Study: Ultra-widefield Photography Misses Many Retinal Detachments

The researchers explained in their paper that “UWFI alone is insufficient for accurate localization” of retinal breaks. “Notably, in eyes where the causative break was visible, about one third had additional breaks missed on UWFI. This is clinically important because reliance on UWFI alone may leave coexisting breaks untreated, leading to incomplete sealing and surgical failure.” Photo: Rami Aboumourad, OD. Click image to enlarge. A recent peer-reviewed article published in Eye examines the effectiveness of ultra-widefield imaging (UWFI) for identifying retinal breaks in primary rhegmatogenous retinal detachments (RRD).For their study, researchers compared patients with a retinal break detected by UWFI to patients without a detected break. Causative breaks were determined based on the surgeon’s judgment and defined as the break responsible for RRD. Also, sensitivity of UWFI was compared across retinal quadrants. It should be noted that the researchers used intraoperative scleral indentation as a reference.“Nearly half of the breaks were not detected on UWFI,” said the authors in their paper. “Sensitivity varied by quadrant, with the temporal quadrant highest and the inferior quadrant lowest. These findings indicate that UWFI alone is insufficient for accurate localization.”A total of 354 eyes with primary RRD were analyzed. A causative break determined by UWFI was found in 208 eyes (58.8%) with an overall sensitivity of 49.1%. As previously stated by the authors, the temporal quadrant had the highest sensitivity (69.2%), followed by the nasal (45.9%), superior (45.2%) and inferior (33%) quadrants.When comparing patients with a causative break to those without one, researchers discovered that the detected group was much younger, had a higher phakic eye rate and showed a smaller detachment extent among all quadrants. Through UWFI observation, horseshoe tears were more common to find in patients with a causative break (80.3% vs 57.5%), while round holes were more likely found in the remaining patients (42.5% vs 16.8%).“UWFI is useful for documenting retinal detachment, but its sensitivity for detecting retinal breaks in RRD is limited, particularly in the superior and inferior quadrants,” concluded the authors. “UWFI should complement, not replace, thorough indirect ophthalmoscopy with scleral indentation.”Click here for the journal source. Chou HC, Su YH, Altamirano F, et al. Sensitivity of ultra-widefield fundus photography for retinal break localisation in primary rhegmatogenous retinal detachment. Eye. June 9, 2026. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.