Comparative analysis of ultra-wide-field fluorescein angiography and early treatment diabetic retinopathy study 7 standard field photography in diabetic retinopathy_Chinese Journal of Ocular Fundus Diseases

Authors：

XuA'min ,  ChenChangzheng , YiZuohuizi , QiHang , LiLu , SuYu

Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan 430060, China;

Corresponding author：

ChenChangzheng, Email: whuchenchzh@163.com

Keywords：

Diabetic retinopathy/diagnosis; Fluorescein angiography; Tomography, optical coherence

DOI：

10.3760/cma.j.issn.1005-1015.2017.01.007

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To observe the ocular fundus features and consistency of classification of diabetic retinopathy (DR) by ultra-wide-field fluorescein angiography (UWFA) and the simulated early treatment diabetic retinopathy study (ETDRS) 7 standard field (7SF) imaging. Methods This is a retrospective clinical description study. Ninety-six eyes of 55 DR patients were included. The ages ranged from 25 to 73 years, with a mean age of (41.34±15.07) years. UWFA examination (British Optos 200Tx imaging system) using the protocol for obtaining 7SF images as described in the ETDRS, 7 circular regions with a range of 30 degrees are spliced as 7SF templates to determine the observation range. This template was then overlaid on the UWFA image to identify the potential viewable area of 7SF. And the visualized area of the retina, retinal non-perfusion (NP) area, retinal neovascularization (NV) area, and pan-retinal photocoagulation (PRP) area of UWFA and 7SF were quantified by a retinal specialist. Results UWFA imaging and 7SF imaging have a high degree of consistency in judging DR classification (kappa=0.851,P=0.000). The retinal visual area, NP area, NV area and PRP area of the UWFA imaging were 3.16, 3.38, 2.22 and 3.15 times more comparing with the simulated 7SF imaging (t=213.430, 45.013, 22.644, 142.665;P=0.000, 0.000, 0.003, 0.000). The lesions of 8 eyes were found outside the range of simulated 7SF imaging, including peripheral NP in 5 eyes, NV areas in 3 eyes, respectively. Conclusion UWFA imaging and simulated 7SF imaging are consistent to judge DR classification, but UWFA can find more peripheral retinal lesions.

Citation： XuA'min, ChenChangzheng, YiZuohuizi, QiHang, LiLu, SuYu. Comparative analysis of ultra-wide-field fluorescein angiography and early treatment diabetic retinopathy study 7 standard field photography in diabetic retinopathy. Chinese Journal of Ocular Fundus Diseases, 2017, 33(1): 23-26. doi: 10.3760/cma.j.issn.1005-1015.2017.01.007 Copy

