Comparison of ultra-widefield fluorescein angiography with the Heidelberg Spectralis noncontact ultra-widefield module versus the Optos Optomap

mparison of ultra-widefield fluorescein angiography with the Heidelberg Spectralis noncontact ultra-widefield module versus the Optos Optomap Original Research (1082) Total Article Views Authors: Witmer MT, Parlitsis G, Patel S, Kiss S Published Date February 2013 Volume 2013:7 Pages 389 - 394 DOI: http://dx.doi.org/10.2147/OPTH.S41731 Received: 17 December 2012 Accepted: 15 January 2013 Published: 21 February 2013 Matthew T Witmer, George Parlitsis, Sarju Patel, Szilárd Kiss Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA Purpose: To compare ultra-widefield fluorescein angiography imaging using the Optos Optomap and the Heidelberg Spectralis noncontact ultra-widefield module. Methods: Five patients (ten eyes) underwent ultra-widefield fluorescein angiography using the Optos panoramic P200Tx imaging system and the noncontact ultra-widefield module in the Heidelberg Spectralis HRA+OCT system. The images were obtained as a single, nonsteered shot centered on the macula. The area of imaged retina was outlined and quantified using Adobe Photoshop C5 software. The total area and area within each of four visualized quadrants was calculated and compared between the two imaging modalities. Three masked reviewers also evaluated each quadrant per eye (40 total quadrants) to determine which modality imaged the retinal vasculature most peripherally. Results: Optos imaging captured a total retinal area averaging 151,362 pixels, ranging from 116,998 to 205,833 pixels, while the area captured using the Heidelberg Spectralis was 101,786 pixels, ranging from 73,424 to 116,319 (P = 0.0002). The average area per individual quadrant imaged by Optos versus the Heidelberg Spectralis superiorly was 32,373 vs 32,789 pixels, respectively (P = 0.91), inferiorly was 24,665 vs 26,117 pixels, respectively (P = 0.71), temporally was 47,948 vs 20,645 pixels, respectively (P = 0.0001), and nasally was 46,374 vs 22,234 pixels, respectively (P = 0.0001). The Heidelberg Spectralis was able to image the superior and inferior retinal vasculature to a more distal point than was the Optos , in nine of ten eyes (18 of 20 quadrants). The Optos was able to image the nasal and temporal retinal vasculature to a more distal point than was the Heidelberg Spectralis , in ten of ten eyes (20 of 20 quadrants). Conclusion: The ultra-widefield fluorescein angiography obtained with the Optos and Heidelberg Spectralis ultra-widefield imaging systems are both excellent modalities that provide views of the peripheral retina. On a single nonsteered image, the Optos Optomap covered a significantly larger total retinal surface area, with greater image variability, than did the Heidelberg Spectralis ultra-widefield module. The Optos captured an appreciably wider view of the retina temporally and nasally, albeit with peripheral distortion, while the ultra-widefield Heidelberg Spectralis module was able to image the superior and inferior retinal vasculat