FUNDUS IMAGING IN PATIENTS WITH CATARACT - ROLE FOR A VARIABLE WAVELENGTH SCANNING LASER OPHTHALMOSCOPE

Aims-An investigation was carried out to compare the image quality of the ocular fundus obtained clinically, photographically, and with the scanning laser ophthalmoscope (SLO) at visible and infrared wavelength s in patients with significant cataract. Methods-Nineteen patients adm itted for routine cataract extraction were examined clinically by two independent observers to ascertain cataract type and clarity of fundus view with an indirect ophthalmoscope. Fundus photography and both con focal and direct (non-confocal) SLO imaging at 590 nm, 670 nm, and 830 nm were carried out after pupillary dilatation. Images obtained were graded independently using a recognised grading system. Results-Qualit y of SLO images appeared to be superior to indirect ophthalmoscopy (p< 0.01) and fundus photography (p<0.001) when graded subjectively. Quant itative analysis of contrast of retinal vessels demonstrated significa ntly higher contrast for the SLO compared with digitised fundus photog raphs at all wavelengths tested (p<0.001), with highest contrast at 59 0 nm. Use of a confocal aperture significantly improved vessel contras t but may reduce overall image intensity. Conclusions-Scanning laser o phthalmoscopy may offer a method to observe and record fine fundus det ail in patients who have marked cataract.