Screening for retinal detachment using a wide field scanning laser ophthalmoscope

Abstract

Abstract Purpose The development of non‐mydriatic retinal photography has changed the clinical practice, allowing detection of abnormalities in the posterior pole without clinical examination in mydriasis. However the field of view does not exceed 60° and peripheral retinal detachments are likely to be missed on these images. The purpose of this study was to evaluate a wide field (200°) imaging system (Optos, UK ) using a scanning laser ophthalmoscope (SLO) for screening purposes in retinal detachment. Methods All patients referred for retinal detachment from November 2007 to April 2008 were examined by one retinal surgeon who also performed the fundus drawing. An SLO image was taken by an orthoptist in training. A masked image lecture of the entire data base was performed by a resident. Both were unaware of the details of the retinal examination. The number of breaks and the extent of the detachment on the drawing were compared with the findings detected on the SLO image. Results 56 eyes with retinal detachment were documented. In 40 out of 56 eyes the retinal breaks could be detected on the SLO images obtained. The retinal breaks situated superiorly between 11 and 1o’clock or inferiorly between 5 and 7 o’clock and two retinal detachments, one superior and one inferior, were not detected on the SLO images. SLO image analysis enabled correct diagnosis of retinal breaks in more than 7/10 cases. Retinal detachments were detected in more than 9/10 cases. Conclusion Although the wide field SLO imaging system is not suitable as a diagnostic tool of retinal breaks and retinal detachment replacing the fundus examination by a retinal specialist, it represents a reliable screening method. Commercial interest