J Korean Ophthalmol Soc.  2014 Dec;55(12):1814-1820. 10.3341/jkos.2014.55.12.1814.

Identifiable Peripheral Retinal Lesions Using Ultra-Widefield Scanning Laser Ophthalmoscope and Its Usefulness in Myopic Patients

• Lee DH
• Kim SS
• Kim M
• Koh HJ

• KMID: 2338966
• DOI: http://doi.org/10.3341/jkos.2014.55.12.1814

Abstract

PURPOSE
To investigate identifiable peripheral retinal lesions in patients with myopia or high myopia and to evaluate the usefulness of ultra-widefield scanning laser ophthalmoscope in retina clinic settings.
METHODS
We evaluated fundus images of 149 patients acquired using an ultra-widefield scanning laser ophthalmoscope. Manual fundus examination by a retinal specialist was performed and sensitivity and specificity were calculated by comparing the findings of the two different fundus examination methods.
RESULTS
Variable peripheral retinal lesions were observed: lattice degeneration (24.1% in myopia, 36.6% in high myopia), white without pressure (17.7% in myopia, 20.7% in high myopia), retinal break (5.1% in myopia, 7.5% in high myopia) and retinal detachment (1.3% in myopia, 4.2% in high myopia). The incidence of lattice degeneration was significantly higher in myopic eyes than in highly myopic eyes (p = 0.043). The examination sensitivities were as follows: lattice degeneration (84.2% in myopia, 91.0% in high myopia), white without pressure (100.0% in both myopia and high myopia), retinal break (75.0% in myopia, 43.8% in high myopia) and retinal detachment (100.0% in myopia, 66.7% in high myopia). The examination specificities were 100.0% in all cases.
CONCLUSIONS
Diagnostic sensitivities of ultra-widefield scanning laser ophthalmoscope were 90.8% in patients with myopia, 91.0% in patients with high myopia and 90.9% in totally myopic patients, which were relatively high values. Therefore, the ultra- widefield scanning laser ophthalmoscope is useful as auxiliary equipment for myopic patients in retina clinic settings.

Keyword

High myopia; Myopia; Optomap; Peripheral retina; Scanning laser ophthalmoscope

MeSH Terms

Humans
Incidence
Myopia
Ophthalmoscopes*
Retina
Retinal Detachment
Retinal Perforations
Retinaldehyde*
Sensitivity and Specificity
Specialization
Retinaldehyde

Figure

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  Figure 1. Image of ultra-widefield imaging device, Optomap® Panoramic 200C (Optos PLC, Dunfermline, Fife, Scotland, UK).

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  Figure 2. Baseline age distribution of each group. 40-49 years old patients showed the highest proportion in myopic group (22.8%). 50-59-year-old patients showed the highest proportion in highly myopic group (27.7%) and in total eyes (23.3%).

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  Figure 3. An example of diagnostic failure of peripheral retinal lesions using ultra-widefield scanning laser ophthalmoscope. Nineteen-year-old male visited our clinic for known retinal detachment at the inferior quadrant of his left eye. (A) On primary gaze, ultra-widefield imaging device couldn't detect the lesion located at the inferior periphery due to eyelashes. (B) After downward gaze, a horseshoe retinal tear with bullous retinal detachment at the inferior was detected at last.

Reference

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