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John P. Campbell, Henry A. Leder, Yasir J. Sepah, Theresa Gan, Elham Hatef Naimi, Brian Cho, Mohamed Ibrahim, Roomasa Chana, Quan D. Nguyen, Retinal Imaging Research and Reading Center, Wilmer Eye Institute, Johns Hopkins University; Effect of Wide-Field Fundus Photography and Fluorescein Angiography System on the Management of Posterior Uveitis. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4292.
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To determine whether the use of wide-field fundus imaging system alters the management of patients with posterior uveitis.
In this prospective, observational study of patients with posterior uveitis, at baseline, and at scheduled follow-up visits, patients receive wide-field pseudo-color imaging and fluorescein angiography (FA) following their routine evaluation. Participating investigators successively determine disease activity and management changes based on exam alone, exam and limited (60 degree FA), and then with the addition of wide-field pseudo-color images, and wide-field FA (performed with Optos P200TM System). Management decisions at each time point are compared to determine whether the wide-field imaging system alters initial management decisions (made without wide-field images).
Twenty-eight patients have been enrolled to date. At the enrollment visit, current management was altered in 4/28 (14%) of patients based on examination findings alone, with or without 60 degree FA (25 of 28 patients received FA). Management was altered in 13/28 (46%) patients based on the addition of wide-field SLO imaging and FA (P < 0.01).
In this prospective, observational study of patients with posterior uveitis, thus far, our results suggest that wide-field imaging may alter management decisions compared to standard-of-care imaging and clinical examination. Such difference may be due to peripheral retinal imaging and angiographic findings not easily visualized or identified without wide-field imaging. Additional studies are indicated to determine whether these findings, or the subsequent management alterations, may be able to improve patient outcomes.
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