Wide-field Imaging of Retinal Diseases

Abstract

125Retinal imaging serves as a critical adjunct to the diagnosis, monitoring, and treatment of numerous ocular diseases. Since the invention of the direct ophthalmoscope by Hermann von Helmholtz in 1851, techniques to visualize the fundus have grown exponentially both in number and sophistication. Notably, wide-field retinal imaging has taken center stage over the past 2 decades. Given its increasing popularity in research and clinical use, it is important to be aware of the different types of wide-field imaging currently available, as well as the clinical applications for, advantages, and limitations of widefield retinal imaging. This review article aims to highlight our current understanding of wide-field retinal imaging and provide an outlook for its future implications. Historical PerspectiveThe first fundus camera was developed by Frederick Dimmer at the turn of the 20th century. Dimmer was the first to incorporate fundus photography into an ophthalmic textbook, and he published the first photographic atlas in black-and-white. AbstractRetinal imaging serves as a critical adjunct to the diagnosis, monitoring, and treatment of numerous ocular diseases. In particular, wide-field retinal imaging is quickly moving to the forefront in imaging the posterior segment. While conventional fundus imaging captures 30 to 50° field of view in a single capture, significant advances have been made in the past 2 decades to increase the viewing angle, speed, and accuracy of fundus photography, such that a single-field capture is now up to 200°. Moreover, multiple imaging modalities, including color fundus photography, fluorescein angiography, and autofluorescence, are now available a single wide-field imaging platform. This breadth of functionality makes wide-field imaging especially useful in peripheral retinal vascular diseases, such as diabetic retinopathy, posterior uveitis, and retinopathy of prematurity. This review aims to provide a historical perspective on wide-field retinal imaging, highlight the imaging platforms currently available, discuss the advantages and disadvantages of wide-field versus conventional fundus imaging, summarize the current clinical applications of wide-field retinal imaging, and provide an outlook for its future implications. KeywordsWide-field imaging, ultra-wide-field imaging, retinal imaging, Optos, Heidelberg, fluorescein angiography, autofluorescence, diabetic retinopathy, retinal vein occlusion, retinopathy of prematurity Disclosure: Esther Kim, MD, has no relevant conflicts of interest to declare. Andrew A Moshfeghi, MD, MBA, has been a consultant

Comparison of early diabetic retinopathy staging in asymptomatic patients between autonomous AI-based screening and human-graded ultra-widefield colour fundus images

“…With modern imaging modalities such as widefield (WF) imaging and ultra-widefield (UWF) imaging of the retina, it is now possible to obtain valuable information from peripheral retinal areas that could otherwise be missed with conventional imaging [ 18 ]. It has been demonstrated that diabetic retinal lesions are present in areas outside the standardised 7 ETDRS fields in about 40% of diabetic eyes, resulting in more severe DR levels in 10% of eyes [ 19 , 20 ].…”

Alpha-Smooth Muscle Actin-Positive Perivascular Cells in Diabetic Retina and Choroid

“…Diabetic retinopathy (DR) is a diabetes complication that affects eyes which can eventually cause blindness. It is well known that DR causes peripheral non-perfusion and late peripheral leakage, which later progresses to the central macular area, and thereby suggests an abnormal regulation of blood flow in the diabetic retina [10,11]. Nonetheless, topographic differences of perivascular mural cells in the normal and diseased retina have not yet been evaluated.…”

An Automatic ROI of The Fundus Photography

“…However, most of the time, the ophthalmologist may have a certain purpose to check the fundus image. Fundus imaging can serve as a critical adjunct to the diagnosis, monitoring, and treatment of numerous ocular, as well as general diseases [31]. Screening of the retina by fundus photographyy may detect ocular diseases, such as macular degeneration, the first and third most important causes of blindness in the developed world.…”