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Maltsev DS, Kulikov AN, Shaimova VA, Burnasheva MA, Vasiliev AS. Spotlight on Lattice Degeneration Imaging Techniques. Clin Ophthalmol 2023; 17:2383-2395. [PMID: 37605766 PMCID: PMC10440085 DOI: 10.2147/opth.s405200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/10/2023] [Indexed: 08/23/2023] Open
Abstract
Lattice degeneration (LD), routinely diagnosed with indirect ophthalmoscopy, is one of the most common and clinically significant peripheral retinal findings. In this review, we have summarized the data on currently available imaging techniques which help to improve diagnosis and our understanding of LD pathogenesis. Ultra-wide field imaging provides reliable color fundus capturing for the primary diagnosis of LD and may also be used as a screening tool. Wide-field imaging can be used for targeted documentation of LD lesions using true colors and with minimal optical distortions. Information on the status of the vitreoretinal interface, including detection of retinal holes, detachments, and vitreous tractions, can be obtained with peripheral structural optical coherence tomography (OCT) or scanning laser ophthalmoscopy in retro-mode. These techniques clarify the associated risks of rhegmatogenous retinal detachment. Fundus autofluorescence can provide details on atrophic changes. However, the risk of retinal detachment by means of this technique requires further investigation. OCT angiography may be successfully performed for some lesions. Taken together, OCT and OCT angiography demonstrate thinning of the choroid, alteration of local choroidal microcirculation, and, in severe lesions, involvement of the sclera. OCT angiography confirms loss of retinal microcirculation within LD lesion, which was previously shown with fluorescein angiography. In conclusion, despite relatively simple primary diagnosis, imaging of LD lesions remains challenging due to their peripheral localization. However, several new strategies, including ultra-wide field imaging, peripheral OCT, and scanning laser ophthalmoscopy, make LD imaging possible on a routine basis, improving diagnosis and understanding of LD pathogenesis.
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Affiliation(s)
- Dmitrii S Maltsev
- Department of Ophthalmology, Military Medical Academy, St. Petersburg, Russia
| | - Alexei N Kulikov
- Department of Ophthalmology, Military Medical Academy, St. Petersburg, Russia
| | - Venera A Shaimova
- Academy of Postgraduate Education of the Federal Scientific and Clinical Center of Specialized Medical Care and Medical Technologies, Moscow, Russia
- “Center Zreniya”, Chelyabinsk, Russia
| | - Maria A Burnasheva
- Department of Ophthalmology, Military Medical Academy, St. Petersburg, Russia
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Li M, Yang D, Shen Y, Shang J, Niu L, Yu Y, Wang X, Yao P, Zhou X. Application of mydriasis and eye steering in ultrawide field imaging for detecting peripheral retinal lesions in myopic patients. Br J Ophthalmol 2022:bjophthalmol-2021-319809. [PMID: 35241443 PMCID: PMC10359684 DOI: 10.1136/bjophthalmol-2021-319809] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 02/16/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To compare mydriatic and eye-steering ultrawide field imaging (UWFI) with standard non-mydriatic UWFI examination in detecting peripheral retinal lesions in myopic patients. METHODS Cross-sectional, observational study. 220 eyes of 110 myopic patients with known peripheral retinal lesions in at least one eye under Goldmann three mirror contact lens examination were recruited. Non-mydriatic standard and eye-steering UWFI images were taken centrally and with eye-steering technique in upper, lower, nasal and temporal gazes under Optomap UWFI (Daytona, Optos, UK). Mydriatic standard and eye-steering UWFI was captured in central gaze and four different peripheral gazes. Sensitivity of detecting peripheral retinal lesions under different UWFI settings was compared. RESULTS 141 (64.09%) eyes were with peripheral retinal lesions. The sensitivity for detecting peripheral lesions from low to high was 41.84% (95% CI 33.62% to 50.54%) under non-mydriatic standard UWFI setting, 52.48% (95% CI 44.08% to 60.75%) under mydriatic standard setting, 75.18% (95% CI 67.21% to 82.06%) under non-mydriatic eye-steering setting and 86.52% (95% CI 79.76% to 91.69%) under mydriatic eye-steering setting. Both mydriasis and eye-steering technique increased sensitivity of detecting peripheral lesions with statistical significance (p<0.001). By applying eye-steering technique, sensitivity of detecting lesions located in superior and inferior quadrants witnessed a greater increase compared with other two quadrants (p<0.05). Neither spherical equivalence (p>0.05) nor axial length (p>0.05) was an independent influence factor for detecting peripheral lesions. CONCLUSIONS Eye-steering technique and mydriasis could both efficiently improve the sensitivity of detecting peripheral retinal lesions in myopic patients. Lesions of superior and inferior quadrants benefited more from eye-steering technique.