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2.	Silva PS, Cavallerano JD, Sun JK, et al. Nonmydriatic ultrawide field retinal imaging compared with dilated standard 7-field 35-mm photography and retinal specialist examination for evaluation of diabetic retinopathy[J]. Am J Ophthalmol, 2012, 154(3): 549-559. DOI: 10.1016/j.ajo.2012.03.019.
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5.	Friberg TR, Gupta A, Yu J, et al. Ultrawide angle fluorescein angiographic imaging: a comparison to conventional digital acquisition systems[J]. Ophthalmic Surg Lasers Imaging, 2008, 39(4): 304-311.
6.	Csutak A, Lengyel I, Jonasson F, et al.Agreement between image grading of conventional (45°) and ultra wide-angle (200°) digital images in the macula in the Reykjavik eye study[J]. Eye (Lond), 2010, 24(10): 1568-1575. DOI: 10.1038/eye.2010.85.
7.	Mackenzie PJ, Russell M, Ma PE, et al.Sensitivity and specificity of the optos optomap for detecting peripheral retinal lesions[J].Retina, 2007, 27(8): 1119-1124. DOI: 10.1097/IAE.0b013e3180592b5c.
8.	Reddy S, Hu A, Schwartz SD, et al. Ultra wide field fluorescein angiography guided targeted retinal photocoagulation (TRP). Semin Ophthalmol, 2009, 24(1): 9-14. DOI: 10.1080/08820530802519899.
9.	Wessel MM, Aaker GD, Parlitsis G, et al.Ultra-wide-field angiography improves the detection and classification of diabetic retinopathy[J].Retina, 2012, 32(4): 785-791. DOI: 10.1097/ IAE.0b013e3182278b64.
10.	Silva PS, Cavallerano JD, Sun JK, et al. Peripheral lesions identified by mydriatic ultrawide field imaging: distribution and potential impact on diabetic retinopathy severity[J]. Ophthalmology, 2013, 120(12): 2587-2595. DOI: 10.1016/ j.ophtha.2013.05.004.
11.	Silva PS, Cavallerano JD, Haddad NM, et al. Peripheral lesions identified on ultrawide field imaging predict increased risk of diabetic retinopathy progression over 4 years[J]. Ophthalmology, 2015, 122(5): 949-956. DOI: 10.1016/j.ophtha.2015.01.008.
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1. Early Treatment Diabetic Retinopathy Study Research Group. Grading diabetic retinopathy from stereoscopic color fundus photographs-an extension of the modified Airlie House classification. ETDRS report number 10 [J]. Ophthalmology, 1991, 98(5 Suppl): S786–806.
2. Silva PS, Cavallerano JD, Sun JK, et al. Nonmydriatic ultrawide field retinal imaging compared with dilated standard 7-field 35-mm photography and retinal specialist examination for evaluation of diabetic retinopathy[J]. Am J Ophthalmol, 2012, 154(3): 549-559. DOI: 10.1016/j.ajo.2012.03.019.
3. 中华医学会眼科学会眼底病学组. 我国糖尿病视网膜病变临床诊疗指南(2014年) [J]. 中华眼科杂志, 2014, 50(11): 851-865. DOI: 10.3760/cma.j.issn.0412-4081.2014.11.014.Chinese Ocular Fundus Diseases Society, Chinese Ophthalmological Society, Chinese Medical Association. The clinical diagnosis and treatment guidelines for diabetic retinopathy in China(2014)[J]. Chin J Ophthalmol, 2014, 50(11): 851-865. DOI: 10.3760/cma. j.issn.0412-4081.2014.11.014.
4. Friberg TR, Forrester JV. Ultra-wide angle (200°+) fluorescein angiography using a modified Optos Panoramic200^TM imaging system[J/OL]. Invest Ophthalmol Vis Sci, 2004, 45(13): 3001 [2004-05-01]. http://iovs.arvojournals.org/article.aspx? articleid=2408542.
5. Friberg TR, Gupta A, Yu J, et al. Ultrawide angle fluorescein angiographic imaging: a comparison to conventional digital acquisition systems[J]. Ophthalmic Surg Lasers Imaging, 2008, 39(4): 304-311.
6. Csutak A, Lengyel I, Jonasson F, et al.Agreement between image grading of conventional (45°) and ultra wide-angle (200°) digital images in the macula in the Reykjavik eye study[J]. Eye (Lond), 2010, 24(10): 1568-1575. DOI: 10.1038/eye.2010.85.
7. Mackenzie PJ, Russell M, Ma PE, et al.Sensitivity and specificity of the optos optomap for detecting peripheral retinal lesions[J].Retina, 2007, 27(8): 1119-1124. DOI: 10.1097/IAE.0b013e3180592b5c.
8. Reddy S, Hu A, Schwartz SD, et al. Ultra wide field fluorescein angiography guided targeted retinal photocoagulation (TRP). Semin Ophthalmol, 2009, 24(1): 9-14. DOI: 10.1080/08820530802519899.
9. Wessel MM, Aaker GD, Parlitsis G, et al.Ultra-wide-field angiography improves the detection and classification of diabetic retinopathy[J].Retina, 2012, 32(4): 785-791. DOI: 10.1097/ IAE.0b013e3182278b64.
10. Silva PS, Cavallerano JD, Sun JK, et al. Peripheral lesions identified by mydriatic ultrawide field imaging: distribution and potential impact on diabetic retinopathy severity[J]. Ophthalmology, 2013, 120(12): 2587-2595. DOI: 10.1016/ j.ophtha.2013.05.004.
11. Silva PS, Cavallerano JD, Haddad NM, et al. Peripheral lesions identified on ultrawide field imaging predict increased risk of diabetic retinopathy progression over 4 years[J]. Ophthalmology, 2015, 122(5): 949-956. DOI: 10.1016/j.ophtha.2015.01.008.
12. Singer M, Sagong M, van Hemert J, et al. Ultra-widefield imaging of the peripheral retinal vasculature in normal subjects[J].Ophthalmology, 2016, 123(5): 1053-1059. DOI: 10.1016/j.ophtha.2016.01.022.
13. Sagong M, van Hemert J, Olmos de Koo LC, et al. Assessment of accuracy and precision of quantification of ultra-widefield images[J]. Ophthalmology, 2015, 122(4): 864-866. DOI: 10.1016/j.ophtha.2014.11.016.

Chinese Journal of Ocular Fundus Diseases

Comparative analysis of ultra-wide-field fluorescein angiography and early treatment diabetic retinopathy study 7 standard field photography in diabetic retinopathy

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