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Abstract
Purpose
To evaluate various types and; characteristics of non-retinal lesions associated with ultra-wide field scanning laser ophthalmoscope images.
Methods
This retrospective study included 139 eyes of 139 patients with non-retinal lesions observed on color images obtained using Optomap 200Tx (Optos PLC, Dunfermline, Scotland, UK). The non-retinal lesion is a hyperreflective or hyporeflective shadow due to anterior segment of the eye or vitreous except the retina. Types and characteristics of red laser separation, green laser separation and autofluorescence images of non-retinal lesions were evaluated.
Results
All non-retinal lesions in images were categorized into 2 groups according to the location of non-retinal lesions. The ante-rior non-retinal lesions group included corneal opacity, cataract and posterior capsular opacity. The posterior non-retinal lesions group included asteroid hyalosis, posterior vitreous detachment, vitreous opacity and vitreous hemorrhage. Anterior non-retinal le-sions were more often hyporeflective in red and green laser separation images ( p < 0.001). Posterior non-retinal lesions were more often hyperreflective in green laser separation images and hyporeflective in red laser separation images ( p < 0.001).
Conclusions
Ultra-wide field scanning laser ophthalmoscope images can frequently have various shadows from anterior or pos-terior lesions of the eye. These shadows show a difference in reflectivity depending on their origins. To understand the difference helps in the interpretation of the fundus images.
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Figure 1.
A case of corneal opacity. Optomap composite color (A), green laser separation (B), red laser separation (C) and fundus autofluorescence image (D) of a 83-year-old female patient with corneal opacity of her right eye. Lesion appears dark in red laser separation image compared to a mixed in green laser separation image and autofluorescence image.
Figure 2.
A case of posterior subcapsular opacity. Optomap composite color (A), green laser separation (B), red laser separation (C) and fundus autofluorescence image (D) of a 74-year-old female patient with posterior subcapsular cortical opacity of her right eye. Lesion appears dark in red and green laser separation image and autofluorescence image.
Figure 3.
A case of asteroid hyalosis. Optomap composite color (A), green laser separation (B), red laser separation (C) and fundus auto-fluorescence image (D) of a 70-year-old female patient with asteroid hyalosis of her right eye. Lesion appears bright in red and green laser separation images. A central part of lesion is invisible in red laser separation image. A part of lesion is dark in autofluorescence image.
Figure 4.
A case of posterior vitreous detachment. Optomap composite color (A), green laser separation (B), red laser separation (C) and fun-dus autofluorescence image (D) of a 67-year-old female patient with posterior vitreous detachment of her right eye. Lesion appears dark in red laser separation image compared to a bright in green laser separation image. Lesion also appears dark in autofluorescence image.
Figure 5.
A case of vitreous opacity. Optomap composite color (A), green laser separation (B), red laser separation (C) and fundus autofluorescence image (D) of a 26-year-old male patient with vitreous opacity of his left eye. Lesion appears dark in red laser sepa-ration image compared to a bright in green laser separation image. Lesion also appears dark in autofluorescence image.
Figure 6.
A case of vitreous hemorrhage. Optomap composite color (A), green laser separation (B), red laser separation (C) and fun-dus autofluorescence image (D) of a 31-year-old male patient with vitreous hemorrhage of his left eye. Lesion appears dark in red & green laser separation image and autofluorescence image.
Table 1.
Baseline characteristics of each group
| Parameter | Anterior non-retinal lesion group (n = 33) | Posterior non-retinal lesion group (n = 106) | p-value |
|---|---|---|---|
| Age (years) | 61.64 ± 12.46 | 59.49 ± 15.83 | 0.121* |
| Sex (male:female) | 14:19 | 48:58 | 0.773† |
| Laterality (OD:OS) | 13:20 | 59:47 | 0.102† |
| Lens (phakic:pseudophakic) | 23:10 | 79:27 | 0.583† |
| Lesion location | 0.228† | ||
| Center | 20 | 47 | |
| Periphery | 7 | 37 | |
| Both | 6 | 22 | |
| Lesion appearance-Green laser | <0.001† | ||
| Hyperreflectivity | 1 | 83 | |
| Hyporeflectivity | 31 | 18 | |
| Mixed reflectivity | 1 | 5 | |
| Lesion appearance-Red laser | <0.001† | ||
| Hyperreflectivity | 1 | 33 | |
| Hyporeflectivity | 32 | 57 | |
| Mixed reflectivity | 0 | 16 | |
| Lesion appearance-Autofluorescence | 0.485† | ||
| Hyperreflectivity | 0 | 2 | |
| Hyporeflectivity | 19 | 54 | |
| Mixed reflectivity | 8 | 35 |
Table 2.
Logistic regression analysis showing the image properties of Optomap images as variables with their contribution to suc-cessfully differentiate anterior non-retinal lesion group form posterior non-retinal lesion group
| Variable* | B | S.E. | Wald | Sig. | Exp (B) |
95% CI for Exp (B) |
|
|---|---|---|---|---|---|---|---|
| Lower | Upper | ||||||
| Hypo-reflectivity | -4.962 | 1.049 | 22.390 | <0.001 | 0.007 | 0.001 | 0.055 |
| Mixed reflectivity | -2.809 | 1.487 | 3.568 | 0.059 | 0.060 | 0.003 | 1.111 |
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