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M. Ghajarnia, L. Y. Ho, W. M. Abdelghani, A. W. Eller, T. R. Friberg, S. Schwartz; OPTOS Panaromic 200 Imaging versus Standard Fundus Photography in Measurement of Pigmented Choroidal Lesions. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1204. doi: https://doi.org/.
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The prevalence of choroidal nevi in the white U.S. population ranges from 4.6% to 7.9%. Accurate clinical documentation of suspicious pigmented lesions is important, particularly when assessing the possibility of growth. Standard fundus photography captures a field of view of approximately 30 to 50 degrees in a single image, while the OPTOS Panoramic 200 TM utilizes scanning laser technology to image a much wider field (210 degrees), giving the latter a possible advantage. A comparison of these two imaging modalities was made to assess their utility and precision in documenting pigmented lesions, in an ongoing study.
Three independent readers were asked to estimate the greatest extent of pigmented lesions to the nearest 0.5 disc diameter (DD) from 10 different patients using both standardized fundus photography and the OPTOS system during separate reading sessions. We used a linear mixed effects analysis to assess possible bias among graders and imaging method. Next we assessed precision for each subject for each method using the Wilcoxon Test. Readers were also asked to comment on the ease of lesion size grading using the two different methods.
Inter-reader agreement was strong with no single outlying reader identified. The observed standard deviation in the standard fundus photography was greater (0.70 DD) compared to the OPTOS system (0.44DD). Measurement of pigmented lesions was facilitated with OPTOS images, with the observed imprecision being on average lower for the OPTOS system. Readers commented on the greater facility of visualizing larger and more peripheral lesions completely in a single image using the OPTOS system compared to standard fundus photography. The fact that the Optos images show both the optic nerve and the lesion in the same image is particularly useful when conducting measurements. Furthermore, when the lesion is in the midperiphery or was elevated, the lesion appeared more distorted with conventional images. This may be due in part to a much greater depth of field with the Optos unit.
The OPTOS imaging system appears to be a viable system for recording pigmented choroidal lesions, offering several advantages to standard fundus photography. Larger sample size may serve to validate the apparent superiority of this imaging system in producing less inter-reader variability and greater ability to image large and peripheral lesions.
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