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Affiliation(s)
- Meiyan Li
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Danjuan Yang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Yang Shen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Jianmin Shang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Lingling Niu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Yongfu Yu
- Department of Biostatistics, School of Public Health of Fudan University, Shanghai, China
| | - Xiaoying Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Peijun Yao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China .,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China .,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
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Ulfik-Dembska K, Teper S, Dembski M, Nowińska A, Wylęgała E. Peripheral Retinal Degenerations and Idiopathic Epiretinal Membrane: Analysis with Ultra-Wide-Field Scanning Laser Ophthalmoscopy. J Clin Med 2021; 10:jcm10173876. [PMID: 34501323 PMCID: PMC8432095 DOI: 10.3390/jcm10173876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/12/2021] [Accepted: 08/24/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The present study examined the relationships among retinal structure, peripheral retinal abnormalities, and epiretinal membrane (ERM) and explored the utility of ultra-wide-field laser scanning ophthalmoscopy in idiopathic ERM assessment. METHODS The study sample comprised 276 eyes of 276 patients. Ultra-wide field fundus imaging was performed without mydriasis using Optos California. Each patient underwent a Goldmann three-mirror contact lens fundus examination. RESULTS Ultra-wide field laser scanning ophthalmoscopy revealed peripheral retinal degeneration in 84 (54.54%) eyes in the ERM and in 28 (22.95%) eyes in the control group. Goldmann three-mirror contact lens examination revealed peripheral retinal degeneration in 96 (62.33%) eyes in the ERM group and 42 (34.42%) eyes in the control group. Ultra-wide field ophthalmoscopy enabled the detection of nearly 87% of all peripheral retinal lesions in patients with ERM, but it cannot replace fundus examination with a Goldmann triple mirror or ophthalmoscopy with scleral indentation. CONCLUSIONS In most patients, idiopathic ERM coexisted with changes in the peripheral retina. Some of these changes promote retinal detachment. Thus, surgeons should consider the risk of retinal tear during vitrectomy, which increases the scope of surgery and may adversely affect prognosis. Although ultra-wide field imaging is a valuable diagnostic method, it is not a substitute for Goldmann three-mirror contact lens fundus examination or ophthalmoscopy with scleral indentation.
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Affiliation(s)
- Klaudia Ulfik-Dembska
- Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Poniatowskiego 15, 40-760 Katowice, Poland; (S.T.); (M.D.); (A.N.); (E.W.)
- Clinical Department of Ophthalmology, District Railway Hospital, Panewnicka 65, 40-760 Katowice, Poland
- Correspondence: ; Tel.: +48-32-605-35-92
| | - Sławomir Teper
- Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Poniatowskiego 15, 40-760 Katowice, Poland; (S.T.); (M.D.); (A.N.); (E.W.)
- Clinical Department of Ophthalmology, District Railway Hospital, Panewnicka 65, 40-760 Katowice, Poland
| | - Michał Dembski
- Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Poniatowskiego 15, 40-760 Katowice, Poland; (S.T.); (M.D.); (A.N.); (E.W.)
- Clinical Department of Ophthalmology, District Railway Hospital, Panewnicka 65, 40-760 Katowice, Poland
| | - Anna Nowińska
- Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Poniatowskiego 15, 40-760 Katowice, Poland; (S.T.); (M.D.); (A.N.); (E.W.)
