage and/or occlusion
- Cystoid macular edema
- Retinal folds
- Crystalline retinopathy
- Uveitis
- Miscellaneous
- Summary
- Acknowledgments
- References
- 91. Photic retinal injuries: Mechanisms, hazards, and prevention
- Introduction
- Photomechanical retinal interactions
- Photothermal retinal interactions
- Laser accidents
- Photochemical retinal interactions
- Photic retinopathy accidents
- Safety standards
- Conclusions
- References
- 92. Traumatic chorioretinopathies
- Introduction
- Direct ocular injury
- Indirect ocular injury
- Conclusions
- References
- 93. Retinal and choroidal disorders in pregnancy (pregnancy-related diseases)
- Retinal and choroidal disorders in pregnancy
- Preexisting conditions
- Diagnostic testing and therapy
- Conclusions
- References
- 94. Optic disc anomalies, drusen, pits, hypoplasia, and associated retinal pathology
- Optic disc anomalies
- Anatomy
- Optic disc drusen
- Optic disc pits
- Congenital optic nerve hypoplasia
- References
- 95. Retina-related clinical trials: A resource bibliography
- Introduction
- Diabetic retinopathy and diabetic macular edema
- Vascular occlusions
- Age-related macular degeneration and other conditions associated with choroidal neovascularization
- Retinopathy of prematurity
- Posterior uveitis
- Other retinal and retina-related conditions
- Vitreo-retinal surgery
- VOLUME 3
- Part 1. Surgical Retina
- Section 1. The Pathophysiology of Retinal Detachment and Associated Problems
- 96. Pathogenetic mechanisms of retinal detachment
- Introduction
- Pathophysiology of retinal detachment
- Rhegmatogenous retinal detachment
- Tractional retinal detachment
- Combined tractional and rhegmatogenous retinal detachment
- Exudative and hemorrhagic retinal detachment
- Conclusions
- References
- 97. Nonrhegmatogenous retinal detachment
- Introduction
- Idiopathic
- Vascular
- Inflammatory and infectious
- Degenerative
- Tumor and malignancy
- Disc anomalies
- Other conditions
- Conclusions
- References
- 98. Degenerative retinoschisis
- Definitions and pathology
- Retinoschisis
- Retinoschisis with retinal breaks
- Schisis detachment
- Progressive rhegmatogenous retinal detachment associated with retinoschisis
- Conclusions
- Acknowledgments
- References
- 99. Pathogenesis of proliferative vitreoretinopathy
- Introduction
- Pathogenesis of PVR
- The pharmacologic management of PVR
- Biomarkers and genetic profiling
- Conclusions
- References
- 100. Pathophysiology of ocular trauma
- Introduction
- Anatomic change
- Histopathologic findings
- Experimental models
- Wound healing and traumatic proliferative vitreoretinopathy
- Special conditions
- Therapeutic aspects
- Conclusions
- References
- Section 2. Retinal Reattachment: General Surgical Principles and Techniques
- 101. The biomechanics of scleral buckles in the treatment of retinal detachment
- Introduction
- Effects of scleral buckles on the geometry of the eye
- Effects of scleral buckles on retinal pigment epithelium and the retina
- Conclusions
- References
- 102. Techniques of scleral buckling
- Introduction
- Preparation for surgery
- Surgical steps
- Final examination of the retina
- Closure
- Documentation
- Outcomes
- Postoperative complications
- References
- 103. Principles and techniques of vitreoretinal surgery
- Introduction
- Vitreoretinal surgical anatomy
- Mechanics of vitreoretinal surgery
- Infusion system management
- Vitreous cutter considerations
- Fluidics
- Control systems
- Microscope requirements
- Tool ergonomics
- Surgical steps
- Lens management
- Epiretinal membrane management
- Management of subretinal proliferation
- Extrusion techniques
- Interfacial surface tension management
- Retinectomy
- Hemostasis
- Retinopexy
- Panretinal photocoagulation
- Subconjunctival pharmacotherapeutics
- Surgical algorithms
- Conclusions
- References
- 104. Intraoperative OCT imaging
- Background and historical prospective
- OCT in the operating room: Integrative advances
- Surgeon feedback platform enhancements
- Surgical findings with intraoperative OCT in vitreoretinal conditions
- Conclusions
- References
