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Mehreen Adhi, Fabiana Queiroga de Paula Araujo Silva, Richard Lang, Raul Seballos, Roxanne Sukol, Steven Feinleib, Rishi P Singh; Comparison Of Non-Mydriatric Fundus Imaging Methods For Screening Of Retinal Pathology In An Internal Medicine Practice. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1867.
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Single-field photography covering 20-50° fundus field is traditionally used to evaluate retinal diseases. Of late, the advent of non-mydriatic ultra-wide field (NM-UWF) imaging has improved visualization of the peripheral retina. This study aims to characterize the prevalence of peripheral retinal pathology in healthy subjects using NM-UWF imaging in comparison to standard single-field imaging in an internal medicine practice
Six-hundred and thirty-two healthy subjects (1260 eyes) that underwent NM-UWF fundus imaging on Optos Daytona device as part of their annual health screening at Cleveland Clinic, Ohio, from October 2016 through March 2016 were retrospectively identified. An automated algorithm processed the raw images into: (1) NM-UWF image with mask/grid outline that delineates a center 45° field simulating the standard single-field photograph and (2) single-field image comprising 45° of the posterior pole extracted from the corresponding NM-UWF image. To be gradable, the NM-UWF images needed to have at least 55° peripheral retinal field visible beyond the mask/grid outline (total 100° field of view or more including the 45° posterior pole). Images were analyzed to characterize the peripheral retinal findings
Mean age of patients was 59.6 ±7.5 years. Of the 1260 eyes, 1 eye failed processing and 21 eyes were considered non-gradeable. Of the remaining 1238 eyes, NM-UWF images detected peripheral retinal pathology in 228 eyes (18.4%) that were not visible on the corresponding single-field images. These included dot-blot hemorrhages in 44/1238 (3.5%), lattice degeneration in 28/1238 (2.2%), choroidal nevi in 23/1238 (1.9%), paving stone degeneration in 20/1238 (1.6%), drusen in 16/1238 (1.3%), retinal tear in 9/1238 (0.7%), chorioretinal atrophy in 9/1238 (0.7%), choroidal lesion suspicious of melanoma in 1/1238 (0.1%) and retinoschisis in 1/1238 (0.1%) eyes (Figure)
NM-UWF imaging enables non-contact photography of a wider field than traditional fundus imaging without need for mydriasis allowing improved visualization of peripheral retinal pathology. This capability may be useful for emerging tele-health screening and disease management programs
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
A1-D1: Single-field fundus images of 4 healthy subjects. A2-D2: Corresponding NM-UWF images with mask/grid outline showing peripheral retinal pathologies that are not visible on single-field images
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