Scanning laser 'en face' retinal imaging of epiretinal membranes.
OBJECTIVE
Comparison of scanning laser ophthalmoscopy (SLO) based 'en face' imaging techniques of patients with epiretinal membranes (ERM) and evaluation of the accuracy of preoperative diagnostic imaging.


METHODS
A consecutive, prospective series of 53 study eyes of 46 patients with clinically diagnosed and in optical coherence tomography (OCT) confirmed symptomatic ERMs were included in this study. Spectral domain (SD-) OCT volume scans (20° × 20° with 49 horizontal sections, ART 15) including SLO en face and fundus autofluorescence (FAF) images of the macula were obtained with HRA2 (Heidelberg Retina Angiograph-Optical Coherence Tomography, Heidelberg Engineering, Heidelberg, Germany). In addition, wide-field SLO color and FAF images (Optomap 200Tx, Optos PLC, Dunfermline, UK) were performed also covering the macular area. En face images of both devices were graded for each included study eye based on SD-OCT cross sectional scans.


RESULTS
Grading of SD-OCT (HRA2) based SLO en face green-blue enhanced multi-color, green reflectance, blue reflectance and standard multi-color visualization revealed a better detectability of ERM than SD-OCT-based en face infrared or FAF images or wide-field SLO (Optomap) based pseudo-color, red laser separation, green laser separation, or FAF images. Both FAF visualizations, HRA2 and Optomap based, achieved low mean scores. SD-OCT based en face thickness map visualization revealed good visualization but poor demarcation of epiretinal membranes.


CONCLUSIONS
In summary, en face regular or enhanced multicolor SLO images acquired with HRA2 allow a better visualization of epiretinal membranes for preoperative evaluation compared to SD-OCT based en face thickness map or pseudo-color images acquired with Optomap while infrared or FAF images are least suitable to depict epiretinal membranes.
Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
Lukas
L
Reznicek
Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
Simeon
S
Dabov
Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
Bader
B
Kayat
Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
Raffael
R
Liegl
Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
Anselm
A
Kampik
Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
Michael
M
Ulbig
Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
Marcus
M
Kernt
En face; Epiretinal membrane (ERM); Fundus autofluorescence; Optical coherence tomography (OCT); Retinal imaging