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Sharma P, Shareef I, Kalaw FGP, Kako RN, Lin A, Alex V, Nudleman E, Walker EH, Borooah S. Prevalence of peripheral retinal findings in retinal patients using ultra-widefield pseudocolor fundus imaging. Sci Rep 2023; 13:20515. [PMID: 37993580 PMCID: PMC10665364 DOI: 10.1038/s41598-023-47761-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/17/2023] [Indexed: 11/24/2023] Open
Abstract
Ultra-widefield retinal imaging is increasingly used in ophthalmology and optometry practices to image patients identifying peripheral abnormalities. However, the clinical relevance of these peripheral retinal abnormalities is unclear. This cross-sectional study aims to firstly validate a new grading system, secondly, assess the prevalence of peripheral retinal abnormalities in retinal patients, and finally understand how peripheral findings may associate with retinal disease. Ultra-widefield pseudocolor fundus images were taken from the eyes of clinic patients. Demographic data and clinical diagnosis for each patient was noted. The grading system was validated using masked retinal specialists. Logistic regression identified associations between retinal disease and peripheral retinal findings. Using the grading system, inter-observer agreement was 76.1% with Cohen's Kappa coefficient 0.542 (p < 0.0001) and the test-retest agreement was 95.1% with Kappa 0.677(p < 0.0001). 971 images were included, with 625 eyes (64.4%) having peripheral abnormalities. Peripheral drusen was the most common abnormality (n = 221, 22.76%) and correlated with age-related macular degeneration (p < 0.001). Novel correlations were also identified between diabetic retinopathy and retinal pigmentation as well as pigmentary degeneration. This study provides a validated system for identifying peripheral abnormalities and adds to literature highlighting peripheral retinal associations with retinal disease which would benefit from further study.
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Affiliation(s)
- Paripoorna Sharma
- University of California San Diego, La Jolla, USA
- Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA, 92093, USA
| | - Ihab Shareef
- University of California San Diego, La Jolla, USA
- Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA, 92093, USA
| | - Fritz Gerald P Kalaw
- Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA, 92093, USA
| | - Rasha Nabil Kako
- Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA, 92093, USA
| | - Andrew Lin
- Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA, 92093, USA
| | - Varsha Alex
- Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA, 92093, USA
| | - Eric Nudleman
- Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA, 92093, USA
| | | | - Shyamanga Borooah
- Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA, 92093, USA.
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Cheung R, Ly A, Katalinic P, Coroneo MT, Chang A, Kalloniatis M, Madigan MC, Nivison-Smith L. Visualisation of peripheral retinal degenerations and anomalies with ocular imaging. Semin Ophthalmol 2022; 37:554-582. [DOI: 10.1080/08820538.2022.2039222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Rene Cheung
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Angelica Ly
- Centre for Eye Health, University of New South Wales, Sydney, Australia
| | - Paula Katalinic
- Centre for Eye Health, University of New South Wales, Sydney, Australia
| | - Minas Theodore Coroneo
- Department of Ophthalmology, Prince of Wales Clinical School, Faculty of Medicine, The University of New South Wales, Sydney, Australia
| | - Andrew Chang
- Sydney Institute of Vision Science, Sydney, Australia
- Save Sight Institute, The University of Sydney, Sydney, Australia
| | - Michael Kalloniatis
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- Centre for Eye Health, University of New South Wales, Sydney, Australia
| | - Michele C. Madigan
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- Save Sight Institute, The University of Sydney, Sydney, Australia
| | - Lisa Nivison-Smith
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- Centre for Eye Health, University of New South Wales, Sydney, Australia
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Peripheral Manifestations in Age Related Macular Degeneration: A Review of Imaging and Findings. J Clin Med 2021; 10:jcm10173993. [PMID: 34501441 PMCID: PMC8432448 DOI: 10.3390/jcm10173993] [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: 03/27/2021] [Revised: 08/11/2021] [Accepted: 08/26/2021] [Indexed: 12/24/2022] Open
Abstract
Purpose: To review novel findings in research with ultra-widefield imaging for analysis of peripheral manifestations in macular degeneration (AMD). We introduce the evolving widefield imaging modalities while summarizing the analytical techniques used in data collection of peripheral retinal findings thus far. Our review provides a summary of advancements to date and a commentary on future direction for AMD research. Methods: This is a literature review of all significant publications focused on the relationship between AMD and the retinal periphery conducted within the last two decades. Results and Conclusion: Promising research has been undertaken to elucidate peripheral retinal manifestations in macular degeneration using novel methodology. Advancements in ultra-widefield imaging and fundus autofluorescence have allowed us to elucidate peripheral retinal pigmentary changes, drusen deposition, and much more. Novel grid overlay techniques have been introduced to aid in analyzing these changes for pattern recognition and grouping of findings. This review discusses these findings in detail, providing evidence for the pan-retinal manifestations of AMD. Inter-study discordance in analytical approach highlights a need for more systematic future study.
