Comparison of Widefield Imaging Between Confocal Laser Scanning Ophthalmoscopy and Broad Line Fundus Imaging in Routine Clinical Practice

BACKGROUND AND OBJECTIVE: The purpose of this study was to evaluate the difference between widefield confocal scanning laser imaging (WSLO) and widefield broad line fundus (WBLF) imaging in their ability to view the peripheral retina in routine clinical practice. PATIENTS AND METHODS: A retrospective chart review identified patients within routine clinical practice who were imaged with a WSLO image and a single and montaged WBLF image. The primary outcome was the number of ultra-widefield quadrants captured utilizing the UWF consensus definitions. Secondary outcomes included the area within each of quadrant and the differences in clinical grading between modalities. RESULTS: More vortex ampullae were identified with the WSLO than either single image or montage WBLF image. The WSLO captured 116 of the possible 260 vortex ampullae (45%) in comparison to the WBLF single image (8 of 260; 3%) and WBLF montage (96 of 260; 37%). Only five eyes from WSLO and no images from the WBLF single image met the ultra-widefield consensus definition in routine clinical practice. The average area per individual quadrant acquired by WSLO image was greater than the single or montage WBLF image (781.67 mm(2), 433.82 mm(2), and 686.03 mm(2), respectively; P < .001). Clinical grading of images found a substantial inter-rater agreement with both technologies (86% on WSLO; 88% on WBLF). CONCLUSIONS: Both systems had a low rate of meeting UWF consensus definitions in routine clinical practice. A single WSLO image acquired a greater area than WBLF image in both single-image and montage formats. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:89-94.].