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Nonmydriatic widefield retinal imaging with an automatic white LED confocal imaging system compared with dilated ophthalmoscopy in screening for diabetic retinopathy

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Abstract

Purpose

To compare nonmydriatic montage widefield images with dilated fundus ophthalmoscopy for determining diabetic retinopathy (DR) severity.

Materials and methods

In this prospective, observational, cross-sectional study, patients with a previous diagnosis of diabetes and without history of diabetes-associated ocular disease were screened for DR. Montage widefield imaging was obtained with a system that combines confocal technology with white-light emitting diode (LED) illumination (DRSplus, Centervue, Padua, Italy). Dilated fundus examination was performed by a retina specialist.

Results

Thirty-seven eyes (20 patients, 8 females) were finally included in the analysis. Mean age of the patients enrolled was 58.0 ± 11.6 years [range 31–80 years]. The level of DR identified on montage widefield images agreed exactly with indirect ophthalmoscopy in 97.3% (36) of eyes and was within 1 step in 100% (37) of eyes. Cohen's kappa coefficient (κ) was 0.96, this suggesting an almost perfect agreement between the two modalities in DR screening. Nonmydriatic montage widefield imaging acquisition time was significantly shorter than that of dilated clinical examination (p = 0.010).

Conclusion

Nonmydriatic montage widefield images were compared favorably with dilated fundus examination in defining DR severity; however, they are acquired more rapidly.

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Authors and Affiliations

  1. Department of Ophthalmology, Ospedale San Raffaele Scientific Institute, University Vita-Salute, Via Olgettina 60, Milan, Italy

    Enrico Borrelli, Lea Querques, Rosangela Lattanzio, Michele Cavalleri, Alessio Grazioli Moretti, Carlo Di Biase, Alberto Signorino, Francesco Gelormini, Riccardo Sacconi, Francesco Bandello & Giuseppe Querques

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  1. Enrico Borrelli
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  2. Lea Querques
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  3. Rosangela Lattanzio
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  4. Michele Cavalleri
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  5. Alessio Grazioli Moretti
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  6. Carlo Di Biase
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  7. Alberto Signorino
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Corresponding author

Correspondence to Giuseppe Querques.

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Conflict of interest

E. Borrelli: Recipient—Centervue (Italy); Zeiss (Dublin, USA). R. Sacconi: Recipient—Zeiss (Dublin, USA). Francesco Bandello: Recipient—Alcon (Fort Worth,Texas,USA), Alimera Sciences (Alpharetta, Georgia, USA), Allergan Inc (Irvine, California,USA), Farmila-Thea (Clermont-Ferrand, France), Bayer Shering-Pharma (Berlin, Germany), Bausch And Lomb (Rochester, New York, USA), Genentech (San Francisco, California, USA), Hoffmann-La-Roche (Basel, Switzerland), NovagaliPharma (Évry, France), Novartis (Basel, Switzerland), Sanofi-Aventis (Paris, France), Thrombogenics (Heverlee,Belgium), Zeiss (Dublin, USA). Giuseppe Querques: Recipient—Alimera Sciences (Alpharetta, Georgia, USA), Allergan Inc (Irvine, California, USA), Amgen (Thousand Oaks,USA), Bayer Shering-Pharma (Berlin, Germany), Centervue (Italy); Heidelberg (Germany), KBH (Chengdu; China), LEH Pharma (London, UK), Lumithera (Poulsbo; USA), Novartis (Basel, Switzerland), Sandoz (Berlin, Germany), Sifi (Catania, Italy), Sooft-Fidea (Abano, Italy), Zeiss (Dublin, USA). Other authors: none.

Ethical statement

The study was approved by the Institutional Review Board and adhered to the tenets of the Declaration of Helsinki.

Informed consent

Informed consent was obtained from all subjects prior to enrollment in the study.

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Borrelli, E., Querques, L., Lattanzio, R. et al. Nonmydriatic widefield retinal imaging with an automatic white LED confocal imaging system compared with dilated ophthalmoscopy in screening for diabetic retinopathy. Acta Diabetol 57, 1043–1047 (2020). https://doi.org/10.1007/s00592-020-01520-w

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  • DOI: https://doi.org/10.1007/s00592-020-01520-w

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