Poster Presentations 363

serial imaging; some eyes with true defects progressed. Aswith fundus photography, serial imaging with Optos hasclinical utility.(Study funded by Optos.)

Poster 39

Peripheral Retinal Vascular Disorders Detected, Treated,and Monitored With Optomap fa as Compared toSpectralis FA

Juliana E. Boneta, Jerome Sherman, O.D., Karl E. Waite,M.D., Sanjeev Nath, M.D., and Michael D. Bennett, M.D.,State University of New York State College of Optometry,New York, New York

Background: Standard fundus cameras are not ideal forcapturing images of the far peripheral retina. Two systemsare available which do, and both can also be used forfundus fluorescein angiography (FA). In this study, wecompare image quality and field of view obtained withboth Optos� Optomap fa and Spectralis� FA in myriadperipheral retina vascular disorders both pre and posttreatment.Methods: A retrospective review of 100 eyes of 50 patientswith peripheral retinal vascular disorders who were imagedwith both Optomap fa and Spectralis FA during the sameclinical session at 2 facilities equipped with both technolo-gies. Early phase angiography images were obtained withSpectralis FA then mid to late stage images were capturedwith the Optomap fa system. Far peripheral lesions imagedwith Optomap fa were then attempted to be imaged withSpectralis FA. The 50 patients included 5 with proliferativesickle cell retinopathy (PSR), 2 with coats disease, 2 withlupus vasculopathy, 1 with ROP, 1 with autosomal reces-sive hypercoagulopathy with temporal avascular zones, 2Eales disease with mid- and far peripheral lesions, 1 withperipheral phlebitis in MS, 1 with Stage 4 IRVAN, 2with ‘‘papillophlebitis’’ with peripheral vasculopathy inthe ‘‘normal eye,’’ and several with AV anastomosis. Alsoincluded were patients with peripheral findings in diabeticretinopathy, hypertensive retinopathy, and various veinocclusions.Results: Both systems were able to obtain high qualityimages of perfused retina, zones of avascularity and areasof leakage in the posterior pole and extending to theequator. The Spectralis FA appeared to have an advantagein the posterior pole but identical, early phase images werenot available with the Optomap fa for direct comparison.Optomap fa images documented significantly more lesionsanterior to the equator in all 4 quadrants than did the Spec-tralis FA. This was especially true in PSR. Post-treatmentimages of far peripheral lesions were also obtainable withOptomap fa but far more difficult (if not impossible) to ob-tain with Spectralis.Conclusions: Neither technology is ideal in all cases. Useof both in most disorders yields more clinically usefuldata than either alone. In disorders with peripheral

pathology, such as PSR, Optomap fa reveals more anteriorlesions.

Poster 40

Comparison of RNFL Assessment With the Optos� P200and 200Dx

Jerome Sherman, O.D., Sarah MacIver, O.D.,Marc Sherman, and Samantha Slotnick, O.D.,State University of New York State College of Optometry,New York, New York

Background: Thousands of clinicians utilize the Optos�

panoramic ophthalmoscopy systems to detect retinal abnor-malities. These same images contain information about theretinal nerve fiber layer (RNFL) which is virtually alwaysneglected; perhaps because the original P200 did not imagethe RNFL effectively and consistently.Methods: Images (OU) of 50 consecutive patients fromboth systems were reviewed retrospectively. A trainedobserver evaluated the RNFL (using green separation) onimage quality (Q) and RNFL integrity (N). Q was gradedon a scale of 1-4: 1 5 poor overall view of RNFL; 4 5well-defined RNFL in at least 1 clock hour. N was gradedon a scale of 1-5: 1 5 profound loss; 5 5 normal RNFL. N% 3 indicates a probable pathological defect. A clinicaldiagnosis based on dilated fundus exam and on GDx,optical coherence tomography, and/or VF was used toconfirm the presence of a pathological defect.Results: According to the grading scale, the 200DX yieldedhigher quality RNFL images; Q R 3 was found in 78 of100 200DX and in 55 of 100 P2 images. In many P200 im-ages, artifacts obscured the RNFL off the disc, reducing Q.Both systems generally had higher Q in superior RNFLthan inferior RNFL. Pathological defects (N % 3) werefound in 39 of 100 200DX and 36 of 100 P200 images.Where N % 3, correspondence with diagnosis was foundin 33 (84.6%) 200DX and 23 (63%) P200 images.Conclusions: In this direct comparison study, 200DXRNFL images were of higher quality than P200. The circu-lar polarizer in the 200DX results in a more uniform qualityimage translating to greater visibility of the RNFL. The200DX was thus better at accurately detecting pathologicalRNFL defects than the P200. The image quality producedby the linear polarizer in the P200 limits its ability to detectpathological RNFL defects.(Study funded by Optos.)

Poster 41

The Pseudotumor Cerebri That Wasn’t

Juliana Yuen Tsz Lam, O.D., Cariboo Eye Care Clinic,Williams Lake, British Columbia

Background: Pseudotumor cerebri, also known as idiopathicintracranial hypertension, is predominantly seen in obese, orsomewhat overweight, women of childbearing age.