title: Scanning laser ophthalmoscopy in the retromode in diabetic macular oedema.
abstract: OBJECTIVE
  To determine the validity of scanning laser ophthalmoscopy in the retromode (RM-SLO) versus other imaging modalities in the diagnosis of diabetic macular oedema (DME).
  
  
  METHODS
  Two hundred and sixty-three eyes were examined. Inclusion criteria were any stage of untreated or treated diabetic retinopathy and four imaging modalities of the macula carried out on the same day: time domain optical coherence tomography (OCT), fundus autofluorescence (FAF), RM-SLO and fluorescein angiography (FA). Two masked retinal specialists independently graded all images. Agreement between RM-SLO and OCT, FA and FAF in evaluating the presence and patterns of DME was evaluated by kappa statistics, sensitivity, specificity, observed proportional agreement, and proportional agreement in positive and negative cases.
  
  
  RESULTS
  The agreement in evaluating the presence/absence of DME between RM-SLO and OCT, FA and FAF was good: κ = 0.73 (confidence interval; CI, 0.64-0.83), κ = 0.71 (CI, 0.61-0.81) and κ = 0.73 (CI, 0.63-0.83), respectively. The agreement in evaluating cystoid pattern of DME was almost perfect between RM-SLO and OCT, RM-SLO and FA, κ > 0.8; and good between RM-SLO and FAF, κ > 0.7. The agreement in evaluating the presence/absence of subfoveal neuroretinal was almost perfect between RM-SLO and OCT (κ = 0.83; 95% CI, 0.70-0.96). Subfoveal neuroretinal detachment did not show any specific pattern on FA or FAF. Sensitivity and specificity of RM-SLO in evaluating DME was 97.7% and 71.9% versus OCT, 97.4% and 68.1% versus FA and 96.1% and 73.3% versus FAF. Retinal thickness of 233 μm represented the cut-off value to define DME by RM-SLO.
  
  
  CONCLUSIONS
  The combined use of non-invasive imaging techniques can improve the diagnostic interpretation of different aspects of DME.
authors.affiliation: G.B Bietti Eye Foundation, IRCCS, Rome, Italy.
authors.forename: Stela
authors.initials: S
authors.lastname: Vujosevic
authors.forename: Barbara
authors.initials: B
authors.lastname: Trento
authors.forename: Elisa
authors.initials: E
authors.lastname: Bottega
authors.forename: Francesca
authors.initials: F
authors.lastname: Urban
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Pilotto
authors.forename: Edoardo
authors.initials: E
authors.lastname: Midena
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003930:Diabetic Retinopathy / Q000175:diagnosis*; D005189:False Positive Reactions; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007834:Lasers; D008269:Macular Edema / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy / Q000379:methods*; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence