Ultra-widefield retinal imaging: an update on recent advances

Abstract

The development of ultra-widefield retinal imaging has accelerated our understanding of common retinal diseases. As we continue to validate the diagnostic and prognostic significance of pathology in the retinal periphery, the ability to visualize and evaluate these features in an efficient and patient-friendly manner will become more important. Current interest in ultra-widefield imaging includes the development of potential biomarkers of disease progression and indicators of preclinical disease development. This article reviews the current ultra-widefield imaging systems and recent advances in their applications to clinical practice with a focus on diabetic retinopathy, retinal vein occlusion, uveitis, and pediatric retina.

Ultra-widefield retinal imaging for adjunctive resident training in retinal break detection

“…It was interesting to find that UWF imaging also had a better retinal break detection rate in the temporal quadrant than that of indirect ophthalmoscopy when examined by the junior residents. While our results may seem at odds with other examples which showed a better retinal break detection rate in the nasal quadrant from the literature [ 14 ], They can be explained because the temporal and nasal quadrants have a common feature, which is that they have no interference from the eyelids and eyelashes. Therefore, UWF imaging may provide a better visible view, resulting in a better detection rate of retinal breaks in these areas.…”

“…However, even a 75˚field of view only partially reveals the retina, which may not be sufficient to see retinal breaks at the peripheral sides. In recent years, ultra-widefield (UWF) retinal imaging has been developed, which allows a 105˚to 200˚field of view (depending on the UWF retinal imaging system used) when taking central images [14][15][16]. When four gaze-steered images (up, down, temporal, and nasal) are obtained along with central images in UWF retinal imaging examinations, a field of view of up to 220˚means that 97% of the retina is visible [17].…”

Diabetic retinopathy screening and management in India

“…Thus, it has utility in early detection of peripheral neovascularization elsewhere (NVE), localization, and quantification of areas of capillary nonperfusion (CNP). [ 16 ] These nonperfused areas are usually anterior to the equator and aid in the pathogenesis of recalcitrant diabetic macular edema. These are not captured by traditional imaging systems.…”

“…It can also act as a guide in planning targeted retinal photocoagulation in some cases of proliferative diabetic retinopathy (PDR). [ 16 ] OCT angiography has also emerged as a noninvasive imaging tool to detect microaneurysms, CNP areas, and NVEs, especially in cases where the injection of fluorescein dye is contraindicated. [ 17 ] It has also become a reliable tool for monitoring and serial follow-up of patients having PDR [ Fig.…”

Wide-field imaging - An update

“…Carl Zeiss company developed the first fundus camera in 1926, providing a 20° and later 30° view of the posterior pole. [ 2 ] Early widefield imaging, capturing more than the standard 30° view, was performed using a traditional camera; the use of a fixation lamp and mirror then allowed for the creation of a 19-photo, 96° montage. [ 2 ] Currently, with advances in retinal imaging one can capture up to 200° of the retina in a single capture.…”