Non-contact ultra-widefield imaging of retinopathy of prematurity using the Optos dual wavelength scanning laser ophthalmoscope

Patel, Chetan K.; Fung, Timothy H. M.; Muqit, Mahiul M. K.; Mordant, D. J.; Brett, Jon; Smith, Lewis M.; Adams, Eleri

doi:10.1038/eye.2013.45

Cited by 64 publications

(53 citation statements)

References 9 publications

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“…RetCam is a well-established retinal imaging modality for infants, both for colour photographs and FFA in the context of ROP 8,9 and AHT. 1 Non-contact ultra-widefield retinal imaging using the Optos P200MA scanning laser ophthalmoscope offers many advantages over RetCam for the documentation of retinal haemorrhages in the context of AHT:…”

Section: Discussionmentioning

confidence: 99%

“…We have not encountered any adverse events in infants undergoing non-contact Optos P200MA imaging in our centre-across any indication-using the 'flying baby position' in more than 100 examinations to date. [8][9][10][11] Larger numbers of Optos non-contact imaging studies are required before definitive conclusions can be made regarding safety.…”

Section: Non-contact Imagingmentioning

confidence: 99%

“…[8][9][10][11] Colour images of both eyes in this series took o5 min in each infant. Retinal haemorrhages are present bilaterally in 83% of infants with AHT 1 ; 2 images are required with Optos P200MA compared to 10-12 images with RetCam (typically 5-6 images are required for each eye to capture the entire retinal periphery which may be montaged).…”

Section: General Anaesthesia and Sedationmentioning

confidence: 99%

“…[8][9][10][11] Mydriasis was achieved with topical phenylephrine 2.5% and cyclopentolate 0.5%. Topical proxymetacaine 0.5% was instilled into each eye followed by insertion of a paediatric Lieberman speculum to part the eyelids, secured to the temple with Micropore tape.…”

Section: Retinal Imaging Protocolmentioning

confidence: 99%

“…When our Retcam was not available in the ophthalmology outpatient facility, we started using the Optos P200MA Scanning Laser Ophthalmoscope (Optos, Dunfermline, UK), which has been demonstrated to attain high-quality retinal images in infants with retinopathy of prematurity (ROP), 8,9 incontinentia pigmenti, 10 and other paediatric retinal disorders 11 without the need for ocular contact. Optos captures a 200°retinal field enabling documentation of the retinal periphery in a single image, typically without the need for sedation.…”

Section: Introductionmentioning

confidence: 99%

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Non-contact ultra-widefield retinal imaging of infants with suspected abusive head trauma

Yusuf

Barnes

Fung

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Section: Non-contact Imagingmentioning

confidence: 99%

Section: General Anaesthesia and Sedationmentioning

confidence: 99%

Section: Retinal Imaging Protocolmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Non-contact ultra-widefield retinal imaging of infants with suspected abusive head trauma

Yusuf

Barnes

Fung

et al. 2017

Eye

Self Cite

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Influence of Computer-Generated Mosaic Photographs on Retinopathy of Prematurity Diagnosis and Management

et al. 2016

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IMPORTANCETelemedicine is becoming an increasingly important component of clinical care for retinopathy of prematurity (ROP), but little information exists regarding the role of mosaic photography for ROP telemedicine diagnosis. OBJECTIVE To examine the potential effect of computer-generated mosaic photographs on the diagnosis and management of ROP. DESIGN, SETTING, AND PARTICIPANTSIn this prospective cohort study performed from July 12, 2011, through September 21, 2015, images were acquired from ROP screening at 8 academic institutions, and ROP experts interpreted 40 sets (20 sets with individual fundus photographs with Ն3 fields and 20 computer-generated mosaic photographs) of wide-angle retinal images from infants with ROP. All experts independently reviewed the 40 sets and provided a diagnosis and management plan for each set presented. MAIN OUTCOMES AND MEASURESThe primary outcome measure was the sensitivity and specificity of the ROP diagnosis by experts that was calculated using a consensus reference standard diagnosis, determined from the diagnosis of fundus photographs by 3 experienced readers in combination with the clinical diagnosis based on ophthalmoscopic examination. Mean unweighted κ statistics were used to analyze the mean intergrader agreement among experts for diagnosis of zone, stage, plus disease, and category. RESULTSNine ROP experts (4 women and 5 men) who have been practicing ophthalmology for a mean of 10.8 years (range, 3-24 years) consented to participate. Diagnosis by the mosaic photographs compared with diagnosis by multiple individual photographs resulted in improvements in sensitivity for diagnosis of stage 2 disease or worse (95.9% vs 88.9%; difference, 7.0; 95% CI, 3.5 to 10.5; P = .02), plus disease (85.7% vs 63.5%; difference, 22.2; 95% CI, 7.6 to 36.9; P = .02), and treatment-requiring ROP (84.4% vs 68.5%; difference, 15.9; 95% CI, 0.8 to 31.7; P = .047). With use of the κ statistic, mosaic photographs, compared with multiple individual photographs, resulted in improvements in intergrader agreement for diagnosis of plus disease or not (0.54 vs 0.40; mean κ difference, 0.14; 95% CI, 0.07 to 0.21; P = .004), stage 3 disease or worse or not (0.60 vs 0.52; mean κ difference, 0.06; 95% CI, −0.06 to 0.18; P = .04), and type 2 ROP or not (0.58 vs 0.51; mean κ difference, 0.07; 95% CI, 0.03 to 0.11; P = .04). After viewing the mosaic photographs, experts altered their choice of management in 42 of 180 responses (23.3%; 95% CI, 17.1%-29.5%). CONCLUSIONS AND RELEVANCECompared with multiple individual photographs, computer-generated mosaic photographs were associated with improved accuracy of image-based diagnosis for certain categories (eg, plus disease, stage 2 disease or worse, and treatment-requiring ROP) of ROP by experts. It is unclear, however, whether these findings are generalizable, and the results of this study may not be relevant to mosaic grading of other retinal vascular conditions.

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Ultra-Widefield Imaging of Retinal Hemorrhages Induced by Scleral Depression

2017

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An infant born at 24 weeks' gestation weighing 0.75 kg underwent examination with indirect ophthalmoscopy and scleral indentation for retinopathy of prematurity at 14 weeks' postnatal age. A second examiner noted widespread retinal hemorrhages (Figure , A). Ultrawidefield noncontact retinal imaging and fundus fluorescein angiography (0.1 mL/kg of 10% fluorescein) were performed (Optos PLC) using the flying baby position (Figure , B). 1,2 The infant was systemically well. Full blood cell count, coagulation studies, sickle cell screen, blood cultures, echocardiography, cerebral, and abdominal ultrasonography results were unremarkable. At 1 week, the superficial retinal hemorrhages had resolved. Plus disease developed in the right eye, and bilateral laser photocoagulation was undertaken.Intraretinal hemorrhages induced by scleral depression (during examination, contact imaging, or laser photocoagulation) have been reported in infants with active retinopathy of prematurity. [3][4][5] Here, we demonstrate its occurrence in the absence of active retinopathy of prematurity, excluded on fundus fluorescein angiography.

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Non-contact ultra-widefield imaging of retinopathy of prematurity using the Optos dual wavelength scanning laser ophthalmoscope

Cited by 64 publications

References 9 publications

Non-contact ultra-widefield retinal imaging of infants with suspected abusive head trauma

Non-contact ultra-widefield retinal imaging of infants with suspected abusive head trauma

Influence of Computer-Generated Mosaic Photographs on Retinopathy of Prematurity Diagnosis and Management

Ultra-Widefield Imaging of Retinal Hemorrhages Induced by Scleral Depression

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