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Virtual clinics using ultra-widefield retinal photography in patients with posterior vitreous detachment

Session Details

Session Title: Imaging II

Session Date/Time: Friday 12/09/2014 | 16:30-18:00

Paper Time: 17:26

Venue: Boulevard C

First Author: : S.Patwary UK

Co Author(s): :    S. Winder              

Abstract Details

Purpose:

A prospective, masked study to assess if virtual clinics using ultra-widefield retinal photography can be used as a substitute for retinal examination with scleral depression.

Setting:

Sheffield Teaching Hospital NHS Trust, UK

Methods:

Within our organization, patients attending with symptoms of posterior vitreous detachment are initially examined in an emergency eye clinic. All of these patients are offered a subsequent review with a retinal specialist for full examination with scleral depression. Previous audit data has shown that during these clinics new breaks are identified in approximately 10% of patients. Within our organization, patients attending with symptoms of posterior vitreous detachment are initially examined in an emergency eye clinic. All of these patients are offered a subsequent review with a retinal specialist for full examination with scleral depression. Previous audit data has shown that during these clinics new breaks are identified in approximately 10% of patients. 50 consecutive patients attending for review with the retinal specialist were enrolled in the study. All patients had ultra-widefield (UWF) retinal photography with the Optos camera using a standard protocol including the 9 positions of gaze. All patients also had a full retinal examination including 360 scleral depression which was recorded on a retinal examination chart. The digital photographs were subsequently examined by a masked observer and findings recorded on a second retinal examination chart.

Results:

Of the 50 patients that were enrolled in the study, 1 patient declined UWF photography. In 4 patients the retinal photographs were of poor quality due to either posterior capsule opacification (2 patients) or positioning of an IOL (2 patients). In all 4 of these patients, the view was not hindered during the clinical retinal examination. 36 patients had no significant abnormality detected. 8 previously unidentified breaks were recorded from 6 eyes of patients during the clinical examination. Of these, only 2 of the breaks were also identified from the UWF photographs. Other retinal pathology such as lattice, atrophy and pigmentation was documented from clinical examination in a further 8 patients. However UWF photography was able to identify these changes in only 2 of the patients. The UWF photographs did not identify any retinal changes that were not already documented through the clinical examination. In particular the superior and inferior view with UWF photographs are limited due to obstruction from the upper and lower eyelids.

Conclusions:

Virtual clinics using ultra-wide field retinal photography does not allow a full retinal assessment and is inferior to retinal examination with scleral depression.

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