OSLI Retina

September 2019

Issue link: http://osliretina.healio.com/i/1165509

Contents of this Issue


Page 13 of 75

544 Ophthalmic Surgery, Lasers & Imaging Retina | Healio.com/OSLIRetina ■ C L I N I C A L S C I E N C E ■ Comparison Between Ultra-Widefield Pseudocolor Imaging and Indirect Ophthalmoscopy in the Detection of Peripheral Retinal Lesions Giovanni Fogliato, MD; Enrico Borrelli, MD; Lorenzo Iuliano, MD; Andrea Ramoni, MD; Lea Querques, MD; Alessandro Rabiolo, MD; Francesco Bandello, MD, FEBO; Giuseppe Querques, MD, PhD BACKGROUND AND OBJECTIVE: To systematically compare the intermodality and inter-rater agree- ment for indirect ophthalmoscopy and ultra-wide- field (UWF) imaging in detecting peripheral retinal lesions predisposing to retinal rhegmatogenous de- tachment. PATIENTS AND METHODS: In this prospective, obser- vational, cross-sectional study, patients with a pre- vious diagnosis of peripheral retinal lesions were enrolled. UWF pseudocolor imaging and dilated fundus examination were obtained. RESULTS: Thirty-seven eyes (20 patients, 12 females) were enrolled. The level of inter-rater agreement was excellent in both the ophthalmoscopy-based and UWF-based assessment. The overall agreement in the UWF-based assessment was found to be Kap- pa = 0.874 (P < .0001). The UWF-based evaluation was demonstrated to have a sensitivity of 89.2% in detecting peripheral retinal lesions. In the sectorial analysis, the UWF-based reading had a lower sen- sitivity in the inferior sector. CONCLUSION: The identification of peripheral reti- nal lesions with UWF imaging allowed for an ac- curate and reproducible assessment. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:544-549.] INTRODUCTION Peripheral retinal degenerations are common al- terations that may predispose eyes to rhegmatogenous retinal detachment (RRD). These lesions vary in preva- lence and rate of progression to RRD, as well as in clin- ical characteristics. 1 Furthermore, these lesions may coexist. As an example, retinal tears are found in 1.4% of eyes affected by lattice degeneration. 2 Patients with peripheral retinal pathology may experience various symptoms, including floaters and phosphenes. However, since such symptoms have low specificity, the clinical assessment remains the gold standard for the diagnosis and follow-up of these le- sions. This requires a thorough evaluation, incorporat- ing a detailed patient history and a stereoscopic ex- amination of the entire retina through a dilated pupil. In addition, the evaluation of conditions predisposing eyes to retinal detachment requires knowledge of pe- ripheral vitreoretinal diseases that may predispose to detachment. However, the diagnosis may be difficult given the unenforceable mydriasis and low compli- ance in a number of patients, as well as the lack of reti- nal specialists in some primary eye care institutions. Ultra-widefield (UWF) imaging has become a key tool in the clinical care of patients with various retinal disorders. The California device (Optos, Dunfermline, Scotland) is a confocal scanning laser ophthalmo- scope-based system that uses an ellipsoidal mirror to obtain a wide (up to 200°) visualization of the retina. This system provides a pseudocolor (two-color) image of the retina using red and green laser wavelengths to From the Department of Ophthalmology, Ospedale San Raffaele Scientific Institute, University Vita-Salute, Milan (GF, EB, LI, AR, LQ, AR, FB, GQ); and Oph- thalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy (EB). Originally submitted August 21, 2018. Revision received August 21, 2018. Accepted for publication January 17, 2019. Dr. G. Querques is a speaker for Allergan, Alimera, Amgen, Bayer, KHB, Novartis, Roche, Sandoz, and Zeiss, as well as a consultant to Allergan, Alimera, Bausch + Lomb, Bayer, Heidelberg Engineering, Novartis, and Zeiss. Dr. Bandello is a speaker for Allergan, Alimera, Bayer, Farmila-Thea, Schering Pharma, Sanofi-Aventis, Novagali, Pharma, Hoffmann-La Roche, Genentech, and Novartis. The remaining authors report no relevant financial disclosures. Drs. Fogliato and Borrelli equally contributed to this paper and should be considered as co-first authors. Address correspondence to Giuseppe Querques, MD, PhD, Department of Ophthalmology, University Vita-Salute San Raffaele, Via Olgettina 60, Milan, Italy; email: giuseppe.querques@hotmail.it. doi: 10.3928/23258160-20190905-02

Articles in this issue

Links on this page

Archives of this issue

view archives of OSLI Retina - September 2019