American Society of Retina Specialists Clinical Practice Guidelines on Multimodal Imaging for Retinal Disease

Meera S. Ramakrishnan, Jaclyn L. Kovach, Charlie C. Wykoff, Audina M. Berrocal, Yasha S. Modi

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Purpose: Advancements in retinal imaging have augmented our understanding of the pathology and structure–function relationships of retinal disease. No single diagnostic test is sufficient; rather, diagnostic and management strategies increasingly involve the synthesis of multiple imaging modalities. Methods: This literature review and editorial offer practical clinical guidelines for how the retina specialist can use multimodal imaging to manage retinal conditions. Results: Various imaging modalities offer information on different aspects of retinal structure and function. For example, optical coherence tomography (OCT) and B-scan ultrasonography can provide insights into the microstructural anatomy; fluorescein angiography (FA), indocyanine green angiography (ICGA), and OCT angiography (OCTA) can reveal vascular integrity and perfusion status; and near-infrared reflectance and fundus autofluorescence (FAF) can characterize molecular components within tissues. Managing retinal vascular diseases often includes fundus photography, OCT, OCTA, and FA to evaluate for macular edema, retinal ischemia, and the secondary complications of neovascularization (NV). OCT and FAF play a key role in diagnosing and treating maculopathies. FA, OCTA, and ICGA can help identify macular NV, posterior uveitis, and choroidal venous insufficiency, which guides treatment strategies. Finally, OCT and B-scan ultrasonography can help with preoperative planning and prognostication in vitreoretinal surgical conditions. Conclusions: Today, the retina specialist has access to numerous retinal imaging modalities that can augment the clinical examination to help diagnose and manage retinal conditions. Understanding the capabilities and limitations of each modality is critical to maximizing its clinical utility.

Original languageEnglish (US)
Pages (from-to)234-246
Number of pages13
JournalJournal of VitreoRetinal Diseases
Volume8
Issue number3
DOIs
StatePublished - May 1 2024

Keywords

  • fluorescein angiography
  • fundus autofluorescence
  • fundus photography
  • indocyanine green angiography
  • macular degeneration
  • multimodal imaging
  • optical coherence tomography
  • optical coherence tomography angiography
  • posterior uveitis
  • retinal dystrophy
  • retinal vascular disease
  • ultra-widefield imaging
  • vitreoretinal surgery

ASJC Scopus subject areas

  • Ophthalmology

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