EVALUATING ULTRA-WIDEFIELD IMAGING UTILITY IN THE DETECTION OF TREATMENT-REQUIRING PERIPHERAL RETINAL TEARS AND HOLES

Author:

Khan Mahmood1,Kovacs Kyle1,Guan Ivan2,Goldblatt Nathaniel2,Foulsham William1,Wu Alan3,Papakostas Thanos1,Gupta Mrinali4,D'Amico Donald J.1,Kiss Szilard1,Orlin Anton1

Affiliation:

1. Department of Ophthalmology, Weill Cornell Medicine, New York, New York;

2. School of Medicine, Weill Cornell Medicine, New York, New York;

3. Division of Biostatistics and Epidemiology, Department of Healthcare Policy & Research, Weill Cornell Medicine, New York, New York; and

4. Retina Associates of Orange County, Laguna Hills, California.

Abstract

Purpose: To determine the utility of ultra-widefield (UWF) imaging in detecting pathologic peripheral retinal tears and holes. Methods: This was a retrospective, observational study. One-hundred ninety-eight eyes of 198 patients diagnosed with acute posterior vitreous detachment were included. Eyes were divided into two groups: 89 eyes with peripheral retinal holes and tears treated with laser retinopexy (treatment group) and 109 control eyes. Patients underwent UWF imaging and indirect ophthalmoscopy with scleral depression. UWF images from both groups were reviewed by two blinded graders and then compared with funduscopic examination and medical records. Results: UWF imaging identified 60 of the 89 eyes (sensitivity of 67.4%) found to have treatment-requiring peripheral retinal lesions and 107 of the 109 control eyes (specificity of 98.2%).The distribution of misses based on octant location did reach statistical significance (P = 0.004). Lesions anterior to the equator were more likely to be missed (21/41 eyes, 51.2%) compared with those located posterior to the equator (4/20 eyes, 25.0%) and at the equator (4/28, 14.3%), P = 0.002. The combined discordance rate between graders in the entire cohort was 12.1% (24/198 eyes) yielding an interrater agreement of 87.9%. Conclusion: UWF imaging showed a moderate sensitivity and high specificity in detecting treatment-requiring retinal tears and holes, with high interrater agreement. Given there is only a moderate sensitivity in identifying treatment-requiring retinal tears and holes, UWF imaging can assist with clinical examination, but a 360-degree scleral depressed examination should remain the gold standard.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Ophthalmology,General Medicine

Reference10 articles.

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2. Clinical utility of ultra-widefield imaging with the Optos optomap compared with indirect ophthalmoscopy in the setting of non-traumatic rhegmatogenous retinal detachment;Kornberg;Semin Ophthalmol,2016

3. Use of Optomap for retinal screening within an eye casualty setting;Khandhadia;Br J Ophthalmol,2009

4. Sensitivity and specificity of the Optos Optomap for detecting peripheral retinal lesions;Mackenzie;Retina,2007

5. Inter-observer agreement and sensitivity of Optomap images for screening peripheral retinal lesions in patients undergoing refractive surgery;Venkatesh;Indian J Ophthalmol,2020

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