![]() Additionally, several images can be combined to a 220°-montage visualizing 97% of the retina 14. Its software Optos Advance™ allows documentation and monitoring as well as analysis including measurement tools. Optos Daytona P200T (Daytona, Optos ®, Dunfermline, Scotland, UK) enables a single 200° image depicting 82% of the retina in less than 0.4 s in miosis. Two of the latest UWFI devices are the Optos Daytona P200T and the Zeiss Clarus 700. Studies suggest that imaging the retinal periphery might have a potential influence on the classification of DR as well as on estimated risk of progression 7, 8, 9, 10, 11.įurthermore, it has been postulated that agreement was high when comparing diagnosis from non-mydriatic-UWFI-modalities with indirect ophthalmoscopy in mydriasis, allowing a much quicker and still reliable retinal examination 12, 13. Ultra-Wide-Field-Imaging (UWFI) devices are defined as having a FOV of up to 220°, depicting an area of more than 3 times the size of the 7SF and including the visualization of the far periphery 6. Wide-Field-Imaging (WFI) devices have a field of view (FOV) of 60°–100° and enable displaying the midperiphery. To date advanced imaging modalities are available allowing visualization up to far peripheral retinal areas. The International Clinical Diabetic Retinopathy (ICDR) Severity Scale was proposed in 2003 to simplify DR grading in clinical use 5. Here 7 stereoscopic pictures (7 standard fields, 7SF) are used to, when combined, show approximately 34% of the retina to evaluate lesions 4. It has been three decades since the modified Airlie-House-Classification from the Early Treatment Diabetic Retinopathy Study was introduced to determine stages of DR. Changes that can be diagnosed during fundus examination are dot and blot hemorrhages, microaneurysms, cotton-wool-spots, and intraretinal microvascular abnormalities (IRMA) 3. Since this disease progresses asymptomatically in early stages, nationwide screening programs are essential to detect early pathologies and identify typical lesions to minimize retinal damages 2. Clarus allowed for better visualization of the inferonasal field, Optos of the temporal field.ĭiabetic Retinopathy (DR) is still a leading cause of visual impairment or blindness 1. Reliability in detecting signs of early DR is high on both devices. Interrater reliability of DR-stage on both devices was almost perfect in the 7SF (κ = 0.975) and the TGA (κ = 0.855). ![]() In 4 eyes DR-stage was higher using Optos due to peripheral lesions not seen on the Clarus. DR stages in the 7SF were no (n = 36 Optos, n = 35 Clarus), mild (n = 16 Optos, n = 17 Clarus), and moderate DR (n = 15). ![]() DR stage was evaluated in the 7SF and the TGA on images of both devices and compared using Cohens κ. Retinal periphery outside the 7 standard fields (7SF) was divided into: F3 temporal, F4 superotemporal, F5 inferotemporal, F6 superonasal, F7 inferonasal. ![]() The total gradable areas (TGA) seen on non-mydriatic CF-images of two UWF-imaging devices (Optos Daytona P200T Zeiss Clarus 700) were compared and differences in projected area measured. ![]() Comparison of two ultra-widefield (UWF) color-fundus (CF) imaging devices in diabetic patients for visualization of retinal periphery and detection of early microvascular lesions. ![]()
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