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Abstract
Purpose
To evaluate the availability of ultrawide-field fundus photography compared to fundus examination after pupil dilatation in Korean patients with retinal break.
Methods
For this retrospective case review of consecutive 160 patients, 230 lesions with retinal breaks were recruited. The ul-tra-wide-field images were taken after fundus examination with pupil dilatation performed by a retinal specialist. We analyzed ul-tra-wide-field images according to patient characteristics and separated area. We divided lesions into anterior and posterior areas, and each area was separated into 4 quadrants (superior, inferior, temporal, and nasal).
Results
The sensitivity of ultrawide-field imaging for detecting retinal break was 72% (95% confidence interval [CI] 65–79%), and the specificity was 94% (95% CI 90–98%). The sensitivity of detection of posterior retina was 89% (95% CI 85–93%), and that of anterior retina was 72% (95% CI 66–78%); this difference was significant (p = 0.007). There was a significant statistical difference at the inferior quadrant between anterior and posterior retina, but not at superior, temporal, or nasal quadrants. The sensitivity of detection in the inferior quadrant in the anterior retina was 43% (95% CI 29–57%).
References
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Table 1.
The patient demographics and the comparison of two patient groups
| Demographics | Total (N = 160) | Positive (N = 115) | Negative (N = 45) | p-value |
|---|---|---|---|---|
| Age (years, range) | 53.8 ± 14.0 | 55.2 ± 12.6 | 50.3 ± 16.6 | 0.079* |
| (14 to 81) | (14 to 81) | (16 to 75) | ||
| Male/Female sex (%) | 96/64 (60/40) | 69/46 (60/40) | 27/18 (60/40) | 1.000†‡ |
| Right/Left eye (%) | 80/80 (50/50) | 59/56 (51.3/48.7) | 21/24 (46.7/53.3) | 0.725†‡ |
| Spherical equivalent (D, range) | –2.76 ± 3.36 | –2.81 ± 4.21 | –2.64 ± 3.54 | |
| (−10.25 to +3.75) | (−10.25 to +3.75) | (−8.25 to +3.50) | ||
| Previous Cataract surgery | 0.235†‡ | |||
| No (N = 26) | 26 (16%) | 16 (61%) | 10 (39%) | |
| Yes (N = 134) | 134 (84%) | 99 (74%) | 35 (26%) |
Values are presented as mean ± standard deviation (SD) unless otherwise indicated. Patient groups are classified by ultrawide fundus photo image which shows total retinal break lesions or not. For example, if three retinal break lesions are found in dilated fundoscopy but only two lesions are found at ultrawide fundus photo image then this patient is under negative group, otherwise, the three lesions are found at the image then this patient is under positive group. p-value was calculated by difference between positive group and negative group.
Table 2.
The sensitivities and specificity of ultrawide field fundus photography by patient characteristics
Table 3.
Identified retinal breaks of retinal areas
| Area | Number (%) |
|---|---|
| Total | 230 (100) |
| Anterior | 161 (70) |
| Temporal | 49 (21) |
| Superior | 38 (17) |
| Nasal | 24 (10) |
| Inferior | 48 (21) |
| Posterior | 69 (30) |
| Temporal | 30 (13) |
| Superior | 12 (5) |
| Nasal | 18 (8) |
| Inferior | 10 (4) |
Table 4.
The sensitivities of ultrawide field fundus photography divided by the areas of the lesions
|
Sensitivity (95% confidence interval) |
p-value | |||
|---|---|---|---|---|
| Total | Antethioth | Postethioth | ||
| Quadrants | 77% (72–82%) | 72% (66–78%) | 89% (85–93%) | 0.007‡ |
| Temporal | 95% (88–100%) | 100% | 0.262* | |
| Superior | 72% (61–83%) | 73% (52–94%) | 0.791† | |
| Nasal | 84% (72–96%) | 88% (76–100%) | 0.611† | |
| Inferior | 43% (29–57%) | 80% (61–99%) | 0.031‡ | |
Table 5.
Intraclass correlation coefficient between retina specialist and ophthalmology resident
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