Precise montaging and metric quantification of retinal surface area from ultra-widefield fundus photography and fluorescein angiography

Ophthalmic Surg Lasers Imaging Retina. Jul-Aug 2014;45(4):312-7. doi: 10.3928/23258160-20140709-07.


Background and objective: Accurate quantification of retinal surface area from ultra-widefield (UWF) images is challenging due to warping produced when the retina is projected onto a two-dimensional plane for analysis. By accounting for this, the authors sought to precisely montage and accurately quantify retinal surface area in square millimeters.

Patients and methods: Montages were created using Optos 200Tx (Optos, Dunfermline, U.K.) images taken at different gaze angles. A transformation projected the images to their correct location on a three-dimensional model. Area was quantified with spherical trigonometry. Warping, precision, and accuracy were assessed.

Results: Uncorrected, posterior pixels represented up to 79% greater surface area than peripheral pixels. Assessing precision, a standard region was quantified across 10 montages of the same eye (RSD: 0.7%; mean: 408.97 mm(2); range: 405.34-413.87 mm(2)). Assessing accuracy, 50 patients' disc areas were quantified (mean: 2.21 mm(2); SE: 0.06 mm(2)), and the results fell within the normative range.

Conclusion: By accounting for warping inherent in UWF images, precise montaging and accurate quantification of retinal surface area in square millimeters were achieved.

MeSH terms

  • Fluorescein Angiography / methods*
  • Fundus Oculi
  • Humans
  • Models, Theoretical
  • Observer Variation
  • Photography / methods*
  • Reproducibility of Results
  • Retinal Diseases / diagnosis*
  • Retinal Vessels / pathology