- 105. Primary vitrectomy in rhegmatogenous retinal detachment
- Introduction
- Pathogenesis of rhegmatogenous retinal detachment
- Categories of rhegmatogenous retinal detachment
- Patient selection for primary vitrectomy
- Principles of vitrectomy
- Surgical techniques
- Surgical outcomes
- Prognostic factors
- Complications
- Perspectives
- References
- 106. Pneumatic retinopexy
- Introduction
- History
- Basic principles
- Surgical technique
- Special procedures
- Summary of procedure
- Postoperative management
- Results
- Complications
- Utilization of pneumatic retinopexy
- Conclusions
- References
- 107. Special adjuncts to treatment
- Intraocular gas
- Perfluorocarbon liquid in vitreoretinal surgery
- Silicone oil in vitreoretinal surgery
- Heavy tamponade
- Chromovitrectomy
- References
- 108. Optimal procedures for retinal detachment repair
- Introduction
- Round hole retinal detachment
- Detachment because of retinal dialyses
- Retinal detachment secondary to “U” (horseshoe) tears
- Conclusions
- References
- 109. Prevention of retinal detachment
- Introduction
- Risk factors for retinal detachment
- Symptomatic eyes
- Asymptomatic eyes without high-risk factors
- Asymptomatic nonfellow eyes with high-risk factors
- Asymptomatic patients with retinal detachment in the fellow eye
- Prophylactic therapy in eyes undergoing vitreoretinal surgery
- Treatment methods
- Results and complications of prophylactic therapy
- Conclusions
- References
- Section 3. Complicated Forms of Retinal Detachment
- 110. Proliferative vitreoretinopathy
- Introduction
- Pathophysiology
- Risk factors for the development of PVR
- Clinical signs and diagnosis of PVR
- Classification of PVR
- Prevention of PVR
- Surgery for PVR
- Postoperative management
- Complications after PVR surgery
- Results of surgery for PVR
- When is surgery for PVR not justified?
- References
- 111. Retinotomies and retinectomies
- Introduction
- Drainage retinotomy
- Retinotomy to gain access to the subretinal space
- Relaxing retinectomy
- References
- 112. Giant retinal tear
- Introduction
- Etiology
- Pathogenesis
- Historical aspects of management of giant retinal tears
- Preoperative evaluation
- Role of nonsurgical treatment
- Role of simple scleral buckling
- Vitreous surgery
- Results
- Management of the fellow eye
- References
- 113. Surgery for ocular trauma: Principles and techniques of treatment
- Extent of ocular injuries
- Ocular trauma classification
- Closed-globe injuries
- Open-globe injuries
- Sympathetic ophthalmia
- Application of online resources and newer technology to ocular trauma
- Prevention
- References
- 114. Surgery for proliferative diabetic retinopathy
- Introduction
- Requirements for surgery in diabetic patients
- Indications and timing of surgery
- Surgical procedure in diabetic patients
- Complications of surgery in diabetic patients
- Postoperative care
- Results of surgery as reported and indicated by medical surveys
- Conclusions
- References
- 115. Management of combined inflammatory and rhegmatogenous retinal detachment
- Introduction
- Epidemiology
- Pathophysiology
- Clinical examination and findings
- Management
- Prognosis
- Conclusions
- References
- 116. High myopia and the vitreoretinal complications
- Introduction
- Retinal detachment from peripheral breaks
- Epidemiology of surgical macular complications
- Etiology and pathophysiology
- Clinical findings
- Treatment of foveoschisis and macular holes with or without retinal detachment
- Postoperative complications
- Conclusions
- References
- 117. Surgical management of retinopathy of prematurity
- Introduction
- Classification system
- Histopathologic features, clinically relevant cell biology, and pathophysiology
- Clinical considerations
- Surgical therapy
- References
- 118. Surgery for pediatric vitreoretinal disorders
- General aspects
- Surgical considerations and techniques
- Injuries
- Conclusions
- References
- Section 4. Vitreous Surgery for Macular Disorders
- 119. Epiretinal membranes, vitreoretinal traction, cystoid macular edema, and submacular hemorrhage
- Introduction
- Epiretinal membranes
- Vitreomacular traction and cystoid macular edema
