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Sean Donghyun Kim, David Rosen, Rui Wang, Esther M Bowie; Evaluation of Ultra-Widefield Fundus Photography as a Screening Tool for New Onset Flashes and Floaters. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1002 – F0249.
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New onset flashes and floaters are common symptoms presenting to ophthalmology clinics. Patients undergo an urgent, thorough dilated ophthalmic exam in order to rule out retinal breaks, holes, or detachments that may require intervention. Utilization of ultra-widefield (UWF) fundus imaging as a screening tool may expedite care received by patients with new symptoms and help guide ophthalmologist examination and intervention. Furthermore, UWF photography may identify breaks not seen on clinical exam to allow earlier detection of retinal breaks, leading to improved outcomes.
The study protocol was reviewed and approved by the Penn State College of Medicine Institutional Review Board. All adult patients presenting to Penn State Eye Center urgent care with new onset flashes or floaters from 12/1/21 to 1/6/22 were identified as potential subjects. Participating subjects underwent a full standard of care indirect ophthalmoscopy by a resident physician. The findings were confirmed with an attending ophthalmologist. Subjects then underwent a UWF photography with the Optos California icg. The results of resident exam, attending ophthalmologist exam, and UWF photography reviewed by a vitreoretinal surgery attending were compared. Descriptive statistical methods were used to compare the results.
29 patients met the inclusion criteria. Twenty-four eyes of 12 subjects were included in the study (41%). Posterior vitreous detachment was detected in 20 eyes by attending examination, compared to 20 eyes by residents (100%) and 14 eyes by photography (67%). Retinal breaks were detected in 3 eyes by attendings, compared to 2 eyes (67%) by residents and 2 eyes (67%) by photography. 1 retinal detachment was detected by all modalities. 18 out of 24 eyes (75%) were described to have significant obstruction of peripheral view of retina by the upper and lower lids and lashes on photography.
While limited by lack of depth perception and inability to visualize the entire retina, UWF photography may still serve as a useful tool for documenting various retinal pathologies, particulaly in settings without access to ophthalmologists or in resident education to aid in visualization of retinal pathologies. More data is required to assess the effectiveness of UWF photography as a screening tool for evaluating new onset flashes and floaters.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
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