title: Wide-field retinal imaging in the management of noninfectious posterior uveitis.
abstract: OBJECTIVE
  To determine whether the use of ultra wide-field imaging changes the management or determination of disease activity in patients with noninfectious posterior uveitis.
  
  
  METHODS
  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.
authors.affiliation: Retinal Imaging Research and Reading Center, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: John Peter
authors.initials: JP
authors.lastname: Campbell
authors.forename: Henry Alexander
authors.initials: HA
authors.lastname: Leder
authors.forename: Yasir Jamal
authors.initials: YJ
authors.lastname: Sepah
authors.forename: Theresa
authors.initials: T
authors.lastname: Gan
authors.forename: James P
authors.initials: JP
authors.lastname: Dunn
authors.forename: Elham
authors.initials: E
authors.lastname: Hatef
authors.forename: Brian
authors.initials: B
authors.lastname: Cho
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ibrahim
authors.forename: Millena
authors.initials: M
authors.lastname: Bittencourt
authors.forename: Roomasa
authors.initials: R
authors.lastname: Channa
authors.forename: Diana V
authors.initials: DV
authors.lastname: Do
authors.forename: Quan Dong
authors.initials: QD
authors.lastname: Nguyen
mesh_terms: D000328:Adult; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D009887:Ophthalmoscopy; D011446:Prospective Studies; D012160:Retina / Q000473:pathology*; D011795:Surveys and Questionnaires; D015866:Uveitis, Posterior / Q000175:diagnosis* / Q000628:therapy*