Comparative diagnostic performance of ultrawide field imaging, retinal nerve fiber layer and Spectralis and Optos Fluorescein Angiography in the detection of Optic Disc Swelling in uveitis
Purpose
To compare the sensitivity and specificity of ultrawide field fundus photographs (UWF-FP), retinal nerve fiber layer (RNFL) thickness on optical coherence tomography and fluorescein angiography (FA) performed with two imaging platforms in the diagnosis of Optic Disc Swelling (ODW) in uveitis.
Methods
Retrospective file review of all consecutive uveitic patients seen at a tertiary care unit during 2022 who underwent UWF-FP, RNFL and FA with both Optos Optomap and Heidelberg Spectralis on the same date. Two masked specialists evaluated the presence of ODW (ie. gold standard) based on fundus examination, UWF-FP, RNFL thickness and FA. The performance of each test was compared to this diagnostic gold standard.
Results
101 eyes of 59 patients with uveitis were included. 56 eyes (55.4%) presented ODW. The sensitivity and specificity of UWF-FP were 24.5% and 92.3%. With an RNFL thickness of <200 µm as reference, the RNFL global (G) sensitivity and specificity were 5.8% and 100%. The supratemporal area (ST) proved to be the most sensitive (23%) with a similar specificity (97.7%). Regarding FA, the sensitivity of the two platforms was 100%. However, the specificity was better with Spectralis (97.8%) versus 68.2% with Optos (p<0.05). Overall, the AUROC for discriminating ODW eyes was the highest on FA performed with Spectralis (0.99) followed by Optos (0.84), RNFL ST (0.60), UWF-FP (0.59) and RNFL G (0.53).
Conclusion
The clinical utility of UWF-FP and RNFL is limited in diagnosing ODW. In contrast, FA, in particular the platform Spectralis, showed the best specificity and sensitivity in detecting uveitic ODW.
Conflict of interest
No
Authors 1
Last name
BOURDIN
Initials of first name(s)
A
Department
Department of Ophthalmology, Pitié Salpêtrière University Hospital, Sorbonne Université
City
Paris
Country
France
Authors 2
Last name
FLOREZ-ESPARZA
Initials of first name(s)
G
Department
Neuroscience (NEUROS) Research Group, Neurovitae Research Center, Universidad Del Rosario
City
Bogotá
Country
Colombia
Authors 3
Last name
DE-LA-TORRE
Initials of first name(s)
A
Department
Neuroscience (NEUROS) Research Group, Neurovitae Research Center, Universidad Del Rosario
City
Bogotá
Country
Colombia
Authors 4
Last name
BODAGHI
Initials of first name(s)
B
Department
Department of Ophthalmology, Pitié Salpêtrière University Hospital, Sorbonne Université
City
Paris
Country
France
Authors 5
Last name
TOUHAMI
Initials of first name(s)
S
Department
Department of Ophthalmology, Pitié Salpêtrière University Hospital, Sorbonne Université
City
Paris
Country
France
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