Optos wide‐field imaging versus conventional camera imaging in Danish patients with type 2 diabetes

Abstract

Purpose: Diabetic retinopathy (DR) screening methods are costly, requiring specialized personnel and patient mydriasis. The Optos apparatus can be operated by nonspecialists and provides ultra-wide-field imaging, with 200°views of the retina in a single image. We compared DR grading obtained from Optos imaging with DR grading from conventional Topcon imaging. Methods: We conducted a cross-sectional study of 101 persons with diabetes who participated in the Addition-DK 10-year follow-up study. Retina fundus photos using both Optos and Topcon imaging were taken for both eyes. All photos were graded by specialist ophthalmologic nurses, using a modified version of the 'Proposed International Clinical DR severity scale'. We constructed frequency tables and assessed levels of agreement between Optos and Topcon gradings using weighted Kappa statistics, separately for peripheral and macular grading. We tested if the agreements between the two cameras were significantly different using a stratified Wilcoxon test. Results: Significantly, more lesions in the periphery were identified by Optos compared with Topcon (p < 0.01), resulting in a fair Kappa agreement of 0.21. We saw no significant differences in the grading of the macula region (p = 0.97) between the two cameras. Although only 7% of the macula image gradings differed between the cameras, the Kappa agreement of macula grading was only moderate (Kappa = 0.52). Conclusion: The inter-camera agreement was acceptable for macula image grading, but only fair for peripheral grading, with Optos identifying more microvascular changes in the periphery. The clinical significance and impact on screening modality and frequency remain to be explored.

Ultra-wide field swept-source optical coherence tomography angiography in patients with diabetes without clinically detectable retinopathy

“…UWF OCTA images should also be compared with standard 7-field fundus photographs. Instead, we used UWF images to match UWF OCTA images, which had acceptable agreement with fundus photographs of diabetic eyes without clinical retinal signs [37][38][39]. However, the alterations in OCTA images might be features in the healthy population due to the lack of control group without diabetes.…”

Comparison of different methods of retinal imaging for the screening of diabetic retinopathy: a systematic review

“…2015; Byberg et al. 2019) used International Clinical Diabetic Retinopathy (ICDR) as the grading system, with only one study (Price et al. 2015) using ICDR when comparing UWF to 7SF.…”

“…In 202 eyes, Byberg et al. (2019) compared UWF (peripheral and macular) with Topcon 5‐field 30° (Table 3). Agreement was fair for peripheral grading (κ 0.21) and moderate for macular grading (κ 0.52).…”

The potential retinal hazards of curing light use for dentists

“…Retinal images were captured using either the OCT instrument, a Daytona™ ultrawide-field imager (Optos, Dunfermline, UK) or a TRC-NW400 fundus camera (Topcon, Tokyo, Japan). Optos imagers and OCT instruments produce en face macular images at least as good as those produced by fundus cameras in terms of imaging inner retinal pathology [21,22] All operators of each instrument received the same training, and images of both dentist and control retinas were captured on all instruments. The images were then examined independently by two optometrists (MRK and ST) to identify any gross retinal abnormalities or defects.…”