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Widefield Retinal

Imaging

Thomas W. Stone, MD Retina Associates of Kentucky

The Springs Medical Center

July 17, 2014

History of Imaging

Optomap fa

optomap

Standard

Images Courtesy of Mat MacCumber, MD,

Rush University

CMV Patient

Same Patient, Same Day

ResMax® = 100° image with a resolution of 11µm

+4 Cortical Cataract

Considerations • Clinic issues

• Location

• Effect on Flow

• Opportunity Cost in Space, Dollars

• People issues

• Photographer use/ease

• Patient use/ease

• Image interaction – software

• Clinical Utility

Considerations • Clinic issues

• Location

• Effect on Flow

• Opportunity Cost in Space, Dollars

• People issues

• Photographer use/ease

• Patient use/ease

• Image interaction – software

• Clinical Utility

Cases

Case 1: Retinal Vascular

DM. Presented with VH/PDR OS.

Case 2: Macular Disease

Case 3: Autofluorescence

Angioid streaks

Case 4: Uveitis

Vasculitis with vitreous hemorrhage

Case 5: Tumors

Case 6: CRVO

Advantages • Provides a detailed view of the

peripheral retina, color, and angiography

• Real-time imaging with angiography

• Easy to use, non-contact, works well

with media opacity

• Integrates well with existing hardware,

mature software platform

• Kernt M, Schaller UC, Stumpf C, et al. Choroidal pigmented lesions imaged by ultra-wide-field

scanning laser ophthalmoscopy with two laser wavelengths (Optomap). Clin Ophthalmol 2010;4:829-

36.

• Meyer CH, Saxena S. Non-mydriatic imaging of a giant retinal tear with the Optos Optomap

Panoramic 200MA. Clin Experiment Ophthalmol 2010;38:427.

• Mudvari SS, Virasch VV, Singa RM, et al. Ultra-wide-field imaging for cytomegalovirus retinitis.

Ophthalmic Surg Lasers Imaging 2010;41:311-5.

• Meyer CH, Holz FG. Documentation of congenital hypertrophy of the retinal pigment epithelium with

wide-field funduscopy. Semin Ophthalmol 2009;24:251-3.

• Coleman P, Barnard NA. Congenital hypertrophy of the retinal pigment epithelium: prevalence and

ocular features in the optometric population. Ophthalmic Physiol Opt 2007;27:547-55. Shah SP, Jain

A, Tsui I, et al.

• Optos Optomap Panoramic 200MA imaging of a serous choroidal detachment responsive to

furosemide. Semin Ophthalmol 2009;24:40-2.

• Khandhadia S, Madhusudhana KC, Kostakou A, et al. Use of Optomap for retinal screening within an

eye casualty setting. Br J Ophthalmol 2009;93:52-5.

• Neubauer AS, Kernt M, Haritoglou C, et al. Nonmydriatic screening for diabetic retinopathy by ultra-

widefield scanning laser ophthalmoscopy (Optomap). Graefes Arch Clin Exp Ophthalmol

2008;246:229-35.

DRCR Protocol AA

• One Optos image appears to give more

information than 7 standard ETDRS

fields

• Early studies show those patients with

peripheral findings progress more rapidly

than those without

Thank You

Thank You