As an eyecare professional, providing comprehensive exams is tantamount to patient care. By adding tools, such as ultra-widefield (UWF™) retinal imaging with multiple modalities, the ability to detect pathology, which may be missed with single-image modality and/or conventional narrow-field fundus photography, is a game changer.
UWF retinal imaging is performed by a specially designed scanning laser ophthalmoscope (SLO) that generates a high-resolution digital image covering 200 degrees (or about 82 percent) of the retina, in a single capture. By comparison, conventional 7 standard field (7SF) ETDRS and fundus camera photographs produce a relatively narrow view (75 degrees or less) of the retina. The SLO simultaneously scans the retina using two low-power lasers (red – 633 nm and green – 532 nm) that enable high-resolution, color imaging of retinal substructures. The resulting UWF digital image – optomap or optomap af – UWF retinal imaging utilizing fundus autofluorescence (FAF), is produced.
What is Fundus Autofluorescence?
FAF, is an imaging modality used to provide information on the health and function of the retinal pigment epithelium (RPE). Over time, the retinal photoreceptors naturally age and produce a metabolic waste known as lipofuscin. Lipofuscin is the fatty substance found in the retinal pigment epithelium. Excessive amounts can …
A recent study (Friberg, Ophthalmology Retina) evaluated morphologic and angiographic changes in the peripheral retina associated with age-related macular degeneration (AMD) using ultra-widefield (UWF™) retinal imaging. The purpose was to illuminate the potential value of using UWF optomap® imaging as a potential tool for detecting peripheral changes that could flag the early warning signs and/or progression of AMD.
AMD is a common eye condition that causes damage to the macula, and is a leading cause of vision loss among people age 50 and older. In some people, AMD advances so slowly that vision loss does not occur for a long time. In others, the disease progresses faster and may lead to a loss of vision in one or both eyes. AMD by itself does not lead to complete blindness, with no ability to see. However, the loss of central vision in AMD can interfere with simple everyday activities, such as the ability to see faces, drive, read, write, or do close work, such as cooking or fixing things around the house.1
Glaucoma is a degenerative, sight-threatening disease regarded as one of the major causes of blindness, accounting for an estimated 60 million people worldwide. By the year 2020 this number is thought to increase to around 80 million people globally.1
In a recent study2, the potential use of UWF imaging to detect glaucoma, and specifically to evaluate the reproducibility of measures of vertical cup-to-disc ratio (VCDR) using UWF, and the agreement between UWF and standard color digital stereoscopy (CDS), was conducted.
The purpose of this study was to evaluate the reproducibility and validity of UWF imaging in estimating VCDR measurements.
Observational study 100 eyes from 100 consecutive patients using CDS and UWF Northern Ireland Cohort for the Longitudinal Study of Aging (NICOLA)
A factor to consider when estimating VCDRs using different ophthalmic techniques is the dimension of the image it produces. 3D v 2D, as well as image color affecting appearance for interpretation of cup depression and elevation and vessel contours. However, previous studies have reported on the value of non-stereo fundus images to evaluate disc cupping reporting no differences in diagnostic performance between monoscopic and stereoscopic images when detecting glaucoma.3,4
Ultra-widefield (UWF™) technology supports and enables practice efficiency for eyecare professionals across all settings1. The integration of optomap® technology as a routine diagnostic and screening tool has shown to improve workflow and increase service capacity within a very short time, according to many eyecare professionals. Its ease of use makes for a smooth implementation process, and clinically, optomap has been found valuable as documented in over 400 peer-reviewed papers. Further, optomap can facilitate timely referrals for clinical opinions, supporting earlier treatment interventions and promoting collaboration between a variety of healthcare professionals and eyecare professionals alike. These all equate to improved patient workflow, clinical accuracy, and timely diagnosis and treatment for patients2.
Practice Efficiency in all Eye Care Settings
In an attempt to improve patient flow in his practice, optometrist David Anderson (Miamisburg Vision Care, Ohio) invested in a Daytona from Optos and, found his expectations exceeded for efficiency and as a diagnostic tool. Dr. Anderson noticed that the addition of the optomap allowed for more proficient patient service, from start to finish. Likewise, ophthalmologist, Scott Segal, MD started using optomap imaging in his practice (Pasadena Eye Associates, Texas) four years ago. Within the first two weeks, it became an integral part of his practice and had positively impacted how he practiced medicine.
As the number of patients with diabetes worldwide continues to skyrocket, Australia’s current population of 24.6 million people is not immune. In fact, 1.1 million individuals have diabetes. As diabetes increases so does the prevalence of Diabetic Retinopathy (DR) making it the leading cause of visual impairment and preventable blindness in working age people in Australia1.
In general, most individuals are not aware how risky DR is to sight loss, therefore it is critical for them to be educated on the risks. Even if a patient is asymptomatic, they may have early non-proliferative stages of DR which typically shows progressive vascular changes within the retina which usually occurs before any change to vision. Once disease reaches the proliferative stage, vision loss can occur rapidly and can be permanent. Key symptoms of proliferative DR include new abnormal blood vessels on the retinal surface, these new blood vessels are weak and may bleed causing retinal damage or lead to vitreous hemorrhage; this may also be associated with the formation of fibrous scar tissue and can cause retinal detachments.
optomap® ultra-widefield (UWF™) retinal imaging assists eyecare professionals detect, manage, and treat the diseases associated with diabetes. In Australia, optomap UWF imaging provides a cornerstone …