Fundus screening for peripheral retinal lesions in myopic patients before refractive surgery using ultra-wide field scanning laser ophthalmoscopy

Purpose The aim of this study was to evaluate the ultra-wide field (UWF) scanning laser ophthalmoscopy using the Optomap 200Tx (Optos) in detecting peripheral retinal lesions in myopic patients. Patients and methods A prospective cross-sectional observational study was conducted from June 2023 to March 2024 at the Department of Ophthalmology, Alexandria University, Alexandria, Egypt. It included 162 eyes of 81 myopic patients (35 males and 46 females). The mean age of the participants was 23.85±3.81 years (range=18–33 years). The mean spherical equivalent of the refractive error was −4.83±1.38 D (range=−1.50 to −7.75 D). All patients were subjected to full ophthalmic assessment. UWF scanning laser ophthalmoscopy using Optomap 200Tx (Optos) without pupillary dilatation with both standard and eye-steering imaging was done and the findings were compared to findings of the dilated fundus examination with slit-lamp biomicroscopy using a 90 D fundus lens. Results Variable degrees of tessellated fundus were observed in 38.3% of the cases with the mydriatic slit-lamp fundus examination with 90 D lens and in 39.5% with Optomap (Optos) imaging, with no statistically significant difference ( P =0.837). Similarly, peripheral pigmentary degenerations were noted in 28.4% and in 30.2% of the cases, respectively, with no significant difference between the two methods ( P =0.708). Lattice degenerations were identified in 19.8% and in 20.4% of the cases, respectively, with no significant difference ( P =0.825). White without pressure lesions were present in 5.5 and 6.8% of the cases, respectively, with no significant difference ( P =0.695). Additionally, atrophic holes and vitreoretinal adhesions were observed in 0.6% of the cases using both methods, indicating no significant difference ( P =1.000). Conclusion Optomap 200Tx (Optos) UWF imaging using the eye-steering technique was a valuable method for detecting peripheral retinal lesions in myopic patients.