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Simone Kellner, Silke Weinitz, Ghazaleh Farmand, Ulrich Kellner; Evaluation Of Multicolor Spectral Reflection Imaging (488 nm, 536 nm & 786 nm) In Comparison With Color Photography, Autofluorescence And Spectral Domain OCT imaging In A Consecutive Series Of Patients With Retinal Disorders. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5874.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the value of multicolor spectral imaging in patients with retinal disorders.
Between February and November 2013 a consecutive series of 534 patients with retinal disorders were examined clinically and with 3 wavelength spectral reflection imaging (blue reflectance 488 nm (BR), green reflectance 536 nm (GR) & near-infrared reflectance 786 nm (NIR); displayed combined in the multicolor display mode (MDM)), fundus autofluorescence (FAF), near-infrared autofluorescence (NIA), spectral domain OCT (SD-OCT) and if applicable fluorescein angiography (FAG; Spectralis HRA & OCT, Heidelberg Engineering, Germany) as well as digital color photography (F450 Carl Zeiss & CCD Imaging device, Carl Zeiss Meditec & Pawlowski Imaging System, Germany).
Multicolor imaging increases the detection of retinal alterations in comparison to ophthalmoscopy and color photography. BR and GR imaging enhance the visibility of epiretinal lesions, whereas NIR enhances the detection of deep retinal and choroidal lesions. The combination of these 3 images in the MDM thus increases the visibility of mild retinal lesions and the definition of lesion borders in more severe retinal lesions. Spectral imaging serves as a screening tool, the diagnostic process needs to be based on FAF, NIA and SD-OCT, and added FAG in exudative lesions. Evaluation of MDM images requires a learning curve because colors may differ markedly from color images. Therefore the MDM image should be evaluated in association with the single BR, GR and NIR images to locate the retinal lesions correctly. Some disorders, e.g. small hemorrhages, may be more difficult to identify on MDM images compared to color photography.
In our experience the combination of separate 3 wavelength spectral imaging and combined MDM images is a valuable screening tool for the detection of retinal disorders. Interpretation of MDM images requires a learning curve and does not simply replace color photography.
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