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Benjamin Guidry, Ching Jygh Chen, Heather Hancock; Advantages of Ultra-Wide Angle Digital Photography of Retinal Diseases. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1600.
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The purpose of our study is to determine any benefit to the treatment of retinal disease by using the Optos© SLO-based ultra wide field fluorescein angiography versus standard 7-field photography.
We conducted a chart review of 85 treatment naive patients with retinal pathology that received mydriatic SLO-based ultra wide field fluorescein angiography. These images have previously been interpreted and a treatment plan had been decided/enacted. The images were then printed and a second interpretation and treatment plan was conducted with a standard 7-field collage stencil covering up the area of peripheral retina that would not be captured using traditional photography. Any changes to diagnosis and/or treatment decisions were recorded. These images were then categorized in one of four levels: Level 0 consisted of images where the traditional imaging did not leave out any information. Level 1 included images where traditional imaging would not have changed the diagnosis or treatment but left out important information. Level 2 consisted of images where traditional photography left out information affecting the diagnosis. Level 3 was reserved for images where traditional photography left out information that affected the treatment decisions.
Of the 85 images utilized in the study, 19/85 (22%) were level one images meaning that there was no difference of the fluorescein interpretation in standard vs wide-field photography. 53/85 (62%) were categorized as level one, meaning that the wide field imaging did not change the diagnosis or treatment but did contribute important information. 5/85 (6%) of images were level two indicating that interpreting a wide field image versus a traditional 7-field image yielded a different diagnosis but did not affect the immediate treatment decision. Finally, 8/85 (9%) of images qualified as level 3 indicating that the interpretation of wide field imaging changed the patient's treatment.
We conclude that the advantage of wide-field SLO-based imaging in fluorescein angiography is multi-fold. Most importantly, we concluded that the diagnosis and/or treatment decisions would have been different in 15% (13/85) had we utilized standard retinal photography versus the newer SLO-based system. Furthermore, the photographer's labor is greatly reduced because the number of images acquired is reduced with the SLO system and no collage needs to be created.
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