Comparison of ultra-wide field laser ophthalmoscopy and indirect ophthalmoscopy for fundus examination of myopia

Objective

To evaluate the clinical reliability of ultra-wide field laser scanning ophthalmoscopy and indirect ophthalmoscopy for the fundus examination of myopia.

Methods

A diagnostic test was performed.A total of 2 104 eyes of 1 052 myopic patients scheduled for corneal refractive surgery were enrolled from March to May in 2017 in Beijing Tongren Hospital, the subjects were firstly examined with ultra-wide field laser scanning ophthalmoscopy, then followed indirect ophthalmoscopy in full dilated pupil for the detection of fundus lesions.The total number of lesions, the number of lesion eyes, the lesions location and the missed diagnosis were analyzed and compared between the two examination methods.The consistency of the two methods was analyzed by Kappa test.This study followed the Declaration of Helsinki.and the written consent was obtained from the patients and their families.

Results

A total of 186 fundus lesions in 137 eyes were screened out, of which 121 fundus lesions in 89 eyes were detected by both the two methods.For ultra-widefield laser ophthalmoscopy, 150 fundus lesions in 110 eyes were found and 36 fundus lesions in 27 eyes were missed; For indirect ophthalmoscopy, 157 of fundus lesions in 116 eyes were found and 29 fundus lesions in 21 eyes were missed.There was a good consistent of the detection rate of fundus leision between the two examination methods (kappa=0.776, P<0.001). There was a significant difference in the number for different kinds of retinal lesions between the two methods (χ²=15.527, P=0.004). Compared with the indirect ophthalmoscopy, the ultra-wide field laser scanning ophthalmoscopy had a higher detection rate for lattice-like degeneration, retinal holes, and retinal detachment.There were no statistically significant differences between the two methods in the detection rate of fundus lesions, the number of fundus lesions among different ages, the number of fundus lesions among different quadrants, and the detection rate of fundus lesions among different diopters.

Conclusions

Ultra-wide field laser scanning ophthalmoscopy is a reliable method for screening the fundus lesions of myopia in prerefractive surgery.The detection rate is similar to conventional dilated pupil indirect ophthalmoscopy.