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Küçükiba K, Erol N, Bilgin M. Evaluation of Peripheral Retinal Changes on Ultra-Widefield Fundus Autofluorescence Images of Patients with Age-Related Macular Degeneration. Turk J Ophthalmol 2021; 50:6-14. [PMID: 32166942 PMCID: PMC7086101 DOI: 10.4274/tjo.galenos.2019.00359] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Objectives: Age-related macular degeneration (AMD) is the most common cause of central vision loss in individuals aged 65 years and older in developed countries. Earlier imaging systems did not enable visualization of the peripheral retina in diseases affecting the macula. With the introduction of new-generation devices, the peripheral retina is easily visualized. In our study, we aimed to evaluate the incidence of peripheral retinal changes in the color and autofluorescence fundus images of patients with AMD. Materials and Methods: In the study group, 550 eyes of 277 patients who were diagnosed with AMD and 90 eyes of 45 healthy patients in the control group were evaluated. An ultra-wide-angle imaging device was used to record standard 200° color and autofluorescence fovea-centered fundus images followed by superior and inferior fundus images obtained using the device’s fixation light. The fundus images were examined in 3 sections: zone 1, zone 2, and zone 3. Results: Evaluation of color fundus images revealed peripheral retinal changes in 67.8% of the 550 AMD eyes and 47.8% of the healthy eyes. Drusen was the most common peripheral retinal change. Evaluation of autofluorescence images revealed peripheral autofluorescence changes in 39.6% of the AMD eyes and 28.9% of the healthy eyes. Hypoautofluorescence was the most common autofluorescence change. Conclusion: Peripheral retinal changes were more common in AMD patients than the control group, indicating that AMD is not only a macular disease, but can affect the entire retina. Future prospective studies will elucidate the relationship between these peripheral retinal changes and patients’ genetic features and their importance in prognosis, diagnosis, and treatment.
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Affiliation(s)
- Kübra Küçükiba
- Eskişehir Osmangazi University Hospital, Clinic of Ophthalmology, Eskişehir, Turkey
| | - Nazmiye Erol
- Eskişehir Osmangazi University Hospital, Clinic of Ophthalmology, Eskişehir, Turkey
| | - Muzaffer Bilgin
- Eskişehir Osmangazi University Hospital, Clinic of Ophthalmology, Eskişehir, Turkey
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Less Expansion of Short-Pulse Laser Scars in Panretinal Photocoagulation for Diabetic Retinopathy. J Ophthalmol 2018; 2018:9371895. [PMID: 29850219 PMCID: PMC5933014 DOI: 10.1155/2018/9371895] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 03/12/2018] [Indexed: 11/17/2022] Open
Abstract
Purpose To compare the expansion rates of laser photocoagulation scars between the conventional laser and short-pulse laser using fundus autofluorescence (FAF). Methods Retrospective chart review. Conventional laser was performed on 6 eyes of 6 patients, and short-pulse laser was performed on 11 eyes of 8 patients with diabetic retinopathy. FAF images were obtained by Optos® 200Tx (Optos, Dunfermline, Scotland, UK) at 1, 3, 6, and 12 months after treatment. The average area of 20 photocoagulation scars was measured by using ImageJ software. The expansion rates were calculated from the proportion of the averaged area against the optic disc area. Regression of retinopathy and central macular thickness were also evaluated. Results The expansion rates of the conventional laser scars compared with the size at 1 month after treatment were 1.12 ± 0.08 (3 M), 1.27 ± 0.12 (6 M), and 1.39 ± 0.11 (12 M). The expansion rates of the short-pulse laser scars were 1.04 ± 0.05 (3 M), 1.09 ± 0.04 (6 M), and 1.13 ± 0.05 (12 M). The expansion rates of the short-pulse laser were significantly lower than those of the conventional laser (p < 0.01). Conclusion FAF images were useful to evaluate the changes in the photocoagulation scar sizes. The scars with the short-pulse laser showed lower expansion rates than those of the conventional laser.
