Skip to main content
Top

17-06-2014 | Retinopathy | Review | Article

Ultra Widefield Fundus Imaging for Diabetic Retinopathy

Journal: Current Diabetes Reports

Authors: Szilárd Kiss, Thomas L. Berenberg

Publisher: Springer US

Abstract

For decades, the standard method for screening and grading severity of diabetic retinal disease has relied upon a montage of photographs using normal angle fundus cameras. With the development of ultrawide field (UWF) fundus imaging, more of the retina can be imaged with fewer pictures, less dependence on photographer skill, and, often, greater ease on the patient. Recent studies have shown comparability between traditional and UWF imaging for standard grading of diabetic retinopathy. Moreover, UWF images can detect peripheral pathology not typically seen in standard photographs, which may enlighten our understanding of disease severity and suggest new indications for treatment.
Literature
1.
Diabetic Retinopathy Study Research Group: design methods and baseline results. DRS report no. 6. Investig Ophthalmol. 1991;21:149–209.
2.
Early Treatment Diabetic Retinopathy Study Research Group. Grading diabetic retinopathy from stereoscopic color fundus photographs—an extension of the modified Airlie House classification (ETDRS report number 10). Ophthalmology. 1991;98:786–806.CrossRef
3.
Hubbard LD, Sun W, Cleary PA, et al. Comparison of digital and film grading of diabetic retinopathy severity in the diabetes control and complications trial/epidemiology of diabetes interventions and complications study. Arch Ophthalmol. 2011;129:718–26.PubMedCrossRef
4.
Gangaputra S, Almukhtar T, Glassman AR, et al. Comparison of film and digital fundus photographs in eyes of individuals with diabetes mellitus. Invest Ophthalmol Vis Sci. 2011;52:6168–73.PubMedCentralPubMedCrossRef
5.
Li HK, Danis RP, Hubbard LD, Florez-Arango JF, Esquivel A, Krupinski EA. Comparability of digital photography to the ETDRS film protocol for evaluation of diabetic retinopathy severity. Invest Ophthalmol Vis Sci. 2011;52:4717–25.PubMedCrossRef
6.••
Silva PS, Cavallerano JD, Sun JK, Soliman AZ, Aiello LM, Aiello LP. Peripheral lesions identified by mydriatic ultrawide field imaging: distribution and potential impact on diabetic retinopathy severity. Ophthalmology. 2013;120:2587–95. This study validates that UWF images can be used for DR severity grading and, moreover, suggests that lesions observed outside the 7SF may influence DR severity level. PubMedCrossRef
7.
Early Treatment Diabetic Retinopathy Study Research Group. Fundus photographic risk factors for progression of diabetic retinopathy: ETDRS reports number 12. Ophthalmology. 1991;98:823–33.CrossRef
8.
Ciardella A, Brown D. Wide-field imaging. In: Agarwal A, editor. Fundus fluorescein and indocyanine green angiography: a textbook and atlas. Thorofare: Slack Inc; 2007. p. 79–84.
9.•
Witmer M, Kiss S. Wide-field imaging of the retina. Surv Ophthalmol. 2013;58:143–54. This paper provides a comprehensive review of wide field imaging for retinal diseases. PubMedCrossRef
10.
Pomerantzeff O. Equator-plus camera. Investig Ophthalmol. 1975;14:401–6.
11.
Noyori KS, Chino K, Deguchi T. Wide field fluorescein angiography by use of contact lens. Retina. 1983;3:131–4.PubMedCrossRef
12.
Spaide RF, Orlock DA, Herrmann-Delemazure B, et al. Wide-angle indocyanine green angiography. Retina. 1998;18:44–9.PubMedCrossRef
13.
Takahashi K, Muraoka K, Kishi S, Shimizu K. Watershed zone in the human peripheral choroid. Ophthalmology. 1996;103:336–42.PubMedCrossRef
14.
Schwartz SD, Harrison SA, Ferrone PJ, Trese MT. Telemedical evaluation and management of retinopathy of prematurity using a fiber optic digital fundus camera. Ophthalmology. 2000;107:25–8.PubMedCrossRef
15.