- Submacular hemorrhage
- Conclusions
- References
- 120. Macular hole
- Introduction
- History
- Epidemiology and risk factors for primary full-thickness macular holes
- Pathogenesis from posterior vitreous detachment to impending MH
- Clinical and imaging features of full-thickness macular holes
- Differential diagnosis
- Secondary macular hole
- Surgery for macular hole
- Results of surgery
- Complications of macular hole surgery
- Vitreolysis as a nonsurgical treatment for macular hole
- References
- 121. Retinal pigment epithelium and choroid translocation in patients with age-related macular degeneration
- Epidemiology
- Alternative treatments for AMD
- Surgical treatment
- Rationale for reconstitution of retinal pigment epithelium
- Transplantation of a full-thickness patch from the midperiphery
- Surgery
- Finding a cleavage plane between sclera and choroid
- Results in neovascular AMD
- Retinal pigment epithelium transplantation in dry AMD
- Surgical aspects in dry AMD
- Conclusions for patient benefit in geographic atrophy
- Retinal pigment epithelium–choroid translocation and future stem cell treatments for AMD
- References
- Section 5. Vitreous Surgery: Additional Considerations
- 122. Infectious endophthalmitis
- Introduction
- Organisms that cause endophthalmitis
- Experimental endophthalmitis
- Clinical findings
- Therapy
- Future directions
- Conclusions
- References
- 123. Diagnostic and therapeutic vitrectomy for uveitis
- Introduction
- Diagnostic vitrectomy
- Therapeutic vitrectomy
- Conclusions
- References
- 124. Vitreous, retinal, and choroidal biopsy
- Introduction
- Vitreous biopsy
- Transvitreal retinal biopsy
- Transvitreal and transscleral choroidal biopsy
- Fine-needle biopsy
- Complications of intraocular biopsy
- Conclusions
- References
- 125. Transplantation frontiers
- Introduction
- History of ocular cell transplantation
- Background and rationale for RPE transplantation in age-related macular degeneration
- Cell selection for RPE transplantation
- Cell delivery strategies
- Iatrogenic retinal detachment
- Results of RPE transplants in humans
- Immune response to RPE transplants
- RPE graft failure
- RPE replacement: Future directions
- Background and rationale for photoreceptor transplantation in retinal dystrophies
- Results of photoreceptor transplants in experimental animals
- Transplantation aimed at photoreceptor cell rescue
- Transplantation aimed at photoreceptor cell replacement
- Stem cells in photoreceptor transplantation
- Results of photoreceptor transplants in humans
- Photoreceptor transplantation: Future directions
- Conclusions
- References
- 126. Artificial vision
- Introduction
- Background and history of artificial vision
- Visual prostheses
- PRIMA
- STS
- BVT
- Electrotherapeutics
- Optogenetics
- Conclusions
- Disclosures
- References
- 127. Pharmacology during surgery
- Introduction
- Pharmacologic vitreolysis
- Enzymatic vitreolysis: Microplasmin, plasmin, and others
- Antiproliverative agents in the management of proliferative vitreoretinopathy
- Tissue plasminogen activator in vitreoretinal surgery
- Visualization of the vitreoretinal interface
- VEGF inhibitors in vitreoretinal surgery
- Endophthalmitis
- Autologous blood and platelet concentrate
- Summary
- References
- 128. Complications and challenges in vitreoretinal surgery
- Introduction
- Subluxated intraocular lens
- Trauma with contact lens
- Subfoveal perfluoro-n-octane heavy liquid
- Intraocular scissors
- Dexamethasone implant migration into the anterior chamber
- Dexamethasone implant induced retinal break
- Iatrogenic retinal break during silicone oil removal
- Iatrogenic breaks during proliferative vitreoretinopathy surgery
- Globe perforation during posterior sub-Tenon triamcinolone injection
- Scleral perforation during scleral buckling procedure
- Macular fold
- Choroidal detachment as a complication of pars plana vitrectomy
- Challenging macular hole surgery
- Complications during chandelier light assisted scleral buckling surgery
- Scleral buckling surgery with slit-lamp microscope
