Application Of Multispectral Retinal Imaging And Optical Coherence Tomography In Screening Of Nonproliferative Diabetic Retinopathy(SCCE)

Objective To explorar the value of optical coherence tomography angiography(OCTA)and multi spectral fundus imaging system(MSI)in screening of nonproliferative diabetic retinopathy(NPDR).Methods There were 118 eyes of 59 patients with type 2 diabetes mellitus and nonproliferative diabetic retinopathy(NPDR)observed and studied.All the patients underwent fundus fluorescein angiography,multispectral retinal imaging,and optical coherence tomography vascular examination.The imaging features of four kinds of fundus lesions including microaneurysm,rigid exudation,velvety spot and hemorrhage in FFA,OCTA and MSI images of DR affected eyes were recorded.The consistency of OCTA and MSI noninvasive examination and FFA in the above fundus changes was analyzed.Results OCTA,MSI and FFA showed no significant difference in retinal microaneurysm in NPDR patients with rigid exudation and retinal hemorrhage in NPDR eyes(all P > 0.05),while there were differences in cotton wool spots(all P <0.05).OCTA,MSI and FFA showed good consistency in detecting retinal microaneurysms in NPDR patients(Kappa value were 0.783 and 0.815,respectively).OCTA sensitivity and Yoden index were all lower than MSI(sensitivity were 98.02%and 99.01%,respectively).The Yoden index were 74.49% and 75.48% respectively,and OCTA specificity was equal to MSI(both were 76.47%).OCTA and MSI showed good consistency in the detection of retinal hard exudation(Kappa value were 0.836 and0.891,respectively),and OCTA sensitivity,specificity and Yoden index were all lower than MSI(sensitivity were 94.59% and 95.95%,respectively).The specificity were88.64% and 93.81%,respectively.The Jorden index are 83.23% and 89.13%,respectively);For cotton wool spots detection,OCTA showed poor consistency,with general MSI consistency(Kappa value were 0.192 and 0.467,respectively).OCTA sensitivity,specificity and Yoden index were all lower than MSI(sensitivity were75.00% and 83.33%,respectively).The specificity were 66.98% and 87.50%,respectively.The Yoden index are 41.98% and 70.83%,respectively);OCTA was generally consistent in retinal hemorrhage,while MSI showed good consistency(Kappa value were 0.684 and 0.906,respectively).OCTA sensitivity,specificity and Yoden index were all lower than MSI(sensitivity were 93.41% and 96.70%,respectively).The specificity were 74.07% and 96.30%,respectively.The Yoden index are 67.48% and 93.00%,respectively).Conclusion OCTA and MSI have higher clinical value in the diagnosis of NPDR with ocular microaneurysms and rigid effusion,while MSI has higher clinical value in the diagnosis of retinal hemorrhage.However,the sensitivity,specificity and accuracy of OCTA and MSI in diagnosing lint spots are low.