Comparison of Digital Widefield Retinal Imaging With Indirect Ophthalmoscopy in Pediatric Patients

Approximately 16,000 children in the United States lose vision each year because of retinal disease. The authors compare digital ultra-widefield (UWF) photography to indirect ophthalmoscopy in children.

Prospective, single-center study of patients ages 3 to 17 years. Retinal area during indirect ophthalmoscopy was compared with retinal area in digital UWF fundus photographs. Image quality was graded. A survey to assess the usefulness of the retinal image was obtained.

The retinal area (mean ± standard deviation, mm²) evaluated with indirect ophthalmoscopy was 413 ± 194 mm², compared with 652 ± 117 mm² with widefield photography (P < .001). The difference was largest in children younger than 14. Image quality was significantly associated with patient cooperation.

High-quality UWF photographs evaluate more peripheral retina than the in-office dilated funduscopic exam in children under 14. Photography assisted with family counseling in 17% of patients and the avoidance of examination under anesthesia in 2% of patients. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:580-585.].