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Optomap ultrawide field imaging identifies additional retinal abnormalities in patients with diabetic retinopathy

Authors Price L, Au S, Chong NV

Received 17 December 2014

Accepted for publication 13 January 2015

Published 24 March 2015 Volume 2015:9 Pages 527—531


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Liam D Price,1 Stephanie Au,2 N Victor Chong1

1Oxford Eye Hospital, University of Oxford, Oxford, UK; 2University of Hong Kong, Hong Kong SAR, People’s Republic of China

Purpose: To compare diabetic retinopathy (DR) severity grading between Optomap ultrawide field scanning laser ophthalmoscope (UWFSLO) 200° images and an Early Treatment Diabetic Retinopathy Study (ETDRS) seven-standard field view.
Methods: Optomap UWFSLO images (total: 266) were retrospectively selected for evidence of DR from a database of eye clinic attendees. The Optomap UWFSLO images were graded for DR severity by two masked assessors. An ETDRS seven-field mask was overlaid on the Optomap UWFSLO images, and the DR grade was assessed for the region inside the mask. Any interassessor discrepancies were adjudicated by a senior retinal specialist. Kappa agreement levels were used for statistical analysis.
Results: Fifty images (19%) (P<0.001) were assigned a higher DR level in the Optomap UWFSLO view compared to the ETDRS seven-field view, which resulted in 40 images (15%) (P<0.001) receiving a higher DR severity grade. DR severity grades in the ETDRS seven-field view compared with the Optomap UWFSLO view were identical in 85% (226) of the images and within one severity level in 100% (266) of the images. Agreement between the two views was substantial: unweighted κ was 0.74±0.04 (95% confidence interval: 0.67–0.81) and weighted κ was 0.80±0.03 (95% confidence interval: 0.74–0.86).
Conclusion: Compared to the ETDRS seven-field view, a significant minority of patients are diagnosed with more severe DR when using the Optomap UWFSLO view. The clinical significance of additional peripheral lesions requires evaluation in future prospective studies using large cohorts.

Keywords: diagnostic imaging, diabetes, retina

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