Abstract
Abstract: :
Purpose: To compare the stereo photographic images produced by the Automated Retinal Imaging System (ARIS) and the retinal image maps created using Optical Coherence Tomography to determine if the ARIS is an effective screening tool to detect the appearance of macular edema in diabetic retinopathy. Methods: Patients who presented to the clinic with a history of diabetes qualified for the study. After a complete ophthalmic exam patients had OCT and photographs taken. OCT images were first taken using the Zeiss OCT3 system. OCT images were collected from eyes using a 6mm cross hair scan and a 5 mm fast macular thickness scan. The ARIS is a fully automated, digital, non–mydriatic fundus camera, which obtains thirty degree stereo fundus photographs which demonstrate the retinal topography. Fundus photographs of retinal fields one, two, and three were obtained from 50 eyes of 25 diabetic patients, using the ARIS. A retinal specialist who had no prior knowledge of the patients nor had access to the OCT readings reviewed the photos. The photographs were subjectively evaluated for the presence or absence of macular edema. The macula was divided into nine standard sections, which correspond to the nine areas that the OCT images depict. The presence of edema was quantified as not present (0), slight edema or possible edema (1), and apparent macular edema (3). The results were then compared to the OCT scans results. Macular edema was defined as greater than 250 microns in the central macula or greater than 300 microns in any of the four adjacent quadrants on the macula map. Results:Fundus photographs were obtained for all patients. The presence of macular edema as recognized viewing stereo pair of field 2 (centered on the macula) correlated with a central macular thickness greater than 250 microns by OCT. There was a short learning curve in operating the ARIS, after which both the quality of the images and the length of the photographic study were greatly improved. Conclusions:The ARIS uses new technology which is user friendly and easily creates high quality stereo photographs, which can provide a vast array of information. In preliminary results, it seems effective at diagnosing macular edema. Advantages of the ARIS camera compared to traditional, non–mydriatic, screening, fundus camera are the ability of providing an automated stereo pair photograph of the macula and optic disc, and can also provide the additional fields (#3 – 7) of the standardized DRS73–7 fields of view of the fundus in an automated standardized fashion.
Keywords: diabetic retinopathy • macula/fovea