OBJECTIVE: To compare the sensitivity of Optomap Panoramic 200 and Clarus 500 in detecting peripheral retinal breaks that required treatment.
METHODS: This prospective study enrolled consecutive patients undergoing laser for treatment-requiring peripheral retinal breaks from May 2019 to July 2019. The patients first underwent indirect ophthalmoscopy examination with scleral indentation by a retinal consultant and then ultra-widefield imaging by a single trained technician on Optomap 200 and Clarus 500 in all nine ocular gazes. The images were analysed by two independent investigators to look for the number and location of the breaks. The sensitivity of each platform was calculated as the number of treatment-requiring breaks identified by the system divided by the number of breaks identified on clinical examination.
RESULTS: Clinical examination of 49 eyes (41 patients) showed 116 treatment-requiring breaks. Overall sensitivity for identifying such breaks for Optomap and Clarus was 80.2% (n = 93) and 74.1% (n = 86) respectively (p = 0.274). The sensitivities in superior (p = 0.665), temporal (p = 0.146) and inferior (p = 0.889) quadrants were statistically similar for both the platforms. The sensitivity of Optomap was slightly higher than Clarus in emmetropic (p = 0.046) and phakic (p = 0.061) eyes, but similar in myopic (p = 0.448) and pseudophakic (p = 0.191) eyes.
CONCLUSIONS: The ability to detect treatment-requiring retinal breaks is similar for both Optomap and Clarus systems.

UNASSIGNED: Inherited retinal degeneration (IRD) refers to a heterogenous group of progressive diseases that cause death of photoreceptor cells and subsequent vision loss. These diseases often affect the peripheral retina, objective evaluation of which has been difficult until recently. Fundus autofluorescence (FAF) is a non-invasive retinal imaging technique that depicts the distribution of intrinsic fluorophores in the retina. The primary source of retinal autofluorescence is lipofuscin, which is contained in the retinal pigment epithelium (RPE). Excessive accumulation of lipofuscin and a window defect attributable to loss of photoreceptor pigment result in increased FAF whereas loss of the RPE results in decreased FAF. These changes can be seen during the course of IRD.
UNASSIGNED: While conventional modalities are limited in their angle of view, recent technologic advances, known as wide-field and ultra-widefield FAF imaging, have enabled visualization of the far peripheral retina. Although clinical application of this technique in patients with IRD is still in its infancy, some studies have already indicated its usefulness. For example, an area with decreased FAF correlates well with a visual field defect in an eye with retinitis pigmentosa (RP) or cone-rod dystrophy. An abnormal FAF pattern may help in the diagnosis of IRD and associated diseases. In addition, female carriers of X-linked RP and female choroideremia show characteristic appearance. Conversely, absence of abnormal FAF despite severe retinal degeneration helps differentiation of cancer-associated retinopathy.
UNASSIGNED: This paper reviews the principles of FAF, wide-field imaging, and findings in specific diseases. Wide-field imaging, particularly wide-field FAF, will provide further information for the characteristics, prognosis, and pathogenesis of IRD.

Cytomegalovirus (CMV) retinitis is an opportunistic infection classically described in patients with acquired immune deficiency syndrome and other immune-compromising situations. As the diagnosis is based on clinical findings, classic retinal imaging montages have been a useful tool, being able to detect up to 140º of the retina. Since ultra-widefield (UWF) imaging systems have been available we can now detect more area of peripheral lesions in the diagnosis and follow-up of patients\' response to antiviral treatment. We present a series of cases in which UWF was used as the main tool for diagnosis, monitoring, and management in patients with CMV retinitis.In all the cases presented, UWF imaging with fundus autofluorescence was able to capture peripheral CMV retinitis areas and discern active from inactive lesions. This, added to the comfort of use, seem to make UWF imaging a useful tool to detect changes in the follow-up of patients with CMV retinitis.

BACKGROUND: Subacute sclerosing panencephalitis (SSPE) is a potentially fatal complication of measles. The authors report a case of recurrent myoclonic jerks under investigation, whose ophthalmic examination pointed to the diagnosis.
METHODS: A 12-year-old boy with recurrent episodes of myoclonic jerks was found to have optic disc pallor and an irregular macular scar with pigmentation in the left eye. The retinal finding proved to be a strong diagnostic clue for SSPE. There was a history of exanthematous fever in childhood. Antibodies against measles were detected in both the cerebrospinal fluid and serum. Retinitis with intraretinal and subretinal hemorrhage in the right eye was noted 6-weeks after the initial presentation.
CONCLUSIONS: The authors describe the importance of ophthalmic evaluation in cases of recurrent myoclonic jerks. Optical coherence tomographic features and ultrawide field imaging characteristics of a case of SSPE are described.

We describe two cases of acute retinal necrosis (ARN) in a post renal transplant diabetic patient and a pregnant female in the first trimester. Serial ultra wide field imaging (UWFI) with comprehensive ocular examination was done to monitor the progression of the disease. All the cases responded favorably with intravenous followed by oral acyclovir, which was captured with UWFI. UWFI provides objective proof of response to therapy in ARN. UWFI may also improve patient education and counseling for this peripheral retinal disorder.

