Fig 1.
Grade assessment based on the degree of posterior retina obscuration by asteroid bodies.
(A–D) Top row: Fundus photographs of patients with asteroid hyalosis (AH) captured using a color fundus camera (CFC). (E–H) Second row: Images of patients with AH taken with an ultrawide-field bicolor confocal scanning laser ophthalmoscope (BC-cSLO). (I–K) Third row: AH patient photos captured using a true-color confocal scanning ophthalmoscope (TC-cSO). Grading was assigned as follows: Grade 1, clearly visible optic disc and second-order vessels; Grade 2, for a visible optic disc and first-order vessels; 3, hazy optic disc with first-order vessels not clearly visible; and Grade 4, posterior pole and optic completely obscured due to dense asteroid bodies. Each column corresponds to the same grade, which increases from left to right. Notably, no images taken with TC-cSO were classified as Grade 4.
Table 1.
Baseline characteristics for eyes with asteroid hyalosis.
Table 2.
Comparison of the grade assessment in fundus photographs by three imaging devices based on the degree of obscuration by asteroid bodies.
Table 3.
Inter-rater reliability in the interpretation of retinal diseases accompanied by asteroid hyalosis across three imaging devices.
Table 4.
Comparative analysis of the diagnostic ability of three imaging devices for concurrent retinal diseases with asteroid hyalosis.
Fig 2.
Differences in fundus images obtained by three imaging devices in patients with asteroid hyalosis.
Each row consists of fundus photographs taken from the same patient with asteroid hyalosis (AH). (A) Grade 3 obscuration in color fundus camera (CFC) shows dense asteroid bodies obscuring the optic disc and macula. (B) Bicolor confocal scanning laser ophthalmoscope (BC-cSLO) also displays similar obscuration, providing no additional information on the macular status. (C) True-color confocal scanning ophthalmoscope (TC-cSO) reveals reduced asteroid bodies, except those shadows on the macula. No retinal disorders are evident. (D) Similar to A, Grade 3 obscuration in CFC is evident, and a single retinal hemorrhage is barely detectable. (E) BC-cSLO shows peripheral retinal photocoagulation scars, indicative of diabetic retinopathy, but asteroid bodies still impede the macular region. (F) TC-cSO uncovers microaneurysms and hard exudates on the macula, leading to a unanimous diagnosis of diabetic retinopathy. (G) CFC displays multiple drusens with asteroid bodies, diagnosed as dry AMD with AH. (H) BC-cSLO reveals faint retinal folding near the fovea, diagnosed by one examiner as an epiretinal membrane. (I) TC-cSO shows membrane reflex and retinal folding, which are previously obscured in images G and H, clearly suggesting ERM and dry AMD with AH. (J) Grade 3 obscuration by asteroid bodies in CFC. (K) BC-cSLO exhibits a faint, round pigment epithelial detachment in the upper parafovea. (L) TC-cSO reveals well-circumscribed hemorrhagic pigment epithelial detachment due to wet AMD.