April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Non-mydriatic ultra-widefield images compared to 7-field ETDRS standard images for screening of diabetic retinopathy
Author Affiliations & Notes
  • Malin Lundberg Rasmussen
    Department of Ophthalmology, Odense University Hospital, Clinical Research Institute, University of Southern Denmark, Odense C, Denmark
  • Rebecca Broe
    Department of Ophthalmology, Odense University Hospital, Clinical Research Institute, University of Southern Denmark, Odense C, Denmark
  • Tunde Peto
    Department of Ophthalmology, Odense University Hospital, Clinical Research Institute, University of Southern Denmark, Odense C, Denmark
    The NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL institute of Ophthalmology, London, United Kingdom
  • Jakob Grauslund
    Department of Ophthalmology, Odense University Hospital, Clinical Research Institute, University of Southern Denmark, Odense C, Denmark
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 2280. doi:
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    • Get Citation

      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.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To compare non-mydriatic ultrawide field images (Optomap) with mydriatic 7-field Early Treatment Diabetic Retinopathy Study (ETDRS) standards.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: 499 diabetic retinopathy • 465 clinical (human) or epidemiologic studies: systems/equipment/techniques • 468 clinical research methodology  
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