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, 35 (12), 2459-63

Assessment of Diabetic Retinopathy Using Nonmydriatic Ultra-Widefield Scanning Laser Ophthalmoscopy (Optomap) Compared With ETDRS 7-field Stereo Photography

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Assessment of Diabetic Retinopathy Using Nonmydriatic Ultra-Widefield Scanning Laser Ophthalmoscopy (Optomap) Compared With ETDRS 7-field Stereo Photography

Marcus Kernt et al. Diabetes Care.

Abstract

Objective: To compare the diagnostic properties of a nonmydriatic 200° ultra-widefield scanning laser ophthalmoscope (SLO) versus mydriatic Early Treatment of Diabetic Retinopathy Study (ETDRS) 7-field photography for diabetic retinopathy (DR) screening.

Research design and methods: A consecutive series of 212 eyes of 141 patients with different levels of DR were examined. Grading of DR and clinically significant macular edema (CSME) from mydriatic ETDRS 7-field stereo photography was compared with grading obtained by Optomap Panoramic 200 SLO images. All SLO scans were performed through an undilated pupil, and no additional clinical information was used for evaluation of all images by the two independent, masked, expert graders.

Results: Twenty-two eyes from ETDRS 7-field photography and 12 eyes from Optomap were not gradable by at least one grader because of poor image quality. A total of 144 eyes were analyzed regarding DR level and 155 eyes regarding CSME. For ETDRS 7-field photography, 22 eyes (18 for grader 2) had no or mild DR (ETDRS levels ≤ 20) and 117 eyes (111 for grader 2) had no CSME. A highly substantial agreement between both Optomap DR and CSME grading and ETDRS 7-field photography existed with κ = 0.79 for DR and 0.73 for CSME for grader 1, and κ = 0.77 (DR) and 0.77 (CSME) for grader 2.

Conclusions: Determination of CSME and grading of DR level from Optomap Panoramic 200 nonmydriatic images show a positive correlation with mydriatic ETDRS 7-field stereo photography. Both techniques are of sufficient quality to assess DR and CSME. Optomap Panoramic 200 images cover a larger retinal area and therefore may offer additional diagnostic properties.

Figures

Figure 1
Figure 1
Overlay montage of a representative Optomap scan and ETDRS 7-field (mild NPDR). (A high-quality digital representation of this figure is available in the online issue.)
Figure 2
Figure 2
Diabetic retinopathy severity threshold of Optomap vs. 7-field photography. (A high-quality color representation of this figure is available in the online issue.)

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References

    1. Ehrlich R, Harris A, Ciulla TA, Kheradiya N, Winston DM, Wirostko B. Diabetic macular oedema: physical, physiological and molecular factors contribute to this pathological process. Acta Ophthalmol (Copenh) 2010;88:279–291 - PubMed
    1. Williams R, Airey M, Baxter H, Forrester J, Kennedy-Martin T, Girach A. Epidemiology of diabetic retinopathy and macular oedema: a systematic review. Eye (Lond) 2004;18:963–983 - PubMed
    1. Fong DS, Aiello L, Gardner TW, et al. American Diabetes Association Retinopathy in diabetes. Diabetes Care 2004;27(Suppl. 1):S84–S87 - PubMed
    1. Cummings DM, Morrissey S, Barondes MJ, Rogers L, Gustke S. Screening for diabetic retinopathy in rural areas: the potential of telemedicine. J Rural Health 2001;17:25–31 - PubMed
    1. Olayiwola JN, Sobieraj DM, Kulowski K, St Hilaire D, Huang JJ. Improving diabetic retinopathy screening through a statewide telemedicine program at a large federally qualified health center. J Health Care Poor Underserved 2011;22:804–816 - PubMed
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