Current status and future possibilities of retinal imaging in diabetic retinopathy care applicable to low- and medium-income countries

Abstract

Diabetic retinopathy (DR) is a leading cause of blindness among adults and the numbers are projected to rise. There have been dramatic advances in the field of retinal imaging since the first fundus image was captured by Jackman and Webster in 1886. The currently available imaging modalities in the management of DR include fundus photography, fluorescein angiography, autofluorescence imaging, optical coherence tomography, optical coherence tomography angiography, and near-infrared reflectance imaging. These images are obtained using traditional fundus cameras, widefield fundus cameras, handheld fundus cameras, or smartphone-based fundus cameras. Fluorescence lifetime ophthalmoscopy, adaptive optics, multispectral and hyperspectral imaging, and multicolor imaging are the evolving technologies which are being researched for their potential applications in DR. Telemedicine has gained popularity in recent years as remote screening of DR has been made possible. Retinal imaging technologies integrated with artificial intelligence/deep-learning algorithms will likely be the way forward in the screening and grading of DR. We provide an overview of the current and upcoming imaging modalities which are relevant to the management of DR.

Microvascular Metrics on Diabetic Retinopathy: Insights from a Meta-Analysis of Diabetic Eye Images from Real-World Data

“…[9][10][11][12][13] Globally, the assessment and management of DR rely on fundus photography, a technique that revolutionized the way DR severity is classified, by documenting and monitoring retinal changes over time. [14][15][16] This method provides quantifiable means of assessing retinal alterations across various disease stages. 17 The precise capture and annotation of several (3 to 7) retinal images enable detailed analysis of microvascular lesions, leading to an accurate and standardized classification.…”

Deep learning–based detection of diabetic macular edema using optical coherence tomography and fundus images

“…It is a vision-threatening complication of diabetes, which can be treated successfully. [ 1 , 2 ] There is an urgent need to identify and treat DME and assess the barriers to the intake and treatment of DME. This calls for an integrated strategy in which eye care and diabetes care services should collaborate to improve the quality of life of all diabetic patients.…”