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E.J. Revelli, K. Lambreghts, F.M. Barker; A Multi–Center, Open, Non–Randomized Comparison Trial of Standard and Steered Optomap Retinal Exam and Binocular Indirect Ophthalmoscopy . Invest. Ophthalmol. Vis. Sci. 2005;46(13):3282.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To compare the detection rates for retinal abnormalities using the Panoramic200 wide field retinal scanning laser ophthalmoscope (SLO) Standard Exam and Steered Exam with Binocular Indirect Ophthalmoscopy (BIO). Methods: 403 subjects (age 18–82, mean 38.91 years) were studied at 3 optometric clinical centers. Subjects were imaged using the Panoramic200 with the subject looking straight ahead (Standard Exam) and looking 15o eccentrically at 12, 3, 6 and 9 o’clock positions with a minimum 5 mm pupil (Steered Exam). These images were evaluated for retinal abnormalities. The subjects were then examined by a different examiner using BIO. The correspondence of the retinal abnormalities from the images and the BIO was determined and when discrepancies were noted, a third referee examiner, who was informed about prior results, performed BIO and re–evaluated the Panoramic200 images as the gold standard. Sensitivity and specificity was determined and McNemar’s test for significance was applied. Results:Comparison of both Standard and Steered Panoramic200 detection rates for abnormalities judged clinically important and located posterior to the equator showed excellent correspondence with BIO (p=0.56). When all exam findings were factored in (anterior and posterior), both the Steered and the BIO exams had sensitivity (84.28/86.12) and specificity (98.02/94.70) measures that differed compared to the referee (gold standard) (P<0.00001) but that were not different from each other (chi–squared test, p=0.465), although the specific findings missed differed by technique. Conclusions: Both Standard and Steered Panoramic200 retinal imaging compare favorably with the BIO in detecting clinically important abnormalities posterior to the equator. Both Panoramic200 Standard and BIO examination of the entire retina failed to detect a small but significant percentage of findings compared to the referee gold standard. Given that the types of findings missed were different between techniques, it is suggested that the combination of Panoramic200 with BIO provides improved detection of retinal abnormalities.
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