Multicolor Scanning Laser Ophthalmoscopy Strengthens Surgeons’ Preoperative Decision-Making and Intraoperative Performance on Epiretinal Membrane

Abstract

Purpose To determine whether multicolor scanning laser ophthalmoscopy (MC-SLO) was better than color fundus photography (CFP) to enhance residents and specialists’ preoperative decision-making and intraoperative performance on the epiretinal membrane (ERM). Methods Consecutive patients with idiopathic ERM were recruited prospectively. All the patients underwent MC-SLO and CFP imagings and were randomized into MC-SLO (n = 20) and CFP (n = 20) groups. Preoperatively, residents and specialists were required to have ERM delineation and select an optimal location for initial ERM peeling independently, based on the MC-SLO (MC-SLO group) or CFP (CFP group) images. Intraoperative optical coherence tomography (iOCT) was introduced to evaluate the accuracy. Results Preoperatively, residents and specialists acted more effectively in ERM delineation and selection of initial grasping location in the MC-SLO group (both P < 0.001). In the MC-SLO group, higher resident–specialist agreements were achieved in ERM delineation ( P = 0.002) and selection of initial grasping location ( P = 0.035). The iOCT revealed greater interobserver (iOCT–resident and iOCT–specialist) agreements of ERM delineation in MC-SLO group ( P < 0.001 and = 0.027, respectively). Surgeons acted more effectively on completely peeling the ERM in the MC-SLO group ( P < 0.001). Conclusions MC-SLO provided a better visual reference for residents and specialists in ERM delineation and the selection of an initial grasping location for the surgery, compared with CFP. Translational Relevance MC-SLO is able to help surgeons achieve better intraoperative performance and shorten the learning process for residents.

Progress of Imaging in Diabetic Retinopathy—From the Past to the Present

“…Later introduced UWF instruments are Mirante (NIDEK, Japan) and Clarus (Carl Zeiss, Germany), and these are characterized as three-color synthetic images, which aim to obtain realistic retinal images. Additionally, the image of single-component colors has its own characteristics and has great potential in diagnosis of retinal diseases [ 97 , 98 , 99 , 100 , 101 ]. The blue SLO image of Mirante can detect retinal non-perfused area without any dye injection and has potential to substitute FA [ 40 ].…”