Comparison of ultra-widefield retinal imaging modalities in eyes with asteroid hyalosis

Purpose: Advancements in ultra-widefield fundus autofluorescence (FAF) and limitations in healthcare delivery have challenged the role of intravenous fluorescein angiography (IVFA) as the “gold standard” for evaluating the retina complicated by asteroid hyalosis (AH). The objective was to compare ul...

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Main Authors: William J. Collins, Cory A. Christensen, Mark P. Breazzano
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:AJO International
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Online Access:http://www.sciencedirect.com/science/article/pii/S295025352500036X
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author William J. Collins
Cory A. Christensen
Mark P. Breazzano
author_facet William J. Collins
Cory A. Christensen
Mark P. Breazzano
author_sort William J. Collins
collection DOAJ
description Purpose: Advancements in ultra-widefield fundus autofluorescence (FAF) and limitations in healthcare delivery have challenged the role of intravenous fluorescein angiography (IVFA) as the “gold standard” for evaluating the retina complicated by asteroid hyalosis (AH). The objective was to compare ultra-widefield retinal imaging methods – both non-invasive (pseudocolor fundus photography [CFP] and FAF) and IVFA modalities – in patients with AH. Design: Retrospective, observational, cross-sectional, single-institution study. Participants: One hundred and thirty patients identified via billing codes. Methods: Same-day, ultra-widefield retinal imaging modality (CFP, FAF, and IVFA) and diagnosis compatible with AH had image quality compared by standardized grading, including sub-analysis with retinal location. Image quality was defined as the degree of retinal image obscuration from asteroids and was independently measured by two researchers. Agreement was calculated based on predetermined definition. Results: Forty-one patients fulfilled criteria. Imaging modality had a statistically significant effect on image quality in patients with AH (F = 69.4, p < 0.001). The region of the retina imaged also had a statistically significant effect (F = 2.9, p = 0.021). Tukey’s honestly significant difference test found that image quality was significantly greater in FAF compared to CFP (p < 0.001), as well as IVFA compared to CFP (p < 0.001). However, there was no significant difference of image quality between FAF and IVFA (p = 0.187). Conclusions: These findings suggest that FAF is comparable in image quality to IVFA when generally assessing the retina with ultra-widefield imaging in patients with AH. Ultra-widefield FAF may serve as a reasonable alternative to IVFA for evaluating patients with these vitreous opacities in the appropriate clinical context.
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spelling doaj-art-e19a5843d5a5489d9eeb5d7f429d84ba2025-08-20T03:19:57ZengElsevierAJO International2950-25352025-07-012210013310.1016/j.ajoint.2025.100133Comparison of ultra-widefield retinal imaging modalities in eyes with asteroid hyalosisWilliam J. Collins0Cory A. Christensen1Mark P. Breazzano2SUNY Upstate Medical University, Norton College of Medicine, 766 Irving Ave, Syracuse, NY 13210, United StatesSUNY Upstate Medical University, Department of Ophthalmology &amp; Visual Sciences, 550 Harrison St, Syracuse, NY 13202, United StatesSUNY Upstate Medical University, Department of Ophthalmology &amp; Visual Sciences, 550 Harrison St, Syracuse, NY 13202, United States; Flaum Eye Institute, University of Rochester Medical Center, 210 Crittenden Blvd, Rochester, NY 14642, United States; Corresponding author at: 210 Crittenden Blvd, Rochester, NY 14642, United States.Purpose: Advancements in ultra-widefield fundus autofluorescence (FAF) and limitations in healthcare delivery have challenged the role of intravenous fluorescein angiography (IVFA) as the “gold standard” for evaluating the retina complicated by asteroid hyalosis (AH). The objective was to compare ultra-widefield retinal imaging methods – both non-invasive (pseudocolor fundus photography [CFP] and FAF) and IVFA modalities – in patients with AH. Design: Retrospective, observational, cross-sectional, single-institution study. Participants: One hundred and thirty patients identified via billing codes. Methods: Same-day, ultra-widefield retinal imaging modality (CFP, FAF, and IVFA) and diagnosis compatible with AH had image quality compared by standardized grading, including sub-analysis with retinal location. Image quality was defined as the degree of retinal image obscuration from asteroids and was independently measured by two researchers. Agreement was calculated based on predetermined definition. Results: Forty-one patients fulfilled criteria. Imaging modality had a statistically significant effect on image quality in patients with AH (F = 69.4, p < 0.001). The region of the retina imaged also had a statistically significant effect (F = 2.9, p = 0.021). Tukey’s honestly significant difference test found that image quality was significantly greater in FAF compared to CFP (p < 0.001), as well as IVFA compared to CFP (p < 0.001). However, there was no significant difference of image quality between FAF and IVFA (p = 0.187). Conclusions: These findings suggest that FAF is comparable in image quality to IVFA when generally assessing the retina with ultra-widefield imaging in patients with AH. Ultra-widefield FAF may serve as a reasonable alternative to IVFA for evaluating patients with these vitreous opacities in the appropriate clinical context.http://www.sciencedirect.com/science/article/pii/S295025352500036XAsteroid hyalosis (AH)Pseudocolor fundus photography (CFP)Fundus autofluorescence (FAF)Intravenous fluorescein angiography (IVFA)
spellingShingle William J. Collins
Cory A. Christensen
Mark P. Breazzano
Comparison of ultra-widefield retinal imaging modalities in eyes with asteroid hyalosis
AJO International
Asteroid hyalosis (AH)
Pseudocolor fundus photography (CFP)
Fundus autofluorescence (FAF)
Intravenous fluorescein angiography (IVFA)
title Comparison of ultra-widefield retinal imaging modalities in eyes with asteroid hyalosis
title_full Comparison of ultra-widefield retinal imaging modalities in eyes with asteroid hyalosis
title_fullStr Comparison of ultra-widefield retinal imaging modalities in eyes with asteroid hyalosis
title_full_unstemmed Comparison of ultra-widefield retinal imaging modalities in eyes with asteroid hyalosis
title_short Comparison of ultra-widefield retinal imaging modalities in eyes with asteroid hyalosis
title_sort comparison of ultra widefield retinal imaging modalities in eyes with asteroid hyalosis
topic Asteroid hyalosis (AH)
Pseudocolor fundus photography (CFP)
Fundus autofluorescence (FAF)
Intravenous fluorescein angiography (IVFA)
url http://www.sciencedirect.com/science/article/pii/S295025352500036X
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