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Joseph T Nezgoda, Natalia Camacho, Dirk-Uwe G Bartsch, Glenn Currie, William R Freeman; Multicolor Imaging Compared with Color Fundus Photography for Retinal, Choroidal and Optic Nerve Pathology. Invest. Ophthalmol. Vis. Sci. 2014;55(13):248.
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To evaluate clinically a recently developed Multicolor Imaging (MCI) system for the Heidelberg Spectralis versus color fundus photography for detecting retinal, choroidal, and optic nerve pathology.
After comprehensive ophthalmic examination, including stereoscopic biomicroscopy, and after color fundus photographs (Topcon TRC-50DX), imaging with the multicolor system for the Hieldelberg Spectralis was performed on the posterior pole and areas of interest. Scans were obtained in 140 consecutive patients (280 eyes) that had imaging in two retina clinics at UCSD-Shiley Eye Center and the Jacobs Retina Center. The pathology was categorized into surface retina, deep retina/RPE, choroid, vascular, optic nerve, and normal. The images were then graded by two independent masked physicians if the pathology was clearer on color fundus images versus multicolor imaging. Digital images were displayed digitally simultaneously for viewing.
Of the eyes imaged, the distribution of disease category was surface 15% (42 eyes), deep 48% (135 eyes), choroid 11% (31 eyes), vascular 8% (23 eyes), optic nerve 6% (16 eyes), normal 12% (33). MCI was found to have a more pronounced pathology in surface (p=0.02), vascular (p<0.01), and optic nerve disease (p<0.01) but was equivalent in deep retinal disease (p=0.57), choroidal disease (p=0.80), and normal eyes (p=1.00). The agreement between observers was high (k, 0.67; P<.001). There were 18 Images too poor to grade for multicolor and 10 for color fundus images.
Multicolor imaging is another tool in investigating posterior ocular disease. Advantages include that it may show surface retinal disease, retinal vascular disease, and optic nerve disease more clearly than color fundus photography. Other benefits not investigated include simultaneous imaging during optical coherence tomography, control of eye movement artifact, imaging through a myopic pupil, and lack of backscatter that may diminish quality of color images. Disadvantages include MCI is more highly operator dependent than color fundus photos. Though few, there were more multicolor images too poor for review, and this may be accounted for by the operator’s focus and angle. Though Multicolor Imaging (MCI) cannot be interpreted in the same way as a color fundus photo, it is an additional tool for ocular imaging.
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