Agreement between image grading of conventional (45°) and ultra wide-angle (200°) digital images in the macula in the Reykjavik eye study

Abstract

Purpose To establish the agreement between image grading of conventional (451) and ultra wide-angle (2001) digital images in the macula. Methods In 2008, the 12-year follow-up was conducted on 573 participants of the Reykjavik Eye Study. This study included the use of the Optos P200C AF ultra wide-angle laser scanning ophthalmoscope alongside Zeiss FF 450 conventional digital fundus camera on 121 eyes with or without age-related macular degeneration using the International Classification System. Of these eyes, detailed grading was carried out on five cases each with hard drusen, geographic atrophy and chorioretinal neovascularisation, and six cases of soft drusen. Exact agreement and j-statistics were calculated. Results Comparison of the conventional and ultra wide-angle images in the macula showed an overall 96.43% agreement (j ¼ 0.93) with no disagreement at end-stage disease; although in one eye chorioretinal neovascularisation was graded as drusenoid pigment epithelial detachment. Of patients with drusen only, the exact agreement was 96.1%. The detailed grading showed no clinically significant disagreement between the conventional 451 and 2001 images. Conclusions On the basis of our results, there is a good agreement between grading conventional and ultra wide-angle images in the macula.

Ultra-Widefield Retina Imaging: Principles of Technology and Clinical Applications

“…Nevertheless, pseudocolor images of Optos can provide an image including macular details, comparable with the Heidelberg Retina Angiograph (HRA) cSLO system [21]. In the Reykjavik Eye Study, UWF imaging showed 96% agreement with conventional 45° images when grading patients with drusen, geographic atrophy, and choroidal neovascularization [46]. In addition, the UWF ICGA can delineate the choroidal vessel of the macula and periphery at high resolution [21].…”

Imaging of retinal and choroidal vascular tumours

“…The main advantages are the high resolution, the extensive focal depth, the ease with which sequential images are compared, the image quality in patients with media opacities, and its tolerance by photophobic patients. 16 It identifies macular pathology as effectively as conventional high-resolution digital imaging. 16 One disadvantage is that some areas of the retinal periphery can be obscured by eyelashes, vitreous opacities, or the edge of an intraocular lens.…”

“…16 One disadvantage is that some areas of the retinal periphery can be obscured by eyelashes, vitreous opacities, or the edge of an intraocular lens. 16 Furthermore, the system generates dual colour images (red and green) so that the apparent colour of some vascular tumours can be very different from the true clinical appearance.…”

Wide-field Imaging of Retinal Diseases

“…However, studies have demonstrated that wide-field imaging systems are equally effective in diagnosing macular pathology as standard 45° fields of view (see Figure 5), with one study demonstrating a 96.4 % agreement between conventional and ultra-wide-angle imaging in grading macular diseases, with no clinically significant disagreements. 66 Furthermore, there is mounting evidence that central retinal pathologies are often linked directly to peripheral changes. Prior to the era of widefield imaging, our understanding of the relevance of peripheral retinal abnormalities in diseases such as age-related macular degeneration (AMD) were limited by the lack of detailed peripheral imaging studies.…”