Abstract
Purpose :
Childhood blindness is the second leading cause for the global burden of eye disease as measured by disability adjusted life years. However, pediatric retinal diseases are often diagnosed too late. The purpose of this project is to implement a method for widespread screening for pediatric retinal diseases using ultra-widefield fundus (UWF) photography. We hypothesize that it is feasible, safe, and easy to obtain good quality images from undilated pediatric patients at routine pediatrician clinic visits to use for retinal screening.
Methods :
We imaged both eyes of 128 pediatric patients from a pediatrics clinic using UWF photography without pharmacologic dilation. Pertinent ophthalmologic and medical history and demographic data was recorded. For each eye, we imaged the posterior pole and four quadrants. Imaging was stopped after: all the quadrants were imaged for both eyes, if the patient/parent appeared uncomfortable, or if requested to stop. We recorded the total time spent imaging, quadrants that were successfully imaged, image quality according to the imager (on a scale of 0-4: 0=unusable, 4=excellent), and ease of imaging per the patient, parent, and imager (on a scale of 0-4: 0=unable, 4=easy).
Results :
UWF photos of 248 eyes of 128 patients were successfully acquired. Patients ranged from 4-17 years old (mean 10.2±3.3), were 53.9% male, and identified as 50% white, 24.2% black, 11.7% other, 10.9% Asian. Iris colors were 62.5% brown, 21.1% blue, 9.4% green, 6.3% hazel. Of all eyes imaged, 96.9% had no known ophthalmologic conditions, 1.6% had amblyopia, 0.8% had strabismus, and 0.8% had glaucoma. During imaging, the photopic pupil size was a mean of 5.7±0.8mm and 5.8±0.8mm in the right and left eyes, respectively. For each patient, imaging time averaged 7.8±2.6 minutes. The imager rated the quality of collected images as 3.1±0.7, and ease of imaging as 3.2±0.7. 35% of the patients required assistance holding their eyelids open during imaging. Patients’ reported ease of imaging was 3.5±0.5, and parents’ reported perceived ease of imaging was 3.8±0.4. No adverse events occurred.
Conclusions :
It is easy, safe, and feasible to obtain good quality widefield fundus photos of undilated eyes of children. UWF photography may be a viable pediatric retinal screening method for children in the primary care setting.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.