Clinical application of multicolour scanning laser imaging in diabetic retinopathy
- 709 Downloads
To compare the visualization of the lesions of diabetic retinopathy (DR) using multicolour scanning laser imaging (MSLI) and conventional colour fundus photography (CFP). The paired images of diabetic patients who underwent same-day MSLI and CFP examinations were reviewed. Combined multicolour (MC) images were acquired simultaneously using three laser wavelengths: blue reflectance (BR, λ = 488 nm), green reflectance (GR, λ = 518 nm) and infrared reflectance (IR, λ = 820 nm). The number of positive DR lesions was calculated using fundus fluorescein angiography as the reference standard. The visibility of the microaneurysms (Mas) was graded using a scale, and the number of Mas for each method was counted by two masked readers. Eighty eyes of 42 diabetic patients were included. The average grading score for Mas visualization was significantly higher with MC (1.50 ± 0.71) and GR (1.55 ± 0.69) than with CFP (0.95 ± 0.81). The average number of Mas was also significantly higher with MC (11.41 ± 14.02) and GR (11.93 ± 13.43) than with CFP (6.43 ± 9.39). The number of positive Mas, diabetic macular edema (DME) and epiretinal membranes (ERM) were significantly higher with MC than CFP (P < 0.05), while the numbers of cotton wool spots, haemorrhages, hard exudates, venous beading and abnormal new vessels were not significantly different (P > 0.05). Mas and ERM were most effectively detected on GR images, and an elevated greenish shift was clearly visualized in patients with DME on the MC images. MSLI can effectively visualize Mas and other pathological lesions of DR compared with CFP. MSLI with superior resolution may be a useful complement for DME and ERM detection.
KeywordsMulticolour scanning laser imaging Colour fundus photography Fluorescein angiography Diabetic retinopathy Confocal scanning laser ophthalmoscope
colour fundus photography
confocal scanning laser ophthalmoscopy
cotton wool spots
diabetic macular edema
intraretinal microvascular abnormalities
multicolour scanning laser imaging
spectral domain optical coherence tomography
This work was supported by the Science and Technology Commission of Shanghai Municipality (Grant NO.16DZ0501100).
Compliance with ethical standards
This work was supported by the Science and Technology Commission of Shanghai Municipality (Grant NO.16DZ0501100). The study protocol was approved by the Institutional Review Board of Shanghai Sixth People’s Hospital and follows the tenets of the Declaration of Helsinki for experimentation on humans. Written informed consent was obtained from all patients. The study was registered in the Chinese clinical trial registry (http://www.chictr.org.cn/, Registration number: ChiCTR-OOC-16010160).
Conflict of interest
The authors declare that they have no conflict of interest.
- 1.Zhou B, Lu Y, Hajifathalian K et al (2016) Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4•4 million participants. Lancet 387(10027):1513. https://doi.org/10.1016/S0140-6736(16)00618-8
- 4.Grading diabetic retinopathy from stereoscopic color fundus photographs—an extension of the modified Airlie House classification (1991) ETDRS report number 10. Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology 98(5 Suppl):786–806Google Scholar
- 7.Classification of diabetic retinopathy from fluorescein angiograms (1991) ETDRS report number 11. Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology 98(5 Suppl):807–822Google Scholar
- 11.Webb R H, Hughes G W, Delori FC (1987) Confocal scanning laser ophthalmoscope. Appl Opt 26(8):1492–9Google Scholar
- 12.Schmitz-Valckenberg S, Steinberg JS, Fleckenstein M, Visvalingam S, Brinkmann CK, Holz FG (2010) Combined confocal scanning laser ophthalmoscopy and spectral-domain optical coherence tomography imaging of reticular drusen associated with age-related macular degeneration. Ophthalmology 117(6):1169–1176CrossRefPubMedGoogle Scholar
- 13.Murphy R (2012) Multicolor fundus imaging prepares for debut. Retin Physician 9:77Google Scholar
- 15.Schmitz-Valckenberg S, Steinberg JS, Fleckenstein M, Visvalingam S, Brinkmann CK, Holz FG (2010) Combined confocal scanning laser ophthalmoscopy and spectral-domain optical coherence tomography imaging of reticular drusen associated with age-related macular degeneration. Ophthalmology 117(6):1169–1176CrossRefPubMedGoogle Scholar
- 22.Körner A (2012) Standards of medical care in diabetes—2012. Diabetes Care 35(Suppl 1):S11–63. https://doi.org/10.2337/dc12-s011