Optimizing visible retinal area in pediatric ultra-widefield fundus imaging: The effectiveness of mydriasis and eyelid lifting

IF 3.1 3区医学 Q2 ONCOLOGY

Photodiagnosis and Photodynamic Therapy Pub Date : 2025-02-25 DOI:10.1016/j.pdpdt.2025.104532

Qingxia Wang , Yuanyuan Xiao , Xiaoyun Ma

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引用次数: 0

Abstract

Background

The increase in visible retinal area (VRA) enhances the detection of peripheral retinal pathologies. This study aims to maximize the VRA in children using ultra-widefield (UWF) fundus imaging.

Methods

This cross-sectional, observational study included 53 children (106 eyes) who underwent examination in the Ophthalmology Department of Zhoupu Hospital from February to October 2023. Fundus images were captured using the ultra-widefield Optos imaging system (Daytona P200T). Parameters such as uncorrected visual acuity (UCVA), Spherical equivalent refraction (SER), axial length (AL), non-contact tonometry (NCT), and pupil diameters (both undilated and dilated) were measured. A custom image segmentation tool based on deep learning technology was used to quantify the VRA. The eyes were categorized into four groups: undilated without eyelid lifting, undilated with eyelid lifting, dilated without eyelid lifting, and dilated with eyelid lifting.

Results

Significant differences in VRA between the four groups (χ² = 79.686, P < 0.001). Mydriasis increased VRA by 8.4 % (P = 0.001), eyelid lifting increased VRA by 18.1 % (P < 0.001), and combining both increased VRA by 20 % (P < 0.001). UCVA was negatively correlated with VRA in the undilated condition without eyelid lifting (r= -0.237, P = 0.014), SER was negatively correlated with VRA and AL was positively correlated with VRA under dilation without eyelid lifting (r = -0.310, P = 0.001; r = 0.264, P = 0.006).

Conclusion

Combining mydriasis with manual eyelid lifting significantly enhances the VRA in UWF fundus imaging, effectively mitigating the effects of artifacts caused by eyelashes and eyelids. This technique improves the detection rate of peripheral retinal pathologies.

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优化小儿超宽视野眼底成像中的可见视网膜面积：瞳孔散大和眼睑上提的效果。

背景：视网膜可见面积（VRA）的增加增强了周围视网膜病变的检测。本研究旨在利用超宽视场（UWF）眼底成像最大化儿童的VRA。方法：本研究采用横断面观察方法，纳入2013年2月至10月在周浦医院眼科检查的53例儿童（106只眼）。眼底图像采用超宽视场Optos成像系统（Daytona P200T）拍摄。测量未矫正视力（UCVA）、球面等效屈光度（SER）、眼轴长度（AL）、非接触眼压（NCT）和瞳孔直径（未扩大和扩大）等参数。使用基于深度学习技术的自定义图像分割工具对VRA进行量化。将受试者的眼睛分为四组：未扩张但不提眼皮、未扩张但提眼皮、扩张但不提眼皮、扩张但提眼皮。结果：四组间VRA差异有统计学意义（χ² = 79.686,P < 0.001）。抽丝使VRA升高8.4% (P = 0.001)，拉眼睑使VRA升高18.1% (P < 0.001)，两者联合使VRA升高20% （P < 0.001）。未扩张不提眼皮状态下，UCVA与VRA呈负相关（r= -0.237, P = 0.014），SER与VRA呈负相关，AL与扩张不提眼皮状态下的VRA呈正相关(r = -0.310,P = 0.001；r = 0.264,P = 0.006)。结论：眼睑上拉联合眼睑上拉可显著提高UWF眼底成像的VRA，有效减轻眼睫毛和眼睑引起的伪影影响。该技术提高了视网膜周围病变的检出率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Photodiagnosis and Photodynamic Therapy ONCOLOGY-

CiteScore

5.80

自引率

24.20%

发文量

509

审稿时长

50 days

期刊介绍： Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process.