Ultra-wide field retinal imaging: A wider clinical perspective

Kumar, Vinod; Surve, Abhidnya; Kumawat, Devesh; Takkar, Brijesh; Azad, Shorya Vardhan; Chawla, Rohan; Shroff, Daraius; Arora, Atul; Singh, Ramandeep; Venkatesh, Pradeep

doi:10.4103/ijo.ijo_1403_20

Cited by 34 publications

(14 citation statements)

References 92 publications

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“… 36 Although such devices cover a larger part of the retina in a non-mydriatic mode, UWFI has been found to have only moderate agreement and lower image gradability rates compared with dilated fundus examination. 37 Devices such as the Ocular Instruments Staurenghi 230 SLO Retina Lens are contact-based systems that require skilled photographers and extremely cooperative patients to image the retina. Devices such as the EIDON (CenterVue) and Clarus (Carl Zeiss Meditec) produce true-color images, but the devices are bulky and expensive and thus limited in their use when it comes to screening.…”

Section: Discussionmentioning

confidence: 99%

A Novel, Smartphone-Based, Teleophthalmology-Enabled, Widefield Fundus Imaging Device With an Autocapture Algorithm

Sivaraman

Nagarajan

Vadivel

et al. 2021

Trans. Vis. Sci. Tech.

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Purpose Widefield imaging can detect signs of retinal pathology extending beyond the posterior pole and is currently moving to the forefront of posterior segment imaging. We report a novel, smartphone-based, telemedicine-enabled, mydriatic, widefield retinal imaging device with autofocus and autocapture capabilities to be used by non-specialist operators. Methods The Remidio Vistaro uses an annular illumination design without cross-polarizers to eliminate Purkinje reflexes. The measured resolution using the US Air Force target test was 64 line pairs (lp)/mm in the center, 57 lp/mm in the middle, and 45 lp/mm in the periphery of a single-shot retinal image. An autocapture algorithm was developed to capture images automatically upon reaching the correct working distance. The field of view (FOV) was validated using both model and real eyes. A pilot study was conducted to objectively assess image quality. The FOVs of montaged images from the Vistaro were compared with regulatory-approved widefield and ultra-widefield devices. Results The FOV of the Vistaro was found to be approximately 65° in one shot. Automatic image capture was achieved in 80% of patient examinations within an average of 10 to 15 seconds. Consensus grading of image quality among three graders showed that 91.6% of the images were clinically useful. A two-field montage on the Vistaro was shown to exceed the cumulative FOV of a seven-field Early Treatment Diabetic Retinopathy Study image. Conclusions A novel, smartphone-based, portable, mydriatic, widefield imaging device can view the retina beyond the posterior pole with a FOV of 65° in one shot. Translational Relevance Smartphone-based widefield imaging can be widely used to screen for retinal pathologies beyond the posterior pole.

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Section: Discussionmentioning

confidence: 99%

A Novel, Smartphone-Based, Teleophthalmology-Enabled, Widefield Fundus Imaging Device With an Autocapture Algorithm

Sivaraman

Nagarajan

Vadivel

et al. 2021

Trans. Vis. Sci. Tech.

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“…For peripheral FAF images, another non-mydriatic, non-confocal ultra-wide-field scanning laser ophthalmoscope provides up to approximately 180–200° images of the retina in a single capture using a green laser for excitation (532 nm) and a detection of emission in the range of 540–800 nm (Optomap, Optos PLC, Dunfermline, UK) [ 39 ]. Ultra-wide-field imaging is of particular importance to visualize lesions anterior to the equator [ 40 , 41 , 42 ].…”

