Abstract
Purpose :
To compare the sensitivities of orthogonal, peripheral steering, and auto-montaged images with ultra-widefield (UWF) imaging and the factors influencing the ability to identify retinal tears.
Methods :
376 treatment-naïve eyes (349 patients) that underwent laser retinopexy for retinal tears/holes between 2015-2021 with available pre-treatment UWF orthogonal, steering and auto-montage. Imaging were graded by trained photographers and reviewed by a retinologist who cross-referenced clinical scleral-depressed examination/drawings to determine whether images visualized all retinal tears/holes. Total retinal area visualized was divided by its optic disc area (pixels,MATLAB) to calculate relative retinal area (RRA). Sensitivities refer to true positive rates of identifying all retinal tears.
Results :
162 eyes (154) patients met inclusion criteria. Orthogonal, steering, and auto-montage images showed sensitvities of 47.5%, 90.7%, and 80.0%, respectively. Useable surface area increased from orthogonal versus montage by 34.7%+/-26.5%(mean+/-SD), which increased deetection of tears by 90.8%(p=0.006). By linear probability model, vertical meridian tears decreased probability of 26.6%, 86.2%, and 68.7%, respectively(all p<0.001), and horizontal meridian tears increased the probability by 62.2%, 92.9%, and 85.5%(all P<0.001). Posterior to the equator tears in orthogonal images increased the probability (91.4%,p<0.001). Artifacts such as lids/lashes, reflection, and faceguard decreased the probability in steering by 28.6%, 50.0%, and 66.7% respectively(p=0.020,p=0.049, and p=0.016).
Conclusions :
Utilizing peripheral steering and auto-montage increases RRA and sensitivity of identifying peripheral retinal tears/holes. Tears in horizontal meridians or posterior to equator increase probability of identification. Common UWF imaging artifacts can significantly limit the probability of identifying retinal tears.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.