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Meshi, Amit MD*; Lin, Tiezhu MD*,†; Dans, Kunny MD*; Chen, Kevin C. MD*; Amador, Manuel MD*,‡; Hasenstab, Kyle PhD§; Muftuoglu, Ilkay Kilic MD*,¶; Nudleman, Eric MD**; Chao, Daniel MD**; Bartsch, Dirk-Uwe PhD*; Freeman, William R. MD*

doi: 10.1097/IAE.0000000000002156
Original Study

Purpose: To compare retinal pathology visualization in multispectral scanning laser ophthalmoscope imaging between the Spectralis and Optos devices.

Methods: This retrospective cross-sectional study included 42 eyes from 30 patients with age-related macular degeneration (19 eyes), diabetic retinopathy (10 eyes), and epiretinal membrane (13 eyes). All patients underwent retinal imaging with a color fundus camera (broad-spectrum white light), the Spectralis HRA-2 system (3-color monochromatic lasers), and the Optos P200 system (2-color monochromatic lasers). The Optos image was cropped to a similar size as the Spectralis image. Seven masked graders marked retinal pathologies in each image within a 5 × 5 grid that included the macula.

Results: The average area with detected retinal pathology in all eyes was larger in the Spectralis images compared with Optos images (32.4% larger, P < 0.0001), mainly because of better visualization of epiretinal membrane and retinal hemorrhage. The average detection rate of age-related macular degeneration and diabetic retinopathy pathologies was similar across the three modalities, whereas epiretinal membrane detection rate was significantly higher in the Spectralis images.

Conclusion: Spectralis tricolor multispectral scanning laser ophthalmoscope imaging had higher rate of pathology detection primarily because of better epiretinal membrane and retinal hemorrhage visualization compared with Optos bicolor multispectral scanning laser ophthalmoscope imaging.

Compared with traditional color fundus photography, multispectral scanning laser ophthalmoscope imaging with either the Spectralis or the Optos devices can be used reliably in clinical setting for the diagnosis and follow-up of common retinal conditions with better epiretinal membrane detection and visualization in the Spectralis images.

*Department of Ophthalmology, Jacobs Retina Center at Shiley Eye Institute, University of California San Diego, La Jolla, California;

He Eye Hospital, He University, Shenyang, China;

Escuela Superior de Oftalmologia, Instituto Barraquer de America, Bogota, Colombia;

§Department of Ophthalmology, Hamilton Glaucoma Center at Shiley Eye Institute, University of California San Diego, La Jolla, California;

Department of Ophthalmology, Istanbul Training and Research Hospital, Istanbul, Turkey; and

**Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, La Jolla, California.

Reprint requests: William R. Freeman, MD, University of California at San Diego, Shiley Eye Institute, 9415 Campus Point Drive, La Jolla, CA 92037-0946; e-mail:

Supported in part by an NIH grant EY016323 (D.-U.B.) and an UCSD Vision Research Center Core Grant P30EY022589, an unrestricted fund from Research to Prevent Blindness, NY (W.R.F).

D.-U. Bartsch has received research support from Heidelberg Engineering. The remaining authors have no conflicts of interests to disclose.

The funding organization had no role in the design or conduct of this research.

© 2019 by Ophthalmic Communications Society, Inc.