- Autologous internal limiting membrane flap technique for optic nerve pit maculopathy
- Scleral inlay for recurrent optic nerve pit maculopathy
- Part 2. Tumors of the Retina, Choroid, and Vitreous
- Section 1. Tumors of the Retina
- 129. Retinoblastoma
- Introduction
- Genetics of retinoblastoma
- Retinoblastoma: The disease
- TNM classification system
- Diagnosis of retinoblastoma
- The approach to the child with cancer
- Treatment methods and techniques
- Conclusions
- References
- 130. Cavernous hemangioma
- Introduction
- Clinical findings
- Differential diagnosis
- Ancillary studies
- Natural history
- Treatment
- Pathology
- Systemic and familial involvement
- Genetics
- References
- 131. Hemangioblastoma of the retina and von Hippel–Lindau disease
- Introduction
- von Hippel–Lindau disease
- History
- The VHL gene and protein
- Clinical features of ocular von Hippel-Lindau disease
- Pathology of ocular lesions
- Diagnosis and surveillance of von Hippel–Lindau disease
- Treatment of ocular von Hippel–Lindau disease
- Conclusions
- References
- 132. Tuberous sclerosis and the eye
- Introduction
- Genetic diagnostic criteria
- Systemic manifestations
- Ocular manifestations
- Genetics and pathophysiology
- Organ-specific surveillance and treatment approaches
- References
- 133. Phakomatoses
- Introduction
- Definition of hamartia, hamartoma, chorista, and choristoma
- Neurofibromatosis
- Encephalofacial hemangiomatosis (Sturge–Weber syndrome)
- Racemose hemangiomatosis (Wyburn-Mason syndrome)
- Retinal cavernous hemangiomatosis
- Organoid nevus syndrome
- Phacomatosis pigmentovascularis
- Oculodermal melanocytosis
- Other phakomatoses
- Combined systemic hamartomatoses
- Conclusions
- References
- 134. Retinal metastases
- Introduction
- Checkpoint inhibition and tumor cell mutations
- Review of case reports
- Summary
- References
- 135. Remote effects of cancer: Paraneoplastic autoimmune retinopathies
- Introduction
- Cancer-associated retinopathy (CAR)
- Melanoma-associated retinopathy (MAR)
- Paraneoplastic vitelliform maculopathy (PVM)
- Paraneoplastic optic neuropathies (PON)
- Bilateral diffuse uveal melanocytic proliferation (BDUMP)
- Conclusions
- References
- 136. Optic disc melanocytoma
- Introduction
- Clinical features
- Differential diagnosis
- Pathology and pathogenesis
- Diagnostic approaches
- Management
- Conclusions
- References
- 137. Congenital hypertrophy of the retinal pigment epithelium
- Introduction
- Epidemiology and demographics
- Clinical findings and classification
- Differential diagnosis
- References
- 138. Combined hamartoma of the retinal pigment epithelium and retina
- Historical review
- Epidemiology
- Clinical manifestations
- Diagnostic evaluation
- Differential diagnosis
- Clinical course
- Etiology and pathogenesis
- Histopathology
- Treatment
- References
- Section 2. Tumors of the Choroid
- 139. Choroidal nevi
- Introduction
- Prevalence of choroidal nevus
- Clinical presentation
- Histopathology of choroidal nevus
- Clinical differential diagnosis of choroidal nevus
- Ancillary studies
- Management of choroidal nevus
- Secondary changes in the neighboring tissues
- Choroidal nevi and systemic disease
- Acknowledgments
- References
- 140. Epidemiology of posterior uveal melanoma
- Introduction
- Incidence
- Host factors
- Hormones and reproductive factors
- Environmental factors
- Conclusions
- References
- 141. Prognosis of posterior uveal melanoma
- Globe-conserving therapies and prognosis
- Clinical prognostic indicators for metastasis
- Histopathologic prognostic indicators for metastasis
- Molecular prognostic indicators for metastasis
- Marker integration
- Liquid biopsies
- Psychological impact
- Improving prognosis with early treatment of uveal melanoma
- Conclusions
- References
- 142. Molecular genetics of choroidal melanoma
- Introduction
- Genomic landscape of uveal melanoma
- Epidemiology and genetic predisposing conditions
- Conclusions
- Acknowledgments
- References
- 143. Pathology of choroidal melanoma
- Introduction
- Processing of specimens
- Gross appearance of choroidal melanoma
- Histopathologic features of tumor cells and their prognostic relevance
