Color fundus photography versus fundoscopy in diabetic retinopathy patients: A pilot study

Abstract

Aims/Purpose: To compare fundoscopy with Color fundus photography (CFP) in identifying diabetic retinopathy (DR) abnormalities.Methods: This is a pilot cross‐sectional study of diabetic patients attending the medical retina clinic for routine examination. All patients underwent dilated indirect ophthalmoscopy and CFP, both performed by the same doctor. The following retinal features were identified in 5 segments during both procedures (CA‐central area, UT‐upper temporal, LT‐lower temporal, UN‐upper nasal, LN‐lower nasal): pre‐retinal/retinal (RH)/vitreous haemorrhages, exudates (EX), intraretinal microvascular abnormalities (IRMA), venous beading (VB), vein loops (VL), cotton wool spots (CWS), retinal neovascularization (NVD/NVE) and ghost vessels (GV).Results: Thirty‐six eyes of 18 patients were included in the study. Overall, CFP recorded more retinal features in comparison with fundoscopy in most segments. In particular, in CFP: RH and VB were identified in 1 extra case but CWS was missed in 2 cases in CA. Imaging in UT segment revealed RH and CWS in 3 and 1 additional cases, respectively. RH, VB, CWS were recorded in 3, 1 and 1 extra cases in LT. RH and EX were documented in 4 and 1 additional cases respectively while CWS and GV were missed in 1 case in UN. In LN, RH and GV were identified in 2 extra cases, but NVD/NVE was missed in 1 case. The main differences were observed in the documentation of RH in all but one segment (apart from CA) as in >3 cases in each segment, RH was missed in fundoscopy. Moreover, in CA, retinal features were similarly identified in both examination techniques.Conclusions: Fundoscopy is part of routine ophthalmic assessment but requires experience and adequate patient cooperation. CFP is a reliable imaging tool that can objectively document diabetic retinopathy lesions. New advances in retina imaging make CFP a promising device for DR assessment patients.