The Sensitivity of Ultra-Widefield Fundus Photography versus Scleral Depressed Examination for Detection of Retinal Horsehoe Tears

Ultra-widefield (UWF) imaging is commonly used in ophthalmology in tandem with scleral depressed examinations (SDE) to evaluate peripheral retinal disease. Due to increased reliance of this technology in tele-ophthalmology, it is critical to evaluate its efficacy for detecting the peripheral retina...

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Bibliographic Details
Published in:American journal of ophthalmology 2023-07
Main Authors: Lin, Andrew C, Kalaw, Fritz Gerald P, Schönbach, Etienne M, Song, Delu, Koretz, Zachary, Walker, Evan, Breazzano, Mark P, Scott, Nathan L, Borooah, Shyamanga, Ferreyra, Henry, Spencer, Doran B, Goldbaum, Michael H, Nudleman, Eric D, Freeman, William R, Toomey, Christopher B
Format: Article
Language:English
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Summary:Ultra-widefield (UWF) imaging is commonly used in ophthalmology in tandem with scleral depressed examinations (SDE) to evaluate peripheral retinal disease. Due to increased reliance of this technology in tele-ophthalmology, it is critical to evaluate its efficacy for detecting the peripheral retina when performed in isolation. Therefore, we sought to evaluate UWF imaging sensitivity in detecting retinal horseshoe tears (HST). A retrospective clinical validity and reliability study METHODS: A single-institutional retrospective analysis was performed on patients at the Shiley Eye Institute, UC, San Diego. Those with HSTs seen on SDE and underwent treatment with laser were included in the study. 140 patients with HSTs in the right and/or left eyes met the inclusion criteria. Those with concomitant ruptured globes, retinal detachments and vitreous hemorrhages were excluded. A total of 123 patients with 135 HSTs were included in the final analysis. The primary outcome was the number of HSTs detected by UWF imaging. A secondary outcome was HST location. Sensitivity was measured with respect to HST location and statistical significance was calculated by Fisher exact testing. 69 (51.1%) HSTs were visualized on UWF images and 66 (48.9%) were not visualized. The sensitivity of UWF imaging in capturing HSTs was 7/41 (17.1%), 8/25 (32.0%), 7/14 (50.0%) and 47/55 (85.5%) for the superior, inferior, nasal and temporal quadrants, respectively. Sensitivities among HST visibility and location were statistically significant (p < 0.001) CONCLUSIONS: Nearly half of HSTs were missed by UWF imaging. This study demonstrates that UWF imagin.
ISSN:1879-1891