TY - JOUR
T1 - Feasibility and quality of nonmydriatic fundus photography in children
AU - Toffoli, Daniela
AU - Bruce, Beau B.
AU - Lamirel, Cédric
AU - Henderson, Amanda D.
AU - Newman, Nancy J.
AU - Biousse, Valérie
N1 - Funding Information:
We thank Drs Amy Hutchinson, Scott Lambert, and Phoebe Lenhart of the Pediatric Ophthalmology Service at Emory University for their assistance. This study was supported in part by a departmental grant (Department of Ophthalmology) from Research to Prevent Blindness, Inc. , New York, by core grant P30-EY06360 (Department of Ophthalmology). Dr. Bruce receives research support from the NIH/PHS ( UL1-RR025008 ), NIH/NEI ( K23-EY019341 ), and the Knights Templar Eye Foundation ; and received the American Academy of Neurology Practice Research Fellowship. Dr. Lamirel receives research support from Institut Servier (Paris, France), Fondation Planiol (Varennes, France), and the Philippe Foundation, Inc. (New York, NY). Dr. Biousse receives research support from NIH/PHS ( UL1-RR025008 ). Dr. Newman is a recipient of the Research to Prevent Blindness Lew R. Wasserman Merit Award. Drs. Toffoli & Henderson have nothing to disclose.
PY - 2011/12
Y1 - 2011/12
N2 - Purpose: Ocular funduscopic examination is difficult in young children and is rarely attempted by nonophthalmologists. Our objective was to determine the feasibility of reliably obtaining high-quality nonmydriatic fundus photographs in children. Methods: Nonmydriatic fundus photographs were obtained in both eyes of children seen in a pediatric ophthalmology clinic. Ease of fundus photography was recorded on a 10-point Likert scale (10 = very easy). Quality was graded from 1 to 5 (1, inadequate for any diagnostic purpose; 2, unable to exclude all emergent findings; 3, only able to exclude emergent findings; 4, not ideal, but still able to exclude subtle findings; and 5, ideal quality). The primary outcome measure was image quality by age. Results: A total of 878 photographs of 212 children (median age, 6 years; range, 1-18 years) were included. Photographs of at least one eye were obtained in 190 children (89.6%) and in both eyes in 181 (85.3%). Median rating for ease of photography was 7. Photographs of some clinical value (grade ≥2) were obtained in 33% of children <3 years and 95% ≥3 years. High-quality photographs (grade 4 or 5) were obtained in both eyes in 7% of children <3 years, 57% of children ≥3 to <7 years, 85% of children ≥7 to <9 years, and 65% of children ≥9 years. The youngest patient with high-quality photographs in both eyes was 22 months. Conclusions: Nonmydriatic fundus photographs of adequate quality can be obtained in children over age 3 and in some children as young as 22 months.
AB - Purpose: Ocular funduscopic examination is difficult in young children and is rarely attempted by nonophthalmologists. Our objective was to determine the feasibility of reliably obtaining high-quality nonmydriatic fundus photographs in children. Methods: Nonmydriatic fundus photographs were obtained in both eyes of children seen in a pediatric ophthalmology clinic. Ease of fundus photography was recorded on a 10-point Likert scale (10 = very easy). Quality was graded from 1 to 5 (1, inadequate for any diagnostic purpose; 2, unable to exclude all emergent findings; 3, only able to exclude emergent findings; 4, not ideal, but still able to exclude subtle findings; and 5, ideal quality). The primary outcome measure was image quality by age. Results: A total of 878 photographs of 212 children (median age, 6 years; range, 1-18 years) were included. Photographs of at least one eye were obtained in 190 children (89.6%) and in both eyes in 181 (85.3%). Median rating for ease of photography was 7. Photographs of some clinical value (grade ≥2) were obtained in 33% of children <3 years and 95% ≥3 years. High-quality photographs (grade 4 or 5) were obtained in both eyes in 7% of children <3 years, 57% of children ≥3 to <7 years, 85% of children ≥7 to <9 years, and 65% of children ≥9 years. The youngest patient with high-quality photographs in both eyes was 22 months. Conclusions: Nonmydriatic fundus photographs of adequate quality can be obtained in children over age 3 and in some children as young as 22 months.
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U2 - 10.1016/j.jaapos.2011.07.010
DO - 10.1016/j.jaapos.2011.07.010
M3 - Article
C2 - 22153402
AN - SCOPUS:83455181437
VL - 15
SP - 567
EP - 572
JO - Journal of AAPOS
JF - Journal of AAPOS
SN - 1091-8531
IS - 6
ER -