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Expanded field: filling the gap between macula and widefield

Eye (2024)Cite this article

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The introduction of optical coherence tomography angiography (OCTA) has ushered retinal specialists in an era of depth-resolved en face examination of the retinal and choroidal vascular layers [1]. Recent advances such as swept-source technology and enhanced image montage capabilities have expanded the field of view from the macular region to near the retinal periphery [2]. This technological leap has however sparked debate regarding the appropriate terminology to adopt for OCTA imaging studies that exceed the macular area. In fact, the initial OCTA volumes larger than the macular area were termed ‘widefield’ [3, 4], a designation that has drawn common criticism for potentially misleading comparisons with other widefield modalities capable of capturing the entire retina, such as fundus photography and dye-based angiography.

To address this issue, in 2019 the International Widefield Imaging Study Group sought to clarify this terminology, designating as ‘widefield’ the retinal area extending from the major retinal vascular arcades (60–70°) to the equator, as delineated by the vortex veins (approximately 110°) [5]. Choudhry et al. also acknowledged the limitations due to the inter-device variability and the anticipated need for ongoing revision of these definitions in light of the rapid technological advances in the field. Subsequently, another group of international experts on retinal vascular diseases has revisited this debate rejecting the definition previously formulated by the International Widefield Imaging Study Group [6]. However, despite a tentative agreement during the third Delphi round to shift the ‘widefield’ posterior boundary to 90°, the panel refrained from issuing a definitive recommendation on this matter.

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Fig. 1: Graphical representation of the proposed field-of-view (FoV) ranges centered on the fovea.

References

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Funding

JBM is a consultant for Alcon, Allergan, Carl Zeiss, Sunovion, Topcon, and Genentech. FR and XD have nothing to disclose.

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Author notes

  1. These authors contributed equally: Francesco Romano, Xinyi Ding.

Authors and Affiliations

  1. Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA

    Francesco Romano, Xinyi Ding & John B. Miller

  2. Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA

    Francesco Romano, Xinyi Ding & John B. Miller

Authors
  1. Francesco Romano
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  2. Xinyi Ding
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  3. John B. Miller
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FR and XD are responsible for analyzing the data and writing the report. JBM contributed to the study design and provided feedback on the report.

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Correspondence to John B. Miller.

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Romano, F., Ding, X. & Miller, J.B. Expanded field: filling the gap between macula and widefield. Eye (2024). https://doi.org/10.1038/s41433-024-02978-6

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