Assessment of vitreous haze using ultra-wide field retinal imaging.
BACKGROUND
Conventional fundus imaging has been used to assess vitreous haze (VH) in patients with uveitis. Ultra-wide field (UWF) retinal imaging that uses scanning laser technology has not been evaluated for the detection of VH. This pilot study evaluates the ability of UWF imaging in detecting VH. Patients with intermediate, posterior, or panuveitis were examined to assess the level of VH using slit-lamp biomicroscopy. Colored fundus images were acquired using a Carl Zeiss FF450 camera. The same photographer obtained fundus images of the same eyes during the same visit by Optos UWF P200Tx retinal camera. Two graders independently analyzed UWF fundus images for presence or absence of VH, without quantifying the degree of VH using any scale. The images were analyzed using the composite red plus red-free wavelengths utilized by the Optos UWF camera and by using each wavelength exclusively. These findings were compared to clinical detection of VH and detection of VH using conventional fundus photography.


RESULTS
Ninety-two eyes were included in the study. For composite UWF images, sensitivity was 0.27, specificity was 0.88, PPV was 0.31, NPV was 0.86, positive LR was 2.25, and negative LR was 0.83. For the conventional Zeiss images, sensitivity was 0.5, specificity was 0.84, PPV was 0.33, NPV was 0.91, positive LR was 3.13, and negative LR was 0.6. Agreement between the composite UWF and Zeiss techniques was substantial with k = 0.64. Inter-observer agreement for composite UWF images was also substantial with k = 0.65. Inter-observer agreement for Zeiss images was moderate with k = 0.471. Intra-observer agreement for both imaging modalities was substantial with a composite UWF k = 0.76 and Zeiss k = 0.7.


CONCLUSIONS
UWF fundus imaging using scanning laser technique may be used to assess VH and employed in the management of intermediate, posterior, and panuveitis.
Ocular Imaging Research and Reading Center (OIRRC), Omaha, NE, 68198-5540, USA.
Drew
D
Dickson
Ocular Imaging Research and Reading Center (OIRRC), Omaha, NE, 68198-5540, USA.|Advanced Eye Center, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Aniruddha
A
Agarwal
Ocular Imaging Research and Reading Center (OIRRC), Omaha, NE, 68198-5540, USA.
Mohammad Ali
MA
Sadiq
Ocular Imaging Research and Reading Center (OIRRC), Omaha, NE, 68198-5540, USA.
Muhammad
M
Hassan
College of Public Health, University of Nebraska Medical Center, 984355 Medical Center, Omaha, NE, USA.
Robin
R
High
Ocular Imaging Research and Reading Center (OIRRC), Omaha, NE, 68198-5540, USA.
Quan Dong
QD
Nguyen
Ocular Imaging Research and Reading Center (OIRRC), Omaha, NE, 68198-5540, USA. yjs@oirrc.net.
Yasir J
YJ
Sepah
Fundus imaging; Scanning laser ophthalmoscopy; Ultra-wide field; Uveitis; Vitreous haze
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