Shields CL, Materin M, Shields JA. Panoramic imaging of the ocular fundus. Arch Ophthalmol. 2003;121:1603–7.PubMedCrossRef
16.
Friberg TR, Pandya A, Eller AW. Non-mydriatic panoramic fundus imaging using a non-contact scanning laser-based system. Ophthalmic Surg Lasers Imaging. 2003;34:488–97.PubMed
17.
Staurenghi G, Viola F, Mainster MA, Graham RD, Harrington PG. Scanning laser ophthalmoscopy and angiography with a wide-field contact lens system. Arch Ophthalmol. 2005;123:244–52.PubMedCrossRef
18.
Witmer MT, Parlitsis G, Patel S, Kiss S. Comparison of ultra-widefield fluorescin angiography with the Heidelberg Spectralis® noncontact ultra-widefield module versus the Optos Optomap. Clin Ophthalmol. 2013;7:389–94.PubMedCentralPubMedCrossRef
19.
Prasad PS, Oliver SC, Coffee RE, Hubschman JP, Schwartz SD. Ultra wide-field angiographic characteristics of branch retinal and hemi-central retinal vein occlusion. Ophthalmology. 2010;117:780–4.PubMedCrossRef
20.
Spaide RF. Peripheral areas of nonperfusion in treated central retinal vein occlusion as imaged by wide-field fluorescein angiography. Retina. 2011;31:829–37.PubMedCrossRef
21.
Kernt M, Schaller UC, Stumpf C, et al. Choroidal pigmented lesions imaged by ultra-wide-field scanning laser ophthalmoscopy with two laser wavelengths (Optomap). Clin Ophthalmol. 2010;4:829–36.PubMedCentralPubMedCrossRef
22.
Coffee RE, Jain A, McCannel TA. Ultra wide-field imaging of choroidal metastasis secondary to primary breast cancer. Semin Ophthalmol. 2009;24:34–6.PubMedCrossRef
23.
Mudvari SS, Virasch VV, Singa RM, MacCumber MW. Ultra-wide-field imaging for cytomegalovirus retinitis. Ophthalmic Surg Lasers Imaging. 2010;41:311–5.PubMedCrossRef
24.
Cho M, Kiss S. Detection and monitoring of sickle cell retinopathy using ultra wide-field color photography and fluorescein angiography. Retina. 2011;31:738–47.PubMed
25.
Kaines A, Tsui I, Sarraf D, Schwartz S. The use of ultra wide field fluorescein angiography in evaluation and management of uveitis. Semin Ophthalmol. 2009;24:19–24.PubMedCrossRef
26.
Yuan A, Kaines A, Jain A, et al. Ultra-wide-field and autofluorescence imaging of choroidal dystrophies. Ophthalmic Surg Lasers Imaging. 2010;41:e1–5.PubMed
27.
Bonnay G, Nguyen F, Meunier I, Ducasse A, Hamel C, Arndt C. Screening for retinal detachment using wide-field retinal imaging. J Fr Ophtalmol. 2011;34:482–5.PubMedCrossRef
28.
Anderson L, Friberg TR, Singh J. Ultrawide-angle retinal imaging and retinal detachment. Semin Ophthalmol. 2007;22:43–7.PubMedCrossRef
29.
Meyer CH, Holz FG. Documentation of congenital hypertrophy of the retinal pigment epithelium with wide-field funduscopy. Semin Ophthalmol. 2009;24:252–3.CrossRef
30.
Coleman P, Barnard NA. Congenital hypertrophy of the retinal pigment epithelium: prevalence and ocular features in the optometric population. Ophthalmic Physiol Opt. 2007;27:547–55.PubMedCrossRef
31.
Shah SP, Jain A, Tsui I, McCannel TA. Optos Optomap Panoramic 200MA imaging of a serous choroidal detachment responsive to furosemide. Semin Ophthalmol. 2009;24:40–2.PubMedCrossRef
32.
Meyer CH, Saxena S. Non-mydriatic imaging of a giant retinal tear with the Optos Optomap Panoramic 200MA. Clin Exp Ophthalmol. 2010;38:427.CrossRef
33.
Khandhadia S, Madhusudhana KC, Kostakou A, Forrester JV, Newson RS. Use of Optomap for retinal screening within an eye casualty setting. Br J Ophthalmol. 2009;93:52–5.PubMedCrossRef
34.
Chiang MF, Wang L, Busuioc M, et al. Telemedical retinopathy of prematurity diagnosis: accuracy, reliability, and image quality. Arch Ophthalmol. 2007;125:1531–8.PubMedCrossRef
35.
Roth DB, Morales D, Feuer WJ, et al. Screening for retinopathy of prematurity employing the Retcam 120: sensitivity and specificity. Arch Ophthalmol. 2001;119:268–72.PubMed
36.
