Evaluation Of The Effect Of Two Ultra-wide-angle Imaging Techniques On The Detection Of Fundus Lesions In High Myopia

Objective: Two ultra-wide-angle fundus imaging systems,Optos P200 dTx and Clarus 500,are used to quickly detect fundus lesions in high myopia(High Myopia,HM).Through the comparative analysis of the diagnostic results,we can understand the characteristic advantages of the two imaging systems and make them better serve the clinic.Method: This paper adopts cross-sectional study.A total of 187 patients with HM from March 2022 to April 2022 in the affiliated Ophthalmology Hospital of Wenzhou Medical University were collected for the final study.Optos P200 dTx and Clarus 500 images of the patients were taken by experienced technicians without mydriasis,and the time used in the shooting process was recorded.Then two experienced ophthalmologists double-blindly read the two kinds of fundus images,and the fundus images with inconsistent diagnosis were re-interpreted by the third senior ophthalmologist.After the collection of the two kinds of ultra-wide-angle equipment is completed,the patient’s pupil is dilated first,and then the fundus is carefully observed by experienced ophthalmologists under the slit lamp,and the examination results are recorded.We take the results of three-mirror examination as the reference standard to evaluate the consistency of the diagnosis results and the difference of lesion detection rate of the two ultra-wide-angle fundus imaging systems in HM rapid fundus screening.Two samples rank sum test was used to compare and analyze the inspection time and photo times of two kinds of ultra wide angle imaging systems,and weighted Kappa test was used to analyze the consistency of three mirrors and Optos P200 dTx,three mirrors and Clarus500,Optos P200 dTx and Clarus 500 s in fundus diagnosis of HM.X-2 test was used to analyze the difference in the detection rate of fundus lesions between three-sided mirror and Optos P200 dTx,three-sided mirror and Clarus 500,Optos P200 dTx and Clarus-500 in patients with HM.Result: In the comparison of examination time,compared with Clarus 500,the shooting time of Optos P200 dTx was saved,and the difference was statistically significant(P<0.001).In the comparison of shooting times,compared with Clarus500,the shooting times of Optos P200 dTx was less,and the difference was statistically significant(P<0.001).In the test of consistency of diagnostic results of lesions,the diagnostic results of three-sided mirror were significantly consistent with those of Optos P200 dTx(Kappa value=0.714～1.00),that of three-sided mirror and Clarus 500 were significantly consistent(Kappa value =0.792～1.00),and that of Optos P200 dTx and Clarus 500 were significantly consistent(Kappa value=0.793-1.00).In the test of the difference in the detection rate of pathological changes,there was a statistically significant difference between three-sided lens and Optos P200 dTx in the detection rate of retinal holes(P=0.04)and choroidal neovascularization(P=0.03).There was no significant difference in the detection rates of non-oppressive white degeneration(P=0.124),lattice degeneration(P =1.00),retinal choroidal atrophy arc(P=1.00),pigmented degeneration(P=0.249),cystic degeneration(P=0.499),other degeneration(P=0.249)and snail trace degeneration(P=0.499).there was a statistically significant difference between three-sided lens and Clarus 500 in the detection rate of non-oppressive white degeneration(P<0.001),lattice degeneration(P<0.011)and frost degeneration(P<0.015)There was no significant difference in the detection rate of retinal hiatus(P=0.499),pigmented degeneration(P=0.061),cystic degeneration(P=0.061),other degeneration(P=0.061),snail trace degeneration(P=0.249)and choroidal neovascularization(P=0.499).There was significant difference between Optos P200 dTx and Clarus 500 in the detection rates of non-oppressive white degeneration(P=0.04),lattice degeneration(P=0.04)and frost degeneration(0.015).There was no significant difference in the detection rate of retinal hiatus(P=0.176),choroidal atrophy arc(P=1.00),pigmented degeneration(P=0.725),cystic degeneration(P=0.249),other degeneration(P=0.449),nail trace degeneration(P=1.00)and choroidal neovascularization(P=0.124).Conclusion: 1.The two ultra-wide-angle fundus imaging systems,Optos P200 dTx and Clarus 500,are consistent in detecting fundus lesions in HM,and both can effectively and quickly screen fundus lesions in HM.2.The characteristic advantage of Optos P200 dTx lies in the wide shooting range,and the characteristic advantage of Clarus500 is that it can better show the detailed lesions.3.As far as possible,Optos P200 dTx and Clarus 500 can be used at the same time,which complement each other and can screen the fundus of HM efficiently and quickly.