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. 2019 Oct 11;8(10):1660.
doi: 10.3390/jcm8101660.

Sensitivity and Specificity of Ultrawide-Field Fundus Photography for the Staging of Sickle Cell Retinopathy in Real-Life Practice at Varying Expertise Level

Roxane Bunod  1 , Alexandra Mouallem-Beziere  2 , Francesca Amoroso  3 , Vittorio Capuano  4 , Karen Bitton  5 , Cynthia Kamami-Levy  6 , Camille Jung  7 , Eric H Souied  8 , Alexandra Miere  9
Affiliations

Sensitivity and Specificity of Ultrawide-Field Fundus Photography for the Staging of Sickle Cell Retinopathy in Real-Life Practice at Varying Expertise Level

Roxane Bunod et al. J Clin Med. .

Abstract

Purpose: To evaluate the sensitivity and specificity of ultrawide-field fundus photography (UWF-FP) for the detection and classification of sickle cell retinopathy (SCR) by ophthalmologists with varying degrees of expertise in retinal disease.

Methods: Patients presenting with sickle cell disease (SCD) in the Créteil University Eye Clinic, having undergone UWF-FP and ultrawide-field fluorescein angiography (UWF-FA) on the same day, were retrospectively included. Eyes with previous retinal photocoagulation were excluded. SCR was graded independently by UWF-FP and UWF-FA using Goldberg classification by two ophthalmologists with varying expertise levels.

Results: Sixty-six eyes of 33 patients were included in the study. The sensitivity of UWF-FP for the detection of proliferative SCR was 100%, (95% confidence interval [CI95%] 76.8-100) for the retinal specialist and 100% (CI95% 71.5-100) for the ophthalmology resident. The specificity of UWF-FP for the detection of proliferative SCR was 100% (CI95% 92.7-100) for the retinal specialist and 98.1% (CI95% 89.7-100) for the ophthalmology resident.

Conclusions: UWF-FP is a valuable exam for proliferative SCR screening, with excellent sensitivity and specificity and a good inter-grader agreement for ophthalmologists with various degree of skills, and is easy to use in a real-life setting.

Keywords: sickle cell retinopathy; ultrawide-field angiography; ultrawide-field fundus photography; ultrawide-field imaging.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) Ultrawide-field fundus photography (UWF-FP) and (B) ultrawide-field fluorescein angiography (UWF-FA) of one of the three cases of inter-grader disagreement regarding the proliferative status. (A) UWF-FP shows peripheral arteriolar occlusions associated with a single red-colored lesion located in the superior temporal quadrant. Zooming on the lesion reveals the presence of small vascular loops suggestive of a nascent “sea fan” neovascularization. (B) UWF-FA and the corresponding zoom on the doubtful lesion confirms the presence of a nascent “sea fan” neovascularization.
See this image and copyright information in PMC

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