Non-Mydriatic Ultra-Widefield Imaging Compared With Single-Field Imaging in the Evaluation of Peripheral Retinal Pathology

Adhi, Mehreen; Silva, Fabiana Q; Lang, Richard; Seballos, Raul; Sukol, Roxanne; Feinleib, Steven; Singh, Rishi P.

doi:10.3928/23258160-20171130-02

Cited by 5 publications

(2 citation statements)

References 31 publications

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“…The incidence of sickle cell disease worldwide is expected to rise significantly over the next few decades [35]. In comparison with 7 standard field photography, the Optos UWF technology permits more efficient imaging because it does not require dilation, and UWF fundus images are high quality and high resolution even when obtained by a trained non-ophthalmic technician [36]. This suggests that UWF technology could advance tele-ophthalmology systems, increasing access to eye care and screening to individuals in medically underserved areas.…”

Section: Future Directionsmentioning

confidence: 99%

Wide-field imaging of sickle retinopathy

Linz

Scott

2019

Int J Retin Vitr

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BackgroundWide-field imaging is a newer retinal imaging technology, capturing up to 200 degrees of the retina in a single photograph. Individuals with sickle cell retinopathy commonly exhibit peripheral retinal ischemia. Patients with proliferative sickle cell retinopathy develop pathologic retinal neovascularization of the peripheral retina which may progress into sight-threatening sequelae of vitreous hemorrhage and/or retinal detachment. The purpose of this review is to provide an overview of current and future applications of wide-field retinal imaging for sickle cell retinopathy, and recommend indications for best use.Main bodyThere are several advantages to wide-field imaging in the clinical management of sickle cell disease patients. Retrospective and prospective studies support the success of wide-field imaging in detecting more sickle cell induced retinal microvascular abnormalities than traditional non-wide-field imaging. Clinicians can easily capture a greater extent of the retinal periphery in a patient’s clinical baseline imaging to follow the changes at an earlier point and determine the rate of progression over time. Wide-field imaging minimizes patient and photographer burden, necessitating less photos and technical skill to capture the peripheral retina. Minimizing the number of necessary images can be especially helpful for pediatric patients with sickle cell retinopathy. Wide-field imaging has already been successful in identifying new biomarkers and risk factors for the development of proliferative sickle cell retinopathy. While these advantages should be considered, clinicians need to perform a careful risk–benefit analysis before ordering this test. Although wide-field fluorescein angiography successfully detects additional pathologic abnormalities compared to traditional imaging, a recent research study suggests that peripheral changes differentially detected by wide-field imaging may not change clinical management for most sickle cell patients.ConclusionsWhile wide-field imaging may not carry a clinically significant direct benefit to all patients, it shows future promise in expanding our knowledge of sickle cell retinopathy. Clinicians may monitor peripheral retinal pathology such as retinal ischemia and retinal neovascularization over progressive time points, and use sequential wide-field retinal images to monitor response to treatment. Future applications for wide-field imaging may include providing data to facilitate machine learning, and potential use in tele-ophthalmology screening for proliferative sickle retinopathy.

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Section: Future Directionsmentioning

confidence: 99%

Wide-field imaging of sickle retinopathy

Linz

Scott

2019

Int J Retin Vitr

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“…8,14 Given these potential benefits, UWF image-assisted fundus examination has been increasingly used as a screening tool. 15 To the best of our knowledge, no previous study has directly compared the effect of add-ing directed peripheral steering and automontage images in identifying the presence of retinal tears. Therefore, the purpose of this study was to compare whether the detection rate of all peripheral retinal breaks in a given eye is enhanced with directed peripheral steering and automontage versus orthogonal UWF images.…”

mentioning

confidence: 99%

Ultra-widefield Imaging Detection Rate in Identifying Peripheral Retinal Tears in Single versus Montage of Peripheral Sweeps

Jung,

Lim,

Chan

et al. 2023

Retina

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Purpose: To compare the detection rate of orthogonal, directed peripheral steering, and auto-montaged images with ultra-widefield (UWF) imaging and the factors influencing the ability to identify retinal breaks. Design: Retrospective cohort study Methods: 376 treatment-naïve eyes (349 patients) that underwent laser retinopexy for retinal breaks between 2015-2021. Pre-treatment UWF orthogonal, peripheral steering, and auto-montage were cross-referenced to scleral-depressed examination to determine whether images successfully visualized all retinal breaks. Total retinal area visualized was divided by its optic disc area (pixels) to calculate relative retinal area (RRA). Potential associations were assessed by linear regression analysis. Results: 162 eyes (154 patients) met inclusion criteria. Orthogonal, peripheral steering, and auto-montage images showed detection rates of 47.5%, 90.7%, and 80.0% respectively. RRA increased from orthogonal versus montage by 34.7% 26.5% (mean SD), which increased detection rate by 90.8% (p=0.006). In linear probability models, vertical meridian tears decreased probability of identification in orthogonal, peripheral steering, and auto-montage by -26.6%, -86.2% and -68.7% respectively (p-values<0.001), and horizontal meridian tears increased the probability by 62.2%, 92.9%, and 85.5% (p-values<0.001). Tears posterior to the equator in orthogonal images increased the probability (91.4%,p<0.001). Artifacts such as lids/lashes, reflection, and faceguard decreased the probability in directed peripheral steering by -28.6%, -50.0%, and -66.7% respectively, (p=0.020, p=0.049 and p=0.016). Conclusions: Utilizing directed peripheral steering and auto-montage increases RRA and detection rate of identifying peripheral retinal breaks. Tears in horizontal meridians or posterior to the equator increase the probability of identification. Common UWF imaging artifacts can significantly limit the probability of identifying retinal tears.

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Comparison of two ultra-widefield imaging for detecting peripheral retinal breaks requiring treatment

Kumar

Kohli

Babu

et al. 2020

Graefes Arch Clin Exp Ophthalmol

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Non-Mydriatic Ultra-Widefield Imaging Compared With Single-Field Imaging in the Evaluation of Peripheral Retinal Pathology

Abstract: NMUWF imaging is feasible in a primary care setting, allows improved visualization of peripheral retinal pathology, and may therefore be useful for telemedicine screening. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:962-968.].

Cited by 5 publications

References 31 publications

Wide-field imaging of sickle retinopathy

Wide-field imaging of sickle retinopathy

Ultra-widefield Imaging Detection Rate in Identifying Peripheral Retinal Tears in Single versus Montage of Peripheral Sweeps

Comparison of two ultra-widefield imaging for detecting peripheral retinal breaks requiring treatment

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