- Other histopathologic characteristics and their prognostic relevance
- Special types of uveal melanoma
- Histologic changes after treatment
- Acknowledgments
- Appendix: Histologic differential diagnoses
- References
- 144. Overview of management of posterior uveal melanoma
- Introduction
- Conditions that predispose to uveal melanoma
- Zimmerman hypothesis
- Posterior uveal melanoma management
- Radiotherapy
- Laser photocoagulation
- Transpupillary thermotherapy
- Photodynamic therapy
- Local resection
- Enucleation
- Orbital exenteration
- Observation
- AURA-011 (AU-011) nanoparticle therapy
- Genetic testing
- Management and prevention of systemic metastasis
- Conclusions
- References
- 145. Enucleation for choroidal melanomas
- Introduction
- Purpose of enucleation
- Enucleation technique
- Conclusions
- Acknowledgments
- References
- 146. Brachytherapy for choroidal melanoma
- Introduction
- Dosimetry
- Isotope selection
- Plaque design
- Indications for treatment
- Plaque placement technique
- Local tumor response
- Recurrences
- Visual outcomes and radiation complications
- Management of radiation-related complications
- Adjuvant therapy
- Conclusions
- References
- 147. Charged-particle irradiation of uveal melanoma
- Introduction
- Treatment
- Results
- Conclusions
- References
- 148. Surgical resection of choroidal melanoma
- Introduction
- Exoresection
- Endoresection
- Secondary local resection for toxic tumor after radiotherapy
- Conclusions
- Acknowledgments
- References
- 149. Laser treatment of choroidal melanoma
- Introduction
- Transpupillary thermotherapy
- Photodynamic therapy
- Photoactivated therapy
- Experimental laser techniques
- References
- 150. Systemic evaluation and management of patients with metastatic uveal melanoma
- Introduction
- Physical examination
- Pathology, genetics, and molecular biology
- Ethical considerations of screening and biopsy
- High-risk disease
- Treatment of metastatic disease
- References
- 151. Collaborative ocular melanoma study
- Introduction
- Background
- Design of the collaborative ocular melanoma study (COMS)
- Methods
- Chronology of the COMS
- Findings from the COMS trial of I-125 brachytherapy for medium choroidal melanoma
- Findings from the COMS trial of pre-enucleation radiation for large choroidal melanoma
- Findings from the COMS nonrandomized prospective study of small choroidal melanoma
- Histopathologic findings from enucleated eyes
- Other published findings
- Conclusions
- References
- 152. Choroidal metastases
- Introduction
- Symptoms and clinical findings
- Diagnostic evaluation
- Differential diagnosis
- Systemic evaluation
- Management
- Prognosis
- Conclusions
- References
- 153. Choroidal osteoma
- Introduction
- Definition and incidence
- Clinical features
- Differential diagnosis
- Pathology and pathogenesis
- Familial choroidal osteoma
- Systemic associations
- Diagnostic approaches
- Management
- Prognosis
- Conclusions
- References
- 154. Circumscribed choroidal hemangioma
- Introduction
- Clinical features
- Differential diagnosis
- Ancillary studies
- Pathology
- Treatment
- Conclusions
- References
- Section 3. Hematologic and Miscellaneous Tumors
- 155. Miscellaneous uveal tumors
- Introduction
- Epithelial tumors of the ciliary body: Congenital
- Epithelial tumors of the ciliary body: Acquired
- Melanocytic tumors
- Neurogenic tumors
- Myogenic tumors
- Miscellaneous
- The role of diagnostic biopsy for uveal tumors
- Conclusions
- References
- 156. Leukemias and lymphomas
- Introduction
- Systemic classification of leukemia and lymphoma
- Leukemia
- Lymphomas
- References
- 157. Primary vitreoretinal lymphoma
- Introduction
- Epidemiology
- Etiology and pathogenesis
- Clinical findings
- Diagnosis
- Differential diagnosis
- Treatment
- Prognosis
- References
- Index
- Edition: 7
- Published: April 13, 2022
- Imprint: Elsevier
- No. of pages: 3112
- Language: English
- Hardback ISBN: 9780323722131
- eBook ISBN: 9780323722148
SS
SriniVas R. Sadda
AS
Andrew P. Schachat
CW
Charles P. Wilkinson
DH
David R. Hinton
PW
Peter Wiedemann
KF
K. Bailey Freund
DS