The following is a summary of “Sensitivity of Ultra-Widefield Fundus Photography Versus Scleral Depressed Examination for Detection of Retinal Horseshoe Tears,” published in the July 2023 issue of Ophthalmology by Lin et al. 

Ultra-widefield (UWF) imaging is often used with scleral depressed examinations(SDE) to evaluate peripheral retinal disease in tela-ophthalmology. The efficacy of detecting peripheral retinas when performed alone should be assessed.

Researchers performed a retrospective study to assess the sensitivity of UWF imaging for detecting retinal horseshoe tears (HSTs). 

The study focused on HSTs patients observed on SDE who received laser treatment. Out of an initial 140 patients meeting inclusion criteria for HSTs in either eye, 123 patients with a total of 135 HSTs were included in the final analysis, following the exclusion of individuals with concomitant ruptured globes, retinal detachments, and vitreous hemorrhages. The primary outcome was the assessment of the number of HSTs detected using UWF imaging, with a secondary outcome involving the examination of HST location. Sensitivity was evaluated with respect to HST location, and statistical significance was determined through Fisher exact testing. 

Of the total 135 HSTs, 69 (51.1%) were visible on UWF images, while 66 (48.9%) were not. The sensitivity of UWF imaging varied across quadrants, with values of (17.1%) for the superior, (32.0%) for the inferior, (50.0%) for the nasal, and 85.5% for the temporal quadrants. Statistically significant differences were observed in sensitivities between HST visibility and location (P< .001). 

The study found that UWF imaging alone is not sensitive enough to rule out retinal horseshoe tears. 

Source: ajo.com/article/S0002-9394(23)00288-X/fulltext