Abstract:
To compare the diagnostic reliability (specificity and sensitivity) of biomicroscopic fundus examination (BFE), digital color photography (d–CP), digital fundus fluorescein angiography (d–FFA) and confocal infrared photography (IR) in detecting threshold photocoagulation scars in the macula region.
Three retinal specialists estimated blindly and independently 56 maculae with clinically significant diabetic edema, by using one of the following methods : a) slit lamp BFE with Goldman applanation lens, b) d–CF examination (Nikon digital camera), c) d–FFA results (Heidelberg Retina Angiograph–HRA) and d) by looking at digital IR images (HRA). Only 34 of the 56 eyes had previously been treated with Argon–laser photocoagulation (threshold grid or modified grid pattern), and the examiners were to answer whether the eye under investigation had previously undergone any laser photopexy in the macula region.
Sensitivity, specificity, false positive and negative results were as follows for each method.
IR fundus imaging scored the highest sensitivity of all methods including FFA, both showing perfect specificity. On the other hand both BFE and d–CF showed poor reliability.
IR imaging is an easy, non–invasive method with excellent sensitivity and specificity in detecting photocoagulation scars from previous threshold laser treatment in the macula region.
Keywords: laser • macula/fovea • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)