Comparison of two ultra-widefield color-fundus imaging devices for visualization of retinal periphery and microvascular lesions in patients with early diabetic retinopathy

Abstract

Comparison of two ultra-widefield (UWF) color-fundus (CF) imaging devices in diabetic patients for visualization of retinal periphery and detection of early microvascular lesions. The total gradable areas (TGA) seen on non-mydriatic CF-images of two UWF-imaging devices (Optos Daytona P200T; Zeiss Clarus 700) were compared and differences in projected area measured. Retinal periphery outside the 7 standard fields (7SF) was divided into: F3 temporal, F4 superotemporal, F5 inferotemporal, F6 superonasal, F7 inferonasal. DR stage was evaluated in the 7SF and the TGA on images of both devices and compared using Cohens κ. 67 eyes of 67 patients (52.5 ± 15.3 years) were analysed. DR stages in the 7SF were no (n = 36 Optos, n = 35 Clarus), mild (n = 16 Optos, n = 17 Clarus), and moderate DR (n = 15). Optos depicted significantly more area in F3 (median [interquartile range]; 2.41% [1.06–4.11] vs 0% [0–0], P < 0.001) and Clarus in F7 (3.29% [0–7.69] vs 0% [0–3.27], P = 0.002). In 4 eyes DR-stage was higher using Optos due to peripheral lesions not seen on the Clarus. Interrater reliability of DR-stage on both devices was almost perfect in the 7SF (κ = 0.975) and the TGA (κ = 0.855). Reliability in detecting signs of early DR is high on both devices. Clarus allowed for better visualization of the inferonasal field, Optos of the temporal field.

Advances in Structural and Functional Retinal Imaging and Biomarkers for Early Detection of Diabetic Retinopathy

“…Clarus™ (CLARUS 500™, Carl Zeiss Meditec AG, Jena, Germany) and Optos ® (Optos California ® , Optos PLC, Dunfermline, UK) are currently the two most used ultra-wide-field (UWF) fundus imaging systems. Although the reliability in detecting signs of early DR is high for both devices [36], the Clarus™ system has demonstrated higher accuracy in detecting microaneurysms and retinal hemorrhages due to its capability of providing true-color retinal images and mitigating artifacts caused by eyelids and eyelashes [37]. Diabetic eyes exhibiting visible lesions exclusively in the periphery tend to present with a milder and earlier form of retinopathy in comparison to those with visible lesions present in either the central retina or spanning both the central and peripheral retina [38].…”

Optomap ultrawide field imaging rapid screening peripheral retinal lesions before refractive surgery

“…The Optomap employs an ellipsometer to capture a wide-eld, high-quality retinal image spanning over 200 degrees, recording peripheral retinal vision without the need for mydriasis and corneal contact. A skilled technician can obtain high-quality Optomap fundus images in less than 0.4 seconds [5].…”