Challenges for interpreting retinal morphology

Abstract

AbstractDiseases in the retina are the most frequent causes of visual impairment and blindness in the Western World. However, it is a paradox that these diseases that are debilitating because of the effects on retinal function, are mainly diagnosed and monitored on the basis of their morphological appeareance in the ocular fundus. The most widespread methods for evaluating retinal morphology are based on the study of light reflected from the fundus background and imaged through the optics of the eye. This imaging principle depends on image contrast, on spatial resolution of the optics of the eye, and on the temporal resolution of the recording system used to image the fundus. The morphological lesions observed in the ocular fundus are often heterogenous with varying number, size, shape, density, location and dynamics. In most cases information about these features are aggregated into more simple qualitative or semi‐quantitative grading systems that can be handled in simple rule based clinical decision models. However, the advent of computerized image processing has allowed a more detailed quantitative evaluation of retinal morphology. Examples will be given of how this may help improving the diagnosis and management of retinal disease.