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E. Escalona-Benz, T.G. Murray, M.S. Benz, N. Villate, B.C. Hayden; Correlation between Optos Ultra Widefield Digital Imaging, Standardized Fundus Photography, and B-Scan Echography in the Detection of Posterior Segment Tumors . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3644.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To investigate the correlation in tumor detection between Optos ultra widefield digital imaging, standardized fundus photography (COMS protocol) and B-scan echography in the screening of posterior segment tumors. Methods: IRB approved, prospective ultra widefield digital imaging, standardized fundus photography and standardized B-scan echography were performed on one hundred and twenty-two consecutive patients with a known intraocular tumor of the posterior segment. Variables measured included quality of image, location of the lesion, distance from the optic nerve, tumor shape, pigment characteristics, maximum length, maximum apical height, and associated findings (retinal detachment, vitreous hemorrhage, retinal or subretinal deposits). Results: In all 122 eyes, the quality of images obtained with the Optos imaging system correlated well with standardized fundus photography and was classified as good or fair in 80% of the patients. Reasons for poor quality imaging included the presence of a lid artifact, far anterior location of the tumor, media opacities, and poor patient fixation. The index lesion was detected by all three imaging modalities in 102/122 (67.2%) patients (p<0.001). The Optos imaging system was able to detect the lesion in 114/122 patients (93.4%). Of these patients, the Optos system imaged one hundred percent of the tumor margins in 89/114 cases. In 8 patients the tumor was not detected with the Optos imaging system due primarily to the peripheral location of the lesions. All of these were detected and measured by ultrasound. B-scan echography was unable to detect the lesion in 12 patients with flat lesions. Of the 12 tumors not visualized by ultrasound, the Optos imaging system was able to image each lesion. In an additional 20 patients (16.4%) the ultrasound was able to measure only the maximum apical height of the tumors and was unable to delimit the lateral dimension. The Optos system was able to determine the maximal lateral dimension in 17 of these 20 patients. Conclusions: We established a significant correlation in tumor detection between the Optos ultra widefield digital imaging system, standardized fundus photography and B-scan echography (COMS protocol). The Optos imaging system was able to localize some lesions (essentially flat) that were not detected by ultrasound. Ultra widefield digital imaging is useful as an adjuvant tool in the screening and follow-up of posterior segment tumors.
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