Diabetic retinopathy and ultrawide field imaging

Area of Science:

• Ophthalmology
• Medical Imaging

Background:

• Diabetic retinopathy (DR) management traditionally used limited 7-standard field Early Treatment Diabetic Retinopathy (ETDRS) photography, visualizing only 30% of the retina.
• Eyes with predominantly peripheral lesions (PPL) show higher DR progression rates, necessitating broader retinal visualization.

Purpose of the Study:

• To review the current applications of ultrawide field (UWF) imaging in diabetic retinopathy.
• To explore the future potential of UWF imaging in retinal diagnostics and artificial intelligence (AI).

Main Methods:

• Comparison of retinal area visualized by UWF imaging versus ETDRS photography.
• Review of studies utilizing UWF imaging in diabetic retinopathy detection and management.
• Discussion of UWF fluorescein angiography for lesion and nonperfusion quantification.

Main Results:

• UWF imaging visualizes approximately 82% of the retinal area, significantly more than ETDRS.
• UWF imaging enhances detection of peripheral lesions, linked to greater DR progression.
• UWF imaging reduces ungradable rates and improves disease identification in telemedicine settings.

Conclusions:

• UWF imaging offers a more comprehensive view of diabetic retinopathy, crucial for identifying PPL.
• Its utility in telemedicine and enhanced lesion detection impacts DR management and monitoring.
• Future applications include AI-driven analysis and vessel caliber measurements for advanced retinal diagnostics.