Abstract
Recent developments in imaging technologies now allow the documentation, qualitative and quantitative evaluation of peripheral retinal lesions. As wide field retinal imaging, capturing both the central and peripheral retina up to 200° eccentricity, is becoming readily available the question is: what is it that we gain by imaging the periphery? Based on accumulating evidence it is clear that findings in the periphery do not always associate to those observed in the posterior pole. However, the newly acquired information may provide useful clues to previously unrecognised disease features and may facilitate more accurate disease prognostication. In this review, we explore the anatomy and physiology of the peripheral retina, focusing on how it differs from the posterior pole, recount the history of peripheral retinal imaging, describe various peripheral retinal lesions and evaluate the overall relevance of peripheral retinal findings to different diseases.
Highlights
Since the invention of the first ophthalmoscope in 1851 by Hermann von Helmholtz, imaging the retina has undergone dramatic improvements, arousing interest in previously undescribed abnormalities but changing our understanding of numerous retinal and choroidal diseases (Keeler, 2002)
As wide field retinal imaging, capturing both the central and peripheral retina up to 200° eccentricity, is becoming readily available the question is: what is it that we gain by imaging the periphery? Based on accumulating evidence it is clear that findings in the periphery do not always associate to those observed in the posterior pole
The significance of the appropriate imaging and analysis of the peripheral retina is being shown in this review by depicting the various imaging and investigative techniques clinicians and researcher have at their disposal
Summary
Since the invention of the first ophthalmoscope in 1851 by Hermann von Helmholtz, imaging the retina has undergone dramatic improvements, arousing interest in previously undescribed abnormalities but changing our understanding of numerous retinal and choroidal diseases (Keeler, 2002). The introduction of ultra-widefield imaging (UWFI) led to a renewed interest in lesions in the peripheral retina and a better understanding of their relevance to the diagnosis and prognosis of different retinal conditions. To develop appropriate understanding of the images generated by novel technologies, several principles need to be considered. An understanding of the anatomy of the entire neurosensory retina and choroid/ retinal pigment epithelium (RPE) interface and the differences and similarities between the different geographic retinal locations must be developed. These can help to establish appropriate descriptive terminologies to describe and interpret the different UWFI modalities such as colour imaging, fundus auto fluorescence (FAF), fundus fluorescein angiography (FFA) and indocyanine green (ICG) angiography
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