Dai S, Chow K, Vincent A. Efficacy of wide-field digital retinal imaging for retinopathy of prematurity screening. Clin Exp Ophthalmol. 2011;39:23–9.CrossRef
37.
Neubauer AS, Kernt M, Haritoglou C, Priglinger SG, Kampik A, Ulbig MW. Nonmydriatic screening for diabetic retinopathy by ultra-widefield scanning laser ophthalmoscopy (Optomap). Graefes Arch Clin Exp Ophthalmol. 2008;246:229–35.PubMedCrossRef
38.
Kernt M, Pinter F, Hadi I, et al. Diabetic retinopathy: comparison of the diagnostic features of ultra-widefield scanning laser ophthalmoscopy Optomap with ETDRS 7-field fundus photography. Ophthalmologe. 2011;108:117–23.PubMedCrossRef
39.
Kernt M, Hadi I, Pinter F, Seidensticker F, Hirneiss C, Haritoglou C, et al. Assessment of diabetic retinopathy using nonmydriatic ultra-widefield scanning laser ophthalmoscopy (Optomap) compared with ETDRS 7-field stereo photography. Diabetes Care. 2012;35:2459–63.PubMedCentralPubMedCrossRef
40.
Silva PS, Cavallerano JD, Sun JK, Noble J, Aiello LM, Aiello LP. Nonmydriatic ultrawide field retinal imaging compared with dilated standard 7-field 35-mm photography and retinal specialist examination for evaluation of diabetic retinopathy. Am J Ophthalmol. 2012;154:549–59.PubMedCrossRef
41.
Wilson PJ, Ellis JD, MacEwen CJ, Ellingford A, Talbot J, Leese GP. Screening for diabetic retinopathy: a comparative trial of photography and scanning laser ophthalmoscopy. Ophthalmologica. 2010;224:251–7.PubMedCrossRef
42.
Kaines A, Oliver S, Reddy S, Schwartz SD. Ultrawide angle angiography for the detection and management of diabetic retinopathy. Int Ophthalmol Clin. 2009;49:53–9.PubMedCrossRef
43.
Win PH, Young TA. Optos Panoramic 200A fluorescein angiography for proliferative diabetic retinopathy with asteroid hyalosis. Semin Ophthalmol. 2007;22:67–9.PubMedCrossRef
44.••
Wessel MM, Aaker GD, Parlitsis G, Cho M, D’Amico DJ, Kiss S. Ultra-wide-field angiography improves the detection and classification of diabetic retinopathy. Retina. 2012;32:785–91. This study showed that UWF-FA revealed significant pathology outside the area captured by 7SF. PubMedCrossRef
45.
Cardillo Piccolino F, Zingirian M, Mosci C. Classification of proliferative diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol. 1987;225:245–50.PubMedCrossRef
46.
Freyler H. Peripheral fluorescence angiography in diabetic retinopathy. Klin Monatsbl Augenheilkd. 1985;186:184–6.
47.
Kimble JA, Brandt BM, McGwin Jr G. Clinical examination accurately locates capillary nonperfusion in diabetic retinopathy. Am J Ophthalmol. 2005;139:555–7.PubMedCrossRef
48.
Reddy S, Hu A, Schwartz SD. Ultra wide field fluorescein angiography guided targeted retinal photocoagulation (TRP). Semin Ophthalmol. 2009;24:9–14.PubMedCrossRef
49.
Pahor D. Visual field loss after argon laser panretinal photocoagulation in diabetic retinopathy: full-versus mild-scatter coagulation. Int Ophthalmol. 1998;22:313–9.PubMedCrossRef
50.
Henricsson M, Heijl A. The effect of panretinal laser photocoagulation on visual acuity, visual fields and on subjective visual impairment in preproliferative and early proliferative diabetic retinopathy. Acta Ophthalmol. 1994;72:570–5.CrossRef
51.
Muqit MM, Marcellino GR, Henson DB, et al. Optos-guided pattern scan laser (Pascal)-targeted retinal photocoagulation in proliferative diabetic retinopathy. Acta Ophthalmol. 2013;91:251–8.PubMedCrossRef

Be confident that your patient care is up to date

Medicine Matters is being incorporated into Springer Medicine, our new medical education platform. 

Alongside the news coverage and expert commentary you have come to expect from Medicine Matters diabetes, Springer Medicine's complimentary membership also provides access to articles from renowned journals and a broad range of Continuing Medical Education programs. Create your free account »