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Drew Dickson, Aniruddha Agarwal, Mohammad Ali Sadiq, Robin High, Quan Dong Nguyen, Yasir Jamal Sepah, ; Assessment of Vitreous Haze using Ultra-Wide Field Retinal Imaging. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):613.
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Conventional fundus imaging has been used to assess vitreous haze (VH) in patients with uveitis. Ultra-wide field (UWF) retinal imaging that uses scanning laser technology has not been evaluated for the detection of VH. A prospective study was performed to explore ability of UWF retinal imaging in assessing VH.
Patients with intermediate, posterior or panuveitis were examined to assess the level of VH using slit-lamp biomicroscopy. Colored fundus images (30°, standard 2M field) were acquired using Carl Zeiss FF450 (Carl Zeiss Meditech, Dublin, CA) camera. Optos UWF 200° retinal camera (Optos P200Tx, Optos, Scotland, UK) was also used to obtain fundus images of the same eyes at the same visit by a single photographer. Two graders, masked to the clinical data, independently analyzed UWF fundus images for presence or absence of VH, without quantifying the degree of VH using any scale. These findings were then compared to the gold standard, i.e. clinical examination, and the detection of VH using conventional Zeiss fundus photography to determine the ability of the UWF technique in detecting VH. Sensitivity, specificity, positive and negative predictive values (PPV and NPV) were calculated for UWF and Zeiss techniques in detecting VH. Agreement between the two imaging techniques and the two observers was calculated using the weighted κ statistic.
Thirty-two eyes (16 patients) were included in the study. In comparing the UWF imaging and the conventional Zeiss photographs to the clinical VH assessment, the sensitivity was 0.6 and 0.8 for Optos UWF and Zeiss photographs, respectively. Specificity was 0.92 for Optos UWF and 0.79 for Zeiss photographs. The PPV was 0.15 and 0.44, while the NPV was 0.84 and 0.95 for Optos UWF and Zeiss photographs, respectively. The agreement between the two imaging techniques was modest, with κ = 0.53 (range: 0.12 - 0.93). There was a good agreement between the two observers for detection of VH using Optos UWF images with κ = 0.64 (range: 0.31 - 0.96). The agreement was modest for Zeiss technique with κ= 0.39 (range: 0.05 - 0.73) (Figure).
UWF fundus imaging using scanning laser technique may be used to assess VH and may be employed in the management of intermediate, posterior and panuveitis.
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