The Scanning Laser Ophthalmoscope and Retinal Assessment in Diabetes

Abstract

In order to evaluate the Scanning Laser Ophthalmoscope as a method of assessing diabetic retinopathy, 57 consecutive patients with diabetes were examined through undilated pupils using laser ophthalmoscopy followed by pupillary dilatation and direct ophthalmoscopy. Results of laser scanning were recorded on videotape and analysed independently. Scanning (both eyes) took under 5 minutes per patient. For the 113 eyes studied, the two techniques gave concordant results in 73/113 (65%). Where there was discordance, laser ophthalmoscopic severity was greater than direct ophthalmoscopy in 36/40 (90% of discordant results). In 4/40 eyes conventional ophthalmoscopic appearances were judged more severe than those seen with the laser. The laser ophthalmoscope may have value as a method of assessing diabetic retinopathy, but further work is required to evaluate its efficacy as a screening tool in patients with moderate to severe retinopathy.

The value of digital imaging in diabetic retinopathy

“…Pope and colleagues (Table 30) have compared a commercial SLO against the results of direct ophthalmoscopy performed by medical staff (a diabetes senior registrar and an ophthalmic clinical assistant). 83 The methodology and results are evaluated in Table 31. In a series of 57 consecutive patients attending a retinal screening centre, agreement of retinopathy grading occurred in 65%, the majority of whom were graded as having mild or no retinopathy.…”

“…However, the evidence of reliability of the SLO as a tool for screening for diabetic retinopathy has been confined to two small comparative studies. 81,83 These are weakened by a lack of validation of the technique against a recognised gold standard and do not give sufficient evidence identified a substitute for continued monitoring of patients with advanced retinopathy by ophthalmologists. G SLO is a promising adjunct to other methods with potential application in the detection of macular oedema.…”