Abstract

P 258

Nonmydriatic screening for diabetic retinopathy by ultra-widefield scanning laser ophthalmoscopy (Optomap) compared to ETDRS 7-field imaging

Florian Pinter, Aljoscha Neubauer, Michael Ulbig, Simon Leicht, Christos Haritoglou, Anselm Kampik, Marcus Kernt
Augenklinik der Ludwig-Maximilians-Universität München, München

Objective
To compare the diagnostic properties of a nonmydriatic 200° ultra-widefield scanning laser ophthalmoscope (SLO) versus mydriatic ETDRS-7-field fundus-photography for diabetic retinopathy screening.
Methods
A consecutive series of 26 eyes of 16 patients with different levels of diabetic retinopathy (DR) were examined. Grading of DR and macular edema (ME) obtained from mydriatic ETDRS-7-field fundus-photography was compared against grading obtained from Optomap Panoramic200 SLO images. All SLOs were performed with an undilated pupil and no additional clinical information was used for evalution of the Optomap images by two independent, masked expert graders.
Results
3 eyes from ETDRS-7-field fundus-photography and 1 eye from Optomap were not gradable due to poor image quality. From ETDRS-7-field fundus-photography only one eye had no or mild DR (ETDRS level<=20) and 5 eyes had no ME. Agreement for Optomap retinopathy grading to ETDRS-7-field fundus-photography was very good (kappa of 0,96 for Optomap, and kappa of 1,00 for 7-field photography). Retinopathy-levels showed a very good agreement between both imaging-techniques (Grader 1: kappa = 0,96; Grader 2: kappa =1,00). Regarding ME there was a sufficient agreement between both techniques (Grader 1: kappa = 0,56; Grader 2: kappa =0,48).
Conclusions
Grading of DR-levels from Optomap Panoramic200 nonmydriatic images show a very good correlation to mydriatic ETDRS-7-field fundus-photography. Both techniques are of sufficient quality to assess DR validly and therefore fulfil the basic requirements for telescreening programs. Optomap Panoramic200 images cover a larger retinal area and therefore might offer additional diagnostic properties.

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