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S. Nath, J. Sherman, M. Battaglia; Is OPTOS Imaging Additive or Duplicative to a Dilated Fundus Exam? . Invest. Ophthalmol. Vis. Sci. 2005;46(13):1554.
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Purpose: To determine whether the acquisition and analysis of OPTOS panoramic imaging of the fundus detects lesions missed during routine dilated exams utilizing slit lamp ophthalmoscopy with a fundus lens and binocular indirect ophthalmoscopy. Methods: As part of a comprehensive exam of 50 consecutive patients with known or suspected disorders of the retina and/or choroid, OPTOS images were obtained. After the traditional ophthalmoscopic exam (that included fundus drawings) was performed, the treating clinician then reviewed the OPTOS images with another clinician experienced in OPTOS analysis but who did not examine the patient. Fundus abnormalities detected by the OPTOS analysis but missed by the treating clinician were noted and categorized. The treating clinician had the opportunity to re–examine the patient in order to confirm the presence of a lesion(s) previously not observed. Results: 13 (or 26%) of the initial fundus drawings failed to document lesions found by the clinician reviewing the OPTOS images only. The lesions missed were choroidal nevi (2), intra–retinal hemorrhages (5), sub–RPE hemorrhage (1), retinoschisis (1), peripheral neovascularization or telangiectasia (2), peripheral retinal horseshoe tear (1), and a mid–peripheral toxo scar. Eight of these lesions were detected by contrasting the red laser channel (that preferentially images the choroid) and green laser channel (that preferentially images the retina). Conclusions: Although originally designed as a screening device for routine (undilated) exams, the OPTOS appears to expose some retinal and choroidal lesions missed during dilated fundus exams. Hence, the OPTOS evaluation appears to be additive (as well as duplicative) to the dilated exam using the BIO or slit lamp with a fundus lens.
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