Widefield and Ultra-Widefield Retinal Imaging: A Geometrical Analysis

Diabetic retinopathy (DR) often causes a wide range of lesions in the peripheral retina, which can be undetected when using a traditional fundus camera. Widefield (WF) and Ultra-Widefield (UWF) technologies aim to significantly expand the photographable retinal field. We conducted a geometrical analysis to assess the field of view (FOV) of WF and UWF imaging, comparing it to the angular extension of the retina. For this task, we shot WF images using the Zeiss Clarus 500 fundus camera (Carl Zeiss Meditec, Jena, Germany). Approximating the ocular bulb to an ideal sphere, the angular extension of the theoretically photographable retinal surface was 242 degrees. Performing one shot, centered on the macula, it was possible to photograph a retinal surface of ~570 mm(2), with a FOV of 133 degrees. Performing four shots with automatic montage, we obtained a retinal surface area of ~1100 mm(2) and an FOV of 200 degrees. Finally, performing six shots with semi-automatic montage, we obtained a retinal surface area of ~1400 mm(2) and an FOV of 236.27 degrees, which is close to the entire surface of the retina. WF and UWF imaging allow the detailed visualization of the peripheral retina, with significant impact on the diagnosis and management of DR.