Wide-field retinal imaging in the management of noninfectious posterior uveitis.

Publications // Roomasa Channa // Nov 01 2012

PubMed ID: 22935598

Author(s): Campbell JP, Leder HA, Sepah YJ, Gan T, Dunn JP, Hatef E, Cho B, Ibrahim M, Bittencourt M, Channa R, Do DV, Nguyen QD. Wide-field retinal imaging in the management of noninfectious posterior uveitis. Am J Ophthalmol. 2012 Nov;154(5):908-911.e2. doi: 10.1016/j.ajo.2012.05.019. Epub 2012 Aug 28. PMID 22935598

Journal: American Journal Of Ophthalmology, Volume 154, Issue 5, Nov 2012

PURPOSE To determine whether the use of ultra wide-field imaging changes the management or determination of disease activity in patients with noninfectious posterior uveitis.

DESIGN Prospective, observational case series.

METHODS setting: Divisions of Retina and Ocular Immunology at single academic medical center. patient population: Total of 43 patients with noninfectious posterior uveitis seen by 4 investigators at the Wilmer Eye Institute. procedures: Each patient underwent standard clinical examination, followed by ultra wide-field scanning laser ophthalmoscope (SLO) imaging and angiography. Investigators successively determined disease activity and management decisions based on clinical examination, examination plus simulated 30- or 60-degree fluorescein angiography (FA) (obtained by physically narrowing the field of view of the wide-field images), examination plus ultra wide-field SLO images, and examination plus wide-field FA. main outcome measures: The primary outcome was the percentage of patients whose management changed based on the availability of wide-field imaging, compared with standard examination and imaging. The secondary outcome was detection of disease activity with and without wide-angle imaging.

RESULTS Management was altered in 7 of 43 patients (16%) based on examination and limited FA, whereas 21 of 43 patients (48%) had management change with the use of the ultra wide-field imaging and angiography (P < .001). Disease activity was detected in 22 of 43 patients (51%) based on examination and simulated conventional imaging, and in 27 of 43 (63%) with wide-field imaging (P = .27).

CONCLUSIONS The index study, with several design limitations, has suggested that ultra wide-field imaging may alter management decisions compared to standard-of-care imaging and clinical examination. Additional studies, including longitudinal evaluations, are needed to determine whether these findings, or the subsequent management alterations, may improve patient outcomes.

Copyright © 2012 Elsevier Inc. All rights reserved.