Comparison between ultra-widefield pseudocolor imaging and indirect ophthalmoscopy in the detection of peripheral retinal lesions

BACKGROUND AND OBJECTIVE: To systematically compare the intermodality and inter-rater agreement for indirect ophthalmoscopy and ultra-widefield (UWF) imaging in detecting peripheral retinal lesions predisposing to retinal rhegmatogenous detachment. PATIENTS AND METHODS: In this prospective, observational, cross-sectional study, patients with a previous diagnosis of peripheral retinal lesions were enrolled. UWF pseudocolor imaging and dilated fundus examination were obtained. RESULTS: Thirty-seven eyes (20 patients, 12 females) were enrolled. The level of inter-rater agreement was excellent in both the ophthalmoscopy-based and UWF-based assessment. The overall agreement in the UWF-based assessment was found to be Kappa = 0.874 (P < .0001). The UWF-based evaluation was demonstrated to have a sensitivity of 89.2% in detecting peripheral retinal lesions. In the sectorial analysis, the UWF-based reading had a lower sensitivity in the inferior sector. CONCLUSION: The identification of peripheral retinal lesions with UWF imaging allowed for an accurate and reproducible assessment.