Abstract
Background: to compare the extent of the detached retina and retinal tears location in rhegmatogenous retinal detachment (RRD) among non-mydriatic ultra-wide field (UWF) imaging, dilated fundus exam (DFE), and intraoperative evaluation. Methods: this retrospective chart review comprised 123 patients undergoing surgery for RRD. A masked retina specialist analyzed the UWF fundus images for RRD area, status of the macula, and presence and location of retinal breaks. The same variables were collected from a database including DFE and intraoperative recordings. Evaluation methods were compared. Results: mean age was 59.8 ± 14.9 years. Best-corrected visual acuity improved from 0.25 ± 0.3 (Snellen) to 0.67 ± 0.3 at 12 months (p = 0.009). The RRD description and assessment of macula status (34.5% macula-on) did not differ between UWF, DFE, and intraoperative examination. The inferior quadrant was involved most frequently (41.5%), followed by the superior (38.9%), temporal (27.8%) and nasal quadrant (14.8%). Intraoperative exam detected 96.7% of retinal tears compared with DFE (73.2%, p = 0.008) and UWF imaging (65%, p=0.003). UWF imaging and DFE did not differ significantly. Conclusion: RRD extent on DFE and UWF images was consistent with intraoperative findings. UWF and DFE detection of peripheral retinal tears was similar, but 25% of retinal breaks were missed until intraoperative evaluation.
Highlights
The ophthalmoscope, developed by Hermann von Helmholtz in 1850, allows for visualization of the structures of the eye fundus and detailed studies of the vitreous, retina, and optic nerve head [1].Subsequent advances in retinal imaging enabled photo-documentation for clinical purposes, research, telemedicine, and patient education during routine eye care, thereby improving both the understanding and management of vitreoretinal diseases [2].For many years, most digital instruments for fundus photography captured images with only a 30 ◦or 45 field of view
ultra-wide field (UWF) and dilated fundus exam (DFE) detection of peripheral retinal tears was similar, but 25% of retinal breaks were missed until intraoperative evaluation
DFE with scleral depression remains the gold standard for diagnosis and documentation of peripheral retinal lesions and rhegmatogenous retinal detachment (RRD) [14]
Summary
The ophthalmoscope, developed by Hermann von Helmholtz in 1850, allows for visualization of the structures of the eye fundus and detailed studies of the vitreous, retina, and optic nerve head [1].Subsequent advances in retinal imaging enabled photo-documentation for clinical purposes, research, telemedicine, and patient education during routine eye care, thereby improving both the understanding and management of vitreoretinal diseases [2].For many years, most digital instruments for fundus photography captured images with only a 30 ◦or 45 field of view. The ophthalmoscope, developed by Hermann von Helmholtz in 1850, allows for visualization of the structures of the eye fundus and detailed studies of the vitreous, retina, and optic nerve head [1]. Subsequent advances in retinal imaging enabled photo-documentation for clinical purposes, research, telemedicine, and patient education during routine eye care, thereby improving both the understanding and management of vitreoretinal diseases [2]. For a wider vision of the retina, the photos were joined to create a composition or collage covering approximately 75◦ [3]. Very useful, these images showed the retina just beyond the equator of the eye, providing no information about the retinal periphery
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