![]() This retrospective study was approved by the Institutional Review Board (C-6) and was in accordance with the tenets outlined in the Declaration of Helsinki. To further characterize the Optomap, analysis was performed separately between retinal lesions which predispose to RRD requiring prophylactic laser treatment and lesions which do not predispose to RRD. We compared the identification of retinal lesions using Optomap images with the gold standard dilated fundus examination with scleral indentation by a retinal specialist. ![]() In this context, we studied the sensitivity of Optomap ultrawide field imaging system as a screening tool for the detection of peripheral retinal degenerations. Identification of lesions on Optomap images can vary between readers and these variations can be used to identify readers with a minimum basic level of retinal training for maximum agreement with retinal examination findings. Also, there is a huge variation in the detection rate of peripheral lesions ranging from 57% to 74% on the non-dilated Optomap images. Although this device has been touted as a baseline retinal examination tool in a number of ocular pathologies like cataract, eye trauma, and diabetic retinopathy, there is little evidence in the literature reporting its sensitivity and specificity for the identification of peripheral retinal lesions. Hence, ultrawide field imaging is increasingly being used in teleophthalmology settings, especially for screening of diabetic retinopathy. This image can be obtained even without pharmacological mydriasis with an acquisition time of <0.4 seconds. It is a confocal laser scanning ophthalmoscope designed to obtain wide-field images of the retina, more than 200° in one single image. The Optos Optomap Daytona Panoramic 200Tx (Daytona, Optos®, UK) is one such device that can be used for retinal screening of peripheral degenerative lesions. Widefield non-mydriatic or mydriatic retinal imaging does allow screening up to 200 degrees of the retina. Large refractive surgery practices without a trained retinal specialist is another such scenario. Another instance is the recent Covid-19 pandemic wherein human-to-human interaction has to be to be kept to a bare minimum. These include patients who do not consent for pupil dilatation, either due to allergy to dilating drops, post-dilatation blurring of vision or lack of time. While a dilated retinal examination with an indirect ophthalmoscope and indentation remains the gold standard to detect these lesions, alternate strategies of retinal screening are required in some instances. Thus, a dilated fundus examination of myopic eyes before undergoing refractive surgery is mandatory to identify these predisposing lesions for appropriate treatment and follow up. The occurrence or the progression of posterior vitreous detachment either due to pre-existing high myopia or following refractive surgery can lead to retinal tears and an RRD. The common refractive procedures used in the correction of myopia include surface ablation techniques like photorefractive keratotomy, laser in-situ keratomileusis (LASIK) and femtosecond LASIK, intraocular surgeries like intrastromal corneal ring segments, phakic intraocular lens and elective refractive lens exchange and newer procedures like small incision lenticule extraction. With improving technology and better outcomes over the past few decades, we have seen an increase in surgical correction of refractive errors, particularly myopia. ![]() A rhegmatogenous retinal detachment (RRD) can occur in eyes with peripheral retinal degenerations like lattice degeneration, snail-track degeneration, retinal tears/holes, degenerative retinoschisis, cystic retinal tufts, and, rarely, zonular traction tufts. Higher the grade of myopia, more is the prevalence of peripheral retinal degenerations. Myopia is the most common type of refractive error seen in day-to-day clinical practice.
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