The Application Of Ultra-wide-field Imaging In Assessment Of Diabetic Retinopathy Severity

Purpose: To compare the agreement between ultra-wide-field(UWF)imaging system and Early Treatment Diabetic Retinopathy Study(ETDRS)7-standard field imaging in diabetic retinopathy(DR)severity grading.And to analyze the ability of UWF imaging system to assess peripheral DR lesions.Methods: UWF images were obtained with Optos 200 Tx system.ETDRS 7-standard field was outlined on UWF images with remaining areas masked.DR severity grading was assessed by two ophthalmologists independently.The agreement between UWF imaging system and ETDRS 7-standard field imaging was analyzed accordingly.The peripheral retinal lesions outside ETDRS 7-standard were also analyzed on UWF images.Results: A total of 222 eyes from 123 Chinese DR patients were included,the patients had a median age of 62.2±12.9 years old,with 54 were men and 69 were women.Of 222 eyes,198 eyes(89.2%)had exact agreement between UWF imaging system and ETDRS 7-standard field imaging in DR severity grading,and 220 eyes(99.1%)agreed within 1 grade difference.15 eyes(62.5%)were assessed higher DR severity level in UWF imaging system,while 9 eyes(37.5%)got higher DR severity grades in ETDRS 7-standard field imaging.Conclusion: DR severity grading by UWF imaging system was considered a highly consistent with ETDRS 7-standard field imaging(kappa: 0.804,95%CI,0.730-0.878).But a higher accuracy could be obtained by assessing additional peripheral DR lesions using UWF imaging system.