Purchase this article with an account.
Malin Lundberg Rasmussen, Rebecca Broe, Tunde Peto, Jakob Grauslund; Non-mydriatic ultra-widefield images compared to 7-field ETDRS standard images for screening of diabetic retinopathy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2280.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To compare non-mydriatic ultrawide field images (Optomap) with mydriatic 7-field Early Treatment Diabetic Retinopathy Study (ETDRS) standards.
Ninety-five patients with type 1 diabetes (190 eyes) had two sets of images taken: a non-mydriatic Optomap image, and then, after pharmacological dilation mydriatic 7-field ETDRS-standards photographs were taken. All images were graded in accordance to the ETDRS protocol by a single trained and certified grader masked to the results of the corresponding relevant grading. For intragrader agreement kappa-statistics were used.
On the 7-field ETDRS images, diabetic retinopathy (DR) was distributed as follows: no DR (ETDRS 10)[2.1%], mild non-proliferative DR (NPDR) (ETDRS 20-35)[50.0%], moderate NPDR (ETDRS 43-47)[15.3%], severe NPDR (ETDRS 53)[2.6%], and proliferative DR (ETDRS >61)[30.0%]. Exact agreement of DR severity between non-mydriatic Optomap and mydriatic 7-field images was 78.7%; and agreement within one level was 84.7% (κ= 0.68 and 0.78, respectively). Amongst those with disagreement (n=50 eyes), DR grade showed more advanced disease in 33 eyes in Optomap images compared to 7-field images. Proliferative DR was found on 7-field ETDRS images in two eyes (2 patients) but was missed on non-mydriatic Optomap due to eyelash covering or to a blurry periphery.
Non-dilated Optomap matched 7-field ETDRS images favorably. With Optomap there is no need for pupil-dilation and only one image of each eye needs to be captured. However, because of overlapping eyelashes, distortion and blurry periphery some lesion might be lost. Further investigations on a broader diabetic population needs to be done before implementing into screening.
This PDF is available to Subscribers Only