Abstract
BackgroundConventional fundus imaging has been used to assess vitreous haze (VH) in patients with uveitis. Ultra-wide field (UWF) retinal imaging that uses scanning laser technology has not been evaluated for the detection of VH. This pilot study evaluates the ability of UWF imaging in detecting VH.Patients with intermediate, posterior, or panuveitis were examined to assess the level of VH using slit-lamp biomicroscopy. Colored fundus images were acquired using a Carl Zeiss FF450 camera. The same photographer obtained fundus images of the same eyes during the same visit by Optos UWF P200Tx retinal camera. Two graders independently analyzed UWF fundus images for presence or absence of VH, without quantifying the degree of VH using any scale. The images were analyzed using the composite red plus red-free wavelengths utilized by the Optos UWF camera and by using each wavelength exclusively. These findings were compared to clinical detection of VH and detection of VH using conventional fundus photography.ResultsNinety-two eyes were included in the study. For composite UWF images, sensitivity was 0.27, specificity was 0.88, PPV was 0.31, NPV was 0.86, positive LR was 2.25, and negative LR was 0.83. For the conventional Zeiss images, sensitivity was 0.5, specificity was 0.84, PPV was 0.33, NPV was 0.91, positive LR was 3.13, and negative LR was 0.6.Agreement between the composite UWF and Zeiss techniques was substantial with k = 0.64. Inter-observer agreement for composite UWF images was also substantial with k = 0.65. Inter-observer agreement for Zeiss images was moderate with k = 0.471. Intra-observer agreement for both imaging modalities was substantial with a composite UWF k = 0.76 and Zeiss k = 0.7.ConclusionsUWF fundus imaging using scanning laser technique may be used to assess VH and employed in the management of intermediate, posterior, and panuveitis.
Highlights
Conventional fundus imaging has been used to assess vitreous haze (VH) in patients with uveitis
The results of this study indicate that Ultra-wide field (UWF) imaging may be used to assess VH and be employed in the management of patients with uveitis with some limitations as well
The results of this pilot study suggest that UWF using Scanning laser ophthalmoscopy (SLO) does detect VH similar to conventional imaging techniques despite the belief that SLO may pierce through opacities caused by inflammation [18]
Summary
Conventional fundus imaging has been used to assess vitreous haze (VH) in patients with uveitis. The images were analyzed using the composite red plus redfree wavelengths utilized by the Optos UWF camera and by using each wavelength exclusively. These findings were compared to clinical detection of VH and detection of VH using conventional fundus photography. Detecting and grading vitreous haze is Fundus imaging using conventional color photographs is commonly used to assess VH in patients with uveitis. A six-step scale of VH was created at the National Eye Institute (NEI) in 1985 [9] This scale was approved by the Standardization of Uveitis Nomenclature (SUN) Working Group in 2005 as an acceptable method of grading VH in clinical research
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