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Characteristic appearances of fundus autofluorescence in treatment-naive and active polypoidal choroidal vasculopathy: a retrospective study of 170 patients. Graefes Arch Clin Exp Ophthalmol 2018; 256:1101-1110. [DOI: 10.1007/s00417-018-3980-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 03/28/2018] [Accepted: 04/05/2018] [Indexed: 10/17/2022] Open
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Kurobe R, Hirano Y, Niwa N, Sugitani K, Yasukawa T, Yoshida M, Ogura Y. Wide-field fluorescein and indocyanine green angiography findings in the eyes with Vogt-Koyanagi-Harada disease. J Ophthalmic Inflamm Infect 2017; 7:16. [PMID: 28695542 PMCID: PMC5503852 DOI: 10.1186/s12348-017-0134-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 07/05/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study is to report wide-field angiography findings before and after steroid therapy in a case with bilateral Vogt-Koyanagi-Harada (VKH) disease. RESULTS A 44-year-old woman presented with bilateral blurred vision and metamorphopsia accompanied by symptoms of headache and tinnitus. The baseline best-corrected visual acuity was 20/20 in both eyes. Ophthalmic examination revealed a shallow anterior chamber and panuveitis accompanied by multiple serous retinal detachments in both eyes and ciliochoroidal detachments in the left eye. Wide-field fluorescein angiograms showed hyperfluorescene indicating pooling corresponding to multiple serous retinal detachments in the posterior lesion and vascular leakage in the peripheral retina and choroid, resolved after steroid tapering therapy. Interestingly, wide-field indocyanine angiograms revealed narrowing of choroidal vessels in the acute phase and its normalization with resolution of inflammation after the therapy. CONCLUSIONS Eyes with Vogt-Koyanagi-Harada disease had peripheral chorioretinal vascular leakage and choroidal vessel narrowing in the acute phase. Wide-field angiography is a useful tool to reveal peripheral chorioretinal findings and assess diameters and density of choroidal vessels.
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Affiliation(s)
- Ryo Kurobe
- Department of Ophthalmology & Visual Science, Nagoya City University Graduate School of Medical Sciences, 1-Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan
| | - Yoshio Hirano
- Department of Ophthalmology & Visual Science, Nagoya City University Graduate School of Medical Sciences, 1-Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
| | - Naomi Niwa
- Department of Ophthalmology & Visual Science, Nagoya City University Graduate School of Medical Sciences, 1-Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan
| | - Kazuhiko Sugitani
- Department of Ophthalmology & Visual Science, Nagoya City University Graduate School of Medical Sciences, 1-Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan
| | - Tsutomu Yasukawa
- Department of Ophthalmology & Visual Science, Nagoya City University Graduate School of Medical Sciences, 1-Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan
| | - Munenori Yoshida
- Department of Ophthalmology & Visual Science, Nagoya City University Graduate School of Medical Sciences, 1-Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan
| | - Yuichiro Ogura
- Department of Ophthalmology & Visual Science, Nagoya City University Graduate School of Medical Sciences, 1-Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan
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