Comparison of conventional color fundus photography and multicolor imaging in choroidal or retinal lesions

  • Ilkay Kilic Muftuoglu
  • Raouf Gaber
  • Dirk-Uwe Bartsch
  • Amit Meshi
  • Michael Goldbaum
  • William R. FreemanEmail author
Retinal Disorders



Our purpose was to compare the characteristics of the retinal and choroidal lesions including choroidal nevus, choroidal melanoma and congenital hypertrophy of the retina pigment epithelium using conventional color fundus photography (CFP) and multicolor imaging (MCI).


The paired images of patients with retinal or choroidal lesions were assessed for the visibility of lesion’s border, halo and drusen using a grading scale (0–2). The area of the lesion was measured on both imaging modalities. The same grading was also done on the individual color channels of MCI for a further evaluation.


Thirty-three eyes of 33 patients were included. There were no significant differences in the mean border, drusen and halo visibility scores between the two imaging modalities (p = 0.12, p = 0.70, p = 0.35). However, the mean area of the lesion was significantly smaller on MCI than that on CFP (14.9±3.3 versus 18.7±3.4 mm2, p = 0.01).


The appearance of choroidal and/ or retinal lesions on MCI may be different than that on CFP. Though MCI can provide similar information with CFP for the features of retinal and/ or choroidal lesions including border, halo and drusen; the infrared light reflection on MCI underestimates the extent of the choroidal lesion by 33%.


Multicolor imaging Fundus photography Choroidal nevus Choroidal melanoma Congenital hypertrophy of the retina pigment epithelium Pseudocolor 



This work was supported in part by an unrestricted grant from NIH grant R01 EY016323-09A1 (D.U.B.) and a core grant from the National Eye Institute P30 EY022589, and an unrestricted grant from Research to Prevent Blindness, NY (WRF). The funding organizations had no role in the design or conduct of this research.

Compliance with ethical standards

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.


  1. 1.
    Sumich P, Mitchell P, Wang JJ (1998) Choroidal nevi in a white population: the Blue Mountains eye study. Arch Ophthalmol 116:645–650CrossRefPubMedGoogle Scholar
  2. 2.
    Shields CL, Furuta M, Mashayekhi A et al (2008) Clinical spectrum of choroidal nevi based on age at presentation in 3422 consecutive eyes. Ophthalmology 115:546–552CrossRefPubMedGoogle Scholar
  3. 3.
    Singh AD, Kalyani P, Topham A (2005) Estimating the risk of malignant transformation of a choroidal nevus. Ophthalmology 112:1784–1789CrossRefPubMedGoogle Scholar
  4. 4.
    Shields CL, Kaliki S, Rojanaporn D et al (2012) Enhanced depth imaging OCT of small choroidal melanoma: comparison with choroidal nevus. Arch Ophthalmol 130:850–856CrossRefPubMedGoogle Scholar
  5. 5.
    Almeida A, Kaliki S, Shields CL (2013) Autofluorescence of intraocular tumours. Curr Opin Ophthalmol 24:222–232CrossRefPubMedGoogle Scholar
  6. 6.
    Shields CL, Bianciotto C, Pirondini C et al (2008) Autofluorescence of choroidal melanoma in 51 cases. Br J Ophthalmol 92:617–622CrossRefPubMedGoogle Scholar
  7. 7.
    Ben Moussa N, Georges A, Capuano V et al (2015) MultiColor imaging in the evaluation of geographic atrophy due to age-related macular degeneration. Br J Ophthalmol 99:842–847CrossRefPubMedGoogle Scholar
  8. 8.
    Yu S, Bellone D, Lee SE, Yannuzzi LA (2015) Multimodal imaging in foveal red spot syndrome. Retin Cases Brief Rep 9:97–101CrossRefPubMedGoogle Scholar
  9. 9.
    Shields CL, Maktabi AM, Jahnle E, Mashayekhi A, Lally SE, Shields JA (2010) Halo nevus of the choroid in 150 cases: the 2010 Henry van dyke lecture. Arch Ophthalmol 128:859–864CrossRefPubMedGoogle Scholar
  10. 10.
    Van de Kraats J, Berendschot TT, Valen S, van Norren D (2006) Fast assessment of the central macular pigment density with natural pupil using the macular pigment reflectometer. J Biomed Opt 11:064031CrossRefPubMedGoogle Scholar
  11. 11.
    Kilic Muftuoglu I, Bartsch DU, Barteselli G et al (2017) Visualization of macular pucker by multicolor scanning laser imaging. Retina.
  12. 12.
    Tan AC, Fleckenstein M, Schmitz-Valckenberg S, Holz FG (2016) Clinical application of multicolor imaging technology. Ophthalmologica 236:8–18CrossRefPubMedGoogle Scholar
  13. 13.
    Reznicek L, Stumpf C, Seidensticker F et al (2014) Role of wide-field autofluorescence imaging and scanning laser ophthalmoscopy in differentiation of choroidal pigmented lesions. Int J Ophthalmol 7:697–703PubMedPubMedCentralGoogle Scholar
  14. 14.
    Zapta MA, Leila M, Teixidor T, Garcia-Arumi J (2015) Compartive study between fundus autofluorescence and red reflectance imaging of choroidal naevi using ultra wide field scanning laser ophthalmoscopy. Retina 35:1202–1204CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Ilkay Kilic Muftuoglu
    • 1
    • 2
  • Raouf Gaber
    • 1
    • 3
  • Dirk-Uwe Bartsch
    • 1
  • Amit Meshi
    • 1
  • Michael Goldbaum
    • 4
  • William R. Freeman
    • 1
    • 5
    Email author
  1. 1.Department of Ophthalmology, Jacobs Retina Center at the Shiley Eye InstituteUniversity of California San DiegoLa JollaUSA
  2. 2.Department of OphthalmologyIstanbul Training and Research HospitalIstanbulTurkey
  3. 3.Also affiliated with Department of OphthalmologyTanta UniversityTantaEgypt
  4. 4.Department of Ophthalmology, Shiley Eye InstituteUniversity of California San DiegoLa JollaUSA
  5. 5.Jacobs Retina Center, Shiley Eye InstituteUniversity of California San DiegoLa JollaUSA

Personalised recommendations