New vessels detected on wide-field imaging compared to two-field and seven-field imaging: implications for diabetic retinopathy screening image analysis.
BACKGROUND
Wide-field retinal imaging (Optomap), used for detecting diabetic retinopathy (DR), has been shown to compare well with seven-field early treatment diabetic retinopathy study (ETDRS) photographs. An Optomap 200° image covers 80% of the retinal surface, compared with the standard seven-field, 30° images, covering 30% of the retinal surface. In England, DR screening is performed by grading two, 45° images per eye, by the DR screening service (DRSS).


OBJECTIVE
To assess how often retinal new vessels (NVs) are observed on Optomap imaging, outside the DRSS two fields and standard seven-field photography, in a cohort of patients referred by the DRSS.


METHODS
A consecutive series of treatment naïve patients with DR, referred from DRSS with pre-proliferative or proliferative DR or diabetic maculopathy, were imaged with Optomap colour images, within 3 months of DRSS referral. The incidence and distribution of NVs were recorded in relation to two-field and seven-field areas.


RESULTS
NVs were found in 102 of 1562 treatment naïve eyes (6.5%) of 781 patients. Of these, 72 were referred from DRSS as having NVs, but an additional 30 eyes (29% of NVs detected) from 25 patients were referred with a lesser degree of DR. In 25 of the 30 eyes without NVs reported on referral, NVs were located outside the standard two fields taken at DRSS, and in 12, NVs were outside the area covered on seven-field imaging (11.7% of eyes with NVs).


CONCLUSIONS
Wide-field imaging with Optomap detected approximately 30% more NVs than standard two-field imaging in patients referred from a UK DRSS.
Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
Stephen James
SJ
Talks
Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
Vina
V
Manjunath
Sunderland Eye Infirmary, Sunderland and Institute of Genetic Medicine, Newcastle upon Tyne, UK.
David H W
DH
Steel
NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
Tunde
T
Peto
Magnetic renounce centre, Campus for ageing and vitality, Newcastle University, Newcastle upon Tyne, UK.
Roy
R
Taylor
D003930:Diabetic Retinopathy / Q000145:classification / Q000175:diagnosis*; D003941:Diagnostic Techniques, Ophthalmological; D005451:Fluorescein Angiography; D006801:Humans; D010781:Photography / Q000379:methods*; D015861:Retinal Neovascularization / Q000175:diagnosis*; D012171:Retinal Vessels / Q000473:pathology*; D014794:Visual Fields
Diagnostic tests/Investigation; Imaging; Neovascularisation; Retina