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Purpose: To compare diabetic retinopathy (DR) severity identified on handheld retinal imaging with ultrawide field (UWF) images.

Methods: Mydriatic images of 225 eyes of 118 diabetic patients were prospectively imaged with the Aurora (AU) handheld retinal camera [5-field protocol (macula-centred, disc-centred, temporal, superior, inferior)] and compared with UWF images. Images were classified based on the international classification for DR. Sensitivity, specificity, kappa statistics (K/Kw) were calculated on an eye and person-level.

Results: Distribution of DR severity by AU/UWF images (%) by eye was no DR 41.3/36.0, mild non-proliferative DR (NPDR) 18.7/17.8, moderate 10.2/10.7, severe 16.4/15.1, proliferative DR (PDR) 13.3/20.4. Agreement between UWF and AU was exact in 64.4%, within 1-step 90.7%, k = 0.55 (95% CI:0.45-0.65), and kw = 0.79 (95% CI:0.73-0.85) by eye, and exact in 68%, within 1-step 92.9%, k = 0.58 (95% CI:0.50-0.66), and kw = 0.76 (95% CI:0.70-0.81) by person. Sensitivity/specificity for any DR, refDR, vtDR and PDR were as follows: 0.90/0.83, 0.90/0.97, 0.82/0.95 and 0.69/1.00 by person and 0.86/0.90, 0.84/0.98, 0.75/0.95 and 0.63/0.99 by eye. Handheld imaging missed 37% (17/46) eyes and 30.8% (8/26) persons with PDR. Only 3.9% (1/26) persons or 6.5% (3/46) eyes with PDR were missed if a referral threshold of moderate NPDR was used.

Conclusions: Data from this study show that comparing UWF and handheld images, when PDR was the referral threshold for handheld devices, 37.0% of eyes or 30.8% of patients with PDR were missed. Due to the identification of neovascular lesions outside of the handheld fields, lower referral thresholds are needed if handheld devices are used.

Titel:	Comparisons of handheld retinal imaging devices with ultrawide field images for determining diabetic retinopathy severity.
Autor/in / Beteiligte Person:	Jacoba, CMP ; Salongcay, RP ; Aquino, LAC ; Salva, CMG ; Saunar, AV ; Alog, GP ; Peto, T ; Silva, PS
Link:	Full Text Finder (Volltext)
Zeitschrift:	Acta ophthalmologica, Jg. 101 (2023-09-01), Heft 6, S. 670-678
Veröffentlichung:	Oxford, UK : Wiley-Blackwell ; <i>Original Publication</i>: Oxford, UK ; Malden, MA : Blackwell Munksgaard, 2023
Medientyp:	academicJournal
ISSN:	1755-3768 (electronic)
DOI:	10.1111/aos.15651
Schlagwort:	Humans Severity of Illness Index Sensitivity and Specificity Mydriatics administration & dosage Mydriasis Photography Prospective Studies Cross-Sectional Studies Male Female Adult Middle Aged Aged Diabetic Retinopathy diagnostic imaging Diabetic Retinopathy pathology Retina diagnostic imaging
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Comparative Study; Journal Article Language: English [Acta Ophthalmol] 2023 Sep; Vol. 101 (6), pp. 670-678. <i>Date of Electronic Publication: </i>2023 Feb 27. MeSH Terms: Diabetic Retinopathy* / diagnostic imaging ; Diabetic Retinopathy* / pathology ; Retina* / diagnostic imaging ; Humans ; Severity of Illness Index ; Sensitivity and Specificity ; Mydriatics / administration & dosage ; Mydriasis ; Photography ; Prospective Studies ; Cross-Sectional Studies ; Male ; Female ; Adult ; Middle Aged ; Aged References: Aiello, L.P., Odia, I., Glassman, A.R., Melia, M., Jampol, L.M., Bressler, N.M. et al. (2019) Comparison of early treatment diabetic retinopathy study standard 7-field imaging with ultrawide-field imaging for determining severity of diabetic retinopathy. JAMA Ophthalmology, 137, 65-73. ; Ashraf, M., Hock, K.M., Cavallerano, J.D., Wang, F.L. & Silva, P.S. 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Grant Information: MR/R025630/1 United Kingdom MRC_ Medical Research Council Contributed Indexing: Keywords: diabetic retinopathy; handheld retinal imaging; screening; telemedicine; ultrawide field imaging Substance Nomenclature: 0 (Mydriatics) Entry Date(s): Date Created: 20230227 Date Completed: 20231101 Latest Revision: 20231101 Update Code: 20240513

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Comparisons of handheld retinal imaging devices with ultrawide field images for determining diabetic retinopathy severity.