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Diabetische Retinopathie

Vergleich der diagnostischen Eigenschaften des Ultraweitwinkel-Scanning-Laser-Ophthalmoskops Optomap mit der ETDRS-7-Feld-Fundusfotografie

Diabetic Retinopathy

Comparison of the diagnostic features of ultra-widefield scanning laser ophthalmoscopy Optomap with ETDRS 7-field fundus photography

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Zusammenfassung

Ziel

Vergleich der diagnostischen Eigenschaften eines 200°-Ultraweitwinkel-Scanning-Laser-Ophthalmoskops (SLO) in Miosis mit der ETDRS-7-Feld-Fundusfotografie in Mydriasis bei diabetischer Retinopathie (DR).

Methode

66 Augen mit DR wurden hinsichtlich DR-Grads nach ETDRS und diabetischen Makulaödems (DME) maskiert von 2 Gradern beurteilt. Referenzstandard war die ETDRS-7-Feld-Fundusfotografie, gegen den Optomap-P200-SLO-Bilder verglichen wurden. Alle SLO-Scans erfolgten in Miosis, die ETDRS-Fotos in Mydriasis.

Ergebnisse

14 Augen (ETDRS) und 11 Augen (Optomap) wurden aufgrund unzureichender Bildqualität nicht bewertet. Für die übrigen 48 Augen bestand zwischen beiden Imagingtechniken mit κ-Werten von 0,70 für Grader 1 und 0,66 für Grader 2 eine gut Übereinstimmung. Bezüglich des DME war die Übereinstimmung mit κ-Werten von 0,68 und 0,74 ebenfalls gut.

Schlussfolgerungen

Die Optomap-Bilder in Miosis liefern eine gute Übereinstimmung mit einer DR-Grad-Beurteilung anhand der ETDRS-7-Feld-Fundusfotografie in Mydriasis. Im Vergleich zu 7-Feld-Fundusfotografien erfassen die Optomap-Bilder – trotz Miosis – deutlich größere Netzhautareale und liefern so zusätzliche diagnostische Möglichkeiten.

Abstract

Objective

The aim of the study was to compare the diagnostic properties of a non-mydriatic 200° ultra-widefield scanning laser ophthalmoscope (SLO) with mydriatic ETDRS 7-field fundus photography for diabetic retinopathy screening.

Methods

A consecutive series of 66 eyes from 34 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 were compared with grading obtained from Optomap Panoramic 200MA SLO images. All SLOs were performed with an undilated pupil and no additional clinical information was used for evaluation of images by two independent, masked experts.

Results

A total of 14 eyes from ETDRS 7-field fundus photography and 11 eyes from Optomap could not be graded by at least one grader due to poor image quality, yielding 48 eyes for comparison purposes. Of the 48 ETDRS 7-field fundus photographs, 9 (11 for grader 2) eyes had no or mild DR (ETDRS levels ≤20) and 17 (23 for grader 2) eyes had no ME. Agreement of Optomap retinopathy grading with ETDRS 7-field fundus photography was good, kappa 0.70 for grader 1 and kappa 0.66 for grader 2. There was good agreement between both techniques for ME, grader 1 kappa 0.68 and grader 2 kappa 0.74.

Conclusions

Grading of DR levels from Optomap Panoramic 200MA non-mydriatic images showed a good correlation with mydriatic ETDRS 7-field fundus photography. Both techniques are of sufficient quality for a valid assessment of DR. Optomap Panoramic 200MA images cover a larger retinal area and might therefore offer additional diagnostic properties.

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  1. Augenklinik der Ludwig-Maximilians-Universität, München, Mathildenstraße 8, 80336, München, Deutschland

    M. Kernt, F. Pinter, I. Hadi, C. Hirneiss, C. Haritoglou, A. Kampik, M.W. Ulbig & A.S. Neubauer

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  1. M. Kernt
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  2. F. Pinter
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  3. I. Hadi
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  4. C. Hirneiss
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  5. C. Haritoglou
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  6. A. Kampik
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  7. M.W. Ulbig
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  8. A.S. Neubauer
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Correspondence to M. Kernt.

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Kernt, M., Pinter, F., Hadi, I. et al. Diabetische Retinopathie. Ophthalmologe 108, 117–123 (2011). https://doi.org/10.1007/s00347-010-2226-4

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