This article is more than 5 years old. Information may no longer be current.
Real-time imaging may assist standardized grading in diabetic retinopathy evaluation
Click Here to Manage Email Alerts
DENVER — A teleophthalmology program using ultra-widefield imaging may assist standardized grading at reading centers for diabetic retinopathy evaluation, according to a presentation here.
In a presentation at the Association for Research in Vision and Ophthalmology annual meeting, Radwan Ajlan, MD, and colleagues discussed point-of-care evaluation for diabetic retinopathy in 3,978 eyes of 1,989 patients using real-time ultra-widefield imaging vs. masked standardized grading at a dedicated reading center over the course of 1 year.
Real-time grading results included ungradable images in 2.1% of eyes and 0.96% of patients, while images were deemed ungradable at the reading center in 5.3% of eyes and 2.9% of patients.
Real-time point-of-care imager grading had a sensitivity of 95% and a specificity of 84% for identifying more than minimal diabetic retinopathy, and the sensitivity was 99% and the specificity was 76% for detecting referable diabetic retinopathy.
Three patients with referable diabetic retinopathy were missed with the real-time imaging, but none with severe nonproliferative diabetic retinopathy or clinically significant macular edema were missed.
“With immediate image evaluation at the point-of-care, less than 0.1% of patients with referable diabetic retinopathy would be missed while the reading center image grading burden would be reduced by approximately 60% and outpatient feedback expedited,” Ajlan said.
To further the teleophthalmology program, he feels providing access to an established teleophthalmology program, defining comprehensive image evaluation protocol, assuring standardized image display, and addressing the availability and costs of the ultra-widefield camera are still issues.
“Although this evaluation approach holds promise with a large diabetic retinopathy teleophthalmology program, prior to the development of more accurate integrated systems, there are challenges that remain to be addressed,” Ajlan said. - by Kristie L. Kahl
Disclosure: Ajlan reports no relevant financial disclosures.