Comparing diabetic retinopathy lesions in scanning laser ophthalmoscopy and colour fundus photography

Nghiem, Allan Zhifa; Nderitu, Paul; Lukić, Marko; Khatun, Mumina; Largan, Ross; Kortuem, Karsten; Balaskas, Konstantinos; Sim, Dawn A

doi:10.1111/aos.14106

Cited by 7 publications

(6 citation statements)

References 16 publications

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“…8 MultiColor imaging was found to have certain advantages over CFP in defining abnormality in patients with age-related macular degeneration (AMD), 2 ERM, 3 central serous chorioretinopathy (CSCR), 4 polypoidal choroidal vasculopathy, 5 and diabetic retinopathy. 6,7 The utility of MCI in eyes with uveitis has not been investigated thus far. The current study compared MCI with CFP in eyes with posterior uveitis and highlights certain limitations of MCI in identifying lesions of retinochoroiditis and choroiditis.…”

Section: Discussionmentioning

confidence: 99%

Multicolor Confocal Scanning Laser Ophthalmoscope Imaging in Posterior Uveitis

Gupta

Agarwal

Arora

et al. 2022

Retina

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Purpose: To study the utility of MultiColor confocal scanning laser ophthalmoscope imaging (MCI) in identifying the morphology of uveitic lesions compared with conventional color fundus photography (CFP) in patients with posterior uveitis.Methods: In this prospective observational study, subjects with posterior uveitis underwent MCI and CFP. The images obtained by the two modalities were analyzed by two independent reviewers for vitreoretinal surface abnormalities, retinal fluid and hemorrhages, and depth/location of lesions. These findings were compared with the clinical findings and other imaging techniques.Results: Sixty-nine eyes of 43 patients (25 men) with mean age of 33.5 ± 13.9 years were studied. MultiColor imaging had better sensitivity and specificity in detecting vitreoretinal interface abnormalities, such as epiretinal membrane and inner retinal striae, compared with CFP. MultiColor imaging failed to detect retinochoroiditis lesions in 5 of 6 eyes (83%) and choroiditis in 9 46 eyes (20%), which were detected on CFP and clinical examination. Also, MCI showed a high false-positive rate of 34% in detecting intraretinal hemorrhages.Conclusion: Retinochoroidal lesions in posterior uveitis may be poorly identified on MCI compared with CFP and clinical examination. One must exercise caution in commenting on disease morphology based on MCI alone.

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Section: Discussionmentioning

confidence: 99%

Multicolor Confocal Scanning Laser Ophthalmoscope Imaging in Posterior Uveitis

Gupta

Agarwal

Arora

et al. 2022

Retina

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“…Traditional fundus camera offers good-quality images but is bulky, office-based, and technician dependent, which limits its use as a community screening tool, especially in remote areas. SLO, with a 180-200°field of view, offers faster and easier image acquisition without pupil dilation when compared to traditional fundus cameras [28]. It is ideal for a hospital-based study.…”

Section: Discussionmentioning

confidence: 99%

Characterization of the retinal vasculature in fundus photos using the PanOptic iExaminer system

Wei

Xiao

et al. 2020

Eye and Vis

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Background The goal was to characterize retinal vasculature by quantitative analysis of arteriole-to-venule (A/V) ratio and vessel density in fundus photos taken with the PanOptic iExaminer System. Methods The PanOptic ophthalmoscope equipped with a smartphone was used to acquire fundus photos centered on the optic nerve head. Two fundus photos of a total of 19 eyes from 10 subjects were imaged. Retinal vessels were analyzed to obtain the A/V ratio. In addition, the vessel tree was extracted using deep learning U-NET, and vessel density was processed by the percentage of pixels within vessels over the entire image. Results All images were successfully processed for the A/V ratio and vessel density. There was no significant difference of averaged A/V ratio between the first (0.77 ± 0.09) and second (0.77 ± 0.10) measurements (P = 0.53). There was no significant difference of averaged vessel density (%) between the first (6.11 ± 1.39) and second (6.12 ± 1.40) measurements (P = 0.85). Conclusions Quantitative analysis of the retinal vasculature was feasible in fundus photos taken using the PanOptic ophthalmoscope. The device appears to provide sufficient image quality for analyzing A/V ratio and vessel density with the benefit of portability, easy data transferring, and low cost of the device, which could be used for pre-clinical screening of systemic, cerebral and ocular diseases.

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“…Initial mitochondrial dysfunction and Müller cell impairment are followed by structural loss of capillary endothelium, neurons, and photoreceptors. This process is visible in the eye as microaneurysms, exudates, cotton wool spots, capillary drop out, retinal edema, and retinal atrophy [132,133].…”

Section: Vitamin B12 (Cobalamin)mentioning

confidence: 99%

Nutritional and medical food therapies for diabetic retinopathy

et al. 2020

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Diabetic retinopathy (DR) is a form of microangiopathy. Reducing oxidative stress in the mitochondria and cell membranes decreases ischemic injury and end-organ damage to the retina. New approaches are needed, which reduce the risk and improve the outcomes of DR while complementing current therapeutic approaches. Homocysteine (Hcy) elevation and oxidative stress are potential therapeutic targets in DR.Common genetic polymorphisms such as those of methylenetetrahydrofolate reductase (MTHFR), increase Hcy and DR risk and severity. Patients with DR have high incidences of deficiencies of crucial vitamins, minerals, and related compounds, which also lead to elevation of Hcy and oxidative stress. Addressing the effects of the MTHFR polymorphism and addressing comorbid deficiencies and insufficiencies reduce the impact and severity of the disease. This approach provides safe and simple strategies that support conventional care and improve outcomes.Suboptimal vitamin co-factor availability also impairs the release of neurotrophic and neuroprotective growth factors. Collectively, this accounts for variability in presentation and response of DR to conventional therapy. Fortunately, there are straightforward recommendations for addressing these issues and supporting traditional treatment plans.We have reviewed the literature for nutritional interventions that support conventional therapies to reduce disease risk and severity. Optimal combinations of vitamins B1, B2, B6, L-methylfolate, methylcobalamin (B12), C, D, natural vitamin E complex, lutein, zeaxanthin, alpha-lipoic acid, and n-acetylcysteine are identified for protecting the retina and choroid. Certain medical foods have been successfully used as therapy for retinopathy. Recommendations based on this review and our clinical experience are developed for clinicians to use to support conventional therapy for DR.DR from both type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) have similar retinal findings and responses to nutritional therapies.

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Comparing diabetic retinopathy lesions in scanning laser ophthalmoscopy and colour fundus photography

Cited by 7 publications

References 16 publications

Multicolor Confocal Scanning Laser Ophthalmoscope Imaging in Posterior Uveitis

Multicolor Confocal Scanning Laser Ophthalmoscope Imaging in Posterior Uveitis

Characterization of the retinal vasculature in fundus photos using the PanOptic iExaminer system

Nutritional and medical food therapies for diabetic retinopathy

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