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American Academy of Ophthalmology Meeting
November 17, 2017
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ETDRS, ultra-widefield imaging on par for identifying retinopathy severity

Lloyd P. Aiello

NEW ORLEANS — In a baseline data review, ETDRS and ultra-widefield imaging appear comparable for determining diabetic retinopathy severity within the ETDRS fields, according to results of the ongoing Diabetic Retinopathy Clinical Research Network Protocol AA trial presented here.

Perspective from Judy E. Kim, MD

“There is moderate to substantial agreement between ETDRS photos and ultra-widefield images masked to the ETDRS area for grading diabetic retinopathy severity,” Lloyd P. Aiello, MD, said at Retina Subspecialty Day preceding the American Academy of Ophthalmology meeting.

Protocol AA is an ongoing observational 4-year evaluation of 766 eyes of 386 patients.

“The primary question is to determine if ultra-widefield images compared to modified ETDRS 7-field fundus imaging allow us comparable ability to assess diabetic retinopathy ... and also to determine if the peripheral information improves ability to predict rates of diabetic retinopathy worsening over time,” Aiello said.

Ultra-widefield images were projected to correct distortion and automatically masked to show only ETDRS area. Then both ETDRS and ultra-widefield images were read by masked readers.

Images were graded identically in 46% of eyes and were within one step in 84% of eyes, Aiello said. After adjudication, diabetic retinopathy severity by ETDRS photos and masked ultra-widefield images matched exactly in 59% of eyes and were within one step in 96% of eyes.

Peripheral lesions were present and affected diabetic retinopathy severity at rates consistent with prior studies.

“These data suggest that protocol AA will be able to address the primary question regarding the effect of peripheral lesions on the rate of diabetic retinopathy progression at the conclusion of the observation study,” Aiello said. – by Patricia Nale, ELS

 

Reference:

Aiello LP. Ultrawide field imaging for diabetic retinopathy severity evaluation. Presented at AAO Subspecialty Days; Nov. 10-11, 2017; New Orleans.

 

Disclosure: Aiello reports he is a consultant for Biogen, Genzyme, KalVista, Merck and Novo Nordisk.

Perspective

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Judy E. Kim, MD
Judy E. Kim, MD

Where ultra-widefield imaging really makes a difference to me in my clinic is not the color imaging but the ultra-widefield fluorescein angiography. I am amazed at how much I can see in terms of ischemia. I am also amazed at how much I can see in terms of neovascularization that I was not expecting. So, in some cases, the eyes that I thought were severe nonproliferative actually become proliferative, and then my treatment management does change.

Judy E. Kim, MD
OSN Retina/Vitreous Board Member
Disclosures: Kim reports financial relationships with DRCR.net, Genentech, Notal Vision and Optos.