Diabetic maculopathy: multicolour and SD-OCT versus fundus photography

Area of Science:

• Ophthalmology
• Medical Imaging
• Diabetic Retinopathy Research

Background:

• Diabetic maculopathy requires timely detection and management.
• The English Diabetic Eye Screening (DES) programme uses fundus photography to identify M1 maculopathy.
• Referral to hospital eye services is recommended for patients with M1 diabetic maculopathy.

Purpose of the Study:

• To compare multicolour fundus photography with standard non-stereoscopic fundus photography for identifying M1 diabetic maculopathy.
• To assess the role of spectral domain optical coherence tomography (SD-OCT) in identifying macular thickening.

Main Methods:

• A cross-sectional study involving 345 patients with R1M1 diabetic maculopathy.
• Maculopathy grading using multicolour and fundus photography by independent graders.
• Macular thickness assessment using SD-OCT.

Main Results:

• Multicolour photography demonstrated substantial agreement with fundus photography (Cohen's κ=0.76).
• Multicolour photography achieved 87% sensitivity and 90% specificity for M1 maculopathy detection compared to fundus photography.
• SD-OCT identified macular thickening missed by fundus photography, and the combined multicolour/SD-OCT approach detected all clinically significant macular edema.

Conclusions:

• Multicolour photography integrated with SD-OCT offers a synergistic platform for monitoring M1 diabetic maculopathy.
• This combined approach can replace traditional fundus photography in specialized R1M1 virtual clinics.
• Eliminates the need for parallel diabetic retinopathy grading in these specific clinics.