Near-infrared video: A technique for dynamic documentation of vitreous floaters

• NIR video achieves 96% detection of floaters versus 43% in static imaging. • Dynamic NIR video improves interobserver agreement to 0.96, indicating high reliability. • This technique enables objective floater documentation for pre- and post-op assessments. • NIR video aids in surgical decision-making by providing visible floater dynamics. • Novel method enhances floater assessment beyond static OCT and other static imaging techniques. The purpose of this study is to describe a technique using near-infrared (NIR) video for the diagnosis and documentation of symptomatic floaters. Subjects with symptomatic floaters were identified through electronic case notes review, in which there was a primary diagnosis of floaters, secondary to PVD or syneresis. The presence of vitreous floaters was evaluated with both 30 °NIR or fundus autofluorescence images and short, dynamic 30°NIR videos, in which subject is asked to briefly look away and refixate on the target. Three retinal specialists assessed both unseen still images and videos to determine the presence or absence of vitreous floaters. Group descriptive statistics and inter/interobserver percentage agreement were calculated using SPSS. Ninety-three eyes from 51 subjects (30 males and 21 females, mean age (±SD) 54 ± 14.7 years and baseline visual acuity 0.13 ± 0.49) were analysed. An underling diagnosis of PVD was noted in 31 eyes and syneresis in 62 eyes. Floaters were observed in 43% of the still images versus 96% of videos. Interrater agreement was 0.75 for still images and 0.96 for videos. Intraobserver agreement was 0.84-0.96 for still images and 1.0 for videos. Dynamic NIR video is an objective imaging test for the detection and recording of floaters in symptomatic patients, demonstrating both superior interobserver and intraobserver test-retest reliability to static fundal imaging. This technique helps visualize and assess symptomatic vitreous floaters, offering objective documentation of their presence or absence. It aids in pre-operative decisions, patient education, and post-operative comparisons.