Use of a Wide Field Scanning Laser Ophthalmoscope for Screening Purposes

Abstract Purpose: The wide field (200°) imaging system (Optos, Great Britain) using a scanning laser ophthalmoscope (SLO) enables to visualize a large part of the retina including the periphery. The present study was designed to evaluate the imaging system for screening purposes. Methods: The SLO system was used in 2 groups of patients:1) Outpatient clinic:An undilated retinal biomicroscopy was performed by a resident, and an undilated SLO image was taken by an orthoptist in training. The images were reviewed by another resident masked to results of the previous retinal biomicroscopy.2) Screening for diabetic retinopathyAn undilated and dilated retinal biomicroscopy was performed by a senior ophtalmologist. An undilated SLO image was taken by an orthoptist in training. The images were reviewed by a resident masked to results of the previous retinal biomicroscopy.The results of the clinical examination were compared with the results of the SLO image analysis. Results: In the outpatient group (n=123 eyes), the undilated retinal biomicroscopy missed 18% of the retinal lesions detected on the undilated SLO images. Less than 1% of the retinal lesions detected with the undilated retinal biomicroscopy were missed on the SLO images.In the diabetes group (n=134 eyes), the undilated retinal biomicroscopy missed 10% and the dilated retinal biomicroscopy missed 5% of the retinal lesions detected on the undilated SLO images. None of the retinal lesions detected with the undilated retinal biomicroscopy were missed on the SLO images. Conclusions: In both groups of patients, the diagnostic rate of undilated SLO images was significantly higher when compared with the diagnostic rate of undilated retinal biomicroscopy.