Author(s): Netan Choudhry, M.D., FRCS(C);1,2* Jay S.Duker, M.D.;3,4 K. Bailey Freund, M.D.;5,6 Szilard Kiss M.D.7, Giuseppe Querques M.D.8, Richard Rosen M.D.9, David Sarraf M.D.10 Eric H. Souied M.D. Ph. D11, Paulo E. Stanga M.D12 Giovanni Staurenghi, M.D.13SriniVas R. Sadda M.D.14


Objective: To summarize the results of a consensus meeting aimed at defining terminology for widefield imaging across all retinal imaging modalities and to provide recommendations for the nomenclature used to describe related images.

Design: An international panel with expertise in retinal imaging was assembled to define consensus terminology for widefield imaging and associated terminology.

Participants: A panel of retina specialists with expertise in retinal imaging.

Main Outcome Measures: Definitions of widefield imaging applicable to multiple imaging modalities.

Methods: Prior to the consensus meeting, set of 7 images acquired with a range of imaging modalities and representing both normal and diseased eyes was circulated to the expert panel for independent assignment of nomenclature to each example. The outputs were assembled and used as the starting point for discussions occurring at a subsequent roundtable meeting. The anatomic location, field of view and perspective provided by each image example was reviewed. A process of open discussion and negotiation was undertaken until unanimous terminology for widefield imaging was achieved.

Results: Across a range of different imaging modalities, the expert panel identified a lack of uniform terminology being used in recent literature to describe widefield images. The panel recommended the term widefield be limited to images depicting retinal anatomy beyond the posterior pole, but posterior to the vortex vein ampulla in all 4 quadrants. The term ultra widefield was recommended to describe images showing retinal anatomy anterior to the vortex vein ampullae in all 4 quadrants. The definitions were recommended over other device-specific terminology,

Conclusions: A consistent nomenclature for widefield imaging based on normal anatomic landmarks that is applicable to multiple retinal imaging modalities has been proposed by the International Widefield Imaging Study Group. The panel recommends this standardized nomenclature for use in future publications.

1Vitreous Retina Macula Specialists of Toronto, Etobicoke ON, Canada

2Department of Ophthalmology & Visual Sciences University of Toronto, Toronto, ON Canada

3New England Eye Center, Boston, MA, USA

4Department of Ophthalmology Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA

5Vitreous Retina Macula Consultants of New York, New York, NY, USA

6Department of Ophthalmology New York University, New York, NY, USA

7 Department of Ophthalmology Weill Cornell Medicine, New York, NY, USA

8Department of Ophthalmology University Vita Salute, IRCCS Ospedale San Raffaele Scientific Institute, Milan, Italy

9New York Eye & Ear Infirmary, New York, NY, USA

10Department of Ophthalmology University of California Los Angeles Stein Eye Institute, Los Angeles, CA, USA

11Department of Ophthalmology Hospital Intercommunal de Creteil, Paris, France

12Department of Ophthalmology Manchester Royal Eye Hospital, Manchester, U.K.

13University Eye Clinic Department of Biomedical and Clinical Sciente Luigi Sacco Luigi Sacco Hospital, Milan, Italy

14Department of Ophthalmology University of California Los Angeles Stein Eye Institute, Los Angeles CA USA.

Financial Disclosure(s):

Netan Choudhry is a consultant for Topcon and Optos and receives research equipment from Topcon, Optos & Carl Zeiss Meditec.

Jay Duker receives research support from Carl Zeiss Meditech, Topcon, and OptoVue.

K.B. Freund is a consultant to Optos, Optovue, Zeiss, Allergan, Novartis and Heidelberg Engineering and receives research support from Genentech/Roche.

Szilard Kiss is a consultant for Adverum, Allergan, Alcon, Alimera, Fortress Bio, Genentech, RegenX, Novartis, Spark, Regeneron, and Optos.

Richard B. Rosen is a consultant for Optovue, Boehringer-Ingelheim, Astellas, Bayer, Nano Retina, Guardion Health, Regeneron, Genentech-Roche, OD-OS, Diopsys, CellView, and has intellectual property with Opticology and Optovue.

David Sarraf is a consultant for Amgen, Bayer, Genentech, Novartis and Optovue and receives research grants from Genentech, Heidelberg, Optovue and Regeneron.

Eric H. Souied is a consultant for Allergan, Bayer, Novartis, and Thea.

Giovanni Staurenghi receives financial support from Heidelberg Engineering, Zeiss Meditec, Optovue, Optos, Centervue, Nidek, Novartis, Bayer; Other Heidelberg Engineering, Zeiss Meditec, Optos, Centervue, Novartis, Bayer, Boeheringer, Allergan and Alcon.

Paolo E. Stanga is a consultant for Allergan Plc., Bausch & Lomb Inc., Bayer AG, Novartis AG, Optos Plc., Second Sight Medical Products, Inc., Topcon Corp., and Carl Zeiss AG.

Giuseppe Querques None

Consultant:  Centervue, Heidelberg, Optos

Research Support: Optos, Carl Zeiss Meditec

Research Instruments: Nidek, Topcon, Centervue, Carl Zeiss Meditec, Heidelberg, Optos

Srinivas R. Sadda is a consultant for Centervue, Heidelberg Engineering and Optos; Research support: Optos, Carl Zeiss Meditec, Research Instruments: Optos, Carl Zeiss Meditec, Nidek, Centervue,Topcon and Heidelberg Engineering.