Ultra widefield imaging of the retina [Imagen de retina de campo ultra-amplio]

Purpose To review the evolution and usefulness of ultra widefield images of the retina. Method Literature review. Results The ability to obtain images of the ocular fundus is one of the greatest breakthroughs in our specialty. This ability has refined over time, from obtaining images with a field of 30 degrees, to obtaining images that exceed 150 degrees using equipment such as the Optos Daytona (Optos, Dunfermline, United Kingdom) or the Heidelberg Spectralis (Heidelberg Engineering, Heidelberg, Germany). These images are extremely useful to evaluate diseases such as diabetic retinopathy, retinal vascular occlusions, pediatric retinal pathology, posterior uveitis, and even diseases which classically affect the macula such as age-related macular degeneration. Conclusion Ultra widefield images of the retina have revolutionized the way we study and understand retinal pathology. As technology for obtaining these images becomes more accessible, it will surely become part of the routine evaluation of retinal diseases. © 2016 Sociedad Mexicana de Oftalmologí

Color Fundus Photography Versus Fluorescein Angiography in Identification of the Macular Center and Zone in Retinopathy of Prematurity

PURPOSE: To examine the utility of fluorescein angiography (FA) in identification of the macular center and the diagnosis of zone in patients with retinopathy of prematurity (ROP). DESIGN: Validity and reliability analysis of diagnostic tools METHODS: 32 sets (16 color fundus photographs; 16 color fundus photographs paired with the corresponding FA) of wide-angle retinal images obtained from 16 eyes of eight infants with ROP were compiled on a secure web site. 9 ROP experts (3 pediatric ophthalmologists; 6 vitreoretinal surgeons) participated in the study. For each image set, experts identified the macular center and provided a diagnosis of zone. MAIN OUTCOME MEASURES: (1) Sensitivity and specificity of zone diagnosis (2) “Computer facilitated diagnosis of zone,” based on precise measurement of the macular center, optic disc center, and peripheral ROP. RESULTS: Computer facilitated diagnosis of zone agreed with the expert’s diagnosis of zone in 28/45 (62%) cases using color fundus photographs and in 31/45 (69%) cases using FA. Mean (95% CI) sensitivity for detection of zone I by experts as compared to a consensus reference standard diagnosis when interpreting the color fundus images alone versus interpreting the color fundus photographs and FA was 47% (35.3% – 59.3%) and 61.1% (48.9% – 72.4%), respectively, (t(9) ≥ (2.063), p = 0.073). CONCLUSIONS: There is a marginally significant difference in zone diagnosis when using color fundus photographs compared to using color fundus photographs and the corresponding fluorescein angiograms. There is inconsistency between traditional zone diagnosis (based on ophthalmoscopic exam and image review) compared to a computer-facilitated diagnosis of zone