Abstract
Purpose :
Currently, mydriatic slit-lamp examination is the gold standard for cataract evaluation. Discomfort following mydriasis, small pupil, and inability to dilate pupil may limit mydriatic examinations. Optomap is a widely used modality that captures ultra-wide fields without mydriasis. In clinical practice, peripheral cataract shadows are often visualized with a single, non-mydriatic ultra-widefield retinal imaging. In this study, we intended to evaluate whether non-mydriatic UWFRI can effectively screen cataracts.
Methods :
Patients who underwent non-mydriatic ultra-widefield retinal imaging with Optomap were included in this study. Two ophthalmologists assessed cataract grading via 2 diagnostic modalities: (1) non-mydriatic ultra-widefield retinal imaging (UWFRI) and (2) mydriatic slit-lamp examination. Lens opacity classification system (LOCS II) was used as a reference grading scheme. Concordance of cataract gradings between the 2 modalities was evaluated. Red and green separation images, that can be generated via embedded software, were also evaluated and their utility in cataract grading was qualitatively assessed.
Results :
A total of 170 eyes from 85 patients with cataract were included in this study. The mean age was 72.5 ± 10.4 years. Concordance between non-mydriatic UWFRI and mydriatic slit-lamp was 90.58%. With respect to cataract types, cortical opacity (CO) and posterior capsular cataract (PSC) had better concordance rate than nuclear sclerosis (NS). Qualitatively, grading of NS was most difficult when it was associated with vitreous disorders. 23 cases had cataract with vitreous opacity and red separation view was useful at differentiating cataract from vitreous opacity. On the other hand, green separation view was more useful at visualization of cataract itself.
Conclusions :
Non-mydriatic ultra-widefield retinal image can be considered as a less inconvenient and effective tool for cataract screening. Various image modes provided by Optomap may aid clinicians to differentiate cataract from non-retinal posterior disorders.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.