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Ultra-widefield imaging improved diabetic retinopathy detection
SAN FRANCISCO — Ultra-widefield imaging with or without fluorescein angiography could have significant implications for identifying and treating diabetic retinopathy, according to data presented at the American Diabetes Association’s 74th Scientific Sessions.
“Ultra-widefield imaging with or without fluorescein angiography can help select patients for more-intensive monitoring for potentially earlier target treatments to minimize loss of visual field due to laser treatments,” Belinda A. Brooks, NP, CDE, MSc, PhD, of the Sydney Diabetes Centre, Royal Prince Alfred Hospital, said during a presentation here. “Ultra-widefield imaging is easier and faster to perform. It is also better-tolerated and more convenient for patients, because no mydriasis is required.”
Brooks presented a case in which a patient presented with mild nonproliferative diabetic retinopathy on a 45° photograph, but was found to have proliferative retinopathy on a 200° photograph using an ultra-widefield camera.
This prompted Brooks and colleagues to examine whether the 45° photograph underestimated the severity of patients’ diabetic retinopathy; they included 45 consecutive patients with 69 out of 90 eyes showing less than moderate nonproliferative diabetic retinopathy in the 45° photograph. They also sought to examine whether an ultra-widefield with fluorescein angiography assisted in the detection of high-risk retinal characteristics.
Data indicated that 10 out of 69 eyes were graded as having more severe diabetic retinopathy on ultra-widefield photography, which was equivalent to a two-step progression on the ETDRS scale, with two eyes showing proliferative diabetic retinopathy. The ultra-widefield photography significantly increased the identification of diabetic retinopathy by 14.9%, according to Brooks.
Additional data showed that the use of ultra-widefield fluorescein angiography identified 22 of 87 eyes (25.3% of patients) with high-risk retinal characteristics that were not otherwise found by conventional fluorescein angiography. This included three additional eyes with proliferative diabetic retinopathy, according to Brooks.
“The higher sensitivity of ultra-widefield imaging may also have implications for studies examining the relationship between risk factors and development of retinopathy,” Brooks said. – by Samantha Costa
Disclosure: Brooks has no relevant financial disclosures.
For more information:
Brooks BA. Abstract #354-OR. Presented at: American Diabetes Association’s 74th Scientific Sessions; June 13-17, 2014; San Francisco.