OBJECTIVE: To compare the lesion characteristics of two different types of confocal scanning laser ophthalmoscopy (cSLO) autofluorescence (AF) images in central serous chorioretinopathy (CSC).
METHODS: The study included 63 eyes of 61 patients; 63 pairs of fundus autofluorescence (FAF) images were compared before CSC resolution in 63 eyes, FAF images of 31 eyes were also compared after CSC resolution. The lesion characteristics (brightness and composite pattern) were compared between Heidelberg Retina Angiograph 2 (HRA2; Heidelberg Engineering, Germany) and Optomap Tx (Optomap; Optos, Scotland) FAF images. The lesion composite pattern was categorized as diffuse or granular. Diffuse AF was defined as homogenously increased or decreased AF, and granular AF was defined as dot-like, coarse changes in AF. The mean disease duration and subretinal fluid (SRF) height in the spectral domain optical coherence tomography were compared according to the FAF image characteristics.
RESULTS: Lesion brightness before CSC resolution was hypo-AF in 48 eyes (76.2 %), hyper-AF in three (4.8 %), and mixed-AF in 12 (19.0 %) in HRA2 FAF images. In comparison, nine (14.3 %) images were hypo-AF, 44 (69.8 %) were hyper-AF, and 10 (15.9 %) were mixed-AF in Optomap FAF images (P < 0.0001). There was no significant difference in lesion composite pattern between the two FAF image wavelengths. Patients with lesions that were hyper-AF in Optomap FAF and hypo-AF in HRA2 FAF had a shorter disease duration and greater SRF height (1 month, 281 um) than those who were hyper-AF in both Optomap and HRA2 images (26 months, 153 um; P = 0.004, 0.001).
CONCLUSIONS: The two types of FAF images of CSC showed different lesion brightness before and after CSC resolution but demonstrated similar lesion composite patterns.

OBJECTIVE: To evaluate the clinical utility of ultra-widefield imaging as an adjunctive tool in the diagnosis, management, and follow-up of eyes with non-traumatic rhegmatogenous retinal detachment.
METHODS: Retrospective chart review of patients with a rhegmatogenous retinal detachment who received ultra-widefield imaging with the Optos® Optomap® P200Tx. Comparisons were made between UWF imaging and indirect ophthalmoscopy for features of detachments, including extent of detachment, holes, retinopexy, and related pathology.
RESULTS: Thirty-six eyes of 34 patients were included. Preoperatively, ultra-widefield imaging more precisely documented the extent of retinal detachments in the superior, inferior, and nasal quadrants in 13.9% of cases. Ultra-widefield imaging failed to detect retinal holes in the superior and inferior quadrants in 11.1% and 19.4% of cases, respectively. In postoperative imaging, UWF photos did not detect retinopexy which was ophthalmoscopy-visible both superiorly and inferiorly in 19.4% of cases. The mean differences in clock hours of the detachments as documented on the clinical exam compared to ultra-widefield imaging in the superior, inferior, temporal, and nasal quadrants were -0.18 ± 0.84, 0.41 ± 1.16, 0.08 ± 1.08, and -0.13 ± 2.25 hours, respectively.
CONCLUSIONS: Ultra-widefield imaging is a useful adjunct for documentation of rhegmatogenous retinal detachments and their postoperative repair. However, detection of retinal holes, tears, and postoperative scarring is poor, especially in the inferior and superior periphery.

OBJECTIVE: To quantify the angle of view, the magnification, and the quality of images acquired with an Optos 200Tx.
METHODS: We obtained fundus images of a model eye with the Optos 200Tx and recorded the maximal scale imaged in each direction. We measured the length of the scale bar and the interval of the scale bars at each angle and calculated the magnification. We also measured the contrast between scale bars and the intervals between scale bars.
RESULTS: The fundus image obtained with the Optos 200Tx covered 96, 101, 76, and 102° in the up, right, down, and left directions, respectively. Quantitative measurement showed that the overall image is stretched 1.12-fold in the horizontal direction with respect to the vertical. The magnification with respect to the posterior pole increased quadratically in all directions, most steeply in the vertical direction, reaching 2.0 × 1.5 in the most extreme case. The image quality was best in the left part and was worse in the inferior and superior parts.
CONCLUSIONS: The Optos 200Tx can obtain an image duplicated, with an angular range of approximately 200° horizontally and 170° vertically, with greatest limitation in the inferior direction. It should be noted that the most peripheral part of the image is significantly and unequally magnified. In addition, the contrast is not the same at all positions. The present data would serve as a guide to correct the peripheral magnification in future studies.

OBJECTIVE: Detection of peripheral fundus autofluorescence (FAF) using conventional scanning laser ophthalmoscopes (SLOs) is difficult and requires pupil dilation. Here we evaluated the diagnostic properties of wide-field FAF detected by a two-laser wavelength wide-field SLO in uveitis patients.
METHODS: Observational case series of four patients suffering from different types of posterior uveitis/chorioretinitis. Wide-field FAF images were compared to visual fields. Panretinal FAF was detected by a newly developed SLO, which allows FAF imaging of up to 200° of the retina in one scan without the need for pupil dilation. Visual fields were obtained by Goldmann manual perimetry.
RESULTS: Findings from wide-field FAF imaging showed correspondence to visual field defects in all cases.
CONCLUSIONS: Wide-field FAF allowed the detection of visual field defect-related alterations of the retinal pigment epithelium in all four uveitis cases.