- Clinical Department of Ophthalmology, District Railway Hospital, Panewnicka 65, 40-760 Katowice, Poland
| | - Edward Wylęgała
- Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Poniatowskiego 15, 40-760 Katowice, Poland; (S.T.); (M.D.); (A.N.); (E.W.)
- Clinical Department of Ophthalmology, District Railway Hospital, Panewnicka 65, 40-760 Katowice, Poland
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Deng X, Tanumiharjo S, Chen Q, Li S, Lin H, He Y, Jiang J, Zhang J. Myopic retinal changes screening: comparison of sensitivity and specificity among 15 combinations of ultrawide field scanning laser ophthalmoscopy images. Ophthalmic Res 2021; 64:1029-1036. [PMID: 33401267 DOI: 10.1159/000514176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 01/02/2021] [Indexed: 11/19/2022]
Abstract
AIMS To investigate the evaluation indices (diagnostic test accuracy and agreement) of 15 combinations of ultrawide field scanning laser ophthalmoscopy (UWF SLO) images in myopic retinal changes (MRC) screening to determine the combination of imaging that yields the highest evaluation indices in screening MRC. METHODS This is a retrospective study of UWF SLO images obtained from myopes and were analyzed by two retinal specialists independently. 5-field UWF SLO images that included the posterior (B), superior (S), inferior (I), nasal (N) and temporal (T) regions were obtained for analysis and its results used as a reference standard. The evaluation indices of different combinations comprising of one to four fields of the retina were compared to determine the abilities of each combinations screen for MRC. RESULTS UWF SLO images obtained from 823 myopic patients (1646 eyes) were included for the study. Sensitivities ranged from 50.0% to 98.9% (95% confidence interval (CI), 43.8-99.7%); the combinations of B+S+I (97.3%; 95% CI, 94.4-98.8%), B+T+S+I (98.5%; 95% CI, 95.9-99.5%), and B+S+N+I (98.9%; 95% CI, 96.4-99.7%) ranked highest. Furthermore, the combinations of B+S+I, B+T+S+I and B+S+N+I also revealed the highest accuracy (97.7%; 95% CI, 95.1-100.0%, 98.6%; 95% CI, 96.7-100.0%, 98.8%; 95% CI, 96.9-100.0%) and agreement (Kappa = 0.968, 0.980 and 0.980). For the various combinations, specificities were all higher than 99.5% (95% CI, 99.3-100.0%). CONCLUSION In our study, screening combinations of B+S+I, B+T+S+I and B+S+N+I stand out with high-performing optimal evaluation indices. However, when time is limited, B+S+I may be more applicable in primary screening of MRC.
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Affiliation(s)
- Xuan Deng
- Aier School of Ophthalmology, Central South University, Changsha, China
| | - Silvia Tanumiharjo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | | | - Shengnan Li
- Aier School of Ophthalmology, Central South University, Changsha, China
| | - Huimin Lin
- Guangzhou Aier Eye Hospital, Guangzhou, China
| | - Yanqiong He
- Guangzhou Aier Eye Hospital, Guangzhou, China
| | - Junyi Jiang
- Aier Eye Institute, Aier Eye Hospital Group, Changsha, China
| | - Jinglin Zhang
- Aier School of Ophthalmology, Central South University, Changsha, China
- Guangzhou Aier Eye Hospital, Guangzhou, China
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Venkatesh R, James E, Jayadev C. Screening and prophylaxis of retinal degenerations prior to refractive surgery. Indian J Ophthalmol 2020; 68:2895-2898. [PMID: 33229665 PMCID: PMC7856971 DOI: 10.4103/ijo.ijo_2101_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The need and demand for surgical correction of refractive errors, particularly myopia, has been increasing. Degenerations involving the peripheral retina are common in myopes and can result in a rhegmatogenous retinal detachment. There are no clear guidelines for retinal screening and management of asymptomatic retinal degenerations prior to refractive surgery or for follow-up of these patients. This article aims to provide a set of guidelines for the management of retinal degenerations in eyes undergoing refractive surgeries.
