Screening diabetic retinopathy using a wide field imaging system

Abstract

Abstract Purpose The wide field (200°) imaging system (Optos, Great Britain) using a scanning laser ophthalmoscope (SLO) enables to visualize a large part of the retina including the periphery. The present study was designed to evaluate the imaging system for screening purposes in diabetic retinopathy. Methods The SLO system was used in diabetic patients in stationary care. Screening for diabetic retinopathy was performed: An undilated and dilated retinal biomicroscopy was performed by a senior ophtalmologist. An undilated SLO image was taken by an orthoptist in training. The images were reviewed by a resident masked to results of the previous retinal biomicroscopy. The results of the clinical examination were compared with the results of the SLO image analysis. Results A total of 251 patients were evaluated (n=503 eyes). Of the retinal lesions detected on the undilated SLO images, the undilated retinal biomicroscopy missed 24% and the dilated retinal biomicroscopy 11%. None of the retinal lesions detected with the undilated retinal biomicroscopy were missed on the SLO images. Conclusion The diagnostic rate of diabetic retinopathy using undilated SLO images was significantly higher when compared with the diagnostic rate of undilated and dilated retinal biomicroscopy. Further work is necessary to evaluate the diagnostic yield of the wide field SLO system in comparison with standard non mydriatic retinography procedures.