How frequently should asymptomatic patients be dilated?

Area of Science:

• Ophthalmology
• Retinal Diseases
• Preventive Eye Care

Background:

• Dilated fundus examination (DFE) is a common ophthalmological procedure.
• The optimal screening interval for asymptomatic patients remains a subject of investigation.

Purpose of the Study:

• To evaluate the necessity of routine dilated fundus examinations (DFE) earlier than 10-year intervals in asymptomatic patients.
• To assess the effectiveness of routine DFE in identifying clinically significant peripheral retinal findings.

Main Methods:

• Systematic review of patient records evaluated over a one-year period.
• Analysis of sequential DFEs for patients surviving 10 years post-initial DFE.
• Database searches for vision-threatening peripheral retinal findings over a 10-year period.

Main Results:

• Only 10 of 592 patients had "clinically-significant" peripheral retinal findings, with no adverse outcomes.
• Nearly 90% of new retinal detachments and intraocular tumors discovered over 10 years were symptomatic.
• Three detachments and one tumor were incidental findings in asymptomatic patients.

Conclusions:

• Routine DFE shows a low yield for discovering serious ocular events in asymptomatic individuals.
• Routine DFE appears ineffective in altering the course of incidental findings.
• DFE is not indicated for older, asymptomatic patients, even at decade intervals; prospective confirmation is recommended.