March 2012
Volume 53, Issue 14
ARVO Annual Meeting Abstract  |   March 2012
Efficient Early Diagnosis of Diabetic Retinopathy using zero-dilation Scanning Laser Ophthalmoscopy
Author Affiliations & Notes
  • Dirk De Brouwere
    i-Optics bv, The Hague, The Netherlands
  • Peter van Etten
    Rotterdam Eye Institute, Rotterdam, The Netherlands
  • Jose Martinez
    Rotterdam Eye Hospital, Rotterdam, The Netherlands
  • Michiel Mensink
    i-Optics bv, The Hague, The Netherlands
  • Footnotes
    Commercial Relationships  Dirk De Brouwere, i-Optics bv (E); Peter van Etten, i-Optics bv (F, C, R); Jose Martinez, i-Optics bv (F, C); Michiel Mensink, i-Optics bv (I, P, S)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 5747. doi:
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      Dirk De Brouwere, Peter van Etten, Jose Martinez, Michiel Mensink; Efficient Early Diagnosis of Diabetic Retinopathy using zero-dilation Scanning Laser Ophthalmoscopy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5747.

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

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Purpose: : The incidence of diabetic retinopathy (DRP) is projected to escalate. Regular DRP screening of patients with diabetes enables early intervention and significantly reduces the risk of vision loss. However, increased demand has created a need for faster, more accessible technology. With a traditional fundus camera, mydriasis is recommended when the pupil diameter is 3.7 mm or less, but mydriasis is time-consuming, expensive and may cause discomfort. To counter this problem, a confocal line scanning laser ophthalmoscope (cLSLO) device has been developed for non-mydriatic diagnosis of DRP. We report data from a pilot study of cLSLO based diagnosis for DRP in the diabetic population in Rotterdam, in which we assessed whether cLSLO technology could achieve successful non-mydriatic imaging with a minimum pupil diameter of 2 mm.

Methods: : 100 diabetic patients (age 60 +/-11 y) were recruited for cLSLO imaging prior to eye examinations with a standard fundus camera at a diabetes center. The cLSLO device (EasyScan v1.2, i-Optics, Netherlands) uses green and infrared light to illuminate the retina through a 2 mm pupil, scanning over a 45 by 45 degree retinal field. After mydriasis, scheduled examinations with a fundus camera (Topcon NW-6) were performed. Pupil diameter was calculated and acquisition time was recorded. Referral for DRP was assessed by two licensed graders based on images of both devices. Both interobserver agreement and agreements between both instruments was analysed

Results: : In this cohort of patients, gradeability of cLSLO images is in line with the criteria for diabetic diagnosis devices specified by the British diabetic association (BDA). 56% of the population had at least one pupil with diameter less than 3.7 mm and would require mydriasis for traditional fundus camera imaging. Average image acquisition time was less than 3 minutes.

Conclusions: : In summary, cLSLO imaging provides an efficient technology that can be used for DRP diagnosis without mydriasis, which may enable a reduction in appointment times, with consequent benefits for both patients and healthcare providers.

Keywords: diabetic retinopathy • imaging/image analysis: clinical • diabetes 

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