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Affiliation(s)
- Ramesh Venkatesh
- Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Edwin James
- Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Chaitra Jayadev
- Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
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Venkatesh R, Cherry JP, Reddy NG, Anilkumar A, Sridharan A, Sangai S, Shetty R, Yadav NK, Jayadev C. Inter-observer agreement and sensitivity of Optomap images for screening peripheral retinal lesions in patients undergoing refractive surgery. Indian J Ophthalmol 2020; 68:2930-2934. [PMID: 33229672 PMCID: PMC7856983 DOI: 10.4103/ijo.ijo_2239_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Purpose: The aim of this study was to compute the sensitivity, specificity and inter-reader variability of ultra-widefield retinal imaging (Optomap 200Tx) for screening retinal lesions before myopic refractive surgery. Methods: Two hundred and eight eyes of 109 consecutive refractive surgery candidates were included in this study. All subjects underwent Optomap 200Tx, mydriatic slit-lamp lens examination and dilated retinal examination with scleral indentation by a retinal specialist. Retinal findings by indirect dilated examination by retinal specialist was considered as the gold-standard. Sensitivity analyses for the readers were calculated between the Optomap images and the gold-standard retinal examination. Results: Seventy-three of the 208 eyes (35.1%) had peripheral retinal lesions diagnosed by the retinal specialist on dilated fundus examination. Peripheral lesions were seen on the Optomap images in 111 (53.4%) eyes. Compared to the dilated retinal examination, the detection rate with the Optomap 200Tx was 78.1% and specificity rate was 60%. The accuracy rate between the 3 readers ranged from 72% to 87%. The highest accuracy was noted with the reader post 1 year of retinal training (86.54%). Conclusion: The Optomap 200Tx showed a high sensitivity and moderate specificity for identifying peripheral retinal lesions in eyes undergoing refractive surgery. The Optomap examination is a convenient, fast and feasible method for detecting the pathological fundus changes in myopic eyes. The reliability of the examination improves when the images are interpreted by a reader with prior retinal training.
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Affiliation(s)
- Ramesh Venkatesh
- Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Jophy Philips Cherry
- Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Nikitha Gurram Reddy
- Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Aaditi Anilkumar
- Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Akhila Sridharan
- Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Sajjan Sangai
- Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Rohit Shetty
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Naresh Kumar Yadav
- Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Chaitra Jayadev
- Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
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Yang D, Li M, Wei R, Xu Y, Shang J, Zhou X. Optomap ultrawide field imaging for detecting peripheral retinal lesions in 1725 high myopic eyes before implantable collamer lens surgery. Clin Exp Ophthalmol 2020; 48:895-902. [PMID: 32510801 DOI: 10.1111/ceo.13809] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 04/30/2020] [Accepted: 06/04/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Danjuan Yang
- Department of Ophthalmology EYE and ENT Hospital, Fudan University Shanghai China
- NHC Key Laboratory of Myopia Fudan University Shanghai China
- Shanghai Research Center of Ophthalmology and Optometry Shanghai China
| | - Meiyan Li
- Department of Ophthalmology EYE and ENT Hospital, Fudan University Shanghai China
- NHC Key Laboratory of Myopia Fudan University Shanghai China
- Shanghai Research Center of Ophthalmology and Optometry Shanghai China
| | - Ruoyan Wei
- Department of Clinical Medicine, Shanghai Medical College Fudan University Shanghai China
| | - Ye Xu
- Department of Ophthalmology EYE and ENT Hospital, Fudan University Shanghai China
- NHC Key Laboratory of Myopia Fudan University Shanghai China
- Shanghai Research Center of Ophthalmology and Optometry Shanghai China
| | - Jianmin Shang
- Department of Ophthalmology EYE and ENT Hospital, Fudan University Shanghai China
- NHC Key Laboratory of Myopia Fudan University Shanghai China
- Shanghai Research Center of Ophthalmology and Optometry Shanghai China
| | - Xingtao Zhou
- Department of Ophthalmology EYE and ENT Hospital, Fudan University Shanghai China
- NHC Key Laboratory of Myopia Fudan University Shanghai China
- Shanghai Research Center of Ophthalmology and Optometry Shanghai China
- Department of Clinical Medicine, Shanghai Medical College Fudan University Shanghai China
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