Section: Fundus Autofluorescence Imagingmentioning

confidence: 99%

Fundus Autofluorescence Imaging in Patients with Choroidal Melanoma

Bindewald-Wittich

Holz

Ach

et al. 2022

Cancers

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Choroidal melanocytic lesions require reliable and precise clinical examination and diagnosis to differentiate benign choroidal nevi from choroidal melanoma, as the latter may become life-threatening through metastatic disease. To come to an accurate diagnosis, as well as for monitoring, and to assess the efficacy of therapy, various imaging modalities may be used, one of which is non-invasive fundus autofluorescence (FAF) imaging using novel high-resolution digital imaging technology. FAF imaging is based on the visualization of intrinsic fluorophores in the ocular fundus. Lipofuscin and melanolipofuscin within the postmitotic retinal pigment epithelium (RPE) cells represent the major fluorophores that contribute to the FAF signal. In addition, the presence or loss of absorbing molecular constituents may have an impact on the FAF signal. A choroidal melanoma can cause secondary retinal and RPE alterations that affect the FAF signal (e.g., occurrence of orange pigment). Therefore, FAF imaging supports multimodal imaging and gives additional information over and above conventional imaging modalities regarding retinal metabolism and RPE health status. This article summarises the features of FAF imaging and the role of FAF imaging in the context of choroidal melanoma, both before and following therapeutic intervention.

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“…In the past, traditional angiography could only show the posterior polar retina at approximately 50°. Ultrawide-eld FFA (UWFA) systems are increasingly being used to examine the peripheral retina [5]. A wider range of nonperfusion areas, microvascular abnormalities, and neovascularization have been found in the peripheral retina and are involved in most DR lesions [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…Ultrawide-eld FFA (UWFA) systems are increasingly being used to examine the peripheral retina [5]. A wider range of nonperfusion areas, microvascular abnormalities, and neovascularization have been found in the peripheral retina and are involved in most DR lesions [5,6]. In the UWFA examination system, the image features of DR patients have been regraded and analyzed to obtain a more comprehensive understanding of DR progression [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Correlation Between Ultrawide-Field Fluorescence Contrast Results and White Blood Cell Indexes in Diabetic Retinopathy

Huang

Wang

et al. 2021

Preprint

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Background: Diabetic retinopathy (DR) is one of the most common microvascular complications of diabetes. DR involves a state of systemic inflammation, and chronic inflammation can promote microvascular and macrovascular diseases in diabetic patients and accelerate disease progression. Ultrawide-field FFA (UWFA) systems are increasingly being used to examine a wider retina. To explore the correlation between the different manifestations of retinopathy under UWFA and the systemic indicators of white blood cells in patients with diabetic retinopathy .Methods: This retrospective study included the hospitalized DR patients in the Department of Ophthalmology and Endocrinology of the Affiliated Hospital 2 of Nantong University between January 2016 and March 2019. This study examined the correlations between the UWFA examination results and glycated hemoglobin (HbA1c), routine blood tests, blood coagulation function, liver and kidney function, and the neutrophil-to-lymphocyte ratio of patients with clinically diagnosed DR during hospitalization.Results: A total of 115 patients with DR (53 females and 62 males) were included (199 eyes: 102 right eyes and 97 left eyes). UWFA revealed that most eyes (77.4%) had grade 4 microvascular leakage, 52.8% had grade 0 capillary non-perfusion area, 59.3% had grade 0 neovascularization, and 92.0% had grade 0 fibrous proliferative membranes. Microvascular leakage was correlated with the NLR (r=0.186, P=0.027). Capillary non-perfusion area was correlated with the monocyte ratio (r=0.144, P=0.042) and the eosinophil ratio (r=0.123, P=0.044). Neovascularization was correlated to the monocyte ratio (r=0.324, P=0.018). Finally, the fibrous proliferative membrane was correlated to the monocyte ratio (r=0.418, P=0.002). Only the eosinophil ratio was independently associated with proliferative DR (odds ratio=1.25, 95% confidence interval: 1.04-1.51, P=0.018).Conclusion: The results of UWFA imaging in patients with DR are correlated with white blood cell population indexes. The eosinophil ratio was independently associated with proliferative DR.

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Ultra-wide field retinal imaging: A wider clinical perspective

Cited by 34 publications

References 92 publications

A Novel, Smartphone-Based, Teleophthalmology-Enabled, Widefield Fundus Imaging Device With an Autocapture Algorithm

A Novel, Smartphone-Based, Teleophthalmology-Enabled, Widefield Fundus Imaging Device With an Autocapture Algorithm

Fundus Autofluorescence Imaging in Patients with Choroidal Melanoma

Correlation Between Ultrawide-Field Fluorescence Contrast Results and White Blood Cell Indexes in Diabetic Retinopathy

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